Biomedical subjects

A Valverde

Publications and source records attributed to A Valverde.

At least 19 recordsLinked to original sources

PubMed2003

[Spontaneous splenic rupture: report of three new cases and review of the literature].

This study reports 3 new cases of spontaneous (or atraumatic) splenic rupture of the spleen, including two with massive hemoperitoneum and one with a secondary rupture of splenic infarct, and reviews the literature about this rare disease. These spontaneous ruptures are rare and potentially fatal. They result from infectious diseases (mainly mononucleosis and and paludism) and hematological diseases (mainly malignant hemopathies) in more than 50% of cases. Mortality is close to 20%, and includes some deaths occurring before diagnosis was established and postoperatives deaths, which can result from delayed management and bad general condition of the patients. Splenectomy is usually mandatory. Non-surgical treatment can be indicated only in young and stable patients.

Diagnosis, Differential↗

PubMed2002

[Effect of different observers on the interpretation of pulmonary perfusion scintigraphy].

AIM: The agreement in the interpretation of the scintigraphic images of pulmonary perfusion in the diagnosis of pulmonary tromboembolism (TEP) is not always the most adequate. The purpose of this study was to evaluate the degree of agreement by eight observers in the interpretation of these studies. MATERIAL AND METHODS: The study population consisted of 180 studies with clinically suspected pulmonary embolism referred to our department for scintigraphic perfusion imaging from April 98 to September 99. The patients received an intravenous injection of 111-148 MBq (3-4 mCi) of 99mTc-macroaggregated albumin whereas the images were obtained in the six routine projections. The observers consisted of five nuclear medicine physicians and three residents who independently reviewed the scintigrams (low, intermediate and high probability). In a second step, the physicians performed consensus interpretations. The Kappa statistics was used to evaluate the degree of agreement between individual observer interpretations beyond that expected by chance alone. RESULTS: The mean value SEM for Kappa index was 0.58 0.02, with maximum and minimum values of 0.76 and 0.27 respectively. The interobserver variability was greater than expected. Except in two observers scans in the interpretation of images in the low and high categories showed minor discrepancies, whereas scans in intermediate probability showed the most important interobserver variations. CONCLUSION: The study manifests the importance of a uniform criteria in lung scintigraphic interpretation.

Humans↗

PubMed2001

A two primers random amplified polymorphic DNA procedure to obtain polymerase chain reaction fingerprints of bacterial species.

Polymerase chain reation (PCR) fingerprints are used to characterize and recognize bacteria and are generally obtained using universal primers that generate an array of DNA amplicons, which can be separated by electrophoresis. Universal primers 8F and 1491 R have been used to amplify specifically 16S rDNA. We have used these primers at an annealing temperature of 50 degrees C. Agarose gel electrophoresis of PCR products revealed several bands. The band pattern of each bacterial species was different and the strains belonging to the same species shared an identical pattern. The patterns obtained did not show variations with plasmid DNA content or the growth stage of the bacteria. The peculiarity of the randomly amplified polymorphic DNA (RAPD) described in this work lies in the use of two large primers (proximately 20 nt) to obtain the pattern, since normally a only smaller primer is used, and in the new application for the primers used to amplify 16S rDNA. This new procedure, called two primers (TP)-RAPD fingerprinting, is thus rapid, sensitive, reliable, highly reproducible and suitable for experiments with a large number of microorganisms, and can be applied to bacterial taxonomy, ecological studies and for the detection of new bacterial species.

Bacteria↗

PubMed2001

Early EUS of the bile duct before endoscopic sphincterotomy for acute biliary pancreatitis.

