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A Cayuela Domínguez

Publications and source records attributed to A Cayuela Domínguez.

At least 19 recordsLinked to original sources
PubMed2006

[Renal oncocytoma. Review of our 22 patients].

UNLABELLED: Renal oncocytoma (OR) is a benign tumor. It may represent up to 3-7% of solid kidney masses, and shows specifics cellular and evolutive characteristics. Metacronicity, multifocality and bilateralism has been reported. MATERIALS AND METHODS: Between 1986 and 2005, 478 kidney tumors have been surgically treated at our institution. We report the frequency and characteristics of OR in our patients, compared with renal cell carcinomas (RCC). We try to find out the rate of multifocality, bilateralism and other tumor association, and the number of neoplasms originally diagnosed as OR before surgery. Mean and median follow up: 36.86 and 13 months (1-193). Specific survival rate 100%. RESULTS: We found 24 OR in 10 men and 12 women with a mean age of 59 years (34-84). 12 in the left kidney and 12 in the right one, one patient presenting oncocytomatosis. Tumor mean size was 4.64 cm (1-12.5 cm). Tumors were discovered incidentally in 17 cases. Presentation symptoms in the rest of patients were gross hematuria. CONCLUSIONS: The rate of OR found in our sample population of renal tumors undergoing surgery matches other series already published. Two synchronic OR, but not metacronous, bilateral or metastatic tumors were found. All cases presented a benign evolution.

Adenoma, Oxyphilic↗
PubMed2006

[High-frequency oscillatory ventilation. A single-center study].

INTRODUCTION: High-frequency oscillatory ventilation is a safe and effective means of delivering mechanical ventilatory support. OBJECTIVE: To evaluate the safety and effectiveness of high-frequency oscillatory ventilation in pediatric patients with acute respiratory failure. PATIENTS AND METHOD: From August 2003 to July 2005, we performed a prospective observational study of 11 children older than 1 month who underwent high-frequency oscillatory ventilation. Pediatric risk of mortality scores (PRISM), Murray lung-injury scores and air leak scores were recorded at baseline before ventilation. The following variables were studied: ventilatory settings (FiO2 and mean airway pressure), gasometric (PaO2, SaO2, PaCO2, pHa, PaO2/FiO2 ratio) and hemodynamic parameters (Partm, PVC), and the oxygenation index. RESULTS: The overall survival rate was 82 %. Significant increases were found in PaO2 (p < 0.05), SaO2 (p < 0.05) and the PaO2/FiO2 ratio (p < 0.05), while mean airway pressure (p < 0.001), oxygenation index (p < 0.001), and FiO2 (p < 0.001) significantly decreased over time. CONCLUSIONS: High-frequency oscillatory ventilation significantly improved oxygenation in children with acute hypoxemic respiratory failure.

Acute Disease↗
PubMed2004

[Analysis of renal neoplasms in adult patients under 40].

OBJECTIVES: To analyze within our sample population the number of patients under 40 receiving surgery as a result of renal neoplasm; to describe the characteristics of these patients and compare them with those of adult patients over 40. PATIENTS AND METHODS: We have revised the clinical history of the 379 patients with renal neoplasm who have undergone surgery in our Service from January 1986 through June 2003. Patients were divided into two groups. Group I, formed by 36 subjects (9.5%) < or = 40. Group II includes 343 patients (90.5%) over 40. Data were included in a database created using the software programme Access and were subsequently analysed using the statistical package SPSS. A descriptive analysis was performed and life expectancy was calculated for both groups using the Kaplan-Meier survival curve. RESULTS: 7.3% of the total number of renal cell carcinomas included in our series occurs in patients of or under 40. No significant differences have been observed as regards the distribution per sexes, laterality, size, incidental occurrence, clinical symptoms, anatomopathology, staging or surgical technique employed. However, we have observed differences as regards cancer-specific survival rate after 5 years, being 94.74% in the case of group I and 68.64% in group II (log-rank 0.0338). CONCLUSIONS: The number of patients < or = 40 undergoing surgery as a result of renal cell carcinoma in the sample under study matches other series already published. No statistically significant difference has been observed as regards staging among patients under and over 40. Differences do exist as regards cancer-specific survival rate. In the case of our patients, irrespective of the age group to which they were ascribed, it is more common to diagnose a renal neoplasm incidentally than through the clinical manifestations.

Adolescent↗
PubMed2004

[CA 19.9 and HDL-cholesterol behaviour in a sporadic colorectal carcinoma sample].

