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Biomedical subjects

P Torre

Publications and source records attributed to P Torre.

At least 55 records · Page 3Linked to original sources
PubMed2000

Coeliac disease and unfavourable outcome of pregnancy.

BACKGROUND: Up to 50% of women with untreated coeliac disease experience miscarriage or an unfavourable outcome of pregnancy. In most cases, after 6-12 months of a gluten free diet, no excess of unfavourable outcome of pregnancy is observed. The prevalence of undiagnosed coeliac disease among pregnant women is not known. AIM: To determine the prevalence of untreated coeliac disease among women attending the obstetrics-gynaecological department. METHODS: Endomysial antibodies, which are specific and sensitive for coeliac disease, were evaluated in all women attending the obstetrics-gynaecology department of a large city hospital over a 90 day period. RESULTS: Of 845 pregnant women screened, 12 were identified as having coeliac disease. Three had previously been diagnosed but were not following a gluten free diet. The remaining nine underwent a small intestinal biopsy, which confirmed the diagnosis. The outcome of pregnancy was unfavourable in seven of these 12 women. Six healthy babies were born with no problems after the women had been on a gluten free diet for one year. CONCLUSIONS: Overall, 1 in 70 women was affected by coeliac disease, either not diagnosed (nine cases) or not treated (three cases). Their history of miscarriages, anaemia, low birth weight babies, and unfavourable outcome of pregnancy suggests that testing for coeliac disease should be included in the battery of tests prescribed for pregnant women. Coeliac disease is considerably more common than most of the diseases for which pregnant women are routinely screened. Unfavourable events associated with coeliac disease may be prevented by a gluten free diet.

Abortion, Spontaneous↗
PubMed2000

Influence of the season on proteolysis and sensory characteristics of Idiazabal cheese.

The present study examined the influence of the manufacturing time on proteolysis and sensory characteristics of Idiazabal cheese. Samples of Idiazabal cheeses made using traditional manufacturing methods at two different times of year were collected at a plant operating under the auspices of the Idiazabal Cheese Appellation of Origin. The cheeses were made in February and June, roughly the beginning and the end of the manufacturing season. Chemical analyses were performed on d 1, 90, and 180 of ripening and sensory analyses on d 90, 120, and 180 of ripening. Higher nitrogen fraction (soluble and nonprotein nitrogen) levels and free amino acid contents were observed in the cheeses manufactured during the month of June. Degradation of the alphas- and beta-caseins was also greater in the cheeses made at that time of year. The cheeses manufactured in February earned higher sensory analysis scores for characteristic odor and taste and higher total sensory scores. The cheeses manufactured in June earned higher scores for the sensory attributes sweet flavor and bitter taste.

Animals↗
PubMed1999

Long-term effect of inhaled budesonide in mild and moderate chronic obstructive pulmonary disease: a randomised controlled trial.

BACKGROUND: Little is known about the long-term efficacy of inhaled corticosteroids in chronic obstructive pulmonary disease (COPD). We investigated the efficacy of inhaled budesonide on decline in lung function and respiratory symptoms in a 3-year placebo-controlled study of patients with COPD. METHODS: We used a parallel-group, randomised, double-blind, placebo-controlled design in a singlecentre study, nested in a continuing epidemiological survey (the Copenhagen City Heart Study). Inclusion criteria were as follows: no asthma; a ratio of forced expiratory volume in 1 s (FEV1) and vital capacity of 0.7 or less; FEV1 which showed no response (<15% change) to 1 mg inhaled terbutaline or prednisolone 37.5 mg orally once daily for 10 days. 290 patients were randomly assigned budesonide, 800 microg plus 400 microg daily for 6 months followed by 400 microg twice daily for 30 months, or placebo for 36 months. The mean age of the participants was 59 years and the mean FEV1 2.37 L or 86% of predicted. The main outcome measure was rate of FEV1 decline. Analyses were by intention to treat. FINDINGS: The crude rates of FEV1 decline were slightly smaller than expected (placebo group 41.8 mL per year, budesonide group 45.1 mL per year). The estimated rates of decline from the regression model did not differ significantly (49.1 mL vs 46.0 mL per year; difference 3.1 mL per year [95% CI -12.8 to 19.0]; p=0.7). Before the study, the minimum relevant difference was defined as 20 mL per year; this difference was outside the 95% CI. No effect of inhaled budesonide was seen on respiratory symptoms. 316 exacerbations occurred during the study period, 155 in the budesonide group and 161 in the placebo group. Treatment was well tolerated. INTERPRETATION: Inhaled budesonide was of no clinical benefit in COPD patients recruited from the general population by screening. We question the role of long-term inhaled corticosteroids in the treatment of mild to moderate COPD.

