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Biomedical subjects

A Miranda

Publications and source records attributed to A Miranda.

At least 55 records · Page 3Linked to original sources
PubMed1998

Prevalence of atopy in students from Málaga, Spain.

BACKGROUND: Epidemiologic studies are necessary to determine the prevalence of allergic diseases. This varies widely depending on allergen preparations and patients studied. OBJECTIVE: To investigate the prevalence of atopic disease, skin test reactivity, total and specific IgE to common allergens, and other variables in a sample of students from Málaga, southern Spain. METHODS: Three hundred sixty-five students (age 17.9 +/- 1.18) were interviewed by an allergist. Skin prick tests were performed with Dermatophagoides pteronyssinus, Artemisia vulgaris, Plantago lanceolata, Chenopodium album, Olea europaea, Phleum pratense, Parietaria judaica, Cynodon dactylon, Alternaria tenuis, and cat dander. Total and specific IgE to D. pteronyssinus, Olea, and Parietaria were determined. RESULTS: Of all subjects studied, 19.9% suffered from rhinoconjunctivitis, 4.1% rhinoconjunctivitis plus asthma, 3.1% asthma alone, and 0.8% atopic dermatitis; 46.4% had a positive skin test to at least one allergen (28.2% to D. pteronyssinus, 20.4% to Olea, 13.8% to Phleum); and 43% had total IgE > 100 kU/L and 44.7% a family history of atopy. Allergic symptoms were strongly associated with skin test positivities and family allergic history. Patients with asthma or skin prick test positive had higher total IgE values than others (P < .01). There was a significant correlation between specific IgE values and wheal size in skin test. CONCLUSIONS: Our findings confirm the high prevalence of atopic diseases, and the close relationship of skin tests reactivity (or presence of specific IgE) to allergens with symptoms of asthma and rhinitis. The presence of a family history of allergic diseases influences the development of positive skin tests and atopic illness. Dermatophagoides pteronyssinus and pollen of Olea europaea were found to be the most common allergens.

Adolescent↗
PubMed1998

Autosomal dominant inheritance of adducted thumbs and other digital anomalies.

Isolated adducted thumbs is an uncommon malformation that occurs sporadically in the majority of cases although some affected families have been reported. Previously, autosomal dominant inheritance was suggested in two familial cases, but this mode of inheritance has not been confirmed. Here we describe a family with adducted thumbs and other digital anomalies in which seven members (six females and one male) are affected in three consecutive generations. Additionally, the patients showed mild abnormalities of fingers 2nd-4th bilaterally and hypoplasia of the middle phalanx of the 5th fingers. This family represents an autosomal dominant condition that apparently has not been previously reported.

Adolescent↗
PubMed1997

Constrained corticotropin-releasing factor antagonists with i-(i + 3) Glu-Lys bridges.

Hypothesis driven and systematic structure-activity relationship (SAR) investigations have resulted in the development of effective central nervous system (CNS) antagonists of corticotropin (ACTH)-releasing factor (CRF) such as alpha-helical CRF(9-41) and analogues of our assay standard [DPhe12,Nle21,38]hCRF(12-41). On the other hand, equally potent CRF antagonists that block the hypothalamic/pituitary/adrenal (HPA) axis had not been described until recently. Predictive methods, physicochemical measurements (nuclear magnetic resonance spectrometry and circular dichroism spectroscopy), and SAR studies suggest that CRF and its family members (urotensins and sauvagine) assume an alpha-helical conformation when interacting with CRF receptors. To further test this hypothesis, we have systematically scanned the hCRF(9-41) or hCRF(12-41) sequences with an i-(i + 3) bridge consisting of the Glu-Xaa-Xbb-Lys scaffold which we and others had shown could maintain or enhance alpha-helical structure. From this series we have identified seven analogues that are either equipotent to, or 3 times more potent than, the assay standard; in addition, as presented earlier cyclo(30-33)[DPhe12,-Nle21,38,Glu30, Lys33]hCRF(12-41) (astressin) is 32 times more potent than the assay standard in blocking ACTH secretion in vitro (rat pituitary cell culture assay). In vivo, astressin is also significantly more potent than earlier antagonists at reducing hypophysial ACTH secretion in intact stressed or adrenalectomized rats. Since the corresponding linear analogues that were tested are significantly less potent, our interpretation of the increased potency of the cyclic analogues is that the introduction of the side chain to side chain bridging element (Glu30-Lys33, and to a lesser extent that of Glu14-Lys17, Glu20-Lys23, Glu23-Lys26, Glu26-Lys29, Glu28-Lys31, Glu29-Lys32, and Glu33-Lys36) induces and stabilizes in the receptor environment a putative alpha-helical bioactive conformation of the fragment that is not otherwise heavily represented. The effect of the introduction of two favored substitutions [(cyclo(20-23) and cyclo(30-33)] yielded 37 with a potency 8 times that of the assay standard but actually 12 times less than expected if the effect of the two cycles had been multiplicative. These results suggest that the pituitary CRF receptor can discriminate between slightly different identifiable conformations, dramatically illustrating the role that secondary and tertiary structures play in modulating biological signaling through specific protein-ligand interactions.

