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Biomedical subjects

P Rico

Publications and source records attributed to P Rico.

29 records · Page 2Linked to original sources
PubMed1990

Treatment of pilonidal sinus by excision and rhomboid flap.

A series of 23 patients with chronic pilonidal disease have been treated by excision and transposition rhomboid flap. Full primary healing was obtained in all patients, with only two cases of wound seroma. The average hospital stay was 9 days. The mean follow-up period was 12 months, and no late recurrences have occurred.

Adolescent↗
PubMed1989

Association of fibronectin with the microfibrils of connective tissue.

The association of fibronectin with the microfibrils of connective tissue was examined in the zonular fibers of the mouse eye by immunohistochemical methods at the light and electron microscopic level. Mouse eyes fixed in formaldehyde were embedded either in paraffin for immunostaining by the peroxidase-antiperoxidase (PAP) method or in Lowicryl for immunolabeling by antirabbit globulin antibodies bound to 5 or 15 nm gold particles. Ultrastructural studies were also carried out after glutaraldehyde perfusion. Both the PAP and immunogold procedures demonstrated the association of fibronectin with microfibrils. After immunolabeling with 5 nm gold particles, examination at high magnification localized fibronectin to fine filaments that appeared to be attached to the surface of microfibrils. The filaments extended outward singly or formed loose aggregates. Their diameter ranged from 1.2 to 3 nm, with a mean of 1.5 nm. Because of their similarity to the fibronectin molecules previously described after rotary shadowing, the filaments were likely to be fibronectin molecules themselves. Since fibronectin is known to have high affinity for the amyloid P component, a model is presented in which fibronectin filaments are bound to the amyloid P component making up the tubular core of microfibrils in mice. Evidence is presented that fibronectin filaments may link microfibrils to one another and thus insure the continuity and strength of zonular fibers. More generally, it is likely that connective-tissue microfibrils, whether or not inserted into elastic fibers, are bonded through fibronectin to surrounding cells, collagen fibrils, or proteoglycans, and thus insure cohesion among connective tissue elements.

Actin Cytoskeleton↗
PubMed1986

The microfibrils of connective tissue: II. Immunohistochemical detection of the amyloid P component.

Immunohistochemical methods were used for the detection of the amyloid P component in the microfibrils of two regions: the zonule of the eye and the connective tissue of the foot pad in 20- to 50-gm mice. Following fixation by immersion in 4% formaldehyde, the eyes and foot pads were embedded in paraffin, and sections were immunostained for light microscopy by using antiamyloid P component antiserum followed by peroxidase-antiperoxidase procedure. For electron microscopy, formaldehyde-fixed tissues were immunostained for the amyloid P component with protein A-gold by using either thin Lowicryl sections or frozen sections which were then embedded in Epon for thin sectioning. In the zonule of the eye, the light microscope showed that zonular fibers were strongly immunostained for the amyloid P component; there was also weak staining of the nonpigmented ciliary epithelium at the distal end of the fibers and of the zonular lamella at their proximal end. The electron microscope revealed clear-cut immunolabeling of the microfibrils making up zonular fibers as well as of individual microfibrils. In the foot pad, the light microscope detected a weak diffuse staining of connective tissue, whereas the electron microscope showed immunolabeling restricted to microfibrils. It was concluded that the amyloid P component was present in, or associated with, microfibrils. Purified amyloid P component was prepared and examined in the electron microscope after either negative staining or routine processing. After negative staining, it appeared as flat pentagonal units, frequently associated into columns. After routine processing, the units looked like cross sections of microfibrillar tubules. The dimensions of the units matched those of the hypothetical segments of the tubules. It was concluded that this tubule consisted of a column of amyloid P units. The cohesion of the units within the column was likely to be reinforced by the bands present at the surface of microfibrils.

Amyloid↗
PubMedDate not supplied

Clustered schedules in allergen-specific immunotherapy.

BACKGROUND: Injective immunotherapy is traditionally performed with a build-up phase lasting 3 to 4 months. The costs, decreasing compliance from both patients and clinicians and inconveniences due to this schedule may be overcome using different schedules. METHODS AND RESULTS: A revision of the published papers with clustered schedules has been made. Attention has been focussed on tolerance and its relationships with relevant parameters such as kind of extract (aqueous or depot), allergens and their pharmaceutical presentation, schedule followed, use or not of a premedication, clinical manifestations of patients before treatment. For a better revision, papers dealing with clustered schedules have been divided into two groups. The first group includes 20 papers not designed to study the clustered schedule but using it to study other parameters affected by specific immunotherapy. The second group includes 9 papers specifically or mainly designed to study the clustered schedule. A huge difference in the rate of side effects could be assessed among different papers, even in studies run with similar allergens from the same producer and with a similar schedule. CONCLUSIONS: Summarizing the results of the revision, the following conditions seem to lead to the optimal tolerance of the clustered schedule: use of a premedication; use of a depot preparation; use of no more than 4 administrations per cluster; administration of 1-2 clusters per week and of 4 to 6 clusters in total. These results seem promising but further efforts are required to better define the optimal clustered schedule.

