Systemic contact dermatitis due to fusidic acid.
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Administration, Oral↗
Biomedical subjects
F J Ruiz
Publications and source records attributed to F J Ruiz.
Palliative care treatment patterns and associated costs of healthcare resource use for specific advanced cancer patients in the UK.
The purpose of this paper is to identify the treatment patterns and corresponding costs of healthcare resource use associated with palliative care for different types of advanced cancer patients, from the time they started strong opioid treatment until death. This was a modelling study performed from the perspective of the UK's National Health Service (NHS). A data set was created comprising 547 patients in the DIN-Link database who had a Read code for malignant neoplasms with a specific tumour-type diagnosis and who received their first strong opioid between 1 January 1998 and 30 September 2000 and died during that period. Palliative care-related resource utilization data were obtained from the DIN-Link database. Unit costs at 2000/2001 prices were applied to the resource use estimates to determine the mean cost of palliative care from the start of treatment until death. There were significant differences in age between patients with different cancer types and in patients' survival from diagnosis, time to the start of palliative care and duration of palliative care. The mean duration from cancer diagnosis to the start of strong opioid treatment ranged from 0.7 to 5.4 years in patients with lung and breast cancer respectively. Moreover, the length of palliative care ranged from 180 to 372 days in patients with these cancer types respectively. There were also statistically significant differences in resource use between patients with different cancer types, but this reflected, in part, the varying durations of palliative care. Nevertheless, there were also differences in the monthly number of primary care visits reflecting the different number of monthly prescriptions. There was no apparent relationship between the length and corresponding cost of palliative care which ranged from 1816 pounds sterling for colon cancer to 4789 pounds sterling for ovarian cancer. Additionally, on average, only a third of all patients also received 4-hourly morphine as part of their initial strong opioid treatment. The total cost of palliative care varied between cancer type and reflects, at least in part, the distinct clinical features associated with different tumours and the varying lengths of survival following the start of strong opioid treatment. Nevertheless, no apparent relationship was found between length of palliative care and corresponding costs. This analysis provides data on palliative care resource use for a variety of cancers and could provide useful input when planning local healthcare strategies and building service commissioning models.
Adult↗
Interaction between milk yield of Holstein cows in Mexico and the United States.
Genotype by environment interaction for milk yield was investigated by analyzing 55,162 mature equivalent, first lactation records of daughters from 1339 Holstein sires in Mexico and 499,401 daughters from 663 Holstein sires in the northeastern US. There were 474 US sires in common. Herd-year standard deviation was used to define non-overlapping high (> or = 1600 kg) and low (< or = 1300 kg) Mexican environments and a low (< or = 1025 kg) US environment. Variance components across Mexican environments were about 40% less than those of the US environment. Genetic correlation coefficients between milk yield in various Mexican environments and all US environments ranged from 0.60 to 0.71 and were different from unity (P < 0.001). Genetic correlation coefficients with low environment in the US ranged between 0.69 and 0.93; the largest correlation was between the low US and high Mexico environments. Both reductions in the size of genetic variance in Mexican environments relative to the US and genetic correlation coefficients less than unity were indicative of genotype by environment interaction. A significant rank change in estimated breeding values (EBV) of sires in Mexican environments relative to the US was another indicator of genotype of EBV of a sire estimated from daughters performances in low and high environments in Mexico were 0.46 and 0.62 against EBV of sires estimated from all data in the US. Against EBV estimated from the low environment in the US they were 0.57 and 0.83. The US low environment was a better predictor of performance in Mexican environments.
Animals↗
Evolutionary instability of the major histocompatibility complex class I loci in New World primates.
Homologues of the human major histocompatibility complex (MHC) HLA-A, -B, -E, -F, and -G loci are present in all the Catarrhini (Old World primates, apes, and humans), and some of their allelic lineages have survived several speciation events. Analysis of 26 MHC class I cDNAs from seven different genera of New World primates revealed that the Callitrichinae (tamarins and marmosets) are an exception to these rules of MHC stability. In gene trees of primate MHC class I genes, sequences from the Callitrichinae cluster in a genus-specific fashion, whereas in the other genera of New World primates, as in the Catarrhini, they cluster in a transgeneric way. The genus-specific clustering of the Callitrichinae cDNAs indicates that there is no orthology between MHC class I loci in genera of this phyletic group. Additionally, the Callitrichinae genera exhibit limited variability of their MHC class I genes, in contrast to the high variability displayed by all other primates. Each Callitrichinae genus, therefore, expresses its own set of MHC class I genes, suggesting that an unusually high rate of turnover of loci occurs in this subfamily. The limited variability of MHC class I genes in the Callitrichinae is likely the result of the recent origin of these loci.
