Outbreak of Q fever among kitchen employees in an urban hospital.
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Adult↗
Biomedical subjects
E Paz
Publications and source records attributed to E Paz.
Incidence of immunoglobulin G antibodies to Chlamydia pneumoniae in acute myocardial infarction patients.
BACKGROUND: Recent studies have suggested a possible association between Chlamydia pneumoniae infection and coronary heart disease. OBJECTIVES: To determine titers of antibodies to C. pneumoniae in patients with acute myocardial infarction compared with titers in several control groups. METHODS: This prospective case-control study investigated 209 individuals. We assessed the serum IgG antibody titers to C. pneumoniae in 57 consecutive patients admitted with AMI to our intensive coronary care unit during a 4 month period. A serum sample was drawn upon admission and after 6 weeks. Results were compared with those of four control groups: a) patients admitted with community-acquired pneumonia (n = 18), b) patients with community-acquired urinary tract infection (n = 42), c) patients with angiographically normal coronary artery disease (n = 44), and d) patients with stable coronary artery disease (n = 48). Serum immunoglobulin G antibody titers to C. pneumoniae were determined using standard micro-immunofluorescence technology. RESULTS: Of 57 patients with AMI, 32 (56%) had a high IgG titer to C. pneumoniae (> or = 1:256) on the initial test, which remained unchanged (62%) after 6 weeks. The percentage of patients with high titers was significantly lower in the control groups: 5 of 18 patients (28%) in the pneumonia group (P < 0.01), 11 of 42 (26%) in the urinary tract infection group (P < 0.01), 11 of 44 (25%) with normal coronary arteries (P < 0.01), and 17 of 48 (35%) with stable chronic ischemic heart disease (P < 0.05). CONCLUSION: The detection of high titers of IgG antibodies to C. pneumonia in many patients with AMI, compared to control groups, suggests that chronic Chlamydia pneumoniae infection plays a role in the pathogenesis of atherosclerosis and acute ischemic events.
Antibodies↗
Interaction between smoking and the Sstl polymorphism of the apo C-III gene determines plasma lipid response to diet.
BACKGROUND: It has recently been demonstrated that the lipid profile of smokers improves if they follow a Mediterranean diet. AIM: To establish whether the Sstl polymorphism of the apo C-III gene interacts with smoking and determines the lipid response to diet in healthy subjects. METHODS AND RESULTS: Fifty-nine volunteers (18 smokers: 8 with the S1S1 genotype, and 10 with the S2 allele; 41 non-smokers: 29 with the S1S1 genotype and 12 with the S1S2 genotype) consecutively followed three different diets: a diet enriched in saturated fatty acids (SFA) (38% fat, 20% SFA) followed by a randomised, cross-over period during which they ate a diet enriched in carbohydrates (NCEP-1) (30% fat, 10% SFA, 55% carbohydrates) and a diet enriched in monounsaturated fatty acids (MUFA) (8% fat, 22% MUFA). Cholesterol, triacylglycerol, LDL-cholesterol (LDL-C) and HDL-cholesterol (HDL-C) levels were measured at the end of each dietary period. The smokers carrying the S1S1 genotype were not influenced by any of the diets, but the atherogenic ratio decreased in the carriers of the S2 allele when they changed from the diet rich in SFA to a diet rich in olive oil or carbohydrates (p < 0.039). No significant difference was observed when the non-smoking carriers of the S2 allele changed from one diet to another, but there was a decrease in the LDL-C/HDL-C ratio when the subjects with the S1S1 genotype changed from the saturated diet to either of the other diets (p < 0.001). CONCLUSIONS: Smoking interacts with the apo CM polymorphism and determines the level of lipid response to dietary changes.
Adult↗
[Mediterranean diet improves low density lipoprotein susceptibility to oxidative modifications].
