[Community-acquired bacteremia and pneumonia caused by Stenotrophomonas maltophilia in a patient with AIDS].
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AIDS-Related Opportunistic Infections↗
Biomedical subjects
R García
Publications and source records attributed to R García.
[Our experience with the Univent tube].
INTRODUCTION: We describe our experience in managing single lung ventilation (SLP) with the Univent bronchial blocker tube from 1993 to the present. PATIENTS AND METHOD: Patients were grouped based on the following criteria: use of a double lumen tube as an alternative to SLP (group 1), use of SLP and tracheotomy (group 2), or difficult or dangerous orotracheal intubation (group 3). RESULTS: The mean age of the 32 patients (22 men and 10 women) studied was 45.7 +/- 12.2 years. Mean weight was 67.9 +/- 13.4 kg. Ten patients were physical status ASA I, 10 were ASA II, 10 were ASA III and 2 were ASA IV. Group 1 contained 28 patients (18 receiving right SLP and 10 receiving left SLP; use of SLP failed to collapse the lung in 4 patients [14.3%]). Group 2 consisted of 5 patients and group 3 contained 11. The Univent tube was used in 4 patients in group 3 who did not require use of SLP but whose intubation was considered difficult and in whom laryngoscopic findings were consistent with a Cormack-Lehane group III classification. The Univent bronchial blocker tube was used as a guide, such that intubation was achieved on the first try. The tube was removed from 3 patients (8%) in the intensive care recovery ward. The remaining 29 tracheas were extubated in the operating room. No side effects attributable to the Univent tube were recorded. CONCLUSIONS: The advantages and disadvantages of this new tool for the management of SLP mean that it may be useful for specific situations (such as for SLP with difficult intubation or in patients with tracheotomies or aneurysms of the descending thoracic aorta), but that it does not replace conventional methods. We believe that the Univent bronchial blocker tube should be available as part of operating room equipment.
Adult↗
Clinicopathological study of an outbreak of squamous cell carcinoma in sheep.
This paper describes the clinical and histopathological features of an outbreak of cutaneous squamous cell carcinomas in a flock of Berrichon du Cher sheep in south-western Spain. The outbreak was unusual because of the high prevalence recorded (15 to 18 per cent over the last two years) and because the majority of the lesions involved the eyelids. Adult and old sheep were the most commonly affected, and the largest numbers of cases were recorded in summer and autumn. The initial lesions were non-specific and consisted of erythema, hyperkeratosis, actinic keratosis, periocular dermatitis and conjunctivitis. The tumours grew slowly but progressively over a period of one to two years, with frequent complications by bacterial infections or secondary myiasis. Histopathological examination of the tumours revealed well-differentiated squamous cell carcinomas, surrounded by a moderate to abundant infiltrate of lymphocytes, plasma cells and macrophages. The overlying epidermis was frequently ulcerated and inflamed. The possible relationships between the high prevalence of the condition and the poorly pigmented skin of this breed, the extensive farming system employed and the exposure of the animals to ultraviolet radiation were analysed.
Animals↗
Discrimination in the sense of flutter: new psychophysical measurements in monkeys.
Humans and monkeys have similar capacities to discriminate the frequencies of mechanical sinusoids delivered to their hands in the range that corresponds to the sense of flutter (10-50 Hz). Previous studies showed that monkeys can discriminate whether comparison stimuli are higher or lower in frequency than a base stimulus that does not vary from trial to trial during an experiment. We verified this result in two monkeys trained in this manner. To confirm that these animals were able to discriminate, we tested them in a variant of the task in which the frequency of the base stimulus changed randomly from trial to trial. The monkeys failed to discriminate in this new testing mode; instead they seemed to categorize the comparison stimuli, ignoring the base stimulus. After further training in the randomized base condition, the two monkeys learned to discriminate accurately. We then explored how the stimulation parameters affected performance. We found that animals could discriminate accurately with stimulus durations as short as 250 msec, with interstimulus intervals as long as 10 sec, with 50% differences between base and comparison stimulus amplitudes or when stimulated on a different finger. Performance did not degrade in these conditions, even though the monkeys had never been trained or tested under them. The results show that monkeys may try to categorize rather than discriminate when the task allows either strategy, although they are capable of performing true discriminations very robustly. These findings have important implications for investigating the neuronal processes underlying sensory discrimination.
