PubMed Health⌕ Search

Biomedical subjects

F Carballo

Publications and source records attributed to F Carballo.

29 records · Page 2Linked to original sources
PubMed1994

Inflammatory response in the early prediction of severity in human acute pancreatitis.

The role of the inflammatory response in acute pancreatitis and its relation with the clinical course was examined. This study examined if the serial measurement of polymorphonuclear granulocyte (PMN) elastase/A1PI complex, phospholipase A catalytic activity, C reactive protein, and other acute phase proteins, and the protease inhibitor alpha 2-macroglobulin, provides meaningful information for prognosis. Eighty non-consecutive patients with acute pancreatitis, classified according to their clinical outcome into mild (n = 40) and severe pancreatitis (n = 40), were followed up daily. Between 48 hours, median values of PMN-elastase, C reactive protein--and most of the acute phase proteins--and phospholipase A activity, were significantly higher in the severe pancreatitis group. PMN elastase shows a dynamic course and it reaches an early peak value at days 1-2, followed by C reactive protein (days 2-4) phospholipase A (day 3), and a negative peak for alpha 2-macroglobulin (days 4-5). PMN elastase (day 1) and C reactive protein (day 2) were selected by discriminant analysis as the most useful variables studied to allow the early accurate prediction of severity (sensitivity 100%, specificity 95%). Little or no predictive additional value was found for all other variables studied. These results strongly suggest a close relation between inflammatory parameters and clinical course in acute pancreatitis, and discriminant analysis of these variables provides a useful method to classify severity.

Acute Disease↗
PubMed1994

[Colorectal cancer: its incidence in the province of Guadalajara].

The present study was designed to establish the incidence of colorectal cancer in the province of Guadalajara. During an 8-year-period, 347 cases of colorectal cancer were detected. The adjusted global incidence rate of colorectal cancer was 15.4 per 100,000 population; 17.5 for men and 13.5 for women. The global crude rate was 29.6; 31.4 for men and 27.8 for women. The global adjusted truncated rate was 23.9; 26.2 and 21.6 for men and women, respectively. The global truncated rate was 29.6; 31.4 for men and 27.7 for women. In the case of colon cancer, the global adjusted rate was 10.9 per 100,000 population; 12.1 for men and 9.8 for women. In the case of rectum cancer, 4.5; 5.3 for men and 3.7 for women. The incidence of colorectal cancer in the province of Guadalajara compared with Spain is medium, and compared with the rest of the world, median-low. The incidence trend is towards a progressive increase for the colon location of cancer among men of non-advanced age.

Age Distribution↗
PubMed1993

Monitoring of serum proteinase--antiproteinase balance and systemic inflammatory response in prognostic evaluation of acute pancreatitis. Results of a prospective multicenter study.

With the aim of studying the clinical usefulness and applicability of circulating levels of protease inhibitors, complement factors, acute phase reactants, and leukocytic enzymes in the prognostic evaluation of acute pancreatitis (AP), the present prospective multicenter study has been carried out. A total of 182 patients with AP have been included, to whom an exhaustive evolutive protocol has been applied from the time of their hospital admission (2-12 hr from the onset of the disease) until the 15th day of evolution in order to clearly define them. The severe episodes exhibit a greater consumption of alpha 2-macroglobulin, and C3 and C4 complement factors, as well as a greater increase of alpha 1-protease inhibitor, C-reactive protein and polymorphonuclear elastase than mild events, with regards to the underlying pathophysiological condition. The determination of the plasma levels of leukocytic elastase in the first hours of evolution allows a prediction of the severity of the acute pancreatitis event with a high reliability (predictive values that become higher than 90%). The clinical value of the remaining parameters analyzed, in this aspect, is less, being applicable to the monitoring of the disease.

Acute Disease↗
PubMed1993

Evaluation of the clinical usefulness of APACHE II and SAPS systems in the initial prognostic classification of acute pancreatitis: a multicenter study.

The clinical usefulness of the APACHE II and SAPS systems in the early prognostic classification of patients with acute pancreatitis has been evaluated in a prospective multicenter study. We aimed to identify early those patients with acute pancreatitis who should be monitored closely to expedite the detection and treatment of complications. One hundred eighty-two patients with acute pancreatitis were included; 28 were classified as severe, having developed at least one major complication of the disease. The scores obtained through the APACHE II and SAPS systems in these severe cases were significantly higher than the scores in the mild cases of acute pancreatitis (p < 0.001). The sensitivity of these systems in the prognostic classification of acute pancreatitis was 70.4% for APACHE II and 66.7% for SAPS, and the specificity was 79.1% for both. When applying APACHE II and SAPS systems in the early phase of acute pancreatitis, the possibility of misdiagnosing the severity exists, thus limiting the application of these systems in the initial assessment of prognostic classification. In conclusion, APACHE II and SAPS systems are of limited clinical utility in the early prognostic evaluation of acute pancreatitis because of their low positive predictive value.

