Biomedical subjects

Manuel Ruiz

Publications and source records attributed to Manuel Ruiz.

17 recordsLinked to original sources

PubMed2007

Cognitive function impairment in patients with neuropathic pain under standard conditions of care.

The objective of this study is to analyze the prevalence to cognitive function impairment (CI) in a pragmatic cohort of subjects with different types of neuropathic pain under standard conditions of care by means of a cross-sectional baseline analysis of a sample of patients with NeP enrolled in a pragmatic, prospective, multicenter study evaluating the effectiveness of gabapentin. A total of 1519 patients (58.8% women), aged > or =18 years (mean [SD]=56.0 [13.7]), with neuropathic or mixed neuropathic and nociceptive pain for a mean (SD) of 1.1 (2.8) years were enrolled in the study. Pain was assessed with the short form of the McGill Pain Questionnaire, and cognitive function was measured with the Mini-Mental State Examination (MMSE). A score < or =24 on the MMSE was considered as CI. Multivariate logistic regression models were used to estimate CI prevalence. CI prevalence was substantially higher in patients with NeP than that reported in the general Spanish population, and significantly higher than in patients with mixed neuropathic and nociceptive pain: 11.4% (8.5%-14.3%) vs. 6.4% (4.6%-8.7%), P=0.006 (adjusted odds ratio=1.88 [1.21-2.91]). Prevalence significantly increased with age, up to 32.2% (20.6%-45.6%) in those with NeP, and to 28.2% (15.0%-44.9%) in those with mixed syndromes, for the age group > or =75 years, P<0.001 within age groups. Symptoms of anxiety and obesity, and to a lesser extent, symptoms of depression, were also factors associated with a higher prevalence rate of CI. This analysis showed that, after adjusting for confounding factors, the prevalence of CI was substantially higher in patients with NeP than those with mixed pain and the reference general population. Age, anxiety, depression, and obesity were factors found to be significantly associated with CI.

Adult↗

PubMed2006

Treatment and outcomes of severe cardiac disease with surgical indication in very old patients.

OBJECTIVE: To describe and compare the crude and risk-adjusted survival of a series of octogenarians with symptomatic severe aortic stenosis (SAS) or severe coronary artery disease (SCAD). METHODS: We reviewed the treatment and outcomes of 130 consecutive patients > or = 80 years old hospitalized for SAS or SCAD. RESULTS: Mean age was 82.8+/-3.1 years, 52% were women. Of 83 patients with SCAD, 52 were treated by coronary stenting (63%), 12 by coronary artery bypass grafting (15%) and 19 medically (23%). There were no significant differences in baseline characteristics among different treatment groups. When comparing the medically treated group with the intervention group (coronary artery bypass grafting or stenting), the former showed a trend to a worse prognosis (adjusted HR 2.5, 95% CI 0.98-6.6, p=0.056). Of 47 patients treated with SAS, 33 were treated surgically (70%), 26 by aortic valve replacement (AVR) alone and 7 combined with coronary revascularization. Fourteen patients were treated medically (30%). Patients treated with AVR were younger, presented less frequently a previous MI and had better left ventricular systolic function. Multivariate analysis did not find AVR associated to a better survival (HR 1.1, 95% CI 0.2-5.4). CONCLUSION: Cardiac surgery in octogenarians is more frequently performed in patients with SAS than in patients with SCAD, but survival benefit is probably greater in the latter. A more conservative approach with medical therapy in patients with SAS and coronary stenting in patients with SCAD are alternatives that should be considered.

Aged↗

PubMed2006

[Linguistic adaptation and Spanish validation of the LANSS (Leeds Assessment of Neuropathic Symptoms and Signs) scale for the diagnosis of neuropathic pain].

