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Biomedical subjects

M Ortiz

Publications and source records attributed to M Ortiz.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

Differential clinical features of late-onset panic disorder.

OBJECTIVES: The aim was to analyse the sociodemographic and clinical characteristics of panic disorder (PD) in patients with a PD onset after 60 years of age, at two outpatient psychiatric clinics in Barcelona (northeastern Spain). MATERIAL AND METHODS: All patients presenting with PD at two outpatient clinics over a 4-year period were assessed by the same team. Patients with PD onset at 60 or after were grouped (late-onset), and compared with the group with an earlier onset. The instruments administered to the sample were: Global Assessment of Functioning scale, Panic-Associated Symptom Scale, Hamilton's Depression and Anxiety Scales and Marks-Matthews' Fear and Phobia scale. RESULTS: Of 5301 patients attended over a 4-year period, 64 (1.2%) were PD patients aged 60 or above. Age at PD onset was over 60 in 27 cases (0.4% of the total population, and 6.1% of all PD patients). The mean age in the late-onset group was 67.0+/-4.9 years. Late-onset PD patients were less likely to report family history of PD. They scored lower on most scales assessing clinical severity (excepting GAF and agoraphobia scores), and they exhibited fewer and milder panic symptoms during the attacks. However, dysthymic disorder, but not major depressive disorder, was more common among late-onset PD patients (P<0.05). COMMENTS: The most notable findings in our late-onset PD subgroup of patients were: lesser severity of the disorder, greater comorbidity with dysthymia, and less family history of PD. Prevalence rates of late-onset PD in our sample appeared to be rather high. Physical illness and less severe panic symptoms may contribute to underdiagnosing PD in this particular subpopulation.

Age of Onset↗
PubMedDate not supplied

[Sequential chemo-radiation in non-small cell lung cancer: a retrospective study of 100 patients].

Combined chemotherapy and radiotherapy has shown to be the correct treatment of unresectable non-small cell lung cancer, after many years of poor survival figures with standard radiotherapy alone. It has also been demonstrated that the benefit of chemotherapy is mainly achieved if cisplatin-based schedules are used. The authors present a retrospective study of 100 cases of stage III non-small cell lung cancer treated with a sequential approach of chemotherapy and radiotherapy and evaluate median and overall survival, local progression-free survival and distant progression-free survival. The results of our series are quite similar to those published in literature.

Adult↗
PubMedDate not supplied

A stage-of-change classification system based on actions and beliefs regarding dietary fat and fiber.

PURPOSE: The objectives of this study were to develop a stage-of-change classification system and to determine the degree to which various adult subgroups have adopted the behavioral changes necessary to achieve a low-fat and/or high-fiber diet as recommended by the Dietary Guidelines for Americans. DESIGN: The study used a mail survey randomly sent to 7110 adults. SETTING: The survey was conducted in 11 states and the District of Columbia. SUBJECTS: The random sample included males and females over age 18. Of the eligible respondents, 3198 (51.5%) were included in this analysis, with 2004 and 2066 unambiguously classified into stages of change for fat and fiber, respectively. MEASURES: Stage of change was defined by an algorithm based on self-reported intent and behaviors to limit fat and/or increase fiber. RESULTS: 45% of the respondents were classified as being in action/maintenance for fat and 38% for fiber. Women, older adults, individuals with advanced education, persons with diet-related chronic disease, people with higher levels of relevant nutrition knowledge and attitudes, and persons who indicated that health concerns were a primary influence on their diet were more likely to be in action/maintenance than other respondents. CONCLUSIONS: The algorithm in this study presents a model that more closely reflects the proportions of the adult population that have achieved low-fat diets and classifies a greater proportion in the preparation stage than classification systems in previous studies.

Adult↗
PubMedDate not supplied

[Validation of the Panic Attack Symptoms Scale].

