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Biomedical subjects

J Vazquez

Publications and source records attributed to J Vazquez.

At least 19 recordsLinked to original sources
PubMed2006

Medical treatment for early fetal death (less than 24 weeks).

BACKGROUND: In most pregnancies that miscarry, arrest of embryonic or fetal development occurs some time (often weeks) before the miscarriage occurs. Ultrasound examination can reveal abnormal findings during this phase by demonstrating anembryonic pregnancies or embryonic or fetal death. Treatment before 14 weeks has traditionally been surgical but medical treatments may be effective, safe, and acceptable, as may be waiting for spontaneous miscarriage. OBJECTIVES: To assess the effectiveness, safety and acceptability of any medical treatment for early pregnancy failure (anembryonic pregnancies or embryonic and fetal deaths before 24 weeks). SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 November 2005). SELECTION CRITERIA: Randomised trials comparing medical treatment with another treatment (e.g. surgical evacuation), or placebo, or no treatment for early pregnancy failure. Quasi-random studies were excluded. DATA COLLECTION AND ANALYSIS: Data were extracted unblinded. MAIN RESULTS: Twenty four studies (1888 women) were included. Vaginal misoprostol hastens miscarriage (complete or incomplete) when compared with placebo: e.g. miscarriage less than 24 hours (two trials, 138 women, relative risk (RR) 4.73, 95% confidence interval (CI) 2.70 to 8.28), with less need for uterine curettage (two trials, 104 women, RR 0.40, 95% CI 0.26 to 0.60) and no significant increase in nausea or diarrhoea. Lower-dose regimens of vaginal misoprostol tend to be less effective in producing miscarriage (three trials, 247 women, RR 0.85, 95% CI 0.72 to 1.00) with similar incidence of nausea. There seems no clear advantage to administering a 'wet' preparation of vaginal misoprostol or of adding methotrexate, or of using laminaria tents after 14 weeks. Vaginal misoprostol is more effective than vaginal prostaglandin E in avoiding surgical evacuation. Oral misoprostol was less effective than vaginal misoprostol in producing complete miscarriage (two trials, 218 women, RR 0.90, 95% CI 0.82 to 0.99). Sublingual misoprostol had equivalent efficacy to vaginal misoprostol in inducing complete miscarriage but was associated with more frequent diarrhoea. The two trials of mifepristone treatment generated conflicting results. There was no statistically significant difference between vaginal misoprostol and gemeprost in the induction of miscarriage for fetal death after 13 weeks. AUTHORS' CONCLUSIONS: Available evidence from randomised trials supports the use of vaginal misoprostol as a medical treatment to terminate non-viable pregnancies before 24 weeks. Further research is required to assess effectiveness and safety, optimal route of administration and dose. Conflicting findings about the value of mifepristone need to be resolved by additional study.

Abortifacient Agents↗
PubMed2005

International, open-label, noncomparative, clinical trial of micafungin alone and in combination for treatment of newly diagnosed and refractory candidemia.

Candida spp. are the fourth leading cause of bloodstream infections, and non-albicans species are increasing in importance. Micafungin is a new echinocandin antifungal agent with excellent in vitro activity against Candida spp. Pediatric, neonatal, and adult patients with new or refractory candidemia were enrolled into this open-label, noncomparative, international study. The initial dose of micafungin was 50 mg/d (1 mg/kg for patients <40 kg) for infections due to C. albicans and 100 mg/d (2 mg/kg for patients <40 kg) for infections due to other species. Dose escalation was allowed. Maximum length of therapy was 42 days. A total of 126 patients were evaluable (received at least five doses of micafungin). Success (complete or partial response) was seen in 83.3% patients overall. Success rates for treatment of infections caused by the most common Candida spp. were as follows: C. albicans 85.1%, C. glabrata 93.8%, C. parapsilosis 86.4%, and C. tropicalis 83.3%. Serious adverse events related to micafungin were uncommon. Micafungin shows promise as a safe and effective agent for the treatment of newly diagnosed and refractory cases of candidemia. Large-scale, randomized, controlled trials are warranted.

