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Biomedical subjects

F Camacho

Publications and source records attributed to F Camacho.

At least 19 recordsLinked to original sources

Oral rabeprazole vs. intravenous pantoprazole: a comparison of the effect on intragastric pH in healthy subjects.

BACKGROUND: Intravenous pantoprazole is often administered inappropriately to hospitalized patients who can take oral medications. AIM: To compare the antisecretory effects of oral rabeprazole and intravenous pantoprazole in healthy subjects. METHODS: In a double-blind, double-dummy, two-way crossover study, 38 Helicobacter pylori-negative volunteers were randomized to oral rabeprazole 20 mg or intravenous pantoprazole 40 mg daily for 3 days followed, after a 14-day washout period by the comparator treatment. Intragastric pH was recorded continuously for 24 h at baseline and on days 1 and 3 of each treatment period. RESULTS: The mean (95% CI) percentage of the 24-h recording with gastric pH >4 was higher with rabeprazole than with pantoprazole on day 1: 37.7% (30.6-44.8%) vs. 23.9% (20.0-27.8). The mean percentage times with pH >3 and >4 for all intervals assessed were greater and the median 24-h intragastric pH values were higher with rabeprazole than with pantoprazole on days 1 and 3. The mean acidity index was lower with rabeprazole on days 1 and 3. CONCLUSIONS: Oral rabeprazole 20 mg produced greater acid suppression than intravenous pantoprazole 40 mg. Therefore, it may be an appropriate and effective alternative in patients who can take oral medication.

2-Pyridinylmethylsulfinylbenzimidazoles↗

Sézary syndrome associated with granulomatous lesions during treatment with bexarotene.

Sézary syndrome (SS) is a leukaemic variant of cutaneous T-cell lymphoma (CTCL). We report a patient with SS who developed granulomatous lesions. These lesions broke out during treatment with bexarotene when the disease had appeared to stabilize. After a partial clinical remission the disease showed rapid progression and finally led to the patient's death. This contradicts the initial assessment, which considered the granulomatous inflammation as a good prognostic factor in CTCL.

Adult↗

Localized Kaposi's sarcoma in a patient with pemphigus vulgaris.

We report the case of a patient with a 13-year history of pemphigus vulgaris (PV) treated with immunosuppressive agents, prednisone and mycophenolate mofetil who had developed lesions of Kaposi's sarcoma (KS) on a sole plaque of PV that had been previously treated with intralesional injections of steroids. The lesions were surgically removed and polymerase chain reaction (PCR) demonstrated human herpesvirus-8 (HHV-8) DNA. There were neither recurrences nor later dissemination of KS following gradual decrease of the immunosuppressive therapy. We suggest that the treatment with intralesional steroids may have influenced the local reactivation of a latent infection of the virus, determining the appearance of this localized KS.

Aged↗

Kinetic and enzymatic adsorption model in a recirculation hollow-fibre bioreactor.

A general procedure has been developed to model the behaviour of enzymatic reactions in a membrane bioreactor. This procedure unifies the kinetics of the reaction and the adsorption of the enzyme or enzymatic complexes on the membrane, enabling the selection of the most appropriate kinetic model. The general procedure proposed has been particularized and applied to experimental results obtained with two enzymatic reactions carried out in a hollow-fibre reactor, enzymatic hydrolysis of lactose by beta-galactosidase and glucose-fructose isomerization by glucose isomerase. The application of the general model has allowed us to determine the mechanism of the reaction for both kinetic reactions, assuming the adsorption of the enzymatic complex EGa for lactose hydrolysis and the adsorption of the free enzyme onto the membrane for glucose-fructose isomerization.

Adsorption↗

Chitosan adhesive for laser tissue repair: in vitro characterization.

