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Biomedical subjects

E Ojeda

Publications and source records attributed to E Ojeda.

83 records · Page 5Linked to original sources
PubMedDate not supplied

[Clinical profile and impact of the unscheduled return to Emergency Department by elders].

BACKGROUND: The characteristics of patients aged 65 years and over that return to the Emergency Department (ED) have not been sufficiently analysed. The aim of this study is to determine the differentiating elements of the elderly that return to ED and evaluate the impact on them of such a return. METHODS: Descriptive study where the unit of analysis is the unscheduled return to ED. The analysis of data begins with a description of the entire sample. After that, comparisons are made between the elderly and patients aged under 65 years that return, and between the elderly that return and those that do not return. The significance level for comparison tests is p< or =0.05. RESULTS: Sixty-one per cent of the reasons for the first visit by the elderly was because of neurological alterations (p<0,001). Only 22% of them had been attended by senior doctors on their first visit (p=0,001). When they returned to ED, 63% of them were admitted to hospital; in contrast to 28% of younger patients (p<0,001). CONCLUSIONS: There are differences between the elderly patients that return and those who do not, and also with respect to young adults. The impact of return on this group of patients is reflected in the high rates of admission to hospital. An adaptation of resources to the special needs of this type of user in ED would be advisable.

Adolescent↗
PubMedDate not supplied

Field performance of sugarcane (Saccharum sp.) plants derived from cryopreserved calluses.

This study compared the field performance of sugarcane plants originating from three different sources: control, non-cryopreserved embryogenic calluses, cryopreserved embryogenic calluses and macropropagated material of the same commercial hybrid. Several agronomic traits were evaluated on 100 plants per treatment over a 27-month period covering the growth of the stool and of the first ratoon. Significant differences between treatments were observed only during the first six months of field growth of sugarcane stools. Stems produced from in vitro cultured material, irrespective of their cryopreservation status, had a smaller diameter and a shorter height than those produced from macropropagated material. These differences disappeared by 12 months of stool field growth.

Cryopreservation↗
PubMedDate not supplied

[Effects of parenteral glutamine in patients submitted to bone marrow transplantation].

UNLABELLED: Bone marrow transplantation (BMT) is a therapy used for hematologic malignancies and solid tumors. Associated chemotherapy and radiotherapy to which these patients are submitted induce secondary effects, with a high metabolic stress. Glutamine is considered a conditionally essential amino acid, and has been shown effective in severe catabolic states. The aim of the study was to assess the effect of parenteral nutrition (PN) therapy supplemented with glutamine on duration of nutritional support in a group of patients with BMT. We have also analyzed associated complications, the nutritional status, the clinical course at 6 months, differences as to type of transplantation, and oral ingestion capability. This is a phase IV, randomized, double blind, and parallel clinical trial, done at a single center. The study was performed on 49 patients, 29% male and 71% female patients, with ages between 21-63 years, distributed in 3 diagnostic groups (leukemia, lymphoma, and solid tumors), and admitted to the Hematology Department of our Hospital. Fifty percent of the patients in each group have received PN supplemented with glutamine (0.4 g/kg/day of L-alanine-L-glutamine), and the other 50% have received standard PN. RESULTS: we have not found significant differences nor at the beginning nor at the end of the study between both groups with regards to studied variables. CONCLUSIONS: PN is and effective therapy for maintenance of the nutritional status in patients submitted to a therapy with a, highly catabolic effect such as BMT. Although we have not been able to show the efficacy of glutamine supplementation in this study with the used dose, it does have been effective in other reports.

Adult↗
PubMedDate not supplied

[Nutritional support in bone marrow transplantation].

