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Biomedical subjects

P Muñoz

Publications and source records attributed to P Muñoz.

At least 145 records · Page 8Linked to original sources
PubMed1994

Treatment of deep mycoses with liposomal amphotericin B.

Amphotericin B is the mainstay of therapy of many deep mycoses, but its use is seriously hampered by dose-limiting nephrotoxicity. In this study a liposomal formulation of amphotericin B was administered to ten patients with proven deep mycoses: invasive aspergillosis (n = 4), deep candidiasis (n = 4) and zygomycosis (n = 2). The mean daily dosage of liposomal amphotericin B was 3.0 mg/kg (range 2.5 to 4 mg/kg), the mean total dosage of liposomal amphotericin B 2,781 mg (range 87 to 5,220 mg) and the mean duration of treatment 17 days (range 3 to 33 days). Treatment with liposomal amphotericin B was associated with little nephrotoxicity and an overall survival rate of 50%. The median increase of serum creatinine from baseline levels was 0.38 mg/dl (-1.2 to 2.6 mg/dl).

Adult↗
PubMed1994

Quantitation of soluble HLA class I heterodimers and beta 2-microglobulin in patients with active pulmonary tuberculosis.

Beta 2m serum levels have been shown to be increased in patients with tuberculosis and HIV infection. We determined the stability of beta 2m and of sHLA-I dimers in serum, and then determined the levels of both molecules in 60 non-HIV-infected patients with active pulmonary tuberculosis and in 55 adult controls. The levels of sHLA-I in samples kept at room temperature declined by 8% at 30 minutes, 16% at 60 minutes, and 36% at 120 minutes. Beta 2m levels remained stable at all times tested. Mean sHLA-I levels were 0.99 +/- 0.16 micrograms/ml in controls and 1.34 +/- 0.11 micrograms/ml in patients with tuberculosis (P < 0.0001). Beta 2m levels were 1.23 +/- 0.26 micrograms/ml in controls and 2.26 +/- 0.64 micrograms/ml in patients with tuberculosis (P < 0.0001). All patients with tuberculosis had elevation of sHLA-I and/or beta 2m above 1 standard deviation of normal values. However, there was no correlation between sHLA-I and beta 2m levels in individual samples. Evaluation of sHLA-I holds the promise of further understanding of the biology and genetic regulation of the immune response to mycobacterial infection.

Adolescent↗
PubMed1994

Evolution of susceptibilities of Campylobacter spp. to quinolones and macrolides.

Erythromycin, new macrolides, and quinolones are alternatives for the treatment of Campylobacter infections. Concerns related to the emergence of resistance to both groups of drugs have been raised. We studied the evolution of antimicrobial susceptibilities of 275 clinical isolates of microorganisms of the genus Campylobacter isolated in our institution during a 5-year period (1988 to 1992). The microorganisms studied were C. jejuni (n = 230), C. coli (n = 42), and C. fetus (n = 3). The overall resistance rates (determined by the agar dilution method and the recommendations of the National Committee for Clinical Laboratory Standards) were as follows: erythromycin, 2.3%; clarithromycin, 2.3%; azithromycin, 1.9%; ciprofloxacin, 28.5%; norfloxacin, 31%; ofloxacin, 26.3%; and nalidixic acid, 36.8%. The evolution of resistance (percent resistance in 1988 versus percent resistance in 1992) was as follows: erythromycin, 2.6 versus 3.1; clarithromycin, 2.6 versus 3.1; azithromycin, 2.6 versus 3.1; ciprofloxacin, 0 versus 49.5; norfloxacin, 2.6 versus 55.5; ofloxacin, 0 versus 45.6; nalidixic acid, 2.6 versus 56.8. Our data show stable macrolide activity against Campylobacter spp. and the rapid development of quinolone resistance over the last 5 years.

4-Quinolones↗
PubMed1994

[Highly homogeneous Trypanosoma cruzi populations in a low endemic region for Chagas disease: importance in the pathogenesis of Chagas disease in Chile].

Trypanosoma cruzi from 23 chronic and acute cases of Chagas disease were isolated and further characterized. They displayed a remarkable similarity, after typification by schizodeme analysis using restriction endonuclease Eco Ri. All T cruzi isolates belonged to the isoenzymatic Zymodeme 2 Bol. These findings were corroborated analyzing cases from families with demonstrated congenital transmission. The acute cases were newborns or offspring of infected mothers or patients with AIDS. All T cruzi strains isolated in these cases were very similar with almost identical schizodemes. Patients with AIDS had severe clinical manifestations whereas children with congenital infections had a great variety of clinical symptoms. In chronic cases, little clinical differences were observed for the different T cruzi strains. It is concluded that there is a low correlation between the T cruzi strain and the clinical prognosis of Chagas disease, being of greater relevance the host's genetic background and immune response.

