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8. Renal Transplantation in Elderly Recipients

Author

Morales, J. M., Andres, A., Prieto, C., Rodriguez, A., Hernandez, E., Ortuño, T., Alcazar, J. M., Paternina, E. Rodriguez, Rodicio, J. L., Andreucci, Vittorio E., editor, and Dal Canton, Antonio, editor

Published
1989
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9. European guidelines on cardiovascular disease prevention in clinical practice: Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of eight societies and by invited experts)

Author

Backer, G., Ambrosioni, E., Borch-Johnsen, K., Brotons, C., Cifkova, R., Dallongeville, J., Ebrahim, S., Faergeman, O., Graham, I., Mancia, G., Cats, V. M., Orth-Gomér, K., Perk, J., Pyörälä, K., Rodicio, J. L., Sans, S., Vedat Sansoy, Sechtem, U., Silber, S., Thomsen, T., and Wood, D.

Subjects
Adult, Male, Clinical Trials as Topic, Epidemiology, Decision Making, Health Behavior, Smoking, Cardiology, Middle Aged, Risk Assessment, Primary Prevention, Europe, Cardiovascular Diseases, Humans, Female, Preventive Medicine, Practice Patterns, Physicians', Clinical Medicine, Cardiology and Cardiovascular Medicine, Exercise, Aged
Abstract

Guidelines aim to present all the relevant evidence on a particular issue in order to help physicians to weigh the benefits and risks of a particular diagnostic or therapeutic procedure. They should be helpful in everyday clinical decision-making. A great number of guidelines have been issued in recent years by different organisations--European Society of Cardiology (ESC), American Heart Association (AHA), American College of Cardiology (ACC), and other related societies. By means of links to web sites of National Societies several hundred guidelines are available. This profusion can put at stake the authority and validity of guidelines, which can only be guaranteed if they have been developed by an unquestionable decision-making process. This is one of the reasons why the ESC and others have issued recommendations for formulating and issuing guidelines. In spite of the fact that standards for issuing good quality guidelines are well defined, recent surveys of guidelines published in peer-reviewed journals between 1985 and 1998 have shown that methodological standards were not complied with in the vast majority of cases. It is therefore of great importance that guidelines and recommendations are presented in formats that are easily interpreted. Subsequently, their implementation programmes must also be well conducted. Attempts have been made to determine whether guidelines improve the quality of clinical practice and the utilisation of health resources. In addition, the legal implications of medical guidelines have been discussed and examined, resulting in position documents, which have been published by a specific task force. The ESC Committee for practice guidelines (CPG) supervises and coordinates the preparation of new guidelines and expert consensus documents produced by task forces, expert groups or consensus panels. The Committee is also responsible for the endorsement of these guidelines or statements.

Published
2003

18. European guidelines on cardiovascular disease prevention in clinical practice: Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of eight societies and by invited experts)

Author

De Backer, G., primary, Ambrosionie, E., additional, Borch-Johnsen, K., additional, Brotons, C., additional, Cifkova, R., additional, Dallongeville, J., additional, Ebrahim, S., additional, Faergeman, O., additional, Graham, I., additional, Mancia, G., additional, Cats, V. M., additional, Orth-Gomer, K., additional, Perk, J., additional, Pyorala, K., additional, Rodicio, J. L., additional, Sans, S., additional, Sansoy, V., additional, Sechtem, U., additional, Silber, S., additional, Thomsen, T., additional, and Wood, D., additional

Published
2003
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22. SIMULTANEOUS DOUBLE KIDNEY TRANSPLANT FROM VERY OLD DONORS

Author

Andres, A., primary, Morales, J M, additional, Praga, M, additional, Ortu??o, T., additional, Hernandez, E, additional, Herrero, J C, additional, Morales-Ruiz, E, additional, Rodicio, J L, additional, D??az Gonz??lez, R., additional, Polo, G., additional, Aguirre, F., additional, and Leiva, O., additional

