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1.
Strahlenther Onkol ; 199(9): 847-856, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37000224

RESUMEN

PURPOSE: To assess the efficacy of lung low-dose radiotherapy (LD-RT) in the treatment of patients with COVID-19 pneumonia. MATERIALS AND METHODS: Ambispective study with two cohorts to compare treatment with standard of care (SoC) plus a single dose of 0.5 Gy to the whole thorax (experimental prospective cohort) with SoC alone (control retrospective cohort) for patients with COVID-19 pneumonia not candidates for admission to the intensive care unit (ICU) for mechanical ventilation. RESULTS: Fifty patients treated with LD-RT were compared with 50 matched controls. Mean age was 85 years in both groups. An increase in arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (PAFI) in the experimental LD-RT-treated group compared to the control group could not be found at 48 h after LD-RT, which was the primary endpoint of the study. However, PAFI values significantly improved after 1 month (473 vs. 302 mm Hg; p < 0.0001). Pulse oxymetric saturation/fraction of inspired oxygen (SAFI) values were also significantly higher in LD-RT-treated patients than in control patients at 1 week (405 vs. 334 mm Hg; p = 0.0157) and 1 month after LD-RT (462 vs. 326 mm Hg; p < 0.0001). All other timepoint measurements of the respiratory parameters were similar across groups. Patients in the experimental group were discharged from the hospital significantly earlier (23 vs. 31 days; p = 0.047). Fifteen and 26 patients died due to COVID-19 pneumonia in the experimental and control cohorts, respectively (30% vs. 48%; p = 0.1). LD-RT was associated with a decreased odds ratio (OR) for 1­month COVID-19 mortality (OR = 0.302 [0.106-0.859]; p = 0.025) when adjusted for potentially confounding factors. Overall survival was significantly prolonged in the LD-RT group compared to the control group (log-rank p = 0.027). No adverse events related to radiation treatment were observed. CONCLUSION: Treatment of frail patients with COVID-19 pneumonia with SoC plus single-dose LD-RT of 0.5 Gy improved respiratory parameters, reduced the period of hospitalization, decreased the rate of 1­month mortality, and prolonged actuarial overall survival compared to SoC alone.


Asunto(s)
COVID-19 , Anciano , Anciano de 80 o más Años , Humanos , COVID-19/radioterapia , Anciano Frágil , Estudios Prospectivos , Estudios Retrospectivos , SARS-CoV-2 , Nivel de Atención , Resultado del Tratamiento
4.
Eur J Clin Microbiol Infect Dis ; 35(9): 1417-24, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27334497

RESUMEN

Urinary tract infections (UTI) are common among elderly patients in residential care facilities, as well as in the hospital setting. Identifying new biochemical markers of UTI is an active line of research since UTI management is resource intensive. Paraoxonase-1 (PON1) forms part of the patient's immune system, the response-to-injury and inflammation. Our study sought to evaluate alterations in inflammation-related paraoxonase-1 (PON1) and chemokine (C-C motif) ligand 2 (CCL2) in patients with an indwelling catheter to assess their potential usefulness as biomarkers of infection. Patients (n = 142) who had had the urinary catheter removed and 100 healthy volunteers were recruited. In all participants we measured serum PON1 activity, PON1 concentration, CCL2, procalcitonin and C-reactive protein (CRP). Results indicated that patients had higher CCL2, CRP and procalcitonin concentrations than the control group, and lower paraoxonase activity. There were no significant differences in PON1 concentrations. When comparing the diagnostic accuracy of CRP, procalcitonin, CCL2 and the PON1-related variables in discriminating between patients with and those without UTI, we found a considerable degree of overlap between groups, i.e., a low diagnostic accuracy. However, there were significant inverse logarithmic correlations between serum paraoxonase activity and the number of days the urinary catheter had been in situ. Our results suggest that measurement of these biochemical variables may be useful in investigating complications of long-term use of these devices and help to improve the economic and clinical investment required in the management of the often-associated infection.


