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Biomedical subjects

A Castro

Publications and source records attributed to A Castro.

At least 73 records · Page 4Linked to original sources
PubMed1998

Low energy intracardiac cardioversion of persistent atrial fibrillation.

The aims of the study were to verify the efficacy and safety of low energy internal cardioversion (LEIC) in patients with persistent atrial fibrillation (AF) and to identify the factors affecting the atrial defibrillation threshold (ADT). Forty-nine patients with persistent (lasting > or = 10 days) AF underwent LEIC. In each patient, two 6 Fr custom-made catheters with large active surface areas were positioned in the coronary sinus (cathode) and the lateral right wall (anode), respectively, for shock delivery, and a tetrapolar lead was placed in the right ventricular apex for R wave synchronization. Truncated, biphasic (3 ms + 3 ms), exponential shocks were used, beginning at 50 V and increasing in steps of 50 V until sinus rhythm had been restored. Mild sedation (diazepam 5 mg i.v.) was administered to 12 patients. Sinus rhythm was restored in all the subjects with mean voltage and energy levels of 352.0 +/- 80.3 V and 8.2 +/- 3.4 J, respectively. The ADT in patients pretreated with amiodarone (6.4 +/- 1.8 J) was lower than that of patients who had not received any antiarrhythmic drugs (9.2 +/- 3.7) (P = 0.04). No ventricular arrhythmias were induced by any of the atrial shocks, and no other complications were observed. During a mean follow-up of 162.9 +/- 58.7 days, AF recurred in 21 (43%) patients; 71% of these occurred in the first week after cardioversion. LEIC is effective in restoring sinus rhythm in patients with persistent AF. The technique seems to be safe and does not require general anesthesia or, in most cases, sedation. Patients pretreated with amiodarone have lower ADTs.

Adult↗
PubMed1998

Treatment with the competitive NMDA antagonist GPI 3000 does not improve outcome after cardiac arrest in dogs.

BACKGROUND AND PURPOSE: We previously showed that treatment with a competitive N-methyl-D-aspartate (NMDA) receptor antagonist GPI-3000 (GPI) improved short-term physiological recovery after incomplete global cerebral ischemia complicated by dense acidosis. We tested the hypothesis that GPI administered after resuscitation from cardiac arrest would improve a more long-term recovery as measured by neurobehavioral assessment and neuropathology 4 days after resuscitation. METHODS: Anesthetized dogs were subjected to 7 minutes of cardiac arrest followed by vest cardiopulmonary resuscitation. Neurobehavioral outcomes were scored daily on a score ranging from 0 (normal) to 500 (worst). On the fourth day, the animals were killed, and neuropathology was evaluated in a blinded manner in the hippocampus and the neocortex by hematoxylin and eosin staining and by determination of percentage of injured neurons. Three groups of animals were treated in a randomized, blinded protocol with either saline (SAL), low-dose GPI (5 mg/kg followed by 1 mg/kg per hour for 2 hours), or high-dose GPI (25 mg/kg, followed by 5 mg/kg per hour for 2 hours). RESULTS: The mortality rate was higher in animals receiving GPI than in saline-treated control animals (4 of 15 deaths in SAL, 6 of 15 in the low-dose GPI group, and 9 of 18 in the high-dose GPI group). Neurobehavioral scores were depressed in GPI-treated animals compared with saline-treated control animals in a dose-dependent manner, with 96-hour scores of essentially normal (9+/-2) in saline-treated animals compared with those animals with significant impairment (181+/-47) treated with high-dose GPI. Neuropathological damage in the neocortex was most severe in GPI-treated animals, with the percentage of injured neurons dependent on the dose: 8.3%+/-2.7% SAL, 13.2%+/-6.4% low-dose GPI, and 39.4%+/-10.1%, high-dose GPI. CA1 neuronal damage was severe regardless of treatment. CONCLUSIONS: Contrary to results seen in experimental global and focal cerebral ischemia, in which NMDA receptor antagonism may improve responses to injury, receptor antagonism with GPI does not improve brain outcome after cardiac arrest and resuscitation in the dog. Behavioral and histological outcomes both were worsened by GPI treatment at two doses, and mortality was higher relative to saline control treatment. We speculate that systemic drug effects, as well as potential neurotoxicity of the drug under ischemic conditions, may be responsible for the deleterious outcomes observed in our cardiac arrest model.

