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M L Sánchez

Publications and source records attributed to M L Sánchez.

At least 19 recordsLinked to original sources
PubMed2007

Ground laser remote sensing measurements of a Saharan dust outbreak in Central Spain. Influence on PM10 concentrations in the lower and upper Spanish plateaus.

This paper presents the hourly evolution of a severe Saharan dust outbreak, (SDO), affecting Central Spain over July 23-24, 2004 measured with a laser remote sensing device at a location close to the Guadarrama mountain range foothills and its impact on PM10 levels (particles with an aerodynamic diameter below 10 microm) recorded at four contrasting monitoring stations located in the upper and lower Spanish plateau, some 170km apart. During the period of study the Saharan dust layer, (SDL), presented significant hourly variability in height (3600-1500m), depth (1500-700m) and aerosol dust loading (extinction coefficient, EC, 0.22-1.28km(-1)). Overnight layering was generally observed whereas a well mixed layer prevailed in the afternoon. The (SDO) impact on the lower levels took place approximately 12h after the (SDL) was initially observed and triggered by a descending dust enriched, evidencing the important role of subsidence over the presence of dust in lower altitudes. During the event, PM10 levels at all the stations exceeded EU air quality daily mean standards, 50 microgm(-3), on 2-4days. The maximum values ranged from 185 to 245 microgm(-3) depending on the monitoring station. The impact on PM10 spread from 2days in the upper plateau to 3-4 in the lower plateau, in agreement with the geographical location of the monitoring stations with respect to the southwest origin of the intrusion. The impact was even more dramatic on PM10 hourly concentrations, leading to maximum hourly peaks ranging from 322 to 598 microgm(-3) again depending on the monitoring station. Correlations between EC vertical profiles and PM10 hourly concentrations at the monitoring stations showed the great influence of the (SDO) on surface concentrations. The best linear fits corresponded to the extinction coefficients in the lower altitudes (close to the lower range of the device 500-650m), EC2, yielding satisfactory correlation coefficients ranging from 0.68 to 0.71. The low variability of the slope of each individual linear fit, 19.2%, shows the similar impact of (SDO) on the PM10 hourly concentrations recorded in the area under study.

Air Movements↗
PubMed2005

Ground level ozone concentrations at a rural location in northern Spain.

A systematic analysis of surface ozone observations at a rural area of the upper Spanish plateau is presented. A near four-year study of ozone concentrations was carried out between February 2000 and October 2003. Diurnal and monthly variations of ozone are studied. The peak concentration levels are obtained between 13:00 and 15:00 GMT and the lowest levels at 4:00 and 5:00 GMT. The highest values together with a slight increase in data variability are found from April to August, when spring and summer maxima are appreciated. The relationship between synoptic-scale atmospheric transport patterns and the maximum ozone concentrations was also examined. Analysis of the 500-hPa synoptic weather patterns revealed that the highest values occur during continental and Atlantic ridges in summer and, to a lesser extent, during troughs in the east-northeast of the Iberian Peninsula in spring. Our approach entailed calculating 3-day isobaric backward air mass trajectories at the observational site sorted on the following main origins: European continent, African continent, Atlantic Ocean and local. The assessment of the results showed the influence of local conditions on the daily maximum ozone concentrations. Moreover, continental air masses provide certain evidence of long-range transport added to the local or regional contribution of the main cities affecting the sampling site. Conversely, Atlantic trajectories show the least contribution to ozone levels.

Air Movements↗
PubMed2005

Ozone concentrations at a high altitude station in the Central Massif (Spain).

In order to contribute to current knowledge of ozone concentrations and transport across the Central Massif, a monitoring station was installed at 1780 m on the upper Spanish plateau about 55 km from the city of Madrid. Ozone concentrations and standard meteorological variables were measured in June and July 2002. A smoothed ozone hourly cycle was obtained with mean values of 120 and 110 microgm(-3) during day-time and night-time, respectively. The highest ozone concentrations were recorded in the SE-S-SW wind sectors, proving the influence of transport from the Madrid urban plume to the upper plateau. This assumption was also supported by the satisfactory correlation between ozone peaks obtained at the monitoring site and those recorded in a representative station on the foothill located on the lower plateau during episodic situations. To assess the contribution of long-range transport, backward air mass trajectories were computed each day of measurements at 820 hPa. The lowest ozone mean was linked to Atlantic Ocean air masses, and the highest to air masses from Central Europe.

