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Biomedical subjects

M García

Publications and source records attributed to M García.

At least 91 records · Page 5Linked to original sources

Identification of two subgroups of mantle cell leukemia with distinct clinical and biological features.

INTRODUCTION: Mantle cell leukemia (MCLeu) has been considered as a leukemic form of mantle cell lymphoma (MCL). However, the presence of certain features rarely observed in MCL, such as transformation to prolymphocytic leukemia (PLL) or indolent clinical course, suggests that MCLeu may represent a distinct disorder. METHODS: Seven cases of MCLeu with t(11;14)(q13;q32) and BCL1-IGH gene rearrangement were ascertained among 140 newly diagnosed chronic B-cell lymphoproliferative disorders with leukemic expression. Comparative genomic hybridization, FISH for specific gene loci, and immunological studies were preformed in them. RESULTS: In comparison with CLL, MCLeu cases had low immunological scores < or =2 with respect to B-CLL (P<0.0001). Expression of CD38 was absent in 43% of MCLeu and in 44% of B-CLL. Comparative genomic hybridization analysis identified genomic imbalances in 86% of MCLeu with a similar pattern than in MCL: gains of 3q, 8q involving MYC gene and 15q, and losses of 6q, 9p, 13q and 17p affecting P53 gene. Differently from MCL and CLL, genomic loss of 8p was frequently detected in MCLeu (83%). Although clinical presentation of MCLeu was indistinguishable from CLL, all patients but one had disease progression within three years. According to the immunologic and genomic profiles, two distinct subgroups of MCLeu were defined: one related to PLL, showing CD38-, deletion of P53, and MYC amplification and another which corresponds to a leukemic form of classical MCL, presenting with CD38+ and normal P53 and MYC status. CONCLUSION: MCLeu and MCL are closely related disorders, as they show similar genomic and molecular patterns. However, the deletion of the short arm of chromosome 8 may represent a specific marker for MCLeu. Two distinct subgroups of MCLeu may also be distinguished according to the immunologic and genomic cell profiles.

ADP-ribosyl Cyclase↗

Characteristics of nitric oxide-induced apoptosis and its target cells in mitogen-stimulated peripheral blood mononuclear cells from HIV+ subjects.

The phenomenon of apoptosis observed in lymphoid cells from HIV+ subjects is an important factor contributing to their massive depletion. Several studies have identified nitric oxide (NO) as one of the molecules involved in the apoptosis phenomenon observed during HIV infection. It has been shown that HIV-derived gp120 enhances NO synthesis in cultured cells from HIV+ individuals. Therefore, we tested the potential of two nitric oxide synthase (NOS) inhibitors with different mechanisms of action as preventive agents of in vitro apoptosis, in peripheral blood mononuclear cells (PBMC) from HIV+ subjects. PBMC isolated from these patients always showed higher apoptosis levels than normal subjects, a fact that correlated with overproduction of NO and with reduction of mitochondrial transmembrane potential in these cells. We identified the CD8+ T lymphocyte sub-population as the major apoptosis target in PBMC cultures. Treatment with NO inhibitors N(G)-monomethyl-L-arginine (L-NMMA) and dexamethasone (DEX) inhibited spontaneous and mitogen-induced apoptosis, while reducing mitochondrial alterations in PBMC from both normal (30%) and HIV+ (70%) subjects. The development of apoptosis in target cells correlated with their mitochondrial transmembrane potential impairment and with increased expression of Fas (CD95) molecules. These results offer additional alternatives for the manipulation of cellular depletion in HIV disease.

Apoptosis↗

Molecular variability of the adhesin-encoding gene pvpA among Mycoplasma gallisepticum strains and its application in diagnosis.

Mycoplasma gallisepticum is an important pathogen of chickens and turkeys that causes considerable economic losses to the poultry industry worldwide. The reemergence of M. gallisepticum outbreaks among poultry, the increased use of live M. gallisepticum vaccines, and the detection of M. gallisepticum in game and free-flying song birds has strengthened the need for molecular diagnostic and strain differentiation tests. Molecular techniques, including restriction fragment length polymorphism of genomic DNA (RFLP) and PCR-based random amplification of polymorphic DNA (RAPD), have already been utilized as powerful tools to detect intraspecies variation. However, certain intrinsic drawbacks constrain the application of these methods. The main goal of this study was to determine the feasibility of using an M. gallisepticum-specific gene encoding a phase-variable putative adhesin protein (PvpA) as the target for molecular typing. This was accomplished using a pvpA PCR-RFLP assay. Size variations among PCR products and nucleotide divergence of the C-terminus-encoding region of the pvpA gene were the basis for strain differentiation. This method can be used for rapid differentiation of vaccine strains from field isolates by amplification directly from clinical samples without the need for isolation by culture. Moreover, molecular epidemiology of M. gallisepticum outbreaks can be performed using RFLP and/or sequence analysis of the pvpA gene.

