[Etiology of the whooping cough syndrome. Study of 50 cases].
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Biomedical subjects
Publications and source records attributed to F Rodríguez.
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In 19 adult patients with choledocholithiasis who were operated on, excretion of free and conjugated sulfobromophthalein (BSP) in the bile collected through a T-tube inserted in the common bile duct was determined. The transport maximum (Tm) for BSP was calculated by the constant-infusion technique after an intravenous infusion of the dye at a rate of 0.3 and 0.09 mg/kg/min for the first and second hour, respectively. Free and conjugated BSP were measured in blood samples obtained at 30, 40, and 50 min of each hourly-infusion period, and in bile collected during the first 30 min (sample A) and between 30-50 min (sample B) after starting the first BSP infusion, and during the first 30 min (sample C) and between 30-50 min (sample D) after starting the second infusion. No correlations between Tm of BSP and glutathione transferase activity and between Tm and bilirubin and alkaline phosphatase in serum were found. Although there was an overall correlation between Tm of BSP and biliary excretion of BSP after 30 min of starting the BSP infusion (samples B, C and D) (r = 0.4716; P = 0.41), Tm values were always lower than recoveries of free BSP in bile. It seems that Tm of BSP (measured with the Wheeler's method) overestimates the actual values of biliary excretion of free BSP, and that the percentage of conjugated BSP in serum is related to the degree of impairment of biliary transport of BSP.
This report describes a large cell immunoblastic lymphoma in a bottlenose dolphin found stranded alive in Gran Canaria, Spain. Diffuse infiltration of round neoplastic cells was observed in the splenic cords and sinuses and in hepatic sinusoids, resulting in moderate organ enlargement. The tumour cells (immunophenotype IgG+ and CD3-) showed scant, lightly eosinophilic or basophilic cytoplasm, distinct cell boundaries and hyperchromatic nuclei, each with one or more nucleoli. Mitoses were common. On the basis of histopathological, immunohistochemical and ultrastructural features, the tumour was classified as an immunoblastic lymphoma. Eleven polychlorinated biphenyl (PCB) congeners, 23 organochlorine pesticides and 16 polycyclic aromatic hydrocarbons (PAHs) were detected in the blubber and liver. High concentrations of PCBs 153, 180, 138 and 187 found in the liver may have been associated with the hepatosplenic lymphoma.
A pool of three monoclonal antibodies, 3H12, 6D11 and 2A3, inhibited the in vitro growth of 12 Mycoplasma mycoides subspecies mycoides small colony (MmmSC) strains and seven Mycoplasma mycoides subspecies mycoides large colony (MmmLC) strains. This test did not cross-react with other 16 Mycoplasma mycoides cluster and nine non-Mycoplasma mycoides cluster strains representing 13 different species. Although MmmSC was not differentiated from MmmLC, the monoclonal antibodies distinguished both M mycoides subspecies mycoides biotypes from the other Mycoplasma species tested in contrast to results with polyclonal antisera.
BACKGROUND: Patients with pheochromocytoma have been reported to show high plasmatic atrial natriuretic factor (ANF) levels. Its source may not be the atrium because blood volume, the most important physiological stimulus for ANF release, is usually reduced in these patients. METHODS: To evaluate ANF secretion functional integrity, we studied three patients with pheochromocytoma before and after surgical removal of the tumor. Extracellular fluid (ECF) volume, plasmatic ANF levels, and plasmatic renin activity (PRA) were measured. ANF was measured before and after an acute saline load of 1.5L in 90 min. RESULTS: Before surgery, ECF volume was normal or reduced, and PRA was normal but decreased after the saline load. By contrast, ANF was elevated and did not change after the saline load. After surgery ANF decreased, ECF volume rose, and the saline load induced a significant increase of plasma ANF and reduction of PRA. ANF was present in significant amounts in tumoral tissue homogenates. CONCLUSIONS: These data suggest that the tumor was the source of ANF in these patients with pheochromocytoma because high levels of ANF, despite reduced or normal ECF volume, as well as unresponsiveness to acute saline infusion, were found before surgery with subsequent normalization after tumor removal.
