PubMed Health⌕ Search

Biomedical subjects

J García-García

Publications and source records attributed to J García-García.

15 recordsLinked to original sources
PubMed2005

Reverse oblique intertrochanteric femoral fractures treated with the gamma nail.

We studied 47 reverse oblique intertrochanteric femoral fractures that were treated with gamma nails between 1992 and 2000. Fracture reduction was satisfactory in 38 patients (81%), the hip screw position was correct in 42 (89%) and there were no peri-operative complications. However, in three patients the nail displaced, resulting in non-union in one and protrusion into the acetabulum in another. A logistical regression analysis of our series showed that an incorrect position of the hip screw in the femoral head was the only predictor for complications. Thus, we consider that the gamma nail is a good option for the treatment of these complex fractures.

Adult↗
PubMed2005

[Bickerstaff's encephalitis].

INTRODUCTION: The clinical and radiological findings in a case of Bickerstaff encephalitis are described and the relationship with Miller Fisher and Guillain Barré syndromes are discussed. CLINICAL CASE: Subsequently to a respiratory infection,a 44-year-old male developed external ophthalmoplegia and cerebellar-like ataxia; his condition deteriorated and he suffered consciousness disturbances and absent tendon reflexes were noted. An MRI scan was performed showing a lesion affecting the brainstem. The cerebrospinal fluid (CSF) revealed albuminocytologic dissociation and the presence of oligoclonal bands. He received high doses of intravenous immunoglobulins and five months later, he had completely recovered. A follow up MRI scan demonstrated complete resolution of the lesion. CONCLUSIONS: The initial condition was diagnosed as Bickerstaff brainstem encephalitis (BBE) with overlapping peripheral nervous system semiology. The presence during the acute phase of oligoclonal bands in CSF, which decreased with the clinical improvement, supports the hypothesis than an autoimmune mechanism may function in its pathogenesis. Our case suggests that intravenous immunoglobulins therapy should be considered in patients with BBE.

Adult↗
PubMed2004

Heraldic seizure.

BACKGROUND: The term heraldic seizures indicates epileptic seizures caused by cerebrovascular disease, believed to be triggered by silent ischemia and occurring before a stroke. This fact widens the spectrum of possible interrelations between epilepsy and cerebrovascular disease outside the well known context of post-stroke epilepsy. METHODS: This is a case report of a healthy 67-year-old male who had a new onset epileptic seizure prior to a lobar intracerebral hemorrhage (ICH). This man began to suffer myoclonic jerks in his left arm which progressed to a generalized tonic-clonic seizure. At the emergency area the physical and neurological examination were unremarkable and a CT scan was normal. The next day the patient developed left hemiparesis, hemianopsia and confusion and a new CT scan showed right parietal-occipital ICH. CONCLUSIONS: This case report exemplifies the concept of heraldic seizures, showing a patient who had a focal seizure preceding an intracerebral hemorrhage. Our etiologic diagnostic work led us to a diagnosis of probable amyloid angiopathy. We suggest that cerebral amyloid angiopathy (CAA) may be the underlying cause, since it may be the origin of both the late event (ICH) and the heralding seizures, resulting from concurrent ischemia.

Aged↗
PubMed2002

[Non-invasive ventilation in patients with severe hypercapnic encephalopathy in a conventional hospital ward].

OBJECTIVE: To report our experience with non-invasive ventilation (NIV) at two levels of pressure (Bi-PAP) on a general respiratory medicine ward with patients in hypercapnic impaired consciousness and/or coma who had not previously been in an intensive care unit (ICU). METHODS: This was a prospective study of 13 patients, mean age 81 years (65-96), treated with NIV through a face mask. Ten had chronic obstructive pulmonary disease, with a mean FEV1 in stable condition of 35.2 14.6%. Glasgow scores upon admission were >/= 7. Arterial gases were monitored until suspension of NIV. RESULTS: After NIV for a mean 19 5 h/day in the first 48 hours and later of 6 1 h/day until a total of 74 9 h, 9 patients (69%) survived. The mean initial pH for these patients was 7.17 0.028 and the mean initial pCO2 was 101 9 mm Hg. In 7 cases (78%), coma was reversed in the first 48 h and a significant improvement in pH was observed in the 12-24 h analysis. Mean pH upon discharge was 7.44 0.013 and mean pCO2 was 54 2.8 mmHg. Four patients died, even though their initial or subsequent arterial gases at 12-24 h were not significantly different from those of the survivors. CONCLUSION: NIV on a general respiratory medicine ward can offer an alternative to oro-tracheal intubation for patients with hypercapnic impaired consciousness and/or coma who do not meet the criteria for admission to the ICU.

