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Biomedical subjects

E Cabrera

Publications and source records attributed to E Cabrera.

At least 19 recordsLinked to original sources

[Analysis of the Educational Program for Self-Care in the Elderly (PECA) for improving the quality of life of the elderly].

OBJECTIVE: To determine the efficacy over 12 months of the educational programme on self-care of the elderly (PECA), which covers quality of life, nutritional status, and perceived social support of people over 65 living in their own homes. DESIGN: Pre-test/post-test experimental study with control group. SETTING: Urban population in the Manso Health District (Example, Barcelona), Spain. PARTICIPANTS: Persons over 65 living in their own homes, healthy or with chronic illnesses characteristic of their age, who had a normal score in the Pfeiffer test. A total of 70 subjects (35 per group) were selected and 5 of the control group left the study. INTERVENTION: Programme on self-care of the elderly, including education on physical activity, nutrition, and social support. MEASUREMENTS: Dependent variables were quality of life, measured by the Nottingham Health Profile; nutritional status, measured by the Mini-Nutritional Assessment (MNA); and social support, measured by the Duke-Unk Functional Social Support Scale. RESULTS: The study sample had an average age of 70.9 (SD, 3.1); 88.2% had self-perception of good health; and 21% lived alone. We only found statistically significant differences between pre- and post-intervention observations in nutritional status (P=.001). CONCLUSION: Despite a statistically significant difference in the variable of nutritional status, the difference was not "clinically" relevant. The ineffectiveness of the intervention is due to our starting from a very homogeneous sample, which had good health status and well-established social networks.

Aged↗

[Vascular access for haemodyalisis. Comparative analysis of the mechanical behaviour of native vessels and prosthesis].

INTRODUCTION: The prosthesis nowadays used in the vascular access for haemodialysis have low patency rates, mainly due to the luminal obstruction, determined by the intimal hyperplasia. Several factors have been related to de development of intimal hyperplasia and graft failure. Among them are the differences in the biomechanical properties between the prosthesis and the native vessels. In the searching for vascular prosthesis that overcomes the limitations of the currently used, the cryopreserved vessels (cryografts) appear as an alternative of growing interest. However, it is unknown if the mechanical differences or mismatch between prosthesis and native vessels are lesser when using cryografts. OBJECTIVE: To characterize and compare the biomechanical behaviour of native vessels used in vascular access and cryografts. Additionally, segments of expanded polytetrafluoroethylene (ePTFE) were also evaluated, so as to evaluate the potential biomechanical advantages of the cryografts respect to synthetic prosthesis used in vascular access. METHODS: Segments from human humeral (n = 12), carotid (n = 12) and femoral (n = 12) arteries, and saphenous vein (n = 12), were obtained from 6 multiorgan donors. The humeral arteries were studied in fresh state. The other segments were divided into two groups, and 6 segments from each vessel were studied in fresh state, while the remaining 6 segments were evaluated after 30 days of criopreservation. For the mechanical evaluation the vascular segments and 6 segments of ePTFE were mounted in a circulation mock and submitted to haemodynamic conditions similar to those of the in vivo. Instantaneous pressure (Konigsberg) and diameter (Sonomicrometry) were measured and used to calculate the viscous and elastic indexes, the compliance, distensibility and characteristic impedance. For each mechanical parameter studied, the mismatch between the prosthesis and the native vessel was evaluated. RESULTS: The ePTFE was the prosthesis with the higher mechanical mismatch (p < 0.05). The venous and arterial cryografts showed the least mismatch with native veins and arteries, respectively. The prosthesis with the least mechanical mismatch was different, depending on the native vessel evaluated, and for a native vessel, on the parameter considered. CONCLUSION: The mechanical mismatch between the native vessel and the vascular prosthesis used in a vascular access could be reduced using cryografts.

Adult↗

First enantiospecific synthesis of the antitumor marine sponge metabolite (-)-15-oxopuupehenol from (-)-sclareol.

