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Biomedical subjects

S García

Publications and source records attributed to S García.

At least 37 records · Page 2Linked to original sources
PubMed2002

Allograft reconstruction of the distal humerus after resection of a breast solitary metastasis: eleven years follow-up.

Resection is a rare indication for the treatment of solitary skeletal metastasis (SSM), and provides an opportunity to cure the oncologic patient. Reconstruction after resection can imply a difficult problem depending on the size and the location of the metastasis. In the reported case, an en-bloc resection of a SSM of a breast cancer located in the distal humerus was performed in 1990. Reconstruction of the osteoarticular defect has been achieved with a massive allograft. At eleven years follow-up the patient remains free of illness and shows a good functional result. With the result obtained in the reported case, we suggest that osteoarticular allograft can be of considerable value for reconstruction after excision of SSM in the distal humerus, and that cure can be achieved with the radical resection of a SSM of breast cancer.

Journal Article↗
PubMed2002

Oral candidiasis as a clinical marker related to viral load, CD4 lymphocyte count and CD4 lymphocyte percentage in HIV-infected patients.

BACKGROUND: High viral load is currently considered to be one of the main indicators of the progression of HIV-induced immunodepression, but few studies have analysed its relationship to the presence of oral candidiasis (OC). The aim of this cross-sectional study is to analyse the relationship between viral load, total CD4 lymphocyte count, and percentage of CD4 lymphocytes to the occurrence of OC. METHODS: The present cross-sectional study included 156 HIV-infected patients seen at a clinic for sexually transmitted diseases and HIV. We assessed the presence or absence of OC, and microbiological samples were obtained from the palatine mucosa and dorsal tongue for a smear stained with KOH (potassium hydroxide) and culture on Sabouraud's dextrose agar in all patients. Viral load was determined by quantification of viral RNA in peripheral blood with a minimum detectable level of 500 RNA copies/ml. CD4+ counts/CD4+ percentage were categorized as <200/<14%, 200-499/14-28%, and >500/>29%, and HIV viral loads were categorized as <500, 500-10,000, >10,000 copies/ml. RESULTS: Thirty-eight percent (37.8%) of the patients had OC. Patients with CD4+ lymphocyte counts below 200 x 10(6)/l and CD4+ percentages below 14% showed a significantly higher frequency of OC (57.9% and 48.0%, respectively). Patients with a viral load over 10,000 copies/ml also had OC more frequently (44.8%). In the multiple logistic regression analysis, OC showed a statistically significant association with high viral load [>10,000 vs <500, odds ratio (OR)=11.4], low percentage of CD4+ lymphocytes (<14% vs >28%, OR=5), and injection drug use (IDU vs heterosexual transmission, OR=10.2). In HIV-infected patients, high viral load was associated with more frequent OC, regardless of CD4+ lymphocyte level. CONCLUSIONS: These findings suggest that oral candidiasis could be a useful clinical marker of patients with high viral load. In view of these results, emphasis should be placed on the importance of systematic examination of the oral cavity in all medical follow-up examinations of HIV-infected patients.

AIDS-Related Opportunistic Infections↗
PubMed2002

Verotoxin-producing Escherichia coli (VTEC), enteropathogenic E. coli (EPEC) and necrotoxigenic E. coli (NTEC) isolated from healthy cattle in Spain.

