Biomedical subjects

M E Fernandez

Publications and source records attributed to M E Fernandez.

At least 19 recordsLinked to original sources

PubMed1999

Heterotopic ovarian transplantation without vascular pedicle in syngeneic Lewis rats: six-month control of estradiol and follicle-stimulating hormone concentrations after intraperitoneal and subcutaneous implants.

OBJECTIVE: To assess the recovery, maintenance, and quality of ovarian function by comparing the success of autotransplantation in intraperitoneal (IP) and SC locations over a 6-month period in syngeneic Lewis rats. DESIGN: Experimental animal study. SETTING: Unit of Experimental Research at the Barcelona University School of Medicine. ANIMAL(S): Female syngeneic Lewis rats. INTERVENTION(S): The animals were randomized to one of three groups: group A, control group with ovariectomy (n = 15); group B, ovariectomy and IP autologous heterotopic transplant of ovarian tissue without vascular pedicle (n = 14); and group C, ovariectomy and SC autologous heterotopic transplant (n = 15). MAIN OUTCOME MEASURE(S): Serum levels of FSH and 17beta-E2 and vaginal cytology. RESULT(S): In groups B and C, E2 serum concentrations from day 7 and day 10 onward remained comparable to basal levels, and significantly higher than in group A, throughout the 6-month period. In group B from day 7 after surgery onward, and in group C from day 10 after surgery onward, FSH concentrations remained low (comparable to basal levels) throughout the follow-up period. Vaginal cytology of groups B and C showed trophic maturation between days 4 and 10 after ovariectomy and insertion of the ovarian tissue implant, whereas the control group remained atrophic. There were no statistically significant differences between IP and SC implants. CONCLUSION(S): A heterotopic autotransplant of ovarian tissue without vascular pedicle in syngeneic Lewis rats is successful for > or =6 months.

Animals↗

PubMed1999

Evaluation of ENCOREplus. A community-based breast and cervical cancer screening program.

BACKGROUND: Minority women and women with low income levels are significantly less likely to practice appropriate mammography and Pap test screening. ENCOREplus is a health promotion program that provides outreach, education, referral, and other service that facilitate breast and cervical cancer screening for medically underserved women. The program is delivered through a network of community-based nonprofit organizations (YWCA of the U.S.A). The purpose of this study was to assess the effectiveness of ENCOREplus in promoting mammography and Pap test screening among women who were nonadherent to screening guidelines. METHODS: Baseline data were collected from women participating in the program. Follow-up occurred within six months of baseline to assess whether or not enrollees received recommended screenings. Screening-completion rates were compared to rates from other published intervention studies. RESULTS: Data from the program's second implementation year show that 27,494 women participated in the ENCOREplus program. Over half the women were racial/ethnic minorities, over 75% reported annual incomes under $15,000, and 49% reported no insurance. Among women 40 and over, 69.7% were nonadherent to ACS mammography screening guidelines at baseline. Among participants 18 and older, 68.9% were nonadherent to Pap test screening guidelines. Of nonadherent participants, 57.8% received mammograms and 36.5% received Pap tests. Both mammography and Pap test screening-completion rates compared favorably with other programs. CONCLUSION: This study demonstrates that programs implemented through community-based organizations can be successful in increasing mammography and Pap test screening among low-income and minority women.

Adolescent↗

PubMed1999

Extensive characterization of the immunophenotype and pattern of cytokine production by distinct subpopulations of normal human peripheral blood MHC II+/lineage- cells.

Dendritic cells (DC) represent the most powerful professional antigen-presenting cells (APC) in the immune system. The aim of the present study was to analyse, on a single-cell basis by multiparametric flow cytometry with simultaneous four-colour staining and a two-step acquisition procedure, the immunophenotypic profile and cytokine production of DC from 67 normal whole peripheral blood (PB) samples. Two clearly different subsets of HLA-II+/lineage- were identified on the basis of their distinct phenotypic characteristics: one DC subset was CD33strong+ and CD123dim+ (0.16 +/- 0.06% of the PB nucleated cells and 55.9 +/- 11. 9% of all PB DC) and the other, CD33dim+ and CD123strong+ (0.12 +/- 0.04% of PB nucleated cells and 44.53 +/- 11.5% of all PB DC). Moreover, the former DC subpopulation clearly showed higher expression of the CD13 myeloid-associated antigen, the CD29 and CD58 adhesion molecules, the CD2, CD5 and CD86 costimulatory molecules, the CD32 IgG receptor and the CD11c complement receptor. In addition, these cells showed stronger HLA-DR and HLA-DQ expression and a higher reactivity for the IL-6 receptor alpha-chain (CD126) and for CD38. In contrast, the CD123strong+/CD33dim+ DC showed a stronger reactivity for the CD4 and CD45RA molecules, whereas they did not express the CD58, CD5, CD11c and CD13 antigens. Regarding cytokine production, our results show that while the CD33strong+/CD123dim+ DC are able to produce significant amounts of inflammatory cytokines, such as IL-1beta (97 +/- 5% of positive cells), IL-6 (96 +/- 1.1% of positive cells), IL-12 (81.5 +/- 15.5% of positive cells) and tumour necrosis factor-alpha (TNF-alpha) (84 +/- 22.1% of positive cells) as well as chemokines such as IL-8 (99 +/- 1% of positive cells), the functional ability of the CD123strong+/CD33dim+ DC subset to produce cytokines under the same conditions was almost null. Our results therefore clearly show the presence of two distinct subsets of DC in normal human PB, which differ not only in their immunophenotype but also in their functionality, as regards cytokine production.

