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Biomedical subjects

A Lozano

Publications and source records attributed to A Lozano.

At least 19 recordsLinked to original sources
PubMed2006

[Control of arterial hypertension by means of a regimen of hemodialysis on alternate days (HDAA or EODD: "Every Other Day Dialysis") versus 2 conventional regiments of 4 and 5 hours per session 3 times a week with 72 hours without sessions during the weekends].

An increase in the frequency of hemodialysis sessions improves control of extracellular volume and blood hypertension and consequently reduces the mortality related to cardiovascular aetiology in hemodialysis patients.We report the evolution of the blood hypertension depending on the need for antihypertensive drugs in a group of 38 prevalent patients that were included in a every-other-day dialysis schedule (EODD), and compare it with the results in two other groups of prevalent patients that were dialyzed in conventional, previously employed schedules without week-end sessions 4 hours x 3 x week and 5 hours x 3 x week. All three groups received hemodialysis treatment for more than 6 months.A 68% (26/38) of the patients received antihypertensive treatment at the beginning the EODD schedule and, after 16 months, only 7.9% (3/38) of them required antihypertensive treatment (p < 0.001) with reduction in two of the three remanent patients; hypertension control in those 25 patients took an average of 100 +/- 15 days. The final frequency of hypertension in EODD was lower (p < 0.002) than the frequency registered in the 84 prevalent patients in 4h x 3 x week schedule, and also lower (p = 0.065) than the frequency of the 56 prevalent patients in 5h x 3 x week schedule. There is a significant difference (p < 0,05) between EODD and 4h x 3 x week schedule as regards average figures of: increase in weight, decrease in dry-weight, blood pressure levels and hypotension incidence. EODD also produced better results than 5h x 3 x week schedule in this regard although statistics did not reflect it. The results using the every-other-day hemodialysis schedule support previous experiences(Lecce, Columbia) which achieved a good control of the dry-weight by means of suppressing the volume overload gained during the weekend and consequently obtaining adequate ultrafiltration rates and high reduction both of the hypertension and of the symptoms of intolerance to hemodialysis, which are so frequent in conventional schedules with 72 hours without hemodialysis sessions.

Aged↗
PubMed2005

[Study of the biopsied nephrotic syndrome for 20 years in the Cadiz Bay Area: histological correspondence, renal prognosis and clinical prognostic factors].

AIMS: To analyse the histological correspondence, the renal survival and the clinical prognostic factors in the nephrotic syndrome for more than 20 years in our environment as well as the influence of the nephrotic proteinuria in the renal survival in the different histological particular types of glomerulonephritis. PATIENTS AND METHODS: Among the 542 primary and secondary glomerulonephritis diagnosed by kidney biopsy for two decades in the Cadiz Bay Area, we selected 242 patients whose clinical presentation and the biopsy indication was the nephrotic syndrome. Statistics methods: means +/- typical deviation, percentiles, percentages, Kaplan-Meier curves, long-rank test, student's t-test, chi-square analysis and Cox proportional hazards model test. RESULTS: 242 patients with nephrotic syndrome (44.66% out of the total of glomerulonephritis), average age of 39.15 +/- 18 years old. Average proteinuria 6.75 +/- 4.53 g/day. ETIOLOGY: membranous nephropathy (33.85%), lupus nephritis (14.46%), minimal change disease (11.57%), focal segmental glomerulosclerosis (10.33%), renal amyloidosis (9.95%). 33%, 45%, 63% and 72% of the patients with nephrotic syndrome developed to the End-stage Renal Disease and starting point of dialysis in 5, 10, 15 and 20 years respectively. After the multivariate model, the age older than 60 years old, the high levels of proteinuria and the coexistence with hypertension or renal failure, in the moment of diagnosis, showed to be independents clinical prognostic factors. The nephrotic proteinuria had a negative influence in the prognosis in the different histological types, especially in the IgA nephropathy and the lupus nephritis. CONCLUSIONS: The nephrotic syndrome is the main indication of the renal biopsy in our environment. In general, as an independent group, its development is slowly progressive to the End-stage Renal Disease, having the possibility of being also conditioned by certain clinical factors present in the moment of the biopsy. The presence of nephrotic proteinuria is also a negative factor in the progression in many of the glomerulonephritis.