Administration, Inhalation↗
PubMed1999

Validation of capillary electrophoresis in the analysis of ewe's milk casein.

Recent investigations have shown that capillary electrophoresis (CE) can be an alternative to other techniques such as polyacrylamide gel electrophoresis (PAGE) or sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) in the qualitative analysis and separation of the different casein fractions in cow's and ewe's milk. However, past work has not yet clarified whether that method can achieve good quantifications. The present study has used a commercial whole ovine casein standard and a mixture of the standard and whole casein extracted from ewe's milk cheese to test the reliability of the technique. The results show that CE was able to quantify the ewe's milk caseins. The areas under four of the most representative peaks on the electrophoretogram for two alpha and two beta-caseins (designated alpha-casein1CE, alpha-casein2CE, beta-casein1CE, and beta-casein2CE in order of elution) were used to validate the method. In relation to linearity, coefficient of determination (r2) values greater than 99% were obtained for the regressions of each of the caseins. Moreover, each casein yielded response factors with a relative standard deviation (R.S.D.) of less than or equal to 5. The coefficients obtained in the day-to-day reproducibility analysis were higher than those for the same-day repeatability, but all the values were within acceptable limits. In the study of accuracy, the percentage recovery rates for the alpha-casein fractions were higher than those for the beta-casein fractions, hence quantification of the latter using this technique would appear to be more accurate under the conditions employed.

Animals↗
PubMed1999

[Treatment of multiple sclerosis. The present and the future. Study Group on Diagnosis and Therapy of Multiple Sclerosis].

The last years have produced a plethora of new information including extensive studies, retrospective analysis and new perspectives on data interpretation on multiple sclerosis (MS) treatment. Considering how difficult it is to study a disease such MS with its variability, unpredictability and duration, it seems hard to resemble definite results from this experience. However, corticosteroids have been the mainstay of treatment for the management of acute relapses, showing the capacity to shorten the duration of relapses, accelerate the recovery. At present, interferon beta is generally considered to be the treatment of choice for patients with relapsing remitting disease. Glatiramer acetate is still not available in many parts of Europe, but its results demonstrate a reduction of relapses in 30% of cases. Most European experts only consider as alternative treatment the immunosuppressive drugs, chosen if patients demonstrate unacceptable side effects of interferon or clearly do not respond. Very different and even more confusing data still come from experimental trial in secondary progressive MS, where the target of treatment is to slow the progression of disability. Different drugs (methotrexate, mitoxantrone, linomide, steroids and even interferons) are employed, but the results are still debated. Future therapies are being derived from constantly changing and evolving concept of MS immunopathogenesis: therefore many experimental and clinical trials use anti-integrin antibodies or insulin growth factors, metallo-proteinase inhibitors or T-cell vaccination. Some of the above treatment may have a chance of producing the gaining control of the disease without much inner toxicity.

Adjuvants, Immunologic↗
PubMed1997

Identification and characterization of proteolytic activity of Enterococcus spp. isolated from milk and Roncal and Idiazábal cheese.

Roncal and Idiazábal cheeses are manufactured from ewe's milk in the Autonomous Region of Navarre in Spain. Levels of enterococci are high in these cheeses and in other types of ewe's-milk cheeses. The present study has identified enterococci present in the milk used and in the Roncal and Idiazábal cheeses after 120 days of ripening. A total of 282 strains were isolated and identified, and the cytoplasmic and extracellular enzymatic activities of some of the strains were assessed. The dominating species were Enterococcus faecalis, which accounted for 85% of the total both in the milk as well as in the two types of cheese, and Enterococcus faecium, Enterococcus durans, and Enterococcus avium which were present in lower proportions. Aminopeptidase and proteinase activity levels in enterococci were low, and considerable variation between strains of the same species was recorded, highlighting the need to study individual strains when selecting the most suitable bacteria as a starter culture. Aminopeptidase activity levels for the enterococci were appreciably higher at pH 7 than at pH 5.5, hence aminopeptidase activity by enterococci would appear to be less significant in the normal manufacturing conditions of the two cheeses.

Aminopeptidases↗
PubMed1997

Effects of rise-fall time and repetition rate on the auditory brainstem response to 0.5 and 1 kHz tone bursts using normal-hearing and hearing-impaired subjects.

