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P Ramos

Publications and source records attributed to P Ramos.

At least 19 recordsLinked to original sources
PubMed2006

Nosocomial outbreak of Pseudomonas aeruginosa infections related to a flexible bronchoscope.

An outbreak of Pseudomonas aeruginosa infections affecting 17 patients was detected in the 27-bed intensive care unit (ICU) of a community hospital from 1 July to 30 September 2003. An ambidirectional cohort study was conducted to identify the risk factors for infection. Nosocomial infections were defined using the criteria of the Centers for Disease Control and Prevention. Random arbitrary polymorphic DNA-polymerase chain reaction was used for genotypic characterization. Logistic regression analyses demonstrated that case patients were more likely than non-cases to have had a longer stay in the ICU, and to have undergone mechanical ventilation and antimicrobial treatment. The multi-variate analysis identified recent bronchoscopy [risk ratio (RR) 3.8, 95% confidence interval (CI) 2.5-3.9] and exposure to an infected patient (RR 2.9, 95% CI 1.1-3.7) as independent risk factors. Molecular analysis showed that of the nine isolates available, four patients had a similar strain. The factor with the strongest influence on the risk of death was infection with P. aeruginosa (RR 2.1, 95% CI 1.0-2.4, P=0.04). A combined infection control strategy was implemented, including strict compliance with isolation precautions and recommendations for cleaning and disinfecting bronchoscopes, and a sharp reduction in the incidence of P. aeruginosa infection followed. It is thought that this outbreak was caused by patient-to-patient transmission and infection from a common source, i.e. the flexible bronchoscope.

Bronchoscopes↗
PubMed2006

Endometrioid adenocarcinoma of the ovary and endometriosis.

OBJECTIVE: We present a retrospective analysis of 22 cases of endometrioid ovarian carcinoma, reviewed to identify endometriosis and its malignant transformation. STUDY DESIGN: Twenty-two patients with endometrioid ovarian cancer were included in the review. Their clinical and histological data were retrospectively reviewed. The origin of the tumours was considered endometriosis-related when the presence of malignant changes in endometriosis glands leading to endometrioid carcinoma were found. RESULTS: Endometriosis was detected in three cases (3/22=14%). One of them presented a clearly benign to malignant transformation area. In another patient, the transition zone was abrupt and present in both ovaries. In the third, a pre-menopausal woman, ovarian endometriosis with only focal endometrioid carcinoma was observed. The three of them had a clear-cell carcinoma component. The presence of a clear-cell component was significantly greater in patients with endometriosis than in patients without endometriosis Each patient had a different clinical presentation: increase in abdominal perimeter, post-menopausal vaginal haemorrhage and hypermenorrhea. Preoperative CA 125 levels were avalaible in 15 of the patients (15/22=68%). Endometriosis was found in two of these 15 patients, both with the highest CA 125 measured levels, exceeding 1700 U/ml. In the remaining of the patients, CA 125 value did not exceed 35 U/ml. CONCLUSION: Although this association is not very frequent, patients with ovarian endometriosis and a high CA 125 serum level should be managed with special care, regardless of their pre-menopausal or post-menopausal status.

Adenocarcinoma, Clear Cell↗
PubMed2006

Evaluation of fruit-vegetable and fish wastes as alternative feedstuffs in pig diets.

Fruit-vegetable and fish wastes were evaluated as potential feedstuffs for growing-finishing pigs. Wastes were collected from shops in the city of Salamanca (Spain) and their nutritional composition, mineral content and digestibility were determined. The dry matter of the wastes under study was relatively low (12% for fruit-vegetable waste and 26% for fish waste), but they presented all of the nutrient requirements for swine diets. The fish waste contained 58% crude protein, 22% ash, 19% ether extract and 1% crude fibre, whereas the fruit-vegetable waste contained 65% nitrogen free extract, 13% crude fibre, 12% crude protein, 8% ash and 2% ether extract. Waste digestibility decreased with temperature, and hence temperatures over 65 degrees C for fruit-vegetable waste and 105 degrees C for fish waste should not be used in the treatment to reduce the moisture and to ensure the microbiology quality. Therefore, two diets were formulated using linear programming. The analysed waste was included in approximately 20% of one of the diets, while another diet was formulated without any type of waste. These data showed that this part of biodegradable municipal waste could be managed as alternative feedstuffs in swine diets, reducing the amount of biodegradable municipal waste going to landfills.

