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Biomedical subjects

F Román

Publications and source records attributed to F Román.

At least 19 recordsLinked to original sources
PubMed2006

Donor-to-host transmission of bacterial and fungal infections in lung transplantation.

The purpose of this study was to evaluate the incidence and etiology of bacterial and fungal infection or contamination in lung allograft donors and to assess donor-to-host transmission of these infections. Recipients who survived more than 24 h and their respective donors were evaluated. The overall incidence of donor infection was 52% (103 out of 197 donors). Types of donor infection included isolated contamination of preservation fluids (n = 30, 29.1%), graft colonization (n = 65, 63.1%) and bacteremia (n = 8, 7.8%). Donor-to-host transmission of bacterial or fungal infection occurred in 15 lung allograft recipients, 7.6% of lung transplants performed. Among these cases, 2 were due to donor bacteremia and 13 to colonization of the graft. Twenty-five percent of donors with bacteremia and 14.1% of colonized grafts were responsible for transmitting infection. Excluding the five cases without an effective prophylactic regimen, prophylaxis failure occurred in 11 out of 197 procedures (5.58%). Donor-to-host transmission of infection is a frequent event after lung transplantation. Fatal consequences can be avoided with an appropriate prophylactic antibiotic regimen that must be modified according to the microorganisms isolated from cultures of samples obtained from donors, grafts, preservation fluids and recipients.

Bacteria↗
PubMed2005

Emotional response in patients with frontal brain damage: effects of affective valence and information content.

The authors investigated the role of the frontal lobes in the emotional response in 19 patients with brain damage and 23 control subjects. They studied the modulation of the startle blink reflex by affective pictures, and other autonomic responses. Patients showed a dissociation between the startle reflex and the affective valence ratings of the pictures, as a result of a low inhibition of the startle reflex by pleasant pictures. Pictures elicited lower skin conductance responses (SCRs) in patients than in controls, whereas the groups did not differ in the SCRs prompted by less significant acoustic stimuli. The findings point to the frontal lobe as a structure involved in the emotional response and in the physiological emotional arousal related to the complexity of the stimuli.

Acoustic Stimulation↗
PubMed2004

[Preliminary study of the drug consumption in hospitalized elders].

BACKGROUND: The absence of studies that evaluate the effect of the medical acts is an example of "mala praxis". The irrational use of medications is one of these cases. This study shows the characteristics of the drugs consumption in elders. MATERIAL AND METHODS: We include 53 elders hospitalized between 1/02/02 and the 31/05/02. RESULTS: The elders received an average of 6.45 medicaments/day. The factors of more consumption are the origin from nursing home residents and the number of previous surgeries. The adverse effects were related in 25% of the hospitalizations. CONCLUSIONS: The basis of this situation is in the loss of the global perspective of the patients and in the abuse of the sanitary resources. Each drug is the result of an isolated medical act, determining the appearance of iatrogenic disease.

Aged↗
PubMed2000

Salmonella endocarditis presenting as cerebral hemorrhage.

The case of a 35-year-old male with cerebral hemorrhage as a presenting complication of infective endocarditis of the aortic valve, caused by Salmonella typhimurium, is described. We emphasize the infrequent etiology and review the mechanisms of intracranial hemorrhage in infective endocarditis.

Journal Article↗
PubMed2000

Progressive multifocal leukoencephalopathy treated with cidofovir in HIV-infected patients receiving highly active anti-retroviral therapy.

Progressive multifocal leukoencephalopathy (PML) has been a devastating disease for HIV-1-infected patients since the beginning of the AIDS pandemic. Currently, highly active antiretroviral therapy (HAART) seems to improve the outcome of PML in many patients. We describe two cases of PML whose course worsened in spite of HAART, but had a good response to cidofovir.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Visceral leishmaniasis: a comparative study of patients with and without human immunodeficiency virus infection].