Amino Acids↗
PubMed1998

Genetic characterization of APOB and D17S5 AFLP loci in a sample from the Basque Country (northern Spain).

VNTR polymorphism of AFLP loci D17S5 and APOB was analyzed in 100 unrelated individuals residing in the Basque Country by PCR amplification and polyacrylamide gel electrophoresis. Population parameters were estimated to validate these loci as routine markers in human identification. Thus, although both loci showed extensive polymorphism (with gene diversities of approximately 80% for both systems) and although concordance with Hardy-Weinberg equilibrium and linkage equilibrium was observed, comparisons with other populations displayed significant differences. Moreover, further analysis of neutral parameters limits this validation to D17S5 because APOB displays excesses of both the total number of alleles and the number of rare alleles; possible reasons for this discrepancy (presence of deleterious alleles, bottleneck effect, admixture, complexity of APOB polymorphism) are discussed.

Alleles↗
PubMed1998

[The efficacy of high- and low-energy intracavitary cardioversion in chronic atrial fibrillation refractory to transthoracic cardioversion].

BACKGROUND: The purpose of our study was to evaluate the efficacy and safety of intracavitary cardioversion (IC) with either high (HEIC) or low (LEIC) energy in patients with chronic atrial fibrillation (AF) refractory to external cardioversion. METHODS: Forty patients underwent IC with either high (30 pts) or low energy (10 pts); HEIC was performed by delivering one or more shocks between one electrode of the lead positioned in the right atrium and a back plate. The following energy values were used in sequence: 100, 200, 300 joules. In LEIC shocks were delivered between two custom-made decapolar leads (one in the coronary sinus and another one in the right lateral atrial wall) beginning from 50 Volts and increasing the voltage by steps of 50 Volts. Another catheter in the right ventricular apex was used for ventricular synchronization. RESULTS: Sinus rhythm was restored in 24/30 (80%) patients undergoing HEIC and in 10/10 (100%) patients undergoing LEIC. No serious or permanent complications occurred. CONCLUSIONS: HEIC and LEIC are effective in patients with AF refractory to external cardioversion. Both the procedures seem to be safe.

Adult↗
PubMed1998

Population genetics and forensic applications using multiplex PCR (CSF1PO, TPOX, and TH01) loci in the Basque Country.

A population study in a sample of 200 unrelated individuals from the Basque Country (Northern Spain) was carried out using the GenePrint STR Multiplex System. The PCR products were electrophorized on a denaturing polyacrylamide gel and visualized by silver staining. The loci are TH01, TPOX, and CSF1PO. All loci meet Hardy-Weinberg expectations, and independence of alelles at these STR loci was found. A comparison with other population groups appeared to indicate that frequencies are well conserved in Caucasians, but differ from those of other racial groups. We have also calculated Fst as a measure of population subdivision. No appreciable genetic subdivision in the Caucasian populations studied here was found. Some statistical parameters of forensic interest (Pex, PM and PD) were also calculated. No exclusions were found in 100 mother-child and father-child meiosis. To evaluate the applicability of these systems to forensic casework, we studied the minimum quantity of DNA which can be used applying the multiplex methodology, and the minimum quantity that can be typed in a mixed sample. We also examined several samples such as hair roots, semen stains, vaginal swabs, blood stains and temporary teeth, each of these of varying ages.

Alleles↗
PubMed1998

[Cardiorespiratory failure and diabetic autonomic neuropathy: a case report].

Advanced autonomic neuropathy in diabetic patients is associated with homeostatic cardiovascular response. Sympathetic compensation diminishes and the organism becomes more susceptible to the depressant effect of certain drugs. The incidence of undesirable cardiovascular effects (bradycardia, hypotension and sudden heart failure) during anesthesia is higher in such patients. We report the case of a woman with diabetes who suffered two episodes of sudden heart failure after brachial plexus block through the axilla, followed one year later by sudden heart failure during general anesthesia for kidney transplantation. The possible contributing mechanisms are described.

