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Biomedical subjects

A Alonso

Publications and source records attributed to A Alonso.

At least 577 records · Page 32Linked to original sources
PubMedDate not supplied

Ocular autoimmune pemphigoid and cyclosporin A.

BACKGROUND: Ocular pemphigoid is a chronic autoimmune disease that leads to vision lost. In its etiology participate autoantibodies against the connective tissue of the conjunctiva of different isotypes (IgM, IgG and IgA) as well as the complement system (C3). Lymphocytes of the CD4 + and CD8 + phenotypes and monocytes were detected in the infiltrates of the biopsies of the conjunctiva. MATERIAL AND METHODS: We treated and studied 82 patients who had several topical and systemic treatments during years to alleviate this condition but whose side effects limited their usefulness. We started the administration of cyclosporin-A (Cy-A) 100 mg/day per os and diminishing gradually the intake of steroids. The relief of ocular pain and headache were the first symptoms that changed the patients' quality of life. Ophtalmological controls revealed improvement of the lesions of the conjunctiva and cornea and subsequent biopsies showed a marked decrease in the cellular infiltrates and in antibody deposits. CONCLUSIONS: Thus, Cy-A is an useful treatment for ocular chronic autoimmune pemphigoid and eventually azathioprine (50 mg/day) can cheaply replace it although its well-known toxicity.

Adult↗
PubMedDate not supplied

Menière's disease and endolymphatic hydrops: clinical-histopathological correlations.

The clinical-histopathological correlation between Menière's disease and endolymphatic hydrops was done to explain, as much as possible, causes of symptoms of Menière's disease. Twenty-three temporal bones with endolymphatic hydrops from 17 patients were reviewed and clinical and histopathological findings were correlated. Histopathological examination revealed frequent, severe deformities in the labyrinthine walls and permanent changes in Reissner's membranes. Evidence of rupture was difficult to assess. Of 21 ears of patients with the clinical diagnosis of Menière's disease, 93% had endolymphatic hydrops. A statistical correlation between increased area of the cochlear duct and hearing loss was found. Some correlation was also found between frequency of vertigo and results of electronystagmography with histopathological findings. Consequently, the mechanical effect of endolymphatic hydrops seems to have greater significance in the production of symptoms of Menière's disease than the biochemical effect of ruptures. In a review of ten unusual cases from this series of 17 patients, traumatic neuromas or remnants of vestibular structures were found after an incomplete labyrinthectomy. Histopathological findings of four patients who had undergone endolymphatic subarachnoid shunt surgery are described.

Adult↗
PubMedDate not supplied

Penetration of the cochlear endost by the fibrous component of the otosclerotic focus.

The role of the "third", "fibrous" component of the otosclerotic focus in penetrating and absorbing the cochlear endost is documented. An otosclerotic focus rich in fibrous-granulomatous component shows equal power as spongiotic or sclerotic components producing fragmentation resulting in rosary-formed absorption of the endost opening access to the soft-tissue containing regions of the cochlea.

Cochlea↗
PubMedDate not supplied

An alternative treatment for the reduction of tympanic membrane perforations: sodium hyaluronate. A double blind study.

Topical treatment with 1% sterile sodium hyaluronate solution applied on the tympanic perforation membrane has been suggested as an alternative to surgical treatment in one study only. To further investigate the effects of such a treatment, we designed a double blind study comparing topical administration of 1% sodium hyaluronate with that of 2% methylcellulose solution (placebo). After treatment the degree of perforation healing was evaluated and expressed in percentage of reduction area. The reduced area turned out to be significantly different in the group treated with sodium hyaluronate solution as compared to the placebo group. We believe that sodium hyaluronate is an alternative to myringoplasty for selected tympanic membrane perforations.

Adolescent↗
PubMedDate not supplied

Effect of long-chain acyl-CoAs and acylcarnitines on gel-fluid and lamellar-hexagonal phospholipid phase transitions.

The effect of a series of long-chain acyl-CoAs and acylcarnitines has been tested by differential scanning calorimetry on the gel-fluid transition of saturated phosphatidylcholines and of dietai-doylphosphatidylethanolamine (DEPE), and on the lamellar-Hexagonal transition of DEPE. Both series of acylderivatives have similar effects (the acylcarnitines being more potent): a decrease in the gel-fluid transition enthalpy and an increase in the gel-fluid transition width. Mixtures of dipalmitoylphosphatidylcholine with palmitoyl-CoA or palmitoylcarnitine (i.e. when all three hydrocarbon chains are 16C in length) display a peculiar behaviour, in that the main endotherm remains unchanged until a high proportion of palmitoylderivative is present, then it collapses suddenly. The disappearance of the gel-fluid main endotherm in the presence of palmitoylcarnitine is due to the fragmentation of the bilayer below the cooperative unit size of the phospholipid, while the same effect is caused by palmitoyl-CoA through the interaction of the coenzyme A polar moiety with the lipid-water interface, the overall bilayer structure being maintained. The effect of both series of compounds on the lamellar to inverted hexagonal phase transition of DEPE is also similar: they both stabilize the lamellar phase, increase the transition temperature and smear out the transition endotherm. Their behaviour may be rationalized considering that they are compounds with a bulky polar head, relative to their single hydrophobic chain, that would favour a positive curvature in the monolayer, while the inverted hexagonal phase requires a negative curvature.

