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P Cortina

Publications and source records attributed to P Cortina.

At least 19 recordsLinked to original sources
PubMed2006

[Preliminary results of DERMATEL: prospective randomized study comparing synchronous and asynchronous modalities of teledermatology].

INTRODUCTION: There is considerable variability in the results of studies that evaluate diagnostic reliability in teledermatology. There are only two studies that compare the synchronous and asynchronous modalities of teleconsult in the same sample. We present the results of the pilot project DERMATEL, a study of diagnostic concordance that aims to increase the evidence of these aspects. MATERIAL AND METHODS: One-hundred-fifty.nine patients referred by the general practitioner in the first consult were randomized (algorithm 3:2:1) in three arms: asyncronous teledermatology (store-and-forward or SAF), synchronous teldermatology (real-time or VTC), and conventional consult (CC). We used high-quality, fixed digital images in all cases. The patients on the VTC teledermatology arm were also evaluated by videoconference. Finally all patients attended a face-to-face consult, considered the gold standard of patient care. A second dermatologist evaluated the diagnostic and management concordance between the teleconsults and the face-to-face consults. RESULTS: One-hundred.forty-seven patients completed the study as follows: 74 in the SAF teledermatology arm, 47 in the VTC teledermatology arm and 26 in the conventional consult (control group). The teledermatological (SAF and VTC) and face-to-face evaluations were identical in 100 of 121 patients (82.6%). The errors were mild in 14 cases (11.6%) and severe in 7 (5.8%). The diagnostic concordance was very high (kappa=0,813). The errors grouped by diseases were as follows: 6/54 (11%) for tumors, 10/30 (33.3%) for inflammatory conditions, 1/20 (5%) for infectious diseases, 3/12 (25%) for alopecia/acne and 1/5 (20%) for others. There were 15 errors in the SAF teledermatology arm (20.3%) and 6 in the VTC teledermatology arm (12.8%); these differences were not statistically significant (chi2 1.12; p=0.288). CONCLUSION: The reliability of dermatological teleconsult is very high, especially for tumoral or infectious diseases. The synchronous interaction with audio requires more resources, is difficult to coordinate and its diagnostic efficacy is not superior to SAF teledermatology.

Adolescent↗
PubMed1997

Diclofenac sodium and cyclosporin A inhibit human lens epithelial cell proliferation in culture.

PURPOSE: To investigate the effect of diclofenac sodium salt and cyclosporin A (CsA) on human lens epithelial cell (HLEC) growth in culture. METHODS: Cultures of HLEC were obtained from anterior capsules from extracapsular cataract surgery. Third-passage cells were seeded in 96-well plates in 0.1 ml culture medium. Cytotoxicity was estimated by the tetrazolium test in confluent monolayers after 24 h exposure to a wide range of concentrations of diclofenac and CsA. The effect of subcytotoxic concentrations of diclofenac and CsA on HLEC proliferation in subconfluent cultures was evaluated after 24 and 72 h of exposure. To investigate the relationship between PGE2 synthesis and the inhibitory effect of these drugs, after 24 h of exposure to diclofenac and CsA the production of PGE2 was measured by radioimmunoassay. We also tested the effect of exogenous PGE2 addition to diclofenac 72-h-treated cultures. RESULTS: Diclofenac and CsA (at concentrations > or = 65 microM and > or = 2.5 microM, respectively) inhibited the proliferation of subconfluent cultures of HLEC in a dose-dependent fashion. Diclofenac inhibits PGE2 synthesis, while CsA at high doses stimulates PGE2 synthesis of cultured HLEC. Exogenous PGE2 addition reversed in part the inhibitory effect of diclofenac. CONCLUSIONS: Diclofenac and CsA at appropriate doses are effective in inhibiting cultured HLEC proliferation. This could be of interest to prevent posterior capsule opacification. Further in vivo experimental studies seem worthwhile.

Aged↗
PubMed1996

Prevention and early detection of tuberculosis.

1,570 subjects with known TB contacts (active TB, old TB and primary infection) and individuals with no known contacts but belonging to 'defined TB risk groups' were screened at the Department of Tuberculosis Prevention at the La Fe Hospital in Valencia. The total infection rate was 40.13% and active TBC was diagnosed in 2.23% of the population screened. Infection and disease rates were significant in all the groups examined, showing the need for correct screening not only for active TB contacts but also for child primary infection contacts, old TB cases not previously screened and subjects with no known contacts but belonging to a 'TB risk group'.

