Biomedical subjects

Alvaro Morales

Publications and source records attributed to Alvaro Morales.

24 records · Page 2Linked to original sources

PubMed2003

An integral view of the neuroendocrine aspects of male sexual dysfunction and aging.

Age is the most important factor associated with sexual dysfunction. The traditional thinking explained this association by the neurovascular events developing with the aging process. More recently, central neuro-endocrine mechanisms resulting from apoptosis in the hypothalamic areas involved in both the production of sex hormones and the control of sexual processes have added a new dimension to human sexuality. This evidence is still controversial but of unquestionable importance in our understanding of endocrine alterations and sexual shortcomings associated with aging.

Aging↗

PubMed2003

A randomized controlled trial comparing split and subunit influenza vaccines in adults in Colombia.

In a two-center, comparative trial, 344 adults were randomly assigned to receive a single dose of inactivated split-virion (Imovax Gripe) or sub-unit (Agrippal S1) influenza vaccine (1999-2000 formulations). For analysis, study groups were subdivided into adult (18-60 years old) and elderly (over 60 years) subjects. Blood was drawn immediately before and one month after vaccination, safety was evaluated using a blind-observer design based on reporting of solicited and unsolicited adverse events. Both vaccines were very well tolerated, had similar reactogenicity profiles, and elicited fewer reports of reactions in elderly individuals. Post-vaccination Imovax Gripe induced seroprotective antibody titers against the three vaccine strains in 94-99% of adults and 88-97% of elderly subjects, compared with 88-100% and 88-98%, respectively, of those given Agrippal S1. In conclusion, the split-virion and sub-unit influenza vaccines had similar safety and reactogenicity profiles, and elicited satisfactory immunity in adult and elderly subjects. However, higher post-vaccination geometric mean titer (GMT) values in response to the B strain were seen with the split vaccine Imovax Gripe, giving it a better overall immunogenicity.

Adolescent↗

PubMed2002

Androgen deficiency in the aging male: when, who, and how to investigate and treat.

Androgen deficiency in the aging male (ADAM), also known as andropause, affects an estimated 1 in 200 men. The abnormally low levels of testosterone in these men can usually be managed with androgen supplementation therapy. Because a large proportion of urologic patients are men at or beyond middle age, urologists should be familiar with ADAM, its clinical manifestations, the rational approach to its diagnosis and treatment, and the consequences of treatment. Equally important is responsibility for the patient's monitoring, because prolonged androgen replacement therapy can be associated with significant complications, particularly in the prostrate.

Age Factors↗

PubMed2002

Androgen replacement therapy and prostate safety.

Progress in the understanding of the action of exogenous testosterone has diminished many of the concerns that existed regarding its safety. The major interest is now focused on the effects of androgen supplementation on the prostate gland. Many such concerns have been addressed but others remain to be fully elucidated. It is well established that hypogonadal men receiving adequate androgen therapy develop a prostate with a volume similar to what would be expected from their eugonadal counterparts. Androgen therapy results in modest elevations in the PSA and minor changes in flow parameters. Prostate cancer, on the other hand, remains the most prominent of the safety concerns. Although there is no evidence that normal levels of testosterone promote the development of cancer of the prostate, it is clear that the administration of testosterone enhances a pre-existing prostatic malignancy. Androgen supplementation studies have been, in most cases, of short duration and lacked a control cohort. The current evidence does not support the view that appropriate treatment of hypogonadal elderly men with androgens has a causal relationship with prostate cancer. Larger experience, however, is needed. The same criteria applies to the use of other hormones such as dehydrotestosterone, dehydroepiandrosterone follicle stimulating and growth hormone. A set of recommendations regarding androgen replacement therapy and prostate safety is proposed.

Age Factors↗

PubMed1999

Metastatic renal cell carcinoma regression after nephrectomy and BCG immunotherapy.

Patients with renal cell carcinoma (RCC) often remain asymptomatic until the disease has progressed beyond the confines of the kidney, as almost one third of patients have metastatic disease at the time of diagnosis.1 The average survival for a patient presenting with metastatic renal cell carcinoma is 4 months and only 10% will be alive at 1 year.2 Many different treatment combinations have tried for metastatic disease, but with limited results. Some success has been shown in smaller studies using nephrectomy and Bacillus Calmette-Guerin (BCG) immunotherapy but these results have not been followed by larger randomized control trials.3 We report a case metastatic renal cell carcinoma with an unusually long survival and regression of metastases from 2 uncommon sites.

Journal Article↗

PubMedDate not supplied

Costs and benefits of influenza vaccination and work productivity in a Colombian company from the employer's perspective.

OBJECTIVES: This study was designed to evaluate the effects of an employee influenza vaccination campaign, measured in terms of health and economic benefits. METHODS: Colombian bank employees volunteered to take part in this prospective observational study involving two groups: vaccinated and nonvaccinated. Socioeconomic and health status information, including influenza-like symptoms, sick leave, and postvaccination adverse events, were collected via questionnaires. Cost-benefit analyses were performed to determine whether the employer would save money overall by paying for the vaccination program. RESULTS: Between October 2000 and May 2001, 424 vaccinated subjects and 335 nonvaccinated subjects volunteered to join the study. Cumulative incidence of influenza-like illness (ILI) was lower among vaccinated (14.6%) than nonvaccinated subjects (39.4%). Fever was the most common ILI symptom (93% of all reported ILI). Absence rates because of ILI were similar in the two groups (2.59%-2.69%). Assuming that employees with ILI who continue to work have reduced effectiveness (30%-70% of normal) the employer can save 6.4 US dollars to 25.8 US dollars per vaccinated employee based on labor costs alone. This saving increases to 89.3 US dollars to 237.8 US dollars when operating income is also considered. Sensitivity analyses indicate that the vaccination program will be cost saving for vaccination coverage above 20% and ILI rates above 10%. CONCLUSIONS: Among the studied volunteers, ILI has significant impact on work productivity in terms of indirect costs. Implementing an influenza vaccination program would reduce the burden of ILI and save substantial amounts of money for the company.

Colombia↗