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Biomedical subjects

L Rivera

Publications and source records attributed to L Rivera.

83 records · Page 5Linked to original sources
PubMedDate not supplied

Developing a community program on cancer pain and fatigue.

PURPOSE: The overall purpose of this project was to establish a community-based educational model on pain and fatigue management for individuals with cancer. The specific aims were: 1) to develop an appropriate educational program; 2) to pilot test this program in a community setting that supported a self-care approach; and 3) to evaluate the program process and outcomes. DESCRIPTION OF PROGRAM: The I Feel Better program was implemented through a two-session educational workshop taught by masters-prepared oncology nurses and was held at four Southern California sites of The Wellness Community. The focus of the sessions was to provide participants with general information about each symptom, assessment and management of those symptoms, and strategies for effectively communicating with their healthcare providers. Sessions of 2.5-hour duration were held on Saturday mornings and required preregistration. RESULTS: The participants were primarily female and White, with an average age of 58 years. Participants reported considerable pain and fatigue. They also lacked accurate information about pain management. Program evaluation revealed that the content and format were well received by the participants. They rated the program as extremely useful and reported positive outcomes after the first session. CLINICAL IMPLICATIONS: This pilot educational intervention program has strong implications for multidisciplinary educational approaches for patients with cancer. Limitations resulted from the setting selected and the possibility that participants were already active in their fight against cancer. Generalization to other community settings may not be as successful. Programs could be cosponsored by several collaborating institutions to share resources. Referral to community programs by physicians, nurses, and social workers can occur as needed when identified during patient interventions. The voluntary participation of health professionals in community education programs could provide a valuable service for patients and a rewarding experience for educators.

Adult↗
PubMedDate not supplied

[Diagnosis of malignant and benign insulinoma. Experience of the National Institute of Nutrition].

INTRODUCTION: Insulinomas are uncommon tumors, their incidence is approximately one case for 1 million population per year. OBJECTIVE: To expose our experience in the diagnosis of these tumors at the Instituto Nacional de la Nutrición Salvador Zubirán. MATERIAL AND METHODS: All patients with histologic diagnosis of insulinoma were reviewed; the period was from 1959 to 1996. The methods used for diagnosis and localization as well as the clinical picture according to the benignity or malignity of the tumor were registered. RESULTS: Eighteen patients were included, four of them with malignant tumors. In two patients islet cell tumors occurred in association with MEN type I, one of them benign and the other malignant. The mean age of patients with benign tumor was 38.2 +/- 13.5 years, in those with malignant tumors it was 51.5 +/- 16.2 years. The median period between symptoms and diagnosis was 34.4 +/- 15 months for benign tumors and 6 +/- 1.1 months for those with malignant tumors (p = 0.02). Patients with increasing weight had benign tumors. The 24 hours fasting test was not done in patients with malignant tumors because of the severity of hypoglycemia. The insulin/glucose ratio in patients with a malignant tumor was 5.2 +/- 4.7, while in patients with a benign tumor it was 1.82 +/- 1.7. The imaging studies showed that three patients with malignant tumors had hepatic metastasis and one had lymph node metastasis. The low accuracy of localization by radiological methods is due to the size of the tumor (> 2 cm). CONCLUSIONS: Malignant insulinomas are more aggressive and the delay of diagnosis is shorter that in cases with benign tumors. Selective arteriography remains the best preoperative localization procedure.

Adenoma, Islet Cell↗
PubMedDate not supplied

Colorectal cancer in a multi-ethnic urban group: its anatomical and age profile.

PURPOSE: To determine the age of presentation and anatomical distribution of colorectal cancer in an urban multi-ethnic group. PATIENTS AND METHODS: Patients with colorectal adenocarcinoma from 1976-1995 in the tumor registry file of a major hospital in New York City's borough of Manhattan were identified. The charts of 688 patients were reviewed and the location of the cancer, ethnicity, and age at diagnosis were recorded. The tumors were classified as: right cancers (RC); from the cecum, to and including the hepatic flexure, transverse (Trans); left cancers (LC): from the splenic flexure down to and including the sigmoid colon, rectum (Rec); rectosigmoid and rectal lesions; and colorectal lesions without known locations (CA). Patients were classified from self identification, place of birth, or race as: Asians (AS); blacks (BL); Hispanics (HI); and white (WH). An ANOVA test, and a Schefee post hoc test were used to compare the mean ages. While a chi2 and a fully saturated log-linear model compared the proportions. RESULTS: We could not identify the ethnicity of three patients, and they were not included in the analysis. There were 295 women and 390 men, with a mean age of 66.6 years and 65.0 years, respectively. The overall mean age was 65.7 years. The ethnicity of the patients were: AS = 102, BL = 98, HI = 189, and WH = 296. The mean ages for the different groups were: AS = 59.9 years, BL = 63.5 years, HI = 60.4 years, and WH = 71.7 years. The age difference was significant (P < 0.05), when comparing WH versus each other group. The regional distribution of the individual groups was: AS, RC = 28, Trans = 3, LC = 31, Rec = 37, CA = 3; BL, RC = 40, Trans = 2, LC = 33, Rec = 22, CA = 1; HI, RC = 45, Trans = 3, LC = 71, Rec = 61, CA = 9; and WH, RC = 76, Trans = 19, LC = 95, Rec = 89, CA = 17. The interethnical regional distribution of the cancers was significantly different (P < 0.05). Blacks had a greater presentation of right-sided lesions than expected, and whites had less Rec and RC lesions than expected. CONCLUSIONS: Minority Americans presented with colorectal cancer at a significantly earlier age than WH Americans. Blacks had a high frequency of proximal lesions, and Caucasian Americans had low presentation of RC and Rec lesions. These findings may prove helpful in deciding when to begin screening for colorectal cancer among the different ethnic groups, and what modalities to apply given the differences in anatomical distribution of this cancer.

