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Biomedical subjects

J Botella

Publications and source records attributed to J Botella.

At least 37 records · Page 2Linked to original sources

In vivo and in vitro studies on the release of cortisol from interrenal tissue in trout. I. Effects of ACTH and prostaglandins.

The secretion of cortisol from the interrenal tissue in trout Salmo gairdnerii was studied in vivo and by an in vitro superfusion method in relation to the effect of adrenocorticotropic hormone (ACTH), prostaglandins (PGE1, PGF2 alpha) and prostaglandin inhibitors. The experiments were performed between April and July. In control, uninjected animals, circulating cortisol was 206 +/- 24 ng/ml. At 24 h following the intraperitoneal injection of indomethacin, dexamethasone, or both, the levels were reduced to 84 +/- 10, 43 +/- 20 and 63 +/- 11 ng/ml respectively. In control animals receiving solvent (ethanol), the value was 190 +/- 30. With longer term duration (72 h) the levels of plasma cortisol following injection of indomethacin, dexamethasone and both drugs together were 120 +/- 29, 120 +/- 10 and 37 +/- 8 respectively. On the contrary, no significant change was produced by prostaglandins. In vitro release of cortisol from superfused head kidneys (which contain the interrenal tissue of teleosts) decreased gradually with time and reached a minimum after 50 min. Addition of ACTH or of PGE1 to the medium induced an immediate, dose dependent increase in cortisol output which reached a maximum after 15-30 min. On the contrary, PGE2 alpha or indomethacin did not modify cortisol release. These results show that cortisol production in trout, which is controlled by ACTH as in other vertebrates, is also under the influence of other hormonal substances acting on the adenyl-cyclase system.

Adrenocorticotropic Hormone

The bone scan in patients with aluminium-associated bone disease.

The bone scans of 32 patients on regular dialysis who received desferrioxamine therapy for fracturing osteomalacia secondary to aluminium intoxication are reviewed. All scans show the same pattern, with lack of tracer deposition in bone and deposition in soft tissues. Therapy with desferrioxamine controlled the aluminium intoxication in all cases, and in 21 patients the bone scan reverted to normal or showed a pattern typical of hyperparathyroidism.

Aluminum

[Polycystic kidneys in adults. A clinical study of 106 cases (author's transl)].

A series of 106 cases of polycystic kidneys in adults is presented. The main clinical, exploratory and therapeutic data are analyzed. The average age of the patients at the time of the first clinical manifestation was 35 years; average age at the time of diagnosis was 43 years. The most common forms of presentation included renal colics, blood hypertension, noncolic lumbar pain, macroscopic hematuria, and polydipsia-polyuria. The most frequent symptoms were: abdominal pain of any type (73 patients), polydipsia-polyuria (66 patients), blood hypertension (61 patients), macroscopic hematuria (47 cases), episodes of urinary infection (41 cases), and passing of calculi (22 cases). Seventy-eight subjects had arterial high blood pressure; it was easily controlled in all except 14 cases. Proteinuria was slight in all except two cases. Values for hematocrit and hemoglobin remained high in relation to the degree of renal insufficiency. The mean value of hematocrit in patients with creatinine clearance below 10 ml/min was 30 percent. Renal function decreased gradually, from normal to a clearance of less than 10 ml/min over a period of 12 years on the average. Diagnosis was based mainly on abdominal physical examination and intravenous urography; 89 patients had palpable abdominal masses. Urography revealed typical images of polycystic kidney in every case. The following associated conditions were also discovered: liver cysts (17 cases among 57 liver scanning; bilateral ovarian cysts in one case; Cacci-Ricci's disease in one case; and cerebral arterial aneurysms in another patient. Treatment was conservative with the aim to control arterial blood pressure and urinary infection. Twenty-nine patients required saline replacement; peritoneal dialysis was practiced in two cases and permanent hemodialysis was prescribed for 15 individuals.

Adolescent

[Clinical course and recurrences of the nephrotic syndrome due to minimal histologic lesions. Review of 73 cases (author's transl)].

