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Biomedical subjects

J A Ruiz

Publications and source records attributed to J A Ruiz.

At least 19 recordsLinked to original sources
PubMed2006

[Persistent acute hepatitis in a patient with chronic hepatitis C].

We describe the case of a patient with chronic hepatitis C (CHC) who showed a progressive increase in aminotransferase level, reaching values of aspartate aminotransferase 1723 UI/L, alanine aminotransferase 1519 UI/L and gamma-glutamyl-transpeptidase 296 with a bilirubin level of 6 mg/dL and direct bilirubin level of 4.6 mg/dL. One year previously, the patient had been diagnosed with CHC, genotype 1, and had an initial hepatitis C virus RNA load of 249,000 UI/mL. All the specific blood tests performed were negative except for antisoluble liver antigen (anti-SLA) antibodies, which were positive in two different determinations. A diagnosis of overlap syndrome CHC and autoimmune hepatitis was made. Steroid and azathioprine treatment was started with good response. The relationship between CHC and anti-SLA is not well characterized but has been described in these patients. We found no prior reports in the literature of CHC associated with positive anti-SLA in a patient with persistent acute hepatitis.

Aged↗
PubMed2004

Design and tests of a portable mini gamma camera.

Design optimization, manufacturing, and tests, both laboratory and clinical, of a portable gamma camera for medical applications are presented. This camera, based on a continuous scintillation crystal and a position-sensitive photomultiplier tube, has an intrinsic spatial resolution of approximately 2 mm, an energy resolution of 13% at 140 keV, and linearities of 0.28 mm (absolute) and 0.15 mm (differential), with a useful field of view of 4.6 cm diameter. Our camera can image small organs with high efficiency and so it can address the demand for devices of specific clinical applications like thyroid and sentinel node scintigraphy as well as scintimammography and radio-guided surgery. The main advantages of the gamma camera with respect to those previously reported in the literature are high portability, low cost, and weight (2 kg), with no significant loss of sensitivity and spatial resolution. All the electronic components are packed inside the minigamma camera, and no external electronic devices are required. The camera is only connected through the universal serial bus port to a portable personal computer (PC), where a specific software allows to control both the camera parameters and the measuring process, by displaying on the PC the acquired image on "real time." In this article, we present the camera and describe the procedures that have led us to choose its configuration. Laboratory and clinical tests are presented together with diagnostic capabilities of the gamma camera.

Biophysical Phenomena↗
PubMed2002

Tumefactive fibroinflammatory lesion of the head and neck treated with steroids: a case report.

Tumefactive fibroinflammatory lesion is an idiopathic fibrosclerosing disorder of the head and neck region that clinically simulates a malignant process, but is histologically benign. This lesion is believed to be part of a broader fibrosclerotic syndrome that includes idiopathic mediastinal and retroperitoneal fibrosis, sclerosing cholangitis and Riedel's thyroiditis. The tumefactive fibroinflammatory lesion differs from other fibrosing conditions encountered in the head and neck region: fibromatoses, nodular fasciitis and fibrosarcomas. Although there is no optimum treatment, steroid therapy is suggested as the first line of management. Our patient was treated with corticosteroids and had a favourable response, supporting this approach as the initial treatment.

Aged↗
PubMed2002

IgM quantification in the cerebrospinal fluid of sleeping sickness patients by a latex card agglutination test.

An increased IgM concentration in cerebrospinal fluid (CSF), occurring as a consequence of massive intrathecal IgM synthesis, is a marker of interest for diagnosis of the meningo-encephalitic stage in human African trypanosomiasis. However, in current practice, IgM in CSF is not determined because of the lack of a simple and robust test that is applicable in African rural regions where the disease prevails. We describe the development of a sensitive semiquantitative card agglutination test, LATEX/IgM, for IgM quantification in CSF. The test is simple and fast and the lyophilized reagent remains stable even at 45 degrees C. CSF end-titres obtained with LATEX/IgM parallel the IgM concentrations determined by nephelometry and enzyme-linked immunosorbent assay. Detection of intrathecal IgM synthesis is the most sensitive marker for CNS involvement in sleeping sickness. At a cut-off value of >or= 8, the sensitivity and specificity of LATEX/IgM for intrathecal IgM synthesis are 89.4 and 92.7%. As a consequence, patients with LATEX/IgM end-titres >or= 8 are likely to have intrathecal IgM synthesis, thus central nervous system involvement and therefore should be treated accordingly. Further studies should concentrate on the relationship between the LATEX/IgM end-titres, presence of intrathecal IgM synthesis and occurrence of treatment failures in patients treated with pentamidine.

