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Biomedical subjects

O Castillo

Publications and source records attributed to O Castillo.

At least 19 recordsLinked to original sources

[Radical laparoscopic cystectomy].

Radical laparoscopic cystectomy is being adopted by most groups with proven experience in laparoscopic surgery, especially by those who have already completed the learning curves in radical laparoscopic prostatectomy. It is still considered a highly complex technique, which has not yet been mastered in many Urology Units. In this article, we review the surgical technique and available literature on this approach, with special emphasis on its indications, advantages and most frequent morbidity.

Cystectomy↗

[Complications of laparoscopic urological procedures].

Laparoscopic urology has evolved considerably during last decade as well as number and spectrum of surgical related complications. Experiences reported by laparoscopic trained groups allow preventing, promptly recognizing, and safe and efficient management of the laparoscopic related complications. We present our complications in all patients undergoing urological laparoscopic procedures from November 1992 to June 2005. A literature search was conduced to evaluate complications of every laparoscopic procedure.

Humans↗

[Complications in laparoscopic nephrectomy].

OBJECTIVE: To report the complications and their respective management in our series of laparoscopic nephrectomy. MATERIAL AND METHODS: Between November 1992 and March 2004, 319 patients underwent laparoscopic ablative renal surgery: 152 were women and 167 were men, mean age was 45 years (range: 0,5-82 years). There were 70 radical nephrectomies, 16 radical nephroureterectomies, 63 partial nephrectomies, 124 simples nephrectomies, 15 simples nephroureterectomies, 8 heminephrectomies and 23 living donor nephrectomies. RESULTS: The complication rate was 5.64%. The most frequent complications were bleeding (2.5%) and retroperitoneal haematoma (1.2%). There was not statically difference in complications rate by age, sex, or approach via: transperitoneal versus retroperitoneal. Complication rate was alike with laparoscopic or hand assisted technique. There was not mortality in the series. CONCLUSIONS: We have a low complication rate in laparoscopic nephrectomy. We believe that laparoscopy is a safe technique for patients that require ablative renal surgery when the surgical team has experience in advanced laparoscopic surgery.

Adolescent↗

[Laparoscopic surgery in the treatment of adrenal pathology: experience with 200 cases].

OBJECTIVE: We report our experience in laparoscopic adrenalectomy, after adopting the laparoscopic technique for 10 years as a primary option for suprarenal surgery. METHODS: We included 200 laparoscopic adrenal surgeries performed consecutively in 183 patients with surgical adrenal pathology between November 1994 and November 2005. Sixty-seven (36.6%) patients were male and 116 (63.4%) were female, with an average age of 49.1 years (age range 8 months to 78 years). RESULTS: The most frequents clinical diagnosis were hyperaldosteronism (17.5%), metastatic cancer (15.8%), pheochromocytoma (15.3%), Cushing syndrome (7.1%), adrenal cyst (4.9%) and myelolipoma (2.7%). A total of 164 total adrenalectomies, 29 partial adrenalectomies and 7 marsupializations of adrenal cysts were performed. Mean surgical time was 82.6 minutes (range 25 to 240 minutes) and mean hospitalization time was 2.5 days (range 1-10 days). The size of the suprarenal gland and/or tumor varied between 1 and 14 cm (average 5.6 cm). The rate of complication was 6%. In 8 of the patients, there was another laparoscopic procedure besides the adrenal surgery: cholecystectomies (2), marsupialization of a renal cyst (2), block nephrectomy (2), partial nephrectomy for a tumor (1) and pancreatic cystectomy (1). One patient underwent a right laparoscopic adrenalectomy and an ipsilateral percutaneous nephrolithotomy. CONCLUSION: The accumulated experience with 200 laparoscopic adrenal procedures has allowed the management of endocrine pathologies, such as, aldosteroma, pheochromocytoma, Cushing syndrome and rare entities, such as, cysts, myelolipomas in a suitable manner. Additionally, it has permitted us to extend the benefits of a minimally invasive procedure for large adrenal masses and selected oncology cases.

