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Biomedical subjects

F Navarrete

Publications and source records attributed to F Navarrete.

16 recordsLinked to original sources

Effects of short-term zinc supplementation on cellular immunity, respiratory symptoms, and growth of malnourished Equadorian children.

OBJECTIVE: To assess the effect of zinc supplementation on respiratory tract disease, immunity and growth in malnourished children. DESIGN: A randomized double-blind placebo-controlled trial. SETTING: A day-care center in Quito, Ecuador. SUBJECTS: Fifty children (12-59 months old) recruited by height-for-age and weight-for-age deficit. INTERVENTIONS: Twenty-five children (supplemented, S group) received 10 mg/day of zinc as zinc sulfate, and 25 (nonsupplemented, NS group) received a placebo during 60 days. All were also observed during a 60-day postsupplementation period. Two children of the S group dropped out. Daily the clinical presence of cough, respiratory tract secretions, and fever, was recorded. On days 0,60 and 120, the cutaneous delayed-type hypersensitivity (DTH) to multiple antigens, and anthropometric parameters were assessed. On days 0 and 60 serum zinc levels were also measured. RESULTS: On day 60, DTH was significantly larger (20.8 +/- 7.1 vs 16.1 +/- 9.7 mm), and serum zinc levels were significantly higher (118.6 +/- 47.1 vs 83.1 +/- 24.5 micrograms/dl) in the S group than in the NS group (P <0.05 for each). The incidence of fever [relative risk (RR): 0.30, c.i. = 0.08- 0.95, P =0.02], cough (RR): 0.52, c.i. = 0.32-0.84, P = 0.004) and upper respiratory tract secretions (RR):0.72, c.i. = 0.59-0.88, P = 0.001) was lower in the S group than in the NS group at day 60. At the end of the postsupplementation observation period (day 120), the incidence of fever and upper respiratory tract secretions was the same in both the S and NS groups. The incidence of cough was higher at day 120 in the S group than in the NS group (RR): 2.28, c.i. = 1.37-3.83, P = 0.001). CONCLUSIONS: This study supports a role for zinc in immunity, and immunity to respiratory infections, while pointing out the need for larger studies.

Adjuvants, Immunologic↗

Pattern of recurrence after esophageal resection for cancer.

BACKGROUND/AIMS: Surgery is still the main treatment option for esophageal cancer; however, long-term survival has remained poor, even when a curative operation is performed. The present study was undertaken to analyze the pattern and time of recurrence after a curative esophagectomy. METHODOLOGY: We studied 53 patients who underwent curative esophageal resection for cancer between 1985 and 1994. We examined number and pattern of recurrences, time after surgery, and any factor with contribution to carcinoma recurrence. RESULTS: During the follow-up period, 34 patients had tumor recurrence. The disease-free interval was 12.7 months (SD = 9.8). Twenty patients (58.9%) developed extrathoracic tumor recurrence and 23 patients (67.6%) intrathoracic. In 3 cases an esophageal stump recurrence was presented. Thirteen patients were considered for palliative treatment after recurrence. The 5-year survival rate was 13%, with median survival time between recurrence and death, 4.1 months. The recurrence of disease was always before 40 months after surgery. Any significant difference related with recurrence was observed between the analyzed factors. CONCLUSIONS: The majority of recurrences are developed before 2 years. Neoplastic recurrence is most common at the mediastinum. Palliative treatments after recurrence do not modify the progression of tumor.

Adult↗

[Absence of bacteremia after dental extractions].

A study was made on 100 subjects of both sexes between the ages of 3 and 15 years to detect the presence of bacteria in the circulation after performing dental extractions. Two groups were formed of 42 and 57 subjects respectively. One of these groups was subjected to preoperative antisepsis of the region to be operated on, the rest of the conditions were similar for both groups. All the patients were submitted to a preoperative gingival smear and 5 c.c. of blood taken for cultures. Two postoperative blood cultures, one immediately after the operations and another 24 hrs. later were also done in all patients. All the extracted teeth presented severe infections at the root level and some showed complicated infection such as osteomyelitis. All blood cultures performed 24, 48, 72 hrs. and 21 days after the operation, were negative; therefore, there is no justification based on the study, to assume the existance of focal infection related to the presence of bacteremia.

Adolescent↗

Biliary lithiasis in the elderly patient: morbidity and mortality due to biliary surgery.

BACKGROUND/AIMS: Diseases of the biliary tract are the most common conditions requiring intra-abdominal surgery in elderly patients. Complications and adverse outcomes of gallstones are more frequent in older people. The present study was undertaken to analyze factors that contributed to overall morbidity and mortality after open cholecystectomy. Laparoscopic surgery and other new techniques were compared with the open method. METHODOLOGY: We studied retrospectively 76 patients that were 80 years and older. Each patient underwent operation in our unit. 40 patients had fewer than 30 days of clinical history, and 69 patients (90.8%) were emergency admissions. From a clinical point of view, 33 patients (43.4%) had jaundice on arrival and 21 (27.6%) fever. The operative findings included gallbladder wall infection in 46 patients (60.5%) and common bile duct stones in 25. Uni- and multivariate analysis was performed to discriminate variables in mortality and morbidity. RESULTS: Nine patients (11.8%) died, and 38 had complications in the postoperative period. The main causes of death were pulmonary complications (4) and multisystem organ failure (3). Morbidity was mainly due to wound infection (14), urinary infection (13) and respiratory disease (10). Three variables influenced morbidity: sex (male), cardiovascular disease and jaundice upon admission. In the regression model only cardiovascular disease and jaundice were of independent influence. The mortality rate was associated with pre-operative jaundice. CONCLUSIONS: Mortality and morbidity are related mainly to preoperative presentation. Jaundice is the main determinant of the outcome.

Aged↗

[Morphological features of the nasal mucosa in healthy children exposed to different concentrations of atmospheric pollution].

OBJECTIVE: During the last decades the impact of pollution in big cities on the upper respiratory tract of children has become an issue of interest. The purpose of the present study was to determine if exposure of healthy children to different concentrations of atmospheric pollution alters morphologically the nasal respiratory epithelium. MATERIAL AND METHODS: In this randomised, prospective, open clinical trial we included 71 healthy children matched for age and sex and divided them into 3 groups: Group I, 31 children from Mexico City. Group II, 21 children from Tula, Hidalgo a moderate polluted area, and Group III, 19 children from Contepec, Michoacán, a rural non-polluted area. We took a nasal biopsy from the lower turbinate and performed nasal cytology in all children. The samples were examined twice by a pathologist with a double-blind technique. Ozone measurements were taken during 1992. RESULTS: Nasal symptoms (nasal obstruction, pruritus and dryness) were present in 96.8%, 71.4% and 52.6% of patients in groups I, II and III respectively (p = 0.001). We also found bilateral hypertrophy turbinates in 100% of children in group I versus 81% and 73% in groups II and III (p = 0.009). Citologic examination disclosed no significant differences among the study groups, although p values were 0.06 respecting inflammation and abnormal goblet cells when we compared group I versus group II and III. Respecting histological examination we found significant differences when comparing group I versus II and III in squamous metaplasia (p = 0.02) and pseudoepitheliomatous hyperplasia (p = 0.003), with not significant differences among keratinization (p = 0.06) and dysplasia (p = 0.06). CONCLUSIONS: The results of this study indicate that exposure to a polluted atmosphere is followed by severe changes in the histology and cytology of the nasal mucosa in healthy children, with these changes being more frequent and severe in the more polluted areas. These findings implicate that we must put more attention on the long term effects of atmospheric pollution in order to establish stronger control measures.

Adolescent↗