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Biomedical subjects

N R Robles

Publications and source records attributed to N R Robles.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Edema caused by diuretic abuse].

We present the case of an "idiopathic" edema induced by the chronic use of diuretics in a 44-years-old patient. The patient showed a significant secondary hyperaldosteronism which have been erroneousley labelled as primary in previous studies. The pathogenicity of the idiopathic edema and its relation to diuretic abuse are discussed.

Adult↗
PubMed1993

Hemodialysis with cuprophane or polysulfone: effects on uremic polyneuropathy.

A longitudinal study was performed of 11 patients on hemodialysis (HD) who where changed from cuprophane (CU) to polysulfone (PSF) membranes. Delivered Kt/V was approximately 1.1 throughout the study period. Motor conduction velocities (MCV) and sensory conduction velocities (SCV) were measured predialysis and postdialysis while the patients were still on CU membranes, 1 month after changing to PSF, and 12 months after changing to PSF. There was no change in predialysis MCV or SCV. For example, predialysis MCV with CU (43.6 +/- 6.2) was still 43.6 +/- 4.8 m/s after 1 year of PSF dialysis (P = NS). Similarly, predialysis SCV with CU (45.1 +/- 4.6 m/s) was not increased after 1 year of PSF dialysis (42.0 +/- 3.6 m/s). However, the predialysis versus postdialysis comparisons did show a difference between CU and PSF for SCV. PSF dialysis increases SCV by 3.0 +/- 3.8, whereas with CU dialysis the increase in SCV (0.7 +/- 2.4) was not significant (delta SCV-CU v delta SCV-PSF, P < 0.05). Acutely, dialysis with both CU and PSF increased MCV by the same amount (CU, 1.5 +/- 2.1; PSF, 2.8 +/- 3.5; delta MCV-CU, P < 0.05; delta MCV-CU v delta MCV-PSF, P = NS). The results suggest that dialysis with PSF membranes acutely improved SCV more than dialysis with CU membranes. However, changing to PSF does not improve predialysis SCV values. Dialysis with both membranes improves MCV to the same extent.

Adult↗
PubMed1993

[The low contagiousness of the hepatitis C virus in hemodialysis].

Due to the short period of the time elapsed since its existence has been described, and the difficulty for its diagnosis, contagiousness of hepatitis C virus in hemodialysis, together with the need of specific measures to avoid its transmission in units where this therapy is performed--similar to the ones adopted with hepatitis B--are still under discussion. A group of thirty patients, dialyzed in the same unit and by the same staff personnel has been studied. All staff members and 29 of the patients were anti-HCV negative. Only one patient was anti-HCV positive, showing at the same time a persistent raise of transaminases and having received previously 12 blood transfusions. On a monthly basis serology for HCV, transaminases GT and alkaline phosphatase were evaluated. Follow-up period has oscillated between 6 and 22 months, mean 14.07 +/- 6.23 months. 53.3% of patients were over a year follow-up, and 43% were over 6 months. A patient died, two were transplanted and a fourth one was lost to follow-up after more than one year. All the transfusions performed in this period (done to six patients) have been checked negative for antibodies anti-HCV. Only an episode of raise in transaminases has been detected during this study, with no serological-conversion to any of the studied virus and with a probable drug-related origin. All negative anti-HCV patients have stayed in the same status. We concluded that HCV shows low contagiousness in hemodialysis. Regular cleaning measures within the Unit seems to be enough to prevent the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Poisoning by delayed-release verapamil in an uremic patient].

The appearance of toxic effects upon consumption of delayed release verapamil at therapeutic doses (120 mg/12 h) in a 64 year old patient with renal failure is described. The patient presented hypotension, bradycardia due to auriculoventricular block, hepatotoxicity, slight hyperglycemia, hyperpotassemia and metabolic acidosis with increased anionic gap. The picture remitted spontaneously with support treatment following discontinuation of the medication. The pathogenesis of the syndrome and the possibility that the hepatotoxicity was the triggering factor are discussed. Extreme precaution is recommended when this type of drugs is used in severe uremic or diabetic patients.

