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Biomedical subjects

T Moreno

Publications and source records attributed to T Moreno.

At least 19 recordsLinked to original sources
PubMed2005

Determinants of health system delay among confirmed tuberculosis cases in Spain.

BACKGROUND: Health system delay (HSD) is an important issue in tuberculosis (TB) control. This report investigates HSD and associated factors in a cohort of Spanish culture-confirmed TB patients. METHODS: Data were collected from clinical records. Using logistic regression with two different cut-off points to define HSD (median and 75th percentile), adjusted odds ratios were used to estimate the association between HSD and different variables. RESULTS: A total of 5184 culture-confirmed TB cases were included. Median and 75th percentile HSD were 6 and 25 days respectively. HSD significantly greater than the median was associated with: age >44 years, past or present intravenous drug use, diagnosis at a primary-care centre, prior preventive therapy, positive histology, request for drug-sensitivity testing, presence of silicosis or neoplasia in addition to TB, presence of non-TB related symptoms, and gastrointestinal site. HSD greater than the 75th percentile was related to the same variables, with the exception of diagnosis at a primary-care centre, positive histology, silicosis, non-TB-related symptoms and gastrointestinal site, for which the association disappeared; in contrast, an association with female gender emerged. CONCLUSION: Despite free health care being universally available in Spain, there are some groups of TB patients whose treatment is unduly delayed.

Adolescent↗
PubMed2004

The spatial and temporal variations in PM10 mass from six UK homes.

People spend the majority of their time indoors mostly in the domestic environment, where their health may be effected by significant airborne particulate pollution. The indoor/outdoor air quality at six homes in Wales and Cornwall was investigated, based on different locations (urban, suburban, rural) and household characteristics (smokers, non-smokers). The spatial and temporal variations in PM10 mass were monitored for a calendar year, including ambient weather conditions. The activities of individuals within a household were also recorded. Monitoring of PM10 took place inside (kitchen, living room, bedroom) homes, along with concomitant collections outdoors. Samples were subjected to gravimetric analysis to determine PM10 concentrations and examined by scanning electron microscopy to identify the types of particles present on the filters. The results of the study show there are greater masses of PM10 indoors, and that the composition of the indoor PM10 is controlled by outdoor sources, and to a lesser extent by indoor anthropogenic activities, except in the presence of tobacco smokers. The indoor and outdoor PM10 collected was characterised as being a heterogeneous mixture of particles (soot, fibres, sea salt, smelter, gypsum, pollen and fungal spores).

Activities of Daily Living↗
PubMed2004

Determinants of patient delay among tuberculosis cases in Spain.

BACKGROUND: Patient delay was investigated in a cohort of TB patients identified from May 1996 until April 1997 in 13 Autonomous Regions in Spain. The study covered almost 67% of the total Spanish population. METHODS: Data were collected from clinical records. Using unconditional logistic regression with two different cut-off points to define 'patient delay' (the median and 75th percentile), the association between patient delay and different factors was estimated. RESULTS: A total of 7,037 cases were included. Median and 75th percentile delays were 22 and 57 days respectively. Factors associated with patient delay greater than the median (p<0.05) were: non-respiratory symptoms of TB and age over 14 years, although the effect of age was not linear. Furthermore, an interaction was observed between intravenous drug user (IDU) and HIV status, in that, whereas patient delay was greater in IDUs than in non-IDUs among cases whose HIV status was either negative or unknown, among HIV-positive patients no such IDU-related differences were in evidence. Factors associated with extreme patient delay (greater than the 75th percentile) were essentially the same, but the above-described interaction disappeared, with IDU status showing no direct effect. In addition, likelihood of extreme patient delay increased in the case of alcoholism and female gender and decreased in the case of chronic renal failure, corticoid treatment, prison inmates and residents of old age homes. CONCLUSION: Although there is a universally enjoyed right to health care in Spain, some groups of TB patients could nevertheless be experiencing problems in seeking medical attention.