Acute Disease↗
PubMed2001

Structural characterization of the C2 domain of novel protein kinase Cepsilon.

Infrared spectroscopy (IR) and differential scanning calorimetry (DSC) were used to study the biophysical properties of the PKCepsilon-C2 domain, a C2 domain that possess special characteristics as it binds to acidic phospholipids in a Ca2+-independent manner and no structural information about it is available to date. When the secondary structure was determined by IR spectroscopy in H2O and D2O buffers, beta sheet was seen to be the major structural component. Spectroscopic studies of the thermal denaturation in D2O showed a broadening in the amide I' band starting at 45 degrees C. Curve fitting analysis of the spectra demonstrated that two components appear upon thermal denaturation, one at 1623 cm(-1) which was assigned to aggregation and a second one at 1645 cm(-1), which was assigned to unordered or open loop structures. A lipid binding assay has demonstrated that PKCepsilon-C2 domain has preferential affinity for PIP2 although it exhibits maximal binding activity for phosphatidic acid when 100 mol% of this negatively charged phospholipid was used. Thus, phosphatidic acid containing vesicles were used to characterize the effect of lipid binding on the secondary structure and thermal stability. These experiments showed that the secondary structure did not change upon lipid binding and the thermal stability was very high with no significant changes occurring in the secondary structure after heating. DSC experiments demonstrated that when the C2-protein was scanned alone, it showed a Tm of 49 degrees C and a calorimetric denaturation enthalpy of 144.318 kJ x mol(-1). However, when phoshatidic acid vesicles were included in the mixture, the transition disappeared and further IR experiments demonstrated that the protein structure was not modified under these conditions.

Animals↗
PubMed1999

The cancer chemopreventive agent resveratrol is incorporated into model membranes and inhibits protein kinase C alpha activity.

Resveratrol is a phytoalexin found in grapes and other foods that cancer chemopreventive and other biological activities have been attributed recently. We report that resveratrol is able to incorporate itself into model membranes in a location that is inaccessible to the fluorescence quencher, acrylamide. Differential scanning calorimetry revealed that resveratrol considerably affected the gel to liquid-crystalline phase transition of multilamellar vesicles made of phosphatidylcholine/phosphatidylserine and increased the temperature at which the fluid lamellar to H(II) inverted hexagonal transition took place in multilamellar vesicles made of 1,2-dielaidoyl-sn-phosphatidylethanolamine. Such a transition totally disappeared at 2.5 mM of resveratrol (resveratrol/lipid molar ratio of 2:1). This effect on 1, 2-dielaidoyl-sn-phosphatidylethanolamine polymorphism was confirmed through (31)P-NMR, which showed that an isotropic peak appeared at high temperature instead of the H(II)-characteristic peak of 42 mM of resveratrol (resveratrol/lipid molar ratio of 1.5:1). Finally, resveratrol inhibited PKCalpha when activated by phosphatidylcholine/phosphatidylserine vesicles with an IC(50) of 30 microM, whereas when the enzyme was activated by Triton X-100 micelles the IC(50) was 300 microM. These results indicate that the inhibition of PKCalpha by resveratrol can be mediated, at least partially, by membrane effects exerted near the lipid-water interface.

Acrylamide↗
PubMed1999

Effect of calcium and phosphatidic acid binding on the C2 domain of PKC alpha as studied by Fourier transform infrared spectroscopy.

Fourier transform infrared (FTIR) spectroscopy was used to investigate the structural and thermal denaturation of the C2 domain of PKC alpha (PKC-C2) and its complexes with Ca(2+) and phosphatidic acid vesicles. The amide I regions in the original spectra of PKC-C2 in the Ca(2+)-free and Ca(2+)-bound states are both consistent with a predominantly beta-sheet secondary structure below the denaturation temperatures. Spectroscopic studies of the thermal denaturation revealed that for the PKC-C2 domain alone the secondary structure abruptly changed at 50 degrees C. While in the presence of 2 and 12.5 mM Ca(2+), the thermal stability of the protein increased to 60 and 70 degrees C, respectively. Further studies using a mutant lacking two important amino acids involved in Ca(2+) binding (PKC-C2D246/248N) demonstrated that these mutations were inherently more stable to thermal denaturation than the wild-type protein. Phosphatidic acid binding to the PKC-C2 domain was characterized, and the lipid-protein binding became Ca(2+)-independent when 100 mol% phosphatidic acid vesicles were used. The mutant lacking two Ca(2+) binding sites was also able to bind to phosphatidic acid vesicles. The effect of lipid binding on secondary structure and thermal stability was also studied. Beta-sheet was the predominant structure observed in the lipid-bound state, although the percentage represented by this structure in the total area of the amide I band significantly decreased from 60% in the lipid-free state to 47% in the lipid-bound state. This decrease in the beta-sheet component of the lipid-bound complex correlates well with the significant increase observed in the 1644 cm(-1) band which can be assigned to loops and disordered structure. Thermal stability after lipid binding was very high, and no sign of thermal denaturation was observed in the presence of lipids under the conditions that were studied.

