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E Salazar

Publications and source records attributed to E Salazar.

At least 19 recordsLinked to original sources

A cDNA for nuclear-encoded chloroplast translational initiation factor 2 from a higher plant is able to complement an infB Escherichia coli null mutant.

Formation of the initiation translation complex containing the three initiation factors, IF1, IF2, and IF3, tRNA(fMet), and GTP constitutes the earliest event in the protein synthesis. IF2, a GTP-binding protein, is the principal factor involved in selecting and binding fMet-tRNA(fMet) to the 30 S ribosomal subunit. Although some chloroplast initiation translational factors have been identified and purified from algae, none of these factors have been characterized from plants. In this work, we report the molecular characterization of a nuclear-encoded chloroplastic IF2 gene from common bean (PvIF2cp). We show that the PvIF2cp gene encodes a protein containing a chloroplast translocation signal peptide, able to target a green fluorescent protein fusion protein to chloroplasts. A high accumulation of PvIF2cp transcript was found in photosynthetic tissues, whereas low mRNA levels were detected in etiolated plants and in nonphotosynthetic organs. Additional data indicate that the PvIF2cp transcript accumulation is modulated by light. The PvIF2cp gene encodes a functional factor, since the PvIF2cp conserved region, containing the G-domain and the C-terminal end, complements an Escherichia coli infB null mutation. Phylogenetic analysis using the PvIF2cp conserved region suggests that the PvIF2cp gene originated via endosymbiotic gene transfer to the nucleus and that it may be a useful marker for phylogeny reconstruction.

Active Transport, Cell Nucleus↗

[Heart disease, anticoagulants and pregnancy].

In patients with mechanical prosthetic heart valves, long-term anticoagulant therapy is mandatory to prevent thromboembolic phenomena. Anticoagulation is also necessary in patients with mitral valvular disease and atrial fibrillation. The risk of maternal thromboembolic events is heightened during pregnancy because of the patient's hypercoagulable state. Controversy exists concerning the appropriate treatment of these patients. No method of anticoagulation is risk free. Coumarin derivatives provide adequate protection against thromboembolism and should be used during pregnancy in patients with mechanical prostheses. The administration of coumarin derivatives in the first trimester is associated with an incidence of 26.7% of spontaneous abortion and a risk of 4.1% of coumarin embryopathy. Heparin does not cross the placental barrier and it is the obvious therapeutic alternative. The teratogenic effects of the coumarinics are prevented if these agents are discontinued and replaced by heparin from before the 6th until the end of the 12th week of gestation. However, subcutaneous unfractionated heparin, in the doses that have been employed, does not provide adequate prophylaxis against thromboembolism in these women. In patients treated with heparin, the incidence of spontaneous abortion is similar to that observed when the mothers are treated with coumarin agents. In order to avoid the delivery of an anticoagulated infant, intravenous heparin in full doses, should be substituted for the coumarin agent in the last two weeks of gestation.When anticoagulant therapy is not necessary, the course of pregnancy in women with bioprostheses is similar to that of the general population. However, the short duration of tissue valves is a clear disadvantage for these women

Abortion, Spontaneous↗

Agonist peptide from a cytotoxic t-lymphocyte epitope of human carcinoembryonic antigen stimulates production of tc1-type cytokines and increases tyrosine phosphorylation more efficiently than cognate peptide.

