Biomedical subjects
Publications and source records attributed to F Díaz.
Electroshock therapy was performed in a patient with Parkinson disease who had shown intolerance to treatment with levodopa. Evaluation at 1 and 6 months post therapy revealed mild and short lived antiparkinsonian effects. The theoretical basis for this therapy are discussed.
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Insulin-induced drinking (IID) in male Wistar rats, evoked by administering 5 U/kg of crystalline porcine insulin i.p., was significantly decreased by propranolol (0.1 and 0.5 mg/kg s.c.) after 1 and 2 h. The blood glucose of rats treated with a much higher dose of propranolol (10 mg/kg body weight) and insulin did not differ from that of rats treated solely with insulin after 30 and 120 min. Atenolol (0.5 mg/kg s.c.) caused a reduction in IID after 1 and 2h. Butoxamine (1 mg/kg s.c.) also reduced IID after 1 and 2h, and at 0.5 mg/kg after 1h. The alpha-blocker, phenoxybenzamine (10 mg/kg s.c.), had the opposite effect, stimulating IID after 2h. There is no direct evidence that insulin activated the sympathetic system at the doses used in these experiments. Nevertheless, the results reported here seem to be compatible with the involvement of the sympathetic system in IID, possible through the renin-angiotensin system.
BACKGROUND: The aim of the present study was to obtain information about tuberculosis (TB) in our area that might contribute to assess the status in Spain. METHODS: A meticulous case finding was carried out during 1988 in all the hospitals of the Gran Canaria island. RESULTS: 214 cases were found (rate 32.2) and 77% were admitted to hospitals. In 160 (74%) the involvement was pulmonary and in 82 (37%) it was extrapulmonary. Mean age was 34 years (range 1-84) and 62% were younger than 40 years. 69% were males. Complete data were obtained in 183 cases (85%). 56% were smokers, 34% alcoholic abusers, 15% drug abusers (35% parenteral) and 4% homosexuals. 26% had some risk factor for TB; 14 of them had been infected by the HIV (8 had AIDS). In 64% there was a diagnostic delay longer than one month. Out of the 214 cases, the diagnosis was made by direct microscopy and/or culture in 110 (51%), by consistent pathological findings in 41 (19%), with some of these studies but with negative results in 35 (16%) and only with clinical and radiological criteria in 28 (13%). 96 (60%) of the pulmonary cases had cavitation. The most common therapeutic schedule (84%) was the recommended 9-month regimen. In 54% no recommendation for the investigation of contacts was made. CONCLUSIONS: In the authors' area, the prevalence of TB is higher than in developed countries. It is more common in middle aged individuals, many diagnoses are still made without bacteriologic studies and in a high number of cases investigation of contacts is not carried out.
From January 1984 to October 1990, 140 of 392 (35.7%) patients with the acquired immunodeficiency syndrome (AIDS) were found to have had tuberculosis. One hundred and sixteen were intravenous drug abusers and 16 were homosexual men. Fever, cough, weight loss and generalised lymphadenopathy were common features of their illness. Tuberculin skin tests were negative in 74% and 55% had intraabdominal lymphadenopathy. The chest radiographs showed hilar lymphadenopathy and lower lobe interstitial or alveolar infiltrates, but rarely cavitation. Forty-one of our patients had pulmonary tuberculosis, 38 had extra pulmonary and in 61 it was disseminated. In 80 cases tuberculosis was the presenting feature of AIDS. Tuberculosis usually responded well to chemotherapy.
The different types of neurons within the visual sector of the rat's thalamic reticular nucleus were studied, both in terms of their morphology and their histochemical activity. Neurons were classified according to their dendritic arrangement into bitufted and multipolar. On the basis of the somal shape, bitufted neurons were further subdivided into two types, triangular and fusiform, and multipolar neurons into stellate and ovoid. Bitufted neurons have moderate succinic dehydrogenase (SDH) activity, while multipolar neurons usually have high SDH activity. Finally, the location of neurons in the visual sector of the thalamic reticular nucleus was described.
