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S Castillo

Publications and source records attributed to S Castillo.

At least 37 records · Page 2Linked to original sources
PubMed2000

Oxcarbazepine add-on for drug-resistant partial epilepsy.

BACKGROUND: Most people with epilepsy have a good prognosis and their seizures can be well controlled with the use of a single antiepileptic drug, but up to 30 % develop refractory epilepsy, especially those with partial seizures. In this review we summarise the current evidence regarding oxcarbazepine when used as an add-on treatment for drug-resistant partial epilepsy. OBJECTIVES: To evaluate the effects of oxcarbazepine when used as an add-on treatment for drug-resistant partial epilepsy. SEARCH STRATEGY: We searched the Cochrane Epilepsy Group's trials register, the Cochrane Controlled Trials Register (Cochrane Library Issue 1, 2000), MEDLINE (January 1966 to December 1999) and reference lists of articles. We also contacted Novartis (manufacturers of oxcarbazepine) and experts in the field. SELECTION CRITERIA: Randomized, placebo-controlled, double-blind, add-on trials of oxcarbazepine in patients with drug-resistant partial epilepsy. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trials for inclusion and extracted the relevant data. The following outcomes were assessed : (a) 50 % or greater reduction in seizure frequency; (b) treatment withdrawal (any reason); (c) side effects. Primary analyses were intention to treat. Summary odds ratios were estimated for each outcome. MAIN RESULTS: Overall Odds Ratio (OR) (95 % Confidence Interval (CIs)) for 50 % or greater reduction in seizure frequency compared to placebo 2.96 (2.20,4.00). Treatment withdrawal OR (95 % CIs) compared to placebo 2.17 (1.59,2.97). Side effects: OR (99 % CIs) compared to placebo, ataxia 2.93(1.72,4.99); dizziness 3.05 (1.99, 4. 67); fatigue 1.80 (1.02, 3.19); nausea 2.88 (1.77, 4.69); somnolence 2.55 (1.84, 3.55); diplopia 4.32 (2.65, 7.04), were significantly associated with oxcarbazepine. REVIEWERS' CONCLUSIONS: Oxcarbazepine has efficacy as an add-on treatment in patients with drug-resistant partial epilepsy, both in adults and children. However, trials reviewed were of relatively short duration, and provide no evidence about the long term effects of oxcarbazepine. Results cannot be extrapolated to monotherapy or to patients with other epilepsy types.

Adult↗
PubMed2000

The relation between baseline HIV drug resistance and response to antiretroviral therapy: re-analysis of retrospective and prospective studies using a standardized data analysis plan.

To assess the relation between resistance to antiretroviral drugs for treatment of HIV-1 infection and virological response to therapy, results from 12 different studies were re-analysed according to a standard data analysis plan. These studies included nine clinical trials and three observational cohorts. The primary end-point in our analyses was virological failure by week 24. Baseline factors that were investigated as predictors of virological failure were plasma HIV-1 RNA, the number and type of new antiretroviral drugs in the regimen, and viral susceptibility to the drugs in the regimen, determined by genotyping or phenotyping methods. These analyses confirmed the importance of both genotypic and phenotypic drug resistance as predictors of virological failure, whether these factors were analysed separately or adjusted for other baseline confounding factors. In most of the re-analysed studies, the odds of virological failure were reduced by about twofold for each additional drug in the regimen to which the patient's virus was sensitive by genotyping methods, and by about two- to threefold for each additional drug that was sensitive by phenotyping.

Anti-HIV Agents↗
PubMed1998

Trophic implications of altered body composition observed in or near the nails of hemodialysis patients.