Adolescent↗

[Urinary undiversion; Bricker to Studer. With regard of two cases].

We present two cases of urinary undiversion from an ileal loop (Bricker) to an orthotopic neobladder. Due to miss adaptation to the stoma, two patients demanded reconversion to a continent urinary diversion. We proceed to change their urinary diversion to an ileal neobladder (Studer), one by open surgery and the other by laparoscopic surgery. In both cases immediate postoperative went uneventful. Both patients are continent, satisfied with their new situation, and without metabolic complications. Urinary undiversion from an ileal conduit to an orthotopic neobladder is technically feasible by open or laparoscopic surgery. It is a valid alternative for patients with complications due to their urinary diversion or miss adaptation to the cutaneous stoma.

Humans↗

Mediterranean diet, but not red wine, is associated with beneficial changes in primary haemostasis.

OBJECTIVE: (1) To compare the effect of an alcohol-free Mediterranean-type diet (MD) and a high-fat diet (HFD) on variables of primary haemostasis (bleeding time, plasma von Willebrand factor and platelet aggregation/secretion). (2) To test whether red wine supplementation modified these variables, independently of the diet. DESIGN, SUBJECTS AND INTERVENTION: Controlled prospective intervention study. Two groups, each consisting of 21 healthy male university students (22+/-3.4 y), received either MD or HFD during 90 days. Between days 30 and 60, both diets were supplemented with 240 ml/day of red wine. Baseline (T0) and T30, T60 and T90-day samples were drawn. Bleeding time was measured before (day 30) and after (day 60) wine supplementation. No drop out from the study was experienced. SETTING: University campus and outpatient nutrition clinic. RESULTS: All baseline (day 0) variables did not differ significantly between study groups. On day 30, individuals on MD had significantly higher levels of plasma beta-carotene, folate, ascorbate, and eicosapentaenoic acid in plasma lipid fractions, than those on HFD. Total plasma cholesterol, HDL and LDL did not change significantly in either study group at any time point. After 30 days on each diet, individuals on MD had longer bleeding time (BT) than those on HFD (7.6+/-2.8 vs 5.8+/-1.7 min; P=0.017). BT did not change significantly after I month of wine supplementation (7.1+/-2.0 vs 5.5+/-2.0 min, respectively). Plasma von Willebrand factor (vWF : Ag) on day 0 was 89+/-40 and 111+/-70% in MD and HFD groups, respectively (P=0.21). These values did not change significantly at 30, 60 or 90 days. MD intake was associated with an increase in platelet serotonin secretion (P=0.02) and a marginal increase in platelet aggregation after stimulation with epinephrine (P=0.07). Wine intake resulted in a marginal decrease in platelet (14)C-5-HT secretion with 4 micro M ADP (P=0.07). However, both platelet aggregation and secretion were consistently increased when using collagen as agonist (1 and 2 micro g/ml, P=0.01). CONCLUSION: The longer BT in individuals on MD, obtained independently of red wine, denotes less interaction of platelets with the vascular wall, which could be beneficial from the point of view of cardiovascular (CV) risk. This effect is not explained by changes in the measured haemostatic determinants of BT (plasma vWF, ex vivo platelet function), and might be attributed to other as yet unknown vascular factors. Moderate consumption of red wine results in a significant increase in ex vivo platelet aggregation and secretion after stimulation with collagen. This observation contradicts previous reports, although further studies are required to elucidate the influence of this finding on CV risk.

Adult↗

Syntheses, crystal structures, and magnetic properties of one-dimensional oxalato-bridged Co(II), Ni(II), and Cu(II) complexes with n-aminopyridine (n = 2-4) as terminal ligand.

