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Biomedical subjects

F Gutiérrez

Publications and source records attributed to F Gutiérrez.

At least 19 recordsLinked to original sources
PubMed2006

[Renovascular hypertension in children and adolescents: diagnosis and treatment over 19 years].

SUMMARY Sixty seven hypertensive children age 2-18 with at least one possible clinical sign of renovascular hypertension (RVH) were enrollment into a screening program for diagnose and treatment of RVH over a 19 year period. Patients underwent a variety of biochemical and imaging studies, but in all cases, renal arteriography was used to determine the precise diagnosis and treatment strategy. Of the 67 patients 21 (31.3%) were identified with renal artery stenosis Group 1, 14 (66.6%) unilateral, 5 (23.8%) bilateral and 2 (9.6%) branches. The mean age was 13.9 +/- 3.73 years, with 26.4 +/- 35.2 months of known hypertension, mean systolic blood pressure 191.1 +/- 30.6 mmHg, mean diastolic blood pressure 135.3 +/- 21.2 mmHg and 69% due to fibromuscular dysplasia. Three therapeutic modalities were chosen: percutaneous transluminal angioplasty (PTA), surgery (autotransplant, and nephrectomy), pharmaceutical therapy with antihypertensive drugs and combination of these. The aim of the treatment was blood pressure control, prevention of chronic renal disease and renal function and organ damage preservation. The outcome was categorized as cure, improvement or no change in hypertension. PTA treated eleven patients, 2 combined with surgery (one nephrectomy and 1 autotransplant). Blood pressure was normalized in 9/11 (81.8%) after a mean follow-up of 11.5 years (range 1-18 years). All 6 RVH cases treated by surgery procedure (one after PTA) were cured and 4 cases were managed medically (pharmacological treatment). On december 2004, 19/21 (90%) RVH adolescents blood pressure was normalized with normal serum creatinina, 10 (48%) of these completed cured, 9/21 (43%) improved (normotensión with decrease in medication requirements) and 2 (9%) other cases ware lost of follow-up. The 46 non-RVH adolescents (68.7%) were treated with long term antihypertensive medications; all of these have adequate BP control and normal renal function. We conclude that our work-up used in order to make a proper and timely diagnosis and treatment of renovascular hypertension in adolescent was successful in our population.

Adolescent↗
PubMed2005

Pulmonary mycetoma caused by an atypical isolate of Paecilomyces species in an immunocompetent individual: case report and literature review of Paecilomyces lung infections.

The first case of pulmonary fungus ball caused by Paecilomyces species is reported. The diagnosis was established by isolation of the fungus in culture from specimens obtained by percutaneous transthoracic needle aspiration in an immunocompetent individual. The isolate was atypical, as it failed to produce fruiting structures on routine mycological media. Identification was achieved by sequencing polymorphisms of the internal transcriber spacer regions of the ribosomal DNA. The antifungal susceptibility profile was also determined. This report underscores the increasing importance of Paecilomyces species in human infections. Paecilomyces should be included among the etiological agents of pulmonary mycetoma.

Adult↗
PubMed2005

Community-acquired pneumonia of mixed etiology: prevalence, clinical characteristics, and outcome.

Community-acquired pneumonia (CAP) of mixed etiology has increasingly been appreciated in the literature, but its clinical significance remains unknown. The aim of this analysis was to describe the prevalence, clinical characteristics, and outcome of CAP of mixed etiology. Data were obtained from a 2-year prospective study of consecutive patients with CAP in whom an extensive microbiological workup was performed. Predefined strict criteria were used to establish the etiology. A total of 493 patients were included. A single pathogen was detected in 222 (45%) cases and two or more pathogens in 28 (5.7%) cases. Mixed infections were seen across all age groups and in patients treated both in hospital and as outpatients. The most frequent combinations of pathogens were those of a bacterium plus an "atypical" organism (28.6%) and of two bacterial organisms (28.6%). Compared with patients with monomicrobial pneumonia, patients with mixed pneumonia were more likely to have underlying conditions (64% vs. 45%, p=0.04) and dementia (25% vs. 10%, p=0.02). The incidence of a defined series of complications was higher in patients with mixed pneumonia (39.3% vs. 18.6%; OR=2.84; p=0.02). Community-acquired pneumonia of mixed etiology is uncommon. Patients with mixed pneumonia are more likely to have underlying medical conditions, and they may have a more severe course of disease.