The identification of an agonist peptide (YLSGADLNL, designated CAP1-6D) to an immunodominant cytotoxic T-lymphocyte (CTL) epitope (designated CAP1) of human carcinoembryonic antigen (CEA) has previously been reported. The agonist peptide harbors a single amino acid substitution at a non-MHC anchor residue and is proposed to exert its effects at the level of the T-cell receptor (TCR). The type and magnitude of cytokines produced by CAP1-reactive CTL upon stimulation with the agonist peptide, CAP1-6D, were compared to those obtained upon stimulation with the cognate CAP1 peptide. In addition, early events in the TCR signaling pathway were examined for differences in tyrosine phosphorylation. Upon stimulation with the agonist peptide CAP1-6D, several different CEA-specific CTL lines exhibited a marked shift in the peptide dose response, which resulted in as much as a 1,000-fold increase in the levels of GM-CSF and gamma-IFN produced as compared with the use of the CAP1 peptide. However, levels of IL-4 and IL-10, which are associated with anti-inflammatory effects, were very low or non-existent. The cytokine profile of CAP1- and CAP1-6D-specific CTL is consistent with a Tc1-type CTL. Consistent with these findings, CEA-specific CTL showed increased tyrosine phosphorylation of TCR signaling proteins ZAP-70 and TCR zeta chains in response to both peptides. However, when CAP1-6D was compared with the wild-type peptide, the increase in ZAP-70 phosphorylation was greater than the increase in zeta phosphorylation. CTL generated with the CAP1-6D agonist were shown capable of lysis of human carcinoma cells expressing native CEA. The ability to upregulate the production of GM-CSF, gamma-IFN, TNFalpha and IL-2 with the agonist peptide, as compared with CAP1, may help in initiating or sustaining anti-tumor immune responses and thus potentially prove to be useful in the treatment of CEA-positive tumors.

Carcinoembryonic Antigen↗

Prevalence of stroke : a door-to-door survey in rural Bolivia.

BACKGROUND AND PURPOSE: We carried out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia. A cluster sample of 10 124 inhabitants was selected, and 9955 subjects were screened. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in this population. METHODS: We used a modified version of the World Health Organization screening instrument. On screening we found that 1130 subjects tested positive, and 1027 underwent a complete neurological examination. According to the World Health Organization guidelines, we defined stroke as "rapidly developing clinical signs of focal (or global) disturbance of cerebral functions, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin." We considered only first stroke and excluded a possible stroke. RESULTS: We found 16 subjects (cases) who had experienced 1 complete stroke on prevalent day (November 1, 1994). The crude prevalence of stroke was 174/100 000 (322/100 000 age-adjusted to the world standard population) and 663/100 000 in subjects aged >/=35 years. Prevalence was >2-fold higher in men than in women (247/100 000 and 99/100 000, respectively) and increased rapidly with age. Seven cases were hospitalized and received specific treatment. CONCLUSIONS: Our crude prevalence is lower compared with rates from developed countries, probably because of a high case fatality rate. Our findings are comparable with those reported from other surveys carried out in rural developing countries.

Adolescent↗

Prevalence of epilepsy in rural Bolivia: a door-to-door survey.

OBJECTIVE: To carry out a door-to-door survey in rural areas of the Cordillera Province, Santa Cruz Department, Bolivia, to determine the prevalence of neurologic diseases (epilepsy, stroke, parkinsonism, and peripheral neuropathy) in a sample of approximately 10,000 inhabitants. METHODS: A team of nondoctor health workers administered a standard screening instrument for neurologic diseases-a slightly modified version of the World Health Organization protocol. All subjects found positive during the screening underwent a neurologic examination. RESULTS: On screening, the authors found 1,130 positive subjects, of whom 1,027 were then investigated by neurologists. On the basis of the definition proposed by the International League Against Epilepsy, we detected 124 epileptic patients (prevalence, 12.3/1,000), 112 of whom had active epilepsy (prevalence, 11.1/1,000) on the prevalence day (November 1, 1994). Peak age-specific prevalence occurred in the 15 to 24-year age group (20.4/1,000). Sex-specific prevalence was higher in women (13.1/1,000) than men (11.4/1,000). Eighty-nine patients (71.8%) underwent a standard EEG recording. Considering both EEG and clinical data, partial seizures were the most common type (53.2%) based on the classification of the International League Against Epilepsy. The mean age at onset was 20.7 years for partial seizures and 13.6 years for generalized seizures. Only 10.5% of patients had received specific treatment for more than 2 months of their life. CONCLUSION: This report on epilepsy prevalence in Bolivia confirms that epilepsy is a major health problem in rural areas of developing countries.

Adolescent↗

Effect of pregnancy on the duration of bovine pericardial bioprostheses.

