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M Ruiz

Publications and source records attributed to M Ruiz.

At least 37 records · Page 2Linked to original sources

[Sedation in digestive endoscopy. Results of a hospital survey in Catalonia (Spain)].

INTRODUCTION: The need for sedation is increasing in digestive endoscopy units (DEU). There are no data on the use of sedation in DEU in Catalonia (Spain). OBJECTIVE: To evaluate the use of sedation in DEU in Catalonia. MATERIAL AND METHOD: A questionnaire on the practice of sedation was designed and sent to the heads of medical and nursing staff of the DEU of 63 public and private hospitals in Catalonia. Two mailings were sent with an interval of three months between each. The questionnaire included 62 items on the characteristics of the hospital and the DEU, number of explorations, frequency of sedation use, drugs employed, participation of an anesthesiologist, use of monitoring, and complications. RESULTS: Forty-four DEU (70%) corresponding to 31 public hospitals and 13 private hospitals completed the questionnaire. Evaluation of sedation patterns was based on 105,904 explorations performed in the various DEU (56,453 gastroscopies, 47,278 colonoscopies and 2,173 endoscopic retrograde cholangiopancreatographies (ERCP) in 2001. Sedation, sedation-analgesia or anesthesia was used in 17% of gastroscopies, 61% of colonoscopies and 100% of ERCP. Sedation was administered by an anesthesiologist in 7% of gastroscopies, 25% of colonoscopies and 38% of ERCP. Anesthesiologist administration was more frequent in private than in public centers (gastroscopies: 25% vs. 2%; colonoscopies: 57% vs. 9%, p < 0.001). No deaths associated with the use of sedation were reported. Eighty-nine percent of the DEU complied with standard recommendations for the practice of sedation. CONCLUSIONS: In Catalonia, the use of sedation is highly variable, depending on the endoscopic procedure and the DEU. Use of sedation in infrequent in gastroscopy, fairly widespread in colonoscopy and routine in ERCP. Anesthesiologist administration is significantly more frequent in private hospitals. Most DEU follow standard sedation practices.

Anesthesia↗

Synergic activity of fluoroquinolones and linezolid against Mycobacterium tuberculosis.

We evaluated the in vitro activity against Mycobacterium tuberculosis of the combination of fluoroquinolones and linezolid with classical drugs. The combination of isoniazid with fluoroquinolones had synergic activity in nine of the ten isoniazid-susceptible strains. We also found synergism between rifampicin and linezolid in five of the 15 strains susceptible to rifampicin. The clinical significance of these findings should be evaluated.

Acetamides↗

In vitro activity of new fluoroquinolones and linezolid against non-tuberculous mycobacteria.

The objective of the study was to determine the activity of new fluoroquinolones and linezolid against 108 clinical isolates of different species of non-tuberculous mycobacteria isolated in Spain. Gatifloxacin and moxifloxacin were found to be more effective than levofloxacin. Mycobacterium kansasii was more susceptible to the fluoroquinolones tested than M. avium complex and M. fortuitum was more susceptible than M. chelonae. Linezolid was more active against M. kansasii than against M. avium complex. A better understanding of the relationship between the in vitro activity of these compounds and their usefulness in the treatment of these infections is needed. The new fluoroquinolones exhibit good activity against M. kansasii and M. fortuitum and linezolid is active against M. kansasii.

Acetamides↗

Characterisation of Salmonella spp. mutants produced by exposure to various fluoroquinolones.

We repeatedly exposed six Salmonella spp. strains of different serotypes (three susceptible to nalidixic acid and three resistant) to constant low concentrations of various fluoroquinolones with the aim of characterising the mutations that produce the first decrease in susceptibility to these agents. The fluoroquinolone-susceptibility of all the strains was reduced after repeated exposure to these agents. However, gyrA mutants were not always produced. Furthermore, the type of mutation produced and the time taken for it to appear varied depending on the initial resistance to nalidixic acid, the antibiotic used and the serotype involved. Therefore, we believe that the initial decrease in quinolone-susceptibility is due to various mechanisms and, in many cases, is not caused by mutations in the gyrA gene

Anti-Infective Agents↗

Effect of clinical and socio-economic factors on the rate of clustering of Mycobacterium tuberculosis clinical isolates in Elche (Spain).