BACKGROUND AND OBJECTIVE: This study was intended to achieve a linguistic adaptation and validation into Spanish of the LANNS scale for the differential diagnosis of neuropathic pain. MATERIAL AND METHOD: Cross-sectional validation study carried out in two phases: first, cultural adaptation into Spanish language, by means of a conceptual equivalence approach, including forward and backward translations in duplicate and review by experts; and second, validation study of the scale in patients with neuropathic, noniceptive and mixed pain, in which the scale properties of reliability (internal consistency and inter-rater agreement with kappa and intra-class correlation coefficients) and validity (ROC curves analisys, agreement with reference diagnosis and determination of sensitivity, specificity and positive and negatives predictive values) were evaluated. RESULTS: A total of 156 subjects (90 women, 58.4%), 89 with pain of neuropathic origin (mean age [SD], 59.6 [19.4] years, 22 with mixed pain due to radiculopathy) and 67 with nociceptive pain (66.6 [11.8] years) were included in the study. Diagnosis of the type of pain was performed by standard clinical criteria. The scale was administrated by trained interviewers, in duplicate and blinded to the reference diagnosis. The scale showed good reliability (internal consistency: Cronbach and Guttman split-half coefficients between 0.68 and 0.71; inter-rater agreement: kappa coefficient of 0.70 and intra-class correlation coefficients between 0.77 and 0.92) and validity for a cut-off value > or = 12 points, which represented the best value to discriminate between patients with neuropathic and nociceptive components of pain (kappa coefficient = 0.70; CI 95%, 0.59-0.81; p < 0.0001); area under the curve, 0.929; (p < 0.0001); specificity, 89.4% (CI 95%, 79.4%-95.6%) and positive value, 91.1%; CI 95%, 82.6%-96.4%). CONCLUSIONS: The Spanish version of the LANSS scale is reliable and valid for the differential diagnosis of neuropathic pain.

Aged↗

PubMed2006

Psychometric properties of the MOS (Medical Outcomes Study) Sleep Scale in patients with neuropathic pain.

OBJECTIVE: This study assessed the psychometric properties of the MOS Sleep Scale in neuropathic pain (NeP). METHODS: Psychometric properties were tested in patients with neuropathic pain enrolled in a prospective study exploring the effectiveness of gabapentin for 3 months. Participants also completed scales for pain intensity, anxiety, depression, disability, and health-related quality of life. Feasibility, reliability, validity and sensitivity to change were measured in this study. RESULTS: Six-hundred-three patients [58.4+/-14.4 years (65.1% female), mean+/-SD] with pain for 1.2+/-3.3 years were included. The MOS Sleep Scale was acceptable (items with missing data <10% and floor and ceiling effects <50% per item and <15% per domain) and reliable (Cronbach's alpha between 0.64 and 0.87, and test-retest intraclass correlation coefficients between 0.79 and 0.91, p<0.001 for all cases). After adjusting for confounders, the MOS Sleep Scale was able to distinguish between sex, present pain intensity, level of disability and presence of anxiety or depression. Correlations with other scales were moderate; rho-coefficients between -0.21 and 0.57 (p<0.01, all cases). The scale was sensitive to change after treatment with gabapentin; after adjusting, responders (50% reduction in baseline pain) showed a decrease in sleep problems index of -25.6+/-14.3 points vs. -12.1+14.5 points in nonresponders (F=80.5, df=1/398, p<0.0001). Score reduction in summary index and subscales correlated significantly with pain intensity reduction (Pearson r-coefficients between 0.428 and 0.116, p<0.01, all cases). CONCLUSIONS: The MOS Sleep Scale showed good psychometric properties and was sensitive to changes in patients with NeP of broad aetiology.

Adult↗

PubMed2006

Cross-sectional evaluation of patient functioning and health-related quality of life in patients with neuropathic pain under standard care conditions.

