Search PubMed⌕ Search

Biomedical subjects

R J Andrade

Publications and source records attributed to R J Andrade.

At least 37 records · Page 2Linked to original sources
PubMed2000

Chronic liver injury related to use of bentazepam: an unusual instance of benzodiazepine hepatotoxicity.

Liver injury induced by benzodiazepines is rare and is classified as an unpredictable or idiosyncratic hepatotoxic reaction. Early reports indicated that in most cases the pattern of liver injury was cholestatic. We describe three patients with persistent increases in liver transaminase levels after several weeks of treatment with bentazepam, a benzodiazepine marketed in Spain for anxiety disorders. In all cases withdrawal of the drug was followed by resolution of transaminase level abnormalities. A liver biopsy (done in one patient only) showed histological evidence of severe chronic active hepatitis. In conclusion, these findings, together with two previously published case reports, suggest that a benzodiazepine can cause chronic hepatitis and argue in favor of using liver function tests to monitor all patients taking bentazepam.

Administration, Oral↗
PubMed2000

Effects of interferon-beta on plasma lipid and lipoprotein composition and post-heparin lipase activities in patients with chronic hepatitis C.

BACKGROUND: Interferon therapy has been shown to induce lipid abnormalities. AIM: We assessed the effects of interferon-beta on the lipoprotein profile and post-heparin lipase activities in 26 normolipaemic patients with chronic hepatitis C. METHODS: Interferon-beta was administered subcutaneously at doses of 6 x 106 U (units) three times a week, over 6 months, and lipoproteins and post-heparin lipases were measured at baseline and at the end of therapy. RESULTS: Plasma triglycerides increased by 21% due to preferential enrichment in those contained in the very low density lipoprotein (VLDL) and low density lipoprotein (LDL) fractions. The concentration of cholesterol decreased slightly in the high density lipoprotein (HDL) subfractions. Lipoprotein lipase, but not hepatic lipase activity decreased by a 36%, and this change showed a significant negative correlation with changes in plasma triglycerides. Five patients (19.5%) responded to interferon-beta therapy. The lipoprotein profile was no different between responders and non-responders to therapy. CONCLUSIONS: Interferon-beta treatment in normolipaemic patients with chronic hepatitis C induced moderate disturbances in plasma lipoproteins, associated with inhibition of lipoprotein lipase activity.

Adult↗
PubMed1999

Acute liver injury associated with the use of ebrotidine, a new H2-receptor antagonist.

BACKGROUND/AIM: Ebrotidine is a new H2-receptor antagonist marketed in Spain in early 1997 and withdrawn in July 1998. We report 11 cases of acute liver injury related to ebrotidine and submitted to a Regional Registry of Hepatotoxicity between June 1997 and August 1998. METHODS: In all cases a structured protocol was used to ascertain the role of ebrotidine and to exclude other causes (viral, immunologic, metabolic) of liver injury. RESULTS: All patients showed clinical symptoms of acute hepatitis, with a marked increase in aminotransferase activities (ALT values ranging from 15 to 91 times the upper limit of normal). Total bilirubin values were also greatly increased (mean 16 mg/dl), and the liver injury was defined as hepatocellular. Features of hypersensitivity were absent. Liver biopsy was done in three patients. Histopathological examination revealed mainly centrozonal necrosis (two cases) or massive necrosis (one patient). Withdrawal of the drug was followed by a gradual improvement in liver dysfunction, except in one patient who developed fulminant hepatic failure and died. There was a positive response to rechallenge in one patient after an inadvertent drug administration. CONCLUSION: Ebrotidine therapy seems to be associated with severe acute liver injury, and therefore its benefit/risk ratio is unfavorable. The relative rareness and unpredictability of the injury, the lack of dose-relationship and the absence of hallmarks of drug allergy are suggestive of an idiosyncratic metabolic mechanism.

Acute Disease↗
PubMed1998

[Chronic cholestasis as a presentation form of portal cavernoma].

A 37 year-old-woman was evaluated in 1993 for a chronic asymptomatic cholestasis. An endoscopic retrograde cholangiopancreatography showed the biliary tract compressed, and a mesenteric angiogram disclosed that the cause of biliary obstruction was a portal cavernoma. In addition, large esophageal varices with "red spots" were observed at endoscopy. Propranolol and ursodeoxicolic acid were started and the patient has remained asymptomatic to date. The biliary features of portal cavernoma are reviewed, as well as its pathogenesis, diagnosis and management. Portal cavernoma should be considered in the differential diagnosis of chronic cholestasis.

Adult↗
PubMed1998

[HELLP syndrome. Analysis of 2 cases].

HELLP syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelets), one of the gestational diseases of the third trimester of pregnancy associated to eclampsia or preeclampsia, has a varied clinical expression, that include poor symptomatic patterns with malaise and/or dyspepsia, even several patterns with fatal outcome. We show two cases with clinical and laboratory criterion of HELLP syndrome, but with different clinical presentations. It's analyzed the pathogenicity, clinical-pathological expression, course and therapeutics options in HELLP syndrome.

Adult↗
PubMed1997

Oral fenoterol versus sustained release theophylline in adult asthmatics.

AIM: The question regarding the minimal effective oral dose of fenoterol remains unanswered. The present study was undertaken to compare the therapeutic effects of sustained release theophylline and a conventional low dose oral fenoterol in patients with asthma. PATIENTS AND METHODS: A double-blind, double-dummy, randomized, 2-phase, cross-over comparison between sustained-release theophylline (SR-T) and oral fenoterol 2.5 mg 3 times daily in 21 patients with stable bronchial asthma (mean age 51 years) was conducted. Each drug was administered for a 2-week period. All patients qualified with a > or = 15% reversibility in forced expiratory volume in 1 second (FEV1) following 200 micrograms of inhaled salbutamol. Spirometric tests and body plethysmography were done at baseline and at the end of each treatment period. Blood was drawn for routine laboratory analysis and serum theophylline concentration. During each treatment period the patient kept a diary of symptoms and the concurrent use of inhaled salbutamol was recorded. RESULTS: During SR-T administration trough serum concentrations were 12.9 (1.5) mg/l mean (+/- SEM). SR-theophylline produced greater maximal changes in all parameters measured: FEV1, forced vital capacity, and specific airway resistance from the pretreatment and fenoterol phase, while fenoterol caused significant changes in none of the test variables. Patients showed an overall preference for SR-T over fenoterol (p < 0.05). CONCLUSIONS: Thus, 2.5 mg of fenoterol at 8-hour intervals did not prove to be an effective alternative to sustained release theophylline for management of patients with asthma. An appropriate dosing schedule for fenoterol needs to be redefined.

Administration, Inhalation↗