Air Movements↗
PubMed2003

Immunophenotypic analysis of Waldenstrom's macroglobulinemia.

Immunophenotyping has become an essential tool for diagnosis of hematological malignancies. By contrast, for diagnosis of Waldenstrom's macroglobulinemia (WM) immunophenotyping is used only occasionally. From 150 patients with a IgM monoclonal gammopathy we have selected 60 cases with (1) morphological lymphoplasmocytoid bone marrow (BM) infiltration (>20%); (2) IgM paraprotein (>10g/L); and (3) absence of features of other lymphoma types. Immunophenotypic analysis was based on the use of the triple or quadruple monoclonal antibody (MoAb) combinations. To increase the sensitivity of the analysis of antigen expression, selected CD19(+)CD20(+) B cells were targeted. We have also explored the antigenic characteristics of both the plasma cell (PC) and mast cell (MC) compartments present in the BM from 15 WM patients. Clonal WM lymphocytes were characterized by the constant expression of pan-B markers (CD19, CD20, CD22, CD24) together with sIg, predominantly kappa (5:1, kappa:lambda ratio). A high proportion of cases (75%) were positive for FMC7 and CD25, but in contrast to hairy cell leukemia (HCL), these lymphocytes were always negative for CD103 and CD11c. CD10 antigen was also absent in all WM patients and less than one fifth of patients were positive for CD5 and CD23, while CD27, CD45RA, and BCL-2 were present in most malignant cells. In two cases, the coexistence of two different clones of B lymphocytes was identified, and in eight additional cases, intraclonal phenotypic heterogeneity was observed. As far as PCs are concerned, in most patients (85%) the number of PCs was within the normal range (median, 0.36%). The antigenic profile of these PCs differed from that observed in normal and myelomatous PC (CD38(++)CD19(++/-)CD56(-)CD45(++)CD20(+)). In three cases, PCs showed aberrant expression for CD5, CD22, or FMC7. Finally, the number of mast cells was significantly higher (0.058 +/- 0.13) as compared to normal BM (0.019 +/- 0.02) (P <.01), although they were immunophenotypically normal (CD117(+)CD2(-)CD25(-)).

Bone Marrow Cells↗
PubMed2002

Soil CO2 fluxes in cereal land use of the Spanish plateau: influence of conventional and reduced tillage practices.

From November 1998 to October 2000, measurements of soil respiration were performed on the Spanish plateau for two patches of non-irrigated barley, one managed with conventional tillage (CT) and the other with reduced tillage (RT). Soil CO2 flux showed seasonal variation on both patches, with an increase from March to October, peaking in May, and a decrease during the winter period by a factor of around 2. The mean value for both combined years was 2.03 and 1.70 micromol m(-2) S(-1), in the CT and RT patches, respectively. In order to analyse the influence of RT on soil CO2 flux, two tests were performed. The first one was the Kruskal-Wallis test to compare whether the differences between the medians in both patches were statistically significant. The results obtained revealed statistically significant differences during the second year, at a 85% and 95% significance level, use being made of annual data and that recorded during the period of maximum interest, March-October, respectively. The decrease in soil respiration in the RT patch was around 24%. The second test was aimed at describing and comparing the influence of soil temperature on soil CO2 flux. By using the data of both patches recorded during the first year, an empirical equation on 10-cm soil temperature was fitted and tested on the data corresponding to the second year in each of the patches. Then, a comparison between the medians of the differences between the estimated and observed values was again performed by means of the Kruskal-Wallis test. The over-prediction of the model in the RT patch, statistically significant at a 90% significance level, was roughly 23%, confirming again the decrease in soil respiration one year after this agricultural management practice had been implemented.

Agriculture↗
PubMed2002

Incidence of phenotypic aberrations in a series of 467 patients with B chronic lymphoproliferative disorders: basis for the design of specific four-color stainings to be used for minimal residual disease investigation.

