Search PubMed⌕ Search

Biomedical subjects

J Castro

Publications and source records attributed to J Castro.

At least 91 records · Page 5Linked to original sources
PubMed1995

A clinical and phenomenological study of 185 Spanish adolescents with anorexia nervosa.

The objectives of the present study were the following to determine the socio-familial, academic and interpersonal characteristics specific to anorexia nervosa (AN); to study comorbidity in patients with anorexia and morbidity in their parents; and to ascertain whether patients with anorexia nervosa in Spain are similar to those in other countries. The research team revised the clinical records of 185 Spanish adolescents with AN (aged 11-18 years). The results were compared with those obtained from a group of 185 psychiatric patients without AN matched by sex, age, time of consultation and centre. No significant differences were found with regard to broken home, birth order or parent-patient conflict. The parents of patients with anorexia have a higher standard of education and develop more affective disorders. When compared with other patients, the individuals with anorexia nervosa perform much better academically but are more socially withdrawn. Males with anorexia nervosa perform worse academically than females and have more anxiety diagnoses. Patients with anorexia have a high comorbidity for affective and obsessive-compulsive disorders. Sufferers from anorexia nervosa in Spain are clinically analogous to patients with anorexia in other countries. The two characteristics specific to these patients are a high standard of academic performance and an intense degree of social withdrawal, although there are certain factors common to other pathologies relating to adolescence.

Adolescent↗
PubMed1995

[Extracorporeal membrane oxygenation in adult respiratory distress syndrome. Experience in 2 patients].

We report two female patients with adult respiratory distress syndrome and severe respiratory failure in whom extracorporeal membrane oxygenation was used. Its indication was due to a bad response to conventional treatment with mechanical ventilation and high levels of positive end expiratory pressure. A 2.0 or 2.2 m2 membrane oxygenator in a veno-venous circuit with systemic anticoagulation was used, maintaining mechanical ventilation. In the first patient, the procedure was done early and was successful, increasing hemoglobin saturation from 39 to 87%. The patient was withdrawn from the procedure 48 hours later and died one week later due to a septic shock. The second patient was connected to the procedure after three weeks of respiratory distress syndrome and no increase in arterial oxygenation was achieved. The patient died due to an intracranial hemorrhage, probably hastened by systemic anticoagulation. The real benefits of extracorporeal membrane oxygenation are not defined yet.

Adult↗
PubMed1994

Concurrent irradiation and intratumoral chemotherapy with cisplatin: a pilot study in dogs with spontaneous tumors.

PURPOSE: A preliminary study was undertaken to determine whether the addition of a collagen gel in the formulation of cisplatin for intratumoral administration of cisplatin affected platinum plasma concentrations. A second study was undertaken to determine the local effects of intratumoral administration of cisplatin mixed with collagen given concurrently with irradiation. METHODS AND MATERIALS: Twelve dogs with advanced stage tumors were administered a dose of 0.25 mg of cisplatin per kg of body weight intratumorally with or without collagen using a two-period crossover design. Twelve additional dogs received concurrent irradiation (48 Gy) delivered in 12 fractions over 4 weeks and intratumoral cisplatin chemotherapy given the first day of each week at a dose of 0.5 mg of cisplatin per cm3 of tissue. RESULTS: The cumulative cisplatin plasma concentrations varied over time from dog to dog, but the use of collagen in the formulation significantly reduced the systemic exposure of cisplatin. For the dogs given intratumoral cisplatin and irradiation, complete responses were observed in 10 dogs. Seven dogs had local recurrence. One dog had tumor recurrence in the radiochemotherapy field and six dogs had recurrence at the margin of the radiochemotherapy field, but within the irradiation field. Normal tissue reactions were similar in the radiochemotherapy field and in the margin treated with radiation only. Cumulative effect of repeated intratumoral administration on plasma concentration of cisplatin was not observed. CONCLUSIONS: These findings provide support for an extended investigation of this combined regimen. The lack of systemic toxicity associated with intratumoral administration of cisplatin mixed with collagen may allow a safe clinical evaluation of the interaction between cisplatin and radiation.

Absorption↗
PubMed1994

Inhibition of carnitine palmitoyltransferase I by hepatocyte swelling.

