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Biomedical subjects

V Moreno

Publications and source records attributed to V Moreno.

At least 109 records · Page 6Linked to original sources
PubMed1995

Cervical cancer: incidence and survival in migrants within Spain.

STUDY OBJECTIVE: This study examined the incidence of cervical cancer and survival rates according to migrant experience of women from different regions of Spain to Girona, Catalonia (Spain). DESIGN: Using data from the population based cancer registry of Girona for the period 1980-89, crude and age adjusted incidence rates were calculated for local-born and first generation migrants from other Spanish regions. The age standardised rate ratio (SRR) was calculated and Cox's regression model was used to adjust survival according to migrant status for age and stage at diagnosis. MAIN RESULTS: The incidence of cervical cancer was significantly higher in first generation Spanish migrants compared with locally born women (SRR: 2.02; 95% CI 1.40:2.92). The stage at diagnosis was more advanced among migrants. Survival probability was significantly associated with stage at diagnosis, but age and region of birth were not. CONCLUSIONS: Migrants from the southern Spanish regions show a twofold excess in the incidence of cervical cancer compared with the Girona-born female population. Cases of cervical cancer in migrants are diagnosed at a more advanced stage and as a consequence have a poorer prognosis.

Adolescent↗
PubMed1994

Risk excess of soft-tissue sarcoma and thyroid cancer in a community exposed to airborne organochlorinated compound mixtures with a high hexachlorobenzene content.

Unusually high levels of hexachlorobenzene (HCB) were detected in the air and in sera of volunteers of a village located in the vicinity of an organochlorinated-compounds factory (Flix, Catalonia, Spain). A significant increase for specific causes of death was obtained only for neoplasms of unknown origin. However, an excess of incident cases was observed for thyroid neoplasms, soft-tissue sarcoma and brain neoplasms in men. These descriptive findings are in agreement with previously reported associations between soft-tissue sarcoma and human exposure to organochlorinated compounds, as well as with animal experiments relating HCB and thyroid cancer, and add new information on the possible relation between organochlorinated compounds, and particularly HCB, and cancer.

Air Pollutants↗
PubMed1994

Effects of morphine in postaddict humans: a meta-analysis.

The literature on assessment of abuse liability of opioid drugs in humans was reviewed, and meta-analysis (a statistical method designed to combine results of different studies) was performed to study a dose-effect relationship for some variables commonly used for the evaluation of the subjective and physiological effects of morphine. Thirty-five studies, published between 1964 and 1991, including the i.m. or s.c. administration of morphine to non-dependent subjects with prior history of opioid abuse, were selected. Logistic regression models were applied for categorically dependent variables, and linear regression models were used for quantitative dependent variables. The log-transformation of the dose of morphine, stratifying by studies, acted as predictor variable. A dose-effect function was demonstrated. Doses producing an average effect across studies ranged from 7 mg (observers-reported 'liking') to 12 mg (subjects-reported 'liking'). Average effect on pupil diameter decreases was obtained for a dose of 8 mg. Doses producing a 50% of maximum positive responses were 10 mg for subjects' opioid classification, and 20 mg for the ARCI-MBG scale. The heterogeneity between studies obtained, along with the large variability present in most of the variables, supports the usefulness of a concurrent assessment of several indexes when assessing the effects of morphine.

Arousal↗
PubMed1994

[Study of 164 episodes of infectious endocarditis in drug addicts: comparison of HIV positive and negative patients].

OBJECTIVE: Intravenous drug-addicts (IVDA) are the most important risk group for acquiring HIV and developing infective endocarditis (IE) in Spain. The clinical and evolutive features of a large series of IE in HIV-infected IVDA are reported and compared with those observed in a smaller group of patients without HIV infection. METHODS: A retrospective analysis was made of 164 episodes of IE from 136 patients diagnosed in a Service of Infectious Diseases in Madrid (1986-1992). IE was defined according to the modified Von Reyn criteria and only the probable and definite IE episodes were evaluated. RESULTS: A total of 143 IE episodes occurred in 117 IVDA infected with HIV (group A) and 21 episodes in 19 HIV-negative patients (group B). Most of seropositive patients were asymptomatic carriers of HIV (54%) and only 22% had AIDS. The IE onset was acute for 97% patients in group A and 81% in group B, with fever and respiratory symptoms as main complaints. Chest X-ray was normal in 19% of cases in group A and in 28% in group B. Septic embolisms were observed in 56% and 41% of patients in group A and B, respectively. The vegetation originated mainly on the tricuspid valve and Staphylococcus aureus was recovered from most blood-cultures. The mortality rate was similar in both groups, 6% and 5% in groups A and B, respectively. CONCLUSIONS: Most IVDA with IE were HIV-positive patients in this series. IE is usually reported in the early stages of HIV infection and apparently its presence has no influence on the clinical course of IE.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Changes in the spectrum of the diseases in patients hospitalized with HIV infection].