UNLABELLED: Bone marrow transplant (BMT) implies the treatment with substances which may compromise the nutritional condition, thus increasing the morbido-mortality of these patients. The objective of this study is to evaluate the efficacy of the nutritional support (NS) protocol for patients subjected to a BMT in our center. PATIENTS AND METHODS: 55 patients were included (24 men and 31 women), who were subjected to BMT during 1994, with prior chemotherapy depending on the underlying disease. The nutritional condition (NC) was evaluated upon initiation and at the end of the NS, using anthropometric, biochemical, and immunological parameters. The NS was given by total parenteral nutrition (TPN), adapted to the needs, as of the second post-transplant day, until such time that oral nutrition was sufficient to supply the nutritional needs of the patients; oral ingestion was permitted at all times, according to the possibilities of the patient. For the statistical analysis, we used the Student's t test, Pearson's Chi squared test, and Spearman's test, with differences being considered significant for values < 0.05. RESULTS: The average duration of the TPN was 16 +/- 6 days, with a significantly longer time (p < 0.05) in patients with leukemia. The NC assessment was no different at the beginning and at the end of the NS, although all groups show a drop in the albumin levels at the end with respect to those at the beginning, with this being statistically significant in patients with leukemia (p < 0.05), and with solid tumors (p < 0.01), 14.5% of the patients maintained an acceptable oral ingestion (with 75% having lymphomas), and 34.5% did not show any associated oral ingestion. Te better albumin maintenance was correlated with acceptable oral ingestion (p < 0.05). CONCLUSIONS: Nutritional support of patients subjected to a BMT is effective for maintaining their NC levels. The longest duration of the TPN, the lowest frequency of associated oral ingestion, and the greatest decrease of the serum albumin, levels are seen in those cases which had the most aggressive chemotherapy prior to the BMT, which requires adaptation of the NS in function of the underlying disease. The association of oral ingestion may be beneficial due to its effect on the gastrointestinal tract.

Adult↗
PubMedDate not supplied

High incidence of chronic graft versus host disease after allogeneic peripheral blood progenitor cell transplantation. The Spanish Group of Allo-PBPCT.

BACKGROUND AND OBJECTIVE: The incidence of acute GVHD (aGVHD) in allogeneic peripheral blood progenitor cell transplantation (allo-PBPCT) seems to be similar to that seen in allogeneic bone marrow transplantation (allo-BMT). In contrast, some preliminary results suggest that the incidence of chronic GVHD (cGVHD) might be higher. The aim of the present study was to analyze the actuarial probability of developing cGVHD in allo-PBPCT, its clinical manifestations and response to treatment. METHODS: We have retrospectively analyzed clinical results from 21 allo-PBPCT recipients that had been transplanted at least 18 months before this study and that fulfilled the following criteria: HLA identical sibling donor, non T-cell depleted apheresis and more than 90 days of survival with sustained engraftment. The median follow-up was 12 months (range 4.5-22). RESULTS: Twelve out of the 21 (57%) patients presented cGVHD, 1 limited and 11 extensive. The actuarial probability of cGVHD was 72.7% (95% CI, 49-96%). The median interval from transplant to onset was 180 days (range 95-270). Nine of the 12 cases (75%) presented combined skin and liver involvement. Of the other three, the liver was involved in one case; skin, mouth, and nail cGVHD was observed in another case; and skin and mouth involvement together with an obstructive pulmonary disease was observed in the remaining case. Under therapy, a complete resolution of cGVHD manifestations was achieved in five cases, and a partial improvement was attained in three other cases. In two responsive patients, cGVHD reappeared after stopping treatment. Four patients were refractory to the treatment. INTERPRETATION AND CONCLUSIONS: It would appear from this retrospective and multicenter study that, after a median follow-up of 12 months, cGVHD after allo-PBPCT could be more frequent than after allo-BMT. A randomized trial with a large number of patients and a sufficient follow-up will be necessary to answer this question definitively.

Adolescent↗
PubMedDate not supplied

[Autoimmune hepatitis with antibodies against liver cytosol (anti-LC1)].

Antibody against liver cytosol (anti-LC1) was proposed in 1988 as a new and very specific immunoserologic marker of autoimmune hepatitis of childhood and young age. In adults, anti-LC1 might be masked by the presence in serum of anti-LKM1, usually associated with antibodies to hepatitis-C virus. We report the case of a 60-year-old woman who had active chronic hepatitis not related to infection by hepatitis C virus, with autoantibody reacting against liver cytosol as the unique marker of autoimmune hepatitis. Treated with corticosteroids (prednisone, 1 mg/kg per day), coagulation disorder, bilirubin, transaminase activity and immunoglobulins normalized in the following months. A year and a half later, autoantibodies anti-LC1 and p-ANCAs were no longer detected. We have only found one report of a young patient with anti-LC1 autoimmune hepatitis who had cirrhosis and portal hypertension, in national publications.

Adult↗