Search PubMed⌕ Search

Biomedical subjects

L Moreno

Publications and source records attributed to L Moreno.

At least 73 records · Page 4Linked to original sources
PubMed1995

Bcl-2 expression is associated with lymph node metastasis in human ductal breast carcinoma.

The Bcl-2 proto-oncogene product blocks apoptosis. We retrospectively studied Bcl-2 expression in 124 primary tumors from patients diagnosed with T1 (2 cm or less) breast carcinoma with (T1N1) or without (T1N0) lymph-node metastasis. Bcl-2 protein was detected by immunohistochemistry on paraffin-embedded tissue sections. Multivariate logistic regression modeling was used to estimate prevalence odds ratios for lymph-node metastasis. Bcl-2 was widely expressed among T1 tumors showing a strong positive relationship with estrogen (ER)- and progesterone (PR)-receptor-positive tumors. However, a significant inverse correlation was seen between Bcl-2 expression and histological grade, Bcl-2 being absent in the majority of T1 undifferentiated tumors (grade-III carcinomas). Furthermore, Bcl-2 was more frequently expressed in T1N1 cases (72.2%) than in T1N0 specimens (45.7%). The odds for lymph-node metastasis in the Bcl-2-positive group was 3.6 times larger than that in the Bcl-2-negative group. The co-expression of PR significantly modified the effect of Bcl-2 on the odds for lymph-node metastasis, suggesting the existence of a synergistic interaction between the 2 parameters. We studied the percentage of dead cells in primary tumors by in situ DNA fragmentation (FDNA), and found an inverse correlation between Bcl-2 expression and FDNA. This supported the hypothesis that Bcl-2 extends cell survival. In conclusion, our study provides evidence that Bcl-2 expression is involved in breast-cancer progression, at least in a subset of well-differentiated and PR-positive tumors.

Adult↗
PubMed1995

Bicarbonate dialysate for continuous renal replacement therapy in intensive care unit patients with acute renal failure.

Lactate-buffered peritoneal solution traditionally has been used as dialysate for continuous renal replacement therapy (CRRT) in the United States because no bicarbonate solution is commercially available. Since 1994, the Cleveland Clinic Foundation Dialysis Unit has prepared a bicarbonate solution (sodium 144 +/- 3 mEq/L, HCO3 37 +/- 2 mEq/L, potassium 3 or 4 mEq/L, calcium 3.0 +/- 0.3 mEq/L, and magnesium 1.4 +/- 0.3 mg/dL) replicating the dialysate for chronic intermittent hemodialysis. No solute precipitation, as calcium or magnesium salts, were observed, and several cultures of the solution, performed at various time periods, remained negative. Fifty critically ill acute renal failure patients have been treated with bicarbonate-CRRT. All patients were in multiple organ failure and required mechanical ventilation; 37 were receiving vasopressors. Forty-four continuous venovenous hemodialysis sessions and eight continuous arteriovenous hemodialysis sessions were performed with a mean duration of 7.8 +/- 6.1 days. The mean inflow dialysate rate was 1,249 +/- 225 mL/hr and the mean outflow rate (dialysate plus ultrafiltration) was 1,399 +/- 237 mL/hr; the inflow rate was constantly kept lower or equal to the outflow rate to avoid an enhanced potential for backfiltration. No related fever spikes or sepsis episodes were noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1995

Brain maturation estimation using neural classifier.

Quantitative electroencephalographic (EEG) signal analysis has revealed itself as an important diagnostic tool in the last few years. Through the use of signal processing techniques, new quantitative representations of EEG data are obtained. To automate the diagnosis, a problem of supervised classification must be solved on these. Artificial Neural Networks provide an alternative to more traditional classifier systems for this task. The objective of this paper is to perform a comparison between several classifiers in a particular problem, the brain maturation prediction. The data preprocessing/feature extraction process and the methodology for making the comparison are described. Performance of the methods is evaluated in terms of estimated percentage of correctly classified subjects.

Adolescent↗
PubMed1995

Protection by almagate of ethanol-induced gastric mucosal damage in rats.

