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Biomedical subjects

S Ochoa

Publications and source records attributed to S Ochoa.

At least 19 recordsLinked to original sources
PubMed2006

Assessment of service use patterns in out-patients with schizophrenia: a Spanish study.

OBJECTIVE: The objective is to describe and characterize patterns of service use by out-patients with schizophrenia in Spain. METHOD: A representative treated prevalence sample of cases with schizophrenia was selected from four Spanish health areas. The evaluation included health service use, clinical severity, functioning and disability. Statistical analysis was based on hierarchical clustering methods. RESULTS: A total of 356 patients were included in the analysis. Five patterns of health service use were defined: heavy out-patient mental health users; mental health and general health service users; heavy hospital service users; nursing service users; low users of mental health services. Patients in each group showed differences in clinical and disability status. Patterns of health service use showed consistency, but also variability, among the geographical areas. CONCLUSION: Development and organization of mental health services should take into account the combinations of services patients most frequently use.

Adult↗
PubMed2005

Needs and its relation to symptom dimensions in a sample of outpatients with schizophrenia.

OBJECTIVE: To analyse the association between symptom dimensions in schizophrenia and number and type of met and unmet needs. METHOD: A sample of 231 outpatients randomly selected from a register that included all patients treated in 5 mental health care centres (MHCC) was evaluated. Assessment instruments included the Camberwell Assessment of Needs (CAN) questionnaire and the PANSS. RESULTS: Number of needs are related to overall severity of psychopathology. Patients with more symptoms have more total needs (p < 0.001) and unmet needs (p < 0.001). A multiple lineal regression model showed that the disorganized and excited dimensions of the PANSS are the most important components for explaining the variance of number of needs. Type of needs is related to subtypes of schizophrenia, specially with disorganized and excited symptoms. CONCLUSION: Psychosocial needs are related to schizophrenia subtypes. Patients with more needs are those with more disorganized and excitatory symptoms.

Adult↗
PubMed2003

Gender differences and outcome in schizophrenia: a 2-year follow-up study in a large community sample.

This study examined gender differences in the short-term (2 years) course of schizophrenia in a sample of 200 schizophrenic (DSM-IV criteria) outpatients (74 women and 126 men). Number and length of hospitalizations during the prospective follow-up were recorded. After 2 years, men were found to have more hospitalizations and longer stays than women. Among subjects who had at least one hospitalization (12 women and 38 men), men had greater length of hospitalization. In conclusion, schizophrenic women had a significantly better short-term outcome.

Adolescent↗
PubMed2003

The Clinical Global Impression-Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia.

OBJECTIVE: To describe the development and validation of the Clinical Global Impression-Schizophrenia (CGI-SCH) scale, designed to assess positive, negative, depressive and cognitive symptoms in schizophrenia. METHOD: The CGI-SCH scale was adapted from the CGI scale. Concurrent validity and sensitivity to change were assessed by comparison with the Positive and Negative Symptom Severity (PANSS) and Global Assessment of Functioning (GAF) scales. To evaluate inter-rater reliability, all patients were assessed by two clinicians. RESULTS: Symptoms were assessed in 114 patients. Correlation coefficients between the CGI-SCH and the GAF and PANSS scores were high (most above 0.75), and were highest for positive and negative symptoms. Reliability was substantial (intraclass correlation coefficient, ICC > 0.70) in all but one dimension (depressive dimension, ICC = 0.64). CONCLUSION: The CGI-SCH scale is a valid, reliable instrument to evaluate severity and treatment response in schizophrenia. Given its simplicity, brevity and clinical face validity, the scale is appropriate for use in observational studies and routine clinical practice.

Adult↗
PubMed2003

Met and unmet needs of schizophrenia patients in a Spanish sample.