Incubation of hepatocytes under conditions known to increase their volume, i.e. with amino acids (glutamine, proline) or in hypo-osmotic medium, decreased carnitine palmitoyl-transferase I (CPT-I) activity. This effect of hepatocyte swelling was antagonized by okadaic acid and dibutyryl-cAMP. Physiological concentrations of glutamate inhibited CPT-I activity in digitonin-permeabilized hepatocytes but not in isolated mitochondria. Results suggest that the amino acid-induced inhibition of CPT-I shares a common mechanism with the amino acid-induced stimulation of acetyl-CoA carboxylase and glycogen synthase [(1993) Eur. J. Biochem. 217, 1083-1089].

Acetyl-CoA Carboxylase↗
PubMed1994

Carcinoma of the extrahepatic bile ducts. The University of California at San Francisco experience.

OBJECTIVE: The authors investigated the combined experience of a single institution in treating bile duct carcinoma during the modern era. SUMMARY BACKGROUND DATA: Bile duct carcinomas are notoriously difficult to cure, with locoregional recurrence the rule, even after radical resection. Adjuvant efforts have included various radiation modalities, with limited success. Recently, charged-particle radiotherapy has also been used in these patients. METHODS: The authors performed a retrospective chart analysis of 129 patients with bile duct adenocarcinomas treated between 1977 and 1987 through the University of California at San Francisco, including 22 patients treated at Lawrence Berkeley Laboratory with the charged particles helium and neon. The minimum follow-up was 5 years. Survival, outcome, and complication results were analyzed. RESULTS: Sixty-two patients were treated with surgery alone (S), 45 patients received conventional adjuvant x-ray radiotherapy (S + X), and 22 were treated with charged particles (S + CP). The median survival times were 6.5, 11, and 14 months, respectively, for the entire group, and 16, 16, and 23 months in patients treated with curative intent. There was a survival difference in patients undergoing total resection compared with debulking (p = 0.05) and minor resections (p = 0.0001). Patients with microscopic residual disease had increased median survival times when they were treated with adjuvant irradiation, most markedly after CP (p = 0.0005) but also with conventional X (p = 0.0109). Patients with gross residual disease had a less marked but still statistically significant extended survival (p = 0.05 for S + X and p = 0.0423 for S + CP) after irradiatio CONCLUSIONS: The mainstay of bile duct carcinoma management was maximal surgical resection in these patients. Postoperative radiotherapy gave patients with positive microscopic margins a significant survival advantage and may be of value in selected patients with gross disease.

Adenocarcinoma↗
PubMed1993

[Cerebral metastasis of melanoma: study of 48 patients].

BACKGROUND: Malignant melanoma is a frequent cause of cerebral metastases (CM). In the present study the characteristics of primitive melanomas of patients with CM, their forms of clinical presentation and treatment were analyzed. METHODS: A retrospective study of the patients with melanoma and CM diagnosed between 1982 and 1991 was carried out. RESULTS: Out of 786 patients with melanoma 48 were identified with CM. In 65% of the melanoma originated in cutaneous areas BANS (of bad prognosis). The median thickness of the tumor (Breslow's index) was of 3.6 mm. The median period of latency between diagnosis of the melanoma and the detection of CM was 22 months. Although recent hemorrhage of the CM was observed in the cranial computerized tomography in 20 of the 48 patients, only 7 presented clinical symptoms of ictus. In 23 patients the CM were the only evidence of metastases of the melanoma. The median survival was one month in the patients treated with only dexamethasone, 3.5 months in the chemotherapy group, 2.5 months for the group given radiotherapy and 6 months for those undergoing surgery. CONCLUSIONS: Most of the patients with cerebral metastasis had a primitive melanoma with criteria of bad prognosis. The presence of hemorrhage in computerized tomography did not always correlate with clinical symptoms of ictus. Surgical treatment must be considered in patient with sole cerebral metastasis without evidence of distant disease.

Adult↗
PubMed1993

What price mental health?

President Clinton aims to guarantee coverage not only to the severely disturbed but to all Americans. The cost, however, could be astronomical.

Adolescent↗
PubMed1993

Paging Dr. Clinton.

Explore the source record for details and available documents.

Competitive Medical Plans↗
PubMed1993

Preparation of cell nuclei from fresh tissues for high-quality DNA flow cytometry.

