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Biomedical subjects

A Nieto

Publications and source records attributed to A Nieto.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

[Importance of the integrated evaluation of the child with asthma].

When evaluating the effects of the practical application of a therapeutic strategy, the results of the controlled and random clinical tests with the above mentioned treatment, as they are important, do not constitute the only factor to be considered. Especially as frequently the clinical tests only take into account the efficiency of the treatment, without considering other essential aspects such as safety, performance and cost. The combination of these factors results in the PRACTICAL efficiency of the treatment, that often differs considerably from the results obtained in clinical tests. Therefore, the clinical tests do not precisely reflect the conditions that exist when a treatment is applied in real life and thus, the evaluation of the practical efficiency of the said treatment is essential if you want to know what the real repercussion that the treatment has on a specific problem, such as asthma, represents. And this is important as, in spite of the notable advances over the last few years in the treatment of this illness, the objectives that the GINA propose in order to consider the control of asthma as sufficient, are a long way from being achieved, as the results of the AIRE study that was carried out in 7 European countries illustrate. On the other hand, the valuation of the efficiency of a treatment is a problem that is worth discussing. As, due to operational and precision reasons, of then the clinical tests consider one or a few variables as objectively as possible (for example, the lung function) when valuing the efficiency of a treatment. However, on many occasions it is possible to appreciate notable discrepancies between these objective variables and the patient's symptoms, the subjective appreciation of how the asthma is affecting them, etc. Therefore, it is necessary to take into account the fact that an integral valuation of the repercusion that asthma has on the patients, their families and their environment, and how a specific treatment changes the situation on these levels, and obligues us to consider in an integral manner, a series of medical (clinical, functional and biological), humanistic (quality of life, patients satisfaction) and economic variables.

Anti-Asthmatic Agents↗
PubMedDate not supplied

[Neuropsychological assessment in multiple sclerosis].

OBJECTIVE: Over the past 20 years great advances have been made in understanding the neuropsychological changes in multiple sclerosis. In this paper we review the nature of mental deterioration in multiple sclerosis and the procedures used for its evaluation. DEVELOPMENT: First we give a short summary of present knowledge of the involvement of different functions and the instruments most generally used to evaluate it. We then consider the different approaches to neuropsychological assessment, the use of broad guidelines as opposed to screening techniques, bearing in mind their advantages and disadvantages in the clinical field and in investigation. Similarly we mention the current trends in the evaluation and treatment of multiple sclerosis. CONCLUSIONS: The general profile of neuropsychological alterations in multiple sclerosis is characterized by the presence of changes in secondary memory and speed of thought, although the nature of this defect is still not clear. Changes are also seen in other neuropsychological functions, although less frequently and more controversially. Our knowledge of the prevalence of these changes comes from the use of guidelines for thorough examination. However, the current tendency is to seek instruments for evaluation which combine diagnostic efficiency, clinical usefulness and brevity. In this respect, although progress is being made, there are still questions to be answered.

Cognition Disorders↗
PubMedDate not supplied

Factors influencing the clinical picture and the differential sensitization to house dust mites and storage mites.

Sensitization to house dust mites and storage mites has been studied in a number of papers, but several environmental factors and clinical conditions that differently affect sensitization to these mites are still controversial. The purpose of this study was to determine the influence of climatic conditions, occupation and patient age in the differential sensitization to house dust and storage mites, and also to search for possible different symptoms caused by each group of mites. Eighty patients sensitized to mites but not to other inhalant allergens were studied by case history and by skin prick test and serum IgE to Dermatophagoides pteronyssinus. Dermatophagoides farinae, Lepidoglyphus destructor and Tyrophagus putrescentiae. Home conditions, including content of the allergens Der p 1, Der f 1, Lep d 2 and Tp, were determined for all patients. Human activities, such as farming or similar occupations, and humidity are conditions for preferential sensitization to storage mites, while we found no difference between living in rural or urban areas. Mean age for the onset of sensitization was 6.7 years for house dust mites and 18.7 years for storage mites. Conjunctivitis was more frequent in patients allergic to storage mites, whereas perioral syndrome (itching of the tongue and swelling of the lips) was only seen in patients sensitized to T. putrescentiae. We concluded that climatic and damp conditions and human activity, but not urban or rural living environments, influence the differential sensitization to house dust mites and storage mites.

