Search PubMed⌕ Search

Biomedical subjects

M Sainz

Publications and source records attributed to M Sainz.

At least 19 recordsLinked to original sources
PubMed2005

Renoprotective effect of early inhibition of the renin-angiotensin system in renal transplant recipients.

The aim of this work was to study the effect of early administration of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II type-I receptors blockers (ARB) on renal function and proteinuria in renal transplant recipients with good, stable renal function and mild proteinuria. Twenty four patients started ACEI/ARB therapy within 14 months after surgery (RAS-). Before (T0) and every month for 2 years after the initiation of ACEI/ARB we evaluated creatinine clearance (CrCl), proteinuria/day (UP), UP/CrCl (FUP), arterial blood pressure, and serum lipid levels. Twenty-eight patients who never received ACEI/ARB (RAS+) were studied in the same fashion. In the RAS+ CrCl was reduced after 2 years compared with T0 (64.5 +/- 2.6 vs 75.0 +/- 3.2 mL/min, P < .003); UP and FUP were both significantly increased (666 +/- 65 vs 132 +/- 20 mg/day 8.8 +/- 1.2 vs 2.6 +/- 0.6 mg/mL x 10(3); P < .001 and .002) compared with T0. Moreover, UP (P < .04), FUP (P < .03), and the percentage reduction of CrCl (11.4% +/- 5% vs 4.6% +/- 1.8%; P < .05) were greater in RAS+ than RAS- subjects at 2 years of the study. The values of other parameters did not show significant differences between the two groups. In conclusion, this study suggested that ACEI/ARB have renoprotective effects, when used in patients with good stable renal function and mild proteinuria. These drugs may play a role to prevent chronic allograft nephropathy.

Angiotensin II Type 1 Receptor Blockers↗
PubMed2004

Liver transplantation from old donors into HCV and non-HCV recipients.

BACKGROUND: Chronic liver failure due to HCV-related cirrhosis is the leading indication for liver transplantation in Western countries. Inferior long-term results have been reported for liver transplantation in HCV patients, especially when marginal donor livers are utilized. The aim of this study was to retrospectively analyze the outcome of liver transplantation from elderly donors in HCV versus non-HCV recipients. METHODS: One hundred seventy-nine patients receiving 204 liver transplantations were divided into four groups according to HCV positivity and donor age (> or <65 years). Long-term survivals were calculated by the Kaplan-Meier method. RESULTS: Grafts from donors of >65 years into HCV-positive patients displayed lower patient and graft survival rates than HCV-negative cases, although macrosteatosis was more frequent (55% vs 9%, P =.02) among organs used for non-HCV cases. Moreover, HCV-positive recipients transplanted with a donor aged >65 years had significantly lower patient and graft survival (40% vs 78% [P =.01] and 40% vs 68% [P =.06], respectively) than patients receiving a liver from a younger donor. CONCLUSIONS: Our retrospective analysis, although hampered by a small number of patients transplanted with an old liver, suggest that the results of liver transplantation with a donor graft >65 years of age into an HCV-positive recipient shows a worse outcome than those from younger donors. Older livers should be reserved for non-HCV cases.

Aged↗
PubMed2004

Renal allograft protection with early angiotensin-converting enzyme inhibitors administration.

