Value of reversed diastolic flow in Doppler sonography of renal transplant.
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Adolescent↗
Biomedical subjects
A García
Publications and source records attributed to A García.
Psychosocial predictors of outcome in major depression: a prospective 12-month study.
This study examined the relationship between clinical and psychosocial variables and unipolar major depression outcome. Ninety ambulatory patients, with an index phase duration of less than 6 months, were followed-up for 12 months. Two measures of outcome were used: persistence of severe or partial symptomatology. Sixty percent of the patients were asymptomatic (HDRS < 8), 24% improved but not totally and 17% persisted with severe symptomatology (HDRS> 18). Personality disorder, recurrent depression, low self-esteem and low satisfaction with social support were associated to non-full remission. Personality disorder and low satisfaction with social support were associated to non-improvement. This work underlines the need during treatment to take into account personality and social variables.
Adult↗
[Characteristics of bleeding from esophageal-gastric varices in patients with HIV infection].
AIMS: Coinfection with human immunodeficiency virus (HIV) and hepatotropic viruses (hepatitis B and C) is frequent because the routes of infection are similar. Liver disease appears earlier in these patients and progression to cirrhosis and its complications is faster. The aim of this study was to determine the incidence and clinical characteristics of bleeding from esophageal-gastric varices in patients with HIV. METHODS: We retrospectively analyzed 258 consecutive episodes of bleeding from esophageal-gastric varices in cirrhotic patients between January 1996 and January 2001, of which 20 episodes occurred in patients with HIV (7.8%). RESULTS: The mean age was significantly lower in patients with HIV infection and all presented hepatitis C infection. The hepatic venous pressure gradient was higher in patients with HIV (22.8 3.4 mmHg vs 19.6 5,4 mmHg; p = 0.05). No differences in the severity of liver disease (Child-Pugh), transfusion requirements, treatment performed, initial hemostasis, early recurrence, or rescue treatment with dipeptidyl peptidase I (DPPI) were found. The development of complications (bacterial infections, hepatic encephalopathy and ascites), hospital stay and mortality were also similar. Mortality was not influenced by HIV stage. Bleeding from esophageal-gastric varices in patients with HIV infection has a similar form of presentation and clinical course with treatment to that in non-cirrhotic patients, despite a higher degree of portal hypertension. CONCLUSIONS: The presence of HIV infection should not modify diagnostic or therapeutic attitudes to bleeding from esophageal-gastric varices.
Adult↗
[Cholestatic jaundice and constitutional syndrome as early manifestations of primary systemic amyloidosis].
We present the case of a 70-year-old woman who had been suffering from constitutional syndrome for several months, abdominal distension, and yellowish coloration of the skin for the previous few days with a rapidly fatal course. Examination revealed hepatomegaly and ascites. Laboratory investigations revealed hyperbilirubinemia with cholestasis. The remaining investigations (abdominal ultrasound, barium transit evaluation, bone marrow study, analysis of ascitic fluid and laparoscopy) did not establish the diagnosis. This was established by liver and subcutaneous fatty tissue biopsies, which revealed type AL amyloid deposits. Autopsy confirmed that the patient had primary systemic amyloidosis. This infrequent form of presentation of systemic amyloidosis and its poor prognosis are discussed.
Aged↗
[Silent ischemia versus angina in Tl-201 tomoscintigraphy].
INTRODUCTION: The aim of this work was to describe the variables associated to silent ischemia in patients with reversible perfusion defects in poststress myocardial perfusion scintigraphy. METHODS: Tl-201 myocardial perfusion SPECT of 522 patients showing total or partially reversible perfusion defects after exercise testing were quantitatively analyzed retrospectively. Relationship between silent ischemia, size of perfusion defect and presence of risk factors was performed. RESULTS: Ischemia was silent in 412 (73 %) patients. In 176 (33 %) patients exercise test was electrically positive. There were no differences in perfusion defect size between patients with and without angina in exercise test (27 +/- 12 vs 27 +/- 14), but patients with angina had a greater degree of reversibility, in left descending artery (LDA) territory (56 +/- 40 vs 45 +/- 40 p < 0.01). Silent ischemia was more frequently observed in patients with previous acute myocardial infarction (46 % vs 35 %). There was no relationship between the production of exertional angina and the presence of risk factors. CONCLUSIONS: A high number of patients with reversible perfusion defects on SPECT had silent ischemia. Patients with angina during exercise test had more defect reversibility in LDA territory. Silent ischemia is more frequent in patients with previous acute myocardial infarction.