AIMS: To determine the prevalence and characteristics of verotoxigenic Escherichia coli (VTEC), enteropathogenic E. coli (EPEC) and necrotoxigenic E. coli (NTEC) in healthy cattle. METHODS AND RESULTS: Faecal samples from 412 healthy cattle were screened for the presence of VTEC, EPEC and NTEC. Four isolates from each sample were studied. VTEC, EPEC and NTEC were isolated in 8.7%, 8.2% and 9.9% of the animals, respectively. VTEC and NTEC were isolated more frequently from calves and heifers than from adults. Seventy (4.2%), 69 (4.2%) and 74 (4.5%) of the 1648 E. coli isolates were VTEC, EPEC and NTEC, respectively. Seventeen (24.3%) of the VTEC strains were eae-positive. Thirty-six (51.4%) of VTEC strains belonged to E. coli serogroups associated with haemorrhagic colitis and haemolytic uraemic syndrome in humans. The serogroups most prevalent among the EPEC strains were O10, O26, O71, O145 and O156. CONCLUSIONS: Healthy cattle are a reservoir of VTEC, EPEC and NTEC. SIGNIFICANCE AND IMPACT OF THE STUDY: Although most of the VTEC strains were eae-negative, a high percentage of VTEC strains belonged to serogroups associated with severe disease in humans.

Animals↗
PubMed2002

Lipomatous melanocytic nevomatosis.

Giant congenital melanocytic nevi (GCMN) are rare and occur in about one out of every 200,000-500,000 births. Their importance resides in the aesthetic alteration they produce and in the possibility of malignant transformation or in their association with nevi in the central nervous system as a distinctive syndrome: neurocutaneous melanoblastosis or nevomatosis, due to the fact that nervous system lesions are produced by infiltration of nevus cells. We present here a patient with a combination of GCMN with an outstanding lipomatosis located on the same area.

Aged↗
PubMed2002

Factors influencing HIV progression in a seroconverter cohort in Madrid from 1985 to 1999.

OBJECTIVE: To study HIV progression from seroconversion over a 15 year period and measure the population effectiveness of highly active antiretroviral therapy (HAART). METHODS: A cohort study of people with well documented dates of seroconversion. Cumulative risk of AIDS and death were calculated by extended Kaplan-Meier allowing for late entry. Cox proportional hazards models were used to study variables associated with HIV progression. To assess the impact of HAART, calendar time was divided in three periods; before 1992, 1992-6, and 1997-9. RESULTS: From January 1985 to May 2000, 226 seroconverters were identified. The median seroconversion interval was 11 months, median seroconversion date was March 1993. 202 (89%) were men, 76% of whom were homo/bisexual. A 66% reduction in progression to AIDS was observed in 1997-9 compared to 1992-96 (HR 0.34 95% CI: 0.16 to 0.70). People with primary education appeared to have faster progression to AIDS compared to those with university studies (HR 2.69 95%CI: 1.17 to 6.16). An 82% reduction in mortality from HIV seroconversion was observed in 1997-9 (HR 0.18 95% CI: 0.05 to 0.68) compared to 1992-6. Progression to death for people with primary education was twice as fast as for those with university education (p 0.0007). People without confirmation of an HIV negative test had faster progression (HR 4.47 95% CI: 1.18 to 16.92). CONCLUSIONS: The reduction in progression to AIDS and death from seroconversion from 1992-6 to 1997-9 in Madrid is likely to be attributable to HAART. HIV progression was faster in subjects with primary education; better educational level may be associated with better adherence to medication.

Acquired Immunodeficiency Syndrome↗
PubMed2002

[Diffusion-weighted magnetic resonance in deep cerebral venous thrombosis].

Changes in the apparent diffusion coefficient (ADC) are well established in acute ischemic stroke of arterial origin. However, ADC behaviour and its prognostic significance in cerebral venous thrombosis (CVT) are not fully understood. Diffusion-weighted imaging (DWI) findings in a 34-year old woman with deep cerebral venous thrombosis are described. Recent literature concerning DWI and cerebral venous thrombosis is also reviewed. A MRI performed within 7 hours from onset revealed hyperintensities in deep grey matter bilaterally (FLAIR/T2), without changes in ADC maps, suggesting vasogenic edema. After anticoagulation a new MRA disclosed complete recanalization of venous thrombosis. Despite her good clinical outcome the MRI showed hemorrhagic lesions suggesting venous infarct. Lesions detected in acute CVT with DWI may have normal ADC values. There is no good correlation between the acute ADC values and clinical and radiological evolution. The prognostic value of ADC in the acute phase of CVT remains unsettled.