AC133 Antigen↗

PubMed1999

Hematopoietic damage prior to PBSCT and its influence on hematopoietic recovery.

BACKGROUND AND OBJECTIVE: Patients with malignancies receive chemotherapy to induce tumor remission which could damage hematopoiesis and adversely influence hematopoietic reconstitution after transplantation. In the present study we used a long-term culture (LTBMC) system and clonogenic assays to evaluate the marrow damage in patients selected to receive peripheral blood stem cell transplantation (PBSCT). DESIGN AND METHODS: Thirty-five patients - 20 with breast cancer (BC), 9 with non-Hodgkin's lymphoma (NHL) and 6 with Hodgkin's disease (HD) - were included. Bone marrow aspiration was performed one day prior to the initiation of the conditioning therapy. CFU-GM were cultured in methylcellulose with PHA-LCM. Delta assays of plastic adherent progenitor cells (PD) were performed according to Gordon's method. LTBMC were established for 5 weeks. RESULTS: There were fewer CFU-GM from all patient groups than from normal BM (p<0.05). In contrast, the number of immature progenitor cells (PD) was not decreased. The total number of CFU-GM produced by LTBMC patients was significantly reduced (p<0.05). The adherent layer from patients was often qualitatively different. In order to know whether the hematopoietic damage could affect hematopoietic reconstitution, we correlated culture data with time taken to reach peripheral cell counts. A negative correlation (r= - 0.71) was found between percentage of stromal layer and time taken to reach 20x10(9) platelets/L (tplat= 20x3-0.08% stromal layer). INTERPRETATION AND CONCLUSIONS: We can conclude that prior to PBSCT, hematopoietic function is impaired at both the level of committed progenitor cells and that of BM stroma. This damage could influence platelet recovery.

Adolescent↗

PubMed1998

Ethnicity, gender, and depressive symptoms in older workers.

We used data from a prospective investigation of full-time workers aged 58 to 64 years and residing in a North Carolina metropolitan area at baseline to examine a causal model for depressive symptomatology among White men, White women, African American men and African American women. We found significant group differences. (1) White men were more vulnerable to social network losses than White women; (2) Work stressors had long-term effects on African American men whose levels of depressive symptoms were also elevated by poor health and retirement; and (3) The influence of income was more dominant among African Americans and its effect was greater for African American women.

Black or African American↗

PubMed1998

New multimeric magnetic resonance imaging agents.

RATIONALE AND OBJECTIVES: The authors investigated the effect of multimerization on the relaxivity of macrocyclic gadolinium (Gd) chelates. The objective was to develop more sensitive magnetic resonance imaging (MRI) contrast agents to study biochemical processes. METHODS: Covalently linked nonionic, macrocyclic, multimeric lanthanide chelates that belong to the classes of dimers, trimers, tetramers, hexamer, and octamer, in the molecular weight range approximately 1 to 5 KDa, were synthesized. The chemical linkage was based on either the amide bond or the 2-hydroxypropylidene bond. Relaxivity values, 20r1, on Gd3+ chelates and hydration numbers, Q, on Tb3+ chelates were determined. RESULTS: Relaxivity values increased with molecular weight and Q values were not affected, the increase in r1 in attributable to the expected increase in the overall rotational correlation time, tau r with an increase in molecular weight. The rigidity of the linkers, which is expected to affect the intrachelate rotational correlation time tau r* that makes a contribution to the overall correlation time, tau r, exerted a noticeable effect. The hydroxyl-based chelates generally had lower r1 values than the amide-based chelates. This is rationalized as arising from the longer and thereby rate-limiting effect of the tau m value for the hydroxyl chelates compared with that reported of the amide-based chelates. This rate limiting effect of tau m becomes a dominant factor controlling attainable enhanced relaxivity when multimers based on traditional chelate designs are used for MRI applications. CONCLUSIONS: Approaches aimed at enhancing relaxivity by modulating the water relaxation time, tau m, will be important for the future development of functional MRI contrast agents for the imaging of biochemical processes.