Multiparameter immunophenotypic analysis of neoplastic cells has proven to be of great help for the investigation of minimal residual disease in acute leukemias; however, its utility has not been systematically explored in B cell chronic lymphoproliferative disorders. The aim of the present study was to investigate the incidence of phenotypic aberrations in a series of 467 consecutive leukemic B cell chronic lymphoproliferative disorders through the comparison of the phenotypic characteristics of tumor vs normal peripheral blood (n = 10) and bone marrow (n = 10) B cells, in order to explore the applicability of this strategy for minimal residual disease monitoring. An additional goal of our study was to evaluate the sensitivity of multiparameter flow cytometry for the detection of minimal residual disease in leukemic B cell chronic lymphoproliferative disorders through dilutional experiments (n = 19). From the patients analyzed 382 corresponded to B cell chronic lymphocytic leukemia/small lymphocytic lymphoma (353 typical and 29 atypical); five to prolymphocytic leukemia; 13 to hairy cell leukemias; 12 to lymphoplasmacytic lymphomas; 14 to splenic marginal zone lymphomas; 22 were follicular lymphomas; and 19 mantle cell lymphomas. The following triple stainings were systematically applied to both normal and leukemic samples: FMC7/CD5/CD19, CD22/CD23/CD19, CD103/CD25/CD19, CD10/CD11c/CD19 and sIg/sIg(lambda)/CD19. Overall, 98% of the leukemic B cell chronic lymphoproliferative disorders cases displayed aberrant phenotypes at diagnosis with no significant differences being found between cases analyzed in peripheral blood vs bone marrow samples. The most common types of aberrant criteria detected included asynchronous antigen expression (92%) and antigen over-expression (54%); abnormally light scatter characteristics were found in 17% of the cases. Most of the cases studied (90%) displayed four or more phenotypic aberrations. Once patients were divided according to the different diagnostic subgroups, the overall incidence of aberrant phenotypes ranged from 79 to 80% among atypical B cell chronic lymphocytic leukemia/small lymphocytic lymphoma and prolymphocytic leukemia to 97% of follicular lymphoma and 100% of typical B cell chronic lymphocytic leukemia/small lymphocytic lymphoma, hairy cell leukemia, lymphoplasmacytic lymphomas, splenic marginal zone lymphomas and mantle cell lymphomas. Based on the aberrant phenotypes detected unique four-color stainings could be built for the specific identification of aberrant phenotypes. These include CD22/CD23/CD19/CD5 and sIg(kappa)/sIg(lambda)/CD19/CD5 for lymphocytic leukemia/small lymphocytic lymphoma and prolymphocytic leukemia, CD103/CD25 or CD22/CD19/CD11c for hairy cell leukemia, FMC7/CD22/CD19/CD103 and sIg(kappa)/sIg(lambda)/CD22/CD19 for splenic marginal zone lymphomas, CD22/CD23/CD19/CD10 for follicular lymphomas and CD10/CD22/CD19/CD5 for mantle cell lymphomas. Serial dilutional experiments showed that the sensitivity level of immunophenotyping ranges between 10(-4) and 10(-5). In summary, the present study shows that immunophenotypic analysis allows the identification of aberrant phenotypes in 98% of leukemic B cell chronic lymphoproliferative disorders and these phenotypes can be used for minimal residual disease monitoring with a sensitivity limit of 10(-4)-10(-5).

Antibodies, Monoclonal↗
PubMed2001

Flow cytometric analysis of cytokine production by normal human peripheral blood dendritic cells and monocytes: comparative analysis of different stimuli, secretion-blocking agents and incubation periods.

