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Biomedical subjects

M Lázaro

Publications and source records attributed to M Lázaro.

At least 19 recordsLinked to original sources

Gemcitabine, cisplatin and vinorelbine as induction chemotherapy followed by radical therapy in stage III non-small-cell lung cancer: a multicentre study of galician-lung-cancer-group.

PURPOSE: To determine the effectiveness of a gemcitabine-cisplatin-vinorelbine combination in patients with stage III non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients (n=46) with stage III NSCLC and naive of therapy were recruited into the trial to receive gemcitabine (G, 1000 mg/m(2)) on days 1 and 8, cisplatin (C, 100 mg/m(2)) on day 1 and vinorelbine (V, 25 mg/m(2)) on days 1 and 8 every 21 days for three cycles. RESULTS: Two patients achieved complete response (CR) and 23 partial response (PR), overall response 52%. Subsequent radical surgery included nine patients of whom four were non-resectable and five were resected and with 1 CR. Radiotherapy was administered to 31 patients, and two achieved CR. The median time to progression and overall survival were 37 and 50 weeks, respectively. Grade 3-4 neutropenia and thrombocytopenia occurred in 35% of cycles, with two toxic deaths. Severe non-haematological toxicity was uncommon. CONCLUSIONS: This GCV combination is effective in patients with stage III NSCLC, and with an acceptable toxicity.

Adult↗

[Glaucoma related with photoreceptor outer segments in aqueous humor. Schwartz-Matsuo syndrome].

CASE REPORT: We present the case of a patient who was initially diagnosed of hypertensive uveitis with marked fluctuation that was resistant to the common treatment. After a systematic examination, retinal detachment of the ora serrata in the inferotemporal quadrant was diagnosed. The sample of aqueous humor showed melanic pigment and degenerated photoreceptor outer segments. After retinal detachment surgery, the intraocular pressure returned to normal levels without antiglaucoma medication. DISCUSSION: The presence of photoreceptor outer segments in aqueous humor confirms the diagnosis of Schwartz-Matsuo syndrome, which should be considered as a differential diagnosis of iritis and glaucoma.

Adult↗

Allergy to plant-derived fresh foods in a birch- and ragweed-free area.

BACKGROUND: Allergy to plant-derived fresh foods has often been reported in geographical areas where birch or ragweed pollens are frequent and has been attributed to cross-reactivity to pollens. OBJECTIVE: The aim of this study has been to evaluate allergy to plant-derived fresh foods among pollen-allergic patients from a birch and ragweed-free area. METHODS: Ninety-five pollen-allergic patients took part in the study. The study consisted of a questionnaire, skin prick tests and challenge tests. Pollen skin tests to five grasses, eight trees and seven weeds were performed in duplicate. Prick tests (prick by prick) and challenge tests were carried out with the fresh foods. RESULTS: Most patients allergic to pollens were sensitized to grass (Lolium and Phleum; 97.9%), followed by tree (Olea; 82.1%) and weed pollens (Plantago; 64.2%). 35 of the 95 pollen-allergic patients had positive skin test responses to some plant-derived fresh foods, the highest percentage corresponding to several fruits in the Rosaceae family (peach and pear, 26.3%), followed by Cucurbitacea fruits (melon, 13.7%). The 21. 05% of the pollen-allergic patients were allergic to some type of plant-derived fresh food. Peach was the plant-derived fresh food which most frequently elicited allergy symptoms (12.6%), followed by melon (7.36%). The cluster of positive responses to Rosaceae fruits was higher for skin testing than for challenge testing. CONCLUSION: Peach was the most important allergy provoking fruit in a birch and ragweed free-area where apples were consumed at a rate of two times more than peaches and the patients allergic to pollen were principally sensitized to grass pollens.

Adolescent↗

[Obstructive myocardiopathic hypertrophy and sequential atrioventricular stimulation. Immediate results and long term follow-up. Seven years experience].