Adolescent↗
PubMed2005

Clinical efficacy of a triclosan/copolymer/NaF dentifrice and a commercially available breath-freshening dentifrice on hydrogen sulfide-forming bacteria.

OBJECTIVE: The objective of this randomized, cross-over clinical study was to compare the 4-h and overnight effects of a triclosan/copolymer/fluoride (TCF-AF) dentifrice and a commercially available breath freshening (CBF) dentifrice containing fluoride for their ability to control H(2)S-forming bacteria. METHODS: Following a 1 week washout period of brushing with a regular fluoride dentifrice, subjects reported to the clinical site without performing oral hygiene, eating or drinking in preparation for baseline saliva sampling. After providing a baseline saliva sample, subjects were randomly assigned a test dentifrice and instructed to brush their teeth for 1 min, twice a day for 1 week. On the morning of the eighth day, subjects returned to the test site having refrained from oral hygiene, eating and drinking for overnight sampling. Subjects then brushed for 1 min with the assigned dentifrice, and returned for 2 and 4 h postbrushing evaluations. Following a second 1 week washout, subjects repeated the same regimen, but now using the other dentifrice. Oral micro-flora samples were collected by subjects rinsing with 10 ml of sterile water for 10 s. Each collected sample was serially diluted and plated in duplicate onto lead acetate agar. After incubating for 72 h, dark colonies were counted, expressed as log colony-forming units/ml, and reductions from baseline were calculated. RESULTS: Compared with baseline, the TCF-AF dentifrice reduced H2S-forming bacteria 0.82, 0.80 and 0.22 log units at the 2 and 4 h and overnight time points compared with 0.60, 0.43 and 0.07 log units for the CBF dentifrice. The TCFAF dentifrice was statistically significantly better (P < 0.05) than the CBF dentifrice at 4 h and overnight after brushing the teeth. CONCLUSION: The results of this randomized study indicate that the TCF-AF dentifrice is effective in controlling H2S-producing bacteria.

Adult↗
PubMed2005

Interactions in biofilms of Lactococcus lactis ssp. cremoris and Pseudomonas fluorescens cultured in cold UHT milk.

Three Lactococcus lactis ssp. cremoris isolates from refrigerated bulk raw milk were cultured separately and in association with a known psychrotrophic dairy Pseudomonas fluorescens strain, in skim UHT milk for 72 h at 7 degrees C, to determine mutual influences in both the planktonic and biofilm phases. Two levels of inoculum of each culture partner were combined. Protocooperation and commensalism cases were found, all of them in the biofilm phase. Type and intensity of the interactions depended on Lactococcus strain and on the cell density of each partner. Maximum enhancement of attachment was observed to be approximately 100-fold for P. fluorescens and 20,000-fold for one of the L. lactis strains. Confocal scanning laser microscopy images show compact masses of Pseudomonas trapping lactococci cells in cooperative biofilms.

Animals↗
PubMed2005

Expression and prognostic value of EGFR in invasive breast cancer.

Epidermal growth factor receptor (EGFR) is a membrane receptor expressed in a variety of solid human cancers and directly related with poor prognosis. The objective of this work was to evaluate the EGFR content in breast carcinomas, its possible relationship with different clinical-pathological parameters, and its potential prognostic significance and predictive value. EGFR levels were examined by radioligand binding assays in 846 patients with invasive breast cancer. The median follow-up period was 50 months. There was a wide variability of EGFR levels among the studied tumors (0.01-403 fmol/mg protein). Statistical analysis showed that EGFR levels were significantly higher in younger patients (p=0.0001). EGFR were also notably higher in ER-negative or PgR-negative tumors than in ER-positive (p=0.0001) or PgR-positive tumors (p=0.001). In addition, the presence of high intratumoral EGFR levels (cut-off: 6 fmol/mg protein) was associated with both shorter relapse-free survival (p=0.04) and overall survival (p=0.01) in the group of patients as a whole, as well as with overall survival in the subgroup of patients without any type of systemic adjuvant treatment (p=0.02). However, EGFR levels did not achieve significance as independent prognostic factor in the multivariate analysis. There is a wide variability of intratumoral EGFR levels in breast carcinomas, and these protein levels correlated positively with a poor prognosis in the t univariate analysis. However, further studies are necessary in order to assess the possible clinical value of EGFR in combination with other essential components of the EGFR family network.