BACKGROUND AND OBJECTIVE: We have carried out a comparative prediction analysis in sporadic colorectal carcinoma of plasmatic lipids and currently tumor markers used in this neoplasia (carcinoembrionary antigen - CEA, CA 19.9 and sialic acid -SA). PATIENTS AND METHODS: Transversal hospital-based case-control study. Sample was composed by 53 sporadic colorectal neoplasia patients just before surgery and 40 non matched controls. A 90 per cent of cases were at Dukes A and B stages. A multivariable model was fitted with non-conditional logistic regression. Confidence intervals were calculated at 95 per cent of confidence. Model sensibility and specificity were performed at 50 per cent cutting point. We also explored possible interactions. RESULTS: All three tumor markers (CEA, CA 19.9 and SA) were elevated in cases (p<0.01). Multivariable model included: Total cholesterol (TC) (OR= 0.69; CI: 0.50-0.96) high density lipoprotein fraction (HDL) (OR = 0.30; CI: 0.11-0.83) very low density lipoprotein fraction (VLDL) (OR = 2.21; CI = 1.07-4.55) years of age (OR = 1.11; CI = 0.98-1.26) CA 19.9 (OR = 1.20; CI = 1.02-1.42) and alkaline phosphatase (OR = 1.09; CI = 1.01 - 1.19). No interactions were found out. Model sensibility reached 96.23% and a specificity of 92.50%. CONCLUSIONS: HDL showed a similar diagnostic strength than CA 19.9 in this sporadic colorectal carcinoma sample but with an inverse OR. This multivariable model is going to be validated.

Biomarkers, Tumor↗
PubMed2003

[Behavior of the night decrease of arterial pressure after suppression controlled of the antihypertensive medication].

OBJECTIVE: The patients with hypertension who do not present a night decrease of the arterial pressure are a bigger degree of target organ damage due to the supported hypertension. In our work we analyzed after ambulatory blood pressure monitoring (ABPM) the prevalence of the condition dipper of the patients with hypertension of degree 1 and/or 2 after the suppression controlled of the antihypertensive medication; as well as the magnitude of the effect of white coat (object of another study). DESIGN: Almost experimental study and descriptive. SETTING: Primary care. Urban health centre. Participants measurements and results. Studies of ABPM were realized in 70 essential hypertense patients with good control of the arterial pressure after pharmacological treatment before suspending the antihypertensive medication (1 phase) and to the 4 weeks of leaving the treatment (2 phase), two periods being programmed: diurnal and night. RESULTS: Of all 70 hypertense patients, 18 (26%) did not manage to carry out 2 ABPM since after the retreat of the medication there presented blood pressure unacceptable values that forced to re-introduce the medicaments. The 79% of the hypertense patients were dipper after the 1 monitoring and that after the suppression of the antihypertensive medication, 83% was continuing being dipper. Depending on the gender there were no statistically significant differences as for the night decrease of the arterial pressure in both periods. Finally, 75% and 11.5% of the patients were dippers or not dippers, respectively, in both phases and only 13.5% of the patients it changed its condition. CONCLUSIONS: The retreat of the medication in hypertense of degree 1 and/or 2 well controlled does not modify the patients' percentage with night decreases of the blood pressure.

Adult↗
PubMed2003

[Lung cancer mortality in Andalucia, 1975-2000].

OBJECTIVE: To describe trends in lung cancer mortality in Andalucia, Spain, during the period from 1975 through 2000. SUBJECTS AND METHOD: Records of lung cancer deaths for the period from 1975 through 2000 were obtained from the Statistical Institute of Andalucia. The following indicators were calculated: crude rates, age-adjusted rates, truncated rates, and cumulative rates. RESULTS: Mortality rates for men dropped in all subject groups aged over 50 years during the period from 1994 through 2000. In women mortality rates were much lower, although we observed an increase in the 35-39 and 45-49 age groups, which is reflected in the 6.1% rise in the truncated rates (35-64 years) during the period from 1994 through 2000. In older women mortality rates fluctuated more within the different age groups, although on the whole the truncated rate for all those over 65 years old fell by 9.7% in the period between 1995 and 2000. CONCLUSION: Lung cancer mortality rates among men in Andalusia began to decrease after 1994. In contrast, mortality increased among young women, although their rates are still very low.

Adult↗
PubMed2002

[Validation of two systems of self-measurement of blood pressure, the OMRON HEM-705 CP and OMRON M1 (HEM 422C2-E) models].