BACKGROUND: This study sought to evaluate the effect of pregnancy on the rate of deterioration of bovine pericardial bioprostheses. To avoid the fetal and maternal risks associated with anticoagulant therapy during pregnancy, the use of bioprostheses has been advocated for young women with cardiac valve disease who may later wish to bear children. Several reports have suggested the probability of pregnancy-related accelerated deterioration of these valves. METHODS AND RESULTS: The incidence of prosthetic dysfunction and the freedom from deterioration were investigated in 48 women who had 58 pregnancies and in a control group of 167 patients in the same age range. There were 39 cases of prosthetic dysfunction (deaths plus reoperations resulting from valve failure): 12 in the pregnant group for a linearized rate of 3.5% +/- 0.99% (SE) per patient-year and 27 in the control group or 3.4% +/- 0.65% per patient-year (P = not significant). The actuarial freedom from dysfunction was 90.4% (95% confidence interval 77.9 to 96.2) at 5 years and 77.0% (59.7 to 88.3) at 8 years for the pregnancy group and 86.3% (77.3 to 92.0) and 73.4% (56.6 to 84.8), respectively, for the control group ( P = not significant). In the Cox proportional hazard regression analysis, pregnancy did not influence dysfunction. A direct correlation was found between freedom from dysfunction and the patient's age at surgery. CONCLUSIONS: Pregnancy does not accelerate the rate of deterioration of bovine pericardial bioprostheses. It is more likely that biological valves deteriorate more rapidly in these patients because of their young age.

Abortion, Spontaneous↗

Effects of whisker trimming on GABA(A) receptor binding in the barrel cortex of developing and adult rats.

Both sensory deprivation and blockade of gamma-aminobutyric acid A (GABA(A)) receptors result in signs of cortical disinhibition. To investigate whether down-regulation of GABA(A) receptors could underlie effects of sensory deprivation, [3H]muscimol binding was assessed in rat whisker barrels after chronic whisker trimming. Vibrissae in row C or rows A,B,D, and E were trimmed during certain developmental periods. When whiskers were trimmed for the first 6 postnatal weeks, [3H]muscimol binding was 8.3% lower in deprived barrel rows than in adjacent nondeprived rows (P < 0.001). The effect may be somewhat selective for GABA(A) receptors because there was no evident change in N-methyl-D-aspartate (NMDA) receptors as indicated by [3H]MK-801 binding. Ten weeks after whiskers were allowed to regrow, the decrease in [3H]muscimol binding was partly reversed (P < 0.002), leaving a 3.3% decrease (P < 0.001). These declines in GABA(A) receptors could contribute to persisting electrophysiological signs of reduced inhibition in similarly deprived barrel neurons (Simons and Land [1987] Nature 326:694-697). A 6-week deprivation beginning in adulthood resulted in a 7.7% decrease (P < 0.001), indicating that the effect is not restricted to an early critical period. In rats trimmed for the first 10 postnatal days, [3H]muscimol binding declined 2.3% (P < 0.05), which is a small change compared with the magnitude of the developmental peak; thus, normal whisker input apparently is not required for the developmental increase in GABA(A) receptors. The present study suggests that sensory input can regulate cortical GABA(A) receptors in adulthood and during ontogeny. Down-regulation of cortical GABA(A) receptors may be a compensatory mechanism that serves to disinhibit the reduced sensory input.

Aging↗

Treatment of severe mitral stenosis with percutaneous balloon valvotomy in pregnant patients.

