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Biomedical subjects

E Vaquero

Publications and source records attributed to E Vaquero.

At least 19 recordsLinked to original sources

Alternate response preparation in a visuomotor serial task.

The preparation of a particular motor pattern is related to the information available that enables the actor to predict the correct response to a forthcoming stimulus. In many situations, however, prediction is not possible. In such cases, the individual can guess the probable parameters of the next stimulus. The authors attempted to establish the bias in the motor intention for movement and its interaction with a possible memory trace of the stimulus-response mapping produced by the preceding stimulus. Two letters were presented bilaterally, and participants (N=21) had to discriminate the target letter and respond with the compatible hand. The present findings support the existence of a memory trace of the previous stimulus-response mapping.

Adult↗

Gender differences in event-related potentials during visual-spatial attention.

The aim of present work is to test possible gender differences in the ERPs to the standards during the performance of a visual-spatial attention task. The sample: 20 subjects (10 women) aged 18-24. Electrodes: F3, F4, C3, C4, P3, P4, T5, T6, O1, O2. ANOVA tests were computed with the following factors: attention, gender, visual field, hemisphere, and electrodes. Results showed that men presented higher amplitudes in P1 and in P3b than did women, and women presented higher amplitudes in the temporal N1 than did men. For the P3, the amplitude in frontal-central regions for the attended condition was higher in men than in women, and men presented a gender-specific right frontal functional asymmetry that was not present in women. Since these components are related with the modulation of visual processing by the effect of spatial attention, the intra- and inter-gender differences obtained suggest possible differences in the processing of visual information in both genders. However, the fact that the brain generators could have a different orientation is also a possible explanation for the differences obtained in the ERPs in both genders.

Adolescent↗

Further improvements in the application of high-performance liquid chromatography, capillary electrophoresis and capillary electrochromatography to the analysis of algal toxins in the aquatic environment.

The presence of algal toxins in the aquatic environment represents an important socioeconomic concern in many places worldwide, due to the toxicity that these compounds can induce in seafood or freshwater organisms at very low levels. Several analytical alternatives have been proposed over the last years for the control of these contaminants, which acute or chronic toxicity requires low detection levels and demands for the search of sensitive methods for their detection and determination. HPLC has been widely used for this purpose, although several alternatives such as CE or capillary electrochromatography (CEC) are being lately developed with this aim. In this work we report on the application of improved HPLC, as well as CE and CEC, for the analysis of diarrhetic shellfish poisoning toxins, amnesic shellfish poisoning (ASP) toxins and microcystins (MCs) present in different matrices such as water, shellfish or algae. Improvements in sample preparation for increasing sensitivity and selectivity are also shown. While UV and fluorimetric detection are the detection methods generally used, mass spectrometric detection was also applied for ASP toxins and MCs, especially for confirmatory purposes. From the results obtained it can be concluded that both HPLC and CE offer a good potential for a sensitive and selective determination of these algal toxins in such complex matrices. The results obtained for CEC allow also to conclude that this technique can result in a promising technique for such application.

Chromatography, High Pressure Liquid↗

Sensory and motor attentional modulation during the manual gap effect in humans: a high-density ERP study.

The present study investigated reaction time (RT) and event-related potential (ERP) differences between gap and step conditions using visual stimulation and manual responses. RTs during the gap condition were facilitated with respect to those of the step condition. The ERPs, which were obtained from electrodes placed at 58 scalp sites, showed differences when the gap and step conditions were compared for the following components: an early positive component centred at the vertex, an enhanced P1 component, a frontal negativity, a negative lateralized motor potential, and an increased P3. All these results suggest that the facilitation induced by the gap is mediated by a modulation of the neural circuits involved in sensory, motor, and cognitive functions.

Adolescent↗

Temporal evolution of alpha and beta bands during visual spatial attention.