This study was designed to compare normal-hearing and hearing-impaired auditory brainstem response (ABR) thresholds using 1 msec rise-plateau-fall times with ABR thresholds using two-cycle rise-fall times and a one-cycle plateau. Because tone bursts of 500 Hz and 1000 Hz were selected for study, the respective two-cycle rise-fall times were 4 msec and 2 msec. This study also compared ABRs using repetition rates of 25.6/sec and 40/sec to determine if these two rates yield different ABR thresholds. Sixteen normal-hearing subjects and 13 subjects with mild-to-moderate sensorineural hearing loss participated in this study. The results revealed that increasing rise-fall time from 1 msec to 4 msec at 500 Hz, and from 1 msec to 2 msec at 1000 Hz, had little or no effect on the ABR threshold. Moreover, no differences in ABR thresholds were observed for the two repetition rates. Thus, these data suggest that differences in repetition rate do not account for the discrepancies in thresholds among studies. The predication of pure-tone thresholds in dB HL from ABR thresholds in dB nHL was assessed using correction factor and regression procedures. Both methods yielded a reasonable approximation of the degree and configuration of hearing loss. Approximately 85% of pure-tone thresholds were predicted within +/- 10 dB at 500 Hz and 1000 Hz. The present investigation suggests that either the 1 msec or 2-cycle-rise-fall times may be used for clinical purposes.

Adolescent↗
PubMed1996

Serial myoglobin levels for patients with possible myocardial infarction.

OBJECTIVES: To determine the sensitivity and specificity of a new myoglobin assay for acute myocardial infarction (AMI), considering both the total amount of serum myoglobin and its percentage change over 2 hours. METHODS: A prospective, observational test performance study for the recognition of AMI was done using serial myoglobin assays of 42 admitted chest pain patients at a large, urban teaching hospital ED. Myoglobin testing was performed at presentation (time 0) and at 1 and 2 hours after arrival. A myoglobin level > 100 micrograms/L (ng/mL) or a change > or = 50% from baseline (increase or decrease) any time during the 2-hour period was considered positive. Patients and their physicians were blinded to the myoglobin results. The managing clinician's final diagnosis of the presenting event was used as the diagnostic criterion standard. RESULTS: The sensitivity of the myoglobin technique for detection of AMI in the first hours in the ED was 13/14 (93%; 95% CI: 66-100%). The 1 patient who had a false-negative test had evidence of AMI on the ECG and an initially abnormal creatine kinase-MB (CK-MB) assay. The specificity was 22/28 (79%; 59-92%). However, of the 6 patients who had "false-positive" myoglobin tests, all had serious illness: significant cardiac disease (n = 4), in-hospital death (n = 1), or deep venous thrombosis (n = 1). CONCLUSION: Myoglobin level determinations are sensitive tests to detect AMI during the first 2 hours of a patient's stay in the ED and may complement current clinical tools.

Adolescent↗
PubMed1995

Double-blind, placebo-controlled, randomized, crossover trial of high-dose methylprednisolone in patients with chronic progressive form of multiple sclerosis.

A double-blind, placebo-controlled, randomized crossover trial of high-dose methylprednisolone (MP) was performed in 35 patients with a primarily chronic progressive form of multiple sclerosis as defined clinically according to Poser's criteria. At time 0 of every course of treatment (1 g MP administered i.v. daily for 5 days followed by oral prednisone tapering over 4 days, or placebo) and at 10, 30 and 90 days thereafter, each patient underwent psychometric tests and was clinically tested according to Kurtzke's Expanded Disability Status Scale (EDSS). The disability pattern of most patients who were treated with placebo either worsened or did not change. A statistically significant improvement (p < 0.001) of EDSS in MP-treated patients was recorded. The improvement mainly concerned the pyramidal, cerebellar and sensitive disorders; it was already evident at the first clinical follow-up and lasted for 3 months from the beginning of the treatment. No frequent and/or important side effects were detected throughout the trial.

Adult↗
PubMed1983

Kinetics of the mediated transport and the passive net flux of phenylalanine across the rat small intestine in vivo.

The kinetics of L-phenylalanine absorption by rat jejunum, in vivo, has been studied with luminal perfusion (0.68 ml/min) during successive periods at different substrate concentrations. The non-saturable passive component, measured by inhibiting the active transport with 60 mM methionine, was a linear function of the substrate concentration with an apparent mass-transfer coefficient of 1.42 nmoles/cm/min/mmoles/l. The transport component, estimated from the difference between total absorption and the passive component, displays saturation kinetics with an apparent transport constant (Km) of 7.5 mM and maximal transport rate (Vmax) of 107 nmoles/cm/min. Active transport seems to be the main component in absorbing phenylalanine proceeding from the digestion of food proteins.

Animals↗
PubMed1983

Absorption kinetics for leucine, cycloleucine and alpha-aminoisobutyric acid by rat small intestine in vivo.

