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Biomedical subjects

Beatriz González

Publications and source records attributed to Beatriz González.

At least 19 recordsLinked to original sources
PubMed2006

Production in Escherichia coli of a recombinant C-terminal truncated precursor of surfactant protein B (rproSP-B Delta C). Structure and interaction with lipid interfaces.

SP-B, a protein absolutely required to maintain the lungs open after birth, is synthesized in the pneumocytes as a precursor containing C-terminal and N-terminal domains flanking the mature sequence. These flanking-domains are cleaved to produce mature SP-B, coupled with its assembly into pulmonary surfactant lipid-protein complexes. In the present work we have optimized over-expression in Escherichia coli and purification of rproSP-B(DeltaC), a recombinant form of human proSP-B lacking the C-terminal flanking peptide, which is still competent to restore SP-B function in vivo. rProSP-B(DeltaC) has been solubilized, purified and refolded from bacterial inclusion bodies in amounts of about 4 mg per L of culture. Electrophoretic mobility, immunoreactivity, N-terminal sequencing and peptide fingerprinting all confirmed that the purified protein had the expected mass and sequence. Once refolded, the protein was soluble in aqueous buffers. Circular dichroism and fluorescence emission spectra of bacterial rproSP-B(DeltaC) indicated that the protein is properly folded, showing around 32% alpha-helix and a mainly hydrophobic environment of its tryptophan residues. Presence of zwitterionic or anionic phospholipids vesicles caused changes in the fluorescence emission properties of rproSP-B(DeltaC) that were indicative of lipid-protein interaction. The association of this SP-B precursor with membranes suggests an intrinsic amphipathic character of the protein, which spontaneously adsorbs at air-liquid interfaces either in the absence or in the presence of phospholipids. The analysis of the structure and properties of recombinant proSP-B(DeltaC) in surfactant-relevant environments will open new perspectives on the investigation of the mechanisms of lipid and protein assembly in surfactant complexes.

Amino Acid Sequence↗
PubMed2006

[Use of betablockers in elderly patients with congestive heart failure].

BACKGROUND AND OBJECTIVE: Few studies of betablockers (BB) have been performed specifically in older patients with congestive heart failure (CHF). We evaluated the characteristics of elderly patients with CHF treated with BB. Moreover, we assessed whether BB are associated with a better outcome in them. PATIENTS AND METHOD: We evaluated clinical and functional characteristics of patients aged > or = 75 years with CHF treated with or without BB, with special interest being paid in the mortality. RESULTS: 47 out of 107 patients were treated with BB. Only in 3 it was necessary to withdraw BB. Patients treated with no BB were older, with a higher New York Heart Association (NYHA) class, more prevalent chronic obstructive pulmonary disease (COPD) and in poorer functional situation. In patients treated with BB, ischemic heart disease was more prevalent. Reasons for "no treatment with BB" were severe aortic stenosis (n = 2), severe mitral regurgitation (n = 9), asthma-COPD (n = 28), arterial disease (n = 16) and fragility (n = 9). 25% of the patients on BB reached the target dose. One-year mortality (5.7% vs 27.6%) and 2-year mortality (20.68% vs 60%) were both significantly lower (p = 0.01 and p = 0.002, respectively) in patients on BB. CONCLUSIONS: 44% of our elderly patients with CHF received BB with good tolerance. Patients treated with BB were younger, with more ischemic heart disease, better NYHA class, less functional deterioration and without COPD. One-year and two-year mortality in patients who can receive BB were lower.

Adrenergic beta-Antagonists↗
PubMed2006

[Use of the European Heart Failure Self-care Behaviour Scale (EHFScBS) in a heart failure unit in Spain].

Self-care is important for patients with heart failure. Recently, the European Heart Failure Self-care Behaviour Scale was developed for its assessment. We evaluated 335 patients using the Spanish version of the scale and assessed whether self-care was influenced by sex, age, etiology, or follow-up duration at a heart failure unit. Possible scores on the scale range from 12 to 60, with a low score indicating good self-care. We observed a mean (SD) score of 24.2 (7.7). There was no significant correlation between the score attained and the value of any of the parameters analyzed, except for follow-up duration at the unit (r=-0.37; P<.001). The score was 28.1 (1.9) in patients evaluated at first visit, 23.1 (6.1) at three months, 24.1 (6.6) at six months, 23.3 (8.2) at nine months, 22.8 (7.3) at twelve months and finally 20.0 (5.5) in patients evaluated fifteen months after their first visit.

