PubMed HealthSearch

Biomedical subjects

C Paniagua

Publications and source records attributed to C Paniagua.

At least 19 recordsLinked to original sources

Common ground, uncommon methods.

The author, an American-trained psychoanalyst, currently a member of a theoretically heterogeneous European psychoanalytic society, reflects on his experiences with the different types of analysis practised in continental Europe and in the United States. Sharing some 'common ground' assumptions does not mean that analysts worldwide use comparable clinical methodology. Practitioners from disparate schools differ not only in their metatheoretical frameworks, but also in their theories of technique. Differences in clinical methods affect the scientific quality of clinical researches and, probably, influence therapeutic outcome. The lack of commonality in psychoanalytic methods often seems related to the disparate uses of logical fallacies in clinical reasoning; this, in turn, may be a consequence of socio-historical determinants. Several discussions of one clinical presentation are supplied as an illustration. It is suggested that efforts be made to further examine the relative validity of disparate inference-making models, and the practical results of applying different clinical methods.

Adaptation, Psychological

Bullfight: the afición.

Bullfighting, as a spectacle, provides a special frame for projections, externalizations, and identifications. The central appeal of bullfighting is sadistic gratification, which seems to be of a mostly parricidal nature. The public experiences intense ambivalence toward the protagonists of the fight, who exert attraction for the id as well as for the superego. The existence of intrasystemic conflicts is pointed out. The history of bullfighting reflects the evolution of collective compromise formations between the fulfillment of sadistic drives and superego sensitivities, as influenced by changing social tolerance. The author reviews the most common rationalizations of the spectators, the sexual prototypes in bullfighting, the manifestations of envy toward the bullfighter, and the public's narcissistic regression due to the grandiose identification with him. Some associations from patients are commented upon.

Animals

[Evolutive epidemiologic profile of myelodysplastic syndromes (1959-1993). Comparative study with acute myeloid leukemia and aplastic pancytopenias].

PURPOSE: To compare the maximum epidemiologic data attained from myelodysplastic syndromes (MDS) with those of two main panmyelopathies, namely acute myeloblastic leukaemia (AML) and aplastic pancytopenia (AP). PATIENTS AND METHODS: A retrospective analysis was carried out on 21,135 patients included in the Bone Marrow Study Registry of the Jiménez Díaz Foundation along 35 years (1959-1993). The data were grouped into seven five-year periods. Of these, in the first three the study was performed on bone-marrow aspirates; after 1976 the histopathological study of bone-marrow biopsies was introduced, and since 1979 the karyotype has been regularly examined. The MDS were classified in accordance with the FAB system. With these premises borne in mind, the following aspects were considered: diagnostic interpretation of MDS along the years; diagnostic incidence of MDS, AML and AP in each of the five-year periods; relative frequency of those diagnosis with respect to the total number of cases; evolutive profile of sex and age at diagnosis; quantitative significance of secondary MDS-AL and toxic AP along the years; MDS subtypes and their epidemiologic characteristics. RESULTS: A total of 510 MDS, 610 AML and 223 AP cases were identified. With respect to the sex of the MDS patients, some changes have been seen along the years, from an M/F ratio of 1.9 to 1.0; and the mean age at diagnosis raised from 53.3 years (with only 1.7% of the cases over 65 years of age) to 71.4 years (with 76.9% of the cases over 65 years of age), all this within the 1959-1989 period. The incidence of AML and AP has remained stable for the last 20 years; on the contrary, MDS have been increasing continuously along the 35 years of the study, which poses for a higher number of new cases in every period (from 35 to 119) and also for a higher relative frequency in the registry (from 1.37% to 4.40%) within the period 1959-1989. Valuable toxic history was progressively increasing in secondary MDS-AML and progressively decreasing in AP. With respect to the FAB subtypes of MDS, and taking into account the last of the five-year periods, the most frequently diagnosed were RA and RSA followed by RAEB, CMML and RAEB-T. CONCLUSIONS: The increment of the incidence of MDS cases correlates significantly with the increment of the patients aged over 65 years. This incidence appears to be scarcely influenced by previous mutagenic agents (radiotherapy, chemotherapy) and might be due to a better understanding of MDS.

Acute Disease

[Idiopathic thrombocytopenic purpura in 5 members of a family].

Five cases of idiopathic thrombocytopenic purpura (ITP) appearing on five members of two generations of a family, with autosomal dominant pattern, are presented. The clinico-biologic behaviour of 2 patients (studied and treated by the authors) plus the available data from the 3 others (diagnosed and treated at other hospitals) allowed us to discard any possibility of hereditary non-immunologic thrombocytopenia. The predisposition of ITP patients and their relatives to present clinico-biological features of autoimmune diseases is commented as a possible explanation for the rare forms of familial ITP.

Adolescent

Influence of growth temperature on the production of extracellular virulence factors and pathogenicity of environmental and human strains of Aeromonas hydrophila.