The clinical course of 73 patients with nephrotic syndrome due to minimal histologic lesions was studied. A renal biopsy was performed in all of the cases; 23 biopsies were studied by immunofluorescence and two renal biopsies were carried out in eight cases. The follow-up period varied from 6 months to 10 years. The following treatment were used: 23 patients received prednisone alone, 48 were given prednisone plus chlorambucil, and 2 were treated only with chlorambucil. Sixty-five patients achieved a complete remission; a total of 39 recurrences occurred in 23 of them. The relapses took place 16 months on the average following complete remission. Twenty-three patients (32.4 percent) cured with only prednisone. Forty-eight required the association with chlorambucil, 8 percent of whom experienced recurrences before being completed cured. Two individuals were treated with chlorambucil alone and ach;eved a complete and stable remission. Eight patients (10.95 percent) could not be cured. Five of them showed a glomerular focal hyalinosis in the second renal biopsy. Six patients had hematuria at the onset: two of them achieved complete remission with recurrences; four did not. Three of the latter had glomerular focal hyalinosis. There were small foci of immunoglobulin deposits in 13 cases; 11 of them obtained complete remission with relapses and 2 achieved partial remission.

Adolescent

[Vascular approach for periodic hemodialysis. Clinical course of 100 internal arteriovenous fistulas (author's transl)].

The clinical course of 100 internal arteriovenous fistulas in patients observed over a period of more than 6 months was analyzed. Ninety-six were practiced in the upper extremities as side-to-side anastomoses in the forearm between the radial artery and the nearest vein; three were constructed in the lower limbs as anastomoses between the femoral artery and the internal saphenous vein; and one was an autograft of the saphenous vein in the forearm. The most important complications observed were thrombosis (arising chiefly from scant venous development, surgical procedures, and episodes of arterial hypotension), distal ischemia, distal venous flow, infection of the fistula, and insufficient flow. A blood flow over 350 ml/min was achieved in all except two patients. The actuarial survival of individuals with arteriovenous fistulas is high at the present time, with 86 percent of the fistulas functioning after 3 years. The longest period of satisfactory arteriovenous fistula function is 8 years and 3 months.

Acute Kidney Injury

Chloramines, an aggravating factor in the anemia of patients on regular dialysis treatment.

In two dialysis centres in the same city, with a total of 56 patients on regular dialysis treatment, it has been shown that the tap water used for the production of the dialysate contains chloramines. Total chlorine concentration and percentage of chloramines varies from 0.5 to 1.1 ppm and from 40 to 95 per cent. There in a high percentage of Heinz bodies in the patients' erythrocytes, and incubation of red cells in vitro with the dialysate raises the methaemoglobin concentration and alters the hexose-monophosphate shunt. The patients' mean haematocrit improved from 23.13 +/- 4.41 SD to 25.93 +/- 5.17 SD (p less than 0.0025) with the administration of ascorbic acid, 500 mg given intravenously once a week, but an unexpected transitory increase of the total chlorine to 3.5 ppm resulted in a serious decline of the mean haematocrit to 20.80 +/- 5.22 SD (p less than 0.0001). Ascorbic acid added to the dialysate at a concentration of 1.7 mg/dl produced a great improvement in the anaemia and the almost total disappearance of Heinz bodies from the patients' red cells.

Anemia

Hemodiafiltration without replacement fluid. An experimental study.

Paired filtration dialysis (PFD) is the only hemodiafiltration (HDF) technique in which the ultrafiltrate is continuously available but not mixed with the dialysate. As is the case during all convective or predominantly convective techniques, use of a replacement fluid is necessary in an amount equal to the difference between the ultrafiltrate and the desired patient weight loss. This replacement fluid must have an adequate electrolytic composition (Na+, Ca++, and buffer), and must be sterile and pyrogen free. Using an uncoated adsorbent charcoal cartridge (130 g), the ultrafiltrate obtained in PFD was regenerated, eliminating both the small (except for urea, glucose, and phosphates) and medium-to-large solutes but not the electrolytes and bicarbonate. This verified the ultrafiltrate's possible use as replacement fluid. This technique experimentally studied during 24 standard PFD sessions, with a total mean ultrafiltrate of 9,950 +/- 860 ml, allowed a replacement solution to be obtained with the following mean +/- SD composition: pH 7.467 +/- 0.122, HCO3- 27.0 +/- 2.12 mmol/L, Na+ 137.4 +/- 2.6 mmol/L, K+ 4.1 +/- 0.83 mmol/L, Ca++ 1.12 +/- 0.19 mmol/L, urea 68.3 +/- 16.2 mg/dl, creatinine 0.08 +/- 0.02 mg/dl, uric acid 0.05 mg/dl, phosphates 2.77 +/- 0.71 mg/dl, beta-2 microglobulin 0.5 +/- 0.4 mg/L, and atrial natriuretic peptide 4.41 +/- 5.6 pg/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Charcoal