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Biomedical subjects

M L Blanco

Publications and source records attributed to M L Blanco.

9 recordsLinked to original sources

[Lung cancer at a university hospital: epidemiological and histological characteristics of a recent and a historical series].

OBJECTIVE: To describe the clinical, histological, and epidemiological characteristics of patients diagnosed with lung cancer in our hospital over a period of 5 years and compare them with those of historical cases treated at the same hospital. PATIENTS AND METHODS: The cases of patients diagnosed with lung cancer from January 1998 through December 2002 were studied retrospectively and compared with data published for the period from 1978 through March 1981. RESULTS: A total of 678 patients (89% men, mean age 67 years) were studied. Fifty-six percent of the men and 38% of the women were smokers (P<.001). The most common histological types were squamous cell carcinoma (33%) and adenocarcinoma (30%): squamous carcinoma in men (36%) and adenocarcinoma in women (56%). Metastasis was present in 42% of the patients with non-small cell lung cancer and in 55% of those with small cell lung cancer. In patients with a history of neoplastic disease, laryngeal tumors were most common in patients with squamous carcinoma whereas bladder tumors were the most frequent in patients with adenocarcinoma. The ratio of men to women was lower in the recent series than in the historical one. The percentage of squamous carcinoma was lower and that of adenocarcinoma higher (P<.001). The percentage of patients diagnosed with regional involvement was greater in the recent series (P<.001). CONCLUSIONS: Squamous cell carcinoma continues to be the most frequent histological type. Male sex and smoking are associated with squamous carcinoma and female sex is associated with adenocarcinoma. Epidemiological and histological patterns have changed, possibly in relation to changes in smoking habits.

Adenocarcinoma↗

Gastro-oesophageal reflux in mechanically ventilated patients: effects of an oesophageal balloon.

Gastro-oesophageal reflux (GOR) and bronchoaspiration of gastric content are risk factors linked with ventilator-associated pneumonia. This study was aimed at evaluating the effect of a nasogastric tube (NGT) incorporating a low-pressure oesophageal balloon on GOR and bronchoaspiration in patients receiving mechanical ventilation. Fourteen patients were studied in a semi-recumbent position for 2 consecutive days. Inflation or deflation of the oesophageal balloon was randomised. Samples of blood, gastric content, and oropharyngeal and bronchial secretions were taken every 2 h over a period of 8 h. A radioactively labelled nutritional solution was continuously administered through the NGT. The magnitude of both the GOR and bronchoaspiration was measured by radioactivity counting of oropharyngeal and bronchial secretion samples, respectively. Inflation of the oesophageal balloon resulted in a significant decrease of both GOR and bronchoaspiration of gastric content. This protective effect was statistically significant from 4 h following inflation throughout the duration of the study. This study demonstrates that an inflated oesophageal balloon delays and decreases gastro-oesophageal and bronchial aspiration of gastric content in patients carrying a nasogastric tube and receiving enteral nutrition during mechanical ventilation. Although the method was found to be safe when applied for 8 h, longer times should be considered with caution.

Aged↗

Supported discharge shortens hospital stay in patients hospitalized because of an exacerbation of COPD.

This prospective, controlled, but not formally randomized study investigates the feasibility and efficiency of an alternative to standard hospitalization for patients with exacerbated chronic obstructive pulmonary disease (COPD), based upon supported discharge with nurse supervision at home. Over a 12-month period, emergency physicians, not directly involved in the study, admitted 205 patients with exacerbated COPD to the authors' respiratory unit. Patients were included in the supported discharge group (n=105) if they voluntarily chose to participate in the programme and lived in the city of Palma de Mallorca (where adequate home support could be provided). Patients not fulfilling these criteria (mainly residents outside the city) served as controls (n=100). Inpatient treatment was standardized in all patients and included oxygen therapy, bronchodilators, antibiotics and steroids. Both groups were comparable in terms of age (mean +/- SD: 70 +/- 10 versus 65 +/- 11 yr for supported discharge and control group, respectively), severity of airflow obstruction (forced expiratory volume in one second 45 +/- 18% reference versus 46 +/- 19% ref.), comorbidity and socioeconomic status. Length of hospital stay (LOS) in the supported discharge group was shorter (5.9 +/- 2.8 versus 8.0 +/- 5.1 days, p < 0.001). After discharge, a respiratory nurse visited supported discharge patients at home during 7.3 +/- 3.8 days. Only one patient (1%) required hospital readmission during this period of time. The reduced LOS resulted in a lower utilization of hospital beds at any given point in time throughout the study period. Within the framework and potential limitations of this study, the results indicate that the supported discharge programme in Spain: 1) allows a significant reduction in the length of hospital stay of patients hospitalized because of an exacerbation of chronic obstructive pulmonary disease; 2) does not result in an inappropriately increased rate of hospital readmissions; and 3) reduces the utilization of hospital resources.

Aged↗

[The cost effectiveness of echography biopsy].

Ecopsy is a postmortem technique which, by means of echography-guided puncture and/or aspiration obtains material for histological analysis. This study compared cost and time employed in 100 ecopsies and 100 classic necropsies and confirmed that cost of materials in ecopsy is 65% lower than that in necropsy. Physicians, necropsy technicians, laboratory technicians and secretary team personnel spent 33%, 54%, 19% and 32% less time than in necropsy. The clinical report of ecopsy was finished within nine days even with the brain study included.

Adult↗

[Risk of transmission of foot and mouth disease by milk and its products: perspectives in South America].

The authors highlight the importance of trade in dairy products in South America and throughout the world, and discuss the problem of restrictions engendered by foot and mouth disease (FMD) on exports to countries free from the disease. The epidemiological features of the disease and properties of the causal agent are described in relation to the dairy industry, with special reference to survival of the virus. Discussion then focuses on the risk of foot and mouth disease in relation to the effects the disease has on animal production before and after milking and the industrial processing of dairy products. Finally, the authors review progress achieved in FMD control and eradication programmes in Latin America, particularly in the southern sector where countries such as Chile and Uruguay are free from the disease, while in other countries (such as Argentina, Paraguay and parts of southern Brazil) no case has been reported for more than two years. It is concluded that dairy products can be exported from the region without creating a risk to animal health, provided that there has been proper risk analysis, according to the clearly defined regionalization criteria.

Animals↗

Displacement of rifampicin bound to serum proteins by addition of levamisole.

We have studied, by ultrafiltration, the interactions between rifampicin (15 and 30 microM) and levamisole (7 microM) since both drugs may be associated for the treatment of brucellosis. We can observe a statistically significant increase in the free plasmatic fraction of rifampicin at the studied concentration of levamisole, which indicated that levamisole reduced rifampicin bound to proteins (290 and 250%, respectively).

Blood Proteins↗

[Prune belly syndrome. Etiopathogenic considerations in 4 cases].

Four cases of prune belly syndrome of 19, 24, and 32 weeks of gestational age, and 14 days of postnatal life are described. All of them show urethral atresia, muscle defects of abdominal wall and undescended testes. Analysis of these four cases at different developmental stages brings authors to approach etiopathogenic basis of this syndrome.

Female↗