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Biomedical subjects

M Esquivel

Publications and source records attributed to M Esquivel.

14 recordsLinked to original sources
PubMed1995

Rapid admission and retention on methadone.

An open clinical trial was conducted to compare the effects of rapid (1-day) admission with slow (14-day) admission to methadone maintenance on pretreatment attrition, retention during treatment, and other outcomes. One hundred eighty-six illicit opioid users eligible for methadone maintenance were randomly assigned to rapid admission or slow admission, with 93 subjects assigned to each group. The random assignment produced two groups that were similar on 22 personal variables. All subjects admitted to treatment were followed for 1 year. Follow-up interviews were obtained with 155 (98%) of the 158 subjects admitted to treatment. During the period from initial contact to medication, only 4% of the rapid admission subjects but 26% of the slow admission subjects dropped out. The risk of dropout during slow admission was 6 times that during rapid admission. A higher percentage of rapid admission subjects, 43%, than of slow admission subjects, 39%, remained continuously in treatment for 1 year, but the difference was not significant. The two subgroups that remained in treatment for 1 year did about equally well on measures of illicit drug use and social performance. The findings indicate that pretreatment attrition can be markedly reduced by prompt medication, and the prompt medication does not adversely affect retention during treatment or other outcomes.

Adult↗
PubMed1995

The link between the Department of Pathology and Laboratory Medicine and medical administration. Managing the quality continuum.

As hospital-based physicians, pathologists are positioned to play a key role in quality management at their institutions. As we enter into the era of increased competition for scarce health care resources, opportunities to increase efficiency, improve quality, and reduce expenses will expand. Laboratory medicine specialists possess much needed expertise in data management and quality improvement. Pathologists must now reach beyond their own departments, redefining their mission through a focus on clinical-managerial relationships.

Laboratories, Hospital↗
PubMed1991

Increased calcium uptake in vascular tissue by plasma of patients with essential hypertension.

Plasma factors have been implicated in causing increased calcium uptake and cytosolic (Ca++) in vascular tissue leading to hypertension. We compared the effect of plasma from hypertensive and normotensive subjects on rat aortic calcium uptake. Plasma from hypertensive subjects was fractionated and the fractions assessed for their activity on aortic calcium uptake. Aortic calcium uptake was significantly higher in plasma from hypertensives as compared to normotensives (p less than 0.05). There was a significant positive correlation between diastolic blood pressure and aortic calcium uptake (r = 0.645; p = 0.002). There was a significant positive correlation between percentage ideal body weight and aortic calcium uptake in normotensives and hypertensives (r = 0.522; p less than 0.05). The calcium uptake stimulatory activity in plasma of hypertensives was found in nonesterified fatty acid and cholesterol ester fractions.

Adult↗
PubMed1991

Methadone dose and urine morphine.

When methadone maintenance was introduced in 1965, daily doses of approximately 100 mg were advocated and used; later, doses under 50 mg became common; recently, doses between 50 and 100 mg have been recommended. In a historical study and a cross-section study in one program the authors found no relationship between methadone dose and urine morphine. Patients on methadone doses under 50 mg had nearly the same percentage of urine tests positive for morphine as did those on doses of 50 mg and more. Gender, ethnic background, and age were also unrelated to urine morphine. Time on methadone was inversely related to urine morphine. Patients maintained on methadone for 3 years or longer showed a marked decrease in urine tests positive for morphine. Increased urine morphine during one decade was associated with program and community changes that could have prompted increased heroin use. These findings suggest that variables other than methadone dose affect heroin use.

Adult↗
PubMed1987

On growth of children: effect of some socioeconomic and genetic factors.

In 8195 boys and girls (2.00 to 7.99 years of age) height, per capita family income and mid-parent height were recorded. Children who lived in good socioeconomic conditions, as measured by per capita family income, achieved greater mean height than those in poorer ones. The greater proportion of variation is explained by mid-parental height and not by income. Apparently there seems to be a relationship between the height percentiles of individuals and the categories of the studied socioeconomic variable.

Analysis of Variance↗
PubMed1987

Pharmacokinetic disposition of isoxicam in hepatic cirrhosis.

To determine the effect of liver dysfunction on the absorption and disposition of isoxicam, we administered a single oral dose of 200 mg to 8 patients with alcoholic cirrhosis, and followed the plasma concentration-time curve for 96 h. The calculated isoxicam disappearance t 1/2 of 30 +/- 19.1 h in these patients was not different from the mean value of 31 +/- 5.7 h obtained in 10 normal subjects studied earlier by our group; however, interindividual variation was larger. No differences in lag time (0.42 +/- 0.3 vs 0.49 +/- .2 h) or time to peak concentration (9.0 +/- 2.5 vs 10.0 +/- 2.9 h) were observed. However, the peak plasma isoxicam concentrations and the areas under the plasma concentration-time curves (AUC) were reduced 32% (p less than 0.01) and 41% (p less than 0.01), respectively. Plasma protein binding of isoxicam studied by equilibrium dialysis was 80 +/- 16% in the cirrhotic patients compared with 96 +/- 1.4% in the normal volunteers (p less than 0.02), again with larger interindividual variation noted in patients with cirrhosis. The binding did not correlate significantly with any laboratory tests of liver function or with the AUC for plasma isoxicam. As compared to the normal subjects, these cirrhotic patients had decreased plasma isoxicam binding, peak plasma isoxicam concentrations and AUC, without a significant change in the apparent disappearance half-life of total plasma isoxicam after a single oral dose.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1986

Cardiovascular effects of enprofylline and theophylline.