BACKGROUND: Pregnancy can cause life-threatening complications in women with mitral stenosis. Frequently, there is an urgent need to increase the mitral valve area mechanically. In selected cases, percutaneous mitral balloon valvotomy (PMBV) has emerged as a safe and effective alternative to surgical commissurotomy. HYPOTHESIS: The study evaluates the effects of PMBV by the Inoue technique in nine pregnant patients with severe symptomatic mitral stenosis. METHODS: The patients were in New York Heart Association (NYHA) functional class II to IV and had echocardiographic scores of < or = 8. The mean gestational age was 24.8 +/- 6.1 weeks. The patient's pelvic and abdominal regions were covered with a lead apron to protect the fetus from radiation. A stepwise dilatation technique was used. Fluoroscopy time was kept to 10 to 15 min. RESULTS: One patient developed severe mitral regurgitation requiring emergency valve replacement. The remaining eight patients showed marked immediate symptomatic and hemodynamic improvement. After dilatation, the transmitral pressure gradient decreased from 20.8 +/- 6.5 to 7.3 +/- 1.4 mmHg (p = 0.001) and the calculated mitral valve area increased from 0.9 +/- 0.1 to 1.8 +/- 0.4 (p < 0.001). All patients had uneventful term deliveries of normal babies. On follow-up they were in NYHA functional class I. CONCLUSIONS: Percutaneous mitral balloon valvotomy is a safe and effective procedure for selected pregnant patients with severe mitral stenosis. The procedure is well tolerated by the fetus. Severe mitral regurgitation requiring immediate surgery may occur occasionally. The possible harmful effects to the fetus from its exposure to radiation during PMBV are unknown.

Adult↗

Patterns of antimicrobial use and antimicrobial resistance among healthy children in Bolivia.

OBJECTIVE: To determine the incidence of antimicrobial-resistant, nonpathogenic Escherichia coli among healthy children aged 6-72 months in Camiri town and a rural village, Javillo, in south-eastern Bolivia. METHOD: A community-based survey: stool samples were obtained from 296 healthy children selected by modified cluster sampling in Camiri and all 25 eligible children in Javillo. E. coli isolates were tested for antimicrobial susceptibility according to the standard disc diffusion method. By a questionnaire survey of 12 pharmacies and by using simulated patients, we investigated the antimicrobial availability and the usage patterns in Camiri town. RESULTS: In Camiri, over 90%, and in Javillo over 70% of children carried E. coli resistant to ampicillin, trimethoprim-sulphamethoxazole (TMP/SMX) or tetracycline. Overall, 63% of children carried E. coli with multiple resistance to ampicillin, TMP/SMX, tetracycline and chloramphenicol. In the simulated patients study, antimicrobials were dispensed inappropriately for 92% of adults and 40% of children with watery diarrhoea, and were under-prescribed for males with urethral discharge (67%) or females with fever and dysuria (58%). The dose and/or duration of antimicrobials dispensed was almost always too low. CONCLUSION: Our study showed a disturbingly high prevalence of carriage of nonpathogenic E. coli resistant to antimicrobials. The prevalence of resistance to ampicillin and TMP/SMX was higher than that previously reported in developing countries. The existence of a large reservoir of resistance genes in healthy individuals in developing countries represents a threat to the success of antimicrobial therapy throughout the world. Programmes to improve rational and effective drug use in developing countries are urgently needed.

Adult↗

A neuroepidemiological survey in rural Bolivia: background and methods.

A door-to-door survey was carried out in rural areas of the Cordillera province, Santa Cruz Department, Bolivia. A cluster sample of 10,124 inhabitants was selected. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism and peripheral neuropathy) in this population using a modification of the World Health Organization screening instrument. 1,130 subjects screened positive and were then investigated by neurologists. In this paper we describe the background and methods of the survey and the characteristics of the population.

Adolescent↗

Failure of adjusted doses of subcutaneous heparin to prevent thromboembolic phenomena in pregnant patients with mechanical cardiac valve prostheses.

