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Biomedical subjects

J Vega

Publications and source records attributed to J Vega.

At least 19 recordsLinked to original sources
PubMed2006

Bioabsorbable staple-line reinforcement to reduce staple-line bleeding in the transection of mesenteric vessels during laparoscopic colorectal resection: a pilot study.

BACKGROUND: Staple line hemorrhage and leak are the 2 most dreaded complications of laparoscopyassisted resection of colorectal cancer (LARCC). Recently, anastomotic staple lines have been reinforced with a range of absorbable and non-absorbable bioprosthetic reinforcement materials. This pilot prospective study used the bioabsorbable Seamguard (BSG; WL Gore & Associates, Flagstaff, AZ) for routine reinforcement of the mesenteric vascular staple transection to prevent mesenteric hemorrhage and to assess its safety and feasibility in a consecutive series of laparoscopic colonic resections. METHODS: Twenty-five patients consecutively scheduled to undergo LARCC were enrolled in the study. All operations were performed with a standard LARCC technique which included loading of the BSG sleeves onto the jaws of the cutter/stapler. RESULTS: There were 23 wholly LARCC cases and 2 open conversions. BSG was used in all 25 patients. No patient experienced staple-line bleeding or other complications during the surgical procedure. The mean number of staple-line reinforcement sleeves used was 2.6 (range, 2-4). The mean operative time was 118 minutes (range, 65-184 minutes). Additional measures to achieve hemostasis were not required in any case. The mean cost was US 475.20 dollars for the procedure. CONCLUSIONS: This small pilot study has shown the routine use of BSG mesenteric staple line reinforcement to be safe, quick and effective during LARCC.

Absorbable Implants↗
PubMed2006

Use of anorectal ultrasounds in perianal Crohn's disease: consistency with clinical data.

BACKGROUND: anorectal ultrasonography (ARU) is a simple technique, and its diagnostic value for anorectal diseases either in conventional subjects or in patients with Crohn s disease (CD) is insufficiently reported. The objective of this study is to evaluate the use of ARU, its consistency with clinical orientation, and its ability to provide relevant information for patients with bowel CD and perianal involvement. METHODS: thirty ARUs were performed for 24 patients (17 male, mean age 35,7 years; range 19-59 years) with diagnosed CD (bowel and anorectal involvement). The reason to perform an ARU was to evaluate an anal fistula (15 patients, 50%), potential abscesses (9 patients, 30%), and fecal incontinence (2 patients, 6,6%), and for post-treatment monitoring purposes (4 patients, 13,3%). RESULTS: diagnostic orientation coincided for 14 patients (46,6%). An abscess was found in eight patients (26,6%), and five patients were clinically suspicious. The abscess was postanal in 3 patients. Fistulas were found in 17 patients (56,6%), and 15 patients were clinically suspicious. Transsphincterian fistulas were observed in seven patients, and abscesses were associated with fistula in six patients. Transsphincteric defects were observed in 10 patients (four internal sphincters, one external sphincter, and five both) but only two patients suffered from incontinence. ARU provided data relevant to therapeutic approach in 19 patients (63,3%). CONCLUSIONS: ARU has provided very important data for the diagnosis and treatment of anorectal diseases. Based on this technique clinical decisions can be improved, which in some instances may prove critical.

Abscess↗
PubMed2005

Hepatotoxicity associated with cyclosporine monitoring using C2 recommendations in adults renal recipients receiving ketoconazole.

Following the change, in the way we monitored cyclosporine (CsA) levels in January 2000 namely from C0 to C2 concentrations, in renal "de novo" allograft recipients, some patients treated with concomitant ketoconazole experienced liver toxicity, a complication that had not been previously seen with CsA monitoring using C0. Therefore, we decided to compare the outcomes of patients transplanted using CsA levels monitored by C0 (1998 to 1999) who also had simultaneous C2 determinations (group A) with those of recipients transplanted after 2000 (group B). All received steroids, azathioprine, and CsA plus ketoconazole. Recipients were followed for at least a year after transplantation. Patients in group B showed higher CsA C2 levels, AUC concentrations, and drug doses during the immediate postsurgical period, and at 2 weeks as well as 4 and 6 months posttransplantation. Six group B patients (26%) but no group A recipients displayed, severe liver toxicity characterized by jaundice, elevated liver enzymes, with negative serological tests for CMV, HVC, and HVB. There was a correlation between the GOT and the C2 CsA levels; both normalized 15 to 55 days after CsA dose reduction. High C2 CsA levels, which have been recommended when the drug is used alone in renal transplantation, cannot be used in patients taking ketoconazole, because C2 neither represents nor correlates with AUC drug exposure. Thus high C2 levels may produce liver toxicity.