Adolescent↗
PubMed2003

Myoglobinuria and COX deficiency in a patient taking cerivastatin and gemfibrozil.

The authors describe a patient who presented with myoglobinuria after starting cerivastatin-gemfibrozil therapy. Muscle histochemistry revealed ragged-red fibers and cytochrome c oxidase negative (COX) fibers, and biochemistry showed a defect of COX activity. Immunoblot analysis showed a 60% reduction of COX I and COX II polypeptides. Cerivastatin myotoxicity might be related to a depletion of essential metabolites needed to anchor COX subunit I to mitochondrial membrane.

Aged↗
PubMed2003

Pulmonary antioxidants exert differential protective effects against urban and industrial particulate matter.

This investigation focuses on the application of an in vitro assay in elucidating the role of lung lining fluid antioxidants in the protection against inhaled particles, and to compare the toxicities of different airborne particulate matter (PM), PM10, collections from South Wales, UK. PM collections from both urban and industrial sites caused 50% oxidative degradation of DNA in vitro at concentrations as low as 12.9 +/- 2.1 microg ml(-1) and 4.9 0.9 mg ml-1 respectively. The primary source of this bioreactivity was found to be the soluble fraction of both particle collections. The coarser PM(10-2.5) fraction also showed greater oxidative bioreactivity than the PM(2.5-0.1) in both cases. When repeated in the presence of a low molecular weight fraction of fresh pulmonary lavage fluid, as well as in artificial lung lining fluid (200 microM urate, glutathione and ascorbate), the DNA damage was significantly reduced in all cases (P < 0.05). The antioxidants exerted a greater effect on the industrial samples than on the urban samples, and on the PM(10-2.5) fractions than on the PM(2.5-0.1) fractions, supporting the previous findings that respirable PM and urban samples contain fewer free radical sources than inhalable PM and industrial samples.

Air Pollutants↗
PubMed2003

[Neurological emergencies in a university hospital].

INTRODUCTION: We analyze the demand and to describe the neurological assistance in a university hospital. MATERIAL AND METHODS: We have performed a retrospective and descriptive study of patients attended in the emergency services by neurologists from June 2000 to May 2001. The inventory and analysis has been carried out across a database in which we codify the reports of the patients diagnosed by means of CIE-9. We have been selected one month where we have collected all calls that neurologist have received, not only those of which reports was realized and codified. RESULT: The total number of neurological patients attended in a year was 1,864 representing 2.85% of all emergencies. The most frequent diagnostic were: cerebrovascular stroke (24.57%), epilepsy (13.06%) and headache (6.07%). Few seasonal variation was noted. There was no difference for sex. In the month's study there were 426 patients, which represented 7.78% of all medical urgencies. The most frequent calls came from internal medicine (65.02%). CONCLUSION: Neurological emergencies constitute a large percentage of third level hospital's emergencies which justify a neurologist in the medical emergencies team.

Emergency Service, Hospital↗
PubMed2002

Pathological and immunohistochemical study of the liver and hepatic lymph nodes of sheep chronically reinfected with Fasciola hepatica, with or without triclabendazole treatment.

Hepatic lesions and changes in the hepatic lymph nodes were examined in groups of sheep infected, and sometimes reinfected, with metacercariae of Fasciola hepatica, with or without treatment with triclabendazole (TCBZ). Hepatic damage was more severe in sheep given small repeated ("trickle") infections than in those given two larger, spaced doses. Inflammatory infiltrates of eosinophils, CD3+ T cells, CD79 alpha+ B cells and IgG+ plasma cells, and the presence of granulomata, were particularly marked in trickle-infected groups, suggesting that the host response to certain fluke or egg antigens causes severe hepatic damage. TCBZ administration induced the elimination of flukes and healing of the majority of hepatic lesions but did not prevent severe hepatic damage produced by later infections.

Animals↗
PubMed2002

Tuberculosis in Spain: epidemiological pattern and clinical practice.