BACKGROUND: Infections in subjects with HIV-1 infection are a frequent cause of hospital admission. Knowledge of the entities which most often motivate hospitalization may aid in designing the most appropriate diagnostic and prophylactic strategies. The causes of hospital admission in individuals with risk practices for HIV-1 infection attended in a Department of Infectious Diseases in Madrid over a period of 4 years were analyzed. METHODS: The records of the patients admitted from 1989 to 1992 were retrospectively reviewed. The principal and associated diagnoses which led to hospitalization were considered. The admissions of the two years were compared. RESULTS: Bacterial pneumonias were the principal cause of hospitalization in the 2 years studied. Forty-five percent of the infections leading to hospital admission were not included among those defining AIDS. Tuberculosis was the most frequent opportunistic infection. Admissions due to pulmonary pneumocystosis, tuberculosis, toxoplasmosis, esophageal candidiasis and Kaposi's sarcoma decreased from 1989-1992. To the contrary, disseminated Mycobacterium avium complex infection and systemic infection by cytomegalovirus significantly increased over the same period. The incidence of other diseases such as endocarditis or leishmaniasis remained stable. More than half of the diseases were diagnosed in association with another entity during the same admission. Likewise, an increase in atypical forms of infections thus making diagnosis and treatment more difficult was observed. The first cases of multiresistant tuberculosis, all of rapidly fatal evolution, were identified in 1992. Mean hospital stay increased 30% and the rate of mortality was of 9% in 1989 and rose to 20% in 1992. CONCLUSIONS: The spectrum of infections which led to hospital admission of patients with HIV-1 infection has significantly modified over the last 4 years being related with the generalization of prophylactic medication for some opportunistic infections, the improvement of certain diagnostic techniques and more frequent ambulatory treatment of some diseases. The mean length of stay and hospital mortality have increased in the HIV+ population.

AIDS-Related Opportunistic Infections↗
PubMed1993

Diet and colorectal adenomas: a case-control study in Majorca.

A case-control study on dietary factors and colorectal adenomas was conducted in the island of Majorca, Spain, from April 1987 to February 1990. Subjects were interviewed using a food frequency questionnaire. Nutrient and caloric intake was estimated using local food composition tables. The risk of colorectal adenomas was related to the consumption of sugar and pastries. Consumption of vegetables was highly protective, irrespective of the cooking procedures. Analyses by nutrients identified as protective factors fiber from fruits and vegetables, magnesium and zinc, and vitamins C, B6 and folic acid. No excess risk was found for alcohol drinking, intake of saturated fats or animal protein. Of the non-dietary factors, sedentariness in the work-place and urban residence were the only risk factors identified.

Adenoma↗
PubMed1993

Diagnosis of visceral leishmaniasis in HIV-infected individuals using peripheral blood smears.

OBJECTIVE: To compare the clinical and laboratory features of visceral leishmaniasis (kala-azar) in HIV-infected and non-infected subjects, and to determine the presence of Leishmania amastigotes in circulating leukocytes using peripheral blood smears. PATIENTS: Twenty-eight HIV-infected and six HIV-negative adult patients diagnosed as having kala-azar presenting at one institution over a 7-year period. METHODS: Retrospective review of clinical charts and re-examination of peripheral blood smears. RESULTS: There were no significant differences in the clinical presentation and laboratory features of HIV-positive and HIV-negative patients. However, Leishmania amastigotes were observed in circulating leukocytes in eight out of the 17 available peripheral blood smears (15 from HIV-infected patients). All eight individuals presenting with Leishmania in peripheral blood leukocytes were HIV-positive. CONCLUSIONS: Direct visualization of Leishmania amastigotes in leukocytes on peripheral blood smears enabled the diagnosis of kala-azar in a high proportion [eight out of 15 (53%)] of our HIV-infected patients.