An easy method for preparation of bare cell nuclei from fresh solid tissues for DNA flow cytometry is described. Pieces of up to 2 x 2 x 2 mm3 size from fresh tissues were fixed in formalin. After removal of formalin by washing with ethanol and rehydration with tap water, the tissue pieces were incubated with subtilisin Carlsberg (pronase, Sigma protease XXIV) and then stained directly with DAPI. Staining with ethidium bromide gave unsatisfactory results. Neither mechanical disaggregation nor centrifugation were used. The resulting cell nucleus suspensions had extremely low frequencies of debris particles and of clumped cell nuclei. A good yield, a minimized loss, and a good stainability of cell nuclei were obtained. The applicability of the method was exemplified by the analysis of biopsies from the colon-rectum in patients with ulcerative colitis and of biopsies from the bladder in patients with bladder cancer and compared to the standard method of this laboratory, which uses mechanical disaggregation, ethanol fixation, pepsin treatment, and staining with ethidium bromide. The formalin-subtilisin Carlsberg technique resulted in good agreement of ploidy measurements compared to the standard method, a higher number of evaluable histograms, an improved detectability of aneuploid cell populations, and an improved accuracy of the S- and G2-phase analysis, particularly in samples with low proliferation. The method also makes it possible to use long-term storage and to transport samples by post.

Animals↗
PubMed1993

Effects of lovastatin on hepatic fatty acid metabolism.

The in vitro and in vivo effects of lovastatin on fatty acid metabolism were studied in isolated rat hepatocytes. When added in vitro to cell incubations, lovastatin stimulated de novo fatty acid synthesis and acetyl-CoA carboxylase activity, whereas fatty acid synthase activity was unaffected. Lovastatin depressed palmitate, but not octanoate, oxidation. This may be attributed to the lovastatin-induced increase in intracellular malonyl-CoA levels, as no concomitant change of carnitine palmitoyltransferase I (CPT-I) specific activity was detected. Lovastatin had no effect on the synthesis and secretion of triacylglycerols and phospholipids in the form of very low density lipoproteins (VLDL). When rats were fed a diet supplemented with 0.1% (w/w) lovastatin for one week, both acetyl-CoA carboxylase activity and de novo fatty acid synthesis were reduced compared to pair-fed controls, whereas fatty acid synthase activity was unaffected. Palmitate oxidation was enhanced in the lovastatin-fed group. There was an increase in CPT-I activity but no change in intracellular concentration of malonyl-CoA. Lovastatin feeding had no significant effect either on the esterification of exogenous palmitic acid into both cellular and VLDL triacylglycerols and phospholipids or on hepatic lipid accumulation. The in vitro and in vivo effects of lovastatin were not significantly different between periportal and perivenous hepatocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetyl-CoA Carboxylase↗
PubMed1993

Sternal blood flow during mobilization of the internal thoracic arteries.

A laser Doppler tissue perfusion monitor was used to measure sternal blood flow before, during, and after mobilization of the internal thoracic arteries in 24 patients undergoing coronary artery bypass grafting. To minimize chest wall injury, a narrow pedicle was mobilized. Bilateral flow data were available from 15 of the 24 patients. Analysis of these 39 studies showed no significant reduction of sternal blood flow as a consequence of mobilization of the internal thoracic arteries except in 2 patients who were both diabetic and obese.

Aged↗
PubMed1993

Ultra-short topical treatment of pityriasis versicolor with 2.5% bifonazole cream.

The therapeutic efficacy of a preparation containing 2.5% bifonazole was investigated by comparing three different treatment modalities--A, B, and C. Group A used bifonazole only on Days 1, 2 and 3, and the Group C on Days 1, 3 and 5. Of the patients in Group A 56% had a negative mycological examination at the end of the study. The results obtained in Groups B and C were not significantly different: 92% of the patients had a negative mycological examination at the end of the study. Electron microscope (EM) studies showed morphological alterations such as loss of cytoplasmic organization with shrinkage and folding of the cell membranes after 1 week of treatment only in Groups B and C. We conclude that 2.5% bifonazole is a highly effective treatment for Pityrosporum ovale infection when applied using a 3-day schedule.

Administration, Topical↗
PubMed1993

Exploring the feasibility of assessing perceived parental rearing styles in Spanish children with the EMBU.

Most of the available data on the dimensional structure underlying the EMBU--an originally Swedish measure designed to assess one's recollections concerning one's parents' rearing behaviour--has been obtained with adults or adolescents. In the present study, using exploratory factor analysis, an attempt was made to determine the EMBU factorial structure in a Spanish sample of children aged 7-12 years (N = 205). Four factors explaining only 24% and 25% of the total variance in the ratings of the fathers and those of the mothers, respectively, and being invariant across parental sex, were interpreted: Emotional Warmth, Rejection, Control Attempts, and Favouring Subject. Results with respect to the internal consistency reliability of the corresponding scales were satisfactory, as were homogeneity figures pertaining to each set of theoretically-related items. Higher-order analyses of the first-order dimensions (mothers and fathers jointly) revealed three factors explaining 85% of the total variance. Control Attempts, Care (Rejection vs. Emotional Warmth), and Favouring Subject. The factorially-derived (first-order) scales were uncorrelated with sex of the recipient. All scales (except Rejection) correlated sizeably, negatively, with age (medium effect size) pointing, as outlined, to the need to take into account the relevant normative, design and research implications in further investigation. Some similarities and differences with findings yielded previously with adults and adolescents are briefly pinpointed.

