Biomedical subjects

A Rodriguez

Publications and source records attributed to A Rodriguez.

At least 19 recordsLinked to original sources

PubMed2006

Implications of COPD in patients admitted to the intensive care unit by community-acquired pneumonia.

The mortality rate of chronic obstructive pulmonary disease (COPD) patients with community-acquired pneumonia (CAP) is reported to be low. However, studies carried out to date have included <20% of critically ill patients. The current authors performed a secondary analysis of a prospective study evaluating 428 immunocompetent patients admitted to the intensive care unit (ICU) for severe CAP. In total, 176 COPD patients were compared with 252 non-COPD patients. In COPD patients, ICU mortality (odds ratio (OR) 1.58; 95% confidence interval (CI) 1.01-1.43) and mechanical ventilation (OR 2.78; 95% CI 1.63-4.74) rates were higher than in non-COPD patients. The ICU mortality was 39% for COPD patients initially intubated and 50% for those who failed noninvasive ventilation. The proportion of patients who were males, aged >/=70 yrs, smokers and who had chronic heart disease or Pseudomonas aeruginosa were higher in COPD patients. Inappropriate empirical antibiotic therapy was associated with higher mortality (OR 3.8; 95% CI 1.19-12.6). ICU mortality in COPD patients with adequate therapy was associated with bilateral pneumonia (OR 2.32; 95% CI 1.18-4.53) and shock (OR 3.53; 95% CI 1.31-9.71). In conclusion, chronic obstructive pulmonary disease patients hospitalised with community-acquired pneumonia in the intensive care unit had higher mortality and need of mechanical ventilation when compared with patients without chronic obstructive pulmonary disease.

Aged↗

PubMed2006

Imaging for evaluation of suspected cervical spine trauma: a 2-year analysis.

OBJECTIVE: To examine the role of radiography in screening trauma patients with suspected injury to the cervical spine. SUBJECTS AND METHODS: Over a period of 2 years, 5172 people were admitted to our trauma service and 297 (5.4%) were found to have cervical fractures. The radiographic and CT films and reports of 245 of these 297 patients were reviewed. RESULTS: The 245 subjects had sustained 309 distinct individual injuries. Radiography detected injuries in 108 cases (44.1%) and CT detected injuries in 243 cases (99.2%). The two fractures missed by CT occurred at C2; one fracture was obscured by dental artefacts and the other was in the horizontal plane of the scan. Both fractures were detected on lateral radiographs of the region. CONCLUSION: CT is superior to radiography for identification of cervical spine fractures. The fractures most likely to be missed by CT occur at C2. We recommend that CT be used as the primary screening method for people with suspected cervical injury, together with a single lateral view of the cervical spine to include the C2 region.

Accidental Falls↗

PubMed2006

Refinement of the mouse model of congenital toxoplasmosis.

The goals of the present investigation, focusing on the BALB/c mouse model of congenital toxoplasmosis, were: (1) to find a method to determine pregnancy in the mouse. The method has 100% sensitivity and 72% specificity; (2) to test congenital transmission during the chronic stage of toxoplasmosis. This occurred in 2 of 10 mice tested; (3) to investigate the relationship between the infective dose and the rate of congenital transmission. This was not demonstrated for doses of 10(2) to 10(3) bradyzoites and oocysts of Prugniaud, M3 and M7741 strains, with transmission rates of 3 of 8 to 6 of 10 mice inoculated; (4) to determine homologous and heterologous protection. Homologous protection was demonstrated with Prugniaud cysts, and heterologous protection was found between ME-49 and M3 cysts. This finding is consistent with the uniform natural protection against congenital toxoplasmosis seen in immune women and ewes.

Animals↗

PubMed2006

Advantages of real-time PCR assay for diagnosis and monitoring of canine leishmaniosis.

The aim of the present study is to highlight the advantages of real-time quantitative PCR intended to aid in the diagnosis and monitoring of canine leishmaniosis. Diagnosis of canine leishmaniosis is extremely challenging, especially in endemic areas, due to the diverse and non-specific clinical manifestations, and due to the high seroprevalence rate in sub-clinical dogs. Veterinarian clinicians are usually confronted with cases that are compatible with the disease, and with several diagnostic tests, sometimes with contradictory results. We have developed a new TaqMan assay, targeting the kinetoplast, applied to 44 samples of bone marrow aspirate or peripheral blood. The dynamic range of detection of Leishmania DNA was established in 7 logs and the limit of detection is 0.001 parasites in the PCR reaction. At the time of diagnosis parasitemia ranges from less than 1 to 10(7)parasites/ml. The ability to quantify the parasite burden allowed: (i) to elucidate the status of positive dogs by conventional PCR, although larger studies are necessary to clarify the dividing line between infection and disease, (ii) to estimate the kinetics of the parasite load and the different response to the treatment in a follow-up and (iii) to validate blood as less invasive sample for qPCR. The continuous data provided by real-time qPCR could solve the dilemma for the clinician managing cases of canine leishmaniosis by differentiating between Leishmania-infected dogs or dogs with active disease of leishmaniosis.

