Biomedical subjects
Carmen García
Publications and source records attributed to Carmen García.
Silent cerebral white matter lesions and their relationship with vascular risk factors in middle-aged predialysis patients with CKD.
BACKGROUND: Silent cerebral white matter lesions are observed on magnetic resonance imaging (MRI) scans in elderly people, and they are related to vascular risk factors, particularly hypertension. No data on the prevalence and risk factors of white matter lesions in patients with chronic kidney disease (CKD) are available. The aim is to analyze the prevalence of white matter lesions and their determinants in this population. METHODS: We studied 52 patients without diabetes with CKD (stage 3 or 4) aged 30 to 60 years (average, 49 years) and a group of 32 normotensive control subjects. MRI studies were performed and subcortical and periventricular white matter lesions were evaluated by using semiquantitative measures. Patients were classified into 2 groups depending on the presence or absence of white matter lesions. Echocardiographic studies and measures of markers of systemic inflammation (C-reactive protein and interleukin 6) also were performed. RESULTS: White matter lesions were more prevalent in patients with CKD than controls (33% versus 6%; P = 0.008). Patients with CKD who had white matter lesions were older; had a greater history of cardiovascular disease and vascular nephropathy as a primary cause of renal disease and greater levels of systolic blood pressure, pulse pressure, left ventricular mass index, and C-reactive protein; and were administered more antihypertensive drugs than patients with CKD without white matter lesions. Stage and duration of CKD were not related to the presence of white matter lesions. After adjusting for several factors, only vascular nephropathy (odds ratio, 15.6; 95% confidence interval, 1.27 to 191.54; P = 0.03) independently predicted an increased risk for white matter lesions. CONCLUSION: One third of middle-aged patients with CKD have silent cerebral white matter lesions. Vascular nephropathy seems to be the most important factor related to the presence of these lesions, suggesting that white matter lesions reflect ischemic brain damage caused by generalized vascular damage.
Spread of Escherichia coli strains with high-level cefotaxime and ceftazidime resistance between the community, long-term care facilities, and hospital institutions.
A total of 151 Escherichia coli strains resistant to cefotaxime and ceftazidime were isolated during a prospective surveillance study. These strains were characterized by clinical, microbiological, and molecular analyses and were distributed into four clusters of 103, 11, 6, and 5 isolates, along with 25 unrelated strains. The principal cluster was isolated from urine, wound, blood, and other samples in three hospitals, eight nursing homes, and a community healthcare center. This cluster was associated with both nosocomial (65%) and community-acquired (35%) infections. Most strains were resistant to ciprofloxacin, gentamicin, tobramycin, cefepime, amoxicillin-clavulanic acid, and trimethoprim-sulfamethoxazole but were susceptible to imipenem. All isolates from the four clusters expressed the extended-spectrum beta-lactamase (ESBL) CTX-M-15. This enzyme was also present in 8 (30.8%) of the 26 unrelated isolates. The other ESBLs, CTX-M-14 and CTX-M-32, were detected in five and seven cases, respectively, but they were detected in individual E. coli isolates only. In three clusters, blaCTX-M-15 alleles were linked to an ISEcp1-like element, while in eight strains of cluster II an IS26 element preceded the blaCTX-M-15 allele. An additional pool of resistance genes included tetA, drfA14 or dfrA17, sul1 or sul2, aac(6')Ib, and aac(3)IIb. All except one of the 27 isolates tested for genetic virulence markers harbored the same three virulence genes: iutA and fyuA (siderophores), and traT (serum survival factor). Epidemic or occasional isolates of cefotaxime- and ceftazidime-resistant E. coli can spread between distinct health facilities including hospitals, community health centers, and long-term care centers.
[Heparin-induced thrombocytopenia with thrombosis and cardiovascular surgery].
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The SV40 T antigen nuclear localization sequence enhances nuclear import of vector DNA in embryos of a crustacean (Litopenaeus schmitti).