AIM: The purpose of this cross-sectional evaluation was to determine the impact of neuropathic pain (NeP) on patient functioning and Health-Related Quality of Life (HRQoL) under standard care conditions. METHODS: Patients with NeP or neuropathic and nociceptive pain [Mixed Pain (MP)] enrolled in the DONEGA study, a naturalistic, prospective and multi-centre study of the effectiveness of gabapentin under usual care conditions, were included in this cross-sectional evaluation before starting study treatments. Participants completed the Short Form-McGill Pain Questionnaire, MOS Short Form-12 (SF-12), and Sheehan Disability Scale (ShDS). Multivariate analysis and regression models were used to analyze patient data. RESULTS: A total of 1519 patients [mean+/-SD; 56.0+/-13.7 yrs old (58.8% female)] with NeP or MP were enrolled in the study. The mean pain history was 1.1+/-2.8 yrs, current pain intensity on a 5-point visual analogue scale was 2.8+/-1.0 and mean pain in previous week was 71.3+/-19.0mm. Pain substantially interfered (i.e., score > or = 5 on 0-10 scale) with normal work (5.9+/-3.0), social life (5.7+/-3.0), and family life (5.3+/-3.0), producing substantial disability (total ShDS score of 16.9+/-8.3 pts). Country-standardised physical (PCS) and mental health (MCS) component summary scores of SF-12 indicated significant impairment in both domains compared with the general Spanish population: PCS; -1.13+/-1.0 SDS (standard deviation score), and MCS; -1.21+/-0.7 SDS, equivalent to the 15th and 25th percentiles of normative populations, respectively. CONCLUSIONS: Under standard care conditions, neuropathic and mixed pain are associated with impaired physical and mental QoL, producing a substantial level of disability in these patients.

Adult↗

PubMed2006

Serum endostatin and bFGF as predictive factors in advanced breast cancer patients treated with letrozole.

INTRODUCTION: To investigate the value of baseline serum levels of VEGF, bFGF, endostatin and their ratio as predictive factors of response to endocrine therapy in patients with metastatic breast cancer (MBC) and positive ER treated with letrozole after tamoxifen failure. MATERIALS AND METHOD: The serum levels of endostatin, VEGF and bFGF were determined in postmenopausal patients with progressing MBC from serum samples obtained before initiation of letrozole. The relation between serum angiogenic factor levels and TTP was investigated. RESULTS: Seventy-six patients (45.2%) presented a high endostatin level (> 24.6 ng/ml), 40% low bFGF levels (0 pg/ml) and 50.4% low VEGF (=/< 187 ng/ml). With a median follow-up of 22 months, the median TTP was 12.3 months. Median TTP was worse in patients with high endostatin concentration as well as in the low bFGF group, but was not affected when VEGF was considered. When the two factors were combined, the median TTP of patients with endostatin > 24.6 ng/ml and bFGF equal 0 pg/ml was 9.5 months versus 19.5 months in patients with endostatin =/< 24.6 ng/ml and bFGF > 0 pg/ml. CONCLUSIONS: The baseline levels of bFGF and endostatin are predictive factors of efficacy in patients with MBC treated with letrozole and can select groups with different TTP.

Adult↗

PubMed2006

[Approach to the present state of proctology in Andalusia (Spain): results of a community survey].

OBJECTIVE: Proctology has acquired such complexity that it requires a specific qualification, as well as the creation of specialized groups. In Andalusia there are proctologists throughout the public health system. Measurement of the quality of the distinct processes is essential. The aim of the present study was to determine the resources available, as well as to identify the management of these patients, with a view to identifying areas requiring improvement. MATERIALS AND METHOD: A descriptive, multicenter, cross sectional study of the current situation of proctology in general surgery services in 25 hospitals in Andalusia (20 public and 5 private) was performed. A survey was used to identify the general characteristics of the hospital, the tests available, and the treatments used. RESULTS: A total of 65.38% of the hospitals have a coloproctology unit, while a drop-in outpatient clinic is available in only 38.46%. Manometry and anal endosonography are available in 50% and 58%, respectively. Treatment of hemorrhoids is predominantly hemorrhoidectomy (92.30%). Medical treatment and sphincterotomy are the most widely used treatments for anal fissure, and anal dilation is still performed in 30.76%. Seton is used in 92.30%, as well as fistulotomy (88.46%), to treat fistula. The most frequent treatment of sinus is en-bloc resection and primary closure (54.16%). Between 30% and 44% report little experience of pelvic floor disorders. CONCLUSION: Although there is a willingness to achieve progress and reach an adequate scientific level, a multitude of obsolete practices should be corrected. Tools such as scientific evidence, information management and evaluation by means of comparison with standards should be diligently included in our clinical practice.