[reaction: see text] A new route toward puupehenone-related bioactive metabolites from (-)-sclareol, based on the palladium(II)-mediated diastereoselective cyclization of a drimenylphenol, is described. Utilizing this, the first enantiospecific synthesis of the antitumor and antimalarial (-)-15-oxopuupehenol, together with improved syntheses of (+)-puupehenone, (+)-puupehedione, and (+)-15-cyanopuupehenone, were accomplished.

Animals↗

Biodiversity of uptake hydrogenase systems from legume endosymbiotic bacteria.

Uptake hydrogenases in legume endosymbiotic bacteria recycle hydrogen produced during the nitrogen fixation process in legume nodules. Despite the described beneficial effect on plant productivity, the hydrogen oxidation capability is not widespread in the Rhizobiaceae family. Characterization of hydrogenase gene clusters in strains belonging to Rhizobium, Bradyrhizobium and Azorhizobium reveals a similar overall genetic organization along with important differences in gene regulation. In addition, phylogenetic analysis of hup genes indicates distinct evolutionary origins for hydrogenase genes in Rhizobia.

Bacteria↗

[The non Q wave myocardial infarction in conventional valvular surgery. Diagnosis with cardiac troponin I].

INTRODUCTION: Morbidity and mortality in elective valve surgery is still significant. The main cause of death in these patients is cardiogenic shock, of which the most frequent etiology is acute myocardial infarction (AMI) with Q wave in the ECG. However, there are patients with cardiogenic shock without Q wave in the ECG and with rises in CK-MB enzyme that makes us suspect non-Q wave AMI. OBJECTIVE: To analyze the use of the determination of cardiac troponin-I, a more specific marker of AMI than CK-MB after cardiac surgery, to detect perioperative non-Q wave AMI, and to establish its clinical significance. METHODS: A total of 147 patients without coronary artery disease scheduled for elective valve surgery were included. We used, based in anterior publications, ECG (presence or not of new Q wave) and cardiac troponin I to define perioperative AMI. Levels of cardiac troponin-I were analysed before surgery and 14 hours after. Non-Q wave AMI was diagnosed when troponin I was superior to 38.85 ng/ml and there was not a phatologic Q wave in ECG. RESULTS: One hundred twenty-three (83.67%) of patients did not have AMI, 9 (6.12%) suffered perioperative AMI with Q wave, and 15 (10.27%) carried out criteria of non-Q wave perioperative AMI. Morbidity and mortality in this last group was similar to that in the group with Q wave AMI. Morbidity and mortality were minimum in patients without AMI. CONCLUSIONS: This study suggest the possibility of in vivo identification of non-Q wave perioperative AMI, an entity with important morbidity and mortality in our series, with a simple determination of cardiac troponin I 14 hours after surgery.

Adult↗

The role of CNSs in promoting elderly patients' autonomy in long-term institutions: problems and implications for nursing practice and research.

Autonomy has become an important focus within healthcare. Elderly patients, however, are often denied the right to independent decision making on grounds of incompetence and incapacity. In long-term institutions there are several ways in which the clinical nurse specialist can promote the autonomy of elderly patients. This article provides an overview of the concept of autonomy and discusses some of the problems in its realization in long-term nursing institutions. It also outlines strategies for supporting autonomy in elderly patients and concludes with a discussion of the implications of autonomy to nursing practice and research.

Age Factors↗

[Gemcitabine in the treatment of 4 patients with cholangiocarcinoma].

Cholangiocarcinoma is a biliary tree cancer of unknown etiology, whose symptoms are unspecific and is usually detected in advanced stages. Surgery continues to be the only curative therapy. Median survival in patients with inoperable tumors ranges between 5 and 8 months. There are few studies on the effects of chemotherapy, with a very small response. We report four patients with advanced cholangiocarcinoma, treated with gemcitabine 1000 mg/m2, weekly for 3 weeks every 28 days. There was a stabilization of tumor size and symptoms were alleviated. Toxicity was low and there was a probable prolongation of survival.