Animals↗
Segments in the C-terminal folding domain of lipoprotein lipase important for binding to the low density lipoprotein receptor-related protein and to heparan sulfate proteoglycans.
Lipoprotein lipase (LpL) can mediate cellular uptake of chylomicron and VLDL remnants via binding to heparan sulfate proteoglycans (HSPG) and the endocytic alpha2-macroglobulin receptor/low density lipoprotein receptor-related protein (alpha2MR/LRP). Whereas it is established that the C-terminal folding domain binds to alpha2MR/LRP, it remains uncertain whether it binds to heparin and to HSPG. To identify segments important for binding to alpha2MR/LRP and to clarify possible binding to heparin, we produced constructs of the human C-terminal folding domain, LpL-(313-448), and of the fragment LpL-(347-448) in Escherichia coli. In addition to binding to alpha2MR/LRP, LpL-(313-448) displayed binding to heparin with an affinity similar to that of the LpL monomer, whereas it bound poorly to lipoprotein particles. Moreover, LpL-(313-448) displayed heparin sensitive binding to normal, but not to HSPG deficient Chinese hamster ovary cells. LpL-(313-448) and LpL-(347-448) showed similar affinities for binding to both purified alpha2MR/LRP and to heparin. Deletion of LpL residues 380-384 abolished the binding to LRP, whereas binding to heparin was unperturbed. The binding to both heparin and alpha2MR/LRP was essentially abolished following deletion of residues 404-430, and pretreatment of CHO cells with the peptide comprising aa 402-423 inhibited the binding of LpL-(313-448). We conclude that the C-terminal folding domain of human LpL has a site for binding to heparin and to HSPG, presumably involving amino acids within residues 404-430. Two segments of the domain are necessary for efficient binding to alpha2MR/LRP, one comprising residues 380-384 and another overlapping the segment important for binding to heparin.
Animals↗
Alternating mini-BEAM/ESHAP as salvage therapy for refractory non-Hodgkin's lymphomas.
Mini-BEAM and ESHAP are two non-cross-resistant salvage regimens that have been used separately in patients with lymphoma. The aim of the present study was to investigate the efficacy of the combination of these two regimens, administered in alternating cycles, as salvage therapy for refractory non-Hodgkin's lymphoma (NHL) patients. A total of 28 patients were included in the study: 14 patients were primary refractory, seven were partial responders, and seven were in relapse. The alternating cycles of mini-BEAM and ESHAP were given until there was maximum response or progression. The overall response rate to mini-BEAM/ESHAP was 39%; 25% of patients achieved a complete response and 14% a partial response. Nevertheless, it should be noted that none of the primary refractory patients responded to this protocol. Nine of the 11 patients who responded to mini-BEAM/ESHAP were consolidated with autologous transplantation using BEAM as a conditioning regimen. The survival at 3 years in this group of 11 patients who responded to the salvage regimen is 64%, with a disease-free survival of 67% at 2 years. No major toxic effects were observed with mini-BEAM/ESHAP. Myelosuppression was the most frequent complication, especially with the mini-BEAM cycles. Other toxicities were infrequent and no treatment-related deaths were observed. These results suggest that alternating mini-BEAM/ESHAP chemotherapy is a safe regimen that is effective in partial responders or relapsing patients with NHL who have sensitive disease, but not in primary refractory patients. Moreover, although this therapy has a potential advantage, combining as it does two non-cross-resistant regimens, it does not seem superior to ESHAP alone.