The forebrain of vertebrates shows great morphological variation and specialized adaptations. However, an increasing amount of neuroanatomical and functional data reveal that the evolution of the vertebrate forebrain could have been more conservative than previously realized. For example, the pallial region of the teleost telencephalon contains subdivisions presumably homologous with various pallial areas in amniotes, including possibly a homologue of the medial pallium or hippocampus. In mammals and birds, the hippocampus is critical for encoding complex spatial information to form map-like cognitive representations of the environment. Here, we present data showing that the pallial areas of reptiles and fish, previously proposed as homologous to the hippocampus of mammals and birds on an anatomical basis, are similarly involved in spatial memory and navigation by map-like or relational representations of the allocentric space. These data suggest that early in vertebrate evolution, the medial pallium of an ancestral fish group that gave rise to the extant vertebrates became specialized for processing and encoding complex spatial information, and that this functional trait has been retained through the evolution of each independent vertebrate lineage.
The aim of this study was to assess serum zinc levels in a cohort of healthy subjects and cirrhotic patients from Mexico City. A total of 153 healthy subjects and 100 cirrhotic patients, males and females aged 18-65, were studied. Inclusion criteria for healthy subjects were (1) Mexican-born with first and second generation relatives born in Mexico, and (2) somatometric (body mass index under 30) and clinical evaluation establishing that they had no underlying disease. Entry criteria for cirrhotic patients were (1) clinical and histological proven cirrhosis, (2) compensated liver disease (absence of coma, bleeding hemorrhage or refractory ascitis), and (3) cirrhosis of any cause. Zinc serum levels were measured with atomic absorption spectrophotometry. In healthy subjects, mean serum levels were 77.4 +/- 4.2 micrograms/dl (range 42.9-105.2 micrograms/dl). In cirrhotic patients zinc serum levels (58.9 +/- 16.1 micrograms/dl, range 22-88 micrograms/dl) were significantly lower than in healthy subjects (p < 0.05). A stepwise decline in serum zinc with worsening Child class (A, 73.4 +/- 13; B, 64.4 +/- 12; C, 55.8 +/- 15.6; p < 0.05 by ANOVA test) was found. In conclusion, this study confirms that zinc serum levels are significantly lower in cirrhotic patients and shows that zinc serum levels in a cohort of 153 healthy subjects from Mexico City were unexpectedly lower compared to those found in other countries. This last finding might be explained by different dietetic patterns and deserves further investigation.
This paper reports the clinicopathologic responses of 93 dogs with spontaneously occurring ehrlichiosis to 3 different treatment protocols. Thirty-two dogs were treated with doxycycline (10 mg/kg/day for 28 days), 31 were treated with imidocarb dipropionate (5 mg/kg given 15 days apart in 2 separate injections), and 30 were treated with both drugs simultaneously, at the doses as specified. The dogs underwent clinicopathologic evaluation before and after treatment, and were examined periodically during the 24-month period after the treatment. No differences were found in the clinical responses among the dogs in the 3 treatment groups. As for the clinicopathologic response, in spite of the fact that at the end of the study the results obtained with the 3 protocols were similar, the platelet count and serum protein electrophoresis results returned to normal more slowly in dogs that received imidocarb dipropionate as compared to those given the other 2 treatments.
OBJECTIVE: To compare and contrast the efficacy and tolerability of a proton pump inhibitor, pantoprazole, to that of an H2 antagonist, ranitidine, in the treatment of patients with mild to severe reflux esophagitis. BACKGROUND: Reflux esophagitis is a common illness affecting 5-10% of the world's population. Acid reflux plays a major role in the disease's genesis, as do esophageal and gastric motility disturbances. METHODS: 315 patients (intent to treat) with endoscopically confirmed reflux esophagitis (Savary-Miller (SM) stages II and III) were recruited to the study by 46 mexican investigators in nine centers. Patients received either pantoprazole 40 mg once daily or ranitidine 150 mg twice daily in this double blind, randomized, parallel group study. Patients not achieving complete endoscopic healing after four weeks of therapy received an additional four weeks of treatment. Drug tolerability was assessed by adverse event reporting during the study. RESULTS: After four weeks pantoprazole therapy, 81% of patients with SM II and 67% of the patients with SM III were healed; in contrast ranitidine healed only 67 and 30% of the patients respectively, all results expressed on an per-protocol basis. After eight weeks therapy the healing rates for pantoprazole group increased to 94% and the ranitidine group to 74% (p = 0.001). The incidence of adverse events was less than 2% in both treatment groups, thus both therapies were found to be well tolerated. CONCLUSIONS: Pantoprazole is superior to ranitidine in the treatment of mild to severe reflux esophagitis and is equally well tolerated.
