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Biomedical subjects

J M García

Publications and source records attributed to J M García.

At least 37 records · Page 2Linked to original sources
PubMed2001

Scanning electron microscopy and calcification in amelogenesis imperfecta in anterior and posterior human teeth.

Teeth fragments from members of a family clinically and genetically diagnosed as having amelogenesis imperfecta were studied by scanning electron microscopy and X-ray microprobe analysis to establish the morphological patterns and the quantitative concentration of calcium in the enamel of anterior (canine, incisor) and posterior (premolar and molar) teeth. The prism patterns in the enamel of teeth from both regions were parallel or irregularly decussate, with occasional filamentous prisms accompanied by small, irregularly rounded formations. Prismless enamel showed the R- and P-type patterns. Calcium levels in enamel of amelogenesis imperfecta and control teeth differed significantly between anterior and posterior teeth, indicating that the factors that influence normal mineralization in different regions of the dental arch are not altered in the process of amelogenesis imperfecta.

Amelogenesis Imperfecta↗
PubMed2001

Similar efficacy following four weeks treatment of asthmatics with formoterol 12 micrograms b.d. delivered by two different dry powder inhalers: differences in inhaler handling.

This randomised, multicentre, parallel-group study compared the clinical efficacy and ease of handling of two dry powder inhalers delivering the long-acting beta 2-agonist formoterol. After run-in, 200 asthmatics on treatment with inhaled corticosteroids and still presenting with suboptimal asthma control were randomised to receive 12 micrograms formoterol twice daily via either the Aerolizer inhaler (Foradil Aerolizer) or the Turbuhaler inhaler (Oxis Turbuhaler) for four weeks. Study variables included the mean morning pre-medication peak expiratory flow (PEF) during the last seven days of treatment and the correct inhaler handling according to inhaler-specific checklists. The mean difference in the effect on morning pre-medication PEF was 13.86 l/min in favour of formoterol via the Aerolizer inhaler (90% confidence interval 2.50, 25.21) in the intent-to-treat population. Eighty-six per cent of the patients under treatment with formoterol via the Turbuhaler inhaler performed correctly all the essential inhalation manoeuvres, whereas 98% of those on the Aerolizer inhaler did so. These results strongly suggest similar clinical efficacy with twice daily treatment of formoterol 12 micrograms metered dose delivered either by the Aerolizer, or the Turbuhaler device. They also suggest that handling the Aerolizer is easier than that of the Turbuhaler.

Administration, Inhalation↗
PubMed2001

[Transesophageal echocardiographic diagnosis of a ruptured sinus of valsalva aneurysm with right atrium fistula].

Congenital aneurysms of the sinus of Valsalva are relatively rare, tending to be most frequent in adults. Untreated, there is a substantial risk of complication due to bacterial endocarditis and, if rupture occurs, rapid and progressive cardiac insufficiency is fatal at short term. We report the case of a 53-year-old male with a ruptured right sinus of Valsalva aneurysm, resulting in an anomalous right atrium fistula. Symptoms presented, clinical diagnosis and, above all, transesophageal echocardiography were crucial in the final diagnosis leading to an early and satisfactory surgical intervention. Catheterization and angiography were not definitive. Echocardiographic data are described and a bibliography of relevant research articles is provided.

Aortic Aneurysm↗
PubMed2000

[Prevalence of anti-HAV antibodies and efficacy of pre-vaccine detection at institutions for mentally retarded of the city of Alicante].

OBJECTIVE: The aim of this study was to investigate the prevalence and efficacy of the anti-HAV antibodies detection in institucions for mentally retarded people in the city of Alicante. DESIGN: Prevalence study. SETTING: Two institucions for mentally retarded people in the city of Alicante. PARTICIPANTS: One hundred and seven residents and seventy seven in care of them. MEASUREMENTS AND MAIN RESULTS: We have investigated the anti-HAV antibodies prevalence by enzymeinmunoanalysis of microparticle test. The efficacy of the anti-HAV antibodies detection before the vaccination has been studied by calculating the threshold of prevalence with the following formula: unit cost of detection + (1 - X) x unit cost vaccination anti-HAV negative subjects = unit cost vaccination. RESULTS: The global prevalence of anti-HAV antibodies was 56.5% (95% CI, 49-63.7). The prevalence of the residents was 55.1% (95% CI, 45.2-64.7) and 58.4% in care of them (95% CI, 46.6-69.5). Among the sociodemographic variables evaluated only the age was associated with the prevalence of anti-HAV antibodies (p < 0.001). The unit cost of prevaccination detection of anti-HAV antibodies was calculated as 998 pesetas and the unit cost of the vaccination as 3595, obtaining a prevalence anti-HAV threshold of 27.8%. CONCLUSIONS: The prevalence of anti-HAV antibodies in this collective studied is similar to the prevalence of anti-HAV antibodies of the spaniard population. The direct vaccination without a previous marker study is recommended to people under the age of 31 in this population group.