Adult↗
PubMed2006

Equity in children's utilization of dental services: effect of a children's dental care programme.

OBJECTIVES: To evaluate the long term impact on fairness of children's dental care programmes. METHODS: Data were taken from the Health Module of the Spanish Disability Interview Survey in 1999 (n=8,049). The probability of visit to a dentist and the number of visits are estimated with binary logistic models and count data models in order to compare the regions with consolidated dental care programmes, PADI regions, with the rest of Spanish regions. The effects of family income, residential status and living in small village settings on dental care access for both regions are investigated and compared. RESULTS: The scope of the dental care programme (PADI) makes a very significant difference. Regions with consolidated PADI are by far more equitable than the rest. Once the other explanatory factors have been controlled, the percentage of users is by far larger in PADI regions, odds ratio 3.47 (95% CI 2.38 to 5.07). In PADI regions family income doesn't have any significance in the probability of visits to the dentist, odds ratio 1.9 (95% confidence interval 0.92 to 1.81). In non PADI regions poorer families have less probability of visiting a dentist, odds ratio 1.68 (95% CI 1.50 to 1.88). In addition, in each region, inequalities discriminating against those children that live in small villages cannot be found in PADI regions. CONCLUSIONS: PADI regions have more equity in access to dental care. The PADI programme managed to drop any income base discrimination in access and succeeded in equalizing access in small villages and in urban areas. The use of dental services is very unequal among the population. Public dental care programmes for children equalize utilization and strongly contribute to improving children's oral health.

Adolescent↗
PubMed2005

[Prognostic significance of diabetes in a heart failure population: one year mortality and heart failure related hospital admission].

BACKGROUND AND OBJECTIVE: The relationship between diabetes mellitus and heart failure is not fully established. The aim of the study was to assess the prevalence of diabetes and its prognostic significance, considering mortality and the need of hospital admission due to heart failure during the first year of follow-up, in an outpatient population with heart failure attended in a specialized Unit. PATIENTS AND METHOD: We studied 362 patients -73% men; mean age (standard deviation) 65.3 (10.9) years-. Mean ejection fraction was 32.2% (12.7%). Patients were in New York Heart Association functional class I (5%), II (47%), III (43%) and IV (5%). RESULTS: One-hundred forty-three out of 362 patients were diabetic (39.5%). Thirty patients (8%) died and 70 (19%) needed to be hospitalized due to heart failure during the first year of follow-up. One year mortality was 5% in non-diabetic patients and 13.3% in diabetic patients (p = 0.005). 13.2% of non-diabetic patients suffered at least one episode of heart failure needing hospital admission, whereas 28.7% of diabetic patients needed to be hospitalized at least once (p < 0.001). In the multivariate regression analysis, diabetes remained statistically associated both with mortality and with the need of heart failure related hospital admission. CONCLUSIONS: Diabetes significantly correlated with a higher one year mortality as well as with a greater need of hospital admission due to heart failure. Prevalence of diabetes in a general population with heart failure was high.

Aged↗
PubMed2005

Patient's education by nurse: what we really do achieve?