1,2-Dipalmitoylphosphatidylcholine↗
PubMedDate not supplied

[Implantation of a computerised clinical history: survey on the degree of utilisation and satisfaction in a tertiary hospital].

BACKGROUND: To assess the utilization of an electronic medical record (EMR), the degree of satisfaction with this tool, as well as to detect problems in its utilization, in a tertiary hospital in Spain. METHODS: A survey was sent by mail to all physicians in the Virgen del Camino Hospital in Pamplona, Spain. RESULTS: Out of 445 staff physicians, 174 answered the survey (39%). Seventy-nine percent considered that the EMR is better than the traditional, paper-based medical record. Sixty-one percent used the EMR for consultation and to introduce clinical data in a regular way. Fifty-five percent agreed that the EMR has advantages for the patient. The main problems detected are a loss in confidentiality, lack of time, insufficient number of computers, and inadequate training. Ninety percent answered that EMR implementation should be continued and only 6% are dissatisfied with the computer application. CONCLUSIONS: There is a high degree of utilization of the EMR in the Virgen del Camino Hospital. Measures should be implemented to resolve the problems detected in this survey.

Consumer Behavior↗
PubMedDate not supplied

[Genetic mechanisms in the hereditary predisposition to colorectal cancer].

A proportion of colorectal cancers shows some type of genetic predisposition that can be recognised in clinical practice. From the classical dominant inheritance pattern of familial adenomatous polyposis or hereditary non-polyposis colorectal cancer, through the recessive transmission of the MYH associated polyposis, to the new syndromes of the "serrated pathway" or low-penetrance alleles, the discovery of new genes and a deeper understanding of the mechanisms of action of already-known ones are enabling us to understand new aspects of the colorectal carcinogenesis. This is throwing a new light on some of the observed familial aggregation patterns which had remained unexplained.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

Bat feces as an indoor allergen.

We have demonstrated in an animal model (specific IgG) as well as in atopic patients suffering from rhinitis/asthma (specific IgE) that bat feces have antigenic properties. A single peak with high glycoprotein content was obtained by chromatography, while SDS-PAGE revealed several proteins between 29 and 116 kDa which showed immune serum blotting at 43.6 and 66 kDa. Positive specific skin tests with bat feces and IgE-RAST anti-bat feces were detected in atopic patients living in tall buildings and old houses in Buenos Aires. As bat feces did not cross-react with bat epithelium, studies evaluating rat serum and epithelium and pigeon feces in order to analyze the role of bat serum proteins, such as IgA, are encouraged.

Adult↗
PubMedDate not supplied

[Brachytherapy results in prostatic cancer].

OBJECTIVE: To analyze the 15-year results of external irradiation combined with radioactive gold grain implantation (Au198) in the treatment of adenocarcinoma of the prostate and to discuss the therapeutic perspectives. METHODS: The present study was conducted on 23 patients with localized prostate carcinoma (17 stage B; 6 stage C) that had been diagnosed and treated at our department from February 1981 to October 1986. The mean patient follow-up was 90.96 months. Au198 implantation (mean dose 3347.6 cGy) was performed through the abdominal approach prior to external irradiation (mean dose 39 Gy) with Co-60 (19 patients) or the 18-MV photon linear accelerator (4 patients). The mean fractionated dose was 180.43 cGy/day. RESULTS: Overall the 15-year locoregional control rate was 61% and disease-free survival was 38%. The overall survival rate was 25%, regardless of the cause of death. The tumor control rate was 61% for stage B and 83% for stage C lesions at 15 years. The disease-free survival rate was 40% for stage B and 50% for stage C tumors. The local control and disease-free survival rates were worse for patients in whom the diagnosis had been made by TUR (p = not significant). CONCLUSIONS: The locoregional tumor control and disease-free survival rates for this group of 23 patients who received combined therapy with external irradiation and radioactive gold grain implantation (Au198) were slightly lower than those obtained in another group of 104 patients treated at our Service of Radiotherapeutic Oncology with radical external radiation therapy and can be ascribed mainly to poor patient selection and inadequate radiation dose.

Adenocarcinoma↗
PubMedDate not supplied

Proteinase and gelatinolytic activities of house dust mite and cockroach extracts.

The presence of gelatinolytic activity in dust mite and Periplaneta americana allergenic crude extracts were studied. The former presented major activity in a broad band between 45 and 66 kDa and minor activity at 32 kDa, while the latter showed a more complex pattern with gelatinolytic activity at 90, 78, 65, 34, 32 and 24 kDa. When the proteolytic activity patterns of dust mites and cockroach crude extracts were analyzed at three different pH levels, the proteases in both cases were optimally active at pH 6, showed no activity at pH 3.5 and little activity at pH 8.5. The susceptibility of both extracts to a set of well-known protease inhibitors suggested that they are composed of cysteine and serine proteinases, the latter probably being a trypsin-like type. When immunochemical properties were studied, dust mite bands of about 200, 110, 65, 60 and 43 kDa showed immunoreactivity against a polyclonal human anti-dust mite serum, with the band of approximately 200 kDa presenting the highest antigenicity. A similar analysis was applied to the cockroach extract, which exhibited immunoreactive bands at 90, 78, 65 and 34 kDa when incubated with a polyclonal rabbit anti-Blatta serum. Only those of 90, 78 and 65 kDa reacted against a polyclonal human anti-Blatta serum. These results suggested a correlation between some proteases with gelatinolytic activity and the allergenicity of both extracts.