Animals↗
[Is it possible to improve psychiatric care through the referral process?].
OBJECTIVE: To evaluate the quality of referral from Primary Care to Mental Health and its relationship to the illness referred. DESIGN: A descriptive retrospective study over 4 years on the quality of the process. SETTING: Mental Health Centre II in the Autonomous Community of Murcia. PATIENTS: 209 patients referred by three Primary Care teams. MEASUREMENTS AND MAIN RESULTS: 91.4% of patients (C.I. 95%: 100%, 81.1%) were accepted with a referral report. 97.9% (C.I. 95%: 100%, 87.8%) presented a reason for psychiatric consultation. The report included the clinical history of the illness in 58.1% of cases (C.I. 95%: 70.3%, 45.9%); a diagnostic opinion was given in 79.6% (C.I. 95%: 91.1%, 68%); and 37.2% (C.I. 95%: 49.3%, 25%) were referred with a request for a specific consultation. 68.4% of the referrals (C.I. 95%: 81.8%, 54.9%) coincided with the Mental Health diagnosis. It was observed that among the most commonly referred pathologies: anxiety disorders (31.6%), affective (28.8%), personality (7.7%), psychotic (5.3%), and adaptive disorders (5.3%); diagnoses were commonly made for affective or anxiety disorders (p < 0.0001); the specific cause of referral of anxiety disorders was recorded (p < 0.01); and in cases of psychotic and personality disorders, the diagnoses did not coincide (p < 0.001). CONCLUSIONS: Referral to Mental Health can be improved, fundamentally by sending a report which includes the clinical history and the reason for referral. It is common to express a diagnostic opinion on affective and anxiety disorders, to note a specific reason for referral in the case of anxiety disorders and not to specify personality and psychotic disorders.
Humans↗
[Salmonella enteritidis multifocal infection of the central nervous system. Efficacy of new cephalosporins].
Focal central nervous system infections, as abscess and empyema, due to Salmonella species are unusual. Even more unusual is the association of cerebral abscess, subdural empyema and epidural abscess we report in the present work. This infection appeared in our patient soon after a brain astrocytoma removal and was treated with cefotaxime and gentamicin during three weeks. In spite of documented genus susceptibility to the drugs the infection relapsed in few days. It was definitely cured with ceftazidime alone for six weeks. Third-generation cephalosporins are good alternatives in uncommon infections and specially in central nervous system salmonellosis, as resistances of this genus to classical drugs are lately increasing.
Brain Abscess↗
Role of nitric oxide and prostaglandins in the regulation of blood pressure in conscious rats.
The present study was designed to investigate the possible role of endothelium-derived vasodilators, nitric oxide and prostaglandins, in the regulation of blood pressure during the presence and absence of the major pressor systems. Conscious rats were infused with a cocktail of inhibitors of the sympathetic nervous system, renin-angiotensin system, and V1 vascular receptor to vasopressin (achieved with hexamethonium, captopril, phentolamine, propranolol, and the V1 vasopressin (AVP) antagonist des-(CH2)5Tyr(Me)-AVP). The cocktail of vasoconstrictor inhibitors induced a marked fall of mean arterial pressure (MAP) from 109 +/- 2 to 52 +/- 2 mmHg (1 mmHg = 133.3 Pa) (n = 24). In animals with blockade, the specific inhibitor of nitric oxide synthesis, NG-nitro-L-arginine methyl ester (L-NAME), induced a significant increase of MAP from 51 +/- 1 to 84 +/- 2 mmHg (n = 6). In the presence of indomethacin, a cyclooxygenase inhibitor, the pressor response to L-NAME was from 52 +/- 2 to 126 +/- 4 mmHg (n = 6). Neither indomethacin (n = 6) nor vehicle (n = 6) alone altered MAP. In intact animals without blockade, L-NAME caused a similar increase of MAP when it was injected alone (from 107 +/- 3 to 144 +/- 4 mmHg, n = 7) or with indomethacin (from 113 +/- 3 to 144 +/- 3, n = 6). Indomethacin alone (n = 8) did not change MAP. In conclusion, in the absence of the major pressor systems, the pressor effect of the inhibition of the production of endogenous nitric oxide and vasodilator prostanoid synthesis appears to be synergistic. These results suggest that these two endogenous vasodilators are involved in the maintenance of blood pressure.