AIM: To evaluate what is really achieved with nurse education in an outpatient heart failure population. METHOD: The answers obtained in a nurse questionnaire performed at the first visit to the Unit and at 1 year of follow-up were compared. The questionnaire was addressed to know how compliant patients were and how much they knew about their disease and their treatment. RESULTS: Two hundred and ninety eight patients (219 men and 79 women) were evaluated. Baseline mean age was 65 years (35-86). At first visit only 30% knew and understood the performance of the heart; 56% at 1 year (p<0.001). Only 28% initially understood the disease; 55% at follow-up (p<0.001). Awareness of more than 3 worsening signs increased from 66.5% to 86.5% (p<0.001). Knowledge of the names of all the pills they were receiving increased from 33% to 44% (p<0.001), of the action of these pills from 24% to 44% (p<0.001), and of how to use nitroglycerine among patients with ischemic heart disease from 87% to 96% (p<0.001). Initially 63% monitored their weight only at the medical visit and 21% monitored it at least once a week; at 1 year these percentages were 16% and 39% respectively (p<0.001). At baseline 45% checked blood pressure only at the medical visit and 28.5% checked it at least once a week; at 1 year these percentages were 12% and 43% (p<0.001). Whereas no significant differences were found in sodium restricted diet compliance, exercise performance increased slightly although statistically significantly (p=0.01). The great majority of patients never or only very rarely smoked or drunk alcoholic beverages, both at first visit and at 1 year, although both habits increased slightly during follow-up. No significant differences in treatment compliance (92% vs. 88% were taking all the medications prescribed) were found. CONCLUSION: Nurse-guided education has changed self-care behaviour of patients with heart failure in several important aspects, as weight and blood monitoring, and has increased their knowledge and understanding of the disease and treatment. However, these improvements have not been reflected in a better compliance of treatment and sodium restricted diet. Such aspects need more and more work to obtain better results.

Adult↗
PubMed2005

Sex and age differences in fragility in a heart failure population.

BACKGROUND: Heart failure (HF) patients have a high degree of fragility and dependence from physical, cognitive and psychological points of view, and are a mainly geriatric population. AIM: To detect the existence of fragility in all patients treated in a Heart Failure Unit and to evaluate age and sex differences. METHODS: All patients underwent a basic geriatric evaluation to detect possible loss of autonomy for doing basic and instrumental activities, cognitive deterioration, emotional disturbance or social risk. RESULTS: Three hundred sixty patients (mean age 65.2 years, 41.7% > or = 70 years, 27.5% women) were evaluated. Fragility was detected in 41.7% of patients, being more prevalent in patients > or = 70 years (p<0.001) and in women (p<0.001). A Barthel Index < 90 was found in 22.5% of patients and an anomalous OARS Scale was found in 18.3%. Pfeiffer test's score was abnormal in 7.8% of patients. A positive depression response in abbreviate GDS was observed in 29.7%. All items analysed were more prevalent in patients > or = 70 years and in women, with the unexpected exception of depression symptoms that were as prevalent in younger as in older patients. CONCLUSION: Fragility is common in patients with heart failure, even in younger patients, and can be detected easily using standardised geriatric scales. Prevalence of fragility was significantly higher in older patients and in women, although the presence of depression symptoms was as prevalent in younger as in older patients.

Adult↗
PubMed2005

[Prognostic significance of hemoglobin levels in patients with heart failure].

INTRODUCTION AND OBJECTIVES: To evaluate the prognostic significance of hemoglobin (Hb) levels in terms of 1-year mortality and hospital admissions due to heart failure (HF) during the first year of follow-up after the first visit to an outpatient HF unit. PATIENTS AND METHOD: Survival status and HF-related hospital admission rate at 1 year were analyzed for 337 patients admitted between August 2001 and March 2003. Plasma Hb level was measured at the first visit to the unit. RESULTS: 28 patients (8%) died and there were 158 HF-related hospital admissions in 66 patients. Plasma Hb level correlated strongly with survival at 1 year, and was 13.0 +/- 1.7 g/dL in patients who were alive after this time, versus 11.7 +/- 1.6 g/dL (P < .001) in patients who died. Plasma Hb level also correlated with HF-related need for hospital admission, and was 13.1 +/- 1.7 g/dL in patients who were not hospitalized, versus 12.2 +/- 1.7 g/dL (P < .001) in patients with at least one hospital admission. In the multivariate logistic regression analysis plasma Hb level remained statistically associated both with 1-year survival and with the need for HF-related hospital admission. On the basis of a cutoff value for anemia of Hb < 12 g/dL, 30% of the patients had anemia. One-year mortality was 17% in patients with anemia and 5% in patients without anemia (P < .001). Among patients without anemia, 31% had at least one HF-related hospital admission, whereas only a 15% of the patients without anemia needed to be hospitalized for HF (P = .001). CONCLUSIONS: Plasma Hb levels correlated inversely with mortality and with HF-related hospital admissions at 1 year. The prevalence of anemia (Hb < 12 g/dL) in the population with HF studied here was high and had independent prognostic value.

