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Biomedical subjects

J García

Publications and source records attributed to J García.

At least 109 records · Page 6Linked to original sources
PubMed2000

[Invasive disease caused by Streptococcus pyogenes. Report of a case with cutaneous and kidney metastasis].

Few cases of invasive disease due to Streptococcus pyogenes in children have been described. Greater knowledge of this disease is needed due to its increasing incidence and seriousness. New serotypes have been discovered with greater virulence due to exotoxin production and to the development of resistance to phagocytosis. We present a case of invasive disease due to S. pyogenes with bacteremia and cutaneous and kidney metastasis, in a non-immunodeficient child. The case is of interest because kidney dissemination has not been described in the literature and because evolution was satisfactory with endovenous beta-lactamica treatment during 15 days for only 48 hours. The importance of ruling out multi-organ metastatic foci, including use of urine cultures to rule out kidney involvement are highlighted. The epidemiological, pathogenic, clinical and diagnostic aspects of this entity, as reported in recent literature, are described.

Female↗
PubMed2000

[Information program applied to the temporal study of pathological processes in animal populations].

WinEpi Tasas 2.0 is a new, globally accessible computer program, which has been developed as a research tool for the epidemiological study of the pathological processes which affect animal populations. This new version of the program, based on the experimental version, WinEpi Tasas 1.0, enables users to study the distribution and evolution of diseases in affected populations, over time. This information, combined with data on spatial distribution, is of fundamental importance for the establishment of appropriate control strategies and health policies. Such disease control measures are of particular significance in the current context of emerging and re-emerging diseases. The program can be run in either English or Spanish.

Animal Diseases↗
PubMed2000

[Significance of random biopsies of healthy mucosa in superficial bladder tumor].

OBJECTIVE: To analyze the characteristics of the random biopsies of normal-appearing mucosa taken during TUR of superficial bladder tumors and to correlate them with the outcome and characteristics of the superficial tumor. METHODS: Multiple random biopsy specimens from normal-appearing areas of 300 TUR procedures for primary or recurrent superficial urothelial carcinoma were analyzed. Preoperative cytologies were obtained in most of the patients and tumor number, localization, size, stage and grade according to the WHO classification were determined. In patients with multiple tumors, the stage, size and grade of the worst tumor were utilized. Patients who showed a risk of recurrence during follow-up received intravesical therapy postTUR of the bladder. The site and characteristics of recurrence were analyzed and compared with the random biopsy findings. RESULTS: In 38 superficial tumors (12.7%), significant histological changes were found in the random biopsies of normal-appearing mucosa taken during resection. A significant difference was found between patients with and without positive random biopsies only for tumor stage. Statistically significant differences were found when comparing the primary and recurrent tumors, due to the greater number of high and moderate grade tumors in the primaries. There were significant differences in regard to the positive preoperative cytologies between the patients with negative and those with positive random biopsies. No statistical correlation was found between the localization of the superficial tumor and a positive biopsy or between the latter and the site of tumor recurrence. There were 126 recurrences (42%); mean time to recurrence was 13.5 months (median 9.5 months). No significant difference was found (log-rank) for time to recurrence in patients with positive or negative random biopsies, but significant differences were found when we analyzed the number of superficial tumors and the use of intravesical therapy, but not for the type of therapy. CONCLUSIONS: Multiple random biopsies permit a better categorization of the tumor and complete staging. The outcome and the decision to administer intravesical therapy following TUR of the bladder are influenced by the foregoing. The practical results of random biopsies, however, are scanty, since the prognostic significance of the histological changes found in these biopsies is not worse than that of the superficial tumor resected. There are, however, a few cases with a higher risk of recurrence and/or progression than the superficial tumor. Preoperative cytology is useful in the selection of these patients. Furthermore, since the proportion of high grade tumors is higher in primary tumors, performing multiple biopsies is mandatory in these cases if previous urine cytology is not available.

Biopsy↗
PubMed1999

Spatially segregated control of Ca2+ release in developing skeletal muscle of mice.