Aged↗
[News about cancer in the press].
BACKGROUND: News on health and health care are increasingly common in the mass media, and cancer is one of the most prominent topic among these news due to its health impact. MATERIAL AND METHODS: All news published in major newspapers in Catalonia, Spain between April to December 1996 were analysed, together with items from science and health supplements general information and science journals. Types of cancer-related topics, sources of information, the importance of cancer in the news item and the theme of the piece were analysed. RESULTS: During the period analysed, 974 news items were published which dealt with cancer. Of these, cancer was the principal topic in 53.5% of the items published in the national press, and 63.4% of the items published in the regional press. Cancer was the subject of an editorial comment on only four occasions. The source of information was mentioned in 64.8% of the items, and mean number of sources was 1.6. Political institutions were the most frequent source of information in newspapers, while science and health supplements and other magazines tended to cite scientific and health care institutions, as well as scientific journals. Basic research was the most common topic for news (30.3%) in science and health supplements while risk and environmental factors (29.6%) were the most common topics in magazines; environmental and technological risk factors (18,6%) and conflicts with health administrative bodies (16%) were the most frequent topics in the newspapers. CONCLUSION: News about risk factors and their prevention as well as technological and environmental factors related to cancer were among the most important topics published in the general press and magazines, together with conflicts with administrative bodies. Informations related to new therapies were a less frequent topic. Scientific journals have an important role as an information source for mass media together with political and scientific institutions.
Humans↗
[Peer-review: good, bad or quite the reverse?].
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Editorial Policies↗
["Collective imaginary": lyricism in public health].
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Imagination↗
Burden of myocardial damage in cardiac allograft rejection: scintigraphic evidence of myocardial injury and histologic evidence of myocyte necrosis and apoptosis.
BACKGROUND: Because myocardial damage determines morbidity and outcomes in heart transplant rejection, assessment of total burden of myocardial damage is highly desirable. In addition to myocyte necrosis, programmed cell death, or apoptosis, has recently been shown to contribute to cardiac allograft rejection. In the present study, we noninvasively determined myocardial damage by antimyosin scintigraphy and compared it with necrotic and apoptotic myocardial damage in endomyocardial biopsy (EMB) specimens. METHODS AND RESULTS: Forty scintigraphic and histologic studies were simultaneously performed. Of these, 19 patients had no EMB evidence of allograft rejection (group I, International Society of Heart and Lung Transplantation [ISHLT] grade 0/4), 12 had mild rejection (group II, ISHLT grades 1A and 1B), and 9 had evidence of moderate allograft rejection (group III, ISHLT grades 2, 3A, and 3B). None of the biopsies demonstrated severe allograft rejection (ISHLT grade 4/4). The severity of global myocyte damage in 40 patients was assessed by antimyosin scintigraphy. Endomyocardial biopsies were performed in these patients within 48 hours of imaging study; biopsy specimens were characterized for presence of myocyte necrosis and apoptosis. Evidence of myocyte necrosis was observed in 9 (23%) of 40 EMB specimens. Nineteen EMB specimens of group I had no inflammation and no myocyte necrosis, 12 of group II specimens showed interstitial mononuclear cell infiltration (only) but no myocyte necrosis, and all 9 of group III specimens had evidence of cellular infiltration and myocyte damage. Myocyte necrosis was assessed by hematoxylin-eosin and trichrome staining of EMB specimens. On the other hand, apoptosis of myocytes, as assessed by TUNEL staining of DNA fragments, was seen in 22 (55%) of the 40 biopsy specimens: 47%, 58%, and 67% in groups I, II and III, respectively. Abnormal antimyosin scan findings, indicating presence of myocardial damage, were observed in 9 of the 19 patients in group I and in all patients in groups II and III. Although positive antimyosin scan results in group III patients are concordant with the presence of histologic myocardial necrosis, myocardial uptake of antimyosin antibodies in groups I and II (no apparent myocyte damage at light microscopic examination) could reflect either sampling error of the biopsy or ongoing apoptotic myocyte damage. CONCLUSIONS: Apoptosis of myocytes is frequently observed during cardiac allograft rejection. The presence of apoptotic myocytes in the absence of histologic rejection activity in patients with antimyosin uptake suggests that apoptosis could be an additional mechanism of transplant-associated myocardial damage.
Adult↗
Noise levels in an urban hospital and workers' subjective responses.