Chemical and Drug Induced Liver Injury↗
PubMed1991

[Membranous nephritis after renal transplantation].

8 cases of membranous glomerulonephritis (MG) after renal transplants (RT) are presented; one being a recurrence of the original disease and the other 7 due to a different cause of renal insufficiency. The total incidence of MG after transplantation was 1.63%; 1.39% being the incidence of MG of new cases. Only 1 patient showed decrease of renal function and in this case the MG was accompanied by chronic rejection lesions. There was no sign of neoplasias nor drugs producing MG. As far as chronic infections are concerned, only one patient showed B antigen and it was not observed during the immunofluorescent test in the biopsy. 6 patients had urological complications after the renal transplant (3 cases of urinary fistula; 2 cases of obstructive uropathy; 1 case of short ureter). 2 patients experienced the start of hemodialysis due to focal and segmentary glomerulosclerosis. The beginning of proteinuria commences between 2 and 23 months after the RT (median 13,0 +/- 7,5 moths); with a range of between 2.0 and 12.0 gr/day (median: 6.8 +/- 3,2 Z gr/day), this being nephrotic in 4 cases. Proteinuria improved 1 case, and persisted in the other patients at the same level registered previous to the diagnosis. MG is a non-frequent complication or RT and is usually benign. Patients with post-transplant urologic complications could be considered to have a higher risk of developing a MG "de novo".

Adolescent↗
PubMed1990

[Antibiotic prophylaxis before kidney transplantation].

The effectiveness of antibiotic prophylaxis was evaluated in the immediate postoperative period of renal transplantation (RT). Before RT, the patients were randomly assigned to one of the following groups: 1) cefotaxime (intravenous infusion of 1 g one hour before the operation). 2) Ceftriaxone (1 g i.v. given in a similar way). 3) Control (without antibiotics). Patients who required antibiotic therapy during the first 3 postoperative weeks were excluded. 20 recipients of cadaveric renal grafts were included in each group. There were 39 males and 21 females with a mean age of 39.9 years. One patient from the cefotaxime group (5%), 2 from the ceftriaxone group (10%) and 2 from the control group (10%) developed infection of the surgical wound, all due to grampositive organisms. 19 patients had urinary tract infections: 7 from the control group (35%), 7 from the cefotaxime group (35%), and 5 from the ceftriaxone group (25%). The development of wound infection was not correlated with urea, creatinine, hemoglobin or total protein levels, or with urinary tract infection or fistula, diabetes or fever. The mean packed red cell volume of the patients who developed wound infection was 24.7 +/- 1.2 vs 28.6 +/- 6.6 in those who did not (p less than 0.01). All patients with visible hematoma and 3 of 10 with perirenal blood collection had wound infection. It was concluded that antibiotic prophylaxis for renal transplantation was useless in our patients.

Adult↗
PubMed1990

Kidney transplantation from anencephalic donors. Report of 5 cases and a review of the literature.

The results of five 'en bloc' kidney transplants from 5 anencephalic newborns are reported. The receptors were 8-50 years old. The graft survival 12 months after transplantation was 60%. The average plasma creatinine level the 1st month after transplantation was 4.0 +/- 0.8 mg/dl, after 6 months 1.5 +/- 0.8, and is currently 1.2 +/- 0.6 mg/dl. The follow-up time ranged from 17 to 55 months (mean 30.3 +/- 17.5 months). Two grafts were lost during the early posttransplantation period (due to arterial thrombosis and vascular rejection, respectively); the other grafts are still functioning. Two grafts showed initial oliguria. All of the patients required hemodialysis or peritoneal dialysis for 5-60 days (mean 22.5 +/- 21.4 days). The time of cold ischemia ranged from 15 to 35 h (mean 25.6 +/- 7.7 h). The literature published on the subject is reviewed, and it is concluded that anencephalic donors are an acceptable option for transplantation.

Adolescent↗