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P Salgado

Publications and source records attributed to P Salgado.

At least 19 recordsLinked to original sources
PubMed2006

Comparative study between nadolol and 5-isosorbide mononitrate vs. endoscopic band ligation plus sclerotherapy in the prevention of variceal rebleeding in cirrhotic patients: a randomized controlled trial.

BACKGROUND: After variceal bleeding, cirrhotic patients should receive secondary prophylaxis. AIM: To compare nadolol plus 5-isosorbide mononitrate (5-ISMN) with endoscopic band ligation. The end points were rebleeding, treatment failure and death. METHODS: One hundred and nine cirrhotic patients with a recent variceal bleeding were randomized: nadolol plus 5-ISMN in 57 patients and endoscopic band ligation in 52 patients. RESULTS: The mean follow-up was 17 and 19 months in nadolol plus 5-ISMN and endoscopic band ligation groups, respectively. No differences were observed between groups in upper rebleeding (47% vs. 46%), variceal rebleeding (40% vs. 36%), failure (32% vs. 22%), major complications (7% vs. 13.5%) and death (19% vs. 20%), respectively. The actuarial probability of remaining free of rebleeding, failure and deaths were similar in both groups. Time to rebleeding shows that endoscopic band ligation patients had an early rebleed, with a median of 0.5 month (95% CI: 0.0-4.2) compared with patients from nadolol plus 5-ISMN, 7.6 months (95% CI: 2.9-12.3, P < 0.013). Multivariate analysis indicated that outcome-specific predictive factor(s) for rebleeding was Child A vs. B + C (P < 0.01); for failure was Child A vs. B + C (P < 0.02); and for death ascites (P < 0.01) and rebleeding (P < 0.02). CONCLUSION: This trial suggests no superiority of endoscopic band ligation over nadolol plus 5-ISMN mononitrate for the prevention of rebleeding in cirrhotic patients.

Endoscopy, Gastrointestinal↗
PubMed2003

Clinical-electroencephalogram patterns at seizure onset in patients with hippocampal sclerosis.

OBJECTIVE: The purpose of this study is to identify specific clinical-electroencephalogram (EEG) patterns at seizure onset in patients with hippocampal sclerosis (HS). METHODS: Sixty-six ictal video-EEG recordings corresponding to 26 patients with HS have been reviewed, focusing on the EEG features found during the first 30 ictal s. The EEG activity has been classified into the following groups: (A) according to spatial distribution: type 1: temporal electrodes on one side; type 2: temporal and adjacent frontal electrodes on one side; and type 3: non-lateralizing electrographic activity; and (B) according to morphology; subtype (a): regular 5-9 Hz rhythmic activity (RA); subtype (b): low-voltage rapid activity, followed by a 5-9 Hz RA; and subtype (c): irregular EEG sharp waves. We analyzed the clinical symptoms sequence and established the relationship with the ictal EEG patterns. RESULTS: Considering spatial distribution and morphology, the most frequent ictal EEG patterns were type 1 (57%), type 2 (37%), and subtype (a): 62%; subtype (b): 27%; and subtype (c): 11%. The sequence of clinical symptoms observed was: aura-->behavioral arrest-->oro-alimentary automatisms-->unilateral hand automatisms. All seizures with aura and including two or more symptoms of the clinical sequence (65%) were associated with a 1a, 1b, 2a or 2b EEG pattern. CONCLUSIONS: The identification of a specific clinical-EEG pattern provides a useful tool for the epileptogenic zone localization in non-invasive pre-surgical assessment of patients with hippocampal sclerosis. SIGNIFICANCE: The identification of a specific clinical-EEG pattern associated to neuroimaging findings and neuropsychological testing allows indicating surgery for the treatment of epilepsy in patients with hippocampal sclerosis, without performing any further complementary studies.

Adult↗
PubMed2002

Obsessive-compulsive disorder (OCD) patients are impaired in remembering temporal order and in judging their own performance.