Twenty renal transplant recipients (RTx) with a normal ultrasound pattern of renal artery who began angiotensin-converting enzyme inhibitor (ACEI) therapy within 14 months after surgery (ACEI(+)) were studied retrospectively to evaluate endogenous creatinine clearance/1.73 m(2) body surface area (CrCl), proteinuria (UP), UP/CrCl (FUP), mean arterial pressure (MBP), total cholesterol, LDL, HDL, and triglycerides. Before (T(0)) and every month for 2 years after initiation of ACEI. Twenty-four RTx who never received ACEI (ACEI(-)) were studied in the same fashion. No differences in the parameters were noted at T(0); all RTx had CrCl >60 mL/min, Up less than 0.5 g/d, and stable renal function for 3 months before the study. In the ACEI cohort CrCl was reduced after 2 years compared with T(0) (65.6 +/- 2.8 vs 76 +/- 3.2 mL/min, P <.004), UP and FUP were both increased (660 +/- 60 vs 130 +/- 20 mg/d, 8.9 +/- 1.3 vs 2.8 +/- 0.6 mg/mL x 10(3); P <.001 and.002, respectively). UP >0.5 g/d was present in three cases. After 2 years the ACEI(+) group showed a decrease in CrCl (68.2 +/- 3.1 vs 73 +/- 2.2 mL/min) and the increase in UP (181 +/- 21 vs 139 +/- 18 mg/d) and in FUP (3.1 +/- 0.7 vs 2.6 +/- 0.9 mg/mL x 10(3)), which were not significantly different from the values at T(0). No cases showed UP >0.5 g/d. Moreover UP (P <.04), FUP (P <.03) and the percent reduction of CrCl (11.2 +/- 2.5% vs 4.6 +/- 1.8%, P <.05) were greater among ACEI(-) than ACEI(+) patients at 2 years. ACEI(-) patients showed correlation between the percent reduction of CrCl and UP (r =.51, P <.04). The values of MBP and lipids did not reveal any significant difference between the two groups. In conclusion, this study suggests that ACEI have a renoprotective effect, when used early, and may also prevent chronic allograft nephropathy.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2004

[Speech understanding in post-lingual adults with cochlear implants].

It is well recognised that multi-channel cochlear implants are highly effective in gaining or regaining auditory perceptual skills of severe to profound hearing-impaired people. Research shows that adults rapidly improve in speech understanding after cochlear implantation. This study reports on speech understanding from two Spanish Clinics. 32 post-lingually deafened adults were fitted with either a MED-EL COMBI 40 or COMBI 40+ cochlear implant at the Hospital Universitario San Cecilio, at the Granada or Hospital Universitario La Fe, Valencia Clinic, Spain. Subjects were assessed at 1, 3, 6 and 12 months post-fitting on a number of speech perception tests. Results showed a highly significant improvement on all speech perception tests over the time. These ratify other studies in saying that cochlear implantation is a viable and successful treatment in post-lingually deafened adults.

Adult↗
PubMed2001

Percutaneous mechanical fragmentation and stent placement for the treatment of early posttransplantation portal vein thrombosis.

BACKGROUND: Early portal vein thrombosis is a rare but severe complication of liver transplantation requiring retransplantation or at least surgical thrombectomy, both hampered by high morbidity and mortality. METHODS: We describe of a case of successful long-term recanalization of early posttransplantation portal vein thrombosis by a minimally invasive percutaneous transhepatic angiographic approach using both mechanical fragmentation and pharmacological lysis of the thrombus followed by stent placement. RESULTS: Mechanical fragmentation and contemporaneous local urokinase administration resulted in complete removal of the clot; the use of a vascular stent after balloon dilatation allowed restoration of normal blood flow to the liver after 9 months of follow-up. CONCLUSIONS: This case report confirms the possibility of successful recanalization of the portal vein after early posttransplantation thrombosis by a minimally invasive angiographic approach. Balloon dilatation and placement of a vascular stent could help to decrease the risk of recurrent thrombosis.

Anastomosis, Surgical↗
PubMed2001

Monitoring the response to antiretroviral therapy in HIV-1 group O infected patients using two new RT-PCR assays.

Failure to recognise infection caused by human immunodeficiency virus type 1 (HIV-1) group O variants has been described using both serological and genetic procedures. Moreover, monitoring the response to antiretroviral therapy is a difficult task in patients infected with HIV-1 group O since commercial tests are not available so far for the quantitation of this virus. In this study, the virological response to antiretroviral therapy were assessed in five HIV-1 group O-infected patients living in Spain by using two new and different RT-PCR methods (MUPROVAMA and LCx). Twenty-four plasma samples belonging to these five patients were selected. As reference, p24 antigenaemia levels and CD4+ cell counts were used. All samples yielded positive viral load values using MUPROVAMA (range: 138 to 595,500 HIV-RNA copies/ml) and 23 of 24 using LCx (range: < 178 to 98,356 HIV-RNA copies/ml). Overall, the results obtained using both assays showed a good correlation among themselves, and in respect to p24 antigenaemia and CD4+ cell counts. However, the values provided by LCx were significantly lower (0.33 logs on average) than those provided by MUPROVAMA. In conclusion, both the highly sensitive MUPROVAMA and LCx Quantitative assays might represent an useful tool for guiding the decision on when start treatment and for monitoring the response to antiretroviral therapy in HIV-1 group O-infected patients.