Adult↗
PubMed2001

Time trend in incidence of HIV seroconversion among homosexual men repeatedly tested in Madrid, 1988--2000.

An open cohort of 2670 homosexual men repeatedly tested for HIV at a Madrid clinic has registered 8050 person-years (PY) of follow-up and 157 seroconversions from 1988 to 2000. After declining from 1988 (4.71 per 100 PY), the incidence rate began a significant upward trend, reaching a figure of 2.16 per 100 PY in 2000. These findings ought to alert surveillance systems and prevention programmes.

AIDS Serodiagnosis↗
PubMed2001

[Valaciclovir in the treatment of initial infection by genital herpes virus: comparative study].

BASIS: To know the therapeutic efficiency in the genital herpes of two drugs: acyclovir and valaciclovir. METHODS: There were included in the study 142 patients with diagnostic of clinic first episode by genital herpes in two equal groups of 71 patients each one. The distribution in both groups was random to receive one of the following treatment standards: acyclovir 200 mg by verbal each 5 hours, during 7 days; valaciclovir: 500 mg by verbal each 12 hours during 7 days being valued objective and subjective response to the treatment. RESULTS: The prevailing symptom was the pain (45% and 46.4%), followed by the warmth or burning sensation. The most frequent lesions in both groups were blisters (39.4% and 46.4%). The analysis response to the treatment in relationship to the symptoms as well as in the lesions it could be appreciated that there are not significant differences in the patients treated in both groups (p = 0.3). The adverse effect communicated by the discussed patients were scarce and similar in both groups. CONCLUSIONS: Both drugs are suitable for the treatment of the genital herpes. The advantage observed with the valaciclovir is the dosing comfort and the facility of completing the treatment.

Acyclovir↗
PubMed2001

Characterization of Galician (N.W. Spain) quality brand potatoes: a comparison study of several pattern recognition techniques.

Authenticity is an important food quality criterion and rapid methods to guarantee it are widely demanded by food producers, processors, consumers and regulatory bodies. The objective of this work was to develop a classification system in order to confirm the authenticity of Galician potatoes with a Certified Brand of Origin and Quality (CBOQ) 'Denominación Específica: Patata de Galicia' and to differentiate them from other potatoes that did not have this CBOQ. Ten selected metals were determined by atomic spectroscopy in 102 potato samples which were divided into two categories: CBOQ and non-CBOQ potatoes. Multivariate chemometric techniques, such as cluster analysis and principal component analysis, were applied to perform a preliminary study of the data structure. Four supervised pattern recognition procedures [including linear discriminant analysis (LDA), K-nearest neighbours (KNN), soft independent modelling of class analogy (SIMCA) and multilayer feed-forward neural networks (MLF-ANN)] were used to classify samples into the two categories considered on the basis of the chemical data. Results for LDA, KNN and MLF-ANN are acceptable for the non-CBOQ class, whereas SIMCA showed better recognition and prediction abilities for the CBOQ class. A more sophisticated neural network approach performed by the combination of the self-organizing with adaptive neighbourhood network (SOAN) and MLF network was employed to optimize the classification. Using this combined method, excellent performance in terms of classification and prediction abilities was obtained for the two categories with a success rate ranging from 98 to 100%. The metal profiles provided sufficient information to enable classification rules to be developed for identifying potatoes according to their origin brand based on SOAN-MLF neural networks.

Food Analysis↗
PubMed2001

Authentication of Galician (N.W. Spain) quality brand potatoes using metal analysis. Classical pattern recognition techniques versus a new vector quantization-based classification procedure.