Animals↗
Indomethacin does not modify the role of nitric oxide on blood pressure regulation of SHR.
1. The endothelium-dependent relaxation is impaired in spontaneously hypertensive rats (SHR) by the release of a vasoconstrictor prostanoid. We evaluated whether such a vasoconstrictor prostanoid is masking the vasodilatation induced by nitric oxide (NO). 2. For this we observed, in SHR, whether indomethacin (INDO) modified both the pressor response to the inhibition of NO biosynthesis with L-nitro-arginine methyl ester (L-NAME) and the acute hypotensive response to acetylcholine. 3. INDO did not modify basal mean arterial pressure (MAP), either the pressor response to L-NAME, or the depressor response to acetylcholine. 4. It shows that, in awake SHR, a vasoconstrictor prostanoid, did not seem to affect the acute regulatory function of NO on MAP.
Acetylcholine↗
N-acetyl-L-cysteine potentiates depressor response to captopril and enalaprilat in SHRs.
Recently, in vivo and in vitro studies have implicated nitric oxide as a mediator of the vascular effects of angiotensin-converting enzyme inhibitors (ACEIs). In the present study we hypothesized that N-acetyl-L-cysteine (NAC), by increasing the availability of reduced sulfhydryl groups, would enhance the antihypertensive response to the ACEIs captopril and enalaprilat by a mechanism dependent on nitric oxide. The experiments were performed on instrumented, indomethacin-pretreated, awake spontaneously hypertensive rats (SHRs). Thirty minutes after a bolus of captopril (10 mg/kg iv) was administered, blood pressure decreased from 167 +/- 5 to 147 +/- 6 mmHg (n = 8). The pretreatment with the donor of thiol groups NAC (300 mg/kg iv) potentiated the depressor response to captopril because blood pressure decreased from 172 +/- 3 to 139 +/- 4 mmHg (n = 6). At the dose of 60 micrograms/kg iv, the ACEI enalaprilat did not acutely modify the blood pressure of SHRs (from 172 +/- 5 to 167 +/- 4 mmHg; n = 6). However, when the SHRs were pretreated with NAC, the same dose of enalaprilat significantly reduced blood pressure from 176 +/- 5 to 151 +/- 5 mmHg (n = 6). This potentiation of the depressor response to ACEIs, due to NAC, was not observed when SHRs were pretreated with the nitric oxide inhibitor NG-nitro-L-arginine methyl ester (L-NAME; 50 micrograms.kg-1.min-1 iv). The results of this study suggest that NAC, a donor of sulfhydryl groups, potentiates the antihypertensive response to captopril and enalaprilat in SHR by a nitric oxide-dependent mechanism.
Acetylcysteine↗
Oxazolidines from sugars: conformationally restricted derivatives of muramic acid.
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Acetylmuramyl-Alanyl-Isoglutamine↗
[Family planning: an evaluation of the program at a health center (1986-1990)].
OBJECTIVE: To gain dome idea of the characteristics of the population attended at a Family Planning Clinic (FPC) in a Health Centre, attempting to find the coverage and performance of the Clinic. DESIGN: Retrospective descriptive study, which analysed 403 cases between July 1986 and December 1990. SITE. Family Planning Clinic in the "Huerta de la Reina" Health Centre. PATIENTS AND OTHERS PARTICIPANTS: Women of child-bearing age who requested a consultation during the period of the study. MAIN MEASUREMENTS AND RESULTS: A uni/bivariate analysis of the studies was carried out. Coverage of 16.3% of the population of child-bearing age, with 69.5% of the women being under 29, was attained. The most frequent motive for a consultation was advice on methods of contraception. Oral contraception (65.0%) was the most common form prescribed. 27.1% of those attending consultation were referred to the second level. Attendance at periodic check-ups was very low.
Age Factors↗
Cost-benefit evaluation of on-farm milk progesterone testing to monitor return to cyclicity and to classify ovarian cysts.