Animals↗

PubMed2006

Absorption cross section and photolysis of OIO.

Pulsed laser photolysis combined with transient absorption spectroscopy and resonance fluorescence was used to examine the photolysis of OIO at a number of wavelengths corresponding to absorption bands in its visible spectrum between approximately 530 and 570 nm. Photolysis at 532 nm was found to result in substantial depopulation of the absorbing ground state, enabling an estimate for the absorption cross section of OIO at 610.2 nm of (6 +/- 2) x 10(-18) cm2 molecule(-1) to be obtained. No evidence was found for I atom formation following photolysis of OIO at 532, 562.3, 567.9 and 573.8 nm, enabling an upper limit to the I atom quantum yield of < 0.05 (560-580 nm) and < 0.24 (532 nm) to be established.

Journal Article↗

PubMed2006

Cushing's syndrome during pregnancy secondary to adrenal adenoma: metyrapone treatment and laparoscopic adrenalectomy.

Cushing's syndrome during pregnancy is a rare and difficult to diagnose disorder. We describe the case of a 30-yr-old woman presenting with symptoms and signs of mild hypercortisolism, in which ACTH-independent Cushing's syndrome was diagnosed. Urinary cortisol excretion was elevated and circadian rhythm of cortisol was absent. ACTH levels were low. In addition, plasma cortisol failed to suppress after a high dexamethasone dose. An abdominal computed tomography scan confirmed a left adrenal mass. While diagnosis work-up was still in progress, the patient became pregnant and wanted to carry her pregnancy to full-term. Hypercortisolism was successfully controlled with metyrapone, which was started at 8 weeks of gestation. At 16 weeks of gestation, a laparoscopic left adrenalectomy was performed. Pathologic examination of the gland showed a benign adrenocortical adenoma. The patient developed secondary adrenal insufficiency and was discharged on 20 mg hydrocortisone daily dose. At 30 weeks of gestation, the patient had a pre-term rupture of membranes and underwent spontaneous vaginal delivery. The newborn was a normal virilized male who weighed 1280 g. No apparent metyrapone-induced teratogenic effects were observed and there was no clinical or biochemical suppression of adrenocortical function. In conclusion, in adrenal Cushing's syndrome during pregnancy, medical treatment with metyrapone as soon as the diagnosis is made, in combination with laparoscopic surgery during the second trimester, are useful in preventing complications secondary to hypercortisolism and safe both for the mother and infant.

Adenoma↗

PubMed2006

Cellular immune response to pulmonary infections in HIV-infected individuals hospitalized with diverse grades of immunosuppression.

The lymphocyte profile of 521 HIV-infected subjects hospitalized at Jackson Memorial (2001-2002) was compared across main respiratory diseases. Study data included medical history and all laboratory evaluations performed during hospitalization. Community-acquired pneumonias (CAP, 52%), Pneumocystis jiroveci pneumonia (PCP, 24%), tuberculosis (TB, 9%) and non-tuberculous mycobacterial diseases (NTM, 12%) were the most frequent causes of admission. Patients hospitalized with PCP and NTM exhibited the lowest CD4 counts (P=0.003). PCP patients had the highest B-cell percentages (P=0.04). CAP patients had the highest CD8 and CD4 percentages and the lowest percentage of Natural Killer (NK) cells and viral burdens. TB patients exhibited the lowest NK-cell (11.4+/-6.3) and B-cell percentages (13.6+/-12) and the highest CD8 (59+/-14) percentage. NTM patients, in contrast, had the highest NK-cell percentages of the groups (19.1+/-11.6, P=0.01). Additionally, immune responses associated with respiratory pathogens differed in HIV-infected patients with CD4(+) cells above and below 200 counts.

Adult↗

PubMed2006

Solid-phase microextraction method for the determination of hexanal in hazelnuts as an indicator of the interaction of active packaging materials with food aroma compounds.

