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Biomedical subjects

R Rodríguez

Publications and source records attributed to R Rodríguez.

At least 307 records · Page 17Linked to original sources
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Purification, characterization and immobilization of proteinase inhibitors from Stichodactyla helianthus.

Isolation of proteinase inhibitors from the sea anemone Stichodactyla helianthus was achieved by trichloroacetic acid treatment of the aqueous extract followed by affinity chromatography on trypsin-Sepharose and ion-exchange chromatography on CM-cellulose. The average molecular mass of the major inhibitor (ShPI-I) obtained by fast atom bombardment mass spectrometry (FAB-MS) was 6110.6 Da. The amino acid sequence was determined by FAB-MS combined with manual Edman degradation, digestions with endopeptidases and exopeptidases and automatic sequencing. The sequence of ShPI-I (55 amino acids) was compared with those reported in the SwissProt database for several proteinase inhibitors and significant similarity to inhibitors belonging to the Kunitz family was observed. ShPI-I exhibits a broad specificity for serine, cysteine and aspartic proteinases. The dissociation constants of the complexes formed with different enzymes were determined. The affinity-purified fraction (PI) was immobilized on Sepharose and used in the purification of different classes of proteinases.

Amino Acid Sequence↗
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[Genital infection and infertility].

BACKGROUND: Genital infection is the most important cause of infertility worldwide, affecting not only Fallopian tubes but all anatomic urogenital sites, both male and female. METHODS: We present a randomized,prospective and normalized study about sexually transmitted diseases(STD). We include 487 patients, 376 of whom were infertile and the remaining 111 were not and act as control group. RESULTS: 47.3% of infertile patients showed at least one infection: 10.7% had Chlamydia trachomatis infection, whereas only 0.3% had gonococal infection. We found none syphilis. 12.9% of the patients showed yeast belonging to genus Candida, 5% bacterial vaginosis, 3.8% Escherichia coli and 0.3% Klebsiella pneumoniae. The percentage of isolation of Ureaplasma urealyticum and Mycoplasma hominis were 23.5% and 4.8%, respectively. We detected antibodies against Hepatitis B (any serological marker) in 7.8% of the cases. Chlamydial infection and the presence of U. urealyticum were related with infertility (X 12=6,070, p<0.005 and X12=8,782, p<0.005,respectively). CONCLUSIONS: We think these results conclude that is necessary to perform routine tests to screen for C. trachomatis, N. gonorrhoeae, and for infections caused by micoplasma as well, among infertile patients. These patients must be considered of being at risk of acquiring STD, since the percentage of these diseases is higher than the percentage we found among the control group. It is important to insist on prevention and early diagnosis and treatment as a main goal to decrease the number of tubal occlusion and infertile couples.

Adult↗
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[National survey of preoperative management and patient selection in ambulatory surgery centers].

BACKGROUND: The objective of this study was to determine both the selection and preparation criteria in patients in various Spanish ambulatory surgery centers, as well as the impact of these criteria on their results. The results were compared according to the type of functional structure of the units (autonomous or integrated). MATERIAL AND METHODS: We performed a cross sectional, descriptive study through postal survey. The survey contained the following items: type of unit, surgical procedures, selection criteria, preoperative assessment and management, and qualitative and quantitative indexes of the activity performed in 2000. A total of 123 units were included with a response rate of 39%. RESULTS: The selection criteria showed a high degree of consensus. The outpatient anesthesia clinic was used for preoperative assessment by 97.9% of the units. Most units routinely requested preoperative tests (hemostasis and hemogram by 89%; biochemical parameters by 72.9%) and to a lesser extent chest X-ray (33.3%) and electrocardiogram (35.4%). The introduction of procedures for the management of coexisting diseases was scarce (25-64.6%). Units using the outpatient anesthesia clinic in all patients had a lower cancellation rate (1.5% vs 4.4%). Autonomous units were significantly more likely to accept patients with high surgical-anesthetic risk than integrated units. Autonomous units also showed a significantly lower number of admissions (1.2% vs 1.9%, p = 0.003), mean stay (240 min vs 367 min, p = 0.002), and recovery time (150 min vs 212 min, p = 0.001) than integrated units. No statistically significant differences were found in the remaining parameters. CONCLUSIONS: Scientifically based protocols for patient selection, preoperative assessment and perioperative management of distinct processes and for the rational use of laboratory tests should be more widely used. The need for an outpatient anesthesia clinic for preoperative assessment was notable. The results of our survey indicate that better results in performance indexes are achieved in autonomous ambulatory surgery units than in integrated units. Given the possibility of defining and validating quality standards, further multicenter studies should be performed.