Adult↗
PubMed2005

CSOs: tools for assessing their operation in our systems.

In recent years, regulations have been introduced under European legislation to govern wastewater discharge into natural environments, with particular provisions for combined sewer overflows. It has therefore become indispensable to control the hydraulic behaviour of these constructions. This article addresses the issue of 1D and 3D hydraulic modelling of CSOs. In the case of 1D modelling, a computational tool that is adapted to the hydraulic complexity of side weirs has been designed. For 3D modelling, the Fluent calculation code has been tested. The two modelling approaches have been validated by the data collected from the small-scale model in Obernai (French).

Evaluation Studies as Topic↗
PubMed2005

Use of 3D modelling and several ultrasound sensors to assess overflow rate.

A new instrumentation mode has been put in place in order to determine the overflow rate of five complex CSOs of the system in Sélestat (French), which are subject to self monitoring. 3D and 1D models have made it possible to predict the shapes of the water lines and suggest a location for the ultrasound sensors. In order to validate the instrumentation principle, three overhead sensors were placed on a weir. The overflow laws suggested are of the type Q(overflow) = a1h1b1 + a2h2b2 + a3h3b3. Early results of the overflow rate that have been obtained by applying the law are close to 10 % of the flow measured in the physical test bench. On the actual site, the ultrasound sensors were assembled on a rail covering the entire weir in order to be able to change their position in future after models calibration.

Computer Simulation↗
PubMed2003

Candidiasis in the intensive care unit.

In the last 2 decades, Candida species have progressed from infrequent pathogens to among the most important and frequent opportunistic microorganisms causing nosocomial infection in intensive care unit (ICU) patients. Medical and surgical ICUs have become the epicenter of the Candida epidemic. Superficial infections causing oropharyngeal and esophageal candidiasis are common, and, although non-life threatening, may be refractory to conventional antifungals. In contrast, invasive candidiasis, candidemia, and hematogenous disseminated infections are associated with considerable attributable mortality. Although blood isolates of C. albicans remain susceptible to fluconazole, the increasing incidence of non- albicans Candida species with intrinsic reduced susceptibility to azoles creates new therapeutic challenges. Fortunately, lipid formulations of amphotericin B and the recently introduced echinocandin group represent new and strategic treatment responses to the challenge of invasive candidiasis.

Journal Article↗
PubMed2002

Trypanosoma cruzi mitochondrial malate dehydrogenase triggers polyclonal B-cell activation.

It has been proposed that Trypanosoma cruzi, the aetiologic agent of Chagas' disease, produces mitogenic substances responsible for the polyclonal B-cell activation observed during the acute phase of the infection. Isolation and characterization of the molecules involved in the induction of polyclonal activation observed during infectious diseases have posed a great challenge for the immunologist over the last decade. In this work we report that a 33 kD protein obtained from an alkaline fraction of T. cruzi epimastigotes (FI) stimulates proliferation and promotes differentiation into antibody-secreting cells of normal murine B cells in a T-cell independent manner. By flow cytometry we also found that the 33 kDa protein induces an increase in the expression of MHC class II and B7.2 but not B7.1 molecules on the B-cell surface. Sequencing by mass spectrometry identified the T. cruzi 33 kD protein as hypothetical oxidoreductase, a member of the aldo/ketoreductase family. In this report we demonstrate that this protein is also present in the infective bloodstream trypomastigote form of the parasite and was identified as T. cruzi mitochondrial malate dehydrogenase (mMDH) by enzyme activity and by Western blotting using a specific mMDH polyclonal antiserum. The biologic relevance of mMDH-induced polyclonal activation concerning T. cruzi infection is discussed.

Animals↗
PubMed2002

Successful medical treatment of two patients with eosinophilic oesophagitis.