UNLABELLED: Most experts, specially from Anglo-Saxon countries, recommend a low fat diet in order to prevent cardiovascular diseases. However, mortality rate by ischemic cardiopathy is low in Mediterranean countries, probably because of the consumption of a Mediterranean diet, with a high level of monounsaturated fats provided by the olive oil. We have conducted this study in order to investigate the possible influence of this kind of diet on the oxidation of LDL in vitro, the key element for the development of atherosclerosis. PATIENTS AND METHODS: 41 healthy male subjects were submitted to three consecutive 4-week diets. The first was a saturated fat-rich diet (SAT diet, 38% fat, 20% saturated). This was followed by a low fat diet (NCEP-I, 28% fat, 10% saturated) and after that a Mediterranean diet (38% fat, 22% monounsaturated fat). Plasma levels of total cholesterol, LDL-c, HDL-c, triglycerides, apolipoproteins A-I and B, -tocopherol, and the in vitro susceptibility to oxidation of LDL particles. Both hypolipidemic diets produced a significant decrease in total cholesterol, LDL-c, and apo-B plasma levels. However, it was only the NCEP-I diet that revealed a decrease in the HDL-c. The shift from a saturated fat-rich diet, or a diet rich in carbohydrates, to a Mediterranean diet increased the resistance of LDL particles to oxidation increasing the lag time period (p < 0.038), and decreasing (p < 0.001) the progression rate of the curve of oxidation of LDL. Our results point out two positive consequences of the consumption of a Mediterranean diet by healthy young males, compared with the low fat diet recommended by most Anglo-Saxon experts. On the one hand, the Mediterranean diet increases HDL-c plasma levels, and on the other hand, it decreases the susceptibility of LDL to oxidation. This is why the Mediterranean diet must be recommended in order to prevent cardiovascular diseases.
Adult↗
The apolipoprotein A-IV-360His polymorphism determines the dietary fat clearance in normal subjects.
Apolipoprotein IV (apo A-IV) has been related to fat absorption and to the activation of some of the enzymes involved in lipid metabolism. Several polymorphic sites within the gene locus for apo A-IV have been detected. Previous studies have shown that the A-IV-2 isoform produces a different plasma lipid response after the consumption of diets with different fat and cholesterol content. The present study was designed to evaluate whether the apo A-IV 360His polymorphism could explain, at least in part, the interindividual variability observed during postprandial lipemia. Fifty-one healthy male volunteers (42 homozygous for the apo A-IV 360Gln allele (Gln/Gln) and nine carriers of the A-IV-360His allele), homozygous for the apo E3 allele, were subjected to a vitamin A-fat load test consisting of 1 g of fat/kg body weight and 60000 IU of vitamin A. Blood was drawn at time 0 and every hour for 11 h. Plasma cholesterol (C), triacylglycerol (TG), and C, TG, apo B-100, apo B-48, apo A-IV and retinyl palmitate (RP) were determined in lipoprotein fractions. Data of postprandial lipemia revealed that subjects with the apo A-IV 360His allele had significantly greater postprandial levels in small triacylglycerol rich lipoproteins (TRL)-C (P<0.02), small TRL-TG (P<0.01) and large TRL-TG (P<0.05) than apo A-IV 360Gln/Gln subjects. In conclusion, the modifications observed in postprandial lipoprotein metabolism in subjects with the A-IV 360His allele could be involved in the different low density lipoprotein (LDL)-C responses observed in these subjects following a diet rich in cholesterol and saturated fats.
Adult↗
The effect of apolipoprotein B xbaI polymorphism on plasma lipid response to dietary fat.
BACKGROUND AND AIMS: Lipid response to dietary fat and cholesterol is, to a large extent, genetically controlled. Apolipoprotein B (apo B) plays a dominant role in cholesterol homeostasis. Several polymorphic sites within or adjacent to the gene locus for apo B have been detected. The X+ allele of the XbaI restriction fragment polymorphism of the apo B gene has been found to be associated with higher serum cholesterol and/or triglyceride levels. In order to study the influence of this mutation on the plasma lipid response in diets of varying fat content, 72 healthy male subjects were studied, 21 X- X- (X-) and 51 X+ (X+ X- or X+ X+). METHODS AND RESULTS: These subjects followed three consecutive 28-day diet periods: one rich in saturated fats (SAT diet; 38% fat, 20% saturated); a National Cholesterol Education Program type I diet (NCEP-I diet) (28% fats, < 10% saturated); and a third monounsaturated (MUFA diet) (38% fats, 22% monounsaturated). The different genotypes can be observed to have significant effects on total and LDL cholesterol concentrations (P < 0.017). X+ individuals had higher levels of total and LDL cholesterol after the consumption of a SAT diet (P < 0.012; P < 0.006, respectively), NCEP diet (P < 0.060; P < 0.054, respectively) and MUFA diet (P < 0.022; P < 0.042, respectively) in comparison with X- individuals. A significant interaction between genotypes and dietary effects was observed for diet-induced changes in plasma triglycerides (P < 0.032). Significant decreases in the absolute values of triglyceride concentrations (-0.18 mmol L(-1), P < 0.024) were noted in the X- subjects after the high intake of a MUFA diet, while no significant differences were observed in the X+ individuals (0.006 mmol L(-1), P < 0.858). CONCLUSIONS: Our results suggest that the total triglyceride response to diet is influenced by the apo B XbaI polymorphism.
