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Biomedical subjects

R Molina

Publications and source records attributed to R Molina.

At least 181 records · Page 10Linked to original sources
PubMed1986

Primary Sjögren's syndrome in men. Clinical, serologic, and immunogenetic features.

Although primary Sjögren's syndrome is a common rheumatic disorder in women, it is not well recognized in men. This study represents the first report of the clinical, serologic, and immunogenetic features of a group of 36 men with primary Sjögren's syndrome, which are contrasted with those of a group of 69 women with primary Sjögren's syndrome. The majority of male patients had extraglandular involvement including articular (78 percent), neurologic (39 percent), inflammatory vascular (25 percent), and lymphoproliferative disorders (17 percent). Although men were at the same risk for the development of extraglandular complications, there were significant serologic and immunogenetic differences. In sharp contrast to women with Sjögren's syndrome, men with Sjögren's syndrome were seronegative with respect to the presence of serum rheumatoid factor (p = 0.008) and antibodies to Ro(SS-A) (p = 0.016). The supertypic specificity, MT2 (DRw52), as in women, was strongly associated with primary Sjögren's syndrome in men when compared with race-matched control subjects (p = 0.0015). In men, however, the frequency of HLA-B8 and HLA-DR3, the most common DR locus specificity observed in women, was not statistically different from that observed in the normal control group.

Adult↗
PubMed1986

Motor activity of esophageal substitute (stomach, jejunal, and colon segments).

Manometric studies were performed to evaluate motor activity of several types of esophageal substitutes: total stomach (5 patients), isoperistaltic gastric tube (5 patients), jejunal Roux-en-Y loops (4 patients), and isoperistaltic left colon (15 patients). Motor behavior of substitutes was assessed following dry swallows and following several stimuli: intraluminar injection of 30 ml of water or 0.1N hydrochloric acid and swallowing pills. Following dry swallows, there was no response with either stomach or isoperistaltic gastric tube, jejunum showed a variable response, and a response was infrequent in patients with colon transplants. After dry swallows, transmission of the pressure wave through the anastomosis was not observed in any patient. Total stomach and isoperistaltic gastric tube did not respond to any stimulus. Jejunum responded with progressive waves after water and solid stimuli, and had a hyperkinetic response after acid injection. Colon had a constant (80 to 90%) and homogeneous response with progressive waves after all stimuli. After wet swallows, there was transmission through the anastomosis in 2 patients with colon transplants. Our data indicate that stomach and isoperistaltic gastric tubes do not contribute actively to the onward transmission of food in the digestive tract. Jejunum may contribute actively in digestive transit, but its responses are variable. Having steady and homogeneous responses, colon segments take an active part in transit.

Adolescent↗
PubMed1986

Serum beta 2-microglobulin as a marker of activity in systemic lupus erythematosus.

A prospective study of 62 patients with systemic lupus erythematosus (SLE) was performed in order to establish whether serum beta 2m could be a good marker of clinical activity. beta 2m was determined by radio-immunoassay and the values compared with a control group of healthy individuals. The mean value of beta 2m in the control group was 1.48 +/- 0.52 mg/l and 2.87 +/- 2.19 mg/l (p less than 0.001) in the SLE group, 4.53 +/- 2.89 mg/l in the 22 patients with active disease and 2.40 +/- 1.80 mg/l (p less than 0.001) in the 40 patients with inactive disease. High beta 2m values (greater than or equal to 3 mg/l) were observed in 64% of the patients with active SLE, VS. only 12% of the patients with inactive disease (p less than 0.001). Significant differences were also observed when beta 2m of the patients with inactive SLE was compared with the control group (p less than 0.001). The beta 2m with a sensitivity of 64%, a specificity of 87%, and an efficiency of 79% could be a good parameter to detect SLE clinical activity.

Adolescent↗
PubMed1986

New method for quantitative evaluation of esophageal sensibility.

A method for quantitating esophagus sensibility by an electric stimulation test is described. Square stimulus waveform at different voltages and durations were transmitted to the esophagus, three series of electric stimuli being used in successive durations (0.5, 1, 2, 4, 8 and 16 ms); in each series the voltage discharge was increased progressively from 0 mV, until the subject noted the first sensation. This procedure was carried out at all esophageal levels. The following parameters were analyzed: sensitive threshold along the esophagus; the relation of threshold sensibility (mV) duration of stimulus (ms), and reobase and cronaxia for each esophageal level. At all esophageal levels, the sensitive threshold was regular and coherent; in the middle esophagus a zone was found having higher sensitive threshold than the proximal and distal esophageal zones. The relationship between sensitive threshold and inverse of the stimulus duration indicated that esophageal sensibility follows the basic law of excitation of WEISS, at least with this type of stimulus, reobase and cronaxia being representative of the sensibility threshold along the esophagus. Quantitative esophageal sensibility, therefore is concluded to be particularly suited to evaluation by electric stimulation.