Adult↗
PubMed2005

Short report: efficacy of pentavalent antimony for treatment of colombian cutaneous leishmaniasis.

Two hundred twenty-six consecutive adult patients with cutaneous leishmaniasis in Colombia were treated with Glucantime and 81% were cured. The 19% who failed treatment had received a statistically significant lower total amount of antimony (354 mg/kg) than those who were cured (405 mg/kg) (P = 0.002). Thirty-nine of the failures were re-treated with Glucantime and 59% were cured. This large experience on initial and re-treatment cure rates probably represents the values found in clinical practice. In this series, parasite resistance may have been induced by the relatively low initial dose of antimony administered to some patients.

Adult↗
PubMed2004

Corneal and conjunctival sensitivity to air stimuli.

AIMS: To determine the repeatability of ocular surface sensitivity to mechanical stimulation using air stimuli and the effect of contact lens (CL) wear on sensitivity. METHODS: Repeatability: 14 subjects (24-39 years) participated. Mechanical sensitivity to warmed (34 degrees C) and ambient (20 degrees C) air was measured for the central cornea (CC), inferior cornea (IC), and inferior conjunctiva (ICON). Measurements were taken on 12 days; six morning and six afternoon measurements. Differences between sites, time of day, and stimulus temperature were evaluated. CL wear: 10 subjects (22-30 years) participated. Measurements were taken at the same time of day, either following no wear, wear of a CL of oxygen permeability [Dk] of 28 x 10(-9) [cm/s][ml O(2)/ml mm Hg] or wear of a CL of Dk 140 x 10(-9) [cm/s][ml O(2)/ml mm Hg]. Differences between sites and wear conditions were evaluated. RESULTS: Repeatability: Sensitivity varied between sites (p<0.01), time of day (p<0.05), and stimulus temperatures (p<0.01). There were no significant differences between days. Mean thresholds for eye temperature stimuli were; CC 64.4 (SD 28.6) ml/min; IC 84.6 (40.0) ml/min; ICON 120.6 (40.4) ml/min and for ambient temperature stimuli were CC 53.9 (16.0) ml/min, IC 59.0 (20.0) ml/min; ICON 72.6 (43.7) ml/min. CL wear: Sensitivity varied between sites and wear conditions (p<0.05). Conjunctival sensitivity was increased after wear of highly oxygen permeable CLs but unaffected by wear of low oxygen permeable CLs. CONCLUSIONS: The prototype gas aesthesiometer is able to repeatably measure ocular surface sensitivity and measurements are consistent with previously reported techniques.

Adult↗
PubMed2004

Comparison of generic to branded pentavalent antimony for treatment of new world cutaneous leishmaniasis.

The cost of generic pentavalent antimony (generic stibogluconate) is approximately one-sixth that of branded pentavalent antimony (stibogluconate in the form of Pentostam or meglumine antimoniate in the form of Glucantime. We compared generic stibogluconate to Pentostam and Glucantime for the treatment of cutaneous leishmaniasis patients in Bolivia and Colombia. For all 114 patients, the per-protocol cure rates were 83-91% and the intent-to-treat cure rates were 75-83%. The highest values were in the generic stibogluconate group. The incidence of pancreatic enzyme abnormalities was 48-88% and the incidence of liver enzyme abnormalities was 48-87%. The lowest incidences were in the generic stibogluconate group. The efficacy and tolerance of inexpensive generic stibogluconate appears comparable to branded formulations for the treatment of cutaneous leishmaniasis in these endemic regions.

Adolescent↗
PubMed2003

Identification and expression analysis of ABC genes in Plasmodium yoelii and P. berghei.

The ATP-binding cassette (ABC) proteins are one of the largest evolutionarily conserved families. They are characterized by the presence of highly conserved nucleotide-binding sites (NBS). In the present study, we identified ABC genes in rodent Plasmodia. We queried the Plasmodium yoelii genome with the ABC signature motif and retrieved 15 contigs. Sequences were classified into seven ABC families by BLAST comparison. Conservation of the five signature ABC motifs in the P. yoelii contigs was examined by multi-alignment of the NBS. Expression of the ABC genes was examined during the blood stages of P. yoelii and P. berghei and the hepatocytic stages of P. yoelii. Our results with RT-PCR on total RNA from blood stages demonstrated the expression of 14 ABC genes in P. yoelii and ten in P. berghei. In P. yoelii hepatocytic stages, the expression of four ABC genes was detected.

ATP-Binding Cassette Transporters↗
PubMed2003

Isolation and characterization of Tha p 1, a major allergen from the pine processionary caterpillar Thaumetopoea pityocampa.

