[Pericardial diseases. Clinical study].
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Biomedical subjects
Publications and source records attributed to E Torres.
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In a three-way crossover study, 23 patients with hepatic cirrhosis, ascites, and dependent edema received 40 mg/day of furosemide alone and combined with triamterene 50 mg/day and triamterine 100 mg/day. Baseline potassium excretion did not increase when furosemide was given alone, but potassium excretion fell when 50 mg or 100 mg of triamterene was also given. Both doses of triamterene augmented the natriuretic effect of furosemide.
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The hypothesis that mild recurrent aortic obstruction produces subtle changes in ambulatory blood pressure was investigated by performing 24-hour monitoring on 11 postoperative coarctation patients. Patients (age 16.1 +/- 2.7 years) were compared with normal controls (age 15.7 +/- 2.5 years, n = 15). Surgery (end-to-end anastomosis) was performed at 6.0 +/- 1.0 years of age. There were no significant differences between patients and controls in terms of baseline blood pressure (right arm 123/78 +/- 4/3 mmHg versus 120/75 +/- 3/2 mmHg) or right leg systolic pressure (125 +/- 6 mmHg versus 123 +/- 4 mmHg). Of the 11 patients 8 had recoarctation by Doppler study (mean gradient 25.3 +/- 2.1 mmHg), 5 of 11 had a postexercise arm-leg pressure difference of > 30 mmHg, and 6 patients had aortic diameters at the site of surgery < 70% of the descending aortic diameter (by magnetic resonance imaging). There were no significant differences between the coarctation and control groups in terms of mean ambulatory systolic (125 +/- 3 mmHg versus 119 +/- 2 mmHg) or diastolic (69 +/- 2 mmHg versus 72 +/- 2 mmHg) pressures throughout the day. However, coarctation patients had a larger number of systolic pressures that exceeded the 95th percentile (18.2 +/- 5.6% versus 6.8 +/- 1.2%). These labile increases in systolic pressure correlated with residual coarctation (r = 0.642, p = 0.003). Ambulatory monitoring is a useful tool for detecting and monitoring subtle abnormalities of blood pressure control after coarctation repair.
Sixty-eight subjects ranging in age from 6 to 23 years were studied in an 'auditory oddball' event-related potential (ERP) paradigm. Our results replicate other studies, finding P3 as the most consistent component of ERPs since childhood, although great variability of this component was found in the 6-year-old group. Separate age/ERP component latency and amplitude linear regressions were computed for subjects 6-14 and 6-23 years old. Our data show in both groups a significant negative and positive correlation between age and P3 latency and N1-P2 amplitude respectively. The age/P3 latency slope for the subjects under 15 years old was -19.00 msec/year versus 8.15 msec/year for all subjects (6-23 years old). Our results indicate that P3 latency during childhood decreases with age, reaching an asymptote after or during the second decade of life. No curvilinear relationship between age and P3 latency was found over the child groups, although a significant curvilinear relationship was found over the entire age range. This study showed no significant gender differences in latency at any age group. However, in the adult group females showed significantly larger amplitudes than males.
Parathyroid hormone-related protein (PTHrP) expression is necessary for differentiation of mesenchymal lipofibroblasts, which induce epithelial type II (TII) cell differentiation, both of which are necessary for alveolarization. PTHrP deficiency may be associated with bronchopulmonary dysplasia (BPD), characterized by truncation of alveolarization among preterm infants. This is supported by the baboon model of BPD (failure of alveolarization) that manifests PTHrP deficiency. We provide evidence that TII cell PTHrP expression is downregulated by alveolar overdistension, resulting in the transdifferentiation of lipofibroblasts to myofibroblasts, characterized by progressive loss of PTHrP receptor expression and triglyceride content, and sequential upregulation of alpha-smooth muscle actin (alphaSMA), typifying fibrosis. PTHrP reverses the downregulation of the PTHrP receptor and upregulation of alphaSMA, reverting myofibroblasts to a lipofibroblast genotype. When TII cells are co-cultured with lipofibroblasts, they proliferate and differentiate, expressing surfactant protein-B; in contrast, TII cells co-cultured with myofibroblasts fail to develop, mimicking the failed alveolarization associated with BPD. Treatment of myofibroblasts with 15-deoxy-Delta 12, 14 prostaglandinJ(2) (PGJ(2)) stimulates ADRP expression, reconstituting the lipofibroblast phenotype. PGJ(2)-treated myofibroblasts promote TII cell growth and surfactant protein-B expression, indicating that failed alveolarization due to transdifferentiation is reversible. We conclude that alveolar overdistension can cause fibroblast transdifferentiation, resulting in failed alveolarization.
This paper presents a novel approach to establishing environmental health priorities for a large society, based upon the concept of principal environmental exposure pathways (PEEPs). Principal environmental exposure pathways extend the concept of a causal pathway backward from health outcome to exposure, then to the industrial, transportation, commercial, or living conditions that gave rise to the pollution of interest. In the Philippines, where the method was developed and used, five PEEPs were identified: an urban air-pollution pathway; a community water-supply pathway; an urban solid-waste pathway; a rural "point-source" pathway; and a pathway whereby fertilizers and pesticides affect food, worker health, and rural water supplies. Characterizing the PEEPs involved pinpointing the populations at risk necessary to estimate the burden of morbidity and mortality related to each as well as identifying the health outcomes that were experienced by those exposed along each pathway or that they could be expected to experience; determining where adequate health-outcome information was available or absent; where exposure sources were or were not adequately identified; where there were significant gaps in agency responsibilities; where new data flows were needed; and where things could have been improved by improving inter-agency cooperation. The most important success of the PEEP method was to reduce the "problem of everything" in a complex country of 65 million people to a small and manageable number of priority environmental exposures.