Animal Feed↗
PubMed2005

Study of drying systems for the utilization of biodegradable municipal solid wastes as animal feed.

The effectiveness of different drying systems used for the dehydration of certain fractions of biodegradable municipal solid wastes with a high moisture content (fruit and vegetable remains) was analyzed. Some tests using small amounts of the material were carried out in natural and forced convection ovens. For larger quantities of wastes, a discontinuous cabinet dryer and a continuous rotary dryer were used. With these dryers, the moisture content was reduced from 800 to 100 g kg(-1). It was verified that the continuous rotary dryer was the most efficient type of equipment studied, since it allowed a dried waste to be obtained with better nutritional and microbiological qualities and in accordance to the specifications of the products for animal feeding.

Animal Feed↗
PubMed2005

Biodegradable municipal solid waste: characterization and potential use as animal feedstuffs.

Five different fractions of the biodegradable municipal solid waste (BMSW) were evaluated as potential animal feedstuffs. For each source of waste (meat waste (MW), fish waste (FW), fruit and vegetables waste (FVW), restaurant waste (RW), household waste (HW)), samples were obtained from small shops (butchers, fishmongers, fruit and vegetable shops), restaurants and a MSW treatment plant (household waste). The chemical composition, microbiological characterization, dioxins, furans, PCB's and mineral content were determined for every type of waste fraction. The analysed biodegradable waste presented high moisture content (from 60% to 90%). Some fractions were dense in one nutrient: meat waste in ether extract, fish waste in crude protein, fruit and vegetable waste in nitrogen free extract. The other studied fractions (restaurant fraction and household fraction) presented a more balanced composition, but the presence of toxic concentrations of contaminants such as metals was higher than European legislation permitted values in animal feeding. From a microbiological standpoint, a heat treatment at 65 degrees C for 20 min was sufficient to ensure microbiological quality of the samples. This treatment was also advisable to reduce the moisture content: a lower moisture content facilitates the waste handling and processing and, therefore, the inclusion of these waste fractions in commercial animal diets. This paper presents a potential alternative for the recovery of organic matter content in municipal solid waste. The results obtained in this research and the feedstuffs legislation in force related to animal feed, indicated that some of the studied biodegradable waste fractions (meat waste, fruit and vegetable waste and fish waste) could be considered as alternatives to typical raw materials used in animal feeds.

Animal Feed↗
PubMed2005

Sewage outfall plume dispersion observations with an autonomous underwater vehicle.

This work represents one of the first successful applications of Autonomous Underwater Vehicles (AUVs) for interdisciplinary coastal research. A monitoring mission to study the shape and estimate the initial dilution of the S. Jacinto sewage outfall plume using an AUV was performed on July 2002. An efficient sampling strategy enabling greater improvements in spatial and temporal range of detection demonstrated that the sewage effluent plume can be clearly traced using naturally occurring tracers in the wastewater. The outfall plume was found at the surface highly influenced by the weak stratification and low currents. Dilution varying with distance downstream was estimated from the plume rise over the outfall diffuser until a nearly constant value of 130:1, 60 m from the diffuser, indicating the near field end. Our results demonstrate that AUVs can provide high-quality measurements of physical properties of effluent plumes in a very effective manner and valuable considerations about the initial mixing processes under real oceanic conditions can be further investigated.

Biomechanical Phenomena↗
PubMed2004

Vitreous humour as a complementary sample to blood for the detection/confirmation of diazepam: ante-mortem and post-mortem studies in an animal model.

