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Biomedical subjects

E Serrano

Publications and source records attributed to E Serrano.

At least 109 records · Page 6Linked to original sources

Heart-lung transplantation for cystic fibrosis. 1: Assessment.

Forty five patients with cystic fibrosis (age 5-15 years) were assessed for heart-lung transplantation between September 1987 and March 1990. The two main conditions for acceptance were (i) life expectancy less than 2 years and (ii) a severely impaired quality of life. Patients were accepted onto an active waiting list (n = 26), a provisional waiting list (n = 15), or not accepted (n = 4). Selection was made on clinical grounds with objective measurements used as an aid in assessment. As expected, the mean values for objective measures were significantly different between patients on the active waiting list compared with the provisional waiting list/not accepted group for resting heart rate (118/minute v 101/minute), percentage of ideal weight (83.2% v 93.1%), forced expiratory volume at one second as percent of predicted normal (27.3% v 47.6%), Shwachman-Kulczycki score (33.6 v 52.5), Chrispin-Norman x ray score (25.8 v 22.1), 12 minute walk (540 m v 854 m), and minimal oxygen saturation (81.5% v 92%). Psychological evaluation demonstrated a 55% incidence of individual and a 50% incidence of family morbidity. Of the 26 patients accepted onto the active waiting list, 11 have been transplanted (mean waiting time 3.3 months), 10 have died within a mean of 3.7 months of acceptance, and five remain on the active list (mean 5.6 months).

Adolescent↗

Coloplasty and free intestinal transplants in the treatment of extensive cancers of the pharyngo-oesophageal junction.

The authors report their surgical experiences with 55 extensive tumours of the pharyngoesophageal junction. Thirty-three of these cases were managed by circular pharyngolaryngectomy, total oesophagectomy with stripping and left coloplasty, and 22 were treated with circular pharyngolaryngectomy with free intestinal transplants. A comparative study of the post-operative courses of the patients and their oncological and functional outcomes shows the advantages, disadvantages and indications of these two techniques.

Adult↗

[Medical treatment of nasosinusal polyposis].

The results of a computerized prospective study in 107 patients suffering from nasal polyposis and medically treated, are reported by the authors. They insist on necessary pretherapeutic investigations according to anatomic, physiologic and physio-pathologic facts, in order to try to achieve an etiologic and evolutive profile of the nasal polyposis. Local and general medical treatment was initially prescribed to all of our patients. The check's reasons analysis and the study of the various evolutions of nasal polyposis enable us to precise surgical indications.

Adult↗

[Cylindroma of the parotid gland. Apropos of 11 cases].

Few studies have been exclusively devoted to date to parotid cylindromas, essentially because of their rarity and their very slow progression. However, these tumours have a serious prognosis. Although local control appears to be better with complementary radiotherapy, the vital prognosis depends entirely on the presence or absence of distant metastases, essentially pulmonary. The analysis of 11 cases of parotid cylindroma leads the authors to propose a rational management. When the tumour is localised, particularly to the superficial lobe, careful total parotidectomy with preservation of the facial nerve is performed; neck dissection is only performed in the presence of obvious lymph node involvement. Postoperative irradiation is not systematically indicated. In the case of a voluminous tumour or in an obviously incomplete resection, deliberate sacrifice of the facial nerve is not essential, as radiotherapy allows good local control. Extensive mutilating operations do not appear to be justified. Chemotherapy requires the use of more effective drugs than those used at the present time. The complete remission rate in the present series was 60% at six years, but a much longer observation period is required, as the very delayed appearance of metastases is always possible.

Adult↗

[Total esophagectomy by stripping without thoracotomy in cancer of the pharynx, esophagus and cardia. 34 cases].

Total oesophagectomy by stripping without thoracotomy was performed in 34 cancer patients to reduce operative mortality and morbidity in those with impaired respiratory function. The carcinoma was located in the pharynx in 20 cases, on the cardia in 9 cases and on the lower oesophagus in 5 cases. Reconstruction in the posterior mediastinum was effected with the descending colon in 32 patients. The operative mortality rate was 11.8% and fistulization developed in 20.6% of the cases. Eight patients (26.5%) required post-operative endoscopic dilatation. Ninety per 100 of the patients who survived surgery resumed satisfactory feeding. Thus, these patients with high operative risk who underwent oesophagectomy by stripping without thoracotomy benefited from tumoral excision and normal feeding with results comparable to those of other types of oesophagectomy.

Adult↗

Management issues related to effectively implementing a nutrition education program using peer educators.