We studied the association that exists between the epidemiological type clustering of isolates of Mycobacterium tuberculosis and certain clinical, epidemiological and socio-economic characteristics of tuberculosis patients in the Elche health district of Spain. A total of 144 patients diagnosed between 1993 and 1999 and whose isolates had been genotyped by IS6110-RFLP in an earlier study were included. Multivariate analysis showed that the independent variables associated with clustering of strain types were: age (1-25 years, OR 2.92, 95% CI 0.83 10.3), a high percentage of infection in the first circle of contacts (OR 2.89, 95% CI 0.96-8.68), urban dwelling (OR 2.12. 95% CI 0.73-6.2), use of bronchoscopy to obtain samples (OR 16.3, 95% CI 2.3-11.5) and working contact with many people (OR 2.81, 95% CI 0.94-8.3). These data contribute to a better understanding of the epidemiology of tuberculosis and improved systems of control.

Adolescent↗

Usefulness of different techniques in the study of the epidemiology of salmonellosis.

Our objective was to evaluate the usefulness of serotyping, phagotyping, antibiotyping and RAPD (random amplified polymorphic DNA) in the study of the epidemiology of salmonellosis in Elche (Spain). We examined 1232 clinical isolates of non-typhoid Salmonella serotypes. Serotyping adequately differentiates 12.3% of the isolates and phagotyping raises this percentage to 37%. Antibiotyping is a suitable complement in certain circumstances, such as in the case of specific outbreaks. RAPD is a fast and simple technique which is within the reach of most laboratories, complementing the results obtained by antibiotyping and serotyping, in order to be able to control outbreaks of salmonellosis in everyday practice.

Agglutination Tests↗

Effect of indapamide SR on microalbuminuria--the NESTOR study (Natrilix SR versus Enalapril Study in Type 2 diabetic hypertensives with micrOalbuminuRia)--rationale and protocol for the main trial.

In type 2 diabetic hypertensive patients, microalbuminuria can be due to hypertension and/or diabetic nephropathy. Angiotensin-converting enzyme (ACE) inhibitors act preferentially on microalbuminuria due to diabetic nephropathy. The objective is to demonstrate the efficacy of a thiazide-like diuretic, indapamide sustained release (SR), at reducing microalbuminuria in hypertensive type 2 diabetic patients in comparison with an ACE inhibitor, enalapril. The study is an international multicentre, 12-month, randomized, double-blind, controlled, two parallel group study of type 2 diabetic patients with hypertension (140 mmHg < or = systolic blood pressure <180 mmHg and diastolic blood pressure <110 mmHg) and microalbuminuria. Intervention is after a 4-week placebo period, patients with microalbuminuria > or = 20 and < or = 200 microg/min are randomized to indapamide SR 1.5 mg or to enalapril 10 mg once a day for a one-year treatment period. An additional label treatment by amlodipine 5-10 mg (1st step) and atenolol 50-100 mg (2nd step) a day is permitted after 6 weeks of treatment based upon blood pressure response. The main outcome measures are microalbuminuria expressed as urinary albumin to creatinine ratio, albumin fractional clearance, and albumin excretion rate evaluated on overnight urine collections. Secondary criteria are supine and standing systolic, diastolic and mean blood pressure; and biological and clinical safety. This study will complete the knowledge of the efficacy of indapamide SR in hypertension and target organ damage and will provide valuable information on the management of type 2 diabetic hypertensives with microalbuminuria.

Adult↗

Basic statistics of PM2.5 and PM10 in the atmosphere of Mexico City.

