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Biomedical subjects

P Solís

Publications and source records attributed to P Solís.

At least 19 recordsLinked to original sources
PubMed2000

Demographic models of birth outcomes and infant mortality: an alternative measurement approach.

Most demographic studies use 2,500 grams of birth weight and 37 weeks of gestation as cutpoints for evaluating the effects of adverse birth outcomes on infant mortality. We propose an alternative strategy, which relies on continuous measures of birth outcomes, identifies an optimal combination of birth weight and gestational age for infant survival, and estimates the effects of adverse birth outcomes in terms of their departure from this "optimal point." We illustrate the advantages of this approach by estimating a logistic model using data from the 1989-1991 NCHS linked birth/infant death files. Finally, we discuss future applications and methodological issues to be resolved in subsequent research.

Birth Weight↗
PubMed1997

Lack of correlation between soluble CD14 and IL-6 in meningococcal septic shock.

Meningococcal sepsis is a good model to study the dynamic response of cytokines and other soluble factors in vivo in the early stages of the disease. Levels of soluble CD14, interleukin-6 (IL-6), IL-6 receptor (IL-6R), and C-reactive protein (CRP) have been measured in plasma from 26 children with septic shock (nine of whom had disseminated intravascular coagulation) and from ten control children. All samples were collected at the onset, before treatment, and, when possible, 24 and 48 hours later. At admission, patients had significantly higher levels of IL-6 (p < 0.001) and CRP (p < 0.001), and lower levels of IL-6R (p < 0.005) than normal controls. After 24 hours, there was a significant increase of sCD24 (p < 0.05) and CRP (p < 0.001). Although IL-6 showed a progressive decline since the onset, its levels were always higher than controls. There was an inverse correlation between IL-6 and both IL-6R (p < 0.001) and CRP (p < 0.001), probably due to the later increase of CRP. Nevertheless, sCD14 did not correlate with IL-6 levels. We have confirmed the finding of IL-6 as a sensitive and reliable inflammatory marker in septic shock. Moreover, the ratio IL-6/IL-6R may have a prognostic value, given a putative role of IL-6R in modulating the effects of IL-6 in meningococcal sepsis.

Bacteremia↗
PubMed1997

[Estimate of the prevalence of Huntington disease in the Valencia region using the capture-recapture method].

INTRODUCTION AND OBJECTIVE: The objective of this study was to estimate the prevalence of Huntington's disease in order to devise a programme for diagnosis and prevention. Because of the characteristics of this disease, which is hereditary and of low incidence, few epidemiological studies have been carried out in Spain. Many studies (Medline 1990-1996) give cross-checking of registers as the key to determining the relative extent of the illness. The findings of this comparison of registers are not limited to the numerical quantification of a health problem, but are combined with active case search strategies, since there is now an approximation of probability to a previously unknown area of the disease. MATERIAL AND METHODS: Prevalence in the Valencia Region (Spain), which has a population census of 3,873,812 inhabitants, was estimated by means of the probability method known as capture-recapture. The estimated maximum probability and its confidence interval were calculated. The sources of information used were clinical histories from the regional hospitals and official figures of registered deaths during the period 1987-1992. RESULTS: It was found that there were 41 cases seen in the regional hospitals and 17 deaths recorded in the official statistics, while 4 cases coincided in both sets of statistics. Recovery of 45 cases histories enabled an analysis to be made of the relationship between the disease, sex, age of onset of symptoms, and family history. CONCLUSION: The estimated prevalence was 5.38 x 10(5). The most notable finding was that of a systematically earlier onset of symptoms in women, which was greater when the family history was on the paternal side.

Adult↗
PubMed1994

[Subdural hemorrhage of aneurysmal origin].

Although most subdural hematomas are considered to be venous in origin, they may also be of arterial origin. When subdural bleeding is due to the rupture of an intracranial aneurysm, most commonly at the middle cerebral or internal carotid arteries, the amount of subdural blood is usually small and of no clinical importance. We describe two patients with subdural hematomas secondary to rupture of an intracranial aneurysm, who needed prompt surgical treatment. The first patient had a left internal carotid artery aneurysm at the origin of the ophthalmic artery. In the second patient the aneurysm was at the anterior communicating artery and rebled into the subdural space directly through a right intraparenchymatous frontobasal hematoma. The most probable mechanism of subdural bleeding in our two patients was the existence of adhesions between the aneurysm and the arachnoid due to previous minor hemorrhages. The indication of cerebral angiography in a patient with subdural hematoma is based mainly upon the existence of meningeal signs, the presence of blood in more than one intracranial compartment or the rapid progression of bleeding.

Aged↗
PubMed1990

Fibronectin in meningococcal sepsis. Correlation with antithrombin III and protein C.