Fatty foods are susceptible to lipid oxidation resulting in deterioration of product quality due to the generation of off-flavours. Hexanal is a good indicator of rancidity. Therefore, a method based on solid-phase microextraction (SPME) coupled to gas chromatograph with flame ionization detection was developed to determine hexanal formation in hazelnuts during storage. Optimum conditions were as follows: carboxen-polydimethylsiloxane 75 microm fibre, extraction time 10 min, equilibrium time 10 min and equilibrium temperature 60 degrees C. The effect of oxygen scavengers on the oxidation process was also evaluated by measuring hexanal formation in hazelnuts stored with/without oxygen absorber sachets. Oxygen scavengers were shown to reduce oxidation; however, analysis of the sachet revealed that other volatile compounds from the headspace were also absorbed.

Aldehydes↗

PubMed2006

[MM1 variant of sporadic Creutzfeldt-Jakob disease with long duration akinetic mutism state].

INTRODUCTION: When patients present with a characteristic clinical picture of Creutzfeldt-Jakob disease (CJD) associated with positive 14-3-3 assay, periodic sharp wave complexes, high-signal of the striatum on magnetic resonance imaging, and homozygosis methionine (M) in codon 129, the median survival is 4 to 6 months. CLINICAL CASE: We report a 58-year-old woman with these typical features who survived 21 months, 19 of them in an akinetic mutism state. The autopsy confirmed the diagnosis of the most common CJD phenotype (MM1), usually associated with a shorter survival, and demyleinitation of the white matter (panencephalopathic form). CONCLUSIONS: The MM1 variant of CJD, with a rapidly progressive course leading into an akinetic mutism shortly after disease onset can be followed by a long akinetic mutism state. This profile is suggestive of panencephalopathic form and should be taken into account when counselling about survival.

Akinetic Mutism↗

PubMed2005

Hexacyanocobaltate(III) anions as precursors of Co(II)-Ni(II) cyano-bridged multidimensional assemblies: hydrothermal syntheses, crystal and powder X-ray structures, and magnetic properties.

Three novel cyanide-bridged heterobimetallic coordination polymers have been synthesized by hydrothermal routes, in superheated water solutions, by using K3[Co(CN)6], NiCl2.6H2O, and alpha-diimine ligands: [Ni(CN)4Co(phen)] (1; phen = 1,10-phenanthroline), [Ni(CN)4Co(2,2'-bipy)] (2; 2,2'-bipy = 2,2'-bipyiridine), and [Ni(CN)4Co(2,2'-bipy)2] (3). The isostructural compounds 1 and 2 contain a two-dimensional network with Co(II) centers octahedrally coordinated by one chelating 2,2'-bipy ligand and four cyanide groups of four distinct [Ni(CN)4]2-, through crystallographically equivalent, bridging units. Compound 3 contains one-dimensional zigzag chains in which the Co(II) ion is coordinated by two chelating 2,2'-bipy ligands and two cyanides from two different [Ni(CN)4]2- units cis to each other. These compounds have been fully characterized by single-crystal or unconventional powder X-ray diffraction analyses and variable-temperature magnetic measurements.

Journal Article↗

PubMed2005

Toxoplasma gondii: partial cross-protection among several strains of the parasite against congenital transmission in a rat model.

Rats were immunized with cysts of two Toxoplasma strains or with RH strain tachyzoites prior to pregnancy. The litters of the 13 rats that received homologous challenges with cysts during pregnancy, were all protected, whereas of 173 rats that received heterologous challenges with cysts or oocysts, only 21 protected their litters. 38.3 and 17% of rats immunized with the RH and with complete strains respectively, and 57% of control rats challenged with cysts, transmitted the infection congenitally. The percentages when similar groups were challenged with oocysts, were 33.3, 48.2, and 56.2%, respectively. Immunization with cysts did not completely protect against challenge with oocysts, even if the same strain was used. The divergence of these results from the complete protection against congenital toxoplasmosis observed in immune women and ewes, might be due to the use of excessive challenge doses in the model.

Animals↗

PubMed2005

Clinical characteristics and significance of Streptococcus salivarius bacteremia and Streptococcus bovis bacteremia: a prospective 16-year study.

