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Biomedical subjects

C Ortega

Publications and source records attributed to C Ortega.

At least 19 recordsLinked to original sources
PubMed2006

[Diagnosis and treatment of carotid body paragangliomas. Presentation of 9 cases and review of the literature].

Carotid body paragangliomas (CBP) are relatively rare tumors arising from the carotid body paraganglion. Clinical signs and images are necessary to establish the diagnosis. Surgery is the preferred method of treatment, paying special attention to the carotid artery. Nine patients with carotid body tumors were identified, three of them with complicated diagnosis. One patient is treated with radiotherapy. Out of the eight surgical patients, three preserved the whole arterial structure, the external carotid artery is resected in two patients, the carotid artery is replaced (safen graft, gore tex prosthesis) in other two patients, and the common carotid was tied in the remaining patient. Our objective is to show the decisions taken in the patients from our casuistic, comparing them to the literature data. We conclude that the diagnosis may be deceptive, and that the attitude forward the carotid is variable, always being prepared to do arterial replacement techniques.

Carotid Body Tumor↗
PubMed2006

[Interobserver concordance in functional assessment by Barthel Index].

BACKGROUND: The aim of this study is to analyze interobserver "reproductiveness" between clinical nurses in gerontology and residents in family medicine in their first contact with the Barthel Index (BI). MATERIALS AND METHODS: One hundred patients were assessed. BI at two weeks before admission was scored by a patient or carer interview. Eighteen patients were excluded because interviews were not completed. RESULTS: Mean BI of 82 patient included, assessed by nurses was 87.3 and by residents 88.2. In 40 patients some differences in the mean values of BI were observed. When analyzing the overall BI score the agreement was high (r=0.793) but interobserver agreement was low (kappa<0.4) in some fields such as eating, dressing and transfers and medium in others (kappa from 0.40 to 0.75). CONCLUSIONS: Low reproductiviness interobserver in some patients of the BI when clinical nurses in gerontology and residents in family medicine are compared suggest that they need specific training in functional capacity evaluation in order to improve the BI use.

Activities of Daily Living↗
PubMed2005

[Functional outcomes of transoral laser surgery of supraglottic carcinoma].

OBJECTIVES: To analyse the functional outcome of patients with supraglottic carcinomas treated by transoral laser surgery. METHODS: The clinical records of 55 patients who underwent transoral laser surgery were reviewed. Swallowing capacity, surgical complications, requirements for tracheotomies, percentage of decannulations, laryngeal paralysis, stenosis, aspiration associated pneumonia, time to remove the nasogastric tube and postsurgical stay in hospital were the studied variables. RESULTS: 52% of the patients had a normal or within functional limits swallowing performance. 18% suffered aspiration pneumonia. 13% developed a laryngeal stenosis. 7% suffered of laryngeal palsy. 18 tracheostomies were performed, of them 10 could be reverted. The mean time to remove the nasogastric tube was 9 days. The mean hospital stay was 23 days. CONCLUSIONS: The main functional advantages of transoral laser surgery for supraglottic carcinoma, when compared with the conventional approach, are a lower incidence of temporary tracheotomies, a faster removal of the nasogastric feeding tube, and a lower incidence of pharyngocutaneous fistulas (0%).

Adult↗
PubMed2005

[Oral clarithromycin as a treatment option in chronic post-operative endophthalmitis].

PURPOSE: To assess the outcome of medical treatment with oral clarithromycin in patients with chronic post-surgical endophthalmitis. METHODS: This prospective study was performed between January 1999 and September 2003. Patients with a diagnosis of chronic post-surgical endophthalmitis of bacterial etiology were included. All received 500 mg of oral clarithromycin twice a day for 14 days. The initial and final visual acuity, etiology, post-surgical time of presentation, treatment-delay time, and follow up were recorded. According to the treatment results, patients were distributed into 3 separate groups: 1) complete response, 2) partial response, 3) no response. Data from these groups were compared by means of the Student's t test and Fisher exact test, depending on which was considered most suitable. RESULTS: Fifteen cases of chronic endophthalmitis (11 of Propionibacterium acnes, 4 of Staphylococcus epidermidis) were diagnosed. A complete response was observed in 4 cases, partial response in 4 cases, and no response in 7 cases. Final visual acuity greater than 0.5 was significantly more likely in the complete response group when compared with the no response group (Fisher exact test = 0.0454, p=0.05), however, the same comparison between the complete response group and the partial response group was not significant. CONCLUSION: Medical treatment with oral clarithromycin could be useful in some patients with chronic post-surgical endophthalmitis.

