Free thermal convection driven by nonlocal effects.
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Journal Article↗
Biomedical subjects
R Soto
Publications and source records attributed to R Soto.
NBME Examination Part I as a predictor of clinical and ABIM certifying examination performances.
The authors studied the extent that National Board of Medical Examiners examination Part I (NBME Part I) performance was predictive of American Board of Internal Medicine examination (ABIME) scores and clinical skill ratings. Information was obtained for Jackson Memorial Hospital internal medicine residents who completed training from 1980 to 1988. There was a highly significant association (r = 0.57, p < 0.0001, n = 117) between ABIME and NBME Part I scores. Clinical evaluations and NBME Part I scores were less strongly related. The data indicate that NBME Part I scores are highly predictive of ABIME outcome. NBME Part I scores also appear to be predictive of clinical performance, but to a lesser extent.
Adult↗
A prospective study of sensory function in patients with type 2 diabetes.
Sensory function was prospectively examined in 201 Type 2 diabetic patients over a 2-year period. Quantitative sensory testing for vibration, cool, warm, and pressure perception at the hallux was performed at baseline, 1-month, 1-year, and 2-year visits. There were statistically significant increments of thresholds for all sensory modalities from the baseline visit to the 1-year visit (p < 0.001) and from the 1-year visit to the 2-year visit (p < 0.001). Thirty percent of 77 subjects considered to be at low risk for foot ulceration at baseline progressed to a higher risk category at the 2-year visit. There were no significant differences in mean glycosylated haemoglobin, height, sex distribution, age, or diabetes duration when patients who had a faster progression of insensitivity were compared with patients who had a slower progression. There was a high degree of autocorrelation between baseline and 2-year visits for all sensory modalities (r = 0.83 to r = 0.88, p < 0.001 for all). Also, changes in sensory thresholds from the baseline to 2-year visits for one modality tended to correlate with other modalities (r = 0.36 to r = 0.70, p < 0.001 for all). These data indicate that an appreciable proportion of Type 2 diabetic patients are at risk for a marked rate of decline of sensory function, and suggest a need for at least yearly quantitative sensory testing.
Age Factors↗
Plasma lipid levels at diagnosis in type 2 diabetic patients.
Plasma lipid measurements were obtained at the time that 545 subjects were screened for diabetes mellitus. Both the women and men diagnosed with diabetes had significantly higher triglyceride levels (p < 0.05) and lower high-density-lipoprotein cholesterol (HDL-cholesterol) levels (p < 0.05) than those with normal glucose tolerance. Low-density-lipoprotein cholesterol (LDL-cholesterol) levels were only higher in the diabetic women (p < 0.001). Differences in lipid values were diminished somewhat with allowances for the waist-hip ratio. HDL-cholesterol values were inversely related to fasting insulin levels in the normoglycaemic men and women (p < 0.01), but not in the diabetic individuals. Triglyceride levels were strongly positively related to insulin values in the normoglycaemic men and women (p < 0.001 for both), while associations tended to be smaller in the diabetic subjects. In 13 of the diabetic individuals who were not medicated for diabetes over a period of 17.5 +/- 4.6 months, changes in HDL-cholesterol levels were positively related (p = 0.80, < 0.001) and changes in triglyceride levels inversely related (r = -0.70, p < 0.01) to changes in insulin values. These data indicate that at diagnosis Type 2 diabetic patients have an atherogenic lipid pattern that may be related in part to differences in adipose distribution. In addition, the data suggest that HDL-cholesterol is positively related and triglyceride inversely related to insulin action.
Adult↗
Immunization against porcine cysticercosis in an endemic area in Mexico: a field and laboratory study.