Adolescent↗
PubMed2000

A statistical analysis of the seasonality in pulmonary tuberculosis.

The present study examines whether pulmonary tuberculosis (PTB) has an annual seasonal pattern. A mathematical model is also obtained to forecast the pattern of incidence. The data for the study are the cases of PTB reported throughout Spain, published in the Epidemiology Bulletin by the Carlos III Health Center of the Spanish Ministry of Health in a 26-year period, 1971-1996. The analytical results show that the low rates in tuberculosis notifications over the period 1971-1981 have changed, halting in 1982 and reversing with high incidence from 1983 onwards. An annual seasonal pattern was also shown with higher incidence during summer and autumn. With the mathematical model we predicted the disease behaviour in 1997 and the results were compared to the reported cases. In Spain, as in several industrialised countries, the reason for this recent increase in the number of reported cases is, mainly, the human immunodeficiency virus (HIV) infection. The seasonal trend, with higher incidence in winter, can be attributed to the increase in indoor activities, much more common than in a warm climate. The tubercle bacilli expelled from infected persons in a room with closed windows may remain infectious for a long time, increasing the risk of exposure of healthy persons to the bacilli. As the preclinical period, from exposure to clinical onset, may be of several weeks, the high incidence in spring would be explained. Moreover, in winter and spring the infections of viral aetiology, like flu, are more frequent and cause immunological deficiency which is another reason for the seasonal trend observed. An incidence greater than that foreseen by the mathematical model would express a failure in epidemiologic surveillance, and thus the results of this study may be used to assess a quality of the preventive measures.

Cohort Studies↗
PubMed2000

Three-dimensional finite element analysis of several internal and external pelvis fixations.

The Finite Element Method (FEM) can be used to analyze very complex geometries, such as the pelvis, and complicated constitutive behaviors, such as the heterogeneous, nonlinear, and anisotropic behavior of bone tissue or the noncompression, nonbending character of ligaments. Here, FEM was used to simulate the mechanical ability of several external and internal fixations that stabilize pelvic ring disruptions. A customized pelvic fracture analysis was performed by computer simulation to determine the best fixation method for each individual treatment. The stability of open-book fractures with external fixations at either the iliac crests or the pelvic equator was similar, and increased greatly when they were used in combination. However, external fixations did not effectively stabilize rotationally and vertically unstable fractures. Adequate stabilization was only achieved using an internal pubis fixation with two sacroiliac screws.

Aged↗
PubMed2000

Mineralization of human premolar occlusal fissures. A quantitative histochemical microanalysis.

The mechanisms of cariogenesis in occlusal fissures remain elusive because of limited information about fissure structure and wall mineralization. The purpose of the present study was to determine the correlation between morphological patterns in occlusal fissures in human premolars and quantitative histochemical patterns of mineralization in the walls of these formations. We used scanning electron microscopy and quantitative X-ray microanalysis with the peak-to-local background ratio method and microcrystalline calcium salts as standards. We distinguished three morphological patterns of fissures in scanning electron microscopic images. The wall of the fissures was less mineralized than the control enamel in all three types of fissures. Because the fissure walls are hypomineralized, we suggest that practicing dentists should take into account the degree of mineralization when they are preparing the fissures for the application of sealant.

Bicuspid↗
PubMed1999

[Carbohydrate metabolic changes in cystic fibrosis].

OBJECTIVES: To assess the prevalence of impaired glucose tolerance and diabetes mellitus in a group of patients with cystic fibrosis and to compare insulin secretion, haemoglobin A1c, age, gender, genotype, and clinical status related variables between the groups with abnormal (impaired glucose tolerance and diabetes mellitus) and normal carbohydrate metabolism. PATIENTS AND METHODS: 66 patients with cystic fibrosis (age 1-38 years). Plasma glucose, insulin and C peptide determinations during an oral glucose tolerance test (OGTT) in 65 patients (one was previously known as diabetic). Based on the Expert Committee from the American Diabetes Association (1997), patients were classified as having impaired glucose tolerance and diabetes mellitus. Haemoglobin A1c, presence of delta F508 mutation, date of diagnosis and first sputum colonization, scores of National Institutes of Health, Schwachman and Chrispin-Norman, pancreatic enzyme intake, weight, body mass index, forced expiratory volume in one second and forced vital capacity determinations in every patient. Comparative analysis of these variables in both groups of patients was performed by Student test. RESULTS: Nine patients (13.6%) showed impaired tolerance glucose and one diabetes mellitus following OGTT, so we have two diabetics in our cystic fibrosis group (3.0%). When compared to cystic fibrosis patients with normal glucose tolerance, tolerance glucose and diabetes mellitus patients had significantly reduced basal insulin levels (8.6 [3.8] vs 15.0 [22.2] microU/ml; p < 0.0001), increased glucose stimulated insulin and C peptide levels (50.2 [19.3] vs 21.4 [19.3] microU/ml; p < 0.0001, and 9.0 [5.9] vs 4.4 [3.2] ng/ml; p < 0.0001), they were older (18.0 [7.5] vs 12.7 [7.3] years old; p < 0.05) and had longer time since diagnosis and since first sputum colonization. The remaining variables did not differ between the two groups. All patients with exocrine pancreatic sufficiency showed normal glucose tolerance. CONCLUSIONS: Abnormalities in carbohydrate metabolism were present in 16.6% of cystic fibrosis patients. These patients had reduced basal but increased glucose stimulated insulin levels. Age, time since diagnosis of cystic fibrosis, time since first sputum colonization and exocrine pancreatic insufficiency are the variables being associated with carbohydrate metabolism abnormalities.