The biochemical properties, virulence for mice and trout, and the extracellular virulence factors at 28 degrees and 37 degrees C of 11 environmental and nine human strains of Aeromonas hydrophila were compared. All the environmental isolates and four of the human group were virulent for trout at 3 x 10(7) cfu, but only human strains were able to cause death or lesions in mice by the intramuscular route. Extracellular virulence factors such as haemolysins, cytotoxins and proteases were also investigated in supernatant fluids of cultures grown at 28 degrees C and 37 degrees C. The production of haemolysins, caseinases, elastases and growth yields of environmental strains decreased sharply during cultivation at 37 degrees C but cytotoxins were produced to the same extent, or slightly less, than at 28 degrees C. The human strains differed from the environmental strains in response to growth temperatures: protease activity decreased at 37 degrees C, although growth yield was not affected, but more haemolysins and cytotoxins were produced by the virulent strains at this temperature than at 28 degrees C. Sodium caseinate SDS-PAGE of culture supernatant fluids of selected human strains revealed that temperature selectively inhibited the production of certain proteases.

Aeromonas hydrophila

Haemolytic anaemia to the alpha-interferon treatment: a proposed mechanism.

Auto-immune haemolytic anaemia (AIHA) has been found in a case of alpha-interferon treatment. Serum antibody and eluate were positive in the absence of the drug. Although the patient recovered after the treatment was stopped, DAGT remained positive for at least 8 months. The mechanism proposed to explain why this drug induced AIHA is similar to that proposed for alpha-methyl-dopa. Drugs could alter the red cell membrane and impair the immune system. Such changes have been observed with alpha-interferon and were related with increased autoimmunity.

Adult

Comparative study of virulence and virulence factors of Aeromonas hydrophila strains isolated from water and sediments of a river.

Seventy-four strains of Aeromonas hydrophila isolated from water and sediments of the River Porma (León, N.W. Spain) were characterized biochemically and biologically. Fifty-seven strains (77.02%) were virulent for rainbow trout (Salmo gairdneri) by intramuscular challenge but showed differing degree of pathogenicity which could not be associated with the source. A lack of correlation between caseinase, haemolytic and cytotoxic activities of the strains and their isolation source was also observed. Only two surface characters, acriflavine 0.2% agglutination and non-agglutinating SP-/PAB-phenotypes, were significantly associated with water and sediment strains, respectively.

Aeromonas hydrophila

[Severe digestive hemorrhage of an unusual etiology. Visible isolated and bleeding esophageal vessels].

We describe two patients with massive upper gastrointestinal bleeding. The upper gastrointestinal endoscopy revealed jet haemorrhage in the distal portion of the esophagus, from a visible vessel, without esophageal mucosal damage. In both cases arteriography was performed, and did not show vascular malformations or fistulous points. The patients were successfully treated, one with endoscopic sclerosis and balloon tamponade, and the other with endoscopic sclerosis and transcatheter embolization through left gastric artery. For the time being we do not know the true importance of these findings, but we hope that other reports help us to understand the clinical and pathologic features of this vascular lesion, and the best therapeutic approach.

Adolescent

Cloning and characterization of an extracellular temperature-labile serine protease gene from Aeromonas hydrophila.

Aeromonas virulence is thought to depend on multigenic functions. The gene for an extracellular protease from Aeromonas hydrophila SO2/2 was cloned in Escherichia coli C600-1 by using pIJ860, bifunctional plasmid, as a vector. The gene encodes for a temperature-labile serine protease (P2) with a molecular mass of approx. 68 kDa which is highly inhibited by PMSF. The gene was expressed in Streptomyces lividans 1326 by transforming protoplasts with the original clone pPA2. We were also able to transfer and express the prt P2 gene in Pseudomonas putida by mating experiments. The protein P2 was secreted into the periplasms of both P. putida and E. coli C600-1 being identical in properties to one of the proteases secreted into the culture supernatant by A. hydrophila SO2/2.

Aeromonas

Patient's surface, clinical surface, and workable surface.

Surface is a term often used in clinical theory, which seems to have eluded a reliable definition. Freud used the term mostly to denote the analysand's consciousness. This patient's surface does not always coincide with the data the analyst can observe, i.e., the clinical surface. It is proposed that clinical surface be understood, in contrast to other psychoanalytic concepts, as the clinical evidence that does not need conjecture to be grasped cognitively. The concept of "average expectable apperception" is introduced. Workable surface is defined as those aspects of the clinical surface that lend themselves well to the exploration of unconscious dynamics or genesis. Ideas about which surfaces are optimally workable vary according to different schools of technique. The advantages of considering clinical surface the objective anchorage of psychoanalysis as a positive science and of differentiating it from patient's surface and workable surface are discussed.

Cognition

Molecular cloning and characterization of an extracellular protease gene from Aeromonas hydrophila.

A structural gene which codes for an extracellular protease in Aeromonas hydrophilia SO2/2 and D13 was cloned in Escherichia coli C600-1 by using pBR322 as a vector. The gene codes for a temperature-stable protease with a molecular mass of approximately 38,000 daltons. The protein was secreted to the periplasm of E. coli C600-1 and purified by osmotic shock. Cloned protease (P3) was identical in molecular mass and properties to the one purified from A. hydrophila SO2/2 culture supernatant as an extracellular product.