Plasma fibronectin was measured with Laurell's immunoelectroassay in 44 patients with meningococcal sepsis. The average value (15.0 +/- 7.9 mg/dl) was lower than that in normal children (27.4 +/- 8.7 mg/dl) (p less than 0.001). Fibronectin in patients correlated positively with antithrombin III (AT-III) values (p less than 0.02), but not with protein C (0.05 less than p less than 0.1). The decrease of fibronectin had no prognostic value. The fibronectin levels were lower in patients with disseminated intravascular coagulation (DIC+), than in those without DIC (DIC-) (p less than 0.02), but were lower in both groups than in a normal control group. A negative correlation between fibronectin and protein C was only present in DIC- patients (r: -0.773 = p less than 0.01). Fibronectin varied independent of AT-III and protein C in DIC+ patients. The study was repeated in 11 patients 24 hours after admission when fibronectin had decreased in 7/11 cases (mean decrease: -2.7 +/- 8.7 mg/dl). This variation correlated in a negative way with AT-III (r: -0.659 = p less than 0.05). In meningococcal sepsis fibronectin decreases very early, even in DIC- patients and its relationship to AT-III and protein C is different, depending on the presence of DIC and on the stage of evolution of the disease.

Antithrombin III↗
PubMed1989

[Absence of fibronectin in a 40-day-old child who died as a result of septicemia with disseminated intravascular coagulation].

A new born infant who died when he was 40 days old, after urinary infection, septicemia and disseminated intravascular coagulation (DIC) is reported. The concentration of fibronectin (FN) was undetectable (less than 1.1 mg/dl). His mother and one sister had also decreased levels (19 and 19.5 mg/dl), although inside normal limits, when they were compared to simultaneously studied normal controls (27 +/- 8). There were not infections, coagulation disturbs neither keloid scars in the family. A patient cousin also died at the first days of life. The deficiency of our case was much more important that FN levels found in 23 children with sepsis and DIC (range 6-38 mg/dl), therefore it is possible he had a primary deficiency. The investigation of FN levels in all newborns with severe infections or other disturbs is recommended, since these patients could be benefit from purified FN or cryoprecipitate therapy.

Disseminated Intravascular Coagulation↗
PubMed1985

[Risk factors in the development of idiopathic pulmonary hemosiderosis].

A long-term study of six children suffering idiopathic pulmonary hemosiderosis (IPH) was realized, in order to evaluate prognostic factors and the best therapy. The treatment was initiated with prednisone 1-2 mg/kg/day which was gradually decreased until total suppression. Clinical remission was always achieved but relapses were frequently observed. All but one of the patients suffered more episodes which were controlled by the initial treatment. In three cases the additional use of immunosuppressors drugs was needed, chlorambucil 0.2 mg/kg/day during a period of 3-6 months or cyclophosphamide 2.5 mg/kg/day for four months, thereby obtaining a better control of the disease and also a decreased number of crises. Two patients died during acute exacerbations. It is suggested that the main risk factors are the male sex and onset before three years of age. The outcome was also worse when the first crisis was more severe.

Child↗
PubMed1983

[Pi phenotypes of alpha-1-antitrypsin and antiproteases in meningococcal sepsis].

Values of mean antiproteases were studied in 60 children with meningococcal sepsis. At illness onset, increased levels of alpha-1 antiquimotrypsin (p less than 0.001) and decreased of alpha-2 macroglobulin (p less than 0.001) were found. Moreover, patients who were complicated with a disseminated intravascular coagulation (DIC) also showed a decrease of antithrombin III (p less than 0.001) and inter alpha-1 trypsin inhibitor (p less than 0.001). There was not relationship between antiproteases levels and mortality. In 33 cases the measures were repeated 24 hours later, but no homogeneous results were found, in spite of alpha-2 macroglobulin fall in patients complicated with DIC (p less than 0.05). Phenotypic variants of alpha-1 antitrypsin were studied in 47 cases by isoelectric focusing. Results did not provide evidence that "abnormal phenotypes" (no-Pi MM) could facilitate meningococcal sepsis or DIC, but an increased number of "abnormal phenotypes" (5/9) were found in dead patients (p less than 0.025).

Antithrombin III↗
PubMed1981

[Immunological diagnosis of collagen diseases and rheumatoid arthritis (author's transl)].

Most helpful immunological tests for diagnosis of connectivities are revised. Among them, antinuclear antibodies (AAN) are the most important. They are usually detected by immunofluorescence and show different patterns, being the peripheral one the most specific of SLE and it is related with antibodies anti-DNA which can make immunocomplexes DNA-anti-DNA and be the cause of lupic nephropathy. The "nucleolar" and "speckled" patterns are more frequent in scleroderma. The LE cells have less value than AAN. The rheumatoid factor is a IgM antibody anti-IgG, but also can be of IgG or IgA class. It is uncommon in the juvenile rheumatoid arthritis of systemic onset and more frequent in oligoarticular adult type. May became positive during disease evolution. Other factors as immunoglobulin of complement usually are increased, except when the activation of complement take place. Acute phase reactants are helpful just for evaluating the importance of inflammation, they have not diagnosis value and commonly do not exceed the value of erythrocyte sedimentation rate.

Antibodies, Antinuclear↗
PubMed1981

[Irregular behavior of complement in coeliac disease (author's transl)].

