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Biomedical subjects

R Arteaga

Publications and source records attributed to R Arteaga.

At least 19 recordsLinked to original sources

Tight binding between a pool of the heterodimeric alpha/beta tubulin and a protein kinase CK2 in Trypanosoma cruzi epimastigotes.

Tubulin is the predominant phosphoprotein in Trypanosoma cruzi epimastigotes and is phosphorylated by a protein kinase CK2. Interestingly, the presence or absence of divalent cations affected the solubilization of a pool of the parasite tubulin and the CK2 responsible for its phosphorylation. This fraction of tubulin and its kinase co-eluted using phosphocellulose, DEAE-Sepharose and Sephacryl S-300 chromatographies. Anti-alpha tubulin antibodies co-immunoprecipitated both tubulin and the CK2 responsible for its phosphorylation, and anti-CK2 alpha-subunit antibodies immunoprecipitated radioactively labelled alpha and beta tubulin from phosphorylated epimastigote homogenates. Additionally, native polyacrylamide gel electrophoresis of the purified and radioactively labelled fraction containing tubulin and its kinase demonstrated the phosphorylation of a unique band that reacted with both anti-CK2 alpha-subunit and anti-tubulin antibodies. Together, these results establish a strong interaction between a pool of the heterodimeric alpha/beta tubulin and a CK2 in this parasite. Hydrodynamic measurements indicated that the T. cruzi tubulin-CK2 complex is globular with an estimated size of 145.4-147.5 kDa.

Animals↗

Glutaryl-CoA dehydrogenase deficiency in Spain: evidence of two groups of patients, genetically, and biochemically distinct.

Glutaryl-CoA dehydrogenase (GCDH) deficiency causes glutaric aciduria type I (GA I), an inborn error of metabolism that is characterized clinically by dystonia and dyskinesia and pathologically by neural degeneration of the caudate and putamen. Studies of metabolite excretion allowed us to categorize 43 GA I Spanish patients into two groups: group 1 (26 patients), those presenting with high excretion of both glutarate and 3-hydroxyglutarate, and group 2 (17 patients), those who might not be detected by routine urine organic acid analysis because glutarate might be normal and 3-hydroxyglutarate only slightly higher than controls. Single-strand conformation polymorphism (SSCP) screening and sequence analysis of the 11 exons and the corresponding intron boundaries of the GCDH gene allowed us to identify 13 novel and 10 previously described mutations. The most frequent mutations in group 1 were A293T and R402W with an allele frequency of 30% and 28%, respectively. These two mutations were also found in group 2, but always in heterozygosity, in particular in combination with mutations V400M or R227P. Interestingly, mutations V400M and R227P were only found in group 2, and at least one of these mutations was found in 11 of 15 unrelated alleles, accounting together for 53% of the mutant alleles in group 2. Therefore, it seems clear that two genetically and biochemically distinct groups of patients exist. The severity of the clinical phenotype seems to be closely linked to the development of encephalopathic crises rather than to residual enzyme activity or genotype. Comparison of GCDH protein with other acyl-CoA dehydrogenases (whose x-ray crystal structure has been determined) reveals that most of the mutations identified in GCDH protein seem to affect folding and tetramerization, as has been described for a number of mutations affecting mitochondrial beta-oxidation acyl-CoA dehydrogenases.

Alleles↗

Reliability of jumping performance in active men and women under different stretch loading conditions.

BACKGROUND: To determine the reliability of squatting jumps (SJ), counter-movement jumps (CMJ) and drop jumps (DJ) tests, as well as the reliability of the optimal dropping height during drop jumping. METHODS: Jumping performance was assessed in 8 male and 9 female physical education students. Their age, weight and height (mean +/- SD) were 23.9 +/- 2.1 years, 72.0 +/- 12.1 kg, 174.3 +/- 10.4 cm, and 23.1 +/- 2.0 years, 54.8 +/- 4.9 kg, 160.1 +/- 5.0 cm for the males and females, respectively. The jumping performance was determined on six different testing days. On each testing day, squatting jumps (SJ) and counter-movement jumps (CMJ) were performed as well as drop jumps (DJ) from heights between 20 and 100 cm. The dropping height given the maximum attained height was registered as the optimal dropping height (ODH). After a 15 min rest period, a 30 sec hopping test (HT) was performed and the mean height attained (MHT) as well as the number of jumps executed (NHT) were recorded. The height attained was computed from the flight time, which was measured with a digital timer (+/- 0.001 sec) connected to a resistive platform. RESULTS: The pooled coefficients of variation in percentage were 5.4 (SJ), 6.3 (CMJ), 6.2 (DJ), 31.9 (ODH), 3.1 (NHT) and 6.7 (MHT). A parabolic relationship between dropping height and attained height was found (r = 0.39-0.43, p < 0.001). The ODH was 48.2 +/- 14.0 cm and 62.9 +/- 21.3 cm for females and males, respectively (p < 0.05). Multiple regression analysis showed than ODH can be predicted from the SJ with a standard error of 9 cm. CONCLUSIONS: The variability of the assessment of jumping performance is similar to that reported for other variables used in the assessment of physical fitness. In contrast, the assessment of the optimal dropping height is less reliable.