Adolescent↗
PubMed2005

Epidemiology of community-acquired pneumonia in adult patients at the dawn of the 21st century: a prospective study on the Mediterranean coast of Spain.

This study presents data from a prospective study of adult patients with community-acquired pneumonia (CAP). Of 493 patients included in the study, 223 (45.2%) were aged > or = 65 years, and 265 (53.7%) had one or more underlying diseases, mostly chronic obstructive pulmonary disease, diabetes mellitus or dementia. In total, 281 microorganisms were identified in 250 (50.7%) patients, with two or more pathogens detected in 28 (5.7%) cases. Microbial diagnosis varied according to age, severity, co-morbidity and site-of-care, but there was much overlap among groups. Streptococcus pneumoniae was the single most prevalent organism in outpatients, patients admitted to hospital, and patients who died, either as a single pathogen or combined with another organism. Infections caused by 'atypical' pathogens were seen across all groups, including the elderly and patients with co-morbidities. Mortality varied according to the pneumonia severity index (PSI) of the pneumonia patient outcomes research team. Shock (OR 34.48), an age of > 65 years (OR 25) and altered mental status (OR 9.92) were factors associated independently with 30-day mortality. Key findings from this study were the advanced age of the population with CAP, and the high prevalence of dementia as an underlying disease. The study also revealed that microbiological diagnosis of CAP remains problematic. Although certain epidemiological features may help to predict the microbial aetiology, the overlap among groups reduces the usefulness of this information in guiding therapeutic decisions. Greater effort should be made to improve identification methods for microbial pathogens causing CAP.

Adolescent↗
PubMed2005

Severe toxicity associated with the combination of tenofovir and didanosine: case report and review.

The combination of tenofovir and didanosine results in an increase in the didanosine plasma exposure and might augment the risk for didanosine toxicity. Although pharmacokinetic studies support a didanosine dose reduction to 250 mg when used concurrently with tenofovir in patients weighing at least 60 kg, no data are available in lower-weight patients. We describe a case of lactic acidosis and acute liver failure in a low-weight patient receiving tenofovir and a reduced dose of didanosine (200 mg/day). To our knowledge, this is the first case of severe toxicity associated with a reduced dose schedule of didanosine. Previous cases of severe toxicity associated with the combination of tenofovir and didanosine are reviewed.

Acidosis, Lactic↗
PubMed2005

[Spanish scientific production in antimicrobial agents and susceptibility procedures during period 1990-2002].

The aim of this study was to analyze the scientific production of Spanish authors on antimicrobial agents and susceptibility tests during the period 1990-2002. Articles from Spanish scientific institutions of microbiology, bacteriology, mycology and parasitology published and recorded in the MEDLINE database (WEBSPIRS version 4.2) during the period 1990-2002 were selected. Only articles about antimicrobial agents and susceptibility procedures were reviewed. A total of 5,259 documents were analyzed, of which 1,041 (19.8%) were about antimicrobal agents. The annual number of documents increased by two-fold (from 48 in 1990 to 101 in 2002). The journal that published most documents was Antimicrobial Agents and Chemotherapy, with 183 (17.1%). The main field of interest of the documents was antimicrobial agents and susceptibility tests (765; 73.5%) and in vitro resistance analyses (265; 25.5%). The highest number of contributions came from hospitals (571; 54.9%), followed by universities (351; 33.7%). The institutions with most documents published were the Ramón y Cajal Hospital (8.6%), and Seville University Faculty of Medicine (6%). The most productive autonomous communities were Madrid (43.4%), Catalonia (16.4%) and Andalusia (4.7%). A total of 787 documents (75.6%) were published in journals with impact factors and the mean expected impact factor was 2.390 +/- 1.546. It was concluded that the scientific production of Spanish researchers in antimicrobial agents had increased during the period 1990-2002, and that hospitals were the most productive institutions in this area of microbiology, with the main areas of interest being antimicrobial agents and susceptibility tests.

Anti-Bacterial Agents↗
PubMed2004

Publication of European Union research on infectious diseases (1991-2001): a bibliometric evaluation.

The study presented here analyzed the contents of 36 international infectious diseases journals from 1991 to 2001 to determine the number of reports prepared by authors in the European Union and to compare the per country scientific productivity. Articles included in the study were identified using the PubMed website. The number of publications in infectious disease journals produced by authors in the European Union experienced an exponential growth from 461 (19.2% of world production) in 1991 to 2,401 (35.9%) in 2001. The mean impact factor increased from 2.259 in 1991 to 3.001 in 2001. The leading countries in the total number of publications were the UK, France, and Germany. After taking population figures into account, Sweden, Denmark, and Finland headed the list, and after correcting for gross domestic product, the greatest producers were Sweden, Finland, and the UK. Overall, the scientific production and repercussion index of European Union research on infectious diseases experienced a notable rise during the last decade of the 20th century.