1. Confocal laser scanning microscopy was used to monitor Ca2+ signals in primary-cultured myotubes, prepared from forelimbs of wild-type or ryanodine receptor type 3 (RyR3) knockout mice. Myotubes loaded with the acetoxymethyl ester (AM) form of fluo-3 were imaged at rest or under whole-cell patch clamp. 2. Discrete Ca2+ release events were detected in intact wild-type and RyR3-knockout myotubes. They showed almost no difference in amplitude and width, but were substantially different in duration. In wild-type myotubes (660 events, 57 cells) the amplitude was 1.27 (0.85, 1.97) (median (25 %, 75 %)) units of resting fluorescence, the full width at half-magnitude (FWHM) was 1.4 (0.9, 2.3) microm, and the full duration at half-magnitude (FDHM) was 25.3 (9.6, 51.7) ms. In RyR3-knockout myotubes (655 events, 83 cells) the amplitude was 1.30 (0.84, 2.08), FWHM was 1.63 (1.02, 2.66) microm, and FDHM was 43.6 (23.6, 76.9) ms. 3. Depolarization under voltage clamp of both wild-type and RyR3-knockout myotubes produced substantial Ca2+ release devoid of discrete Ca2+ events. Discrete events were still present but occurred without correlation with the applied pulse, largely at locations where the pulse did not elicit release. 4. The local correspondence between voltage control and absence of discrete events implies that the functional interaction with voltage sensors suppresses the mechanism that activates discrete events. Because it applies whether RyR3 is present or not, it is this exclusion by voltage of other control mechanisms, rather than isoform composition, that primarily determines the absence of discrete Ca2+ events in adult mammalian muscle.

Animals↗
PubMed1999

Levels of serum cathepsin L and several glycosidases in patients operated for colorectal cancer.

The activities of several glycosidases and cathepsin L were determined in the blood serum of a control group of ten healthy humans in comparison with a group (group I: 32 subjects) of preoperative colorectal cancer patients (1 week before surgical exeresis) and with another two groups: group II, comprising 18 operated subjects (1 week after surgery), and group III, of 15 operated subjects (4 months after surgery). All subjects were 48-88 years old. Both 'enzyme activity' and 'specific activity' determinations of serum beta-galactosidase, alpha-L-fucosidase and cathepsin L revealed peculiar profiles that differed from one another. Control values differed from those of some stages of the pathological groups, but not of others. These values were compared also with the levels of total, lipid- and glycoprotein-associated serum sialic acid. The usefulness of some assays (especially cathepsin L activity measurement) in the follow-up of the health status of humans operated for colorectal cancer is discussed.

Aged↗
PubMed1999

[Molecular study of red cell pyruvate kinase deficiency in 15 patients with chronic hemolytic anemia. Group of Erythropathology of Hematology and hemotherapy Association of Spain (HHAS)].

BACKGROUND: Identification of RBC pyruvate-kinase (PK) gene mutations by polymerase chain reaction (PCR) and single strand conformation polymorphism (SSCP) followed by PK gene sequencing in positive cases has been assessed and the results obtained with a preliminary study of 15 unrelated patients of Spanish origin are presented. PATIENTS AND METHODS: Patients have been classified into two different groups: group 1, propositus (15 cases), and group 2, relatives of the patients included in group 1 (10 males and 5 females). In group 1, a PCR was followed by SSCP and sequencing, and in group 2, the PCR was followed by digestion with specific restriction endonucleases (PCR-ER). RESULTS: Group 1: from 15 patients included in the study 2 were identified as homozygous, 4 as heterozygous and 9 as compound heterozygous. In this group, were identify 26 affected alleles with 11 different mutations: T1456 10 alleles (38.6%), T721 3 alleles (11.6%), A1010, C514, C1015 and T1223 2 alleles (7.7%), and C1070, A1291, T1508, A1595 y T1675 one allele. Relatives from 8 out of 15 patients from group 1 showed the following pattern: homozygous (one case), heterozygous (10 cases), compound heterozygous (2 cases) and normal (2 cases). CONCLUSIONS: SSCP procedure followed by direct gene sequencing in positive cases is fast and simple enough to allow the identification of PK deficient variants, avoiding the need of biochemical characterisation of semipurified deficient enzyme, which is more cumbersome and time consuming. In addition, the PCR-ER method is a very useful tool for screening of the most frequent molecular variants, as well as, for the detection of the carrier condition of this enzymopathy (family studies).

Amino Acids↗
PubMed1999

Risk factors associated with the seroprevalence of leptospirosis among students at the veterinary school of Zaragoza University.