Adult↗
PubMed1994

Aeromonas peritonitis.

Five new cases of peritonitis caused by Aeromonas species are reported, and 29 others described in the literature are reviewed. Males predominated (71%), and the mean age was 56.9 years. Acquisition was nosocomial in 20% of the cases. All patients except one (3%) had significant underlying diseases; 73% had chronic hepatic disease, 15% had chronic renal failure (treated with chronic ambulatory peritoneal dialysis [CAPD]), and 9% had an intestinal perforation. Symptoms were similar to those of peritonitis caused by other pathogens, with the exception of diarrhea, which occurred in 25% of cases. Blood cultures were positive in 74% of the cases. The species isolated were Aeromonas hydrophila (27), Aeromonas sobria (5), and Aeromonas caviae (2). The overall case-fatality rate was 57%. Three strains were resistant to cotrimoxazole. Aeromonas species should be taken into account as a cause of peritonitis in patients with cirrhosis or who are undergoing CAPD.

Adolescent↗
PubMed1993

Rapid screening of Salmonella species from stool cultures.

The authors compared a three-minute fluorescence method (MUCAP test; Biolife Italiana, Milan, Italy) with standard microbiologic procedures for the presumptive identification of Salmonella from stool cultures on three solid culture media. From 976 suspect colonies, 176 proved to be Salmonella by the traditional methods. They all were detected by the MUCAP test (sensitivity, 100%). There were 65 false-positive results, corresponding mostly to Pseudomonas (specificity, 91.8%). Neither the culture medium used nor the production of H2S affected the accuracy of the test. The results from this study showed that the MUCAP test is a rapid, simple, and sensitive method for the presumptive identification of Salmonella species.

Evaluation Studies as Topic↗
PubMed1993

[Prevalence of mental disorders at emergency service].

Aiming to know the frequency of mental disorders among patients consulting a general hospital emergency ward, 2834 medical records of such patients were retrospectively reviewed. 8.4% of consultations were due to mental disorders. Sixty four percent of patients consulting for mental disorders were women. Anxiety disorders comprised 57.6% of consultations due to mental disorders and intoxications 7.6%. Eighty percent of the latter were consequence of suicidal attempts, being the most common method the use of benzodiazepines. A low percent of these patients were referred to psychiatry. The low frequency of psychiatric referrals and the importance of psychiatric advice in emergency rooms is discussed.

Chile↗
PubMed1992

Trisomy 8: an additional case with unique manifestations [correction].

We report on an infant with multiple congenital anomalies and mosaic trisomy 8 [corrected]. Clinical findings are presented, and compared with those of the 24 cases previously reported. Some unusual characteristics found in this patient include macrocephaly, an extreme degree of palatal hypoplasia, and abnormally shaped long bones.

Abnormalities, Multiple↗
PubMed1992

Vanadate stimulates system A amino acid transport activity in skeletal muscle. Evidence for the involvement of intracellular pH as a mediator of vanadate action.

Sodium orthovanadate caused a 2-fold stimulation of system A transport activity in soleus muscle, as assessed by the uptake of the nonmetabolizable analog 2-(methylamino)isobutyric acid (MeAIB). The effect of vanadate on system A was rapid, concentration-dependent and was characterized by an increased Vmax without modification of Km for MeAIB. Under these conditions, vanadate also activated 3-O-methylglucose uptake and lactate production. The effects of vanadate on muscle metabolism showed a complex interaction with the effects of insulin. Thus, the stimulatory effects of vanadate and insulin on MeAIB and 3-O-methylglucose uptake were not additive; however, the effects of insulin and vanadate on lactate production were additive. In spite of the lack of additivity, insulin- and vanadate-induced stimulation of system A differed in their sensitivity to gramicidin D, being the vanadate effect more susceptible to inhibition by gramicidin D than the insulin effect. System A transport activity shows a dependence on pH, and recent results suggest the presence of critical histidine residues on the A carrier that may be responsible for its pH dependence (Bertran, J., Roca, A., Pola, E., Testar, X., Zorzano, A. & Palacín, M. (1991) J. Biol. Chem. 266, 798-802). In this regard, a rise in extracellular pH led to a substantial activation of system A. Furthermore, lowering of muscle intracellular pH induced by ethylisopropylamiloride (EIPA), a specific inhibitor of sodium/proton exchange activity, led to inhibition of system A. This suggests that critical histidine residues are present in an intracellular localization on the A carrier. Furthermore, the rate of muscle glycolysis was also altered in response to a rise in extracellular pH or to EIPA treatment. Regarding the mechanisms involved in vanadate action, vanadate treatment in the incubated soleus muscle did not cause any significant stimulation of tyrosine kinase activity after partial purification of muscle insulin receptors. On the other hand, vanadate but not insulin caused a substantial increase in muscle intracellular pH as assessed by 5,5'-dimethyloxazolidine-2,4-dione equilibrium. This effect of vanadate on intracellular pH was not due to activation of the sodium/proton exchanger, since it was not blocked by EIPA. Based on these findings, we suggest that alkalinization of muscle intracellular pH might mediate the effects of vanadate on system A and on glycolysis.

