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Biomedical subjects

J Castillo

Publications and source records attributed to J Castillo.

At least 19 recordsLinked to original sources
PubMed1992

Predictors, mechanisms and outcome of severe mitral regurgitation complicating percutaneous mitral valvotomy with the Inoue balloon.

During 241 consecutive percutaneous mitral valvotomy (PMV) procedures performed with the Inoue balloon, 16 patients (6.6%) developed severe mitral regurgitation (MR). Baseline clinical, echocardiographic (Doppler mitral valve area and Wilkins' score) and hemodynamic data were not different from those of patients without this complication. Severe MR occurred during the first inflation in 7 patients and after several stepwise inflations in 9. Although maximal balloon size was similar in both groups, unusual indentations and subvalvular inflations were more frequently observed in patients who developed severe MR. Early mitral valve replacement was required in 6 patients. All of them had a leaflet rupture either along the midportion (2 patients), along a commissure (4 patients), or both. Commissural calcium was present in 5 valves and 5 also had severe subvalvular involvement that had been underestimated by echocardiography. Of the 10 nonsurgically treated patients, 4 had chordal rupture by echocardiographic criteria, whereas in the remaining 6 the precise mechanism of MR could not be determined. During follow-up (11.4 +/- 4 months, range 1 to 30), 1 patient required surgery for symptoms and the remaining 9 were symptomatically improved and free of left ventricular dilatation. In conclusion, severe MR complicated 6.6% of PMV procedures with the Inoue balloon, and its mechanism was leaflet or chordal rupture. Although one third of the patients required early mitral surgery, most of the remaining obtained midterm symptomatic benefit.

Adult↗
PubMed1992

Human bactericidal/permeability-increasing protein and a recombinant NH2-terminal fragment cause killing of serum-resistant gram-negative bacteria in whole blood and inhibit tumor necrosis factor release induced by the bacteria.

The bactericidal/permeability-increasing protein (BPI) of neutrophils and BPI fragments neutralize the effects of isolated Gram-negative bacterial lipopolysaccharides both in vitro and in vivo. Since endotoxin most commonly enters the host as constituents of invading Gram-negative bacteria, we raised the question: Can BPI and its bioactive fragments also protect against whole bacteria? To determine whether the bactericidal and endotoxin-neutralizing activities of BPI/fragments are expressed when Gram-negative bacteria are introduced to the complex environment of whole blood we examined the effects of added BPI and proteolytically prepared and recombinant NH2-terminal fragments on: (a) the fate of serum-resistant encapsulated Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa that survive the antibacterial actions of whole blood and (b) the ability of these bacteria to trigger cytokine release. Added BPI in nanomolar concentrations killed each of three encapsulated strains of E. coli and in closely parallel fashion inhibited tumor necrosis factor (TNF) release. Holo-BPI and its NH2-terminal fragment were equipotent toward a rough LPS chemotype K1-encapsulated strain, but the fragment was substantially more potent than holo-BPI toward two encapsulated smooth LPS chemotype strains. TNF release induced by K. pneumoniae and P. aeruginosa was also inhibited by both holo-BPI and fragment but, at the protein concentrations tested, P. aeruginosa was killed only by the fragment and K. pneumoniae was not killed by either protein. The bactericidal action of BPI/fragment toward E. coli is inhibited by C7-depleted serum, but accelerated by normal serum, indicating that BPI, acting in synergy with late complement components, enhances extracellular killing of serum-resistant bacteria. Thus, BPI and an even more potent NH2-terminal fragment may protect against Gram-negative bacteria in the host by blocking bacterial proliferation as well as endotoxin-mediated effects, not only as components of the intracellular antibacterial arsenal of the neutrophil, but also as potentially therapeutic extracellular agents.

Antimicrobial Cationic Peptides↗
PubMed1992

Central and peripheral corneal thickness in full-term newborns by ultrasonic pachymetry.

To establish a standard of normality, the authors studied the central and peripheral (superior, inferior, nasal, and temporal) corneal thickness of 152 healthy, white race, full-term newborns (304 eyes) between 1 and 6 days old, using ultrasonic pachymetry. The mean central corneal thickness (CCT) was 585 +/- 52 microns (ranging from 446-706 microns). The mean peripheral corneal thickness (PCT), significantly thicker than CCT (P = 0.0001), was: superior (SCT) 696 +/- 55 microns, inferior (ICT) 744 +/- 62 microns, nasal (NCT) 742 +/- 58 microns, and temporal (TCT) 748 +/- 55 microns. The SCT was significantly thinner than the ICT, NCT, and TCT (P = 0.0001). Differences among ICT, NCT, and TCT were not statistically significant. The mean CCT of the 1-day-old group was 611 +/- 58 microns, this being thicker than those of the other age groups (P = 0.0001). The differences between male and female babies and between right and left eyes were not statistically significant. This is the first study on peripheral corneal thickness at the limbus in the four meridians in live newborns.

Cornea↗
PubMed1992

[Intraocular absorption of cyclosporin A eyedrops].