Adult↗
PubMed1997

Single-molecule detection of specific nucleic acid sequences in unamplified genomic DNA.

A new technique is described for the rapid detection of specific nucleic acid sequences in unamplified DNA samples. The method consists of using two nucleic acid probes complementary to different sites on a target DNA sequence. The two probes are each labeled with different fluorescent dyes. When mixed with a sample containing the target DNA, the two probes hybridize to their respective binding sites on the same target DNA molecule. The sample is then analyzed by a laser-based ultrasensitive fluorescence system capable of detecting single fluorescent molecules at two different wavelength channels simultaneously. Since the probes are bound to the same target DNA molecule, their signals appear simultaneously. Thus, coincident detection of both dyes provides the necessary specificity to detect an unamplified, single-copy target DNA molecule in a homogeneous assay. If the target is not present, only uncorrelated events originating from free probes will be observed at either channel. Phage lambda DNA in a background of salmon genomic DNA was detected as a two-dye coincident signal at a relative concentration of one lambda molecule per salmon genome. In a control sample, cleavage of the lambda DNA between the two probe binding sites eliminated the coincident signals. In a second experiment, a single-copy transgene was detected in maize. Detection parameters and possible future applications to genetic analysis are discussed.

Animals↗
PubMed1997

Newborn genetic identification: a protocol using microsatellite DNA as an alternative to footprinting.

Newborn identification by foot- or finger-printing presents serious drawbacks. This study proposes an alternative method based on DNA analysis of blood-spots taken from the newborn child. CSF1PO, TPOX and TH01 microsatellite loci were chosen to develop a fast and reliable protocol to be applied in cases where it is suspected that newborn children have been exchanged. The advantage of these loci is that one can simultaneously amplify them by PCR multiplex reaction and determine their alleles, thereby reducing the time needed for identification tests. Moreover, the amplification products of these loci are very small (< 350 bp) and so can be analyzed in samples with degraded DNA. We have been able to prove that it is possible to obtain results in blood-spots taken from newborns up to 13 years before and kept at room temperature. Thus the protocol proposed here can be applied in long-term post-natal identification cases.

Base Sequence↗
PubMed1997

Local capture by atrial pacing in spontaneous chronic atrial fibrillation.

BACKGROUND: Atrial fibrillation (AF) is considered to be maintained by multiple reentrant circuits without or with a very short excitable gap. However, the possibility of local atrial capture has been shown recently in experimental AF or induced AF in humans. METHODS AND RESULTS: This study was undertaken to evaluate the feasibility of atrial capture-suggestive of an excitable gap-in spontaneous chronic AF. Decremental pacing was performed in 47 right atrial sites in 14 patients with chronic AF, not taking antiarrhythmic drugs. A Franz catheter (for pacing and monophasic action potential recording) and a recording quadripolar catheter positioned about 10 mm apart were used. Local capture was achieved in 41 (87.2%) sites for a total of 100 captures. In 71 episodes the capture was lost within 15 seconds, while in the remaining 29, pacing was stopped after 15 seconds of stable capture. AF types immediately before capture were type 1 in 83 and type 2 in 17 episodes. Type 3 AF was never captured. Pacing cycle at capture was 175.7 +/- 20.9 ms. The baseline atrial interval (FF) was 185.4 +/- 24.5, significantly longer than the FF recorded during pacing immediately before capture (176.0 +/- 19.8 ms) (P < .02). CONCLUSIONS: During spontaneous chronic AF in humans, (1) local capture by atrial pacing is possible up to at least 15 mm from the pacing site, (2) regional entrainment is possible during type 1 and type 2 AF but not type 3 AF, and (3) pacing before capture accelerates AF, probably by transient or local capture. These findings suggest that an excitable gap is present in chronic AF, therefore supporting the hypothesis that leading circle reentry is not the unique electrophysiological mechanism maintaining the arrhythmia.

Aged↗
PubMed1997

Changes in intracardiac atrial cardioversion threshold at rest and during exercise.