The reaction of M(ox) x 2H(2)O (M = Co(II), Ni(II)) or K(2)(Cu(ox)(2)) x 2H(2)O (ox = oxalate dianion) with n-ampy (n = 2, 3, 4; n-ampy = n-aminopyridine) and potassium oxalate monohydrate yields one-dimensional oxalato-bridged metal(II) complexes which have been characterized by FT-IR spectroscopy, variable-temperature magnetic measurements, and X-ray diffraction methods. The complexes M(mu-ox)(2-ampy)(2) (M = Co (1), Ni (2), Cu (3)) are isomorphous and crystallize in the monoclinic space group C2/c (No. 15), Z = 4, with unit cell parameters for 1 of a = 13.885(2) A, b = 11.010(2) A, c = 8.755(1) A, and beta = 94.21(2) degrees. The compounds M(mu-ox)(3-ampy)(2).1.5H(2)O (M = Co (4), Ni (5), Cu (6)) are also isomorphous and crystallize in the orthorhombic space group Pcnn (No. 52), Z = 8, with unit cell parameters for 6 of a = 12.387(1), b = 12.935(3), and c = 18.632(2) A. Compound Co(mu-ox)(4-ampy)(2) (7) crystallizes in the space group C2/c (No. 15), Z = 4, with unit cell parameters of a = 16.478(3) A, b = 5.484(1) A, c = 16.592(2) A, and beta = 117.76(1) degrees. Complexes M(mu-ox)(4-ampy)(2) (M = Ni (8), Cu (9)) crystallize in the orthorhombic space group Fddd (No. 70), Z = 8, with unit cell parameters for 8 of a = 5.342(1), b = 17.078(3), and c = 29.469(4) A. All compounds are comprised of one-dimensional chains in which M(n-ampy)(2)(2+) units are sequentially bridged by bis-bidentate oxalato ligands with M.M intrachain distances in the range of 5.34-5.66 A. In all cases, the metal atoms are six-coordinated to four oxygen atoms, belonging to two bridging oxalato ligands, and the endo-cyclic nitrogen atoms, from two n-ampy ligands, building distorted octahedral surroundings. The aromatic bases are bound to the metal atom in cis (1-6) or trans (7-9) positions. Magnetic susceptibility measurements in the temperature range of 2-300 K show the occurrence of antiferromagnetic intrachain interactions except for the compound 3 in which a weak ferromagnetic coupling is observed. Compound 7 shows spontaneous magnetization below 8 K, which corresponds to the presence of spin canted antiferromagnetism.

Journal Article↗

Complementary effects of Mediterranean diet and moderate red wine intake on haemostatic cardiovascular risk factors.

OBJECTIVES: To compare the effect of alcohol-free Mediterranean-type diet (MD) and high-fat diet (HFD) on plasma concentration of emergent haemostatic cardiovascular risk factors (HCVRF). Also, to test if red wine supplementation modifies HCVRF, independent of diet. DESIGN, SUBJECTS AND INTERVENTION: Controlled prospective intervention study. Two groups, each of 21 healthy male university students (22+/-3.4 y), received either MD or HFD for 90 days. Between days 30 and 60, both diets were supplemented with 240 ml/day of red wine. Baseline and T30, T60 and T90-day samples were drawn. No drop out from the study was observed. SETTING: University campus and outpatient nutrition clinic. RESULTS: Volunteers on HFD at T30 had increases in pro-coagulants fibrinogen (22%), factor VIIc (9%), and factor VIIIc (4%), and decreases in natural anticoagulants antithrombin III (3%), protein C (11%) and protein S (6%) and of 20% in plasminogen activator inhibitor-1. At the same time, individuals on MD had increases in fibrinogen (4%), antithrombin III (5%), protein C (3%), protein S (2.7%), and decreases in factor VIIIc (9%), and plasminogen activator inhibitor-1 (21%). After adjusting by baseline values, MD was associated with lower plasma fibrinogen (P=0.03), factor VIIc (P=0.034) and factor VIIIc (P=0.0057) and with higher levels of protein S (P=0.013). Red wine supplementation, in both diets, resulted in decreased plasma fibrinogen (P=0.001) and factor VIIc (P=0.05), and increased tissue plasminogen activator antigen (P=0.01) and plasminogen activator inhibitor-1 antigen (P=0.0003). Wine consumption was also associated with significantly (P=0.01) divergent effects on antithrombin III: it decreased by 10% in individuals on HFD but increased slightly in those on MD. No effects of diet or wine were detected in plasma protein C and C-reactive protein. CONCLUSION: MD and moderate consumption of red wine have complementary, mostly beneficial effects on HCVRF.