Animals↗
PubMed1999

The sialyl Lewis X analogue, CY-1503, down-regulates leucocyte-endothelium interactions and the inflammatory response.

OBJECTIVE: To elucidate mechanisms of protection of ischaemic liver with the sialyl Lewis X analogue CY-1503 by regulation of inflammatory mediators such as oxygen free radicals and cytokines as well as blocking the migration of leucocytes. DESIGN: Laboratory study. SETTING: Teaching hospital, Spain. ANIMALS: 122 male Sprague-Dawley rats divided into four groups: normal (n = 18), sham-operated (n = 28), ischaemic controls (n = 38), and CY-1503 (n = 38). INTERVENTIONS: Warm total hepatic ischaemia for 90 minutes followed by various periods of reperfusion. MAIN OUTCOME MEASURES: Survival, liver histology, liver function, neutrophil infiltration, and free radical and cytokine concentrations. RESULTS: 2/20 ischaemic controls survived, compared with 14/20 given CY-1503. Liver function was better, as was histological appearance judged by the Suzuki score); myeloperoxidase activity was significantly decreased (n = 6 in each group, p<0.01) as were concentrations of free radicals (n = 12 in each group, p<0.05) in the group given CY-1503. CY-1503 had no effect on concentrations of the cytokines tumour necrosis factor-alpha or interleukin 1-alpha. CONCLUSIONS: CY-1503 exerts a protective effect in that it able to down-regulate concentrations of free radicals in our rat model. It is a potent inhibitor of neutrophil migration, but has no effect on cytokine concentrations.

Analysis of Variance↗
PubMed1999

Long-term results of the Spanish trial on treatment and survival of patients with predominantly mild heart failure.

A randomized open-label clinical trial was conducted to determine whether mortality, readmission, or quality of life differed between heart failure patients managed with captopril plus diuretics and those with digoxin plus diuretics. A total of 345 heart failure patients in New York Heart Association functional classes 2 and 3 without atrial fibrillation, dyspnea of bronchopulmonary origin, or hypertension not controlled with diuretics was randomized for digoxin (n = 175) or captopril (n = 170) treatment and followed up for a median of 4.5 years. Socioeconomic, demographic, electrocardiographic, echocardiographic, spirometric, and chest radiograph data were obtained at the initial examination. In a random sample of half the patients, ergometric, echocardiographic, and Holter records were obtained at entry and at 3 and 18 months. Patients were followed up for > or = 3 years. The end points were mortality, hospitalization for cardiac events, deterioration in quality of life, worsening of functional class, and need for digoxin or captopril in the captopril and digoxin groups, respectively. The trial had to be terminated prematurely owing to the difficulty in finding candidates free of angiotensin-converting enzyme (ACE)-inhibitor treatment. Baseline patient characteristics were similar in both groups. From the clinical point of view, only the 48-month mortality was relevantly lower (20.9 vs. 31.9%, respectively) among patients treated with captopril than that in those receiving digoxin (log rank test, p = 0.07). No statistically or clinically relevant differences were found in other end points or adverse effects. The results suggest but do not confirm the hypothesis that captopril treatment in mild to moderate heart failure might provide better long-term survival than digoxin.

Aged↗
PubMed1998

Combined effect of age and right ventricular involvement on acute inferior myocardial infarction prognosis.