Event-related potentials (ERPs) are an electrophysiological index of various cognitive processes such as attention. However, this kind of analysis does not allow observation of differences in the spectral content taking place during a sensory, cognitive or motor task. The goal of the present work was to compute the temporal dynamics of EEG oscillations using a technique called temporal spectral evolution (TSE). The electroencephalogram (EEG) was recorded during the presentation of flashed stimuli that were randomly presented to the left or right visual field. Subjects were asked to pay attention, alternately in different blocks of trials, to the left or to the right to detect an infrequent target. The results showed a decrease in the alpha band in a time window of 375-500 ms and an increase in the beta band at 500-875 ms after stimulus onset, for both attended and unattended stimuli. Statistical analysis showed that the decrease in alpha and the increase in beta were more marked during the attentional condition. In conclusion, these results demonstrate that the decrease in alpha band and the increase in beta band are electrophysiological markers of visual spatial attention.

Adolescent↗

Hysteroscopic findings in 344 women with recurrent spontaneous abortion.

STUDY OBJECTIVE: To evaluate the prevalence of different anatomic factors in women with recurrent spontaneous abortion (RSA). DESIGN: Retrospective analysis over 9 years (Canadian Task Force classification II-2). SETTING: University hospital-affiliated endoscopic unit. PATIENTS: Three hundred forty-four consecutive patients with RSA and 922 controls referred for abnormal uterine bleeding. INTERVENTION: Diagnostic hysteroscopy. MEASUREMENTS AND MAIN RESULTS: Major and minor uterine mullerian abnormalities (septate, unicornuate uteri) were found significantly more often in women with RSA than in controls (32% vs 6%, p <0.001). The frequency of acquired uterine anomalies (submucous myomas, polyps) was significantly higher in controls (32% vs 9%, p <0.001). No significant differences were observed between groups in frequency of adhesions (4% vs 2%). CONCLUSION: Major mullerian uterine abnormalities are associated with RSA, and minor uterine anomalies may be correlated with an increased risk of recurrent miscarriage.

Abortion, Habitual↗

Current source density analysis of CNV during temporal gap paradigm.

The present report studied the contingent negative variation during Gap and Non-Gap conditions using visual stimulation and manual responses. The reaction times during the Gap condition were facilitated compared with those of the Non-Gap condition. The contingent negative variation component was obtained during the preparatory period from electrodes placed at 58 scalp sites for both Gap and Non-Gap conditions. The comparison between both conditions: Gap and non-gap did not show statistically significant differences during the preparatory period. The topography of the voltage and current source density maps showed three different foci: (i) an early negativity centred in electrodes overlying the supplementary motor area and cingulate motor areas, (ii) an activation over the primary motor cortex contralateral to the finger movement, and (iii) a bilateral activation on posterior sites. All these results suggest that the facilitation induced by the warning stimuli occurs in neural circuits that would be recruited for the subsequent processing of the imperative stimulus. The facilitation of the reaction times during the gap condition with respect to non-gap condition must be justified by neural events occurring during the gap period.

Adolescent↗

Pregnancy outcome in recurrent spontaneous abortion associated with antiphospholipid antibodies: a comparative study of intravenous immunoglobulin versus prednisone plus low-dose aspirin.

PROBLEM: To compare the use of intravenous immunoglobulins (IVIG) with prednisone plus low-dose aspirin (LDA) in treating pregnant women with a history of recurrent fetal loss having the antiphospholipid antibody (aPL), in terms of live-birth rate and maternal and perinatal morbidity. METHOD: A prospective, two-centers trial study included 82 recurrent aborters with aPL syndrome. Twenty-nine were treated with prednisone and LDA in one center, 53 received IVIG in the other center. Maternal and fetal outcomes and pregnancy complications were compared between groups. RESULTS: Live-birth rates were equivalent between groups (78 vs 76%). Mean birth weight was higher in the IVIG group than in the prednisone plus LDA group. In the prednisone- plus LDA-treated patients, gestational hypertension and gestational diabetes were found significantly more often than in the IVIG-treated group (14 vs 5% and 14 vs 5%, respectively). CONCLUSION: In patients with aPL syndrome, IVIG treatment improved pregnancy outcome, with significantly lower pregnancy complication rates, when compared with prednisone plus LDA therapy.