BACKGROUND: The changes that HIV coinfection can induce in clinical symptoms, response to treatment and prognosis of visceral Leishmaniasis (VL) are not well known. METHOD: We retrospectively describe the characteristics of VL in patients with and without HIV infection, between 1988-1998. RESULTS: Fifty episodes of VL were diagnosed in 40 patients. Nineteen (47.5%) were HIV coinfected, 57.8% of them have had an aids defining illness, and the median of CD4+ lymphocytes was 50/mm3. Clinical and laboratory data were similar to patients non HIV infected, except for lower levels of LDH (437 vs 578 U/ml; p = 0.02) and total lymphocytes (665 vs 1.500/mm3; p = 0.004) and higher levels of hemoglobin (9.8 vs 8.7 gr/dl; p = 0.01) and ESR (85 vs 44 mm; p = 0.01). The first episode of VL was diagnosed in 87.5% patients through bone marrow aspirate, and the other cases were diagnosed by biopsies of gum (2), lymph node (1) or liver (1). One patient was diagnosed clinically: he had a positive serology and a good response to antileishmanial therapy. Treatment failed in nine patients (22.5%), 7 HIV-coinfected. Eight patients died (20%), 6 HIV-coinfected. Five deaths were directly attributed to VL. Six coinfected patients (31.5%) relapsed and only one (4.7%) in the other group. CONCLUSIONS: We did not find major differences in clinical manifestations or laboratory data between the two groups. Biopsies of several tissues can be particularly helpful for diagnosis in immunocompromised patients with negative bone marrow aspirates. Failures, mortality and relapses are more common in HIV infected patients. VL coinfection usually affects HIV infected patients when they develop severe immunodepression.

AIDS-Related Opportunistic Infections↗
PubMed1997

Molecular genetic studies in monogenic and polygenic human diseases.

The main goal of this study was to determine and characterise the types of mutations in two monogenic human disorders: cystic fibrosis (CF) and Duchenne/Becker muscular dystrophy (DMD, BMD) and the susceptibility allele frequency in a polygenic disease: type I insulin-dependent diabetes mellitus (IDDM). After analysing 220 chromosomes for mutations in the CF (Cystic Fibrosis Transmembrane Conductance Regulator = CFTR) gene, delta F508 mutation was most abundant (41%) and out of the non-delta F508 CF mutations 5% was identified as G542X, G551D, R553X, N1303K and W1282X. The CF haplotype analysis by using linked markers to the CFTR gene revealed that the CF "B" haplotype occurred in 66.7% of patients, and this haplotype was 57.2% in patients carrying the delta F508 mutation. Prenatal genetic diagnosis for CF was performed in 10 fetuses: 3 were affected, 6 were carriers, and 1 without any CF mutation. Fifty % of 66 patients with DMB/BMD muscular dystrophy had one or more exon deletions in the dystrophin gene. Eighty-five % of the deletions occurred at the 3' and 15% at the 5' end of the gene. Out of the three prenatal diagnosis in one case DMD was substantiated. Thirty-six % of 50 patients with IDDM possessed four, 44% three and 20% two susceptibility markers in the HLA-DQA1, -DQB1 region. The onset of the disease correlated with the number of susceptibility alleles.

Alleles↗
PubMed1996

[The prevalence of markers for the hepatitis A and B viruses in the population of Gijón between 6 and 25 years old].

BACKGROUND: The aim of this study was to know the prevalence of previous infection markers for hepatitis A and B viruses in a pediatric-juvenile population from Gijón, Spain. PATIENTS AND METHODS: A representative (according to the census) transversal randomized sample of a population from 6 to 25 years in age from Gijón, Spain, was included in the study analyzing demographic, epidemiologic and clinical variables, liver tests, anti-HAV IgG and anti-HBc. RESULTS: Of the 630 individuals selected a demographic error was detected in 28 (4.4%) and 453 subjects were studied (71.9%) in whom the anti-HAV IgG was positive in 37 cases (8.75% of prevalence adjusted for age), with 4.4% (12/271) (CI 95% 2.3%-7.6%) for the younger cases and 13.7% (25/182) (CI 95% 9.1%-19.6%) in the group ranging from 18 to 25 years in age (p < 0.001). No anti-HAV IgG positive case was detected in the population under the age of 10 years. Among the young adults the prevalence of anti-HAV IgG positive cases was higher in those born in the south of Spain (2/6, 33.3%) (CI 95% 4.3%-77.7%) with respect to those from the northern regions of Spain (9/259, 3.5%) (CI 95% 1.6%-6.4%). (p = 0.02). With respect to HBV markers, of the 433 unvaccinated cases, 6 (1.4%) presented markers of past infection and 2 (0.46%) HBsAg positivity. Both had normal serum ALT without viral replication. Six cases of hypertransaminasemia levels (1.3%) were detected all being related with obesity or alcoholism. All the cases with previous acute clinical hepatitis were found to be anti-HAV IgG positive and anti-HBc negative. CONCLUSIONS: The current prevalence of anti-HAV IgG in the population from 6 to 25 years from Gijón, Spain is very low and given the high degree of susceptibility (86%) for HAV infection in the young adult population (18-25 years) the implementation of vaccination programs is recommended even without previous serologic screening. The low prevalence of anti-Hbc would also undervalue its use as prevaccination screening against HB in this geographical area.