OBJECTIVES: This report describes our experience with the use of an anticoagulant regimen of adjusted doses of subcutaneous heparin during pregnancy in women with cardiac valve prostheses. BACKGROUND: Gravid patients with prosthetic heart valves require long-term anticoagulant therapy. To avoid the increased incidence of fetal morbidity and mortality associated with the use of coumarin agents in such patients during pregnancy, anticoagulation with subcutaneous heparin has been suggested. Controversy exists concerning the appropriate treatment of these patients. METHODS: Forty pregnancies in 37 women with prosthetic heart valves were prospectively followed up. Subcutaneous heparin was administered from the 6th until the end of the 12th week and in the last 2 weeks of gestation. Heparin was given every 8 h in the first 36 cases and every 6 h in the last 4 cases, and the dose adjusted to maintain the activated partial thromboplastin time at 1.5 to 2.5 times the control level. Acenocoumarol was used at other times. RESULTS: The incidence rate of spontaneous abortions was 37.5%; there was one neonatal death (2.5%) due to cerebral hemorrhage. No signs of coumarin-induced embryopathy were found in any of the 16 live-born infants studied by the geneticist. One mother died of gastrointestinal bleeding while receiving oral anticoagulant agents. There were two cases of fatal massive thrombosis of a mitral tilting-disk prosthesis during heparin therapy. The study was interrupted after the last of these two cases. CONCLUSIONS: The regimen of adjusted doses of subcutaneous heparin used in this study is not effective to prevent thrombosis of mechanical valve prostheses during pregnancy. The use of heparin from the 6th to the 12th week of gestation does not decrease the high incidence of fetal wastage associated with anticoagulant therapy. Coumarin agents provide adequate protection against thromboembolism during pregnancy in patients with mechanical valve prostheses.

Abnormalities, Drug-Induced↗

Safety, immunogenicity, and excretion pattern of single-dose live oral cholera vaccine CVD 103-HgR in Peruvian adults of high and low socioeconomic levels.

Groups of 122 Peruvian adults of low socioeconomic level (SEL) and 125 of high SEL received a randomly allocated 5 x 10(9)- or 5 x 10(8)-CFU dose of CVD 103-HgR live oral cholera vaccine or a placebo. The vaccine was well tolerated. Vibriocidal seroconversions occurred in 78% of high-SEL and 72% of low-SEL subjects who ingested the high dose and in 78 and 49%, respectively, of those who received the low dose.

Administration, Oral↗

High frequency of coinfecting enteropathogens in Aeromonas-associated diarrhea of hospitalized Peruvian infants.

Rectal swabs from 391 infants less than 18 months of age who were hospitalized with acute diarrhea and from 138 similarly aged healthy infants were examined for the etiologic agents of diarrhea. Aeromonas spp. were recovered from 205 of 391 (52.4%) diarrheic patients, whereas they were recovered from 12 of 138 (8.7%) controls (P less than 10(-11). Among the 205 Aeromonas-positive diarrheic patients, 118 (57.6%) were found to be coinfected with other common enteropathogens. Of the 164 Aeromonas-positive initial diarrheic specimens, 82 (50.0%) had one or more other enteropathogens present; 30 patients were coinfected with rotavirus, 20 with enterotoxigenic Escherichia coli, 16 with Campylobacter spp., 14 with Shigella spp., 13 with enteropathogenic E. coli, 4 with Vibrio spp., 1 with Salmonella spp., and 1 with Plesiomonas spp. of Aeromonas strains from cases compared with that from controls supports an etiologic role for this organism. However, frequent concomitant infections with other well-recognized enteropathogens and a lack of disease correlation with common Aeromonas phenotypes suggest that only a subset of Aeromonas strains may be diarrhea causing and that such strains may be common to several of the existing species.

Aeromonas↗

Risks of anticoagulant therapy in pregnant women with artificial heart valves.

In an attempt to identify the best treatment for pregnant women with cardiac-valve prostheses who are receiving oral anticoagulants, we studied 72 pregnancies prospectively. In 23 pregnancies (Group I), the coumarin derivative acenocoumarol was discontinued and the patients received 5,000 U of subcutaneous heparin every 12 hours from the 6th to the 12th week of gestation, in 12 pregnancies (Group II), heparin was not substituted for the coumarin derivative until after the 7th week, and in 37 pregnancies, detected after the first trimester (Group III), the coumarin derivative was given throughout gestation. In most patients heparin was again substituted for the oral anticoagulant after the 38th week. Three mothers had thrombosis of a tilting-disk mitral prosthesis (two cases were fatal) during heparin treatment. No differences were found in the rates of spontaneous abortion in the three groups. Coumarin embryopathy occurred in 25 percent and 29.6 percent of the pregnancies in Groups II and III, respectively. We conclude that in the second and third trimesters of pregnancy, coumarin derivatives provide effective protection against thromboembolism while causing few fetopathic effects, but that these agents are contraindicated from the 6th to the 12th weeks of gestation. Low-dose heparin does not protect against prosthetic-valve thrombosis, and the possibility that a larger dose might be more effective requires further exploration.

