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Biomedical subjects

H García

Publications and source records attributed to H García.

At least 55 records · Page 3Linked to original sources

The effects of beta 1-adrenergic blockade on the growth response to growth hormone (GH)-releasing hormone therapy in GH-deficient children.

Acute suppression of SRIH secretion with a beta-adrenergic antagonist can increase the GH response to GHRH. To determine whether chronic beta-blockade could enhance the growth-promoting effects of GHRH therapy, we conducted a double blind, placebo-controlled, randomized, cross-over trial of coadministration of the selective beta 1-antagonist atenolol together with GHRH in 11 GH-deficient children. In randomly chosen order, each patient received two 12-month treatment periods with a single daily injection of GHRH (20 micrograms/kg, sc, at bedtime), plus daily oral administration of either atenolol (1 mg/kg) or placebo. The growth velocity increased, rising from a mean +/- SD of 2.6 +/- 0.4 cm/yr before treatment to 5.4 +/- 1.0 cm/yr during the first year of treatment with GHRH plus placebo and to 6.8 +/- 1.2 cm/yr during the first year of treatment with GHRH plus atenolol. The mean growth velocity during treatment with GHRH plus atenolol was significantly greater than that observed during GHRH plus placebo (P < 0.05). After cross-over, however, during the second year of therapy, we did not observe any significant differences in growth velocity between the two groups (4.2 +/- 1.4 vs. 3.9 +/- 0.8 cm/yr during treatment with GHRH plus placebo and GHRH plus atenolol, respectively). The mean 24-h serum GH levels were 1.4 +/- 0.9 micrograms/L during the baseline period, 1.3 +/- 0.2 and 2.0 +/- 1.4 micrograms/L during the first year of GHRH plus placebo and GHRH plus atenolol, respectively (P = NS), and 2.7 +/- 1.4 and 1.4 +/- 0.4 micrograms/L during the second year of GHRH plus placebo and GHRH plus atenolol, respectively (P < 0.05). This is the first demonstration that alteration of neurotransmitter action can enhance the therapeutic response to a hypothalamic releasing factor.

Adrenergic beta-1 Receptor Antagonists↗

[A comparative randomized controlled study of the efficacy of interferon alfa-2b and interferon alfa-2a in the treatment of chronic hepatitis C].

Interferon (INF) is the treatment of choice in active chronic hepatitis C although the optimum therapeutic schedule remains undefined to date. One forty-eight patients with active chronic hepatitis C were included in a randomized controlled study to compare the therapeutic efficacy of 2 types of recombinant alpha IFN: alpha-2b IFN and alpha-2a IFN. Twelve patients were excluded from the study for different reasons. The groups were made up of 34 untreated patients (group I), 68 patients treated with 5 MU of alpha-2b IFN three times per week for 12 months (group II) and 32 patients with 6 MU of alpha-2a IFN three times per week for one year (group III). On finalization of the treatment 39 patients from group II (57%) and 20 (63%) from group III showed normal transaminases (p > 0.05) while this was not so in any patient from group I (p < 0.001). HCV infection of less than 5 years was significantly associated with complete biochemical response. During the post treatment follow up (16.2 +/- 11.1 months; range: 6-45 months) the transaminase levels reelevated in 26 (67%) responding patients from group II and in 12 (60%) patients from group III (p > 0.05). Therefore complete biochemical response was maintained in only 12 (19%) of the patients from group II and in 8 (25%) of the patients from group III (p > 0.05). Liver biopsy was carried out in the 3 post treatment months in 15 patients from group I, 29 from group II and 18 patients from group III with all the rebiopsied patients from groups II and III having demonstrated complete or partial response to IFN.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Teratogenic and reproductive studies of policosanol in the rat and rabbit.

The present studies evaluated the teratogenic potential and reproductive toxicity of Policosanol, a new hypocholesterolemic drug. Policosanol was administered by oral gavage to Sprague-Dawley rats and New Zealand White rabbits during the period of organogenesis at dosages up to 500 and 1,000 mg/kg/day, respectively. There was no evidence of teratogenicity or any other embryonal toxicity. In a fertility and reproductive study female rats were treated with Policosanol by oral gavage at dosages up to 500 mg/kg/day, 2 weeks prior to mating and throughout mating and pregnancy to day 21 of lactation. Males were given treatment 60 days before and during mating. Reproductive parameters of mothers were normal. There was no evidence that treatment affected the survival, postnatal growth, or behavior of the offspring. No maternal treatment-related adverse side effects occurred in these studies. It is concluded that Policosanol was not teratogenic in either rats or rabbits, nor did it induce reproductive toxicity in rats.

Abnormalities, Drug-Induced↗

Zinc supplementation increases growth velocity of male children and adolescents with short stature.