Adult↗
Metalloproteinase activity during growth, maturation and atresia in the ovarian follicles of the goat.
Metalloproteinases are an important group of hydrolytic enzymes which participate in interstitial matrix degradation during tissue remodelling processes and therefore may be required during follicular growth and maturation. The activity of metalloproteinases (collagenases, gelatinase, and Pz-peptidase), was measured during growth, maturation and atresia of goat antral follicles. These follicles (n = 67) were separated by size and also classified into four groups: non-atretic (Group I); early atretic (Stage I) (Group II); moderately atretic (Stage II) (Group IIIa); and, late atretic (Stage III) (Group IIIb). Pz-peptidase was greater in granulosa than in thecal cells, and almost absent in follicular fluid. In non-atretic follicles, activity in granulosa cells increased with increasing follicle size, whereas activity peaked in 3-6 mm follicles in thecal cells. Atresia was associated with declining activity in thecal cells from follicles in the 3-6 mm range and in granulosa cells from the > 6 mm range. Interstitial collagenase activity was significant and similar in granulosa and thecal cell extracts and low in follicular fluid from non-atretic follicles. Activity increased significantly in thecal cells, but decreased significantly in granulosa cells from large (> 6 mm) non-atretic follicles. Atresia was associated with declining activity in both types cells and increasing activity in follicular fluid. Gelatinase activity was some times associated with five regions corresponding to molecular weights of 22.1, 30.7, 39.6, 63.8 and 71.4 kDa, and rarely at 91.3 and 81.2 kDa. Overall activity declined with atresia in thecal cells from follicles in the 3-6 mm range, but not in those > 6 mm. In granulosa cells from follicles 3-6 mm, activity varied widely with stage of atresia, while in cells from follicles > 6 mm, activity was greatly increased in atretic follicles.
Animals↗
Phytochemical and biological study of radal Lomatia hirsuta (Proteaceae).
The anti-inflammatory property of Lomatia hirsuta (Lam.) Diels ex Macbr. (Proteaceae), leaves (radal), a plant used in Chilean traditional medicine for bronchial troubles and asthma, was evaluated. The biological assays showed infusion of L. hirsuta leaves inhibits the inflammation induced by lambda-carrageenan corresponding to a 29.2% anti-inflammatory effect, and to 53.5% of the maximum effect observed with sodium naproxen (4 mg/kg) in the same experimental conditions. The coumarins, umbelliferone and scopoletin, were the major compounds isolated, along with quercetine, rhamnetin and iso-rhamnetin, with minor quantities or quercitrine and no presence of toxic naphthoquinone derivates. These results supported the folk use of L. hirsuta.
Animals↗
Biological and chemical study of paico (Chenopodium chilense, Chenopodiaceae).
The methanolic extract of the aerial portion of Chenopodium chilense Schrad., used in Chilean traditional medicine as a remedy for stomach-ache, has been found to exert the major spasmolytic activity in acetylcholine contracted rat ileum. This extract, with a complex flavonoid patterns on thin layer chromatography (TLC) analysis, is practically non-toxic both for rats and brine shrimp Artemia salina in acute toxicity test.
Acetylcholine↗
Circulating immune complexes from HIV-1+ patients induces apoptosis on normal lymphocytes.
Isolated immune complexes from sera of 49 out of 67 human immunodeficiency virus-1-positive (HIV-1+) patients (CIC-HIV+), composed of anti-HIV-HIV-Ag, could induce apoptosis on normal phytohaemagglutinin (PHA)-activated lymphocytes. DNA degradation was detected by propidium iodide staining. This activity is directed against CD4+ lymphocytes as demonstrated by double binding of CIC-HIV+ and anti-CD4 on apoptosis cells. Expression of Fas antigen is prior to apoptotic phenomena. CIC-HIV+ apoptosis inducers belong mainly to asymptomatic HIV-infected patients, indicating that immune complexes from these patients can destroy CD4+ lymphocytes.