Adolescent↗
PubMed1998

Spanish study group on cochlear implants for persons with marginal benefit from acoustic amplification.

Recently the U.S. Food and Drug Administration approved the use of cochlear implants (CI) in patients with severe-to-profound sensorineural hearing loss with marginal benefit (< 30% speech discrimination) from hearing aids (HA). A multicentre trial was developed to determine whether this approval could be applied to the Spanish population. Nine postlingual adults from 3 centres were selected for the study. The mean preoperative unaided PTA threshold (0.25 to 4 KHz) was 108.6 dB HL for the poorer ear and 99.8 dB HL for the better. In all subjects the poorer ear was implanted with a Mini Nucleus 22 device. A single subject design study was used to compare performance with HA preoperatively and with CI postoperatively, or CI with contralateral HA. PTA measures and Spanish open set speech recognition tests were used. Comparing pre-implant levels with results after 6 months of CI use, all subjects improved significantly on all test measures: i) Mean aided soundfield threshold: 73.6 dB vs 39.8 dB ii) Mean bisyllabic recognition: 20% vs 57% iii) Mean consonant discrimination: 20% vs 49% iv) Mean CID sentences: 22% vs 73%. Five subjects discontinued use of the contralateral HA after implantation, three continued occasionally to use the HA, and one continued to use both on a full-time basis. Patients performed significantly better post-implant on speech recognition compared with their best pre-implant HA scores. Therefore the CI appears an appropriate treatment for Spanish speakers with a severe-to-profound hearing loss and marginal benefits with HA.

Adolescent↗
PubMed1995

[Neurological follow-up of newborn infants at risk for cerebral palsy].

BACKGROUND: Traditional neurological examination of newborns at risk for cerebral palsy (CP) is based on periodic assessment of normal milestones so that the diagnosis of CP can be very late. A complementary neuromotor evaluation based on two motor series has been proposed in order to make possible an early affirmation of integrity of motor paths. POPULATION AND METHODS: Eight hundred and seventy three infants including 371 preterms had been admitted to a neonatal intensive care unit from 1990 to 1992. Then, they were examined as outpatients by a multidisciplinary team. They were especially tested for lateral support on right and left superior limbs, alternately, and for lateral abduction reaction of each hip. RESULTS: Absence of manifestations of CP was noted in 87% of infants with a corrected age of 4 months; a correct prediction of future normal walking was made for all babies. Both tests could not be correctly performed by those babies who lately developed manifestations of CP. CONCLUSIONS: These two simple tests appear to be accurate to early predict normality.

Cerebral Palsy↗
PubMed1995

[Complementary neuromotor examination of infants at risk for sequelae.Why? How?].

In many cases the traditional neurological examination of high risk newborns for neurological problems secondary to perinatal difficulties does not identify easily the absence or the presence of cerebral palsy before walking. To help the neuromoteur follow up in these children, the authors suggest a complementary neuromotor examination that is successful only in normal infants. This examination is done in front of a mirror in the presence of the parents in order to increase the attention of the child, whose participation is necessary for a successful examination. Two motor responses are evaluated: the lateral support on, alternately, right and left superior limbs, and the lateral abduction reaction of the hip of each limb. When normal these two motor responses allow an early affirmation of integrity of motor paths if the examination is performed under carefully controlled conditions.

Cerebral Palsy↗
PubMed1994

Relationship between immune complex and total hemolytic complement in endolymphatic hydrops.