BACKGROUND/PURPOSE: Significant oesophageal eosinophilia is associated with oesophagitis and gastroesophageal reflux (GER). Eosinophilic oesophagitis is a rare disease that causes thickening of the oesophageal wall, narrowing of the oesophageal lumen, and severe motor disturbance. METHODS AND RESULTS: Two 12 yr-old patients with eosinophilic oesophagitis were studied prospectively. Clinical and investigation details are presented. Elemental formula was administered until complete remission of disease. Final outcome was assessed after 3 months on regular diet with exclusion of specific allergic components. Both patients responded to the dietary manipulation. CONCLUSIONS: Eosinophilic oesophagitis must be included in the differential diagnosis when dealing with oesophageal strictures of unknown or unclear aetiology. Elimination diet therapy plays a crucial role in ameliorating the course of the illness. Blood eosinophilia correlates with therapeutic response and with improvement of the disease.

Barium Sulfate↗
PubMed2001

Major histocompatibility complex class I molecules bind natural peptide ligands lacking the amino-terminal binding residue in vivo.

Major histocompatibility complex (MHC) class I-peptide complexes are stabilized by multiple interactions, including those of the peptidic NH(2)-terminal group in the A pocket of the MHC molecule. In this study, the characterization of four natural HLA-B39 ligands lacking the amino-terminal binding residue is reported. These peptides were found in the endogenous peptide pool of one or more of the B*3901, B*3905, and B*3909 allotypes and sequenced by nanoelectrospray mass spectrometry. Control experiments ruled out that they resulted from exopeptidase trimming of their NH(2)-terminally extended counterparts: NAc-SHVAVENAL, EHGPNPIL, IHEPEPHIL, and EHAGVISVL, also present in the same peptide pools, during purification. HAGVISVL and HVAVENAL behaved similarly to the corresponding NH(2)-terminally extended peptides in their binding to B*3901 and B*3909 at the cell surface in vitro, and in cell surface stabilization of B*3901. This is, to our knowledge, the first demonstration that peptides lacking the amino-terminal binding residue bind in vivo to classical MHC class I molecules. The results indicate that canonical MHC-peptide interactions in the A pocket are not always necessary for endogenous peptide presentation.

Amino Acid Sequence↗
PubMed2001

Multiple regimes of constrained chromosome motion are regulated in the interphase Drosophila nucleus.

BACKGROUND: Increasing evidence indicates specific changes in the three-dimensional organization of chromosomes in the cell nucleus during the cell cycle and development. These changes may be linked to changes in both the coordinated regulation of gene transcription and the timing of chromosome replication. While there is cytological evidence for short-range diffusive motion of chromosomes during interphase, the mechanisms for large-scale chromosome remodeling inside the nucleus remain unknown. RESULTS: Chromosome motion was tracked in Drosophila spermatocyte nuclei by 3D fluorescence microscopy. The Lac repressor/lac operator system was used to label specific chromosomal sites in live tissues, allowing extended observation of chromatin motion in different cell cycle stages. Our results reveal a highly dynamic chromosome organization governed by two types of motion: a fast, short-range component over a 1-2 s time scale and a slower component related to long-range chromosome motion within the nucleus. The motion patterns are consistent with a random walk. In early G2, short-range motion occurs within a small, approximately 0.5 microm radius domain, while long-range motion is confined to a much larger, chromosome-sized domain. Progression through G2 as cells approach meiotic prophase is accompanied by a complete arrest of long-range chromosome motion. CONCLUSIONS: Our analysis provides direct evidence for cell cycle-regulated changes in interphase chromatin motion. These changes are consistent with changes in local and long-range constraints on chromosome motility. We propose that dynamic interactions between chromosomes and internal nuclear structures modulate the range and rate of interphase chromatin diffusion and thereby regulate large-scale nuclear chromosome organization.

Animals↗
PubMed2001

Surgical approach to funnel-shaped congenital tracheal stenosis.

