PubMed Health⌕ Search

Biomedical subjects

O Ferrer-Roca

Publications and source records attributed to O Ferrer-Roca.

At least 19 recordsLinked to original sources
PubMed2002

Aviation medicine: challenges for telemedicine.

The number and seriousness of medical problems on passenger-carrying aircraft in flight are increasing. Medical incidents occur at a rate of approximately 10-50 per million passengers carried. Medical equipment carried on commercial aircraft is limited to three items: a first-aid kit, an emergency medical kit and sometimes an automatic external defibrillator. Telephone medicine, a lower level of telemedicine support, is well established for commercial air operations. The availability of satellite telecommunications on passenger-carrying aircraft permits more sophisticated forms of telemedicine. Recent telemedicine experiments have involved the transmission of three-lead electrocardiograms (ECGs), heart rate, blood pressure, arterial oxygen saturation, end-tidal CO2, respiratory rate, body temperature and realtime video. The challenge is to demonstrate that such techniques are practicable, improve patient outcomes and are cost-effective.

Aerospace Medicine↗
PubMed2001

[Medical training in the information society. Preparing legislation for health care revolution].

The information society is continuously pushing to a rapid change und updating of laws and training and qualification programs from which medicine is not excluded. This paper summarises the norms and laws applicable to telemedicine with three basic principles involved: medical practice, data management, and communication technologies. Following the subsidiary principle, the applicable legislative levels are: European Union, National, Autonomous Community, Medical Professional Colleges, and Local Medical Colleges. Contradictory and little innovative issues appear in the results and discussion sections of the deontologic codes, the pressing demand on doctors' awareness and to provide them with technical skills. An exhortation follows to work out an informative-ethic code for the telemedicine practice.

Access to Information↗
PubMed2001

A cost-minimization analysis of oncology home care versus hospital care.

We compared the costs of patient care for two groups of 10 oncology patients. The test group was treated at home and had access to 24 h telephone support, and the control group was treated in hospital, either as inpatients or as outpatients. Direct variable costs were provided by health insurance companies. The time invested by the health-care staff was recorded. The amount of time devoted to patients was more uniform in hospital than in the patients' homes, which suggests that patients at home received a less generic, more specific form of care. The nurses spent four times as long caring for home care patients as for hospital patients. The total cost of home care was 64% of that of hospital care, although this difference was not significant. The mean daily costs were three times lower at home than in hospital. All direct costs, except laboratory tests, were lower at home. Pharmaceutical costs were six times lower at home. Telephone support for home oncology care was cost saving and avoided 27 nursing home visits, which represented 35 working hours and Pta270,000 in savings to the health insurance companies.

Aged↗
PubMed1998

Genetic heterogeneity of benign thyroid lesions. Static and flow cytometry, karyotyping and in situ hybridization analysis.

The present series includes 75 thyroid lesions (38 goiters, 30 adenomas, 3 follicullo-papillary encapsulated carcinomas and 4 normal thyroid) that were studied by static and flow cytometry. Four cases were also analyzed by in situ hybridization (centromeric probes for chromosomes 1 and 17) and 10 cases by G-banding cytogenetics. Results demonstrate a polymorphism and genetic instability in the thyroid tissue that may be related to the spontaneous polyploidization of their cells. The most consistent finding in cytometry was the presence of two clones associated with clinical or histological hyperactivity (46% versus 23% in non-functioning cases; chi2 distribution with a p < 0.05). Chromosomal anomalies were detected in two out of 10 cases: 46, XX, t(5,19) in 87% of cells of a diffuse hyperplastic goiter and 49, XX, +7, +17, +22 in 19% of cells of thyroiditis case. Finally, the in situ hybridization technique showed hidden trisomies of clonal origin in all of the cases studied. Evaluation of clonal trisomies by the in situ hybridization technique using the confidence interval of a binomial distribution is discussed.

Adenoma↗
PubMed1998

Chromatin texture from hematoxylin stained thyroid lesions.

Quantitative aspects of cytology and histology should be considered in diagnostic standardisation processes. The present paper summarises the cytological differences detected in 75 thyroid lesions using a computerized textural analysis. Cells stained with progressive hematoxylin and taken from paraffin blocks were overlaid with the extracted texture. This technique was based on the lineal detection of a grey level gradient of the common logarithm of the integrated optical density (IOD) of each nucleus. Diffuse and nodular goiters (36 cases) were demonstrated to be composed of small cells containing high density texture that, on microscopical visual inspection, gave a "salt and pepper" appearance. The adenomatous goiters (2 cases) and adenomas (26 cases) were composed of low texture cells with a visual "blurry or smudgy" chromatin, while the atypical adenomas with capsular invasion (4 cases) were characterised by a "woodworm" nuclear appearance that produced the highest texture of the series. Finally, encapsulated folliculo-papillary carcinomas (3 cases) were composed of large clear nuclei with high IOD, low texture, and scattered lines that resulted in an "empty grape skin" aspect. Our findings seam to confirm the suitability of computerized textural techniques that aid in recognizing cell microscopic features objectively. The one used in the present work, based on a mathematical function of the DNA content of each individual nucleus (IOD), fulfills all microscopy detection criteria.