The objective of this work was to develop a classification system in order to confirm the authenticity of Galician potatoes with a Certified Brand of Origin and Quality (CBOQ) and to differentiate them from other potatoes that did not have this quality brand. Elemental analysis (K, Na, Rb, Li, Zn, Fe, Mn, Cu, Mg and Ca) of potatoes was performed by atomic spectroscopy in 307 samples belonging to two categories, CBOQ and Non-CBOQ potatoes. The 307 x 10 data set was evaluated employing multivariate chemometric techniques, such as cluster analysis and principal component analysis in order to perform a preliminary study of the data structure. Different classification systems for the two categories on the basis of the chemical data were obtained applying several commonly supervised pattern recognition procedures [such as linear discriminant analysis, K-nearest neighbours (KNN), soft independent modelling of class analogy and multilayer feed-forward neural networks]. In spite of the fact that some of these classification methods produced satisfactory results, the particular data distribution in the 10-dimensional space led to the proposal of a new vector quantization-based classification procedure (VQBCP). The results achieved with this new approach (percentages of recognition and prediction abilities > 97%) were better than those attained by KNN and can be compared advantageously with those provided by LDA (linear discriminant analysis), SIMCA (soft independent modelling of class analogy) and MLF-ANN (multilayer feed-forward neural networks). The new VQBCP demonstrated good performance by carrying out adequate classifications in a data set in which the classes are subgrouped. The metal profiles of potatoes provided sufficient information to enable classification criteria to be developed for classifying samples on the basis of their origin and brand.

Journal Article↗
PubMed2001

Prevalence of hepatitis C virus infection in the general population of northern Spain.

OBJECTIVES: To estimate the prevalence of hepatitis C in a population of northern Spain and describe (i) the risk factors associated with infection and (ii) the distribution of genotypes. DESIGN: Randomized cross-sectional study. METHODS: A random sample of 1,170 people participated in the study. Sociodemographic data were obtained. Antibodies against hepatitis C virus (anti-HCV) and hepatitis C virus (HCV) genotypes were determined. RESULTS: Nineteen of 1,170 (1.6%) subjects were anti-HCV positive (95% CI 1.0-2.6%). In 12 cases (63%), viraemia was present, and the predominant genotype was 1 b (80%). Anti-HCV positive subjects were older than anti-HCV negative subjects (55.8 +/- 15.3 v. 44.8 +/- 20.9; P = 0.02). Two peaks of maximum frequency were found (in the fourth decade and in those over 60 years). Parenteral drug addiction predominates among those of the fourth decade, while transfusion and surgery predominate in people over 60 years. Three (16%) subjects knew they were carriers of HCV. Only three variables remained significant in the multivariate model (illegal drug use, P< 0.0001; previous hepatitis, P< 0.0001; and age, P< 0.02). CONCLUSIONS: Our study emphasizes the need to develop health policies that can cope with the foreseeable increases in the problems associated with HCV infection in the near future.

Adolescent↗
PubMed2001

Microbiological survey of retail herbs and spices from Mexican markets.

In the present study, 304 samples of herbs and spices (garlic powder, cumin seeds, black pepper, oregano, and bay leaves) widely used in Mexico were analyzed for the presence of Bacillus cereus, Salmonella Typhi, Shigella dysenteriae, Escherichia coli, total and fecal coliforms, total mesophilic aerobic organisms, and fungi. Samples were nonpackaged or packaged in polyethylene bags or glass containers. High levels (10(5) to 10(7) CFU/g) of mesophilic aerobic microorganisms were found in most of the samples of garlic powder, cumin seed, and black pepper. Lower levels (<102 CFU/g) were found in oregano and bay leaves. Total and fecal coliforms counts were dependent on the type of packaging. More than 70% of the polyethylene-packaged samples had less than 10(3) CFU/g of microorganisms. Glass and nonpackaged spices showed lower levels of these microorganisms. B. cereus was present in 32 samples of which most were polyethylene packaged. The other pathogenic bacteria were not detected. Aspergillus niger was detected in 29% of the samples, Rhizopus sp. in 19%, and Penicillum sp. and Cunninghamella in 8%.

Bacteria↗
PubMed2001

Microbiological condition of ground meat retailed in Monterrey, Mexico.