OBJECTIVE: To explore the influence of administrative aspects of a nutrition education program with peer educators delivering the program. DESIGN: Telephone interviews with peer educators trained to deliver La Cocina Saludable, a nutrition education program for Hispanics. Open- and closed-ended questions. SUBJECTS/SETTINGS: Abuelas (grandmothers) recruited and trained as peer educators for the program. The sample included peer educators no longer teaching (22%), currently teaching (30%), and who never taught after training. MAIN OUTCOME MEASURES: Motives and incentives for becoming peer educators, challenges for peer educators, and reasons peer educators withdrew from the program. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were used to analyze quantitative data from the closed-ended questions. Qualitative analysis was applied to data from open-ended questions. RESULTS: Working with community and learning about nutrition were prime motivators. Recruiting participants and coordination of classes appeared to be major challenges. Personal issues and traveling in a large geographic area were cited as the main reasons for quitting. IMPLICATIONS: The effectiveness of using peer educators for La Cocina Saludable may be improved through empowerment, additional training, a structured and equitable reimbursement system, and assistance to carry out administrative tasks.

Adult↗

Polychlorinated biphenyl residues in various fatty foods consumed in Guipúzcoa, the Basque Country (Spain).

Three congeners of polychlorinated biphenyls (PCBs)--the 2, 2', 3, 4, 4', 5'-, 2, 2', 4, 4', 5, 5'-hexachloro, and 2, 2', 3, 4, 4', 5, 5'-heptachlorobiphenyls--were determined in 18 samples of butter, 44 of fish (hake and anchovy) and 24 of egg, all of which came from markets in Guipúzcoa. The total content as Araclor 1260 was also determined. Quantitation was carried out by gas chromatography in a capillary column and electron capture detector. The total content in butter ranged from 20 to 60 ng/g (fat basis), in fish from 10 to 250 ng/g (edible part), and in eggs from 1 to 10 ng/g (edible part). None of these exceeded the tolerance limits established by the Canadian Government Guideline and USFDA.

Animals↗

Proposal for relative units of value (RUV) for use in allergy examinations.

Health resources are limited and consequently real cost generators must be identified to optimize resources. In the present article, we describe the structure of the Homogeneous Functional Groups (HFG) for Diagnostic Techniques in the Allergy Department of the Virgen de la Arrixaca University Hospital in Murcia (Spain) and the healthcare products generated. Based on the 2005 budget, variable costing was used to calculate the costs of the healthcare products generated (skin tests, investigation of drug allergies, etc.) by one of the three HFG (the HFG for complementary investigations). On the basis of these costs, and taking as the unit the cost of one skin prick test, we assigned relative units of value (RUV) to each of the products in our services portfolio. The following conclusions can be drawn: 1) the current system of variable costing provides information, which should be useful to health professionals; 2) the real cost generators in the microcosm of daily clinical practice should be identified to allow resource reallocation; 3) the costing system used enables modifications to be made that allow decision making on optimal use of the budget; 4) to take the decisions required to optimize resources, clinical management and complementary tests should go hand-in-hand.

Allergy and Immunology↗

[Transfer factor as specific immunomodulator in the treatment of moderate-severe atopic dermatitis].

BACKGROUND: Atopic dermatitis is a skin inflammatory disease which has been associated to high levels of IgE, eosinophiles and change of T lymphocytes. The transfer factor is an immunomodulator active substance and decreases the number of inflammatory cells and the severity of the symptoms of atopic dermatitis. OBJECTIVE: To determine the efficacy of the transfer factor as treatment of moderate and severe atopic dermatitis. MATERIAL AND METHODS: Articles related to treatment with transfer factor in the atopic dermatitis were looked up in Medline and EMBASE, and the ones referring to controlled studies in patients with moderate and severe atopic dermatitis in accord to SCORAD. RESULTS: We found seven articles with 121 patients and 88 controls demonstrating significant decrease in the symptoms of the SCORAD index, decreased IgE, and eosinophils in patients treated with transfer factor. CONCLUSIONS: The transfer factor is a choice treatment for moderate and severe atopic dermatitis.

Dermatitis, Atopic↗

[Diagnostic aids in bronchial asthma using macrophage and neutrophil indices and serum IgE levels].

There are compared the total IgE levels with the macrophages and the systemic neutrophil levels in thirty one patients with bronchial asthma and without previous treatment, in order to establish the correlation between the IgE elevation and this kind of cells, as a guide in allergic illness. Our results didn't prove any significant variation in the studied parameters.

Asthma↗