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Biomedical subjects

A Aguilera

Publications and source records attributed to A Aguilera.

At least 19 recordsLinked to original sources
PubMed2004

Topical disposition of two strengths of a 125I-rhEGF jelly in rat skin wounds.

Growth factors have proved to be an effective therapeutic strategy. However, some controversies have arisen concerning their efficacy in topical wound treatments. Stabilization of epidermal growth factors at the wound site and long-lasting receptor occupancy are important factors for wound repair. This study evaluated the cumulative profiles of two jellies containing 10 or 20 microg of 125I-rhEGF per gram of jelly, in a rat full-thickness skin lesion model. The prolonged time-courses at the wound sites for both strengths compared with saline solutions previously evaluated using a similar skin lesion model are reported. It seems that these two topical formulations that provide more sustained amounts of 125I-rhEGF over the period of sampling, would probably achieve the required wound healing response in terms of cell proliferation, collagen deposition and protein synthesis. Further studies need to be developed in order to elucidate whether such an in vivo disposition pattern is consistent with an earlier and stronger promotion of wound healing events.

Administration, Topical↗
PubMed2004

Previous cognitive impairment and failure to thrive syndrome in patients who died in a geriatric convalescence hospitalization unit.

Cognitive impairment and depression are commonly associated with poor outcomes in geriatric patients. Both are part of the "failure to thrive syndrome" (FTS), that is a combined group of symptoms as a result from progressive functional, mental and nutritional impairment status in older patients. This paper was aimed at evaluating the presence of FTS in the patients who died in a geriatric convalescence unit (GCU) (intermediate care facility) and comparing the characteristics of patients with primary FTS (not associated with an evident identifiable disease) and secondary FTS (associated with an evident identifiable disease). Finally, we wanted to analyze if the presence of cognitive impairment before admission was associated with the type of FTS. We analyzed 78 patients retrospectively. The presence of the next three conditions was necessary to define the FTS: (i) Impaired functional status and malnutrition. (ii) Cognitive impairment and/or depression. (iii) Absence of improvement, after a specific geriatric intervention program during the hospitalization. Functional status for basic and instrumental activities of daily living (ADL and IADL) and the presence of symptoms cognitive impairment before admission were evaluated. Of the 78 analyzed patients, there were 30 (38.4%) with symptoms of FTS. Seventeen of them (56.6%) had a secondary FTS and 13 (43.3%) a primary one. This last group of patients had a significantly higher mean age (84.7 +/- 5.8 vs. 78.6 +/- 7.2; p < 0.02) and before admission they were significantly more dependent for ADL: 10 patients (76.9%) vs. 7 (41.0%) chi2 = 3.833, p < 0.05. A higher proportion of subjects with cognitive impairment before admission was found in the group of patients with primary FTS, than in those secondary FTS, although this difference did not reach statistical significance. Patients with primary FTS seem to be older and more dependent for ADL before admission, than those with secondary FTS.

Aged↗
PubMed2004

Clinical impact of different scores of the mini nutritional assessment (MNA) in the diagnosis of malnutrition in patients with cognitive impairment.

It was aimed at evaluating the clinical usefulness of the mini nutritional assessment (MNA) to identify malnutrition in elderly patients with cognitive impairment, admitted to a geriatric convalescence unit (intermediate care facility). Sixty-three patients with cognitive impairment were studied. Cognitive impairment was considered when mini mental state examination (MMSE) scores were below 21. MNA and a nutritional evaluation according to the sequential model of the American Institute of Nutrition (AIN) were performed at admission. According to the AIN criteria, malnutrition was considered, if there were abnormalities in at least one of the following parameters: albumin, cholesterol, body mass index (BMI), and branchial circumference. Based on these criteria, 27 patients (42.8%) proved to be undernourished at admission, whereas if taking the original MNA scores, 39 patients (61.9%) were undernourished, 23 (36.5%) were at risk of malnutrition, and 1 (1.5%) was normal. The analyzed population was divided in four categories (quartiles) of the MNA scores: very low (</= 13.5), low (> 13.5 and </= 16), intermediate (> 16 and </= 18.5) and high (> 18.5). Likelihood ratios of each MNA quartile were obtained by dividing the percentage of patients in a given MNA category who were undernourished (according to AIN) by the percentage of patients in the same MNA category who were not undernourished. In the very low MNA quartile, this likelihood ratio was 2.79 and for the low MNA quartile it was 0.49. For intermediate and high MNA categories, likelihood ratios were 1.0 and 0.07 respectively. In the present study, MNA identified undernourished patients with a high clinical diagnostic impact value only, when very low scores (</= 13) are obtained.