Adult↗

[Role of retrograde endoscopic dilatation with balloon and derivation using double pig-tail catheter as an initial treatment for vesico-ureteral junction stenosis in children].

UNLABELLED: The purpose of this project is to determine the role of the retrogade endoscopic dilatation with balloon and derivation using double pig-tail catheter, as inicial treatment for the vesicoureteral junction stenosis in children. As there are no previous paediatric publications, we present the technical details and early results. From August 1994 to December 1995, we have treated 11 children (8 boys and three girls), whose ages were between 4 months and eleven years, with objectivated vesicoureteral stenosis. Six of which were primary obstructive megaureters, and the other five were secondary obstructive megaureters (two were secondary to posterior urethral valves, one to neurogenic bladder, another one to ectopic ureter, and the last one was secondary to previous antirreflux surgery). We have used rigid dilatators and 7 Fr balloons over guide. All the patients have improved from their obstruction (proved by renogram). In six of the cases only one dilatation was needed, and in the other five only two dilatations. Only two patients presented reflux (grade I and IV). CONCLUSIONS: The endoscopic dilatation of the obstructive megaureter in children is possible, and reflux is rare.

Catheterization↗

Vigabatrin serum concentration to dosage ratio: influence of age and associated antiepileptic drugs.

The relationship between the ratio of vigabatrin concentration to dosage (VGB C/D) and both patient age and the presence of other antiepileptic drugs (AEDs) was analyzed retrospectively by bivariate and multivariate methods in 179 patients with epilepsy (114 children and 65 adults). Of the 179 patients, 33 received VGB alone (30 children and 3 adults) and 146 received VGB with other AEDs (84 children and 62 adults). Vigabatrin trough steady-state serum concentration correlated better with VGB dosage in milligrams per kilogram than the dosage in milligrams in children (r = 0.62 vs. r = 0.17, P < 0.001) but not in adults (r = 0.51 vs. r = 0.49, NS). The correlation between milligrams per kilogram and serum concentration of VGB was greater in children on monotherapy (r = 0.83) than in those on polytherapy (r = 0.46). Vigabatrin C/D ratio increased significantly with age (r = 0.51, P < 0.001), being lower in children than in adults both by Student's t-test (0.087 +/- 0.039 vs. 0.128 +/- 0.057, mean +/- SD, P < 0.001) and by two-way analysis of variance when controlling for other AEDs (P < 0.001). Inducing AEDs seemed to increase VGB C/D ratio in the bivariate tests, but this influence decreased and even disappeared if patient age was considered in the multivariate analysis. However, the increase in VGB C/D ratio with VPA serum concentration (r = 0.46, P < 0.001) was confirmed by multiple regression including age (P < 0.001). Intrapatient variability of VGB C/D ratio was 29 +/- 18%. It was concluded that trough steady state VGB serum concentration may be more predictable in children based on the milligrams per kilogram dosage than on the milligram dosage, and that the influence of patient age should be considered if the VGB C/D ratio is used to estimate patient compliance.

Adolescent↗

[Our experience in endoscopic teflon treatment in vesicoureteral reflux in children].

We report our experience with the endoscopic treatment of vesicoureteral reflux by submucosal injection of Teflon (STING) in children. Since December of 1992, 45 children and a total of 67 ureters were treated. The overall success rate was 90% after one injection and 95% after two injections. The success rate was better in primary reflux with 95%, 87.5% in duplicated ureters and 75% in secondary reflux after one injection. Actually we treat the reflux grade II and III with STING when it doesn't improve after one year with medical treatment.

Adolescent↗

Platelet GABA-transaminase in epileptic children: influence of epilepsy and anticonvulsants.