The quantification of medical or toxic substances in vitreous humour (VH) could be very useful in forensic toxicology when blood sample determinations are impossible due to absence or deterioration. However, few studies have been made in this area and even fewer have tried to find a relationship between drug levels in both samples. To determine a correlation ratio between blood and VH diazepam (DZ) levels, we performed an experimental study using rabbits administered with a sub-toxic dose of DZ under known and controlled conditions. Blood and VH samples were collected 0.5, 1, 2, 3 and 6 hours after the drug administration in order to determine DZ and its main active metabolite, desmethyldiazepam (DMD). In addition, we have studied an animal group sacrificed 2 hours after intramuscular (i.m.) drug administration with blood and VH collection 24 hours later, to evaluate the existence of possible post-mortem changes. After DZ administration, a fast absorption phase was observed with a plasma Cmax value 1 hour after, followed by a rapid concentration decrease, with a half-life of 1 hour, indicating that, besides elimination, a fast distribution to other organs and tissues and/or hepatic metabolism occurred. Diazepam Cmax value in VH was achieved between 1 and 2 hours, when plasma concentrations had already decreased to half the value. The plasma/VH DZ ratio calculated at this time was 10. In the post-mortem study, while plasma DZ concentration at 24 hours was smaller, DMD levels were higher than those at the time of death. In the VH, both DZ and DMD concentrations at 24 hours were higher than those obtained at the time of death. That is, in both fluids DZ and DMD concentrations were different from those at the time of death and post-mortem distribution and redistribution phenomena occurred. The combination of ante-mortem and post-mortem studies has allowed the determination of a correlation ratio for DZ in the rabbit of 6 x, comparing the concentrations in VH collected 24 hours after death with the concentrations detected in plasma at the time of death. This study opens new perspectives for the use of VH as a complementary sample to blood for DZ detection and confirmation. The putative relevance of the correlation ratio obtained, for forensic toxicology practice with medical substances, namely benzodiazepines, recommends further studies in humans.

Animals↗
PubMed2004

[Coverage of the 23-valent pneumococcal vaccine in those older than 64 years of age in the region of Castellon and Valencia, Spain].

The different serotypes of Streptococcus pneumoniae isolated from adults aged over 64 years in the Valencia and Castellon health region of Spain from June 1999 to December 2003 were analyzed. A total of 163 strains were evaluated; 58.3% were invasive, 47.24% were from respiratory source, and 4.9% were from exudates. The greatest percentage of samples was obtained from the group of patients aged 65 to 75 years (60.7%), while the lowest percentage was obtained from the group of patients aged over 85 years (10.4%). In the latter group, 53% of the strains were invasive and 29.4% were isolated from sputum. A total of 21 serotypes were identified, with the most common (> 3%) being: serotype 3 (22.1%); serotype 19 (12.9%); serotype 6 (12.3%); serotype 9 (8.6%); serotype 14 (10.4%); serotype 23 (8%); serotype 29 (3.7%); and serotype 18 (3.1%). Serotype 3 was the most common serotype found in all samples, with the exception of exudate, while serotype 23 was not isolated in blood. In this population group, the coverage of the 23-valent vaccine was 88.4%. Serotypes not included in this vaccine but isolated from invasive samples were serotypes 16, 24, 29 and 35. No changes were observed in serotype distribution over the 4-year period of the study. However, it is necessary to continue epidemiological monitoring to determine whether serotype substitution occurs.

Aged↗
PubMed2003

Preoperatively irradiated rectal carcinoma: analysis of the histopathologic response and predictive value of proliferating cell nuclear antigen immunostaining.

