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Biomedical subjects

E Alvarez

Publications and source records attributed to E Alvarez.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

[Olanzapine and cognitive-behavioural group therapy in borderline personality disorder].

INTRODUCTION: Borderline Personality Disorder (BPD) is considered one of the most difficult psychiatric conditions to treat, neither psychological nor pharmacological treatments have been shown to be particularly effective. We present a proposal for the treatment of patients diagnosed with BPD which uses an atypical neuroleptic, olanzapine, and cognitive-behavioural group therapy aimed at dealing with the following problems: Interpersonal Conflict, Affective Instability, Impulsiveness, and Confused Identity. METHODS: Six patients diagnosed with BPD using the International Personality Disorder Evaluation (IPDE) were treated during 6 months with olanzapine (at dosages of 5-20mg/day) and dialectical behaviour therapy, with weekly 2-hour sessions. RESULTS: All of these patients followed the programme during the first 2 months, and 3 of the 6 completed it, showing an improvement in their behavioural disorder, as indicated by a decrease in parasuicidal episodes (i.e. suicide attempts and self-mutilative acts) and fewer visits to the emergency department. One of the patients dropped out due to side effects. DISCUSSION: The possibility of using a combined therapeutic approach enables us to project controlled clinical trials over a longer period of time, thus making it possible to assess behavioural changes which are difficult to observe in conventional clinical trials.

Adult↗
PubMedDate not supplied

Antiangiogenic and antitumor effects of a protein kinase C beta inhibitor in human hepatocellular and gastric cancer xenografts.

Hepatocellular carcinoma and gastric cancer are the most prevalent tumors worldwide. Hep3B hepatocellular carcinoma and HS746T gastric cancer were used as models for these diseases in culture and in vivo. The PKC beta inhibitor 317615.2HCl was not very cytotoxic toward HS746T or Hep3B cells in culture and was, in the main, additive in cytotoxicity with cisplatin, 5-fluorouracil and gemcitabine when cell in monolayer were exposed to these agents in combination with 317615.2HCl. Treatment of nude mice bearing HS746T or Hep3B xenografts with 317615.2HCl orally twice daily resulted in a small decreased in CD31-stainable intratumoral vessels in the HS746T tumors and 60% decrease in CD31-stainable vessels in the Hep3B tumors. Somewhat larger decreases were observed in the vessel stained with CD105. As a single agent 317615.2HCl produced tumor growth delays between 6.5 and 15 days in the HS746T xenograft and between 5 and 25 days in the Hep3B xenograft over the dosage range (3 to 30 mg/kg). Sequential and simultaneous combinations with 317615.2HCl and 5-fluorouracil and gemcitabine resulted in increases in tumor growth delay on both schedules. Gemcitabine produced a 15-day tumor growth delay of the HS746T gastric carcinoma that was increased to 40 days when combined simultaneously with 317615.2HCl and to 30 days with the sequential treatment regimen. 5-Fluorouracil produced a 9-day tumor growth delay of the Hep3B hepatocellular carcinoma that increased to 31 days by simultaneous treatment with 317615.2HCl and to 43 days with the sequential treatment regimen. Treatment with the protein kinase C beta inhibitor 317615.2HCl decreased HS746T and Hep3B angiogenesis and improved treatment outcome with 5-fluorouracil and gemcitabine.

Aged↗
PubMedDate not supplied

[An automatic system for anatomophysiological correlation in three planes simultaneously during functional neurosurgery].

INTRODUCTION: The Neurosurgical Deep Recording System (NDRS) using a personal computer takes the place of complex electronic equipment for recording and processing deep cerebral electrical activity, as a guide in stereotaxic functional neurosurgery. It also permits increased possibilities of presenting information in direct graphic form with automatic management and sufficient flexibility to implement different analyses. OBJECTIVE: This paper describes the possibilities of automatic simultaneous graphic representation in three almost orthogonal planes, available with the new 5.1 version of NDRS so as to facilitate the analysis of anatomophysiological correlation in the localization of deep structures of the brain during minimal access surgery. MATERIAL AND METHODS: This new version can automatically show the spatial behaviour of signals registered throughout the path of the electrode inside the brain, superimposed simultaneously on sagittal, coronal and axial sections of an anatomical atlas of the brain, after adjusting the scale automatically according to the dimensions of the brain of each individual patient. This may also be shown in a tridimensional representation of the different planes themselves intercepting. RESULTS: The NDRS system has been successfully used in Spain and Cuba in over 300 functional neurosurgery operations. The new version further facilitates analysis of spatial anatomophysiological correlation for the localization of brain structures. CONCLUSION: This system has contributed to increase the precision and safety in selecting surgical targets in the control of Parkinson s disease and other disorders of movement.