Aged↗

[Effect of anti-inflammatory drugs, alone and combined with ofloxacin, on the respiratory burst of human polymorphonuclear leukocytes].

The antibacterial activity of polymorphonuclear leukocytes (PMNs) is based on the production of superoxide anion and H(2)O(2) in the respiratory burst and can be impaired in different ways. The combination of an antibacterial agent and an antiinflammatory drug is quite common in immunodepressed patients whose respiratory burst of PMN could be impaired. In this study we examine in vitro the effect of pretreating (35 degrees C for 30 min) PMNs with the antiinflammatory drugs dexamethasone (0.4, 4 and 40 microgram/ml), methylprednisolone (0.37, 3.7 and 37 microgram/ ml), hydrocortisone (0.048, 0.48 and 4.8 microgram/ml), betamethasone (0.1, 1, 5 and 10 mg/ml), phenylbutazone (1000 microgram/ml) and acetylsalicylic acid (25, 250, 2500 microgram/ml) alone, and combined with 10 mg/ml of ofloxacin on the respiratory burst. Superoxide anion was measured by the cytochrome c reduction microtechnique and H(2)O(2) by phenol red. The antiinflammatory drugs alone decreased the production of H(2)O(2) (except dexamethasone and methylprednisolone) and superoxide anion (except betamethasone) from 15-45%, depending on the antiinflammatory drug and concentration, while ofloxacin increased the production of superoxide anion (20.2 +/- 6.7%). The combination of antiinflammatory drugs with ofloxacin neutralizes the inhibitory effect of the former on the respiratory burst of PMNs. It is therefore important to know the effect of drugs on the respiratory burst in order to choose those that have the same therapeutic effect without interfering with PMN functions.

Adult↗

ESR and optical absorption studies of gamma- and electron-irradiated sugar crystals

Electron spin resonance (ESR) studies of the free radicals induced in gamma- or electron-irradiated sugar crystals were performed. The number of radicals increases linearly, pointing out that this material can be used as a dosimeter. The optical absorption studies show the presence of several distinctive bands in the infrared and UV region, whose intensity changes with the irradiation dose. An interpretation of these results in terms of the formation of free radicals and possible crosslinking along the sugar molecular chains is presented.

Journal Article↗

Natural and synthetic podolactones with potential use as natural herbicide models.

A collection of 11 natural and synthetic podolactones have been tested as allelochemicals in a range between 10(-4) and 10(-9) M, and their potential use as natural herbicide models is discussed. Their effects on the germination and growth of the dicots Lactuca sativa (cv. Nigra and cv. Roman), Lepidium sativum, and Lycopersicon esculentum and the monocots Allium cepa, Hordeum vulgare, and Triticum aestivum as standard target species have been studied. An important inhibitory effect on the germination and growth of all tested species (average = 90%) was produced by compounds 9-11 at 10(-4) M. The specific structural requirements related to their activities are studied. On the basis of these results, their use as potential natural herbicide models is proposed.

Herbicides↗

[Effect of antiinflammatory agents on the accumulation of ofloxacin in human polymorphonuclear leukocytes].