OBJECTIVES: To investigate the relationship between the histopathologic effects of preoperative chemoradiotherapy in rectal cancer and the proteins, proliferating cell nuclear antigen (PCNA) and p53. METHODS: Samples from 73 tumors were examined. The histopathologic effects observed in the resected specimens induced by preoperative chemoradiotherapy were correlated with the inmunohistochemical expression of PCNA and p53 in biopsies obtained by rectoscopy before chemoradiotherapy. RESULTS: Thirty-five tumors showed a high PCNA index (48%). Nuclear accumulation of p53 protein was detected in 53 tumors (72%). Specimens were assigned one of four grades based on the amount of residual viable tumor. Three neoplasms (4%) showed complete regression; 8 other carcinomas (11%) showed only small numbers of tumor cells scattered within the field of stromal reaction. In these cases, it was considered that the tumor had responded significantly to radiotherapy. Tumors with a high PCNA index responded to chemoradiotherapy more frequently (8/35; 72%) than tumors with a low index (3/38; 43%) (p = 0.07). p53-negative tumors responded more frequently (4/20; 20%) than positive tumors (7/53; 13.2%) (p = 0.50). When pathologic and immunohistochemical characteristics of the tumors were included in a logistic regression model, only high PCNA index (odds ratio 5.35, 95% confidence interval 1.07-26.7) (p = 0.04) was significantly associated with the histologic response to preoperative chemoradiotherapy. CONCLUSION: High proliferative activity of rectal cancer, as determined by PCNA immunostaining, is predictive of the response to preoperative chemoradiotherapy.

Aged↗
PubMed2002

Müllerian adenosarcoma of the cervix with heterologous elements: report of a case and review of the literature.

BACKGROUND: Müllerian adenosarcoma (MA) is a rare neoplasm composed of benign epithelial and malignant stromal components. Its location in the cervix and the presence of heterologous elements are extremely infrequent (to our knowledge, only 14 more cases have been reported in the English literature). We describe another case of MA of the uterine cervix with heterologous elements and review the clinical and pathological features of these tumors. CASE REPORT: A nulliparous 25-year-old woman was admitted to the hospital because of metrorrhagia and recurrent masses, dependent on the cervix, initially considered endocervical polyps. Microscopically, the last curettage performed revealed a tumor composed of two elements, epithelial and mesenchymal. The epithelial elements were benign endocervical type glands, and the mesenchymal were sarcomatous, containing minor foci of cartilage. A diagnosis of endocervical heterologous adenosarcoma was reached, and a total hysterectomy and bilateral salpingo-oophorectomy were performed. The patient is alive 2 years after the surgical procedure. Neither chemotherapy nor other adjuvant therapies have been administered, and she is clinically free of disease at the moment. CONCLUSION: Because MA with heterologous elements seems to appear at the earliest stages of the reproductive lifespan in women, commonly with a history of recurrent polyps, and because its malignant potential is uncertain, gynecologists and pathologists should be aware and think about the possibility of this tumor. Long-term follow-up is essential and so is the accumulation of individual cases to provide further experience with these unusual neoplasms.

Adenosarcoma↗
PubMed2001

Detection of Leishmania infantum by PCR, serology and cellular immune response in a cohort study of Brazilian dogs.

The sensitivity and specificity of PCR, serology (ELISA) and lymphoproliferative response to Leishmania antigen for the detection of Leishmania infantum infection were evaluated in a cohort of 126 dogs exposed to natural infection in Brazil. For PCR, Leishmania DNA from bone-marrow was amplified with both minicircle and ribosomal primers. The infection status and time of infection of each dog were estimated from longitudinal data. The sensitivity of PCR in parasite-positive samples was 98%. However, the overall sensitivity of PCR in post-infection samples, from dogs with confirmed infection, was only 68%. The sensitivity of PCR varied during the course of infection, being highest (78-88%) 0-135 days post-infection and declining to around 50% after 300 days. The sensitivity of PCR also varied between dogs, and was highest in sick dogs. The sensitivity of serology was similar in parasite-positive (84%), PCR-positive (86%) and post-infection (88%) samples. The sensitivity of serology varied during the course of infection, being lowest at the time of infection and high (93-100%) thereafter. Problems in determining the specificity of serology are discussed. The sensitivity and specificity of cellular responsiveness were low. These data suggest that PCR is most useful in detecting active or symptomatic infection, and that serology can be a more sensitive technique for the detection of all infected dogs.

Animals↗
PubMed2000

Nitric oxide inhibits isoproterenol-stimulated adipocyte lipolysis through oxidative inactivation of the beta-agonist.