PURPOSE: The aim of this study was to evaluate the results obtained by 2 different techniques of tracheoplasty in the treatment of long-segment, funnel-shaped congenital tracheal stenosis (CTS) in 2 tertiary paediatric hospitals. METHODS: The clinical records of patients with long segment congenital tracheal stenosis during the period January 1990 to June 1999 were reviewed retrospectively. Age, gender, symptoms, imaging (x-ray, computed tomography, magnetic resonance imaging, or bronchography), endoscopic findings, associated anomalies, treatment, intubation time, postoperative treatment, intensive care unit stay, complications, hospital stay, evolution, and follow-up time were analyzed. Short congenital tracheal stenosis treated by resection and end-to-end anastomosis are not included. Results are given as mean +/- SEM. RESULTS: Ten (7 boys, 4 girls) of 14 patients with CTS had a funnel-shaped CTS. Mean age at treatment was 9.7 +/- 4.8 months (range, 3 days to 4.7 years). All of the patients presented with CTS affecting the distal third of the trachea and 4 of them extension to 1 main stem bronchus. They were treated by 2 different types of tracheoplasty: anterior costal cartilage graft (ACGT, 6 patients) and slide tracheoplasty (ST, 4 patients). All the patients treated by ACGT failed: 4 died and 2 required further surgery for restenosis. Causes of death were acute respiratory failure during surgery (2 cases) and anastomotic dehiscence (2 cases). The patients treated with ST are asymptomatic and doing well. Mean postoperative intubation time of the ACGT group was 35 +/- 25 days (10 to 60 days), whereas in the ST group it was 14 +/- 12 days (0 to 51 days). Mean hospital stays were 292 +/- 271 days (21 to 563 days) and 24 +/- 13 days (7 to 63 days), respectively. Mean follow-up time is 28 +/- 14 months (3 to 94 months). CONCLUSIONS: Surgery of long-segment congenital tracheal stenosis has a high failure and complication rate with vital implications in prognosis. Treatment should be done in a multidisciplinary basis by a highly trained and motivated team. Slide tracheoplasty seems to be the better option, although further multicentre studies should be conducted.

Child, Preschool↗
PubMed2001

Basal forebrain acetylcholine release during REM sleep is significantly greater than during waking.

Cholinergic neurons of the basal forebrain supply the neocortex with ACh and play a major role in regulating behavioral arousal and cortical electroencephalographic activation. Cortical ACh release is greatest during waking and rapid eye movement (REM) sleep and reduced during non-REM (NREM) sleep. Loss of basal forebrain cholinergic neurons contributes to sleep disruption and to the cognitive deficits of many neurological disorders. ACh release within the basal forebrain previously has not been quantified during sleep. This study used in vivo microdialysis to test the hypothesis that basal forebrain ACh release varies as a function of sleep and waking. Cats were trained to sleep in a head-stable position, and dialysis samples were collected during polygraphically defined states of waking, NREM sleep, and REM sleep. Results from 22 experiments in four animals demonstrated that means +/- SE ACh release (pmol/10 min) was greatest during REM sleep (0.77 +/- 0.07), intermediate during waking (0.58 +/- 0.03), and lowest during NREM sleep (0.34 +/- 0.01). The finding that, during REM sleep, basal forebrain ACh release is significantly elevated over waking levels suggests a differential role for basal forebrain ACh during REM sleep and waking.

Acetylcholine↗
PubMed2001

Sensory input directs spatial and temporal plasticity in primary auditory cortex.

