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Biomedical subjects

J Castaneda

Publications and source records attributed to J Castaneda.

7 recordsLinked to original sources

CHEK2 is a multiorgan cancer susceptibility gene.

A single founder allele of the CHEK2 gene has been associated with predisposition to breast and prostate cancer in North America and Europe. The CHEK2 protein participates in the DNA damage response in many cell types and is therefore a good candidate for a multisite cancer susceptibility gene. Three founder alleles are present in Poland. Two of these result in a truncated CHEK2 protein, and the other is a missense substitution of an isoleucine for a threonine. We ascertained the prevalence of each of these alleles in 4,008 cancer cases and 4,000 controls, all from Poland. The majority of the common cancer sites were represented. Positive associations with protein-truncating alleles were seen for cancers of the thyroid (odds ratio [OR] 4.9; P=.0006), breast (OR 2.2; P=.02), and prostate (OR 2.2; P=.04). The missense variant I157T was associated with an increased risk of breast cancer (OR 1.4; P=.02), colon cancer (OR 2.0; P=.001), kidney cancer (OR 2.1; P=.0006), prostate cancer (OR 1.7; P=.002), and thyroid cancer (OR 1.9; P=.04). The range of cancers associated with mutations of the CHEK2 gene may be much greater than previously thought.

Case-Control Studies↗

Combination therapy for erectile dysfunction: a randomized, double blind, unblinded active-controlled, cross-over study of the pharmacodynamics and safety of combined oral formulations of apomorphine hydrochloride, phentolamine mesylate and papaverine hydrochloride in men with moderate to severe erectile dysfunction.

Oral therapy has become first line treatment for patients with mild to moderate erectile dysfunction (ED). Studies have shown that sildenafil may not be effective in all patients, and has been associated with a variety of adverse effects and an adverse interaction with nitrates and inhibitors of cytochrome P450 enzymes. The objective was to compare the efficacy and safety of three different oral combinations with the highest dose of sildenafil in men with moderate to severe ED. Randomized, double blind, unblinded active-controlled, Phase II study was carried out at three sites in Mexico. After a 4-week placebo run-in period, patients received all four of the following treatments using a 4-way cross-over design: 40 mg phentolamine (PM) +6 mg apomorphine (Apo); 40 mg PM +150 mg papaverine (Pap); 40 mg PM +6 mg Apo +150 mg Pap (Tricombo); 100 mg sildenafil (SC). With the exception of sildenafil tablets, all study medication was blinded. Moderate to severe ED was defined as a less than 50% vaginal penetration success rate during the placebo run-in period. A total of 44 patients were enrolled, of whom 36 completed all four treatment periods. All treatments produced a significant effect in primary efficacy variable (Sexual Encounter Profile) compared to baseline, however, no statistically significant differences were found between treatments. A significant period effect was observed. Also, the four treatments were found not to differ significantly in five out of six secondary efficacy variables. The lowest incidence of treatment-related adverse events (AE) occurred in the 40 mg PM +6 mg Apo group (9.8%), followed by 100 mg SC (15%), and the other two combinations (16.7 and 17.5%, respectively). Nasocongestion and headache were the most frequently reported AE. An oral combination of vasoactive agents may provide an alternative approach to sildenafil. Based on these results a combination of phentolamine and apomorphine warrants further clinical investigation.

Adrenergic alpha-Antagonists↗

Critical care experience for baccalaureate nursing students.

The projected need for critical care nurses can be met through the collaborative efforts of nursing education and nursing service. An approach as implemented at our institution with the support of community agencies can be mutually beneficial. It is generally recognized that new graduates tend to seek employment where they had positive student experiences. Although few students may choose critical care as a career, the majority will have a positive memory, which is supportive of the unique contribution of critical care nursing within the scope of the health and care of patients and their families.

Clinical Competence↗

Photorefractive keratectomy for myopic astigmatism using the emphasis erodible mask. Spanish User Group.

Photorefractive keratectomy (PRK) using the Summit emphasis erodible mask was performed on 229 eyes with myopic astigmatism. To analyze the efficacy and safety of the method, we evaluated the following: spectacle corrected visual acuity and refractive error as parameters of efficacy; corneal clarity, decentration of the ablation zone and complications as parameters of safety. Despite the short follow up (the longest was 12 months) our results show that the emphasis erodible mask appears to be an effective surgical method for correcting myopic astigmatism. However, we found a great number of complications and subjective symptoms that worsened the visual outcome. We conclude that the emphasis erodible mask has satisfactory efficacy but unsatisfactory safety.

Astigmatism↗