Abnormalities, Drug-Induced↗

Copper distribution in the normal human brain.

Copper concentration was determined in samples from 38 areas of 7 normal human brains. The grey matter contained higher concentrations of copper than the white matter. Identical areas of the grey and white matter of the cerebral cortex showed significant differences between individuals. In the caudate nucleus the highest concentrations of copper were found in the tail followed by the body and the head, respectively. A negative linear regression between age and brain copper levels was demonstrated.

Adolescent↗

The problem of cardiac valve prostheses, anticoagulants, and pregnancy.

To assess the maternal and fetal risks in patients with cardiac valve prostheses, a series of 223 pregnancies in 156 women was studied. In 68 pregnancies (group I) treatment with antiplatelet agents was substituted for that with coumarinics from the first trimester on. Group II (128 pregnancies) received coumarinics through the thirty-eighth week of gestation. Three patients in group I died as a result of thrombosis of their caged-ball valves. The incidence of cerebral embolism was 25.0% in group I and 2.3% in group II patients, while that of spontaneous abortion was 10.3% and 28.1%, respectively. Coumarin embryopathy was found in 7.9% of group II infants. Fetal death did not occur in the 12 cases in which subcutaneous heparin was substituted for the coumarin derivative in the first trimester and the last 2 weeks of pregnancy (group III), but maternal cerebral embolism developed in 8.3% of the patients. Finally, uneventful pregnancies and deliveries were observed in 12 of 15 mothers (group IV) with biological prostheses who received no anticoagulants. It is concluded that (1) women with cardiac valve prostheses should be counseled against becoming pregnant, (2) antiplatelet agents do not provide protection against thromboembolism in these patients, (3) because of the high incidence of fetal death and birth defects use of coumarinics is contraindicated in the first trimester and the last weeks of pregnancy, (4) the substitution of heparin at these times may decrease the incidence of these complications, and (5) bioprostheses are indicated in women who wish to bear children.

Acenocoumarol↗

Beliefs regarding the etiology and treatment of infantile diarrhea in Lima, Peru.

Three groups of women in Lima, Peru, were interviewed regarding their beliefs about the etiology and treatment of infantile diarrhea. The first group consisted of 91 mothers of children under the age of 2. These were interviewed at two locations: the pediatric emergency service of a teaching hospital serving northern Lima and a health center located in one of the rapidly growing shantytowns surrounding Lima. The second group consisted of 25 women interviewed in their homes in several shantytowns. Answers given by mothers in both groups were similar. All women were of low socioeconomic status. The third group consisted of 23 adolescent girls and young women interviewed briefly at two schools in Lima. Results of the interviews confirm that diarrhea is not seen as an infectious disease. Instead, it is placed within the framework of the hot--cold dichotomy prevalent in Latin America; diarrhea is believed to be caused by invasion of the body by cold or by ingestion of foods designated as being 'cold'. Suspension of milk feeding is also thought to be an essential part of treatment, a finding of importance in view of the decline in breastfeeding.

Adolescent↗

The regional distribution of manganese in the normal human brain.

The concentration of manganese per gram dry tissue weight was determined in samples from 39 areas of 8 normal human brains. Manganese was shown to be unevenly distributed with the largest concentrations in the pineal gland and the olfactory bulb. The gray matter yielded a higher content of manganese than the white matter. Significant differences between individuals were found for identical areas of the gray and white matter of the cerebral cortex. Higher levels of manganese were demonstrated in the tail of the caudate nucleus than in the body and the head of the same structure. No significant correlation was shown between the amount of manganese in brain and age.

Adolescent↗