The bromocriptine-TRH test was performed in 11 patients with advanced Parkinson's disease and in 10 control subjects. Seven patients were receiving treatment with Levo-DOPA, which was discontinued 12 h prior to the test. Basal prolactin levels were 5.88 ng/ml in treated and 18.22 ng/ml in untreated patients as compared to 9.68 mg/ml in controls. Bromocriptine induced a similar reduction of about 60% in prolactin levels in all groups (3.28, 11.5 and 5.95 ng/ml, respectively). After TRH, prolactin levels increased to 13.8 ng/ml in controls and 15.2 ng/ml in patients treated with levo-DOPA. Untreated patients remained with prolactin below basal levels (11.6 ng/ml). We postulate that low basal levels of prolactin in patients treated with levo-DOPA reveal a residual suppressing effect of the drug. The sharp increase after TRH is related to a significant dopaminergic hypofunction as evidenced by clinical findings. A high sensitivity of dopaminergic receptors in the anterior hypofisis is suggested as an explanation for the findings of the test in the untreated patients.
After 6 years of operation of a National (autonomous) Board for Certification of Medical Specialists, the number, distribution and training of medical specialists is analyzed. Problems regarding significant differences in the quality of training and imbalance among different specialties are identified. The medical profession has expressed its confidence and feels supported by the activities of the Board. However, health care deliverers and users in general are expected to increase their support and consideration for the information provided by the Board, in order to fulfill the purpose for which it was established.
Ten advanced Parkinson pts (mean 8 years since diagnosis), 6 male and 4 female, 57 to 69 years old, mean 5.9 years on L-Dopa therapy, were put on Madopar HBS to assess the efficacy of the drug. All the pts had levodopa end-of-dose wearing-off type secondary motor fluctuations, 9 of them with dyskinesia and dystonia. Clinical evaluation was performed in basal conditions (pts on standard L-Dopa therapy) 1.6 and 12 months on Madopar HBS therapy. Parkinson signology was quantified with the modified Columbia scale (0 to 44), and motor fluctuations and dyskinesia with a scale 0 to 4 according to intensity and frequency. Pts received mean 1.150 mg. HBS daily dose plus 100 to 200 mg standard L-Dopa added to the early morning dose for a faster effect. At 12 months, a 60% decrease in "off" periods, a 50% decrease in feet dystonia, with no change in orofacial dystonia were observed. Dyskinesia decreased in intensity but not in frequency. There was a 50% decrease of Parkinson signology in "on" periods. In conclusion, Madopar HBS reduces the signology of the long-term Levodopa therapy syndrome and therefore is commendable in pts with advanced Parkinsonism.
Fetal life develops in a fluid environment. Amniotic fluid is not inert. It contains proteins, hormones, fetal urine and electrolytes, known to interact with a variety of fetal processes such as wound healing, intestinal growth, etc. Interest in its study has been increasing recently. In order to determine the effect of amniotic fluid, intra-amniotic and extra-amniotic fetuses should be compared. We describe a model that allows isolation of a fetal portion from amniotic fluid. Sixty 23-day pregnant rabbits were operated on. Surgery was performed in two fetuses of each mother. One fetus was replaced into the amniotic sac; the other was sutured along its waist to the histerotomy orifice, leaving the caudal half of the fetus in an extra-amniotic position. The mothers continued their pregnancy and were sacrificed on day 30. Maternal survivance rate was 82 per 100. Twelve intra-amniotic fetuses (FIA) and nine extra-amniotic fetuses (FEA) were obtained, as well as 16 nonoperated littermates that served as controls. The average weight of FIA fetuses was 31 g, FEA fetuses weighed 37 g and controls 36 g. The difference was not statistically significant between any of the groups. This model allows the study of a variety of fetal conditions in the absence of amniotic fluid. The survivance rate of this technique of extrauterine fixation has been 75 per 100.