Aged↗
PubMed2004

Validation of a modified version of the Gijon's social-familial evaluation scale (SFES): the "Barcelona SFES Version", for patients with cognitive impairment.

The aim was to validate an abbreviated version of the Gijon's social-familial evaluation scale (SFES) (Barcelona-SFES version), on patients with cognitive impairment. A group of 34 patients with cognitive impairment, admitted to an intermediate-long-term-care facility, were analyzed. Mean age was 80.2 +/- 7.4 years. Gijón's SFES was abbreviated and only the first three item groups corresponding to family conditions, social contacts and assistance from the social network were selected. Barcelona-SFES version had a range score between 3 to 15 points, in which low scores identify older patients who live with their family, have good contacts, and participate in community activities. In contrast, high scores identify older persons who live alone and have poor social support and little participation with community activities. Three social risk categories were established according to the Barcelona-SFES score: low social risk (>/= 7 points), intermediate social risk (8-9 points) and high social points). Validation criteria used in the present study were: predictive value of Barcelona-SFES score of post-discharge destination (home or institution), and patient's (or family's) request for a definitive institutionalization in a nursing home. There were 9 patients with low social risk (26.4 %), 8 with intermediate social risk (23.5 %) and 17 with high social risk (50 %). A significant relationship between Barcelona-SFES scores and post-discharge destination was found. Eighty percent of patients discharged to an institution(nursing and residential homes), they had high social risk SFES scores (>/= 10) Also, a significant correlation was found between the number of patients for which a definitive institutionalization request was performed and the Barcelona-SFES scores. Fifteen (88.2 %) of the 18 patients for whom the request was done, were in the high social risk group. The lowest scores from SFES were predictive of home discharge, while the highest scores were predictive of a definitive institutionalization.

Aged↗
PubMed2004

Observational scale and geriatric depression scale of Yesavage to identify depressive symptoms in older patients.

The diagnosis of depression by clinical interview may be difficult in the patients with communication problems (aphasia, severe cognitive impairment or severe deafness). In these cases, depressive symptoms may be observed by others (nurses and caregivers). The aim of this study was to evaluate the clinical usefulness of an observational scale to identify depression in older patients. Seventy-six institutionalized patients in an intermediate-long-term care center were evaluated. Of them, 39 were excluded because they were unable to perform a clinical interview, needed to diagnose depression. Of the excluded patients, 18 had aphasia, 7 showed severe cognitive impairment: their mini mental state examination (MMSE) score < 14, and 14 collaborated very poorly. Thus 37 patients were analyzed, mean age was 83 +/- 0.86 years (30 women and 7 men). Diagnostic categories were: neurological 16 patients (43.2%), fractures/orthopedics 6 (16.2%), pulmonary/cardiology 5 (13.5%) and others 10 (27.1%). The mean Barthel index was 57.0 +/- 31.6 and mean MMSE score was 21.1 +/- 4.3. The observational scale (OS) designed with six items, was applied to all patients. Each item was scored as never (0 points), sometimes (1 point) and always (2 points). Thus total OS score ranged from 0 to 12. Two observers, who knew the patients (nurses), applied the OS. A trained geriatrician, using the 15-item geriatric depression scale (GDS) performed detection of depressive symptoms. There were 15 patients (40.5 %) with depression on the GDS. OS scale score with a cutoff point of 5 or more was present in 13 patients; nine of them had depression (69.2 %). In the remaining 24 patients with an OS score < 5, depression was present only in 6 cases (25%) (chi2 = 6.844; p < 0.01). The OS >/= 5, in the present study, obtained a sensitivity of 60 %, a specificity of 81 %, a positive predictive value of 69 %, and a negative predictive value of 75 %.We concluded that (i) the OS has been useful for identifying depressive symptoms with an acceptable sensitivity and specificity, and (ii) the OS may be an alternative to detect depression in patients who are unable to perform a clinical interview.

