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Biomedical subjects

E Ramos

Publications and source records attributed to E Ramos.

At least 19 recordsLinked to original sources
PubMed2006

Comparative study of left colonic Peritonitis Severity Score and Mannheim Peritonitis Index.

BACKGROUND: Prognostic evaluation of patients with left colonic perforation is useful in predicting mortality. The aims of this prospective study were to determine the prognostic value of the left colonic Peritonitis Severity Score (PSS) and to compare it with the Mannheim Peritonitis Index (MPI). METHODS: One-hundred and fifty-six patients underwent emergency operation for distal colonic peritonitis. The PSS and MPI were calculated for each patient. The Spearman rank correlation coefficient was used to measure the association between the two scores. The predictive power of the two scoring systems and their differences were studied using the area under the receiver-operator characteristic (ROC) curve. RESULTS: Forty-one patients died (26.3 per cent). The relationship between scores and mortality was statistically significant for each scoring system (P < 0.001). The Spearman rank correlation coefficient for the correlation between the MPI and PSS was 0.55 (P < 0.001). There was no difference between areas under the ROC curves for the two systems. CONCLUSION: The PSS and MPI are both well validated scoring systems for left colonic peritonitis. Their routine use might allow stratification of patients according to mortality risk.

Adult↗
PubMed2006

Polyomavirus-associated nephropathy: update of clinical management in kidney transplant patients.

Over the last decade, polyomavirus-associated nephropathy (PVAN) has occurred with increasing frequency after renal transplantation, leading to significant renal dysfunction and graft loss. More than 95% of all cases are caused by the human polyomavirus type 1 called the BK virus. The primary treatment for PVAN is immunosuppression reduction, which must be carefully balanced against increased risks of rejection. Although no validated protocols exist, a first step commonly involves reduction of calcineurin inhibitors with antiproliferative agents by more than one-third, e.g., reaching trough levels of tacrolimus <6 ng/mL, of cyclosporine <150 ng/mL, dosing of mycophenolate mofetil to <1 g/day, and azathioprine <75 mg/day. When rejection is diagnosed together with PVAN, a transient pulse treatment is recommended before subsequent reduction in immunosuppression. No antiviral treatments for PVAN have been approved by the United States Food and Drug Administration. The antiviral drug cidofovir has shown in vitro activity against murine polyomaviruses, and has been used in some patients in lower doses in an effort to minimize the nephrotoxic effects of cidofovir while treating PVAN. Small series of PVAN patients treated with leflunomide, intravenous immune globulin therapy, and fluoroquinolones have also been reported recently.

BK Virus↗
PubMed2005

[Hypoglycemia associated with oral sulfonylurea hypoglycaemic agents in an 11-year-old girl].

UNLABELLED: In children more than 8 years old, hyperinsulinism is the most common cause of hypoglycemia. CASE REPORT: We report the case of an 11-year-old girl who presented recurrent hypoglycemia with endogenous hyperinsulinism (high insulin and C-peptide concentrations). The morphological investigations didn't find insulinoma. Finally the questioning identifies the voluntary intoxication with hypoglycemic agent. At a later date, the sulfonylurea dosage during an hypoglycaemic episode was positive. CONCLUSION: The sulfonylurea drugs can mimic an endogenous hyperinsulinism and mislead the diagnostic to an insulinoma suspicion and lead to a surgical exploration. A sulfonylurea dosage should be done before planning out surgery.

Child↗
PubMed2005

Erectile dysfunction, obstructive sleep apnea syndrome and nasal CPAP treatment.