Amino Acid Sequence↗
PubMed1997

Pollinosis due to Australian pine (Casuarina): an aerobiologic and clinical study in southern Spain.

An aerobiologic and clinical survey was conducted in Málaga, southern Spain, in order to determine fluctuations of Australian pine (Casuarina) pollen in the atmosphere of the city, and the prevalence of sensitivity in a nonatopic population. The aerobiologic survey, using a Burkard spore trap, was conducted from January 1991 to December 1994, and sensitization was ascertained by the skin prick test. The pollen season is relatively short and the pollen dispersion period occurs during October and November, mainly during the last 3 weeks of October. Diurnal patterns showed that the highest concentrations of pollen occur between 12 a.m. and 2 p.m., the most influential variables in its dispersion being temperature, sunshine, and rainfall. The prevalence of sensitization to Casuarina pollen was determined by skin prick test (SPT) in a nonatopic population of 210 patients with a previous history of autumn rhinitis, asthma, or rhinitis asthma. Six subjects showed a positive reaction to the pollen extracts, and the presence of specific IgE was demonstrated by the conventional radioallergosorbent test (RAST > or = 2) in five of these patients with positive SPT.

Adolescent↗
PubMed1997

Comparative evaluation of the synthesis and purification of transmembrane peptide fragments. Rat bradykinin receptor fragment 64-97 as model.

The 34-residue peptide CTVAEIYLGNLAGADLILASGLPFWAITIANNFD (TM-34), corresponding to the 64-97 sequence of the rat bradykinin, receptor, was selected as a model of hydrophobic transmembrane peptide segment for systematic study of synthesis and purification strategies. Application of conventional Boc/Bzl chemistry resulted in very low yield of the synthesis (around 4%) when DMF was used as the solvent for coupling reactions. As shorter resin-bound fragments of TM-34 showed improved swelling in 80% NMP/DMSO, the synthesis was repeated in this mixed solvent and the yield increased to 12%. A comparative synthesis using optimized Fmoc chemistry and Fmoc-(FmocHmb) derivatives of Ala and Leu to prevent aggregation did not provide any detectable TM-34. Taken together, these results illustrate the synthetic problems associated with hydrophobic sequences, almost regardless of the chemistry used. As expected, the hydrophobicity of TM-34 and of most of its minor fragments made them scarcely soluble in common solvents. Purification could be achieved by loading the crude materials dissolved in 90% AcOH onto a C4 HPLC column and eluting with a TFA/MeCN linear gradient. CD studies of the TM-34 and of the shorter fragment with the 74-97 sequence (TM-24) showed a higher percentage of alpha-helix structure for the latter. This suggests that the shorter sequence may better represent the correct transmembrane region of the second helix of the rat bradykinin receptor.

Amino Acid Sequence↗
PubMed1997

The outcome of walking in stable neuromuscular deficiencies.

In some patients with stable or very gradually worsening neuromuscular disorders, walking performance nevertheless decreases with increasing hip flexion and spinal deformity as the patient grows. The relations between muscular deficiency, pelvic and spinal deformity, head stability, gravity parameters and walking performance were studied in 43 patients aged 18 months to 38 years with a view to finding out how these parameters are related, whether progressive spinal deformity and loss of walking can be avoided or delayed, and whether specific therapy for each of these parameters can help. Early combating of hip flexion deformity by physiotherapy, accompanied by limbering-up exercises of the spine to counteract lumbar and thoracic lordosis are useful, as are orthoses to correct pelvic tilt anteversion, spinal lordosis and head instability. If physiotherapy is ineffectual or too late, tenoctomy of the rectus femoris may help.

Adolescent↗
PubMed1996

Cross-reactivity between a penicillin and a cephalosporin with the same side chain.