Adult↗
Low-fat and high-monounsaturated fatty acid diets decrease plasma cholesterol ester transfer protein concentrations in young, healthy, normolipemic men.
BACKGROUND: Cholesterol ester transfer protein (CETP) mediates the transfer of cholesteryl esters from HDL to apolipoprotein (apo) B-containing lipoproteins. The possible atherogenic role of this protein is controversial. Diet may influence plasma CETP concentrations. OBJECTIVE: The objective was to determine whether the changes in plasma lipids observed after consumption of 2 lipid-lowering diets are associated with changes in plasma CETP concentrations. DESIGN: : We studied 41 healthy, normolipidemic men over 3 consecutive 4-wk dietary periods: a saturated fatty acid-rich diet (SFA diet: 38% fat, 20% saturated fat), a National Cholesterol Education Program Step I diet (NCEP Step I diet: 28% fat, 10% saturated fat), and a monounsaturated fatty acid-rich diet (MUFA diet: 38% fat, 22% monounsaturated fat). Cholesterol content (27.5 mg/MJ) was kept constant during the 3 periods. Plasma concentrations of total, LDL, and HDL cholesterol; triacylglycerol; apo A-I and B; and CETP were measured at the end of each dietary period. RESULTS: Compared with the SFA diet, both lipid-lowering diets significantly decreased plasma total and LDL cholesterol, apo B, and CETP. Only the NCEP Step I diet lowered plasma HDL cholesterol. Positive, significant correlations were found between plasma CETP and total (r = 0.3868, P < 0.0001) and LDL (r = 0.4454, P < 0.0001) cholesterol and also between changes in CETP concentrations and those of total (r = 0.4543, P < 0.0001) and LDL (r = 0.4554, P < 0.0001) cholesterol. CONCLUSIONS: The isoenergetic substitution of a high-saturated fatty acid diet with an NCEP Step I or a high-monounsaturated fatty acid diet decreases plasma CETP concentrations.
Adult↗
Ten-year follow-up study of hepatitis B virus infection and vaccination status in hospital employees.
We sought to determine the incidence of infection with hepatitis B virus (HBV) amongst hospital employees over a 10-year period and to assess the extent and efficacy of vaccination against HBV in this population. In 1984 a cohort of 301 hospital employees was tested for hepatitis B surface antibody (anti HBs), hepatitis B core antibody (anti HBc), and hepatitis B surface antigen (HBsAg). Ten years later, 160 (53%) of these workers remained at the hospital and were re-tested. In addition, they were tested for hepatitis C virus antibody (anti HCV). Records of the hospital vaccination program were inspected to determine the rate and effectiveness of vaccination in these workers. Over the ten year period two of the 160 retested workers (1.25%) had sero-converted to anti HBc positive, yielding an incidence density of 0.27 cases per 100 person-years exposed in unvaccinated workers. While the overall seroprevalence of anti HBc did not change significantly between 1984 (81/301, 27%) and 1994 (39/160, 24%), it was much greater than that of the general population (10%). A significantly greater percentage of Jews of Sephardi ancestry (22/65, 34%) were positive for anti HBc than those of Ashkenazi ancestry (15/90, 17%, P < 0.05). In addition, doctors were found to be less likely to be anti HBc positive than nurses (4% vs. 25%, respectively, P < 0.01). Two cases of anti HCV positivity were discovered yielding a prevalence of 1.25% in the 1994 cohort as compared to 0.15% in the population of healthy blood donors. Of the 93 employees of the 1994 cohort eligible for vaccination (i.e., anti HBc-negative and employed in an occupation involving potential exposure to HBV), 53 (57%) had received vaccination and showed protective antibody titers (anti HBs > or = 10 i.u./ml). 17/52 workers with documented vaccinations (33%) did not have detectable antibody levels one to eight years after vaccination. In conclusion, the seroprevalence of anti HBc and anti HCV is significantly higher in this cohort of hospital employees than in the general population. The relatively low vaccination rate among at-risk personnel emphasizes the need for more effective vaccination programs.