Administration, Oral↗
PubMed2005

[Health risks associated with the migration of Atlantic salmon (Salmo salar L.): an epidemiological surveillance programme in Northern Spain].

The authors present the results of an epidemiological surveillance programme involving Atlantic salmon (Salmo salar) populations in north-eastern Spain. The study investigates the risk factors critical in disease transmission, which include the presence of potentially pathogenic micro-organisms, the innate cell-mediated immune response of the salmon, and the potential interactions between the two. Also taken into account are the biological and migratory cycles of these salmon populations. The results showed that Aeromonas salmonicida and Saprolegnia parasitica were the micro-organisms that played the most important role in the transmission of the disease by virtue of their pathological characteristics, their occurrence in large numbers, and their capacity to transmit disease. With regard to the cell-mediated immune response, the authors observed a wide variability between individuals in some cell groups, as well as certain seasonal and age differences. These may be factors that predispose the animals to infection or to becoming asymptomatic carriers, with the attendant risk of transmitting infection in the course of migration. This could be especially relevant in the case of salmon infected with A. salmonicida and S. parasitica, since it has been observed that such salmon have a decreased number of leucocytes compared to non-infected salmon.

Aeromonas salmonicida↗
PubMed2004

Efficient lentiviral transduction of Herpesvirus saimiri immortalized T cells as a model for gene therapy in primary immunodeficiencies.

Infection of human T lymphocytes with the Herpesvirus saimiri (HVS) yields immortalized T-cell lines (HVS-T) which retain all the phenotypical and functional characteristics of their parental cells. This represents a new experimental model for studying genetic disorders of T lymphocytes. In spite of the efforts of many laboratories, no satisfactory way has been found so far to modify HVS-T cells genetically. We have analyzed the capacity of oncoretroviral (MLV)- and lentiviral (HIV-1)-based vectors pseudotyped with vesicular stomatitis virus glycoprotein (VSVg) to transduce HVS-T cells. HIV-1-derived vectors efficiently transduced HVS-T cell lines, reaching up to 85% of cells expressing the transgene in a single round of infection. MLV-based vectors, on the other hand, were unable to transduce more than 1% of any of the HVS-T cell lines analyzed. Lentiviral-driven gene expression was maintained constant and stable in HVS-T cells for a minimum of 48 days. We also observed that although the lentiviral transduction efficiency achieved on HVS-T cells is lower than that obtained with tumor or primary endothelial cells, it is nevertheless similar to that found with activated primary T cells.

Adoptive Transfer↗
PubMed2004

End-of-life preferences in elderly patients admitted for heart failure.

BACKGROUND: Heart failure is increasing in prevalence and incidence, with considerable mortality among the elderly. AIM: To determine preferences concerning cardiopulmonary-resuscitation (CPR) and end-of-life care in elderly patients hospitalized for heart failure. DESIGN: Prospective interview-based survey. METHODS: Patients >64 years old admitted for acute heart failure were interviewed to address their preferences regarding end-of-life care and cardio-pulmonary resuscitation (CPR) when facing the last stages of their disease. RESULTS: We interviewed 80 patients (mean age 79 years; 58% women). Thirty-two (40%) expressed a wish not to have CPR. Only two had previously discussed their CPR preferences with their physicians. When recovery from the illness was considered unlikely, 40 (50%) participants preferred to receive treatment at home, 32 (40%) preferred in-hospital management, and 8 (10%) were unsure. Thirty-three patients (41%) expressed a desire for spiritual support, 38 (48%) said not and the remaining 9 (11%) were indifferent. DISCUSSION: Advance planning of end-of-life procedures and doctor-patient communication regarding these items remains poor and must be improved.

