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Biomedical subjects

C Moreno

Publications and source records attributed to C Moreno.

At least 235 records · Page 13Linked to original sources

Does antibody to mycobacterial antigens, including lipoarabinomannan, limit dissemination in childhood tuberculosis?

Serum immunoglobulin (Ig) G responses to a variety of mycobacterial antigens were measured in children from the UK, in children with tuberculosis from Hyderabad, India and Dhaka, Bangladesh, classified according to whether the disease was disseminated or localized, and in non-tuberculous controls. Anti-lipoarabinomannan (LAM) IgG responses in UK children showed a marked trough between 6 months and 3 years coincident with the reported peak incidence of disseminated tuberculosis. Geometric mean IgG responses to sonicates of slow-growing mycobacteria (rich in LAM) in 36 children with disseminated tuberculosis were markedly lower than in 99 children with localized tuberculous lesions (for Mycobacterium scrofulaceum P < 0.01, for M. tuberculosis P < 0.01, and for M. vaccae P < 0.01). Responses to purified LAM were also lower in the disseminated tuberculosis group (P < 0.05) but there was no difference between the groups in their response to mycobacterial 65 kDa protein. Multiple regression analysis showed that the reduced response to sonicated mycobacterial antigens and to LAM in children with disseminated disease was independent of age, nutritional status, skin test reactivity, duration of previous symptoms, and city of origin. There was no evidence for sequestration of antibody to immune complexes. These findings are compatible with the hypothesis that children with low levels of antibody to sonicated mycobacterial antigen and to LAM, or those who cannot mount an antibody response, are predisposed to dissemination. A role for antibody in preventing disseminated forms of tuberculosis in childhood has implications for the development of improved vaccines and for the optimum timing of vaccination with bacille Calmette-Guérin.

Adolescent↗

TNF alpha-mediated tissue damage in mouse footpads primed with mycobacterial preparations.

Tissue sites involved in certain types of inflammation become sensitive to the destructive effect of a subsequent injection of tumour necrosis factor alpha (TNF alpha). To try to further delineate the cascade of effector and regulatory events controlling this activity, a new model is described and its main properties characterized. C57BL/GrFa mice received mycobacterial products subcutaneously in the footpads. Recombinant TNF alpha was injected 24 h later into the same sites. To assess the tissue-destructive effect of TNF alpha in these "primed" footpads, swelling and haemoglobin content of injected footpads were measured, 16 h and 20 h respectively after the injection of TNF alpha. When loaded with either Escherichia coli LPS (10 micrograms) or Mycobacterium vaccae soluble sonicate (17 micrograms), footpads were reactive to the subsequent injection of 1 microgram recombinant TNF alpha, as assessed by both swelling and haemoglobin content. When C57BL/GrFa mice received 10(9) autoclaved M. vaccae subcutaneously in the back 10 days before the footpad was "primed" with soluble M. vaccae sonicate, the destructive effect of TNF alpha was significantly enhanced, becoming 5-10-fold greater than that seen in sites "primed" with an optimal dose of LPS. This higher reactivity was abrogated by a single dose of anti-CD4 given just before the injection of TNF alpha. This local reactivity to TNF alpha of skin sites loaded with mycobacterial products is compared to the local LPS-dependent Shwartzman reaction, and the relevance of this assay as a model with which to delineate the mechanisms of tissue damage in tuberculosis is discussed.

Animals↗

[Giant ethmoid neurinoma with intracranial extension].

The schwannomas are tumors arising from nervous tissue. It appears very rarely in the nose and paranasal sinuses. Intra and extracraneal extension of these tumors are even more uncommon. In this paper we report a case of a esfeno-ethmoidal schwannoma with anterior skull fossa extension. We describe the CT scan and magnetic resonance imaging and the histological features. Surgical resection was carried through a craniofacial approach. Some data about diagnosis, treatment and outcome of these tumors are revised.

Aged↗

[Time trends in cancer incidence in Navarra and Zaragoza, spain].