The study was designed to analyse the protective effects of almagate on a model of gastric injury, ethanol-induced mucosal damage, in which acid plays little, if any, role. Pretreatment with almagate dose-dependently reduced the level of gastric damage induced by oral administration of 1 mL 100% ethanol. Administration of 12 mumol kg-1 alamagate 30 min before ethanol significantly reduced the area of mucosal damage by 65 +/- 10%, and the maximum level of inhibition (74 +/- 11%) was obtained with 150 mumol kg-1 almagate. Administration of higher doses of almagate (200-250 mumol kg-1) did not result in any further increase in the level of protection against ethanol-induced gastric damage. Administration of 1 mL 100% ethanol induces substantial damage to the gastric mucosa, with nearly 40% of the length of the section evaluated exhibiting deep necrotic and haemorrhagic damage. Pretreatment with almagate caused a significant diminution in all parameters of histological damage, whereas damage to the epithelial cell layer was only significantly reduced by pretreatment with the highest doses evaluated (25, 50 and 150 mumol kg-1). Administration of aluminium hydroxide did not modify ethanol-induced mucosal damage, even at doses containing concentrations of aluminium higher than those present in gastroprotective doses of almagate. Pretreatment with sucralfate, another aluminium containing compound, at doses of 250 mumol kg-1 protected the mucosa, although lower doses did not. The present study has shown that almagate prevents ethanol-induced gastric mucosal damage.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1995

Do transition grants help rural hospitals?

Congress introduced the Rural Health Care Transition (RHCT) Grant Program in 1989 to assist financially troubled, small rural hospitals. This article discusses grant effects on the second cohort of hospitals to complete their 3-year grants. Although three-quarters of the grantees implemented all or most of their goals, 11 percent could not implement a viable project. Grantees added or upgraded 523 services with the help of their grants, especially outpatient and social services, most of them financially self-supporting. Except among the largest hospitals, there was no evidence that the grants improved grantee finances. Management appeared unaffected by the grants.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1994

[Attitude of primary care personnel towards HIV infection. Results of a survey].

OBJECTIVE: To evaluate the understanding, previous experience and attitudes of Primary Care (PC) staff regarding the Human Immunodeficiency virus (HIV) and to identify the preferred care environment for these patients. DESIGN: An observation study of a crossover type done by filling in a questionnaire. SETTING: Nine Primary Care centres in the province of Valladolid. PATIENTS: Random sample of the staff of the PC teams at the above-mentioned centres. RESULTS: Questionnaires returned by 174 health-workers, averaging 34.5 years old, were studied. 61.49% evaluated their own knowledge as acceptable, though all those surveyed wished to broaden their information concerning HIV infection. 71.83% had cared for under 5 patients in the previous ten years. 20.69% would refuse to look after these patients. There was a significant link between professionals' attitudes and the variables of age and their particular professional activity. 80.23% chose a single location as their preferred option for care, the majority in special centres. CONCLUSIONS: The knowledge that Primary Care health staff have about HIV infection does not seem to come from their experience in handling these patients. To achieve a greater commitment of the PC professional to caring for these patients, it would be necessary to offer specific clinical, epidemiological and preventive training and provide the requisite funds and resources. These kinds of study are a contribution to the widening of the documentation on the level of knowledge and attitudes towards HIV infection and their handling by professionals working in PC teams.

Adult↗
PubMed1994

Frailty selection in bivariate survival models: a cautionary note.

"One problem that researchers face in analyzing the survival times of groups of related individuals is selecting how the distribution of frailty--an unobserved (or not adequately observed) random factor--should be specified. Several distributions have received attention--for instance, the gamma distribution and a nonparametric N-point, discrete probability distribution. Researchers have selected these distributions more for mathematical convenience than for their ability to represent biological, social, or economic reality, and the implications of choosing one functional representation of frailty over alternative choices have not been studied extensively.... This research paper explores the association among survival times under gamma, inverse Gaussian, nonparametric N-point, and Poisson distributions. It shows that the pattern and strength of this association depends on how the distribution of frailty is specified." (SUMMARY IN FRE)

Demography↗
PubMed1994

Identification of allergens from the mite Blomia tropicalis.

In some tropical areas the mite Blomia tropicalis is a clinically important allergenic component of house dust, inducing specific IgE immune response in patients with allergic respiratory diseases such as asthma and rhinitis. The identification of allergens of this mite is necessary to obtain appropriate reagents for diagnostic and treatment procedures. We carried out this study using immunoblotting to detect the allergens of B. tropicalis. Our results demonstrate that this mite has one major allergen (11-13 kDa) and three other important allergens with about 50% binding (64, 36 and 33 kDa). Therefore, B. tropicalis should be regarded as an important source of allergens in the house dust in tropical areas, besides those derived from other mites.

Adolescent↗
PubMed1994

Spontaneous pneumothorax. Long-term results with tetracycline pleurodesis.