We assessed the effect of zinc supplementation on growth velocity in 79 children and adolescents (48 males, 38 females) with idiopathic short stature. Their height-for-age was < 5th percentile (NCHS standards) and their weight-for-age was normal. Patients were assigned randomly to a supplemented group (S) to receive Zn 10 mg/day or to a placebo (P) group, according to gender and age, and were followed-up for 12 months using a double-blind design. Weight, height, armspan, length of lower segment and plasma and hair concentrations of Zn were measured at 0, 3, 6 and 12 months. On admission and at 6 months, energy, protein, dietary fiber and zinc intakes were similar for groups S and P; mean zinc intake was < 6.5 mg/day. No differences were found in plasma zinc, hair zinc, weight, armspan or lower segment increments. Pre-adolescent males in group S had a significantly greater increase in stature compared with group P (6.2 +/- 2.1 versus 4.5 +/- 1.2 cm/year p < 0.025); z score improved from -2.42 to -2.24 in group S and from -2.63 to -2.61 in group P. For adolescent males, the difference was also significant (8.3 +/- 1.5 versus 6.2 +/- 2.1 cm/year; p < 0.025). No differences were noted in females. In Chilean male schoolchildren and adolescents with idiopathic short stature, zinc supplementation increases growth velocity over a 12-month period.

Adolescent↗

[Post-pancreatitis diabetes: clinical experience in 40 cases].

The clinical features and evolution of 40 patients with diabetes mellitus secondary to chronic pancreatitis were reviewed and compared with 40 insulin dependent diabetics, matched for the disease duration. The diagnosis of pancreatitis was confirmed by the existence of pancreatic calcifications, surgery or autopsy and was associated to alcoholism in males and biliary diseases in females. Diabetes appeared, as a mean, 3 years after the diagnosis of pancreatitis. Ninety percent of subjects required insulin and, in males, these requirements were higher than their matched controls. Episodes of ketoacidosis were less frequent than in insulin dependent patients (8 vs 48% p < 0.001) and pulmonary tuberculosis had a higher prevalence (22.5 vs 5% p < 0.01). Nephropathy was observed with equal frequency in both groups but the incidence of retinopathy was higher in postpancreatic diabetics (38 vs 20% p < 0.01). It is concluded that the features of diabetes secondary to chronic pancreatitis are similar to those of insulin dependent diabetes, with some quantitative differences.

Adolescent↗

[Permanent venous access through a +portacath reservoir in patients receiving prolonged chemotherapy].

A significant number of oncology patients need intravenous chemotherapy. Peripheral venous access is generally difficult, frequently requiring central venous access. This study reviews the Author's experience with permanent venous portals. A total of 66 patients records, from January 1992 to April 1994, were reviewed. The central venous portals remained in place an average of 272 days. An average of 8 courses of chemotherapy were given through each port. There was no significant difference in the rate of complications secondary to the portal site. The Authors conclude that the placement of permanent venous portals is a safe and reliable chronic venous access in patients with cancer who require intravenous therapy. The rate of serious complication was 3% which is relatively low for these immunosuppressed patients. All venous portals, except one (98.5%) remained functional.

Antineoplastic Agents↗

Quantified electroencephalographic correlates of depression in Alzheimer's disease.

While depression is one of the most frequent psychiatric problems among patients with probable Alzheimer's disease (AD), its mechanism is not well known. We performed quantified EEGs in a consecutive series of seven patients with mild dementia and depression, six patients with mild dementia and no depression, eight patients with moderate dementia and depression, and eight patients with moderate dementia and no depression. Regardless of the severity of dementia, depressed patients had a significantly higher percent theta in posterior brain areas. Moreover, depressed patients with mild AD showed a similar theta frequency as non-depressed patients with moderate AD. These findings suggest that the presence of depression may contribute to the qEEG changes of AD.

Aged↗

[Prevalence of Helicobacter pylori in patients with gastric cancer in Panama].

Cancer of the stomach is the second in incidence in Panama after the cancer of the prostata. It is studied now the incidence of infection due to Helicobacter pylori in patients with gastric carcinoma. It seems to be a significative relationship between the prevalence of gastric carcinoma and H. pylori infections. This observation is important because by the similar therapeutic implications in virus DNA hepatitis type B and hepatoma.

Adenocarcinoma↗

[Treatment of Hodgkin's disease. National Protocol of Antineoplastic Drugs: preliminary report].

We report preliminary results of treatment of Hodgkin disease according to the National Protocol on Antineoplastic Drugs. 37 males and 22 females with a median age of 34 years (range 16 to 76) were treated. Patients with stages I or II received radiotherapy alone or chemotherapy (C-MOPP) followed by radiotherapy. Patients with stages III or IV received radiotherapy and chemotherapy or alternating courses of C-MOPP and ABVD. Complete remission was observed in 74% of 39 patients completing full therapy. Complete remission was more common in patients with nodular sclerosis without B symptoms and under 45 years of age. Actuarial survival at 22 months was 79%, significantly higher for patients with nodular sclerosis compared to patients with lymphocytic depletion. Different treatments in patients at stages I and II or III and IV gave comparable results. Complications included infection with the Chickenpox-Zoster virus, pneumonia and fever of unknown origin. Mortality was associated to older age, complications of treatment or failure to comply with therapy.

