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Biomedical subjects

S Tomás

Publications and source records attributed to S Tomás.

At least 19 recordsLinked to original sources

[Myocardial necrosis is not observed during acute cocaine abuse detectable by the serum levels of troponin T].

BACKGROUND: Recently we can use a new family of serological markers to objective myocardial damage with hig sensibility and specificity. One of these markers is T troponin (c-TNT). Some cocaine abusers have chest pain during drug consumption due to myocardial ischemia produced by the drug. OBJECTIVE: To study if in the chest pain appeared after cocaine consumption a c-TNT increased is objective, showing myocardial cellular damage. PATIENTS AND METHODS: We studied 65 patients; 35 cocaine abusers that were admitted into the emergency room for chest pain after cocaine consumption and 30 patients with no coronary chest pain. To all of them were determined c-TNT and CK. RESULTS: An increase in c-TNT or CK was not observed in both groups. CONCLUSION: We don't observe an increase in c-TNT in the group of cocaine abusers that evidence myocardial cellular damage.

Acute Disease↗

[Usefulness of troponin T and troponin I in the diagnosis and prognostic stratification of patients with ischemic cardiopathy attending an emergency service].

BACKGROUND: Diagnostic of chest pain in the emergency services supposes a serious problem. This study wants objective if the new non enzymatic markers of myocardial necrosis (T troponin and I troponin) may be an aid for the diagnostic and prognostic stratification of patients with myocardial ischemia. PATIENTS AND METHODS: 82 successive patients who went to the emergency room for chest pain were studied. Electrocardiogram and blood samples were obtained at 0,4, and 12 house of admission. A clinic-evolutive study was performed at discharge, and they were classified in 3 categories: a) myocardial infarction, b) unstable angina (Braunwald classification) and no coronary pains. RESULTS: In the 27 patients with myocardial infarction the markers of troponin group were more sensitive than creatinine kinase to determine myocardial necrosis at 4 hours of admission. Of 41 patients with unstable angina, 34% were of Braunwald III-B class. Troponin group markers discriminate a group of high risk patients, 70% of the patients that need an emergency coronarography for bad clinical evolution were troponin group marker positive. CONCLUSIONS: The use in the emergency room of troponin necrosis markers (T and I troponin) allows to optimize the sanitary resources, detecting quickly the patients with acute myocardial infarction and discriminate a group of high risk of patients with angina.

Aged↗

[Immunohistochemical study of inflammatory infiltrates in minor salivary glands in Sjögren's syndrome and other autoimmune diseases].

BACKGROUND: A study of the phenotype, activation and adhesive cells factors and cytokines in minor salivary glands in patients with primary Sjögren's syndrome (pSS), secondary Sjögren's syndrome (sSS) and autoimmune diseases (AD) without Sjögren's syndrome. PATIENTS AND METHODS: We have studied the minor salivary glands in 30 patients with pSS, 30 patients with sSS, 19 patients with AD without SS and 18 controls, using immunohistochemical techniques to analyze the molecular expression of CD3, CD4, CD8, CD20, CD25, CD14, CD56, CD11a, CDw50 (ICAM-3), HLA-DR, IL-1, TNF-alpha and IFN-gamma in lymphocytic infiltration and epithelial cells. RESULTS: Phenotype features were similar in patients with pSS and sSS, except that CD20+ lymphocyte expression was significantly higher in the sSS group (p = 0.023). The patients affected by AD without SS had activated lymphocytes in minor salivary glands in a similar manner to patients affected by pSS and sSS. No significant differences were found in HLA-DR expression in epithelial cells. We found unusual CD25 expression in epithelial cells in patients with SS but not in patients with AD without SS. The differences between pSS and sSS are related to SS theoretical time development and to immunosuppressive treatments. CONCLUSIONS: The immunohistochemical pattern of minor salivary glands is similar in patients with pSS and sSS. Patients with AD are likely to develop immunological changes in minor salivary glands attributable to activated lymphocytes.

Adult↗

[Clock drawing test: qualitative and quantitative evaluation methods].

INTRODUCTION: The interest about the Clock Drawing Test (CDT) is justified because the importance of praxic disorders and especially the constructive apraxias in demented patients. Generally, this kind of deficits or intellectual losses has been less studied than aphasisas and agnosias. Nevertheless, praxias are usually affected in demential processes, even in initial stages. OBJECTIVE: We try to determine if the CDT can be useful as an assessment tool for dementia. We have used two assessment systems of the clock drawing in order to select an useful and reliable method of correction. PATIENTS AND METHODS: The sample is made up of 35 subjects older than 60 years, they were administered the Mini Cognitive Examination (MCE) and the CDT. Patients with previous diagnosis of dementia, others with physical pathology without neurological affectation and, finally, subjects without any kind of pathology were included in order to get a wide rank of punctuations. We carried out a reliability analysis between two raters and the discriminant validity of the CDT compared to the Spanish adaptation of the Mini Mental Examination. RESULTS: We achieve a high reliability inter examiner rates. Quantitative criteria of both scales are more objective than qualitative ones, therefore, these last should be more operativized. CONCLUSIONS: The results obtained in this work suggest that the clock drawing allow a rapid evaluation of cognitive function as the presence of cognitive impairment.