Objective. To validate two monitors on the market for self-measurement of blood pressure (SMBP), an automatic one (OMRON HEM-705 CP) and a semi-automatic one (OMRON M1).Design. Descriptive study of validation of diagnostic tests.Setting. Primary care. San Pablo University Health Centre, Sevilla.Participants. 85 individuals (20 men and 65 women) with a wide range of age and blood pressure (BP), belonging to the population attended at the health centre or to its staff. People with arrhythmia and Korotkoff's V phase close to zero were excluded. Main measurements and results. BP and cardiac frequency (CF) measurements obtained with the SMBP devices to be validated were compared with readings on a mercury sphygmomanometer, used as the standard method. The differences between the SMBP devices and the gold standard were quantified and are presented on the scale proposed by the protocol of the British Hypertension Society (BHS). The mean (SD) of the systolic BP differences (in mm Hg) between the devices evaluated and the standard device was 1.084.73 for the automatic monitor and 1.255.30 for the semi-automatic one. The mean differences of diastolic BP were 0.444.03 for the automatic monitor, and 0.513.90 for the semi-automatic one. The cumulative percentage differences of systolic/ diastolic BP5, 10 and 15 mm Hg were 85.5, 98, 98.8/90.6, 98.4, 100% for the automatic monitor and 82.7, 95.7, 98.8/91, 99.6, 100% for the semi-automatic one. This supposes a Grade A on the BHS procedure, which is maintained on analysis of the results by blood pressure rankings. Conclusion. As both monitors meet the internationally accepted validation criteria, they can be recommended for the monitoring and self-monitoring of BP in patients with hypertension.

Adolescent↗
PubMed2002

[Venous compression ultrasonography of the lower limbs: a diagnostic tool in the hands of pneumologists].

Our objective was to study agreement between the compression ultrasound images taken in our respiratory medicine department and the duplex ultrasound images obtained by radiologists at our hospital for patients admitted to our ward with suspected diagnoses of venous thromboembolism.Seventy-eight consecutive patients admitted to our respiratory medicine ward suspected of venous thromboembolism were enrolled. Both types of images were available for all patients studied. Agreement was 90% with a Kappa coefficient of 0.81. Agreement between the two techniques was good. Therefore, compression ultrasonography is a technique that can be handled by respiratory medicine specialists for the diagnosis of venous thromboembolism.

Humans↗
PubMed2001

[Risk factors for bronchial asthma in patients with rhinitis].

OBJECTIVES: To identify risk factors for bronchial asthma in a large sample of patients with rhinitis. PATIENTS AND METHODS: One thousand seven hundred sixty patients with rhinitis treated at the respiratory medicine out-patient service of Hospital Universitario Virgen de Rocío in Seville (Spain) in 1997 and 1998 were studied. Six hundred forty-one (36.4%) had isolated rhinitis and 1,119 (63.6%) had rhinitis and bronchial asthma. The following variables were analyzed for both groups: 1) age, 2) sex, 3) clinical diagnosis, 4) age of onset of symptoms, 5) a family history of asthma and/or atopy, 6) housing conditions, 7) smoking, 8) a history of skin allergy, 9) recurrent episodes of respiratory infection with wheezing during early childhood, 10) a diagnosis of nasosinus polyposis, 11) atopy and sensitivity (pollens and/or household allergens), 12) peripheral blood eosinophil count. RESULTS: The variables that best differentiated the group with rhinitis from the group with both rhinitis and asthma were age, family history of asthma and/or atopy, exposure to household humidity or damp, a history of skin allergy, recurrent episodes of respiratory infection with wheezing in early childhood, atopy, sensitivity to household allergens and peripheral blood eosinophil count. The probability of correctly classifying patients in the appropriate group using this model was 69.7%. Among atopic patients, the best predictive variables were the same, with the exception of household humidity/damp. The probability of correct classification using this model was 69.7%. CONCLUSIONS: Patients with rhinitis have risk factors for bronchial asthma. As many such patients as possible should be identified so that long-term follow-up can take place and strategies to prevent bronchial asthma can be implemented.

Adult↗
PubMed2000

[An alternative method for the diagnosis of an anterosuperior hemiblock].

