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J Torras

Publications and source records attributed to J Torras.

At least 19 recordsLinked to original sources
PubMed1992

Antilymphocyte globulin versus OKT3 induction therapy in cadaveric kidney transplantation: a prospective randomized study.

Different induction therapies have been used in renal transplantation to avoid cyclosporine (CsA) nephrotoxicity and early acute graft rejection. This study compares the efficacy of a short course of prophylactic OKT3 to that of antilymphocyte globulin (ALG) in preventing acute renal allograft rejection when administered concomitantly with CsA and steroids. Between March 1988 and December 1990, 140 first-cadaver renal transplant recipients were randomly allocated to two immunosuppression groups--ALG group (n = 68): ALG 15 mg/kg just before transplant surgery, ALG 12 mg/kg the first day after transplant, followed by four doses of 10 mg/kg on alternate days; and OKT3 group (n = 72): OKT3 5 mg just before transplant, followed by four doses of 5 mg/d. Both groups included low-dose CsA and steroids. The incidence of rejection during the first 3 months after transplantation was 15% in the ALG group and 19% in the OKT3 group (NS). Kaplan-Meier estimates of patients free of rejection at 2 years was 85% in the ALG group and 77% in the OKT3 group (NS). The 3-year actuarial graft survival was 82% and 85% (NS), and 3-year patient survival was 97% and 98% (NS), in the ALG and OKT3 groups, respectively. These results indicate that the concomitant association of CsA and ALG or OKT3 constitutes a safe and effective therapeutic strategy that provides a low incidence of rejection and gives good results for patient and graft survival.

Adolescent↗
PubMed1992

[Long-term results of surgical treatment of soft tissue retroperitoneal sarcomas].

Soft-Tissue Retroperitoneal Sarcomas (STRP) are rare tumors. Late diagnostic and extreme technical difficulties to obtain total resection with margins free of tumor, are associated to a high relapse rate. Eighteen patients with STRP were retrospectively reviewed, evaluating: Clinical onset, histology, treatment-type performed, mortality and survival rate. Total resection was performed in eleven patients (61%), with inclusion of neighbor organs or structures in five of them (45%). In one case partial exeresis associated with left hemicolectomy was done, and only biopsy was performed in six cases. After total exeresis, seven patients showed local relapse (64%) and four of these patients (57%) underwent surgery again. Global surgery mortality was one patient. Survival at five years in resected patients was 57%. In patients with biopsy only, mean survival was 16.6 months, patients with total or partial resection, survival was 79.1 months. An aggressive surgical approach, with tumor total exeresis and a block resection of neighbor affected organs or structures, is the best alternative in the treatment of STRP.

Adult↗
PubMed1991

Pharmacokinetics of vancomycin in patients undergoing hemodialysis with polyacrylonitrile.

The pharmacokinetics of vancomycin in patients undergoing dialysis with cuprophane membranes are well known, however little has been reported of the use of polyacrylonitrile membranes in dialysis. We studied, in a crossover design, eight dialysis patients (7 men, 1 woman) aged 30 to 66 years who prospectively received 1 gram of vancomycin i.v. before first dialysis and were subsequently hemodialyzed with cuprophane every second day for a total of three times. A month later trial was repeated using polyacrylonitrile. A mono-compartment model was used to calculated pharmacokinetic parameters. Mean +/- standard deviation of vancomycin clearance varied from 5.2 +/- 2.1 ml/min in the interdialysis period to 9.7 +/- 2.7 ml/min during dialysis with cuprophane and to 58.4 +/- 15.6 ml/min during dialysis with polyacrylonitrile (p less than 0.001). Vancomycin half-life varied from 71.5 +/- 23.0 to 35.9 +/- 9.8 and to 6.1 +/- 1.4 hours, respectively (p less than 0.001). Fractional removal of vancomycin increased from 4% using the cuprophane dialyzer to 34% using the polyacrylonitrile dialyzer (p less than 0.001). Serum vancomycin levels at 100 and 168 hours were higher with cuprophane than with polyacrylonitrile (7.0 +/- 2.2 vs 3.9 +/- 1.2 micrograms/ml) (p less than 0.001). Moreover, the mean levels at 100 hours were suboptimal on polyacrylonitrile. Approximately 208 +/- 53 mg of vancomycin were removed during one polyacrylonitrile dialysis. Thus, those patients who undergo dialysis with polyacrylonitrile and are treated with vancomycin may need supplementary doses post dialysis or to lessen dosage intervals than those traditionally used for dialysis patients since clearance of the drug is significantly higher than with cuprophane dialyzers. Continuous monitoring of vancomycin levels is also recommended.

Acrylic Resins↗
PubMed1988

Histiocytoid hemangioma of the innominate vein.

Primary malignancies originating in large veins are infrequent. Leiomyosarcomas and malignant vascular tumors have been occasionally reported. The recently described histiocytoid hemangioma has a predilection for medium-sized and large vessels. A case is reported of histiocytoid hemangioma arising in the innominate vein and presenting clinically as a mediastinal mass.

Adult↗
PubMedDate not supplied

[Comparison of venous pressure in the external jugular vein and the superior vena cava during anesthesia].

Venous pressure between the external jugular vein (EJV), and the superior caval vein (SCV) was compared in 15 patients, free of cardiorespiratory disease and undergoing abdominal surgery. In each patient data was taken in four different positions: A) anaesthetized patient in supine position and mechanical ventilation; B) anaesthetized patient in Trendelenburg position and mechanical ventilation; C) anaesthetized patient in anti-Trendelenburg and mechanical ventilation, and D) awake patient in supine position and spontaneous ventilation. A short, thick catheter with unique end lumen was used for EJV, and a long catheter from the basilic vein, to the SCV. Significant differences between mean and standard deviations of EJV and SCV were not founded. Linea correlation for the 4 positions was performed (r = 0.97, 0.91, 0.88 and 0.60 respectively) being significant for A-B y C positions. 4.5 cm H2O was the maximal difference obtained between SCV and EJV for A, B and C positions, and 10 cm H2O the maximal difference for the D position. The mean changes between the positions A-B, A-C and A-D was compared and significant differences (p less than or equal to 0.001) for A-C were seen, whereas A-B did not attain significant differences. We conclude that the EJV cannulation, with a short and thick catheter, allow the central venous pressure control during anaesthesia, in supine position, Trendelenburg and anti-Trendelenburg, but not during the recovery.

Abdomen↗