Hepatitis: Teruel JL

Barril G, Teruel JL. · Hospital de La Princesa, Madrid. · Nefrologia. · Pubmed #19018745 No free full text.

Abstract: 1. VACCINATION AGAINST HEPATITIS B a) All patients with chronic advanced renal disease and negative serology for HBsAg and antiHBs are to be vaccinated against hepatitis B (Evidence level: B). b) For classic vaccines (Engerix B and HBVAxpro) the adult vaccine dose is 40 mcg (20 mcg in the paediatric population). There are two dose regimens based on the medicinal product used: 0, 1 and 6 months with HBVAxpro and 0, 1, 2 and 6 months with Engerix B. With the new vaccine Fendrix, the dose is 20 mcg and the schedule 0, 1, 2 and 6 months (Evidence level: C). c) The antiHBs titre is to be measured 1-2 months after administration of the last dose. In patients whose antibody titres are below 10 mIU/mL, a booster may be administered, checking the response or administering a second full vaccination (Evidence level: B). d) In responders, antibody levels are to be tested at least once a year. If the antiHBs titre is below 10 mIU/mL, a booster is to be administered (Evidence level: C). 2. VACCINATION AGAINST INFLUENZA a) All patients with chronic advanced renal disease are to be vaccinated every year against influenza (Evidence level: B). b) The vaccination dose and regimen are the same as recommended for the general population (Evidence level: C) 3. VACCINATION AGAINST PNEUMOCOCCUS a) Vaccination against pneumococcus is recommended in patients with chronic renal disease associated with nephrotic syndrome or who may be future candidates for renal transplant (Evidence level: B). b) There is no evidence of the clinical value of the pneumococcal vaccine in adult patients with chronic renal failure, not transplanted. However, some regions are recommending routine vaccination in the population aged >or= 60 years, the age of a high percentage of our patients. c) To maintain immunisation, revaccination is required every 3- 5 years. 4. OTHER VACCINES a) Vaccination against hepatitis A is recommended in patients with renal failure associated with chronic liver disease or who are candidates for renal transplant (Evidence level: C). b) The recommendations for vaccination against tetanus and diphtheria are the same as for the general population (Evidence level: C). c) Chickenpox vaccine is indicated in children with chronic renal disease, particularly if they are candidates for transplant (Evidence level: B). Although there is no evidence of the value of this vaccine in adults, it is advisable to perform it in those who may be candidates for renal transplant with no protecting antibodies. d) There is no evidence of the clinical value of the vaccine against Staphylococcus aureus.

Teruel JL. · No affiliation provided · Nefrologia. · Pubmed #11987679 No free full text.

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Mateos ML, Camarero C, Lasa E, Teruel JL, Mir N, Baquero F. · Department of Microbiology, Hospital Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain. · Vox Sang. · Pubmed #10085522 No free full text.

Abstract: BACKGROUND AND OBJECTIVES: Hepatitis E virus (HEV) infection usually causes acute self-limited disease. HEV is associated with faecal-contaminated drinking water, but other vectors, such as blood, are possible. The aim of this study was to investigate the prevalence of HEV in blood donors and in two groups at high risk for parenteral infections, namely, haemodialysis patients, and children infected with HCV via blood transfusion. MATERIALS AND METHODS: We investigated the prevalence of anti-HEV in 863 blood donors, 63 haemodialysis patients, and 42 children infected post transfusion with HCV. RESULTS: The prevalence rates were 2.8, 6.3%, and zero, respectively. CONCLUSIONS: (1) The incidence of HEV in Spain is similar to that in other Western European countries, and (2) HEV is probably not transmitted parenterally to children.

Teruel JL, Fernández Lucas M, Mateos ML, Ortuño J. · No affiliation provided · Nefrologia. · Pubmed #16053018 No free full text.

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Arambarri M, Fernández Lucas M, Echarri R, Teruel JL, Alarcón C, Merino JL, Ortuño J. · Servicio de Nefrología, Hospital Ramón y Cajal, Madrid. · Nefrologia. · Pubmed #15219067 No free full text.

Abstract: Traditionally, the treatment of viral hepatitis C (positive Polymerase Chain Reaction -PCR-) was with Interferon. A combination of Interferon plus Ribavirin has been producing better results in last years. Currently, Ribavirin is not indicated for patients with Chronic Kidney Disease because of a high risk of severe anaemia. In a few cases, this treatment is producing good results with previous dose adjustment. We show a case of a 28-year-old man with Chronic Kidney Disease on treatment with periodical hemodialysis and chronic hepatopathy HCV Positive RNA HCV (> 1,000,000 copies/ml) and persistent transaminase elevation. Before kidney transplantation, we decided to use Interferon (3,000,000 IU/48 hours) and Ribavirin (200 mg/24 hours) treatment. After 15 days, we saw normal transaminase values and HCV RNA was negative. The patient required temporary suspension of Ribavirin and two red blood cell transfusions due to severe anaemia. Ribavirin was reintroduced 200 mg/48 h posthemodialysis. The patient did not present any complication again, and could be treated for 14 months. After next 11 months of evolution the patient has normal rates of liver function and negative HCV RNA values.

Rivera M, Mateos ML, Teruel JL, Marcén R, Ortuño J. · No affiliation provided · Perit Dial Int. · Pubmed #11117252 links to  free full text

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García F, Mateos ML, García-Valdecasas J, Teruel JL, Bernal C, Fernández-Lucas M. · Servicio de Microbiología y Nefrología, Hospital Universitario San Cecilio, Granada, Spain. · Am J Nephrol. · Pubmed #10773620 No free full text.

This publication has no abstract.

Teruel JL, Mateos ML, Fernández Lucas M, Ortuño J. · No affiliation provided · Nefrologia. · Pubmed #15789543 No free full text.

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Alarcón MC, Fernández Lucas M, Teruel JL, Ortuño J. · No affiliation provided · Nefrologia. · Pubmed #12085426 No free full text.

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Rivera M, Mateos ML, Teruel JL, Tarrago D, Rodriguez JR, Fernandez-Lucas M, Ortuño J. · No affiliation provided · Perit Dial Int. · Pubmed #11007381 links to  free full text

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Rivera M, Gonzalo A, Mampaso F, Teruel JL, Ortuño J. · No affiliation provided · Nephrol Dial Transplant. · Pubmed #10052526 links to  free full text

This publication has no abstract.