An antigenic extract from Taenia solium metacestodes was evaluated for immunogenicity in pig populations from a large area of endemic porcine cysticercosis in the State of Guerrero, Mexico. A total of 3,295 pigs from 18 villages were immunized with a single dose of 250 micrograms of protein administered intramuscularly. Systematic immunization was also performed on pigs (1,076 immunizations) from two of the villages with the highest percentages of cysticercosis. A year after immunization, porcine cysticercosis decreased from 4.8% and 5.4% to 0%. Immunity against the T. solium metacestode was estimated in vitro by measurements of 3H-thymidine uptake and inhibition of leukocyte migration. Peripheral blood lymphocytes from immunized cysticercotic (pigs that had cysticercosis prior to immunization), cysticercotic immunized (pigs that acquired cysticercosis after immunization), and normal control pigs incorporated 3H-thymidine better than lymphocytes from cysticercotic pigs when stimulated with concanavalin A. A significant inhibition in the leukocyte migration inhibition test was also found in leukocytes from immunized cysticercotic pigs (P < 0.01). Histopathologic studies revealed granuloma formation surrounding the metacestodes of the immunized cysticercotic and cysticercotic immunized pigs. These metacestodes exhibited several stages of destruction. Large numbers of eosinophils were frequently observed in a close association with the degeneration and destruction of parasites. Metacestodes in control cysticercotic pigs were intact and surrounded by a minor inflammatory reaction. Finally, the rate of in vitro evagination of scolices was high in metacestodes obtained from cysticercotic pigs and low or absent in those from immunized pigs (P < 0.01).
Animals↗
[Bladder psoas hitch. Report of 11 cases].
Bladder psoas hitch is an surgical technique which, in very complicated cases, like repeated failures of vesico-ureteral re-implants or undiversions, allow us to bridge the shortness of the ureter and obtain a good vesico-ureteral reimplant. The surgical maneuver is described and several of the 11 cases operated by this technique are commented. The results are presented.
Adolescent↗
A comparison of adiposity measures for screening non-insulin dependent diabetes mellitus.
We compared the accuracies of adiposity distribution measures (waist and hip circumferences, subscapular and triceps skinfold thicknesses, waist-hip and subscapular-triceps ratios) with a measure of adiposity extent (body mass index) for screening non-insulin dependent diabetes mellitus (NIDDM). Of 521 subjects (218 men and 303 women) who had 2 h oral glucose tolerance tests, 43 men and 28 women were found to have NIDDM. Allowing for age, ethnicity, and family history in analyses of covariance, the subscapular skinfold thickness and the ratio of the subscapular to triceps skinfold thicknesses were significantly higher (P < 0.05) in both the men and women found to have diabetes than in their non-diabetic counterparts. The waist-hip ratio was also significantly higher in diabetic women; however, the elevation was not as marked in diabetic men (P = 0.06). The body mass index did not differ between diabetic and non-diabetic men and was only moderately elevated in diabetic women (P = 0.04). Receiver-operator curves were employed to examine the relative accuracies of the body mass index, waist-hip ratio, and subscapular skinfold thickness for screening NIDDM. In both men and women, the waist-hip ratio and subscapular thickness were superior to the body mass index. These data suggest that certain measures of adiposity distribution are more accurate than measures of overall adiposity extent for screening NIDDM and that they may be useful in screening programmes.
Adipose Tissue↗
Sensory function at diagnosis and in early stages of NIDDM in patients detected through screening.
OBJECTIVE: We studied whether sensory function abnormalities are present at diagnosis and whether they develop in the early stages of non-insulin-dependent diabetes (NIDDM). RESEARCH DESIGN AND METHODS: Quantitative assessments of vibration sensitivity at the hallux and index fingers, and thermal sensitivity at the hallux were performed at screening (2-h oral glucose tolerance tests) for diabetes in 364 individuals. Twenty-five subjects diagnosed with NIDDM and 25 matched nondiabetic subjects were restudied after an interval of 12-41 mo. RESULTS: When those with NIDDM (n = 41) or impaired glucose tolerance (IGT) (n = 38) were compared with nondiabetic subjects, there were no significant differences in sensory function indices. However, the vibration threshold and HbA1c were related among those found to be hyperglycemic (IGT and NIDDM combined P less than 0.05; NIDDM alone P less than 0.05). Among diabetic subjects, the vibration threshold and interaction term of height and Hba1c were positively related in a multiple regression analysis (P less than 0.01). There were increments in all sensory thresholds in diabetic patients at follow-up (P less than 0.05 for all). Increments were smaller in control subjects. CONCLUSIONS: These data suggest that although sensory function tends to be normal at diagnosis in NIDDM patients, there appears to be a diminution in sensory function as the disease progresses. An interaction between metabolic factors and height may influence sensory function early in the course of NIDDM.
