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Biomedical subjects

P Gutierrez

Publications and source records attributed to P Gutierrez.

At least 37 records · Page 2Linked to original sources
PubMed1997

Influence of glaucomatous visual field loss on health-related quality of life.

We examined the influence of glaucomatous visual field defects on vision-targeted and generic health-related quality of life. Vision-targeted and generic health status were assessed across 5 glaucoma treatment categories and a normal reference group from 5 tertiary care ophthalmology practices during regularly scheduled eye care visits. The sample consisted of 147 patients who were members of specific glaucoma treatment categories and 44 reference group patients. For patients with glaucoma, eligibility included a diagnosis of glaucoma at least 1 year prior to enrollment and no evidence of other eye disease. Participants completed 2 vision-targeted surveys, the National Eye Institute Visual Functioning Questionnaire and the VF-14, and a generic health-related quality of life measure, the Medical Outcomes Study 36-Item Short Form. Data from automated perimetry (Humphrey Field Analyzer 24-2, Humphrey Instruments, San Leandro, Calif) were used to generate Advanced Glaucoma Intervention Study scores for all participants. The Medical Outcomes Study 36-Item Short Form scores from glaucoma and reference group participants collected on a random half of the sample were similar. However, comparisons of the vision-targeted surveys demonstrated significant mean differences on 7 of 11 National Eye Institute Visual Functioning Questionnaire scales, and a trend toward significant differences for the VF-14 (P < .07 by linear regression). Greater visual field defects in the better eye were significantly associated with poorer National Eye Institute Visual Functioning Questionnaire scores (P < .05), as well as with worse VF-14 scores. These findings were most dramatic for patients with the most severe field loss in the better eye. Vision-targeted questionnaires were more sensitive than a generic health-related quality of life measure to differences between glaucoma and normal reference participants. Our findings indicate that self-reports of vision-targeted health-related quality of life are sensitive to visual field loss and may be useful in tandem with the clinical examination to fully understand outcomes of treatment for glaucoma.

Adult↗
PubMed1996

Erectile dysfunction in men with and without diabetes mellitus: a comparative study.

The aetiology of erectile dysfunction in men with diabetes remains unclear and is likely to be multifactorial. To explore clinical factors of possible aetiological relevance, 59 men with diabetes and erectile dysfunction (ED), referred to a sexual problem clinic, were compared with an age-matched group of non-diabetic clinic attenders with ED. Sexual interest was both higher and correlated negatively with age in the diabetic groups. There were differences in the sexual problems experienced by partners in the two groups. Both groups had received nocturnal penile tumescence (NPT) monitoring and the majority had received intracavernosal injections of PGE1 to assess capacity for erectile response. Twenty-nine percent of the diabetic men had satisfactory NPT, and most of these had other evidence of psychogenic causation. The men with diabetes were more likely to have a satisfactory response to intracavernosal injections of PGE1, and this was particularly the case among those with impaired NPTs. This difference requires explanation and may be of aetiological relevance.

Adult↗
PubMed1996

Adolescent attitudes about death in relation to suicidality.

This study examined psychiatrically disturbed adolescents' history of exposure to suicide attempts, completions, and other deaths in relation to attitudes about life and death. A primary goal of the study was to study the mediating processes involved in the impact of loss on suicidality. Adolescents who experienced the suicide of a friend or immediate family member reported a weaker attraction to life and stronger attraction to death than adolescents lacking this experience. Exposure to attempted suicide resulted in attitudes indicating a stronger attraction to death and repulsion by life. We conclude that a comprehensive history of loss and assessment of current attitudes toward death are important aspects of evaluation and subsequent treatment of at-risk adolescents.

Adolescent↗
PubMed1995

Acute and subacute rehabilitation for stroke: a comparison.

Subacute rehabilitation, a recent innovation, is a less intense form of traditional inpatient rehabilitation. This study is a retrospective comparison of stroke treatment in a comprehensive inpatient service (acute rehabilitation) and subacute rehabilitation in a skilled nursing facility. Consecutive records during 1990 and 1991 resulted in 331 patients at the acute level and 97 at the subacute. Analysis of patient characteristics found few major differences between the two populations. Scrutiny of billing records found that acute program patients had twice as much treatment during a stay, twice the daily treatment hours, and twice the average charge per day. Acute rehabilitation patients showed substantially greater gains in functional impairment measures (FIM), but the proportion of patients discharged to the community varied little. Cost-effectiveness analysis found that the charge per successful discharge was more than double for acute rehabilitation. The charge per one point of FIM gain also was substantially higher. Although subacute rehabilitation was found to be more cost-effective than acute, additional research is needed to establish policies regarding rehabilitation services.

Activities of Daily Living↗
PubMed1995

Comparison of home and laboratory based monitoring of NPT using the Rigiscan; a preliminary report.

Laboratory based and home based monitoring of nocturnal penile tumescence (NPT) with the Rigiscan device was compared in a consecutive series of 100 men monitored in the laboratory, and a further consecutive series of 100 men monitored at home. Recordings at home were significantly shorter and involved more interruptions than laboratory based records. With subgroups, matched for diagnosis or the reporting of waking erections as well as age, laboratory monitoring tended to produce more sustained erections. However, in spite of the matching of subgroups, this trend may have resulted from aetiological rather than methodological differences, and further comparison of the two methods in the same subjects is now warranted. In the meantime, home monitoring should be used with diagnostic caution.

Adult↗
PubMed1994

Rapid and efficient construction of yeast artificial chromosome contigs in the mouse genome with interspersed repetitive sequence PCR (IRS-PCR): generation of a 5-cM, > 5 megabase contig on mouse chromosome 1.