Ambulatory Surgical Procedures↗
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[Professional perspective in primary health care reform: a qualitative approximation].

The objective of this study was to find out opinions and experiences of primary health centre professionals on the process of implementation and development of the New Model of Primary Health Care in the Valencian Community. Nin semi-structured group interviews with professionals were carried out, directed by two researchers who proposed the topics for discussion by means of open questions and took notes on the interventions. Some others aspects of health centres' situation were also assessed by observation. The majority of the professionals thought high prevalence disease programmes should be elaborated by the Health Administration that community participation was an important dimension but difficult to develop, that the population perceived an improvement in health care with the new model, and that relationships with Health Area Managers were good, even though they were not thought to have a real management role. The greatest differences in opinions and experiences among primary health care teams concerned the development of some dimensions of the new model, especially comprehensive care, continuous care and team work.

Health Care Reform↗
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[Content analysis in the assessment of the new model of primary health care in the Valencian community].

The objective of this research is to find out how the process of implementation and development of the new model of primary health care is taking place in the Valencian Community, according to the press and the opposition political parties. An analysis of two types of texts was conducted: daily journal articles parliamentary questions. The press referred to implementation more often than to development, assessing the implementation in a positive way and the development in a negative one. The opposition political parties in the regional parliament also questioned on the model implementation more often on its development, and negatively assess the process as a whole.

Evaluation Studies as Topic↗
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Induction of protective immunity against experimental infection with malaria using synthetic peptides.

Synthetic peptides are potential vaccine candidates because they may be able to induce high antibody titres and specific cellular immune responses against native proteins and thus the whole invading organism. In a previous study we showed that immunization with molecules of relative molecular mass (Mr) 155,000 (155K) 83K, 55K and 35K, specific for the late schizont and merozoite stages of Plasmodium falciparum, could elicit either partial or total protection in Aotus trivirgatus monkeys experimentally infected with P. falciparum. Here we have chemically synthesized 18 peptides corresponding to different fragments of these proteins to immunize Aotus trivirgatus monkeys. Some peptides gave partial protection from challenge with P. falciparum parasites, but none provided complete protection individually. A combination of three partially protective peptides gave complete or almost complete protection, however, suggesting that this particular combination of peptides is a good candidate for a malaria vaccine.

Animals↗
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CT in local recurrence of rectal carcinoma.

OBJECTIVE: We evaluated the effectiveness of CT in detecting the recurrence of rectal cancer. MATERIALS AND METHODS: As part of a postoperative follow-up protocol, periodic CT examinations were performed on 67 patients who had had potentially curative surgery for rectal carcinoma. Retrospectively we evaluated the CT of these patients. In 21 patients there was local tumoral recurrence, which was detected by CT in 15. We classified the patients into two groups according to the surgical technique employed: anterior resection (AR) or abdominoperineal resection (APR). RESULTS: The sensitivity of CT for the diagnosis of local recurrence was greater in patients with APR (12/13; S = 92%) than in those with AR (3/8; S = 37%). In each group there was one false-positive result--thus both groups showed a similar specificity (94% in APR and 96% in AR). In the APR group, 38% of the recurrences (5/13) were detected initially by CT. Computed tomography was not the first diagnostic test in any of the recurrences after AR. CONCLUSION: On the basis of these results, we think that CT is a good diagnostic test for local recurrence in patients with rectal cancer and APR.

Female↗
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The normal electrocardiogram of the unanesthetized peregrine falcon (Falco peregrinus brookei).