Adhesins, Bacterial↗

Allergy to dermatophagoides in a group of Spanish gypsies: genetic restrictions.

BACKGROUND: Spanish gypsies have traditionally lived as nomads, a reason why few epidemiological studies were done in this ethnic group. However, the high prevalence of asthmatic diseases demonstrated in a population residing in the North of Spain induces us to analyse whether it was due to the influence of genetic loci previously implicated in other population studies as causing the disorders. METHODS: DRB1* and DQB1* HLA class II, TCR-Valpha8.1, FcepsilonRI-beta Rsa I exon 7 and intron 2, TNF-beta (LTalpha-Nco I) and CD14, were tested for association with asthma and atopy by multiple regression analysis, in 5 families comprising 87 individuals. RESULTS: Significant associations were found with DQB1*02 (p = 0.02) and DQB1*0301 (p = 0.008) and elevated levels of total serum IgE. A negative association (p = 0.02) was found between total serum IgE and DRB1*14. FcepsilonRI-beta Rsa I-In2 allele 1 was associated with high levels of total serum IgE (p = 0.04). Levels of Der p 1 IgE antibodies were negatively associated with DRB1*11-DQB1*0301 (p = 0.007), and positively with TCR Valpha-8 allele 1 (p = 0.04) and with FcepsilonRI-beta Rsa I-In2 allele 1 (p = 0.009). CONCLUSIONS: Our results do not show any association between asthma and the genetic loci studied although they do suggest the existence of multiple genetic influences on the allergic response in these families.

Adult↗

Assessment of hospital costs related to the diagnosis and treatment of upper gastrointestinal haemorrhages in patients consuming non steroid anti-inflammatory drugs.

BACKGROUND: Non-steroid anti-inflammatory drugs (NSAIDs) can produce haemorrhages of the digestive tract, whose treatment result in significant hospital costs. OBJECTIVE: The aim of this analysis has been to estimate hospital costs related to the treatment of digestive haemorrhages potentially caused by the intake of NSAIDs. MATERIAL AND METHODS: The study was conducted by reviewing the clinical history of all patients admitted in two tertiary Spanish hospitals during 1998 due to digestive haemorrhage following NSAID treatment. After the identification of cases, all resources consumed during their hospitalisation (concomitant medication, complementary examinations and tests, surgery, blood products consumption, inpatient consultations and length of stay in the hospital) until the complete resolution of each case, were recorded. RESULTS: Thirty-six percent of patients admitted due to digestive haemorrhage had taken some NSAID the same day of their hospitalisation (85.4%) or in previous days. The cost related to the treatment of these patients amounted to some 71 million pesetas for both hospitals, with a cost/patient of 434,407 pesetas. CONCLUSIONS: Given the high consumption of NSAIDs in our normal clinical setting, costs related to the diagnosis and treatment of digestive haemorrhages in hospitals are a highly significant burden for the National Health System.

Adolescent↗

[CD44 (HCAM) expression in subserous gallbladder carcinoma].

BACKGROUND: HCAM or CD44 is a multifunctional cell adhesion molecule, related to cell-cell, cell-extracellular matrix interactions and involved in tumor invasion. AIM: To study the importance of CD44 expression in subserous gallbladder carcinoma. MATERIAL AND METHODS: One hundred five samples (93 female) of subserous gallbladder carcinoma and 33 non tumoral gallbladder were studied. CD44 was stained using the streptavidine-biotin technique, using human anti CD44 antibodies. Eighty subjects with carcinoma were followed for a period up to 105 months. RESULTS: Mean age of patients was 62.6 years old, all tumors were adenocarcinoma, all were silent and 13% were well differentiated. CD44 was expressed in all controls and in 91%, the expression was normal. In 57% of cancer samples, CD44 expression was abnormal, in 50% it was less expressed and in 24%, it was not expressed. No differences in CD44 expression was observed between mucosa from control samples and mucosa adjacent to the tumor or superficial or deep tumoral areas. Global five years survival was 40%. No significant differences in survival were observed in those tumors with a lower of absent CD44 expression. Six patients with a higher expression died before 18 months of follow up. CONCLUSIONS: Nearly 50% of subserous gallbladder carcinomas show an abnormal CD44 expression.

Adenocarcinoma↗

[Severe gastrointestinal complications potentially associated with the use of non-steroidal anti-inflammatory agents: hospital treatment costs for the National Health System of our country].