Internal noise levels were measured in a 232-point grid that encompassed the main building of a major University Hospital in Valencia, Spain. Most noise equivalent sound levels that were obtained exceeded 55 dBA, and in some instances these sound levels were very high. Hospital workers' subjective responses to noise were evaluated with a self-answered questionnaire. A total of 295 workers volunteered to participate. Their answers revealed that the most important noise sources were located primarily inside the hospital. Noise levels were perceived to be sufficiently high to interfere with their work, and noise levels were also thought to affect patients' comfort and recovery. Most subjects thought it feasible to reduce noise levels in the hospital, and some preventive measures were proposed.
Adolescent↗
Acrosome reaction in fertile and subfertile boar sperm.
The main purpose of sperm evaluation is to predict its fertilizing ability. However, basic sperm test results show a low correlation with fertilizing ability. The purpose of this study was to determine whether there is an association between acrosome reaction (AR) and the incidence of subfertility of normal sperm boar. The production records of 22 farms were analyzed to identify boars with low fertility and/or prolificity, classified as subfertile. Twenty-two subfertile boar semen samples were analyzed and compared with 51 samples of fertile boars. Sperm were capacitated during 4 h at 39 degrees C. viability was determined by bisbenzimide (Hoechst-33258) staining. Acrosome reaction was assessed with fluorescein isothiocyanate conjugated Pisum sativum agglutinin. The percentage of spontaneous acrosome reaction (SAR) was not significantly different in fertile (4.5%) and subfertile boars (4.75%) (p > .05). Nevertheless, the percentage of progesterone-induced acrosome reaction (IAR) was significantly lower in subfertile boars (5.75%) as compared with fertile boars (10%) (p < .01). These results suggest that assessment of IAR in vitro may be a useful parameter to identify subfertility in boars.
Acrosome Reaction↗
[Hyperemic reactivity scintigraphy in endothelial function].
OBJECTIVE: The aim of this study was to compare a recently described method to evaluate endothelial function; the hyperemic reactivity scintigraphy (HRS) with the ultrasonographic flow-mediated dilatation (FMD) in brachial artery and its relationship with myocardial SPECT. METHODS: 42 consecutive patients that underwent myocardial scintigraphy were included. Thirty-six patients had simultaneous measurement of FMD. Both studies were obtained after 5 minutes occlusion of the upper arm with a blood pressure cuff inflated at 250 mmHg. HRS was performed dynamically at rate 1 frame/sec during 3 minutes after intravenous injection of 740 MBq of Tc-99 sestamibi. Time-activity curves allowed obtaining the following indexes: medium hyperemic activity/medium contrallateral activity (MHA/MCA) and maximum hyperemic activity/maximum contrallateral activity (MxHA/CxHA). RESULTS: In 13 patients SPECT was normal. Twenty-nine patients had perfusion defects in scintigraphy. There was relationship between the FMD and the MHA/MCA (r = 0.23; p = 0.018) and the FMD and the MxHA/CxHA (r = 0.18; p = 0.05). Patients with alterations in the SPECT had an index MxHA/CxHA lower than patients with normal SPECT (1.8 +/- 0.2 vs 1.5 +/- 0.4; p = 0.04). We did not find relationship between FMD and alterations in SPECT. CONCLUSIONS: There is relationship between FMD and HRS. HRS is lower in patients with perfusion defects in the SPECT. HRS could provide additional value to myocardial scintigraphy.
Aged↗
Malignant oncocytoma of a minor salivary gland: an unusual presentation at the base of the tongue.
In contrast to malignant oncocytomas of the parotid gland, malignant oncocytomas arising from minor extraparotid glandular tissue are rare. The latter may display a locally aggressive behaviour as well as a variable tendency to develop secondary cervical lymph nodes. We report a new case of malignant oncocytoma in a 43-year-old man presenting with greatly enlarged cervical lymph nodes accompanied by a poorly defined swelling at the base of the tongue microscopically identified as a malignant oncocytoma. The diagnosis was strongly supported by the ultrastructural features of the cells almost completely filled with mitochondria. The cervical mass was excised, and the patient has suffered no recurrence for nearly 2 years after surgical treatment.
Adenoma, Oxyphilic↗
CA 549 and SP2: new tumor markers in breast cancer.
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Antibodies, Monoclonal↗
Secondary metabolites from a Streptomyces strain isolated from Livingston Island, Antarctica.
