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C Serrano

Publications and source records attributed to C Serrano.

At least 37 records · Page 2Linked to original sources

Chronic idiopathic sensory ataxic neuropathy: immunological aspects of a series of 17 patients.

Sensory ataxic neuropathies (SANs) are characterized by loss of proprioceptive sensations and preservation of muscle strength. They may be idiopathic or associated with different toxic, infectious or autoimmune causes. Reactivity against gangliosides containing disialosyl groups, particularly GD1b, has been reported in isolated cases of acute and chronic idiopathic ataxic neuropathies (iSAN) and different experimental findings (in vivo animal models and in vitro preparations) suggest that antidisialosyl or antiGD1b antibodies could play a role in the pathogenesis of some ataxic neuropathies. We present the clinical, immunological and immunohistochemical characteristics of 17 patients who had a chronic iSAN without gammopathy. Patients were selected from a large group of 130 subjects with SAN: 93 with known etiology and 37 with iSAN. IgM and IgG antibodies to GM1, GM2, GM3, aGM1, GD1a, GD1b, GD3, GT1b and GQ1b were investigated by ELISA (INCAT protocol) and thin layer chromatography. Immunohistochemistry, using biotinylated Ig extracted from the patientś serum, was performed on human dorsal root ganglia (DRG), spinal cord, anterior and posterior roots, sural nerve and muscle tissue. The mean age of the 17 patients was 62 (37-80 years). The most disabling features were unsteadiness and severe ataxia of gait. Only one patient of this group was wheelchair-bound. The clinical data of these 17 patients were similar to those of the other patients with SAN, except that progression was slower. Antibodies to GD1b, GD3 and GT1b were found in 1/17. Two more patients (one with an acute iSAN and one with chronic iSAN and gammopathy), also had antibodies to disialosyl or GD1b. No immunohistochemical pattern of reactivity was found in any of the tissues tested with the 17 sera. In summary, this study demonstrates antidisialosyl or anti GD1b antibodies only in 3/37 (8.1p. cent) of patients with iSAN, either acute, chronic, or with gammopathy. However, their value seems to be reinforced by the negativity of antiganglioside antibodies in the large group of patients with SAN of known etiology (0/93). Further studies will be necessary to confirm the importance of target antigens containing disialosyl moieties in a subset of iSAN patients. However, the negativity of antiganglioside antibodies in most cases suggests that the pathology of the sensory neurons and/or axons is probably not humorally mediated in the majority of patients with iSAN.

Adult↗

Placement of endosseous implants in patients with oral epidermolysis bullosa.

OBJECTIVE: To evaluate the feasibility of placing endosseous implants in patients with recessive dystrophic epidermolysis bullosa. This article reports on 4 patients subjected to follow-up. STUDY DESIGN: Implants were placed in 4 cases. All patients have marked oral involvement, with devastating alterations in the soft and hard tissues in all cases. RESULTS: A total of 15 implants (7 maxillary, 8 mandibular) were placed. All implants integrated successfully and have been restored. The average follow-up from implant placement was 2.5 years (range, 1-4). CONCLUSIONS: Our preliminary findings suggest that endosseous implants can be successfully placed and can provide support for prosthetic restoration in patients with recessive dystrophic epidermolysis bullosa.

Adult↗

[Candidemia in AIDS. A retrospective study of nine cases].

Prevalence of candidemia has increased during the last decade, numerous predisposing factors are invoked, like parenteral drug abuse in the case of brown heroin syndrome, neutropenia, prolonged antibiotic therapeutics and immunosupression. Only a few articles are published about candidemia. Candidemia in AIDS patients seems very low; its incidence is estimated approximately one candidemia per 120 patients.

English Abstract↗

Digital imaging in remote diagnosis of burns.

Images are capable of giving an accurate representation of skin color and have been used extensively in teaching about and researching burn therapy. The advance from analogue to digital imaging allows the remote transmission of the clinical information contained in the digital image of a burn, using a suitable system. The large size of these image files reduces transmission speed and makes data compression desirable. Compression, by means of the JPEG algorithm, of up to 50 times the original size of 38 digital images of burns suffered by 22 consecutive patients did not lessen its great usefulness in determining the depth of burn injuries, according to a group of experts in burn care. The success rate was close to 90%, both for non-compressed images in original BMP format (mean size:1500 Kb) and for compressed images with a Q index of 50 (30 Kb files), when compared with the clinical diagnoses confirmed one week after the accident.

Adult↗

Asymmetries in brain maturation and behavioral disturbances: multivariate electroencephalogram and P300 studies.