Contrast Media↗

PubMed1998

The value of cell cultures for the diagnosis of mixed myelodysplastic/myeloproliferative disorders.

BACKGROUND AND OBJECTIVE: Myelodysplastic syndromes (MDS) are a group of disorders characterized by dyshematopolesis in bone marrow (BM) and peripheral blood (PB) cytopenias. In recent years particular attention has been paid to myeloproliferative disorders with dysplastic features or myelodysplastic syndromes that evolve into a myeloproliferative disorder. The present study was designed to analyze patients with MDS but with a normal or increased colony forming capacity, in order to see whether or not cell cultures could contribute to the diagnosis of intermediate MDS-MPD conditions. DESIGN AND METHODS: A total of 80 patients diagnosed as having MDS were included in the study. CFU-GM assay was performed by plating 1 x 10(5) mononuclear cells/mL in IMDM and 0.9% methyl-cellulose containing 10% PHA-LCM. In all cases cultures were run in parallel without PHA-LCM to assess autonomous growth. Cultures were incubated at 37 degrees C in a fully humidified atmosphere with 5% CO2 and scored at day 14. Cytogenetic analysis was performed according to standard procedures. Short-term cultures of 24 and/or 48 hours were used. RESULTS: Twenty-two patients out of the 80 MDS cases included in the study showed a normal or increased cell growth pattern. Among these 22 patients, eight were diagnosed as suffering from chronic myelomonocytic leukemia (CMML) according to the FAB criteria and were excluded from the present analysis. The remaining 14 cases, which constitute the body of this study, displayed an increased number of clusters and/or colonies, with an altered cluster/colony ratio (anomalous growth) in 10 cases. Autonomous colony formation was present in five of these 14 cases and autonomous cluster growth was seen in all but three of them. In addition, one patient showed endogenous BFU-E growth. Morphological diagnoses were then revised due to this aberrant colony growth pattern: based on actual criteria, 3 patients could have been considered as having a-CML (atypical chronic myeloid leukemia). Another 6 cases evolved to a more proliferative disorder: 5 to CMML, and one to a-CML. Interestingly, in 3 of these 6 patients the evolution took place concomitantly with an infectious episode. In one additional patient the platelet count increased up to 1000 x 10(9)/L and required treatment with hydroxyurea. INTERPRETATION AND CONCLUSIONS: Our results show that intermediate MDS-MPD cases are relatively common and that in vitro characteristics, i.e. high clonogenic capacity with a high cluster/colony ratio and scanty autonomous growth, in patients showing myelodysplastic features could contribute to an early diagnosis in these cases. It is possible that in some cases an infectious episode, through higher cytokine secretion, contributes to the development of these disorders.

Adult↗

PubMed1997

Self-esteem and subjective responses to work among mature workers: similarities and differences by gender.

This study addressed three questions that underlie the experiences of middle-aged working individuals: (1) What factors influence workers' quality of time spent at work, their feelings of competence as a worker, and their satisfaction with work? (2) What is the impact of subjective responses to work on self-esteem? and (3) What effect does gender have on subjective responses and self-esteem? These data are derived from an ongoing study of full-time working men and women (N = 770). Subjective responses to work are affected by poor health. Quality of time at work (meaningful, not boring), job satisfaction, and an identity as a competent worker are associated with self-esteem. Self-esteem was higher among women in highly autonomous jobs, and nonmarried women had higher self-esteem than others. The strongest effect on self-esteem was that of feeling competent as a worker. Positive perceptions of work increased self-esteem, facilitating the transition into retirement.

Employment↗

PubMed1996

Preretirement influences on postretirement self-esteem.

Data derived from in-depth telephone interviews with 300 retired workers from the Raleigh-Durham-Chapel Hill, North Carolina, metropolitan area are used to investigate whether preretirement self-investments in the roles of worker and spouse have positive or negative consequences for postretirement self-esteem. We find evidence that suggests that: (a) self-esteem does not decline in the transition into retirement; (b) commitment to the role of worker and worker identity meanings have a positive influence on postretirement self-esteem; but it may be indirect, operating through preretirement self-esteem; (c) commitment to the role of spouse has a positive impact on self-esteem in retirement; and (d) preretirement self-esteem continues to exert a positive effect on postretirement self-esteem. Thus, the findings suggest that preretirement self and identity factors continue to influence postretirement self-esteem.

