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Biomedical subjects

F Vargas

Publications and source records attributed to F Vargas.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Efficacy of twice-daily amoxycillin/clavulanate in lower respiratory tract infections.

In this double-blind, double-dummy study, 324 patients with clinical evidence of community-acquired pneumonia (CAP) or an acute exacerbation of chronic bronchitis were randomly assigned to receive 10 days' treatment with either amoxycillin/clavulanate 875/125 mg twice daily or amoxycillin/clavulanate 500/125 mg three times daily. At the end of therapy, clinical success rates were 92.4% for the twice daily regimen and 94.2% for the three times daily regimen. There was no statistically significant difference between treatments (p = 0.647) and the 95% confidence interval around the treatment difference indicated that the two treatments were equivalent. Treatment equivalence was also confirmed at follow-up, four weeks after the end of treatment. Both regimens were well tolerated. In conclusion, amoxycillin/clavulanate 875/125 mg twice daily is as effective as amoxycillin/clavulanate 500/125 mg three times daily for the treatment of community-acquired lower respiratory tract infections and could improve patient compliance.

Adolescent↗
PubMedDate not supplied

Bronchial challenge with aspirin lysine in the diagnosis of asthmatics with sensitization to aspirin and its inhibition by aerosolized furosemide.

We performed bronchial challenge with ASA lysine in 9 patients with a history of aspirin-induced asthma, 4 asthmatics with no history of hypersensitization to aspirin and 4 control subjects. The test consisted of successive inhalations of increasing concentrations of ASA lysine (11.25, 22.5, 45, 90, 180 and 360 mg/ml) and was interrupted when FEV1 showed a decrease of at least 20%. In order to determine the degree of bronchial hyperreactivity, we first carried out a bronchial challenge with histamine. All patients in the group sensitive to aspirin had a positive reaction to ASA lysine, while this was negative for patients in the two control groups. There was no significant correlation between PC20 to histamine and ASA lysine in any of the groups. On the other hand, 6 patients with sensitivity to ASA repeated the bronchial challenge with ASA lysine after previously inhaling furosemide, and in this second test, none of the 6 had a positive reaction. The variation of ASA lysine PC20 in both tests was positive for these patients (p < 0.001).

Adolescent↗
PubMedDate not supplied

[Diagnostic accuracy of fine needle aspiration cytology guided by ultrasonography in intra-abdominal and retroperitoneal lesions].

UNLABELLED: Evaluation of the fine needle aspiration cytology guided by ultrasonography in the diagnosis of abdominal and retroperitoneal tumors. DESIGN: Transversal study of diagnostic standard-criterion test. PLACE: Ultrasonographic Unity Digestive Disease Department. Hospital Oncológico Padre Machado. SAMPLE: 98 patients with intraabdominal and retroperitoneal lesions. INTERVENTION: Fine needle aspiration cytology guided by Ultrasonography. INDICE TEST: Laparoscopy and/or laparotomy. MEASUREMENTS: Estimation of sensibility (S), Specificity (E), Efficacy (Ef), positive predictive value (VPP), negative predictive value (VPN), measure of false positives (TFP) and measure of false negatives (TFN) by diagnosis method. RESULTS: VP: 81%; VN: 12%; FP: 1%; FN: 6%; S: 93%; E: 92.3%; Ef.: 97%; VPP: 98.7%; VPN: 66%; TFP: 1.25%; Benign lesions: 22.5%; Malignancy lesions: 65.5%; non lesions: 12%; complications: severe: 1%, non significance: 5%. CONCLUSIONS: Fine needle aspiration cytology guided by ultrasound has high sensibility, specificity, efficacy, with low value of false positive. However, it has high incidence of false negatives and negative predictive value. We recommend diagnostic procedures when the suspicion of tumor is high did the cytology is negative.

Abdominal Injuries↗
PubMedDate not supplied

[Multi-technical management of biliary fistula].

Biliary fistula is an occasional complication of cholecystectomy and are usually associated to retained biliary stones, surgical trauma of the biliary ducts and local infection. They were mainly treated by surgical methods up to the acquisition of the new endoscopic and percutaneous techniques used together with parenteral and enteral nutrition and new antibiotics. A total of seven patients with diagnosis of biliary fistula were seen between 1984 and 1990 at the "Unidad de Gastroenterología y Cirugía Digestiva" of the Clínica Sanatrix en Caracas. Average age was 50 with ranged between 31 and 76, 4 were male and 3 female. The fistulas were in 1 due to necrotizing pancreatitis, in 3 to lost of the ligation of the cystic duct, 2 were due to accidental injury of the common duct and the last case was a partial dehiscence of a choledoco-jejunostomy after the resection of a common duct cyst. Four of the cases were choledoco-cutaneous fistula, one hepatocutaneous, two hepatoduodenal. All the seven patients had subhepatic collections, one had a retroperitoneal collection, two had subdiaphragmatic collections and one had multiple hepatic abscesses. The abdominal collections were treated by percutaneous drainage using mainly the Ring-McLean and Van Sonnenberg tubes. The fistula was occluded with biliary prosthesis in four cases, using either endoscopic, percutaneous or mixed technique to place the stent. Patency of the stents ranged between 2 weeks and 24 months. Control time was from 2 to 40 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[The recurrence of duodenal ulcer in patients undergoing treatment with ranitidine and placebo. A multicenter study].