Adult↗
PubMed2005

[Systemic arterial hypertension in primary chronic glomerulonephritis: prevalence and its influence on the renal prognosis].

UNLABELLED: Nowadays, glomerulonephritis is one of the most common causes of End-stage Renal Disease and starting point of dialysis in Spain. Several factors may influence negatively in this prognosis; among them, we may show up the systemic arterial hypertension. Though its prevalence in the glomerulonephritis is considered higher than in other nephropathies, with variations among series, probably due to difference in ages, in geographical areas, in histological types, in time on evolution of the nephritis ... and because it is difficult to distinguish if the hypertension is a consequence of the nephritis or a consequence of the renal failure that can be present in several cases. In the same way, its negative influence in the renal prognosis may be influenced more by this renal failure, which can be its cause when it is quite severe, than by the hypertension itself. Our aims were to analyse, on the one hand the prevalence of hypertension in the 394 patients diagnosed of primary glomerulonephritis by means of a renal biopsy during two decades in the Bay of Cadiz, as well as its influence in the renal prognosis since the moment of the diagnosis, even with the absence of severe renal failure. We gathered demographic, clinical, analytical and histological data, as well as the situation of the renal function and the survival period of it at the end of each patient study. For the analysis prognosis and renal survival, Kaplan-Meier curves and the long-rank test were used. Of the 394 patients, 247 are men and 147 are women, with an average age of 36.7 +/- 17.7 years old. The global prevalence of hypertension was 39%, with a higher frequency in older patients. The gathered rate of renal survival for hypertensive patients was 54%, 28%, 20% and 4% at 5, 10, 15 and 20 years respectively; while for non-hypertensive patients, it was 83%, 75%, 66% and 62% for the same periods of time (p < 0.001). This worse tendency for hypertensive patients is observed too in each particular histological type, especially in the IgA nephropathy and membranous nephropathy. These results were the same for the patients who did not have severe renal failure in the moment of the biopsy. CONCLUSIONS: Hypertension is a common fact in the primary glomerulonephritis, which also conditions, in an important way, the renal prognosis itself in a long term, from the moment of diagnosis and even before the existence of a significant renal failure.

Adolescent↗
PubMed2004

Tuberculous vertebral osteomyelitis in the new millennium: still a diagnostic and therapeutic challenge.

In order to determine the clinical features and current prognosis of tuberculous vertebral osteomyelitis, the charts of all patients diagnosed with definite or probable tuberculous vertebral osteomyelitis from January 1983 to June 2002 ( n=78) were reviewed. The mean delay to diagnosis was 6.1 months. Sixty-five (83.3%) patients had inflammatory spinal pain, 35 (44.9%) had some neurological deficit, and only 27 (34.6%) had fever. Paravertebral, epidural, and psoas abscesses were detected in 73.1, 65.4, and 24.4% of the cases, respectively. Culture was positive in 48% of the percutaneous biopsies and in 61.7% of the open biopsies. After histological findings were included, the diagnostic yield of percutaneous biopsies was 68%. Fifty-five (70.5%) patients required surgical treatment at some stage of the disease. Although no deaths were directly attributable to tuberculous vertebral osteomyelitis and only 5.1% of patients relapsed, the mean overall hospital stay was 69.1+/-36.9 days, and 30 (38.5%) patients had severe functional sequelae. In conclusion, diagnosis of tuberculous vertebral osteomyelitis requires a high degree of suspicion. Percutaneous biopsy should be undertaken as soon as possible in any patient with compatible symptoms or radiological images in order to initiate suitable therapy.

Adolescent↗
PubMed2003

Common herbs, essential oils, and monoterpenes potently modulate bone metabolism.