Advance Care Planning↗
PubMed2004

Necrotic cell death induced by photodynamic treatment of human lung adenocarcinoma A-549 cells with palladium(II)-tetraphenylporphycene.

In this study we describe photodamaging and photokilling effects of palladium(II)-tetraphenylporphycene (PdTPPo) (previously incorporated into dipalmitoylphosphatidylcholine liposomes) on the human lung adenocarcinoma A-549 cell line. No dark cytotoxicity was found when the drug was applied at 10(-6) M or 5 x 10(-7) M for 1 or 18 h, respectively. After 1-h treatment with 10(-7) M or 5 x 10(-7) M PdTPPo followed by red light irradiation for variable times, dose-dependent lethal effects were observed in A-549 cells. Apoptosis was not found after the above photodynamic treatments or under even milder sublethal conditions. In contrast to HeLa cells subjected to PdTPPo photosensitization where either apoptosis or necrosis were induced, morphological analysis and electrophoretical DNA pattern of A-549 cells always revealed a clearly necrotic death mechanism. However, A-549 cells died by apoptosis after serum and L-glutamine deprivation, indicating that only the photodynamically induced apoptosis was inhibited. Immunofluorescent labeling revealed that microtubules and actin microfilaments were immediately and strongly damaged by photodynamic treatments with PdTPPo. No metaphase arrest and/or mitotic alterations were observed after phototreatments. Present results show that the cell type plays a fundamental role in relation to the apoptotic or necrotic response to photosensitization, and that cytoskeletal components are important targets implicated in cell death processes.

Actin Cytoskeleton↗
PubMed2004

[The current importance of veterinary public health: the SAPUVET project].

The authors propose reviewing the current needs for implementing veterinary public health programmes, from both the teaching and professional standpoints. This is warranted by the fact that veterinary public health has become extremely important in various fields of work, beyond conventional food inspection. The article discusses the public health role which veterinarians must play and the interactions between their activities and those of other groups such as doctors, epidemiologists, ecologists, chemists, or even sociologists and anthropologists. The authors also study and assess the basic working tool in veterinary public health--epidemiological surveillance--and how it operates on the basis of diagnosis and risk analysis. The second part of the article discusses the need to unify criteria for veterinary public health training and the role which the SAPUVET network is playing in doing so (SAPUVET is a European Union-supported project within the ALFA programme that is designed to establish links between Latin American and European veterinary faculties).

Animals↗
PubMed2003

The influence of various methods of cold storage of skin on the permeation of melatonin and nimesulide.

The purpose of this study was to investigate the influence of different methods of skin preservation on the percutaneous permeation of two drugs with varied physicochemical properties (melatonin and nimesulide). Hairless rat skin was freshly excised and immediately stored at three different storage conditions: (a). 4 degrees C in minimal essential medium eagle (MEM), (b). frozen at -22 degrees C and (c) frozen at -22 degrees C in 10% glycerol (as a cryoprotective agent). The permeation of melatonin and nimesulide from saturated solutions was studied using the skin stored at various cold storage conditions for 6 months. At 4 degrees C, the flux of melatonin was similar to fresh skin for up to 7 days (P>0.05) and increased 2.4-fold at 14 days (P<0.001). The flux of melatonin was similar to fresh skin for 14 days with skin at -22 degrees C (P>0.05) and then steadily increased from 30 days onwards and at 180 days, the flux was 5-fold greater than fresh skin (P<0.001). Freezing of skin at -22 degrees C with 10% glycerol showed similar flux values for melatonin up to 60 days and at 180 days the flux increased 2.2-fold as compared to fresh skin (P<0.001). In the case of nimesulide, the skin stored for 2 days at 4 degrees C showed similar flux as compared to fresh skin (P>0.05) and increased steadily from 4 days onwards and at 14 days the flux was 3.5-fold higher than fresh skin (P<0.001). The skin frozen at -22 degrees C with or without 10% glycerol showed no difference in flux up to 4 days which however increased from 7 days onwards. At 180 days, the skin at -22 degrees C showed 2.5-fold increase in the flux (P<0.001) whereas the skin frozen with 10% glycerol showed 2-fold increase in the flux (P<0.001) as compared to fresh skin. The results of the present study demonstrate that the permeability of the drugs across the stored skin was dependent on the storage condition, the length of storage and the physicochemical properties of the drug under study. Overall, the freezing of skin at -22 degrees C with 10% glycerol was found to be very helpful for the long-term storage of skin for percutaneous permeation studies.