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We report the case of a 13-yr-old patient with retarded growth and a 2-yr background of asthenia, anorexia, and fever, whose laboratory data revealed anemia, thrombocytosis, an elevated erythrocyte sedimentation rate, ferropenia, hyperglobulinemia, hyperfibrinogenemia, and presence of a lupus-like circulating anticoagulant. Clinical studies revealed a tumor-like overgrowth in the gastric wall, and surgery confirmed its subserosal localization in the gastric fundus. After total removal of the mass, the systemic manifestations disappeared. The pathological study revealed the existence of the hyaline-vascular variety of Castleman's disease. Having reviewed the medical literature, we have not found a single unquestionable case of gastric Castleman's disease, although three other cases have been described as gastric pseudolymphoma which, when analyzed, could correspond to typical cases of Castleman's disease. Likewise, this is the second case associated with a circulating anticoagulant of lupoid characteristics. We conclude that Castleman's disease should be included in the differential diagnosis of gastric lesions of lymphoid nature and in the series of processes associated with lupus anticoagulant.
The effect of insulin administration on water intake, was studied in children submitted to standard protocols for stimulation of secretion of hypophyseal hormones by i.v. treatment with several different drugs: insulin, insulin plus TRH and LH-RH; and propranolol, clonidine or LH-RH. Drinking was measured from 0 to 90 min after drug administration; from blood samples taken at 60 min for hypophyseal hormones analysis, microhaematocrit values were measured, as well as plasma renin activity (PRA) and glycaemia. Water intake was significantly higher in both groups of patients receiving insulin than in the control group (no insulin). Haematocrit values did not change after 60 min. There was a significant correlation of glycaemia of individuals from all three groups and water intake at 60 min. PRA was significantly higher in insulin treated individuals.
The chronology of dLGN development was studied in the rat from birth to 90 days postnatal (dpn). Our results indicate the faster dLGN growth occurs from 1 dpn to 21 dpn. The neuronal number and density was calculated. No significant neuronal loss was detected in the period investigated but the present study shows evidence of an important decrease (of 75%) in the neuronal density between 7 dpn and 21 dpn. Immediately the study of neuronal sizes and shapes was undertaken. Approximately at 14 dpn the deep neurons get a size significantly bigger than the marginal neurons. Finally, the different neuronal sizes were used for determining the successive phases of the neuronal development.
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The appearance and fluctuations of specific insulin binding sites in several tissues in vivo during rat development, have been determined. After intravenous administration of 125I-insulin to fetal, suckling and adult rats, changes on specific hormone uptake were observed depending on the tissues tested and on the age of animals. Thus, in liver, specific insulin uptake was much greater in 19 day-old fetuses and 10 day-old suckling animals than in adult rats. By contrast, brown fat and spleen insulin uptake was undetected in fetal animals but present in suckling rats, while lung insulin uptake was absent in the adults but present in fetal and suckling animals. Of interest were the specific insulin uptakes by three different muscle tissues. In fact, heart insulin uptake was much higher in younger animals than in adult rats, while in the diaphragm it was significantly smaller in all groups and in skeletal muscles hormone uptake was much smaller than in the other two muscle tissues and was even absent in the fetuses. In those tissues that had previously been shown to exhibit a specific insulin uptake, the iodinated hormone uptake decreased proportionally with simultaneous injection of increasing amounts of unlabelled insulin. These results indicate that insulin binding sites appear at different times and fluctuate in a different manner according to the tissues tested during rat development; this might be important in the stimulation of the functional activities of those tissues during perinatal age.
A 73-year-old man had unusual acute, generalized panniculitis. The patient had elevation of serum amylase and lipase levels with signs or symptoms of pancreatic disease. Skin specimens from the lesions showed subcutaneous fat necrosis.