Aged↗
PubMed2005

[Reduction in heart failure hospitalization rate during the first year of follow-up at a multidisciplinary unit].

INTRODUCTION AND OBJECTIVES: Heart failure leads to frequent hospital readmissions. The aim of this study was to assess how receiving attention at our multidisciplinary unit influenced hospitalization for heart failure. We compared the number of admissions in the year preceding attendance with that in the first year of follow-up. PATIENTS AND METHOD: In total, 366 patients were admitted between August 2001 and June 2003. Of these, 332 were still alive and could be assessed clinically 1 year later. The most common etiologies were ischemic heart disease in 60%, and dilated cardiomyopathy in 10%. RESULTS: The number of admissions in the year preceding attendance was 246, while that during the first year of follow-up was 125, which corresponds to a statistically significant reduction of 49% (P<.001). The reduction was even greater (54%, P<.001), when only patients who were hospitalized more than once in the preceding year were analyzed. Moreover, in addition to the improvements noted during follow-up in patients' understanding of the disease and in several aspects of self-care, the increase in treatment use was also remarkable: beta-blocker use increased from 53% to 70%, spironolactone use from 20% to 30%, and statin use from 36% to 58%. CONCLUSIONS: The number of hospital admissions for heart failure among patients who received attention at our multidisciplinary unit was significantly less in the first year of follow-up than in the year preceding attendance. This reduction was probably due to educational and pharmacologic interventions and to closer follow-up.

Female↗
PubMed2004

Structure of a human inositol 1,4,5-trisphosphate 3-kinase: substrate binding reveals why it is not a phosphoinositide 3-kinase.

Mammalian cells produce a variety of inositol phosphates (InsPs), including Ins(1,4,5)P3 that serves both as a second messenger and as a substrate for inositol polyphosphate kinases (IPKs), which further phosphorylate it. We report the structure of an IPK, the human Ins(1,4,5)P3 3-kinase-A, both free and in complexes with substrates and products. This enzyme catalyzes transfer of a phosphate from ATP to the 3-OH of Ins(1,4,5)P3, and its X-ray crystal structure provides a template for understanding a broad family of InsP kinases. The catalytic domain consists of three lobes. The N and C lobes bind ATP and resemble protein and lipid kinases, despite insignificant sequence similarity. The third lobe binds inositol phosphate and is a unique four-helix insertion in the C lobe. This lobe embraces all of the phosphates of Ins(1,4,5)P3 in a positively charged pocket, explaining the enzyme's substrate specificity and its inability to phosphorylate PtdIns(4,5)P2, the membrane-resident analog of Ins(1,4,5)P3.

Adenosine Triphosphate↗
PubMed2004

Crystal structure of rat liver betaine homocysteine s-methyltransferase reveals new oligomerization features and conformational changes upon substrate binding.

Betaine homocysteine S-methyltransferase (BHMT) is one of the two enzymes known to methylate homocysteine to generate methionine in the liver. It presents a Zn(2+) atom linked to three essential Cys residues. The crystal structure of rat liver BHMT has been solved at 2.5A resolution, using crystals with P2(1) symmetry and 45% solvent content in the cell. The asymmetric unit contains the whole functional tetramer showing point symmetry 222. The overall fold of the subunit consists mostly of a (alpha/beta)(8) barrel, as for human BHMT. From the end of the barrel, the polypeptide chain extends away and makes many interactions with a different subunit, forming tight dimers. The most remarkable structural feature of rat liver BHMT is the presence of a helix including residues 381-407, at the C terminus of the chain, which bind together the dimers AB to CD. A strong ion-pair and more than 60 hydrophobic interactions keep this helix stacked to the segment 316-349 from the opposite subunit. Moreover, the crystal structure of free rat liver BHMT clearly shows that Tyr160 is the fourth ligand coordinated to Zn, which is replaced by Hcy upon binding. Two residues essential for substrate recognition, Phe76 and Tyr77, are provided by a conformational change in a partially disordered loop (L2). The crucial role of these residues is highlighted by site-directed mutagenesis.