Vitamin A is considered an anti-infectious disease vitamin, and its deficiency is associated with severe infections such as in measles. In developing countries the low concentrations of vitamin A are a public health problem. The aim of this study is to describe serum vitamin A concentrations among children with visceral leishmaniasis (VL). Blood sample was collected from 22 children with VL, and stored in a freezer, 9 siblings, with no clinical signs of the VL patients had their blood collected for a control group. Samples were assayed by high performance liquid chromatography. The median vitamin A concentration in the LV group was 21.38 microg/100ml and in the control group it was 31.39 microg/100. The mean in the LV was statistically lower than in the control group, using Student's t test, p<0.01.
The malarial GBP 130 protein binds weakly to intact human erythrocytes; the binding sites seem to be located in the repeat region and this region's antibodies block the merozoite invasion. A peptide from this region (residues from 701 to 720) which binds to human erythrocytes was identified. This peptide named 2220 did not bind to sialic acid; the binding site on human erythrocyte was affected by treatment with trypsin but not by chymotrypsin. The peptide was able to inhibit Plasmodium falciparum merozoite invasion of erythrocytes. The residues F701, K703, L705, T706, E713 (FYKILTNTDPNDEVERDNAD) were found to be critical for peptide binding to erythrocytes.
PURPOSE: This study determined the vertical response of class III patients in the primary, mixed, and late mixed dentition phases fitted with a protraction mask and expansion. METHODS: The before and after cephalometric records of 112 patients divided by sex were analyzed at ages 3 to 6, > 6 to 9 and > 9 to 12 years to assess the vertical changes. Data was correlated by means of paired t tests and scheffe's multiple contrasts. The study showed: (1) descriptive statistics and the before and after results in males and females in the different age groups; (2) the changes in males and females disregarding age; and (3) the changes at the different ages disregarding gender. RESULTS: The main vertical changes in this study were seen in the FMA angle, GoGn to SN, Facial axis, and ANS-Me between the ages of 3 to 6 years. Between 6 to 9 years, a lesser significant opening existed and no significant change could be seen in the GoGn-SN angular measurement. Between 9 to 12 years all linear and angular measurements became non significant with the exception of ANS-Me. CONCLUSIONS: Class III corrections should be started as early as possible, once the diagnosis is made and cooperation allows it. Most of the changes were seen between the ages of 3 to 6 years. No significance was seen after the age of 9 years with the exception of ANS-Me in both males and females (P < 0.05). No differences were seen between males and females in all measurements at the different ages with the exception of occlusal plane to SN (P < 0.05) between 3 to 6 years. The vertical changes were mostly seen in the mandible with no direct benefit from the changes in the midfacial region.
Tumoral angiogenesis is regulated by the balance between factors that activate and inhibit angiogenesis. Elevated levels of activators have been associated with a poor prognosis in cancer patients, but little is known about the net balance between circulating activators and inhibitors in these patients. This study was designed to determine whether the balance between circulating concentrations of the angiogenesis inhibitor TSP-1 and the activator VEGF differs from that in healthy persons, and to shed light on the possible role of platelets in this balance. Twenty-five cancer patients and 18 healthy subjects were included. Serum and plasma concentrations of VEGF, TSP-1 and PF4 were measured by ELISA. Our results showed that in healthy subjects the balance between the TSP-1 and VEGF concentrations in serum and in serum minus plasma was twice to three times as high as in cancer patients (p < 0.05). The theoretical TSP-1 content per platelet was greater in healthy subjects than in patients (94 vs. 53.6 ng/mL, p < 0.05), and platelet activation (determined indirectly as the plasma concentration of PF4) was greater in cancer patients (129 vs. 48 IU/mL, p < 0.01). Platelet activation correlated significantly with serum concentration of TSP-1 (r = 0.470, p = 0.018) and showed a tendency toward correlation with plasma concentration of TSP-1 (r = 0.382, p = 0.059). Our findings show that the circulating TSP-1/VEGF balance is diminished in cancer patients. Platelet activation may play an important role in this decrease and may ultimately lead to increased angiogenic activity in these patients.
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Viridans Streptococci (VS) may cause meningitis although, in most cases, they are isolated as contaminants in CSF. However VS should not be systematically underestimated as contaminants in CSF without a suitable clinical and analytical evaluation. Meningitis as a result of VS is being diagnosed with increasing frequency, especially in new born babies. Classic predisposition factors and illnesses (traumatism, surgery and infection) have increased, one frequent pathogenic mechanism being rupture of the mucous membrane with subsequent meningitis. VS are normally sensitive to penicillin G. However VS may be resistant to penicillin (low affinity of PBP to penicillin) and cause serious infections, including meningitis. For this reason it is convenient to perform sensitivity tests on VS in vitro in isolation to determine the appropriate therapy.