A genetic transformation system for penaeid shrimp could provide a powerful technique for the improvement of different production traits of importance for a sustainable aquaculture. The development of a successful transformation system depends on the ability to efficiently introduce exogenous DNA into the target species. The ability of the nuclear localization signal (NLS) peptide of the SV40 T antigen to facilitate nuclear import and transient gene expression is known from vertebrate systems and for the first time, is shown here to be efficient in a crustacean species, i.e. the shrimp Litopenaeus schmitti. Electroporation was used to introduce the pCMV-lacZ plasmid that contains the human cytomegalovirus promoter/enhancer (CMV) fused to the beta-galactosidase (lacZ) coding region, into L. schmitti zygotes. Supercoiled DNA was used at 50 or 500 ng/microl naked or bound to NLS peptide. The hatching rate of electroporated zygotes was around 60% for all groups, except from the pCMV-lacZ:NLS group at 500 ng/microl (43%). Based on Southern blot analyses of polymerase chain reaction (PCR) products the gene transfer frequency was 2-fold higher using DNA:NLS complexes than with naked DNA (23.8% vs. 11.5%, with 50 ng/microl of plasmid DNA, 44.3% vs. 28.8% with 500 ng/microl). The beta-galactosidase activity assay indicated that nuclear uptake is faster for the DNA:NLS complexes than for naked DNA. The beta-galactosidase activity was always higher in the DNA:NLS groups than in the naked DNA groups. To our knowledge, this is the first report on the use of an NLS peptide to improve gene transfer and nuclear uptake in crustaceans.
Effect of the immunosuppressive treatment on long-term renal graft survival.
BACKGROUND: Although new immunosuppressive agents have improved the results of renal transplants (RTs), long-term graft loss remains high. We evaluated the impact of different immunosuppressive regimens on patient and graft survival. METHODS: Data from 3365 patients receiving cadaver RTs in Spain during the years 1990, 1994 and 1998 were retrospectively analysed. All data were entered into a specially designed database. Graft and patient survival rates were estimated by the Cox regression method and results expressed as percentage survival. A maximum-likelihood estimate of the projected graft half-life (median value) was calculated by Weibull regression. RESULTS: In 1990 graft and patient survival differed significantly from the other treatment years (P = 0.0006 and P = 0.0101, respectively). The risk of graft loss was significantly higher for cyclosporine (CsA), prednisone (P) and azathioprine (Az) than for CsA + P, which in turn was higher than for CsA + P plus polyclonal antibodies [antilymphocyte globulin (ALG)/antithymocyte globulin (ATG)]. Risk of patient death was also significantly higher for CsA + P + Az than for CsA + P. No significant differences between treatment groups were found in graft and patient survival for 1994 and 1998. The projected median graft life for patients with the most used immunosuppressive regimen for each year was 12.9 years for CsA + P + Az and 15.6 years for CsA + P plus mycophenolate mofetil (MMF). CONCLUSIONS: Triple therapy with Az in 1990 and 1994 and with MMF in 1998 were the most frequently used immunosuppressive regimens in the Spanish kidney transplant population. The best results were seen after induction therapy with polyclonal antibodies.
Contact dermatitis from the staples of neuroreflexotherapy.
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Odor-active compounds of Iberian hams with different aroma characteristics.
The odor-active compounds of different commercial types of Iberian hams (Montanera and Pienso) were researched by gas chromatography-olfactometry based on a detection frequency method. The hams (long- and short-Montanera and Pienso Iberian hams) showed different sensory profiles, differences being significant for Montanera ham typical odor, aroma intensity and persistence, and cured and moldy aroma. Significant differences were also found for some odorants. The largest differences appeared in 2-acetyl-1-pyrroline, hexanal, (Z)-3-hexenal, ethyl 2-methylbutyrate, (E)-2-hexenal, 1-octen-3-one, 1-octen-3-ol, 2-propionyl-1-pyrroline, octanal, and an unknown odorant. Sensory characteristics and olfactometric profiles were significantly different between Montanera and Pienso hams. Significant differences also appeared between long- and short-Montanera hams, which shows great variability in this commercial type. Otherwise, the largest scores for moldy aroma in long-Montanera hams matched with the largest detection frequency of 1-octen-3-one and 1-octen-3-ol in this group.
Characterization of the most odor-active compounds of Iberian ham headspace.
Gas chromatography-olfactometry (GC-O) based on detection frequency (DF) was used to characterize the most odor-active compounds from the headspace of Iberian ham. Twenty-eight odorants were identified by GC-O on two capillary columns, including aldehydes (11), sulfur-containing compounds (7), ketones (5), nitrogen-containing compounds (2), esters (2), and an alcohol. Among them, the highest odor potencies (DF values) were found for 2-methyl-3-furanthiol, 2-heptanone, 3-methylbutanal, methanethiol, hexanal, hydrogen sulfide, 1-penten-3-one, 2-methylpropanal, ethyl 2-methylbutyrate, and (E)-2-hexenal. Nine of the 28 most odor-active compounds were identified for the first time as aroma components of dry-cured ham, including hydrogen sulfide, 1-penten-3-one, (Z)-3-hexenal, 1-octen-3-one, and the meaty-smelling compounds 2-methyl-3-furanthiol, 2-furfurylthiol, 3-mercapto-2-pentanone, 2-acetyl-1-pyrroline, and 2-propionyl-1-pyrroline.