If behavior results from brain function, some evidence of dysfunction could be expected in children with major behavioral problems. Yet, neurophysiologic studies in these children are frequently normal. We hypothesized a relationship between maturational asymmetry and behavior, given the role of hemispheric imbalance in adult psychopathology. The purpose of this study was to investigate whether age-sensitive neurophysiologic measures could identify behaviorally relevant maturational asymmetries in otherwise healthy children. Ninety-five children were studied; reasons for testing were behavioral (19), academic (12), medical nonneurologic (16), and mixed (28), along with 20 control subjects. Academic, behavioral (Child Behavioral Checklist), and psychometric (Wechsler Intelligence Scale for Children-Revised; WISC-R) measures were analyzed in relation to four neurophysiologic parameters: P300 Latency, P300 Latency Asymmetry, Maturational Z-score, and Maturational Z-score Asymmetry, within a canonical design. The highest correlation was behavior with Maturational Z-score Asymmetry. Academic scores were predicted by the three-variable interaction of P300 Latency,Maturational Z-score, and Maturational Z-score Asymmetry. We concluded that behavior was strongly influenced by maturational asymmetry, while academic performance depended on both global maturation and maturational asymmetry. Our results suggest that behavioral disturbances can have a neural substrate despite apparently normal electroencephalograms (EEGs) and event-related potentials (ERPs). They open the possibility for specific therapeutic interventions to improve behavior and performance, and, perhaps, prevent major psychopathology in later life.

Achievement↗

Utility of anti-Hu antibodies in the diagnosis of paraneoplastic sensory neuropathy.

Anti-Hu antibodies (Hu-Abs) were positive in 40 patients with paraneoplastic sensory neuropathy (PSN) and in 1 patient with idiopathic sensory neuropathy in a series of 126 patients who presented with clinical features suggestive of PSN. The specificity of Hu-Abs was 99% and the sensitivity was 82%. Nine (18%) PSN patients were Hu-Ab-negative, and their sera did not harbor other specific anti-neuronal or anti-ganglioside antibodies. Small cell lung carcinoma (SCLC) was the leading neoplasm in the Hu-Ab-positive (79%) and Hu-Ab-negative (44%) groups. This study confirms the value of Hu-Abs for the diagnosis of PSN and SCLC and also emphasizes that in patients with possible PSN, the absence of Hu-Abs does not exclude cancer, particularly in those patients with risk factors for SCLC.

Adult↗

Oesophageal narrowing in chronic granulomatous disease.

A 14 year-old boy with X-linked chronic granulomatous disease (CGD) developed a long smooth narrowing at the mid oesophagus with severe dysphagia. Endoscopy revealed a normal mucosa and biopsy showed non-specific acute inflammatory changes. Bacterial cultures of the biopsy specimens were sterile. Combined treatment with antibiotics and steroids resulted in a transitory remission, but symptoms recurred after 2.5 months. One second course of steroids and antibiotics lead to a long-term remission. Oesophagogram was more useful than endoscopy to evaluate the severity of the stricture.

Adolescent↗

Dysferlin, a novel skeletal muscle gene, is mutated in Miyoshi myopathy and limb girdle muscular dystrophy.

Miyoshi myopathy (MM) is an adult onset, recessive inherited distal muscular dystrophy that we have mapped to human chromosome 2p13. We recently constructed a 3-Mb P1-derived artificial chromosome (PAC) contig spanning the MM candidate region. This clarified the order of genetic markers across the MM locus, provided five new polymorphic markers within it and narrowed the locus to approximately 2 Mb. Five skeletal muscle expressed sequence tags (ESTs) map in this region. We report that one of these is located in a novel, full-length 6.9-kb muscle cDNA, and we designate the corresponding protein 'dysferlin'. We describe nine mutations in the dysferlin gene in nine families; five are predicted to prevent dysferlin expression. Identical mutations in the dysferlin gene can produce more than one myopathy phenotype (MM, limb girdle dystrophy, distal myopathy with anterior tibial onset).

Adult↗

Whey protein/casein ratio and nonprotein nitrogen in preterm human milk during the first 10 days postpartum.

BACKGROUND: This study was designed to describe the longitudinal changes in the casein and whey fractions and the total and nonprotein nitrogen contents of preterm human milk for the first 10 days postpartum. METHODS: Eleven mothers delivering at 30 to 34 weeks of gestation were studied, six throughout the first 10 days and five on the first postpartum day. Four milk samples were collected every day by expression of one breast with an electric breast pump. Casein and whey protein were separated from the defatted milk by isoelectric precipitation in calcium chloride and by subsequent ultracentrifugation. The milk nitrogen content was determined before and after acid precipitation. Whey protein and casein were characterized by electrophoresis in polyacrylamide gel. RESULTS: Total and protein nitrogen showed a sharp decrease during the first 3 postpartum days, whereas the nonprotein nitrogen did not change markedly (mean concentration, 0.58 mg.ml-1). Casein content expressed as nitrogen in preterm human milk was 0.35 mg.ml-1 between days 3 and 5 and 0.60 mg.ml-1 between days 6 and 10. The whey protein-casein ratio before day 2, was 100:0, at day 3, 86:14, at day 5, 76:24, and at day 10, 70:30. Three days after delivery, casein levels rose progressively, increasing markedly after day 6. CONCLUSIONS: These findings suggest that delivering before term affects neither casein production nor its chemical characteristics.

