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Biomedical subjects

J Durán

Publications and source records attributed to J Durán.

At least 19 recordsLinked to original sources
PubMed2006

Antioxidant status in patients with sleep apnoea and impact of continuous positive airway pressure treatment.

The episodes of hypoxia/re-oxygenation associated with the respiratory disturbances observed in patients with obstructive sleep apnoea syndrome (OSAS) may induce the generation of oxygen free radicals. Indeed, several studies suggest that OSAS is associated with oxidative stress. The present study tested the hypothesis that patients with OSAS have an alteration in antioxidant defences. The plasma levels of total antioxidant status (TAS), glutathione peroxidase (GPX), gamma-glutamyltransferase (GGT), vitamins A, E, B12 and folate, and homocysteine were determined in 47 patients with OSAS and 37 healthy subjects. Of these, 27 patients who used continuous positive airway pressure (CPAP) for >4 h.night-1 were re-examined 12 months later. Patients with OSAS had lower TAS (1.4+/-0.16 versus 1.50+/-0.10 mmol.L-1), vitamin A (64+/-19 versus 74+/-17 microg.dL-1) and vitamin E levels (1,525+/-499 versus 1,774+/-503 microg.dL-1), and increased values of GGT (42+/-22 versus 32+/-16 U.L-1) than controls. There was no difference between groups in GPX, homocysteine, vitamin B12 and folate plasma levels. CPAP treatment normalised the levels of TAS (1.50+/-0.13 mmol.L-1) and the activity of GGT (30+/-14 U.L-1) without any influence on vitamins levels. In conclusion, the results indicate that patients with obstructive sleep apnoea syndrome have a decreased antioxidant capacity that is partially reversed by continuous positive airway pressure treatment.

Adult↗
PubMed2005

[Comparison of three methods of inducing chronic elevation of intraocular pressure in the pig (experimental glaucoma)].

PURPOSE: To compare three methods of inducing experimental glaucoma in the adult pig, based on achieving chronic elevation of the intraocular pressure (IOP). METHODS: A total of 16 adult pigs were used in the present study. In all instances, the right eye was used as control and the left eye as the experimental eye. The animals were divided into three groups: 1) 3 pigs in which 3 episcleral veins were cauterized (experimental period = 21 weeks); 2) 6 animals in which the anterior chamber of the eye was injected with a solution containing latex fluorospheres (experimental period = 11 weeks); and 3) 4 pigs in which the anterior chamber of the eye was injected with a solution containing latex fluorospheres plus methylcellulose (experimental period = 11 weeks). RESULTS: The episcleral vein cauterization was the only method which produced a sustained elevation of the IOP throughout most of the experimental period. Moreover, the elevation of the IOP achieved by this method resulted in selective retinal ganglion cell (RGC) loss that affected mainly the mid-peripheral and peripheral retina and caused an increase in the mean soma area of the remaining RGCs. CONCLUSIONS: Cauterization of the episcleral veins resulted in a significant and sustained elevation of the IOP and RGC loss when compared with the other two approaches tested in the present study, which barely modified the pig's RGC distribution. Thus, we conclude that the episcleral vein cauterization is the best of the methods tested to induce experimental glaucoma in the pig.

Animals↗
PubMed2003

Remote sensing study of emissions from motor vehicles in the Metropolitan Area of Mexico City.

Remote sensing was employed for the first time to measure nitric oxide (NO) levels of on-road light-duty motor vehicles of the Metropolitan Area of Mexico City (MAMC). The sensor placed at 12 different sites also measured the concentration of CO2, CO, and total hydrocarbons (THC) in the exhaust emissions. A database was compiled containing 122 800 readings, of which 84 650 (69%) records were valid emissions measurements. CO, HC, and NO valid readings were 68.9, 63.4, and 62.9%, respectively, of the total attempted measurements. Furthermore, 42 822 vehicles were number-plate-matched to model year with the information provided by the Inspection/Maintenance Program. The mean emissions of total valid readings for CO, HC, and NO were determined to be 1.31 vol %, 440 ppm (propane), and 914 ppm, respectively. In 1991 and 1994, remote sensing measurements of CO and HC tailpipe emissions were performed in the MAMC in five different locations (30 000 valid readings). Large drops in both pollutants were observed for the intervening years, but sufficient vehicle information was not available at that time to fully explain the observed trends. Compared with those reports, our results point out to a steady decrease in CO and HC exhaust emissions with vehicle model year. The fleet emissions measured exhibit a gamma-distribution, with 10% of the most polluting fleet studied being responsible for 45%, 25%, and 29% of the CO, HC, and NO emissions, respectively. NO emissions in taxis are the highest among the vintage of vehicles, a matter of concern since according to the distance traveled per year, they represent 22% of the total activity in the MAMC.

