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C Ochoa

Publications and source records attributed to C Ochoa.

35 records · Page 2Linked to original sources

[Multicenter study of the variability and adequacy of antimicrobial therapy for community-acquired pneumonia in adults]

We performed a study to evaluate the variability and adequacy of prescribing antibiotics in community-acquired pneumonia (CAP) in 10 Spanish hospitals. We studied 452 patients with CAP. Initial empirical administration of antibiotics was prescribed in 90.7% of the cases, 82.5% as monotherapy. Macrolides and third and second generation cephalosporins were the most widely used groups of antibiotics. Penicillin and amoxicillin were only prescribed in 1.7% of the patients. A significant variability between hospitals was observed. Reference patterns for the use of antibiotics in CAP were devised by a panel of experts. According to the recommendations of this panel, 29% of the total prescriptions were not adequate, with this percentage reaching 65% in outpatients older than 65 years or with comorbidity. This was mainly due to the fact that monotherapy with erythromycin, which was considered inadequate, was the most widely prescribed treatment.

Journal Article↗

Anthelmintic activity of 6,7-diaryl-pteridines.

In a search for new anthelmintic compounds, some 6,7-diaryl-pteridines were synthesized from the corresponding diaminopyrimidines and aromatic aldehydes. Their anthelmintic activity was tested in vitro against Caenorhabditis elegans and Heligmosomoides polygyrus and in vivo against Trichinella spiralis. Structure-activity relationships are discussed.

Animals↗

Anthelmintic activity of pyrazinothiadiazine dioxide derivatives.

In a search for new anthelmintic compounds, some pyrazinothiadiazine dioxide derivatives were synthesized. Their anthelmintic activity was tested against larva and preadult stages of Trichinella spiralis. The mode of action and acute toxicity of these compounds were investigated. Structure-activity relationships are discussed.

Animals↗

Synthesis and antiprotozoal properties of 1,2,6-thiadiazine 1,1-dioxide derivatives.

The synthesis and spectroscopical data of 1,2,6-thiadiazine 1,1-dioxides, designed as antiprotozoal agents, are reported. The in vitro trichomonacidal and trypanocidal activities of new compounds and their precursors were evaluated against Trichomonas vaginalis and Trypanosoma cruzi. The chemoprophylactic activity on mice treated with blood infected with T. cruzi and their mortality percentage were tested. Compounds 2 and 8b show a higher chemoprophylactic activity and lower mortality percentage than Nifurtimox used as reference drug.

Animals↗

Activity assays of thiadiazine derivatives on Trichomonas vaginalis and amastigote forms of Trypanosoma cruzi.

Eight thiadiazine 1,1-dioxide derivatives were evaluated for antitrichomonal and antitrypanosomal activities. In vivo tests were performed on a murine model for trichomoniasis standardized in our laboratory. The capacity of compounds to clear visceral lesions in experimentally infected animals as well as their effects on the mortality time of mice were used as criteria for activity. One of the thiadiazines (compound 7b) showed an efficacy similar to that obtained with the reference drug metronidazole, although higher doses were required. Its toxicity on cell proliferation in tissue culture was moderate. In vitro assays on amastigote forms of Trypanosoma cruzi were carried out using cultures of Vero cells infected with metacyclic trypomastigotes. For one compound (1) trypanocidal activity resembled that of nifurtimox as assessed by microscopic counts of infected and uninfected cells. Unfortunately, this compound showed a high degree of cytotoxicity on Vero cell cultures.

Animals↗

Effect of Somatostatin on TSH levels in non-toxic sporadic goiter.

Somatostatin (SS-14; growth hormone-release inhibiting hormone) was infused into eight patients with non-toxic sporadic goiter and into eleven normal control subjects. Each patient was given 150 microgram(s) of somatostatin as an intravenous bolus and 350 microgram(s) by infusion over a period of 60 minutes. Somatostatin did not lower the basal TSH levels as compared to the pre-infusion levels in this type of goiter, but produced a decrease in the TSH response to TRH during and after the infusion.

Adult↗

[Idiopathic perforation of the choledocus in childhood].

The purpose of this report is to describe a seven-years-old patient with an idiopathic perforation of the common bile duct. This disorder is more frequent in the first weeks of life, and the clinical features are not well known. Properly treated, the majority of infants survive without sequelae. Furthermore, a review of the literature is made.

Child↗

17 beta-Hydroxysteroid dehydrogenase activity in human breast epithelial cell and fibroblast cultures.

