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Biomedical subjects

F Gude

Publications and source records attributed to F Gude.

34 records · Page 2Linked to original sources
PubMed2000

The predictive value of inguinal herniography for the diagnosis and treatment of cryptorchidism.

PURPOSE: We evaluated the role of a patent processus vaginalis for cryptorchidism as well as inguinal herniography as a predictor of the efficacy of human chorionic gonadotropin (HCG) treatment. MATERIALS AND METHODS: We studied 244 boys with unilateral and 66 with bilateral cryptorchidism. All patients underwent inguinal herniography and received HCG. Nonresponders to treatment subsequently underwent orchiopexy, when processus vaginalis status, testicular position and epididymal characteristics were assessed. RESULTS: HCG was effective for 139 of 281 testes (49.5%) with an obliterated and 0 of 95 with a patent processus vaginalis on herniography. We further evaluated herniography in accordance with orchiopexy findings of persistent unilateral and bilateral cryptorchidism in 206 boys (237 testes) after HCG. Herniography findings of processus vaginalis morphology revealed a close correlation with that reported by the surgeon after orchiopexy (p<0.000005). The incidence of a patent processus vaginalis increased as testicular position became more caudal. The processus vaginalis was obliterated in all cases of anorchia. The incidence of more severe epididymal anomalies decreased as the testicular position became more caudal. Epididymal abnormalities were more common when the processus vaginalis was patent. CONCLUSIONS: Pretreatment herniography assessment of processus vaginalis morphology is of prognostic value for predicting the efficacy of hormone treatment, the presence or absence of testes when they are nonpalpable and future fertility.

Child↗
PubMed1999

Atherosclerosis profile and microalbuminuria in essential hypertension.

Whether microalbuminuria (MA) is the result of intrarenal hemodynamic changes induced by increased systemic blood pressure (BP) or a marker of capillary leakiness at the glomerular level that reflects more generalized atherosclerotic vascular damage is still debated. To address this question, 319 patients without diabetes, 154 men and 165 women aged 57 +/- 8.6 years (range, 37 to 73 years), but with essential hypertension (EH) never treated with drugs were enrolled onto the study. Using a multiple linear regression analysis, we analyzed the prevalence of MA and its relationship with BP level as well as with other risk factors for the development of atherosclerosis. MA was present in 40% of the population studied. A univariable analysis of ambulatory BP monitoring measurements showed that only 24-hour systolic BP (P = 0.04), daytime systolic BP (P = 0. 02), and 24-hour daytime and nighttime systolic BP load (P < 0.01) predicted the presence of MA, whereas all BP variability parameters significantly predicted it. Multivariable analysis showed that only a positive family history of hypertension (P < 0.001), BMI (P < 0. 001), glucose (P < 0.001), and 24-hour systolic BP coefficient of variation (P < 0.001) independently predicted MA. In summary, the prevalence of MA in our group of patients with EH was high, presumably as a consequence of the older mean age of the population and the selection criteria. Besides being a marker of concomitant cardiovascular damage, MA was associated with a worse pattern of atherosclerotic risk factors. Although its pathophysiological meaning remains to be completely clarified, MA seems to be more related to other atherosclerosis risk factors and presumably reflects a more diffuse vascular injury.

Adult↗
PubMed1999

Snoring and myocardial infarction: a 4-year follow-up study.

The association between snoring and myocardial infarction was studied in 1453 people of both sexes aged 20-70 years. The study was carried out in a population of 92,364 residents and the subjects were recruited using the Electoral Census. A questionnaire was sent to all participants, asking about snoring and cardiovascular risk factors. Hospital records were checked for the next 4 years to establish how many of them developed myocardial infarction. At the beginning of the follow-up study 39 patients were diagnosed with ischaemic heart disease. Of the other 1414 participants, 571 (40.4%) were snorers and 843 (59.6%) non-snorers. Twenty-one developed myocardial infarction in the snorer group and four in the non-snorer group. The snorer group presents an adjusted relative risk of myocardial infarction of 3.08 (95% CI 1.01-9.46) with respect to non-snorers. We conclude that snoring seems to be a potential risk factor for myocardial infarction.

Adult↗
PubMed1999

Serum cytokines and increased total serum IgE in alcoholics.

