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Biomedical subjects

S Riestra

Publications and source records attributed to S Riestra.

At least 37 records · Page 2Linked to original sources
PubMed1994

[A comparative analysis of blood donors with antibodies to the hepatitis C virus, positivity for the hepatitis B surface antigen and hypertransaminasemia in Asturias].

BACKGROUND: A comparative study of the differences with respect to prevalence, epidemiologic risk factors, clinical and analytical status and histologic data of blood donors with different liver diseases detected in the same geographical area and time period was carried out. METHODS: HBsAg or anti-HCV positive blood donors detected in Asturias (Spain) from October 1989-1991, and a third group of 115 consecutive donors with negative viral markers and an increase in ALT, as well as a fourth control group with no alterations were compared with a BMDP statistical program and logistic regression analysis. RESULTS: The prevalence of anti-HCV+ donors was greater than that of those with HBsAg+ in both general donors (0.87% vs 0.28%) as well as in new donors (1.77% vs 1.2%) with a constant incidence of HBsAg+ cases of around 0.16% of the donations with a decrease being observed in the anti-HCV+ (ELISA 1) cases from 0.76% to 0.25%. The mean age was significantly higher among the anti-HCV+ donors with respect to the remaining groups (41 vs 36 years). Likewise, the cases of anti-HCV+ presenting parenteral risk factors, such as intravenous drug addiction, transfusion or surgery were significantly higher, with the latter two having an independent predictive value. Signs or symptoms of liver disease were more frequently detected in the anti-HCV+ (10.8%) vs the HBsAg+ (2.3%) as were an increase in ALT (52.8% vs 12.7%) and histologic signs of chronic hepatitis (36.4% vs 6.9%). CONCLUSIONS: Anti-HCV+ blood donors more frequently present previous parenteral risk factors, signs or symptoms of chronic liver disease, hypertransaminasemia or histologic data of chronic hepatitis, thus its detection in al altruistic blood donor indicates a high probability of chronic subjacent liver disease. This is in contrast to donors with HBsAg+ which do not normally present liver disease and those with hypertransaminasemia with negative viral markers who generally have slight liver lesions.

Adult↗
PubMed1994

[Blood donors with positive HBsAg in Asturias: its current prevalence and significance].

BACKGROUND: The aim of the present study was to know the current prevalence of HBsAg positivity in Asturias blood donors and to carry out a clinical study of the carriers of the hepatitis B virus (HBV) accidentally detected in a blood donation program. METHODS: A prospective study of incidence and prevalence of HBsAg positivity in blood donations performed in Asturias over two years from October 1989 and 1991 was carried out and the epidemiologic, clinical, and analytical characteristics, as well as histologic liver lesions in the HBsAg positive cases were determined. RESULTS: Among the 42,789 blood donors during this above mentioned period in Asturias 119 cases of HBsAg positivity were found, representing a prevalence of 0.16% of the donations and 0.28% of the donors, generally new donors (95.8%) with a prevalence of 1.2% in this subgroup. No risk factors or known source of contagion were found in 43.6% of the cases and in most occasions the donors were asymptomatic HBsAg carriers (96.5%) with normal transaminases (87.3%) with 4.6% of the cases being HBeAg positive and 3.5% being mutant "e minus" carriers. CONCLUSIONS: The prevalence of HBsAg was almost limited to new donors with a higher prevalence being observed with respect to other regions. Most of the cases may be considered as "apparently healthy" and in the group with positive replicative markers a similar number of positive HBeAg carriers and "e minus mutants" were present.

Adolescent↗
PubMed1994

Heterosexual transmission of hepatitis C virus and the possible role of coexistent human immunodeficiency virus infection in the index case. A multicentre study of 423 pairings.

