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Biomedical subjects

C Colás

Publications and source records attributed to C Colás.

14 recordsLinked to original sources

Effect of omalizumab on adenosine 5'-monophosphate responsiveness in subjects with allergic asthma.

BACKGROUND: The objective of this study was to evaluate the effects of omalizumab on bronchoconstriction induced by methacholine and adenosine 5'-monophosphate (AMP). METHODS: Thirty-four subjects with mild to moderate allergic asthma were randomized to receive placebo (n = 16) or omalizumab (n = 18) subcutaneously during 12 weeks. Airway responsiveness to AMP was measured at baseline and after 4 and 12 weeks of treatment, whereas the response to methacholine was measured at baseline and after 12 weeks of treatment. RESULTS: After 4 weeks of treatment, the increase in AMP PC(20) (provocative concentration required to produce a 20% fall in FEV(1)) was significantly greater in the omalizumab group than in the placebo group, the mean difference in the change between the groups being 1.52 doubling concentrations (95% CI, 0.25-2.79, p = 0.02). Compared with baseline, the mean AMP PC(20) values at 12 weeks were increased by 1.91 doubling concentrations with omalizumab (p < 0.001) and 1.01 doubling concentrations with placebo (p = 0.16), but changes were not significantly different between the treatment groups. Changes in methacholine PC(20) values were not significantly different between the omalizumab and placebo groups. CONCLUSIONS: In subjects with allergic asthma, omalizumab reduces the response to AMP without decreasing the response to methacholine. These findings are consistent with the conclusion that the contribution of IgE to the development of AMP bronchoconstriction is more important than their role in the induction of methacholine hyperresponsiveness.

Adenosine Monophosphate↗

[Breast reconstruction with expander prostheses].

Breast reconstruction with tissue expanders is a technique that has been known to clinical practice since 1978. The authors present their clinical experience in the Plastic and Reconstructive Surgery Service of the Virgen del Camino Hospital from 1980 to 2005. They describe breast reconstruction using tissue expanders and the evolution towards immediate breast reconstruction with durable expanders prostheses, which resemble conventional breast prostheses and try to emulate the extirpated breast. They provide an historical review of the repercussion of mastectomy and breast reconstructive surgery in the different professional and social areas, as well as the change in mentality of society and health professionals that has benefited patients. The characteristics of post-mastectomy breast reconstruction, using expanders prostheses, are set out, as well as its advantages and drawbacks.

Breast Implantation↗

[Breast reconstruction with latissimus dorsi musculocutaneous flap].

In breast reconstruction we try to achieve the greatest possible symmetry with the contralateral breast, with the smallest number of interventions, the least possible sequel and the greatest safety. When we find poor cutaneous quality in the thorax we must use techniques that provide a well vascularised tissue of good quality, which we obtain at a certain distance instead of using the thorax tissues themselves. This article reviews the latissimus dorsi musculocutaneous flap, the technique of elevation, variations of the flap, and the advantages and drawbacks involved. This is a very safe and versatile technique, with few sequels in the donor area, with a relatively short surgery time and with good aesthetic results.

Female↗

[Breast reconstruction with microsurgical perforator flaps].

Autogenous breast reconstruction is frequently carried out with abdominal tissue, since a better and lasting aesthetic result is obtained, providing a new breast that is very similar in texture, consistency and ptosis to the contralateral breast. The main problem presented by this type of reconstruction is the sequel at the level of the donor abdominal area. Perforator flaps are being developed as the main resource for solving this problem, as they hardly damage the muscle and its fascia. The DIEP flap (deep inferior epigastric perforator) has proved itself to be an alternative for reconstruction for many women, with low rates of local complications, due to the absence of any sacrifice of the abdominis rectus muscle, and a significant level of satisfaction with the result obtained. One drawback is its greater technical difficulty and the need for a surgical team that is expert in vascular microsurgery. However, the DIEP flap is a surgical technique for which there is growing demand.

Female↗

Correlation between Chenopodiacea/Amaranthacea pollen counts and allergic symptoms in Salsola kali monosensitized patients.

UNLABELLED: We performed a prospective observational study to establish a relationship between pollen counts of Chenopodiacea/Amaranthacea and clinical symptoms of rhinoconjunctivitis and asthma in a group of monosensitised patients. MATERIAL AND METHODS: A total of 60 patients (19 with asthma) were included in the study. All patients collected daily symptom scores during the summer months of 1999, 2000 and 2001. The questionnaire included ocular, nasal and pulmonary symptoms. Pollen counts were expressed as pollen grains/m3. Symptom scores and pollen counts were correlated using correlation coefficients and Log transformed variables. RESULTS: In the 3 seasons studied we identified a peak of pollen and clinical symptoms in the second half of August and first half of September. In 1999, there was a significant positive correlation between total symptoms and daily pollen grains/m3 (p<0.005, r = 0.347). This correlation was not significant for the summers of 2000 and 2001. After further analysis, and by displacing one of both variables between 11 to 17 days, the correlation coefficients for total symptoms, improved for 1999 (r = 0. 744; p < 0.0001) and became significant for 2000 (r = 0. 521; p < 0.0001) and 2001 (r = 0.635; p < 0.0001). CONCLUSION: We identified a significant time lag between pollen counts and symptom scores in S. kali monosensitized patients.