Actuarial Analysis↗

[Malignant lymphomas. Preliminary report of the National Protocol of Antineoplastic Drugs].

The first results of the management of adult non-Hodgkin lymphoma according to the National Protocol are reported. 164 pts (71 female and 93 male), aged 50 (range 15 to 79 years) were included. 89 pts had lymphomas with intermediate, 34 with low and 24 with high grade malignancy. 65% had advanced stages (III and IV). In the low grade malignancy group 38% were in complete remission and actuarial survival at 20 months was 80%. In the intermediate grade group, stages I and II the corresponding values were 79 and 85%; in the intermediate grade stages III and IV, 58 and 69%, and in the high grade group 61 and 77%. Bone marrow toxicity and infections were the main complications. 32 pts have died, 10 of them with drug toxicity complications.

Adolescent↗

[Adult non-insulin-dependent diabetic: limitation of articular mobility and soft tissue involvement].

Periarticular involvement and joint mobility were investigated in 100 non insulin dependent diabetic patients, compared to 100 healthy control subjects of similar age and sex. Periarticular involvement was much more common in diabetics (p < 0.01) including limitation of joint mobility (hands) (40% vs 9%), Dupuytren (29% vs 2%), palmar synovitis (59% vs 7%) and capsulitis (16% vs 1%). Diabetic patients with limitation of joint mobility had more neuropathy (80% vs 56%), retinitis proliferans (35% vs 17%) and alterations of the skin of the hands, compared to diabetics without limitation of joint mobility. Diabetes should be investigated in subjects with periarticular manifestations such as those described in this paper. Also, a more advanced stage of diabetes may be suspected in diabetics with such manifestations.

Adult↗

[Regional pancreatectomy in tumors invading the portal vein].

The authors present the clinical history of a patient who underwent the first regional pancreatectomy performed in Panama. The patient had been operated on one year before and the tumor in the head of the pancreas had been considered unresectable at that time because it had invaded the portal vein. Since the patient was in excellent health and her diabetes and hypertension (diagnosed ten years before) were well controlled, the size of the tumor, as demonstrated in CAT scans, had not changed in one year and the biopsy of the tumor had characterized it as of neuroectodermic origin without regional lymph node involvement, it was decided to perform a regional pancreatectomy. The authors describe the different stages of the resection of the tumor and the anatomical reconstruction. They point out the recommendations of different schools of thought about the operation and report on the excellent results obtained in this patient.

Humans↗

[Treatment of acute lymphoblastic leukemia in adults: preliminary report of the national protocol on antineoplastic drugs].

We report preliminary results from a national protocol for treatment of acute lymphoblastic leukemia. 44 patients, 15 females and 29 males with age range 15 to 65 years (median 27) were treated and followed for 22 months. Complete remission was observed in 33 (77%) of 43 patients with a known induction result. Remission was 100%, 86% and 61% for low (3), medium or high risk patients (p = 0.03). Complete remission occurred more often in patients with WBC less than 35,000 or granulocyte counts greater than 100. Actuarial survival rate at 22 months was 60% overall and 100%, 64% and 50% for the low, intermediate and high risk groups, respectively (NS). Death occurred in 16 patients, 5 during induction, 3 during complete remission, 6 during relapse and 2 after induction failure. Infections were the main cause of death in all groups.

Actuarial Analysis↗

[Treatment of acute non-lymphoblastic leukemia in adults. Preliminary report from the national protocol on antineoplastic drugs].

After a follow up of 22 months we report results of treatment on 44 patients (22 males), aged 16 to 63 years, with acute non lymphoblastic leukemia. Complete remission was obtained in 22 patients. This was significantly more frequent in patients under 40 years of age with white cell counts under 35,000 and without metabolic complications nor disseminated intravascular coagulation before treatment. Delaying chemotherapy for 5 days after diagnosis was also associated to a better prognosis. Overall actuarial survival rate was 37% at 15 months, 55% for those experiencing a first remission. A total of 25 patients [corrected] have died, 15 during induction of therapy, 7 after complete remission and 3 after failure of induction. Infections are the main cause of death during induction, with a high lethality for sepsis (33%) and pneumonia (40%).

Actuarial Analysis↗

Prospective study about the incidence of B lactamase producing bacteriae in otitis media in the population of the emergency room of the University Pediatric Hospital.

The purpose of the study is to determine the incidence of beta-lactamase producing pathogens causing otitis media (O.M.) in the Emergency Room population of the University Pediatric Hospital. In our first four months of study, 22 patients, between the ages of 6 months to 13 y/o have been evaluated. Middle ear secretion cultures were obtained by tympanocentesis. The organisms recovered from cultures were S. epidermidis 3 (14%), S. pneumoniae 2 (9%) H. influenzae 1 (5%), mix flora 1 (5%) and 13 (59%) with no growth. None of these organisms were beta-lactamase producers. Up to 64% of the patients had history of 2 to 5 OM episodes during the last six months. Interesting is the association of bronchial asthma, sinusitis and allergy history with OM. Final study results will be presented in a near future.

Adolescent↗