BACKGROUND AND PURPOSE: To evaluate the effect of one month of continuous positive airway pressure (CPAP) in a subgroup of obstructive sleep apnea (OSA) patients with erectile dysfunction (ED) and compare this subgroup with age- and body mass index (BMI)-matched OSA patients without ED. PATIENTS AND METHODS: Prospective general, sleep, psychiatric and sexologic evaluations were conducted. Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), Sleep Disorders Questionnaire (SDQ), Quality of Life SF-36, and polysomnography were used. Seventeen OSA patients with ED were compared prior to CPAP treatment and during CPAP treatment with age- and BMI-matched OSA patients without ED. Parametric and non-parametric statistics, chi-square, Fisher exact test and multiple regression analyses were performed. RESULTS: Ninety-eight men (BMI=28.8 kg/m2, apnea-hypopnea index (AHI)=49.6 events/h, ESS=14.8, BDI=8.4, and lowest SaO2=75.3%) were divided into subgroups of lowest SaO2>80% (A) and lowest SaO2< or =80% (B). (A) Forty-six men had a mean lowest SaO2 of 85.7%+/-2.9, AHI=29.5+/-17.6, age=46.3+/-9.3 years, ESS=13.6+/-4.2, BMI=25.8+/-4.8. Seven of the patients had ED. (B) Fifty-two men had a mean lowest SaO2=60.10+/-10.0%, AHI=67.4+/-24.5, BDI=9.0+/-6.9, age=47.4+/-9.4 years, ESS=16.2+/-4.4, BMI=31.4+/-5.1. Twenty-one of the patients had ED (chi2: P=0.006). Significant variables for ED were lowest SaO2 and age (r=0.17). CPAP-treated subgroup: ED subjects had significantly lower SaO2, ESS, BDI and SF-36 subscale scores than OSA controls. Nasal CPAP eliminated the differences between groups, and ED was resolved in 13 out of 17 cases. CONCLUSIONS: ED in OSAS is related to nocturnal hypoxemia, and about 75% of OSAS patients with ED treated with nasal CPAP showed remission at one-month follow-up, resulting in significant improvement in quality of life.

Body Mass Index↗
PubMed2005

An unusual complication of tonsillectomy.

We report the case of a 30-year-old man who experienced a potentially fatal haemorrhage on the tenth post-operative day after the development of a pseudoaneurysm of the muscular branch of the lingual artery. Due to the nature of the development of these pseudoaneurysms they are difficult to detect until such time that they present with a massive haemorrhage or a rapidly expanding parapharyngeal swelling. There are only several reported cases in the literature to date.

Adult↗
PubMed2004

Optimization of pulping conditions of abaca. An alternative raw material for producing cellulose pulp.

The influence of temperature (150-170 degrees C), pulping time (15-45 min) and soda concentration (5-10%) in the pulping of abaca on the yield, kappa, viscosity, breaking length, stretch and tear index of pulp and paper sheets, was studied. Using a factorial design to identify the optimum operating conditions, equations relating the dependent variables to the operational variables of the pulping process were derived that reproduced the former with errors lower than 25%. Using a high temperature, and a medium time and soda concentration, led to pulp that was difficult to bleach (kappa 28.34) but provided acceptable strength-related properties (breaking length 4728 m; stretch 4.76%; tear index 18.25 mN m2/g), with good yield (77.33%) and potential savings on capital equipment costs. Obtaining pulp amenable to bleaching would entail using more drastic conditions than those employed in this work.

Bioreactors↗
PubMed2004

Improved outcome of polyoma virus allograft nephropathy with early biopsy.

Polyoma virus allograft nephropathy often results in accelerated graft loss despite reduction of immunosuppression and/or treatment with antiviral agents. Irreversible renal fibrosis due to late diagnosis is likely to be one of the important causes of treatment failure. Early biopsy in 14 patients resulted in stable graft function after a mean follow-up of 22 months.

Biopsy↗
PubMed2004

Cost efficiency in the prospective diagnosis and follow-up of polyomavirus allograft nephropathy.

Evaluation of urine cytology (UC) for decoy cells and quantitative determinations of viruria (urine viral load [UPCR])and viremia (viral load in blood [VLB]) have been proposed as surrogate markers of polyomavirus allograft nephropathy (PVAN). In this study, we present the experience with the concurrent evaluation of UC, UPCR, and VLB in 349 patients (940 sets of samples). Results were correlated with each other and with a previous, concurrent, or subsequent biopsy diagnosis of PVAN. Patients were followed up for a mean of 27 months posttransplantation. We conclude that both UC and UPCR are useful for screening of renal transplant recipients. Simultaneous performance of both UC and UPCR does not add useful clinical information. In patients with positive UC, performance of UPCR, however, can allow for the distinction between BK and JC polyoma viruses. Quantitative measurement of viremia is not indicated in patients lacking viruria because no patients with PVAN present with this combination of findings. In patients with viruria, a positive viremia strongly correlates with PVAN. Rationale selection of screening protocols based on the current knowledge of the infection and tailored to the available laboratory capabilities in each transplantation center can optimize the use of resources.

Biopsy↗
PubMed2004

A prospective study of nocturia and the quality of life of elderly patients with obstructive sleep apnea or sleep onset insomnia.