BACKGROUND: Non-steroidal antiinflammatory drugs (NSAIDs) produce severe gastrointestinal (G-I) complications in 1-4% of cases which need to be treated into the hospital. The aim of this study has been to assess the hospital cost secondary to treat these complications in our National Health Service (NHS). MATERIAL AND METHODS: In the first phase a cross-sectional study was performed in order to know the number of patients who were hospitalized due to a severe G-I complication during 1998 in two tertiary hospital in our country. It was reviewed their clinical charts to know whether they had taken any NSAIDs. In those positive cases all resources used during the hospitalization were collected. RESULTS: In both hospitals studied 38.1% of hospitalized patients for a severe G-I complication had taken any NSAIDs during the same day or previous days. The cost/patient was of 389,831 pesetas. During 1998 in the whole NHS there were 54,623 hospitalizations owing to the same reason. Assuming that 38.1% of them had also taken any NSAIDs, 20,811 patients would have suffered a severe G-I complication potentially due to the intake of NSAIDs. Extrapolating the cost/patient obtained in both hospitals to the global number of patients hospitalized into the NHS, the cost of treating all severe G-I complications related to the consumption of NSAIDs during 1998 was of 8,112 millions pesetas. CONCLUSIONS: Bearing in mind the elevated prevalence of osteo-articular pathology in our country and the high consumption of NSAIDs for its treatment, the coming of new therapeutic options with a better safety profile would mean an important resources' saving for our NHS.

Anti-Inflammatory Agents, Non-Steroidal↗

Evaluating changes in health status in HIV-infected patients: Medical Outcomes Study-HIV and Multidimensional Quality of Life-HIV quality of life questionnaires. Spanish MOS-HIV and MQOL-HIV Validation Group.

OBJECTIVE: To compare the sensitivity to change of two HIV-health-related quality of life (HRQoL) questionnaires--the Medical Outcomes Study (MOS-HIV) and Multidimensional Quality of Life (MQOL-HIV) for use in clinical research. METHODS: A sample of 296 HIV-infected patients starting or switching antiretroviral treatment were randomly assigned either the MOS-HIV or MQOL-HIV questionnaires at baseline and after 3 months of treatment. Ceiling and floor effects were evaluated. Sensitivity to change was assessed by comparing the percentage of dimensions with statistically significant pre-post-treatment changes and the effect sizes in those groups of patients who reported improvement and no change in self-report questions (overall, physical, mental and social health status) and clinical characteristics (number of opportunistic infections, number of symptoms, viral load level and CD4+ count). RESULTS: Ceiling effects were found in HRQoL scores at baseline and after 3 months of treatment in Pain (42.3-41.6%), Role Function (73.1-77.6%) and Social Function (60.9-63%) on MOS-HIV subscales, and in Social Support (38.2-37.6%) and Partner Intimacy (38.2-33.7%) on MQOL-HIV. For patients who improved in self-reported and objective clinical indicators of health status, mean percentage of dimensions with statistically significant pre-post-treatment changes was 86.4% on MOS-HIV and 50% on MQOL-HIV, where mean standardized effect size was 0.45 on MOS-HIV and 0.33 on MQOL-HIV for the total of dimensions. CONCLUSIONS: Based on sensitivity to change the results suggest that for 3 months both questionnaires can be used, but the MOS-HIV is more sensitive than the MQOL-HIV for use in clinical research.

Adolescent↗

[Inequalities in health according to social class in Catalonia, 1994].

OBJECTIVE: To study social inequalities in health in Catalonia. DESIGN: Cross-sectional survey of a representative sample of the population of Catalonia, Spain (Catalan Health Interview Survey, 1994). PARTICIPANTS: Responses from 5641 males and 6604 women aged 15 years or over were included for analysis. MEASUREMENTS AND MAIN RESULTS: We analysed the information about self-perceived health, restriction of activity, and presence of chronic conditions according to social class by means of logistic regression models. The proportion of subjects that rated their health as fair or poor was higher in social classes IV-V than in classes I-II (men: 25.0% vs. 14.5%; OR, 1.8, 95% CI, 1.5-2.3; women: 34.4% vs. 21.5%; OR, 1.7, 95% CI, 1.4-2.1). There were differences by social class in respect to restriction of activity and presence of chronic conditions. CONCLUSIONS: Despite the decrease of social inequalities in accesibility and use of health services due to the universalisation of health coverage, differences by social class remain in the perception of health status. These inequalities should be addressed by the health system within the framework of broad public and social policies.

Adolescent↗

[Cancer mortality in Spain, 1955-1994].

BACKGROUND: To analyze the mortality from the eight main cancer sites in men and women from Spain between 1955-1994. MATERIAL AND METHODS: Age-standardized mortality rates were computed. RESULTS: In men, an increase in lung cancer mortality as well as in the other 8 sites was registered, except for stomach cancer. In women, breast, ovary, and pancreas cancer mortality continue to increase. CONCLUSIONS: Cancer mortality in Spain has dismal trends. This fact implies the need of strong interventions.

Adult↗