Allergens↗
PubMedDate not supplied

Long-term immunotherapy with an optimal maintenance dose of a standardized Dermatophagoides pteronyssinus extract in asthmatic patients.

In a previous dose-titration study of specific immunotherapy (SIT) with a Dermatophagoides pteronyssinus extract in asthmatic patients, we proposed a dose of 3.2 micrograms of Der p and 1/1.6 micrograms of Der p 2 as an optimal maintenance dose. Changes presented by a high-dose immunotherapy group, with a maximum tolerated dose between 4 and 16 micrograms Der p 1, were compared with those of a conventional immunotherapy group, with a maximum tolerated dose of 3.2 micrograms Der p 1 or lower. After 2 years of SIT, both groups achieved the same level of clinical benefit. We now present the results of long-term monitoring of 25 of these patients, covering the 5 years of SIT in which the maintenance dose was set at 3.2 micrograms Der p 1. The aims of the study were firstly to examine if this maintenance dose could sustain the changes induced by immunotherapy in the first 2 years; and secondly, to determine if this dose is clinically effective in patients known to tolerate higher maintenance doses. The clinical severity index (CSI), medication and symptom scores, cutaneous sensitivity and specific IgE and IgG4 to D. pteronyssinus, Der p 1 and Der p 2 were measured. Positive clinical and immunological changes presented in the first 2 years of SIT were sustained (CSI, medication score, specific IgE) or even increased (symptom score, cutaneous sensitivity) after 3 additional years of SIT. In conclusion, a maintenance dose of 3.2 micrograms of Der p 1/1.6 micrograms of Der p 2 induced intense clinical and immunological changes which were sustained during a 5-year course of treatment, even in patients able to tolerate higher doses.

Adolescent↗
PubMedDate not supplied

Dermatophagoides pteronyssinus cluster immunotherapy. A controlled trial of safety and clinical efficacy.

We designed a cluster schedule of immunotherapy for patients allergic to Dermatophagoides pteronyssinus to reach the maximal recommended dose in 7 weeks. We compared its safety and clinical efficacy with those of a conventional schedule in a controlled trial. Sixty-three patients were randomized as follows: 29 were treated with the cluster schedule, 15 with a conventional schedule and 19 without immunotherapy. A standardized extract was used. Clinical efficacy was measured by visual analog scale, clinical severity score, symptom/medication diary cards and control of peak expiratory flow (PEF) in asthmatic patients, before immunotherapy (T0), on reaching the maintenance phase (T1), and after 6 (T2), 12 (T3) and 18 months of maintenance (T4). The safety of immunotherapy was found to be good. Visual analog scale improved significantly at T4 in the cluster and conventional schedules, and clinical severity score also improved from T1 in these schedules. Diary cards improved from T1 in the cluster schedule and from T2 in the conventional schedule in asthmatic patients. Significant improvements in diary cards in rhinitis patients and PEF were found only in the cluster schedule. There were no changes in the group without immunotherapy. In conclusion, our cluster schedule showed as good tolerance and clinical efficacy as the conventional schedule in patients allergic to D. pteronyssinus. These clinical improvements did not appear in the group without immunotherapy.

Adolescent↗
PubMedDate not supplied

Clinical efficacy and tolerance of two year Lolium perenne sublingual immunotherapy.

Last years, in spite of increasing use of sublingual immunotherapy (SLIT), not enough clinical studies have been published and its efficacy ought to be documented still more. For that purpose, 54 patients suffering seasonal rhinoconjunctivitis--with or without asthma--were allocated to either six month preseasonal SLIT with Lolium perenne extract (n = 35) or to a control group (n = 19). In the following year, thirty from previously treated patients and 12 from former control group, received a nine-month pre-coseasonal SLIT. Skin (SPT) and conjunctival (CPT) allergen response were monitorized several times along the study. Either seric antibodies or intraseasonal eosinophil cationic protein (ECP), as symptom, medication scores and peak nasal inspiratory flow (PNIF) were also assessed, fifty-five adverse reactions were recorded (0.7% doses), although only four required treatment. No main changes in CPT, SPT and antibodies were detected. Nevertheless, during the first pollen season, treated patients needed less medication than their control counterparts (p < 0.05). In the second season, the twelve ex-control subjects also required fewer drugs than in the first one (p < 0.01). Moreover, the whole forty-two treated patients showed a lesser intraseasonal ECP than a reference set of grass-allergic individuals (p < 0.05). We conclude that Lolium perenne SLIT is well tolerated and induces fewer drug requirements during pollen season, being eosinophil activation additionally reduced.

Administration, Sublingual↗