Amiloride↗
PubMed1992

Effect of diabetes and fasting on GLUT-4 (muscle/fat) glucose-transporter expression in insulin-sensitive tissues. Heterogeneous response in heart, red and white muscle.

1. GLUT-4 glucose-transporter protein and mRNA levels were assessed in heart, red muscle and white muscle, as well as in brown and white adipose tissue from 7-day streptozotocin-induced diabetic and 48 h-fasted rats. 2. In agreement with previous data, white adipose tissue showed a substantial decrease in GLUT-4 mRNA and protein levels in response to both diabetes and fasting. Similarly, GLUT-4 mRNA and protein markedly decreased in brown adipose tissue in both insulinopenic conditions. 3. Under control conditions, the level of expression of GLUT-4 protein content differed substantially in heart, red and white skeletal muscle. Thus GLUT-4 protein was maximal in heart, and red muscle had a greater GLUT-4 content compared with white muscle. In spite of the large differences in GLUT-4 protein content, GLUT-4 mRNA levels were equivalent in heart and red skeletal muscle. 4. In heart, GLUT-4 mRNA decreased to a greater extent than GLUT-4 protein in response to diabetes and fasting. In contrast, red muscle showed a greater decrease in GLUT-4 protein than in mRNA in response to diabetes or fasting, and in fact no decrease in GLUT-4 mRNA content was detectable in fasting. On the other hand, preparations of white skeletal muscle showed a substantial increase in GLUT-4 mRNA under both insulinopenic conditions, and that was concomitant to either a modest decrease in GLUT-4 protein in diabetes or to no change in fasting. 5. These results indicate that (a) the effects of diabetes and fasting are almost identical and lead to changes in GLUT-4 expression that are tissue-specific, (b) white adipose tissue, brown adipose tissue and heart respond similarly to insulin deficiency by decreasing GLUT-4 mRNA to a larger extent than GLUT-4 protein, and (c) red and white skeletal muscle respond to insulinopenic conditions in a heterogeneous manner which is characterized by enhanced GLUT-4 mRNA/protein ratios.

Adipose Tissue↗
PubMed1992

Inhibitors such as staurosporine, H-7 or polymyxin B cannot be used in skeletal muscle to prove the role of protein kinase C on insulin action.

The precise role of protein kinase C in insulin action in skeletal muscle is not well defined. Based on the fact that inhibitors of protein kinase C block some insulin effects, it has been concluded that some of the biological actions of insulin are mediated via protein kinase C. In this study, we present evidence that inhibitors of protein kinase C such as staurosporine, H-7 or polymyxin B cannot be used to ascertain the role of protein kinase C in skeletal muscle. This is based on the following experimental evidences: a) staurosporine, H-7 and polymyxin B markedly block in muscle the effect of insulin on System A transport activity; however, this effect of insulin is not mimicked in muscle by TPA-induced stimulation of protein kinase C, b) H-7 and polymyxin B block insulin action on System A transport activity in an additive manner to the inhibitory effect of phorbol esters, c) staurosporine, H-7 and polymyxin B block the effect of insulin on lactate production, a process that is activated by insulin and TPA in an additive fashion, and d) staurosporine completely blocks the tyrosine kinase activity of insulin receptors partially purified from rat skeletal muscle.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
PubMed1992

Group B Streptococcus: a cause of urinary tract infection in nonpregnant adults.

Group B Streptococcus (GBS) is a well-known cause of infection in the perinatal and puerperal periods, but its role as a urinary tract pathogen of adults in nonobstetric situations has not yet been defined. We carried out a prospective 19-month study of all nonpregnant adult patients with significant GBS bacteriuria. This microorganism accounted for 2% of positive urine cultures. Our series included 60 patients, 85% of whom were women and 95% of whom had at least one underlying condition. Urinary tract abnormalities (60%) and chronic renal failure (27%) were among the most frequent underlying problems. The infection was community acquired in 65% of cases. Clinical manifestations were related equally to the upper and the lower urinary tract (37% and 38% of cases, respectively). The clinical outcome was poor in 18% of episodes despite treatment. All isolates were sensitive to all antibiotics tested except gentamicin. We conclude that GBS is a significant urinary pathogen in nonpregnant adults and that its presence signals a need for screening for urinary tract abnormalities.