Aged↗

Soluble interleukin-2 receptor in primary and secondary Sjögren's syndrome.

Serum levels of soluble interleukin-2 receptor (sIL2-R) were studied in patients with or without Sjögren's syndrome (SS). The mean sIL2-R level was significantly higher (P < 0.0001) in those with autoimmune diseases, whether with or without SS, than in healthy people. The serum level of sIL2-R did not help to distinguish primary from secondary SS, or the absence of this syndrome in patients with autoimmune diseases. We found a correlation between the sIL2-R level and the presence of SS-A and SS-B antibodies or antinuclear antibody levels, and no correlation with other serological and clinical markers. Salivary gland anomalies were always accompanied by high sIL2-R levels, but there was no correlation between sIL2-R levels and degree of glandular lesion. Routine determination of sIL2-R in patients with dry syndrome is likely to prove useful for ruling out SS without resorting to invasive testing.

Antibodies, Antinuclear↗

Immunohistochemistry of minor salivary gland biopsy specimens from patients with Sjögren's syndrome with and without hepatitis C virus infection.

OBJECTIVES: To characterise phenotypically the minor salivary glands of patients with clinical and histological features of Sjögren's syndrome (SS) infected with hepatitis C virus (HCV). PATIENTS AND METHODS: 75 consecutive patients with SS (31 primary SS, 44 secondary SS) diagnosed by preliminary European classification criteria. The presence of anti-HCV antibodies was detected by commercial third generation ELISA and by a second generation immunoblot assay. Presence of HCV genome in serum was determined by polymerase chain reaction analysis. Expression of CD3, CD4, CD8, CD20, HLA-DR, and CD25 molecules in lymphocytic and epithelial cells on minor salivary glands was detected by immunohistochemical assays. Expression of interferon gamma and interleukin 4 cytokines was determined by in situ hybridisation. RESULTS: Six of 31 primary SS (19%) and one of 44 secondary SS (2%) serum samples were positive for anti-HCV by ELISA. Three samples were positive, three indeterminate, and one sample corresponding to a secondary SS patient was negative by immunoblot. The three immunoblot positive serum samples were also HCV-RNA positive by PCR assay. The study of lymphocytic cells in the diffuse infiltrate of minor salivary glands showed a predominance of the CD3 lymphocytic population. A predominance of CD4 over CD8 T cells (ratio 2:1) was observed in HCV and non-HCV infected patients. The analysis of the lymphocytic focus showed that the HCV infected patients had a predominance of CD20 positive cells. Activation molecules (CD-25 and HLA-DR) were expressed in HCV and non-HCV infected patients in lymphocytic and epithelial cells, however epithelial cell expression of CD25 was low in HCV infected patients. As expected, a pronounced Th1 response was observed in the lymphocytic foci of HCV patients. CONCLUSIONS: HCV infected patients may develop an autoimmune sialadenitis, similar to that described in primary SS.

Adult↗

Interleukin-2 receptor expression in salivary glands of patients with Sjögren's syndrome.

OBJECTIVE: To study interleukin-2 receptor (IL-2R) expression in lymphocytic and epithelial cells in salivary glands of patients with Sjögren's syndrome (SS). METHODS: Minor salivary glands of 29 patients with primary SS, 28 with secondary SS, 19 with autoimmune diseases without SS, and 17 controls were studied using immunohistochemical techniques. Sections were analyzed with 3 different antibodies reacting with CD25 molecule. RESULTS: The presence of IL-2R (CD25) was observed in minor salivary gland lymphocytic infiltrate in 26 (89.6%) primary SS, 24 (85.7%) secondary SS, and 16 (84%) autoimmune diseases without SS. CD25 antibody was expressed in epithelial cells in 12 (41%) patients with primary SS and 11 (39%) with secondary SS, but was absent in the group of autoimmune diseases without SS and the control group. CONCLUSION: The lymphocytic infiltrate of minor salivary gland expressed IL-2R in patients with primary SS, secondary SS and autoimmune diseases without SS. IL-2R expression in epithelial cells was only present in patients with primary or secondary SS.

Antibodies, Monoclonal↗

Autoimmune sialadenitis: a form of onset of Sjögren's syndrome?

We analyzed phenotype, activation factors and adhesion molecules in minor salivary glands of patients with incomplete Sjögren's syndrome (SS) criteria and those with autoimmune diseases without defined SS criteria who presented non-specific sialadenitis. These data were correlated with those observed in patients with established SS. A total of 76 minor salivary gland biopsies were analyzed. Twenty-five patients had defined SS, 23 probable SS and 28 had diffuse infiltrates without forming foci (12 had probable SS and 16 had autoimmune disease without associated SS). When a group of 23 patients with focal infiltrates ("focal sialadenitis") and probable SS was compared with another of 25 with defined SS, no significant differences were detected in the phenotype, activation or adhesion molecules studied or in HLA-DR expression in epithelium. In patients with diffuse infiltrate ("non-specific sialadenitis"), no differences were found in phenotype cell activation molecules expression was observed in the lymphocytes of some biopsies of patients with autoimmune disease without SS, though without statistical significance. Statistically significant differences were found in HLA-DR expression in epithelium.

Autoimmune Diseases↗