The mean duration and amplitudes of the lead II electrocardiogram were determined in the peregrine falcon (Falco peregrinus brookei) using 10 birds ranging in age from 1 to 5 yr. Electrocardiograms were performed on unanesthetized falcons in order to avoid the anesthesia effect on the electrocardiogram, by a method which seems to induce a tonic immobility-like reaction. All the falcons had a normal sinus rhythm, with a mean heart rate of 268 beats per minute. Mean durations of PR, ST, QT, and RR intervals were higher (but not statistically significant) in females than in males, except for the ST segment, with similar values in both sexes. P-wave deflections were positive in I, II, III, aVL, and aVF and negative in aVR. The normal patterns of wave forms of the QRS complexes in all leads were of QS and rS types, except for aVR and aVL, which presented an R configuration. The mean electrical axis was negative, with an average of -99.9 degrees. T-wave deflections were positive in I, II, III, and aVF leads II and negative in aVR and aVL. The data collected in this study may serve as a guide for electrocardiographic monitoring of peregrine falcons.

Anesthesia↗
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Serum levels of soluble interleukin-2 receptor in patients with ANCA-associated vasculitis.

Serum soluble interleukin-2 receptor (sIL-2R) concentrations were determined using the ELISA method in 19 cases of ANCA-associated vasculitis. These patients were classified as 7 cases of Wegener's granulomatosis (WG) and 12 cases of microscopic polyangiitis (MPA). Elevated levels of sIL-2R were present in the sera of these patients. Levels of serum sIL-2R were not significantly different in patients with WG and MPA either in the active or inactive phase, so the results were expressed as a unified ANCA associated vasculitis group. Concentrations of serum sIL-2R were significantly higher in ANCA-associated vasculitis during the active phase than during the inactive phase (p<0.05), and serum sIL-2R levels were significantly increased in these patients, in the active or inactive stage, compared with a group of healthy subjects (p<0.05). In patients with vasculitis, serum sIL-2R levels correlated with serum levels of C-reactive protein (p<0.05). In the active phase, concentrations of serum sIL-2R correlated to creatinine concentrations. No correlation was found between sIL-2R and ANCA levels in any of the stages of the disease. These findings suggest cellular immune activation in ANCA associated vasculitis.

Adult↗
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[Study of patients admitted to a telemetry unit].

The current situation of the telemetry unit of Vigil de Quiñones Hospital was studied. Telemetry indications, results, and problems observed since the unit was inaugurated were studied to determine the usefulness of telemetric heart rate monitoring and centralized surveillance in an intensive care unit (ICU) in detecting severe arrhythmias, controlling antiarrhythmic treatment, and evaluating why and to what extent telemetry is clinically useful. In our center, telemetry is used to monitor patients with well-established needs. In most cases, arrhythmias are monitored, most frequently premature ventricular complexes, sinus bradycardia and supraventricular tachycardia. Telemetry was useful in arrhythmia treatment and the follow-up of patients with temporary or permanent pacemakers. In a significant percentage of patients (8.62%), telemetry was the key to their ICU admission and, possibly, their survival. There were generally few problems with signal transmission.

Age Distribution↗
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[Immunological study in patients with severe myoclonic epilepsy in childhood].

OBJECTIVE: Clinical and experimental data support the role of immune mechanisms in the pathogeny of childhood epilepsy. The purpose of this report is to study the immunological aspects in severe myoclonic epilepsy in infancy (SMEI). PATIENTS AND METHODS: 12 patients selected according to the following criteria: no previous personal history of disease, frequent familial history of epilepsy, beginning in the first year of life with seizures usually febriles, onset of afebrile seizures between 18 months and 4 years, normal EEG and psychomotor development are at the onset, seizures resistant to antiepileptic drugs. The following immunological evaluation, has been carried out: granulocytes phagocytic activity, lymphocytics subpopulations, serum immunoglobulins and IgG subclasses, hemolytic capacity of complement, lymphocytic transformation test. RESULTS: In five cases the immunological study was normal; five cases had IgA deficiency, associated in two to high serum IgG1 levels and in two to high IgG1 and low IgG2 levels; one case shows an IgM increase associated to hemolytic capacity of complement deficiency (CH50); four cases have a reduced response to different mitogens. CONCLUSIONS: The value of this results is doubtful. It is possible that genetical and environmental factors are involved in SMEI and that the immunological abnormalities found favor the hyperergic reactions in given circumstances.