Obsessive-compulsive disorder (OCD) has been related to frontostriatal dysfunction, but some inconsistencies between studies and a relative paucity of neuropsychological research still characterizes the study of OCD. We compared 28 patients with OCD and matched healthy controls on two neuropsychological tests sensitive to frontal dysfunction: temporal ordering and a "feeling-of-doing" (FOD) judgment about ordering. The OCD group performed significantly worse than controls in the temporal ordering task despite showing normal recognition memory. Patients were also impaired in "feeling-of-doing" judgments suggesting they have a lack of self-awareness of their performance. Thus, the results of the current study reinforces previous research that indicates that OCD patients fail on tasks that require adequate functioning of the frontal-striatal pathways.

Adolescent↗
PubMed2001

Impairment of incidental memory for frequency in patients with obsessive-compulsive disorder.

The aim of our study was to investigate whether patients with obsessive-compulsive disorder (OCD) have impaired incidental memory for frequency. Fifty-four subjects (27 OCD patients and 27 matched control subjects) performed a task assessing estimation of occurrence of previously heard words. Performance on this task was compared with other intentional verbal memory tasks (recognition, recall and learning of common words). We also correlated memory for frequency with frontal lobe tests (Wisconsin Card Sorting Test, Trail Making Tests A and B, and verbal fluency). Performance on incidental learning of frequency was significantly worse in the OCD group than in control subjects. Other verbal memory measures did not show significant differences. Performance in the frequency task correlated with verbal fluency. Although intentional verbal memories are normal in OCD patients, incidental memory for frequency is impaired, suggesting that prefrontal systems are involved in OCD.

Adolescent↗
PubMed2001

Long-term follow-up and predictors of clinical outcome in obsessive-compulsive patients treated with serotonin reuptake inhibitors and behavioral therapy.

BACKGROUND: The objective of this study was to examine the long-term course of obsessive-compulsive disorder (OCD) in patients treated with serotonin reuptake inhibitors (SRIs) and behavioral therapy and to identify predictors of clinical outcome. METHOD: Sixty outpatients meeting DSM-II-R or DSM-IV criteria for OCD were followed up for 1 to 5 years (mean = 2.5 years). All of them received prolonged pharmacologic therapy with an SRI. RESULTS: Thirty-seven patients (61.7%) completed an adequate behavioral treatment. At long-term assessment, 22 patients (36.7%) exhibited a global Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score greater than 16 or a final reduction in Y-BOCS global score of less than 35% and were considered nonresponders. Patients who completed behavioral therapy showed a significant decrease in Y-BOCS compulsions subscale score (p = .01), whereas no significant differences in either Y-BOCS global or obsessions subscale scores between those who did and those who did not undergo behavioral therapy were detected. Obsessions of sexual/religious content were the unique factor related to a poorer long-term outcome. CONCLUSION: A substantial number of OCD patients showed persistent disabling symptoms at the long-term follow-up in spite of combined pharmacologic and behavioral treatment. Major benefits from behavioral therapy appeared to be the improvement of ritualistic behaviors. Sexual/religious obsessions predicted poorer long-term outcome, whereas short-term response to SRI treatment failed to achieve predictive value in the long-term course of OCD.

Adolescent↗
PubMed2000

Brain somatic representation of phantom and intact limb: a fMRI study case report.

Reports on phantom limb patients concerning neuronal reorganization using non-invasive methods have focused mainly on the cortical regions and suggest the presence of pain as the cause of this reorganization. The phantom limb, however, includes other somatic and motor sensations other than pain. Here we describe the results of non-painful stimulation in cortical and subcortical lateralization and reorganization and also examine the involvement of subcortical structures in phantom limb telescoping perception. We describe an enlarged contralateral cortical representation of the stump, a cortical and thalamic bilateral representation of the remaining leg, and a neuronal correlate of a telescoping perception of the phantom limb. The missing leg produces an enlarged cortical representation due to abnormal information and the remaining leg has a bilateral SII representation, which could be related to new, compensatory functions. The telescoping perception of a phantom limb by the stimulation of misallocation points was correlated with lenticular nuclei, thalamic and cingulate gyrus activation. We therefore propose that the reorganization concept of a phantom limb, applied mainly to the cortex, must extend to the thalamic and the somatosensory and motor systems (pathways and relay nuclei).