The high levels of fine particulate matter in Mexico City are of concern since they may induce severe public health effects as well as the attenuation of visible light. Sequential filter samplers were used at six different sites from 23 February to 22 March 1997. The sampling campaign was carried out as part of the project 'Investigación sobre Materia Particulada y Deterioro Atmosferico-Aerosol and Visibility Evaluation Research'. This research was a cooperative project sponsored by PEMEX and by the US Department of Energy. Sampling sites represent the different land uses along the city, the northwest station, Tlalnepantla, is located in a mixed medium income residential and industrial area. The northeast station, Xalostoc, is located in a highly industrialized area, Netzahualcoyotl is located in a mixed land use area, mainly commercial and residential. Station La Merced is located in the commercial and administrative district downtown. The southwest station is located in the Pedregal de San Angel, in a high-income neighborhood, and the southeast station located in Cerro de la Estrella is a mixed medium income residential and commercial area. Samples were collected four times a day in Cerro de la Estrella (CES), La Merced (MER) and Xalostoc (XAL) with sampling periods of 6 h. In Pedregal (PED), Tlalnepantla (TLA) and Netzahualcoyot1 (NEZ) sampling periods were every 24 h. In this paper the basic statistics of PM2.5 and PM10 mass concentrations are presented. The average results showed that 49, 61, 46, 57, 51 and 44% of the PM10 consisted of PM2.5 for CES, MER, XAL, PED, TLA and NEZ, respectively. The 24-h average highest concentrations of PM25 and PM10 were registered at NEZ (184 and 267 microg/m3) and the lowest at PED (22 and 39 microg/m3). The highest PM10 correlations were between XAL-CES (0.79), PED-TLA (0.80). In contrast, the highest PM2.5 correlations were between CES-PED (0.74), MER-CES (0.73) and TLA-PED (0.72), showing a lower correlation than the PM10 one. The results of the PM10 from 12.00 to 18.00 h at CES and MER presented the highest variability and also the highest median concentrations, meanwhile XAL showed them from 06.00 to 12.00 h. The highest variability and median concentrations of PM2.5 were from 06.00 to 12.00 h for the three stations.

Air Movements↗

Mesenteric tuberculosis with jejunal infiltration.

A 69-year-old female was admitted to our hospital because of asthenia, anorexia and 20 kg weight loss. An ultrasound study and computerized tomography (CT) imaging revealed a mesenteric mass and laparotomy was performed. The diagnosis was mesenteric tuberculosis with jejunal involvement. This represents an atypical onset of tuberculosis in a non-immunosuppressed patient.

Aged↗

In vitro activity of moxifloxacin, levofloxacin, gatifloxacin and linezolid against Mycobacterium tuberculosis.

The in vitro activity of moxifloxacin, gatifloxacin, levofloxacin and linezolid was evaluated against 234 strains of Mycobacterium tuberculosis isolated in the Southeast of Spain. All drugs tested showed good activity, with an MIC(90) of less than 1 mg/l, and were active against isociacide and rifampicin resistant strains. Three strains were resistant to isoniazid and to the fluoroquinolones, which suggested the existence of mechanisms of resistance not yet described. These new compounds may prove to be therapeutic alternatives for treatment of multi-resistant tuberculosis and further studies should be done to demonstrate their true usefulness.

Acetamides↗

Implications on human fertility of the 677C-->T and 1298A-->C polymorphisms of the MTHFR gene: consequences of a possible genetic selection.

Mutant alleles with the 677C-->T and 1298A-->C polymorphisms of the MTHFR gene, and consequent lower methylentetrahydrofolate reductase enzyme activity, have been related to higher plasma homocysteine levels, which are associated with cardiovascular diseases. We assessed the genotype frequencies, degrees of fertility and homocysteine levels, and discuss a possible genetic selection for the gene polymorphisms studied. A total of 1777 subjects (897 women and 880 men), divided into four age groups, were genotyped by PCR and restriction fragment length polymorphism. The total homocysteine concentration in plasma was determined by fluorescence polarization immunoassay. Based on random pairs and linkage disequilibrium of the two polymorphisms, we estimated the rate of fetal non-viability according to the combinations of these two polymorphisms to be 4.63% for the group >24 years old and 6.31% for the group <24 years old. We detected an increased frequency of mutant alleles in the youngest age group, coincident with a generally increased folate intake by pregnant women in Spain. The genetic selection detected leads to an increase in mutated individuals, the number of whom could increase four-fold over the next 75 years. Although generally reduced in the younger age groups, the homocysteine plasma levels were shown to increase in individuals according to the number of mutations, especially those of the 677T allele.

Adult↗

[Serotypes and antibiotic susceptibility of the genus Salmonella in Elche, Spain].

Salmonellosis is one of the main public health problems in developed countries. The most common serotype is Salmonella enteritidis, followed by S. typhimurium, S. hadar and S. virchow. Each serotype's sensitivity to antibiotics is different, but in general, there has been an increase in the number of isolates resistant to antibiotics. This is especially true for S. hadar and nalidixic acid, although we have not isolated any strains resistant to ciprofloxacin. Our study provides data that may help to control these infections and draws attention to the increase in resistance to certain antibiotics. This should give rise to the implementation of measures to protect public health and control the use of antibiotics, especially in animals.