SETTING: Thirteen Autonomous Regions in Spain. OBJECTIVE: To study the incidence of all forms of tuberculosis (TB) and investigate clinical practice in TB. DESIGN: Cases of all forms of tuberculosis diagnosed in the study setting from May 1986 to April 1997 were identified though active search of different databases. Clinical and epidemiological information on cases was collected from clinical records or by interview with physicians. RESULTS: The overall incidence of all forms of tuberculosis was 38.5/100,000 and the incidence of smear-positive disease was 13.83/100,000. Most cases (97.1%) were Spanish nationals, with rates higher in men than in women (52.7/100,000 vs. 24.87/100,000) and in groups aged 25-34 and 75 years and over (61.35/100,000 and 59.35/100,000, respectively). Disseminated forms were frequent (6.6%), and the most common risk factor was human immunodeficiency virus (HIV) infection (17.7% of cases). Hospitalisation was common (71.6%). Microbiological confirmation of diagnosis was sought for 87.7% of the cases (91.8% of pulmonary vs. 75.5% of extra-pulmonary cases), and 65.2% were culture-positive (73.8% of pulmonary vs. 39.7% of extra-pulmonary cases). HIV-infected patients were treated in almost equal proportions with three or four drugs (49.7% and 48.2%, respectively), while HIV-negative cases or those whose HIV status was unknown were usually treated with three drugs. CONCLUSION: The epidemiological pattern of TB in Spain is different to other industrialised countries in the age distribution of cases and the proportions of foreigners and cases with HIV infection. Microbiological confirmation of diagnosis is more common in pulmonary than in extra-pulmonary disease, and treatment with four drugs more frequent in HIV-positive cases.

Adolescent↗
PubMed2001

Recruiting a community sample in collaboration with farmworkers.

Few studies have examined health effects of pesticides in farmworkers, possibly because researchers perceive this population to be relatively inaccessible. We conducted an epidemiologic study of health effects among farmworkers in two towns in central Florida--Apopka and Pierson. Apopka is a suburb of Orlando with a diffuse farmworker community working in many crops, whereas Pierson is a small rural town with a tightly knit farmworker community working mainly in ferns. We collaborated with the Farmworker Association of Florida, a grassroots organization representing 6,700 farmworker families. We identified potential participants using membership lists of the Community Trust Federal Credit Union. Members of the Farmworker Association served as recruiters for the study, locating randomly selected Credit Union members and administering a screening interview to determine eligibility. In Apopka 90% of contacted workers were screened, and 79% of eligible workers participated in the study; corresponding proportions in Pierson were 94 and 85%. Farmworkers who had worked for 6-15 years and those who worked in a defined type of agriculture (nursery, citrus, or ferns) were more likely to enroll than others. Thus, while the response rate was good for a multistage recruiting process, study participants had a slightly different work history from those who chose not to enroll. We conclude that it is possible to conduct a study of health outcomes in farmworkers with a defined population and good response rates. Collaboration with the community is essential to the success of such a project, and community characteristics can affect response rates.

Adult↗
PubMed1999

Liver pathology and immune response in experimental Fasciola hepatica infections of goats.

The relationship between the immune response and the pathogenesis of the disease was studied in different primary and secondary experimental Fasciola hepatica infections of goats. The establishment of the infection, measured as percentage of recovered flukes at the necropsy, was similar in primarily and secondarily infected animals (between 19.7% and 24.3%), but the hepatic damage was much more severe in secondarily infected goats, as revealed by the levels of serum hepatic enzymes GGT and LDH. Primary infection evolves to chronic fasciolosis that did not induce the development of resistance, since goats were highly susceptible to secondary infection, showing severe acute and chronic hepatic lesions that led to the death of some animals in each group. The immune response to the infection was proved by the production of specific IgG antibodies to ESP of F. hepatica and the involvement of CD3+ T lymphocytes and lambda IgG+ plasma cells in the hepatic infiltrate. Secondary infection did not induce any difference in either IgG response or in the cellular composition of the infiltrate of hepatic lesions, although this was much more extended. However, neither antibodies nor cell-mediated response were protective: there was no correlation between IgG levels and fluke burden and there was no evidence of cell-mediated killing of the parasite. This suggests the existence of some immune evasion mechanisms in goat infection with F. hepatica. The parasite may depress the local inflammatory and immune response, as suggested by the scarcity of CD3+ T cells in the infiltrate surrounding acute migratory tunnels. Moreover, in secondary infected goats can be suspected an immunological damage of the liver, since a very severe infiltrate of immune cells replaced wide areas of hepatic parenchyma and an immune-mediated damage of hepatocytes could occur.