Adolescent↗
PubMedDate not supplied

[Neoadjuvant chemotherapy with cis-platin and 5-fluorouracil in continuous infusion (96 h.), in stages III and IV of carcinomas of the upper aerodigestive tract].

We have studied 37 patients with advanced head and neck cancer. A combination of Cis-Platinum and 5-Fluorouracil, both administered four days continuously as infusion, was assessed. There were 15 complete responses (40.5%), 15 partial responses (40.5%) and the number of objective responses was 30 (81.5%). Survival is 79.1% at 22 months and none of the patients in complete responses has relapsed during this period.

Adult↗
PubMedDate not supplied

[Induction chemotherapy with cisplatin and 5-FU in locally advanced head and neck cancer. Study of 2 administration schedules].

67 patients were included in two different protocols with cisplatin and 5-fluorouracil as induction chemotherapy. Group A (30 patients), received cisplatin in bolus and 5-FU in continuous infusion for 120 hours, and Group B (37 patients), were treated with cisplatin and 5-FU both in continuous infusion for 96 hours. All patients received surgery and/or radiotherapy after chemotherapy. Overall response in Group A was 73% with 27% Complete Clinic Response (CCR), and in Group B 81% with 40.5% (CCR). Overall survival at 24 months was 58% and 63%, respectively.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Reactivity of a purified antigen of Paracoccidioides brasiliensis with paracoccidioidomycosis and histoplasmosis sera].

The immunoelectrophoretic reactivity of a "crude" and a "purified" antigens of Paracoccidiodes brasiliensis against the sera of confirmed cases of paracoccidioidomycosis and histoplasmosis was evaluated. The "crude" antigen revealed precipitating antibodies in both the homologous and the heterologous human sera; the number of precipitating systems being higher with the former. The "purified" antigen reacted only with the homologous sera. It is postulated that the use of such "purified" antigen may significantly reduce the non specificity of the serologic tests in the immunodiagnosis of paracoccidioidomycosis.

Antigen-Antibody Reactions↗
PubMedDate not supplied

[Computer use in voice analysis: clinical applications].

Computers play an important role in voice analysis both in research and in the clinic. We have revised some basic concepts in signal digitization and some of the options present in the different voice analysis systems as: intensity and fundamental frequency measurement, perturbation calculation (jitter and shimmer) and spectrographic analysis. Clinical applications are outlined in conclusion.

Computers↗
PubMedDate not supplied

[S/z ratio in glottic closure defects].

The quotient between the maximum phonation time (MPT) of the sound /s/ and a vowel sound, measures the relation of resistances to the expiratory air flow. When the sound /s/ is emitted, resistance is located at the teeth, and when a vowel is phonated, the site of resistance is the glottis. Estimating the quotient instead of measuring only the MPT, we avoid the influence of respiratory alterations in the results. We evaluated the utility of the s/z ratio as a clinical indicator of laryngeal pathology in 72 patients with organic vocal cord pathology. We compared the results of the s/z ratio to the degree of glottic closure defect, measured by videolaryngostroboscopy. S/z ratio in 22 normal-speaking subjects was also measured. S/z ratio in normal-speaking subjects was nearly 1.0. When a glottic closure defect was present, the ratio was over 1.4. Organic lesions that difficult glottic closure, produce a decrease of air flow resistance and, therefore, a shortening of the MPT of the vowel sounds.

Adolescent↗
PubMedDate not supplied

[The inverse filtering in the investigation of the laryngeal pathology:a quantitative study of the airflow of glottogram of various intensity].

Inverse filtering is a method of investigate the larynx function that reflects the vibratory movement of the vocal folds by approximately reconstruct the glottal excitation wave. Basically the method creates a filter which characteristics revert the influence of the supraglottal tract and the radiation component on the glottal wave. In this report different quantitative parameters of the flow glottogram (FGG) are studied by means of a computer based program named Superscope in two subjects, one without pathology and another affected of a vocal polyp, at different intensities.