Ninety-six sera from coeliac children were studied, 55 were taken during a normal diet and 41 with a gluten-free diet. C'3, C'4, C'5, C'3, PA, C'1 INH and C'3b INA were measured. No significant differences were found between coeliac patients and normal controls. Results were also similar for gluten-free diet coeliac childrens and for active patients. A challenge was performed with 20 g. of gluten in 14 active patients. The levels of C'3, C'3 PA had a large variability, increasing and decreasing, but no similar and constant pattern was found. Activation products of C'3 appeared, specially between 4 and 24 hours, and disappeared about 48 hours. These results support an alteration of complement in coeliac patients but there is not a constant and steady pattern. Our hypothesis is that complement activation is not a pathogenic mechanism of coeliac disease. Maybe is just a consequence or epiphenomenon.

Celiac Disease↗
PubMed1980

[Immunocomplexes in pediatrics. I: Detection with polyethilenglycol precipitation (author's transl)].

Circulating seric immunocomplexes have a variable significance in every case and small amounts can be founded in nornal people. Sometimes immunocomplexes are a defensive mechanism against chronic antigenemia, but in other cases they produce important tissue injury, as in glomerulonephritis. There are many tests for detecting them, but no single test detects all types of complexes because of their heterogeneity. Authors explain the polyehthilene-glycol precipitation test which is compared it to other methods, as binding to C'1q, Fc or C'3b receptors or physical separation tests. Polyethilene-glycol precipitation was performed in several concentrations of albumin-antialbumin complexes. When eight sera were heated to 60 degrees C during 30 minutes the levels of precipitate decreased and they suggest it is due to antigen and antibody dissociation. Inversely, IgG progressive concentrations increased by formation of heat aggregated immunoglobulins. The 10 times repeated freezing and thawing of sera increased the optical density of precipitates from 0.047 to 0.057 and the raising was higher in pathological than in normal sera. Although the repeated thawing must be avoid its' role does not seem be very relevant.

Antigen-Antibody Complex↗
PubMed1980

[Immunocomplexes in pediatrics. II: Investigation in neurological patients (author's transl)].

Circulating immune complexes were investigated by polyethilene-glycol precipitation in the serum of 101 neurological patients from four months to 15 years old. The test was positive in 21 cases (20.7%) and 24 normal controls were negative. The polyethilene-glycol positive group had a lower seric C'3 than negative group [p < 0.02]. The highest positivity was found in meningoencephalitic infections with sequelae [6/6: 100%] and in cerebral atrophy or very important mental deficiency [11/30: 37%]. The polyethilene-glycol test was not correlated with seric IgG levels, neither in positive nor in negative groups. All patients were receiving anticonvulsivant treatment. The detection of circulating immune complexes may be the result of either brain tissue injury or of another immunological disturb found in epilepsy. There was no relationship between seric immunocomplexes and severity of epileptic disorders and it is not likely that they have any influence over seizures. The role played by anticonvulsivant drugs remains uncleared and further studies are needed.

Adolescent↗
PubMed1980

[Modification of complement factors and their inhibitors during meningococcal sepsis (author's transl)].

Various complement components (C'1s, C'3, C'4, C'5, C'8, C'9, C'3 act., C'1 inh., C'3b inact.) and seric immunocomplexes (by polyethylene glycol, PEG) were evaluated in 43 children with meningococcal sepsis. 28 patients had disseminated intravascular coagulation (DIC), group I, and 15 did not show it, group II; 14 patients died in group I and none of group II. In 21 cases studies were repeated 24 hours later. In group I all complement components were decreased, specially C'3 (x: 67 mg./100 ml., p < 0.01) and C'5 (x: 8 mg./100 ml., p < 0.01) and they were lower 24 h. later. Results of group II were normal, except a decrease of C'5. Catabolic products of C'3 were founded in 11/14 cases of group I and two/nine of group II and products of C'3 act. in four/14 and one/10. PEG precipitation was positive in 10/14 cases of group I and 10/12 of group II and IgG, IgM, C'3 and C'4 were found in precipitations. This complement components were more frequently present in sepsis without DIC and after 24 h. of evolution. C'1 and C'3b inhibitors decreased after evolution in group I and by contrast increased in group II. This fall enhances complement activation.

Antigen-Antibody Complex↗
PubMed1977

[Immunological abnormalities in epileptic children treated with anticonvulsivant drugs (author's transl)].

Seric IgA, IgE and IgD; antinuclear antibodies and lymphocyte and eosinophil counts were studied in 61 epileptic children; 22 patients were treated with phenobarbital and 39 with hydantoine. The mean length of treatment was 12 months to phenobarbital and 23 to hydantoins. Seric IgA was deficient in 4/36 children taking hydantoins and only 1/20 receiving phenobarbital. IgE mean was increase in hydantoins treated patients and also IgD was found higher than normal in 6 patients. Only one case showed seric antinuclear antibodies but they disappeared with drug withdrawal. The lymphocyte count was normal but an important eosinophilia rise with treatment (phenobarbital or hydantoins). These immunological abnormalities were meanly found in idiopatic epilepsy. These suggest they are produced by anticonvulsivant drugs but also by an important constitutional factor. In this way immunology and epilepsy may be related.

Adolescent↗