INTRODUCTION AND METHOD: The ESAP is a self-rating scale based on the panic attack with 0 to 3 scoring and the total score is obtained by adding the 14 scores- the highest score thus being 42. Forty patients were included for the study, and the were assessed at their first visit, after one week and after one month in the treatment. RESULTS: The items at the first basal assessment followed a normal distribution (Test Shapiro-Wilk w: 0.97, p< 0.57). The mean score was 18.5 with a SD of 7.43. The scale's internal consistency was measured by Cronbach's alpha, which was 0.66 at the first visit, 0.60 at the second one and 0.90 at the third one. Test-retest reliability was good in most cases, with values greater than 0.7 (p< 0.001). The correlation between the first visit total score and the second one was 0.89 (p< 0.001). The correlation with other scales (concurrent validity was highly significant with Hamilton's anxiety scale, total PASS and most of the PASS sub-scales (unexpected panic, limited and anticipatory anxiety) and slightly significant with the number of crises in past month. Four factors accounting for 65% of variance were identified in the factor analysis.

Adult↗
PubMedDate not supplied

Prevalence of dermographism in children.

The prevalence of dermographism in our pediatric population was studied in 238 children of both sexes (128 boys and 110 girls) aged 2-14 years, randomly selected from a health care center. Skin reaction was evaluated after 5 min pressure (3,200 g/cm2) applied with a dermatographometer on a 5-cm length of dorsal skin. The reaction was considered positive when a wheal of more than 2 mm was observed. The prevalence of dermographism was found to be 24%, with a significant female predominance (33%) over males (16%). Forty-one percent of the children with dermographism reported exanthema in response to friction and pressure, which was compatible with symptomatic dermographism, compared with only 5% of those who yielded negative reactions. In order to assess the prevalence of dermographism in the atopic population, 100 patients in the 4-14 age range with respiratory disease (perennial allergic rhinitis and/or bronchial asthma) involving sensitization to aeroallergens (house dust mites and/or Alternaria) were studied. A positive response to the application of pressure (3,200 g/cm2) was observed in 47% of cases, this figure being significantly higher than in the general pediatric population.

Adolescent↗
PubMedDate not supplied

[Diagnostic and clinical course features of lupus membranous glomerulonephritis].

BACKGROUND: Lupus membranous glomerulonephritis (LMG) is sometimes difficult to distinguish from idiopathic membranous glomerulonephritis (IMG) and little is known about its natural history. METHODS: We have performed a retrospective study of 16 patients with LMG, types Va ("pure" LMG) (8 patients) and Vb (mesangial proliferation) (8 patients). Analytical and clinical characteristics were analyzed in each case at the onset of the disease and during follow-up. RESULTS: At the time of diagnosis, 7 patients (43%) did not present any extrarenal manifestations of systemic lupus erythematosus (SLE). Nephrotic syndrome was the most common clinical presentation (81%). 14 patients (87%) showed positive antinuclear antibodies (ANA), but at low titres (< 1/300); anti-DNA antibodies were positive only in 3 cases (18%) and hypocomplementemia was observed in 2 (12%). The most relevant histological findings were the presence of Clq deposits (83%) and subendothelial and mesangial deposits. Treatment consisted of corticosteroids, adding immunosuppression when no response was obtained in 2-3 months. In recent years, an angiotensin-converting enzyme inhibitor (ACEI) was added before immunosuppression. At the end of the study, 6 patients (42%) developed chronic renal insufficiency and 8 (58%) renainea with normal renal function. Actuarial renal survival was 100% at 5 years and 75% at 10 years. The evolution towards a non-nephrotic range proteinuria throughout the follow-up was the only parameter significantly associated with a good prognosis. CONCLUSIONS: LMG can present without extra-renal symptoms of SLE and even with very poor expression of its serological markers. Almost half of the patients (42%) developed chronic renal insufficiency. The evolution towards a non-nephrotic range proteinuria correlated with the maintenance of a normal renal function.

Adult↗
PubMedDate not supplied

[Comparative study of vecuronium and atracurium at low doses in minor pediatric surgery under combined anesthesia].