Adult↗

[Differences in plasma antioxidants according to socioeconomic level in Chilean women].

BACKGROUND: Free radical-mediated oxidative damage is a known initial event in atherogenesis. Cardiovascular disease is frequent in the Chilean population showing differences in the prevalence of risk factors of the disease according to socioeconomic level (SEL). AIM: To determine levels of antioxidants and lipid peroxides in Chilean women from different SEL. PATIENTS AND METHODS: Blood samples were taken from 81 women for measurements of plasma ascorbic acid, beta-carotene, alpha-tocopherol, licopene, ubiquinol, glutathione, total plasma antioxidant capacity, and lipid peroxides (TBARS). RESULTS: Individuals in the lower SEL showed reduced levels of plasma beta-carotene, ascorbic acid, alpha-tocopherol, and ubiquinol compared to women in the higher SEL. There were no differences between groups in the plasma levels of glutathione, total antioxidant capacity, or TBARS. CONCLUSIONS: The results could be explained in part by the higher consumption of fruits and vegetables in women from the upper SEL.

Adult↗

[Bilateral pheochromocytoma: laparoscopic surgery in 2 cases].

Laparoscopic adrenalectomy, if done by skilled surgeons, is now the first choice for treating most adrenal tumors, including bilateral pheochromocytoma. We report two women, aged 35 and 34 years old, with bilateral adrenal pheochromocytoma successfully excised by laparoscopic surgery. Both had severe hypertension, high urinary catecholamine values (epinephrine + norepinephrine: 528 and 1083 ug/24 h) and bilateral adrenal tumors at CT scan. After 4 weeks of doxazosin treatment, a laparoscopic transperitoneal adrenalectomy was done (Gugner's technique), with surgical times of 7 and 5 hours respectively. Both patients received hydrocortisone and only the second one required one unit of packed cells. Postoperative evolution was uneventful and both patients were discharged at the fifth postoperative day. At two months of follow up, both patients are asymptomatic and normotensive.

Adrenal Gland Neoplasms↗

Determination of beta-globin gene cluster haplotypes and prevalence of alpha-thalassemia in sickle cell anemia patients in Venezuela.

Sickle cell anemia and alpha-thalassemia have a heterogeneous distribution in Venezuela with a high frequency in the coastal area (sea level) and few cases in the mountains. Most of our population is an ethnic admixture of Europeans (Spaniards colonists), Africans (slaves), and Amerindians. The purpose of our study was to determine the origin of the beta(s) globin haplotype, age and survival dependency, and the admixture among the different African groups in our population. The alpha(3.7) globin gene deletion status was also studied and found in a very high frequency. DNA from peripheral blood of 191 non-related patients (81 with HbS homozygous and 15 patients compound heterozygous for HbS, HbC, HbD with beta-thalassemia, and 95 with sickle cell trait) were studied. The beta(s) chromosome was linked 51% to the Benin Haplotype, 29.5% with the CAR, 12.5% to the Senegal, and 2.5% to the Cameroon. We did not find any significant difference between the haplotype distribution among adults and children and among sickle cell patients and traits. Only 8.6% of the patients have homozygosity for the Benin haplotype. These results show a very high frequency of admixture in our African origin population.

Age Distribution↗

A high-fat diet induces and red wine counteracts endothelial dysfunction in human volunteers.

