Biomedical subjects
M Díaz-Rubio
Publications and source records attributed to M Díaz-Rubio.
[Diagnosis of Gilbert's syndrome: current status of the fasting test. Review of the literature].
UNLABELLED: Gilbert's syndrome is a benign, often familial condition characterized by recurrent but asymptomatic jaundice. AIM: To describe the involvement of the reduced caloric intake test, used as a diagnostic test in Gilbert's syndrome. METHOD: 49 patients were diagnosed of Gilbert's syndrome for 6 years. 39 patients took 400 kcal/day for three days. The unconjugated bilirubinemia levels were measured at 0, 24, 48 and 72 hours. RESULTS: The 82.05% of test were diagnostics at 24 hours (p < 0.001), while it was necessary 48 hours to 100% of tests were diagnostics (p < 0.05). In any case was necessary to determinate the unconjugated bilirubinemia at 72 hours (p < 0.5). CONCLUSIONS: The best diagnostic efficiency of the reduced caloric intake test is at 48 hours, while the 24 hours determination could be considered diagnostic in a big percentage of the cases. It is not necessary the determination at 72 hours in any case.
Topical anesthesia and urease tests.
Explore the source record for details and available documents.
Hepatocellular carcinoma with metastasis to the pharyngeal lymph nodes.
Explore the source record for details and available documents.
Rsa I polymorphism at the cytochrome P4502E1 locus is not related to the risk of alcohol-related severe liver disease.
Ethanol-inducible cytochrome P4502E1 is the main pathway in the non-alcohol dehydrogenase oxidation of ethanol. Its coding gene, CYP2E1, is polymorphic at the Rsa I restriction site in the 5'-flanking region. The mutant genotype c2c2 has a higher transcriptional activity than the genotype c1c1 or c1c2. Heavy drinkers carrying the c2 allele might be at a higher risk of alcoholic cirrhosis since they might synthesize greater amounts of acetaldehyde, the compound believed responsible for hepatotoxicity of ethanol. With the aim of establishing if the c2 allele increases the risk of cirrhosis in heavy drinkers, we studied 58 (6 female) chronic heavy drinkers with liver cirrhosis and 137 healthy normal controls of the same ethnic (white Spaniards) origin. After extraction of DNA from white blood cells, alleles c1 and c2 of CYP2E1 were identified by restriction fragment length polymorphism (RFLP) with endonuclease Rsa I. Fifty-six patients and 130 controls were classified as homozygous c1c1 and two and seven, respectively, as heterozygous c1c2. No homozygous c2c2 were detected. The c2 allele frequencies were 0.017 in patients and 0.026 in controls (non-significant differences). We conclude that the Rsa I RFLP polymorphism is probably not related to the risk of cirrhosis in Spanish heavy drinkers.
CYP2D6 genes and risk of liver cancer.
We have studied by use of PCR and XbaI and EcoRI restriction-fragment-length polymorphism whether mutations at the polymorphic CYP2D6 (debrisoquine hydroxylase) gene locus are associated with liver cancer. The frequency of CYP2D6 genes containing inactivating mutations was lower among 75 liver cancer patients than 200 healthy controls, and 40 cirrhotic subjects that did not develop liver cancer (frequency for carriers of two or more functional genes was 95% vs 74% vs 78%, respectively). Subjects who were homozygous for functional CYP2D6 genes appear to be at higher risk of developing primary liver cancer (odds ratio 6.40 [95% Cl] 2.4-17.5).
[Changes in the use of percutaneous liver biopsy over time].
AIM: To study, through the pathology diagnosis obtained, the current use of percutaneous liver biopsy and its change with time. MATERIALS AND METHODS: Pathology diagnosis of 759 liver biopsies performed during last 5 years are reviewed and compared with our previously published experience. RESULTS: Neoplasms have decreased from 16% of all pathologic diagnosis obtained in 1961-81 to less than 1% in the last 5 years. In 1985-87, liver cirrhosis was the final diagnosis in 60% of all biopsies, while currently it is only 18%, with a steady absolute number of cirrhosis each year. The most remarkable change is the number of biopsy diagnosis of chronic hepatitis, which has increased from 19% in 1985-87 to 51% in the last 5 years. Ten percent of all biopsies was performed in HIV-positive patients; granulomatous hepatitis and tuberculosis were more prevalent in them. CONCLUSIONS: Percutaneous liver biopsy has been displaced for the diagnosis of liver cirrhosis and has been focussed on the diagnosis of chronic hepatitis. HIV-positive patients represent an important population for those who perform liver biopsy.
[Subphrenic abscess related to hidden perforated duodenal ulcer].
Explore the source record for details and available documents.
[Recurrent ascites in peritoneal mesothelioma. Its diagnostic and therapeutic management].
Peritoneal mesothelioma is an uncommon neoplasm often related to previous asbestos exposure. It is necessary to exclude other secondary peritoneal neoplasm. The application of immunohistochemical analysis in the biopsy sample is important for establishing an accurate diagnosis. We report the case of a peritoneal mesothelioma that started as a haemorrhagic ascites. After laparotomy, the initial diagnosis was peritoneal carcinomatosis from adenocarcinoma of unknown origin. The diagnosis was obtained by using immunohistochemical analysis: vimentin and keratine antibodies were positive and leu M1, antibodies were negative. The interest of our case resides in the difficulty for obtaining the diagnosis and the complicate management of refractory ascites. Our patient required intraperitoneal 5-fluorouracil for controlling the ascites.