Adolescent↗
PubMed1999

Fully automated liquid culture system compared with Löwenstein-Jensen solid medium for rapid recovery of mycobacteria from clinical samples.

The aim of this study was to compare the rate of recovery of mycobacteria and the time to detection in 5208 samples using the MB/BacT culture system (Organon Teknika, USA) and Löwenstein-Jensen medium. Mycobacteria were recovered from 301 (5.7%) samples. Two hundred fifty-seven (85.3%) isolates from 114 patients were Mycobacterium tuberculosis [135 (52.5%) smear-positive, 122 (47.4%) smear-negative], and 44 (14.6%) were potentially pathogenic environmental mycobacteria. The yield with the MB/BacT was higher than that with Löwenstein-Jensen [287 (95.3%) vs. 200 (66.4%), P<0.001] for both Mycobacterium tuberculosis [247 (96.1%) vs. 187 (72.7%), P<0.001] and potentially pathogenic environmental mycobacteria [40 (90.9%) vs. 13 (29.5%), P<0.001], mainly at the expense of the smear-negative samples. Moreover, 70 (27.2%) samples were positive only in the MB/BacT, whereas ten (3.8%) samples were positive only in Löwenstein-Jensen. The number of patients with tuberculosis detected by the MB/BacT was higher than that detected by Löwenstein-Jensen medium [111 (97.3%) vs. 89 (78%), P<0.001]. In 25 (21.9%) patients the diagnosis was established solely by means of the MB/BacT. In smear-positive and smear-negative samples, the mean times to detection of Mycobacterium tuberculosis were 16.7 and 26.3 days, respectively, with Löwenstein-Jensen and 11.5 and 19.3 days, respectively, with the MB/BacT. These results indicate that the MB/BacT is more efficient and faster than Löwenstein-Jensen for the recovery of mycobacteria.

Bacteriological Techniques↗
PubMed1999

Allogeneic bone marrow transplantation vs chemotherapy for the treatment of childhood acute lymphoblastic leukaemia in second complete remission (revisited 10 years on).

In 1989 we carried out a trial comparing allogeneic BMT to chemotherapy (CT) in 76 children with relapsed acute lymphoblastic leukaemia (ALL). Ten years on we have clinically revised outcome to firmly establish the role of each treatment, to analyse the importance of length of first remission and to provide long-term actuarial results for disease-free survival (DFS) and relapse rate in each group. For 21 patients within the transplantation group, probability of DFS and relapse are 42.8 +/- 10.8% and 40.2 +/- 11.7% (s.e.), respectively. In the chemotherapy group, probability of DFS is 10.0 +/- 4.74% (P = 0.001) and probability of relapse 87.5 +/- 5.2% (P = 0.0004). These results strongly reflect those at initial analysis, confirming a key role of BMT in the management of ALL in second remission. Moreover, on univariate analysis only two factors influenced DFS: treatment group and length of first complete remission (less or more than 30 months from first CR). Thus, it seems clear that the best therapeutic option in early relapse is BMT, whereas DFS in late relapse is at the limit of significance (P = 0.07), with a higher relapse rate in the CT group. Although encouraging results using intensified rotational combination chemotherapy have been published, prospective randomised studies are needed to assess with certainty the best therapeutic option in these patients.

Adolescent↗
PubMed1999

The crystalline pattern of calcium in different topographical regions of the otoconial membrane. An electron probe and spectroscopic diffraction study.

Quantitative electron probe microanalysis and electron spectroscopic diffraction analysis was used to determine the gradient of distribution of calcium and its crystalline pattern at different levels (lower gelatinous membrane, upper gelatinous membrane and otoliths) in the otoconial membrane of adult OF1 mice. Our quantitative electron probe microanalytical data, obtained with scanning-transmission electron microscopy, indicated that there was a gradient in calcium concentration which increased from the vestibular surface towards the otoliths. Differences between the three regions of the otoconial membrane were statistically significant in both the utricle and saccule. Our results with electron spectroscopic diffraction revealed an increasing crystalline development from the lower gelatinous membrane towards the otoliths. Our findings with both techniques suggest that the gelatinous membrane is involved in the maturation and crystallization of the otoliths.

Animals↗