Amputation Stumps↗
PubMed2000

Noninvasive cerebrovascular assessment of Takayasu arteritis.

BACKGROUND AND PURPOSE: Despite prominent neurological symptoms reported in Takayasu arteritis (TA), a complete evaluation of the cerebral circulation has not been consistently performed. The purpose of this study is to describe MR angiography (MRA), color Doppler flow imaging, and transcranial Doppler (TCD) findings in the extracranial and intracranial cerebral arteries in TA. METHODS: MRA, color Doppler flow imaging, and TCD were performed in 21 patients with TA. Intima-media thickness was measured in the common carotid artery. The correlation between noninvasive studies and panaorto-arteriography was examined for supraortic vessels. Cerebral angiography findings were compared with the noninvasive methods in 7 patients. Intracranial hemodynamic changes detected by TCD were compared with extracranial circulation lesions assessed by panaorto-arteriography. RESULTS: Noninvasive vascular techniques showed at least 1 abnormality in the extracranial and/or intracranial cerebral arteries in 20 of 21 patients (95%). Both MRA and color Doppler flow imaging showed a substantial correlation in the ability to detect obstructive lesions in supra-aortic vessels compared with panaorto-arteriography. High-resolution ultrasonography displayed common carotid artery wall thickening in 5 vessels that were considered normal by arteriography. In 24% of patients, MRA and TCD showed abnormalities consistent with stenosis of the basal cerebral arteries. In 10 patients with severe extracranial circulation involvement (detected by arteriography), TCD displayed intracranial hemodynamic changes consisting of dampened or blunted waveforms with low pulsatility. CONCLUSIONS: The comprehensive assessment of cerebral circulation in TA patients by noninvasive methods allowed the detection of a high rate of diverse vascular abnormalities in both extracranial and intracranial circulation.

Angiography↗
PubMed1999

Immunochemical studies on gastric and intestinal digestion of soybean glycinin and beta-conglycinin in vivo.

Two experiments were conducted to study gastric and small intestinal digestion of soybean glycinin and beta-conglycinin in preruminant calves fed milk replacers containing a mixture of skim milk powder and antigenic heated soybean flour. In experiment 1, duodenal passage of immunoreactive beta-conglycinin lasted for a much longer time after the morning meal than that of glycinin. Western blotting revealed the early abomasal outflow of glycinin subunits that associated nearly intact basic polypeptides to partially degraded acidic polypeptides. Intact beta-conglycinin was evidenced at most sampling times. In experiment 2, intact basic glycinin (M(r) = 21000) associated with partially digested acidic glycinin (7000 < M(r) < 25000) was demonstrated in ileal digesta up to 8-10 h after the meal. beta-Conglycinin immunoreactivity could not be evidenced by Western blotting in ileal digesta.

Animals↗
PubMed1998

Ecotoxicological assessment of ashes and particulate matter from fluidized bed combustion of coal.

Toxicity of ash and particulate matter from the gases generated in coal fluidized bed combustion (FBC) has been determined by the Microtox assay according to the standard leachate procedure. Results are compared with the polycylic aromatic hydrocarbon (PAH) content of the particulate matter, which was determined by fluorescence spectroscopy. Although PAHs are considered highly toxic compounds, the low ecotoxicity values obtained could be explained by the low solubility of the compounds in water. The Microtox assay may underestimate the toxicity of water-insoluble compounds unless they are previously extracted with an organic solvent. Nevertheless, this type of assay can be very useful for measuring the potential toxicity of residues when exposed to water sources such as rain water and the risk of the components being dissolved and transported by runoff water.