Animals↗
PubMedDate not supplied

Immunological changes during cockroach immunotherapy.

Data obtained in a 3-year survey of specific immunotherapy (SIT) with a Periplaneta americana antigen (Pa-1) are presented. Parameters such as serum IgE-paperadioimmunosorbent test, specific IgE and IgG, interleukin (IL)-2, IL-4 and IL-4R levels were recorded before and after SIT. While serum IgE levels and IgE-RAST-anti-Pa-1 did not change throughout SIT (p = not significant), IgG-RAST-anti-Pa-1 showed a marked increase from the first year (p < 0.002 to p < 0.001). Only after 3 years of SIT did the serum levels of IL-2, IL-4 and IL-4R show lower values than before this period (p = 0.05, p = 0.05, p = 0.01, respectively). The comparative statistical analysis of the cytokine data between the nonatopic subjects and the atopic treated patients revealed no significant differences (p = 0.02). The symptomatic scores showed significant results at the third year of SIT in sneezing attacks, nose blowing and nasal obstruction (p = 0.001, p < 0.001, p = 0.001, respectively).

Adolescent↗
PubMedDate not supplied

Desensitization to azathioprine.

Azathioprine is an immunosuppressant drug which is an analog to 6-mercaptopurine and has been used in the last 20 years to prevent organ transplant rejection. It has also been used in the treatment of some autoimmunological diseases. We present a case of a 24-year-old woman with systemic lupus erythematosus, suffering from nephritis, who developed angioedema after using azathioprine to control her illness. She had never reported similar episodes. The involvement of the drug was demonstrated by positive oral challenge test without changes in biochemical and complement blood determinations. She reached tolerance to the drug after a desensitization procedure (increasing 5 mg each day to reach 125 mg daily). We are not able to propose the involvement of an IgE-mediated mechanism, but rather a hypersensitive one with a non-dose-dependent effect. These desensitization procedures show great potential as therapeutic safeguards against harmful drugs in some patients. We have not found any other desensitization procedure for this drug.

Adult↗
PubMedDate not supplied

[Morbidity of childhood bronchial asthma in the emergency room].

BACKGROUND: An allergic etiology could be found in more than the 80% of the patients with bronchial asthma. Specific immunotherapy is the only known etiologic treatment, reducing clinical symptoms and requirement of medication. However only a few patients are controlled by an allergist. The aim of the present study was to verify the influence of control and treatment carried out by patients in childhood asthma recruitment that came to the emergency room of our hospital (Hospital Clínico San Carlos) between December 95 and June 96. MATERIAL AND METHOD: Children to 15 years old were included in the study. We analysed: age, sex, clinical record, previous treatment (pharmacological and etiological), basal symptoms, necessity to be admitted to hospital, medical previous control. RESULTS: 163 patients came to emergency room because of asthma exacerbation. They were divided in two groups: less than 3 years (average 17.45 months) and more than 3 years (average 8 years) (Sd: 3.4). Sex: 65% male sex and 35% female sex. 44.17% came during the greater pollinization period in our field, with a statistical significance compared with other periods (p: 0.0023). 81 patients (49.7%) had been previously diagnosed of bronchial asthma. 15% of the patients were controlled by an allergist, with a stable situation in 92% of them. 68.4% of patients who were controlled by a paediatrician and 40% who were controlled in a officially approved centre (p: 0.015) were stable. 55 patients had continuous treatment and 21.8% of them were been treated with immunotherapy. 17.7% of patients without immunotherapy were admitted to hospital. None of the patients on immunotherapy were hospitalised. CONCLUSIONS: It is essential to do an early diagnosis and a combined follow-up by an allergist and a paediatrician to succeed in a good control of the disease from its beginning. In our experience, the children who were controlled by an allergist had a more stable situation and were also more easily controlled. The specific treatment should be initiated in the early stage of the disease being the only factor that modify the immune response and prevents against the development of asthma in children with rhinitis.

Adolescent↗
PubMedDate not supplied

[VIGILA: a tool for the epidemiologic surveillance of transmissible diseases].

It is described an instrument for the epidemiological surveillance of communicable diseases (VIGILA) that is based on the generalization of a modification of the statistical model proposed by Serfling for the prognosis of the endemic levels of the rates of communicable diseases in a period of 52 weeks (1 year). The comparison made between the observed rates and the prognosticated rates allows to detect unusual patterns of this indicator. The observation of rates over the higher limit of the prognosis interval during successive periods is suggested as a signal of alert. The introduction of this method in a computer program allows its application in the epidemiological surveillance units at the different levels of the health system.

Communicable Diseases↗