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Biomedical subjects

J Saavedra

Publications and source records attributed to J Saavedra.

At least 19 recordsLinked to original sources
PubMed2005

Correlations of smoothness index and trough-to-peak ratio with left ventricular mass index changes induced by lercanidipine in hypertensive patients. A pilot trial.

AIM: The aim of this study was to determine the correlation of changes in left ventricular mass, with changes in office blood pressure (BP) and in 24-h ambulatory (ABP), with the trough-to-peak (T/P) ratio and with the smoothness index (SI), as induced by antihypertensive treatment with lercanidipine. METHODS: This was done through an observational, prospective, open, non-comparative, single centre, pilot study in patients naïve to antihypertensive therapy. All patients were treated with lercanidipine 10-20 mg/day plus hydrochlorothiazide 12.5-25 mg/day if treated BP exceeded an arbitrarily defined safety level (>160/100 mmHg) after 1 month on monotherapy. ABP monitoring was repeated after 1 month and after 6 months. Two-dimensional mode echocardiography was performed twice, at the beginning and end of the study. Seventeen patients were included in the final analysis (aged 45.8 +/- 10.7 years, 35% women). RESULTS: Treatment-induced changes in left ventricular mass index (LVMI) were not found to correlate neither with changes in office BP, with changes in ABP values, nor with T/P. However, a significant correlation was found between LVMI changes and SI at 6 months (r=0.50, P=0.039). CONCLUSION: The results of this study suggest that the SI has a higher predictive value, compared to other BP-derived parameters, for treatment-induced LVMI changes, in hypertensive patients treated with lercanidipine.

Adult↗
PubMed2001

Hydatid disease of the interventricular septum causing pericardial effusion.

Echinococcal infestation of the heart is uncommon. We report a case of a 35-year-old man with an hydatid cyst located in distal interventricular septum. Clinical presentation was chest pain and urticaria. Diagnosis was made by echocardiography and magnetic resonance imaging. Surgical resection was performed; the cyst was punctured and its content was drained, hypertonic glucose solution was instilled for sterilization, and it was removed. The patient did well and remains asymptomatic. Diagnosis and ultimate surgical treatment of this disease prevented potentially lethal complications such as cyst rupture with embolic phenomena and anaphylactic shock.

Adult↗
PubMed2001

BMS-284756 in experimental cephalosporin-resistant pneumococcal meningitis.

BMS-284756 is a novel des-fluoro(6) quinolone with a broad antimicrobial activity, including Streptococcus pneumoniae. The purpose of this study was to evaluate the pharmacodynamic profile and effectiveness of BMS-284756 for therapy of experimental meningitis caused by penicillin- and cephalosporin-resistant S. pneumoniae (CRSP). Meningitis was induced in rabbits by intracisternal inoculation of CRSP. BMS-284756 was given intravenously 16 h after intracisternal inoculation in single doses of 2.5 (n = 5 animals), 5 (n = 6), 10 (n = 6), 20 (n = 8), and 30 mg/kg (n = 6), in two doses of 10 mg/kg each separated by 5 h (n = 4), and as a 20-mg/kg dose followed 5 h later by 10 mg/kg (n = 5). The MICs and MBCs of BMS-284756, ceftriaxone, and vancomycin were 0.06 and 0.06, 4 and 4, and 0.25 and 0.25 microg/ml, respectively. After single doses of 10, 20, and 30 mg/kg, the maximum concentrations in cerebrospinal fluid (CSF) (mean +/- standard deviation) were 0.32 +/- 0.12, 0.81 +/- 0.38, and 1.08 +/- 0.43 microg/ml, respectively; the elimination half-life in CSF was 4.5 to 6.3 h. The CSF bacterial killing rates (BKR) at 5 h of the single-dose regimens of 10, 20 and 30 mg/kg were -0.84 +/- 0.48, -1.09 +/- 0.32, and -1.35 +/- 0.05 Deltalog(10) CFU/ml/h. The BKR(0-5) of the divided regimens (10 mg/kg twice and 20 mg/kg followed by 10 mg/kg) was -0.82 +/- 0.52 and -1.24 +/- 0.34 Deltalog(10) CFU/ml/h, respectively. The BKR(0-5) of the combined therapy with vancomycin and ceftriaxone was -1.09 +/- 0.39 Deltalog(10) CFU/ml/h. The penetration of BMS-284756 into purulent CSF relative to plasma was 14 to 25%. The bactericidal effect of BMS-284756 in CSF was concentration dependent. BMS-284756 at 30 mg/kg as a single or divided dose was as effective as standard therapy with vancomycin and ceftriaxone.