INTRODUCTION: Myotonic dystrophy is an autosomal dominant hereditary disorder with variable expression, associated with expansion of the CTG triplet on the gene which codifies myotonia situated on chromosome 19q. We present an unusual case of myotonic dystrophy in a pair of monozygotic twin sisters, determination of CTG expansion in lymphocytes of members of their family and in their father's spermatozoids. CLINICAL CASE: The patients presented the phenomenon of anticipation of paternal transmission with an expansion of triplet CTG of lymphocyte DNA in a range of 300-1,400 identical repetitions in both. DNA of the paternal lymphocytes and spermatozoids showed a similar expansion of 75 repetitions. CONCLUSIONS: CTG expansion is not due to previous expansion of DNA in the paternal gametes but to instability of DNA in the cellular mitoses following formation of the zygote.
Papain is a plant protein with a wide pharmacological, domestic and industrial use. It leads a high sensitisation, being the most common rotue of entry the inhalation. The occupational allergy to papain in exposed workers was described some years ago, being presented with bronchial asthma, rhinitis or both. In most of the cases, the specific IgE was positive. We present a case contact urticaria, rhinoconjunctivitis and bronchial asthma per papain of occupational origin. Papain prick test, specific IgE and nasal challenge were positive. The peak flow record showed diary decreases during the working week and the basal spirometry showed obstruction to the airflow. The patient was moved away the place where papain was handled and this resolved the clinical symptoms and the spirometry returns to the normal values. We present a case of IgE-mediated allergy, vehicled by tow routes: contact and airborne. The latest produced clinical manifestations later. Papain was used as Cephalopoda softening, because of that it worth emphasising its seasonal use.
INTRODUCTION: The prevalence of epilepsy in multiple sclerosis (MS) is low and the occurrence of an epileptic seizure as a first sign of this illness is even more infrequent. The relationship between both these illnesses is not clear; as epilepsy is a common condition, a coincidental association only could exist between the two diseases. OBJECTIVE: To establish a nexus of causality between epilepsy an MS. Clinical case. We present one case of epileptic seizures as the first manifestation of MS. The patient was a woman of 25 years old. The only result of the clinical examination was a right homonymous inferior cuadrantanopsy. The patient presented a high Tibbling index, lesions of demyelination in the subcortical occipital region and semioval centrum in the MRI and a pathological electroencephalogram; also, the visual and auditory evoked potential latency were delayed. CONCLUSIONS: We related he results of the neuroimaging, the clinical examination and the complementary tests of the patient. The appears to be a causal association between epilepsy and MS.
In order to improve the quality of prescription and reduce expenditure, the artificial nutrition department has designed a new usage protocol: justification sheet, table of indications for parenteral nutrition (PN), nutritional assessment, etc. The Pharmacy Department is in charge of the follow-up of this programme and maintaining the database derived from it. Comparing the data for the year before (1996) and after (1998) implementation of this programme, we can see that as a result 9 patients/day switched from total parenteral nutrition by central administration to hypocaloric peripheral nutrition, with the prevalence of the former dropping to 1.4% of admissions and 2% of stays. The share of enteral nutrition (30.6%) and hypocaloric peripheral nutrition (27.8%) increases in the overall expenditure on artificial nutrition, with a reduction in the total parenteral nutrition (41.6%). The costs of parenteral nutrition per admission and stay are reduced by 39.3% and 33.5%, respectively, to 1,625 and 183 pesetas. This represents a saving of 16.5 million pesetas. The expenditure on PN elements declines by two percentage points to 2.2% of pharmaceutical expenditure. As an additional benefit, it is possible to identify each of the clinical situations which give rise to this indication and to allocate costs by diagnosis and department. Together with the containment of expenditure, it has been possible to increase the participation of everyone in the rational use of clinical nutrition thus highlighting its interdisciplinary nature.