Revisiting the James versus Cannon debate on emotion: startle and autonomic modulation in patients with spinal cord injuries.
James' hypothesis that impaired peripheral physiology in patients with spinal cord injuries (SCI) impairs emotional processing, as manifested in the modulation of physiological responses and in the subjective component of emotions, was examined in the present study. A pilot study confirmed the utility of Lang's picture viewing paradigm in a group of 78 students using the Spanish norms of the International Affective Picture System. In the main study, 19 patients with SCI and 19 well controls matched for sex, age and education were examined. Results showed: (1) no differences between SCI and control participants in the valence and arousal ratings of the pictures; (2) similar heart rate modulation in both groups, i.e. the unpleasant pictures produced greater deceleration than the pleasant ones; and (3) no decrease in emotional experience in the SCI group compared with the control group. The implications of the results for the James versus Cannon controversy on the theory of emotions are discussed.
p16(INK4a) is selectively silenced in the tumoral progression of mycosis fungoides.
Knowledge about the molecular mechanisms involved in the pathogenesis of tumoral progression in mycosis fungoides (MF) is still scarce. Because the 9p21 locus seems to be a good target for a detailed study in MF, this prompted us to compare the mechanisms of inactivation of the p16(INK4a), p15(INK4b), and p14(ARF) genes in aggressive and stable forms of MF, performing microsatellite analysis, methylation-specific polymerase chain reaction, direct sequencing, and p16(INK4a) protein expression by immunohistochemistry. Additionally, the p53 gene was also sequenced in tumoral lesions. Thirty-nine patients with stable MF were studied. Alterations in p16(INK4a) and p15(INK4b) genes were detected in 18% and 5% of the cases, respectively. None of the cases analyzed showed alterations of the p14(ARF) gene. In contrast with these findings, in the 11 patients with aggressive MF, alterations of the p16(INK4a), p15(INK4b), or p14(ARF) genes were found in 8 (73%), 3 (27%), and 2 (18%) cases, respectively. A significant proportion (4/11) of these alterations were already present in the p16(INK4a) gene in the initial plaque lesions in these aggressive forms of MF. Alterations in the p16(INK4a) gene, either methylation or loss of heterozygosity, were clearly more frequent than those in the p15(INK4b) and p14(ARF) genes. These p16(INK4A) alterations were confirmed using immunohistochemistry. None of the nine tumoral lesions analyzed showed mutations in exons 1-2 of the p16(INK4a) gene or in exons 5-8 of the p53 gene. These results seem to suggest that 9p21 alterations, and selectively p16(INK4a) silencing, could be a characteristic phenomenon in MF progression.
[Mortality surveillance in cities: results in Valencia and Alicante, [Spain]].
OBJECTIVES: To describe mortality patterns, in general and by selected specific causes in Valencia and Alicante, to establish internal inequalities by districts, and to evaluate changes in the magnitude of these inequalities over time. METHODS: Deaths among residents of Valencia and Alicante in the periods 1990-1992 and 1996-1998 were assigned to residential municipal districts. Comparisons between the periods studied and between cities were carried out using the relative risk derived from a Poisson regression model. A comparative mortality figure was calculated using the 17 largest groups of the 9th International Classification of Diseases. Rates adjusted by the direct method, standardized mortality ratio, potential years of life lost (PYLL) ratio and life expectancy at birth were calculated by districts in each study period. RESULTS: The risks of death from all causes decreased between the first and second periods in both men and women in both cities. Life expectancy significantly increased in both cities for men and in Valencia for women. The city of Valencia had the greatest risk of death in both periods. Some causes of death increased (groups 5 and 6, mental and nervous system disorders and sensory organ diseases). By districts, there was greater variability in Valencia than in Alicante, especially in districts 1 and 11 in Valencia, which showed a high risk of death. CONCLUSIONS: The process of internal mortality surveillance by districts is reproducible. In the city of Valencia there were inequalities in mortality that were maintained over time. The city of Alicante showed less internal variability in its mortality indicators.
Metastasis to the male breast from hypopharyngeal squamous cell carcinoma.
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