Brain↗
PubMedDate not supplied

[Obtention, characterization of antigens and evaluation of the immunotransfer technique for the detection of systemic candidiasis].

A culture media containing peptone, glucose, yeast extract and serum was evaluated to promote the development of the mycelium formation in Candida albicans and it was compared with the commercial media Tc 199. No significant difference was found between them. Somatic antigens characterized by PAGE-SDS were obtained from yeast and mycelial forms. Proteins reported as having high diagnostic value were expressed in both antigens. It was determined by immunotransference that the antigenic proteins predominating in the mycelium formation had molecular weights of 19, 21, 27 and 57 Kda. The immunotransference was standardized for detecting antibodies in patients with systemic candidiasis. 24 positive sera were evaluated by this technique and it was compared with the ELISA technique, which proved to be more sensitive and less specific. The most recognized proteins were those of 136 and 21 Kda and the complex from 42 to 45 Kda.

Animals↗
PubMedDate not supplied

Antiangiogenic and antitumor effects of a protein kinase Cbeta inhibitor in human HT-29 colon carcinoma and human CaKi1 renal cell carcinoma xenografts.

The compound 317615 x 2HCl, a selective protein kinase Cbeta inhibitor, was not very cytotoxic toward human CaKi1 renal cell carcinoma cells or human HT-29 colon carcinoma cells in monolayer culture. Isobologram analysis was used to determine additivity or synergy of the combination regimens. Exposure of CaKi1 cells to 317615 x 2HCl (10 or 100 mM) along with gemcitabine or 5-fluorouracil for 24 hours resulted in cytotoxicity that appeared to be less-than-additive to additive for the two agents. Exposure of HT-29 cells to gemcitabine along with 317615 x 2HCl (10 mM or 100 mM) resulted in a synergistic cytotoxicity while combinations with 5-fluorouracil resulted in additive to greater-than-additive cytotoxicity for the agents. After treatment of CaKi1 or HT-29 xenograft-bearing mice with 317615 x 2HCl, immunohistochemical staining for expression of endothelial specific markers, either CD31 or CD105, was used to quantify the number of intratumoral vessels in the samples. CaKi1 tumor angiogenesis was very responsive to treatment with 317615 x 2HCl such that the number of intratumoral vessels stained by CD31 or CD105 was decreased to 20% of the control. The HT-29 colon carcinoma angiogenesis was also responsive to 317615 x 2HCl, such that the number of intratumoral vessels stained by CD31 or CD105 was decreased to 40% to 50% of the controL 5-fluorouracil, cisplatin or fractionated radiation therapy was combined with treatment with 317615 x 2HCl in the simultaneous combination treatment regimen in animals bearing HT-29 colon carcinoma xenografts. The resulting tumor growth delays indicated that administration of 317615 x 2HCl increased the effects of the cytotoxic therapy. Both a simultaneous or an overlapping treatment regimen and a sequential treatment regimen were used to assess 317615 x 2HCl alone and along with fractionated radiation therapy or gemcitabine against the human CaKi1 renal cell carcinoma xenograft. The CaKi1 tumor was quite sensitive to fractionated radiation therapy and to gemcitabine and, although 317615 x 2HCl was an effective single agent in this tumor, the combination regimens did not reach additivity for the combination regimens in vivo. 317615 x 2HCl is in early clinical testing.

Adult↗
PubMedDate not supplied

[Validation of a Spanish version of the Diagnostic Interview for Bordelines-Revised (DIB-R)].

INTRODUCTION: Borderline Personality Disorder (BPD) is the most studied Axis II disorders. However, there are no Spanish versions of specific interviews. The Diagnostic Interview for Borderlines-Revised (DIB-R) is a semistructured interview used to determine the diagnosis and severity of BPD patients. The aim of this study was to validate the DIB-R for use in a Spanish-speaking sample. METHOD: The psychometric characteristics of the DIB-R Spanish version were assessed in a sample of 156 patients with the possible diagnosis of borderline personality disorder. There were 29 men and 127 women with a mean age of 27.6 years (SD: 6.5; range: 18-45). The Spanish adaptation of the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) was used as gold standard. RESULTS: The DIB-R showed good total internal consistency (Cronbach's alpha: 0.89) and high inter-rater reliability (within-class correlation: 0.94). Using logistic regression analyses the best cut-off was judged to be 6 or more, obtaining high sensitivity (0.81), specificity (0.94) and moderate convergent validity of the diagnosis with the SCID-II (kappa: 0.59). CONCLUSIONS: The Spanish version of the DIB-R showed psychometric characteristics similar to those in the original interview and may be useful to determine BPD presence and severity.