The prevalence and risk factors associated with leptospirosis were studied in veterinary students in Zaragoza. Sera were collected at the beginning and end of the academic year 1994 to 1995 and were tested by ELISA against a pool of Leptospira interrogans serovars bratislava, canicola, grippotyphosa, hardjo, icterohaemorrhagiae and pomona antigens. At the beginning of the study the prevalence was 8.14 per cent and at the end it was 11.4 per cent. The incidence of the disease during the study was 0.0394. Risk factors associated with leptospirosis included: taking the course specialising in food inspection and technology, on-farm work, contact with pets in general, and particularly carnivores, and contact with animal traders. The symptoms associated with the disease were myalgia and fever, and the treatment of the symptoms provided some protection.

Antibodies, Bacterial↗
PubMed1999

CD7 expression on CD34+ cells from chronic myeloid leukaemia in chronic phase.

Thirty-seven patients with chronic phase chronic myeloid leukaemia and fourteen healthy controls have been evaluated for lineage differentiation with immunological markers on purified bone marrow CD34 positive cells by multiparameter flow cytometry. The myeloid-associated antigen CD33 and the stem cell factor receptor (CD117, c-kit) was expressed by 82.3% and 73.5% on CP-CML patients and by 57% and 57.5% on healthy donors, respectively (P < 0.005). CD34+/CD19+ or CD34+/CD10+ B-lymphoid cell population represented 9. 1% and 10.7% of the CD34+ cells in CML whereas in normal controls this subpopulation was expressed by 27.9% and 30.4% of the CD34+ cells, respectively (P< 0.005). The T-lineage associated markers (CD7 and CD2) were detected on a minor population of CD34+ BM cells of healthy controls (mean, 3.6% and 4.6%, respectively). The CD2 positive cells represented 1.5% of the CD34+ cells in CML patients. CP-CML patients co-expressed the CD7 antigen on a mean of 32.6% of the CD34+ BM cells. Moreover, 93% of this CD34/CD7 double positive subpopulation co-expressed CD33 antigen in CML patients. Co-expression of CD7 on CD34+ cells was induced to decrease significantly after short-term in vitro culture with the differentiation-inducing agent phorbol ester (PMA) and with a combination of cytokines (stem-cell factor, interleukin-3 and granulocyte colony-stimulating factor). In conclusion, a high co-expression of CD7 antigen is demonstrated on CD34+ cells of chronic phase-chronic myeloid leukaemia patients. The loss of CD7 marker following incubation with PMA and cytokines suggests that this antigen is expressed transiently in early myeloid leukaemic CML haemopoiesis.

Adult↗
PubMed1999

Expanding subintimal coronary dissection under a stent-covered arterial segment: serial intravascular ultrasound observations.

A patient with an angiographically unrecognized minor coronary dissection in a stent-covered coronary segment in which a type D spiral dissection extended submedially to the distal artery is described. This complication occurred 6 months after stent implantation and was ascribed to injury of the stented vessel wall during an intravascular ultrasound study.

Aortic Dissection↗
PubMed1999

Identification of the occluded artery in patients with myocardial ischemia induced by prolonged percutaneous transluminal coronary angioplasty using traditional vs transformed ECG-based indexes.

We have studied the spatial properties of ischemic changes as induced by prolonged angioplasty and how the changes are related to different ECG indexes. Indexes based on measurements at specific points in time (ST level at J + 60 ms point, maximal T wave amplitude and position, QT interval, and QRS duration) and global indexes (based on the Karhunen-Loève transform and applied to the QRS complex, ST-T complex, ST segment, and T wave), considering both repolarization and depolarization information, were analyzed. The changes during the occlusion period of the different indexes were used as variables in a multivariate discriminant analysis to determine which indexes showed the best discrimination of the three major occlusion sites (corresponding to LAD, RCA, and LCX coronary arteries). Occlusions in LCX artery were the most difficult to classify. With three local indexes (ST60 level measured in lead V3, T wave amplitude in I, and ST60 in III) it was possible to correctly classify 76% of patients by the occlusion site, and with three KLT-derived indexes (first-order KLT index for ST-T complex in I and for QRS in leads V3 and I) 83% of correct classification was obtained. Using six indexes for local and KLT-derived indexes the correct classification was increased to 85 and 90% of patients, respectively. The use of different ECG indexes (from different intervals) on quasiorthogonal leads permitted the identification of the occluded artery in patients undergoing PTCA and may be extended to more general use.

Angioplasty, Balloon, Coronary↗
PubMed1999

Analysis of the ST-T complex of the electrocardiogram using the Karhunen--Loève transform: adaptive monitoring and alternans detection.