In this paper, we comparatively analyze the effects of the following different stimuli on the production and intracellular accumulation of the interleukin (IL)-1 beta, IL-6, IL-12, tumor necrosis factor-alpha (TNF-alpha), and IL-8 inflammatory cytokines in both normal human peripheral blood (PB) dendritic cell (DC) subsets and monocytes: lipopolysaccharide (LPS) versus Staphylococcus aureus cowan I (SAC) in the presence or absence of interferon-(IFN)-gamma-, cytokine secretion-blocking agents (brefeldin A alone versus brefeldin A plus monensin), and incubation periods (6, 12, and 24 h). For this purpose, a four-color multiple-staining direct immunofluorescence technique analyzed by flow cytometry was systematically used in all experiments (n = 19). Our results show that after stimulation, an important proportion of each of the two CD33(+) myeloid DC subsets as well as the monocytes produce significant amounts of all cytokines analyzed under each of the experimental conditions assayed. In contrast, CD33(-/+lo) lymphoplasmocytoid DC failed to produce detectable levels of any of the above-mentioned cytokines under the same stimulatory conditions. Upon comparing the different stimuli used, LPS was associated with higher percentages of cytokine-producing cells compared with SAC, especially within the CD33(hi) DC subset; interestingly, the addition of IFN-gamma enhanced the response of monocytes to both LPS and SAC. As regards the secretion-blocking agents, brefeldin A alone was superior to the combination of brefeldin A and monensin. This is because it was frequently associated with both a higher percentage of cytokine-positive cells and greater amounts of detectable cytokines per cell. Sequential analysis of cytokine production by PB DC and monocytes after 6, 12, and 24 h of cell culture showed that after 6 h, an increased cell death rate existed among DC, which became even undetectable at 24 h, in the absence of a significant increase in cytokine secretion. In summary, our results show that from the experimental conditions assayed in this paper, to induce cytokine production by normal human DC and monocytes, maximum response is obtained once PB samples are stimulated for 6 h with LPS (with or without IFN-gamma) in the presence of brefeldin A alone.

Adolescent↗
PubMed2000

Aerosols in a Mediterranean forest: sulfates, particle size distribution, and growth rates.

Particle size distribution measurements in 16 nonlinear intervals covering the 0.1-7.5 microns range and concurrent sulfate concentrations were continuously recorded in September 1996 over the period of two weeks in a Mediterranean forest. Sulfate size distribution was derived from a linear correlation fit between the concentrations and the number of particles recorded at each particle size interval. The results revealed two modal diameters for sulfates, with typical diameters at 0.3 and 0.675 micron. These results were associated with two different dominant chemical mechanisms governing sulfate formation. In order to describe the dominant chemical mechanism, the growth law approach was applied. Growth rates were determined using the parameter estimates of the fitted particle size distribution function. By matching these data with sulfate concentrations, the dominant chemical reactions were identified. The results have shown that sulfate formation is governed by both homogeneous and heterogeneous reactions and that the latter process was dominant. Condensation reactions prevailed in the early morning and late afternoon, and volume reactions at night, particularly in high-moisture conditions. From the observational data, the gas-to-particle conversion rate for sulfur dioxide (SO2) at nighttime was also derived, yielding a 2.18%/hr-1.

Air Pollutants↗
PubMed1998

Characterization of 3-nitropropionic acid-induced bradycardia in isolated atria.

3-Nitropropionic acid (3-NPA) was identified as the toxic component of several plants and fungi. Recently, it was described that 3-NPA produced hypotension, accompanied by a paradoxical bradycardia. In this study, we identified a possible mechanism of action, explaining the effect of 3-NPA on cardiac tissue. We used isolated, spontaneously beating atria and heart mitochondria to measure electrophysiological properties and mitochondrial oxygen consumption. We also measured Na+/K+ ATPase activity and intracellular ATP levels. In isolated spontaneously beating atria, 3-NPA (10(-4) M) decreased heart rate by 62 +/- 3%. This agent did not affect the amplitude or duration of action potentials. The duration of intervals between two action potentials, however, was prolonged from 530 +/- 285 to 1400 +/- 600 ms after 3-NPA exposure (10(-2) M). Oxygen consumption by heart mitochondria was inhibited by 3-NPA when either malate/glutamate or succinate were used as metabolism substrates. Cytochrome C oxidase activity was not affected by 3-NPA. Finally, atrial ATP content decreased 65 +/- 3% after 3-NPA treatment. In conclusion, we show that 3-NPA decreases atrial rate by increasing the action potential phase 4, probably by inhibition of mitochondrial respiration, thereby decreasing cardiac ATP content. This suggests that 3-NPA-induced bradycardia may be related to intracellular ATP depletion.