AIDS-Related Opportunistic Infections↗
PubMed1993

Spontaneous pneumothorax in patients with the human immunodeficiency virus: study of eight cases.

OBJECTIVE: To evaluate the risk factors and the natural history of spontaneous pneumothorax in patients with human immunodeficiency virus infection (HIV). METHODS: We studied eight HIV infected patients with spontaneous pneumothorax. Variables assessed included sex, age, risk factor for HIV infection, use of Pneumocystis carinii pneumonia prophylaxis, total and CD4 positive lymphocyte count, previous history of Pneumocystis carinii pneumonia or pulmonary tuberculosis, chest X-ray film, presence of simultaneous opportunistic infection, partial pressure of oxygen in arterial blood gas determination and clinical outcome. RESULTS: The patients were predominantly male and intravenous drug abusers. Mean age was 28 years (range: 21-44). Five patients had acquired immunodeficiency syndrome, 2 oral candidiasis and one asymptomatic HIV infection. Three had previously had Pneumocystis carinii pneumonia and six a concurrent opportunistic infection. No one was receiving aerosolized pentamidine prophylaxis. The pneumothorax was bilateral in two cases. Chest tube evacuation was required in seven, and six patients died. Only two patients without opportunistic infection were discharged. CONCLUSIONS: We conclude that spontaneous pneumothorax is a serious problem with high mortality in patients with advanced human immunodeficiency virus infection. Previous or active Pneumocystis carinii pneumonia appear to be a risk factor for developing pneumothorax. It seems to be independent of aerosolized pentamidine use.

AIDS-Related Opportunistic Infections↗
PubMed1992

Metal-ion-directed site-specificity of hydroxyl radical detection.

A wide variety of .OH detectors are in use for determination of biological .OH production. The chemical generation of .OH is site-specific with respect to the metal-binding site, and thus .OH detectors with metal-binding properties may affect the biological damage and bias .OH detection. The present study shows that both salicylate and phenylalanine, added as low molecular weight .OH indicators, decreased Cu(II) binding to erythrocyte ghosts. In a cell-free system, Cu(II) complexed to both salicylate and phenylalanine. Phenylalanine is a stronger Cu(II) chelator than salicylate, both when competing for Cu(II) bound to ghosts and when competing directly with each other. When OH radicals were generated by ascorbate and Cu(II), the amount of .OH detected as dihydroxybenzoates was proportional to the amount of .OH produced. However, when phenylalanine was added to this system, the efficiency of .OH detection by salicylate strongly decreased, concomitant with the transfer of Cu(II) binding from salicylate to the amino acid. This decrease was larger than that predicted by calculations for random competition of the two detectors for .OH. Deoxyribose and mannitol, which do not bind copper appreciably, competed poorly with salicylate for the .OH. Hydroxylation of phenylalanine, on the other hand, was only slightly affected by the presence of salicylate and unaffected by deoxyribose and mannitol. These results suggest that the detection of .OH by low molecular weight .OH indicators was related to the relative affinity of the detectors for the catalyzing metal, and thus partially site-specific. Furthermore, glutamate, which does not contain an aromatic ring but binds Cu(II) with considerable affinity, competed strongly with salicylate for the .OH, indicating that metal-binding properties rather than the presence of an aromatic ring were the cause of the deviation from random competition. The results indicate that .OH indicators with metal-binding properties affect the distribution of catalytic metal ions in a biological system, causing a shift of free radical damage and localizing a site-specific reaction of .OH on these detectors, with a resulting positive bias in the apparent .OH production.

Ascorbic Acid↗
PubMed1992

Ventricular arrhythmias in aortic valve disease: a further marker of impaired left ventricular function.