Adult↗
Cadmium determination in Mexican-produced tobacco.
Exposure to cadmium by inhalation or ingestion is dangerous for human health. This metal induces damage to the kidneys, the bones, the prostate, and the lungs. In the lungs, cadmium can produce cancer, emphysema, and fibrosis. It is well known that tobacco leaves are contaminated with cadmium, a metal that has been related to pulmonary damage. In this paper we report the concentration of cadmium in tobacco leaves and in cigarettes produced for domestic consumption. Fifty-five cigarettes of different brands, prices, and stocks were analyzed as well as 48 samples from four different types of tobacco. The average concentration of cadmium in cigarettes was 4.41 +/- 0.67 micrograms/g, and 2.65 +/- 0.99 micrograms/g for tobacco leaves; the content of cadmium was 2.8 +/- 0.4 micrograms/cigarette. It was estimated that a person that smokes 20 Mexican cigarettes per day can increase his (her) cadmium burden by 1.4 to 2.8 micrograms per day.
Cadmium↗
The prevalence and extent of vibration sensitivity impairment in men with chronic ethanol abuse.
We have studied vibration sensitivity impairment in 100 male alcoholic veterans and 52 control subjects who had no etiologic factors for peripheral neuropathy. Vibration sensitivity was quantitated at the hallux with the Vibration Sensitivity Tester. Alcoholic subjects had impairment of vibration sensitivity when compared with control subjects (p less than .001). This difference persisted when a covariance analysis was performed which included age (coefficient +/- SE: 1.40 +/- 0.35 units, p less than .001). Asymptomatic subjects also had vibration sensitivity impairment (p less than .01). In subjects whose ages were greater than or equal to 45 years, 47% of the alcoholics had poorer vibration sensitivity than did any of the controls. Among the alcoholic subjects there were significant correlations of the vibration perception threshold with both age (r = 0.39, p less than .001) and drinking duration (r = 0.35, p less than .001). In multiple regression analyses these associations remained significant (p less than .05). These data indicate that vibration sensitivity impairment is highly prevalent in alcoholic subjects and that impairment may even occur in those who are asymptomatic.
Adult↗
Comparison of the lipid profiles of Cubans and other Hispanics with non-Hispanics.
We compared the plasma lipid profiles of Cuban Americans and other Hispanic-American subgroups with those of non-Hispanics. High-density lipoprotein cholesterol levels were lower and triglyceride levels were higher when Hispanic women were compared with non-Hispanic women, and this pattern was also apparent for men. The lower high-density lipoprotein cholesterol and higher triglyceride levels were consistent for both Cuban and non-Cuban Hispanics. There were higher waist-hip ratios and insulin levels in both Hispanic men and women. When allowances were made for these attributes in covariance analyses, the lipid differences were markedly diminished. These data suggest the lower high-density lipoprotein cholesterol and higher triglyceride levels are consistent across Hispanic subgroups and that this lipid pattern may be attributable at least in part to increased insulin resistance in Hispanics.
Adult↗
The relation between the plasma lipoprotein pattern and the waist/hip ratio in non-diabetic individuals.