Abortion, Habitual↗

Localized pancreatic NF-kappaB activation and inflammatory response in taurocholate-induced pancreatitis.

Transcription factor nuclear factor-kappaB (NF-kappaB) is activated in cerulein pancreatitis and mediates cytokine expression. The role of transcription factor activation in other models of pancreatitis has not been established. Here we report upregulation of NF-kappaB and inflammatory molecules, and their correlation with local pancreatic injury, in a model of severe pancreatitis. Rats received intraductal infusion of taurocholate or saline, and the pancreatic head and tail were analyzed separately. NF-kappaB and activator protein-1 (AP-1) activation were assessed by gel shift assay, and mRNA expression of interleukin-6, tumor necrosis factor-alpha, KC, monocyte chemoattractant protein-1, and inducible nitric oxide synthase was assessed by semiquantitative RT-PCR. Morphological damage and trypsin activation were much greater in the pancreatic head than tail, in parallel with a stronger activation of NF-kappaB and cytokine mRNA. Saline infusion mildly affected these parameters. AP-1 was strongly activated in both pancreatic segments after either taurocholate or saline infusion. NF-kappaB inhibition with N-acetylcysteine ameliorated the local inflammatory response. Correlation between localized NF-kappaB activation, cytokine upregulation, and tissue damage suggests a key role for NF-kappaB in the development of the inflammatory response of acute pancreatitis.

Amylases↗

[Embolization of the uterine artery in the treatment of uterine myoma].

PURPOSE: To propose uterine myoma embolization as an alternative to myomectomy or hysterectomy in the treatment of symptomatic myomas; to evaluate the efficacy of the procedure in terms of clinical outcome, adopting all procedural and technical precautions to ensure minimal X-ray exposure and preserve reproductive potential. MATERIAL AND METHODS: Between April 1998 and February 2000, 26 patients, age range 32-54 years (mean 41 years), underwent uterine arterial embolization for menorrhagia, pelvic pain, and sensation of mass and pressure. Inclusion criteria were: single myomas, intramural localization and rich vascolarization of the lesion. Dose to patient was obtained by placing a thermoluminescent dosimeter (Harshaw, Solon, Ohio) both placed in posterior fornix of the vagina and on the skin at the beam entrance site. The procedure was performed under peridural anesthesia; polyvinil alcohol particles 355-500 mu (Contour) (Target Therapeutics, Boston Scientific Corporation, Fremont CA, USA) were employed as embolic agent. The uterine arteries were incannulated with a 5F (Glidecath, Terumo, Europe NV, Belgium) and successively 3F coaxial microcatheter (Target, Boston Scientific Corporation, Fremont CA, USA); the embolic material was injected as distally as possible. Color Power Doppler Ultrasound follow-up before and after i.v. contrast media administration (Levovist SHU 508 A, Shering, Berlin, Germany) was carried out at 15 days, at 1, at 3, at 6 months, and at 1 year from embolization. Pre-procedural evaluation and follow-up at 1 year was performed by MRI using T1 and T2 weighted images before and after Gadolinium (GdDTPA Shering, Berlin, Germany) administration. RESULTS: The technical success of the interventional procedure was 100% (26/26 cases). The mean fluoroscopy time was 20 minutes, and the mean number of angiographic exposures was 10. The mean estimated ovarian dose was 18.75 cGy and the mean adsorbed skin dose was 126.71 cGy. The imaging follow-up showed a 55% reduction of myoma volume at 6 months and a 75% reduction at 1 year. All patients reported a marked decrease in symptoms. No major complications were observed. The appearance of pelvic pain in the 24-48 hours after the procedure required sedation by analgesic pump; transitorial amenorrhea was observed in 3 patients. As for term complications, 2 patients have eliminated necrotic material through the vagina four weeks after procedure. The patients reported great satisfaction with the procedure. DISCUSSION: Many treatment options are currently available for symptomatic uterine myomas. One is surgical myomectomy which is associated with increased blood loss, pain and post operative morbidity and requires an additional surgical procedure for fibroma recurrence in 20-25% of patients. Another alternative treatment is hormonal therapy, which drammatically improves symptoms and reduces fibroid size although leiomyomas regrow to their original size within a few months of discontinuing treatment. Uterine embolization is a relatively new treatment for uterine fibroids that can be considered as an alternative to surgical and medical procedures. The radiation exposure adsorbed by the patient is reduced by using pulsed fluoroscopy and taking all the precautionary measures required to minimize the dose. CONCLUSIONS: The technical success, the patient' satisfation, the short hospitalization time and preservation of fertility confer to uterine artery embolization the role of a new alternative therapy for the treatment of symptomatic uterine myomas.