BACKGROUND: Sequential pacing as a primary treatment for patients with severe hypertrophic obstructive cardiomyopathy is still under controversy. In this study we sought to evaluate the effects of pacing on left ventricular systolic and diastolic function, its repercussion on pathophysiology and the possible changes in clinical evolution and functional class in patients who didn't respond to medical therapy. PATIENTS AND METHODS: Thirty-four patients with severe hypertrophic obstructive cardiomyopathy in functional class III-IV underwent evaluation. The mean age was 64 +/- 11 years. Sixty-two per cent were over 65. The study protocol included Holter monitoring, baseline echo-Doppler, during pacing, at 6 months and at the end of follow-up, and a complete catheterization and coronary angiography. Mean follow-up time was 36 +/- 20 month (range 6-74). In four patients sequential pacing was ineffective and the protocol had to be discontinued. Thirty patients received a permanent dual-chamber pacemaker and systolic and diastolic function were evaluated by hemodynamic, angiographic and eco-Doppler studies. RESULTS: Long-term stimulation reduced the subaortic gradient from 95 +/- 38 to 39 +/- 28 mmHg (p < 0.001), left ventricular systolic pressure from 207 +/- 38 to 164 +/- 30 mmHg (p < 0.001) and left ventricular end-diastolic pressure from 23 +/- 7 to 14 +/- 5 mmHg (p < 0.001), pulmonary capillary wedge pressure from 19 +/- 7 to 14 +/- 5 mmHg (p < 0.001), ejection fraction from 79 +/- 6 to 71 +/- 6% (p < 0.001) and mitral insufficiency. Diastolic function improved with an increase in early filling from 39 +/- 11 to 52 +/- 10% (p < 0.001) and E/A relation from 0.93 +/- 0.4 to 1.6 +/- 0.8 (p < 0.001), and a reduction in late filling from the left ventricle from 36 +/- 10% to 24 +/- 10% (p < 0.001). The speed of the E wave increased from 0.83 +/- 0.3 to 0.92 +/- 0.3 (p < 0.001) and we observed a reduction of the A wave from 93 +/- 0.3 to 0.66 +/- 0.2 (p < 0.001), pressure-half time from 95 +/- 34 to 66 +/- 19 ms (p < 0.001) and we observed deceleration time from 320 +/- 90 to 221 +/- 57 (p < 0.01). All patients have improved their functional class, allowing a reduction in pharmacological therapy. Two exitus of cardiological origin occurred. CONCLUSIONS: Sequential AV pacing in selected patients with severe hypertrophic obstructive cardiomyopathy can reduce subaortic gradient, pulmonary capillary wedge, left ventricular filling pressures and the severity of mitral regurgitation, and improve the markedly altered diastolic function. The significant symptomatic improvement allows a reduction in medical treatment. Thus, it represents a viable alternative to open-heart surgery, particularly in elderly patients, with lower morbidity and mortality rates.

Adult↗

Pollen allergy in peach-allergic patients: sensitization and cross-reactivity to taxonomically unrelated pollens.

BACKGROUND: Fruit allergy has been attributed to cross-reactive IgE to pollens and has been associated with a particular pollen sensitization. OBJECTIVE: The aim of the study was to evaluate sensitization to several taxonomically unrelated pollens in peach- and pollen-allergic patients and to study cross-reactivity between them. METHODS: One hundred sixty-five patients were evaluated: 70 peach- allergic patients together with 95 pollen-allergic patients (control group). Pollen skin tests in duplicate were performed to 5 grasses, 8 trees, and 7 weeds. Cross-reactivity between peach and taxonomically diverse pollens was determined by radioallergosorbent inhibition and Western blot inhibition tests. Experiments were also carried out after preadsorption of the sera with purified natural profilin. RESULTS: The skin test results revealed that peach-allergic patients frequently reacted to most pollens-grasses, weeds, and trees-even when some of these are not found in our geographic area. There was a statistically significant increase in sensitization frequency to most trees and weeds, with a statistically higher occurrence of asthma (odds ratio 2.98, 95% confidence interval 1.46-6.09). Inhibition test results provided evidence that taxonomically unrelated grasses, weeds, and trees produced various and substantial degrees of inhibition in specific IgE to peach and that the peach extract elicited strong inhibitions to those pollens. Profilin was found to be a relevant cross-reactive antigen in these patients. CONCLUSION: The results of this study provide evidence that peach allergy is linked to sensitization to several taxonomically unrelated pollens. This is attributable to the ubiquitous nature of the IgE binding determinants-such as profilins-between peach and taxonomically unrelated pollens.

Adolescent↗

A method for quantitation of food biologic activity: results with peach allergen extracts.

OBJECTIVE: The aim of this study was to develop a quantitative skin test assay for measurement of the biologic activity of food allergen extracts, as well as to report the results obtained with a peach extract labeled in food biological units (FBUs). METHODS: We prepared a biologically quantified peach extract. The biologic activity was measured in FBUs by assigning 100 FBU/ml to the biologic activity of the extract that elicited a wheal area with a geometric mean equal to that produced by the prick-prick method by using the food itself in a population of 30 patients allergic to food. We evaluated 265 patients, including 70 patients allergic to peach and 195 control subjects (100 nonatopic subjects and 95 subjects allergic to pollen). The biologically quantified peach extract was used during the study and was compared with four commercial peach extracts, which were labeled in weight per volume. RESULTS: The sensitivity of the nonstandardized commercial peach extracts varied from 4.3% to 74%, with biologic activity being very low in all of them. The sensitivity of the biologically quantified peach extract was 100%, with a 100% concordance between the prick-prick and the skin prick test results. CONCLUSION: These data demonstrate that if peach allergen preparations were biologically standardized in FBUs, the quality of these food extracts used for diagnosis would be improved.

Adolescent↗

Peach allergy pattern: experience in 70 patients.