BACKGROUND: The cross-reactivity between penicillins and cephalosporins can be influenced by different factors, which are not all well known. The chemical structure of the side chain may contribute to the cross-reactivity. OBJECTIVE: The study was carried out in allergic subjects who are selectively responsive to amoxicillin to determine allergenic cross-reactivity with a cephalosporin containing a side chain identical to that of amoxicillin, cefadroxil, and one containing a different side chain, cefamandole. METHODS: Allergic subjects with a selective response to amoxicillin were chosen according to the following criteria: history of an immediate allergic reaction to amoxicillin, negative skin test responses to benzylpenicilloyl and minor determinant mixture of benzylpenicillin, negative RAST response to benzylpenicilloyl, and good tolerance to benzylpenicillin and phenoxymethyl penicillin challenges. In addition, subjects had to have a positive skin test response to amoxicillin and/or positive RAST response to amoxicilloyl or, if these test results were negative, a positive challenge test response to amoxicillin. In vivo cross-reactivity to cefadroxil was assessed by giving oral cefadroxil at increasing doses from 5 to 500 mg. In vitro cross-reactivity was determined by RAST inhibition studies with amoxicilloyl RAST disks and the following monomeric conjugates in the fluid phase: amoxicillin-butylamine, cefadroxil-butylamine, and the side chain para-hydroxy-phenylglycine. Tolerance to cefamandole was determined by giving 100 mg and then 500 mg parenterally. RESULTS: Twenty-one patients with a selective response to amoxicillin were included in the study. Eight subjects (38%) had a positive response to cefadroxil, and none reacted to cefamandole. In vitro RAST inhibition studies indicated that cefadroxil-butylamine monomers cross-reacted with amoxicillin butylamine and the side chain contributed relevantly to the inhibition. CONCLUSIONS: These results indicate that the percentage of cross-reactivity between penicillins and cephalosporins with an identical side chain is high and that this critical part of the molecule seems to be an important contributor to these results. The value is higher than previously reported data from similar studies of non-side-chain-related cephalosporins.

Adolescent↗
PubMed1996

Anaphylaxis to penicillins after non-therapeutic exposure: an immunological investigation.

BACKGROUND: There are instances where individuals may come into contact with penicillins without being aware of it. This non-therapeutic exposure from different sources may cause sensitization and even clinical manifestations in subjects allergic to penicillins. OBJECTIVE: To determine the capacity that inadvertent contact with penicillins may have in inducing resensitization and symptoms in patients diagnosed as allergic to penicillins who were followed over a long period of time after their initial evaluation. METHODS: A follow-up study of penicillin-allergic subjects who agreed to be regularly tested for in vitro and in vivo control of their sensitivity. Skin tests were carried out with major and minor determinants of benzylpenicillin (BPO and MDM), amoxicillin (AX), and ampicillin (AMP), and specific IgE antibodies were determined by radioallergosorbent test (RAST). A questionnaire was sent to and answered by the subjects in order to see if they experienced symptoms at any time during the follow-up period. In addition, if any unexplained symptoms occurred, a bleeper system was used to contact the allergy centre. RESULTS: Seven subjects experienced anaphylactic reactions with no obvious cause. At the time of their initial allergic reaction, which was caused by exposure to prescribed penicillin, the subjects had one or more positive skin tests and/or RAST results to penicillin related reagents. However, over the following 2-4 years all their tests became negative. After reporting their unexplained reaction all seven had one or more positive skin tests and/or RAST results again and when retested 1 week later RAST measurements showed that levels of penicillin-specific IgE were maintained or increased. None of the subjects had knowingly received penicillin but the questionnaire showed that six had been exposed to it and in the seventh case exposure was likely. In two cases contact was by sexual intercourse with a partner who was receiving penicillin, three subjects had handled penicillin formulations and one had drunk from a glass previously used for giving penicillin. In the seventh case exposure could have occurred whilst in hospital for surgery, although this was not proven. CONCLUSIONS: these results show that non-therapeutic exposure to penicillin can cause severe symptoms and that in vitro and in vivo testing can help in the diagnosis of such cases.

Adult↗
PubMed1995

Comparative study between European and American species of Polistes using sera from European sensitized subjects.

Although the different vespid species of the genus Polistes are found all over the world, studies about allergy sensitization to these species have been made mainly in North America. We studied the specific IgE in a large group of sera from patients sensitized to Polistes dominulus (PD) and determined the crossreactivity with another important European Polistes (P. gallicus [PG]) and with five American relevant species of this genus: P. exclamans (PE), P. fuscatus (PF), P. metricus (PM), P. annularis (PAN) and P. apachus (PAP). Studies indicated that 96.7% of sera with IgE positive to PD were positive to PG. No case positive to just PG was found. The comparison of these two European species with the American relatives indicated that most cases were positive to all the insects although there were significant differences in the radioallergosorbent test (RAST) value. These results were confirmed by RAST inhibition studies, and indicate that although the European and American species are closely related, species specific allergenic differences exist. These data suggest that in vivo studies should be carried out in order to determine the sensitivity and specificity of the European venoms compared with the American species.