Recently there has been considerable investigation into the relationship of the immune system and immune disorder to Meniere's disease. Immunoglobulin G (IgG) antibody and complement are both present in endolymphatic fluid and it is possible that endolymphatic hydrops is due to immune complex. The authors' results show that patients with endolymphatic hydrops had elevated levels of circulating immune complex (CIC) of IgG (24.80 micrograms/mL). The levels of functional complement activity (CH50) were significantly lower in patients (249.7 HU) than in controls. Circulating levels of CIC and CH50 were positively correlated. Immunoglobulin G, immunoglobulin M (IgM), and subpopulation of B lymphocytes were elevated, but there was no alteration in subpopulations of T-helper, T-suppressor, and natural killer (NK) cells in peripheral blood.

Adult↗
PubMed1992

Changes in immunologic response in tonsillectomized children. I. Immunosuppression in recurrent tonsillitis.

The possible immunoregulatory role of the tonsils was studied by determining immunoglobulins IgG, A, M, E and factors C'3, C'4 and PFB of the complement system before and after tonsillectomy. The synthesis in vitro of IgG and IgM by lymphocytes stimulated with pokeweed mitogen was also measured. There were statistically significant differences between pre and post-operative levels of serum IgG, IgA and IgM, which decreased after surgery. Practically no change in the mean values of IgE and no significant differences in the levels of serum C'3, C'4, and PFB, were found. The in-vitro synthesis of both immunoglobulins (IgG, IgM) by lymphocytes increased significantly after tonsillectomy. Our results suggest that not only does tonsillectomy have no counterproductive effect on the immune system, but that, on the contrary, it seems to improve the immune response, since it appears to unblock the suppression to which the immune system was subject.

Child↗
PubMed1992

Changes in immunological response in tonsillectomized children. II. Decreased cellular response.

The immunological cellular response was studied in 22 children aged between 5 and 10 years. One week before and one month after tonsillectomy, the mitogenic response to phytohaemagglutinin (PHA), concanavalin (ConA) and pokeweed mitogen (PWM) was tested. Our results showed statistically significant decreases in stimulation index (SI) to PHA, ConA and PWM after tonsillectomy. This suggests that the tonsils may influence the cellular immune status in children. The higher level of preoperative activity in children with recurrent tonsillitis could be understood as the result of stimulation of lymphocytes by bacteria.

Child↗
PubMed1989

[Cochleovestibular manifestations in hypothyroidism].

An study of cochleo-vestibular disturbances in different kinds of hypothyroidism is carried out. The majority of the patients suffered from sensorineural deafness of the flat type, lacking Recruitment. The evoked potentials of the brainstem were normal, where as myogenic ones showed a decrease in their amplitude. Evident central disturbances appeared on vestibular examination and a saccadic pursuit was frequently observed in the tracking test. The topography of the lesions is discussed.

Acoustic Impedance Tests↗
PubMed1982

Binaural voltage summation of brainstem auditory evoked potentials: an adjunct to the diagnostic criteria for multiple sclerosis.

Brainstem auditory evoked potential (BAEP) amplitude is modified according to whether or not the stimulus is applied monaurally or binaurally. In normal subjects, wave V amplitude increases by an average of 68.7% upon changing stimulation from monaural to binaural. From earlier studies there is evidence that brainstem potential amplitude is reduced in patients with multiple sclerosis (MS) but none to suggest that binaural stimulation results in increased amplitude. This study evaluated the extent of binaural summation of BAEPs in patients with MS. In a large majority of patients with MS who have no hearing deficit, BAEPs showed no increase in wave V amplitude on binaural stimulation. This finding is in contrast to the normal group and thus has diagnostic importance. Measurements of binaural summation therefore might usefully be applied to the clinical assessment of disease progression, or lack of it, in individual patients.

Acoustic Stimulation↗
PubMed1981

Effect of interaural intensity differences on binaural summation of brainstem auditory-evoked potentials.

