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Biomedical subjects

R Aller

Publications and source records attributed to R Aller.

At least 73 records · Page 4Linked to original sources
PubMed1999

Etiology and frequency of gas exchange abnormalities in cirrhosis.

OBJECTIVE: gas exchange abnormalities are frequent in cirrhosis. These abnormalities can be considered an indication or contraindication for liver transplantation. The aim of this study was to investigate the etiology and frequency of these alterations. METHOD: seventy-eight patients with cirrhosis and 20 healthy subjects were selected randomly. Arterial basal blood gases, diffusing capacity of carbon monoxide (DLco), pulmonary function test (PFT) and contrast transthoracic echocardiography (CTTE) with 0. 9% saline were done. RESULTS: patients showed lower DLco (79 +/- 23. 2 vs 96 +/- 20; p < 0.01), lower PaCO2 levels (32.2 +/- 4.5 vs 37.5 +/- 4; p < 0.001) and higher alveolar-arterial oxygen difference (AaPaO2) (22.5 +/- 11.4 vs 12 +/- 7.4; p < 0.001) than controls, but the difference between groups in mean PaO2 levels was not significant. Twenty-three patients (29.5%) had pulmonary vasodilatation (PV) and 28 (36%) altered PFT. Hypocapnia was the most frequently observed alteration in gas exchange (73.4%). Hypoxemia and decreased DLco were more frequent in the presence of altered PFT than in the presence of PV. Both PFT abnormalities and PV were associated with increased AaPaO2. Child stage was higher in patients with PV (7.9 +/- 2.3 vs 9.2 +/- 2; p = 0.01) than in those without PV. CONCLUSIONS: gas exchange abnormalities are frequent in cirrhosis. The most frequent alteration is hypocapnia, which is associated with PV. The main cause of severe hypoxemia in these patients is PFT abnormality. Pulmonary vasodilatation is more frequent and more severe in patients with advanced hepatocellular dysfunction.

Blood Gas Analysis↗
PubMed1998

Chronic pancreatitis.

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Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1998

A case of spontaneous peritonitis caused by Weeksella virosa.

A case of spontaneous peritonitis caused by Weeksella virosa is reported. This Flavobacterium has never been reported as a cause of spontaneous bacterial peritonitis. The patient responded to antimicrobial therapy. Clinical and therapeutic implications are discussed.

Flavobacterium↗
PubMed1998

Shewanella amazonensis sp. nov., a novel metal-reducing facultative anaerobe from Amazonian shelf muds.

A new bacterial species belonging to the genus Shewanella is described on the basis of phenotypic characterization and sequence analysis of its 16S rRNA-encoding and gyrase B (gyrB) genes. This organism, isolated from shallow-water marine sediments derived from the Amazon River delta, is a Gram-negative, motile, polarly flagellated, facultatively anaerobic, rod-shaped eubacterium and has a G&C content of 51.7 mol%. Strain SB2BT is exceptionally active in the anaerobic reduction of iron, manganese and sulfur compounds. SB2BT grows optimally at 35 degrees C, with 1-3% NaCl and over a pH range of 7-8. Analysis of the 16S rDNA sequence revealed a clear affiliation between strain SB2BT and members of the gamma subclass of the class Proteobacteria. High similarity values were found with certain members of the genus Shewanella, especially with Shewanella putrefaciens, and this was supported by cellular fatty acid profiles and phenotypic characterization. DNA-DNA hybridization between strain SB2BT and its phylogenetically closest relatives revealed low similarity values (24.6-42.7%) which indicated species status for strain SB2BT. That SB2BT represents a distinct bacterial species within the genus Shewanella is also supported by gyrB sequence analysis. Considering the source of the isolate, the name Shewanella amazonensis sp. nov. is proposed and strain SB2BT (= ATCC 700329T) is designated as the type strain.

Base Sequence↗
PubMed1998

Diagnosis of hepatopulmonary syndrome with contrast transthoracic echocardiography and histological confirmation.

We report a patient with cirrhosis and hepatopulmonary syndrome. This syndrome is an entity characterized by anomalies in the arterial oxygenation in patients with chronic hepatic disease and/or portal hypertension and demonstration of pulmonary vasodilatation (PV) in absence of primary cardiac or pulmonary disease. We show that the finding of PV with transthoracic contrast enhanced echocardiography (TCEE) in the diagnosis of PV is real and corresponds to direct measurement of capillary diameter by morphometry.

Adolescent↗
PubMed1998

Isolated ACTH deficiency.

Isolated ACTH is a rare cause of secondary adrenocortical insufficiency. The diagnosis is made by the demonstration of low cortisol production with low plasma ACTH, absent adrenal responses to stimulation for pituitary or hypothalamus with intact adrenal response to exogenous ACTH, and normal secretory indices of other pituitary hormones. We conclude that the diagnosis of this condition may be difficult due to the varied clinical presentation and etiologies.

Adrenal Insufficiency↗
PubMed1998

Association of Helicobacter pylori infection with cardiovascular and cerebrovascular disease in diabetic patients.

OBJECTIVE: Infection by Helicobacter pylori has been epidemiologically linked to some extradigestive conditions, including ischemic heart disease. Diabetic patients are an at-risk population for cardiovascular and thrombo-occlusive cerebral disease. The aim of the study was to examine a possible relationship between H. pylori infection and cardiovascular or cerebrovascular disease in diabetic patients. RESEARCH DESIGN AND METHODS: This was a cross-sectional case-control study with 127 diabetic patients (both IDDM and NIDDM). Special emphasis was placed on the detection of clinical macro- and microvascular complications, cardiovascular risk factors, acute phase reactants, and serological markers of increased cardiovascular disease risk. H. pylori infection was assessed through the determination of specific Ig-G titers, measured by a commercial enzyme-linked immunosorbent assay. RESULTS: Coronary heart disease was more prevalent in diabetic patients with than without H. pylori (odds ratio [OR] 4.07; 95% CI 1.21-13.6; P < 0.05). A history of thrombo-occlusive cerebral disease was also more frequent in H. pylori-positive diabetic patients (OR 4.8; 95% CI 1.24-18.51; P < 0.05). Other complications such as peripheral arteriopathy, advanced nephropathy, neuropathy, or retinopathy were no differently distributed according to serological status. Alterations in the levels of the following acute-phase reactants and blood chemistry determinations were significantly more profound in H. pylori-positive diabetic patients: high fibrinogen (P < 0.05), high erythrocyte sedimentation rate (P < 0.001), high triglycerides (P < 0.001), and low HDL cholesterol (P < 0.001). There values were also more deeply altered in H. pylori-positive diabetic patients with a history of coronary heart disease, thrombo-occlusive cerebral disease, or both, when compared with H. pylori-positive diabetic patients without those complications. CONCLUSIONS: Our data indicate a possible association of H. pylori infection and the development of coronary heart disease, thrombo-occlusive cerebral disease, or both, in diabetic patients. The importance of this link is highlighted by the possibility of an effective intervention against H. pylori infection.

Biomarkers↗
PubMed1997

Fulminant acute Budd-Chiari syndrome stemming from an adrenal tumor.

Adrenal neoplasm is a rare cause of Budd-Chiari syndrome. We report a case of fulminant acute Budd-Chiari syndrome due to inferior vena cava thrombosis stemming from invasion by a clinically nonfunctioning adrenal neoplasm. We also review briefly the clinical characteristics of the seven previously reported cases.

Acute Disease↗