The producing strain Streptomyces sp. 1010 was isolated from a shallow sea sediment from the region of Livingston Island, Antarctica. From the culture broth of this strain naturally active secondary metabolites were isolated identical to phthalic acid diethyl ester (C12H14O4, MW. 222); 1, 3-bis (3-phenoxyphenoxy)benzene (C30H22O4, MW.446); hexanedioic acid dioctyl ester (C22H42O4, MW.370) and the new substance 2-amino- 9, 13 -dimethyl heptadecanoic acid (C19H39NO2, MW.313). These compounds represent diverse classes of chemical structures and provide evidence for the untapped biosynthetic potential of marine bacteria from Antarctica.
Amino Acids↗
Use of a triple-stain technique to detect viability and acrosome reaction in deer spermatozoa.
A procedure is described for simultaneously evaluating of sperm viability and acrosomal status in fixed deer spermatozoa. This technique, which is a modification of the triple-stain technique (TST) developed for human sperm, utilizes trypan blue to identify the percentage of live sperm in culture and subsequent staining of fixed sperm to differentiate the acrosome. Four classes of deer sperm can be distinguished with the TST: (1) live unreacted sperm, (2) live acrosome-reacted sperm (true acrosome reaction), (3) dead unreacted sperm, and (4) dead acrosome-reacted sperm (false acrosome reaction). The study shows that the acrosome status can be detected either by TST stain or by phase-contrast microscopy (r = .971, p < .001) and that TST does not differ from 0.4% trypan blue in its ability to identify live and dead sperm (r = .995, p < .001). This staining procedure enables differentiation of spermatozoa that have undergone a true acrosome reaction (TAR) from those that have undergone a false acrosome reaction (FAR). In this way, incubation of deer spermatozoa for 30 min at 37 degrees C in the presence of calcium ionophore A23187 increased the proportion of spermatozoa undergoing a TAR. Sperm incubated in the absence of A23187 undergo the TAR at a much lower rate (p < .001) than those incubated in the presence of ionophore. This stain procedure was also used to study the time course of the true acrosome reaction of deer sperm in vitro. Incubation of deer spermatozoa for up 24 h at 37 degrees C resulted in a decrease in the percentage of live acrosome-intact spermatozoa and a simultaneous increase in the percentage of spermatozoa categorized as having undergone a TAR and FAR.
Acrosome↗
[A system of multidimensional behavior assessment. A scale for parents of children from 6 to 11 years of age. Colombian version].
INTRODUCTION: Behavioral Assessment System for Children (BASC) has demonstrated to be useful in the diagnosis of Attention Deficit Disorder (ADD). PATIENTS AND METHODS: A randomized sample of 120 children, 6 to 11-year-old, participants from the school of the city of Medellín, Colombia, was selected. The sample was stratified by sex and two socioeconomic status (SES). Parents were asked to answer the BASC Parent Rating Scale (PRS) 6-11, authorized Spanish version. RESULTS: Cronbach's alpha coefficient was 0.85 for the clinical scale (9 items). It was 0.75 for the Adaptive Scale (3 items). A scale designed with 4 items to assess ADD (hyperactivity, attention problems, aggression, and conduct problems) showed an alpha coefficient of 0.82. Male children scored significantly higher than female (ANOVA, p < 0.05) in hyperactivity, conduct problems, and atypicality. Children from low SES scored significantly higher than children of high SES on the most of clinical measures (p < 0.05) and lower on the three adaptive measures. Cluster analysis selecting six clusters found a prevalence of 61.6% for normal male children. In the total sample there were a 4% at risk of DDA type II (inattentive) and 14% at risk of DDA type I (combined). CONCLUSIONS: BASC PRS (6-11) showed reliability and validity to assessing the behavior in Spanish speaking Colombian children.
Attention Deficit Disorder with Hyperactivity↗
Identification of immunodominant antigens by immunoelectrotransfer in hydatid fluid.
Identification and characterization of immunodominant antigens in hydatid fluid was performed by electrophoresis in polyacrylamide gels (SDS PAGE) followed by immunoelectrotransfer (Western Blot). The studies were performed in sera of 23 patients with surgically confirmed hydatid disease, 12 patients with clinical suspicion of the infection and positive serology according to conventional serology (double diffusion with detection of are 5 and ELISA test), 28 healthy subject and 23 patients with parasitic infections different from hydatidosis. The results showed 7 antigenic bands located between 8 and 120 kDa, two immunodominant bands (MW 8 and 12 kDa) were recognized by the sera of patients suffering from hydatid disease and those with positive serology. Two additional bands were detected by the sera of healthy subjects and by the samples of patients presenting cysticercosis. It is concluded that the antigens with molecular weights of 8 and 12 kDa. would be those of major diagnostic value, while those of 32 and 60 kDa are nonspecific.
Antigens, Helminth↗