The Karhunen-Loève transform (KLT) is applied to study the ventricular repolarisation period as reflected in the ST-T complex of the surface ECG. The KLT coefficients provide a sensitive means of quantitating ST-T shapes. A training set of ST-T complexes is used to derive a set of KLT basis vectors that permits representation of 90% of the signal energy using four KLT coefficients. As a truncated KLT expansion tends to favor representation of the signal over any additive noise, a time series of KLT coefficients obtained from successive ST-T complexes is better suited for representation of both medium-term variations (such as ischemic changes) and short-term variations (such as ST-T alternans) than discrete parameters such as the ST level or other local indices. For analysis of ischemic changes, an adaptive filter is described that can be used to estimate the KLT coefficient, yielding an increase in the signal-to-noise ratio of 10 dB (u = 0.1), with a convergence time of about three beats. A beat spectrum of the unfiltered KLT coefficient series is used for detection of ST-T alterans. These methods are illustrated with examples from the European ST-T Database. About 20% of records revealed quasi-periodic salvos of ischemic ST-T change episodes and another 20% exhibit repetitive, but not clearly periodic patterns of ST-T change episodes. About 5% of ischemic episodes were associated with ST-T alterans.

Electrocardiography↗
PubMed1999

Deinstitutionalization and psychiatric reform in Spain.

The transformation of psychiatric care which has been carried out in Spain since the 1980s, under the name of "Psychiatric Reform", had produced as it most significant achievements: (i) the development of a new organizational structure for mental health care, (ii) the integration of psychiatric patients in the general health care system, (iii) the creation of an extensive community network of mental health centers, and (iv) the adoption by the general public of more positive attitudes towards mental illness and its treatment and the passing of legislative measures aimed at improving the civil rights of these patients. However, the application of the Psychiatric Reform has followed an uneven course in Spain as a whole, with marked differences between the different autonomous communities. The main deficiency has been in the development of intermediate community services and programs to rehabilitate and resettle patients in the community. With regard to deinstitutionalization, the results have also been insufficient and it is still possible to observe a strong tendency, within the system, to maintain the old mental hospitals for both long-term and short-term illness care. Finally, the analysis of the Spanish experience has revealed that (i) many of the criticisms leveled at deinstitutionalization are not aimed at its "conceptual core" but stem from its inadequate implementation, and (ii) it is wrong to equate deinstitutionalization and psychiatric reform with closure of psychiatric hospitals, without the awareness that this process is far more complex.

Deinstitutionalization↗
PubMed1999

Relationship between serum magnesium and parathyroid hormone levels in hemodialysis patients.

Acute magnesium (Mg) infusion decreases patathyroid hormone (PTH) secretion. However, the effect of chronic hypermagnesemia on PTH levels in dialysis patients is not well established. We studied 110 hemodialysis patients (mean age, 55 +/- 14 years; time on dialysis, 35 +/- 28 months) not receiving vitamin D and undergoing dialysis with an Mg dialysate concentration of 1.2 mg/dL. The primary phosphate binder was calcium carbonate, and 43% of the patients also needed aluminum hydroxide. During a 6-month period, calcium (Ca), phosphorus (P), and total serum Mg were measured every 2 months; intact PTH and aluminum (Al) were measured every 6 months. The mean value of each parameter was computed. Hypermagnesemia (serum Mg > 2.47 mg/dL) was observed in 73% of the patients. Mg and Ca were inversely correlated with PTH levels (r = -0.48; P < 0.001 and r = -0.21; P < 0.05, respectively). After adjusting for Ca and P (partial correlation analysis), Mg and PTH were inversely correlated (r = -0.58; P < 0.001). A stepwise multiple regression analysis showed that PTH levels were predicted by Mg (P < 0.001), alkaline phosphatase (P < 0.01), and P levels (P< 0.05; multiple R = 0.57; P < 0.001), whereas Ca level, sex (dummy variable), diabetes (dummy variable), time on dialysis, and Al level were not predictive. Patients with inadequately low PTH levels (relative hypoparathyroidism, PTH < 120 pg/mL; n = 52) showed greater serum Mg concentrations than the rest (n = 58; 3.01 +/- 0.33 v 2.63 +/- 0.38 mg/dL; P < 0.001). In conclusion, serum Mg concentrations in dialysis patients are independently associated with PTH levels, suggesting that chronic hypermagnesemia may decrease PTH secretion and/or synthesis. In addition, chronic hypermagnesemia of dialysis patients may have a role in the pathogenesis of adynamic bone disease.

Chronic Kidney Disease-Mineral and Bone Disorder↗