BACKGROUND AND OBJECTIVES: The knowledge of time-related changes occurring in cancer incidence and mortality is an essential element for cancer control. This paper aims to describe the time trends of the more important cancer sites in Navarra and Zaragoza. METHODS: The influence of age, diagnosis period and birth cohort on the observed time trend cancer incidence in Navarre and Zaragoza was assessed using a log-linear model. Results are showed graphically, for the different tumour sites by sex and each registry. RESULTS: Among males, a considerable rise in the incidence of lung cancer (5% per year), prostate cancer (> 2% per year) and non-Hodgkin's lymphomas was found. Among females, the highest increases corresponded to non-Hodgkin's lymphomas, with a yearly rise greater than 7%, and ovarian cancer (4% per year). Breast cancer in women increased in both registries (3.5% per year in Navarre and 0.9% per year in Zaragoza), part of the increment in Navarra being explained by a higher case detection rate. Finally, the incidence of colorectal, bladder and kidney cancer rose more than a 3% per year in both registries and sexes. For most types of tumours, cancer risk increased with subsequent generations. CONCLUSION: The substantial cancer increment observed points out the inefficacy of primary prevention policies, the importance of studying cancer incidence for long time periods and the need to increase the population coverage of Spanish cancer registries.

Adult↗

[Comparability between the ninth and tenth revisions of the International Classification of Diseases applied to coding causes of death in Spain].

OBJECTIVE: To analyze comparability between the ninth and tenth revisions of the International Classification of Diseases (ICD) applied to coding causes of death in Spain. METHODS: According to the ninth and tenth revisions of the ICD, 80,084 statistical bulletins of mortality registered in 1999 were assigned the Basic Cause of Death. The statistical bulletins corresponded to the Autonomous Communities of Andalusia, Cantabria, Murcia, Navarre and the Basque Country, and the city of Barcelona. The underlying causes of death were classified into 17 groups. Simple correspondence, the Kappa index and the comparability ratio for major causes were calculated. RESULTS: A total of 3.6% of deaths changed group due to an increase (36.4%) in infectious and parasitic diseases, mainly because of the inclusion of AIDS, and a corresponding decrease due to the exclusion of endocrine, nutritional and metabolic disorders. Furthermore, myelodysplastic syndrome was moved to the category of neoplasm. The group including nervous system diseases, eye and related diseases, and ear and mastoid apophysis diseases increased (14.7%) at the expense of mental and behavior disorders, due to the inclusion of senile and presenile organic psychosis. Poorly-defined entities increased (14.1%) due to the inclusion of cardiac arrest and its synonyms, together with heart failure, to the detriment of diseases of the vascular system. Diseases of the respiratory system increased (4.8%) due to the inclusion of respiratory failure, previously considered as a poorly defined cause. The correspondence for all causes was 96.4% and kappa's index was 94.9% CONCLUSIONS: The introduction of ICD-10 affects the comparability of statistical series of mortality according to cause. The results of this study allow us to identify the main modifications and to quantify the changes in the major causes of mortality in Spain.

Cause of Death↗

[Cancer mortality in the counties of Catalonia (1983-1989)].

OBJECTIVES: To compare mortality among counties (comarques) in Catalonia, Spain for the most frequent malignant tumors. METHODS: Overall mortality data and for five specific tumor sites were analyzed for a five-year period (1983-1989). Crude and site-specific mortality rates were computed. The comparison between counties was adjusted for the 1986 population of Catalonia using the direct method. Comparative mortality ratios (CMR) were obtained for each county with respect to Catalonia. RESULTS: Overall cancer mortality was higher in the Barcelonès for men and in Osona form women. The CMR for men in the Barcelonès was the highest for cancer of the trachea, bronchi and lungs; the CMR in Solsonès was the highest for stomach cancer, while in Cerdanya it was the highest for colorectal cancer. Among women, the highest CMR for cancer of the trachea, bronchi and lungs was in Montsià, whereas for breast cancer it was Baix Empordà, and Alt Urgell for stomach cancer. CONCLUSIONS: Comparative analyses of cancer mortality by county in Catalonia and sex underscores differences in its distribution, allowing the orientation of cancer control policies and research to be developed in each geographical area.