Animals↗
PubMed2001

Pre-treatment with candesartan protects from cerebral ischaemia.

Angiotensin II (Ang II) regulates cerebral blood flow by stimulating cerebral vasoconstriction via AT1-receptors. In adult spontaneously hypertensive rats (SHR), the cerebrovascular autoregulatory curve is shifted to the right, in the direction of higher blood pressures, an indication of excessive cerebrovascular vasoconstriction. A restricted capacity to dilate cerebral blood vessels may be responsible for the enhanced vulnerability to cerebrovascular ischaemia during hypertension. We found that chronic treatment with the AT1-receptor antagonist, candesartan, (0.5 mg/kg/day for 14 days, via osmotic minipumps implanted in the subcutaneous tissue) blocked Ang II binding to AT1-receptors in cerebral blood vessels and in brain areas involved in the regulation of cerebrovascular flow, and increased the ratio of lumen-wall area in the middle cerebral artery. Candesartan treatment normalised the lower part of the autoregulatory curve in SHR, and markedly decreased cerebral ischaemia as a consequence of middle cerebral artery occlusion with reperfusion. Protection from ischaemia is related to arterial remodelling, enhanced compensatory vasodilatation in the peripheral area of ischaemia, decreased reduction in cerebral blood flow following the occlusion of a major cerebral blood vessel, and protection from injury in the periphery of the lesion. Our results indicate that pre-treatment with AT1-antagonists such as candesartan could be of benefit in the prevention and treatment of brain ischaemia.

Angiotensin Receptor Antagonists↗
PubMed2000

Probiotics and infectious diarrhea.

Numerous probiotic agents have been studied for the management of diarrheal disease. In particular, the prevention and management of acute viral diarrhea, the treatment of recurrent Clostridium difficile diarrhea, as well as the control of antibiotic-associated diarrhea seem to be areas of significant potential benefit. A few agents, including Lactobacillus GG, Lactobacillus reuteri, and Saccharomyces boulardii, seem to be promising agents for the amelioration of the course of acute diarrhea in children when used therapeutically. The use of other agents, particularly Bifidobacteria, supplementing the regular feed of infants may have an effect as prophylactic agents against acute diarrheal diseases. In general, in pediatric populations, the effect of probiotic agents appears to be most significant against viral (rotaviral) diarrhea, suggesting that an immunological mechanism is responsible for the beneficial effects. The numerous agents, doses, and populations used make generalization difficult. Nevertheless, it is clear probiotic agents are becoming an important part of the armamentarium against gastrointestinal problems in infants and children.

Child, Preschool↗
PubMed1999

Elevated cytokine concentrations in the nasopharyngeal and tracheal secretions of children with respiratory syncytial virus disease.