One hundred and twenty stable patients with pure and severe aortic valve disease and without coronary lesions (aortic stenosis, 43 patients; aortic regurgitation, 45 patients; combined aortic stenosis and regurgitation, 32 patients) who had been submitted to haemodynamic studies were prospectively studied with standard electrocardiograms, M-mode echocardiograms, and 24-hour ambulatory electrocardiography (Holter recording). The frequency and complexity of ventricular arrhythmias were related to clinical parameters such as functional class, type of lesion and presence of syncope, and to parameters of left ventricular hypertrophy and function. Ventricular arrhythmias were present in 92% of patients. A high number of ventricular premature beats was directly correlated with parameters of complexity of the arrhythmia. A significant relation was found between electrocardiographic left ventricular hypertrophy and Ryan class (P less than 0.05), and an inverse relation between maximal number of ventricular premature beats in any hour and left ventricular ejection fraction (P less than 0.05). The group of patients with aortic regurgitation showed a higher total number of ventricular premature beats per 24 hours (P less than 0.001), a higher maximal number of these in any hour (P less than 0.01), a higher number of patients with pairs (P less than 0.001), and a higher number of patients in Ryan classes 3, 4A, 4B (P less than 0.01). This study shows a high incidence of ventricular arrhythmias in aortic valve disease, and especially in aortic regurgitation, with a significant relation between left ventricular hypertrophy and function, and number and complexity of arrhythmias.

Adult↗
PubMed1992

The comparison of two gonadotropin-releasing hormone agonists in an in vitro fertilization program.

OBJECTIVE: To compare two gonadotropin-releasing hormone agonists (GnRH-a), buserelin acetate and leuprolide acetate [LA], used in combination with gonadotropins in ovarian stimulation for in vitro fertilization (IVF). DESIGN: Randomized prospective study. SETTING: Assisted Reproduction Unit of the Hospital Clínic i Provincial in Barcelona. PATIENTS: Thirty-five pairs of IVF patients who were matched on age, indication, and number of attempts. These women were randomized to receive either buserelin acetate plus gonadotropins (group B) or LA plus gonadotropins (group L). MAIN OUTCOME MEASURES: Luteolysis, ovarian response, and IVF outcome. RESULTS: The mean time for total ovarian arrest and the total dose of gonadotropins and estradiol levels on the day of human chorionic gonadotropin administration were similar in the two groups of patients. The number of follicles punctured, the number of oocytes retrieved, and the percentage of mature oocytes in group L were significantly higher. The number of embryos suitable for replacement and cryopreservation was higher in group L compared with group B approaching statistical significance. CONCLUSION: Our results warrant further studies to compare different GnRH-a as therapeutic tools in IVF.

Adult↗
PubMed1992

[Clinical and angiographic course after coronary angioplasty. Analysis of predictor factors of restenosis].

In order to know the restenosis rate and its predictive factors and the short-term clinical outcome (6-12 months) after coronary angioplasty (PTCA), we prospectively followed 200 consecutive patients with 231 coronary stenoses successfully dilated (residual stenosis < 50%). Patients have been clinically and angiographically followed 6-9 months after the procedure. Forty-nine clinical, hemodynamic, angiographic and technical variables were analyzed. Restenosis (stenosis > or = 50% in late angiographic control) rate was 51.5%, and 61% of the study population was symptomless. Variables associated with restenosis in the univariate analysis were: pre-PTCA positive exercise test (p = 0.004); stenosis severity pre-PTCA (p = 0.04); eccentricity (p < 0.0001) and irregularity (p < 0.0001) of the pre-PTCA stenosis; total dilation time (p = 0.02) and post-PTCA dissection (p = 0.002). The multivariate analysis revealed the following variables as independent predictors of restenosis: presence of dissection after PTCA, eccentricity and irregularity of pre-PTCA stenosis, positive pre-PTCA stress test and duration of symptoms before the procedure. These data suggest that the probability of restenosis after PTCA is predominantly determined by the characteristics of the lesion being dilated and the degree of intimal injury produced during the procedure. These variables could define high and low risk populations and may modify PTCA indications and follow up strategies.

Angioplasty, Balloon, Coronary↗
PubMed1991

[Cough caused by angiotensin-converting enzyme inhibitors. A series of cases collected by spontaneous notification of adverse reactions].

Cough is one of the possible untoward adverse drug effects of angiotensin converting enzyme inhibitors. We describe the available information on 50 cough episodes attributable to captopril and 18 episodes attributable to enalapril reported to the Spanish Drug Surveillance System. Cough represented 37% and 39% of the reports of side effects of captopril and enalapril, respectively. There was a remarkable female predominance among the patients with cough. Cough developed at very low doses (15 mg of captopril and 5 mg of enalapril daily), although the patients on captopril who developed cough were receiving higher doses than those who presented other side effects. A high proportion of patients (29%) continued with the drug for more than six months after cough had developed, suggesting the need for a wider knowledge of this side effect.

Aged↗