During our survey of herbs looking for activity on bone metabolism, we found that the dried leaves of sage strongly inhibit bone resorption. Therefore, we investigated several common herbs rich in essential oils (sage, rosemary, and thyme) and essential oils extracted from these herbs and other plants (oils of sage, rosemary, juniper, pine, dwarf pine, turpentine, and eucalyptus) as well as their monoterpene components (thujone, eucalyptol, camphor, borneol, thymol, alpha-pinene, beta-pinene, bornylacetate as well as menthol) and found that they inhibit bone resorption when added to the food of rats. Pine oil, used as a representative essential oil, protects an osteoporosis model, the aged ovariectomized rat, from bone loss. The monoterpenes borneol, thymol, and camphor are directly inhibitory in the osteoclast resorption pit assay. Nonpolar monoterpenes may require metabolism to be active in vitro, for example, cis-verbenol, a metabolite of alpha-pinene occurring in human urine, inhibits osteoclast activity in contrast to the parent compound. Within 30 min borneol inhibits the formation of actin rings, a characteristic of resorbing osteoclasts indicating cell polarization. Both the in vitro and the in vivo effects of borneol are reversible. Our study demonstrates for the first time that essential oils and monoterpenes are efficient inhibitors of bone resorption in the rat.

Animals↗
PubMed2003

Activation of electrocorticographic activity with remifentanil and alfentanil during neurosurgical excision of epileptogenic focus.

BACKGROUND: Opioids are known to stimulate surface electroencephalographic activity in patients with temporal lobe epilepsy. The objective of the current study was to compare the electrocorticographic activation effects of the newer short-acting opioid remifentanil with those of alfentanil during epilepsy surgery under general anaesthesia. METHODS: Thirteen patients undergoing temporal lobe epilepsy surgery under general anaesthesia received alfentanil 30 microg kg(-1) and remifentanil 1 microg kg(-1) as i.v. boluses in sequence. The design was a randomized double-blind cross-over study. After opening the dura, electrocorticogram (ECoG) electrode contact strips were placed over the temporal and supratemporal neocortex and depth electrodes were inserted in the amygdala and hippocampus. Alfentanil 30 microg kg(-1) or remifentanil 1 microg kg(-1) were administered randomly in a blinded fashion. The ECoG was recorded continuously before and after the injection of each drug. The interictal epileptiform activity (spikes and sharp waves) above baseline was analysed. RESULTS: Both drugs increased epileptiform activity especially that recorded from depth electrodes in the temporal limbic structures. No epileptiform activity was recorded from the electrodes overlying the supratemporal neocortex before or after drug administration. The more potent activator was alfentanil, which caused an increase in activation from baseline of 99.8% compared with 67.4% for remifentanil. In addition, alfentanil activated the epileptiform activity in 3 patients in which remifentanil had no effect. There were no changes in heart rate after the opioid boluses. Both remifentanil and alfentanil caused significant reductions in blood pressure at 3 and 5 min after administration. CONCLUSION: We conclude that at the doses used in this study, alfentanil is the better opioid for intraoperative activation of the ECoG in neurosurgical patients undergoing resection of a temporal lobe epileptic focus. This pharmacological activation of epileptiform activity assists in localizing and confirming the site of surgical excision. Neither alfentanil nor remifentanil activated epileptiform activity in non-epileptic brain tissue.

Adult↗
PubMed2002

In vitro comparison of root-canal measurements with conventional and digital radiology.

AIM: The present study compared the efficacy of digital and conventional radiology for root-canal length measurement. METHODOLOGY: Seventy extracted teeth with pre-served roots were used. Root-canal length measurements were completed with K-Flexofiles (numbers 08, 10 and 15) with conventional and digital radiography using two systems (radiovisiography and photostimulate storage phosphor). All films and sensors were exposed at projections of 0 degrees and 20 degrees to the mesial. The images obtained were evaluated with and without magnification, and analysed using the Cohen's kappa test. The accuracy of the three systems to determine the root-canal length were evaluated by measuring the distance from the tip of the file to the apex. RESULTS: Most of the values corresponding with the apex occurred with conventional radiology. The digital systems yielded negative values that improved with a size 15 file. The agreement between the two digital systems was the best with size 15 file using 0 degrees projection (66.7%). CONCLUSIONS: Conventional radiology remains the technique of choice in determining the root-canal length; the digital techniques yielded good results for size 15 file.