We report the clinical characteristics of peach allergy encountered in a population of peach-allergic patients. We evaluated 165 patients. The 70 peach-allergic patients were diagnosed through clinical history, the skin prick-prick test, and open oral challenge and rub tests to peach. As a pollinic control group, 95 pollen-allergic patients were also evaluated. Some 49% of the patients were male and 51% female. The mean age was 20 +/- 8 years. Oral allergy syndrome (86%) was the most common symptom, followed by contact urticaria (61%) and systemic symptoms (26%). Some 67% of the patients were allergic to peach pulp and 36% reported symptoms related to canned peach. Canned peach and pulp symptoms were statistically associated (P < 0.01), and symptoms to canned peach were more frequently reported by patients with systemic symptoms (P < 0.05). On evaluation of the peach-allergic patients' characteristics, three risk factors--allergy to peach pulp, allergy to canned peach, and peach allergy in non-pollen-allergic patients--were found, indicating development of systemic symptoms on eating peach. Most of the peach-allergic patients (81%) also had pollen allergy, which was linked to a higher prevalence of asthma (73%) than in the pollen-allergic patients of the control group (48%); this difference was statistically significant (P < 0.01). Finally, two groups were clearly defined by the seriousness of the peach allergy--the non-pollen-allergic patients were more predisposed to the occurrence of systemic symptoms (> 50%), and the pollen-allergic patients to asthma (> 70%).

Adolescent↗

[Hypertension and dyslipidemia].

Hypertension is a very important cardiovascular risk factor and directly leads to major atherosclerotic cardiovascular diseases, including coronary artery disease, stroke cardiac failure and peripheral artery disease. Hypertension tends to cluster with other atherogenic risk factors like dyslipidemia, insulin resistance, obesity and others. The association between hypertension and dyslipidemia is very frequent and the risk is more than additive and its possible pathogenesis may be of a common mechanism. Insulin resistance is the main cause of both risk factors. Endothelium dysfunction is present in arterial hypertension and dyslipidemia and the pathogenesis of atherosclerosis. The treatment of hypertensive patients must be individualized to accommodate both the concomitant dyslipidemia and other atherogenic factors.

Arteriosclerosis↗

Delayed allergic reaction to cefonicid.

We report a case of delayed cutaneous reaction to intramuscular treatment with cefonicid, a second generation cephalosporin. An isolated late skin test response was observed to cefonicid only and not to other beta-lactams. A patch test with cefonicid 1% was positive after 48 and 96 hours.

Cefonicid↗

Anaphylactic reaction to ranitidine.

Ranitidine is a well-tolerated H2-receptor antagonist with a furan ring as nucleus. Anaphylactic reactions are seldom reported despite the wide use of the drug. We report a patient who presented an anaphylactic reaction with ranitidine (Zantac). The positive skin prick test and oral challenge suggest type I hypersensitivity. Specific IgE determination by RAST technique and histamine release test with ranitidine were negative. The patient did not react to other H2-receptor antagonists or to another furan-derivative (nitrofurantoin).

Adult↗

IgG subclass response to Aspergillus fumigatus.

The exact clinical meaning of the IgG subclass antibodies remains obscure. In order to contribute to the study of the IgG subclass response, specific IgGtotal and IgG subclass antibodies to Aspergillus fumigatus (Af) were determined by enzyme-linked immunosorbent assay (ELISA) in three groups of patients: 30 asthmatics due to an IgG-mediated hypersensitivity to Af, 30 atopic and 30 nonatopic controls. The results demonstrated that Af-specific IgGtotal, IgG2 and IgG4 antibodies are increased in Af-sensitive patients, although detectable levels of each specific IgG subclass could be found in all the three groups. No differences between atopic and non-atopic controls could be demonstrated.

Adolescent↗

Immediate adverse reaction to aminophylline.

We present a patient who experienced an immediate adverse reaction following intravenous administration of aminophylline. Skin prick, intradermal, and patch tests, RAST and indirect ELISA assays with aminophylline, theophylline and ethylenediamine were negative. A positive histamine release test was found only with ethylenediamine. Single-blind placebo-controlled challenges were positive with aminophylline and negative with theophylline. Our results suggest the reaction was a type I hypersensitivity reaction to ethylenediamine, but a nonimmune mechanism could not be excluded.

Administration, Oral↗

Bronchial asthma caused by two unrelated vegetables.

Vegetable-induced asthma is an uncommon hazard. We report an atopic housewife, in whom rhinoconjunctivitis and acute asthma were associated with two vegetables of taxonomically unrelated botanical families (Swiss chard/Chenopodiaceae family and green beans/legume family). Type I hypersensitivity to the antigens in Swiss chard and green beans was demonstrated by means of skin tests, histamine release test, and specific IgE determination by RAST. Bronchial responses after specific bronchial challenges indicated that Swiss chard and green beans might be the causative factor for the acute asthma.

Antibodies↗