The cortical representation of the sensory environment is continuously modified by experience. Changes in spatial (receptive field) and temporal response properties of cortical neurons underlie many forms of natural learning. The scale and direction of these changes appear to be determined by specific features of the behavioral tasks that evoke cortical plasticity. The neural mechanisms responsible for this differential plasticity remain unclear partly because important sensory and cognitive parameters differ among these tasks. In this report, we demonstrate that differential sensory experience directs differential plasticity using a single paradigm that eliminates the task-specific variables that have confounded direct comparison of previous studies. Electrical activation of the basal forebrain (BF) was used to gate cortical plasticity mechanisms. The auditory stimulus paired with BF stimulation was systematically varied to determine how several basic features of the sensory input direct plasticity in primary auditory cortex (A1) of adult rats. The distributed cortical response was reconstructed from a dense sampling of A1 neurons after 4 wk of BF-sound pairing. We have previously used this method to show that when a tone is paired with BF activation, the region of the cortical map responding to that tone frequency is specifically expanded. In this report, we demonstrate that receptive-field size is determined by features of the stimulus paired with BF activation. Specifically, receptive fields were narrowed or broadened as a systematic function of both carrier-frequency variability and the temporal modulation rate of paired acoustic stimuli. For example, the mean bandwidth of A1 neurons was increased (+60%) after pairing BF stimulation with a rapid train of tones and decreased (-25%) after pairing unmodulated tones of different frequencies. These effects are consistent with previous reports of receptive-field plasticity evoked by natural learning. The maximum cortical following rate and minimum response latency were also modified as a function of stimulus modulation rate and carrier-frequency variability. The cortical response to a rapid train of tones was nearly doubled if BF stimulation was paired with rapid trains of random carrier frequency, while no following rate plasticity was observed if a single carrier frequency was used. Finally, we observed significant increases in response strength and total area of functionally defined A1 following BF activation paired with certain classes of stimuli and not others. These results indicate that the degree and direction of cortical plasticity of temporal and receptive-field selectivity are specified by the structure and schedule of inputs that co-occur with basal forebrain activation and suggest that the rules of cortical plasticity do not operate on each elemental stimulus feature independently of others.

Acoustic Stimulation↗
PubMed2001

Cellular immune response and Th1/Th2 cytokines in human neurocysticercosis: lack of immune suppression.

Some reports have suggested that human neurocysticercosis (NCC) induces immunosuppression. To test this hypothesis, we performed a study on active cases of NCC who had not received cestocidal or immunosuppressive treatments. We examined blood counts and specific T cell markers (CD3, CD4, and CD8) by flow cytometry and found no differences between patients with NCC and healthy individuals. Both groups responded to concanavalin A (Con A), and patients with NCC responded more to a parasite crude antigen than uninfected individuals. Peripheral blood mononuclear cells were examined for interleukin (IL)-2, interferon-gamma, IL-10, and IL-4 mRNA. Regardless of infection status, more than 60% of individuals synthesized IL-2 mRNA and, less frequently, the other cytokines. These data suggest that immunosuppression does not occur in NCC patients.

Adult↗
PubMed2000

Low-energy pathway for pauson-khand reactions: synthesis and reactivity of dicobalt hexacarbonyl complexes of chiral ynamines

A family of dicobalt hexacarbonyl complexes of 1-(dialkylamino)-2-(trimethysilyl)acetylenes (3a-f) derived both from achiral and chiral amines [a, morpholine; b, (S)-2-methoxymethylpyrrolidine; c, (2R,5R)-2, 5-bis(methoxymethyl)pyrrolidine; d, (+/-)-trans-2, 5-bis(benzyloxymethyl)pyrrolidine; e, (2R,5R)-2, 5-dimethylpyrrolidine; f, (S)-(alpha-methylbenzyl)benzylamine] has been prepared by a one-stage process from dichloroacetylene. The methanolysis at room temperature of these complexes (MeOH/K(2)CO(3)) induces the selective cleavage of the carbon-silicon bond, leading to the thermally unstable terminal ynamine complexes 12a-f. The Pauson-Khand reaction of 12a-f with strained olefins (norbornadiene and norbornene) takes place at unprecedentedly low temperatures (-35 degrees C) in the absence of chemical promoters. Diastereoselectivities of up to 94:6 are recorded in these reactions with the ynamine complexes derived from C(2) symmetrical chiral auxiliaries (12c,d). The high reactivity depicted by terminal ynamines in the Pauson-Khand reaction has been analyzed by theoretical semiempirical procedures [PM3(tm)] and with density functional theory (VWN/B88), and appears to reflect an easy CO loss from the ynamine-dicobalt hexacarbonyl complexes.

Journal Article↗