Breast Neoplasms↗

Clustered schedules in allergen-specific immunotherapy.

BACKGROUND: Injective immunotherapy is traditionally performed with a build-up phase lasting 3 to 4 months. The costs, decreasing compliance from both patients and clinicians and inconveniences due to this schedule may be overcome using different schedules. METHODS AND RESULTS: A revision of the published papers with clustered schedules has been made. Attention has been focussed on tolerance and its relationships with relevant parameters such as kind of extract (aqueous or depot), allergens and their pharmaceutical presentation, schedule followed, use or not of a premedication, clinical manifestations of patients before treatment. For a better revision, papers dealing with clustered schedules have been divided into two groups. The first group includes 20 papers not designed to study the clustered schedule but using it to study other parameters affected by specific immunotherapy. The second group includes 9 papers specifically or mainly designed to study the clustered schedule. A huge difference in the rate of side effects could be assessed among different papers, even in studies run with similar allergens from the same producer and with a similar schedule. CONCLUSIONS: Summarizing the results of the revision, the following conditions seem to lead to the optimal tolerance of the clustered schedule: use of a premedication; use of a depot preparation; use of no more than 4 administrations per cluster; administration of 1-2 clusters per week and of 4 to 6 clusters in total. These results seem promising but further efforts are required to better define the optimal clustered schedule.

Allergens↗

Tolerance and short-term effect of a cluster schedule with pollen-extracts quantified in mass-units.

We performed a prospective, multicenter study to assess the tolerance and possible short-term effects of allergen vaccines administered according to a cluster schedule in the months immediately preceding the onset of the pollen season. The study was carried out in eight centers and included 191 patients (children and adults) with allergic respiratory disease due to sensitization to olive tree and/or grass pollen. Of these, 34 patients acted as controls and the remaining patients received immunotherapy administered in the initiation phase according to a cluster schedule of eight doses injected on four visits. After 3 months of treatment, significant differences were found between the two groups in medication consumption (antihistamines in drops and oral formulations: p = 0.045 and p = 0.001, respectively; short-acting beta2-agonist treatments: p = 0.004) and respiratory symptoms (wheezing and coughing: p = 0.035 and 0.014, respectively). The cytokine profile (interleukin [IL]-4, 5, 10 and 2, interferon [IFN-gamma], and tumor necrosis factor [TNF-alpha]) was determined before the start of treatment and at the end of follow-up (4-5 months). Levels of IL-4, 5 and 10 (Th2 profile) decreased while those of IL-2, IFN-gamma, and TNF-alpha (Th1 profile) decreased. These differences were more marked in the active group than in the control group but were not statistically significant. No severe adverse effects were recorded. This study shows that the schedule tested had an acceptable tolerance profile and produced significant changes in symptom and medication scores after a few months of treatment. A double-blind, placebo-controlled study is needed to confirm these results.

Adult↗

Adsorption-desorption of antigen to polystyrene plates used in ELISA.

Since ELISA reliability depends to a great extent upon solid-phase reagent concentration and stability, we sought to analyse the influence of experimental conditions during ELISA performance on the adsorption/desorption of proteins to microplates. The effect upon desorption of several experimental parameters (antigen concentration, antibody concentration and affinity, washings, conjugate and inhibitor incubations) and quantitative treatment of protein-polystyrene adsorption were analysed. The adsorption to polystyrene microplates was studied with a hapten-conjugated protein (BSA-Ar36) in order to facilitate the analysis of the influence of antibody affinity on desorption during ELISA. Our results show that polystyrene plates adsorb BSA-Ar36 according to the Langmuir isotherm. The adsorption constant was 2.1 X 10(8) L/mol and maximal surface concentration of protein on solid phase was 1.8 X 10(-7) g/cm2. Although desorption was present, we observed that it did not affect the reliability of results of either direct or inhibition ELISA, because it was not dependent on the composition of the sample.

Adsorption↗

Esophageal pH monitoring of postprandial gastroesophageal reflux. Comparison between healthy subjects, patients with gastroesophageal reflux and patients treated with Nissen fundoplication.