Adult↗

Mild thyroid abnormalities and recurrent spontaneous abortion: diagnostic and therapeutical approach.

PROBLEM: The aim of this study is to evaluate the role of mild thyroid abnormalities in recurrent spontaneous abortion, and to assess the effects of two different therapeutical protocols. METHOD: A prospective study in the population of recurrent aborters with mild thyroid abnormalities, evaluating the obstetric outcome in 42 patients. Sixteen thyroid autoantibodies positive patients were treated with thyroid replacement therapy, while 11 patients received intravenous immunoglobulins (IVIG). Fifteen patients, characterized by negative antithyroid antibodies, and having underlying thyroid pathology, were treated with thyroid replacement therapy. RESULTS: Among patients with thyroid antibodies, 6 out of the 11 pregnancies (54.5%) treated with IVIG ended in live birth. In the thyroid supplementation group, 13 out of 16 pregnancies (81.2%) ended in live birth. Only one pregnancy loss occurred among patients with a mild underlying thyroid pathology treated with thyroid replacement therapy. CONCLUSIONS: Mild thyroid abnormalities are associated with an increased rate of miscarriage. This poor obstetrical prognosis seems to be related to an impaired thyroid adaptation to pregnancy. Thyroid replacement therapy appears to be more effective than IVIG in preventing a new miscarriage.

Abortion, Habitual↗

Myofibroblast proliferation, fibrosis, and defective pancreatic repair induced by cyclosporin in rats.

BACKGROUND: Full recovery is always achieved after caerulein induced pancreatitis. Cyclosporin stimulates transforming growth factor beta (TGF-beta) and may interfere with pancreatic regeneration. AIM: To investigate the effects of cyclosporin after caerulein induced pancreatitis or after caerulein injury. METHODS: Protocol A: rats received cyclosporin daily (20 mg/kg) and caerulein pancreatitis was induced on days 2 and 8. Protocol B: six courses of caerulein pancreatitis were induced at weekly intervals. Cyclosporin was administered on induction and the day before. Rats recovered for two weeks before being killed. Control groups received saline, cyclosporin, or caerulein alone. RESULTS: Protocol A: plasma TGF-beta1 and tissue collagenase rose after pancreatitis but decreased towards baseline values on day 15, matching a low collagen content. Morphology disclosed minimal inflammatory infiltration and some interstitial cells immunoreactive for smooth muscle alpha-actin (SMA). TGF-beta1 increased, and remained high in cyclosporin treated groups (cyclosporin alone and cyclosporin plus caerulein). Rats treated with cyclosporin and caerulein showed severe pancreatic weight reduction, abundant inflammatory infiltrates, increased SMA immunoreactive interstitial cells, high collagen content, and delayed collagenase response. No SMA immunoreactive cells were detected in normal rats. Cyclosporin alone also increased SMA immunoreactive cells, despite the absence of inflammatory infiltration and fairly conserved pancreatic structure. Protocol B: the combined pulse treatment induced appreciable collagen deposition and resulted in a smaller pancreas than controls. Morphological examination showed atrophy, fibrosis, fibroblast proliferation, and mononuclear infiltrates. CONCLUSION: Cyclosporin greatly distorts pancreatic repair, transforming caerulein induced pancreatitis into a fibrotic chronic-like disease. The mechanism involves TGF-beta, myofibroblasts, and defective collagenase activation.