Air Pollutants↗
PubMed2003

Evaluation of the vehicle inspection/maintenance program in the Metropolitan Area of Mexico City.

The Inspection/Maintenance Program in the Metropolitan Area of Mexico City (MAMC) mandates a test every 6 months for all gasoline motor vehicles as one of the strategies to decrease emissions of vehicular pollutants. FTP-75 and ASM procedures were performed in our facilities to a fleet of 108 in-use motor vehicles before and after the approval of the I/M mandatory test When our laboratory-simulated ASM data were compared with those of the official certificate, a large difference was observed between them. On the other hand, audits at the test-only centers indicate poor maintenance of the analytical instruments and dynamometers. On the basis of our FTP results, an estimation of the emissions change for the MAMC fleet shows a net 4% decrease in CO emissions, while total hydrocarbons and NOx increased 9 and 8%, respectively. Our results indicate that the I/M system in the MAMC lacks the technical capability and investment to ensure that software and hardware are properly maintained, calibrated, and upgraded. Sometimes limited attention is paid to ensure adequate training of inspectors, auditors, and quality control staff.

Air Pollutants↗
PubMed2003

Clinical characteristics and response to newer quinolones in Legionella pneumonia: a report of 28 cases.

Twenty-eight (11.6%) out of 241 Spanish patients enrolled in an international phase III clinical trial of mild to moderate community-acquired pneumonia (CAP) comparing gemifloxacin vs. trovafloxacin were diagnosed of Legionnaires' disease. A definite diagnosis was established by seroconversion in 13 patients of whom only 2 had a positive Legionella urinary antigen. The remaining 15 patients were possible Legionella infections based on a single elevated IgG titer (> or = 1:512). All patients had a radiologically confirmed diagnosis of pneumonia, 5 (19%) patients were older than 65, comorbidity was present in 9 (33%), and 10 (36%) had to be hospitalized. Fifteen patients were treated with oral gemifloxacin (320 mg/day) and 13 with oral trovafloxacin (200 mg/day). Overall, clinical success occurred in 25 (89.3%) patients after 7 days of treatment and only 1 patient needed a 14-day treatment. There were only one adverse event withdrawal and one clinical failure, and no patients died. In light of the favorable clinical outcome, the use of newer fluoroquinolones seems adequate for the treatment of suspected or proven Legionella pneumonia.

Community-Acquired Infections↗
PubMed2002

Comparison of a cardiorespiratory device versus polysomnography for diagnosis of sleep apnoea.

This study assessed the accuracy of a cardiorespiratory monitoring device versus polysomnography for the diagnosis of suspected sleep apnoea/hypoponea syndrome (SAS). A total of 86 patients (89% male, mean age 52 yrs) that had been referred to a sleep laboratory with a clinical diagnosis of SAS underwent cardiorespiratory polygraphy in an unattended mode using an ambulatory device (MERLIN). Analysis was carried out both automatically and manually. Conventional overnight full-channel polysomnography was performed simultaneously. Valid polygraphical recordings were obtained from 79 patients. The mean+/-SD apnoea/hypopnoea index (AHI) was 34.4+/-29.2. The results obtained with manual scoring were superior to automatic scoring for all AHI thresholds. For an AHI of > or = 5, which is diagnostic SAS, the optimum cut-off value for the manual respiratory event index was 6.7 and the cardiorespiratory monitoring device had 97.1% sensitivity and 90.9% specificity. Correct classification according to the different cut-off points obtained via polysomnography and the corresponding cut-off points in the MERLIN manual index were confirmed in 90-96% of patients. The MERLIN device is a useful diagnostic approach for the initial assessment of adult patients with clinical suspicion of sleep apnoea/hypopnoea syndrome. Manual scoring is clearly better than automatic scoring in terms of agreement with the apnoea/hypopnoea index and to discern patients with sleep apnoea/hypopnoea syndrome.

