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C Perez

Publications and source records attributed to C Perez.

206 records · Page 12Linked to original sources
PubMedDate not supplied

[Dyspepsia and Helicobacter (Campylobacter) pylori. Results of a randomized therapeutic trial using amoxicillin versus placebos].

A population of non ulcer dyspepsia outpatients with a normal gastroscopy was assessed. Clinical complaints, the type of the gastritis, its activity and bacterial density were evaluated. Helicobacter pylori (HP) was sought by histology, urease test and culture, on 3 distinct locations. HP was found in 62 p. cent of the patients, always in association with gastritis. Urease test and histology had the same sensitivity in the detection of HP. A randomized double blind study with amoxicillin vs placebo was carried out in 23 patients. At the end of 4 week treatment, a gastroscopy with biopsies was performed. The amoxicillin treated patients were significantly cured or improved. HP was undetectable or the bacterial density was decreased in this group. After amoxicillin, urease test was more sensitive than histology. HP might be involved in the pathophysiology of non ulcer dyspepsia in patients where HP was found.

Adult↗
PubMedDate not supplied

Proteoglycans in bones of streptozotocin-induced diabetic rats.

Insulin seems to regulate the biosynthesis of proteoglycans in some tissues such as growth plate and glomeruli. The present investigation was undertaken to assess the ex vivo influence of insulin on proteoglycan metabolism in bones. Mandible and femur bones were used. Xiphoid cartilage was used as a control tissue of high glycosaminoglycan content. Diabetes was induced by 0.12 mg/g b.w. streptozotocin in male Sprague-Dawley rats, a number of which was treated with insulin (1 I.U./100 g b.w.) for 6 days. As compared with control animals, diabetic rats exhibited a decreased [35S]sulfate uptake as well as a shift to the right in Sephacryl S-500 chromatography. In addition, they showed lower density of proteoglycans in sucrose gradient and shorter glycosaminoglycan side chains in Sephadex G-200 chromatography. These changes were partly reversed by insulin.

Animals↗
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Cisplatin, fluorouracil, and L-leucovorin induction chemotherapy for locally advanced head and neck cancer: the M.D. Anderson Cancer Center experience.

PURPOSE: To determine the efficacy of the combination of cisplatin, fluorouracil, and high-dose l-leucovorin (PFL) as organ-preserving induction therapy followed by radiotherapy in untreated patients with advanced squamous cell carcinoma of the head and neck. PATIENTS AND METHODS: This was a phase II study of PFL in 47 patients with resectable stage III (n = 20) and IV (n = 27) M0 squamous cell carcinoma of the head and neck, including larynx (n = 20), hypopharynx (n = 14), and oropharynx (n = 13). The PFL regimen consisted of cisplatin 25 mg/m2 on days 1 through 5, fluorouracil 800 mg/m2 CI on days 2 through 6, and l-leucovorin 250 mg/m2 on days 1 through 6, all by continuous intravenous infusion every 21 to 28 days for three courses. The primary study endpoint was initial response to and local disease control rate with PFL as induction chemotherapy, with an aim to confirm the previously reported complete response rate of 60% to 70%. RESULTS: Of 47 patients enrolled, 46 were evaluable for response to PFL, 14 (30%) achieved a complete response, and 25 (54%) achieved a partial response, for an overall response rate of 84%. Of 39 patients evaluable for response after radiation therapy, 27 (69%) achieved a complete response and 11 (28%) a partial response. Local disease control was achieved in 37 of 46 (80%). Grade 3 or 4 toxic effects occurred frequently, with neutropenia in 27 (59%) of 46 evaluable patients, thrombocytopenia in 30%, mucositis in 41%, diarrhea in 13%, and nausea/ vomiting in 13%, but there were no treatment-related deaths. With a median follow-up of 35 months there have been nine recurrences (four local/regional and five distant) and 17 deaths (12 in patients with disease progression and five not directly related to the primary tumor). Second primary tumors have developed in six patients. At 3 years 62% of the patients remain alive with no disease progression, and the 3-year survival estimate with preserved organ function is 66%. CONCLUSION: PFL induction chemotherapy produced only a modest complete response rate, possibly due to suboptimal dose intensity, and was associated with substantial, although not life-threatening, toxicity. Newer regimens and treatment modalities are still needed in the management of advanced squamous cell carcinoma of the head and neck.

Adult↗
PubMedDate not supplied

The next frontier in clinical pathways. The journey to outcomes management.

The Children's Memorial Hospital, a 265-bed pediatric hospital in Chicago, Illinois, is a leader in pediatric clinical pathway development. Significant improvements in care coordination and cost savings have been realized from the 14 pathways implemented to date. Use of a project management methodology and adaptation of continuous quality improvement tools for pathway development have proven effective to streamline and standardize this process. Despite its success in pathway development, Children's Memorial Hospital has realized the need to go further. It is necessary to measure outcomes--real clinical, patient outcomes--not just financial or utilization outcomes. Solid comparative data from which practice changes can be made are needed. Additional ways must be found to facilitate movement along the care continuum. Pathways must be used consistently. This article will outline the process Children's Memorial Hospital used and share the development tools that have been implemented. Children's Memorial Hospital's vision for the future and the technology designed to realize that vision are delineated.

Case Management↗