Bibliometrics↗
PubMed2004

Epidemiological and clinical characteristics of occult bacteremia in an adult emergency department in Spain: influence of blood culture results on changes in initial diagnosis and empiric antibiotic treatment.

A prospective study was carried out to analyze the usefulness of blood culture results for adult patients who were discharged from the emergency department with bacteremia. Over a 29-month period, 110 patients with significant bacteremia who were seen in the emergency department and discharged home were studied. The mean age of the patients was 61.8 years. The most frequent initial major diagnosis was urinary tract infection (UTI) (n=63; 57.3%). Gram-negative organisms were isolated in 79 (71.8%) cases. A change in diagnosis (44.5% cases) was more common when the initial diagnosis was something other than UTI or when empiric antimicrobial therapy was ineffective or was not given (P<0.001). The significant predictors of modification of the initial empiric antibiotic therapy were ineffective empiric antimicrobial therapy and transfer of the patient from the emergency department to an infectious diseases outpatient clinic (P=0.01). Blood culture results may be useful for achieving the correct diagnosis in adult patients with bacteremia and for guiding treatment in the subsequent management of outpatients.

Adult↗
PubMed2002

Determinant parameters and components in the storage of virgin olive oil. Prediction of storage time beyond which the oil is no longer of "extra" quality.

This work studies the changes in the quality indices standardized by the European Union, together with the evolution of the oxidative stability and sterols, polyphenols, alpha-tocopherol, pigments, and fatty acids contents throughout the storage of Picual and Hojiblanca olive cultivar "extra" virgin olive oils at 2 degrees C + darkness and 30 degrees C + illumination. Only two quality indices (K(270) and sensory evaluation) indicate the loss of the extra quality of the oil during storage, and there is an excellent correlation between initial stability and the time to reach the limit of K(270) > 0.25 (after which the oil quality is no longer of "extra" quality). This time can be predicted with an error of <10%, which is of great commercial interest and previously unknown. Also unknown until now is that the changes in polyphenols, pigments, and alpha-tocopherol with storage time follow first-order kinetics.

European Union↗
PubMed2001

[Influenza vaccination of human immunodeficiency virus-infected patients with severe immunodepression. Impact on CD4 lymphocytes and plasma viral load].

BACKGROUND: The aim of this study was to assess the effect of influenza vaccination on plasma HIV viral load and CD4 T-lymphocytes in patients with advanced HIV disease. PATIENTS AND METHOD: Observational study carried out in HIV-infected patients with a CD4 cell count < 200 X 10(6)on highly active antiretroviral therapy(HAART). Influenza vaccine was voluntarily offered and plasma viral load and CD4 cell counts were measured at baseline, 4 weeks and 12 weeks in vaccinated and control subjects. RESULTS: Sixteen patients were analysed, 10 of them being immunized with the influenza vaccine. A significant decline in CD4 cell counts at 4 and 12 weeks and an increasing trend of viral load were seen in all immunized patients who had a high viral load at the time of vaccination (n = 6), but not in those with an undetectable viral load. The mean decrease of CD4 T-lymphocytes in these 6 patients was 49.8%. Three patients showed a huge drop of the CD4 cell count (over 60% of baseline). CONCLUSIONS: Influenza vaccination of severely immunocompromised HIV-infected patients who are failing to HAART might be associated with an immunological impairment.

Adult↗
PubMed2001

Double-blind olanzapine vs. haloperidol D2 dopamine receptor blockade in schizophrenic patients: a baseline-endpoint.