Deinstitutionalization of people with schizophrenia increases the importance of evaluating their needs. This study set out to identify the most common needs of people with schizophrenia who live in the community, analyze how those needs differ when evaluated by staff or by patients, describe the kind of help patients receive, and find out the variables that correlate with having unmet needs. A random sample of 231 outpatients with schizophrenia were evaluated with the Camberwell Assessment of Need and other predictor and outcome variables. Staff detected more needs than patients did. Mean number of needs as rated by patients was 5.36 and staff 6.6 (p < 0.001). Mean number of unmet needs was also greater when assessed by staff than by patients: 1.38 versus 1.82 (p < 0.001). The most frequently detected needs by patients involved psychotic symptoms, house upkeep, food, and information. Staff most often detected needs involving psychotic symptoms, company, daytime activities, house upkeep, food, and information. In a multiple regression model, needs were weakly associated with the clinical variables and quality of life. Needs assessment is complementary to clinical evaluation in schizophrenia.

Activities of Daily Living↗
PubMed2002

Influence of gender on social outcome in schizophrenia.

OBJECTIVE: To study the relevance of gender on social functioning in schizophrenia. METHOD: A sample of 200 schizophrenic (DSM-IV criteria) out-patients were followed-up during 2 years and were administered the following instruments: Positive and Negative Symptom Scale (PANSS), Disability Assessment Scale (DAS-sv), and Global Assessment of Functioning (GAF) Scale. A regression model was created with DAS and GAF as dependent variables, and gender, PANSS, age of onset, duration of illness and marital status as independent variables. Separate regression models were then generated for females and males. RESULTS: Gender influenced significantly on DAS and GAF, with men showing worse functioning. In gender specific analyses, we found a significant influence of illness duration and Positive and Negative PANSS on social functioning in men, and of age at onset and Negative PANSS in women. CONCLUSION: Gender had a significant influence on social functioning in schizophrenia, even after adjusting for the other independent variables.

Age Factors↗
PubMed2001

Results of a randomized phase III trial in children and adolescents with advanced stage diffuse large cell non Hodgkin's lymphoma: a Pediatric Oncology Group study.

The Pediatric Oncology Group (POG) adopted a histology-based approach to the management of pediatric non-Hodgkin's lymphomas (NHL) utilizing the National Cancer Institute Working Formulation for Clinical Usage. Patients with diffuse large cell lymphoma (DLCL) were treated on a separate protocol from small cell diffuse undifferentiated or lymphoblastic lymphomas. This study assessed the overall and event free survival of children with DLCL and determined the effects of cyclophosphamide upon these end-points in a prospective randomized trial. One hundred and twenty eligible stage III or IV NHL patients with the confirmed diagnosis of diffuse large cell or immunoblastic histology were enrolled on study between October 1986 and November 1991. Patients were randomized to receive or not receive cyclophosphamide; 58 received cyclophosphamide, doxorubicin, vincristine, 6-mercaptopurine (6-MP), and prednisone (ACOP+) and 62 were treated with doxorubicin, vincristine, 6-MP, and prednisone (APO). In both treatment programs methotrexate was substituted when the doxorubicin cumulative dose reached 450 mg/m2. Radiation was administered to bulky disease if progression or no response were observed after induction therapy. Planned duration of therapy was 12 months. The 5-year event free survival (EFS) rates of patients treated with ACOP+ versus APO were 62% +/- 7% and 72% +/- 6%, respectively. While there was no statistically significant difference between the two treatment arms (p = 0.28), we can only say that we are 95% confident that the difference in 5-year EFS falls in the wide range from 28% in favor of APO to 8% favoring ACOP+. Marrow suppression was the main toxicity with one fatal infection. There were three other deaths on study due to respiratory failure in patients with mediastinal masses. Only one patient experienced cardiotoxicity requiring discontinuation of doxorubicin. Ten patients received radiation therapy to achieve. In conclusion the efficacy of elimination of cyclophosphamide from the treatment program of children and adolescents with advanced stage diffuse large cell lymphoma was inconclusive as to its effect on EFS. Furthermore, the majority of the patients (92%) did not require any radiation therapy to bulky disease indicating that the chemotherapy regimens are quite efficient for achievement of complete remission.

