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Biomedical subjects

M García

Publications and source records attributed to M García.

390 records · Page 22Linked to original sources

A test of alternative supervision strategies for family planning services in Guatemala.

This report presents results of an operations research project that tested the impact and cost-effectiveness of alternative supervision schemes of reproductive health services in Guatemala. The strategies tested were (1) indirect supervision, in which one of the two annual supervised visits to each health unit was replaced by a one-day meeting at the district level with the supervisor; and (2) self-assessment, in which one supervised visit was replaced by a two-day workshop where participants filled out self-assessment checklists identifying quality of care problems and made a plan to solve identified problems during the following months. Health units in the two experimental groups showed greater increases in productivity than units receiving traditional supervision. In both alternative strategies, supervisors were able to reach a larger proportion of health units and service providers than through the traditional supervision system. The supervised cost per unit was also lower in the two experimental groups than in the control group. Few differences were observed between the experimental and control groups in terms of the satisfaction of service providers with their jobs and of clients with services received.

Contraception Behavior↗

Linear monitoring of patients sensitive to Olea and grass pollens treated with immunotherapy based on glutaraldehyde-modified (allergoid) extracts.

Extracts modified with glutaraldehyde (allergoid) have been offered to allergologists for immunotherapy in the last few years as supposedly clinically effective agents that diminish undesirable side-effects (allergenicity vs. immunogenicity). In order to acquire experience in the use of this therapeutic resource, we monitored a group of patients with pollinosis sensitive to Olea, grass pollens or both, who suffered from seasonal rhinoconjunctivitis (SRC) or rhinoconjunctivitis and seasonal asthma (RCSA) and were administered allergoid treatments standardized in biological units (HEP). The patients were monitored by determination of specific IgE and IgG4, endpoint prick tests and conjunctival provocation tests (CPT) with two types of antigen: Lolium perenne and Olea europaea. Measurements were made at baseline (T1), when the maximal tolerated dose had been given (T2) and 1 year after the treatment was started (T3). According to our results, this type of extract is tolerated quite well and causes no alterations in specific IgG4 or IgE levels. On the other hand, it features significantly decreased allergen-specific skin reactivity and increased response thresholds to the CPT (p < 0.01). A high correlation between skin and conjunctival provocation tests was observed at some stages (r = 0.79, p < 0.01).

Adult↗

Node-negative breast cancers with p53(-)/HER2-neu(-) status may identify women with very good prognosis.

BACKGROUND: The contribution of p53 and HER-2/neu to the management of node-negative breast cancer (NNBC) could be improved by combining their results. MATERIAL AND METHODS: We studied paraffin-embedded primary tumors for p53 (BP-53-12-1) (n=57) and HER2/neu (pAB1) (n=63) from NNBC patients. The results were grouped in a negative (p53(-)/neu(-)) versus a positive group (one or both overexpressed). The association between both groups (negative and positive) and clinicopathologic parameters, S-phase fraction and DNA ploidy, and patients' outcome, was analyzed. RESULTS: In 28% of the tumors p53 was overexpressed, and HER2/neu in 11%. Sixty-five percent (37 out of 57) were p53(-)/neu(-), and 35% overexpressed one (31.5%) or both (3.5%) oncoproteins. Significant correlations were found between p53(-)/neu(-) tumors and age greater than 50 (p=0.003), S-phase fraction lower than 7 (p=0.03), and positive estrogen receptor contents (p=0.049). Actuarial 5-year disease-free and overall survival for p53(-)/neu(-) tumors were 88% and 97%, respectively, versus 50% and 66%, for tumors overexpressing one or both oncoproteins (p=0.004).

Age Factors↗

[Results of the cochlear transplant program of the University of Navarra].

From October 1989 to the end of 1991, 33 patients have received a Cochlear Implant Nucleus 22 Channel, that have been selected from over 150 patients that consulted the possibility of implantation. A cochlear implant program should count with a group of professionals of diverse areas, that work in coordination without losing contact with the rest of the member of the implant team. Cochlear Implant are considered an efficient technique in the treatment of profound neurosensorial deafness, in Pre and Postlinguistic patients. The results obtained have been better in the last group of patients, but results on the whole are considered satisfactory. In prelinguist there is a progressive positive tendency, therefore a longer amount of time is necessary to define the final results. The therapeutic capacity of this method of treatment is not limited only to the auditory area, but it has effect also in other fields related to communication and the integral development of the patients on whom it is applied.

Adolescent↗

Actions of diethylcarbamazine in experimental anaphylaxis.