The aim of this study was to compare in vivo striatal D2 dopamine receptor occupancy induced by olanzapine and haloperidol in schizophrenic patients using a baseline-endpoint [(123)I]IBZM single photon computed emission tomography (SPECT) design. The relationships of striatal D2 receptor occupancy with clinical efficacy and extrapyramidal symptoms (EPS) were also assessed. Twenty-seven inpatients with schizophrenia or schizophreniform disorder were included in a 4-week prospective, randomized, double-blind, parallel and comparative clinical trial. Thirteen patients were treated with haloperidol (10 mg/day) and 14 with olanzapine (10 mg/day). Ratings of clinical status and EPS were obtained weekly. The percentage of D2 receptor occupancy was estimated by using basal ganglia (striatum)/frontal cortex IBZM uptake ratios obtained from each patient before and after 4 weeks of maintained antipsychotic treatment. Olanzapine led to a mean striatal D2 receptor occupancy of 49% (range 28-69%), which was significantly lower than that induced by haloperidol (mean 64%, range 46-90%). The baseline-endpoint SPECT design used in this study revealed lower antipsychotic D2 occupancy percentage values than those reported in the literature, using other approaches. The degree of striatal D2 receptor occupancy correlated to the EPS, which predominantly appeared in patients on haloperidol. No relationship was found between the striatal D2 receptor occupancy and clinical improvement. Olanzapine induced a lower striatal D2 occupancy than haloperidol. This low striatal D2 occupancy, together with the lower incidence of EPS in olanzapine-treated patients, contributed to confirm the atypical behavior of this new antipsychotic drug. Nevertheless, conclusions based on SPECT-estimated percentages of antipsychotic D2 occupancy should be cautious, since the SPECT design could influence the results. In this regard, SPECT studies including baseline and endpoint examinations should be encouraged.

Adult↗
PubMed2001

Cloning and sequence analysis of the LEU2 homologue gene from Pichia anomala.

The Pichia anomala LEU2 gene (PaLEU2) was isolated by complementation of a leu2 Saccharomyces cerevisiae mutant. The cloned gene also allowed growth of a Escherichia coli leuB mutant in leucine-lacking medium, indicating that it encodes a product able to complement the beta-isopropylmalate dehydrogenase deficiency of the mutants. The sequenced DNA fragment contains a complete ORF of 1092 bp, and the deduced polypeptide shares significant homologies with the products of the LEU2 genes from S. cerevisiae (84% identity) and other yeast species. A sequence resembling the GC-rich palindrome motif identified in the 5' region of S. cerevisiae LEU2 gene as the binding site for the transcription activating factor encoded by the LEU3 gene was found at the promoter region. In addition, upstream of the PaLEU2 the 3'-terminal half of a gene of the same orientation, encoding a homologue of the S. cerevisiae NFS1/SPL1 gene that encodes a mitochondrial cysteine desulphurase involved in both tRNA processing and mitochondrial metabolism, was found. The genomic organization of the PaNFS1-PaLEU2 gene pair is similar to that found in several other yeast species, including S. cerevisiae and Candida albicans, except that in some of them the LEU2 gene appears in the reverse orientation.

3-Isopropylmalate Dehydrogenase↗
PubMed2001

Psychometric properties of the Temperament and Character Inventory (TCI) questionnaire in a Spanish psychiatric population.

OBJECTIVE: The psychometric properties of the Spanish version of Cloninger's Temperament and Character Inventory (TCI) were examined in a psychiatric population. METHOD: Internal consistency, factor structure and concurrent validity were studied in a sample of 416 psychiatric patients. RESULTS: A moderate to high internal consistency for all personality dimensions was found, except for Persistence. A confirmatory factor analysis of the TCI performed at the subscale level revealed an uncertain factor structure. However, when analysed separately, both the 11 temperament subscales (plus Persistence) and the 13 character subscales shaped four and three factors, respectively, in agreement with the biosocial model of personality. Finally, concurrent validity analyses were conducted using EPQ, SPSR and SSS questionnaires showing results consistent with theory. CONCLUSION: The Spanish version of the TCI is a reliable and valid instrument, although the Persistence dimension might require further revision.

Adult↗
PubMed2001

Are conjunctive inferences easier than disjunctive inferences? A comparison of rules and models.

We report four experiments investigating conjunctive inferences (from a conjunction and two conditional premises) and disjunctive inferences (from a disjunction and the same two conditionals). The mental model theory predicts that the conjunctive inferences, which require one model, should be easier than the disjunctive inferences, which require multiple models. Formal rule theories predict either the opposite result or no difference between the inferences. The experiments showed that the inferences were equally easy when the participants evaluated given conclusions, but that the conjunctive inferences were easier than the disjunctive inferences (1) when the participants drew their own conclusions, (2) when the conjunction and disjunction came last in the premises, (3) in the time the participants spent reading the premises and in responding to given conclusions, and (4) in their ratings of the difficulty of the inferences. The results support the model theory and demonstrate the importance of reasoners' inferential strategies.

Cognition↗