Aged↗
PubMed2004

Prevalence of delirium in a geriatric convalescence hospitalization unit: patient's clinical characteristics and risk precipitating factor analysis.

The aim was to evaluate the prevalence of delirium among patients discharged from an acute care hospital and admitted to a geriatric convalescence unit (GCU), and to analyze patient's characteristics and risk precipitating factors. Sixty-eight patients were analyzed during a 2-week period. The confusion assessment method (CAM) was used to detect delirium. The precipitating factors evaluated were: major surgery-intensive care unit(ICU) stay, pulmonary and heart failure, acute infections, metabolic disorders/anemia,psychoactive medications, other drugs, severe pain, changing environmental influences and others. According to CAM, fifteen patients presented delirium (22%), and in 14 of them(93.3 %) the delirium was developed before admission at GCU. The precipitating factors in the studied population were the following: changing environmental influences in 66 patients(97%) (15 with delirium and 51 without delirium); other drugs 56 (82.3 %) (11 vs. 45);others 56 (82.3%) (9 vs. 24); psychoactive medications 50 (73.5%) (12 vs. 38); acute infections 48 (70.5 %) (13 vs. 35); metabolic disorders/anemia 40 (58.8 %) (9 vs. 31); major surgery-ICU stay 28 (41 .1%) (8 vs. 20); severe pain 26 (38.2%) (6 vs. 20); pulmonary and heart failure 22 (32.3%) (5 vs. 17). The univariant analysis showed that, none of the precipitating factors studied was significantly related to delirium. Seventy-two patients (91.1%) had simultaneously >3 precipitating factors. There were 16 patients with >6 precipitating factors, 7 of 15 with delirium and 9 of the 53 without delirium (46.6 % vs 16.9 %) (p < 0.05). The prevalence of delirium has been 22 %. Most of the patients had developed delirium before the admission at GCU. A high proportion of patients had >3 precipitating factors. In the study the presence of > 6 precipitating factors simultaneously has been significantly related to delirium.

Aged↗
PubMed2004

Breast metastasis of primary colon cancer.

Metastatic tumors to the breast from colon adenocarcinoma are very rare. They are usually indicative of disseminated disease, and the prognosis is poor. Generally, radical operation should be avoided unless needed for palliation. This case report described a patient with breast metastasis from colon adenocarcinoma treated by simple mastectomy.

Adenocarcinoma↗
PubMed2004

[Utility of intra-access pressure].

Monitoring of vascular access is essential for clinical evaluation on hemodialysis patients, detects early disfunction of access, allows adequate dialysis and decreases the morbidity associated. Although is demonstrated that intra-access pressure (IAP) is a good method of screening to evaluate arterial-venous (AV) fistulas, its utility is uncommon because its measurement requires a complex system. We would like to validate the utility of IAP monitoring using a simplified measure of IAP and its relation with other methods of screening in detecting stenoses prior to thromboses of AV grafts. We studied 24 AV grafts of 24 patients during 18 months we measured arterial pressure, mean arterial pressure (MAP), dynamic venous pressure, IAP, Kt/v, URR, recirculation index (RI), access flow and color Doppler flow, dividing the patients in two groups, with stenoses or not, if IAP/MAP > 0.5 and stenoses > 0.50 by Doppler we performed arteriography and percutaneous transluminal angioplasty with stent if stenoses exits. The values of IAP, MAP, RI were higher significantly in the stenoses group with increase of vascular access in grafts were dilation by angioplasty was made. All stenoses detected with IAP were confirmed by Doppler and arteriography but one. We conclude that IAP is an early, useful, easy, effective method in detecting stenoses of AV grafts prior to thrombosis.

Aged↗
PubMed2003

Recombinogenic effects of DNA-damaging agents are synergistically increased by transcription in Saccharomyces cerevisiae. New insights into transcription-associated recombination.