Adolescent↗
PubMed1996

Long-term persistence of ciprofloxacin-resistant Haemophilus influenzae in patients with cystic fibrosis.

Ciprofloxacin has been a major advance in the treatment of chronic respiratory infections. Three patients with cystic fibrosis and colonized by 5 nontypeable Haemophilus influenzae strains exhibiting low- (MIC, 2 microg/mL) and high-level ciprofloxacin resistance (MICs, 16-32 microg/mL) are described. The patients had received several courses of ciprofloxacin. These MICs represent a decrease in ciprofloxacin susceptibility of 200-3200 times. Molecular epidemiologic methods demonstrated that 2 patients were chronically colonized by their own ciprofloxacin-resistant strains for > or = 15-17 months. Three strains showed simultaneous resistance to ampicillin and chloramphenicol by enzyme inactivation, and 2 had ampicillin resistance without beta-lactamase activity. These data suggest that the emergence and long-term persistence of ciprofloxacin-resistant H. influenzae in patients with cystic fibrosis can be a consequence of antibiotic treatment.

Adult↗
PubMed1996

Ciprofloxacin-resistant Haemophilus influenzae strains possess mutations in analogous positions of GyrA and ParC.

The nucleotide sequences of the quinolone resistance-determining regions of the gyrA and parC genes from five ciprofloxacin-resistant strains of Haemophilus influenzae (MICs, 2 to 32 micrograms/ml) isolated from patients with cystic fibrosis and three ciprofloxacin-susceptible strains of H. influenzae (MICs, < or = 0.1 micrograms/ml) were determined. Four of the five resistant strains possessed at least one amino acid substitution in each of the GyrA and ParC fragments studied. The mutations identified in GyrA were a serine at residue 84 (Ser-84) to Leu or Tyr and Asp-88 to Asn or Tyr. ParC mutations were in positions exactly analogous to those identified in GyrA, namely, Ser-84 to Ile and Glu-88 to Lys. The Glu-88 to Lys ParC substitution was identified only in high-level ciprofloxacin-resistant strains. These mutations have been shown to be the origin of the observed resistance after transformation into ciprofloxacin-susceptible H. influenzae isolates. These results suggest that H. influenzae isolates require at least one amino acid substitution in both GyrA and ParC in order to attain significant levels of resistance to quinolones.

Amino Acid Sequence↗
PubMed1996

[Epidemiological characterization of Haemophilus influenzae using molecular markers].

BACKGROUND: Haemophilus influenzae is the etiological agent of acute- (meningitis, sepsis, pneumonia, epiglottis) and chronic infections (cystic fibrosis, chronic obstructive pulmonary infections). Several clinical (chronic infections) and epidemiological situations (community and hospital outbreaks) require the use of epidemiological typing methods. OBJECTIVE: We evaluated four typing methods to characterize clinical isolates of H. influenzae. METHODS: Forty-five clinical strains of H. influenzae were studied by biotype, serotype and antibiotype techniques, and the following methods: isoenzyme electrophoresis mobility, outer membrane proteins (OMP), ribotyping and pulsed field gel electrophoresis (PFGE). RESULTS: Type b strains had one pattern with Isoenzyme, OMP and ribotyping techniques. Only PFGE enabled us to differentiate between several type b patterns, although all of them were close related. All methods showed a great variety of patterns with the non-typable H. influenzae although clinical- or epidemiological-related strains had identical patterns. CONCLUSIONS: Results obtained with all four markers studied showed good agreement. Type b strains, in contrast to non-typable strains, had a strong clonal structure with all the assayed techniques; only PFGE showed differences. In terms of technical and financial cost, as well as reproducibility and discriminative power, we suggest as a markers for H. influenzae OMP and PFGE.