Female↗
PubMed2001

Physiological concentrations of melatonin and corticosterone affect phagocytosis and oxidative metabolism of ring dove heterophils.

A functional connection between the neuroendocrine and the immune systems has been established. Of particular interest is the finding that hormones such as melatonin and corticosterone are able to exert modulating effects on the immune function. Therefore, after determining the circadian rhythms of melatonin and corticosterone, we evaluated the in vitro effect of physiological concentrations of melatonin and corticosterone, separately and together, on the phagocytic function and superoxide anion levels of heterophils in ring dove (Streptopelia risoria). Trials were performed with concentrations corresponding to the nocturnal and diurnal levels reached by each of the hormones (50:300 pg/mL and 100:10 ng/mL for melatonin and corticosterone, diurnal:nocturnal, respectively). The phagocytes were incubated with the hormones both alone and concurrently. At the highest (nocturnal) concentration, melatonin augmented phagocytic function and at the same time inducing a fall in superoxide anion levels. At the highest (diurnal) concentration, corticosterone also enhanced phagocytic function, but without modifying the phagocyte oxidative metabolism. In the presence of both hormones, however, whether with nocturnal or diurnal concentrations, there was a greater increase in phagocytic function and a decrease in superoxide anion levels than was produced by either of the hormones alone. In conclusion, our findings suggest that melatonin and corticosterone may have an additive effect in the modulation of phagocytic function.

Animals↗
PubMed2001

Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr.

The prevalence and related clinical features of obstructive sleep apnea-hypopnea (OSAH) in the general population were estimated in a two-phase cross-sectional study. The first phase, completed by 2,148 subjects (76.9%), included a home survey, blood pressure, and a portable respiratory recording, whereas in the second, subjects with suspected OSAH (n = 442) and a subgroup of those with normal results (n = 305) were invited to undergo polysomnography (555 accepted). Habitual snoring was found in 35% of the population and breathing pauses in 6%. Both features occurred more frequently in men, showed a trend to increase with age, and were significantly associated with OSAH. Daytime hypersomnolence occurred in 18% of the subjects and was not associated with OSAH. An apnea-hypopnea index (AHI) > or = 10 was found in 19% of men and 15% of women. The prevalence of OSAH (AHI > or = 5) increased with age in both sexes, with an odds ratio (OR) of 2.2 for each 10-yr increase. AHI was associated with hypertension after adjusting for age, sex, body mass index, neck circumference, alcohol use, and smoking habit. This study adds evidence for a link between OSAH and hypertension.

Adult↗
PubMed1999

[The reform of primary health care: the economic, care and satisfaction results].

OBJECTIVE: To compare the overall effect on the general public before and after the primary care reform, its economic outcome and professional satisfaction, following the model of the European Foundation for Quality Management. DESIGN: A descriptive analysis of results at reformed primary care centres compared with results at non-reformed centres in the same city. SETTING: The study was conducted at Sant Boi de Llobregat, a town of 77,591 inhabitants in Baix Llobregat county (Barcelona). 32.7% of the population was covered by two reformed centres. The rest was covered by one single non-reformed primary care centre. MEASUREMENTS AND RESULTS: Clinical audits and data on pharmaceutical prescription quality were used to find attendance. For economic results, the formula of attribution of cost/inhabitant and cost/inhabitant seen, including the costs of labour, structure, referral, further tests and pharmacy, were used. The satisfaction of the outside customer (user) was measured by a population survey. Internal customer satisfaction was measured by a survey of the professionals. Results were compared with those for 1997. The study showed that the reformed primary care sector's results, measured in terms of professional satisfaction, user-outside customer, attendance, economic results and social impact, were better than the non-reformed sector's. Inside and outside customers' satisfaction was higher in the reformed network. The cost per inhabitant in the reformed network was 31,874 pesetas, against 25,177 in the non-reformed network. The cost per inhabitant seen was 34,482 and 44,603, respectively. CONCLUSIONS: The reform creates efficient resource management and greater satisfaction of the general public and professionals, when an indicator sensitive to the real use of services is used.

Costs and Cost Analysis↗
PubMed1999

Correlation between the circadian rhythm of melatonin, phagocytosis, and superoxide anion levels in ring dove heterophils.