OBJECTIVES: To define the role that sexual transmission plays in the spread of hepatitis C virus (HCV) infection, and to examine the influence of coexistent human immunodeficiency virus (HIV) infection on this mode of transmission. DESIGN: A multicentre, seroprevalence study of anti-HCV performed in the stable heterosexual partners (SHP) of index cases reactive for anti-HCV. SETTING: Department of Internal Medicine and Section of Gastroenterology of three University Hospitals, Spain. SUBJECTS: A total of 423 stable heterosexual partners of index cases reactive for anti-HCV. This included a group of 142 intravenous drug users (IVDU), 120 of whom were coinfected with HIV. Additionally, 2886 first-time voluntary blood donors selected at random were included to compare the prevalence of anti-HCV. MAIN OUTCOME MEASURES: Serum samples were screened for anti-HCV by a commercially available, second-generation enzyme-linked immunoassay. Tests repeatedly reactive for anti-HCV were analysed by a four-antigen, recombinant immunoblot assay. Anti-HIV was tested by enzyme immunoassay and Western blot was used for confirmation of positive cases. RESULTS: The prevalence of anti-HCV, was 7.1% in SHP and 1.2% in random donors (P < 0.001). This prevalence was higher in SHP of index cases coinfected with HIV in comparison with that shown in the SHP of index cases only reactive for the anti-HCV (9.1 vs. 6.3%; P = 0.2), particularly when a younger and more homogeneous group such as the SHP of IVDU index cases was considered alone (9.2 vs. 0%; P = 0.1). However, the SHP of IVDU index cases coinfected with HIV were almost three times more likely to be infected with HIV than HCV (24.2 vs. 9.2%). CONCLUSIONS: These data suggest that HCV infection may be sexually transmitted but with low efficiency, and this could be increased in the presence of coexistent HIV infection in the index case.

Adolescent↗
PubMed1994

[Ulcerative colitis with Coombs+ autoimmune hemolytic anemia. A report of a case with favorable response to medical treatment].

We report the case of a patient with ulcerative colitis and autoimmune hemolytic anemia, that improved with steroid therapy, and during the follow-up showed analytical changes of iron deficiency anemia and anemia of chronic disorders. We discuss the possible etiologies of the anemia in patients with ulcerative colitis, and the treatments suggested for the associated Coombs-positive hemolytic anemia in these cases, stressing the good response to steroids in our patient.

Anemia, Hemolytic, Autoimmune↗
PubMed1994

[Usefulness of endoscopic hemostasis in Dieulafoy's vascular disease].

We report three cases of "Dieulafoy's gastric erosion" or "Exulceratio simplex", which is rarely recognized but is not an uncommon cause of upper gastrointestinal hemorrhage, usually very dangerous, as it's an arterial bleeding. In all cases an emergency endoscopy was performed, and treatment with combination of local sclerosis and vessel's electrocoagulation was successful. We insist in the potential benefits of endoscopic treatment in all these occasions, if it's possible, since even exact diagnosis of the bleeding site is very difficult in some patients.

Adult↗
PubMed1993

Treatment of chronic hepatitis C with recombinant interferon alfa-2b for nine months.

This randomised, controlled trial was designed to assess the response to a nine month course of interferon (IFN) alfa-2b, starting with a higher than usual dose. Forty eight patients received IFN 5 million units (MU) three times a week for eight weeks followed by 3 MU three times weekly for seven months; 25 patients in the control group received no treatment. The overall response to treatment was 68.7%, an improvement over other studies, but the high rate of relapse (85% in patients who responded) suggested that a nine month treatment period was insufficient in most cases. Histological improvement was seen in more than 80% of responders to interferon, including a reduction in inflammatory activity, necrosis, and fibrosis.

Adolescent↗
PubMed1993

Response related factors in recombinant interferon alfa-2b treatment of chronic hepatitis C.

In an analysis of the clinical and laboratory variables that can influence the response to interferon alfa-2b treatment, 48 patients with chronic hepatitis C virus infection received interferon 5 million units (MU) subcutaneously three times weekly for eight weeks followed by 3 MU three times weekly for seven months. Response related factors on univariate analysis were found to be age > 40 years, non-parenteral source of infection, pretreatment positive antinuclear antibodies (ANA), cirrhosis, and high serum iron, ferritin, gamma glutamyl transferase, and IgM. An independent predictive value (multivariate analysis) was also found for cirrhosis, ANA, serum iron, and ferritin. A baseline aspartate aminotransferase/alanine aminotransferase ratio of 0.5 and a striking increase during interferon treatment were associated with a complete response.