In the absence of biochemically determined nutrient status, renal nutrition specialists have been left to assume that hemodialysis (HD) patients with a stable body weight and acceptable macronutrient intakes had adequate micronutrient stores. However, at the University of California Renal Center, using physical examination and laboratory studies, approximately one in three HD patients were found to have micronutrient imbalance. The Nutrition Physical Examination (NPE), an advanced practice, nutrition-focused, physical examination, can be a timely, cost-effective strategy in assessing nutrient status. Trophic changes that have been identified in and around the nails of HD patients suggestive of protein, vitamin, or mineral imbalance include (1) Beau's lines (zinc); (2) koilonychia (iron, copper, zinc, protein); (3) leukonychia (zinc); (4) pale nail beds (iron); (5) Muehrcke's lines (protein); (6) splinter hemorrhages (V-C); (7) onycholysis (iron, niacin); and (8) chronic paronychia (zinc). While these lesions are not pathognomonic of nutrient deficiency, they do provide valuable direction in diagnostic reasoning essential to problem-solving potential maladaptive alterations in the stimulus and function of micronutrients and their enzyme systems.

Body Composition↗
PubMed1998

Neonatal lupus syndrome: a case with chondrodysplasia punctata and other unusual manifestations.

We report a case of a newborn infant whose mother had systemic lupus erythematosus (SLE) diagnosed before pregnancy. The child had clinical manifestations of neonatal lupus as well as chondrodysplasia punctata and other findings that resemble the congenital anomalies associated with the use of oral anticoagulants, with no history of exposure. We speculate that the combined action of the different maternal autoantibodies may produce the whole spectrum of manifestations.

Abnormalities, Multiple↗
PubMed1997

Mite-contaminated foods as a cause of anaphylaxis.

BACKGROUND: Although insect and arthropod contamination of certain foods has been recognized for many years, allergic manifestations caused by ingestion of mite allergens have only rarely been reported. OBJECTIVE: The purpose of this study is to present clinical observations in patients who experienced acute anaphylaxis after eating mite-contaminated foods. METHODS: Thirty atopic subjects who were first seen with systemic anaphylaxis precipitated by the ingestion of wheat-containing foods underwent skin prick tests with inhalant and food extracts, as well as with uncontaminated and mite-contaminated wheat flour. Flour samples were examined microscopically for identification and counting of mites. Der p 1 and Der f 1 levels were quantitated by using immunochemical methods. RESULTS: The most common symptoms were breathlessness, angioedema, wheezing, and rhinorrhea, which started between 10 and 240 minutes after eating. Abundant mites were present in the flour obtained from 28 patients; Suidasia spp. mites were found in grated bread from the other two patients. Positive prick test responses to Dermatophagoides farinae-and mite-contaminated flour and negative skin test responses to wheat extract, other food extracts, and uncontaminated wheat flour were found in all patients. Skin test responses were positive in volunteers with mite allergy even after heating the mite-contaminated flour at 100 degrees C. Screening of 35 unselected flour samples demonstrated the presence of mites in 13 of them (37.1%). CONCLUSIONS: Systemic anaphylaxis can occur after the ingestion of heated or unheated mite-contaminated foods. This problem may be more prevalent in tropical and subtropical countries than previously recognized.

Adolescent↗
PubMed1997

[Situation of genetics services in Chile].

Due to the demographic changes in Chile, where preventable causes of death are being controlled and congenital malformations arise as an important cause of morbidity and mortality during infancy, of pathological pregnancies and reproductive alterations, medical genetics is becoming increasingly important. Using data from an inquiry that was answered by thirteen medical genetics centers in the country, this article reviews the history of the discipline in Chile, the available resources, the existent services, the main problems found and their eventual solutions, genetics teaching and the research that is being conducted.

Chile↗
PubMed1996

[Use of molecular biology techniques in clinical research, in Chile].

Medical investigation in Chile is beginning to apply molecular biology methods as diagnostic tools and in studies establishing the prevalence of pathologies with Mendelian or multifactorial genetic origin. In this way, we are getting nearer to the strategies used worldwide for these purposes. Two studies published in this journal, one about hemophilia A where an analysis of intron-18 and intron-7 of the Factor VIII gene was applied as strategy for the diagnosis of carrier state in a Chilean population, and the other one about insulin-dependent diabetes mellitus in Santiago, Chile, with an analysis from immunogenetics to some environmental risk factors, constitute good examples about this integration.

Chile↗
PubMed1995

The adverse impact of heavy episodic drinkers on other college students.