Animals↗
PubMed2001

Beyond health gain: the range of health system benefits expressed by social groups in Mexico and Central America.

Current health reform proposals in most developing countries stress health gain as the chief evaluation criterion. Essential service packages are formulated using cost-effectiveness methods for the selection of interventions without sufficient regard for other factors that are significant for successful implementation and acceptance by the needy. This paper presents the results of research undertaken in Mexico and Central America to test the hypothesis that population groups view health gain as only one among several benefits derived from health systems. The goal at this stage was two-fold: (a) to identify through qualitative methods the range of benefits that are significant for a wide cross-section of social groups and (b) to classify such benefits in types amenable to be used in the development of instruments to measure the benefits intended and actually produced by health systems. Fourteen focus groups were undertaken in Costa Rica, El Salvador, Guatemala, Mexico and Nicaragua representing diverse age, gender, occupation and social conditions. Six major types of health system benefits were identified besides health gain: reassurance/uncertainty reduction, economic security, confidence in health system quality, financial benefits derived from the system, health care process utility and health system fairness. Benefits most often mentioned can be classed under health care process utility and confidence in system quality. They also have the most consensus across social groups. Other benefits mentioned have an affinity with social conditions. Human resource-derived utility stands out by its frequency in the range of benefits mentioned. Health systems and health sector reform proposals must emphasise those aspects of quality related to human resources to be in accord with population expectations.

Adolescent↗
PubMed2001

Descriptive sensory analysis of meat from broilers fed diets containing vitamin E or beta-carotene as antioxidants and different supplemental fats.

The objective of this study was to investigate the effects of dietary fat (lard, sunflower oil, and olive oil) and supplementation of alpha-tocopheryl acetate or beta-carotene on descriptive sensory changes in broiler leg meat as evaluated by a trained panel. Twenty-five descriptors were analyzed from chicken leg meat: 11 in raw meat and 14 in cooked meat. Rancid values were very low, possibly because samples were consumed between 1 and 4 d after slaughter, which maybe insufficient time for oxidative processes to decrease meat sensory quality. However, samples supplemented with vitamin E showed lower rancidity levels, although the differences were only significant when compared to a beta-carotene diet, whereas the control treatment showed intermediate scores. Beta-carotene modified texture scores compared to the control diet, although the differences were only significant in initial juiciness and teeth adhesion compared to the vitamin E treatment and in tenderness compared to the control. In addition, juiciness and tenderness were positively correlated according to the principal component analysis of sensory attributes. The effect of dietary fat on analyzed attributes was lower than the effect of dietary antioxidant. The most important effect of fat type was on hardness of internal fat. Chickens whose diets were supplemented with lard had higher scored values than chickens whose diets were supplemented with vegetable oils. However, type of fat added to diet did not significantly influence rancidity values. These results indicate that an increase in the degree of unsaturation of fat in meat does not cause an increase in the oxidation levels detected by the panel under the conditions of short-term storage.

Animals↗
PubMed2001

Polyhydroxyalkanoate degradation is associated with nucleotide accumulation and enhances stress resistance and survival of Pseudomonas oleovorans in natural water microcosms.

Pseudomonas oleovorans GPo1 and its polyhydroxyalkanoic acid (PHA) depolymerization-minus mutant, GPo500 phaZ, residing in natural water microcosms, were utilized to asses the effect of PHA availability on survival and resistance to stress agents. The wild-type strain showed increased survival compared to the PHA depolymerase-minus strain. The appearance of a round cellular shape, characteristic of bacteria growing under starvation conditions, was delayed in the wild type in comparison to the mutant strain. Percent survival at the end of ethanol and heat challenges was always higher in GPo1 than in GPo500. Based on these results and on early experiments (H. Hippe, Arch. Mikrobiol. 56:248-277, 1967) that suggested an association of PHA utilization with respiration and oxidative phosphorylation, we investigated the association between PHA degradation and nucleotide accumulation. ATP and guanosine tetraphosphate (ppGpp) production was analyzed under culture conditions leading to PHA depolymerization. A rise in the ATP and ppGpp levels appeared concomitant with PHA degradation, while this phenomenon was not observed in the mutant strain unable to degrade the polymer. Complementation of the phaZ mutation restored the wild-type phenotype.

Biodegradation, Environmental↗
PubMed2001

[New trends in the regulation of medical practice in the context of health care reform: the Mexico case].

