Search PubMed⌕ Search

Biomedical subjects

R Roca

Publications and source records attributed to R Roca.

34 records · Page 2Linked to original sources

Instruments for screening for depression and dementia in a long-term care facility.

The high prevalence of mental disorders such as depression and dementia in institutionalized elderly patients warrants screening for psychiatric diagnosis in patients newly admitted to long-term care facilities. The diagnostic accuracy of the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) was evaluated against a standardized psychiatric interview. The MMSE was found to be 81% sensitive and 83% specific in screening for dementia using a previously established cutpoint of less than 24/30 points. Adjusting MMSE scores for physical disabilities precluding completion of specific tasks on the MMSE did not significantly change the diagnostic accuracy of the test. The GDS was 47% sensitive and 75% specific in screening for depression using the suggested cutpoint of greater than 13/30 points. The MMSE was significantly correlated with functional status (r = 0.48, P = .0001), but not with the scores on the GDS or the clinical diagnosis of depression. The GDS did not correlate with functional status. In summary, the MMSE is a good screening test for dementia in institutionalized elderly, but the GDS is not sensitive for depression in this population.

Activities of Daily Living↗

The use of radioiodinated alpha-fetoprotein for the scintigraphic detection of mouse mammary carcinomas.

Alpha-fetoprotein (AFP) is taken up by developing fetal cells but not by normal adult cells. This finding together with the resemblance between fetal cells and cancer cells suggests that malignant tissue could incorporate AFP in opposition to normal tissue. In the present work, we injected mice bearing spontaneous mammary adenocarcinomas with 131I-radioiodinated AFP. The scintigraphic images obtained with a gamma camera showed that 11 out of 12 carcinomas displayed strong radiolabelling with very low activity in the surrounding normal tissues. In addition, three non-neoplastic cystic lesions were found to be negative. The future implications of this result for tumour diagnosis, as well as the possible mechanisms of AFP uptake are discussed.

Adenocarcinoma↗

[Gynecomastia: effect of prolonged treatment with dihydrotestosterone by the percutaneous route].

Gynaecomastia is a frequent disorder, sometimes painful or psychologically disturbing. Percutaneous dihydrotestosterone (DHT) was used to treat 30 patients with idiopathic gynaecomastia (IG) and 17 patients in whom the condition was associated with hypogonadism. All patients complaining of pain were relieved. Breast enlargement regressed or was substantially reduced in 22 of the IG patients and in all cases with hypogonadism, except those with gonadal dysgenesis. Plasma levels of testosterone and 17 beta-estradiol were significantly lowered in patients with IG as compared with controls. There was a significant increase in plasma DHT levels and in plasma androgen/estradiol ratio in all cases. The beneficial effects of the drug were manifest within 1 to 2 months in responsive patients. These effects may be due to a local and/or systemic activity. It is suggested that this medium-term treatment without side-effects should be tried in all cases of hypogonadism with gynaecomastia and in IG before considering more drastic therapeutic measures.

Administration, Topical↗

Studies on the treatment of idiopathic gynaecomastia with percutaneous dihydrotestosterone.

We have studied clinical and endocrine parameters in a group (group A) of forth men referred to us because of persistent idiopathic gynaecomastia (of more than 18 months duration), before and during the administration of percutaneous dihydrotestosterone (DHT). The endocrine parameters (testosterone (T), 17 beta-oestradiol (E2), DHT, gonadotrophins (FSH and LH) and prolactin (PRL), were compared to those of control groups of 12 healthy men on DHT therapy (group B) and 10 on placebo (group C). Local administration of DHT was followed by the complete disappearance of gynaecomastia in 10 patients, partial regression in 19 and no change in 11 patients after 4 to 20 weeks of percutaneous DHT (125 mg twice daily). Before treatment the T + DHT/E2 ratio was significantly (P less than 0.001) lower in group A 244 +/- 21 (SEM) than in groups B and C (361 +/- 21) while T, DHT and E2 concentrations were all within the normal range. During DHT treatment plasma hormone levels were measured in 26 patients from group A: DHT levels increases significantly (day 0: 1.63 +/- 0.14 nmol/l; day 15: 12.8 +/- 1.6 nmol/l, P less than 0.001) while T and E2 levels fell significantly (T: day 0: 22.6 +/- 1.2 nmol/l; day 15: 11.0 +/- 1.5 nmol/l, P less than 0.001; E2: day 0: 110.5 +/- 7.12 pmol/l; day 15: 86.79 +/- 9.4 pmol/l, P less than 0.01). The T/E2 ratio decreased from 231 +/- 20 to 164 +/- 27 (P less than 0.05) while the T + DHT/E2 ratio increased significantly (P less than 0.02) to a normal mean value (day 15: 354 +/- 57).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Assessment of the tracheal cross-section by computerised tomography (author's transl)].

Tracheal cross-sections can be measured by means of computerised tomography with hitherto unparalleled accuracy. Among the patients examined by the authors (43) women following tracheopexy because of tracheomalacia), computerised tomography yielded approximately 3 times as many pathological findings as was possible by conventional x-ray diagnosis. Over and above this, it is always possible to calculate the flow resistance, a fact which can be of great importance for therapy planning and control. Hence, in all cases where accurate visualisation of the tracheal cross-section is necessary, computerised tomography appears to be the method of choice at the present time.

Adult↗

HCS, estriol and oxytocinase in maternal serum and neonatal condition in high risk pregnancies.

In order to find a reliable index of fetal wellbeing, maternal estriol, hCS and oxytocinase levels were related with condition of the neonate. Fifty six high risk pregnancies were studied. Estriol and hCS were determined by specific radioimmunoassay and oxytocinase with a colorimetric method. The condition of the newborn was evaluated by the APGAR score. Neonates were divided into two groups, depressed (APGAR score 0-6) and vigorous (APGAR score 7-10). When the mean birthweights of both groups were statistically different, maternal estriol levels were corrected to avoid the influencing factor of newborn weight. Mean maternal estriol level corresponding to vigorous newborns was 46.73 ng/ml. This value was statistically higher than that corresponding to the group of depressed newborns, which was 26.25 ng/ml (Fig. 1). The mean birthweight of depressed infants (2,382.75 g) was statistically lower than that of the vigorous group (3,044.75 g). The corrected mean maternal estriol values of vigorous neonates (45.44 ng/ml) was different from that of depressed ones (25.14 ng/ml) (Fig. 2). When patients were divided according to maternal diseases (diabetes, vascular pathology, Rh sensitization) serum estriol levels of the mother were statistically different according to the Apgar score of the newborns. There was no significant difference between serum hCS and oxytocinase levels of mothers with depressed and vigorous newborns. Discarding fetal weight as an influencing factor in maternal hormone level, our results indicate the suitability of maternal serum estriol determinations to predict condition of the newborns in high risk pregnancies.

Aminopeptidases↗