Homologous recombination of a particular DNA sequence is strongly stimulated by transcription, a phenomenon observed from bacteria to mammals, which we refer to as transcription-associated recombination (TAR). TAR might be an accidental feature of DNA chemistry with important consequences for genetic stability. However, it is also essential for developmentally regulated processes such as class switching of immunoglobulin genes. Consequently, it is likely that TAR embraces more than one mechanism. In this study we tested the possibility that transcription induces recombination by making DNA more susceptible to recombinogenic DNA damage. Using different plasmid-chromosome and direct-repeat recombination constructs in which transcription is driven from either the P(GAL1)- or the P(tet)-regulated promoters, we have shown that either 4-nitroquinoline-N-oxide (4-NQO) or methyl methanesulfonate (MMS) produces a synergistic increase of recombination when combined with transcription. 4-NQO and MMS stimulated recombination of a transcriptionally active DNA sequence up to 12,800- and 130-fold above the spontaneous levels observed in the absence of transcription, whereas 4-NQO and MMS alone increased recombination 193- and 4.5-fold, respectively. Our results provide evidence that TAR is due, at least in part, to the ability of transcription to enhance the accessibility of DNA to exogenous chemicals and internal metabolites responsible for recombinogenic lesions. We discuss possible parallelisms between the mechanisms of induction of recombination and mutation by transcription.

4-Nitroquinoline-1-oxide↗
PubMed2003

[GB virus C: lack of association with transaminases levels, CD4 and HIV viral load in aids patients].

OBJECTIVE: To study the prevalence of GBV-C-RNA in sera of HIV-infected patients and determine whether differences in immunological condition and hepatic disease exist between GBV-C positive and negative patients. METHODS: The presence of GBV-C-RNA was determined in sera of 222 HIV-positive patients by semi-automated RT-PCR. A comparison of GBV-C-RNA positive and negative patients was made by studying a series of clinical and analytical parameters. This same comparison was made in particular between those coinfected with HCV and GBV-C and those who only presented GBV-C. RESULTS: Prevalence of GBV-C-RNA was 28.8%. The most frequent hepatotropic virus was HCV, appearing in 71.6% of cases. Coinfection with HCV and HGV was present in 17% and 8.6% only had GBV-C. Patients positive for GBV-C-RNA showed clinical and analytical characteristics similar to those found in GBV-C-RNA negative patients. Among the HCV-GBV-C coinfected and those presenting HGV as the only virus it was observed that the coinfected group presented alterations in transaminases and predominance of parenteral transmission as a risk factor for HIV, whereas the GBV-C group presented normal transaminases and predominance of sexual transmission. No differences were perceived in mean CD4 and HIV-RNA values in both groups. CONCLUSIONS: Being positive for GBV-C in HIV-positive patients does not influence the presence of hepatic disease that in these patients is frequently accompanied by coinfection with other hepatotropic viruses. Moreover, it does not seem to influence the viremia of the HIV nor the CD4 cell counts.

Adolescent↗
PubMed2003

[Influence of different pharmacological agents in the ex vivo proliferation of mesothelial cells obtained from the peritoneal effluent of patients treated with peritoneal dialysis].

UNLABELLED: Mesothelial cells (MC) are the first peritoneal membrane barrier in contact with dialysate. The aim of this study was to analyze the in vitro capacity of different pharmacological agents to modify the ex vivo proliferation of MC obtained from the peritoneal effluent of patients treated with peritoneal dialysis (PD). MATERIAL AND METHODS: Thirty cultures of MC taken from nocturnal peritoneal effluent were performed. After identification, MC are subcultured in 24 multi-well plates, adding the different exogenous agents. Proliferative capacity and cell morphology were estimated on day 16th of culture. The agents evaluated were insulin, IGF-1, tamoxifen, labetalol, carvedilol, enalapril and losartan. RESULTS: Insulin shows a dose-dependent effect on MC growth, with a limit that is stimulated by the addition of fetal bovine serum (FBS). Concentrations higher than 100 micrograms/ml, are not associated with further growth, even with cell damage. In contrast, the wide range of IGF-1 dose used did not affect to MC proliferation. Tamoxifen causes negative effects on MC growth just a very high doses, not resembling doses in clinical practice. Labetalol does not modify MC proliferation used under therapeutic calculated range. However, concentrations higher than 40 micrograms/ml showed a negative influence on growth, behaving as lethal doses that over 100 micrograms/ml. The addition of FBS attenuates this effect. These effects were very similar to that caused by carvedilol addition. Enalapril and losartan act as antiproliferative agents for MC. This effect is potentiated with angiotensin II, reaching lethal concentrations increasing the dose. In conclusion, mesothelial cell growth ex vivo taken from nocturnal peritoneal effluent on PD patients is an useful tool to explore the effects of any pharmacological agent on the biology of the cell of the peritoneum. The agents used had any influence in the proliferation capacity of mesothelial cells.