Actins↗

High-dose intravenous immunoglobulin treatment activates complement in vivo.

Several complement modulating effects of high-dose intravenous immunoglobulins (IVIG) have been proposed from in vitro studies and experimental animal models. However, the in vivo effects of IVIG on plasma complement in humans are yet not known. We have investigated the in vivo effects of IVIG on complement in seven women with unexplained recurrent spontaneous abortion who were without evidence of autoimmune disease. Samples were obtained before and after the very first infusion of IVIG. There was a marked increase in immunoglobulin G (IgG) from (median and range) 12.4 (9.4-15.9) to 26.8 (22.4-30.0) g/l but no change in immunoglobulin A (IgA) or immunoglobulin M (IgM). A significantly increased complement activation was demonstrated using neoepitope-specific enzyme immunoassays to the activation products C3bc (median increased from 9.8 to 31.2 AU/ml), Bb (0.66-1.66 g/ml), C5a (10.5-12.7 ng/ml), and TCC (0.81-2.19 AU/ml) (P = 0.015 for all). There were no changes in antigenic concentrations of individual complement components or regulators (C1q, C4, C3, C1-inhibitor, C4b-binding protein) and no decrease in complement haemolytic activity (classical and alternative CH50), which were all within the normal range. The classical pathway activation products C1rs/C1-inhibitor complexes, C4bc and C4d were elevated in all patients before IVIG treatment and did not change significantly during treatment. In conclusion, IVIG induced a significant activation of complement in vivo.

Abortion, Habitual↗

Hydrogen breath test with glucose in exocrine pancreatic insufficiency.

The present study was designed to investigate the prevalence of bacterial overgrowth in patients with exocrine pancreatic insufficiency by using the hydrogen breath test with glucose. Thus, in 30 patients with exocrine pancreatic insufficiency (in 15 due to chronic pancreatitis and in 15 associated to primary immunodeficiency), established by quantifying trypsin output before and after stimulation with cerulein using a duodenal perfusion technique, a glucose test was performed by administering 50 g of glucose and quantifying H2 in the breath by gas chromatography. The glucose test was positive in six of 15 patients with chronic pancreatitis but in only one of 15 immunodeficient patients (p < 0.05). Age, sex, etiology, time of evolution, associated diabetes, pancreatic calcifications, duodenal pH, or duodenal trypsin output did not differ between patients with and those without bacterial overgrowth. Previous gastroduodenal surgery was more common in chronic pancreatitis patients with overgrowth (six of six vs. four of nine; p < 0.05). Five patients with a positive glucose test were treated with antibiotics for 2 weeks and became negative in two of them. These results suggest that a positive glucose test indicating overgrowth is relatively common in exocrine pancreatic insufficiency due to chronic pancreatic, especially in patients with previous gastroduodenal surgery.

Adolescent↗

Contrasting effects of circulating nitric oxide and nitrergic transmission on exocrine pancreatic secretion in rats.