Animals↗
PubMed2003

Comparison of a high-protein disease-specific enteral formula with a high-protein enteral formula in hyperglycemic critically ill patients.

AIMS: To determine whether a specific high-protein enteral formula with a similar caloric percentage of fat and carbohydrates achieves greater control over glycemic levels and reduces insulin requirements in hyperglycemic critically ill patients when compared to a control high-protein enteral formula. DESIGN: A prospective, randomized, controlled, single-blind trial in two University Hospital Intensive Care Units in Spain. METHODS: We enrolled 50 patients with diabetes mellitus or stress hyperglycemia with basal glycemia > or =160 mg/dl and indication for enteral nutrition > or =5 days. Patients with severe kidney failure, liver failure or obesity were excluded from the study. In the first 48 h of admission, after randomization, 26 patients received the study diet and 24 patients received the control diet. The variables were monitored for 14 days. The Harris-Benedict formula with a fixed stress factor of 1.2 was used to calculate caloric needs. Insulin was administered by continuous infusion. An intention-to-treat analysis was performed. RESULTS: On admission, there were no differences between the study and control group in plasma glucose levels (mg/dl) (190.9+/-45 vs 210.3+/-63) and capillary glucose levels (mg/dl) (226.1+/-73 vs 213.8+/-67). After the feeding trial, there were differences between the study and control group in plasma glucose levels (mg/dl) (176.8+/-44 vs 222.8+/-47, P=0.001), capillary glucose levels (mg/dl) (163.1+/-45 vs 216.4+/-56, P=0.001), insulin requirements/day (IU) 8.73 (2.3-27.5) vs 30.2 (21.5-57.1) (P=0.001), insulin/received carbohydrates (UI/g) 0.07 (0.02-0.22) vs 0.18 (0.11-0.35) (P=0.02) and insulin/received carbohydrates/kg 0.98 (0.26-3.59) vs 2.13 (1.44-4.58) (P=0.04). These differences remain in a day-to-day comparison. There were no differences in the analytical tests, or in digestive or infectious complications. Intensive Care Unit length of stay, mechanical ventilation and mortality were similar in both groups. CONCLUSIONS: Hyperglycemic critically ill patients fed with a high-protein diet with a similar caloric percentage of fat and carbohydrates show a significant reduction in plasma glucose levels, capillary glucose levels and insulin requirements in comparison to patients on a conventional high-protein diet. This better glycemic control do not modify Intensive Care Unit length of stay, infectious complications, mechanical ventilation and mortality.

APACHE↗
PubMed2002

Adsorption in noninterconnected pores open at one or at both ends: a reconsideration of the origin of the hysteresis phenomenon.

We report on an experimental study of adsorption isotherm of nitrogen onto porous silicon with noninterconnected pores open at one or at both ends in order to check for the first time the old (1938) but always current idea based on Cohan's description which suggests that the adsorption of gas should occur reversibly in the first case and irreversibly in the second one. Hysteresis loops, the shape of which is usually associated with interconnections in porous media, are observed whether the pores are open at one or at both ends, in contradiction with Cohan's model.

Journal Article↗
PubMed2002

[Diagnosis and treatment of refractory sprue].