Published
1998
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26. MEMBRANOUS GLOMERULONEPHRITIS ASSOCIATED WITH HEPATITIS C VIRUS INFECTION IN RENAL TRANSPLANT PATIENTS1,2

Author

Morales, J. M., primary, Pascual-Capdevila, J., additional, Campistol, J. M., additional, Fernandez-Zatarain, G., additional, Mu??oz, M. A., additional, Andres, A., additional, Praga, M., additional, Martinez, M. A., additional, Usera, G., additional, Fuertes, A., additional, Oppenheimer, F., additional, Artal, P., additional, Darnell, A., additional, and Rodicio, J. L., additional

Published
1997
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28. The E.L.S.A. Trial

Author

Bond, G., primary, Dal Palú, C., additional, Hansson, L., additional, Magnani, B., additional, Mancia, G., additional, Neiss, A., additional, Rahn, K. H., additional, Reid, J. L., additional, Rodicio, J. L., additional, Safar, M., additional, and Zanchetti, A., additional

Published
1994
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31. Syst-Eur—A Multicenter Trial on the Treatment of Isolated Systolic Hypertension in the Elderly

Author

Staessen, J., primary, Amery, A., additional, Birkenhager, W., additional, Bulpitt, C. J., additional, Cox, J., additional, de Leeuw, P., additional, Cort, P. De, additional, Fagard, R., additional, Fletcher, A., additional, Forette, F., additional, Fowler, G., additional, Girerd, X., additional, Leonetti, G., additional, OʼBrien, E. T., additional, OʼMalley, K., additional, Petrie, J., additional, Rodicio, J. L., additional, Rosenfeld, J., additional, Slovick, D., additional, Terzoli, L., additional, Thijs, L., additional, Tuomilehto, J., additional, Webster, J., additional, and Yodfat, Y., additional

Published
1992
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37. Antiproteinuric effect of angiotensin-converting enzyme inhibition and C5b-9 urinary excretion in membranous glomerulonephritis.

Author

Praga, M, Paz Artal, E, Hernández, E, Segura, J, Moreno, M A, Morales, J M, and Rodicio, J L

Abstract

BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors have an antiproteinuric effect in membranous glomerulonephritis (MGN). However, no studies have investigated whether this antiproteinuric effect is influenced by urinary C5b-9 excretion, a marker of immunological activity in this disease. METHODS: Eleven patients with biopsy-proven MGN were treated with captopril for 8 weeks. The evolution of several clinical and biochemical parameters, including 24-h urinary protein excretion was evaluated every 4 weeks. Urinary C5b-9 excretion was measured at the onset and at the end of captopril treatment. RESULTS: Patients with MGN had significantly higher C5b-9 excretions than a group of 14 healthy controls (89 +/- 23 vs 3.7 +/- 1.4 ng/mg UCr; P < 0.001). A significant correlation was found between urinary C5b-9 and the magnitude of proteinuria, both at the onset and at the end of treatment. After 8 weeks of captopril treatment, proteinuria had decreased from 8 +/- 1.8 to 5.2 +/- 1.3 g/day (P < 0.05). Four weeks after captopril discontinuation, proteinuria rose to 7.3 +/- 1.7 g/day (P < 0.05). A marked variability in the antiproteinuric response was observed, ranging from 0 to 85% with respect to baseline values. No correlation between decrease in proteinuria and baseline urinary C5b-9 levels was observed. Several patients with elevated urinary C5b-9 levels had captopril-induced decrease in proteinuria. CONCLUSIONS: ACE inhibition induces an antiproteinuric effect in patients with MGN. The urinary C5b-9 excretion does not predict the magnitude of this response. [ABSTRACT FROM PUBLISHER]

Published
1997
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38. L-arginine reverses the antinatriuretic effect of cyclosporin in renal transplant patients.