Colorectal Surgery↗

PubMed2006

Generation Challenge Programme (GCP): standards for crop data.

The Generation Challenge Programme (GCP) is an international research consortium striving to apply molecular biological advances to crop improvement for developing countries. Central to its activities is the creation of a next generation global crop information platform and network to share genetic resources, genomics, and crop improvement information. This system is being designed based on a comprehensive scientific domain object model and associated shared ontology. This model covers germplasm, genotype, phenotype, functional genomics, and geographical information data types needed in GCP research. This paper provides an overview of this modeling effort.

Crops, Agricultural↗

PubMed2005

IMGT unique numbering for immunoglobulin and T cell receptor constant domains and Ig superfamily C-like domains.

IMGT, the international ImMunoGeneTics information system (http://imgt.cines.fr) provides a common access to expertly annotated data on the genome, proteome, genetics and structure of immunoglobulins (IG), T cell receptors (TR), major histocompatibility complex (MHC), and related proteins of the immune system (RPI) of human and other vertebrates. The NUMEROTATION concept of IMGT-ONTOLOGY has allowed to define a unique numbering for the variable domains (V-DOMAINs) and for the V-LIKE-DOMAINs. In this paper, this standardized characterization is extended to the constant domains (C-DOMAINs), and to the C-LIKE-DOMAINs, leading, for the first time, to their standardized description of mutations, allelic polymorphisms, two-dimensional (2D) representations and tridimensional (3D) structures. The IMGT unique numbering is, therefore, highly valuable for the comparative, structural or evolutionary studies of the immunoglobulin superfamily (IgSF) domains, V-DOMAINs and C-DOMAINs of IG and TR in vertebrates, and V-LIKE-DOMAINs and C-LIKE-DOMAINs of proteins other than IG and TR, in any species.

Amino Acid Sequence↗

PubMed2005

Presynaptic NMDA autoreceptors facilitate axon excitability: a new molecular target for the anticonvulsant gabapentin.

Gabapentin is a drug with anticonvulsant and analgesic properties causing the reduction of neurotransmitter release. We show that one of the mechanisms implicated in this effect of gabapentin is the reduction of the axon excitability measured as an amplitude change of the presynaptic fibre volley (FV) in the CA1 area of rat hippocampal slices. Interestingly, we found that gabapentin-induced depression of FV is mimicked and occluded by NMDA receptor (NMDA-R) antagonists, indicating that these receptors are located presynaptically and are activated by ambient levels of glutamate. Conversely, NMDA application (20 microM, 10 min) elicits a reversible FV potentiation which is reduced by gabapentin. Both NMDA- and gabapentin-induced FV changes are partially explained by modifications in the firing threshold of individual fibres. Increasing [K(+)](o) does not mimic or occlude (at a concentration of 6.5 mM) the effect of NMDA on FV amplitude, which makes it unlikely that a rise in [K(+)](o) induced by NMDA receptor activation could indirectly participate in the potentiation of the FV. The NMDA-induced FV potentiation is independent of extracellular calcium presence but is completely inhibited in a low-Na(+) solution (50% reduction) or under NMDA channel block (high Mg(2+) or MK 801). These findings suggest that sodium entry through presynaptic NMDA-R channels facilitates axon excitability. The interaction of gabapentin with this newly described mechanism might contribute to its therapeutic benefits.

Amines↗

PubMed2005

Linguistic adaptation and validation into Spanish of the Diagnostic Interview for Borderline Personality Disorders-Revised (DIB-R).