BACKGROUND: It has been reported that total serum IgE is increased in alcohol abusers, but the mechanisms responsible are not known. Production of IgE depends on B-cell stimulation by both antigens and some cytokines, particularly IL-4 and IL-13. Chronic alcoholism and alcoholic liver disease are accompanied by changes in cytokine production. AIM OF THE STUDY: To evaluate if IgE increase in alcoholics could be associated to a ethanol-induced imbalance of the cytokine profile. PATIENTS AND METHODS: A total of 65 patients (53 males and 12 females, aged 47 +/- 12 years), admitted to the hospital because of ethanol abstinence symptoms entered the study. On admission, total serum IgE was measured by chemiluminescent EIA and serum IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, and interferon-gamma were measured by ELISA. Data were compared with those of 40 healthy control subjects. RESULTS: Serum IgE, IL-6, IL-8, IL-10, IL-12, and IL-13 were found to be high in alcoholic patients compared with healthy volunteers. Some parallelism was observed between serum IgE and both serum IL-10 and IL-13 were increased in alcoholics. CONCLUSIONS: Total serum IgE elevation in alcoholics with abstinence syndrome is accompanied by an increase of some type 2 cytokines. Ethanol-induced alterations in the cytokine profile may contribute to increased IgE levels in alcoholics.

Adult↗
PubMed1999

Prevalence of sleep disordered breathing and sleep apnea in 50- to 70-year-old individuals. A survey.

PURPOSE: To determine the prevalence of sleep disordered breathing (SDB) and sleep apnea syndrome (SAS) in a general population aged from 50 to 70 years. SUBJECTS AND METHODS: We recruited 76 individuals aged between 50 and 70 years, chosen at random from the electoral census. They were invited to the clinic where a detailed medical history was taken and physical examination, ENT examination, pulmonary function tests and night time recording of respiratory variables performed. RESULTS: The prevalence of SDB (apnea-hypopnea index >/= 5) was 28.9%, and there were no differences between men (28%) and women (30%). However, the prevalence of SAS was 6.8%, and there were differences between men (5 cases) and women (0 cases) (p = 0.0521). Subjects in the SDB group had higher systolic blood pressure than in the non-SDB group (p < 0.05). CONCLUSIONS: SDB and SAS are common among 50- to 70-year olds. The prevalence of SDB was 28.9% and the prevalence of SAS was 6.8%.

Aged↗
PubMed1999

Oximetry spectral analysis in the diagnosis of obstructive sleep apnoea.

Using spectral analysis of oximetry data, we prospectively evaluated the validity of this methodology in patients clinically suspected of suffering from obstructive sleep apnoea (OSA). A total of 233 outpatients were studied. Nocturnal oximetry was performed simultaneously with conventional polysomnography for all participants. The power density of oxygen saturation was analysed using Fast-Fourier transformation of the oximetric signal. Nocturnal oximetry test results were considered as abnormal (suspicion of OSA) if a peak in the spectrum between the period boundaries 30 and 70 s was observed. A normal test result was defined as the absence of the 30-70 s peak from the spectrum. Single-blind evaluation was performed by three independent observers, and agreement of two or more of these was considered definitive. The peak amplitude and the ratio of the area enclosed in the 30-70 s peak to the total area of the spectrum (r(S)) were measured. The presence of a peak has a sensitivity of 78%, a specificity of 89%, a positive predictive value of 89% and a negative predictive value of 78%. Apnoea-hypopnoea indexes were correlated significantly with peak amplitude (r=0.74; P<0.001) and with r(S) (r=0.69; P<0.001). For a peak amplitude threshold of 0.7%(2), the sensitivity was 94% and the specificity was 65% for OSA diagnosis. Using a threshold for r(S) of 0.15, the sensitivity was 91% and the specificity was 67%. Thus the spectral analysis of nocturnal oximetry and identification of a peak at 30-70 s could be useful as a diagnostic technique for OSA subjects.

Adult↗
PubMed1998

Myoelectric activity during unilateral chewing in healthy subjects: cycle duration and order of muscle activation.

