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Biomedical subjects

F Torres

Publications and source records attributed to F Torres.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Clinical manifestations of infective endocarditis].

Infective endocarditis has a broad clinical picture, with systemic and multiorgan impairment. The organs most frequently involved are the heart, the central nervous system and the kidneys. Complications are caused by several mechanisms: direct effect on the heart, septic embolisms and immunological phenomena. We review some of the main clinical aspects of this disease, as well as the results of a wide series of patients with infective endocarditis from our hospital.

Aged↗
PubMed1998

Comparison of the efficacy and tolerability of dexketoprofen and ketoprofen in the treatment of primary dysmenorrhea.

Dexketoprofen, the pure S(+)-enantiomer of ketoprofen, is a promising new analgesic, but few clinical trials have yet examined its efficacy and tolerability. In this study, patients with a history of primary dysmenorrhea were treated with dexketoprofen doses of 12.5 and 25 mg, ketoprofen 50 mg, and placebo using a randomized, four-way crossover design. Efficacy analyses showed that dexketoprofen 12.5 and 25 mg and racemic ketoprofen 50 mg significantly reduced pain intensity compared with placebo from 1 h after dose to 4-6 h after dose. Interestingly, dexketoprofen at 12.5 mg was significantly superior to placebo at 30 min after dose. Mean pain relief scores also demonstrated that both doses of dexketoprofen and racemic ketoprofen were significantly superior to placebo at 1-6 h after the first dose. No indices of analgesic efficacy showed any significant differences between the two doses of dexketoprofen or between dexketoprofen and ketoprofen. After repeated dose administration, similar results were obtained. There were no significant effects of any treatment on activities of daily living, menstrual flow, or associated symptoms. Dexketoprofen was effective, well tolerated, and had no difference in the incidence of adverse events compared to ketoprofen or placebo.

Adolescent↗
PubMed1998

Comparison of dexketoprofen trometamol and ketoprofen in the treatment of osteoarthritis of the knee.

Dexketoprofen, the active enantiomer of the racemic compound ketoprofen, is a new nonsteroidal antiinflammatory drug (NSAID) of the arylpropionate family. The efficacy and safety of dexketoprofen trometamol were compared with the equivalent enantiomeric dose of ketoprofen in a multicenter, randomized, double-blind 3-week trial of adult outpatients with pain due to osteoarthritis of the knee. After a washout period of 7-15 days, patients were randomly assigned to receive either dexketoprofen trometamol 25 mg tid (N = 89) or ketoprofen 50 mg tid (N = 94). Of the 183 patients enrolled, two were lost to follow-up. At the end of treatment (3 weeks), the main efficacy outcome measures were significantly better in the dexketoprofen trometamol group than in the ketoprofen group. In addition, overall physician assessment indicated that 75% of the dexketoprofen group had improved compared with 50% of the ketoprofen patients. There were fewer adverse events in the dexketoprofen treatment group, but the difference did not reach statistical significance. These results demonstrate that dexketoprofen trometamol 25 mg tid is more effective than ketoprofen 50 mg tid in short-term symptomatic treatment of knee osteoarthritis and suggest that the tolerability of dexketoprofen trometamol is more favorable than ketoprofen. Therefore, the substitution of dexketoprofen for racemic ketoprofen may be advantageous in clinical practice.

Adult↗
PubMed1997

Danielone, a phytoalexin from papaya fruit.

A new phytoalexin was induced and isolated from papaya fruit slices treated with copper salts; its structure was established as 3',5'-dimethoxy-4'-hydroxy-(2-hydroxy)acetophenone. This compound showed high antifungal activity against Colletotrichum gloesporioides, a pathogenic fungus of papaya.

Acetophenones↗
PubMed1996

Combined analysis of matched and unmatched case-control studies: comparison of risk estimates from different studies.