Adenosine Triphosphate↗
PubMed1998

BN 52021 (a platelet activating factor-receptor antagonist) decreases alveolar macrophage-mediated lung injury in experimental extrinsic allergic alveolitis.

Several lines of research indirectly suggest that platelet activating factor (PAF) may intervene in the pathogenesis of extrinsic allergic alveolitis (EAA). The specific aim of our study was to evaluate the participation of PAF on macrophage activation during the acute phase of EAA in an experimental model of this disease developed in guinea pigs. Initially we measured the concentration of PAF in bronchoalvedar lavage fluid, blood and lung tissue. In a second phase we evaluate the participation of PAF on alveolar macrophage activation and parenchymal lung injury. The effect of PAF on parenchymal lung injury was evaluated by measuring several lung parenchymatous lesion indices (lung index, bronchoalvedar lavage fluid (BALF) lactic hydrogenase activity and BALF alkaline phosphatase activity) and parameters of systemic response to the challenge (acute phase reagents). We observed that induction of the experimental EAA gave rise to an increase in the concentration of PAF in blood and in lung tissue. The use of the PAF-receptor antagonist BN52021 decreases the release of lysosomal enzymes (beta-glucuronidase and tartrate-sensitive acid phosphatase) to the extracellular environment both in vivo and in vitro. Furthermore, antagonism of the PAF receptors notably decreases pulmonary parenchymatous lesion. These data suggest that lung lesions from acute EAA are partly mediated by local production of PAF.

Alveolitis, Extrinsic Allergic↗
PubMed1998

[Continuous parascalene block for shoulder surgery].

OBJECTIVE: To evaluate the efficacy and incidence of side effects of parascalene brachial plexus block for shoulder surgery and for postoperative analgesia. PATIENTS AND METHODS: This prospective descriptive study enrolled 186 patients scheduled for conventional (open) and arthroscopic shoulder operations. The parascalene approach to the brachial plexus was used, with an 18-G x 4.5 cm cannula (30 degrees bevel), applying the technique of detecting perforation of the prevertebral fascia. Mepivacaine 1.5% was administered for anesthesia, beginning with a test dose of 5 ml followed by doses of 25 ml. Bupivacaine 0.125% with 1/400,000 adrenaline was given for postoperative analgesia. Two groups were established according to type of surgery. In group A were patients undergoing open surgery and those with articular stiffness undergoing arthroscopic surgery; analgesics were delivered in continuous perfusion of 5 to 8 ml/h. Group B patients, who underwent arthroscopic surgery, received the analgesic in boluses of 10 to 14 ml every 4 to 6 hours. We assessed perception of perforation of the fascia, provocation of paresthesia, number of puncture attempts, anesthetic efficacy, postsurgical analgesia (visual analogue scale from 0 to 10) and complications. RESULTS: Blockade was effective for 155 of the 186 patients (83.33%). In 118 (63.44%) the perception of perforation of the prevertebral fascia was ostensible, in 52 (27.95%) it was slight and in 16 (8.6%) it was undetectable. Paresthesia was triggered by the cannula in 18 cases (9.13%) and by the test dose in 181 cases (97.31%). The mean number of puncture attempts was 1.2 +/- 0.09 per patient. During the early postoperative period analgesia was adequate for 92 (84.40%) of the 109 patients in group A. In group B, 45 patients (97.82%) required 1 to 2 analgesic doses (mean 1.4 +/- 2 doses) and one patient (2.17%) needed 6 doses within the first 24 hours. Catheters remained inserted as long as 36 hours to 10 days (mean 3.5 days) in group A. In group B they had been removed by 24 hours. Complications were transitory and slight. No cases of pneumothorax, no intra- or epidural anesthesia was required and no instances of vascular puncture occurred. CONCLUSIONS: The parascalene approach is easy to use and entails few risks while providing excellent anesthetic conditions for open and arthroscopic shoulder operations. It is useful for ambulatory analgesia to facilitate early rehabilitation after surgery.

