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Biomedical subjects

G Rubio

Publications and source records attributed to G Rubio.

69 records · Page 4Linked to original sources
PubMed1975

Lethal faciocardiomelic dysplasia- a new autosomal recessive disorder.

Three male sibs from consanguienous parents were found to have a strikingly similar pattern of multiple congenital anomalies. The main features were polyhydramnios; low birthweight; dwarfism; epicanthal folds; abnormal ears; microretrognathia; microstomia; microglossia; glossoptosis; webbed neck; severe cardiac defects; radial and ulnar hypoplasia; radial deviation of the hands; brachymetacarpalia; thumb hypoplasia; clinodactyly and hypoplasia of the 5th finger; simian creases; fibular and tibial hypoplasia; talipes varus with hypoplastic heels; wide gap between 1st and 2nd toes; and delayed bone age. Neonatal death occurred in the 3 babies by severe cardiac failure. Differential diagnosis permits one to conclude that this is a new type of faciocardiomelic dysplasia with a probable autosomal recessive inheritance.

Abnormalities, Multiple↗
PubMedDate not supplied

Readiness to change questionnaire: reliability study of its Spanish version.

The present study explored the reliability and validity of a Spanish version of the Readiness to Change Questionnaire (RCQ) (12-item short form) as it might be used for opportunistic intervention. The test has three scales to allocate patients to a stage of change: pre-contemplation (P), contemplation (C) or action (A). The RCQ was translated and back-translated prior to pilot administration to 15 patients. From two settings (a general hospital ward and a primary health care centre), 201 patients were identified as excessive drinkers on the Alcohol Use Disorders Identification Test. Patients known to be alcohol-dependent and attending for alcohol-related reasons were excluded. Patients completed the RCQ. Test-retest reliability after 2 days was assessed in 35 patients. A components analysis was performed. Patients were classified on RCQ scores to a stage of change. Two experts separately interviewed the patients and made an allocation to stage of change, blind to the RCQ score. Test-retest reliability was good (P: r = 0.81; C: r = 0.87; A: r = 0.86). Within the three scales, RCQ items showed fair consistency in terms of Cronbach's alpha (P: 0.58, C: 0.75, A: 0.80). Component analysis showed that together the scales accounted for 57. 4% of the variance. The experts agreed between themselves on patients' stage of change (weighted kappa 0.92) but much less with the stage of change according to RCQ (expert A, kappa = 0.44; expert B, kappa = 0.52). Omitting patients with low consumption did not improve internal reliability, and omitting those with low educational level who might have filled in the questionnaire wrongly did not improve internal reliability or agreement between RCQ and the experts. We conclude that the Spanish RCQ did not function efficiently in a population of opportunistically identified excessive drinkers.

Adult↗
PubMedDate not supplied

Naltrexone versus acamprosate: one year follow-up of alcohol dependence treatment.

Naltrexone and acamprosate reduce relapse in alcohol dependence. They have not yet been compared in a published trial. The aim of this study was to compare the efficacy of these compounds in conditions similar to those in routine clinical practice. Random allocation to a year of treatment with naltrexone (50 mg/day) or acamprosate (1665-1998 mg/day) was made in 157 recently detoxified alcohol-dependent men with moderate dependence (evaluated using the Addictions Severity Index and Severity of Alcohol Dependence Scale). All were patients whom a member of the family would accompany regularly to appointments. Alcohol consumption, craving and adverse events were recorded weekly for the first 3 months, and then bi-weekly, by the treating psychiatrist who was not blinded. At 3-monthly intervals, investigators who were blinded to the treatment documented patients' alcohol consumption based on patients' accounts, information given by the psychiatrists when necessary, and reports from patients' families. Serum gamma-glutamyltransferase (GGT) was also measured. Efforts were made to sustain the blindness of the investigators. The same investigator did not assess the same patient twice. The integrity of the blindness was not checked. There was no difference between treatments in mean time to first drink (naltrexone 44 days, acamprosate 39 days) but the time to first relapse (five or more drinks in a day) was 63 days (naltrexone) versus 42 days (acamprosate) (P = 0.02). At the end of 1 year, 41% receiving naltrexone and 17% receiving acamprosate had not relapsed (P = 0.0009). The cumulative number of days of abstinence was significantly greater, and the number of drinks consumed at one time and severity of craving were significantly less, in the naltrexone group compared to the acamprosate group, as was the percentage of heavy drinking days (P = 0.038). More patients in the acamprosate than the naltrexone group were commenced on disulfiram during the study. Naltrexone patients attended significantly more group therapy sessions, though this could not explain their better outcome. There were non-significant trends for the naltrexone group to comply better with medication, to stay in the study longer, and to show greater improvement over baseline in serum GGT.

