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Biomedical subjects

A Supervía

Publications and source records attributed to A Supervía.

At least 19 recordsLinked to original sources
PubMed1998

[Screening for bone disease risk with clinical factors in women after physiologic menopause].

BACKGROUND: Densitometric screening for osteoporosis in postmenopausal women has not been demonstrated cost-effective. We have tried to identify clinical factors for screening previous to densitometry avoiding unnecessary explorations. PATIENTS AND METHODS SETTING: outpatient clinics of a menopausal unit in a 450-bed general hospital. Cross-sectional study, in two steps, of two groups of 140 and 284 women attending for physiological menopause. A clinical questionnaire, physical data and lumbar densitometry (Hologic QDR 1000) were obtained classifying the cases as "normal" or "low bone mass" (osteopenia or osteoporosis) according with the WHO criteria. In the first group a logistic regression analysis was done to identify predictive factors for abnormal densitometry, then validated in the second group. Sensitivity, specificity, predictive values (PV) and classification ability of clinical factors were analyzed. RESULTS: Four factors were independent predictors of abnormal densitometry: age > 51 (odds ratio [OR] = 6.64; 95% CI, 2.36-18.7); body weight < 70 kg (OR = 4.32; 95% CI, 1.71-10.09); years of fertility < 32 (OR = 3.77; 95% CI, 1.36-10.04), and number of live births > 2 (OR = 3.47; 95% CI, 1.27-9.53). Presence of one factor offers: sensitivity 91.9%; specificity 15%; positive PV 66.6%, and negative PV 50%, whereas the presence of two factors offers: sensitivity 62.7%; specificity 70%; positive PV 79.9%, and negative PV 50.3%. Clinical screening allows, when two factors are present, to avoid a 35.5% of densitometries and the false-negative cases represent 18%. CONCLUSIONS: Detection of bone-risk clinical factors (abnormal densitometry) yields a screening, previous to densitometry, that avoids at least one third of explorations in women with physiological menopause, improving the efficiency of the test.

Cross-Sectional Studies↗
PubMed1998

Vitamin D treatment in myelodysplastic syndromes.

Myelodysplastic syndromes (MDS) are a group of clonal disturbances with defective cellular differentiation. Vitamin D3 (VD) analogues can act on the differentiation and maturity of different cell lines. We studied the effects of VD on a series of patients with MDS in an open-design trial. Nineteen patients, 12 men and seven women, with MDS were included. Patients were 74.8 +/- 5.6 years (mean +/- SD), seven had refractory anaemia with ringed sideroblasts, five had refractory anaemia, one had refractory anaemia with excess of blasts and six had chronic myelomonocytic leukaemia. All the patients were in a low to intermediate risk group. Mean follow-up period was 26.21 months, range 9-75. Responders were defined as follows: granulocyte or platelet count increase by 50%, or haemoglobin increase of 1.5 g/dl or transfusion needs decrease by 50%. The first five patients received 266 microg of calcifediol three times a week and the other 14 received calcitriol (0.25-0.75 microg/d). Response was observed in 11 patients. In the calcifediol-treated group, one case responded, three were nonresponders, and one showed progression. In the calcitriol group, 10 were responders (two with major response), and four were non-responders. No correlation was observed between baseline levels of vitamin D metabolites and the presence of response. No hypercalcaemia was observed. Treatment with vitamin D3 metabolites could induce a long-standing response of the haematological disturbance in some low-intermediate risk MDS patients without inducing hypercalcaemia.

Aged↗
PubMed1998

Piroxicam fast-dissolving dosage form vs diclofenac sodium in the treatment of acute renal colic: a double-blind controlled trial.