Acute Disease↗
PubMed1992

Role of interleukin-6 in acute pancreatitis. Comparison with C-reactive protein and phospholipase A.

Plasma values of immunoreactive interleukin-6, C-reactive protein and phospholipase A have been determined in serial samples from 24 patients with acute pancreatitis ('mild' pancreatitis nine, 'severe' pancreatitis 15). Median plasma concentrations of interleukin-6, C-reactive protein, and phospholipase A activity were significantly higher in patients with 'severe' illness (p < 0.001) than those with 'mild' illness. A particularly marked increase in interleukin-6 was found in two patients with necrotising pancreatitis and fatal outcome. Significant correlations between plasma concentrations of interleukin-6 and phospholipase A (p = 0.0218) and C-reactive protein and phospholipase A activity (p < 0.0001) were found in patients with 'severe' disease. These findings in a limited number of patients with acute pancreatitis are promising in that raised interleukin-6 correlated with clinical severity and with two other established markers, C-reactive protein, and phospholipase A activity.

Acute Disease↗
PubMed1991

Clinical usefulness of polymorphonuclear elastase in predicting the severity of acute pancreatitis: results of a multicentre study.

The usefulness and clinical applicability of quantitative plasma polymorphonuclear elastase determinations in the diagnosis of the severity of acute pancreatitis was analysed in a multicentre study and was compared with the usual prognostic systems of Ranson and Osborne et al. The study comprised 182 patients, 154 with a mild episode of acute pancreatitis and 28 with a severe episode, defined by the development of major complications or a fatal outcome. In the severe cases neutrophilic elastase reached significantly higher values than in mild cases (P less than 0.001) by the time the patient was admitted (2-12 h after the onset of the disease), reflecting considerable leucocyte activation. The sensitivity and specificity of this test are therefore greater than 90 per cent, with a positive severity predictive value of almost 80 per cent at the time of admission and 97 per cent after 24 h, and a negative predictive value of approximately 98 per cent. In addition to requiring 48 h for evaluation, the usual prognostic systems show a sensitivity of 77-85 per cent, a specificity of 70-77 per cent, a positive predictive value of 40-48 per cent, and a negative predictive value of 92-95 per cent, clearly lower than those obtained with leucocyte elastase. Polymorphonuclear elastase is therefore a very early and reliable marker in the diagnosis of the severity of acute pancreatitis, in addition to being easily adaptable to the routine of any hospital laboratory.

Acute Disease↗
PubMed1990

[An analysis of 14,000 patients admitted to an internal medicine service during 1982-1988].

We analysed the discharge reports of patients admitted during 1982-1988 to an internal medicine department of a university hospital. There were 927 deaths among 13,913 patients (6.66%); the median age of the persons admitted was 59.50 years while the median age of the patients who died was 72.87 years. Both groups suffered from several afflictions; the most frequent among the hospital-admission group being: blood hypertension, pneumonia, diabetes mellitus, and the group who eventually died: pneumonia, cerebrovascular and neoplastic disease.

Age Factors↗
PubMedDate not supplied

[Review of ethical aspects in biomedical research. The experience of the Ethics Committee of the Center for Toxic Oil Syndrome and Rare Diseases [CISATER]].

This Field Note aims to make known the decisions taken by the Ethics Committee of the Instituto de Salud Carlos III for Toxic Oil Syndrome regarding the secondary use of research specimens in biological research when informed consent is lacking. This is a common concern in the field of biomedical research. After debating the ethical suitability of the secondary use of these samples, our main conclusion is that researchers conducting prospective studies should expressly solicit written informed consent from participants in the study about i) whether there will or could be any secondary use of the samples and, if so, ii) whether such secondary use would be conditional on the type of research.

Biomedical Research↗
PubMedDate not supplied

Epidemiological aspects of acute pancreatitis.

An epidemiologic analysis is carried out on incidence rate, mortality rate and etiology of acute pancreatitis, both from a general point of view and by the Spanish experience. In particular the linkages between biliary lithiasis, alcoholism and acute pancreatitis are investigated.

Acute Disease↗