Animals↗
PubMed1995

Nonimmediate reactions to betalactams: prevalence and role of the different penicillins.

In patients treated with penicillins, adverse cutaneous reactions can occur within minutes or may take several days to develop. IgE antibody-mediated reactions are well documented, but other mechanisms may also be involved. In particular, nonimmediate reactions have not been studied extensively, and the purpose of the present work was to establish the incidence of such reactions among a large group of patients and to study the penicillins involved. A total of 380 subjects with a history of a cutaneous reaction following administration of a penicillin antibiotic was included in the study. Skin tests and specific IgE measurements (RAST) were carried out using various penicillins and penicillin-related reagents, and patients were also challenged with various penicillins. In some patients with delayed skin test responses, skin biopsies were carried out. The tests confirmed that 74 subjects (19.4% of total investigated) had suffered a cutaneous reaction to a penicillin derivative, and 29 of these subjects (7.6% of total or 39% of confirmed) showed evidence of having suffered a nonimmediate reaction. The latter group were identified by giving a positive delayed direct challenge, and in 65% of the cases a delayed skin test response was detected. In most cases, these responses were to amino penicillins. Skin biopsies showed a lymphomonocytic cell infiltrate. Nonimmediate reactions to penicillins are a reproducible phenomenon, suggesting that a specific mechanism is responsible. By direct challenge, 93% of responders were positive to amino penicillins (10.3% ampicillin, 82.7% amoxicillin), indicating a major role for these penicillins in nonimmediate reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Studies of the specificities of IgE antibodies found in sera from subjects with allergic reactions to penicillins.

Penicillins are immunogenic when administered to humans and in some instances they can also be allergenic, inducing specific IgE antibodies. Whilst the major haptenic group, the penicilloyl, is well characterised, less is known about the relative importance of the different parts of the structure for antibody binding and how this can influence the specificity of patients response. In order to investigate this further, sera from subjects who had suffered an IgE-mediated reaction to penicillins were studied using the radioallergosorbent test (RAST) and RAST inhibition. The assays employed reagents related to the penicillins causing the reaction. Using 173 sera, positive RAST results were only found with reagents based on benzyl penicillin (BP) and amoxicillin (AX). Fifty-three positive sera were selected for further studies and categorized into three groups: (A) sera only RAST positive to AX, (B) sera only positive to BP and (C) sera positive to both penicillins. RAST inhibition studies were then carried out using monomeric penicilloyl conjugates and compounds representing parts of the penicilloyl structures of BP and AX. For all three groups, monomeric penicilloyl conjugates were the most efficient inhibitors but there were differences for the other compounds. Group A sera were also inhibited by the side chain amoxicillin, whereas group B sera were poorly inhibited by all other inhibitors. Group C sera showed two patterns of inhibition, both consistent with their more cross-reactive profile.

Amoxicillin↗
PubMed1995

Serological survey for avian paramyxoviruses from wildfowl in aquatic habitats in Andalusia.

A serological survey for a range of avian paramyxoviruses (PMV) was carried out among wildfowl from southern Spain, 1990 to 1992, using the hemagglutination inhibition technique. We collected 579 sera from 24 avian families (18 aquatic and six non-aquatic). Antibodies were detected to all paramyxoviruses in waterfowl, with a notable prevalence of antibodies to PMV-8 (43%) and to a lesser extent PMV-6 (21%). By contrast, in non-aquatic species high antibody prevalences were detected only to PMV-2 (60%), particularly in sparrows (68%), while antibody prevalences to other PMV's were moderate or low.

Animals↗
PubMed1995

[Spinal opiates in obstetrics. Theoretical aspects and criteria for practical use].

Spinal opiates were introduced for use in obstetrics during the 1980's. The possibility of achieving analgesic effects with small doses, without motor and/or vegetative involvement, initially aroused a great deal of enthusiasm. After extensive experience using these drugs, however, it seems they only partially live up to these great expectations. Savings on dose seem to be attained only with morphine and the efficacy of spinal opiates used as the only agents against pain during childbirth is limited. Intradural administration is often accompanied by vegetative involvement, and the reduction in motor blockade generally does not have substantial effect on the progression of labor. On the other hand, it is important to underline the advantages of combining opiates with local anesthesia: both doses are reduced, quality of analgesia is greater, as is maternal satisfaction, and fetal/neonatal repercussions are scarce. Finally, in certain cases, opiates may constitute a valid alternative for local anesthesia, especially if delivery is intradural. The use of spinal opiates is certainly an important qualitative advance, though not a definitive one, in obstetrics.