Acamprosate↗
PubMedDate not supplied

[Round Table: Urticaria in relation to infections].

OBJECTIVES: 1) To study the clinical and analytic features of infectious disease associated to urticaria in children. 2) To look into the probable etiology of the infectious disease. 3) To determine atopic predisposition and previous urticarial episodes and to rule out the involvement of antibiotics. DESIGN: Transversal and observational study. SETTING: Pediatric Allergy Outpatient Clinic of a tertiary Hospital. PATIENTS: Forty-four children, aged 1 to 12 years with acute urticaria associated to clinically infectious or febrile illness attending an Emergency Pediatric Department. INTERVENTION: Symptoms evaluation and physical examination in the seventh first days and follow over 3-6 weeks by the same physician. MEASUREMENTS: Clinical features of urticaria (duration, angioedema associated); Clinic diagnosis of illness infectious (acute respiratory infection, gastroenteritis, febrile syndrome); white blood cells count, C-reactive protein, aminotransferases (AST, ALT), L-Y-glutamyl transferase; viral culture and antigen detection: enterovirus (EV), adenovirus, respiratory syncytial virus (RSV), parainfluenza 1, 2 and 3, influenza A y B and cytomegalovirus (CMV); serological assay: CMV, enterovirus, mycoplasma pneumoniae, Epstein-Barr, parvovirus B19. RESULT: 22 children (50%) are between 1-2 years old. 40 patients (90,9%) had symptoms of respiratory tract infection and only four patients had a pneumonia. The other 4 children had a gastroenteritis. The analytic was suggestive of viral infection in 35 (79.5%) and unknown on seven patients. In 20 children (45.4%) was identified a probable infection. The viral detection was positive in 3 patients: CMV, herpes simplex 1 and influenza A. Twenty microbiological findings for seventeen patients was found by serological criterion of probable infection: enterovirus (10); parvovirus B19 (4); Epstein-Barr (3) y mycoplasma (3). Evidence of a double serologic infection was found in three patients. In comparison with a serological control group encountered that acute urticaria during a infectious disease is significantly associated (p = 0.0054) to high titer to enterovirus by complement-fixation. The urticaria was associated with angioedema in 38.6% and 9 children (20.4%) related an previous similar episode. Twenty-one (47.7%) had been treated with antibiotics before development the urticaria. All patients was given the suspected antibiotic and no patient developed any adverse reaction. CONCLUSIONS: The clinically infectious associated to urticarial rash in children, usually is a viral respiratory infections. Is more frequent at infant. In spite of antibiotic therapy is often related to development the urticaria, the subsequent challenge with the same antibiotic is good tolerated.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Nursing news in senology: creation of an ambulatory nursing clinic].

The IEO has starded an outpatient senology clinic conducted by nurses, and inspired by the successful experience of a similar clinic at the Gustave Roussy Institute of Paris. The purpose of the clinic is to expedite a series of procedures best carried out prior to hospital admission. First, the patient presents for the selection and examination of pre admission tests, following which the standard examinations related to the admission are programmed; the results are then examined, and the clinical record prepared for consignment to the Division the day before admission. The service began in April 1998 and has already received 750 patients.

Ambulatory Care Facilities↗
PubMedDate not supplied

[Validation in the adult Spanish population of the Wender Utah Rating Scale for the retrospective evaluation in adults of attention deficit/hyperactivity disorder in childhood].