INTRODUCTION: Listeria monocytogenes is a microorganism with marked tropism towards the central nervous system. One of the commonest forms of presentation is as a meningeal infection. The objective of this study is to describe the epidemiological, clinical and laboratory characteristics and therapeutic implications. PATIENTS AND METHODS: We made a retrospective analysis of four patients, admitted to hospital with the diagnosis of meningeal infection and positive culture for L. monocytogenes in the cerebrospinal fluid (CSF), who were admitted to our centre between 1 January 1996 and 31 December 2000. The overall rate of meningitis due to L. monocytogenes in the province of Segovia is similar to that reported from the USA and Europe (six cases per million inhabitants per year). All the patients were male, aged between 19 and 79 years. The commonest form of presentation was a meningeal syndrome. Analysis of the CSF showed pleocytosis with high protein and low glucose levels. Gram staining was negative in all cases. Initial empirical treatment proved to be correct in two of the four patients. The only predisposing factors observed were alcoholism and diabetes mellitus. All four cases recovered. CONCLUSION: We emphasize the difficulty in diagnosing meningitis due to L. monocytogenes, since the presenting symptoms are relatively non specific, CSF analysis gives variable results and Gram staining is of little use. Clinical suspicion is important so that specific antibiotic treatment may be given to improve the prognosis.
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OBJECTIVE: We review the current knowledge relative to the role of different immune system components and their contribution the spread of prions throughout the infected organism. DEVELOPMENT: During the last years research made on transmissible spongiform encephalopathies conducted to the assumption that changes in the structure of a determined protein (prion protein, PrP) may become self-propagative. The generally assumed finding of an abnormally folded protein as the causative agent, able to propagate in hosts different from it was originated, is changing our views of transmissible diseases. The concept of infection resulting from pathogen propagation within a susceptible host has been steadily linked to the ability of nucleic acids to replicate their own coded information. In the prionosis, term comprising all known prion disorders, the information seems to be coded within the own protein conformation. This phenomena, once again, challenges the well-established principles of molecular biology. CONCLUSIONS: Propagation of prions uses strategies not previously recognized, and depends upon prion conformation and/or specific host restrictions. Thus, certain sheep and goat prion strains (scrapie) or human (variant of Creutzfeldt-Jakob disease) invade the brain after an initial interaction with the immune system of affected individuals. The involvement of the lymphoreticular system or, at least, certain host's immune competence seems to be a prerequisite for neuro-invasion after a natural infection or peripheral inoculation. On the other hand, proper identification of immune cell types involved may open the possibility for post exposure prophylaxis.
BACKGROUND: The serious problem of hospital undernutrition is still being underestimated, despite its impact on clinical evolution and costs. The screening methods developed so far are not useful for daily clinical practice due to their low effectiveness/cost ratio. OBJECTIVE: We present an screening tool for CONtrolling NUTritional status (CONUT) that allows an automatic daily assessment of nutritional status of all inpatients that undergo routine analysis. DESIGN: The system is based on a computer application that compiles daily all useful patient information available in hospital databases, through the internal network. It automatically assesses the nutritional status taking into account laboratory information including serum albumin, total cholesterol level and total lymphocyte count. We have studied the association between the results of the Subjective Global Assessment (SGA) and Full Nutritional Assessment (FNA) with those from CONUT, in a sample of 53 individuals. RESULTS: The agreement degree between CONUT and FNA as measured by kappa index is 0.669 (p = 0.003), and between CONUT and SGA is 0.488 (p = 0.034). Considering FNA as "gold standard" we obtain a sensitivity of 92.3 and a specificity of 85.0. CONCLUSIONS: CONUT seems to be an efficient tool for early detection and continuous control of hospital undernutrition, with the suitable characteristics for these screening functions.