Diethylcarbamazine citrate (DEC) is an anthelmintic drug which has been used recently, with varying results, in the treatment of bronchial asthma. We have examined the pharmacological activity of this drug in several in vivo and in vitro models of experimental anaphylaxis. DEC at doses of 25 and 50 mg per kg given intraperitoneally significantly reduced the mortality rate in sensitized guinea pigs during protracted shock phase but did not modify the time for the appearance of dyspnoea when antigen (egg albumin) was administered as aerosol. Nor did DEC at therapeutic doses inhibit the degranulation and histamine release from rat isolated peritoneal mast cells induced by phospholipase A, compound 48/80, and antigen respectively. It has been suggested that one possible explanation for the apparent effectiveness of DEC in asthma is its ability to antagonize prostaglandin F2 alpha. Our results using in vivo and in vitro models of bronchoconstriction in guinea pigs do not support this hypothesis to explain the inhibition of protacted shock by DEC.

Anaphylaxis↗

Anisakis simplex induces not only anisakiasis: report on 28 cases of allergy caused by this nematode.

Anisakis simplex R., parasitizes several sea-fish and cephalopods. This parasite induces not only anisakiasis but also anaphylactic reactions, as has recently been confirmed. We present 28 patients with immediate hypersensitivity to Anisakis simplex, developed after parasitized fish ingestion. Each case was diagnosed by suggestive anamnesis, skin prick tests with an A. simplex extract, specific IgE detection in serum (CAP System), and histamine release test. The clinical manifestations were urticaria/angioedema in all 28 patients and respiratory arrest in one. Paradoxically, the patients reported tolerance to ingestion of the same kind of fish between and after the allergic episodes. Type 1 hypersensitivity to A. simplex was demonstrated by a positive skin-prick test reaction, specific IgE detection in all cases and positive histamine release in a representative case. Sensitization to the proteins of the fish themselves was ruled out by negative reactions of the same tests in all cases. It was also proven that the allergen/s involved may be resistant to cooking and deep freezing. Hence, anaphylactic reactions may result either from infection or, more frequently, from mere exposure to the allergen. The results confirm that A. simplex can develop IgE-mediated anaphylactic reactions, the clinical severity of which was pronounced in the patients examined. Physicians must take into account that the consumption of parasitized fish may cause severe reactions, even if fish of the same kind is subsequently tolerated. A higher frequency of reactions of this type can be expected in countries where fish is a staple diet.

Adolescent↗

Comparative study of ascorbic acid and disodium cromoglycate in some models of experimental anaphylaxis.

The pharmacological activity of vitamin C and the antiallergic drug disodium cromoglycate are compared in models of rat mast cell degranulation and histamine release, and in protracted anaphylactic shock in the guinea pig. Our results demonstrate that ascorbic acid has a very weak inhibitory effect on degranulation and histamine release from mast cells, and therefore cannot be considered a prophylactic antiallergic drug such as disodium cromoglycate.

Anaphylaxis↗

[Various epidemiological aspects of Enterobius vermicularis infection inpatients served at public outpatient clinics and hospitals from the northern section of Santiago, Chile, 1995].

During 1995, we examined 2,666 Graham's tests (five perianal swabs with adhesive cellulose tape) prescribed to ambulatory patients attended in 14 public outpatient clinics and four hospitals from the north section of Santiago. The infection rates found by age groups were the following: 6.1% in infants (< 2 years old), 20.9% in pre-schoolchildren (2 < 6 years old), 35.2% in elementary schoolchildren (6 < 15 years old) and 15.2% in adults (> 15 years old). Similar percentages of E. vermicularis infections were observed in females and males patients. Frequency of infection in each month of the year varied between 17.4 and 26.8%, with no seasonal variation. This study and previous surveys are stressing that E. vermicularis is the most frequent helminthic agent found in Chile, specially in elementary school children.

Adolescent↗

Rheumatic manifestations in the course of anaphylaxis caused by Anisakis simplex.

Human anisakidosis is a parasitic infection caused by the larvae of Anisakis simplex. Classical clinical manifestations include epigastric pain, occlusion, diffuse abdominal pain, appendicitis, and anaphylactoid reactions. Arthralgias or arthritis have been infrequently reported. We present three patients with proven hypersensitivity to A. simplex together with rheumatologic complaints after ingestion of parasitized fishes. A. simplex must be considered in the differential diagnosis of arthralgias/ arthritis especially if associated with urticaria.

Adult↗

[Comparative study of 2 antibiotic prophylactic protocols in oncologic surgery of the pharynx and larynx].

The use of antibiotic prophylaxis in oncological pharyngeal and laryngeal surgery has reduced the risk of postoperative wound infection, which decreases morbidity and health-care costs. We report the results of a prospective randomized study in our hospital comparing the effectiveness of two antibiotic protocols, amoxicillin-clavulanate and clindamycin plus gentamicin, both given for 24 hours, in patients who underwent clean-contaminated oncological surgery of the pharynx or larynx.

Amoxicillin↗