Adult↗
Value of single oral loading dose of propafenone in converting recent-onset atrial fibrillation. Results of a randomized, double-blind, controlled study.
AIMS: To evaluate the efficacy and safety of a single loading oral dose of propafenone in the interruption of recent-onset atrial fibrillation. METHODS: After a complete medical history, physical examination, 12-lead ECG, chest X-ray, and routine biochemical laboratory testing, 55 consecutive patients with recent-onset atrial fibrillation were randomized double-blind in the emergency department for the administration of either a single oral dose (450 to 750 mg) of propafenone (29 cases) or a placebo (26 cases). After the 24-h observation period, comprehensive echocardiographic examination was performed. RESULTS: The groups were homogeneous as regards biological, clinical and echocardiographic characteristics. Two hours after treatment, 12 patients (41%) on propafenone but only two (8%) on placebo had converted to sinus rhythm (P = 0.005). This striking difference was maintained 6 h after treatment (65 vs 31%; P = 0.015) but lessened at 12 h (69% vs 42%; P = 0.060) and was insignificant at the end of the 24-h treatment period (79%, vs 73%; P = 0.752). Apart from hypotension, transient in three cases and sustained in one whose later echocardiographic examination demonstrated left systolic ventricular dysfunction, propafenone was well tolerated. CONCLUSION: Although there is no significant difference in the rates of conversion 24 h after treatment, propafenone works faster than placebo in achieving sinus rhythm. This rapid action of oral propafenone can be useful to solve quickly the clinical problems of a high proportion of patients arriving at the emergency department with acute atrial fibrillation.
Acute Disease↗
Mercurochrome allergy. Immediate and delayed hypersensitivity.
We describe eight patients suffering from Mercurochrome allergy. Patch and prick tests were carried out with the following organic and inorganic mercury compounds: thimerosal, Mercurochrome, phenylmercuric acetate, phenylmercuric nitrate, metallic mercury, and mercuric chloride, and with sodium fluorescein. Two patients had an anaphylactic reaction a few minutes after application of Mercurochrome. The prick tests with Mercurochrome were positive and they were negative with the other tested products. All patch tests were negative. In the other six patients, the clinical picture was local eczema, and the patch tests were all positive with Mercurochrome and the inorganic mercuric derivatives. Positive patch tests with thimerosal were found only in two patients, and only one had a positive patch test with salts of phenylmercury. In four patients, the prick test with Mercurochrome, negative in immediate reading, gave a late eczematous reaction.
Adolescent↗
Renal duplex ultrasonography in the diagnosis and follow-up of a case of accelerated transplant rejection treated with OKT3.
Several studies have discussed the value of ultrasonography in the differential diagnosis of early renal allograft dysfunction. However, much controversy still remains regarding its real usefulness in this clinical setting. Among the causes of early graft dysfunction, accelerated rejection is one of the most serious and leads frequently to early graft loss; early diagnosis and aggressive therapy are essential to prevent irreversible graft damage or even graft rupture. Limited attention has been paid to the evaluation of accelerated rejection treated with monoclonal CD3 antibodies by means of combined B-mode and Doppler ultrasonography. We report one such a case with a favorable outcome.
Graft Rejection↗
[Genotype and phenotype of apolipoprotein E in patients with Alzheimer's disease in Castille and Leon].
We determined the variants of the apolipoprotein E (apo-E) in a sample taken from a castellano-leonesa population with Alzheimer's disease (AD). The prevalence of the allele E-4 is 0.33 in AD and 0.12 in the control group. This results allow us to estimate that the risk of suffering from the disease is higher when the patients have an allele E-4. A significant correlation was found between the presence of the allele E4 and the AD (p < 0.005).
Aged↗
The anatomy of language revisited.