With binaural stimulation the two specific parameters that can modify the neural responses substantially are the intensity differences and the time of arrival of the stimulus at the two ears; these events on electrophysiological evidence, being mediated at the superior olivary complex and at the inferior colliculus, the origins of Waves III and V respectively. Comparison of the brainstem auditory-evoked potentials to monaural stimulation with that due to binaural stimulation reveals a significant increase only in the amplitude of Wave V. The amount of increase is reduced from 68.7% with equal intensities at the two ears to 44% with a 10-dB interaural intensity difference. With a 20-dB interaural intensity difference the amplitude of Wave V reverts to that due to monaural stimulation. The 68.7% greater amplitude for Wave V was not due to effective increase in loudness sensation on binaural stimulation (which is equivalent to a monaural increase in intensity of 3 dB) but to binaural summation. In contrast to Wave V, Wave III decreased in amplitude below that resulting from monaural stimulation with intensity differences of 10 and 20 dB at the two ears. This supports the suggestion of inhibitory processes at that level of the brainstem. As only Wave V shows binaural summation the region of inferior colliculus is suggested as the site for the occurrence of this phenomenon. Binaural interaction can also be demonstrated within a limited range with intensity differences at the two ears.

Brain Stem↗
PubMedDate not supplied

Cryopreserved human hepatocytes from cell bank: in vitro function and clinical application.

UNLABELLED: We Aimed to analyze the in vitro function of isolated and cryopreserved human hepatocytes (CHH) from a cell bank and to define their potential clinical application in a bioartificial liver (BAL) device. METHODS: Over 24 months, 103 not transplantable livers were utilized for human hepatocytes isolation and cryopreservation. Hepatocytes isolated by collagenase were analyzed for yield, viability, diazepam metabolism, and production of human albumin after isolation and cryopreservation in LN(2). RESULTS: The causes for refusal for transplantation were macrosteatosis >60%, ischemic damage due to donor hypotension, and nonviral cirrhosis in 60%, 11%, and 8%, respectively. Cell yields averaged 7 million hepatocytes per gram of liver of mean viability of 80% +/- 13%. The viability of CHH after thawing averaged 50%. Thawed hepatocytes showed diazepam metabolism, and human albumin synthesis comparable to fresh cells. CHH were utilized as the biological component of a BAL for temporary support as three applications of two patients affected by fulminant hepatic failure awaiting urgent transplant. Ten to 13 billion viable CHH were loaded into each BAL. Liver function showed bilirubin and ammonia reduction at the end of each treatment. One patient was successfully bridged to emergency OLTx after one BAL; in the second case there was spontaneous recovery of liver function after two BAL. CONCLUSIONS: Recovery of donor human livers unwanted for transplantation allowed isolation and cryopreservation of viable and functionally active human hepatocytes, which have been banked and successfully used for clinical applications of a BAL device.

Cryopreservation↗
PubMedDate not supplied

Effects of successful renal transplantation on left ventricular mass.

Left ventricular hypertrophy is an independent cardiovascular risk factor in the general population and in patients with chronic renal failure. Relatively little is known about the effects of renal transplantation on left ventricular hypertrophy. The aim of this study was to determine the changes in left ventricular mass after successful renal transplantation and to evaluate the importance of some clinical, laboratory, and echocardiographic variables on the trend to left ventricular hypertrophy. Twenty-three patients with end-stage renal disease were studied by ambulatory blood pressure monitoring and echocardiography before and 2 years following renal transplantation. After 24 months of follow-up, all transplant recipients had adequate renal function (serum creatinine <2 mg/dL). At the end of the study, we observed a significant decrease in left ventricular mass and left ventricular mass index compared to the pretransplantation period. In renal transplant recipients, the prevalence of left ventricular hypertrophy significantly decreased (78% versus 44%, P < .03) after 2 years of follow-up. Systolic 24-hour blood pressure was the only predictor of left ventricular mass and of left ventricular mass index at 2 years after transplantation. In conclusion, successful renal transplantation produces a regression of left ventricular hypertrophy. This beneficial effect depends on a decrease in systolic pressure levels.

Adult↗