Adult↗
PubMed1997

Herpes simplex virus encephalitis in a renal transplant patient: diagnosis by polymerase chain reaction detection of HSV DNA.

A case of herpes simplex virus (HSV) encephalitis with disseminated primary HSV infection in a renal transplant patient is described. The diagnosis of the disease was achieved by nested polymerase chain reaction (PCR)-DNA in cerebrospinal fluid (CSF). Other diagnostic measures (immunoglobulin [Ig] M and virological cultures both in blood and CSF) were negative. Blood IgG gave a false-positive signal. Although ganciclovir is not the drug of choice, its concomitant administration in our patient as a prophylactic measure against CMV infection may have decreased the usual severity normally expected in this kind of primary HSV infection. The subsequent increase in ganciclovir dose to full therapeutic range, which was implemented before the diagnosis was achieved, led to the disappearance of symptoms. The detection of PCR-DNA in CSF will probably become the diagnostic method of choice. One of its great advantages, in addition to its diagnostic reliability, is that it may obviate the performance of many cerebral biopsies.

Adult↗
PubMed1997

[Isolation and characterization of Yersinia enterocolitica from pigs and bovines in Chile].

The occurrence of Yersinia enterocolitica in tonsils and rectal swabs from 100 healthy pigs and the rectal swabs of 100 healthy cattle slaughtered at Santiago-Chile were analysed. Yersinia enterocolitica was isolated from 48 (48%) pigs but not from cattle. 98.2% of strains were of 4/O3 bioserogroup, considered to be pathogenic for humans. All of the strains were resistant to penicillin producing beta-lactamase. Most of them were resistant to neomicin and tetracycline. The pYV marker was used to demonstrate pathogenicity in all strains by four different assays: 65.5% of the strains were pYV positive by their plasmid profile; 73.3% by crystal violet binding; 84.5% by calcium dependency and 87.9% by hybridization with probe associated with cytotoxicity to Hep-2 cells in vitro. All of the Yersinia enterocolitica strains were pYV positive with at least one of the four tests analysed, 46/58 strains were positive by three tests simultaneously. The similarities between associated cytotoxic genes of porcine and human strains is discussed. The phenotypic and genotypic characteristics demonstrated by the isolates strains suggest that the pigs in Chile are reservoir of potential pathogenic Yersinia enterocolitica for humans.

Animals↗
PubMed1996

Hydrolytic enzyme of the alveolar macrophage in diffuse pulmonary interstitial disease.

Hydrolytic enzymes [acid phosphatase, beta-glucuronidase, beta-D-N-acetyl glucosaminidase (beta-D-NAGA), lysozyme and angiotensin-converting enzyme (ACE)] are the major constituents of alveolar macrophages (AM). These enzymes play a crucial role in the pathogenesis of interstitial lung diseases. Cell-associated activity of several enzymes in alveolar macrophages obtained from control subjects (n = 5) and patients suffering five representative types of interstitial pulmonary diseases [sarcoidosis (n = 10), extrinsic allergic alveolitis (n = 5), idiopathic pulmonary fibrosis (n = 5), neoplastic infiltration of the lung (n = 5) and Pneumocystis carinii pneumonia (n = 5)] were evaluated. Cells were obtained by bronchoalveolar lavage and isolated by Ficoll-Hypaque gradient. Enzymatic activity was assessed by standardized tests. Bronchoalveolar lavage (BAL) lymphocyte counts were significantly elevated in the patients with active sarcoidosis (median: 57%), allergic extrinsic alveolitis (median: 51%) and neoplastic infiltration (median: 31%) as compared with the other groups, whereas BAL neutrophil and eosinophil counts were significantly elevated in the patients with idiopathic pulmonary fibrosis (neutrophil median: 29%; eosinophil median: 3%). The highest alveolar macrophage enzymatic activities were obtained in the active sarcoidosis group (median ACE: 23.38 microKat 10(-6) AM; median lysozyme: 8.64 nKat 10(-6) AM; median beta-glucuronidase: 324.22 U 10(-6) AM; median acid phosphatase: 0.78 nKat 10(-6) AM; median beta-D-NAGA: 1.85 nKat 10(-6) AM) which was significantly greater than in the control group (median ACE: 6.69 microKat 10(-6) AM; median lysozyme: 1.95 nKat 10(-6) AM; median beta-glucuronidase: 39.88 U 10(-6) AM; median acid phosphatase: 0.38 nKat 10(-6) AM; median beta-D-NAGA: 0.44 nKat 10(-6) AM). However, intracellular lysosomal enzymatic activities of alveolar macrophages from patients with allergic extrinsic alveolitis, a disease in which the degree of alveolar macrophage activation is maximal, were similar to those of the control group. These findings demonstrated a different pattern of expression of alveolar macrophage's hydrolytic enzymes in lymphocytic diffuse pulmonary interstitial disease. In sarcoidotic patients, hydrolytic enzymes were increased whereas in allergic extrinsic alveolitis, hydrolytic enzyme activities were similar to control groups. Indirect data suggest that the release of lysosomal enzymes by alveolar macrophages during allergic extrinsic alveolitis may be a factor involved in the pulmonary lesions appearing in this disease.