Asunto(s)
Arildialquilfosfatasa/sangre , Enfermedades Asintomáticas , Bacteriuria/diagnóstico , Infecciones Relacionadas con Catéteres/diagnóstico , Quimiocina CCL2/sangre , Suero/química , Infecciones Urinarias/diagnóstico , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/análisis , Calcitonina/sangre , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
5.
Aten Primaria ; 36(1): 19-24, 2005 Jun 15.
Artículo en Español | MEDLINE | ID: mdl-15946611

RESUMEN

OBJECTIVES: To confirm that high differential pressure (DP) supposes greater risk of ischaemic cardiopathy and to assess whether it is also an independent risk factor of suffering a cerebrovascular accident. DESIGN: An analytical, observational, retrospective and longitudinal study with historic cohorts. SETTING: Urban population of about 18 000 inhabitants. PARTICIPANTS: 300 patients aged between 15 and 75 with hypertension of > or =2 years evolution, who have had their blood pressure taken by nurses 4 or more times (excluding casualty) and have not suffered a cardiovascular event (CVE), whether coronary accident, cerebrovascular accident or peripheral vasculopathy. MAIN MEASUREMENTS: The history relating to cardiovascular risk was recorded: lipaemia, obesity, tobacco dependency, diabetes mellitus, left ventricular hypertrophy (LVH). These factors were considered present if their diagnosis preceded the CVE diagnosis. They were placed in 2 groups, depending on the degree of differential pressure: "high" if >60 mm Hg and "not high" if (3/4)60 mm Hg. They were analysed for intention to treat over 10 years, with the appearance or not of a CVE as a response variable. RESULTS: 300 participants (73.3% women), 150 exposed to risk and 150 not exposed. The initial analysis showed significant differences between the 2 groups for age (P<.0001), diabetes (P<.0001), and LVH (P<.001). After logistic regression, the OR of suffering LVH was 2.38 (95% CI, 1.19-4.74) in the group with high DP; the OR of ischaemic cardiopathy, 2.84 (95% CI, 1.16-6.96); and of cerebrovascular accident, 2.70 (95% CI, 1.09-6.68). There were no significant differences for peripheral arteriopathy. CONCLUSIONS: DP was confirmed as an independent factor of cardiovascular risk and, despite the limitations of the study, it was pointed to as a possible independent factor of cerebrovascular risk.


Asunto(s)
Presión Sanguínea , Enfermedades Cardiovasculares/epidemiología , Hipertensión/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/tratamiento farmacológico , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo
6.
Clin Chem ; 47(9): 1673-8, 2001 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11514402

RESUMEN

BACKGROUND: There is considerable evidence to suggest that plasma lipoprotein(a) [Lp(a)] concentration is a cardiovascular risk factor. Confusing results in epidemiologic studies, however, suggest that the effects of storage should be further investigated. The influence of the assay method, the initial plasma Lp(a) concentration, and the apolipoprotein(a) [apo(a)] genotype are all factors that should be considered. METHODS: Blood was obtained from 65 survivors of premature myocardial infarction and 95 age-matched controls. The plasma samples were stored in sterile conditions at -70 degrees C for 5 years in the presence of antioxidant and antiproteolytic substances. Plasma Lp(a) was measured by immunoturbidimetry, and apo(a) alleles were determined by pulsed-field gel electrophoresis and Southern blotting. RESULTS: Plasma Lp(a) was significantly higher in patients. The mean kringle number for the smallest isoform was also lower in patients than in controls, but no differences were found in the distribution of the largest isoform. All patients and controls were heterozygotes. During storage, mean Lp(a) decreased significantly in samples from patients (-23%; P <0.001) but not in samples from controls (-9%; P, not significant). This was not related to the kringle number and was limited to samples with initial plasma Lp(a) concentrations between 41 and 345 mg/L. CONCLUSIONS: Plasma Lp(a) from patients is less stable than Lp(a) from controls, and the difference is not related to distribution of apo(a) genotypes but may be concentration-dependent. Differential sample stability may complicate the interpretation of several studies.


Asunto(s)
Apolipoproteínas A/genética , Recolección de Muestras de Sangre , Criopreservación , Lipoproteína(a)/química , Infarto del Miocardio/sangre , Adulto , Apolipoproteínas A/química , Electroforesis en Gel de Campo Pulsado , Genotipo , Humanos , Kringles , Lipoproteína(a)/sangre , Nefelometría y Turbidimetría/métodos
7.
J Mol Med (Berl) ; 79(5-6): 294-9, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11485023