BACKGROUND: Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract disease in infants. The role of inflammatory mediators in the pathogenesis of RSV disease is not well-understood. The present study was designed (1) to determine whether RANTES (regulated on activation, normal T cell expressed and presumably secreted), macrophage-inflammatory protein-1-alpha (MIP-1-alpha), interleukin (IL)-6, IL-8 and IL-10 can be detected in respiratory secretions of children with RSV infection and (2) to assess whether the concentrations of these cytokines in respiratory secretions correlate with white blood cell (WBC) counts and RSV concentrations and with disease severity. METHODS: During the 1996 to 1997 RSV season, we studied prospectively 14 intubated and 14 nonintubated children hospitalized with RSV disease. Nasal wash (NW) and tracheal aspirate (TA) samples were obtained from intubated patients on Hospital Days 1, 3 and 5. NW samples were obtained from nonintubated patients on hospital days 1 and 3. Seven healthy children undergoing elective surgery served as controls. All samples were analyzed for: (1) WBC and differential counts; (2) concentrations of RANTES, MIP-1-alpha, IL-6, IL-8 and IL-10; and (3) quantitative RSV cultures, except in control patients. RESULTS: RANTES, MIP-1-alpha, IL-6, IL-8 and IL-10 were detected in NW and TA samples from all children with RSV infection. The concentrations of these cytokines in samples obtained from children with RSV infection were significantly greater than those in samples obtained from control children. NW WBC counts significantly correlated with NW RANTES, IL-6, IL-8 and IL-10 concentrations, whereas TA WBC counts significantly correlated with TA IL-6, IL-8, IL-10 and MIP-1-alpha concentrations. NW RSV concentrations correlated with NW WBC counts and with NW cytokine concentrations. Among children with RSV infection nonintubated patients had greater NW WBC counts and NW RANTES concentrations than intubated patients. TA RANTES, IL-8 and IL-10 concentrations inversely correlated with clinical markers of RSV disease severity. CONCLUSION: The presence of cytokines in NW and TA samples of children with RSV infection suggests that they have a role in mediating the respiratory tract inflammation induced by RSV. These observations could have implications for designing new therapeutic strategies directed at immunomodulation of RSV disease.

Child, Preschool↗
PubMed1997

Rapid and large-scale method to detect K-ras gene mutations in tumor samples.

We have developed a rapid and large-scale method for the detection of K-ras gene mutations in tumors. First, DNA is amplified by an asymmetric PCR; second, the single-strand dinitrophenyl (DNP)-labeled amplified DNA is hybridized specifically to oligonucleotide probes affixed on a tube. Finally, perfectly matched duplexes are easily detected by a monoclonal anti-DNP antibody bearing 125I. The usefulness of this technique is illustrated by analyzing K-ras codon 12 mutations in human colorectal samples. This reliable assay procedure can be applied to the rapid screening of virtually any genetic disease caused by previously described point mutations.

Aged↗
PubMed1996

Corpus luteum activity, fertility, and adrenal cortex response in lactating Carora cows during rainy and dry seasons in the tropics of Venezuela.

The effect of the rainy (RS) and the dry season (DS) on fertility, corpus luteum activity, and adrenal cortex response relationships were evaluated after first service (49 +/- 6 d postpartum) in Carora cows, a dairy cattle of Venezuela raised in tropical conditions. Cows (n = 84 in RS and n = 98 in DS) were kept semistabled, had two or three calvings, body condition score 3.5 on a 5-point scale and similar milk yield (2450 +/- 560 kg of milk during the previous lactation). Cows were grouped retrospectively according to pregnancy status. A split-plot model with repeated measures over Days 5, 7, 10, 14, and 15 after insemination was used to analyze the effects of season, pregnancy status, and their interaction involving the day on: 1) serum concentration of progesterone in four treatments: RS pregnant (n = 26), RS nonpregnant (n = 24), DS pregnant (n = 24), and DS nonpregnant (n = 20) cows; 2) serum concentration of cortisol at Days 0, 10, 14, 15, and 16 postservice in the previous treatments (n = 9, 7, 6, and 8, respectively); and 3) concentrations of cortisol after 0.1 mg of adrenocorticotropin in these last four groups of cows at Day 14 postinsemination. Breeding during the DS decreased (P < 0.05) conception rate to first service and increased (P < 0.01) days in service. In addition, the DS decreased (P < 0.05) the percentages of cows with normal interestrous interval (20-22 d), expression of estrus, and (P < 0.01) luteal phase progesterone; but DS increased (P < 0.05) percentages of short and long estrous cycles, anovulatory estrus, and repeat breeding rate. Mean serum concentration of progesterone was lower (P < 0.05) at Days 10, 14, and 15 in DS nonpregnant than in DS pregnant cows, and lower during luteal phase (P < 0.05) in DS nonpregnant than RS nonpregnant cows. Serum cortisol concentration was greater (P < 0.05) at Days 10, 14, and 16 in DS nonpregnant than DS pregnant cows. A significant (P < 0.05) negative correlation (r = -0.78) between serum concentrations of progesterone and cortisol was found within DS nonpregnant cows. Concentrations of cortisol after adrenocorticotropin were greater (P < 0.05) in DS nonpregnant cows than in other groups. These results indicate that elevated concentrations of cortisol associated with the DS may decrease progesterone secreted by the corpus luteum and therefore mediate the negative effect of the DS on fertility.