Author

Andrés, A, Morales, J M, Praga, M, Campo, C, Lahera, V, García-Robles, R, Rodicio, J L, and Ruilope, L M

Abstract

BACKGROUND: Cyclosporin has been shown to facilitate renal vasoconstriction and to have an antinatriuretic effect. The existence of an interference of cyclosporin with the vasodilating properties of endothelium mediated by nitric oxide production could mediate these effects. On the other hand, the infusion of the nitric oxide precursor L-arginine has been shown to induce renal vasodilatation and to facilitate natriuresis in normal volunteers. We have investigated the renal effects of the administration of an infusion of L-arginine in renal transplant patients chronically treated with cyclosporin. To facilitate the analysis of the data the effects of the administration of a similar dose of cyclosporin on renal function during the infusion of a vehicle were also investigated during the administration of a vehicle of L-arginine. DESIGN: Ten male renal transplant patients, chronically treated with cyclosporin and with a stable renal function were studied during 2 consecutive days after the administration of the usual morning dose of cyclosporin. The first day they received an intravenous infusion of vehicle and the second the infusion of graded doses of L-arginine (50, 100, 150 mg/kg/h) during 3 consecutive h. RESULTS: The first day, after cyclosporin administration a significant fall (P < 0.01) was observed in natriuresis and kaliuresis in the absence of changes in renal plasma flow and glomerular filtration rate. After the administration of L-arginine significant (P < 0.01) increases of renal plasma flow, glomerular filtration rate, and natriuresis were seen. The increase in blood levels of cyclosporin after its administration did not differ between days 1 and 2. CONCLUSION: These results indicate that L-arginine facilitates renal vasodilatation and natriuresis in renal transplant patients. Furthermore, the observed increase in sodium excretion could indicate that L-arginine counteracts the antinatriuretic effect of cyclosporin. [ABSTRACT FROM PUBLISHER]

Published
1997

40. Improvement of Anaemia With Desferrioxamine in Haemodialysis Patients.

Author

Praga, M., Andrés, A., de la Serna, J., Ruilope, L. M., Nieto, J., Estenoz, J., Millet, V. G., Arnaiz, F., and Rodicio, J. L.

Abstract

We have prospectively investigated the effect of desferrioxamine(DFO) administration (2 g i.v. after every haemodialysis session for 6 months) on the normocytic and normochromic anaemia of seven haemodialysis patients. None had either clinical or analytical data characteristic of chronic aluminium intoxication. At the end of DFO therapy, the haematocrit had increased from 20.5±2.7% to 30.4±7.7% (P< 0.005), and the transfusional requirements decreased from 3.5±2.2 units (range 1–8 units) in the 6 months prior to DFO, to 0.7±0.9 units (range 0–2 units) during DFO administration (P<0.01). No transfusion was required during the second half of the DFO therapy period. Serum ferritin decreased from 1059±532 nmol/l (2649±1331 ng/ml) to 507±403 nmol/l (1268±1008 ng/ml) (P<0.025). Two months after DFO withdrawal the haematocrit value fell significantly to 22.2±1.6% (P<0.01). DFO therapy was restarted in one patient at a lower dose (1 g i.v. after every haemodialysis session) and an increase of haematocrit from 23.8% to 40.2% was again observed after 3 months of treatment. The tolerance to DFO was excellent. We conclude that DFO therapy should be considered in haemodialysis patients with severe anaemia and increased blood transfusion requirements. [ABSTRACT FROM PUBLISHER]

Published
1987

50. Renal effects of fenoldopam in refractory hypertension.

Author

Ruilope, Luis M., Robles, Rafael Garcia, Miranda, Blanca, Tovar, Julia, Alcazar, José M., Sancho, José, Rodicio, José L., Martinez, Adelaida, Astorga, Antonia, Beck, Thomas, Ruilope, L M, Robles, R G, Miranda, B, Tovar, J, Alcazar, J M, Sancho, J, Rodicio, J L, Martinez, A, Astorga, A, and Beck, T

Published
1988
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