BACKGROUND: Nitric oxide (NO) blockade by L-nitroarginine methyl ester (L-NAME) inhibits pancreatic secretion in vivo and aggravates caerulein induced pancreatitis. Nitric oxide synthase (NOS) is present in pancreatic islets, endothelium, and nerve fibres. L-NAME blocks all known NOS isoforms. AIM: To investigate the source of NO blocked by L-NAME that inhibits amylase secretion. METHODS: Amylase output was measured in rats in response to caerulein (0.1-50 microg/kg) alone or with indazole. Baseline secretion and the response to supramaximal caerulein were also examined after administration of indazole, L-NAME, haemoglobin, or aminoguanidine under continuous blood pressure measurement. In separate experiments, pancreatic secretion was measured after blockade of afferent nerve fibres by either systemic or local capsaicin. The effect of neural NOS inhibition on caerulein induced pancreatitis was also investigated. RESULTS: L-NAME, haemoglobin, and supramaximal caerulein (10 microg/kg) increased blood pressure, whereas indazole and suboptimal caerulein (0.1 microg/kg) did not. Indazole and capsaicin decreased basal amylase output. L-NAME and haemoglobin reduced basal amylase output to a lesser extent and potentiated the inhibitory response to supramaximal caerulein. In contrast, full neural NOS inhibition by L-NAME partially reversed the expected caerulein induced suppression of amylase output. This effect was reproduced by indazole and capsaicin. Indazole did not alter responses to either optimal (0.25 microg/kg) or suboptimal (0.1 microg/kg) caerulein, nor, in contrast with L-NAME, aggravate the outcome of caerulein induced pancreatitis. CONCLUSIONS: Reduction of circulating NO availability, probably of endothelial origin, is responsible for the decrease in amylase secretion observed in the early response to L-NAME. Nitrergic neurotransmission plays an important role in the control of pancreatic secretion and may induce opposite effects to endothelial NOS activity.

Acute Disease↗

Frequency analysis of the EEG during spatial selective attention.

In this study, we recorded the event-related potentials (ERPs) elicited by stimuli appearing at attended and unattended locations. The voltage amplitudes and latencies of the P1, N1, P2, N2 and P3 visual components showed statistically significant differences in the attended condition with respect to the unattended one. The power spectral density of the EEG following stimulus onset was calculated. The difference between the spectral densities of the attended and unattended conditions was computed. Statistically significant differences were found in the decrease of alpha (9-11 Hz) and the increase of beta (15-17 Hz) frequencies during the attention condition with respect to the unattended condition. These results suggest that the arrival of a visual stimulus during the attended condition generates a complex reorganization of neuronal activity in both time and frequency domains.

Adolescent↗

[Thrombocytopenia onset in acute episodes of pancreatitis].

BACKGROUND: The objective of this study was to determine the prevalence of thrombocytopenia in acute pancreatitis and its value as a prognostic marker for complications. METHODS: The records of all patients admitted to our institution between January and June 1993 were reviewed. After exclusion of other possible causes of thrombocytopenia, 104 patients were evaluated. The prognostic value of thrombocytopenia was determined by evaluation of the length of hospital stay, radiologic severity, complications, need for ICU care, need for surgery and mortality. RESULTS: The etiology of pancreatitis was as follows: gallstone-induced in 49 patients, alcoholic in 35, idiopathic in 12 and due to other causes in the remaining 8 cases. Thrombocytopenia developed early, within the first 48 hours and was moderate (106 +/- 27 x 10(9)/l). Alcoholic pancreatitis was associated to a higher probability to develop thrombocytopenia (43% vs 36% in gallstone-induced pancreatitis and 4% in idiopathic pancreatitis, p = 0.02). Thrombocytopenic patients had a greater radiologic severity (Balthazar's scores D or E 78% vs 49%, p = 0.04), a higher number of acute complications (28% vs 10%, p = 0.05) and a more frequent need for ICU care (25% vs 7%, p = 0.01). No differences were seen in length of hospital stay, need for surgery and mortality between the two groups of patients. CONCLUSIONS: Thrombocytopenia is frequent in acute pancreatitis, especially in cases of alcoholic origin. Its presence suggests a higher risk to develop complications.

Acute Disease↗