Analgesia, Obstetrical↗
PubMed1994

Conformationally restricted competitive antagonists of human/rat corticotropin-releasing factor.

Corticotropin releasing factor (CRF) is a 41-peptide amide which stimulates the release of ACTH (Vale et al. Science 1981, 213, 1394). CRF has been postulated to assume an alpha-helical conformation upon binding to its pituitary receptor (Hernandez et al. J. Med. Chem. 1993, 36, 2860). We have exploited this hypothesis in the design of a limited series of cyclic analogues and have taken into consideration the effects of side-chain deletion (Alanine scan, Kornreich et al. J. Med. Chem. 1992, 35, 1870) as well as of changes in chirality (Rivier et al. J. Med. Chem. 1993, 36, 2851), with the rationale that side chains necessary for binding could also be replaced by side-chain bridges. In particular, we have used computer modeling to predict likely side chain bridging opportunities and evaluated the effects of such replacements by correlating biological results with those derived from CD spectroscopy. We have synthesized 38 monocyclic peptide amides, competitive antagonists of human/rat CRF, using solid-phase methodology on MBHA resin. After purification by preparative RP-HPLC, the peptides were analyzed by RP-HPLC and capillary zone electrophoresis and characterized by mass spectroscopy and amino acid analysis. CRF antagonists were tested for their ability to interfere with CRF-induced release of ACTH by rat anterior pituitary cells. In most cases, one of the bridge heads was located at a position where substitution by a D-residue was tolerated (i.e., positions 12 and 20). It has become clear that careful optimization of bridge length and chirality is critical. This is best exemplified by the fact that out of the 38 analogues that were synthesized and tested, only two, [cyclo(20-23)[DPhe12,Glu20,Lys23, Nle21,38]h/rCRF12-41 and cyclo(20-23)[DPhe12,Glu20,Orn23,Nle21,38] h/rCRF12-41], were found to be more potent (3 and 2 times, respectively) than [DPhe12,Nle21,38]h/rCRF12-41, the parent compound. Six analogues belonging to two different families were found to be half as potent as the standard, 18 had 2-20% of the potency of the standard, and the others were significantly less potent. CD results of all analogues in 50% TFE (a concentration of TFE that induced nearly maximum helicity of [DPhe12,Nle21,38]h/rCRF12-41) suggest that while helicity may be an important factor for CRF analogue recognition, little correlation is found between percent helicity as determined by spectral deconvolution and biological activity in vitro.

Adrenocorticotropic Hormone↗
PubMed1994

Immediate allergic reactions to amoxicillin.

A large group of patients with suspected allergic reactions to beta-lactam antibiotics was evaluated. A detailed clinical history, together with skin tests, RAST (radioallergosorbent test), and controlled challenge tests, was used to establish whether patients allergic to beta-lactam antibiotics had selective immediate allergic responses to amoxicillin (AX) or were cross-reacting with other penicillin derivatives. Skin tests were performed with benzylpenicilloyl-poly-L-lysine (BPO-PLL), benzylpenicilloate, benzylpenicillin (PG), ampicillin (AMP), and AX. RAST for BPO-PLL and AX-PLL was done. When both skin test and RAST for BPO were negative, single-blind, placebo-controlled challenge tests were done to ensure tolerance of PG or sensitivity to AX. A total of 177 patients were diagnosed as allergic to beta-lactam antibiotics. We selected the 54 (30.5%) cases of immediate AX allergy with good tolerance of PG. Anaphylaxis was seen in 37 patients (69%), the other 17 (31%) having urticaria and/or angioedema. All the patients were skin test negative to BPO; 49 of 51 (96%) were also negative to MDM, and 44 of 46 (96%) to PG. Skin tests with AX were positive in 34 (63%) patients. RAST was positive for AX in 22 patients (41%) and to BPO in just 5 (9%). None of the sera with negative RAST for AX were positive to BPO. Challenge tests with AX were performed in 23 subjects (43%) to establish the diagnosis of immediate allergic reaction to AX, and in 15 cases (28%) both skin test and RAST for AX were negative. PG was well tolerated by all 54 patients. We describe the largest group of AX-allergic patients who have tolerated PG reported so far. Diagnosis of these patients can be achieved only if specific AX-related reagents are employed. Further studies are necessary to determine the exact extent of this problem and to improve the efficacy of diagnostic methods.

Adolescent↗