BACKGROUND: Pine processionary caterpillars induce dermatitis by a toxic-irritative mechanism. The existence of true allergic reactions to allergens from these caterpillars has been recently demonstrated by positive immediate skin prick tests and specific IgE determination by immunoblotting using crude larval extracts. The aim of this work was to purify allergens from the crude larval extract in order to characterize IgE-binding proteins from these caterpillars. METHODS: Allergens were separated by ethanol gradient fractionation and reversed phase HPLC. The N-terminal amino acid sequence of a selected allergen was obtained after SDS-PAGE and transfer. The clinical relevance of this allergen was measured using sera from patients allergic to caterpillar. RESULTS: An allergen with a molecular weight close to 15 kDa was purified. It was recognized by 9 out of 11 allergic patients (82%). Its N-terminal amino acid sequence had no homologies to any other protein already described in data bases. For this reason, no information about its biological function could be obtained. CONCLUSIONS: This 15-kDa IgE-binding protein is a major caterpillar allergen and shows no homologies to other insect allergens already described.

Allergens↗
PubMed2003

Cutaneous reactions to pine processionary caterpillar (Thaumetopoea pityocampa) in pediatric population.

Cutaneous lesions caused by pine processionary caterpillar (Thaumetopoea pityocampa, TP) are frequent in pinewood areas. However, no epidemiological studies have been performed so far in the pediatric population. In this study, we evaluated the relevance of reactions to pine processionary caterpillar in the pediatric population of our environment and determined the possible role of an IgE-mediated mechanism. A questionnaire was developed and given to 1,101 children and adolescents ranging from 3 to 17 years of age from rural areas with large pine forests. A total of 653 questionnaires were answered by the children or their parents. The search for immunoglobulin E (IgE)-mediated cases was based on the presence of a suspected reaction to caterpillar and confirmed by in vivo (skin prick) and in vitro (immunoblotting) tests. Sixty of the 653 people interviewed (9.18%) identified a cutaneous reaction from exposure to the processionary caterpillar. Within this group only four cases (6.7%) were because of an IgE-mediated mechanism. The predominant clinical feature of these patients with allergy to caterpillar was contact urticaria. We present the first study of cutaneous reactions to pine processionary caterpillar in a large pediatric population. This is a frequent pathology in pinery zones and only in a minority of the cases are because of an IgE-mediated allergic mechanism. This fact contrasts with studies in adults, where this percentage is much greater.

Adolescent↗
PubMed2003

Income inequality and health: multilevel analysis of Chilean communities.

STUDY OBJECTIVE: The evidence supporting the effect of income inequality on health has been largely observed in societies far more egalitarian than the US. This study examines the cross sectional multilevel associations between income inequality and self rated poor health in Chile; a society more unequal than the US. DESIGN: A multilevel statistical framework of 98 344 people nested within 61 978 households nested within 285 communities nested within 13 regions. SETTING: The 2000 National Socioeconomic Characterization Survey (CASEN) data from Chile. PARTICIPANTS: Adults aged 18 and above. The outcome was a dichotomised self rated health (0 if very good, good or average; 1 if poor, or very poor). Individual level exposures included age, sex, ethnicity, marital status, education, employment status, type of health insurance, and household level exposures include income and residential setting (urban/rural). Community level exposures included the Gini coefficient and median income. MAIN RESULTS: Controlling for individual/household predictors, a significant gradient was observed between income and poor self rated health, with very poor most likely to report poor health (OR: 2.94) followed by poor (OR: 2.77), low (OR: 2.06), middle (OR: 1.73), high (OR: 1.38) as compared with the very high income earners. Controlling for household and community effects of income, a significant effect of community income inequality was observed (OR:1.22). CONCLUSIONS: Household income does not explain any of the between community differences; neither does it account for the effect of community income inequality on self rated health, with more unequal communities associated with a greater probability of reporting poor health.

Adolescent↗
PubMed2003

Ultrastructural alterations in cortex of adrenal gland caused by the toxic effect of bee (Apis mellifera) venom.