Adult↗
Cytomegalovirus infection and disease in the Jerusalem area.
We studied the epidemiology of cytomegalovirus (CMV) infection in women and neonates in the Jerusalem area. During the 6-month period from January to June 1982, we recorded the presence of antibody to CMV in pregnant and parturient Jewish and Arab women from West and East Jerusalem, respectively, in 18- to 22-year-old female students at a religious college, in female university students, in 18- to 22-year-old student nurses, and in the nursing staff of the Neonatal Intensive Care Unit in our hospital. In the 18- to 22-year-old age-group, the religious college students not working in a medical setting had the lowest rate of seropositivity. No difference in the rate of CMV infection was found between Jewish and Arab parturient women. In five cases of congenital CMV infection, representing different clinical aspects of the disease, a comparative study of diagnostic procedures for congenital CMV infection was performed.
Adolescent↗
Surveillance of congenital rubella and the immunity status to rubella in the Jerusalem area.
A retrospective study on the incidence of congenital rubella (CR) in the past 10 years in the Jerusalem area was conducted. After the 1972 epidemic, which resulted in 48 cases of congenital rubella, few sporadic cases of CR appeared each year, and in the 1978-79 period the number of CR cases was relatively small. Immunity to rubella in different categories of population (children 3 months to 18 years, college students, nurses in pediatric, newborn and intensive care units, student nurses, and women of childbearing age) was determined by hemolysis in gel (HIG) and hemagglutination inhibition (HI) methods. Susceptibility was defined as an absence of antibody at a dilution of 1:16 in HI, and hemolysis of less than 7 mm in the HIG test. Compared with previous studies on the incidence of antibodies to rubella in women of childbearing age, a mild decrease in the percentage of sero-negative women was found.
Adolescent↗
Mutation rate estimate for traits with incomplete penetrance and high fitness.
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Child↗
[Monitoring patients on mechanical ventilation].
The clinical situation of a patient with acute respiratory failure, indicates the level of care and mechanical ventilatory support required. The aims of mechanical ventilation are to correct hypoventilation, improve oxygenation and oxygen transport and reduce the work of breathing. Nursing care of patients under mechanical ventilation varies according to their state and the ventilation mode. When establishing a care plan, nurses identify the objectives, which will be useful to measure the interventions. These interventions include aspects related to monitoring and indicate whether or not the objectives are met. In this article the items that allow monitoring of a patient under mechanical ventilation grouped into general monitoring and respiratory monitoring are reviewed.
Humans↗
[Numerical analysis of western blot digitalized images. The case of HIV].
The present work explores the use of image digitalization of western blot (WB) aiming to extract more information about the humoral immune response of human immunodeficiency virus (HIV) infected individuals, and to analyze obtained data in a multivariate manner. The digitalization and analysis of WB images was performed on 115 sera. Images were analyzed either qualitatively: dendogram and principal component analysis (PCA) or quantitatively: PCA of the total bands, taking either the antigens, which belong to the virus, or only those which do not. Results show the feasibility of mechanical diagnosis of a large number of WB images. The dendogram and the qualitative PCA satisfactorily separated white images, images with less than four bands, and images with more complex patterns. Quantitative analysis, which keeps more information, separated the images of negative, undetermined and positive diagnosis quite precisely. It was also found that the positive images with complex patterns of antigen recognition correlate better with asymptomatic individuals. Image analysis also revealed various other bands in WB which do not seem to correspond to viral proteins and could represent autoantigens or crossed antigens between HIV and humans which may cause autoimmunity. Digital analysis of WB images is thus demonstrated to be of great usefulness in the diagnosis and of potential great interest in following the evolution and exploring the pathogenesis of AIDS.
AIDS Serodiagnosis↗