The recent panorama of medical practice regulation in Mexico is exposed. The dynamics of regulation changes is observed in different areas, with particular intensity in the labor market. Changes seem to be moving towards the constitution of a new regulatory model. A full state regulation for the last 50 years, is being substituted by a model where private and professional corporations are increasing their influence through informal mechanisms of regulation. In the constitution of this new model, the presence of a wide variety of actors claiming regulatory authority is notorious. Three of these new actors are analyzed: The National Commission for Medical Arbitrage, managed care models of medical services, and Specialists Certification Councils. The changes that have occurred in the process of regulation and its future transformation have an intimate link with the reform of the Mexican health care system.

Certification↗
PubMed2000

Effect of dietary iron and copper on performance and oxidative stability in broiler leg meat.

1. An experiment was carried out to determine the effect of removal of supplemental iron and copper from broiler diets during the last 3 weeks before slaughter on broiler performance, tissue vitamin E concentrations and oxidation values in raw; cooked and stored broiler leg meat. 2. Removal of supplemental iron and copper from the diet slightly decreased food efficiency; the differences were significant only when both minerals were removed simultaneously 3. Effect of iron withdrawal on iron concentration in tissue was low. However, total copper concentration in tissue was reduced in animals deprived of iron or both minerals simultaneously. 4. Removal of dietary iron and copper did not affect vitamin E concentration in raw and cooked meat, while stored meat showed lower concentrations in animals deprived of iron and copper simultaneously. 5. The removal of iron and copper from the diet reduced oxidation values in cooked broiler leg meat as measured by the thiobarbituric acid-reacting substances method (TBARS).

Animals↗
PubMed2000

Superficial granulomatous pyoderma.

We report the case of a 30-year-old man who, from the age of 16, presented with abscess-type lesions that turned into ulcers with a torpid course and with histopathologic characteristics of superficial granulomatous pyoderma. The patient has been followed for 6 years, during which time the only treatment necessary to prevent recurrence of lesions has been the administration of different doses of minocycline.

Adult↗
PubMed1999

Effect of beta-carotene and vitamin E on oxidative stability in leg meat of broilers fed different supplemental fats.

The objectives of this study were to investigate the effects of dietary fat (6% lard and sunflower and olive oil) and supplementation of alpha-tocopheryl acetate or beta-carotene on vitamin E content and lipid oxidation in raw, cooked, and chilled-stored broiler leg meat. Vitamin E increased its tissue level, reducing lipid oxidation. The oxidative stability of leg meat tended to decrease with dietary sunflower oil. Effects of beta-carotene on vitamin E levels and oxidation depended on dietary fat and its concentration in feed, decreasing vitamin E, mainly at 50 ppm. beta-Carotene at 15 ppm acted as antioxidant in fresh and cooked meat in the sunflower and olive oil diets. However, in stored meat, beta-carotene at 50 ppm increased TBARS, probably due to a decrease in vitamin E content and direct prooxidant effects per se. It is suggested that the antioxidant effect of beta-carotene requires the presence of vitamin E in tissues.

Animals↗
PubMed1999

Relevance of multicultural training to students' applications to clinical psychology programs.

Interest in the efficacy of multicultural training for practitioners and scientists working with multicultural populations has led to questions about the characteristics of students who seek this training. Students of ethnic minority background, as compared with White students, may be more likely to seek programs that offer this training, and their ethnic or racial identity may be related to this preference. This study explores the relevance of multicultural training to White and ethnic minority graduate students in accredited clinical psychology programs. Students rated the relevance of multicultural and general training components to their decisions about where to apply to graduate school. The ethnic minority students' mean ratings of the relevance of multicultural components were higher than those of White students, and the degree of ethnic minority students' ethnic identification was positively correlated to these relevance ratings.

Adolescent↗
PubMed1999

Detection of Trypanosoma brucei gambiense in sleeping sickness suspects by PCR amplification of expression-site-associated genes 6 and 7.

We have developed a sensitive and specific method to identify Trypanosoma brucei ssp. using PCR to amplify conserved expression-site-associated gene 6 and 7 DNA target sequences. Amplification of 10% of the DNA in a single trypanosome produced sufficient PCR product to be visible as a band in an agarose gel stained with ethidium bromide. We analysed 59 blood samples of serologically positive cases of sleeping sickness by PCR, and directed parasitological examination of tissue fluids. The PCR test detected 87% of the parasitologically positive cases, with a specificity of 97%. In 5 cases, the parasite was demonstrated by the PCR test 4-6 months prior to parasitological detection. This result shows the potential of the assay in early diagnosis of actual T. b. gambiense infections in apparently aparasitaemic sleeping sickness patients.

Angola↗
PubMed1999

Attitude towards CATT-positive individuals without parasitological confirmation in the African Trypanosomiasis (T.b. gambiense) focus of Quiçama (Angola).