OBJECTIVE: To assess the possible therapeutic effect of 40 mg sublingual piroxicam (fast-dissolving dosage form, FDDF) compared with intramuscular 75 mg diclofenac, as a reference drug, on acute renal colic in a randomized, double-blind controlled clinical trial. PATIENTS AND METHODS: Eighty patients were assigned to one of two treatment groups; one received an intramuscular injection with 0.2 mL distilled water and two sublingual tablets of 20 mg piroxicam FDDF, and the other received an intramuscular injection with 75 mg diclofenac sodium and two sublingual tablets of placebo. Pain intensity was evaluated by the patient using a visual analogue scale and by the observers. Vital signs at baseline and 30 min after the administration of the study drugs were also recorded. RESULTS: The overall efficacy of the treatment was 81%; nine patients in the piroxicam and six in the diclofenac group (no significant difference) required rescue treatment. Compared with baseline levels, the pain relief was significant (P < 0.001) at 30 min in both groups. Twenty-two patients in the piroxicam and 25 in the diclofenac group attained complete pain relief at 30 min, as evaluated by the observer (no significant difference). Both treatments were similarly effective in decreasing vital signs, mainly systolic blood pressure, heart and respiratory rates. However, when the percentage change was compared between the groups, piroxicam significantly decreased the respiratory rate (P < 0.03). CONCLUSION: Piroxicam FDDF is as effective as parenteral diclofenac in emergency renal colic treatment. Furthermore, its ease of self-administration increases patient compliance and potential use in general practice.

Acute Disease↗
PubMed1996

Idiopathic bilateral diaphragmatic paralysis: effectiveness of bilevel intermittent positive airway pressure.

A 49-year-old woman presented with idiopathic bilateral diaphragmatic paralysis. The patient benefited from bilevel intermittent positive airway pressure-type assisted ventilation with rapid, excellent and long-lasting results. This case emphasizes the need for correct diagnosis and therapeutic management, particularly with a bilevel intermittent positive airway pressure-type home ventilation technique, in idiopathic bilateral diaphragmatic paralysis.

Female↗
PubMed1996

[Effects of Sjögren's syndrome on pulmonary function impairment in patients with rheumatoid arthritis].

The influence of Sjögren syndrome (SS) on pulmonary function impairment in rheumatoid arthritis (RA) patients has been few studied. The aim of this study was to analyse the pulmonary function impairment in RA patients, and to establish differences between patients associated or not to SS. Pulmonary function of 57 patients, non smokers and without another pulmonary disease, diagnosed of RA were studied. Fourteen (24.6%) were associated to SS, and 43 (75.4%) to RA without SS. Age and time of evolution of disease were similar. Eight patients with associated SS (57.2%), and in 20 (46.5%) without SS showed pulmonary function disorder. Airflow obstruction and DLCO diminution were the most common types of impairment, respectively. The comparison between the types of impairment and the mean values of FEVI, FVC, FEVI/FVC %, FEF 25-75 and DLCO were not statistical different. This results suggest a poor influence on pulmonary function impairment in RA patients with SS.

Aged↗
PubMed1996

[Efficiency of bone marrow aspirate for diagnosis of opportunistic infections in HIV infected patients].

AIDS is the first cause of opportunistic infections. The objective of the present study was the evaluation of the efficiency of bone marrow aspirate (BMA) for diagnosis of opportunistic infections in HIV infected patients with prolonged fever. Charts from 92 patients with BMA from 1992 to 1994 were reviewed. Diagnosis was achieved in 14.1% of cases. Diagnosis cannot be made by other methods in six leishmaniasis and in two disseminated tuberculosis. The sensibility was of 33.3% for mycobacterial infections, the sensibility of hemoculture was of 50%. The hemoglobin level was lower for patients with diagnostic BMA than for patients with not diagnostic BMA (77 g/l vs 97 g/l, p < 0.0004). The WBC counts was not different in both groups of patients, and platelets counts was greater in patients with BMA diagnostic (165 x 10(9)/l vs 102 x 10(9)/l, p < 0.001). In the patients with hemoglobin lower than 100 g/l the diagnostic efficiency was 18.6% (11 of 59 cases). The BMA was unprofitable in HIV infected patients with prolonged fever without hemocytopenias. Profitability increase in patients with hemoglobin lower than 100 g/l. The BMA in useful for leishmania identification. The hemoculture has greater sensitivity than BMA for the diagnosis of mycobacterial disseminated infection.

AIDS-Related Opportunistic Infections↗