Aeromonas

Pathogenicity factors and virulence for rainbow trout (Salmo gairdneri) of motile Aeromonas spp. isolated from a river.

Ninety-seven motile Aeromonas strains were isolated over a period of a year from samples of water and sediment collected at different sites along a river. Strains were regularly recovered from all samples, regardless of the source of isolation or seasonal conditions. Isolates were biochemically characterized by the API 20NE system (Analytab Products, Plainview, N.Y.) and classified as Aeromonas hydrophila (74 strains), Aeromonas sobria (11 strains), and Aeromonas caviae (12 strains). Despite the high level of homogeneity observed in their biochemical patterns, they displayed different degrees of virulence for fish; 72.02% of A. hydrophila isolates and 63% of A. sobria isolates were virulent for fish by intramuscular challenge, but lower frequencies of virulence were observed when intraperitoneal injections were used. All A. caviae strains proved to be avirulent. Caseinases, hemolysins, and Vero cytotoxins were produced by 100, 91, and 94.59%, respectively, of A. hydrophila strains and with lower frequencies and lower caseinase activities by A. sobria isolates. No correlation was found between these activities and the degree of virulence of the strains for fish. Most hydrophobic strains seem to be concentrated in A. caviae, A. sobria, and avirulent A. hydrophila groups. Known virulence markers commonly associated with virulent strains (acriflavine negative and self-pelleting negative and precipitation after boiling positive phenotypes) had a low representation in the total of strains studied and were not associated with virulence.

Aeromonas

[Acute promyelocytic leukemias: clinico-biological aspects, prognostic factors, therapeutic response, and possibilities of cure in 34 cases (1970-1988)].

Thirty-four new cases of acute promyelocytic leukaemia (M3) were diagnosed at the authors' Centre between 1970 and 1988 (19 males and 15 females) with ages between 5 and 73 years (median age, 32 years). Three cases were of the hypogranular variant or M3-v (8.8%). The clinical picture included: haemorrhagic diathesis (85%), pallor/malaise (82%), fever/infection (41%), hepatomegaly (26%), splenomegaly (12%). Leucopenia of less than 5 x 10(9)/L was present in 23/34 cases, laboratory signs of DIC in 26/31, increased LDH, over 400 U/mL, in 6/31, and abnormal karyotype in 7/15. One of the patients rejected any treatment; two others died of brain haemorrhage before therapy was started, and seven died in the first two weeks of treatment. Of the 31 patients treated, complete remission (CR) was achieved in 21 cases (67.7%). Allogeneic BMT was carried out in two of them, with further relapse and death. Post-remission treatment was given to the remaining 19 patients, and there were 13 relapses. Six patients have been in CR, 5 of them after cessation of therapy, for the last 1.5-11.5 years. Age under 50 years and leucocyte count below 5 x 10(9)/L at diagnosis were favourable prognostic factors according to the univariate statistical analysis performed. The survival plateau of the actuarial curve was reached beyond 2.75 years by 15% of all the patients treated (33 cases), 23% of the patients who achieved CR (21 cases), 31% of the patients under 50 years of age and 5 x 10(9)/L leucocyte count at diagnosis (15 cases) and 36% of these last achieving CR (13 cases).

Actuarial Analysis

Unusual serotypes of Escherichia coli from piglet diarrhea in north Spain.

Eighteen strains of Escherichia coli isolated from piglet diarrhea were examined with a wide range of antisera and were found not to belong to the common serotypes found in this disease. Several different serotypes were found; nine strains belonged to O153, and an O group (not commonly associated with piglet diarrhea) belonged to four different serobiotypes.

Animals

Stereotactic evacuation and local administration in intracerebral haematomas. A comparative study.

Based on current controversies on optimal treatment for spontaneous intracerebral haematomas, chronic experiments to investigate the validity of open surgery, stereotactic evacuation and local urokinase administration in these lesions were performed in 52 dogs. Under general anesthesia diverse volumes of autologous blood were intracerebrally injected to produce the haematoma. A catheter was introduced and chronically implanted in the contralateral ventricle for intracranial pressure monitoring. The animals were divided in two groups of 26 dogs each, according to haematoma location in subcortical or basal ganglia structures. The natural history was studied in both groups. Different types of treatment consisting in surgery, stereotactic evacuation, urokinase injection within the clot and both latter techniques combined were carried out 24 or 72 hours following haematoma production. Clinical status, systemic arterial pressure, intracranial pressure and CT scanning were used for result evaluation. Brain specimens were submitted for pathological examination. Our results indicate that stereotactic evacuation performed during the first 24 hours after haematoma occurrence was the most effective and innocuous procedure for basal ganglia lesions. Local urokinase plus stereotactic aspiration showed a high efficacy in controlling delayed basal ganglia and subcortical blood collections. Other therapeutic approaches behaved almost as the natural history.

Animals