The authors propose a method to perform a combined analysis of matched and unmatched case-control studies that is based on an adaptation of logistic regression and can be performed using standard software. This methodology can be used to do pooled analyses of studies with different designs. Likelihood ratio tests can be performed to assess association, heterogeneity, or trend. The standard errors of the coefficients allow the derivation of a Wald test and the calculation of confidence intervals. Another application is to compare relative risk estimators for the same risk factors studied in different phases of a disease in an effort to explore factors that may be more important in one phase than in another. Interaction terms of risk factors with variables that code the different pooled studies can be used for this purpose. The advantage of using this method is that a formal statistical comparison can be performed in which the regression coefficients of the interaction terms estimate the relative differences in risk (odds ratio ratios) between the studies. This estimation can be adjusted for other confounder factors. Two examples of application using data from case-control studies on cervical cancer and colorectal cancer are presented to illustrate the use of this epidemiologic method.

Case-Control Studies↗
PubMed1996

Intraoperative complications of planned extracapsular cataract extraction versus manual nucleofragmentation.

PURPOSE: To compare the intraoperative complications of planned extracapsular cataract extraction (ECCE) with those of manual nucleofragmentation. SETTING: Hospital de la Esperanza, Universitat Autónoma de Barcelona, Spain. METHODS: This retrospective study comprised 567 eyes; 444 had planned ECCE and 123, manual nucleofragmentation through a scleral tunnel incision. RESULTS: No significant differences between techniques were found in terms of intraoperative complications (P < .05). Manual nucleofragmentation did not increase the risk of intraoperative complications (P < .05). CONCLUSIONS: Although phacoemulsification is the procedure of choice in many cases, manual nucleofragmentation is a safe and valid alternative that achieves the goals of small incision cataract surgery.

Aged↗
PubMed1996

[Characteristics and course of patients over 65 years of age with severe heart failure].

INTRODUCTION AND OBJECTIVES: Although there have been many studies on the prognosis of congestive heart failure, most of them have not provided specific data about older patients. The aim of our study is to evaluate general characteristics and short and medium-term evolution of patients older than 65 years with severe heart failure. PATIENTS AND METHODS: We have carried out a prospective study of all patients older than 65 years admitted to our Department during 1993 due to severe heart failure (functional class III or IV of the NYHA classification), regardless of the etiology. In that year, 84 patients who fulfilled those criteria were admitted. RESULTS: The mean age was 72 +/- 6 years, 56% were male and 44% female. Age distribution was as follows: 36 patients were between 65 and 70 years, 27 between 70 and 75, 8 between 75 and 80, and 13 older than 80. The etiology of heart failure was: ischemic heart disease 44%, valvular heart disease 36%, idiopathic dilated cardiomyopathy 8%, systemic arterial hypertension 7% and other etiologies 5%. Significant systolic dysfunction (left ventricular ejection fraction < 0.45) was present in 36% of the patients. Ten percent of the patients suffered from severe ventricular arrhythmias (ventricular tachycardia or fibrillation). Regarding treatment, 24% underwent valvular surgery, 74% received only medical treatment and coronary angioplasty was performed in one patient. In hospital mortality was 9% (8 patients). After a mean follow-up of 8 +/- 4 months, the probability of survival was 78% at 1 month, 71% at 6 months and 63% at 1 year. The survival rate was better in patients with higher ejection fraction (53% for patients with ejection fractions of less than 0.45, 64% for those with ejection fractions between 0.45 and 0.60 and 79% for those with ejection fractions greater than 0.60). Considering etiology, the survival rate was worse for patients with acute myocardial infarction (30%) and aortic valve stenosis (58%). CONCLUSIONS: Patients older than 65 years admitted to the hospital for severe congestive heart failure represent a heterogeneous population in respect to etiology, systolic function and prognosis. Nevertheless, from this study it appears that a worse prognosis was associated with the lower left ventricular ejection fractions and with certain etiologies; such as acute myocardial infarction or aortic stenosis.

Age Factors↗
PubMed1996

[Value of a short (7 days) prophylactic course of ganciclovir in the prevention of cytomegalovirus disease after heart transplantation].