Adolescent↗
PubMed1996

Dietary habits and geographic variation in stomach cancer mortality in Spain.

Following examination of the geographical pattern of stomach cancer incidence in Spain, the possible relationship between diet and stomach cancer has been assessed using an ecological model which looks into the relationship between the consumption of different foods and the nutrient intake in each of the 50 Spanish provinces during the period 1964-65, and the mortality rate for stomach cancer in these same 50 provinces during a period 20 years later (1984-86). The geographical pattern of stomach cancer mortality has been arrived at using the standardized mortality ratios (SMRs) calculated for each province. The per capita consumption of foods was obtained from the National Institute for Statistics and the calculation of nutrient intake was based on tables of nutritional composition. The results have been obtained using the statistical techniques of linear and Poisson regression. Stomach cancer mortality in Spain exhibits a stable and well-defined pattern, with less risk being apparent in the Mediterranean coastal provinces. The variability in the geographical distribution of stomach cancer mortality can, in large part (76%), be explained by the variation in the types of foods consumed between provinces, and this figure rises to 82% when one considers other socio-economic variables. A significant inverse association has been found between gastric cancer mortality and consumption of vegetables, fruits and vegetable oil as well as with vegetative growth and population density. From the multiple regression analysis, which considered both nutritional and socio-economic variables, the strongest inverse association with stomach cancer mortality was found in the consumption of green vegetables. The estimated relative risk (RR) of dying, for an increase in consumption of vegetables of 100 g per capita per day is 0.72, (95% CI: 0.53-0.91). These results are consistent with those of similar studies elsewhere.

Feeding Behavior↗
PubMed1996

The effectiveness of health systems in influencing avoidable mortality: a study in Valencia, Spain, 1975-90.

OBJECTIVES: To measure variations in the Holland and Charlton classifications of avoidable death causes and to estimate the effect of the Spanish national health system on avoidable mortality. DESIGN: Mortality in the Valencian Community was assessed between 1975 and 1990. The classifications of Holland and Charlton, used to assess avoidable causes of death, were compared. Holland's classification was then used to divide avoidable mortality into two groups--medical care indicators (MCI), which show the effectiveness of health care, and national health policy indicators (NHPI), which show the status of primary prevention. Comparisons were made with rates, group rates, and population rates. Trends and indices were also studied. SETTING: Valencia, Spain, 1975-90. RESULTS: During the study period, avoidable morality (only assessed by MCI) fell 63%, whereas the remainder of the mortality (non-MCI causes, that is all the non-avoidable causes together with the NHPI group) fell by 17%. If it is assumed that the mortality due to non-MCI causes indicates the overall effect of the environmental, social, nutritional, and genetic influences, then the difference between this and the MCI group would take us nearer the actual effect of the intervention of the health system. CONCLUSIONS: It is concluded that in this community, the health system has been responsible for approximately 47% of the total reduction in mortality from avoidable causes in the period studied.

Adolescent↗
PubMed1995

[Latex allergy].

In 1979 the first case of contact urticaria to rubber gloves was reported in a patient with a positive skin prick test to latex. The use of articles containing rubber is widespread and this can explain the increasing frequency of allergic reactions to natural rubber latex. The symptoms may be localized like contact urticaria or systemic like angioedema, generalized urticaria or anaphylactic shock. In this study we have considered 12 patients who presented clinical manifestations after direct contact with objects containing rubber. Three patients had eczema and pruritus after the use of household gloves, 4 subjects had lips and tongue oedema following the contact with rubber tube during a dental treatment, 5 patients suffered from urticaria and pruritus during the use of surgical gloves. Generalized angioedema was also present in 4 out of 12 patients. All the patients had positive Skin prick test and Rast to latex. Three out of 12 patients were atopic. Our study confirms the increasing frequency of immediate hypersensitivity reactions to latex. This phenomenon must be taken into account especially before surgery, since severe clinical manifestations such as anaphylactic shock may occur.

Adult↗
PubMed1994

Cyclosporin in Behçet's disease: results in 16 patients after 24 months of therapy.