BACKGROUND AND OBJECTIVES: Laser tissue repair usually relies on hemoderivate protein solders, based on serum albumin. These solders have intrinsic limitations that impair their widespread use, such as limited tensile strength of repaired tissue, poor solder solubility, and brittleness prior to laser denaturation. Furthermore, the required activation temperature of albumin solders (between 65 and 70 degrees C) can induce significant thermal damage to tissue. In this study, we report on the design of a new polysaccharide adhesive for tissue repair that overcomes some of the shortcomings of traditional solders. STUDY DESIGN/MATERIALS AND METHODS: Flexible and insoluble strips of chitosan adhesive (elastic modulus approximately 6.8 Mpa, surface area approximately 34 mm2, thickness approximately 20 microm) were bonded onto rectangular sections of sheep intestine using a diode laser (continuous mode, 120 +/- 10 mW, lambda = 808 nm) through a multimode optical fiber with an irradiance of approximately 15 W/cm2. The adhesive was based on chitosan and also included indocyanin green dye (IG). The temperature between tissue and adhesive was measured using a small thermocouple (diameter approximately 0.25 mm) during laser irradiation. The repaired tissue was tested for tensile strength by a calibrated tensiometer. Murine fibroblasts were cultured in extracted media from chitosan adhesive to assess cytotoxicity via cell growth inhibition in a 48 hours period. RESULTS: Chitosan adhesive successfully repaired intestine tissue, achieving a tensile strength of 14.7 +/- 4.7 kPa (mean +/- SD, n = 30) at a temperature of 60-65 degrees C. Media extracted from chitosan adhesive showed negligible toxicity to fibroblast cells under the culture conditions examined here. CONCLUSION: A novel chitosan-based adhesive has been developed, which is insoluble, flexible, and adheres firmly to tissue upon infrared laser activation.

Animals↗

Ofuji papuloerythroderma evolving to cutaneous T-cell lymphoma.

Ofuji papuloerythroderma is an uncommon entity of unknown aetiology, characterized by a pruritic eruption of widespread, red-brown, flat papules that leads to spare skin folds. A number of cases have been described associated with tumour pathology, mainly cutaneous T-cell lymphomas. We report a new case of Ofuji papuloerythroderma evolving to cutaneous T-cell lymphoma in an 85-year-old woman who had been previously diagnosed with papuloerythroderma 7 years previously.

Aged↗

Teledermatology as a filtering system in pigmented lesion clinics.

Teledermatology was evaluated as a filtering system for a pigmented lesion clinic (PLC). A total of 219 teleconsultations were received at the PLC in a 12-week period. The outcome of the teleconsultation was that 49% of patients were referred to the face-to-face clinic. Teleconsultation reports were available to the general practitioner (GP) in a mean time of 44 h and patients attended the face-to-face clinic within the following two weeks. Agreement between different dermatologists was almost perfect, with k =0.91 (95% confidence interval [CI] 0.87-0.96) for diagnosis and kappa =0.92 (95% CI 0.86-0.98) for management options ("referral" or "non- referral"). Agreement within observers was excellent, with kappa =0.93 (95% CI 0.87-0.98). The accuracy of diagnosis, as judged by the histology, was less good, with kappa =0.79 (95% CI 0.70-0.89). In all, 86% of patients and 97% of GPs stated that they were "very satisfied" with the new system. Teledermatology performed well as a filtering system for the PLC. However, more experience is needed to detect the real effect, if any, of teleconsultation on the early diagnosis and prognosis of melanoma.

Adolescent↗

Estimation of pressure pulse amplification between aorta and brachial artery using stepwise multiple regression models.

The pressure pulse is amplified between the aorta and peripheral sites. This study compares two methods to estimate pressure pulse amplification (PPA) between the aorta and the brachial artery. Method 1: PPA was determined from a multi-parameter linear regression of subject parameters (gender, age, height, weight, heart rate (HR), brachial systolic pressure (BSP), diastolic pressure (BDP), mean pressure (MP)). Method 2: PPA was calculated from central aortic pressure waveforms (CW) estimated from the same subject parameters. The sample population (1421 male, 992 female) was selected from a database where aortic pressure was estimated by mathematical transformation of a peripheral (radial) pulse calibrated to sphygmomanometric BSP and BDP. The two methods were consistent in showing HR and MP as the most important parameters to estimate PPA. Correlation coefficients (R2) of 0.48 (method 1) and 0.44 (method 2) were obtained using height, weight, HR, BSP, BDP and age. Inclusion of MP increased R2 to 0.77 (method 1) and 0.71 (method 2). This study shows that databases containing peripheral and central aortic pressure waveforms can be used to construct multiple regression models for PPA estimation. These models could be applied to studies of similar subject groups where peripheral waveforms may not be available.

Adult↗

Efficacy and safety of transdermal fentanyl and sustained-release oral morphine in patients with cancer and chronic non-cancer pain.