Serologically positive individuals without parasitological confirmation constitute an important problem for trypanosomiasis control programmes because of epidemiological and therapeutical consequences. In July 1997, in the focus of Quiçama (Angola), 4753 individuals were screened using CATT/T.b.gambiense on whole blood. In CATT-positive but parasite-negative individuals, CATT titration on serum was performed. Sixteen individuals showing an end-titre lower than 1/4 were considered noninfected according to the results of a previous study of serological status of parasitologically confirmed cases; 86 individuals with end titres >/= 1/4 were considered suspected of trypanosomiasis and were followed-up from July 1997 to July 1998 with controls every three months. After one year, 32 individuals whose antibody titres dropped < 1/4 were considered noninfected, 22 were confirmed by demonstration of parasites, 17 were further followed-up because antibody titres remained >/= 1/8 but parasites could not be found. Fifteen individuals did not show up for testing. Following the usual criterion, only parasitologically confirmed cases were treated. However, if it had been decided to treat parasite-negative individuals with a CATT end-titre > 1/8, 22 initially unconfirmed but infected individuals would have been treated earlier, whereas 5 noninfected individuals would have been treated unnecessarily. CATT titration on diluted serum or plasma is useful for making therapeutical decisions.

Angola↗
PubMed1999

A study of the variability seen in the international normalized ratio obtained using different sensitivity thromboplastin reagents on different instrument types.

We performed an extensive study to check international normalized ratio (INR) recovery using three different rabbit thromboplastin reagents of different sensitivities [international sensitivity index (ISI) circa 1.1, 1.3 and 2.0] on two different instrument types. Both instrument types used an optical end point: one nephelometric at 660 nm, one photometric at 880 nm. Each thromboplastin reagent in the study had an instrument-specific ISI value assigned to it by the reagent manufacturer. Samples obtained from stable orally anticoagulated patients were tested on four different instruments of each type with the three different sensitivity reagents. Excellent correlation between INR values was seen between all results (r values between 0.97 and 0.99). Regression analysis gave slopes between 0.92 and 1.07, and a maximum deviation of intercept from zero of 0.21. Variations in CV of less than 2% were seen within each instrument type. This study shows that if instrument-specific ISI values are used, comparable INR values can be obtained using reagents of different sensitivity on multiple instruments of the same or different types. This study demonstrates the validity of the INR/ISI system.

Adult↗
PubMed1999

[PET-FDG in thyroid cancer with high thyroglobulin levels and negative 131-I scan. A case report].

The value of whole body PET-FDG in the evaluation of metastases has been demonstrated in a wide variety of tumors. In this report, we present the case of a patient with antecedent of papillary thyroid carcinoma, who was operated twelve years ago, and submitted to an ablative dose of residual thyroid tissue through 131I, being the levels of thyroglobulin normals. After twelve years of evolution, the patient refers bag pain and respiratory trouble, appearing in the CT image suspicious of metastases in right pulmonary base. The levels of thyroglobulin were shown increased, being the 131I scan negative. A whole body PET-FDG study was performed in order to exclude metastases of his malignant process, showed multiple high FDG uptake focus in brain, cerebellum, neck, chest, lymphatic nodes and bone, suggestive of dedifferentiated disease These findings were confirmed subsequently in the clinic evolution. Therefore, whole-body PET-FDG is a complementary diagnostic technique for study patients with CDT (Thyroid Differentiated Carcinoma) with 131I scan negative and rising thyroglobulin levels.

Aged↗
PubMed1999

[Barrett's esophagus: diagnosis and coexistent diseases in childhood].

From 1990 to 1998, 12 patients with columnar metaplasia of the lower esophagus were diagnosed. Only 4 of them displayed a Barrett's epithelium (BE) with a specialized columnar epithelium and globet cells. As it is already published, a male predominance was observed. In three of these patients some predisposing factor to develop BE was detected (i.e. severe central nervous system damage, chronic pulmonary disease, esophageal atresia and chemotherapy). All patients had severe gastroesophageal reflux (GER) with abnormal pH probe. Diagnosis was suggested by characteristic endoscopy images in 2 patients and was confirmed by biopsy in all cases. All patients had been primary treated with proton-bomb inhibitors. Two patients were treated by a Nissen fundoplication, 4 and 6 month after diagnosis, respectively. One patient with severe neurological damage will undergo the same surgery soon. In another patient with caustic esophageal injury, the affected esophagus will be resected, restoring continuity with stomach or colon. In view of the potential oncogenous transformation of BE, the importance of not overlooking this anomaly in all patients with severe GER is highlighted. All cases with predisposing factors to develop BE should be closely followed by periodic examination and multiple biopsies.

Adolescent↗