Endothelial dysfunction is associated with atherogenesis and oxidative stress in humans. In rat and rabbit blood vessels, wine polyphenol antioxidants induce vascular relaxation in vitro through the NO-cGMP pathway. To assess the effect of a regular high-fat diet (HFD) and moderate red wine consumption on endothelial function (EF), a study was performed in healthy male volunteers. EF was measured as flow-mediated dilatation of the brachial artery, employing high-resolution ultrasound after an overnight fast. Other clinical and biochemical parameters related to EF were also measured. Six volunteers received a control diet, rich in fruits and vegetables (27% calories as fat) and five volunteers received an HFD (39.5% calories as fat). Measurements were done twice on each volunteer: after a period of 30 d with diet plus 240 mL of red wine/d, and after a period of 30 d with diet, without wine. In the absence of wine, there is a reduction of EF with HFD when compared to the control diet (P = 0.014). This loss of EF is not seen when both diets are supplemented with wine for 30 d (P = 0.001). Plasma levels of n-3 fatty acids (R2 = 0.232, P = 0.023) and lycopene (R2 = 0.223, P = 0.020) show a positive correlation with individual EF measurements, but they do not account for the significant differences observed among dietary groups or after wine supplementation. These results help elucidate the deleterious effect of a high-fat diet and the protective role of wine, n-3 fatty acids and dietary antioxidants in cardiovascular disease.

Alkaline Phosphatase↗

Enhancement of diphtheria toxin potency by replacement of the receptor binding domain with tetanus toxin C-fragment: a potential vector for delivering heterologous proteins to neurons.

This study describes the expression, purification, and characterization of a recombinant fusion toxin, DAB(389)TTC, composed of the catalytic and membrane translocation domains of diphtheria toxin (DAB(389)) linked to the receptor binding fragment of tetanus toxin (C-fragment). As determined by its ability to inhibit cellular protein synthesis in primary neuron cultures, DAB(389)TTC was approximately 1,000-fold more cytotoxic than native diphtheria toxin or the previously described fusion toxin, DAB(389)MSH. The cytotoxic effect of DAB(389)TTC on cultured cells was specific toward neuronal-type cells and was blocked by coincubation of the chimeric toxin with tetanus antitoxin. The toxicity of DAB(389)TTC, like that of diphtheria toxin, was dependent on passage through an acidic compartment and ADP-ribosyltransferase activity of the DAB(389) catalytic fragment. These results suggest that a catalytically inactive form of DAB(389)TTC may be useful as a nonviral vehicle to deliver exogenous proteins to the cytosolic compartment of neurons.

3T3 Cells↗

[The impact of antimicrobial resistance and Streptococcus pneumoniae serotype distribution on the mortality of children under 5 years of age with invasive disease].

Severe pneumonia and meningitis caused by Streptococcus pneumoniae have been persistently associated with high mortality rates, despite advances in antimicrobial therapy and the development of vaccines. Resistance to penicillin and other antimicrobial agents is increasing and spreading worldwide. Even though risk factors for development of antimicrobial resistance have been identified, their influence on mortality has not been clarified. With regard to virulence, differences among serotypes have been determined, but their impact on mortality is unknown. The aim of this study was to determine the risk factors associated with mortality in children with invasive pneumococcal disease. Clinical records for 245 children under 5 years of age with invasive disease due to S.pneumoniae were reviewed. Children were diagnosed between 1994 and 1996 in Colombia, during the study of S.pneumoniae capsular types conducted by the Pan American Health Organization's Regional System for Vaccines. Of the 245 patients whose charts were examined, 29 (11%) died. No significant differences in age, gender, underlying disease, nor antimicrobial treatment concordance were found. Variables associated with mortality in the univariate analysis were a diagnosis of meningitis; antimicrobial resistance to penicillin, trimethoprim-sulfamethoxazole (TMS), or erythromycin; multiresistance, and serotypes 6, 23F, 7F, 8, and 35B. In the logistic regression, serotypes 7F (OR = 7.13; P = 0.04) and 8 (OR = 13.8; P = 0.07), polipnea (OR = 2.74; P = 0.03), meningitis (OR = 5.02; P = 0.0001) and TMS resistance (OR = 2.62; P = 0.02) continued to be associated with mortality. In patients with pneumonia, serotype was the factor most consistently associated with mortality; in meningitis patients, it was antimicrobial resistance. Differences in mortality according to serotype must be taken into account in developing a vaccine if a substantial impact on pneumococcal disease morbidity and mortality is to be achieved.