INTRODUCTION: Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders in the early ages. Recently, it has been verified that presence of ADHD in early ages could be a vulnerability factor for developing different psychiatric disorders in adults, such as substance abuse and personality disorders. The retrospective diagnosis of this disorder in early ages of adult patients is specially problematic. OBJECTIVE: The Wender Utah Rating Scale (WURS) has been translated and adaptated with the purpose of validating it in the Spanish population. PATIENTS AND METHOD: It was administered the questionnaire to 266 patients of an Addictive Behaviours Unit. In 82 cases it was realized a clinical diagnosis of ADHD in early ages, and others 184 cases did not show antecedents of this disorder. RESULTS: 25 items which better discriminate cases from controls were chosen. The Cronbach s coefficient for this subscale was 0.94. The cut off 32 optimized sensitivity (91.5%) and specificity (90.8%). The positive and negative predictive values was 81% and 96% respectively. The total of incorrectly classified subjects was 9%. CONCLUSIONS: Our version of the WURS shows an adequate psychometric characteristics, that indicate an adequate validity for the detection of adult patients with antecedents of ADHD in early ages. In our population of patients with addictive behaviours, it has demonstrated to be very useful to differentiate an important subgroup of patients with antecedents of ADHD in early ages. It would be very interesting the replication of this study in other psychopathological and neurological conditions.

Adult↗
PubMedDate not supplied

[Combination therapy with reboxetine for major depression patients who are partial or nonresponders to serotonin selective reuptake inhibitors].

INTRODUCTION: Recent studies have confirmed the usefulness of the therapeutical combination of two antidepressants from different pharmacological families in patients with single drug therapy resistant depression. METHODS: In this prospective 6 weeks open-labeled study, efficacy of combination strategy was evaluated. This included the addition of reboxetine to 34 outpatients with DSM-IV major depressive disorder, who had not responded previously, or who partially responded to conventional treatment in single drug therapy with serotonin selective reuptake inhibitors (SSRI). Data were analyzed on a intent-to-treat basis. RESULTS: Mean decrease in the 21 item Hamilton depression rating scale (HDRS) score was 49.4% (from 26.9 to 13.6; p<0.0001) and in the clinical global impressions scale (CGI) was 40.4% (from 4.6 to 2.7; p < 0.0001). At the end of the treatment, 47.1% of the patients we re considered in remission (HDRS < or = 10), 55.9% evaluated as responders (HDRS < or = 50%) and 58.8% considered as having improvement (CGI<4). No serious side effects were observed during combination therapy, the most frequent being nervousness and the urinary hesitancy (5.9%). CONCLUSIONS: The results of this study suggest that addition of reboxetine to SSRI may be an effective and well-tolerated strategy in treatment-resistant patients who have failed to adequately respond to single drug therapy with SSRI.

Adolescent↗
PubMedDate not supplied

[Efficacy of naltrexone in the treatment of alcohol dependence disorder in women].

UNLABELLED: Alcoholism is a major public health problem. Although its prevalence is higher in men, the clinical and social repercussions of alcoholism in women are also of great concern, as they have differential characteristics in different vulnerability, and thus therapeutic implications. In recent years, we have seen an increase of the percentages of women with problems related to alcohol consumption in Spain. Several pharmacological treatments as the antagonist of the opioid receptors naltrexone have demonstrated efficacy in the treatment of dehabituation of alcoholism in males, however, there are no studies in the female population. This report is the first randomized study about the efficacy of naltrexone in the treatment of dehabituation in women with alcohol dependence disorder. METHODS: In a 12 week, single-blind, randomized trial, we studied 100 women with alcohol dependence disorder (DSM-IV), evaluating the efficacy of adding naltrexone as adjunctive treatment to the dehabituation treatment. RESULTS: The naltrexone group showed a lower rate of alcohol relapse during the follow-up period (76 % vs. 46%; chi2=8.239; p=0.004), and significantly lower dropout rates (16% vs. 38 %; chi2=5.074; p=0.024). We also found a lower number of days of intoxication (2.88 vs. 14.64; t=2.732; p=0.011). CONCLUSIONS: Naltrexone shows efficacy as adjunctive treatment to maintain abstinence in women with alcohol dependence disorder. Further studies are needed to confirm the efficacy of this treatment and to find specific predictors of good outcome in women.

Adult↗
PubMedDate not supplied

[Oxcarbazepine in the prevention of epileptic syndromes in alcohol detoxification].