A study was carried out on ocular and systemic absorption after topical application of 2% cyclosporin A in patients requiring corneal transplants, determining by polarized light immunofluorescence the levels of this drug in the cornea, aqueous humor and blood. Between 30 and 85 minutes after the last application, considerable levels of cyclosporin A were found in the explanted cornea (236 +/- 42 ng/mL). Relatively lower levels were found in the aqueous humor although there were significant differences between the patients who received a total topical dosage of 5 mg (16.92 +/- 6.86 ng/mL) and those who received 10 mg (25.06 +/- 9.13 ng/mL) over the same period of time. No analytically detectable levels were found in the plasma. We consider that topically administered cyclosporin A can reach immunosuppressive levels of activity in some ocular compartments thus eliminating the potential systemic effects resulting from its utilization by general administration.

Aqueous Humor↗
PubMed1992

[The results of drug holiday in Parkinson's disease].

The transitory suppression of L-dopa in patients with advanced Parkinson's disease improves motor response upon reintroduction of the drug although this improvement is not constant. The degree and duration of clinical improvement obtained following L-dopa drug holiday were studied and the factors which may intervene in the result of 32 patients with Parkinson's disease were analyzed. Improvement was found in 100% (24.9 +/- 6.7%) with significant differences being observed in the degree of disability (p < 0.05) and the final decrease of the doses of L-dopa (p < 0.05). Improvement was maintained during 10.3 +/- 7.9 weeks. Linear regression studies did not show any relation between the length of the drug holiday, longer than 4 days, and the degree and maintenance of improvement or final decrease of the doses of L-dopa. The authors consider this procedure useful in patients with important fluctuations in treatment response or with important refractory side effects to other measures.

Adult↗
PubMed1992

[Rhombencephalitis caused by Listeria monocytogenes].

The observation of an abscess in the brain stem and cerebellum due to Listeria monocytogenes is presented. The patient was a 55 year old diabetic, alcoholic, gastrectomized male in whom a febrile and meningeal syndrome developed. Three days later he had a progressive unilateral dysfunction of the cranial nerves. The cerebrospinal fluid showed pleocytosis of the polymorphonuclear cells, an increase in proteins and low glucose in relation with the glycemia. No parenchymatous lesion was observed upon emergency computerized tomography. Magnetic resonance imaging showed a hyper-signal lesion in the brain stem and cerebellum with a contrast enhancement in ring. Following antibiotic treatment the clinical evolution of the patient was favorable with slight focal sequelae persistent at discharge. A review of the epidemiology, clinical manifestations and treatment of this infection is carried out.

Encephalitis↗
PubMed1992

[Biologic markers in multiple sclerosis (I). Clinical correlations].

Seven biological markers were studied in a population of 236 patients (144 females, 92 males) with multiple sclerosis as was the relation with the different degrees of diagnostic certainty (Rose and Poser scales), the time of evolution and number of bouts of the disease. The IgG concentrations, IgG ratio and the quantification of the intrathecal IgG synthesis by the Tourtellotte formula isolatedly constituted the most sensitive biological markers for the diagnosis of multiple sclerosis. Altogether, the determination of the number of cells, IgG and the IgG ratio achieved diagnostic sensitivity of 94% for defined multiple sclerosis. The IgG ratio was the most closely related biological marker related with the number of bouts and the time of evolution of the disease.

Adult↗
PubMed1992

[Biologic markers in multiple sclerosis (and II). Neurophysiologic and imaging correlations].

The relation between the results of 7 biological markers (cells, total protein, albumin, IgG, IgG ratio, Tibbling ratio, and Tourtellotte's formula) and 4 paraclinical tests (PEV, PEATC, CT and MR) in 236 patients with multiple sclerosis (MS) not selected by the localization of symptoms were studied. One hundred forty-one had clinically defined MS, 22 had defined MS supported by a laboratory and 68 had clinically probable MS. The existence of a relation between PEV and MRI abnormality and the increase in the concentration and the ratios of intrathecal IgG synthesis and the degree of certainty of disease diagnosis was demonstrated. The most sensitive test was MRI (93%) followed by VEP (83%) and BAEP (60%) and the sensitivity of the study with high resolution CT including 59 patients explored by double enhancement and delayed cut off was very low (33%). It was considered that for the lack of a specific diagnostic test the use of biological markers PEV and MR constituted a necessary aid in the diagnosis of MS.

Adult↗
PubMed1991

Bone anomalies in myotonic dystrophy.

Sixteen patients with myotonic dystrophy underwent CT examination of the skull, and measurement of bone mineral density at lumbar spine and hip by dual-photon absortiometry. The results were compared with those of 20 normal subjects of similar age and sex distribution. Hyperostosis of the calvarium, and increased bone mineral density at lumbar vertebrae were observed. One case showed basal ganglia calcification associated with hyperparathyroidism secondary to deficiency of vitamin D. In the other 15 patients, studies of calcium metabolism were normal. There results suggest the existence of generalized hyperostotic potential in patients with myotonic dystrophy.

Adolescent↗
PubMed1991

Molecular and epidemiological study of Salmonella clinical isolates.