STATEMENT OF PROBLEM: Craniomandibular disorders, unilateral mastication, and asymmetry of masticatory muscles appear to be related to each other. Thus, it is of interest to investigate masticatory muscle activity during unilateral mastication in healthy subjects. PURPOSE: This study monitored contractile activity of the right and left masticatory muscles during right- and left-side gum chewing. MATERIAL AND METHODS: Electromyographic techniques were used to determine chewing cycle duration and duration of contractile activity of the masticatory muscles (right and left masseter and anterior temporalis muscles) during unilateral chewing in 40 subjects without orofacial pain. The time-course of activation of the 4 muscles was also investigated. RESULTS: Electromyographic traces showed extensive interindividual variation. In both right- and left-side chewing tests, and regardless of whether the masseter or the temporalis muscles were considered, mean duration of the contraction phase did not differ significantly between the working and nonworking sides. The working side temporalis contracted first, whether alone or at the same time as the other muscles. CONCLUSIONS: In healthy subjects, no significant differences in masticatory muscle activity should be expected between either the right and left or the working and nonworking sides.

Adult↗
PubMed1998

[Symptoms of sleep apnea syndrome in the general population].

The aim of this study was to determine the clinical features of patients with sleep apnea syndrome (SAS) in the general population. One hundred ten individuals were selected randomly from the census and given hospital appointments. Case histories were taken and complete physical examinations were made. Nighttime respiratory polysomnograms were performed. Twenty-two (20%) of the 110 subjects presented SAS. In the SAS group, 59.1% were habitual snorers and 22.7% reported daytime hypersomnolence. The SAS patients has a mean age of 59.6 +/- 8.8 years and 45.4% showed alterations of the pharynx. No differences in spirometric variables were observed. Only age and daytime hypersomnolence predicted SAS in the multivariate analysis. We conclude that the prevalence of snoring, daytime hypersomnolence, pharyngeal alterations are higher in patients with SAS. The patients are also older. Only age and daytime hypersomnolence predicted of SAS.

Adult↗
PubMed1996

EMLA cream for renal extracorporeal shock wave lithotripsy in ambulatory patients.

The effectiveness of a Eutectic Mixture of Local Anaesthetics (EMLA cream) for pain control during renal extracorporeal shock wave lithotripsy (ESWL) was evaluated in a group of 20 patients who had not been able to tolerate a previous session without intravenous (i.v.) analgesia. EMLA cream (10 g) was applied on the skin over the area (64-100 cm2) where the shock waves were to be focussed. A second generation lithotriptor Siemens Lithostar was used. The following measurements were made: the shock wave (kV) maximum voltage, the number of successful stone fragmentations (SSF), the visual analogue scale score (0-10) for pain (VAS), and the tolerance scale score (1-4) for the tolerance for the procedure. Significantly higher voltage (17.9 +/- 0.6 kV vs. 16.2 +/- 0.8 kV), lower VAS scores (5.9 +/- 1.1 vs. 8.7 +/- 1.3), lower TS score (2.3 +/- 0.6 vs. 3.6 +/- 0.6) and a higher number of SSF (18 vs. 5) were found in those patients for whom EMLA cream was used. Intravenous analgesia was not needed in nine patients. Nine patients received fentanyl 0.05 mg, one 0.10 mg and another 0.15 mg. These favourable results were attributed both to the sequence of gradual voltage increments used and to the cutaneous analgesia produced by EMLA cream.

Ambulatory Care↗
PubMed1995

Plasma leukocyte elastase concentration in angiographically diagnosed coronary artery disease.

OBJECTIVE: To evaluate the clinical usefulness of leukocyte elastase determination in the diagnosis of coronary artery disease (CAD). BACKGROUND: Recent research has shown the important role of elastase, a proteolytic enzyme released by neutrophils, in the pathogenesis of CAD. METHODS: 141 patients underwent coronary angiography during investigation of chest pain and/or heart valve disease. Ninety-six had coronary lesions and 45 non-stenotic coronaries. The patients were characterized as regards presence or absence of angina (stable or unstable), family history of CAD, smoking, diabetes mellitus, hypertension, leukocyte counts, and plasma lipid and elastase concentrations. Among CAD-group patients, those with simple atheromatous plaques were distinguished from those with complex plaques. RESULTS: Elastase concentrations were greater in the CAD group than in the non-CAD group (49.7 +/- 2.8 micrograms.l-1; as against 29.5 +/- 2.2 micrograms.l-1; P < 0.001), and greater among complex-plaque CAD patients than among simple-plaque CAD patients (65.2 +/- 5.3 micrograms.l-1 as against 38.6 +/- 1.9 micrograms.l-1; P < 0.001). Logistic regression analysis showed (a) that the risk of CAD varied with elastase concentration, angina status, age and sex, increasing by 11% for every 1 microgram.l-1 increase in elastase concentration; and (b) that among CAD patients the risk of complex plaques was greatest for those with unstable angina and high elastase concentration, increasing by 6% for every 1 microgram.l-1 increase in elastase concentration. CONCLUSIONS: Peripheral blood leukocyte elastase concentration is a sensitive diagnostic marker of CAD. High values suggest the presence of complex atheromatous plaques.