RESUMEN

Elevated plasma levels of lipoprotein(a) [Lp(a)] represent a major independent risk factor for the development of atherosclerosis. The kringle IV type 10 of apolipoprotein(a) [apo(a)] is the primary lysine binding site (LBS) of Lp(a) and is associated with lesion formation in transgenic mice. The purpose of this study was to search for mutations in the apo(a) kringle IV type 10 which could alter the LBS activity of Lp(a) from patients with coronary artery disease. We found the DNA region of kringle IV type 10 of apo(a) to be mutable but relatively well preserved in the Spanish population. We identified a novel mutation which probably leads to a truncated form of apo(a) in a patient heterozygous for the mutation and with low lysine binding activity and low plasma Lp(a) concentration. Two other mutations have been previously identified in humans, the substitutions W81R and M75T. The W81R was not found in our sample, but the M75T mutation was present in 43% of patients with coronary artery disease and 23% of age-matched controls. The genotype TT conferred a significant risk for myocardial infarction (odds ratio 2.53). This association was not due to linkage disequilibrium with kringle IV repeats. The M75T polymorphism was not associated with the LBS function of apo(a), but it influenced plasma Lp(a) concentration.


Asunto(s)
Apolipoproteínas/química , Apolipoproteínas/metabolismo , Enfermedad de la Arteria Coronaria/genética , Kringles/genética , Lipoproteína(a)/sangre , Lipoproteína(a)/química , Lipoproteína(a)/metabolismo , Lisina/metabolismo , Polimorfismo Genético/genética , Adulto , Alelos , Apolipoproteínas/genética , Apoproteína(a) , Sitios de Unión , Enfermedad de la Arteria Coronaria/sangre , Frecuencia de los Genes , Genotipo , Humanos , Lipoproteína(a)/genética , Masculino , Persona de Mediana Edad , Mutación Missense/genética , Fenotipo , Reacción en Cadena de la Polimerasa , Polimorfismo Conformacional Retorcido-Simple , España
8.
Thromb Haemost ; 85(3): 412-7, 2001 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11307806

RESUMEN

Elevated plasma Lp(a) is an independent risk factor for cardiovascular disease. Unique to Lp(a) is the apoprotein, apo(a) which can vary from 250 to 800 kDa in molecular weight. Small isoforms are also associated with the risk of cardiovascular disease. The purpose of this study was to examine the association of Lp(a) concentration, apo(a) size, and Lp(a) lysine-binding site(s) (LBS) function in patients with early onset heart disease, and age-matched controls. Mean values of Lp(a) were significantly higher in the patients than for the age-matched group. The smallest molecular weight isoform for each subject had significantly fewer kringles for the patients than the age-matched controls. There was a significant correlation between LBS activity and kringle number in the single-banded phenotypes of the patients, but not the controls. LBS activity was significantly higher in patients with small isoforms (< or =18 kringles) compared to controls. The odds ratio for coronary artery disease for high LBS activity and high Lp(a) concentration was 4.4 (p = 0.002) and for high LBS activity and small isoforms was 10.1 (p = 0.002). In the patients, Lp(a) concentration was higher, apo(a) size was smaller, and LBS activity higher in the small isoforms compared to the controls. This study suggests an association of high LBS activity in small isoforms of Lp(a) with disease in humans.


Asunto(s)
Apolipoproteínas A/farmacología , Enfermedad Coronaria/sangre , Lipoproteína(a)/metabolismo , Adulto , Edad de Inicio , Apolipoproteínas A/química , Apolipoproteínas A/metabolismo , Sitios de Unión/efectos de los fármacos , Humanos , Lipoproteína(a)/sangre , Lisina/metabolismo , Masculino , Análisis por Apareamiento , Persona de Mediana Edad , Peso Molecular , Infarto del Miocardio/sangre , Oportunidad Relativa , Unión Proteica/efectos de los fármacos , Unión Proteica/fisiología , Isoformas de Proteínas/química , Isoformas de Proteínas/farmacología
11.
Clin Biochem ; 33(3): 191-6, 2000 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10913517

RESUMEN

OBJECTIVES: To evaluate a turbidimetric immunoassay for the measurement of ferritin, and to assay this method in a group of patients undergoing an autologous blood transfusion program. DESIGN AND METHODS: We used an ILab 900 analyzer. This instrument automates a particle-enhanced immunoturbidimetric assay with an analysis time of 9 min. This technique was compared with a microparticle immunoassay. The turbidimetric assay was used to measure ferritin in a group of 30 patients undergoing an autologous blood transfusion program. RESULTS: The assay was linear in the range 3-1400 microg/L (r = 0.9999). The intra- and inter-assay imprecision (CV) at 20, 97 and 469 microg/L were <3.0 and <5.0%, respectively. Recovery was 88. 7 to 97.4%. The detection limit was 3 microg/L. Hemoglobin (