OBJECTIVE: This paper describes the linguistic adaptation and psychometric validation into Spanish of the Diagnostic Interview for Borderlines-Revised (DIB-R) scale for diagnosing borderline personality disorder (BPD). METHODS: A conceptual equivalence approach was undertaken, including forward and backward translations of the scale and patient debriefing in a pilot phase. BPD and control patients were included in the validation study, and all of them were administered the scale by well trained interviewers, blinded to the clinical diagnosis. Reference diagnosis for BPD was done according to DSM-IV criteria. The interview was independently administered in a subset of patients by different interviewer to test inter-rater reliability . Reliability and validity of the instrument were tested by calculating the Cronbach alpha and Guttman split-half coefficients and by receiver operating characteristic (ROC) curve analysis, kappa agreement coefficient determination and assessment of sensitivity and specificity of the scale. RESULTS: A cohort of 111 subjects, 84 BPD patients (33.6 +/- 9.3 years) and 27 control subjects (34.9 +/- 9.3 years), were included in the study. A cut-off point > or = 7 showed a kappa agreement coefficient of 0.853 (95% confidence intervals: 0.739-0.967, p < 0.00001). The figures for sensitivity and specificity values were 0.964 (0.899-0.993) and 0.889 (0.708-0.977) respectively. Inter-rater reliability showed a kappa coefficient of 0.783 (p < 0.0001). CONCLUSION: The Spanish version of the DIB-R showed adequate psychometric properties for diagnosing BPD in Spain.

Adult↗

PubMed2004

IMGT/3Dstructure-DB and IMGT/StructuralQuery, a database and a tool for immunoglobulin, T cell receptor and MHC structural data.

IMGT/3Dstructure-DB and IMGT/Structural-Query are a novel 3D structure database and a new tool for immunological proteins. They are part of IMGT, the international ImMunoGenetics information system, a high-quality integrated knowledge resource specializing in immunoglobulins (IG), T cell receptors (TR), major histocompatibility complex (MHC) and related proteins of the immune system (RPI) of human and other vertebrate species, which consists of databases, Web resources and interactive on-line tools. IMGT/3Dstructure-DB data are described according to the IMGT Scientific chart rules based on the IMGT-ONTOLOGY concepts. IMGT/3Dstructure-DB provides IMGT gene and allele identification of IG, TR and MHC proteins with known 3D structures, domain delimitations, amino acid positions according to the IMGT unique numbering and renumbered coordinate flat files. Moreover IMGT/3Dstructure-DB provides 2D graphical representations (or Collier de Perles) and results of contact analysis. The IMGT/StructuralQuery tool allows search of this database based on specific structural characteristics. IMGT/3Dstructure-DB and IMGT/StructuralQuery are freely available at http://imgt. cines.fr.

Animals↗

PubMed2004

TropGENE-DB, a multi-tropical crop information system.

TropGENE-DB, is a crop information system created to store genetic, molecular and phenotypic data of the numerous yet poorly documented tropical crop species. The most common data stored in TropGENE-DB are information on genetic resources (agro-morphological data, parentages, allelic diversity), molecular markers, genetic maps, results of quantitative trait loci analyses, data from physical mapping, sequences, genes, as well as the corresponding references. TropGENE-DB is organized on a crop basis with currently three running modules (sugarcane, cocoa and banana), with plans to create additional modules for rice, cotton, oil palm, coconut, rubber tree, pineapple, taro, yam and sorghum. The TropGENE-DB information system is accessible for consultation via the internet at http://tropgenedb.cirad.fr. Specific web consultation interfaces have been designed to allow quick consultations as well as complex queries.

Computational Biology↗

PubMed2003

INFEVERS: the Registry for FMF and hereditary inflammatory disorders mutations.