Dental Pulp Cavity↗
PubMed2001

Effect of several germination conditions on total P, phytate P, phytase, and acid phosphatase activities and inositol phosphate esters in rye and barley.

Two assays were conducted to study the evolution of rye and barley phosphatases (phytase and acid phosphatase) and the degradation of its substrates (inositol phosphate esters) during seed germination. In this manner we could obtain a low-phytate, endogenous phosphatase rich ingredient to be used in animal nutrition. In the first assay, the seeds were soaked for 1 and 14 h and germinated for 3 and 5 days with and without the addition of gibberellic acid (GA3). In the second assay, the seeds were soaked for 1 h and germinated for 1, 3, and 5 days with GA3. Phytase (up to 5739 and 3151 U x kg(-1)) and acid phosphatase (up to 18288 and 3151 U x g(-1)) activities, and IP6 (6.09 and 6.01 mg x g(-1)), IP5 (0.48 and 0.48 mg x g(-1)), and IP4 (0.13 and 0.06 mg x g(-1)) were detected in ungerminated rye and barley, respectively. The germination process caused a significant increase of Phy and AcPh activities in rye (up to 112 and 213%) and barley (up to 212 and 634%) and a reduction in the phytate phosphorus content (up to 84 and 58%, respectively). Phytate phosphorus content was affected only by soaking time in the case of rye. Finally, during the course of germination, IP6 and IP5 were rapidly degraded in rye (88 and 79%) and barley (67 and 52%), and IP4 was only a short-living intermediate, which was increased during hydrolysis and degraded to IP3. In conclusion, a marked increase of Phy and AcPh activities in rye and barley with a concomitant decrease in phytate phosphorus content and an increase in the content of lower inositol phosphates were observed during the rye and barley germination.

6-Phytase↗
PubMed2001

Biweekly gemcitabine, doxorubicin, and paclitaxel as first-line treatment in metastatic breast cancer. Final results from a phase II trial.

In a single-center, open, phase II trial, we assessed the toxicity and activity of a triple combination therapy--doxorubicin at 30 mg/m2 (day 1), paclitaxel (Taxol) at 135 mg/m2 (day 2), and gemcitabine (Gemzar) at 2,500 mg/m2 (day 2 after paclitaxel)--administered biweekly in a 28-day cycle for six cycles. This was given as first-line treatment in 41 patients with metastatic breast cancer. Granulocyte colony-stimulating factor was used in 27 patients to permit maintenance of dose density. Hematologic toxicity was moderate. Nonhematologic adverse events were generally mild. The objective response rate was 82.9% (34/41) with 18 patients (43.9%) achieving complete response and 16 (38%) achieving partial response; progressive disease was observed in 4 patients (9.8%). Responses were observed at all metastatic sites, including complete responses in lung, liver, bone, and soft tissue. Median duration of response was 14.1 months and median time to progression was 13.9 months. Median survival was 26.2 months. The biweekly combination of gemcitabine, doxorubicin, and paclitaxel is safe and highly active as first-line treatment in metastatic breast cancer.

Adult↗
PubMed2000

16. FDG-PET in the Detection of Recurrence in Colorectal Cancer Based on Rising CEA Level. Experience in 72 Patients.

Purpose: A rising CEA level after the resection of colorectal cancer is an early indicator of tumour recurrence. However, conventional imaging techniques have limited sensitivity for detecting recurrent disease in such patients. Our group has evaluated the role of Positron Emission Tomography with 18F-Fluorodeoxiglucose (FDG-PET) in this clinical situation.Material and Methods: Seventy-two patients with abnormal CEA levels and normal results of conventional methods of tumour detection were studied with FDG-PET. The PET results were compared with pathologic findings (n = 25) long-term radiological (n = 9) and clinical follow-up (n = 38). Influence of PET findings in therapeutic management was also considered in this study.Results: PET detected lesions in 63/72 patients (87.1%). Metabolic imaging showed metastases in the liver (44.1%), ganglionar nodes (27.5%), local recurrence (20.4%) and lung metastases (8%). Overall, the sensitivity of PET was 94.4%, specificity was 83.3%, the positive-predictive value was 97.1%, the negative-predictive value was 71.4% and the diagnostic accuracy was 92.8%. FDG-PET findings change therapeutic decision in 68/72 patients (94.1%)Conclusion: When conventional examinations are normal, FDG-PET is a valuable imaging tool in patients who have rising CEA level after colorectal surgery. Metabolic imaging represents a very cost-effectiveness diagnostic procedure in this clinical situation, avoiding unnecessary invasive techniques.