The aim of this study was to determine the clinical significance of Streptococcus salivarius isolates recovered from blood cultures and compare them with isolates of Streptococcus bovis biotypes I and II. Seventeen of the 52 (32%) S. salivarius isolates recovered were considered clinically significant, compared with 62 of the 64 (97%) S. bovis isolates (p<0.0001). Bacteremia caused by S. salivarius occurred mostly in patients who showed relevant disruption of the mucous membranes and/or serious underlying diseases. Patients with S. salivarius bacteremia were younger than those with S. bovis bacteremia (57 vs. 67 years; p<0.01). Patients with S. salivarius bacteremia and patients with S. bovis II bacteremia had similar rates of endocarditis, colon tumors, and non-colon cancer. On the other hand, when compared with S. bovis I bacteremia, S. salivarius bacteremia was associated with lower rates of endocarditis (18% vs. 74%, respectively) (p<0.01) and colon tumors (0% vs. 57%, respectively) (p<0.005) and higher rates of non-colon cancer (53% vs. 9.5%, respectively) (p<0.01). Bacteremia caused by S. bovis II had a hepatobiliary origin in 50% of the patients, while, in contrast, that due to S. salivarius or S. bovis I was less frequently associated with a hepatobiliary origin (12% and 5%, respectively) (p<0.00001). The rate of penicillin resistance was 31% among S. salivarius isolates and 0% among S. bovis isolates (p<0.0001). In conclusion, the clinical characteristics of S. salivarius bacteremia and S. bovis II bacteremia are similar, and the isolation of S. salivarius in blood should not be systematically regarded as contamination.

Adult↗

PubMed2005

Treatment of postoperative pain for burn patients with intravenous analgesia in continuous perfusion using elastomeric infusors.

INTRODUCTION: Postoperative pain after surgery with patients suffering from burns tends to be moderate or severe, and its treatment requires a combination of high-strength analgesics (opioids) with others having different action mechanisms according to the concept of multimodal analgesia. AIMS: In this article we propose the use of continuous intravenous analgesia with morphine using elastomeric infusors at fixed dose for the treatment of this kind of pain. An evaluation is made of its analgesic efficacy, side effects and level of satisfaction. MATERIAL AND METHODS: A study was made of 17 burn patients operated on in our unit who received continuous intravenous analgesia during the postoperative period, with morphine at 1mg/h, using elastomeric infusors for a period of 24h. Its analgesic efficacy was analysed using the visual analogical scale (VAS) at different moments; side effects and the level of acceptance by the patient was also evaluated. RESULTS: The results confirm a good analgesic effect after 2h from starting perfusion (VAS < 3). The side effects reveal a similar or lesser incidence to the use of morphine in bolus or using the PCA system, and in no cases did they require treatment to be halted. The level of acceptance of the procedure by patients was good. CONCLUSION: This method reveals a high level of analgesic efficacy in the postoperative period with burn patients in this study. However, it is important to note the lower results obtained in the first hours of perfusion, and proposing a heavy initial dose of analgesics when starting perfusion. This is presented as an efficient analgesic method that is easy to apply, has a low cost, and the possibility of extending its indications to ambulatory treatment.

Adolescent↗

PubMed2005

New techniques for imaging, digitization and analysis of three-dimensional neural morphology on multiple scales.

Cognitive impairment in normal aging and neurodegenerative diseases is accompanied by altered morphologies on multiple scales. Understanding of the role of these structural changes in producing functional deficits in brain aging and neuropsychiatric disorders requires accurate three-dimensional representations of neuronal morphology, and realistic biophysical modeling that can directly relate structural changes to altered neuronal firing patterns. To date however, tools capable of resolving, digitizing and analyzing neuronal morphology on both local and global scales, and with sufficient throughput and automation, have been lacking. The precision of existing image analysis-based morphometric tools is restricted at the finest scales, where resolution of fine dendritic features and spine geometry is limited by the skeletonization methods used, and by quantization errors arising from insufficient imaging resolution. We are developing techniques for imaging, reconstruction and analysis of neuronal morphology that capture both local and global structural variation. To minimize quantization error and evaluate more precisely the fine geometry of dendrites and spines, we introduce a new shape analysis technique, the Rayburst sampling algorithm that uses the original grayscale data rather than the segmented images for precise, continuous radius estimation, and multidirectional radius sampling to represent non-circular branch cross-sections and anisotropic structures such as dendritic spine heads, with greater accuracy. We apply the Rayburst technique to 3D neuronal shape analysis at different scales. We reconstruct and digitize entire neurons from stacks of laser-scanning microscopy images, as well as globally complex structures such as multineuron networks and microvascular networks. We also introduce imaging techniques necessary to recover detailed information on three-dimensional mass distribution and surface roughness of amyloid beta plaques from human Alzheimer's disease patients and from the Tg2576 mouse that expresses the "Swedish" mutation of the amyloid precursor protein. By providing true three-dimensional morphometry of complex histologic structures on multiple scales, the tools described in this report will enable multiscale biophysical modeling studies capable of testing potential mechanisms by which altered dendritic structure, spine geometry and network branching patterns that occur in normal aging and in many brain disorders, determine deficits of functions such as working memory and cognition.

Aged↗

PubMed2005

Influence of ganciclovir prophylaxis on citomegalovirus, human herpesvirus 6, and human herpesvirus 7 viremia in renal transplant recipients.