Computers↗
PubMedDate not supplied

[Phonetograms in laryngeal lesions due to vocal abuse].

Using this test, we measure maximum and minimum vocal capacity (sound pressure in dB) from the lowest to the highest frequency that a person can emit and sustain. These measurements are represented on an easily interpreted graph that allows the magnitude of the vocal area to be evaluated. We made phonetograms of persons with nodules (3), polyps (16) and Reinke edema (10) and compared their results to those of a group of 25 healthy subjects. The vocal fields of patients with laryngeal polyp and Reinke's edema were severely reduced.

Laryngeal Diseases↗
PubMedDate not supplied

[Electroglottography in the research and physiology of larynx].

Electroglottography (EGG) is a noninvasive method of monitoring the movement of the vocal folds by measuring the variation of impedance to a weak alternating current through the tissues of the neck. Basically EGG is an index of the vocal fold contact area. Despite recent controversy EGG continues being an easy to handle method in larynx basic research, with increasing use in clinical diagnosis and rehabilitation of vocal pathology. EGG technique is described and some of its applications in clinical practice and voice research are pointed out.

Electric Impedance↗
PubMedDate not supplied

Study of HLA-DQA1 alleles in celiac children.

The familial incidence of celiac disease (CD) confirms its genetic basis, although acquired factors are also involved. Many authors have reported a linkage between celiac disease and HLA antigens, but there are differences which depend on geographical areas, and nowadays the study must be done at the genetic level. Thirty-eight celiac children and 52 normal controls were included in this study. All individuals were chosen from the Castilla and Leon area. We used the reverse ¿dot block¿ technique, using sequence-specific oligonucleotide DNA probes (Cetus, USA) to determine the HLA-DQA1 alleles in DNA samples previously amplified by PCR (polymerase chain reaction). The different frequency of alleles in patients and controls was assessed by 3 statistical tests: chi square (chi(2)), relative risk (RR) and etiologic fraction (EF). A very high frequency of DQA1*0201 (chi(2):p <0.0001) and DQA1*0501 (chi(2): p <0.0001) alleles was observed in patients; all but one (97%) had the DQA1*0501 allele vs. 40% of controls (RR: 37.00; EF: 0.955). The DQA1*0201 allele also had a high prevalence in celiacs (58%)(RR: 1.375: EF:0.438). The DQA1*01 allele was only found in 10.5% of patients compared to 79% of controls (chi(2): p <0.0001) and the DQA1*03 allele was also decreased in celiacs. There was only one celiac girl without the DQA1*0501 allele. She had no other clinical or serological differences, as compared to the other patients. In the study of allele subtypes, among the DQA1*01 allele, 50% of patients were positive for DQA1*101 and the remaining 50% had DQA1*0102, but none of the individuals were positive for DQA1*0103. Among normal controls, 32 individuals (61.5%) expressed the DQA1*0102 subtype, 15 (28.9%) the DQA1*0101 subtype and 5 (9.6%) the DQA1*0103 subtype. All positive cases for DQA1-*05 belong to the DQA1* 0501 subtype, in both celiac and control groups. There were 10 possible combinations of HLA-DQA1 genes, but we found a very unequal distribution in both celiacs and controls. Only 4 genotypes were found in patients (DQA1*01/1*0501, DQA1* 0201/1*0501, DQA1*03/1*0501 and DQA1*0501/1*0501) and 8 in controls. The DQA1*0201/1*-0501 genotype was the most discordant, being positive in 55.3% of patients vs. 3.8% of controls (chi2:p < 0.001; RR: 1.235; EF:0.534). None of the 90 individuals studied expressed the DQA1*0311*03 genotype. The DQA1*0201/1*03 genotype was not shown by any control and by only 1 celiac patient. It is noteworthy that the DQA1*0201/1*0501 genotype was more frequent than the homozygous genotype DQA1*0501/1*0501. Our results do not suggest a dosage effect for the DQA1*0501 allele. The determination of the HLA-DQA1 gene is a helpful tool for the screening of individuals with a high risk of being celiacs.

Adolescent↗