Journal Article↗
PubMed2000

Enteroviruses in Spain: virological and epidemiological studies over 10 years (1988-97).

A total of 15,662 clinical samples were analysed for enterovirus (EV) isolation in cell cultures during a 10-year period (1988-97). Furthermore, 210 isolates of EV obtained in primary laboratories within Spain from patients with meningitis were characterized. The total number of EV typed was 758, including 727 non-polio EV and 31 Sabin-like (SL) polioviruses. Twenty-eight EV serotypes were represented. Echoviruses comprised 90% (653/727) of fully typed non-polio EV. The four most prevalent serotypes were echovirus 30, echovirus 9, echovirus 6 and echovirus 4. Echovirus 30 was the main serotype associated with meningitis. Echovirus 9 was the aetiological agent in 20 outbreaks of meningitis while the occurrence of echovirus 6 was localized in 1 year (1997). Coxsackieviruses A and B occurred in 3 and 7% of the non-polio EV respectively. Coxsackievirus B5 presented the relative greater abundance. This paper examines the epidemiology of EV in Spain to serotype level over a 10-year period with special attention to non-polio EV associated with meningitis.

Adolescent↗
PubMed2000

Phytase and acid phosphatase activities in plant feedstuffs.

A total of 183 samples representing 24 feedstuffs were analyzed for total phosphorus, phytate phosphorus content, phytase (Phy), and acid phosphatase (AcPh) activities with the objective to predict the capacity to hydrolyze phytic acid and to contribute to formulating environmentally adequate diets for monogastric animals. Of the cereals and cereal byproducts analyzed, only rye (5147 U kg(-)(1); 21 955 U g(-)(1)), wheat (1637 U kg(-)(1); 10 252 U g(-)(1)), rye bran (7339 U kg(-)(1); 56 722 U g(-)(1)), and wheat bran (4624 U kg(-)(1); 14 106 U g(-)(1)) were rich in Phy and AcPh activities. Legume seeds and oilseeds contained negligible Phy activity and a moderate amount of AcPh activity, except for kidney bean (33 433 U g(-)(1)) and full-fat linseed meal (13 263 U g(-)(1)). On the other hand, a significant linear regression between phytate phosphorus (y) and total phosphorus (x) was observed in cereal byproducts (R(2) = 0. 95; y = 0.8458x - 0.0367; P < 0.001) and oil seeds (R(2) = 0.95; y = 0.945x - 0.20; P < 0.001). Phy and AcPh were positively correlated with respect to phytate phosphorus in cereals, cereal byproducts, and other byproducts and negatively correlated in legume seeds and oilseeds. Except for cereals, the highest correlation between enzyme activities and phytate phosphorus was found for phytase. It is not possible to predict Phy and AcPh activities from phytate phosphorus content by linear and quadratic regressions. Finally, only highly significant and positive correlation was found between Phy and AcPh activities for cereals, cereal byproducts, and oilseeds.

6-Phytase↗
PubMed2000

Detection of hepatitis G virus (HGV) RNA and antibodies to the HGV envelope protein E2 in a cohort of hemodialysis patients.

An analysis of the evolution of hepatitis G virus (HGV) infection markers was performed for a cohort of 58 hemodialyzed patients. During follow-up (4.88 +/- 0.42 years), a group of these patients cleared their antibodies against the envelope protein E2 with (4 of 29 cases; 13.8%) or without (9 of 29 cases; 31%) the reappearance of viremia. This finding implies a temporally limited protection in patients previously infected with HGV.

Adult↗
PubMed2000

Phase II trial of gemcitabine/doxorubicin/paclitaxel administered every other week in patients with metastatic breast cancer.