Aged↗

PubMed1996

Does retirement hurt well-being? Factors influencing self-esteem and depression among retirees and workers.

A set of older workers from the Raleigh-Durham-Chapel Hill metropolitan area were followed for two years in order to explore the social psychological consequences of retirement. Three findings are of particular interest. First, when we separated workers who retired from those who continued to work and compared their self-esteem and depression scores over the two-year interval, we found that self-esteem scores did not change for either group, but that depression scores declined for workers who retired. Turning to differences between retirees and those who continued to work, regression analyses revealed that retirement had a positive influence on self-esteem and a negative influence on depression. In addition, earlier worker identity meanings had a stronger negative effect on the depression scores of respondents who continued to work than on those who retired.

Aged↗

PubMed1995

Social support, depression, and recovery of walking ability following hip fracture surgery.

The importance of social support and depression to recovery from illness is examined with reference to hip fracture. Subjects were community-dwelling, ambulatory White females 59 years of age and over who were recovering from hip fracture surgery. The respondents were interviewed at baseline and clinically interviewed 2 and 6 months postsurgery. Inadequacy of social support and depression resulted in less improvement in walking ability at 2 months. By 6 months, the flow of casual influence was in the reverse direction, with low improvement in walking ability leading to increased level of depression. Social support's influence mediated the impact of health and background factors, but this was primarily at 2 months. If social support is to influence recovery, it must be present early in the recovery process. Social support's long-term consequences are indirectly operating through recovery measures taken shortly after the illness event.

Age Factors↗

PubMed1994

Detection of postoperative sepsis in infants with the use of metabolic stress monitoring.

OBJECTIVES: To evaluate the ability of serial protein metabolic monitoring to detect postoperative injury due to serious bacterial infection in infants by comparing changes observed in these protein parameters with more conventionally accepted indexes of infection. DESIGN: Retrospective review of infants whose postoperative course was complicated by bacterial infection compared with a matched cohort of infants in whom bacterial infection did not develop postoperatively. SETTING: Neonatal and pediatric intensive care units at the Wake Forest University Medical Center, Winston-Salem, NC. PATIENTS: Critically ill infants (N = 40) recovering from major surgical intervention. MAIN OUTCOME MEASURES: Serum C-reactive protein, prealbumin, and tumor necrosis factor concentrations were compared with the white blood cell count, immature-total neutrophil ratio, and body temperature obtained within 24 hours before and following the new onset of culture-established postoperative bacterial infection in 13 infants. These infants were compared with a matched cohort of 27 infants in whom postoperative bacterial infection did not develop. RESULTS: Only C-reactive protein (P = .0001) and prealbumin (P = .0003) levels were significantly altered in association with the onset of serious bacterial infection (paired t test). The C-reactive protein levels were clearly superior to all other variables in predicting postoperative infection (at cutoff point > 6.0 mg/dL; sensitivity, 92%; specificity, 96%). The predictive power of prealbumin level was lower, but acceptable (at cutoff point < or = 9.0 mg/dL; sensitivity, 85%; specificity, 74%). CONCLUSIONS: Monitoring of serial protein metabolic stress with C-reactive protein and prealbumin levels in infants following operations is more effective than the white blood cell count, immature-total neutrophil ratio, or temperature in detecting serious postoperative infections.

Bacterial Infections↗

PubMed1993

Relationship of metabolic indexes to postoperative mortality in surgical infants.

Acute injury is known to evoke a metabolic stress response, characterized by cytokine release and reprioritization of hepatic protein synthesis to increase acute phase proteins at the expense of visceral proteins. The impact of these evolving, stress-induced, perioperative metabolic changes on clinical outcome in surgical infants has not yet been determined. The cytokine (tumor necrosis factor [TNF]), acute phase protein (C-reactive protein [CRP]), and visceral protein (prealbumin [PA]) responses to acute metabolic stress were evaluated in 41 infants (average age, 47 days) preoperatively and on postoperative days 1 through 7 (POD 1 to 7) following major surgery. Infants were retrospectively grouped according to whether they survived (group 1) or died within 30 days of surgery (group 2). Peak CRP values in the postoperative period were also included for both groups. Peak CRP levels (14.9 +/- 5.5 v 8.1 +/- 5.7 mg/dL) were significantly increased (P = .0056) and preoperative prealbumin levels (6.0 +/- 2.7 v 11.0 +/- 5.2 mg/dL) were significantly decreased (P = .0005) in group 2 (nonsurvivors) compared with group 1 (survivors). Though serum TNF levels were substantially increased in nonsurvivors compared with survivors, both preoperatively (16.5 +/- 35.2 v 0.6 +/- 2.6 pg/mL) and on POD 1 (3.6 +/- 6.8 v 0.6 +/- 2.7 pg/mL), these values did not reach statistical significance (P > .05). The most significant difference (P = .0001) was observed in persistently depressed late (POD 4 to 7) prealbumin levels in nonsurvivors relative to survivors (5.3 +/- 3.1 v 10.5 +/- 4.3 mg/dL), suggesting an increased risk of poor outcome if acute metabolic stress had not abated by this time.(ABSTRACT TRUNCATED AT 250 WORDS)