Bee accidents incidence is underestimated because many people do not consult to the physicians. Here it is described for the first time the severe mice adrenal gland damage induced by Apis mellifera venom. Biopsy specimens were obtained from mice adrenal gland and after sample preparation observed in Hitachi H-7100 electron microscope. In this work the ultrastructural analysis showed, 6 h after injection, a non homogeneous smooth endothelial reticulum, and in some places loss of plasma membrane. The fenestrae spaces were bigger and detritus in the capillary lumen were observed. Erythrocytes were seen in a cortical cell. After 48 h of venom injection, expanded fenestrae were observed. Capillary basal membrane was interrupted. Myelin-like figures and autophagic vacuoles were noticed. Swollen smooth endoplasmic reticulum elements and endothelial unfolding to the light were seen. Moreover, swollen Golgi and mitochondria were observed, in some places forming myelinic-like figures. At 144 h after venom injection, widened spaces were noticed in capillary fenestrae. Cellular section showed swollen and lost smooth endoplasmic reticulum elements. Smooth endoplasmic reticulum tubules disappearance suggested non steroidogenesis. In conclusion, we suggest that some of the bee envenoming human clinical manifestations, as is observed in mice, are determined by suprarenal gland damage produced by toxins present in this venom.

Adrenal Cortex↗
PubMed2002

Molecular characterisation and evolutionary relationships of a potyvirus infecting Crotalaria in Brazil. Brief report.

The 3' terminal genomic region of a potyvirus causing mosaic disease in several Crotalaria species has been cloned and sequenced. Comparisons of the nucleotide and deduced amino acid (aa) sequences of the cloned cDNA with those from other potyviruses show that the Crotalaria-infecting virus (designated Crotalaria mosaic virus; CrMV) is closely related to Cowpea aphid-borne mosaic virus (CABMV). Maximum identity (95.4%) at the coat protein (CP) aa level was observed between CrMV and a Brazilian strain of CABMV. Phylogenetic analyses derived from the sequence alignments of the CP and 3' untranslated region confirmed the identification of CrMV as a strain of CABMV and the name CABMV-Cr is suggested.

3' Untranslated Regions↗
PubMed2001

[An intervention to improve diabetes control in Chile].

OBJECTIVE: Previous research has shown that controlling blood glucose improves short-term and long-term outcomes among patients who have either type 1 or type 2 diabetes. The objective of this study was to investigate, in a developing country, the effectiveness of an intervention that included patient education, self-monitoring of blood glucose, and determination of the level of glycosylated hemoglobin (HbA1c). METHODS: The patients were grouped into three categories, taking into account such clinical manifestations as the duration of their diabetes, its treatment, and their hospitalization history. After the inclusion and exclusion criteria were applied, the persons were randomly assigned to two groups. One group (210 patients) received the educational intervention, and the control group (206 patients) received customary care. The intervention group received educational information needed for self-monitoring of blood glucose and for the self-evaluation of positive and negative behaviors related to metabolic control of the disease. RESULTS: The two groups were similar with respect to age (mean of 52.3 and 50.5 years) and to the proportion of patients with type 1 diabetes (13.8% and 16.0%). There were no initial differences in the average concentration of HbA1c in the two groups (8.9% +/- 0.1% and 8.9% +/- 1.4%). A total of 50 persons dropped out of the study, 14.8% of those in the intervention group and 9.2% of those in the control group. In the intervention group, compliance with dietary recommendations increased by 43.5%, from 57.5% at the beginning of the study to 82.5% at the end (P < 0.001); in the control group there was also a change but it was not significant. Although patients with a high initial HbA1c concentration were underrepresented in this study, the average HbA1c concentration declined significantly in the intervention group (-0.4% +/- 1.1%, P = 0.001) but not in the control group (-0.1% +/- 0.1%). CONCLUSIONS: In one developing country, educating patients about diabetes helped improve metabolic control, a fact that can be attributed mainly to the intervention's positive impact on those persons' diet.

Adolescent↗
PubMed2000

Molecular evidence that sugarcane yellow leaf virus (ScYLV) is a member of the Luteoviridae family.

A previously uncharacterized virus was reported in southeast Brazil causing a yellowing leaf disease in sugarcane. The virus, termed sugarcane yellow leaf virus (ScYLV), shares features typical of the luteoviruses. To start the molecular characterization of ScYLV, the nucleotide sequence of the coat protein (CP), 17 kDa protein and C-terminus of the RNA-dependent RNA polymerase coding regions was determined from an RT-PCR amplification product. Comparisons showed that the deduced amino acid sequences share a considerable degree of identity and similarity with corresponding sequences of known luteoviruses, thus clearly establishing ScYLV as a member of the family Luteoviridae. The authenticity of the CP open reading frame was confirmed by its expression in Escherichia coli. The recombinant CP positively reacted in immunoblot assays with polyclonal antibodies raised against native ScYLV. Furthermore, phylogenetic analyses also suggest that the 5' and 3' coding blocks of the ScYLV genome possess different taxonomic affinities within the Luteoviridae family, as does also the genome of soybean dwarf virus.

Amino Acid Sequence↗