BACKGROUND: The incidence of cytomegalovirus disease remains important after heart transplantation, mainly in the first months after transplantation. We undertook a study to evaluate a short (7 days) prophylactic administration of ganciclovir to prevent cytomegalovirus disease after heart transplantation. PATIENTS AND METHODS: There were two groups of patients: patients transplanted in 1993 (37) and patients transplanted in 1992 (38). In the first group, ganciclovir was given intravenously at a dose of 10 mg per kilogram of body weight every day from postoperative day 1 through day 7. In the second group, ganciclovir was not given. Similar regimens of immunosuppression (ATG, deflazacort, azathioprine and cyclosporine) were given. RESULTS: Age, sex, serology in recipients and donors and incidence of acute rejection were comparable between both groups. Mortality was slightly higher in ganciclovir group (35%) than in control group (26%), although this difference was not statistically significant. There were two cases of cytomegalovirus disease in the ganciclovir group (6%) and nine cases in the control group (27%) (p < 0.05), all of them treated successfully. Cytomegalovirus disease in ganciclovir group occurred in two children, who were seronegative before transplantation. The incidence of cytomegalovirus disease in the pediatric recipients of ganciclovir group were 50% (2 of 4) and 100% in the control group (1 of 1). The incidence of cytomegalovirus disease were therefore 0% in the adult subgroup of ganciclovir group and 24% in the adult subgroup of control group. CONCLUSIONS: A short (7 days) prophylactic administration of ganciclovir reduces the incidence of cytomegalovirus disease. In the pediatric group, the effectiveness is lower.

Adult↗
PubMed1996

Magnetoencephalographic assessment of spontaneous brain activity in schizophrenia.

Magnetoencephalography (MEG) offers an attractive alternative to electroencephalography (EEG) in the assessment of psychiatric patients. In this study, a whole-head biomagnetometer equipped with 122 super-cooled sensors was used to assess spontaneous neuromagnetic activity in 11 unmedicated schizophrenic patients and 8 schizophrenic patients medicated for more than 8 weeks with novel antipsychotics (5 of whom were initially studied as part of the unmedicated group). Ten normal (nonpsychiatric) controls were also examined. For each subject, 5 minutes of data were collected in an eyes-closed state. Data were visually inspected for gross MEG abnormalities, and average power spectra were calculated for the data at each sensor. No gross abnormalities were identified for control subjects. One unmedicated schizophrenic patient showed epileptiform sharp waves, and 4 showed abnormal slow waves. No gross MEG abnormalities were found for the medicated schizophrenic group (which included 3 patients who had previously shown slow waves in the unmedicated state). Spectral analyses showed that the schizophrenia patients demonstrated lower alpha power and peak frequency than controls. The data are interpreted within the context of previously reported magnetic resonance abnormalities of the thalamus.

Adult↗
PubMed1996

[Long-term clinical course of acute myocarditis. Prospective study of a series of 99 patients (1987-1995)].

BACKGROUND: The natural history of acute myocarditis is not well known. The aim of our study was to assess the spontaneous outcome of patients with this disease and its possible relation with progression to chronic dilated cardiomyopathy. METHODS: With this aim, we have carried out a prospective study of 99 patients consecutively diagnosed with acute myocarditis in our hospital from 1987 to April 1995, with a mean follow-up of 34 +/- 25 months. Acute myocarditis was diagnosed by clinical, echocardiographic and isotopic (detection of myocite damage) data, in absence of any other cardiac lesion. RESULTS: Mean age was 26 +/- 17 years; 70% of the patients were male. Initial symptoms were dyspnea in 58% of the patients, chest pain in 33% and arrhythmias in 9%. Severe heart failure was present in 62% of the patients, ventricular arrhythmias in 16% and supraventricular arrhythmias in 16%. Cardiothoracic index was 0.50 +/- 0.07. Left ventricular ejection fraction was 0.40 +/- 0.18, although in 44% of the patients it was lower than 0.30. Immunosuppressive therapy was not used in any case. Outcome was favorable in 70% of the patients, who had a normal ejection fraction, while 13% died or needed heart transplantation during follow-up and 17% progressed to stable chronic dilated cardiomyopathy. Final ejection fraction was 0.53 +/- 0.17, significantly higher than the initial, 0.40 +/- 0.18 (p < 0.05); this improvement in ejection fraction was mainly observed during the first month after diagnosis (0.49 +/- 0.18). The proportion of patients with an ejection fraction of less than 0.30 decreased from 44% to 21% at the end of follow-up. CONCLUSIONS: Spontaneous outcome of acute myocarditis is good in the majority of patients, although an unfavourable evolution was observed in almost 30% of the patients (death, need of heart transplantation or chronic dilated cardiomyopathy). Improvement in ventricular function mainly occurs at short-term, during the first month of evolution in our study.