To analyze postprandial gastroesophageal reflux by means of ambulatory gastroesophageal pH monitoring for 24 h, four groups were studied prospectively: group A: 22 healthy volunteers; group B: 31 consecutive patients undergoing medical treatment for gastroesophageal reflux, group C1: 20 consecutive patients with symptomatic reflux awaiting surgical treatment by means of Nissen fundoplication (pre-Nissen evaluation) and group C2: group C1 patients reevaluated 6 months postoperatively (post-Nissen evaluation). Gastro-esophageal pH, as a measure of post-prandial reflux following the main meal of the day was evaluated by the Kaye test. In groups B, C1 and C2, esophageal manometry was also performed. Gastroesophageal pH monitoring revealed significant qualitative as well as quantitative differences in postprandial gastroesophageal reflux experienced by healthy subjects (group A) and surgically treated patients (group C2) compared to patients with pathologic reflux (groups B and C1). The postprandial reflux was significantly more acid and more important (Kaye's test value) in groups C1 and B than in groups A and C2. There were no differences in postprandial reflux between healthy subjects and patients treated by Nissen fundoplication (group C2). Only the pressure and length of the lower esophageal sphincter (LES) showed differences after Nissen fundoplication. We conclude that patients with pathologic reflux have more severe postprandial reflux than normal subjects; Nissen fundoplication corrects the degree of postprandial reflux to a normal range by elevating the LES pressure (11.3 x 1.4 vs. 22.4 +/- 1.6 mm Hg; p < 0.001) and length (2.7 +/- 0.2 vs. 3.7 +/- 0.1 cm; p < 0.001) in our patients.

Adolescent↗

Hypothesis testing for the genetic background of quantitative traits.

The testing of Bayesian point null hypotheses on variance component models have resulted in a tough assigmment for which no clear and generally accepted method exists. In this work we present what we believe is a succeeding approach to such a task. It is based on a simple reparameterization of the model in terms of the total variance and the proportion of the additive genetic variance with respect to it, as well as on the explicit inclusion on the prior probability of a discrete component at origin. The reparameterization was used to bypass an arbitrariness related to the impropriety of uninformative priors onto unbounded variables while the discrete component was necessary to overcome the zero probability assigned to sets of null measure by the usual continuous variable models. The method was tested against computer simulations with appealing results.

Algorithms↗

[Gender and night work: sleep, daily life and the experiences of night shift workers].

This paper deals with the impact of night work from a gender perspective, through a field study at a factory employing men and women on the night shift. It is based on data for hours of sleep over the course of several weeks, socio-demographic data, and job information, using a semi-structured interview. The methodology includes chronobiological aspects of sleep (mainly quantitative data) and workers' discourse concerning gender-related experiences in the day-to-night switch. Despite gender issues and differences in daily life, the switch is perceived quite vividly by both men and women, permeating several aspects of life, like health, leisure, studies, and intimate personal relations. Quantitative sleep analysis showed more severe effects of night work on women, especially those with children. Such sleep patterns were associated with different expectations among men and women, revealing gender issues that are essential for understanding the reality of individuals who work odd hours.

Adaptation, Physiological↗

[Epidemiological surveillance of HIV/Aids infections in Navarra between 1985 and 2002].

In the year 1985, the first cases of Aids were diagnosed in Navarra. Since then and until December 2002, according to the notifications received, 2,329 persons with HIV have been counted, of whom 1,538 were from Navarra and 791 temporary residents in this autonomous community. In recent years, the incidence of new diagnoses of HIV infection and cases of Aids has shown a clear tendency to fall in Navarra. The decrease in cases has been very important amongst the users of intravenous drugs, while the cases amongst homo/bisexuals and cases related to heterosexual transmission have remained fairly stable. In the 1999-2002 period, the cases of infection through a sexual relationship have been more numerous than the cases registered in users of intravenous drugs. The proportion of cases in persons originating from countries with a high endemicity is increasing, coming to represent about 25% of the new cases of infection in the 2000-2002 period. The follow up of the 1,538 HIV patients of Navarra has shown that, at the end of 2002, death had occurred in 39.5% of cases, and it was possible to confirm that 55% were still alive. With regard to their relation to the health services, it has been found that of the 847 patients who are still living, the great majority (80%) are being attended to by the Infectious Services of the Hospital of Navarre and another 9.4% in the Internal Medicine Services of the Garcia Orcoyen and Reina Sofia Hospitals.