OBJECTIVE: College student survey data were examined to assess the impact of campus levels of heavy episodic drinking on nonheavy episodic drinking college students. METHOD: Analyses are based on a survey mailed to a random sample of college students at 140 American colleges. A total of 17,592 students (69%) at participating colleges responded. The study defined "heavy" drinking as the consumption of five or more drinks in a row for men and four or more for women, and divided schools into approximately equal categories: lower drinking level schools where 35% or fewer students were heavy drinkers; midlevel schools (36-50% heavy drinkers); and high drinking level schools where over 50% of the students were heavy drinkers. RESULTS: Residing on campus at high drinking level schools adversely affected students who were not engaging in heavy drinking. The odds of experiencing at least one problem from other students' drinking was 3.6 to 1 when nonheavy drinking students at high drinking level schools were compared to nonheavy drinking students at lower drinking level schools. Examples of such secondary heavy drinking effects included being hit or assaulted, having one's property damaged or experiencing an unwanted sexual advance. CONCLUSIONS: College alcohol prevention efforts should include a focus on the needs of students who are not engaging in heavy drinking yet may be adversely impacted by other students' heavy drinking.

Adolescent↗
PubMed1995

Correlates of college student binge drinking.

OBJECTIVES: This study examines the individual correlates of college student binge drinking. METHODS: Questionnaires were completed by a representative national sample (n = 17,592) of students on 140 campuses in 1993. Binge drinking was defined as five or more drinks per episode for men and as four or more drinks per episode for women. RESULTS: Overall, 44% of the students (50% of the men and 39% of the women) binged. While demographic factors such as sex and race were significantly related to binge drinking, prior binging in high school was crucial, suggesting that for many students, binge drinking begins before college. The strongest predictors of college binge drinking were residence in a fraternity or sorority, adoption of a party-centered life-style, and engagement in other risky behaviors. CONCLUSIONS: Interventions must be targeted at high school binge drinking as well as at several characteristics of college life--most notably fraternity residence. Legal drinking age fails to predict binge drinking, raising questions about the effectiveness of the legal minimum drinking age of 21 in college alcohol policies.

Adult↗
PubMed1995

[Dyslipidemia and hyperinsulinemia in normoglycemic-obese relatives of patients with non-insulin dependent diabetes mellitus].

To determine the most frequent dyslipidemias among first-degree relatives of NIDDM patients, and its association with their glucose-tolerance status and hyperinsulinemia, we have started to examine members of NIDDM pedigrees, according to American Diabetes Association guidelines for nuclear family studies. In a large family with 2 NIDDM siblings in the 2nd generation, and 4 siblings with NIDDM in the 3rd generation, we have evaluated 14 first degree relatives and also 15 sex and aged matched healthy control subjects without family history of diabetes. The NIDDM relative group presented BMI = 31.8 +/- 3.9 kg/m2, SBP = 128 +/- 18.2 mmHg, DBP = 84 +/- 12.7 mmHg. Both relatives and controls were subjected to a 2h 75g OGTT for glucose and insulin determinations. Although none of NIDDM relatives has IGT, both Glycemic Area (GA) and Insulin Area (IA) were greater (p < 0.01) in the NIDDM relative group. The Insulin/Glucose ratio was also higher (p < 0.01) at 0 and 120 min of OGTT, this might be indirect evidence of Insulin- Resistance. Fasting serum lipids in the NIDDM relatives were TG = 148 +/- 24mg/dl, T-Chol = 244 +/- 10.7mg/dl, HDL-C = 34.2 +/- 2.5mg/dl; lipids in the control group were TG = 84.8 +/- 10.1mg/dl, T-Chol = 167 +/- 10.2mg/dl, HDL-C = 44.4 +/- 2.6mg/dl. Electrophoretic pattern showed type IIa (30.7%) and IIb (61.5%) hyperlipidemias in the NIDDM relatives. In this group, there was a positive and significant association between basal insulin and DBP (r = 0.67; p < 0.01), and between DBP and both TG (r = 0.74; p < 0.01)) and VLDL-C (r = 0.58; p < 0.05). It was also obtained a negative association between basal insulin and HDL-C (r = -0.89; p < 0.001). These data suggest that hyperinsulinemia in association with lipid abnormalities could appear early (before the development of Impaired Glucose Tolerance and Diabetes) in first degree relatives of NIDDM patients.