BACKGROUND: In patients with acute inferior myocardial infarction (AIMI), right ventricular involvement (RVI) is one of the strongest predictors of in-hospital death. We hypothesized that the impact of RVI on AIMI prognosis depends on the patient's age. METHODS AND RESULTS: The in-hospital clinical outcome of 798 consecutive patients admitted to the coronary care unit within 48 hours of symptom onset with AIMI was analyzed according to patient age and to the presence of RVI diagnosed by ECG and/or echocardiographic criteria. The total incidence of RVI was 37%, and it increased as age advanced. Patients with RVI had a significantly higher incidence of major complications (45% versus 19%, P<0.0001) and a higher in-hospital mortality rate (22% versus 6%, P<0.0001). The prognostic effect of RVI was independent of sex, smoking, diabetes, shock on admission, left ventricular ejection fraction, and reperfusion therapy, all age-dependent predictors. A multivariate analysis showed a significant (P=0.03) interaction between age and RVI on AIMI mortality. RVI increased mortality risk only in the oldest patients. CONCLUSIONS: In patients with AIMI, RVI substantially increases mortality risk in elderly patients, whereas it has a nonsignificant effect in young subjects.

Aged↗
PubMed1993

Improved sensitivity in the antibody-forming cell assay for Japanese encephalitis virus in mice by optimal fixation of cells and avidin-biotin complex (ABC) immunocytochemistry.

A sensitive modified method for the detection in vitro of antibody-forming cells (AFCs) in Japanese encephalitis (JE) virus infected mice is described. The procedure involves the selection of the most appropriate incubation period, after the infection of monolayer cells, for expression of viral antigens to be recognized by AFCs. Adequate preservation of the expressed antigens was achieved after fixation with paraformaldehyde-lysine-periodate buffer (PLP). The development of spots which corresponded to AFCs was successfully obtained with the use of the avidin-biotin complex (ABC) amplification reaction. The number of the spots developing after completion of the assay was greater after PLP fixation compared with other fixation solutions such as methanol, formalin and acetone-water. Optimum antigen expression on the infected cells for recognition by lymphoid cells was reached after 24 h of infection. However, it was possible to detect viral antigens on the infected cells 8 h after infection. The ABC reaction was shown to be the best procedure for developing spots compared with other immunocytochemical methods. A linear increment was observed in the number of spots that developed at different spleen cell densities. This assay is simple to perform and could detect virus-specific Ig producing cells from the spleens of mice infected with JE virus. It also makes it possible to enumerate accurately the kinetics of the AFC response in different lymphoid organs during infection or after vaccination.

Animals↗
PubMed1986

[Evaluation of a technic for the isolation of mammotropic cells using dopamine as a ligand].

Pituitary cell suspension from female Wistar rats were allowed to enter the 6MB sepharose gel with added dopamine, which acts ligand attaching the mammotrophs to the gel grains. After eluting the column with 3 different dopamine buffer concentration, 3 different cellular fractions were obtained. Fraction F1 contains 5% of mammotroph cells, fraction F2 2-4% and fraction F3 90%, as determined by immunocytochemistry. The absolute amount of mammotroph cells contained in F3 fraction increases by gradually warming up the column from room temperature to 37 degrees C. The eluted F3 fraction mammotroph cells from female lactating rats is observed to be twice the amount eluted in experiments performed with virgin rats. No ultrastructural differences between fraction F1 and fraction F3 mammotroph cells have been found.

Animals↗
PubMedDate not supplied

[Adequacy of anticoagulant prevention in patients with atrial fibrillation].

INTRODUCTION: Although there is a consensus about the use of oral anticoagulants (OAC) to prevent stroke in patients with atrial fibrillation this treatment is underused in actual practice. Our aim was to determine the proportion of patients with previously known atrial fibrillation who were receiving OAC before stroke onset and their characteristics. PATIENTS AND METHODS: We recruited 50 patients who were admitted with acute stroke and previously known atrial fibrillation over a period of one year. Patients were classified according to the type of antithrombotic treatment they were on. The clinical picture was evaluated by the NIHSS. Functional prognosis was estimated by modified-Rankin score at discharge. RESULTS: Of 50 patients, 16 (32%) were receiving OAC before stroke. Four variables were associated with prescription of OAC: treatment with digoxin, previous ischemic stroke or transient ischemic accident, congestive heart failure and the type of AF (chronic vs paroxysmal). Age and medical history of arterial hypertension, diabetes mellitus or ischemic cardiopathy did not influence the prescription. According to the NIHSS and modified-Rankin scales patients on OAC showed less serious strokes and presented a better functional situation at discharge than those who were not on that treatment. CONCLUSIONS: This study highlights the need to improve medical education about OAC in patients with atrial fibrillation because only 32% of patients received OAC before stroke although 90% of them should receive it according to current guidelines. Our results suggest that OAC treatment not only prevents stroke but may also contribute to the development of less serious strokes with a better functional prognosis.

Aged↗