BACKGROUND: Endoscopic sphincterotomy can benefit patients with suspected biliary pancreatitis, although there are procedure-related complications. EUS can be used to select patients for endoscopic sphincterotomy. The results of this strategy were assessed. METHODS: Information on patients referred for EUS were recorded in a database. One hundred twenty-three patients with suspected biliary pancreatitis (57 men, 66 women; median age 55 years) were included and followed. All underwent EUS followed by endoscopic sphincterotomy during the same procedure if choledocholithiasis was identified. Outcomes were studied in relation to the initial severity of biliary pancreatitis (Ranson and Balthazar scores), presence of stones, and time span between onset of biliary pancreatitis and EUS plus endoscopic sphincterotomy. RESULTS: Thirty-five patients (28%) had a Ranson score greater than 3 on admission and 38 (31%) were Balthazar D-E. The median time from admission to EUS was 3 days. EUS imaging of the bile duct was complete in all but 3 patients. Thirty-three patients (27%) had choledocholithiasis on EUS and underwent endoscopic sphincterotomy. Stones were more frequent in patients with jaundice (p < 0.005) and when EUS was performed less than 3 days after admission (p < 0.05). One hundred patients (81%) recovered without complication. Two patients (1.6%) died, 1 had recurrent BP develop, 6 (5%) had further biliary symptoms, and 16 (13%) had complications of pancreatitis develop (9 pseudocysts). There were 3 mild endoscopic sphincterotomy-related complications (complication rate 6.5%). CONCLUSIONS: In this series in which endoscopic sphincterotomy was performed selectively depending on the endosonographic presence or absence of ductal stones early in the course of the pancreatitis, and not according to its predicted severity, mortality and complications of endoscopic sphincterotomy were low and unrelated to the predicted severity of biliary pancreatitis or the presence of choledocholithiasis. Controlled trials are needed to confirm the superiority of this strategy compared with ERCP alone for the management of biliary pancreatitis.

Adolescent↗

PubMed2001

In vitro activities of 10 antifungal drugs against 508 dermatophyte strains.

We have tested 508 strains belonging to 24 species of dermatophytes against 10 antifungal drugs following mainly the NCCLS (M38-P) standard for filamentous fungi. However, several important factors, such as the temperature (28 versus 35 degrees C) and time of incubation (4 to 10 days versus 21 to 74 h), have been modified. The antifungals used were itraconazole, ketoconazole, miconazole, clotrimazole, voriconazole, terbinafine, amphotericin B, fluconazole, UR-9825, and G-1. In general, with the exception of fluconazole and G-1, all antifungals were shown to be highly effective.

Antifungal Agents↗

PubMed2000

Influence of heat treatment of casein in presence of reducing sugars on Zn solubility and Zn uptake by Caco-2 cells after in vitro digestion.

The effect of the heat treatment of casein in presence of reducing sugars on some aspects of Zn availability was investigated. Samples were prepared by mixing casein with glucose-fructose, and were used unprocessed (C) or heated (HC). Changes in Zn speciation after the in vitro digestion of the samples, both as part of a diet and in isolation, were studied. The uptake of soluble Zn from the digested samples was investigated in Caco-2 cells. After in vitro digestion, the percentage of precipitated Zn was significantly higher with the HC sample, both when digested alone and as a part of the diet. In assays with Caco-2 cells, a significant decrease in Zn uptake was observed when the uptake buffer contained the sample C digest, by comparison with the control buffer, without casein digest. When the digested heated mixture was added, Zn uptake by the cells was significantly lower than in either of the two other cases. It may be concluded that the heat treatment of casein in the presence of glucose-fructose has a negative effect on Zn availability because, after in vitro digestion, Zn insolubilization was enhanced and Zn uptake by the enterocyte was impaired, compared with the unheated mixture. In addition, the usefulness of Caco-2 cells in this kind of research has been shown.

Caco-2 Cells↗

PubMed2000

[Susceptibility to fluconazole and itraconazole in isolates of Candida spp. from HIV-positive and HIV-negative patients].

We studied the possible differences in the pattern of susceptibility to fluconazole and itraconazole in 393 isolates of Candida spp. from the oral cavity of HIV-positive patients and 102 isolates from HIV-negative patients with candidemia or candiduria. We used the broth microdilution method according to the NCCLS guidelines. We observed a decrease in the susceptibility to fluconazole in the group of HIV-positive patients in comparison to those who were HIV negative, especially in Candida albicans (MIC(90) 32 mg/l vs. 1 mg/l and Candida glabrata (MIC(90) 64 mg/l vs. 16 mg/l). Furthermore, we did not find any resistant strains in the HIV-negative group. For itraconazole, the MIC(90) was two dilutions greater in the HIV-positive patients, except for C. albicans, which had a much higher MIC(90) (4 mg/l vs. 0.12 mg/.). Therefore, the decrease in the susceptibility of Candida spp. in the HIV-positive patients must be taken into account when establishing a specific antifungal therapy.