We have developed a new technique for the generation of YAC contigs in the mouse genome that is based on the ability to detect overlapping clones by hybridization of shared IRS-PCR products. As a demonstration of the technique, a 5-cM, > 5 megabase contig was developed on the distal half of mouse Chromosome (Chr) 1, spanning the region from Lamb2 to At3. The contig covers roughly 5% of the genetic distance of the chromosome and is comprised of more than 80 clones; 71 probes were assigned physical order to the chromosome, of which 59 were new markers generated in this study. Eight of the new probes were shown to be polymorphic between C3H/HeJ-gld and M. spretus. Three probes were mapped on a [(C3H/HeJ-gld x M. spretus) x C3H/HeJ-gld] interspecific backcross to integrate the physical map with a high-resolution genetic map of the region.

Animals↗
PubMed1994

Herpes simplex brainstem encephalitis with a relapsing course.

We report a patient with a relapsing form of acute brainstem encephalitis. Pathological examination demonstrated necrotizing encephalitis in the cerebral cortex and, more pronounced, throughout the diencephalon, as well as in the pes pontis. Neurons and glial cells in the cerebral cortex and brainstem contained herpesvirus antigens. The clinical interrelationship of brainstem encephalitis, Miller Fisher syndrome and Landry-Guillain-Barré syndrome is discussed.

Adolescent↗
PubMed1993

What does duplex ultrasound add to sexual history, nocturnal penile tumescence and intracavernosal injection of smooth muscle relaxant, in the diagnosis of erectile dysfunction?

A consecutive series of 52 men presenting with erectile dysfunction were assessed with (i) standardized sexual history, (ii) nocturnal penile tumescence and rigidity monitoring (NPTR), (iii) Rigiscan assessment of response to intracavernosal papaverine or prostaglandin injection (ICI), and (iv) duplex ultrasonography. Subjects were categorized into 'organic', 'psychogenic' or 'uncertain' on the basis of the first three assessments, and duplex variables compared across the diagnostic groups. Maximum increase in arterial diameter and maximum systolic flow following ICI did not discriminate between groups. End diastolic flow and resistance index at 15 min following ICI was significantly higher in the organic than the psychogenic groups. None of the duplex variables helped to diagnose further those in the 'uncertain' categories. The diagnostic value of the duplex is probably substantially reduced by psychological inhibition of the response to ICI. Duplex ultrasound scanning does not appear to be a helpful initial diagnostic method for erectile dysfunction, but may have value in further identifying the aetiology in 'organic' cases, especially venous leakage. NPTR appears to be the best single diagnostic procedure. Methods of identifying the occurrence of psychological inhibition and 'false negative' results with ICI will enhance the diagnostic value of duplex ultrasonography.

Adult↗
PubMed1992

Infection by hepatitis B and C virus in non-intravenous drug using female prostitutes in Spain.

We have studied the prevalence of hepatitis B (HBV) and hepatitis C virus (HCV) serologic markers in female blood donors and in female prostitutes and the relationship of antibodies to hepatitis B core antigen (anti-HBc) and of antibodies to HCV (anti-HCV) with the presence of treponemal antibodies (FTA-ABS) in non-intravenous drug using female prostitutes. Hepatitis B surface antigen (HBsAg) was found in 1.0% of the female blood donors, anti-HBc in 15.6% and anti-HCV in 0.7%. In the prostitutes, the prevalence of HBsAg was 6.1%, anti-HBc was positive in 29.0% and anti-HCV in 8.8%. No significant statistical association between the prevalence of anti-HBc or anti-HCV and the age of prostitutes (p = 0.9111 and p = 0.8254 respectively) or the length of time as prostitutes (p = 0.3583 and p = 0.5770) was found. FTA-ABS positive prostitutes had a significantly higher prevalence of anti-HCV than FTA-ABS negative prostitutes (p < 0.001). No statistical association was found between anti-HBc antibodies and positive FTA-ABS prostitutes (p = 0.336).

Adolescent↗
PubMed1990

[Pericardial disease erroneously diagnosed as endomyocardial fibrosis. Report of 2 cases].

Two patients who were sent to operation with diagnosis of endomyocardial fibrosis (EMF) turned out to have pericardial disease. EMF had been suspected on the basis of clinical history, electrocardiographic, radiologic and echocardiographic data. The hemodynamic studies were "typical", and included apex amputation, flat ventricular surface and mitral and tricuspid insufficiencies. Thus, ventriculography should not be considered specific, but rather suggestive of endomyocardial fibrosis.

Adult↗
PubMed1987

Continuous respiratory support in quadriplegic children by bilateral phrenic nerve stimulation.

Three children, aged 6-10 years, in whom cervical cord injury at the C1-C2 level resulted in apnoea had bilateral implantation of diaphragm pacemakers. With periods of gradual conditioning of the diaphragm muscle to low frequency stimulation and slow respiratory rates they adapted to continuous ventilatory support by simultaneous stimulation of both hemidiaphragms without evidence of fatigue, so far for periods of 23-47 months.

Apnea↗
PubMed1986

Permanent artificial respiration by diaphragm pacemaker in tetraplegic children.

This is a study of two children, aged respectively 10 and 6 years, who sustained a spinal cord injury at the C1 C2, causing apnoea. After the bilateral implantation of diaphragm pacemakers and periods of conditioning, they were able to adapt to continuous and simultaneous full-time ventilatory support of both diaphragms without any sign of fatigue, for more than 24 and 11 months, respectively.

Child↗