The aim of this prospective study was to determine the rate of recurrence for spontaneous pneumothorax (SP) after tetracycline pleurodesis (TCP), using that of observation, tube thoracostomy alone, and thoracotomy as references. From 1985 to the end of 1991, 78 patients were treated with tetracycline pleurodesis and 135 patients served as control subjects. Pleurodesis was induced by instillation of tetracycline and ascorbic acid through the pleural drain. The indication was any SP treated with tube thoracostomy, without active pulmonary infection. Follow-up period was from 13 to 95 months (mean, 45 months); follow-up rate was 94 percent. Post-therapy surgery was necessary for eight patients in whom pleurodesis failed due to presence of a persistent air leak. The ipsilateral recurrence rate of patients treated with TCP was 9 percent (6/66) and recurrence time ranged from 2 days to 9 months. The recurrence rate for patients treated with observation was 36 percent, 35 percent for those having chest tube alone, and none for those undergoing surgery. No death occurred as a direct result of this procedure and all patients could be released from the hospital. Eleven subjects died during the follow-up period; the mean follow-up until death was 37 months (range, 2 to 87 months). Five deaths were due to respiratory causes and six were due to extrapulmonary causes. Tetracycline pleurodesis has been shown to be a good alternative for the prevention of recurrence of SP. Its recurrence rate is lower than that of tube drainage but higher than that of surgical treatment.

Adolescent↗
PubMed1994

Evaluation of the costs to Medicare of covering therapeutic shoes for diabetic patients.

OBJECTIVE: A three-year demonstration was fielded in three states to evaluate the cost to Medicare of a therapeutic shoes benefit for Medicare Part B beneficiaries with severe diabetic foot disease. RESEARCH DESIGN AND METHODS: Eligible Medicare beneficiaries who applied were randomly assigned to either a treatment group that received the extra therapeutic shoe coverage or a control group that received only standard Medicare coverage. This study analyzes the Medicare payments and service use of 3,428 demonstration participants in California, Florida, and New York for whom data on a 12-month follow-up period were available. These results are comparable to those for the entire sample over a variable length follow-up period that averaged 20 months but ranged from 3 months to 3 years. RESULTS: Differences between groups are not statistically significant. However, Medicare payments for all services among the treatment group were $451 (3.8%) higher than those for all services among the control group. Similarly, Medicare payments for foot-care services were $318 (14.6%) higher among beneficiaries in the treatment group, which considerably exceeded the cost of the shoe benefit ($118). CONCLUSIONS: The demonstration produced no definitive evidence that expanding Medicare Part B to cover therapeutic shoes for beneficiaries with severe diabetic foot disease would increase total Medicare costs. However, our findings indicate that the demonstration was successful at increasing therapeutic shoe ownership and was instrumental in increasing beneficiaries' use of the shoes when walking outdoors.

Aged↗
PubMed1992

[Fertility decline and changes in proximate determinants in Latin America and the Caribbean].

"The objective of this paper is to discuss the role that three of the proximate determinants of fertility (marriage, contraception and post-partum insusceptibility) have played in fertility change in Latin America and the Caribbean. First we look at issues of data availability and comparability on measures of the proximate determinants from retrospective surveys. Most of the data utilized come from the World Fertility Survey (WFS) and the Demographic and Health Surveys (DHS) projects. Second, we present results from the most widely applied model for assessing the impact that these proximate determinants have on fertility, that of Bongaarts....Finally, we compare the results from the application of the Bongaarts model with those from an alternative method proposed by Moreno. Both models show that increased use of contraception is by far the most important reason for fertility decline, with marriage and post-partum insusceptibility making much smaller contributions. However, the second model suggests that the role of the marriage and post-partum insusceptibility factors is much smaller than is shown by the Bongaarts model." (SUMMARY IN ENG)

Amenorrhea↗
PubMed1991

[Use of a monthly calendar for collecting retrospective data on contraception: an evaluation of the experimental field studies of the Demographic and Health Surveys (DHS)].

A methodological experiment was conducted as part of the Demographic and Health Surveys (DHS) project to determine whether different approaches to measuring the same variables would yield similar results. The experiment consisted of the use of a new questionnaire, incorporating variants of many of the traditional approaches to the collection of demographic and health data. The experimental questionnaire was applied in 2 countries, Peru and the Dominican Republic at the same time as the standard survey. The most salient feature of this new questionnaire pregnancies, contraceptive practice, and postpartum, marriage, employment, and migration information. In this paper, the authors evaluate whether the use of the calendar in the experimental questionnaire improved the quality of the resulting information on contraception in the DHS surveys from the abovementioned countries. Specifically, the author determine whether the monthly calendar led to better estimates of contraceptive prevalence, failure, and discontinuation, and discuss the advantages and drawbacks of the calendar over the more standard approach. Results from this evaluation suggest that the major advantages of the calendar over the more standard questionnaire are 3-fold: it allows for more complete reports of use for periods prior to the survey; it allows for a detailed study of contraceptive use patterns; and it obtains information which is more internally consistent with other types of information. On the bases of these findings, the DHS project will include a calendar in the new standard questionnaire to be used in the 2nd round of surveys (DHS II).

Americas↗