Chromatin↗
PubMed1998

The environment for telemedicine in the Canary Islands.

We studied the environment for telemedicine in the Canary Islands. The population's attitude to telemedicine was surveyed in 503 questionnaire interviews with doctors, nurses, paramedical staff and patients on the seven islands. Almost half the respondents (46-50% across groups) had a positive opinion of telemedicine. We also collected data about telephone medicine. A total of 479 medical-support telephone calls were made to four doctors, in psychiatry, ophthalmology and paediatrics. The telephone calls resolved the problem in 73% of cases and 86% would have come to the doctor if not made. Therapy was prescribed in 11% and 10% were just for information. The number of telephone calls per day was highest in psychiatry. Finally, we carried out a detailed analysis of the number of transfers between the islands (14,942 people in 1995 and 22,418 in 1996). According to the number of transfers and location of the referral hospital, oncology, psychiatry, dermatology and traumatology were the specialties that would be most likely to benefit from telemedicine.

Child↗
PubMed1997

Estradiol, progesterone and steroid receptors. Benign cycling versus malignant non cycling cells.

Levels of estradiol and progesterone from blood together with oestrogen (ER) and progesterone receptors (PgR) from breast tissue were studied from a total of 2500 data bank cases of breast neoplastic disease. We report here, 340 premenopausal women with recorded menstrual cycle data which enabled the study of the effect of peripheral hormone variation on ER and PgR with respect to cycle phase. The findings were also correlated with 30 immunohistochemical specimens. In the specimens with benign neoplasm (141 cases, age 28 +/- 18 years) the ER levels were low (9.2+/-9.4 fmol/mg protein) as in normal breast tissue, whereas PgR levels were high ( 76+/-102.4 fmol/mg protein). Both ER and PgR levels decreased in association with the peak of blood progesterone of the early secretory phase. In the 15 cases of benign neoplasm from the luteinic phase studied by immunohistochemistry there were few ER positive cells (29+/-15%) which were small (265+/-27 pixels) and faintly stained (MOD: 34+/-3UA), while the PgR positive cells were more numerous (79+/-15%), bigger (377+/-70 pixels), strongly stained (MOD: 48+/-5UA), and centrally located in the breast ducts. The differences in size and optical density were statistically significant indicating that both receptors are expressed by different cells. The cell cycle dependence of these differences is discussed. In the series of malignant neoplasms (199 cases, age 41+/-6 years), ER and PgR cytosol levels were both generally high (ER: 38+/-75.9, PgR: 86.6+/-137), and did not show variations due to the menstrual cycle, while blood progesterone, PgR, and the percentage of ER positive cases increased during the menstrual cycle. The 15 malignant cases in the luteinic phase showed, through immunohistochemistry, that size and staining intensities of receptor positive cells were similar to the other 199 cases and were not found to be directly influenced by hormonal activity related to the menstrual cycle. Comparisons between benign and malignant specimens showed significant biochemical and immunohistochemical differences in the degree of ER positivity while, on the contrary, PgR levels were similar.

Journal Article↗
PubMed1996

What do physicians think of telemedicine? A survey in different European regions.

To discover the perception of telemedicine in a sample of physicians not yet participating in telemedicine networks, a questionnaire was sent to doctors in different European countries. The questions covered various general aspects of telemedicine. The percentage of questionnaires returned ranged from 12% (Central Europe) to 27% (Spain). Apart from the rather disappointing response rates the results document a strong interest in telemedicine on the part of the physicians surveyed. Knowledge of the existence of telemedicine was high. Most of the respondents would have liked to have had their clinic's telemedicine system in their own laboratory. More than 50% of the physicians thought that their work would be improved by using telemedicine. Respondents from Central Europe were significantly less enthusiastic about telemedicine than those from other regions. However, the answers to the majority of the questions were similar in the different groups.

Attitude of Health Personnel↗
PubMed1993

[The role of calcium ions and temperature on the effect of exogenous semisynthetic surfactants (experimental study)].