Adolescent↗
PubMed1999

Comparison of two doses of intravenous immunoglobulin after allogeneic bone marrow transplants.

Intravenous immunoglobulin has been used after bone marrow transplants to prevent infections and acute graft-versus-host disease. However, the minimum dose required for protection is unknown. This may have significant economic implications. A multicenter randomized clinical trial compared the impact of two intravenous immunoglobulin doses on systemic infections and acute graft-versus-host disease in transplant recipients. Either 250 mg/kg or 500 mg/kg was given weekly from day -8 to day +111. Multivariate analysis was used to assess the effect of dose and other risk factors on event-free survival, systemic infection, and acute graft-versus-host disease. The two-dose cohorts had similar event-free survival and infection frequencies. The higher dose was associated with less acute graft-versus-host disease (P = 0.03).

Bone Marrow Transplantation↗
PubMed1997

Dermal fibroblasts from venous ulcers are unresponsive to the action of transforming growth factor-beta 1.

Failure to reepithelialize is the major clinical problem in venous ulcers. It is not clear whether the problem resides with keratinocytes or with inadequate and improper formation of extracellular matrix. In this study, we characterized the biosynthetic activity and response to transforming growth factor-beta 1 (TGF-beta) of dermal fibroblast cultures isolated from biopsies of venous ulcers and from normal thigh skin (controls) of seven patients. We found that baseline 3H-proline incorporation was similar in fibroblasts from venous ulcers and control skin (p= 0.1716). No difference was detected by ELISA between ulcer and control fibroblasts in the synthesis of total TGF-beta (p = 0.2309), and the mRNA levels for alpha 1(I) procollagen and TGF-beta were comparable in both groups. However, TGF-beta (0.1-5 ng/ml) enhanced collagen protein synthesis by more than 60% and in a dose-dependent manner (r = 0.997) in control fibroblast cultures, while failing to stimulate collagen production by venous ulcer fibroblasts (p = 0.0001). This unresponsiveness to TGF-beta was associated with up to a fourfold decrease in TGF-beta Type II receptors. We conclude that fibroblasts from the edge of non-healing venous ulcers are unresponsive to the action of TGF-beta, and that this blunted response may cause faulty deposition of the extracellular matrix needed for reepithelialization and wound healing.

Cells, Cultured↗
PubMed1997

Toxicity associated with high-dose cytosine arabinoside and total body irradiation as conditioning for allogeneic bone marrow transplantation.

Seventy-three patients with hematological cancers undergoing allogeneic bone marrow transplantation (BMT) were evaluated for event-free survival (EFS) and toxicity. All received 36 g/m2 cytosine arabinoside (HDA) and 1200 cGy fractionated total body irradiation (TBI). We assessed the association of EFS and toxicities with the following risk factors; age, gender, diagnosis, initial relapse risk and patient-donor histocompatibility. The EFS probability is 33% at 800 days post-BMT. Twenty-six patients (36%) died of toxicity within 100 days and 14 (19%) have relapsed. EFS was inversely associated with age (P < 0.0001) and initial relapse risk (P = 0.007). The risk of pulmonary (P = 0.023) and hepatic toxicity (P = 0.011) increased with age. Diagnosis other than acute lymphoblastic leukemia (ALL) was a risk factor (P = 0.015) for graft-versus-host disease (GVHD); and fewer ALL patients died from toxicity (P = 0.014). The probability of sepsis within 100 days post-BMT correlated (P = 0.007) with initial relapse risk. We conclude: (1) the lower EFS and greater pulmonary and hepatic toxicity associated with increasing age indicate a need for less toxic regimens that maintain high antileukemic efficacy for older patients; (2) the high GVHD and sepsis rates seen in certain categories of patients indicate a need for careful definition of eligibility criteria for this still highly toxic treatment.