Ascitic Fluid↗
PubMed2002

The yeast THO complex and mRNA export factors link RNA metabolism with transcription and genome instability.

The THO complex is a multimeric factor containing four polypeptides, Tho2, Hpr1, Mft1 and Thp2. Mutations in any of the genes encoding THO confer impairment of transcription and a transcription-dependent hyper-recombination phenotype, suggesting that THO has a functional role in gene expression. Using an in vivo assay developed to study expression of long and G+C-rich DNA sequences, we have isolated SUB2, a gene involved in mRNA splicing and export, as a multicopy suppressor of the gene expression defect of hpr1 Delta. Further investigation of a putative functional relationship between mRNA metabolism and THO revealed that mRNA export mutants sub2, yra1, mex67 and mtr2 have similar defective transcription and hyper-recombination phenotypes as THO mutants. In addition, THO becomes essential in cells with a defective Mex67 mRNA export er. Finally, we have shown that THO has the ability to associate with RNA and DNA in vitro. These results indicate a functional link between the processes of elongation and metabolism of nascent mRNA mediated by THO and mRNA export proteins, which have important consequences for the maintenance of genome stability.

Biological Transport↗
PubMed2002

[Intraductal papillary mucinous tumors of the pancreas: diagnostic and therapeutic approach].

OBJECTIVES: Literature review of the diagnostic and therapeutic approach to intraductal papillary mucinous tumors of the pancreas and report of a new case. CASE REPORT: We present the case of an 85-year-old man treated in our center for steatorrhea and weight loss. Abdominal computerized tomography (CT) showed a heterogeneous pancreatic mass, affecting the hilus, surrounding the superior mesenteric artery and producing dilatation of the biliary tract. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a polypoid neoformation in the lower part of the duodenum and leakage of mucus through the papilla. Biopsy revealed pancreatic adenoma. CONCLUSION: Intraductal papillary mucinous tumor of the pancreas is potentially curable with an uncertain prognosis. Correct diagnosis is required for optimal treatment. One of the greatest problems in this entity continues to be the difficulty of predicting the presence of an infiltrating component, which significantly worsens prognosis. The various diagnostic methods used are abdominal CT, echoendoscopy, ERCP, endoscopy of the Wirsung duct, intraoperative ultrasonography and study of the intraoperative pancreatic resection margin. Treatment requires complete resection of the lesion, although if this provokes pancreatic failure, only tumors with invasive components should be extirpated.

Adenocarcinoma, Mucinous↗
PubMed2001

Lectin analysis of surface saccharides during the cell cycle in four dinoflagellate species.

The surface glycocalyx of four dinoflagellate species were examined by fluorescent lectins. Cultures were synchronized by darkness for 82 h and changes in DNA content, cell density and surface sugars composition were monitored at 2 h intervals for 52 h in populations of four species: Alexandrium minutum, Gymnodinium catenatum, Prorocentrum micans and Gyrodinium impudicum. Lectin binding properties indicated changes in the glycoconjugate composition of the cell surface during the cell cycle. Differences in the lectin binding pattern among species were also observed. No detectable alpha-D-N-acetyl-galactosaminyl residues were found in A. minutum and G. catenatum at the cell surface and only small and irregular amounts of alpha-L-fucose were detected. However, large amounts of alpha-mannose, alpha-glucose, (N-acetyl-beta-D-glucosamine)(2) and, N-acetyl-beta-D-glucosaminyl were found during the greater part of the cell cycle of this species. P. micans only showed positive labeling when ConA was used, suggesting the presence of alpha-mannosyl and alpha-glucosyl residues. More complex sugars such alpha-L-fuc and alpha-galNAc were never observed or were present in low amounts. All the sugar residues analyzed were present in the cell surface of G. impudicum in significant amounts. Evidence was also obtained for internalization of WGA receptors in P. micans and its binding to the nuclear membrane.

Journal Article↗