Eighty-eight samples of ground meat were randomly collected from retail stores in the metropolitan area of Monterrey, Mexico, and were analyzed for microbial contamination. Methods were those recommended by the Mexican regulation and/or the U.S. Food and Drug Administration. Over 75% of the samples contained > 10(5) total mesophilic microorganisms per g, and over 40% had >10(6) total coliforms per g. Fecal coliforms were present in most samples. Staphylococcus aureus was detected in 2.3% of the samples, Salmonella spp. in 11.4%, Listeria spp. in 62%, and L. monocytogenes in 16%. Escherichia coli was detected in 76% of samples, but none was serotype O157:H7. Shigella spp. was not found in any sample. Fusarium spp. and Mucor spp. were detected in 3.4% of the samples, and low levels of yeast in 93%. The microbiological quality of the ground meat analyzed was unsatisfactory, and the product could be an important cause of food poisoning.

Animals↗
PubMed2001

[The scintigraphy of somatostatin receptors in the carcinoid tumor].

UNLABELLED: This study aimed to evaluate the diagnostic utility of 111In-DTPA-D-Phe1-octreotide scintigraphy in the different situations that can be present when an examination is requested during the clinical course of the carcinoid tumor (CT). MATERIALS AND METHODS: We have performed 41 scintigraphies with 111In-octreotide (145-185 MBq) in 35 patients (19 females and 16 males) with clinically suspected or confirmed CT. The patients were classified into five groups: Group A: Indolent symptoms of CT (n=9); B: CT staging located in lung (n=4), stomach (n=2), cecum (n=1), thymus (n=1) and pancreas (n=1); C: Carcinoid syndrome (n=1); D: CT staging after surgery located in pancreas (n=1), ovary (n=1), cecum (n=1), stomach (n=1), appendix (n=1) and ileum (n=1); and E: Post-treatment follow-up (n=13), with CT located in bronchial tree (n=5), small intestine (n=3), appendix (n=2), thymus (n=1), ovary (n=1) and unknown primary tumor (n=1). Three patients of this group had one scintigraphic study before the treatment. Head and neck, thorax and abdomen images were obtained at 4 and 24 h in all of the patients and SPECT images of the abdomen (n=14), thorax (n=10), and brain (n=1) were obtained at 24 h in 25 patients. RESULTS: Group A: In the 3 patients with a positive scintigraphy, the definitive diagnosis was meningioma, Hurtle cell's carcinoma and lung adenocarcinoma. The clinical follow-up in the six other patients, at least during one year, did not show any evidence of CT. Group B: Six of the 9 CT were detected with the scintigraphy. In 2 cases of bronchial CT, the scan showed sarcoidotic regional lymph node involvement and CT hepatic and bone metastases, respectively. Group C: The scintigraphy detected hepatic metastases from an unknown primary tumor. Group D: The scintigraphy was positive in 3 cases (hepatic or/and abdominal metastases) and was normal in the other 3. The scintigraphy was negative in one patient with peritoneal metastases. Group E: The scintigraphy was normal in 7 patients in concordance with the clinical follow-up. In 3 patients with a scintigraphy performed prior to treatment, the scintigraphy detected recurrence (thymic CT), progression of the metastatic disease (ovarian CT) and partial regression of the hepatic metastases (carcinoid syndrome). In the three other patients, the scintigraphy showed metastases located in liver in one patient and hepatic and extra-hepatic metastases in the two other patients. The sensitivity and specificity of 111In-Octreotide in the detection of the primary tumor and metastases were 72% and 84% respectively. CONCLUSIONS: The 111In-Octreotide scintigraphy has a low diagnostic utility in patients with indolent symptoms of CT. However, it is the first line of diagnosis for the staging of the CT and to evaluate the follow up after therapy.

Adult↗
PubMed2001

[Behcet's disease: retrospective study].

