[Multi-organ transplantation of liver and pancreas].
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Adolescent↗
Biomedical subjects
M Lluch
Publications and source records attributed to M Lluch.
[Hemodynamic changes in hepatic transplant in pigs anesthetized with isoflurane].
An anesthetic model with isofluorane is reported, with the hemodynamic abnormalities induced in 10 pigs of Landrace breed undergoing orthotopic hepatic transplant with centrifugal pump. ECG, arterial blood pressure, central venous pressure, pulmonary artery pressure and rectal temperature were monitored in all the animals. Hemodynamic parameters were measured in four periods: a) baseline; b) preanhepatic phase; c) anhepatic phase, and d) after revascularization. After a period of hemodynamic stability in preanhepatic phase, there was a reduction in cardiac output (p less than 0.01) and stroke volume (p less than 0.05) and an increase in heart rate, which were maintained during the rest of the operation. Central venous pressure, pulmonary capillary pressure and mean arterial pressure remained constant. Throughout the process there was a progressive increase in systemic vascular resistances, particularly pulmonary vascular resistance which, together with mean pulmonary arterial pressure, showed a significant increase in the last phase. During the bypass period there was a significant reduction of temperature. It was concluded that satisfactory results in experimental liver transplant are achieved with isofluorane and venous bypass with centrifugal pump.
Anesthesia↗
[Hepatitis B and professional groups with high risks of exposure].
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Dental Auxiliaries↗
Clinical and immunological effects of immunotherapy with glutaraldehyde modified house dust mite extract.
The aim of this study was to demonstrate the clinical effectiveness of treatment with specific immunotherapy using allergenic mite extracts modified with glutaraldehyde. The results showed an improvement both in clinical symptoms and a reduction in the complementary pharmacological therapy used. Several clinical "in vitro" and "in vivo" parameters were analysed during this study. The results obtained from the Nasal Challenge Test and the Skin Test (prick-test) were the most relevant. Patient tolerance to the diagnostic extract was increased in 45% of the patients, the result of which was registered in the Nasal Challenge Test. Evaluation of the results derived from the skin tests on conclusion of immunotherapy, showed a reduction in response in 55% of the patients. Progressive immunotherapeutic doses were applied at short intervals with no record of severe reactions.
Adolescent↗
Parameters of immunotherapy: a retrospective study.
This is the second in a series of studies carried out on a group of 26 patients undergoing immunotherapy (IT) (9). The objective of this paper was to determine a new subclass of specific IgG, IgG1, so as to achieve comparable results with the previous study on IgG4. All patients in the study group were suffering from respiratory diseases and were all sensitized to Dermatophagoides pteronyssinus (DPT). They were subjected to IT for a period of 36 months. A 6 monthly control on the levels of anti-DPT specific IgE, anti-DPT specific IgG1 and anti-DPT specific IgG4 was done. Our results showed a level drop in anti-DPT specific IgE after 12 months of immunotherapy (p < 0.001) which was maintained in the 6 monthly controls which followed levels of anti-DPT (p < 0.01). Levels of anti-DPT specific IgG1 (p < 0.05) were lowered following 30 months of IT and were maintained till the end of treatment. The levels of anti-DPT specific IgG4 showed a level increase (p < 0.05) between 6 and 24 months of IT. The anti-DPT specific IgG4 level after 36 months of immunotherapy were lower than those obtained after 24 months of immunotherapy and were of no statistical significance. These values were statistically significant, however, when compared with the levels obtained prior to IT (p < 0.05). The IgG4/IgG1 ratio showed a gradual increase and reached extreme values after 24 months of IT (p < 0.05). There was no relationship between these values and the clinical evolution of each patient.
Adolescent↗
Contact dermatitis: clinical review of 800 patients tested using the standard European series.
The results of the use of the European Standard Series on 800 patients suffering from Contact Dermatitis, including occupational Dermatosis is reported. This work also attempts to provide insight into the interests and difficulties of carrying out an epidemiological study in an Allergy Centre and Immunology Clinic. All the patients underwent a Patch Test following the guidelines laid out by the International Contact Dermatitis Research Group. The results of the patch tests were positive in 462 patients (57.7%) and negative in 338 cases (42.3%). The agents responsible for the symptoms in our study were as follows: metals (33%), parafenilen-diamine (13.9%), cobalt (13.3%), perfumes (5.5%), benzocaine (5.4%) and potassium dichromate (5.4%). In this study 72 patients were verified to have Occupational Dermatosis, corresponding mainly to the following occupational sectors: metal industry workers, hairdressers and bakers and pastry makers.
Adolescent↗
[Anesthetic management in unilateral lung transplantation].
OBJECTIVE: To describe and evaluate anesthetic treatment during single lung transplantation (SLT). PATIENTS AND METHODS: This is a retrospective study of patients undergoing SLT during one year of our program's operation. We describe the surgical technique and method of anesthesia, which consisted in combined general and epidural anesthesia. Systemic and pulmonary arterial pressures, heart rate, arterial and mixed venous oxygen saturation were monitored throughout the procedure, along with inspired and expired gases and airway pressure. The following parameters were recorded for the various phases of surgery: cardiac index (CI), right ventricular ejection fraction (REF) and systemic and pulmonary vascular resistances, arterial and mixed venous blood gas readings. RESULTS: Eight SLT were performed during the study period and the survival rate was 100%. PaCO2 and pulmonary artery pressure increased at the start of ventilation of a single lung. These values increased again when the pulmonary artery was clamped. During this period, however, CI and REF held steady and venous oxygen saturation decreased only slightly. Cardiopulmonary bypass was therefore never used. The variables returned to normal upon revascularization of the new lung. CONCLUSIONS: In spite of the small series studied, the excellent results obtained lead us to conclude that our method is appropriate and that SLT is a valid therapeutic alternative for our patients.
Adult↗