Adult↗
PubMed1995

[Paternity study applying DNA polymorphism: evaluation of methods traditionally used in Chile].

Simultaneous detection of several VNTR loci using a single DNA probe is the basis of the technique called "DNA fingerprint" (DNAfp) of increasing application in parenthood identification. According to the data gathered by different laboratories worldwide, father exclusion can be made in a larger number of cases when compared with the customary tests based on erythrocyte antigens. The question could then be whether DNAfp will completely replace erythrocyte antigens tests. We report here our experience in applying DNAfp to 92 samples corresponding to 34 paternity cases and comparing these with the results obtained with the antigens of the systems ABO, Rh, MNSs, Duffy and Kidd. Most of the HaeIII/digested DNA samples produced 13 to 16 bands larger than 4.3 Kb (average 14,0761 +/- 2,205). Average band sharing between pairs of unrelated individual was 1,9107 +/- 1,083. Two cases presenting an a posteriori probability of being the father of 80.7% and 76.5% by erythrocyte antigens were clearly excluded by DNAfp. All exclusions made by antigens were confirmed by DNAfp. In the cases reported as father "rather probable" (28 cases) by DNAfp, these shared with the child 6,7407 +/- 1.7 bands on average. Because of time, cost and simplicity we favor a procedure starting with the antigens test and continuing with DNAfp only when an exclusion is not possible. Economy will increase as the number of exclusions increases.

Blood Grouping and Crossmatching↗
PubMed1994

Health and behavioral consequences of binge drinking in college. A national survey of students at 140 campuses.

OBJECTIVE: To examine the extent of binge drinking by college students and the ensuing health and behavioral problems that binge drinkers create for themselves and others on their campus. DESIGN: Self-administered survey mailed to a national representative sample of US 4-year college students. SETTING: One hundred forty US 4-year colleges in 1993. PARTICIPANTS: A total of 17,592 college students. MAIN OUTCOME MEASURES: Self-reports of drinking behavior, alcohol-related health problems, and other problems. RESULTS: Almost half (44%) of college students responding to the survey were binge drinkers, including almost one fifth (19%) of the students who were frequent binge drinkers. Frequent binge drinkers are more likely to experience serious health and other consequences of their drinking behavior than other students. Almost half (47%) of the frequent binge drinkers experienced five or more different drinking-related problems, including injuries and engaging in unplanned sex, since the beginning of the school year. Most binge drinkers do not consider themselves to be problem drinkers and have not sought treatment for an alcohol problem. Binge drinkers create problems for classmates who are not binge drinkers. Students who are not binge drinkers at schools with higher binge rates were more likely than students at schools with lower binge rates to experience problems such as being pushed, hit, or assaulted or experiencing an unwanted sexual advance. CONCLUSIONS: Binge drinking is widespread on college campuses. Programs aimed at reducing this problem should focus on frequent binge drinkers, refer them to treatment or educational programs, and emphasize the harm they cause for students who are not binge drinkers.

Adult↗
PubMed1994

Sympathetic nervous system activity in major depression. Basal and desipramine-induced alterations in plasma norepinephrine kinetics.

BACKGROUND: To determine whether elevations of plasma norepinephrine (NE) in major depression represent increased sympathetic nervous system (SNS) activity and to assess the effects of desipramine hydrochloride on sympathetic function. METHODS: SNS activity was assessed in depressed patients and controls by an isotope-dilution, plasma NE kinetic technique using mathematical modeling and compartmental analysis. This approach provided estimates of the rate of NE appearance into an extravascular compartment, which is the site of endogenous NE release from SNS nerves, the corresponding rate of NE appearance into plasma, and the rate of NE clearance from plasma. RESULTS: Norepinephrine appearance into the extravascular and vascular compartments was significantly elevated in 17 depressed patients compared with that in 36 controls. The rate of NE clearance from plasma was similar in both groups. This is compatible with increased SNS activity in major depression. Desipramine, given for 2 days, significantly reduced the concentration of NE in plasma of patients and controls by markedly suppressing the rates of extravascular and vascular NE appearance, compatible with a short-term reduction in SNS activity. Desipramine prolonged the rate of NE clearance from plasma, consistent with a blockade of NE re-uptake into SNS nerve terminals. The initial suppression of SNS activity by desipramine was reversed by long-term (28 days) treatment of patients, with extravascular and vascular NE appearance rates returning to approximately basal levels. An associated rise in plasma NE concentrations compared with the baseline was attributable to a progressive reduction in plasma NE clearance. CONCLUSION: Sympathetic nervous system activity is elevated in major depression and is suppressed by short-term desipramine administration. The demonstration of SNS reactivation occurring with prolonged desipramine treatment is compatible with the theory that long-term treatment desensitizes CNS alpha 2-adrenergic receptors and emphasizes the value of examining the temporal course of responses to pharmacological challenges of neuroendocrine systems. Previously reported elevations of plasma NE during prolonged administration of tricyclic antidepressants are probably the result of a reduction in plasma NE clearance, not an increase in SNS activity.