The uptake of quinolones is a recently defined pharmacokinetic parameter which is increasing in importance in clinical practice, especially for immunocompromised patients whose polymorphonuclear leukocytes (PMNLs) have their bactericidal systems impaired, or in infections due to bacteria able to survive in the phagocytes. In both situations, antibiotics able to penetrate and be active in the phagocytes are required. The simultaneous administration of an antibiotic and an antiinflammatory drug is frequent, and previous studies have described interactions between the intracellular activity of the quinolones and the presence of phenylbutazone. We studied the effect of the presence of and the pretreatment (37 C for 30 and 60 min) of human PMNLs with the antiinflammatory drugs betamethasone (1 mg/l), hydrocortisone (1 mg/l), phenylbutazone (10 mg/ml), and acetylsalicylic acid (200 mg/l) on the uptake of ofloxacin (10 mg/l) by the PMNLs using a fluorometric method to measure the intra-PMNL concentration of ofloxacin. The presence of betamethasone did not modify the uptake of ofloxacin by PMNLs. Pretreatment of PMNLs with hydrocortisone, phenylbutazone and acetylsalicylic acid produced a significant decrease in the maximum intracellular concentration/extracellular concentration ratios compared with the maximum reached without pretreatment. These results suggest that hydrocortisone, phenylbutazone and acetylsalicylic acid interfere with the uptake of ofloxacin by PMNLs and increase the efflux of ofloxacin from PMNLs.

Anti-Infective Agents↗

[Subcutaneous heparin during the first trimesters of pregnancy in women with prosthetic heart valves].

BACKGROUND: Oral anticoagulation therapy in pregnant women with prosthetic heart valves is associated with a greater risk of abortion, fetal malformations and thromboembolic complications. AIM: To assess the use of subcutaneous heparin in women with pregnancies of less than 12 weeks as an alternative to oral anticoagulation therapy. MATERIAL AND METHODS: Pregnant women were admitted to the hospital and coumarinics were replaced with not fractionated subcutaneous heparin in a dose of 10,000 IU every 12 hours, aiming at prolonging partial thromboplastin time, 2 or 2 1/2 times. During the hospitalization period, women were taught about the heparin injection technique. Coumarinics were restarted after week 13 of pregnancy until 10 days prior to the delivery date in which women were again admitted to the hospital and intravenous heparin was used until the delivery. RESULTS: Between 1991 and 1997, this protocol was used during ten pregnancies in seven women aged 19 to 36 years old. Five had a Starr-Edwards prosthesis, one had a mitral Björk-Shilley prosthesis and one, a double prosthesis (mitral Starr-Machi and aortic St Jude). Subcutaneous heparin was started in the fifth week of pregnancy in 1 case, in the sixth week in seven and in the seventh week in two. There was no maternal mortality and one transient ischemic attack without sequelae. One non compliant patient had a Björk Shilley prosthetic valve dysfunction that required a valve replacement at the twelfth week of pregnancy and she had a spontaneous abortion at week 15. Other patient had a pneumonia at week 37 and gave birth to a stillbirth. There were no fetal malformations. CONCLUSIONS: This therapeutic protocol can be used among Chilean patients, but must be restricted to compliant women and a strict surveillance must be maintained.

Abortion, Spontaneous↗

[Effect of fluconazole and itraconazole on human polymorphonuclear leukocyte oxidative metabolism and phagocytosis].

The effect of pretreatment of human polymorphonuclear leukocites (PMNs), for 30 min with fluconazole (0.1, 1, 5 and 50 microgram/ml) and itraconazole (0.05, 0.5 and 5 microgram/ml) on phagocytosis and generation of free radicals (superoxide anion and hydrogen peroxide) was studied in vitro. Phorbol miristate acetate (200 nM) was used as a stimulant. The mean amount of superoxide anion generated by 2.5 x 10(5) PMNs per hour was 4.39 +/- 1.13 nmol for fluconazole-treated PMNs and 4.56 +/- 1.2 nmol for itraconazole, and that of hydrogen peroxide was 11.19 +/- 2.18 and 11.28 +/- 3.61 nmol, respectively. The phagocytosis percentages were 83.8% for the control group and 88. 7% in antifungal agent- treated PMNs; the phagocytosis index was 3.0 yeasts per PMN for both groups. The differences between the control and treated PMNs were not statistically significant at any of the tested concentrations.

Antifungal Agents↗

Hydrogenase genes from Rhizobium leguminosarum bv. viciae are controlled by the nitrogen fixation regulatory protein nifA.