BACKGROUND: Since the criteria for the diagnosis of Behçet's disease was established several isolated cases have been reported to the literature with clinical manifestations associated. We tried to analyze the clinical parameters associated to this disease in 24 patients in our hospital. METHODS: A retrospective analysis was made of the patients diagnosed of Behçet's disease at Hospital General of Valencia since 1990 to 2000. The diagnosis of Behçet's disease was made by the criteria of the International Study Group for Behçet disease. Data regarding personal, clinical manifestations and clinical course were collected. RESULTS: Of the 24 cases, fourteen (58%) were men and ten (42%) were women. The median of the diagnosed was 33 years. All of them had oral recidivant ulcers. The genital ulcers appeared in twenty (83%) cases. Thirteen cases (54%) had ocular manifestations, and the skin lesions appear in 10 cases (42%). We review other clinical manifestations associated to Behçet disease: articular clinical appear in 17 cases (70%), digestive manifestations in six cases (25%), neurological manifestations three cases (12%), vascular clinical two cases (8%). CONCLUSIONS: Our results are similar to the Mediterranean expression of Behçet's disease. We must study the clinical manifestations associated to this disease that are not include in the criteria of diagnosis.

Adult↗
PubMed2001

The use of proximal femoral allografts in revision total hip arthroplasty.

The implant of a proximal femoral structural allograft is one of the possibilities to restore circumferential defects of multiply revised total hip arthroplasties. A review of 7 patients who underwent proximal femoral reconstruction with an allograft-prosthesis composite to restore bone loss in revision hip replacements is presented. The average follow-up period was 50.2 months. Two patients developed an infection and in one case an instability of the prosthesis appeared. Incorporation in the remaining 5 cases was/achieved in an average period of 8.2 months. Neither fractures nor high rate of resorption appeared in our series. The majority of patients have improved in the functional assessment. Despite the rate of complications, structural femoral allografts can be used with success in this difficult challenge of reconstructing major segmental bone loss of the proximal femur in revision hip surgery.

Arthroplasty, Replacement, Hip↗
PubMed2000

[High eradication rates in Helicobacter pylori infection in patients with duodenal ulcer who failed previous eradication therapy].

BACKGROUND: To analyze the effectiveness of a second-line treatment of Helicobacter pylori infection in patients with duodenal ulcer based on previous antibiotic regimen. PATIENTS AND METHODS: Open, prospective, uncontrolled study, but guided by protocol including 30 consecutive patients with endoscopic diagnosis of active duodenal ulcer and failure of a first-line H. pylori eradication treatment diagnosed by urea breath test or a new endoscopy with histology and positive urease test. Treatment consisted in 10 days with omeprazole (20 mg/12 h), bismuth subcitrate (120 mg/6 h), tetracycline (500 mg/6 h) and metronidazole (500 mg/8 h) (OBTM) if previous regimen was with clarithromycin; or 10 days with omeprazole (20 mg/12 h), clarithromycin (500 mg/12 h) and amoxycillin (1g/12 h) (OCA) if previous regimen did not include clarithromycin; using metronidazole (500 mg/8 h) instead of amoxycillin (OCM) in case of allergy. Eradication was defined as a negative 13C-urea breath test 2 months after the end of therapy. RESULTS: One patient had to stop treatment due to the side effects and in 2 patients urea breath test was not performed (3 patients due to the OBTM group). Per protocol eradication was achieved in 25 out of 27 patients (92.6%) and by intention-to-treat eradication was attained in 25 out of 30 cases (83.3%). When both groups analyzed separately, the OCA combination was successful in 5 from 6 patients (83.3%; 95% CI 35.9-99.6); while the OBTM combination was successful in 20 from 21 valuable patients (95. 2%; 95% CI 76.2-99.9). In this second case we make an intention to treat analysis and eradication was achieved in 20 from 24 (83.3%; 95% CI 62.6-95.3). CONCLUSION: The eradicative treatment for H. pylori based in different antibiotics used in subsequent attempts get high eradication rates in patients with duodenal ulcer.

Adult↗