The language areas have been classically viewed as a posterior, perceptual Wernicke's region connected with an anterior, motor Broca's area via a tract of long fibers denominated the arcuate fasciculus. Recent connectional studies in the monkey indicate that there may be few direct connections between the regions strictly corresponding to Broca's or Wernicke's areas, and that inferior parietal areas may serve as a link between them. The proposed connectional pattern of the language regions fits the network of parietotemporal-prefrontal connections that participate in working memory, a type of memory used in immediate cognitive processing. Supporting this concept, brain activation studies in the human during linguistic working memory tasks have determined a close relation between the supramarginal gyrus (parietal area 40) and Broca's area. We suggest that language processing is closely related to working memory networks, and that the language regions in fact originated in evolution from a working memory network for linguistic utterances.
Animals↗
[The prevalence of markers for the hepatitis A and B viruses in the population of Gijón between 6 and 25 years old].
BACKGROUND: The aim of this study was to know the prevalence of previous infection markers for hepatitis A and B viruses in a pediatric-juvenile population from Gijón, Spain. PATIENTS AND METHODS: A representative (according to the census) transversal randomized sample of a population from 6 to 25 years in age from Gijón, Spain, was included in the study analyzing demographic, epidemiologic and clinical variables, liver tests, anti-HAV IgG and anti-HBc. RESULTS: Of the 630 individuals selected a demographic error was detected in 28 (4.4%) and 453 subjects were studied (71.9%) in whom the anti-HAV IgG was positive in 37 cases (8.75% of prevalence adjusted for age), with 4.4% (12/271) (CI 95% 2.3%-7.6%) for the younger cases and 13.7% (25/182) (CI 95% 9.1%-19.6%) in the group ranging from 18 to 25 years in age (p < 0.001). No anti-HAV IgG positive case was detected in the population under the age of 10 years. Among the young adults the prevalence of anti-HAV IgG positive cases was higher in those born in the south of Spain (2/6, 33.3%) (CI 95% 4.3%-77.7%) with respect to those from the northern regions of Spain (9/259, 3.5%) (CI 95% 1.6%-6.4%). (p = 0.02). With respect to HBV markers, of the 433 unvaccinated cases, 6 (1.4%) presented markers of past infection and 2 (0.46%) HBsAg positivity. Both had normal serum ALT without viral replication. Six cases of hypertransaminasemia levels (1.3%) were detected all being related with obesity or alcoholism. All the cases with previous acute clinical hepatitis were found to be anti-HAV IgG positive and anti-HBc negative. CONCLUSIONS: The current prevalence of anti-HAV IgG in the population from 6 to 25 years from Gijón, Spain is very low and given the high degree of susceptibility (86%) for HAV infection in the young adult population (18-25 years) the implementation of vaccination programs is recommended even without previous serologic screening. The low prevalence of anti-Hbc would also undervalue its use as prevaccination screening against HB in this geographical area.
Adolescent↗
The structural protein p54 is essential for African swine fever virus viability.
Protein p54, one of the most antigenic structural African swine fever virus (ASFV) proteins, has been localized by immuno-electron microscopy in the replication factories of infected cells, mainly associated with membranes and immature virus particles. Attempts to inactivate the p54 gene from ASFV by targeted insertion of beta-galactosidase selection marker was uniformly unsuccessful, suggesting that this gene is essential for virus viability. To demonstrate that, we inserted in the TK (thymidine kinase) locus of the virus a construction containing a second copy of the p54 gene and beta-glucuronidase selection marker under the control of p54 and p73 promoters, respectively. Virus mutant clones expressing a second copy of p54 and beta-glucuronidase were used to achieve deletion mutants of the original copy of the gene. Virus mutants expressing only the second inserted copy of p54 and the two selection markers mentioned above were successfully obtained. Therefore, we have demonstrated that the p54 gene product plays an essential role in virus growth, characterizing for the first time in ASFV an essential virus gene.
African Swine Fever Virus↗
Diuretic activity of an Equisetum bogotense tea (Platero herb): evaluation in healthy volunteers.
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Adult↗