In order to know the influence of ganciclovir (GCV) prophylaxis on cytomegalovirus (CMV) human herpesvirus (HHV)-6 and HHV-7 replication in renal transplant recipients, three groups were studies: 54 patients without GCV; 29, with short-term GCV prophylaxis (less than 30 days); and 51, with long-term GCV prophylaxis (more than 60 days). CMV viremia was more prevalent in the first group (74%, 55%, and 29%, respectively), but CMV replication was also found in 14 patients during therapy, in the other two groups. The antiviral did not affect the prevalence of HHV-6 (67.2%) or HHV-7 (76%), but HHV-6 viremia appeared later (42 +/- 31 vs 21 +/- 25/38 +/- 29 days posttransplant) and was shorter (29 +/- 30 vs 62 +/- 34/41 +/- 33 days) among patients with long-term GCV prophylaxis. On the other hand, CMV viremia was longer when HHV-6 replication was present (40 +/- 25 days vs 18 +/- 16 days). In addition, HHV-7 DNA was detected in all patients with CMV disease.

Antiviral Agents↗

PubMed2005

Nonesophageal side-effects after antireflux surgery plus acid-suppression duodenal diversion surgery in patients with long-segment Barrett's esophagus*.

SUMMARY: During the last years we have employed acid-suppression duodenal diversion procedures (truncal vagotomy-partial gastrectomy plus Roux-en-Y gastrojejunostomy) in addition to antireflux surgery in order to treat all the pathophysiological factors involved in the genesis of Barrett's esophagus. We have observed very good results concerning the clinical and objective control of GERD at the long-term follow up after this procedure. However, it could be associated with other nonesophageal symptoms or side-effects. This study was conducted to evaluate the presence of gastrointestinal symptoms (diarrhea, vomiting, dumping, weight loss and anastomotic ulcers) after this operation. In this prospective study 73 patients were assessed using a careful clinical questionnaire asking regarding these complications at the early (< 6 months) and late (> 6 months) follow-up (average of 32.4 months). In the early postoperative period, diarrhea was present in 64% (19% considered severe 10-90 days after surgery), dumping in 41% and loss of weight in 71% of cases. Diarrhea occurred daily in 47.7% in the early postoperative period, but only in 16% of cases after 1 year. Shortly after surgery, steatorrea was observed in 9% of cases and responded well to medical treatment. Severe diarrhea or dumping was rare (5% of cases). These symptoms improved significantly after 1 year with medical management (45%, 20% and 30%, respectively) and 42% of patients regained their normal body weight. Only two patients presented anastomotic ulcers and were treated satisfactory with proton pump inhibitors. Revisional surgery was indicated in two patients with severe dumping syndrome. Most side-effects identified by this study were mild and diminished 1 year after operation.

Adult↗

PubMed2005

The influence of cellular seeding density in the microencapsulation of hybridoma cells.

The aim of this study was to assess the influence of different seeding densities on the function of hybridoma cells (clone 1B5, IgG 2alpha) producing an anti-angiogenic monoclonal antibody (mAb), microencapsulated using a high-voltage electrostatic field. Viable cells were microencapsulated in alginate/poly-L-lysine/alginate (APA) capsules and maintained in tissue culture. Cellular growth rates, production and release of mAb from the capsules were assessed. This study shows that hybridoma cells survive, proliferate and remain functionally competent for over one month in vitro after microencapsulation in APA capsules generated in an electrostatic field. However, the cell seeding density had to be at least 10(7) cells/ml for the microencapsulated cells to be viable and to produce and release mAb through the capsule membrane. The maximum monoclonal antibody concentration in this culture was 29.1 microg/ml by day 17, with a tendency to increase, but capsule breakage impeded the follow-up of this determination.

Alginates↗

PubMed2005

Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial.

We hypothesized that the six-monthly application of silver diamine fluoride (SDF) can arrest the development of caries in the deciduous dentition of six-year-old schoolchildren and prevent caries in their first permanent molars. A prospective controlled clinical trial was conducted on the efficacy of a 38% SDF solution for caries reduction. Four hundred and twenty-five six-year-old children were divided into two groups: One group received SDF solution in primary canines and molars and first permanent molars every 6 mos for 36 mos. The second group served as controls. The 36-month follow-up was completed by 373 children. The mean number of new decayed surfaces appearing in primary teeth during the study was 0.29 in the SDF group vs. 1.43 in controls. The mean of new decayed surfaces in first permanent molars was 0.37 in the SDF group vs. 1.06 in controls. The SDF solution was found to be effective for caries reduction in primary teeth and first permanent molars in schoolchildren.

Cariostatic Agents↗