Asunto(s)
Estudios de Evaluación como Asunto , Ferritinas/análisis , Inmunoensayo/métodos , Nefelometría y Turbidimetría/métodos , Adulto , Anciano , Transfusión de Sangre Autóloga , Femenino , Ferritinas/sangre , Ferritinas/inmunología , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia
12.
Aten Primaria ; 25(6): 377-82, 2000 Apr 15.
Artículo en Español | MEDLINE | ID: mdl-10857226

RESUMEN

OBJECTIVES: To evaluate the clinical evolution and the use of Primary Care health resources one year after treatment to eradicate Helicobacter pylori (Hp) infection in patients with peptic ulcers and Hp infection. DESIGN: Retrospective study on the effect of an intervention. SETTING: Urban, reformed primary care centre. PATIENTS: 102 patients with peptic ulcers and Hp infection. INTERVENTION: Treatment to eradicate Hp. MEASUREMENTS AND MAIN RESULTS: a) Total medical attendance; b) attendance for dyspepsia; c) number of ulcerous outbreaks; d) medicines taken to treat dyspepsia. 79.4% of the patients treated were male. Overall mean age was 47.8 +/- 12.4. After the intervention, total attendance (from 8.3 to 6.6, p < 0.001), attendance for dyspepsia (from 3.1 to 1.1, p < 0.00001), and ulcerous outbreaks (from 1.2 to 0.06, p < 0.00001) all dropped sharply. The mean number of medicines prescribed for dyspepsia per patient fell from 1.24 to 0.43, p < 0.0001. Ranitidine prescription fell from 72.7 to 13.8 days (p < 0.001); and omeprazol from 35.1 to 12.2 days (p < 0.03). Estimated total saving per patient was 26,792 pesetas at 1998 values. CONCLUSIONS: Treatment in primary care to eradicate Hp(+) in ulcerous patients reduced the needs of attendance and the prescription of drugs for ulcers. Just in the first year this supposed a clinical benefit for these patients and important economic savings for the public health service.


Asunto(s)
Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Úlcera Péptica/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Úlcera Péptica/microbiología , Atención Primaria de Salud/estadística & datos numéricos , Estudios Retrospectivos
13.
Clin Chem ; 45(9): 1557-61, 1999 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-10471661

RESUMEN

BACKGROUND: The measurement of immunoglobulin E (IgE) in serum is widely used in the diagnosis of allergic reactions and parasitic infections. We describe here a fully automated assay for human IgE suitable for routine application in a general chemistry analyzer. METHODS: We used an ILab 900 analyzer. This instrument automates a particle-enhanced immunoturbidimetric assay with an analysis time of 9 min. RESULTS: The assay was linear in the range 4-1000 kIU/L (r = 0.9998). The intra- and interassay CVs at 57, 235, and 434 kIU/L were <3.5% and <7.4%, respectively. The detection limit was 4 kIU/L. Hemoglobin (

Asunto(s)
Inmunoglobulina E/sangre , Autoanálisis , Humanos , Inmunoensayo/métodos , Nefelometría y Turbidimetría , Paraproteinemias/sangre
14.
Neuroreport ; 10(10): 2035-8, 1999 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-10424670

RESUMEN

Disturbances in methyl-carbon metabolism, which result in hyperhomocysteinemia, have been associated with schizophrenia. Homozygosity for the T677 allele of the methylenetetrahydrofolate reductase (MTHFR) gene, which encodes for a thermolabile enzyme associated with hyperhomocysteinemia, has been found to be increased in schizophrenic patients. We have investigated whether plasma homocysteine concentration and the frequency of C677T MTHFR variant were increased in schizophrenic inpatients of a psychiatric hospital (n=210) compared with controls (n=218). There were no significant differences in plasma homocysteine concentrations between the schizophrenia and the control group. The distributions of T allele and TT genotype frequencies were similar in both groups (40% and 15%). These results show that impaired homocysteine metabolism is unlikely in schizophrenia.