Attitude↗
PubMed1993

[Comparative study of famotidine vs ranitidine in critically ill patients in mechanical ventilation].

Stress ulcers are frequent in critically ill patients. Gastric mucosa protection with antacids, H2 blockers or sucralphate decrease the incidence of stress ulcers and upper gastrointestinal bleeding but may have adverse effects. The present study compares the efficacy of continuous infusions of famotidine on gastric pH control and bleeding prevention in critically ill patients receiving mechanical ventilation. Fifty six patients (aged 55 +/- 22 years, 26 male) were randomly assigned to receive famotidine 40 mg/day (n = 27) or ranitidine 150 mg/day (n = 29) during 5 days. Gastric pH was measured every 6 hours and when it was below 5, aluminum hydroxide (30 ml every 2 hours) was administered to obtain values over 5. Patients receiving famotidine had higher mean gastric pH (6.3 +/- 0.2 and 93% of measurements over 5 vs 5.8 +/- 0.6 and 83% of measurements over 5 (p < 0.05), and required lower amounts of aluminum hydroxide (1.880 vs 2.770 ml). No patient had evidence of gastrointestinal bleeding and one had a mild psychomotor agitation. No other adverse reactions were observed. It is concluded that famotidine was more effective than ranitidine on gastric pH control in mechanically ventilated critically ill patients.

Acute Disease↗
PubMed1992

Somatostatin in the management of gastrointestinal fistulas. A multicenter trial.

To evaluate the effectiveness of treatment with total parenteral nutrition (TPN) alone (group A) or combined with continuous intravenous infusion of somatostatin (group B) in postoperative gastrointestinal fistulas, a multicenter, controlled and prospective randomized trial was designed. We present the results obtained after the evaluation of 40 cases (group A, n = 20; group B, n = 20). No significant differences among these treatment schedules were observed in the percentage of closure of fistulas (group A, 81.25%; group B, 85%), but patients treated with total parenteral nutrition plus somatostatin had the fistulas close within a significantly shorter period of time. Moreover, this treatment was associated with a significantly lower morbidity. These preliminary results indicate that somatostatin is a useful therapeutic complement in the conservative treatment of patients with gastrointestinal fistulas.

Adult↗
PubMed1992

A comparative analysis of the neuroendocrine mechanisms regulating ovulation, affected by a unilateral implant of atropine in the preoptic-anterior hypothalamic area, in intact and hemiovariectomized adult rats.

The effects were analysed of a unilateral implant of atropine on ovulation in intact and hemiovariectomized adult rats, together with the response of the atropine-implanted rats to hormone replacement. An outer cannula directed to the left or right preoptic (POA)-anterior-hypothalamic area (AHA) was implanted into cyclic adult rats. A group of animals in oestrus was hemiovariectomized and some were also implanted with a cannula. After two consecutive 4-day cycles, the hemiovariectomized animals were implanted with atropine (23 +/- 4 micrograms) or cholesterol (25 +/- 2 micrograms) on the day of oestrus. Atropine implanted into the left side of the POA-AHA blocked ovulation and compensatory ovarian hypertrophy, whilst implants in the right side had no effects. Administration of gonadotrophin-releasing hormone (GnRH; 3.7 micrograms/kg) at 13.00 h on the expected day of pro-oestrus induced ovulation in six out of seven treated animals. Of 19 rats with an implant of atropine in the left side of the POA-AHA, one ovulated after treatment with pregnant mare serum gonadotrophin (PMSG) on oestrus, or oestradiol benzoate or human chorionic gonadotrophin (hCG) on day 2 of dioestrus. The effects on ovulation of a unilateral implant of atropine into the POA-AHA of cyclic adult rats and the responses of such rats to GnRH, PMSG, hCG and oestradiol benzoate replacement were also studied. Ovulation was induced in rats with a unilateral implant of atropine and which had been treated with GnRH or hCG at 13.00 h on the expected day of pro-oestrus after the implant.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