Acetylglucosaminidase↗
PubMed1995

Measurement of clinical activity of systemic lupus erythematosus and laboratory abnormalities: a 12-month prospective study.

OBJECTIVE: To assess flares in outpatients with systemic lupus erythematosus (SLE) using SLAM (systemic lupus activity measure) and to determine laboratory abnormalities as predictors of disease activity. METHODS: Fifty-three Mexican patients were assessed using SLAM scale. They were evaluated monthly for a total of at least 572 months. The SLAM scale was applied at each visit. Samples were drawn for complete blood cell count, erythrocyte sedimentation rate, urinalysis, 24-h protein and creatinine clearance, anti-DNA, C3 and C4. An SLE flare was defined as the occurrence of new clinical manifestations or worsening compared to the previous month that usually required restarting or increasing prednisone or immunosuppressive drugs. RESULTS: Thirty-three patients had flares, mainly in minor organs. The incidence of flares was 0.69/patient/year of followup. Active nephritis and extrarenal manifestations correlated with high levels of dsDNA and low complement levels. We found an odds ratio (OR) = 3 (CI = 1.7-5.7) for flare in asymptomatic patients with high dsDNA and OR = 2 (CI = 1.3-4.5) for low C3 levels. CONCLUSION: Flares are frequent in patients with SLE and they occur independent of disease duration and the time the disease has been under control. Flares are apparently predictable and are related to serologic abnormalities.

Adult↗
PubMed1995

[Beta-lactamase producing bacteria in the pharyngeal flora of patients with acute pharyngitis].

BACKGROUND: Production of beta-lactamase by normal pharyngeal flora could account for penicillin treatment failure in patients with acute streptococcal pharyngitis. The aim of the present investigation was to study the beta-lactamase-producing bacteria (BLPB) in 58 patients with acute pharyngitis, and to investigate the impact of two antibiotics, amoxycillin vs amoxycillin/clavulanic acid in the pharyngeal microflora. METHODS: Rapid antigen detection tests for S. pyogenes and standard microbiologic cultures were performed on simultaneously obtained throat swabs from each enrolled patient. Patients with group A streptococcal pharyngitis (GASP) were randomized in two groups: patients treated with 10 days of oral amoxycillin (group I), and patients treated with 10 days of oral amoxicyllin/clavulanic acid (group II). Patients without GASP and without antibiotic treatment were considered as controls (group III). Cultures were repeated 15 days following the first culture. All of them were processed for aerobic and anaerobic organisms. RESULTS: S. pyogenes was recovered in 25 patients (43.1%) and BLPB were isolated in 64% of the treated patients and in 78% of the non-treated control patients. We observed that the number of patients harboring BLPB did not change significantly in the untreated control group. After treatment we detected a similar increase in the number of patients harboring BLPB in groups I and II. In the present study BLPB were found in more than 70% of the patients and the failure rate was less than 10%. CONCLUSIONS: The results of this study indicate that production of beta-lactamase by pharyngeal organisms does not fully explain the failures of penicillin therapy for acute streptococcal pharyngitis.

Acute Disease↗