Asunto(s)
Homocisteína/sangre , Oxidorreductasas actuantes sobre Donantes de Grupo CH-NH/genética , Polimorfismo Genético , Esquizofrenia/genética , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Estudios de Casos y Controles , Femenino , Genotipo , Humanos , Masculino , Metilenotetrahidrofolato Reductasa (NADPH2) , Persona de Mediana Edad
16.
Atherosclerosis ; 140(1): 155-9, 1998 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-9733226

RESUMEN

Platelet glycoprotein IIb/IIIa may be involved in the pathogenesis of myocardial infarction as the key element in platelet aggregation and as the binding site of lipoprotein(a) to platelets, inhibiting plasminogen binding and activation. Recently, a strong association between the P1A2 polymorphism of the glycoprotein IIIa gene and acute coronary thrombosis has been reported. although this has not been confirmed. In an associated study, we determined plasma lipoprotein levels, the apo E genotype and the P1A genotype in 250 males under 55 years with myocardial infarction and they were compared with 250 age- and sex-matched controls. Patients showed an over-representation of the epsilon3/4 genotype with respect to the control group. We found that there were no differences in the allelic frequency of P1A2 between case patients and age-matched controls (chi2 = 0.05, P = 0.92) and that subjects bearing the P1A2 allele showed higher plasma lipoprotein(a) concentration than p1A1/P1A1 individuals. Therefore, in this population there is no association between carriage of p1A2 allele and increased risk of myocardial infarction but the carriage of P1A2 is associated with higher plasma Lp(a) concentration.


Asunto(s)
Lipoproteína(a)/sangre , Infarto del Miocardio/genética , Complejo GPIIb-IIIa de Glicoproteína Plaquetaria/genética , Polimorfismo Genético , Adulto , Alelos , Apolipoproteínas E/genética , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/sangre , Factores de Riesgo
17.
Clin Chem ; 44(6 Pt 1): 1233-41, 1998 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-9625047

RESUMEN

We evaluated the performance of a homogeneous assay for the automated measurement of high-density lipoprotein cholesterol (HDL-C) and compared it with a conventional precipitation technique in the following groups of people: control subjects (group A), clinically-healthy elderly (group B), myocardial infarction patients (group C), nephrotic syndrome patients (group D), and liver cirrhosis patients (group E). The performance of the technique was acceptable with respect to precision, accuracy, linearity, and detection limit. Triglycerides up to 40 mmol/L and bilirubin up to 150 micromol/L did not cause interferences. Hemoglobin decreased HDL-C measurements. Samples were stable at -20 degrees C for up to four months. Bland-Altman plots showed a good agreement between both techniques in the control group but with a progressive divergence in the patient groups B to E. Results indicate limitations of the technique in certain clinical conditions and, coincidentally, the need for reliable calibration materials.


Asunto(s)
HDL-Colesterol/sangre , Cirrosis Hepática/sangre , Infarto del Miocardio/sangre , Síndrome Nefrótico/sangre , Adulto , Anciano , Anciano de 80 o más Años , Precipitación Química , Estabilidad de Medicamentos , Humanos , Persona de Mediana Edad , Paraproteinemias/sangre , Sensibilidad y Especificidad
18.
Atherosclerosis ; 126(2): 243-52, 1996 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-8902150

RESUMEN

Lipoprotein measurements in a group of 29 patients with massive proteinuria and without hypoalbuminemia, were compared with those observed in matched controls and patients with overt nephrotic syndrome to assess the influence of plasma albumin concentration and proteinuria in modulating blood lipid levels. Plasma apoprotein B and apo B containing lipoproteins were not increased in proteinuric normoalbuminemic patients. There was a good correlation between plasma albumin and oncotic pressure (r = 0.937; P < 0.001). Plasma oncotic pressure was inversely correlated with plasma apoprotein B in nephrotic patients (r = -0.44, P = 0.017) but not in normoalbuminemics (r = 0.17, P = 0.369), suggesting that plasma albumin affects apoprotein B secretion. Other findings, however, indicate that multiple processes are ocurring simultaneously in these patients. There was an accumulation of very low- and intermediate density lipoproteins in normoalbuminemics, suggesting a residual defect in the lipoprotein removal. Also, raised (P < 0.05) lipoprotein(a) levels respect to controls (median, 0.15 g/l) were noted in both, normoalbuminemics (median, 0.72 g/l) and hypoalbuminemics (median, 0.84 g/l) with similar degree of proteinuria (6.4 vs. 6.6 g/24 h), suggesting that other mechanisms may be operative in lipoprotein(a) derangements. Our findings suggest that there is no unique mechanism in the pathogenesis of nephrotic hyperlipidemia but that both hypoalbuminemia and proteinuria can have a distinct contribution, individually or in combination.