Relations between lipoprotein indices and the waist/hip ratio (WHR) were examined in normoglycemic subjects (124 women and 63 men). Among women, an atherogenic lipoprotein pattern was strongly associated with WHR. The relation was greater than that of the lipoprotein pattern with either the body mass index or the subscapular/triceps ratio, and was independent of these adiposity measures. The association between low-density-lipoprotein cholesterol (LDL-cholesterol) and WHR was much stronger in thinner women than in those more obese (r = 0.64 vs r = 0.22, p = 0.001 for difference). Men had a more atherogenic lipoprotein pattern than women; however, with allowances for WHR the lipoprotein patterns were similar. These findings suggest that: (1) WHR is more strongly related to plasma lipoproteins than other adiposity measures; (2) there is effect modification by the extent of adiposity for the relation between LDL-cholesterol and WHR; and (3) the adipose distribution may be important in explaining lipoprotein differences between men and women.
Abdomen↗
Potential exposure and health risks of infants following indoor residential pesticide applications.
Air and surface chlorpyrifos residues were measured for 24 hours following a 0.5 percent Dursban broadcast application for fleas inside a residence. Two of the three treated rooms were ventilated following application. Maximum air concentrations were measured 3-7 hours post-application. Peak concentrations in the infant breathing zone were 94 micrograms/m3 in the nonventilated room and 61 micrograms/m3 in the ventilated room, and were substantially higher than concentrations in the sitting adult breathing zone. Concentrations of approximately 30 micrograms/m3 were detected in the infant breathing zone 24 hours post-application. Surface residues available through wipe sampling were 0.7-1.6 micrograms/cm2 of carpet on the day of application and 0.3-0.5 micrograms/cm2 24 hours post-application. Estimated total absorbed doses for infants were 0.08-0.16 mg/kg on the day of application and 0.04-0.06 mg/kg the day following application, with dermal absorption representing approximately 68 percent of the totals. These doses are 1.2-5.2 times the human No Observable Effect Level (NOEL). Exposures to cholinesterase inhibiting compounds following properly conducted broadcast applications could result in doses at or above the threshold of toxicological response in infants, and should be minimized through appropriate regulatory policy and public education.
Air Pollutants↗
Comparison of quantitative sensory-threshold measures for their association with foot ulceration in diabetic patients.
We compared the accuracy of cutaneous pressure perception-threshold measurements with that of other sensory-threshold measurements for detecting diabetic foot ulcer patients. Three hundred fourteen non-insulin-dependent diabetic patients were studied, of whom 91 had either a current foot ulcer or a history of foot ulceration. Foot ulcer patients had much higher pressure perception thresholds at the hallux than those without foot ulcers (mean +/- SE 4.63 +/- 0.05 vs. 3.54 +/- 0.04 U, P less than 0.001). The magnitude of association was higher than that for vibration thresholds and markedly greater than those for cool and warm thresholds. Pressure thresholds were highly accurate for identifying foot ulcer patients. At a threshold level of 4.21 U, the sensitivity was 0.84, with a specificity of 0.96. At similar sensitivities for vibration and thermal thresholds, specificities were lower. Foot ulceration and cutaneous pressure perception threshold are strongly associated. Pressure-threshold measurements are extremely accurate and perform at least as well as other quantitative sensory tests in identifying foot ulcer patients. Assessment of the foot pressure threshold may have promise as a simple and inexpensive method for detecting diabetic patients at risk for foot ulcers.
Cold Temperature↗
Methods for assessing fieldworker hand exposure to pesticides during peach harvesting.
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Agricultural Workers' Diseases↗
Immunological aspects of Graves' disease patients in different clinical stages.