Antifungal Agents↗

PubMed2000

[Susceptibility to fluconazole and itraconazole in isolates of Candida spp. from HIV-positive and HIV-negative patients]

Journal Article↗

PubMed2000

[Incidence of genitourinary infection caused by Chlamydia trachomatis in a STD center calculated by direct antigen detection].

OBJECTIVE: Chlamydia trachomatis is one of the most common sexually transmitted agents which causes a wide spectrum of diseases including urethritis in men and endocervicitis in women. We analyzed patients with genitourinary C. trachomatis infections evaluating risk factors and the association with other sexually transmitted infections. MATERIAL AND METHODS: We processed 1,180 specimens from 913 patients (772 women and 141 men), attended at a Sexually Transmitted Diseases (STD) Center. The diagnostic of C. trachomatis infection was made by an enzyme-linked fluorescent immunoassay, Vidas Chlamydia test (bioMérieux). RESULTS: The incidence of C. trachomatis infection was 4.8% (57 cases) and was higher in women (70.1%) than in men (29.8%). The risk groups observed were: 26 prostitute, 7 contact with prostitute or risk partner, 5 homosexual, 5 promiscuous heterosexual and 14 without risk groups. Associated with this infection we observed other: 10 bacterial vaginosis, 8 Papillomavirus infection, 3 Trichomonas vaginalis infections, 2 Neisseria gonorrhoeae infections and 2 Candidiasis. The 53.4% of these patients didn't have any symptomatology at the consult moment. CONCLUSIONS: The control of patients with risk factors is important for the diagnostic of C. trachomatis and other sexually transmitted infections, because most of them were prostitutes and asymptomatic. Within men, homosexuality, contact with prostitute or risk partner were the practices with higher risk.

Antigens, Bacterial↗

PubMed1999

Senna vs polyethylene glycol for mechanical preparation the evening before elective colonic or rectal resection: a multicenter controlled trial. French Association for Surgical Research.

HYPOTHESIS: Senna is more efficient than polyethylene glycol as mechanical preparation before elective colorectal surgery. DESIGN: Prospective, randomized, single-blind study. SETTING: Multicenter study (18 centers). PATIENTS: Five hundred twenty-three consecutive patients with colonic or rectal carcinoma or sigmoid diverticular disease, undergoing elective colonic or rectal resection followed by immediate anastomosis. INTERVENTION: Two hundred sixty-two patients were randomly allotted to receive senna (1 package diluted in a glass of water) and 261 to receive polyethylene glycol (2 packages diluted in 2-3 L of water), administered the evening before surgery. All patients received 5% povidone iodine antiseptic enemas (2 L) the evening and the morning before surgery. Ceftriaxone sodium and metronidazole were given intravenously at anesthetic induction. MAIN OUTCOME MEASURES: Degree of colonic and rectal cleanliness. RESULTS: Colonic cleanliness was better (P=.006), fecal matter in the colonic lumen was less fluid (P=.001), and the risk for moderate or large intraoperative fecal soiling was lower (P=.11) with senna. Overall, clinical tolerance did not differ significantly between groups, but 20 patients receiving polyethylene glycol (vs 16 with senna) had to interrupt their preparation, and 15 patients (vs 8 with senna) complained of abdominal distension. Senna, however, was better tolerated (P = .03) in the presence of stenosis. There was no statistically significant difference found in the number of patients with postoperative infective complications (14.7% vs 17.7%) or anastomotic leakage (5.3% vs 5.7%) with senna and polyethylene glycol, respectively. CONCLUSION: Mechanical preparation before colonic or rectal resection with senna is better and easier than with polyethylene glycol and should be proposed in patients undergoing colonic or rectal resection, especially patients with stenosis.