The effect of using on-farm milk progesterone testing to monitor return to cyclicity after parturition and to classify correctly and to treat cystic cows was evaluated using modeling and simulation. The test was evaluated assuming low and high accuracies of progesterone measurement, first breeding policy of 40 d, average estrus detection rate of 55%, and an average fertility rate of 55%. Three testing schemes (starting milk progesterone testing on d 30, 40, or 50 after parturition) were compared against a control to evaluate the effect of monitoring return to cyclicity on cows' reproductive and economic performance. For this purpose, the use of the test was an economically justifiable management intervention. Starting to test on d 30 after parturition was the most effective scheme, reducing days open by 18 d, replacement rate by 2.4%, and increasing net return per cow per year by $11. Starting to test on d 50 postpartum was not economically justifiable. Accuracy of the test, within the range used in this study, was unimportant. Testing was most profitable in herds with low fertility and low efficiency of estrus detection. The use of the test to classify follicular and luteal cysts and to select the appropriate therapy was not economically justifiable because of the low proportion of cystic cows and the high variation in response to therapy.
Animals↗
[Factors affecting the duration of maternal breast-feeding in a cohort of urban mothers studied longitudinally].
A prospective study on the incidence and duration of breastfeeding in a cohort of urban women of the city of Tlaxcala was carried-out in a private pediatric clinic from January, 1983 to December, 1987. In a total of 547 women studied, breastfeeding had a median of three months, and only 5% of the children continued to be breastfed at one year of age. Family tradition of breastfeeding, late introduction of solid foods and/or whole milk and less formal education of the mother were factors related with breastfeeding beyond three months. About 70% of the mothers weaned their children claiming a rejection of the breast-milk by the child, a lack of sufficient quantity to fulfill the child's needs or because of their work outside the home.
Adult↗
Gallstone ileus with two separate biliary-enteric fistulae.
A patient with gallstone ileus associated with two separate biliary-enteric fistulae has been reported. The patient had exploratory laparotomy with removal of the gallstone from the distal ileum, repair of the two fistula tracts, and cholecystectomy. The pathology report showed adenocarcinoma of the gallbladder. The patient was discharged 14 days after surgery. It is important to point out that the diagnosis was not suspected prior to surgery, although the patient was elderly with known cholelithiasis, no prior abdominal surgery, and clinical symptoms of bowel obstruction. The plain abdominal film showed a partial small bowel obstruction pattern with a pair of air-fluid levels in the right upper quadrant, no air in the biliary tract, and no visible calculus. When there is a clinical suspicion of gallstone ileus and the plain abdominal film is not diagnostic, there are several modalities available that have been proven to be useful (ie, contrast medium examinations, ultrasound, and hepatobiliary scan).
Adenocarcinoma↗
[Prick tests for histamine and cow milk in children].
Three hundred and one children were evaluated in six different rural areas in Tlaxcala, State (México). Through skin prick tests which included histamine, glycerine, cow's milk antigen and a drop fulfill a registration form including: personal data; personal and family atopic background; degree and frequency of gastrointestinal, respiratory and cutaneous diseases, as well as the child temperament. Besides, feeding history (length and type of breast-feeding). Six cases were found positive to cow's milk antigen (1.9%) by Prick test but none of them had showed signology related to (83%) were breast-fed at least for the first month of life. Histamine wheal size increased progressively up to eight months of age and reached a plateau.
Animals↗
[Compliance with and abandonment of immunotherapy].
The charts of 247 allergic patients (all ages) who were receiving immunotherapy were studied retrospectively. They belong to a private setting at the city of Santa Ana Chiautempan, Tlax (Mexico). We looked at whether they were compliant or noncompliance. Compliance was considered as those who did not stop immunotherapy during a 18-month period, and shorter periods s noncompliance. One hundred and fifty two (62%) were compliant and 95 (38%) were not. Noncompliance causes were: 29 patients felt better soon, 19 claimed high costs, 8 changed to alternative medicine. 6 felt worse because of immunotherapy, 6 moved to other cities, 2 preferred other allergists and 25 did not answer the questionnaire. Forty six per cent stopped during the first 2 to 6 months and 56% within 8 and 14 with a median of 5.4. Eighty per cent from those who were compliant claimed they felt much better and 18% only slightly better. The average length-compliance was 29.7 months.
Adult↗