The present trial was designed to determine the efficacy of the combination of gemcitabine/doxorubicin/paclitaxel (GAT) delivered every other week as first-line therapy in patients with metastatic breast cancer. From February 1998 to September 1999, 41 patients were included in this trial. Doses delivered were doxorubicin 30 mg/m2 on day 1 and paclitaxel 135 mg/m2 plus gemcitabine 2500 mg/m2 both given on day 2, every 14 days. Doses were selected from a previous phase I trial conducted at our institution. Eligibility criteria for the phase II trial included histologically confirmed metastatic breast cancer with bidimensionally measurable lesions; no prior therapy for metastatic disease; adjuvant or neoadjuvant chemotherapy was allowed if given more than 1 year before and cumulative doses of doxorubicin or epirubicin were less than 200 mg/m2 or 360 mg/m2, respectively; Eastern Cooperative Oncology Group (ECOG) performance status of 2 or less; and adequate hematological, hepatic, and renal function. Prophylactic use of granulocyte colony-simulating factor (G-CSF) was allowed if patients were not fully recovered (absolute neutrophil count greater than 1500/microL) from chemotherapy administration before the next dose. Left ventricular ejection fraction was determined initially, at the end of the study, and every 6 months thereafter. The patients' median age was 55 years (range, 33-68 years), and their median ECOG performance status was 0 (range, 0-1). Twenty-eight patients had received adjuvant therapy, 17 with epirubicin (none with doxorubicin). Metastases were present in the bone (19 patients), lung (19 patients), liver (11 patients), and soft tissues (18 patients). Twenty patients had one metastatic site and 21 had two or more sites. Efficacy was assessed on an intent-to-treat basis. A total of 216 cycles of GAT were given. Twenty-two percent of the courses were delayed or given at reduced doses mostly due to neutropenia or thrombocytopenia. G-CSF was required in 58% of the cycles. Grade 3/4 neutropenia was the main toxicity and appeared in 17 patients, one of whom had an episode of febrile neutropenia. Nonhematological toxicities consisted mainly of neurotoxicity and myalgias. A drop of 10%-20% in the left ventricular ejection fraction was detected in two patients and another patient had a decrease greater than 20%, although none developed symptoms of heart failure. Overall response rate was 80.4% (95% confidence interval: 68.3-92.5), with 15 patients (36.6%) achieving a complete response. Median survival time was 27 months and median time to progression was 15 months. The GAT combination is feasible and very active in patients with metastatic breast cancer, with an encouraging response rate including a high rate of complete responses. No congestive heart failure was documented and other toxicities were mild, with the exception of neutropenia.

Adult↗
PubMed2000

Some vegetables (commonly consumed by humans) efficiently modulate bone metabolism.

We have hypothesized that some vegetables which are part of the regular human diet may contain modulators of bone metabolism. To mimic a typical Western diet with large proportions of refined components, rats were pair-fed a semi-purified diet to which, in the treated animals, the dried material under investigation was added. Effects are expressed as % of untreated control. Bone parameters in rats were assessed in the proximal tibia by pQCT. Bone resorption (BR) was assessed by the urinary excretion of [3H]-tetracycline from prelabeled rats. Daily administration of 1 g of onion during 4 weeks increased total bone mineral content by 17.4% (p<0.05), trabecular bone mineral density by 13.6% (p<0.05). One g of onion/day administered to male rats blunted BR by 23-/+5% (p<0.05). Daily administration of onion to ovariectomized rats inhibited BR in a dose-dependent manner. At the highest dose (1.5 g of onion) BR was inhibited by 26-/+4% (p<0.01) as compared to 24-/+3% (p<0.001) for estradiol (27microg/kg/day). An additional 13 vegetables displayed significant effects on BR at the dose of 1g/day. Interestingly, 1g/day of soy did not inhibit BR in this model. Also, skimmed milk, meat and egg (all 1 g/day) were ineffective. Thus, common vegetables consumed by humans potently modulate bone metabolism in the rat. This opens the possibility to develop the basis for a low-cost, safe and effective nutritional approach to osteoporosis.

Journal Article↗