Clinical Enzyme Tests↗
PubMed1995

Increased serum IgE in alcohol abusers.

BACKGROUND: It has been reported that total serum IgE is increased in patients with alcoholic cirrhosis, but it is not clear if this fact is related to alcoholic liver disease or to alcohol intake. OBJECTIVE: To measure serum IgE in a group of chronic alcoholics with different stages of liver injury in order to elucidate if IgE increase in related to alcoholic liver damage. PATIENTS AND METHODS: Total serum IgE was determined by enzyme immunoassay in 186 chronic alcoholic patients (137 male/49 female) and 101 healthy controls. Patients and controls with known reasons for IgE elevation were excluded. Among alcoholic patients, 24 had fatty liver, 28 hepatic fibrosis, 29 alcoholic hepatitis, and 67 liver cirrhosis (38 patients were not evaluable concerning liver injury). RESULTS: Total serum IgE was found to be increased in alcoholics (median 154.5 IU/mL, range 1-7329 IU/mL) with respect to healthy controls (median 20 IU/mL, range < 1-1417 IU/mL) (P < 0.001). IgE increase was moderate (180-1000 IU/mL) in 60 alcoholics (32.3%) and marked ( > 1000 IU/mL) in 27 (14.5%). Male alcoholics had higher IgE levels than females (median 191 IU/mL and range 1-7329 IU/mL vs 105 IU/mL and range 2-2189 IU/mL) ( P = 0.009). On logistic regression analysis, alcoholism, male sex and younger age (but not smoking) were independently associated with higher IgE levels. No clear relationship was noted between serum IgE and severity of alcoholic liver disease. Thus, no correlation was observed between IgE and parameters of liver function (serum bilirubin, albumin or prothrombin index). Likewise, IgE concentrations were not significantly different in patients with liver cirrhosis with respect to patients with less severe liver disease. Serum IgE was increased ( > 180 IU/mL) in 47.8% of cirrhotics and in 44% of patients without liver cirrhosis. In contrast, other immunoglobulins (IgG, IgA and IgM) were significantly correlated with liver dysfunction. CONCLUSION: Chronic alcoholism should be considered as a cause of increased total serum IgE, regardless of the severity of the underlying liver disease.

Adolescent↗
PubMed1995

Activity of leucocyte elastase in women with coronary artery disease documented using angiography.

BACKGROUND: Recent studies suggest that leucocyte elastase is involved in the pathogenesis of atherosclerosis. The objective of this study was to characterize the role of leucocyte elastase in arterial disease in women. METHODS: Forty-two women underwent coronary angiography because of chest pain or valvulopathy. Twenty-three showed no signs of lesions (group 1) and 19 had coronary stenosis (group 2). Their age, weight and height were recorded, together with the presence of angina, arterial hypertension, diabetes mellitus, any family history of coronary disease and levels of tobacco consumption. Leucocyte counts, lipid levels and neutrophil elastase concentrations were determined from peripheral blood samples. RESULTS: Levels of elastase were found to be significantly higher in group 2 than in group 1 (mean +/- SD 53.3 +/- 15.9 compared with 28.6 +/- 16.8 micrograms/l, P < 0.01). Patients from group 2, who had a greater mean age (69 +/- 7 compared with 58 +/- 9 years for group 1, p < 0.001), were more often diabetic (26% compared with 0%, p < 0.05) and were more likely to have family histories of ischaemic cardiomyopathy (59% compared with 18%, P < 0.05). However, multivariate analysis indicated that age and elastase levels were of independent value as predictors of coronary artery disease. CONCLUSION: The concentration of elastase in peripheral blood is higher in women who have stenosis on coronary angiography.