Celiac disease is a gluten-sensitive enteropathy characterized by villous atrophy that is reversed by gluten withdrawal. A minority of these patients is resistant to a gluten-free diet or, after a period of remission, they experience relapse despite continued adherence to treatment, which is called unclassified sprue or refractory sprue.The prognosis of refractory sprue may be poor: patients may die of severe malabsorption or from the development of an enteropathy-associated T-cell lymphoma. We report a 72-year-old-woman with a diagnosis of refractory sprue who responded well to treatment with corticosteroids and a gluten-free diet.

Aged↗
PubMed2001

Fast analysis of important wine volatile compounds development and validation of a new method based on gas chromatographic-flame ionisation detection analysis of dichloromethane microextracts.

A method for the simultaneous determination of major (10-200 mg/l) and minor (0.1-10 mg/l) volatile compounds from wine has been optimised and validated. A 3-ml volume of wine is diluted with water (7 ml), salted with 4.5 g of ammonium sulfate and extracted with 0.2 ml of dichloromethane. The extract is injected in the split mode in a GC system, separated on a Carbowax 20M capillary column and detected by flame ionisation detection. Volatiles from wine are divided into four groups according to their behaviour in the extraction, and a specific internal standard has been selected for each group. The method allows satisfactory determination of more than 30 volatile compounds of wine. Compounds analysed include acetaldehyde, diacetyl, acetoine (3-hydroxy butanone), fusel alcohols and their acetates, and fatty acids and their ethyl esters. The linear dynamic range of the method covers the normal range of occurrence of analytes in wine and extends from at least one magnitude order to more than two, with typical r2 between 0.9938 and 0.9998. Reproducibility ranges from 3.1 to 10% (as RSD) with 5.5% as the average. The analysis of spiked samples has shown that matrix effects do not significantly affect method performance.

Chromatography, Gas↗
PubMed2001

WIN EPISCOPE 2.0: improved epidemiological software for veterinary medicine.

Recent changes in veterinary medicine have required quantitative epidemiological techniques for designing field surveys, identifying risk factors for multifactorial diseases, and assessing diagnostic tests. Several relevant techniques are brought together in the package of veterinary epidemiological computer software, WIN EPISCOPE 2.0, described in this paper. It is based on Microsoft Windows and includes modules for the design and analysis of field surveys, control campaigns and observational studies, and a simple mathematical model. It provides comprehensive 'Help' screens and should therefore be useful not only in field investigations but also for teaching veterinary epidemiology.

Animal Diseases↗
PubMed2001

Accidental dichloromethane fatality: a case report.

A case of accidental dichloromethane poisoning by inhalation is presented. It is of interest that carboxyhemoglobin levels were within the normal range, suggesting that the narcosis and respiratory depression were due to the direct effect of DCM on the central nervous system. The accidental death was attributed to improper ventilation of vapors in the working area.

Adult↗
PubMed2001

Expression of CD94 and NKG2 molecules on human CD4(+) T cells in response to CD3-mediated stimulation.

We investigated the ability of human peripheral CD4(+) cells to express CD94 and NKG2 molecules as a consequence of CD3-mediated activation. Using highly purified peripheral CD4(+) T cells, we found expression of both CD94 and NKG2A 15 days after CD3-mediated stimulation of cells. We also determined by reverse transcriptase-PCR that all gene members of NKG2 family-namely, NKG2A, -C, -D, and -E-are sequentially expressed on CD4(+) cells. We found that this expression is tightly regulated by cytokines, and we identified transforming growth factor-beta1 and interleukin-10 as the main factors that, on CD3-dependent stimulation, positively contribute to the expression of CD94 and NKG2A on CD4(+) cells. We also investigated the functional role of NKG2A and found that coligation of CD3 and NKG2A by specific monoclonal antibodies results in significant inhibition of interferon gamma and tumor necrosis factor alpha production by stimulated CD4(+) cells. The presence and function of these receptors on CD4(+) lymphocytes support a more general role for NKG2 molecules, whose functions were originally thought to be confined to cytotoxic cells, in the immune system.

Antigens, CD↗