Adolescent↗
PubMed1993

[A ventriculoperitoneal shunt as a rare cause of ascites].

We report the case of a 22-year-old man with a craniopharyngioma, who developed ascites following a ventriculoperitoneal shunt procedure for hydrocephalus. The ascites was resolved with diversion of the distal catheter into the right atrium. A ventriculoperitoneal shunt can cause ascites, even without neurological symptoms suggestive of shunt malfunction.

Adult↗
PubMed1992

Prevalence of antibodies against hepatitis C virus in primary biliary cirrhosis and autoimmune chronic hepatitis.

We have determined the prevalence of antibodies against hepatitis C virus (anti-HCV) in 45 patients with primary biliary cirrhosis (PBC) and 6 with autoimmune chronic active hepatitis (AI-CAH). Anti-HCV was positive in two cases of PBC, both with a history of previous blood transfusion, and in one patient with AI-CAH, only during an active phase of the disease.

Autoimmune Diseases↗
PubMed1992

Prevalence of antibody to hepatitis C virus in acute non-A, non-B hepatitis in patients from different epidemiological categories.

The prevalence of antibodies to hepatitis C virus (HCV) was determined in 65 patients with acute non-A, non-B hepatitis (NANBH). The results suggest that HCV is the most common causative agent in posttransfusion NANBH and in drug-related hepatitis. Detection of HCV antibodies does not appear to be a particularly useful diagnostic criterion due to the kinetics of the immune response in the course of the disease.

Hepacivirus↗
PubMed1992

Antibody to hepatitis C virus in acute, self-limited, type B hepatitis.

Sera from 104 patients with self-limited, acute type B hepatitis were tested for the presence of anti-HCV antibodies. The results show that especially drug users with acute type B (and occasionally coinfected with type D) hepatitis commonly are infected with HCV. Furthermore, HCV infection may have preceded infection with the other agents and may be responsible for high ALT levels.

Alanine Transaminase↗
PubMed1992

Prevalence of antibody to hepatitis C virus in chronic HBsAg carriers.

The presence of the anti-HCV antibody was investigated in sera from 102 chronic HBsAg carriers. The subjects varied as to the characteristics of the clinical states. It was found that HCV coinfection was more common in HBsAg positive intravenous drug addicts than in other parenteral risk groups. It also appears that HCV may be the causative agent of chronic liver disease in HBsAg carriers with undetectable HBV (and possibly HDV) replication.

Carrier State↗
PubMed1992

Involved factors in the intrafamilial spread of hepatitis C virus.

To investigate the risk of non-parenteral HCV infection, sera from 302 relatives of 120 anti-HCV positive subjects were tested for the presence of anti-HCV antibodies. For the sake of comparison, sera from 17,000 blood donors were also assayed. The prevalence of HCV positivity was 4.3% in household contacts, compared to 0.78% in the donor population, indicating a significantly higher risk of infection for family members. Close personal contact may not be as critical a factor for infection as is duration of the disease.

Blood Donors↗
PubMed1992

[The prevalence of HCV antibodies in 3 groups with distinct patterns of sexual activity].

We studied the prevalence of antibodies to hepatitis C virus (anti-HCV) among 164 heterosexual partners of anti-HCV-positive subjects, 131 prostitutes and 52 homosexual men. 6.7% of heterosexual monogamous partners had anti-HCV; the seropositivity rate was associated with a long-term sexual practice and with age. Of the 131 prostitutes, 6 (4.6%) had anti-HCV; there were significant associations in patients positive for anti-HCV, with a history of parenteral drug addiction. 11.5% of homosexual men were anti-HCV positive; there were significant associations with positivity for antibodies to HIV, intravenous drug abuse and with the number of sexual partners. We concluded that the HCV may be transmitted by sexual route, but the high seroprevalence among prostitutes and homosexuals may be explained by other parenteral mechanisms.

Age Factors↗