Adrenal Cortex↗
PubMed1996

A necrotic soft-tissue lesion due to Corynebacterium urealyticum in a neutropenic child.

Corynebacterium urealyticum has been associated mainly with infections of the urinary tract. Other infections due to this organism are highly unusual. We report what we believe is the first case of necrotic infection of soft tissue due to C. urealyticum in a neutropenic child who was previously treated with chemotherapy. The infection was cured when the patient was treated with vancomycin and surgical debridement. The increase in the number of neutrophils may also have contributed to the patient's recovery.

Child↗
PubMed1996

[Cerebrovascular pathology: inpatient study in a community hospital. A prospective study].

We present the preliminary results of six months cerebrovascular pathology follow-up carried out at the Sant Boi Local Hospital as from when a Neurological Unit was set up within the Internal Medecine Service. For this purpose we drew up a prospective study based on questionnaires. A total of 69 neurological patients (2.45% of all those hospitalized) were studied, 62.3% of whom suffered acute stroke. Diagnostic and therapeutic activities were analyzed with regards to the afore mentioned pathology, as well as various data of an epidermiological nature. Lastly we present the experimental multidisciplinary approach to acute stroke as performed during hospitalization by the Internal Medecine Service, Convalescence Unit and an Interdepartmental Socio-Sanitary Functional Unit.

Aged↗
PubMed1996

[Infectious gastroenteritis in relapses of inflammatory bowel disease. Therapeutic implications].

The incidence and clinical importance of infectious gastroenteritis was studied in 67 consecutive relapses of inflammatory bowel disease (IBD). A stool culture was done in every case before starting treatment. Stool culture was positive in 6 relapses (8.9%): Four were exacerbations of ulcerative colitis and two of Crohn's disease (8.8% in ulcerative colitis vs 9% in Crohn's disease; NS). The microorganisms isolated were Campylobacter jejuni in three cases, Salmonella enteritidis in two and Staphylococcus aureus in one case. There were not clinical differences between patients with positive and negative stool culture. Treated with antibiotics, stool cultures became negative in all of them but only in three the disease was controlled. The other three had to be treated with corticosteroids to achieve remission. We conclude that stool culture should be practised in all relapses of IBD and in case of positivity, antibiotic therapy should be started. With this approach the use of corticosteroids can be avoided in some patients.

Adrenal Cortex Hormones↗
PubMed1994

Haemophilus aphrophilus as a rare cause of arthritis.

A case of septic arthritis due to Haemophilus aphrophilus is presented. This organism has rarely been reported as a cause of bone or joint infections. We believe this is the third reported case of septic arthritis caused by this microorganism. We review the clinical and bacteriologic findings and the previously reported cases of infection caused by H. aphrophilus. Treatment with ceftriaxone was followed by full recovery without sequelae.

Arthritis, Infectious↗
PubMed1994

[S. pneumoniae sternoclavicular arthritis in a patient with HIV infection].

HIV infection is a predisposing factor for pneumococcic infection. While pneumonia is the most frequent location, other locations (articular, meningeal, endocardiac, etc) have been less frequently described. Among the articular infections described in patients with HIV infection, the sternoclavicular affection is extremely rare and it usually develops in association with parenterally drug addiction, being Staphylococcus aureus and Pseudomonas aeruginosa the most frequently germs involved. We describe the first case of sternoclavicular arthritis by Streptococcus pneumoniae in a patient with HIV infection. In our case, the chronic hepatopathy associated to alcohol consumption is a predisposing factor related to the pneumococcic infection. Our case suggests the need to formally investigate the HIV infection in young patients with invasive pneumococcic infection.

Adult↗