Nitric oxide has been implicated in the inhibition of catecholamine-stimulated lipolysis in adipose tissue by as yet unknown mechanisms. In the present study, it is shown that the nitric oxide donor, 2,2-diethyl-1-nitroso-oxyhydrazine, antagonized isoproterenol (isoprenaline)-induced lipolysis in rat adipocytes, freshly isolated from white adipose tissue, by decreasing the potency of the beta-agonist without affecting its efficacy. These data suggest that nitric oxide did not act downstream of the beta-adrenoceptor but reduced the effective concentration of isoproterenol. In support of the latter hypothesis, we found that pre-treatment of isoproterenol with nitric oxide abolished the lipolytic activity of the catecholamine. Spectroscopic data and HPLC analysis confirmed that the nitric oxide-mediated inactivation of isoproterenol was in fact because of the modification of the catecholamine through a sequence of oxidation reactions, which apparently involved the generation of an aminochrome. Similarly, aminochrome was found to be the primary product of isoproterenol oxidation by 3-morpholinosydnonimine and peroxynitrite. Finally, it was shown that nitric oxide released from cytokine-stimulated adipocytes attenuated the lipolytic effect of isoproterenol by inactivating the catecholamine. In contrast with very recent findings, which suggest that nitric oxide impairs the beta-adrenergic action of isoproterenol through intracellular mechanisms and not through a chemical reaction between NO and the catecholamine, we showed that nitric oxide was able to attenuate the pharmacological activity of isoproterenol in vitro as well as in a nitric oxide-generating cellular system through oxidation of the beta-agonist. These findings should be taken into account in both the design and interpretation of studies used to investigate the role of nitric oxide as a modulator of isoproterenol-stimulated signal transduction pathways.

3T3 Cells↗
PubMed2000

Autologous peripheral blood progenitor cell transplantation with <2 x 10(6) CD34(+)/kg: an analysis of variables concerning mobilisation and engraftment.

INTRODUCTION: This study analyses the factors affecting mobilisation and engraftment in autologous peripheral blood progenitor cell transplantation according to the number of CD34(+) re-infused. MATERIALS AND METHODS: A total of 190 patients underwent mobilisation with G-CSF alone (n=113) or in combination with chemotherapy (n=77). A total of 116 patients (61%) were autografted with <2 x 10(6) CD34(+) cells/kg and 74 patients were transplanted with >2 x 10(6) CD34(+) cells/kg. Rates of granulocyte and platelet recovery were estimated using the product-limit method of Kaplan-Meier and compared using a log-rank test. The Cox regression model was used for the multivariate analysis of factors influencing engraftment. Differences between cohorts were evaluated by one-way ANOVA or Mann-Whitney tests, and multivariate analysis was performed using a stepwise lineal regression. RESULTS: Neutrophil and platelet engraftment was significantly longer with <2 x 10(6)/CD34(+)/kg (12 vs 10 days, P=0.014 and 16 vs 13 days, P=0.0001 respectively). Platelet recovery was affected by exposure to alkylating agents (P=0.04), refractory disease (P=0.02) and AML (P=0.0001), but only the last two variables remained significant in Cox regression (P<0.01). Granulocyte engraftment was longer in CML (univariate, P=0.04) and in refractory disease (multivariate, P=0.02). In patients re-infused with >2 x 10(6)/CD34(+)/kg, the Cox model did not identify prognostic factors for haematopoietic recovery. CONCLUSION: Although mobilisation schedules and disease status influenced not only the yield of progenitor cells, but also the engraftment kinetics, the number of CD34(+) re-infused was the main predictor of haematopoietic recovery. While engraftment succeeded in most of the cases, the re-infusion of >2 x 10(6)/CD34(+)/kg resulted in significantly shorter recovery times.

Adolescent↗
PubMed2000

[Efficacy of the impulse magnetic field therapy in patients after the outer drainage of abdominal cysts diagnosed with the use of isotopic and ultrasound techniques].

154 patients with pancreatic, renal or hepatic cysts have been treated with the outer drainage under USG monitoring. Because of cysts' contact with tracts penetrating to an organ or its lack, the patients have been divided into two groups. Directly after the puncture all the patients have undergone the high frequency impulse magnetic field therapy. A distinct, positive treatment effect has been found in patients who have gone through not only drainage, but also magnetic field.

Cysts↗