OBJECTIVE: To develop and validate a rapid method for diagnosing superior anterior hemiblock, comparing it with the system seen as standard. DESIGN: Comparison study of two diagnostic tests. SETTING: Urban health centre. PARTICIPANTS: Adult population with prior diagnosis of superior anterior hemiblock included in a computer file of clinical records. MEASUREMENTS AND RESULTS: The presence or otherwise of superior anterior hemiblock was found by applying the standard criteria for electrocardiograms contained in the clinical records of the participating patients. The proposed test was then applied by finding the precise cardiac axis and the confirmation or rejection of the diagnosis of superior anterior hemiblock. Out of the 121 histories analysed, 40 had superior anterior hemiblock according to the standard criteria, and 81 did not. The system proposed detected 38 of the 40 hemiblock cases, 95% sensitivity, and rejected as normal 76 of the 81 electrocardiograms without superior anterior hemiblock according to the standard pattern, specificity of 93.8%. CONCLUSIONS: Superior anterior hemiblock can be diagnosed by an alternative method which was quicker than the standard pattern, so markedly simplifying the analysis of this feature of the electrocardiogram.

Adult↗
PubMed1997

[Stroke mortality in Andalusia: where are we going?].

OBJECTIVE: The aim of the study was to explore temporal changes in stroke mortality in Andalusia over the period 1975-1994 and estimate the rates until the year 2000. DESIGN: Descriptive study. SETTING: Comunidad Andaluza. PATIENTS AND METHODS: The number of death from stroke was obtained for the period 1975-1994. Mortality raes were standardized directly using those of the "European population" as the standard, and regression analysis was undertaken. RESULTS: Age standardized overall mortality rates for stroke decreased considerably among men (45.6%). A similar pattern has been also observed among women (43.2%) during the period 1975-1992. If the trends continue during the period 1992-2000 we will observe an important reduction in both men (23.4%) and women (24.9%). CONCLUSIONS: In conclusion, this analysis shows a marked an steady fall in stroke mortality over the last two decades in Andalusia. Little is known about the factors that have led to the decline and further studies are necessary. A better understanding of these factors is important for planning the most effective intervention strategies to reduce, stroke mortality in our community.

Adolescent↗
PubMed1997

[Clinical assessment systems in the diagnosis of pulmonary thromboembolism].

We proposed developing two symptom-based systems for assessing the presence of pulmonary thromboembolism (TEP) in our practice, using a standardized questionnaire and multivariate models. Data were collected from September 1993 through November 1994 (case reports, physical examination findings and complementary test results) of patients admitted to our ward with a suspicion of TEP. The calculated odds ratio for each of the variables recorded were used as weights to determine their relevance or not for the group at risk for TEP. The yield of the two systems developed (a weights system and a logistical model) were studied by plotting ROC curves. Eighty-two patients (40 women and 42 men, mean age 60.94 +/- 14.39 years) were admitted. The questionnaire had a sensitivity of 88% and a specificity of 75%, a positive predictive value of 94% and a negative predictive value of 60%. The logistical regression model had a sensitivity of 96.3% for a diagnosis of TEP with inclusion of the following variables: female sex, disease-related immobility, presence of deep venous thrombosis (DVT) in the lower extremities and the appearance of unexplained dyspnea. Neither system was clearly superior to the other for arriving at a clinical diagnosis of TEP.

Aged↗
PubMed1997

Stroke: trends in mortality in Andalusia (Spain), 1975-1992.

The aim of this study was to explore temporal changes in stroke mortality in Andalusia over the period 1975-1992. Mortality rates were standardized directly using those of the European population as the standard, and regression analysis was undertaken. Age standardized overall mortality rates for stroke decreased considerably among men, from 199.42 to 103.74 (-3.5% per year). A similar pattern was also observed among women as mortality rates diminished from 160.48 in 1975 to 92.43 in 1992 (-3.3% per year). Despite the remarkable decline in the death rate, this disease still accounted for 1 in 35 deaths in women and for 1 in 23 deaths in men in 1992. This study confirms that time trends in stroke mortality are similar to those of most industrial countries.

Adult↗
PubMed1996

[Analysis of mortality trends of ischemic heart disease in Andalucia (1975-1992)].

OBJECTIVE: To describe the evolution of mortality due to ischaemic heart diseases in Andalucia between 1975 and 1992 and predict rates up to the year 2000. DESIGN: Descriptive study. SETTING: The Autonomous Community of Andalucia. Patients and other participants. Deaths because of ischaemic heart diseases between 1975 and 1992 were obtained. MEASUREMENTS AND MAIN RESULTS: The direct method was used for the standardisation of mortality rates for age and sex, with the European population as the standard. Logarithmic transformations of the standardised rates for mortality due to ischaemic heart diseases for both sexes were performed and the regression lines were adjusted. Between 1975 and 1992 the theoretical rates went down both in men and women. If the same tendency were maintained, we would expect to see a moderate reduction between 1992 and 2000 in men and in women. CONCLUSIONS: The tendency of mortality due to ischaemic heart diseases in Andalucia is downwards in both men and women.

Adolescent↗