Adolescent↗
PubMedDate not supplied

[Knowledge and perception about depression in the Spanish population].

INTRODUCTION: The aim of this study is to investigate the Spanish people's perception of depression. Identification of the existing mistakes in depression perception will be the first step to correct them and to contribute to the patients' well being. MATERIAL AND METHODS: More than 1,000 structured surveys were conducted all around Spain with segmented representation for each regional community. RESULTS: Two out of three interviewed people considered depression to be a disease, in a somewhat higher degree those who had suffered from depression (67%). Forty two percent of people thought depression affects more than 25% of the population. Spanish people think that the incidence of depression will increase in the future. Their opinion of the importance of depression is high, considering it among the three most prevalent diseases, even exceeding that of coronary diseases. Most people interviewed would not accept a pharmacological treatment of at least one year of duration. The most mentioned adverse effect of antidepressants is dependency, and it is the reason why interviewed people are reluctant to maintain long term treatment. Only 50% of people treated for depression thought they had had enough family and social support. Eighteen percent of depressed people hide their diagnosis, basically for fear of stigma at work. CONCLUSIONS: Nowadays, the Spanish population has a good knowledge of depression. However, there are still some prejudices that make more difficult both the treatment and the recovery of depressed people and their social readjustment. These beliefs make up small stigmas that hinder treatment adherence, which is doubtlessly the most important factor to improve the outcome of depression.

Adolescent↗
PubMedDate not supplied

[A naturalistic study: 100 consecutive episodes of acute agitation in a psychiatric emergency department].

INTRODUCTION: Psychomotor agitation is a common event in psychiatric emergency services (PES) with a prevalence of approximately 10 %. There is no general consensus on to how to manage psychomotor agitation; benzodiazepines, typical antipsychotics and now atypical antipsychotics have demonstrated similar efficacy. The aim of our study was to describe the epidemiology and clinical management of agitation in "real-life" in a psychiatric emergency service. METHODS: A naturalistic study was performed in acutely agitated patients recruited consecutively in a psychiatric emergency service. Demographics, clinical and therapeutic characteristics were analyzed. Efficacy was assessed by the Excitement Component of the Positive and Negative Syndrome Scale (PANSS-EC) and the Agitation-Calmness Evaluation Scale (ACES). Pragmatic variables such as the need for second pharmacological intervention and the need for physical restraints were assessed. RESULTS: The study included 100 patients with psychomotor agitation. Mean age was 36.2 % and 54% were women. The most prevalent diagnoses were psychotic disorder (48 %) and personality disorder (24 %). Physical restraint was required in 39 % of patients and 52 % accepted oral treatment. Haloperidol was the most frequent oral treatment and olanzapine was the most frequent intramuscular treatment. CONCLUSIONS: A naturalistic approach provides data based on clinical reality in psychiatric emergency services. Strict research designs of clinical trials of efficacy imply sample selection biases and are generally distanced from the clinical reality. Atypical antipsychotics have become the first-line treatment in acute agitation

Adult↗
PubMedDate not supplied

[Penile self-injection of a papaverine-phentolamine combination, as treatment of impotence, in patients treated with radical cystoprostatectomy].

Four patients with impotence secondary to radical cystoprostatectomy due to infiltrant vesical urothelial carcinoma, received treatment with a mixture of papaverine-phentolanin, at dosages of 18-0, 34 mg respectively. Good results were obtained in every occasion, all four cases achieving rigid erection for over an hour which allowed penetration. Currently, patients continue peneal self-injection treatment with these drugs, with no complications or therapy failure being reported.

Adolescent↗
PubMedDate not supplied

Immunogenicity of monomeric and polymeric house dust mite Dermatophagoides pteronyssinus.

A methodology for the preparation of a polymerized antigen from house dust mites Dermatophagoides Pteronyssinus is described. Polymerization was carried out by glutaraldehyde treatment in PBS and Sephacryl S300 column fractionation. A polymer of 135 Kd was obtained. Rabbits immunized with the soluble polymer (HDMP) elaborated specific antibodies as measured by a Dot-immunobinding assay. The reaction was inhibited by previous incubation with the HDMP antigen. It is suggested that the polymerized antigen may be employed in the treatment of patients with house dust mite anaphylaxis.

Allergens↗