Acquired Immunodeficiency Syndrome↗

[Evaluation of the Program for the Prevention and Control of Tuberculosis during the period January 1993 - June 1996].

In 1992 a Technical Commission was formed in Navarra with the participation of different specialists who drew up the Program of Vigilance and Control of Tuberculosis. We present the results of the evaluation of this program for the period from January 1993 to June 1996. In the 3.5 years of the study, 419 cases of tuberculosis were found, 317 belonging to respiratory forms and 102 to extra-respiratory forms. The annual rate of incidence of total tuberculosis, 22.8 cases per 100,000 inhabitants observed in Navarra, is the lowest of those registered at the level of the Autonomous Communities according to the TIR study of the SEPAR (acronym for Spanish Society of Pneumology and Thoracic Surgery) in 1996, and the second lowest, after Castilla-La Mancha, according to the multicentric study of the National Centre of Epidemiology. In Navarra the highest rates of incidence are produced in those over 65 years of age, following the pattern observed in the more developed countries. 13.9% of the patients with respiratory tuberculosis showed co-infection by HIV, and besides more than 90% of these were users of intravenous drugs. The percentage of immigrants, prisoners and the destitute observed in the Navarra series is lower than that found in areas such as Madrid, Barcelona or Zaragoza. 91% of the cases of respiratory tuberculosis showed bacteriological confirmation and 98% of the cases were diagnosed and treated in specialised care. Outstanding were the high follow-up of the cases until discharge and the high percentage of cures achieved, some 85.4%.

English Abstract↗

[State of infectious disease notification (I.D.N.'s) in Navarra. 1996].

The System of Infectious Disease Notification (I.D.N.) encompasses the notification of 41 infectious transmissible diseases to which are added epidemic outbreaks of any etiology or cause. In Navarra, the I.D.N.'s are reported to the Section of Vigilance and Epidemiological Control of the Public Health Institute. A sharp increase of alimentary toxic-infections is observed due to two community outbreaks produced by Salmonella enteritidis that affected 410 persons. The incidence of pulmonary tuberculosis, 15.37 cases per 100,000 inhabitants has remained at the same levels as previous years and with lower rates than those published in neighbouring Autonomous Communities such as La Rioja and the Autonomous Community of the Basque Country. In the group of Exanthematic Diseases, an outbreak of German measles is noteworthy that affected males between the ages of 16 and 20. During the year 1996 there were 17 cases of Meningococcal Disease that meant a rate of 3.27 per 100,000 inhabitants, the second lowest rate in the last 25 years after the rate of 2.29 of 1994. With respect to the causative serogroup, serogroup C was isolated on 7 occasions, serogroup B on four occasions and on 6 it could not be grouped. Hydatidosis through reports of I.D.N.'s and active search in the hospitals remained steady, with 26 cases, remaining within the regular values of recent years. An important decline with respect to recent years was observed in cases of hepatitis A, hepatitis B and brucellosis.

English Abstract↗

[Evolution of mortality amongst the youth of Navarra: 1985-1995].

Recent publications show that mortality rates amongst young people and adolescents in some industrialised countries have increased in recent years. The addition of new diseases such as AIDS, which principally affect the young population, to those inevitable deaths brought about through causes such as traffic accidents has increased interest in this public health problem. The number of deaths and the adjusted global mortality rates amongst men and women of 15-34 years did not increase in Navarra in the 1985-1995 period. These are situated around 70 per 100,000. Changes have taken place in the pattern of causes, similar to those observed in other industrialised areas, with an increase of deaths through overdose and AIDS, and a decline in mortality due to traffic accidents in recent years. Traffic accidents were the first cause of death amongst youths until 1993. From this year onwards deaths from AIDS became the first cause amongst women, while amongst men the number of deaths from AIDS is equal to those caused by traffic accidents.

English Abstract↗