Age Factors↗

Plasma polyphenols and antioxidants, oxidative DNA damage and endothelial function in a diet and wine intervention study in humans.

An intervention study was performed to evaluate the influence of a Mediterranean diet, a high fat diet, and their supplementation with red wine in moderate amounts, on biochemical, physiological, and clinical parameters related to atherosclerosis and other chronic diseases. For 3 months two groups of 21 male volunteers each, received either a Mediterranean diet or a high fat diet; during the second month, red wine was added isocalorically, 240 ml/day. Participants were kept under close medical and nutritional surveillance. At days 0, 30, 60 and 90, clinical, physiological and biochemical evaluations were made. Plasma vitamin C was significantly decreased in the high fat diet group compared to the Mediterranean diet group. After wine supplementation to the Mediterranean diet, a significant 13.5% increase in plasma vitamin C was observed. Furthermore, when wine was added vitamin E decreased significantly in plasma, 15% in the high fat diet and 26% in the Mediterranean diet. Total plasma antioxidant capacity (total antioxidant reactivity) increased 28% above basal levels in the Mediterranean diet group, but not in the high fat diet group. In both groups, wine induced a marked increase in total antioxidant reactivity above basal levels, 56% and 23%, respectively. Oxidative DNA damage, detected as 8-hydroxydeoxyguanosine (8-OHdG) levels in blood leukocyte DNA, was markedly increased by the high fat diet; however, it was strongly reduced, to approximately 50% basal values, after wine supplementation, both in the high fat diet and Mediterranean diet groups. Endothelial function, evaluated noninvasively as flow-mediated vascular reactivity of the brachial artery, was suppressed by the high fat diet, and was normal after wine supplementation. These effects are attributed to oxidative stress associated with a high fat diet, and to the elevated plasma antioxidant capacity associated with wine consumption and the Mediterranean diet. The results presented support the following conclusions: a high fat diet induces oxidative stress; a diet rich in fruits and vegetables enhances antioxidant defenses; wine supplementation to a high fat or a Mediterranean diet increases plasma antioxidant capacity, decreases oxidative DNA damage, and normalizes endothelial function.

Adult↗

[Usefulness of free prostate specific antigen in the detection of prostate cancer].

BACKGROUND: The predictive value of prostate specific antigen for prostate cancer, when levels are between 4 and 10 ng/ml, is low. Within these range of values, some authors recommend the measurement of the free fraction of the antigen to improve its predictive capacity. AIM: To evaluate the predictive value of the free fraction in subjects with prostate specific antigen values between 4 and 10 ng/ml. PATIENTS AND METHODS: One hundred and forty subjects with prostate specific antigen between 4 and 10 ng/ml were evaluated. All were subjected to transcrectal ultrasound examination with biopsies and the free fraction of the antigen was measured by enzyme immuno assay. RESULTS: Cancer was diagnosed in 36 subjects, all others had a benign prostatic hyperplasia. Mean prostate specific antigen values were 7.4 and 7.1 ng/ml in patients with cancer and hyperplasia, respectively. The percentage of free prostatic specific antigen was 9.8 and 19.8% in subjects with cancer and hyperplasia respectively (p < 0.001). Using receiver operating characteristic (ROC) curves, a free prostate specific antigen of 13% was the best cutoff value for predicting prostate cancer. CONCLUSIONS: In subjects with prostate specific values between 4 and 10 ng/ml, the measurement of the free fraction of this antigen can improve the predictive value of this parameter for the detection of prostate cancer.

Adult↗