The aim of this study was to evaluate the usefulness of cyclosporin in Behçet's disease. Sixteen subjects (10 males and 6 females; mean age 25.2 years) affected by the complete type of Behçet's syndrome received 5 mg/kg/day of cyclosporin for 24 months. A marked improvement of the symptoms was observed after three months of therapy. Within 6 to 12 months of treatment 14 of the 16 patients obtained a complete clinical remission. Biochemical and immunological parameters were controlled periodically to evaluate the clinical response and the possible side-effects. Two patients dropped out of the study because of anaemia and renal dysfunction, which returned to normal when cyclosporin was withdrawn. Our results confirm the efficacy of cyclosporin in the treatment of Behçet's disease.

Adult↗
PubMed1994

[Efficacy of salmeterol in patients with allergic bronchial asthma].

Inhaled beta 2-agonists play a central role in the treatment of acute bronchial asthma. A new long-acting beta 2-receptor agonist has recently become available: salmeterol. It improves FEV 1, has an antiinflammatory effect on bronchial airways, provides a strong protection against histamine-and allergen-triggered bronchoconstriction, thus leading to better control of asthmatic symptoms during day and night. The aim of this study was to evaluate the efficacy of salmeterol in 22 patients with allergic bronchial asthma. Our results show that inhaled salmeterol (50 micrograms twice daily) can successfully control diurnal and nocturnal asthmatic attacks and can induce an important increase of PEFR. During the study no further treatment with bronchodilator drugs was necessary.

Administration, Inhalation↗
PubMed1993

[Effectiveness of loratadine vs. placebo in the treatment of urticaria-angioedema syndrome in patients with food allergy].

Loratadine is a new, highly selective, non sedating, H 1-receptor antagonist, without central nervous system activity. In a randomized double-blind, crossover study, we evaluated the effects of loratadine and placebo administered once daily in 184 food intolerant patients affected by urticaria-angioedema. The difference between loratadine and placebo treatment was significant in relieving symptoms. Adverse reactions reported in the treatment were mild, in fact somnolence was reported by 3.4%, dry mouth by 2.2% of patients.

Adult↗
PubMed1992

Inguinal hernia and certain risk factors.

There are several studies on inguinal hernias that give some clues about the association between this type of hernia and certain risk factors. This association was suspected long ago but had not been demonstrated. The present study tries to correlate the origin of inguinal hernias and the physical effort of the subjects in accordance with their work activity. The results of this study show that physical effort, as a risk factor, is closely related to the appearance of inguinal hernias. A person whose work involves lifting or other strenuous exertion has a higher risk than those whose jobs are less strenuous (p less than 0.05). This conclusion was reached after taking into account not only the weight lifted but also the number of years in this activity.

Alcohol Drinking↗
PubMed1992

[Diet manipulations and nickel sulphate-induced contact dermatitis evaluated in 24 cases].

The wide distribution of nickel in the environment as well as in animal and vegetable foods has led a large number of authors to investigate the oral absorption of nickel. The aim of this study was to evaluate the effect of a free-nickel diet in 24 patients affected by nickel sulphate-induced contract dermatitis. The diagnosis was made on the basis of their past history and of Patch test. A complete remission of symptoms was obtained with a nickel-free diet for two months; Patch test became partial negative in 50% of patients and completely negative in 33%. In conclusion our results confirm the relationship between nickel-induced dermatitis and oral nickel absorption and suggest that diet manipulations can be useful in cases of refractory skin manifestations.

Administration, Oral↗
PubMed1992

[Food allergy and asthma].

The prevalence of asthma in patients suffering from food allergy or food intolerance had been studied in 1339 subjects. Of them, 165 patients (12.8%) were affected by asthma. However only 77 (5.7%) had positive prick tests for food antigens and 52 of these have a significant benefit when a suitable oligoallergenic diet was introduced. 35 out of patients were positively tested with a double-blind food challenge. The most frequent food antigen involved were milk and its derivatives and cereals, but some importance have also the additives to the food. In conclusion, in our patients suffering from food allergy or food intolerance asthma was present in 12.8% of the cases, but in only 77 (5.7%) the symptoms might be due to diet. When tested with oligoallergenic diet or with food challenge the percentage of positivity fall to 3.9% and 2.6% respectively.

Adult↗