PURPOSE: To evaluate effectiveness and safety information of transdermal fentanyl (TDF) (Duragesic/Durogesic) and sustained-release oral morphine (SRM) in cancer pain (CP) and chronic non-cancer pain (NCP), a pooled analysis was conducted on datasets of published, open label, uncontrolled (no comparator group) and randomised controlled (with SRM as comparator) studies of TDF. PATIENTS AND METHODS: Eight trials with treatment durations of at least 28 days met the inclusion criteria. The effectiveness analysis assessed changes in average pain and pain 'right now' scores between baseline and Day 28. The safety analysis evaluated the incidence of adverse events (AEs) reported within the first 28 days of treatment with TDF or SRM. Subgroup analyses included pain type, gender, age, weight, and body mass index. RESULTS: Pooled efficacy data were available from 1220 patients; these showed that both TDF and SRM were effective in improving pain 'right now' scores (0-100 scale) from baseline to Day 28. The improvement was significantly more pronounced in the TDF treatment group (-26.7 +/- 31.3 for TDF, -18.7 +/- 30.9 for SRM, p = 0.002). This favourable effect of TDF was most apparent amongst patients with NCP. Data concerning AEs were available from over 2500 patients with CP (3 out of 10 patients) or chronic NCP (7 out of 10 patients). Significantly fewer patients in the TDF than in the SRM group reported any AE (72% vs. 87% respectively; p < 0.001), or an AE leading to the study drug being permanently discontinued (16% vs. 23% respectively; p < 0.001). Constipation and somnolence occurred considerably less frequently in the TDF than in the SRM treatment group. This difference was statistically significant in both the CP and NCP subgroups. CONCLUSION: This pooled data analysis provides expanded insight into the safety and effectiveness profile of transdermal fentanyl in patients with chronic pain. It shows significantly improved pain relief with transdermal fentanyl compared with sustained-release oral morphine, and supports current evidence of favourable tolerability of transdermal fentanyl, particularly with regard to reduced constipation and somnolence.

Administration, Cutaneous↗

Reliability of a quantification imaging system using magnetic resonance images to measure cartilage thickness and volume in human normal and osteoarthritic knees.

OBJECTIVE: The aim of this study was to evaluate the reliability of a software tool that assesses knee cartilage volumes using magnetic resonance (MR) images. The objectives were to assess measurement reliability by: (1) determining the differences between readings of the same image made by the same reader 2 weeks apart (test-retest reliability), (2) determining the differences between the readings of the same image made by different readers (between-reader agreement), and (3) determining the differences between the cartilage volume readings obtained from two MR images of the same knee image acquired a few hours apart (patient positioning reliability). METHODS: Forty-eight MR examinations of the knee from normal subjects, patients with different stages of symptomatic knee osteoarthritis (OA), and a subset of duplicate images were independently and blindly quantified by three readers using the imaging system. The following cartilage areas were analyzed to compute volumes: global cartilage, medial and lateral compartments, and medial and lateral femoral condyles. RESULTS: Between-reader agreement of measurements was excellent, as shown by intra-class correlation (ICC) coefficients ranging from 0.958 to 0.997 for global cartilage (P<0.0001), 0.974 to 0.998 for the compartments (P<0.0001), and 0.943 to 0.999 for the condyles(P<0.0001). Test-retest reliability of within-reader data was also excellent, with Pearson correlation coefficients ranging from 0.978 to 0.999 (P<0.0001). Patient positioning reliability was also excellent, with Pearson correlation coefficients ranging from 0.978 to 0.999 (P<0.0001). CONCLUSIONS: The results of this study establish the reliability of this MR imaging system. Test-retest reliability, between-reader agreement, and patient positioning reliability were all extremely high. This study represents a first step in the overall validation of an imaging system designed to follow progression of human knee OA.

Adult↗

Cutaneous pseudolymphoma in association with molluscum contagiosum in an elderly patient.

BACKGROUND: Molluscum contagiosum (MC) is a common cutaneous infection, which has been reported in association with cutaneous pseudolymphoma in few cases. METHODS: A 72-year-old woman with a nodule arising on the external canthus was reviewed. The lesion was surgically removed, and the histopathological study demonstrated an epidermal invagination filled by molluscum bodies and a diffuse infiltrate comprising atypical lymphocytes. RESULTS: Immunohistochemical stains disclosed predominance of T cells with positive CD30 labeling. Polymerase chain reaction failed to demonstrate clonal rearrangement of the T-cell receptor. CONCLUSION: After ruling out systemic involvement, the patient was followed up for 2 years with no evidence of recurrence. We report this case to the best of our knowledge and discuss the literature about atypical clinical and histological presentations of MC.