[Leiomyoma-dependent ileal invagination as a cause of intermittent intestinal obstruction].
We report the case of a 35-years-old-woman with history of abdominal surgery who presented several episodes of intermittent intestinal obstruction. Postoperative adhesions were suspected; laparoscopy surgery was made and uterine and anexial inflammation was observed. She was discharge with the diagnosis of inflammatory pelvic disease. Posteriorly, she was admitted with a new episode of intestinal obstruction. At laparotomy, intestinal intussusception was founded due to the presence of intestinal leiomyoma. We stress the relevance of two possible etiologies of intestinal obstruction; the coexistence of them difficult the diagnosis. Epidemiology, clinical presentation and diagnosis of leiomyomas of small intestine were reviewed.
[Malignant pleural effusion in a cirrhotic patient].
Explore the source record for details and available documents.
[Digestive hemorrhage caused by duodenal ectopic pancreas and diffuse angiodysplasia of the colon].
We present the case of a 79-years-old male with episodes of digestive bleeding in the form of melenas in which two pathological findings were observed as potential causes: ectopic pancreas in subpyloric position and diffuse colon angiodysplasia. The difficult management of the digestive bleeding when two lesions are associated as potential causes is stressed.
[Physiological reflux in proximal esophagus (assessment with simultaneous pH monitoring in proximal and distal esophagus in healthy subjects].
Two-level pH monitoring was performed for 24 hours in 20 healthy subjects to document the presence of reflux episodes and to obtain reference values for reflux studies. The pH probes were placed 5 and 20 centimetres above the LES by means of a manometric technique. Significant differences were found at these two levels. At the proximal esophageal level 18 of the 20 subjects had reflux episodes. Five centrimetres above the lower esphageal sphincter the total reflux time was 1.35%, 2.05% in the upright and 0.15% in the supine positions. At 20 centimetres level it was significantly lower: 0.5% the total percent time with pH below 4, 0.8% and 0% in the upright and supine positions respectively. The mean reflux time was about 40% of the distal value, but the same pattern of reflux was observed at two levels of the esophagus. This technique is useful in documenting the cephalad extend of GER and allows to identify normal GER patterns at different levels of the esophagus.
[A consensus on Helicobacter pylori and gastroduodenal pathology].
The current debate involving Helicobacter pylori (H.p.) and its potential role as an etiological factor for some digestive diseases, as well as the recent discussion through different mass media of this bacterium, including the American N.I.H. Consensus, have lead to the discussion of the H.p. problem, in order to clarify its real importance in acid-related diseases. Thus we want, as gastroenterologists, to give an overview of the current status, so as to facilitate the general practitioner work when confronted with gastrointestinal diseases, particularly related to H.p. Our purpose is to provide a critical and objective view regarding the implications of H.p. infection, and explain when treatment is needed and how this treatment should be accomplished.
[Effect of endoscopic sclerotherapy of esophageal varices on the survival of patients with hepatic cirrhosis].
Explore the source record for details and available documents.
Multicenter clinical trial of zinc acexamate in the prevention of nonsteroidal antiinflammatory drug induced gastroenteropathy. Spanish Study Group on NSAID Induced Gastroenteropathy Prevention.
OBJECTIVE: To assess in a multicenter double blind clinical trial the gastroenteroprotective effect of zinc acexamate (ZAC). METHODS: 276 patients with rheumatic disease and history of peptic ulcer or intolerance to nonsteroidal antiinflammatory drugs (NSAID), and requiring treatment with these drugs were included. An initial normal endoscopy was needed for inclusion. Patients were treated with one NSAID (diclofenac, piroxicam, naproxen or ketoprofen) and one capsule (300 mg) of either ZAC (141 patients) or placebo (135 patients) at single nocturnal dose. After 28 days, patients underwent a clinical and endoscopic control. RESULTS: 26 patients withdrew from the trial (10 of ZAC and 16 of placebo) and 41 were lost to followup (22 of ZAC and 19 of placebo). Gastroduodenal mucosal damage was graded according to a modified Lanza score. The incidence of gastric ulcer was null with ZAC and 6.0% with placebo (6 cases) (p < 0.05). The incidence of duodenal ulcer was 0.9% with ZAC (1 case) and 6.0% with placebo (12 cases) (p < 0.001). Nine patients of ZAC group (8%) and 25 of placebo (25%) presented some gastric damage (p < 0.001), and 5 (5%) and 19 (19%) respectively presented some duodenal damage (p < 0.005). After treatment, 88% of patients treated with ZAC and 66% with placebo had a completely normal endoscopy (p < 0.0005). No major side effects were reported through the study. CONCLUSION: ZAC has shown to be effective and well tolerated for the prevention of NSAID induced gastroduodenal damage in patients with rheumatic disease at risk. The incidence of gastric and duodenal ulcers decreased in 92% (13 times the risk), when compared to placebo.
[Hyperferritinemia in hyperthyroidism].
Explore the source record for details and available documents.
[Acute pancreatitis in thrombotic thrombocytopenic purpura. Apropos 2 cases].
Thrombotic thrombocytopenic purpura (TTP) is a syndrome characterized by fever, microangiopathic hemolytic anemia, thrombocytopenia, renal disease and neurologic changes. The development of little thrombi in the systemic microcirculation is thought to play an important role, however the etiology is unknown. We present two cases in which pancreatic disease was the first manifestation of TTP.