With the final aim of preventing neonatal respiratory distress syndrome (RDS), the present study was carried out on premature rabbits (28 days of gestation) that showed a moderate level of RDS. These animals were treated intratracheally with 25 microliters of semisynthetic surfactant, composed of natural adult rabbit surfactant/DPC/DPPG (1/0.6/0.6 mol P) in two types of carriers, saline solution (Sf) and a calcium solution (5 mM of Cl2Ca), which were also used as controls. This was maintained throughout the experimental period at 37 degrees C or 60 degrees C, while checking the effect of temperature on their behavior. The final results in the P/V curves showed a significant increase in the maximum distention in the cases treated with semisynthetic surfactant at 60 degrees C with calcium vehicle (60.96 ml/kg) and with saline solution as the vehicle (58.51 ml/kg) with respect to the control without treatment (44.08 ml/kg) (p < 0.05). In the morphometric quantification of the lungs fixed to 10 cm H2O, the highest distention (VV) is reached by the semisynthetic surfactant in calcium solution (Mez.Ca) at 37 degrees C (56.30%) and 60 degrees C (56.31%), followed by the semisynthetic surfactant in saline solution at 37 degrees C (55.17%). The maximum compliance expressed the highest distention (with or without emphysema) and the morphometric distention together with the compliance at 10 cm H2O showed the residual trapping and/or anticollapsing effect. The temperature and the type of vehicle used for the semisynthetic mixture did not significantly influence the lung distention.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Factors that influence the distention of immature lung with artificial surfactant.

The exogenous therapy of respiratory distress syndrome with artificial surfactants is controversial. In the present work we treated premature rabbits with artificial ultrasonic obtained surfactant suspensions [dipalmitoyldiphosphatidylcholine:dipalmitoyldiphosphatidylglyc erol (DPPC:DPPG) 7:3] in various physical conditions produced by changing the carrier (saline solution and amniotic fluid) or incubating at 41 degrees C. Nonincubated samples (S0) were nonactive, the best effect on alveolar distention being found after 8 h incubation (S8), while 16 h incubated samples (S16) were less effective. Liposomal size of the mixtures correlated with their effectiveness; small unilamellar liposomes were nonactive, large unilamellar ones were active and in presence of large multilamellar liposomes the tensioactive effect decreased. Fifty-one percent of the alveolar distention, evaluated by morphometry, was due to treatment and 11% was linearly related to body weight. The ponderal effect of body weight was mathematically excluded in order to obtain more uniform results; the resulting parameter was called true treatment influence on alveolar distention (TIAD). 15% of TIAD varied due to the carrier, with significantly better results when saline solution was used as a carrier. These findings question the hypothesis of the prevention of respiratory distress syndrome by means of intraamniotic injection of surfactants.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1990

Morphometric, densitometric and flow cytometric criteria for the automated classification of thyroid lesions.

An automated classification of 73 thyroid lesions using a logical and mathematical approach was attempted. Densitometric, morphometric and flow cytometric parameters were used in Fisher linear discriminant functions to separate goiters or normal thyroids from adenomas and from carcinomas; the combination of this approach with binary discrimination improved the initial classification to a final efficiency of 81%. This approach, which is useful for classifying individual cells, was thus insufficient for classifying these cases. Analysis of the individual parameters showed that thyroid lesions were mainly in the near-diploid region. Two G0G1 populations were present in both benign and malignant lesions and were particularly frequent (50%) in atypical invasive follicular adenomas, probably related to the additional presence of an invasive clone. Near-triploid peaks were associated with malignancy as well as with high proliferative indexes. Nuclear and nucleolar sizes were larger in carcinomas; however, the percentage of the nucleolar area in the nucleus was greater in adenomas and nodular adenomatous goiters. A corrected staining index correlated with the nuclear size and the ploidy of abnormal cells (r = .50), being higher in malignant lesions.

Cytological Techniques↗
PubMed1989

Nuclear chromatin texture to differentiate follicular and papillary carcinoma of the thyroid.

This study presents the results of an automatic classification of six purely papillary, five purely follicular and five mixed papillary-follicular carcinomas of the thyroid. All cases were correctly classified with only two chromatin textural parameters obtained in the Olga's scan software package developed in our laboratory. Chromatin texture lines were generated by a unidirectional grey level gradient, obtained as a natural logarithmic function of the integrated optical density of each nucleus; this increased the difference between clear papillary and granular follicular nuclei. The accuracy of the method allowed a follicular carcinoma to be correctly classified as a mixed follicular-papillary. Finally a columnar-cell carcinoma of the thyroid was detected by means of its atypical DNA histogram.

Adenocarcinoma↗