Adult↗

PubMed1999

Resection of intrahepatic cholangiocarcinoma: a Western experience.

We analyzed the results of an aggressive surgical approach to intrahepatic cholangiocarcinoma. Between 1990 and 1997, 30 of 42 patients with intrahepatic cholangiocarcinoma underwent resection with curative intent. Mean tumor size was 10 +/- 5 cm, and the tumors were classified as TNM type III, IVa, and IVb in 63%, 34%, and 3% of the patients, respectively. All patients underwent hepaticoduodenal lymphadenectomy. Fifteen patients received adjuvant radio- and chemotherapy. The overall survival rates at 1, 2, and 3 years were 86%, 63%, and 22%, respectively, and the median survival time was 28 months. Tumor recurrence was the main cause of death. Three patients survived for more than 5 years, including 2 patients with no evidence of recurrence. Factors influencing survival were: presence of satellite nodules (P = 0.007) and lymph node invasion (P = 0.05). The width of the resection margin and the use of an adjuvant therapy had no impact on survival. Complete surgical resection may offer a chance for long-term survival in selected patients and may improve the quality of life of patients with more advanced disease.

Adult↗

PubMed1999

Is there a role of preservation of the spleen in distal pancreatectomy?

BACKGROUND: The spleen may be preserved during distal pancreatectomy (DP) for benign disease. The aim of this retrospective study was to compare the postoperative course of DP with or without splenectomy. STUDY DESIGN: From June 1992 to June 1997, 40 adult patients without chronic pancreatitis underwent elective DP for benign lesions. Fifteen underwent spleen-preserving DP (Conservative Group) and 25 DP with splenectomy (Splenectomy Group). In spleen-preserving DP, we attempted to preserve the splenic artery and vein. RESULTS: Spleen-preserving DP was successfully performed in all 15 cases. Patient groups were comparable for clinical features, indication for DP, and surgical procedure. There were no postoperative deaths. The overall incidence of pancreatic fistula was 23%, but was significantly higher in the Conservative Group (40%) than in the Splenectomy Group (12%; p < 0.05). Subphrenic abscesses were more frequently observed in the Conservative Group than in the Splenectomy Group (p < 0.05). The mean duration of postoperative hospital stay was 19 days (range 6 to 46 days) in the Conservative Group and 12.5 days (range 7 to 45 days) in the Splenectomy Group (p < 0.05). At the end of mean followup of 30 months (range 8 to 40 months), no severe postsplenectomy sepsis was observed in the Splenectomy Group. CONCLUSIONS: In our experience, DP with splenectomy has a lower morbidity rate and we consider it to be the best procedure for benign pancreatic disease.

Adult↗

PubMed1999

In-vitro activity of voriconazole (UK-109,496), LY303366 and other antifungal agents against oral Candida spp. isolates from HIV-infected patients.

In this report we compare the activity of two new antifungal agents, voriconazole (UK-109,496) and LY303366 with the activities of other antifungals including fluconazole, itraconazole, 5-fluorocytosine (5FC) and amphotericin B against 219 oral Candida spp. isolates from HIV-infected patients. We used the broth microdilution method following the guidelines of the NCCLS. The in-vitro activity of voriconazole (UK-109,496) (MIC(90) 0.12 mg/L) and LY303366 (CMI(90) 0.25 mg/L) against clinical isolates of Candida spp. was excellent and comparable with that of amphotericin B (MIC(90) 0.5 mg/L), and better than those of fluconazole (MIC(90) > or = 64 mg/L), itraconazole (MIC(90) 4 mg/L) and 5FC (MIC(90) 1 mg/L).

AIDS-Related Opportunistic Infections↗

PubMed1999

[Mediastinal and cervical diffusion of necrosis infiltration in acute pancreatitis].

Thoracic complications of acute pancreatitis are mainly caused by the rupture of the main pancreatic duct leading to the diffusion of pancreatic juice into the mediastinum. Occasionally, esophagus or respiratory tract may also be involved. We report here the case of a 51-year-old man with acute alcohol-related pancreatitis who developed mediastinal and cervical infiltration through a wirsungo-mediastinal fistula caused by the leak of the main pancreatic duct which was successfully treated by splenopancreatectomy.