Rhizobium leguminosarum bv. viciae expresses an uptake hydrogenase in symbiosis with peas (Pisum sativum) but, unlike all other characterized hydrogen-oxidizing bacteria, cannot express it in free-living conditions. The hydrogenase-specific transcriptional activator gene hoxA described in other species was shown to have been inactivated in R. leguminosarum by accumulation of frameshift and deletion mutations. Symbiotic transcription of hydrogenase structural genes hupSL originates from a -24/-12 type promoter (hupSp). A regulatory region located in the -173 to -88 region was essential for promoter activity in R. leguminosarum. Activation of hupSp was observed in Klebsiella pneumoniae and Escherichia coli cells expressing the K. pneumoniae nitrogen fixation regulator NifA, and in E. coli cells expressing R. meliloti NifA. This activation required direct interaction of NifA with the essential -173 to -88 regulatory region. However, no sequences resembling known NifA-binding sites were found in or around this region. NifA-dependent activation was also observed in R. etli bean bacteroids. NifA-dependent hupSp activity in heterologous hosts was also absolutely dependent on the RpoN sigma-factor and on integration host factor. Proteins immunologically related to integration host factor were identified in R. leguminosarum. The data suggest that hupSp is structurally and functionally similar to nitrogen fixation promoters. The requirement to coordinate nitrogenase-dependent H2 production and H2 oxidation in nodules might be the reason for the loss of HoxA in R. leguminosarum and the concomitant NifA control of hup gene expression. This evolutionary acquired control would ensure regulated synthesis of uptake hydrogenase in the most common H2-rich environment for rhizobia, the legume nodule.

Bacterial Proteins↗

Characterization of transgenic tilapia lines with different ectopic expression of tilapia growth hormone.

The transfer of growth hormone (GH) genes has opened new possibilities for the manipulation of growth in economically important fish species. However, the ectopic GH levels to optimize growth acceleration in fish, and specially in tilapia, are not known and must be determined experimentally. The tilapia GH (tiGH) cDNA was used to construct chimeric genes expressing different levels of tiGH in vitro and in vivo. These constructs were used to generate four lines of transgenic tilapia by microinjection into one-cell embryos. Different patterns and levels of ectopic expression of tiGH and IGF were detected in organs of transgenic tilapia by RNA or protein analysis. The two lines with lower ectopic tiGH mRNA levels were the only ones showing growth acceleration, suggesting that the expression of ectopic tiGH promoted growth only at low expression levels. The effect of higher ectopic tiGH levels resembled the physiologic situation of low condition factor and permitted us to postulate a model for growth acceleration in transgenic tilapia expressing ectopic tiGH.

Animals↗

[Acute myeloid leukemia MO: clinical and laboratory characteristics].

BACKGROUND: A recent update of FAB classification has included a myeloid leukemia subtype with a minimal degree of differentiation, that has been denominated LMA-MO. AIM: To report the clinical, morphological and immunophenotypic features of patients with LMA-MO. PATIENTS AND METHODS: Eight patients, out of 368, with acute myeloid leukemia that were studied in the Hematology Laboratory of a public hospital in Santiago, were classified as LMA-MO. RESULTS: Blast cell morphology was undifferentiated or of subtype FAB-L2 lymphoblastic leukemia with medium sized blasts, agranular basophilic cytoplasm, reticular nuclear chromatin and a prominent nucleolus. Cytochemical staining was negative for peroxidase and esterases, immunophenotyping showed the expression of one or more myeloid antigens (CD13, CD33) and was negative for lymphoid antigens. Immunocytochemical expression of myeloperoxidase was positive in the three cases where it was performed. Only one patient achieved complete remission and is free of disease after 36 months of follow up. All other patients died without obtaining remission, six shortly after the onset and one 12 months after. CONCLUSIONS: The diagnosis of LMA-MO is essential considering its dismal prognosis.

Acute Disease↗