Caseins↗

[Factors related to the appearance of peripheral vascular complications after taneous cardiovascular interventions].

BACKGROUND: Percutaneous diagnostic and therapeutic cardiac catheterization procedures carries some risks, most of them related to the appearance of peripheral vascular complications. These complications imply additional treatments for the patient including vascular surgery, longer hospital stays and increased costs. Some clinical and procedural variables have been pointed out as independent predictors of appearance of vascular complications. Nevertheless, no information have been reported concerning to the influence of the experience of the cardiologist who performs the procedure or provides the local hemostasia and the rate of vascular complications. OBJECTIVE: To characterise the type and incidence of peripheral vascular complications in patients undergoing a percutaneous cardiac procedure, to identify the predictors and to determine the influence of the professional experience and the complexity of the technique in the complications rate. METHODS AND RESULTS: Within 1-year (1994 to 1995) period, 1,008 consecutive patients undergoing a percutaneous cardiovascular procedure (750 diagnostic and 258 therapeutic) were prospectively included. Seventy percent were male. Mean age was 63 +/- 2 years. A total of 55 vascular complications were demonstrated (5.6%): 36 (3.6%) hematomas, 14 (1.4%) pseudoaneurysms, 2 (0.2%) arteriovenous fistula, 2 (0.2%) episodes of limb ischemia and 1 (0.1%) retroperitoneal hematoma. Only 28 (2.8%) were severe complications. By multivariate analysis, only experience to perform hemostasis (OR: 3.36; 95% CI: 1.37-8.22), previous treatment with aspirin (OR: 2.69; 95% IC: 1.31-5.52), left femoral artery puncture (OR: 2.53; 95% IC: 1-1.02), sheath removal later than 60 minutes (OR: 1.02; 95% IC: 1.01-1.04) and hemostasis which lasted > 30 minutes (OR: 1.01; 95% IC: 1-1.02), were independent predictors of vascular complications. CONCLUSIONS: Vascular complications rate after percutaneous cardiovascular procedures was low. Most of them associated to procedural variables and potentially avoidable, with promotion of a well planned policy of training in order to modify the factors involved.

Aged↗

[Grouped crises and status epilepticus in complex partial epilepsy].

INTRODUCTION: In complex partial crises (CPC) some characteristics of the way in which they occur may be helpful in localizing the focus of origin in the cerebral cortex. Thus, the appearance of any kind of status epilepticus will not predominate depending on the origin of the epileptic focus, but the complex partial state will be rare when the origin is temporal and more frequent when the origin is frontal. The appearance of CPC in a cluster form is, on the other hand, characteristic of crises originating in the frontal lobe. MATERIAL AND METHODS: We review the clinical history of 151 epileptics with CPC, evaluating the way in which the crises appear, together with other clinical data. We define the start of the crisis in a specific lobe, when this was the site of maximum voltage of the epileptic anomaly or of maximum phase opposition. RESULTS: 10% of the patients showed grouping of their CPC; in the remainder the appearance was isolated, 15% showed status epilepticus at some point in their illness. We found a statistical difference when relating this to the anomalous topography of the EEG; between 15% and 42% more patients with status epilepticus were counted when the topography of the anomaly in the EEG was extratemporal. There was also between 37.2% and 76.4% more patients with cluster crises in the cases with an extratemporal focus.

Adolescent↗

Signal transducer and activator of transcription 1 in human muscle: implications in inflammatory myopathies.

Polymyositis (PM) and dermatomyositis (DM) are two major and distinct inflammatory myopathies. Cytokines, implicated in the immune process, have been recognized in the muscle tissue from PM and DM patients, but their functional in situ role has not been identified. We analyzed the expression of the signal transducer and activator of transcription 1 (STAT1), a molecule whose up-regulation indicates the interaction of cytokines, or growth factors, with their target receptors in muscle fibers and inflammatory infiltrates in PM and DM. An immunohistochemical analysis was performed using monoclonal antibodies to STAT1 in 57 muscle biopsies from 10 patients with DM, 10 with PM, and 37 controls. The profile of STAT1 up-regulation was also investigated in cultured muscle stimulated by interferon-gamma, epidermal growth factor, platelet-derived growth factor, and interleukin-2, using semiquantitative polymerase chain reaction and Western blot. High STAT1 expression was observed in many perifascicular atrophic muscle fibers from DM patients in 10/10 biopsies. In contrast, only a few muscle fibers undergoing necrosis were STAT1 positive in 2/10 patients with PM and in 2/37 controls. STAT1 reactivity was noted in most cells of the infiltrates in DM, PM, and controls. In vitro, STAT1 was stimulated by interferon-gamma but not by the other molecules studied. These results suggest that in DM, but not in PM, there is distinctive functional local cytokine activity able to increase STAT1 expression in muscle fibers. As interferon-gamma specifically activates STAT1 in vitro, this cytokine in conjunction with ischemia is probably involved in perifascicular muscle fiber pathology in DM.

Blotting, Western↗