Animals↗
PubMed2004

[Prevalence of anemia and its correlation with clinical parameters in patients from a multidisciplinary heart failure unit].

BACKGROUND AND OBJECTIVE: There is a high prevalence of anemia in patients with heart failure which is related to their outcome. The aim of the study was to evaluate the prevalence of anemia (haemoglobin < 12 g/dl) in patients attended in a Multidisciplinary Heart Failure Unit and to analyze the correlation of hemoglobin levels and the presence of anemia with demographic, clinic, biological and therapeutic parameters. PATIENTS AND METHOD: Between August 2001 and February 2003, 330 patients were attended (mean age [SD], 68.0 [9.3] years). Simple lineal regression, multiple lineal regression, *2 test, Student t test and Kruskal-Wallis test were used for statistical analysis. RESULTS: 30% patients had anemia. We found a significant correlation between plasmatic hemoglobin levels and age, gender, etiology of heart failure, coexistence of diabetes, absence of smoking habit, functional class, quality of life, plasmatic levels of urea, creatinine and cholesterol, treatment with diuretics and nitrates and the absence of treatment with betablockers. Surprisingly, there was no relationship between treatment with angiotensin-converting enzyme inhibitors, antiplatelet drugs or anticoagulants and the presence of low levels of hemoglobin. CONCLUSIONS: The prevalence of anemia in a general population with heart failure is high. Plasmatic hemoglobin levels were related to several parameters, mainly age, gender, functional class and plasmatic levels of urea and cholesterol.

Aged↗
PubMed2004

Induction, modification and accumulation of HSP70s in the rat liver after acute exercise: early and late responses.

Liver cells synthesize HSP72, the cytosolic highly stress-inducible member of the 70 kDa family of heat-shock proteins (HSP70s), in response to acute exercise. This study was aimed at obtaining further insight into the physiological relevance of the hepatic stress response to exercise by investigating the induction and long-term maintenance of increased levels of HSP70s of the HSP and glucose-regulated protein (GRP) families, their post-translational modifications during or after exercise and the possible relation of HSP induction to oxidative stress. In a running rat model, acute exercise activated the synthesis and accumulation of HSP72, GRP75 and GRP78 in liver cells, pointing towards a multifactorial origin of this response. A peak HSP72 accumulation was observed shortly after exercise as a result of transcriptional activation. HSP72 was reduced shortly after exercise preceding the disappearance of its mRNA. Two further waves of HSP72 accumulation peaked 8 and 48 h after exercise without transcriptional activation. A transient increase in the proportion of acidic variants of HSP72 and HSP73 was also observed shortly after exercise as a result, at least in part, of protein phosphorylation. Free and protein-bound lipid peroxidation derivatives (TBARS) showed a tendency to increase in the early post-exercise and the free-to-protein-bound TBARS ratio decreased significantly after 2 h. During the early post-exercise period, protein-bound TBARS correlated positively with HSP72 and 73, but not with GRP75 or GRP78. Altogether, the reported results indicate that the early induction and post-translational modification of HSP70s in liver cells following exercise is a preliminary step of a series of long-lasting HSP70-related events, possibly designed to preserve liver cell homeostasis and to help provide a concerted response of the whole organism to physical stress.

Animals↗
PubMed2004

ESCRT-II, an endosome-associated complex required for protein sorting: crystal structure and interactions with ESCRT-III and membranes.

ESCRT-I, -II, and -III protein complexes are sequentially recruited to endosomal membranes, where they orchestrate protein sorting and MVB biogenesis. In addition, they play a critical role in retrovirus budding. Structural understanding of ESCRT interaction networks is largely lacking. The 3.6 A structure of the yeast ESCRT-II core presented here reveals a trilobal complex containing two copies of Vps25, one copy of Vps22, and the C-terminal region of Vps36. Unexpectedly, the entire ESCRT-II core consists of eight repeats of a common building block, a "winged helix" domain. Two PPXY-motifs from Vps25 are involved in contacts with Vps22 and Vps36, and their mutation leads to ESCRT-II disruption. We show that purified ESCRT-II binds directly to the Vps20 component of ESCRT-III. Surprisingly, this binding does not require the protruding N-terminal coiled-coil of Vps22. Vps25 is the chief subunit responsible for Vps20 recruitment. This interaction dramatically increases binding of both components to lipid vesicles in vitro.