The cardiovascular effects of enprofylline (with no adenosine receptor antagonism) and of theophylline (with adenosine receptor antagonism) were compared in six normal subjects in a double-blind trial at steady-state concentrations of theophylline (12.5 +/- 1.6 mg/L) and enprofylline (2.7 +/- 0.3 mg/L). The mean (+/- SD) recumbent heart rate (HR) was higher (P less than 0.04) after enprofylline (70 +/- 14 bpm) than after theophylline (58 +/- 13 bpm) or saline solution (57 +/- 10 bpm). Forearm arterial resistance determined by plethysmography was lowered (P less than 0.01) by theophylline (-37% +/- 14%) and enprofylline (-43% +/- 24%) but not by saline solution (-6% +/- 16%). In the semiupright position, the mean arterial pressure was lower (P less than 0.01) after enprofylline (93 +/- 15 mm Hg) than after theophylline (108 +/- 16 mm Hg). The cardiac index (CI) and left ventricular ejection fraction (LVEF) determined by radionuclide angiocardiography and the left ventricular end-systolic pressure/volume ratio were not different for any regimen. During maximal exercise, HR was higher (P less than 0.01) after both enprofylline (176 bpm) and theophylline (175 bpm) than after saline solution (161 bpm), but the increases in mean arterial pressure (18% to 32%), CI (153% to 167%), and LVEF (34% to 74%) were similar for all three regimens. Both theophylline and enprofylline lowered forearm arterial resistance without an increase in CI, LVEF, or cardiac inotropy, although enprofylline tended to cause a lower blood pressure and higher HR than did theophylline.

Adult↗
PubMed1984

Interaction of isoxicam with acetylsalicylic acid.

Ten healthy male volunteers were given 200 mg p.o. of isoxicam after an overnight fast and the plasma concentrations over time followed for 96 h by h.p.l.c. Five days later enteric coated acetylsalicylic acid (ASA) 650 mg four times daily was started and continued for 10 days producing steady state trough plasma salicylate of 83 mg/l (range 21-133). A second 200 mg isoxicam dose was given 5 days after starting ASA and the plasma concentration time-curve again followed. After ASA, there was no change in lag time (0.54 vs 0.51 h), time to peak concentration (10 vs 10 h), or disappearance t1/2 (28.7 vs 31.0 h) however the peak isoxicam concentration and AUC were reduced 18 and 22% respectively (P less than 0.01). Plasma protein binding of isoxicam studied by equilibrium dialysis was 96 +/- 1% in the absence and 86 +/- 5% in the presence of ASA. The reduction in binding was unrelated to plasma SA concentrations achieved or observed reductions in AUC for plasma isoxicam. ASA decreased plasma isoxicam binding, peak plasma isoxicam concentrations and AUC without altering the apparent disappearance half-life of total plasma isoxicam after a single oral dose.

Adult↗
PubMed1980

Outpatient methadone withdrawal for heroin dependence.

The outcome of outpatient methadone withdrawal reported in 20 published studies during the 1970s varied widely: none to 62% of the patients completed withdrawal, none to 35% became abstinent at termination of withdrawal, and none to 38% were abstinent at follow-up. Although somewhat ambiguous, the results indicated that outpatient withdrawal did not lead to prolonged abstinence in most heroin users. In two studies in San Antonio we attempted to compare opioid use and other behavior during 1 year before and 1 year after outpatient withdrawal. In the first study the before and after comparison of opioid use was unsatisfactory because of follow-up attrition. The frequency of arrest, based on police records and not affected by the follow-up attrition, changed only slightly. In the second study the follow-up attrition was small (8%), and satisfactory comparison could be made. Months abstinent did not increase, but months maintained on methadone increased significantly. The follow-up results did not differ notably from those in inpatient withdrawal. Outpatient withdrawal limited to 21 days has the disadvantage that many persons are prematurely withdrawn and consequently resume heroin use.

Adult↗
PubMed1978

Arrests before and during methadone maintenance.

The effect of methadone maintenance on criminal behavior remains ambiguous, in part because of major methodological problems with most studies. We attempted to approach the problem more precisely than previous studies by comparing official police arrest records of 100 heroin addicts for 1 year before admission with those for 1 year after admission. The total number of criminal charges decreased from 189 before admission to 129 after admission. Excluding vagrancy, because of a change in police arrest practice, we found only a 14% reduction in criminal charges. A statistically significant decrease of 40% occurred in one category, burglary and theft. Arrest frequencies were generally correlated with other outcome measures such as employment status and continuation in methadone treatment. The results suggest a modest reduction in criminal behavior as a result of methadone maintenance, with insignificant reduction in crime not directly related to narcotic addiction.

Adult↗
PubMed1976

Methadone dispensing by community pharmacies.

This study reports 1 year follow-up data of 96 patients who received methadone at selected community pharmacies instead of traditional program dispensaries. Outcomes are comparable to those reported for traditional programs. Security measures were not a problem. The results indicate that most patients can begin methadone maintenance at a pharmacy without a period of stabilization at a program unit. Of several factors studied, arrest record, both preceding and during treatment, based on official police data was the single factor significantly associated with employment and continuation in methadone treatment. Community pharmacy dispensing of methadone is a useful means of operating a methadone treatment program.

Adult↗
PubMedDate not supplied

[Clinical and epidemiologic aspects of acute diarrhea caused by rotavirus in children. Cuba, 1982-1984].

A total of 256 infants younger than three years, hospitalized by acute diarrhea, was studied from December 1983 to May 1984. Presence of rotavirus in their feces was demonstrated in 27.7%; in 4.3% of them, rotaviruses were associated with other agents. Vomiting followed by respiratory symptoms and fever were the main clinical symptoms observed in such patients, and in most of them diarrhea was profuse and liquid. Influence on infection by rotavirus of maternal feeding, hygienic-sanitary conditions, presence of domestic animals, and so forth, could not be demonstrated.

Acute Disease↗