Biomedical subjects
Publications and source records attributed to J Rovira.
We describe a case of a solitary pelvic kidney coexisting with adrenal and pelvic neuroblastoma in a child with multiple malformations, including microcephaly, hypertelorism, aortic coarctation and a bifid uterus. The association of a solitary kidney and neuroblastoma has not been reported previously.
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OBJECTIVES: To make and validate a data base that allows to collect information about clinical characteristics and use of health care services by HIV-infected patients. An additional purpose is to obtain some data about costs of health care services utilization. METHODS: We have designed an informatic data base that includes: demographic data, clinical data and health care services utilization during the follow up. One hundred and nine patients were selected from 5 different hospitals in Spain and they were followed for 6 months (from January to June 1997). Analytic accounting of one hospital and official tariffs were used to calculate costs of the health care services. RESULTS: The informatic data base designed is useful and appropriate to collect the information of these patients. The annual average cost is 2.5 millions dollars, ranging from 1 million dollars for asymptomatic patients to 3.8 millions for AIDS patients. The comparison of our results with previous studies shows an increased cost of asymptomatic patients. CONCLUSIONS: These results give a preliminary information about health care services utilization by HIV-infected patients and confirm the possibility of using the designed instrument in the future. Since HIV-infection presents an uncertain evolution and a variable prognosis, to implant a tracking system is a necessary requirement in order to obtain a fast and accurate information system about the evolution of clinical variables and their economic repercussions.
Regulation of drugs from the public administration is an activity which is produced in different countries independently from the sanitary model they own. In the field of public financing of drugs there have been several measures to improve the efficiency of their use. However, the analysis of the impact of these measures is complex and this may justify the shortage of objectivable results, especially at long term. The objective of this study is to perform a systematic review of such measures due to the need to have information about the different alternatives before making a decision. The introduction of an isolated measure is in many cases compensated by other changes in other regulating or aiding fields which suggests the creation of an integral strategy which affects different fields (supply/demand of drugs and prescribers). It seems necessary to suggest a social debate taking as a basis the scientific information available at the moment and promote the taking of decisions which lead to a rational use of the available pharmacological resources.
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A prospective cross-sectional study was performed in 81 consecutive patients with low-risk singleton pregnancies and gestational age from 9 to 12 weeks of gestation in order to assess the fetal circulation at this stage of pregnancy. Patients' mean age was 29.8 +/- 3.8 (SD) years. Mean gestational age was 10.5 +/- 1.1 weeks. All patients underwent transvaginal color velocity imaging and pulsed Doppler ultrasound to obtain the blood flow velocity waveforms (FVWs) from three fetal vessels: umbilical artery, abdominal aorta, and intracranial vessels. The peak systolic velocity (PSV) and pulsatility index (PI) were analyzed. Optimal FVWs from each vessel were obtained in 98.8, 75.3 and 91.3% of fetuses, respectively. Linear regression analysis showed a significant progressive increase in PSV in the umbilical artery (r = 0.49, p < 0.0001) and intracranial vessels (r = 0.36, p = 0.018) simultaneous to a significant decrease in PI in both vessels (umbilical artery r = -0.37, p = 0.0007; intracranial vessels r = -0.56, p < 0.0001). No significant change was noted in the abdominal aorta in PSV (r = 0.06, p > 0.05) or in PI (r = -0.15, p > 0.05).
Since it was defined, SOP has been related to surgery. Before clomifero was introduced, ovarian wedge resection was the only way to stimulate ovulation and gestation in women with this syndrome. Surgical techniques were derelict in favour of less aggressive medical treatments. However, surgery has reduced its side effects due to the incorporation of laparoscopic techniques and other advances. Because of this fact, surgery is being reintroduced in the treatment of polycystic ovarian disease.
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