Aged↗
PubMed1995

[Hepatitis C virus antibodies in alcoholic patients].

It has been reported that chronic alcoholics show a high prevalence of hepatitis C virus (HCV) infection, with a possible role in the pathogenesis and severity of underlying liver disease. Thus, the present study was aimed to evaluate the prevalence of HCV antibodies (anti HCV-Ab) in a group of patients admitted to an Internal Medicine Department, as well as to compare characteristics of anti-HCV-Ab(+ve) respect to anti-HCV(-ve) patients. The presence of anti-HCV-Ab was prospectively studied in 180 alcoholic patients admitted during a 16-month period using a second generation ELISA. Intravenous drug abusers were excluded. Reasons for admittance were as follows: alcohol withdrawal syndrome (92 cases), complications of liver cirrhosis (mainly ascites) (54 cases), acute pancreatitis (12 cases) and miscellaneous causes (22 cases). Sixty-six patients were cirrhotics, 23 had fatty liver, 27 had liver fibrosis and 28 alcoholic hepatitis (36 patients were not evaluable concerning liver lesion). Twelve patients (6.7%) were anti-HCV-Ab(+ve). Prevalence was higher in patients admitted because of complications of cirrhosis (16.7%) than that of those admitted due to alcohol abstinence syndrome (1.1%, p < 0.01). Likewise, the proportion of HVC-Ab(+ve) patients was higher in patients with liver cirrhosis (16.7%) respect to those with lesser degrees of liver injury (1.3%; p < 0.01). In the latter group, the prevalence of anti-HCV-Ab(+ve) was similar to that of the normal population. Anti-HCV-Ab patients were older than anti-HCV-Ab(-ve) cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Serum IgE levels in liver cirrhosis. Contrasting results in alcoholic and non-alcoholic patients.

Hypergammaglobulinemia is a well-known feature of liver cirrhosis, but studies on serum IgE in this setting are limited. The present study evaluates serum IgE concentration in a group of cirrhotic patients and examines their relationship with aetiological, clinical and analytical parameters (including liver function tests and hepatic phagocytic activity). The presence of specific IgE against common dietary antigens was also investigated. Total serum IgE was determined by enzyme immunoassay (EIA) in 52 cirrhotics (27 alcoholic and 25 non-alcoholic, including eight virus B and seven virus C-related cirrhosis, three primary biliary cirrhosis, three cryptogenic, three haemochromatosis and one Wilson's disease) and 34 healthy subjects (used as controls). Serum IgE (IU/ml) in controls was not significantly different from that of cirrhotic patients (median 42, range 2-726 vs median 86, range 2- > 1000, respectively) (P = NS). However, serum IgE among alcoholics (median 199, range 19- > 1000) was higher than that of controls (P < 0.001), virus B-related cirrhotics (median 25, range 3- > 1000) (P < 0.05), virus C-related cirrhotics (median 47, range 2-170) (P < 0.05), or non-alcoholic cirrhotics as a whole (median 23, range 2- > 1000) (P < 0.01). High IgE levels (> or = 170 IU/ml) were detected in 55.5% of alcoholics compared with only 12% of non-alcoholic cirrhotics (P < 0.01). Moreover, IgE levels were very high (> 1000 IU/ml) in six patients of the alcoholic group (22.2%) compared with only one non-alcoholic patient (4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

The tropicamide test in patients with dementia of Alzheimer type and frontotemporal dementia.

The tropicamide test was applied to 30 patients with probable Alzheimer's disease (pAD), 12 with frontotemporal dementia (FTD) and 46 healthy subjects. One drop of 0.01% tropicamide was instilled in one eye and one drop of saline solution in the other. The pupil diameter was measured with a Goldmann pupillometer in its basal condition and 10, 15, 20, 25, 30, 35, 45 and 55 minutes afterwards. The results do not show differences between pupil dilation observed in pAD and in FTD; in both groups, from the beginning of the test, the pupil dilated more than in healthy people. A high interindividual variability was observed. The best cutoff point is 38% of interpupillary difference at minute 25 (sensitivity = 63%, specificity = 80%). If we consider the prevalence of AD in a population over 40 years old to be 1.4%, the adjusted positive predictive value of the test would be 4.2%. According to these results, the test is not a true diagnostic marker of AD.

Adult↗