Air Pollutants, Occupational↗
PubMed1997

Cysticercosis. Clinical classification based on imaging studies.

Cysticercosis is a pleomorphic disease in which the diagnosis, treatment, and prognosis greatly vary in relation to the location, number, and stage of the lesions. A new classification is proposed that includes the information gathered by magnetic resonance imaging and computed tomography, supplemented by immunodiagnostic studies and clinical data. The different clinical entities produced by cysticercosis are grouped by the frequency and location of the parasites, including valuable data as the number and stage of the lesions as well as the degree of the inflammatory response from the host to the parasite. In this way, the disease can be individualized to define the reliability of diagnostic studies and to design specific therapeutic approaches that depend on the characteristics that the disease acquires in every location.

Brain↗
PubMed1991

Medulloblastoma presenting as blindness of rapid evolution. A case report.

An 18-year-old man reported rapid decrease of visual acuity that progressed to total blindness in 1 month. Computed tomographic scanning showed two neoplastic masses: a large one, intra- and suprasellar, and a smaller cerebellar nodule. Histologically, the former proved to be a large metastasis of the small cerebellar medulloblastoma, which infiltrated and compressed the chiasm. Direct compression of the optic pathways by metastasis of a medulloblastoma is a rare event.

Adolescent↗
PubMed1989

Intracranial tuberculoma: MR imaging.

MR studies of 6 patients with intracranial tuberculoma are reviewed. All patients also underwent CT scans which showed hypo- or isodense lesions with abnormal enhancement following contrast administration. MR showed lesions with prolongation of the T1 relaxation time in every case. On the T2-weighted sequences, the signal properties of the tuberculoma varied according to the stage of evolution of the lesion. Incipient tuberculomas appeared as scattered areas of hypointensity surrounded by edema. Mature tuberculomas were composed of a dark necrotic center surrounded by an isointense capsule which was, in turn, surrounded by edema. In one patient, the center of the lesion was hyperintense probably because of liquefaction and pus formation (tuberculous abscess). While both, CT and MR, were equally sensitive in visualizing the intracranial tuberculoma in every patient, MR was slightly superior in demonstrating the extent of the lesion, especially for brainstem tuberculomas. Nevertheless, the potential role for MR diagnosis of intracranial tuberculoma is limited by the fact that other infectious or neoplasic diseases may present similar findings. The diagnosis of intracranial tuberculoma should rest on a proper integration of data from clinical manifestations, cerebrospinal fluid analysis, and neuroimaging studies.

Adolescent↗
PubMed1975

Replication of the Achievement Place model in California.

Attempting to replicate procedures from Achievement Place, token reinforcement procedures were used to modify savings, conversational interruptions, and table-setting of delinquent boys residing in a home-style, community based, treatment setting. The tokens (points) were redeemable for various privileges and could be earned for specified appropriate behaviors and lost for specified inappropriate behaviors. Contingent point fines reduced the frequency of interruptions. Point rewards improved table-setting, but even large point rewards did not substantially increase savings. Baseline data indicated that lateness to dinner was not a problem, as it was in Achievement Place. Withdrawal of contingent points and back-up rewards did not disrupt the clean-up behavior of two boys.

Adolescent↗
PubMedDate not supplied

Antiserum for insulin radioimmunoassay generated by an insulin derivative devoid of hypoglycemic activity.

A tetraiodinated derivative of bovine insulin, prepared at pH 1 with stable iodine, was unable to cause signs of hypoglycemia in doses up to 2.4 micrograms/g in fasting mice, when native insulin caused 100% mortality. In neutral and acidic solutions, in absence of chaotropic agents, it behaved as the monomer, and could be separated from less iodinated, active species, that appeared as dimers, by conventional gel filtration. To generate antibodies in guinea-pigs, the tetraiodinated insulin was injected in doses three times higher than native insulin, without any harm to recipient animals. The induced antiserum was compared with antiserum generated by conventional methods in radioimmunoassay (RIA) of native insulin, and parallel curves were obtained.

Animals↗