UNLABELLED: Humoral immunological differences and the relation between circulating immune complexes (CIC) and the thyrotropin-receptor antibody (TRAB) were evaluated in newly diagnosed (n = 30), relapsed (n = 27) and remission patients (n = 29) with Graves' disease. CIC were assessed by C1q-binding assay (CIC-C1q) and the PEG precipitation test (CIC-PEG); TRAb by the radioreceptor method and microsomal antibody (MAb) by passive hemagglutination test. The data were expressed as mean +/- SE. No difference was observed in the CIC-C1q among newly diagnosed, relapsed and remission patients, but they were elevated vs controls (p less than 0.01, less than 0.05, less than 0.05, respectively). In newly diagnosed subjects with positive TRAb, CIC were higher than in those with negative TRAb (p less than 0.05) and also higher than in relapsed patients with positive TRAb (p less than 0.05). In newly diagnosed group CIC-C1q correlated to TRAb presence but not to TRAb values. CIC-PEG and TRAb levels were similar in newly diagnosed and relapsed patients, being higher than in controls (p less than 0.01) and in remission patients (p less than 0.01). No significant differences were observed in MAb in any of the groups. CONCLUSIONS: i) Patients in remission were immunologically active and they differed from newly diagnosed and relapsed patients by CIC-PEG and TRAb values; ii) in hyperthyroid patients with positive TRAb, CIC-C1q were higher at the initial stage of the disease; iii) A direct correlation between CIC-C1q and TRAb presence was observed in newly diagnosed patients, but no relation could be seen in the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
AT III Barcelona: a familial quantitative-qualitative AT III deficiency.
A quantitative and qualitative deficiency of antithrombin III (ATIII) was found in four members of a Spanish family with thrombotic tendency. In all affected members, levels of ATIII antigen and activity (heparin cofactor activity) were reduced to 50% of the normal range. When crossed immunoelectrophoresis (CIE) was performed in the presence of heparin, an abnormal slow-moving peak was found. Crossed immunoelectrofocusing (CIEF) from normal and affected individuals showed that normal ATIII migrated between pH 4.9-5.3 while the ATIII under study was asymmetrically distributed between two pH ranges: 4.9-5.3 and 4.6-4.8. Affinity adsorption of affected members' plasma to heparin-sepharose beads revealed one population of ATIII in the supernatant corresponding to the abnormal ATIII, devoid of heparin cofactor activity and showing a peak between pH range: 4.6-4.8 in CIEF. Our data supports the view that a quantitative-qualitative deficiency was present in the heterozygous state in all the affected family members. Both normal and abnormal ATIII were present in plasma of the affected individuals. This abnormal ATIII was characterized by a lack of affinity for heparin. This familial ATIII deficiency was named ATIII Barcelona.
Adult↗
Surgical results in subaortic stenosis.
Since 1965, 46 patients aged 4 to 42 years, underwent cardiac surgery for subaortic stenosis. Resection of the subvalvar obstruction without myomectomy was performed in all cases. Three patients died during the operation, another one after 6 months due to infective endocarditis and one more suddenly 11 years after treatment. One patient was lost to follow-up but 41 were available after at least 1 year of follow-up. Before surgery, 21 cases were in NYHA class I, 17 in class II and 8 in class III. One year after surgery 36 were in class I, 4 in class II and only one in class III. Actuarial survival rate was 91% from 1 to 12 years and 79% from 13 to 18 years. Event-free survival was 45% up to 18 years. The mean preoperative peak systolic gradient was 93.15 +/- 35.57 mm Hg. The first postoperative peak systolic gradient was 21.61 +/- 17.91 mm Hg (P = 0.001). Cases with adverse postoperative events such as aortic regurgitation (13 cases), restenosis (13 cases), death (2 cases) and infective endocarditis (2 cases) had a mean peak systolic gradient of 55.78 +/- 35.97 mm Hg, while in the event-free patients the gradient was 14.61 +/- 13.34 mm Hg (P = 0.001). Recurrent obstruction was observed in seven patients and an increase in the residual gradient in six. The initial mean postoperative peak systolic gradient in these patients had been 18.23 +/- 17.32 mm Hg and the second postoperative cardiac catheterisation showed a mean gradient of 59.23 +/- 37.78 mm Hg (P = 0.001). We conclude that long-term follow-up following removal of subaortic stenosis is mandatory in order to detect and treat adverse events.
Adolescent↗