Asunto(s)
Hiperlipidemias/complicaciones , Síndrome Nefrótico/sangre , Albúmina Sérica/análisis , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Apolipoproteínas B/sangre , Colesterol/sangre , Femenino , Humanos , Hiperlipidemias/sangre , Lipoproteínas/sangre , Masculino , Persona de Mediana Edad , Síndrome Nefrótico/clasificación , Síndrome Nefrótico/complicaciones , Síndrome Nefrótico/orina , Presión Osmótica , Proteinuria , Triglicéridos/sangre
19.
Transfusion ; 36(9): 822-6, 1996 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-8823459

RESUMEN

BACKGROUND: Clinical and pharmacokinetic data suggest that very low doses of subcutaneous recombinant human erythropoietin (rHuEPO) may be effective in a preoperative autologous blood deposit program. STUDY DESIGN AND METHODS: Fifty-two patients, scheduled for orthopedic surgery, were enrolled in a double-blind and placebo-controlled study. Patients were randomly assigned to the placebo group or to receive 30, 60, or 100 IU per kg of rHuEPO subcutaneously twice a week for 2 weeks before surgery. The dose of rHuEPO that was effective in facilitating the collection of 4 units of blood in the 2 weeks before surgery and that prevented a sharp decrease in hematocrit was determined. RESULTS: Only in patients receiving 100 IU per kg of rHuEPO did the outcome measurements differ significantly from those in the placebo group. With a higher (p < 0.01) cumulative increase in red cell volume during the study period (297 +/- 127 vs. 121 +/- 44 mL), 64 percent of those receiving 100 IU per kg of rHuEPO were able to donate 4 units of blood for autologous use, as compared with 23 percent of the placebo group (p < 0.05). Allogeneic transfusion was avoided, and the preoperative hematocrit and reticulocyte count were significantly higher in the patients receiving 100 IU per kg of rHuEPO (p < 0.05 and p < 0.01, respectively). CONCLUSION: Subcutaneously administered rHuEPO at a dose of 100 IU per kg twice a week for 2 weeks is effective in facilitating the collection of blood for autologous use and may improve the cost-benefit ratio of blood conservation interventions. Doses < or = 60 IU per kg are ineffective in facilitating such collections in this surgical setting.


Asunto(s)
Transfusión de Sangre Autóloga/métodos , Eritropoyetina/administración & dosificación , Anciano , Eritropoyesis/efectos de los fármacos , Femenino , Hematócrito , Cadera/cirugía , Prótesis de Cadera , Humanos , Inyecciones Subcutáneas , Rodilla/cirugía , Prótesis de la Rodilla , Masculino , Persona de Mediana Edad , Proteínas Recombinantes , Recuento de Reticulocitos
20.
Clin Chem ; 41(6 Pt 1): 908-13, 1995 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-7768011

RESUMEN

Although lipoprotein abnormalities of the nephrotic syndrome are assumed to be related to the presence of proteinuria, this topic has not been investigated extensively. We measured lipoproteins from 19 nonuremic patients during and after remission of the nephrotic syndrome in an effort to determine the extent of their putative atherogenicity. As expected, disturbances involved primarily the apoprotein B-containing lipoproteins. No patient showed serum lipoprotein(a) [Lp(a)] < 300 mg/L during the acute phase. Lp(a) concentrations correlated significantly with those of apoprotein B, and both values decreased dramatically with the remission of the nephrotic syndrome. Surprisingly, despite the resolution of proteinuria, concentrations of intermediate-density lipoproteins and Lp(a) remained above normal in hypertriglyceridemic patients, suggesting a residual effect of nephrosis in the overall lipoprotein transport. Accumulation of atherogenic remnants should be considered a characteristic of the hyperlipidemia of the nephrotic syndrome, and aggressive treatment to reduce proteinuria is mandatory.


Asunto(s)
Arteriosclerosis/etiología , Lipoproteína(a)/sangre , Lipoproteínas/sangre , Síndrome Nefrótico/sangre , Adolescente , Adulto , Apolipoproteína A-I/sangre , Apolipoproteína A-II/sangre , Apolipoproteínas B/sangre , Colesterol/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome Nefrótico/complicaciones , Proteinuria/sangre , Triglicéridos/sangre
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