A functional role for melatonin is its relationship to circadian timing mechanisms. In addition, there has recently been assumed to be a functional connection between the pineal gland and the immune system in mammals and birds, with some findings showing melatonin to be a free radical scavenger and general antioxidant. The present study investigates the possible relationship between the circadian rhythm of melatonin and the ingestion capacity as well as superoxide anion levels of ring dove (Streptopelia risoria) heterophils. In birds, heterophils, with their ability to ingest and kill different antigens, play a central role in the host defence mechanism. All determinations were made during 24 hr periods at 2 hr intervals. Radioimmunoassay showed an increase of melatonin serum levels during the dark period (from 20:00 to 07:00 hr) with a maximum at 04:00 hr, and a significant decline during the hours of light with a minimum at 16:00 hr. Similarly, the phagocytic index was enhanced during the night, with the maximum at approximately 04:00 hr and the minimum at approximately 18:00 hr. The same was the case in relation to phagocytic percentage. However, the superoxide anion levels were lower during darkness (minimum at 04:00 hr) and higher during the light period (maximum at 14:00 hr). In conclusion, our findings show that one pineal-mediated effect on the immune system may be a direct action of melatonin on phagocytosis and the phagocytic biochemical process, and that this neurohormone might act as an antioxidant.

Animals↗
PubMed1997

Effect of serum from breast- or formula-fed infants on polymorphonuclear leukocyte function.

The aim of the present study was to determine the influence of serum from formula and breast-fed infants on neutrophil function (as measured by the attachment and phagocytosis of Candida albicans) as well as the chemoattractant activity of the serum. The results indicate that: (a) serum from breast-fed infants induces a greater chemoattractant activity in neutrophils than serum from 3-month-old formula-fed infants; (b) the highest values of the attachment capacity were obtained after incubation of neutrophils with serum from 1-month-old breast-fed infants; and (c) serum from breast-fed infants induces a greater phagocytic capacity against C. albicans in neutrophils than serum from formula-fed infants.

Adult↗
PubMed1996

Diagnostic accuracy of a portable recording device (MESAM IV) in suspected obstructive sleep apnoea.

This study evaluated the accuracy of a portable recording device (MESAM IV) in identifying obstructive sleep apnoea (OSA). The MESAM IV system measures arterial oxygen saturation (Sa,O2), heart rate, snoring sounds and body position, and allows both automatic and manual scoring of the recordings. Nocturnal polysomnography and MESAM IV recordings were performed simultaneously in 150 patients with suspected OSA, and were analysed blindly by a different observer. Patients with an apnoea-hypopnoea index (AHI) greater than or equal to 10 were diagnosed as having OSA. In the evaluation of the discriminatory ability of MESAM IV scores, the cut-off point was set to minimize first the exclusion of truly diseased patients (i.e. false-negative interpretations), and then confirmation of nondiseased subjects (i.e. false-positives). When used as an exclusion test, the portable device reached a sensitivity of 0.98 and a specificity of 0.78; as a confirmation test, these values were 0.69 and 0.97, respectively. These results were achieved with manual scoring, which was superior to automatic scoring. Manual scoring was also better than automatic scoring when OSA was defined according to other threshold values (> or = 5, 15 and 20) for the AHI. The combination of MESAM IV manual scores could reduce the need for diagnostic polysomnography in three quarters of the patients clinically suspected of having obstructive sleep apnoea, substantially reducing costs associated with diagnostic procedures.

Evaluation Studies as Topic↗
PubMed1980

[Wilms' tumor: a series of 79 cases (author's transl)].

79 cases of Wilms' tumor with age at diagnosis between 0 and eight years, are reported. 76 of them are evaluable for therapeutic results. 54 (71%) are alive and disease-free, with a mean survival of 53 months. Group A (35 patients) received pre-surgical treatment with radiotherapy and the survival rate is 77%. Group B (32 patients) were not treated before surgery and the survival rate is 84%. Both groups received post-surgical treatment with radiotherapy and chemotherapy (vincristine and actinomycin D). Patients in group C, chronologically the oldest, did not receive chemotherapy and its survival rate was 20%. Prognostical significance of age, sex, site, clinical stage and histology are examined. Classical concepts on histological classifications are revised and present criteria are shown, along with its' therapeutic and prognostic implications.

Child, Preschool↗