Adult↗
PubMed1994

[Risk factors for coronary atherosclerosis. Comparison between two Argentine regions].

The prevalence of risk factors for coronary atherosclerosis were studied in two population samples, Northeast (Posadas, n = 498) and South (Viedma, C. Rivadavia and Cipolletti, n = 652) of 20 years and older, males and females. The diet in the Northeast (n = 102) contained more monounsaturated acids and polyunsaturated acids than the one in the South (n = 62), 9.5 +/- 4.1 vs. 8.1 +/- 3.5% TCV (Total Caloric Value) (P < 0.02) and 8.1 +/- 4.1 vs. 6.2 +/- 3.0% TCV (P < 0.001) respectively. The P/S relationship was greater in the Northeast, 1.02 +/- 0.44 vs. 0.85 +/- 0.50 (P < 0.001). Total cholesterol (TC) in the Northeast was less than in the South, in males 176 +/- 41 vs. 213 +/- 43 mg/dl (P < 0.001); CLDL (LDL cholesterol) 109 +/- 37 vs. 141 +/- 41 mg/dl (P < 0.001). The most frequent risk factors in the South vs. Northeast (males) were: TC > or = 240 mg/dl, 26.7% vs. 9.5% (P < 0.001); LDL-C > or = 160 mg/dl, 30.3% vs. 10.9% (P < 0.001); Cig > or = 10/d (equal or more than 10 cigarettes per day), 30.0% vs. 16.4% (P < 0.001). The hypertension prevalence (HTA, 160/95), in males, was higher in the Northeast than in the South, 23.7% vs. 11.5% (P < 0.001). BMI > 27 Kg/m2 was higher in the women of Northeast than in the South, 38.4% vs. 24.2% (P < 0.001). In the males of the Northeast, the combination Cig > or = 10/d and HTA, 4.1 vs 0.9% was more common; in the South Cig > or = 10/d and LDL-C > or = 160 mg/d, 8.2% vs. 1.8% (P < 0.001) was more common. The differences in the prevalence of the risk factors between the population samples indicate the need to plan the prevention of coronary atherosclerosis locally.

Adult↗
PubMed1993

Effect of desipramine on cerebrospinal fluid concentrations of corticotropin-releasing factor in human subjects.

To assess the effect of desipramine (DMI) on corticotropin-releasing-factor (CRF) activity in the central nervous system, we measured cerebrospinal fluid (CSF) concentrations of CRF in healthy volunteers following short-term administration of DMI or placebo. DMI administration for 2 days was associated with a significant dose-related reduction in CRF concentrations. There was a nonsignificant 6% reduction in CRF concentrations among the 10 subjects who received 50 mg DMI (delta CRF: -3 +/- 2 pg/ml) and a significant 14% fall in the CRF concentrations of the eight subjects who received 100 mg DMI (delta CRF: -8 +/- 3 pg/ml). The mean CSF concentration of CRF was unchanged in the six subjects randomized to placebo (delta CRF: 1 +/- 5 pg/ml). DMI administration had no effect on CSF norepinephrine concentrations (n = 24) or on plasma cortisol (n = 25). We conclude that short-term administration of DMI in healthy volunteers is associated with a dose-related reduction in CSF concentrations of CRF.

Adult↗