To compare, the time of onset and time of recovery of muscular blockade after use of half doses of vecuronium and atracurium, we studied 18 children ASA I who were proposed for short lasting pediatric surgery and combined anesthesia. Patients were divided into two groups: group V (n = 10) was treated with a single dose of 0.05 mg/kg of vecuronium and group A (n = 8) with 0.25 mg/kg of atracurium. Assessment of muscular relaxation was performed by measuring the electromyographic responses to a train of four stimuli applied to the cubital nerve at the level of the hypothenar eminence. We administered 0.02 mg/kg of atropine, 5 to 10 mg/kg of thiopental, and the muscular relaxing dose together with orotracheal intubation when the first stimulus of the train of four stimuli was blocked at 90% of its initial value (T90). Maintenance of the anesthetic level was performed with 50% of N2O-O2 without inhalational anesthetics. A caudal blockade was induced by 1 ml/kg of bupivacaine at 0.25%. We measured the following parameters of muscular relaxation: T90, T10 (time at which the 10% of the first stimulus reappears), T25 (time of clinical efficacy) and IR (index of recovery). Only 60% of patients (6 out of the 10 patients of vecuronium group and 5 out of the 8 subjects of atracurium group) achieved the T90. This occurred 2.5 +/- 0.7 min after vecuronium and 3.2 +/- 0.6 min after atracurium. T10 was 13.7 +/- 4.1 min for vecuronium and 13.3 +/- 4.1 min from atracurium. T25 occurred 18.2 +/- 6.5 min after vecuronium and 19.4 +/- 2.1 min for atracurium.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Caudal↗
PubMedDate not supplied

[Rett syndrome].

The case of a girl carrier of the Rett syndrome is presented. During the first year of life general growth and psychomotor development were normal. Afterwards progressive neurological and mental impairment, loss of ability for the intentional use of hands together with stereotyped movements were seen. At the same time autistic behaviour, progressively abnormal EEG and microcephalia as well as bruxism were evident. Clinical diagnosis was done according to internationally accepted criteria.

Electroencephalography↗
PubMedDate not supplied

Topography of peribulbar anesthesia.

BACKGROUND AND OBJECTIVES: Peribulbar anesthesia has fewer complications than retrobulbar anesthesia, but ocular perforation has also been described in peribulbar anesthesia. This study aims to verify by computed tomography that the recommended points for performing peribulbar anesthesia are safe. METHODS: Three human corpses were used. The puncture points were position A (superior internal orbital angle and inferior external orbital angle), position B (superior and inferior orbital median line), and position C (superior external and inferior internal orbital angle). Contrast diffusion was studied in each position at 3, 4, 5, and 10 minutes after contrast injection. RESULTS: Among upper eyelid punctures, the only one anatomically safe is the internal angle puncture, given that either in the median line or the external angle there is a chance of eye globe perforation. Lower eyelid positions are a safe distance from the optic nerve and ocular globe. Contrast diffusion was satisfactory in positions A and B. There was little diffusion in position C. CONCLUSIONS: The median or external superior angle eyelid puncture may cause eye globe perforation.

Anesthesia, Local↗
PubMedDate not supplied

Spread of local anesthetic into the epidural caudal space for two rates of injection in children.

BACKGROUND AND OBJECTIVES: The optimal rate of injection of local anesthetic in pediatric caudal blocks has not been determined. The purpose of this study was to determine the influence of two rates of injection on the level of analgesia in children. METHODS: The patients, 79 children, American Society of Anesthesiologists class 1, who were scheduled for minor surgery, were allocated to three groups according to age: group 1, 0-12 months; group 2, 13-36 months; and group 3, 37-72 months. Each age group was further divided randomly into two subgroups according to rate of injection: subgroup A received 1 mL/kg of 0.25% bupivacaine with 1:200,000 epinephrine at a rate of 1 mL/s, and subgroup B received the same dose at a slower rate of 1 mL per 10 s. Level of analgesia was assessed by loss of sensation to skin pinching. Age, weight, height, time of surgery, onset, and level of analgesia and complications were recorded. RESULTS: For the faster rate, significant differences in level of analgesia were found between groups 1 and 2; the groups were not significantly different for the slower rate, however. The median level in patients 12 months and under was two dermatomes above that of patients older than 12 months at both rates. The levels for each rate (subgroups A and B) were not significantly different in any age group. The time needed to reach the highest level became progressively longer with age (from group 1 to 3), and differences were significant at both rates. CONCLUSIONS: Level of analgesia is not affected by the rate injection of 0.25% bupivacaine into the epidural caudal space in children. The time needed to reach the highest level increases as the child ages.

Anesthesia, Epidural↗
PubMedDate not supplied

[Clinical subgroups of anxiety disorders: from phenomenology to cluster diagnosis].

The panic disorder is heterogeneous. The factorial study of the phenomenology of panic crisis suggests the existence of different subtypes: the cardio-respiratory, the vestibular, the despersonalization, the gastrointestinal and others. We review the clinical and biological data which suggest the display of these subtypes.

Adult↗