OBJECTIVE: To prospectively evaluate the relationship between obstructive sleep apnea syndrome (OSAS), nocturia and quality of life in elderly patients free of the urologic and medical conditions that lead to increased nocturia. METHODS: Prospective study of nocturia in men 65 years and older with isolated OSAS or sleep onset insomnia. After a 7-day nocturia evaluation and nocturnal polysomnography, Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), Quality of Life (SF-36) were administered. RESULTS: OSAS patients with frequent nocturia had significantly greater body mass index (BMI), greater apnea-hypopnea index (AHI), lower lowest oxygen saturation and lower SF-36 subscale scores. Treatment with nasal continuous positive airway pressure (CPAP) for OSAS and behavioral techniques for insomnia improved ESS and BDI scores for all three groups. SF-36 subscale scores improved more in subjects with multiple nocturia. AHI and BMI explain 38% of the variance for nocturia. CONCLUSION: Nasal CPAP reduces OSA and nocturia and improves quality of life of elderly patients.

Aged↗
PubMed2004

Mammographic features and correlation with biopsy findings using 11-gauge stereotactic vacuum-assisted breast biopsy (SVABB).

BACKGROUND: Mammograms are assigned a BI-RADS (Breast Imaging Reporting and Data System) category, which indicates the level of suspicion for cancer. OBJECTIVES: (i) To evaluate the use of BI-RADS categories in a non-academic radiology practice based in a community hospital compared with local radiology private offices; (ii) to determine positive predictive value (PPV), sensitivity and specificity of mammograms; and (iii) to explore the correlation of BI-RAD 3-5 and lesion description with diagnosis of cancer. PATIENTS AND METHODS: We performed 947 SVABBs (stereotactic vacuum-assisted breast biopsies) on 911 patients with BI-RADS 3-5. Lesions were classified as: 1=microcalcifications; 2=asymmetric density; 3=circumscribed mass; and 4=spiculated mass. RESULTS: BI-RADS category correlated with diagnosis of breast cancer (atypia excluded): category 3=4%; category 4=15%; and category 5=79%. The PPV of BI-RADS 4 and 5 for breast cancer or atypia was 20%, in contrast to 5% for BI-RADS 3. Sensitivity and specificity were 95% and 19%, respectively. For BI-RADS 3 without microcalcifications only 3% were positive, in contrast to 8% for remainder. CONCLUSIONS: First, there is a stepwise increase in cancer for each of the BI-RADS categories 3-5. Secondly, in BI-RADS 3 with microcalcifications, a biopsy is indicated according to our findings. Finally, the sensitivity of mammograms is 95% but the specificity is 19%.

Adult↗
PubMed2004

Naturally occurring fruit juices dislodge meat bolus obstruction in vitro.

Oesophageal meat bolus obstruction is often removed endoscopically/surgically with attendant morbidity and mortality. Anecdotal evidence suggests that fruit juices' enzymes may dissolve meat boluses. To assess this, an in vitro study was carried out. Cooked chicken was tightly packed between 10 and 8 mL markers of 80, 10 mL syringes. Two millilitres of fresh juice from lemons, papaya, kiwi fruits, pineapples, frozen and then thawed pineapple juice, processed pineapple juice, Coca-Cola and saliva were added to 10 syringes each. By 4 h, the meat boluses significantly moved in the pineapple juice both fresh and frozen and kiwi juice groups (P < 0.001), little movement in the Coca-Cola group (P < 0.05), and no movement in the saliva, processed pineapple juice, lemon juice and papaya groups. In conclusion, pineapples and kiwi fruits contain enzymes which can dislodge meat boluses. Freezing does not denature the enzyme and provides a convenient way of storing the juice.

Beverages↗
PubMed2003

[Human serum alcaline phosphatase and ageing].

BACKGROUND: In experimental ageing models an inverse relationship between age and alkaline phosphatase activity has been observed. OBJECTIVE: To characterize serum levels of alkaline phosphatase activity in humans according to age and gender. METHODS: Serum alkaline phosphatase was determined in a random sample of 203 community dwellers aged 40 or more years. RESULTS: In men (n=87) total serum alkaline phosphatase markedly increased from the 5th to the 6th decade and then stabilized. For women (n=116) there was a slight increase in total serum alkaline phosphatase from the 5th to the 6th decade, followed by a bend upward after 69 years of age. There was a significant positive correlation between total serum alkaline phosphatase and age for the whole population. CONCLUSIONS: Serum alkaline phosphatase activity appears as a biomarker of age in humans, similarly to what has been described for experimental animal models.

Adult↗