Bacterial Outer Membrane Proteins↗
PubMed1993

Characterization of protein kinase C in rat and human prostates.

The properties of protein kinase C (PKC) activity have been studied in cytosolic and membrane fractions from rat and human prostate. Ion exchange chromatography indicated the existence of different PKC isoforms, PKC from rat ventral prostate behaved as a classical Ca(2+)- and phospholipid-dependent enzyme and was activated by 1,2-diacylglycerol as well as by high concentrations of arachidonic acid. PKC activity in the cytosolic fraction was higher and presented different cofactor requirements than that in the membrane fraction. PKC from human benign hyperplastic prostate was also phospholipid dependent, activated by tumor-promotong phorbol esters, and appeared to belong to the group of PKC isozymes which lack Ca2+ sensitivity. Human prostatic PKC activity appeared to be of similar nature in both membrane and cytosolic fractions but the specific activity was higher in the particulate preparation which could be related to the stage of endogenous activation of the enzyme. These results extend previous observations in rat ventral prostate and present evidences on the human counterpart. Forthcoming experiments are needed to establish the exact nature of PKC isozymes and their physiological and pathophysiological role in this gland.

Aged↗
PubMed1993

[Auditory evoked potentials and magnetic resonance in the diagnosis and follow-up of central pontine myelinolysis].

We report the case of a woman who developed central pontine myelinolysis in spite of gradual correction of hyponatremia. The good clinical evolution as well as the influence of rapid correction of serum sodium concentration in the unfolding of this rare condition are discussed. Several diagnostic procedures, mainly auditory-evoked responses and magnetic resonance imaging are also analysed. We remark the particular interest of the auditory-evoked responses in the attestation of an eventual remyelination.

Aged↗
PubMed1992

Responsiveness patterns and handedness differences in bilateral electrodermal asymmetry.

The aim of the present study was to examine the relationship between subjects' handedness and electrodermal asymmetry when subjects were divided according to their electrodermal Responsiveness Patterns, obtained during a stimulus-free period. Skin conductance was bilaterally recorded in a sample of 48 subjects (24 dextrals and 24 sinistrals) during the performance of two tasks (watching a film and listening to neutral tones). Subjects were divided into four groups of 12 subjects each (dextral right-hand responders, dextral left-hand responders, sinistral right-hand responders and sinistral left-hand responders). No differences were found between dextral and sinistral subjects. Orientation of electrodermal asymmetry in each Responsiveness Patterns remained constant throughout the two conditions: right-hand responders showed higher electrodermal activity on their right hand, while left-hand responders showed higher electrodermal activity on their left hand. In addition, left-hand responders showed a slower habituation rate on their left hand than on their right hand, whereas right-hand responders showed no significant differences between hands.

Acoustic Stimulation↗
PubMed1991

[Is the biopsy of the temporal artery necessary? A study of 204 biopsies].

Due to the controversy on the need of performing temporal artery biopsies for the diagnosis of giant cell arteritis (GCA), we have reviewed 204 biopsies of temporal arteries as well as the clinical histories of the 190 patients. Patients without local manifestations were excluded from this study. From the 173 remaining patients, 54 presented a diagnostic biopsy of GCA. The 119 patients with a negative biopsy were divided into different groups according to the final diagnosis. From our data we could not find a clinical pattern which could permit the prediction of biopsy positiveness. We could not find either any clinical entity in the nondiagnostic group which would permit to exclude a diagnosis before performing the biopsy. We consider that the biopsy of the temporal artery can not be avoided nowadays and that it represents the only decisive diagnostic method of GCA.

Aged↗