Adolescent↗
PubMed1997

TGF-beta3 stimulates and regulates collagen synthesis through TGF-beta1-dependent and independent mechanisms.

In contrast to the TGF-beta1 and beta2 isoforms, TGF-beta3 has shown the ability to downregulate scarring and fibrosis in vivo under certain experimental conditions. In this study, we determined the direct effects of TGF-beta3 on cultures of human dermal fibroblasts. TGF-beta3 (0.1 to 100 pg per ml) increased DNA synthesis up to 50% (p < 0.01, r = 0.970), collagen protein synthesis up to 200% (dose range of 0.1 to 5 ng per ml, p < 0.001, r = 0.990), and increased alpha1(I) procollagen mRNA levels (r = 0.999), with maximal effects (200% of control) observed by 24 h. Collagen lattice contraction was increased by more than 50% in response to TGF-beta3 (p < 0.001), and to a similar extent as the TGF-beta1 isoform. Stimulation of collagen synthesis and of alpha1(I) procollagen mRNA levels in response to TGF-beta3 was partially blocked by a TGF-beta1-specific anti-sense oligonucleotide but was still detectable (35% greater than baseline) when TGF-beta3 was added to dermal fibroblasts from TGF-beta1 knock-out mice. In contrast with these stimulatory effects, however, downregulation of alpha1(I) procollagen, alpha1(III) procollagen, and TGF-beta1 mRNA levels toward baseline occurred when TGF-beta3 (0.1 to 5 ng per ml) was added simultaneously and in combination with TGF-beta1. We conclude that stimulation of collagen synthesis by TGF-beta3 occurs through TGF-beta1-dependent and independent pathways. By downregulating the response to TGF-beta1 and by shifting from one pathway to the other, TGF-beta3 can dampen and provide fine-tuning to the overall TGF-beta's induced program of collagen deposition.

Animals↗
PubMed1995

Human dermal fibroblast clones derived from single cells are heterogeneous in the production of mRNAs for alpha 1(I) procollagen and transforming growth factor-beta 1.

Fibroblast clonal heterogeneity has been reported for growth and protein synthesis, but quantitative studies of synthetic phenotype at the pretranslational level have been limited because of difficulty in reliably growing large numbers of clonal cells. We have recently shown a unique stimulatory activity of low oxygen tension in the early phases of clonal growth, which can be used to establish clonal fibroblast cultures suitable for Northern analysis. Using this methodology, we have measured mRNA levels of alpha 1(I) procollagen and transforming growth factor-beta 1 (TGF-beta) both at baseline and after TGF-beta stimulation in a total of 43 clones derived from single cells and from seven different cell strains. We report a remarkable baseline heterogeneity, commonly four- to six-fold, in procollagen mRNA levels among clones and between clones and their parent cultures. Conversely, differences in baseline TGF-beta mRNA levels among clones were either not present or less than onefold. The clonal phenotypic expression of alpha 1(I) procollagen mRNA remained stable after eight additional cell passages. TGF-beta stimulation of itself (autoinduction) was highly variable among clones (range of increases 30% to 150%), and up-regulation of procollagen mRNA levels after TGF-beta stimulation was detected in only 15 (54%) of 28 clonal cultures (range of increases 30% to 353%). A notable lack of correlation was found between baseline mRNA levels of TGF-beta and alpha 1(I) procollagen in clonal cultures. In conclusion, fibroblast clonal populations are remarkably heterogeneous in their baseline procollagen mRNA levels and in their response to TGF-beta.

Adult↗
PubMed1990

Vertical ocular motor apraxia.

We report a case of vertical ocular motor apraxia in a 4-year old boy whom we have followed for 2 years. The patient had no upward and downward voluntary movements of the eyes since birth, but horizontal movements were normal. He achieved gaze changes in the vertical plane by combined blinks and head movements. Magnetic resonance imaging demonstrated bilateral lesions at the mesencephalic-diencephalic junction.

Apraxias↗