Aged↗

Gender differences in rising trends in cutaneous malignant melanoma in Spain, 1975-98.

BACKGROUND: Cutaneous malignant melanoma (CMM) morbidity and mortality rates have increased over the past several decades all around the world, but some developed countries have experienced recent declines in mortality from CMM among the young and middle-aged and even a reversal in the long-term increase in deaths attributable to CMM. OBJECTIVES: To describe CMM mortality trends, by age and gender, in Spain between 1975 and 1998. METHODS: Crude, age-adjusted, truncated, cumulative, age-specific and potential years of life lost rates of CMM mortality were calculated by gender. Age and period Poisson regression models were fitted to gender- and age-specific CMM mortality rates. RESULTS: In males there were marked increases in all CMM mortality rates between 1975 and 1994, followed by their decrease during 1995-98. In contrast, rates rose in females between 1975 and 1998. There were annual increases of 13% in the risk of dying among males and 33% among females. Relative risks of CMM mortality increased with age in both genders: (i) 21.75 (95% confidence interval, CI 17.32-27.30) in males, and (ii) 28.27 (95% CI 24.99-31.97) in females in the > or = 70-year-old group, when compared with those < 35 years. CONCLUSIONS: CMM mortality rates continue to rise in females while males have experienced a recent reversal of this trend in Spain. Emphasizing the danger of overexposure to ultraviolet radiation may be especially important in females.

Adolescent↗

Investigating correlates of health related quality of life in a low-income sample of patients with diabetes.

OBJECTIVE: We sought to describe and find correlates of health-related quality of life among under-served low-income patients in North Carolina with diabetes mellitus. METHODS: A telephone survey of 310 patients recording quality of life, patient satisfaction, self-reported health, and patient complaints was conducted as part of a diabetes care improvement project. Demographic and clinical records were available for 249 of these patients: 69% were female, 45% were minority, and 84% had type 2 diabetes. Ages ranged from 18 to 88 years with a mean of 56. Quality of life indices consisted of SF-36 physical functioning, mental health and diabetes-39 sub-scores. RESULTS: Comparison to SF-36 norms showed the sample had lower sub-scores than expected. The multivariate analysis suggested that being within an acceptable metabolic control predicted better quality of life physically, mentally, and sexually. Strong associations were detected between most sub-scores and complaints involving legs and feet, self-rated vision, and hassles in self-management. CONCLUSIONS: The consistent associations between the sub-scores and complaints, symptoms, and hassles underscore the strong relationship quality of life may share with the severity of diabetes complications as well as with psychosocial factors. Significantly lower quality of life in this sample highlights the need to improve the care of minority low-income diabetes patients.

Adolescent↗

Use of the Self-Administered Eczema Area and Severity Index by parent caregivers: results of a validation study.

BACKGROUND: The Eczema Area and Severity Index (EASI) is used by dermatological investigators world-wide to assess eczema disease severity. EASI measures are, however, time-consuming and require trained personnel, thereby limiting its application to large-scale epidemiological studies. Additionally, the use of self-assessed severity indices in dermatology is restricted to adult subjects and conditions, thereby not addressing the needs of paediatric patients. OBJECTIVES: To develop and validate an instrument for a caregiver's self-assessment of the severity of his/her child's atopic dermatitis (AD), the Self-Administered EASI (SA-EASI). METHODS: Trained investigators performed a modified EASI assessment on the same day as an SA-EASI was obtained from 47 caregivers of children with AD. RESULTS: The SA-EASI was found to be a valid measure of the severity of AD. Total, acute and chronic SA-EASI scores predicted total, acute and chronic modified EASI scores (P < 0.0001). SA-EASI body surface area (BSA) scores predicted EASI BSA scores (P < 0.0001). SA-EASI pruritus scores correlated with the acute, chronic and total EASI scores (P = 0.0001). CONCLUSIONS: The SA-EASI may provide caregivers the means to report the severity of their child's skin disease objectively. The high correlation with the EASI score observed in this sample implies that statistical inferences with the SA-EASI will be valid for large populations. In future studies, this will permit analysis of the relationship of skin disease severity to such measures as quality of life, disability, patient satisfaction and the costs of various therapies. Moreover, this SA-EASI instrument may allow older children, over 12 years old, to assess the severity of their AD.

Acute Disease↗