Adolescent↗
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Attitudes toward euthanasia, assisted suicide and termination of life-sustaining treatment of Puerto Rican medical students, medical residents, and faculty.

OBJECTIVE: To elicit the opinion of Puerto Rican medical students, residents and internal medicine faculty as to the appropriateness of euthanasia and physician-assisted suicide and end-of-life management. DESIGN: Survey using a 16-item questionnaire answered within a two-month period in the fall of 1996. SETTING: Rounds or faculty meetings at teaching hospitals located in the north, south and southwest of the island of Puerto Rico. PARTICIPANTS: There were 424 participants. The questionnaires of 279 medical students, 75 medical residents, and 35 internal medicine faculty members were analyzed. Thirty-five questionnaires, which were incomplete or answered by non-Puerto Rican participants, were excluded. MAIN OUTCOMES MEASURES: Frequency of support of active euthanasia, physician-assisted suicide, withholding or withdrawing life-sustaining treatment with informed consent was determined. Whether it was ethical to prescribe full doses of drugs needed to alleviate pain even if it would hasten death, or agree to limit or restrict resources for the terminally ill was also determined. RESULTS: Forty per cent of the students, 33% of the residents, and 20% of the faculty supported euthanasia. If physician-assisted suicide were legalized, 50 per cent of the students, 43 per cent of the residents and 45 percent of the faculty would not be opposed to it. Sixty-eight per cent of the students, 67 per cent of the residents and 88 per cent of the faculty would support withholding or withdrawing life-sustaining treatment for dying patients with informed consent. Seventy-nine per cent of residents, 80 per cent of the faculty but only 54 per cent of medical students would prescribe full doses of drugs needed to alleviate pain in dying patients even if they would hasten death. Thirty-six per cent of the residents and faculty would agree to limit the use of medical resources for the terminally ill but only sixteen per cent of medical students would do so. CONCLUSIONS: The acceptance of euthanasia was inversely proportional to the clinical experience of the respondents: 40 per cent among students but only 20 per cent by the faculty. Withholding and withdrawing of life-sustaining treatment was most acceptable to the faculty (88 per cent) but it was also favored by most of the students and residents (68 and 67 per cent respectively). Eighty per cent of the faculty, 79 per cent of the residents, but only 50 per cent of the students considered that prescribing full doses of drugs to alleviate pain if they knew it would hasten death, was ethical. The medical profession should take notice of evolving concepts in end-of-life management.

Attitude of Health Personnel↗
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[Hematophagic activity of and environmental effect on the main malaria vector in Cuba: Anopheles albimanus].

An ecological study of Anopheles (N) albimanus in a suburban population of Camagüey province was carried out using a human bait in two trap points (indoor and outdoor). A higher quantity of females in the rainy season was observed together with a marked exophagic trend with peak activity in the early hours of the evening outdoor and in the early hours of the morning indoor. The abiotic influence on the fluctuation of the anophele population in both trap station was proved.

Animals↗
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[Study of various biological properties of 3 strains of dengue 2 with differences in their nucleotide sequences].

Some biological properties of Dengue-2 strains such as A-15 (isolated in Cuba in 1981); Jamaica (isolated in Jamaica in 1981) and New Guinea "C" (NG"C") standard strain differing in their nucleotide sequences were studied. The results showed that the cytopathic effect in C6/36 HT cell line occurred earlier in A-15 strain and that fluorescence was first detected in Jamaica and A-15 strains. This seems to indicate that rapid detection of strains does not have any relation to neither their history of passage nor the original isolation system. A-15 and NG"C" strains exhibited an heterogeneous pattern formed by big and small plaques but average size of plaques in NG"C" was lower whereas Jamaica showed only small plaques. The most neurovirulent strain in mice was NG"G" followed by A-15 whereas Jamaica was not neurovirulent at all. These results indicate that A-15 has a different biological behaviour which is probably due to intrinsic differences. It should be taken into account that 7 amino acid changes were found in the envelope protein which may have affected the expression of some biological properties.

Animals↗
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The role of community organizations in the transformation of the health services delivery system in the Montreal metropolitan area.