Adult↗
PubMed1992

Developmental regulation of GLUT-1 (erythroid/Hep G2) and GLUT-4 (muscle/fat) glucose transporter expression in rat heart, skeletal muscle, and brown adipose tissue.

The expression of GLUT-1 (erythroid/Hep G2) and GLUT-4 (muscle/fat) glucose transporters was assessed during development in rat heart, skeletal muscle, and brown adipose tissue. GLUT-4 protein expression was detectable in fetal heart by day 21 of pregnancy; it increased progressively after birth, attaining levels close to those of adults at day 15 post natal. In contrast, GLUT-4 messenger RNA (mRNA) was already present in hearts from 17 day-old fetuses. GLUT-4 mRNA stayed low during early postnatal life in heart and brown adipose tissue and only increased after day 10 post natal. The expression pattern for GLUT-4 protein in skeletal muscle during development was comparable to that observed in heart. In contrast to heart and skeletal muscle, GLUT-4 protein in brown adipose tissue was detected in high levels (30% of adult) during late fetal life. During fetal life, GLUT-1 presented a very high expression level in brown adipose tissue, heart, and skeletal muscle. Soon after birth, GLUT-1 protein diminished progressively, attaining adult levels at day 10 in heart and skeletal muscle. GLUT-1 mRNA levels in heart followed a similar pattern to the GLUT-1 protein, being very high during fetal life and decreasing early in post natal life. GLUT-1 protein showed a complex pattern in brown adipose tissue: fetal levels were high, decreased after birth, and increased subsequently in post natal life, reaching a peak by day 9. Progesterone-induced postmaturity protected against the decrease in GLUT-1 protein associated with post natal life in skeletal muscle and brown adipose tissue. However, GLUT-4 induction was not blocked by postmaturity in any of the tissues subjected to study. These results indicate that: 1) during fetal and early post natal life, GLUT-1 is a predominant glucose transporter isotype expressed in heart, skeletal muscle, and brown adipose tissue; 2) during early post natal life there is a generalized GLUT-1 repression; 3) during development, there is a close correlation between protein and mRNA levels for GLUT-1, and therefore regulation at a pretranslational level plays a major regulatory role; 4) the onset of GLUT-4 protein induction occurs between days 20-21 of fetal life; based on data obtained in rat heart and brown adipose tissue, there is a dissociation during development between mRNA and protein levels for GLUT-4, suggesting modifications at translational or posttranslational steps; and 5) postmaturity blocks the decrease in GLUT-1 expression but not the induction of GLUT-4, observed soon after birth.(ABSTRACT TRUNCATED AT 400 WORDS)

Adipose Tissue, Brown↗
PubMed1992

[Pneumocystis carinii infection. Various aspects on its clinical and laboratory diagnosis].

P carinii is an opportunistic pathogenic agent able to produce severe infection that must be diagnosed promptly. We analyzed 138 samples from 100 patients suspected of having infection by P carinii. The ortho-toluidine blue and the methenamine stains were used to analyze the samples. Infection was demonstrated in 18 patients, 13 adults and 5 children. Underlying disease was AIDS in 7 and other immunosuppressive disorders in the rest. No immunocompetent patient was infected with P carinii. Proper sample collection is important for diagnosis. When bronchoalveolar lavage is not possible, pharyngo-tracheal aspirate in children and sputum sampling after assisted coughing in adults are recommended. At least 2 staining methods and proper controls are advisable.

Adult↗
PubMed1991

Leuconostoc species as a cause of bacteremia: two case reports and a literature review.

Two new cases of significant bacteremia caused by Leuconostoc spp. are reported and five others described in the literature are reviewed. Four of the seven patients were under one year old and presented with prolonged diarrhea related to gastrointestinal disorders. The remaining three patients were over 50 years of age and being treated in intensive care units. Six patients had nosocomially acquired catheter-related bacteremia. Leuconostoc spp. are naturally resistant to vancomycin, and five patients had received this antibiotic for prior bacteremia caused by methicillin-resistant staphylococci. The majority of patients presented with fever without severe complications. Penicillin is the treatment of choice and there is no report of any death directly attributable to infection by these microorganisms. Infection with Leuconostoc spp. should be suspected if "vancomycin-resistant streptococci" are isolated from the blood, and recorded as a potential cause of bacteremia in patients with indwelling intravenous catheters.

Age Factors↗