The intestinal absorption kinetics of three neutral amino acids, leucine, cycloleucine and alpha-aminoisobutyric acid, has been studied in rat jejunum in vivo, with luminal perfusion during successive periods, by measuring the passive component and the active transport. The mass-transfer coefficients of the passive process, are similar for the three amino acids and increase with the perfusion rate. The transport component, obtained from the difference between total absorption and passive diffusion, shows saturation kinetics and also increases with the perfusion rate. The apparent Michaelis constants, Km, and the maximal transport rates for the three amino acids have been determined. The Km values are greater than those reported for in vitro studies, a result imputable to greater thickness of the unstirred layers in vivo and to the unequal signification of the constant in both conditions. Passive flux has proved to be an important component for in vivo absorption, even at low substrate concentrations (1-5 mM), so that its evaluation cannot be neglected for the calculation ot the kinetic constants of the mediated transport.

Amino Acids↗
PubMedDate not supplied

Endocrine and neuropsychological assessment in a child with a novel mutation of thyroid hormone receptor: response to 12-month triiodothyroacetic acid (TRIAC) therapy.

OBJECTIVE: To determine the endocrine, neuropsychological and genetic features of a child with resistance to thyroid hormone (RTH), and his response to long-term triiodothyroacetic acid (TRIAC) therapy. METHODS: Growth, thyroid function, and neuropsychology were assessed at baseline and during 12-month TRIAC therapy. Genetic analysis was performed by PCR and denaturing high performance liquid chromatography. RESULTS: The main clinical finding was the attention deficit-hyperactivity disorder (ADHD). A novel mutation in exon 10 (phenylalanine to isoleucine in codon 455) was found. Long-term TRIAC therapy was effective in the management of the endocrine and neuropsychological manifestations of the syndrome. CONCLUSIONS: ADHD was the only phenotypic manifestation of this novel mutation of thyroid hormone (TH) receptor. TRIAC is an effective and safe drug in the long-term treatment of children with RTH.

Child↗
PubMedDate not supplied

Risk adjustment: beyond patient classification systems.

UNLABELLED: Diagnosis related groups (DRGs) are widely used in several countries. Their various versions aim to value the cost of hospital production. In Europe, the patient classification systems and standard weights used are usually the American originals. OBJECTIVES: The objective of this study was to analyse the extent to which DRGs and DRG-weights explain patient cost variability. Different components of patient cost (severity, comorbidities, complications and socioeconomic status), which are not well explained by DRG and which can be approximated by using administrative data, were also analysed. METHODS: A total of 35,262 discharges from two public hospitals in Barcelona were analysed. The Health Care Financing Administration (HCFA)-DRGs and the All Patient Refined (APR)- DRGs were calculated. Severity was adjusted by Disease Staging, and comorbidities and complications were calculated using Elixhauser and Charlson comorbidities groupings. An ecological socioeconomic status indicator was used. Linear regressions were estimated to explain per-patient cost variability. RESULTS: We found that Medicare's DRG-weights explained only 19% of cost variability. Cost-based weights explained nearly 40% (38-42%, depending on the DRG classification used). Exclusion of outliers increased explanatory power to R² = 47-48%. The remaining adjustment variables increased R² to 49-51%. DISCUSSION: Medicare's DRG-weights are not well-suited to Europe. Cost-based DRG-weights and outlier trimming have significantly greater explanatory power. The remaining clinical and socioeconomic variables have considerably less explanatory power but were statistically significant and behaved as expected. Spanish and other European health authorities should adapt DRG-classification systems to their environments for use in hospital production cost valuation.

Diagnosis-Related Groups↗
PubMedDate not supplied

[Analysis and classification of hospital emergencies through Ambulatory Patient Groups].

AIM: To assess the feasibility and results of application of Ambulatory Patient Groups (APG) patient's classification system to the case-mix of patients seen at the Emergency Departments (ED) of 6 Barcelona metropolitan area hospitals. METHODS: Development of a minimum discharge data set specific for the Emergency Departments (CMBDAU). Gathering of relevant variables from a random sample of patients seen at the ED using the ED discharge reports. Use of the APG classification system to those episodes. RESULTS: A total of 11.188 episodes were codified and grouped with the APG system. Fifteen diagnostics identified 25% of all episodes. Nearly 50% of all procedures performed at the ED were common and simple procedures. Fifteen APG's grouped 50% of all cases seen at the ED. CONCLUSIONS: The ED Uniform Discharge Data Set (CMBDAU) developed is a valid instrument for describing the case-mix seen at the ED, and its grouping by means of the APG system provides consistent and meaningful results. The widespread use of systems like APG in the ED requires a former validation of relative weights assigned in the US system. The availability of human and technical resources must also be assessed, in order to guarantee the quality and sustainability of such a system.

Adolescent↗