Primary cultures of human breast cells prepared from surgical specimens of reduction mammoplasty were used to study the activity of the enzyme 17 beta-hydroxysteroid dehydrogenase (E2DH) which converts estradiol (E2) into its less active metabolite estrone. This study was performed in both epithelial and stromal cells separated, after collagenase digestion of the tissue, on a Percoll gradient, and then cultured as monolayers in Ham's F 10 medium supplemented differently for epithelial cells and fibroblasts. E2DH activity was strikingly higher in epithelial cells than in fibroblasts, since after [3H]E2 incubation (2 nM), 600 fmol/micrograms DNA were metabolized to estrone in epithelial cells after 1 h, whereas an equivalent amount was hardly obtained in fibroblast cultures after 24 h. The affinity and capacity of E2DH were greater in epithelial cells with apparent Michaelis-Menten constant (Km) = 0.6 +/- 0.1 microM and maximum velocity (Vmax) = 250 to 360 pmol/micrograms DNA/h, whereas they were 10 +/- 1 microM and 50 to 70 pmol/micrograms DNA/h, respectively, in fibroblast cultures. Moreover, the E2DH activity was 2 to 5 times higher in epithelial cells cultured in the presence of the progestin medroxyprogesterone acetate, whereas it remained unchanged in fibroblasts cultured under the same conditions. This increase in E2DH activity was dose dependent from 10(-10) to 10(-7) M medroxyprogesterone acetate and inhibited by both actinomycin D and cycloheximide. This system of differential breast cell culture appears to be a fruitful tool for the study of the hormone dependence of normal breast growth and differentiation. Due to the presence of E2DH, epithelial cells are more apt to undergo and to moderate E2 action. Moreover, epithelial cells are a possible site of progesterone modulation of E2DH activity. Therefore, E2DH could be a good marker both for epithelial cells and their hormone dependence.

17-Hydroxysteroid Dehydrogenases↗

Fertility and contraception of 6 patients with ovarian pregnancy.

A series of 6 ovarian pregnancies out of 369 ectopic (1.65/100 tubal) were selected to evaluate the fertility and contraception of patients with this rare condition. Mean patients' age was 28.5 years, mean previous parity was 1.5 children and all but one were using some sort of contraception (four had an IUD inserted and one had a previous laparoscopic tubal ligation). Clinical features on admission were as reported for the ectopic pregnancy and surgical findings at laparotomy showed an otherwise intact tubes. Postoperative further contraception was used by four patients and the two non-users became pregnant easily within an 18 month period. We conclude that ovarian pregnancy is an accident which occurs in a rather fertile population with an intact genital tract and who were using intrauterine contraceptive devices. Postoperative reproduction performance shows a high fertility rate in those patients who were not using any contraceptives at all.

Adult↗

Simultaneous measurement of beta-endorphin, lipotrophins and met-enkephalin in phaeochromocytomas.

Tissue concentrations of immunoreactive lipotrophin, beta-endorphin, and met-enkephalin were determined in 10 phaeochromocytomas, 3 of which were responsible for the ectopic ACTH syndrome. Lipotrophin and beta-endorphin immunoreactivities could be detected in all cases, whether or not Cushing's syndrome was present, and their tissue concentrations were significantly correlated (r = 0.95, P less than 0.001). Chromatographic studies showed that gamma-lipotrophin and beta-endorphin were the main peptides in the tumours. Met-enkephalin immunoreactivity was also found in all tumours examined, at much higher concentration and showing no correlation with either lipotrophin or beta-endorphin immunoreactivity. Although beta-endorphin and met-enkephalin are thought to originate from different precursor molecules, these data show that the two opioid peptides may be secreted by the same tumour. The evidence for excess secretion of opioid peptides and their pathological significance in phaeochromocytomas remain to be established.

Adolescent↗

Minor hemoglobin components in diabetic and uremic patients.

Hemoglobins A1c and A1a+b were measured by an automated chromatographic method in 11 control subjects, 100 diabetics and 30 subjects with renal failure not induced by diabetes. Hb A1c was higher in diabetics than in controls (8.26 +/- 0.31 versus 5.24 +/- 0.28, p less than 0.01) and strongly correlated with blood glucose values for the preceding 4 months. In poorly controlled diabetics, submitted to an intensive therapeutic program, Hb A1c decreased rapidly. Hb A1c was slightly but significantly elevated in the uremic, non-diabetic patients who were not submitted to periodic hemodialysis: 6.42 +/- 0.32, p less than 0.05. It returned, in hemodialyzed patients, to a level not significantly different from the control value. Hb A1a+b was elevated in diabetic subjects (2.43 +/- 0.04 vs. 1.55 +/- 0.01 in controls, p less than 0.001). It was also higher in the uremic patients (2.71 +/- 0.14, p less than 0.001). No decrease occurred in the hemodialyzed patients (3.27 +/- 0.31). Glycosylated hemoglobin values, as routinely estimated and expressed under the name of "Hb A1", should be interpreted with caution in patients with renal failure. Methods discriminating Hb A1a+b have to be used.

Diabetes Mellitus↗

Impact of a daily 10-minute strength and flexibility program in a manufacturing plant.