Acute Disease↗
PubMed1996

[Myocardiopathies (XIII). Markers of clinical course in patients with dilated myocardiopathy].

The natural history of dilated cardiomyopathy, above all in asymptomatic patients, is not easily predictable. Nevertheless, when congestive heart failure is present, prognosis is significantly worse. The development of new therapeutic methods, both pharmacological (angiotensin converting enzyme inhibitors and other drugs) and surgical (heart transplantation), have improved the prognosis of this disease. In this article, we review some subjects of interest related to the management and treatment of patients with dilated cardiomyopathy that have been studied recently: identification of potentially reversible causes, optimization of medical therapy, prognostic markers, identification of high-risk patients and selection of candidates for heart transplantation.

Cardiomyopathy, Dilated↗
PubMed1995

Incidence of specific etiology and role of methods for specific etiologic diagnosis of primary acute pericarditis.

To assess the incidence of a specific etiology and the role of methods for specific etiologic diagnosis in patients with primary acute pericarditis, we studied 100 patients with primary acute pericarditis consecutively admitted to our hospital between 1991 and 1993. A general diagnostic protocol was performed in all patients, whereas only pericardiocentesis was performed in patients with clinical cardiac tamponade or an unfavorable course with anti-inflammatory drugs. Surgical drainage and pericardial biopsy was performed in patients with tamponade relapse. A specific etiology was discovered in 22 patients (22%) (neoplasms in 7, tuberculosis in 4, other infections in 3, collagen diseases in 3, thyroid disorders in 4, and dissecting aortic aneurysm in 1). The general diagnostic protocol led to a specific diagnosis in 15 patients (68% of all patients with specific acute pericarditis) and pericardiocentesis in the other 7 patients (32%). The role of a diagnostic protocol, therapeutic pericardiocentesis, and diagnostic pericardiocentesis was similar and complementary. Pericardial biopsy results were negative in the 5 patients in whom it was performed. Cardiac tamponade and an unfavorable clinical outcome were significantly (p < 0.001) associated with the finding of a specific etiology; when both features were combined, sensitivity was 86% and specificity 85%, positive predictive value 63% and negative predictive value 96%. We conclude that the specific etiology in patients with primary acute pericarditis is about 20% to 25%, and that about 90% of these specific cases can be discovered by using the described systematic diagnostic protocol only in patients with an unfavorable outcome (cardiac tamponade or poor clinical course).

Acute Disease↗
PubMed1995

Balloon-expandable stent repair of severe coarctation of aorta.

Experimental studies have shown that stents implanted at the aorta become incorporated within the aortic wall and can be further expanded in growing animals. This study evaluates the feasibility and immediate results of balloon-expandable stent implantation in 10 patients with severe coarctation of aorta. The ages of the patients ranged from 1 month to 43 years; 1 was an infant, 8 were children (mean age 5.3 +/- 4 years), and 1 was an adult. All had an unfavorable anatomy for balloon angioplasty; 9 had isthmus hypoplasia. Balloon predilation was first performed and its immediate effect evaluated. Then a balloon-expandable stent that was 30 mm long and covered the isthmus and coarctation levels was deployed, and it was further expanded to the preselected final diameter (12 +/- 4 mm). A final hemodynamic and angiographic evaluation was then obtained. Full deployment of an incompletely expanded and distally displaced stent in the infant led to aortic disruption that was controlled by a second stent covering the disrupted zone and the isthmus. After balloon angioplasty alone was done, the mean gradient (43 +/- 12 vs 31 +/- 10 mm Hg) and the percentage stenosis (72% +/- 11% vs 54% +/- 11%) had an insufficient decrease. However, after stent implantation was done, the gradient almost disappeared (mean 2 +/- 3 mm Hg). The angiographic stenosis disappeared in 7 patients and was markedly reduced in 3. The ratio of isthmus/descending aorta changed from 0.65 +/- 0.14 to 1 +/- 0.08 (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