A survey of Salmonella infections was carried out over a 1-year period in the rural community covered by the Hospital Reina Sofía (Tudela, Spain). The 255 strains that were collected were studied by serotyping, antimicrobial resistance, and plasmid profile analysis. The predominant serotype was S. enteritidis (85.90%), followed by S. typhimurium (7.06%) and S. virchow (2.36%). Only 7.84% of the strains were resistant to antimicrobial agents. The most common resistance was to beta-lactam antibiotics. This resistance was due to the presence of one of two types of beta-lactamases, TEM-1 or TEM-2. Resistance to kanamycin was associated with the synthesis of a 3'-O-phosphotransferase. The resistance to streptomycin and chloramphenicol was either not enzymatic or was due to a 3"-O-phosphotransferase and a chloramphenicol acetyltransferase, respectively. Analysis of total plasmid DNA content revealed the presence of plasmids in 96.08% of the isolates. According to their plasmid profile, the strains could be classified into different groups. The three main groups, which accounted for 50.19, 20.78, and 4.70% of the isolates, respectively, corresponded to the antimicrobial-susceptible S. enteritidis serotype. These results suggested that plasmid profile analysis in conjunction with antimicrobial resistance determination can be useful for subtyping resistant Salmonella isolates.

DNA, Bacterial↗
PubMed1991

[The complications of radical hysterectomy in the treatment of cervix uteri carcinoma].

Complications of radical surgery in 60 cases of cervicouterine cancer are presented with the purpose of evaluating the morbi-mortality associated with this treatment. Radical hysterectomy with pelvic lymphadenectomy was the most frequent surgery. Intraoperative complications reached to 13.3%; the most frequent was the vascular venous lesion. Minor postoperative complications reached to 15% and majors to 6.7%. There was no mortality associated with the treatment. Five year survival for this series was 91% for FIGO Stage IB and 86% for FIGO Stage IIA.

Adult↗
PubMed1991

Thrombocytopenia associated with carbamazepine: a case series.

Carbamazepine is increasingly being used in the acute and maintenance treatment of patients with bipolar disorder. Thrombocytopenia represents a serious adverse effect of carbamazepine with which clinicians need to be familiar. The authors describe the course of thrombocytopenia associated with carbamazepine in four patients with bipolar disorder. In all cases, thrombocytopenia appeared 14 to 16 days after the initiation of carbamazepine; also in all cases the platelet count completely recovered within 7 days after the carbamazepine treatment was discontinued. Thrombocytopenia secondary to carbamazepine appears soon after the initiation of treatment and is rapidly followed by recovery after drug discontinuation.

Adolescent↗
PubMed1991

[Platelets and migraine. Correlation between biochemical markers of platelet aggregation and serotonin].

The correlation between the biochemical markers of platelet activation and serotonin in migraine was investigated. The beta-thromboglobulin (beta-TG), platelet factor 4 (PF-4) and serotonin levels in 105 patients with migraine were measured. The results confirmed an increase in beta-TG and PF4 levels and a reduction in serotonin levels during the migraine attacks. However, we did not find a significant correlation between these fluctuations. These findings suggest the existence of extraplatelet mechanism in the pathophysiology of migraine.

Adolescent↗
PubMed1991

[Insulinoma and pregnancy. Clinical case].

A 25 year old woman developed severe episodes of hypoglycemia during the first weeks of pregnancy. Insulin blood levels of 53 uU/ml and Peptide C levels of 6.5 ng/dl were shown associated to a blood glucose level of 34 mg/dl. Echotomographic examination of the abdomen was unrewarding. Surgical exploration revealed a 1.5 cm tumor located at the junction of the body and tail of the pancreas, which was removed. Hypoglycemia disappeared and pregnancy continued uneventfully ending in a normal delivery at 40 weeks. The newborn was normal and no motor or psychologic abnormalities have been noted during follow up to 2 years of age.

Adult↗
PubMed1991

[Serotypes of Salmonella enterica in sewage effluent from Zaragoza. Comparison with clinical isolates. 1982-1989].

Between 1982 and 1989, 560 Salmonella enterica strains belonging to 63 serovars, were isolated from Zaragoza urban sewage. During the same period of time there were 45 different serovars isolated from faeces of patients from a hospital (in the same city). Only a reduced number of serovars comprised the majority of the human and environmental isolates. An approximately rectilinear relationship is shown between the isolated strains number and the number of different serovars, in non human Salmonella strains. In clinical isolates, we have not found this relation. We have compared the local results with those reported in other different Spanish regions.

Agglutination Tests↗
PubMed1990

[Transient block of the brachial plexus after catheterization of the subclavian vein].

Two cases are reported of brachial plexus anaesthesia and palsy after catheterization of the subclavian vein. This very rare complication occurred after several unsuccessful attempts to catheterize one or both subclavian veins. This was due to inexperience, with insufficient knowledge of clinical anatomy, infiltration with unnecessarily high doses of local anaesthetic, and accidental puncture of the brachial plexus by an infraclavicular approach. One of the patients also had iatrogenic pneumothorax.

Aged↗