This randomised, double-blind multicenter study was conducted in order to evaluate the long-term effect (one year) of 150 mg ranitidine vs placebo in 51 patients with healed duodenal ulcer. Seventeen patients had ulcer recurrence at the end of follow-up, one among the 24 patients that received ranitidine and 16 among the 27 patients that received placebo (p = 0.00009). No side effects was detected. Our results support the usefulness of a one-year maintenance therapy with 150 mg ranitidine.

Adult↗
PubMedDate not supplied

[Biliary lithiasis. Non-surgical treatment].

Between 1979 and 1989, forty-six patients with biliary lithiasis were treated by non-surgical methods. Jaundice was present in 32 (70%) patients. In five patients (11%), the bile stones were found during the routine ERCP for cholelithiasis. Five patients (11%) had stones with diameter of 30 mm and over. Clearing of biliary ducts was achieved in 44 patients (95.7%). Forty-five patients required endoscopic sphincterotomy, the other one, had a surgical sphincteroplasty performed at the time of cholecystectomy. The stones passed spontaneously in eight patients (17.4%), Dormia basket, shock-wave and mechanical lithotripsy, and contact chemical dissolution, alone or combined, were the methods of treatment. There were two faults (4.3%). In the first case, after the attempt to retrieve the stone with a Dormia basket, as no other method was available (1979), surgical treatment was done. The other case had multiple stones in the biliary tree located in both, intra and extrahepatic ducts. In this case, the use of all available procedures did not clear the biliary tract, so a surgical procedure was ordered. There was one complication (2.2%), a retroduodenal perforation that was treated medically. There was no mortality.

Adolescent↗
PubMedDate not supplied

[A 10-year prolective study on cancer of the digestive system].

OBJECTIVE: A ten year prolective and multicentre study of cancer of the Digestive Tract aims to evaluate the variations on frequency and to identify risk factors. METHODS: Ten hospitals are participating five in Mexico City and five in other states. Data were obtained through the hospitals files and specially designed questionnaires, the latter mainly diet and habits oriented. RESULTS: Through this ten years in the 4,715 cases studied we can appreciate a decreasing tendency of the carcinoma of the stomach (GC) that has been the most frequent until 1984 in the general group General Hospital and Instituto Nacional de la Nutrición. Since then and up to date, first place in frequency in shared between the stomach and colorectal carcinoma (CRC). CRC has been increasing even in the General Hospital in which GC was very high. Eighth years ago we found that people in those hospitals in which GC was high the diet was poor in proteins, fat A and C vitamin. People in those hospitals with high frequency of CRC had diet high in protein, fat and low in fiber. A new study on diet is ongoing. Gallbladder and biliary tract carcinoma has been increasing in all the hospitals. A high O blood group was found in the Juarez Hospital in which gallbladder carcinoma was the highest. O group is highest in the indian people. Cancer of the gallbladder is very high in Pimas and Navajos indians. A plan to study litogenic index and culture of salmonella is going to be practiced in bile from normal and gallbladder carcinoma. Concerning habits, tobacco and alcohol consumption are most frequent in cancer of the esophagus and pancreas. Also coffee consumption is high in the latter. CONCLUSIONS: Along this 10-year study, the frequency of gastric cancer has been decreasing. Instead, the frequencies of colo rectal and biliary tract cancers have been increasing. Variations in frequencies correlated with the composition of the diet, fiber consumption habits and racial characteristics of the different groups.

Adult↗
PubMedDate not supplied

[Colitis caused by radiation: 20 years' experience].

The 20 year experience with diagnosis and management of radiation colitis at the Gastroenterology Department of the Hospital Oncológico "Padre Machado" is presented. Of 404 cases, 98% were treated for carcinoma of the cervix. The most frequent symptoms were rectal bleeding (71%) and changes in the intestinal habitus (27.2%). Symptoms were present from one month to one year prior to radiation. Flexible sigmoidoscopy in 77.5% of patients showed Grade I and II actinic disease, and X Ray studies sowed Grade II and III in 80%. Thirty eight patients required surgical treatment.

Adult↗
PubMedDate not supplied

[Smoking, consumption of alcoholic beverages and coffee as factors associated with the development of cancer of the pancreas].

The purpose of this study was to evaluate retrospectively the role of alcohol intake, smoking and coffee consumption as risk factors in the development of cancer of the pancreas. Twenty nine cases with pancreatic cancer and 29 controls matched by sex, socioeconomic status and age were evaluated. Information on alcohol, tobacco and coffee consumption was obtained by specially designed questionnaires. Odds ratios were calculated and analyzed by chi square testing. The combination of the 3 factors gave an odds ratio of 26.3, whereas alcohol and coffee consumption gave an odds ratio of 13.9. Considered independently, only alcohol and coffee consumption were found to be significantly associated with cancer of the pancreas.

Adult↗