The relationship between platelet GABA-transaminase (GABA-T) activity and either epilepsy or its treatment has been studied in 281 epileptic children: 55 were newly diagnosed untreated patients and 226 were chronically receiving anticonvulsants (154 in monotherapy and 72 in polytherapy). Results were compared with those from 48 control children. Untreated children had a GABA-T activity of 9.1 +/- 3.7 pmol/min/mg protein, lower than the control group (10.6 +/- 3.8 pmol/min/mg, P < 0.05), whereas treated epileptic children had higher values (11.9 +/- 6.3 pmol/min/mg) than those untreated (P < 0.01). In untreated children, the seven with absences and the nine with simple partial seizures had a GABA-T activity of 6.9 +/- 3.3 and 7.8 +/- 3.2 pmol/min/mg, respectively, lower than the control group (P < 0.05). In treated patients, those receiving valproate (VPA) in monotherapy had a GABA-T activity of 15.3 +/- 7.5 pmol/min/mg, higher than both the control group and the untreated children (P < 0.001). All patients receiving VPA in mono- or polytherapy had a higher activity than those receiving other anticonvulsants (16.4 +/- 8.4 vs. 9.9 +/- 3.9 pmol/min/mg, P < 0.001), the activity in Lennox syndrome and myoclonic epilepsies being significantly higher than in those with absences and partial epilepsy. GABA-T activity did not correlate with doses or trough steady-state serum levels of VPA. Platelet GABA-T could be useful as a peripheral marker of GABAergic alterations and GABAergic effects of antiepileptic drugs in epileptic patients.

4-Aminobutyrate Transaminase↗

Coadministration of vigabatrin and valproate in children with refractory epilepsy.

The effects of adding vigabatrin (GVG) to the antiepileptic regimens of 16 children with refractory epilepsy have been studied. One-half of the regimens included sodium valproate (VPA). Parameters studied were seizure reduction, platelet GABA-T activity, and steady-state plasma concentrations (CSS) of GVG and VPA. Add-on GVG reduced the seizure frequency both in patients receiving VPA (from 42.9 to 4.5 seizures/month, p < 0.01) and in those without VPA (from 60.0 to 31.7 seizures/month, p < 0.05). GVG also reduced GABA-T activity in both groups (from 19.4 to 5.4, p < 0.001 and from 8.3 to 4.5 pmol/min/mg of protein, p < 0.05, respectively). Seizure reduction and GABA-T inhibition were greater in patients taking VPA than in those who were not. In patients receiving VPA, no significant changes were observed in VPA CSS values before and after the addition of GVG. On the other hand, no differences were found in GVG CSS values between patients with and without VPA. It is concluded that the coadministration of GVG to valproate reduces the frequency of seizures in refractory epileptic children and does not affect the steady-state plasma concentrations of either drug. Therefore, their association could be useful in clinical practice.

4-Aminobutyrate Transaminase↗

[Multicenter evaluation of a diabetes program in primary care in Tarragona].

To evaluate a provincial diabetes program for primary care in Tarragona 14 months after its implementation, the data provided by all centers were evaluated. The participants were 8 CAPS and the professionals of a rural area, with a reference population of 170,159. A total of 1,766 diabetic patients were sensed. 131 were type I (7.4%) and 1,635 type II (90.6%). The health care variables of 1,197 patients (67.7%) and the rate of complications of 654 (54.6%) were assessed. A high prevalence of hypertension (50.0%) and dyslipemia (40.5%) were found associated with diabetes. Overall 868 individuals (72.5%) received individualized education in the clinic; 112 of these (12.9%) were included in collective education programs for groups. At the time of this evaluation, the proportion of patients treated with insulin (174/545) was significantly higher than that found before the program (79/402, p less than 0.0001). The practice of glycemic self assessment at home was also significantly increased (82/691 versus 440/1, 124; p less than 0.0001). The initial impact on the professional and diabetic patients of our area has been remarkable. Although the planning of multicentric evaluation systems in complex, it is possible to implement it if the data and recording system are coordinated.

Diabetes Mellitus↗

Dose-response study of vigabatrin in children with refractory epilepsy.

Twenty children aged 2 months to 18 years were included in a dose-response study of vigabatrin as add-on therapy to preexisting antiepileptic drugs (up to two per patient). All children had severe refractory epilepsy: partial seizures with or without secondary generalization in 19, and myoclonic seizures in one. After a 2-month observation period and a 1-month add-on placebo period, a fixed dose of add-on vigabatrin was given for 2 months: 1, 1.5, or 2 g/day, according to body weight (mean dose, 60 mg/kg/day). Three patients (15%) became seizure free, and nine (45%) showed a 50% to 99% reduction in seizure frequency. In the 17 patients whose seizures were not totally suppressed, vigabatrin dose was increased for a further 2 months, and in 7 patients who still showed less than 50% reduction in seizure frequency, vigabatrin dose was increased again. Efficacy appeared unchanged by these higher doses. During a 9-month follow-up phase, no tolerance to the effects of vigabatrin was observed, with three children seizure free and 13 (65%) reporting a 50% to 99% reduction in seizure frequency. During the study, adverse effects were recorded in three children (15%), namely drowsiness, constipation, fatigue, and apathy. These effects were generally transient, being observed during the dose-modification phase and disappearing either spontaneously or on reduction of vigabatrin dose. Clinical and laboratory tolerability to vigabatrin appeared to be very good, with no patients having withdrawn from the study because of side effects. A slight reduction in red blood cell count and hemoglobin levels was noted but was of doubtful clinical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Influence of solar irradiation on vitamin D levels in children on anticonvulsant drugs.