Amino Acid Motifs↗
PubMed2004

Nurse evaluation of patients in a new multidisciplinary Heart Failure Unit in Spain.

AIM: To know how compliant patients are, how much they know about their disease and treatment, and how their level of self-care is. METHODS: We performed a short nurse questionnaire during the first visit to a new Heart Failure Unit. RESULTS: Three hundred and twenty-four patients have been evaluated, with a mean age of 65.4 years. Ninety-eight patients (30%) knew and understood the performance of the heart and 85 (29%) understood the disease. Two-hundred and nineteen (67%) knew more than three signs of worsening symptoms. One-hundred and five (32%) knew all the names of the medication they were taking and 74 (23%) knew the action of these medications. Two-hundred and ninety-four (91%) said they were taking all the medication prescribed and 229 (71%) carried on always their written prescription. Sixty-two percent of patients controlled weight only at the medical visit and only 14% controlled weight more than once a week. Fifty-nine (18%) controlled blood pressure more than once a week, while 45% controlled it only at the medical visit. Only 33% of patients were said always to follow sodium restricted diet. The great majority (93%) never smoked and only very rarely took alcohol (83%). While only 18 (6%) performed some kind of physical exercise, the majority (83%) did walking and daily living activities. The 85% of patients with ischemic heart disease knew how to use sublingual nitro-glycerine. When subgroups were analysed, we found significant differences by age, gender and previous specialist management. Younger patients, men and patients referred from the Cardiology outpatient clinic showed a higher level of knowledge and understanding of several aspects of disease and treatment, and performed more physical activities, compared to older patients, women and patients referred from other departments. On the contrary, older patients showed better adherence with sodium restriction, and, as women, better smoking and drinking habits. CONCLUSION: There is a lot of work to do in nurse-guided education of patients with heart failure, although treatment compliance, use of nitro-glycerine and abstinence of smoking and alcohol intake seem to be quite assumed by the majority of our patients. Significant differences in knowledge and behaviour were evident between younger and older patients, between men and women, and relating to previous specialist management. In spite of that, we found no differences in treatment compliance.

Adult↗
PubMed2004

Basal cell carcinoma in childhood after radiation therapy: case report and review.

We describe 2 patients who received ionizing radiation as part of a curative regimen for childhood malignancy which later developed basal cell carcinoma at an early age. They do not occur within the context of well-defined syndromes, such like basal cell nevus syndrome, albinism, or xeroderma pigmentosum. Basal cell carcinomas appears on radiated areas in older individuals, less often in younger patients, in which the period of latency between exposure to radiation and the appearance of basal cell carcinomas is shorter than in older patients. Our 2 cases presented a period of latency of 11 and 10 years. Radiated skin areas must be explored as part of the follow-up in children who received radiotherapy and should probably be maintained for life. The basal cell carcinoma in childhood is best treated by excision.

Brain Neoplasms↗
PubMed2004

[Public and private supply of health services by autonomous communities in Spain].

This chapter summarizes the main territorial inequalities in health care supply, and the related effects on access and use of health care facilities. Firstly, in the field of primary health care, the most notable inequalities refer to the process of introduction of the reform and to complementary services supply, together with the coverage of and access to some health care programs. Secondly, the distribution of hospital beds across regions is far from being uniform, specially with respect to geriatric and psychiatric beds. In addition, profit oriented private care is unequally distributed across territories. Thirdly, the availability of high-tech health care services is remarkably different across regions, although inequalities have been reduced during the last decade. Inequality in long-term care (not only in terms of supply, but also in access and use) is even higher than regional inequalities in health care supply. In addition to these territorial inequalities there are some significant gender inequalities.

Female↗