In summary, employees' flexibility and mood showed modest improvements following the implementation of a plant-wide, 10-minute, daily flexibility and strength program. The initial six-week pilot study, administered prior to the plant-wide program implementation, successfully assessed program feasibility, assessed the efficiency of program implementation, identified administrative and logistical concerns, and generated pilot data needed to secure managerial support. Despite the noted significant increases in grip strength in the pilot study, no increases were observed following the six months of plant-wide implementation. This may be related to the differences in low average pretest grip strength for the pilot study compared to the higher scores for the main study population. The pilot study subjects may have received a sufficient exercise stimulus to increase grip strength over the course of six weeks. In contrast, this may not have been the case for the main study subjects due to their higher initial mean grip strength. An increased number of exercises designed to directly impact grip strength may be needed to improve this parameter.

Biomechanical Phenomena↗

[Practice variation and appropriateness study of antimicrobial therapy for acute pharyngotonsillitis in adults].

OBJECTIVE: Infectious pharyngotonsillitis is usually managed with antibiotics by general practitioners and pediatricians both in primary care and the emergency services. In the present work we try to assess the antibiotic variability and appropriateness in the management of acute pharyngotonsillitis among several emergency services in our country related to scientific evidence based in an expert panel criteria. METHOD: A transversal trial was carried on in ten emergency services of our country. We included patients older than fourteen years an analyzed the following variables: type of respiratory infection, antibiotic prescription, comorbidity, physician's status and hospital admission. The antibiotics were classified in three levels according to the expert panel criteria: first election, alternative use and inappropriate use. We compared the antibiotic treatments to these three levels. RESULTS: 2,869 patients were diagnosed of acute respiratory infection, 356 (12.4%) with pharyngotonsillitis. Commonly the patients were prescribed antibiotics (315; 81%) and the most used were amoxicillin-clavulanate (33%), amoxicillin (16%), penicillin (7%), cefuroxime (6%), erythromicin (4%) and cefixime (3%). Among the 315 prescriptions, 98 (32%) were first election, 147 (50%) alternative use and 50 (17%) inappropriate use. CONCLUSIONS: Most of the patients suffering of pharyngotonsillitis were empirically prescribed antibiotics probably many of these cases were non-bacterial pharyngotonsillitis. Alternative and inappropriate use of antibiotics was high.

Acute Disease↗

[Membranous glomerulonephritis. Experience at the Instituto Nacional de la Nutrición Salvador Zubirán].

The purpose of this retrospective study was to study the incidence of idiopathic and secondary forms of membranous nephropathy in our institution, its clinical course and progression to chronic renal failure, and the risk factors associated with it. Two hundred fourteen (16%) of the 1,287 renal biopsies obtained between 1962 and 1988 were primary glomerular diseases and 28 of this 214 (13%) were idiopathic membranous nephropathy. On the other hand 59 of 1,287 biopsies were membranous nephropathy of whom 28 were idiopathic, 27 secondary to systemic lupus erythematosus, 2 due to drugs, one associated with rheumatoid arthritis, and one more with breast cancer. The clinical picture was: nephrotic syndrome in 84%, hypertension in 15%, non-nephrotic proteinuria in 14%, chronic renal failure in 8.4%, and renal vein thrombosis in 6.3%. In the idiopathic group 75% of the patients were male while in the lupus group 85% were female. For the analysis of progression to chronic renal failure we excluded 5 patients with renal failure when the biopsy was taken, 2 because the nephropathy was due to drugs, one associated with breast cancer, and nine were within the first year of follow-up. Thus, for this analysis the group consisted of 22 patients with idiopathic form and 20 with systemic lupus erythematosus. The idiopathic and lupus groups were similar except for a lower serum albumin in the former. The progression to renal failure was seen in 9 patients: six in the idiopathic group and the other 3 in the lupus group; this difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

[Fasting and postprandial lipids and lipoproteins during the chronic administration of antihypertensive drugs].

To evaluate the effect of various antihypertensive drugs on fasting and postprandial lipids and lipoproteins, we studied 39 normolipidemic hypertensive patients, 28 men and 11 women aged 52.3 +/- 9.0 and 58.5 +/- 7 years, respectively. After four weeks of placebo administration, lipids and lipoproteins were measured in the fasting state and every three hours for a period of nine hours after intake of a standardized fat mixed load (65 g/m2). Following this test, the patients were randomly assigned to one of four treatment groups: group I metoprolol (n = 10), 100 mg/day; group II nicardipine (n = 9), 90 mg/day; group III captopril (n = 11), 75 mg/day. At the end of week four of treatment the fasting and postprandial lipid measurements were repeated. Blood pressure mean values were significantly (p < 0.05) reduced in the four treatment groups. We found no statistically significant lipids or lipoproteins changes neither in the fasting nor in the postprandial state, but a trend toward lower concentrations in the postprandial lipemia after treatment was observed in three groups (metoprolol, nicardipine and captopril), whereas no change was observed in the chlorthalidone group. These data confirm that fasting lipids and lipoproteins in normolipidemic hypertensive patients are not unfavorably changed by low doses of the drugs studied. In addition, we inform that postprandial lipemia is not affected by these four drugs in the doses used.

Adult↗