C-Reactive Protein↗

PubMed1993

Breast-feeding patterns in the Philippines: a prospective analysis.

Data from the Cebu Longitudinal Health and Nutrition Survey have been used to examine breast-feeding patterns in the Metropolitan Cebu region of the Philippines. The results show that there is extensive and early use of non-nutritive liquids, resulting in low levels of exclusive breast-feeding. The use of cross-sectional versus longitudinal data, the definition of exclusive breast-feeding, and movements in and out of the exclusively breast-fed category, are considered.

Adolescent↗

PubMed1992

Serum visceral protein levels reflect protein-calorie repletion in neonates recovering from major surgery.

Protein catabolism resulting from acute metabolic stress causes significant postoperative decreases in visceral proteins, including albumin (Alb) and prealbumin (PA). Although clinical trials have suggested an advantage of PA over Alb in monitoring the visceral protein response to nutritional supplementation following surgery, the capability of the neonate to generate such a response has yet to be evaluated. Therefore, this study was undertaken to determine if PA is superior to Alb in assessing postoperative repletion of the visceral protein pool in neonates. Serum Alb and PA levels were measured and energy balance (EB) and protein intake (PI) were recorded in 10 neonates less than 48 hours after major surgery and again following 4 consecutive days of positive EB. Resting energy expenditure (REE) was measured using indirect calorimetric methodology. Mean PI (g/kg/d) was lower (0.78 +/- 0.78) and mean EB (kcal/kg/d) was negative (-2.92 +/- 10.05) less than 48 hours postoperatively compared with mean PI (2.52 +/- 0.57; P = .0006) after 4 consecutive days of positive EB (34.84 +/- 16.5; P = .0004). Mean percent change (mean% delta) from negative EB to positive EB was significantly greater for PA (100%; P = .0002) as compared with Alb (18.5%). These data appear to support the conclusion that serial serum PA levels are superior to Alb to monitor the visceral protein response to nutritional supplementation in neonates following surgery.

Energy Intake↗

PubMed1991

Use of plasmid profiles in the investigation of a patient with Helicobacter pylori infection and peptic ulcer disease.

Plasmids may effect bacterial virulence and antibiotic resistance, and serve as epidemiologic markers. In this study, plasmid DNA profiles of serial isolates of Helicobacter pylori showed persistence of an identical strain of this organism in a patient with duodenal ulcer disease. Three control strains of H. pylori isolated from other patients contained plasmids different from each other and from that of the original patient; two of these strains had two plasmids each. These data have important implications for further study of the epidemiology and pathogenesis of H. pylori-related diseases.

DNA, Bacterial↗

PubMed1990

Immunoglobulin V regions of a bactericidal anti-Neisseria meningitidis outer membrane protein monoclonal antibody.

C6 is a potentially therapeutic murine monoclonal antibody that recognizes the class 1 outer membrane protein of Neisseria meningitidis. C6 specifically immunoblots this antigen and augments in vitro killing of N. meningitidis bacteria. We describe a general method of obtaining the heavy and light chain variable-region sequence from immunoglobulin-secreting cells. The method uses mixed polymerase chain reaction (PCR) primers designed from the 5' end of the framework 1 (FR1) sequences of the heavy and light chains, and 3'-end primers for constant-region conserved sequences. The method has been applied to the cloning and sequencing of the variable region of C6 to construct a humanized monoclonal antibody. Rapid amplification and sequencing of variable regions by this general method have multiple applications in the study of the immune response to infectious diseases.

Amino Acid Sequence↗

PubMed1990

Infant formula promotion and the health sector in the Philippines.

We use data collected in 1984, 1986, and 1988 from public and private health facilities in the Metropolitan Cebu area of the Philippines to assess effects of World Health Organization and Government of the Philippines Codes of Marketing of Breast Milk Substitutes on distribution of formula supplies. Distribution of free and low-cost infant formula declined drastically between 1986 and 1988. Industry compliance was almost complete.

Breast Feeding↗