Anti-Bacterial Agents↗

[Dyspepsia-related quality of life. Spanish adaptation and validation of the questionnaire Dyspepsia-Related Health Scale].

BACKGROUND: Dyspepsia affects about 25 % of the population and may cause an important decrease in quality of life. The aim of this work was to perform a Spanish validation and adaptation of the questionnaire DRHS (Dyspepsia Related Health Scale), a tool that assesses dyspepsia-related quality of life. PATIENTS AND METHOD: The study was carried out in 234 subjects, 163 with symptoms of dyspepsia and 71 health volunteers. Two rheumatologists, 2 general practitioners, 1 gastroenterologist, 1 clinical pharmacologist, 1 pharmacoepidemiologist and 1 psychologist were involved in the work. The process of adaptation and validation included translation and re-translation, pilot study in 16 patients, dimensionality, reliability and validity (of content, of construct, convergent, predictive and discriminative). RESULTS: The mean age was 49.1 years (SD: 18) and 60.7 % were females. The between-judges agreement rate of Hambleton and Rovinelli, which evaluates the content validity, was lower than 0.41. The construct validity assessed by the factorial analysis of responses showed that each subscale may be considered unidimensional in both health volunteers and individuals with dyspepsia. Reliability was satisfactory (Cronbach's alpha = 0.92) and stability of measures (test-retest) was excellent with a correlation coefficient of 0.95. The convergent validity, assessed by means of the EuroQoL, was only moderate with a correlation coefficient of 0.54 (p < 0.001). The predictive validity, assessed by administering the questionnaire 12 days after treating dyspepsia, showed a correlation coefficient of 0.47 between the two measures (p < 0.001). There was also a relationship between scores variation and outcome. CONCLUSIONS: The Spanish version of the DRHS, so-called QoL-PEI (questionnaire of quality of life related with problems of stomach and intestine), displays good metric properties and is able to predict the evolution of dyspepsia. The results of this study show that this tool is essentially unidimensional, yet it can be used on a multidimensional form to perform a differentiated assessment of each evaluated case.

Adolescent↗

Pharmacological stress myocardial perfusion imaging with the potent and selective A(2A) adenosine receptor agonists ATL193 and ATL146e administered by either intravenous infusion or bolus injection.

BACKGROUND: Adenosine (Ado) and dipyridamole are alternatives to exercise stress for myocardial perfusion imaging. Though generally safe, side effects frequently occur that cause patient discomfort and sometimes lead to premature termination of the study or require aminophylline administration. Recently, a new class of A(2A) Ado receptor agonists was synthesized. ATL193 and ATL146e are 2-propynylcyclohexyl-5'-N-ethylcarboxamido derivatives of Ado. The study goals were to evaluate the potency and selectivity of these new compounds on recombinant canine Ado receptors and to evaluate their hemodynamic properties in dogs to assess their usefulness as vasodilators for myocardial perfusion imaging. METHODS AND RESULTS: In assays of recombinant canine Ado receptors, ATL-193 and ATL-146e were highly selective for the A(2A) over the A(1) and A(3) receptors and were more potent than MRE-0470 and CGS-21680. In 16 anesthetized dogs, the agonists were administered by infusion (ATL-193; n=7 normal) or bolus injection (ATL-146e; n=9 critical left anterior descending coronary artery stenosis), and hemodynamic responses were compared with those of Ado. Both agonists produced dose-dependent coronary flow (CF) elevation without provoking the hypotension observed with Ado. After an ATL-146e bolus, the CF increase was sustained for several minutes, providing ample time for injection and myocardial uptake of (99m)Tc-sestamibi, and CF returned to baseline within 20 minutes. The CF increase was completely blocked by the selective A(2A) antagonist ZM241385 (3 microgram. kg(-1). min(-1)). CONCLUSIONS: ATL-193 and ATL-146e are highly potent and selective Ado A(2A) receptor agonists with excellent potential for use as vasodilators for myocardial perfusion imaging. An important advantage of ATL-146e is the ability to administer it by bolus injection.

Adenosine↗