Adolescent↗
PubMed1986

Continuous arterio-venous ultrafiltration in cirrhotic patients with ascites or renal failure.

To assess whether continuous arteriovenous ultrafiltration (CAVU) might constitute a useful alternative to hemodialysis in the management of patients with advanced liver failure, we carried out CAVU in 3 patients with decompensated Laennec's cirrhosis. CAVU was utilized in two patients with acute renal failure and pulmonary edema to stabilize renal function and facilitate administration of large amounts of fluid. In the third case, CAVU was successfully utilized to mobilize fluid in a patient refractory to conventional diuretic regimens. We conclude that CAVU may constitute an appropriate alternative to traditional hemodialysis in patients with advanced liver disease and renal functional impairment.

Aged↗
PubMed1985

Two types of inflammatory vascular disease in Sjögren's syndrome. Differential association with seroreactivity to rheumatoid factor and antibodies to Ro (SS-A) and with hypocomplementemia.

Two types of inflammatory vascular disease (IVD) occur in Sjögren's syndrome: neutrophilic IVD (NIVD) and mononuclear IVD (MIVD). In 45 patients with Sjögren's syndrome, we examined the 2 types of IVD with respect to serologic associations. NIVD, unlike MIVD, was significantly associated with seroreactivity reflected by hyperglobulinemia (P = 0.01), rheumatoid factor (P = 0.002), antinuclear antibodies (P = 0.02), and antibodies to Ro (SS-A) (P = 0.00006), and with hypocomplementemia (P = 0.03). The differential association of the 2 types of IVD with serologic reactivity and hypocomplementemia suggests that there may be basic differences in the immunopathogenesis of these 2 forms of IVD in Sjögren's syndrome.

Adolescent↗
PubMed1985

Peripheral inflammatory vascular disease in Sjögren's syndrome. Association with nervous system complications.

Two histopathologic types of inflammatory vascular disease (IVD) occur in Sjögren's syndrome (SS): mononuclear IVD (MIVD) and neutrophilic IVD (NIVD). We describe 50 SS patients with IVD (30 with NIVD and 20 with MIVD). Thirty-three (66%) of the SS patients with biopsy-documented IVD had nervous system disease unattributable to other causes. Nineteen patients (58%) had involvement of both the central and peripheral nervous systems, while 9 had peripheral and 5 had central nervous system dysfunction alone. Patients with both histopathologic types of IVD were at risk for the development of nervous system abnormalities (57% of NIVD patients and 80% of MIVD patients). Indirect evidence is presented which suggests that IVD may play a role in the immunopathogenesis of nervous system disease, at least in a subset of SS patients.

Adolescent↗
PubMed1985

Total fundoplication with or without gastroplasty for gastroesophageal reflux: comparative study.

The results of clinical, radiographic, manometric, and pH-metric studies of two groups of patients with reflux esophagitis treated by total (Nissen) fundoplication with or without a Collis esophagus-lengthening gastroplasty were compared. On postoperative follow-up, clinical recurrence of gastrophageal reflux was found in 5 of the 76 patients in the Nissen group, whereas none of the 46 patients in the Collis-Nissen group had reflux. A dramatic reduction in the clinical score was observed for all patients, and postoperative clinical morbidity was similar in both groups. Postoperative radiographic recurrence of hiatal hernia was found in 11 of 60 patients in the Nissen group, but not in any of the patients in the Collis-Nissen group. The lower esophageal sphincter pressure was significantly increased after operation in both groups (p less than 0.05). The postoperative "common cavity test" and acid reflux test were positive in 9% of the patients having Nissen fundoplication alone and 11% of those having the Collis-Nissen procedure; in the latter group, both tests were positive in only 1 asymptomatic patient. These results demonstrate that the standard Nissen repair is a good surgical technique for management of uncomplicated reflux esophagitis and that the Collis-Nissen procedure is the most effective method of surgical repair for almost all patients with complicated reflux esophagitis.

Adolescent↗
PubMed1985

Neuropsychiatric dysfunction in primary Sjögren's syndrome.

Neuropsychiatric complications developed in 40 patients with primary Sjögren's syndrome, none of whom met American Rheumatologic Association criteria for systemic lupus erythematosus. Twenty-five patients had psychiatric abnormalities, the commonest of which were affective disturbances. Of 30 patients tested, 23 had an abnormal pattern in the Minnesota Multiphasic Personality Inventory, the commonest pattern being a "conversion V." In general, patients presented with hysteroid dysphoric features. Of 16 patients undergoing cognitive function testing, 7 showed mild memory impairment with attention and concentration deficits. On clinical evaluation, 27 patients had neurologic abnormalities unattributable to other causes (central and peripheral nervous system in 16 and 19 patients respectively). There was a significant correlation between psychiatric disturbances and neurologic dysfunction, suggesting a possible organic basis for psychiatric dysfunction. The diagnosis of primary Sjögren's syndrome should be considered in patients with unexplained neuropsychiatric illness.

Adolescent↗