INTRODUCTION: Alcohol withdrawal syndrome may be accompanied by severe complications, such as epileptic syndromes or delirium tremens. A number of pharmacological strategies, especially benzodiazepines (BZD), have been used in their treatment and prevention, although problems can arise from the use of these drugs due to their addictive properties. The classical anticonvulsive drugs are rarely employed as an alternative because of their side effects, but the latest generation of substances could be especially useful. AIMS. The aim of this study was to examine the safety of oxcarbazepine (OXC) in the prevention of epileptic seizures and complications deriving from the withdrawal syndrome in alcohol detoxification treatment. PATIENTS AND METHODS: The study involved a comparison of two groups of patients with a syndrome of physical dependence on alcohol, 42 of whom were treated with OXC and the remaining 42 received BZD as part of a programmed detoxification therapy. RESULTS: Both OXC and BZD were equally efficient in preventing the appearance of epileptic complications and in reducing withdrawal symptoms. Overall, OXC produced fewer adverse events (p < 0.001) and offered fewer problems when it came to ending administration (p < 0.001). CONCLUSIONS: OXC can be a valuable alternative to BZD and other pharmacological treatments in the prevention of complications in detoxification therapy, especially because of the absence of addictive properties and its having a better safety profile than classical anticonvulsant drugs.

Adult↗
PubMedDate not supplied

Effects of tubulin-inhibiting agents in human lung and breast cancer cell lines with different multidrug resistance phenotypes.

Drug sensitivity was studied for the tubulin inhibitors taxol, taxotere, rhizoxin and for doxorubucin and cisplatin, in human lung and breast cancer cell lines, including drug-selected cell lines, overexpressing the membrane transporter P-glycoprotein (Pgp) or the multidrug resistance protein (MRP). All tubulin-inhibiting agents were more potent than doxorubicin and cisplatin in all cell lines. In the drug resistance-selected cell lines (doxorubicin or mitoxantrone resistant) there was cross-resistance between the tubulin inhibitors and the selecting agent; however, MRP overexpressing cells were relatively less resistant to taxanes than the Pgp overexpressing cells. Polymerization of microtubules after exposure to taxol was observed in drug sensitive cell lines, but not in resistant cell lines, even at high taxol concentrations and after long exposure times. In the Pgp overexpressing cell lines, steady accumulation of 14C-taxol was defective and could be reverted by verapamil. MRP overexpressing cells did not have a significant accumulation defect of taxol, compared to the parental cell lines, and verapamil did not have any effect. These data confirm that the Pgp overexpression is an important mechanism of resistance to taxanes and rhizoxin in human lung and breast tumor cells. However, the presence of mechanisms other than transport defects may play an important role in non-Pgp expressing cells, and these may include an altered function of tubulins.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMedDate not supplied

[Effect of antidepressant drugs on cytochrome P-450 isoenzymes and their clinical relevance: differential profile].

The P-450 enzymatic complex (CYP) is one of the main enzymatic systems used by the organism to metabolize different substances, including 90% of drugs of common clinical use. Drugs can act on the CYP as substrates or as modifiers of its activity, either as inhibitors or as enzymatic inducers. Antidepressant drugs, including tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI), are widely metabolized by CYP. In addition, SSRI are potent inhibitors of different isoenzymes of this family. This fact allows to establish interesting differences relating the safety profile of these agents. In this review we analyze in detail, and comparatively, the effects of the different classes of antidepressants on CYP. Knowledge of these effects is of great relevance for an optimum clinical practice, allowing us to know the basis of some interactions, providing guidance for the use of correct dosage in different groups of patients and to explain some cases of unexpected toxicity or lack of therapeutic effect.

Antidepressive Agents↗
PubMedDate not supplied

[Psychiatric disorders and consumption of ecstasy drug (MDMA): review of published case reports].

BACKGROUND: Ecstasy use have raised in recent years and it have been related to psychopathological symptoms. The comsumption pattern associated with psychiatric complications is unknown. METHOD: Thirty-six case reports about psychiatric complications due to ecstasy and published from 1985 to 1997 were studied. RESULTS: The disorders with higher prevalence were psychosis (n = 21), panic attacks (n = 12) and depressive symptoms (n = 3). Seventy two per cent were substance abusers. Urinary drugs screening were present in 28%, only in two subjects might detect amphetamine. Men had higher MDMA doses compsumption and higher prevalence of background psychiatric disorders than women. Subjects with psychotic symptomatology had more psychiatric background, higher doses of MDMA comsumption and for a long time than individuals with depressive or panic attacks symptomatology. CONCLUSIONS: The review of the case reports of psychiatric complications related to ecstasy use do not allow to conclude that ecstasy use was the main responsible factor for psychiatric symptoms. They could be related to an individual vulnerability and or to lasting of comsumption.

Adolescent↗