Black or African American↗
PubMedDate not supplied

Oral-disease prevention in children with cancer: testing preventive protocol effectiveness.

UNLABELLED: Mucositis, gingivitis, herpetic stomatitis and candidiasis are a potential source of systemic infection in patients undergoing chemotherapy. Their severity and incidence may be reduced with procedures based on the prevention and elimination of sources causing oral infection and irritation. OBJECTIVE: The purpose of this investigation was to evaluate the effectiveness of an Oral Disease Preventive Protocol in children with cancer, subjected to chemotherapy and prior to application of dentobacterial infection control. MATERIAL AND METHODS: A controlled clinical test was run, with random assignations, on twelve 5-to-12-year-old patients diagnosed with Acute Lymphoblastic Leukemia (ALL) or Lymphoma, evaluated for twelve months, with a total of 154 evaluations. Five patients were boosted with oral physiotherapy, with non-alcoholic 0.05% fluoride mouthwashes, with topical application of myconazole oral gel; seven patients were given instructions on oral physiotherapy. RESULTS: There were no significant differences between the groups under evaluation (p>0.05). Of the oral complications evaluated, gingivitis registered the highest percentage (60%), followed by mucositis (18%) and candida albicans infection (7%). Most affected were the submandibular and cervical ganglions (59% and 41%, respectively). CONCLUSIONS: Prior control of sources causing oral infection and irritation effectively prevents complications during non-surgical cancer therapy.

Antineoplastic Agents↗
PubMedDate not supplied

Calcium-permeable glutamate receptors in horizontal cells of the mammalian retina.

Mechanisms that mediate the calcium influx in mammalian horizontal cells were studied. Horizontal cells (HCs) enzymatically dissociated from the rabbit retina were recorded by the whole-cell configuration of the patch-clamp technique and by calcium image ratioespectrophotometry of Fura-2 loaded cells. AMPA-preferring glutamate receptors were shown to permeate Ca2+ in mammalian HCs by ionic substitution experiments. Furthermore, after blocking the L-type calcium current with nifedipine (100 microM), calcium current through the AMPA-preferring glutamate receptors was measured. Calcium image ratioespectrophotometry was performed on the dissociated HCs in order to determine the changes in the intracellular calcium ([Ca2+]i). Fura-2 microspectrophotometry showed that in HCs, K+-induced cell depolarization promoted an increase in [Ca2+]i, mediated by the L-type calcium channels, since it was abolished in the presence of nifedipine. The increase in [Ca2+], upon cell depolarization was observed throughout each cell: however, it was maximal at the cell soma. Activation of glutamate receptors in dissociated HCs by glutamate, AMPA or kainate promoted an increase in [Ca2+]i. This increase in [Ca2+]i, was abolished in nominally Ca2+-free solution (0 mM Ca2+); in contrast, nifedipine decreased the glutamate-induced influx of calcium in ca. 50%. The present study demonstrates that calcium may permeate through glutamate receptors expressed in HCs of the rabbit retina.

Animals↗
PubMedDate not supplied

[Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina].

Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.

Argentina↗
PubMedDate not supplied

[Epidemic human fascioliasis. Cuba 1983. VI. Clinical study of 40 children in the Hospital Provincial of Sagua la Grande].

We studied forty children with "Febrile-eosinophilic-Syndrome". They presented Fasciola Hepatic infection confirmed by: Fever, high eosinophils and abdominal pain. 82% used to eat watercress. All of them had positive biopsies-laparoscopies-intradermo-reaction and also reaction to Fasciola antigen. We present the results of and epidemic in Cuba during 1983.

Adolescent↗
PubMedDate not supplied

[A bio-psycho-social approach to acute hypertensive disease in pregnancy].

In this paper, the approach to the genesis of the acute hypertension of pregnancy, uses a conceptual and methodological perspective adjusted to its multifactorial nature; a set of questions with epidemiologic focus is proposed, in order to vinculate psychosocial factors with the biologic processes characteristic of this health problem.

Acute Disease↗
PubMedDate not supplied

[Pancreatic insufficiency: an infrequent manifestation of primary hyperparathyroidism].

A case of malabsorption of pancreatic etiology secondary to primary hyperparathyroidism (HPT) is reported. Normalization of calcemia was achieved with parathyroidectomy and oral administration of pancreatic enzymes was initiated. HPT is an infrequent cause of pancreatic inflammatory disease. Although its association is controversial, its inclusion among the causes of exocrine pancreatic failure allows correct diagnosis and therapeutic management with a favorable prognosis.

Combined Modality Therapy↗