Previous studies about the serum levels of vitamin D metabolites in epileptic patients have given conflicting results. We have investigated the influence of chronic anti-epileptic treatment on mineral metabolism in 17 ambulatory epileptic children who were studied for 2 seasons with high and low levels of solar radiation, respectively. No differences in serum calcium, phosphate or 1.25-dihydroxyvitamin D were observed between patients and control children. Patients also had normal levels of 25-hydroxyvitamin D [25(OH)D] in summer. However, serum 25(OH)D concentrations were lower in patients than in controls in winter months (12.6 +/- 1.4 versus 19.6 +/- 1.2 ng/ml, P less than 0.001). These findings point out the influence of the intensity of solar irradiation, and subsequently of vitamin D availability, on the effect of anticonvulsant drugs on vitamin D metabolism, and may help to explain the conflicting results of previous reports. Prophylactic vitamin D therapy should be considered when climatic conditions or patients' life styles do not allow an adequate exposure to sunlight.

Adolescent↗

Platelet GABA-aminotransferase in epileptic patients.

Platelet GABA-aminotransferase (GABA-T) activity was determined in 12 adults (six healthy volunteers and six long-term treated epileptic patients) and 17 children (six non-epileptic, and 11 long-term treated epileptic patients). Platelet GABA-T activity was about 60% higher in the epileptic patients than in the controls, both in adults (14.7 +/- 8.6 versus 8.8 +/- 3.5 pmol/min/mg of protein,) and children (13.1 +/- 4.8 versus 8.3 +/- 3.3 pmol/min/mg of protein, p less than 0.05). The relationship between this increase and either epilepsy or anti-epileptic treatment should be clarified in further studies.

4-Aminobutyrate Transaminase↗

Effectiveness and toxicity of phenobarbital, primidone, and sodium valproate in the prevention of febrile convulsions, controlled by plasma levels.

The effectiveness and toxicity of phenobarbital (PB), primidone (PRM), and sodium valproate (VPA), used exclusively in monotherapy, were compared in 95 children affected with febrile convulsions. Treatment was restricted to either complicated or simple febrile convulsions with risk factors. The effectiveness and toxicity of each drug were related to the daily dose and the steady-state plasma levels. PB (4.8 +/- 0.7 mg/kg/day) achieved plasma levels of 16.4 +/- 2.8 micrograms/ml and prevented febrile convulsions in 80% of the patients. Side effects were observed in 76.7% of the patients, a change in dose being required only in 13.3%. PRM (17.8 mg/kg/day) yielded PB plasma levels of 14.1 +/- 3.7 micrograms/ml and was effective in 88.2% of the patients. The incidence of side effects was 53%, but no change in treatment was required. VPA (35.2 +/- 5.9 mg/kg/day) achieved plasma levels of 57.2 +/- 15.3 micrograms/ml (measured before the first dose in the morning) and was effective in 91.7% of the patients. Side effects were detected in 45% (significantly lower than after PB, p less than 0.01), and required a change in treatment in 14.3%. No differences in doses and plasma levels were found between patients with or without recurrence of febrile convulsions and with or without side effects; an exception was the higher doses of VPA administered to patients who showed side effects. It is concluded that PRM and VPA were at least as effective and well tolerated as PB. Because the plasma levels of the three drugs were near the lower limit of the therapeutic range, it remains to be elucidated whether higher doses may increase the benefit without adding unacceptable toxicity.

Child↗

Side effects of sodium valproate in monotherapy controlled by plasma levels: a study in 88 pediatric patients.

The incidence of toxicity associated with the use of valproic acid (VPA) is considered remarkably low compared to other antiepileptic drugs. This study reports the toxicity of VPA administered as a single drug to 88 children in relation to the daily dose and drug plasma level. The frequency of side effects observed clinically was 42.0%, but it increased to 80.7% when a questionnaire was introduced. In spite of the limitations of this method, the results show the need to perform systematic surveillance for side effects of all antiepileptic drugs, similar to those made to assess their clinical effectiveness. Anorexia, vomiting, and sleep alterations were the most common side effects detected in the clinical record; patients who showed anorexia, hyperactivity, lassitude, sleep disturbances, and sadness had received daily doses significantly higher than patients not showing side effects. Similarly, the children who needed to reduce or discontinue the treatment were receiving the highest doses. No relations, however, could be established between the incidence of side effects and plasma levels of VPA except for lassitude and drowsiness. Severe or fatal toxicity was not detected.

Child↗