We have established the INFEVERS--INternet periodic FEVERS--website (which is freely accessible at http://fmf.igh.cnrs.fr/infevers/). Our objectives were to develop a specialist site to gather updated information on mutations responsible for hereditary inflammatory disorders: i.e. Familial Mediterranean Fever (FMF), TRAPS (TNF Receptor 1A Associated Syndrome), HIDS (HyperIgD Syndrome), MWS (Muckle-Wells Syndrome)/FCU (Familial Cold Urticaria)/CINCA (Chronic Infantile Neurological Cutaneous and Articular Syndrome). Contributors submit their novel mutations through a 3 step form. Depending on the disease concerned, a member of the editorial board is automatically solicited to overview and validate new submissions, via a special secured web interface. If accepted, the new mutation is available on the INFEVERS web site and the discoverer, who is informed by email, is credited by having his/her name and date of the discovery on the site. The INFEVERS gateway provides researchers and clinicians with a common access location for information on similar diseases, allowing a rapid overview of the corresponding genetic defects at a glance. Furthermore, it is interactive and extendable according to the latest genes discovered.

Data Collection↗

PubMed2003

The MetaFMF website: a high quality tool for meta-analysis of FMF.

We present here the MetaFMF database (freely accessible at http://fmf.igh.cnrs.fr/metaFMF/index_us.html) that attempts to gather and unify, in a common resource, data on phenotype-genotype correlation in familial Mediterranean fever (FMF). A single accession form, including a large number of quality controls, has been implemented such that data, collected worldwide, are included in an homogeneous manner. The inclusion criterion has the objective to avoid interpretational bias: patients will be included only if they bear at least two mutations. The clinical form has been set up by an International editorial board (12 FMF expert centres), which guarantees the validity of the data. Data are anonymous and submitted by a secure interface, in which the researcher is logged in with a specific ID and password. A pilot study on 211 patients has shown the feasibility and relevance of this project. We anticipate that the use of MetaFMF will enable reliable assessment of phenotype-genotype correlations in FMF, and define a set of severe versus mild mutations/genotypes. It should also highlight reasons for previous inconsistencies in such correlations.

Data Collection↗

PubMed2003

IMGT unique numbering for immunoglobulin and T cell receptor variable domains and Ig superfamily V-like domains.

IMGT, the international ImMunoGeneTics database (http://imgt.cines.fr) is a high quality integrated information system specializing in immunoglobulins (IG), T cell receptors (TR) and major histocompatibility complex (MHC) of human and other vertebrates. IMGT provides a common access to expertly annotated data on the genome, proteome, genetics and structure of the IG and TR, based on the IMGT Scientific chart and IMGT-ONTOLOGY. The IMGT unique numbering defined for the IG and TR variable regions and domains of all jawed vertebrates has allowed a redefinition of the limits of the framework (FR-IMGT) and complementarity determining regions (CDR-IMGT), leading, for the first time, to a standardized description of mutations, allelic polymorphisms, 2D representations (Colliers de Perles) and 3D structures, whatever the antigen receptor, the chain type, or the species. The IMGT numbering has been extended to the V-like domain and is, therefore, highly valuable for comparative analysis and evolution studies of proteins belonging to the IG superfamily.

Amino Acid Sequence↗

PubMed2002

IMGT gene identification and Colliers de Perles of human immunoglobulins with known 3D structures.

A new database, IMGT/3Dstructure-DB, was developed and implemented in the IMGT (international ImMunoGeneTics database) information system (http://imgt.cines.fr) to provide a unique expertised resource on immunoglobulin and T-cell receptor structural data. Corresponding protein sequences were annotated with IMGT tools, which allow the precise identification of the genes expressed in these proteins, and the description of framework and complementarity determining regions according to the IMGT standardized nomenclature and IMGT unique numbering. Two-dimensional graphical representations of the V-DOMAINs, designated as Colliers de Perles, are automatically produced. A query Web interface allows interactive search of the IMGT/3D structure-DB data. In this article, IMGT gene identification and Colliers de Perles of human immunoglobulins with known 3D structures in the Protein Data Bank are presented.

Alleles↗