Adolescent↗

Immunochemical characterization of Russian thistle (Salsola kali) pollen extracts. Purification of the allergen Sal k 1.

BACKGROUND: Salsola kali (Russian thistle) is a weed which belongs to the Chaenopodiacea family. It is widely distributed along the coasts of Europe, North Africa, USA and Australia. The objectives of this study were to study the allergenic composition of S. kali pollen and to purify an important allergen from the pollen extracts of this plant. METHODS: A population of 66 individuals with specific IgE-mediated allergic symptoms and positive skin tests to S. kali were included in the study. Specific IgE to S. kali was determined by direct enzyme-linked immunosorbent assay (ELISA). The antigenic and allergenic profile of S. kali was evaluated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), isoelectric focussing (IEF) and immunoblot. Allergen purification was conducted by preparative SDS-PAGE. The allergenicity of the protein was evaluated by skin testing, direct ELISA, ELISA inhibition and immunoblots. RESULTS: Specific IgE to S. kali was detected in 39 of the 66 individuals (59%). An allergen with a molecular weight of approximately 43 kDa was purified. This allergen was termed Sal k 1. A partial sequencing was obtained and no homology was found with other known proteins/allergens. The allergenicity of Sal k 1 was tested in vitro and in vivo. Of the 39 individuals with a positive specific IgE determination to S. kali, 26 (66.6%) had detectable specific IgE to Sal k 1. Twenty of these 39 individuals were skin-prick tested with the purified allergen (0.5 mg/ml) and all of them had a positive skin test to the purified allergen. Ten additional individuals, used as negative controls, had a negative response. CONCLUSIONS: Sal k 1, an important allergen of S. kali, is recognized, in vitro, by approximately 67% of the patients sensitized to S. kali. Twenty patients with a positive skin test to a standardized S. kali extract had a positive reaction to the purified allergen.

Allergens↗

Atopy and pulmonary function abnormalities in children with a history of acute bronchiolitis.

To assess the relationship between acute viral bronchiolitis and subsequent development of asthma, we studied retrospectively 97 index children, aged between 9 and 14 years, and 52 controls. The bronchiolitis group showed significantly lower values for mean expiratory flow at 50% of vital capacity (MEF50) higher incidence of atopy, and were more sensitive to methacholine than were controls, even if they had not shown recurrent wheezing episodes. It is suggested that an increased incidence of atopy, bronchial hyperresponsiveness, and reduced expiratory flows may be detectable in children with a history of acute bronchiolitis, regardless of the fact that they did not develop subsequent clinical symptoms suggestive of bronchial asthma.

Acute Disease↗

[The specific bronchial provocation test in the diagnosis of occupational asthma].

Specific bronchial challenge (SBC) testing is a key technique for diagnosing the origin of occupational asthma (OA). SBC is indicated in specific circumstances, including whenever several agents present in the work environment may be the cause of OA, when new or unusual occupational agents need to be identified, when evidence for legal action is required, or when research is conducted. SBC procedures are not standardized, because of the great diversity of occupational agents and the variety of physical and chemical properties involved. Thus, SBC testing with agents found in fumes, gases or vapors can be administered in special cabins or in closed circuits with continuous monitoring of sub-irritant concentrations. Agents found in dust, most but not all of which have high molecular weights, may be appropriate for routine SBC testing in an allergy laboratory. This paper will treat only these cases. SBC must be formed in specialized centers by experienced personnel, as it is a sophisticated and potentially dangerous technique. We describe a series of 20 patients diagnosed of OA in our unit over the past two years in whom SBC provided an etiologic diagnosis. All were exposed to dust or aerosols at work. The cause was a substance of high molecular weight in 17 cases, and low molecular weight in 3. The procedure used is described and models of bronchial response are discussed.

Adolescent↗

Occupational asthma induced by aniseed.

This report deals with clinical and immunologic studies in a butcher with work-related asthma. Both the positive methacholine inhalation test and the significant changes observed in PEFR measurements supported the diagnosis of asthma. The significant fall observed in PEFR measurements when the patient handled aniseed supported the diagnosis of occupational asthma. Skin prick tests carried out with 13 spices showed positive reactions only to aniseed extract. The patient had high levels of specific antianiseed IgE antibodies. The bronchial challenge test with an aniseed extract showed an immediate response without a late response. These findings suggest that the respiratory symptoms in our patient were induced by the inhalation of aniseed dust through an IgE-mediated immunologic mechanism of immediate hypersensitivity. This study established the diagnosis of occupational asthma from aniseed dust sensitization.

Adult↗