Humans↗

PubMed1998

Evaluation of the new API Candida system for identification of the most clinically important yeast species.

The API Candida system (bioMérieux) a new yeast identification system, was evaluated for its reliability in identifying 198 clinical yeast isolates in comparison with the API 20C system (bioMérieux) that was used as reference standard. The API Candida system correctly identified 91.4% and 71.7% of the isolates, with and without additional tests, respectively. The API Candida system identified 96.3% of common isolates studied, and 66.6% of uncommon isolates. We think that API Candida system is an easy and good yeast identification system and it could be used in a routine clinical microbiology laboratory.

Candida albicans↗

PubMed1998

[Activity of trovafloxacin and ten other antimicrobials against gram negative anaerobic bacilli].

As an increase in anaerobes resistant to a great variety of antimicrobials have been seen in the last few years, a search for new agents with activity against these microorganisms is needed. One of these agents is trovafloxacin. In our study, all strains were susceptible to imipenem, metronidazole, chloramphenicol and piperacillin/tazobactam. A total of 97% of the strains were inhibited with 2 mg/ml of trovafloxacin. The microorganisms Bacteroides fragilis and B. uniformis showed the least susceptibility against the antimicrobials studied, with a MIC90 for trovafloxacin of 1 and 2 mg/ml, respectively. Fusobacterium spp. were the most susceptible, with an MIC90 for trovafloxacin of 0.5 mg/ml. Trovafloxacin showed good activity against Gram-negative anaerobe rods, and could therefore be considered as an alternative in the treatment of the infections produced by these microorganisms.

Anti-Infective Agents↗

PubMed1997

Estrogenic effects of p-hydroxybenzoic acid in CD1 mice.

Xenobiotic estrogens in the environment or diet have received much attention as a possible source of certain hormonal disease states in human and wildlife. Therefore, the detection of estrogenic activity of any substance, especially those related to the food industry, is important. The estrogenic activity of p-hydroxybenzoic acid (PHBA), a compound related to a commonly used group of preservatives in food, cosmetic, and pharmaceutical preparations, was evaluated with immature and adult ovariectomized female mice (CD1) using two well-known bioassays. Subcutaneous administrations (s.c.) of different doses of PHBA were compared with estradiol (E2), and their effects on vaginal cornification and uterotrophic activities were evaluated. Different groups of animals were treated s.c. daily for 3 days with vehicle (corn oil, 0.3 ml/100 g), E2 (1 microgram/100 g), and PHBA (0.5, 5, 50, and 500 micrograms/100 g). Four days after treatment, PHBA produced a dose-dependent response on vaginal cornification and uterotrophic activity in both immature and adult ovariectomized mice. The relative uterotrophic potency of PHBA (500 micrograms/100 g) to E2 (1 microgram/100 g) was 0.0011 in immature mice and 0.0018 in ovariectomized animals.

Animals↗

PubMed1997

Effect of age on the exocrine pancreatic secretion of the preruminant milk-fed goat.

The effect of age on the exocrine pancreatic function was studied in fifteen Granadina goat kids during the second, third and fourth postnatal week. The animals, chronically catheterized, were bottle-fed on goat milk twice a day. Pure pancreatic juice was collected from 1 hour before and throughout 8 hours after milk ingestion. Pancreatic flow rate, bicarbonate and chloride concentrations, total protein content and enzyme activities were determined. In resting conditions, pancreatic flow rate augmented with age, probably reflecting an increase in body and pancreas weight. Resting amylase and lipase activities recorded significant increases during the fourth week of life. That may be associated, respectively, to the immediate change to a high-starch diet and to a simultaneous decrease in the salivary lipase levels. Our results also showed age-related differences after ingestion of milk, mainly concerning the volume response and the lipase output. The latter can be explained in the same way as regarding resting conditions. With respect to the volume response, several factors could be implicated, such as the circulating levels of gastrointestinal hormones, the sensitivity of the pancreas to such stimuli, the maturation degree in the secretory mechanisms of the gland or the development of the digestive tract.

Aging↗