In 1995 the Montreal Regional Health and Social Services Board began a major process of change to its health care system. This transformation places particular emphasis on primary health care and increases the role of local community services centres (CLSCs) and community organizations (COs). In order to understand this process as experienced by COs, the present exploratory study was conducted during the summer and fall of 1996. We targeted 12 COs, 4 CLSCs, the Quebec Federation of CLSCs, and the Montreal CLSC Working Group. Semi-structured group interviews and CO documents were used as sources of information. Most participants believe in the need for change but feel that the strategies and implementation have been mismanaged. COs are feeling the pressure to professionalize and specialize current and future services. The "social economy" appears to be gaining momentum in the health sector.

Community Health Services↗
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[Viral hepatitis C in patients with terminal chronic renal insufficiency. III. Viral quantification].

BACKGROUND: We have previously shown that the prevalence of hepatitis associated with the hepatitis C virus (HCV) in patients with end stage renal disease in our institution is 10.2%. However, quantification of viral RNA in plasma and its relation with clinical variables has never been studied in our patients. Thus, the aim of the present work was to quantify the HCV viral load in patients with ESRD in dialysis, and to correlate these values with the dialysis modality and the viral genotype. METHODS: We performed a transverse, prospective and comparative study in patients with HCV infection in hemodialysis, continuous ambulatory peritoneal dialysis and patients in peritoneal dialysis, but with history of hemodialysis. Viral load was quantified with RT-PCR by using a commercial kit known as Amplicor HCV 2.0. Clinical variables studied were: age, gender, end stage renal disease etiology, modality and time in dialysis, transfusions, serum albumin, aminotransferases, blood urea nitrogen, and serum creatinine. RESULTS: Twenty four patients in dialysis with HCV infection entered into the study. Of these patients, 25% were on peritoneal dialysis, 29% on peritoneal dialysis with history of hemodialysis, and 46% were in hemodialysis. The average viral load (copies x 10(6)/mL) was 1.41 +/- 3.01. Viral load was lower in patients on peritoneal dialysis than in patients treated, or with history of hemodialysis (0.20 +/- 0.12 vs 2.04 +/- 0.88; p < 0.05). We observed no differences in viral load among patients with different viral genotypes. DISCUSSION: The average viral load of our patients in dialysis is lower than the levels usually observed in hepatitis C infected patients without end stage renal disease. The lower viral load in patients treated with peritoneal dialysis, and no history of hemodialysis, probably denotes lower risk of chronic liver disease in these subpopulation.

Adult↗
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[Rapid-detection GBM-ANCA ELISA. An emergency tool for the early diagnosis of type I and II rapidly progressive glomerulonephritis].

Rapidly progressive glomerulonephritides (RPGN) are forms of necrotizing glomerulonephritis associated with anti-glomerular basement membrane (anti-GBM) and anti-neutrophil cytoplasmic antibodies (ANCA) against the antigens proteinase-3 (anti-PR3) and myeloperoxidase (anti-MPO). RPGN have a course of rapid progression to renal failure. We compared the results from the semiquantitative ELISAs for anti-GMB antibodies, PR3-ANCA and MPO-ANCA and the indirect immunofluorescence technique (IIF) against a new rapid assay (30 minutes) for the same antibodies in patients with clinically suspected RPGN. The semiquantitative ELISAs for anti-GBM antibodies and PR3-ANCA and MPO-ANCA have a proven diagnostic significance in patients with RPGN I and III. There were no significant differences between the ANCA-GBM screening test and the results from the semiquantitative ELISAs (p > 0.05). We did not find significant differences between the results for PR3-ANCA and MPO-ANCA from the ANCA-GBM screening test with C-ANCA and P-ANCA IIF values (p > 0.05). We also corroborated that the ANCA-GBM screening test is a diagnostic tool for RPGN I and III as useful as the semiquantitative ELISAs and the IFF technique. The ANCA-GBM ELISA screening test is a tool as useful as the semiquantitative ELISA against anti-GBM antibodies for diagnosis of RPGN I. The comparison of the screening ELISA with the IIF technique and the semiquantitative ELISAs against PR3-ANCA and MPO-ANCA showed similar utility for diagnosis of RPGN III. The advantages of the new screening assay are that three antibodies are tested at the same time, yielding results in only 30 minutes.

Adolescent↗