Animals↗
PubMed1998

Serum copper concentration in HIV-infection patients and relationships with other biochemical indices.

We have determined the degree of abnormalities in serum copper concentrations in HIV-seropositive individuals. The study was conducted at the Virgen de las Nieves Universitary Hospital in Granada (Spain). A total of 142 HIV-infected individuals and 84 control subjects were included in the study. The HIV-infected subjects were divided into three groups following the 1993 criteria of the Center for Disease Control and Prevention (Atlanta, USA). Serum copper levels in HIV-infected subjects were significantly higher than those found in control individuals (P < 0.001). Moreover, there were no statistically significant (P > 0.05) differences in serum Cu levels among the three groups considered although serum Cu enhancement occurred at the beginning of the infection process (group A). This increase then remains constant in advanced stages of HIV infection (groups B and C). The mean serum Cu concentration in women (1.41 mg/l) was not significantly higher than that found in men (1.39 mg/l) (P > 0.05). Linear regression analyses between serum copper concentrations and nutritional or biochemical indices (prealbumin, albumin, transferrin, lymphocytes CD4, body mass index, weight) were not statistically correlated (P > 0.05). These data suggest that copper which is an acute phase reactant, may be a useful marker of HIV activity and progression to AIDS as in other chronic infective diseases.

Adult↗
PubMed1995

Humoral and cell-mediated immunity in natural and experimental canine leishmaniasis.

This paper describes immunological and clinicopathological findings in dogs naturally and experimentally infected with progressive visceral leishmaniasis. Eight dogs were intravenously inoculated with 5 x 10(7) stationary phase promastigotes of Leishmania infantum (LEM 2002, ZMON-1). A further eight naturally infected dogs were diagnosed by parasitological and serological methods and selected according to their clinical and immunological condition. Clinical, hematological, pathological and parasitological examinations, including parasite burden and distribution, were included in the study. Antibody production was estimated by means of enzyme-linked immunosorbent assay and immunofluorescence assay techniques; the cellular immune response was studied by means of the skin test and the lymphocyte proliferation test. Experimentally infected dogs developed a chronic and progressive disease with the same clinical signs shown by naturally infected dogs. Both naturally and experimentally infected dogs developed the same histopathological reaction, but to differing degrees. Parasite burden and distribution were related to the extent of lesions, and were consequently less pronounced in experimentally infected dogs. The main feature of the immune response in experimental and natural infection was the lack of specific T-cell response to leishmanial antigen. Non-specific responses to mitogens were normal (i.e. as compared with healthy dogs) throughout the experimental infection, but were partially suppressed (65.3%) in naturally infected animals. A remarkable humoral response was evident in both natural and experimental infection: IgG-isotype antibodies were detected in experimental infection at 50-70 days post infection, and their production increased during the course of the infection. However, high titers were observed only in naturally infected dogs.

Animals↗
PubMed1995

Gunshot wounds to the male genitalia.

Fifty consecutive cases of gunshot wounds to the male external genitalia were treated by the Tulane University Urology Service at the Medical Center of Louisiana in New Orleans. Fifty percent of the patients had significant associated injuries. Eight anterior urethral injuries were identified, all by retrograde urethrography. Five of 17 testicular injuries were salvaged with conservative operative technique. Review of this series suggests that good functional integrity of the male genitalia after gunshot injury can be maintained by following a strict diagnostic and therapeutic regimen.

Adolescent↗