OBJECTIVES: We sought to analyze in patients with chronic atrial fibrillation (AF) the change in the intracardiac atrial defibrillation threshold (ADT) at rest and during exercise, to quantify the effective risk of low energy endocavitary cardioversion during the effort and to compare the ADT of chronic and reinduced AF. BACKGROUND: Low energy endocavitary cardioversion is a new alternative to transthoracic shock in patients with chronic AF. Nevertheless, patient discomfort and possible induction of ventricular arrhythmias should be further evaluated. METHODS: Sixteen patients with chronic AF were included in the study. Two 6F custom-made catheters (Electro-Catheter, Inc.) were used for shock delivery and one tetrapolar lead for ventricular synchronization. Without sedation and in a random order, patients underwent two sequences of shocks to determine the ADT at rest and during exercise. Exercise was performed isometrically by the superior limbs. Atrial fibrillation was reinduced by atrial pacing. After each shock, the patients were requested to grade their discomfort with a score from 1 to 5. The power of the study was > 90% in detecting a 25% difference in the ADT between groups. RESULTS: Patients were classified into two groups: Nine patients (group A) underwent the first cardioversion during exercise; seven patients (group B) underwent the first cardioversion at rest. In total, the mean (+/-SD) ADT was 6.70 +/- 1.54 J during exercise and 7.02 +/- 1.82 J at rest (p = 0.59). A significantly lower ADT was observed in the second shock sequence than the first one (6.32 +/- 2.09 J vs. 7.40 +/- 0.87 J, p < 0.05). The discomfort score was 3.25 +/- 0.86 at rest and 2.94 +/- 0.77 during exercise (p = 0.09). No complications occurred. CONCLUSIONS: Low energy endocavitary cardioversion is a safe and effective procedure in patients with chronic AF. Discomfort is not generally severe enough to result in procedure termination. The ADT is not influenced by exercise and is higher in chronic than in reinduced AF.

Adult↗
PubMed1997

Cyclin A is present in the endocytic compartment of rat liver cells and increases during liver regeneration.

Recent studies have implicated the cell cycle kinase cdc2 and cyclin A in the inhibition of the fusion of endocytic vesicles in vitro during mitosis. However, the presence of cyclins or their associated cyclin dependent kinases (cdks) in the endocytic fractions have not been reported. Using Western-blotting and immunocytochemistry approaches with different anticyclin A antibodies we have detected cyclin A in the endocytic compartment of the rat liver. During the pre-replicative phase of liver regeneration the amount of cyclin A in endosomes increases significantly with a peak around 12 hours after partial hepatectomy. Cyclin A-dependent kinases, cdc2 and cdk2, were also found in isolated endosome fractions, showing a distinct kinetics of accumulation during the regenerative period. Finally, histone H1 kinase activity was detected associated with cyclin A in endocytic vesicles and increased in regenerating liver. These results suggest that changes in the organization and in the function of the endocytic compartment during the hepatocellular proliferation may be modulated by proteins involved in the regulation of the cell cycle.

Animals↗
PubMed1997

A pilot study on the efficacy of escalating dosage of alpha-interferon for chronic hepatitis C in HIV-infected patients. The Hepatitis/HIV Spanish Study Group.

Chronic liver disease caused by hepatitis C virus (HCV) seems to present a more accelerated course in HIV-infected patients, leading to cirrhosis and liver failure in a shorter period of time than in HIV-negative individuals. As efforts to increase life expectancy in HIV-infected people progress, substantial morbidity and mortality from HCV infection is likely to arise amongst subjects infected parenterally, such as injecting drug users, haemophiliacs and transfusion recipients. Preliminary results have suggested that alpha-interferon (IFN) treatment allows higher rates of response in HIV-infected patients with higher CD4+ lymphocyte counts, suggesting a primary dependence of IFN on a preserved immune system in order to act appropriately. In an open, multicentre, prospective trial we analysed whether the use of larger doses of IFN, through an escalating schedule, might overcome the limits imposed by immune dysfunction. An interim analysis performed in 29 patients concluded that escalating the dosage did not improve the rate of response to IFN. In fact, only one (8.3%) out of 12 patients without response after 3 months of being on IFN therapy achieved response after the dosage was increased from 5 MU to 8 MU s.c. three times a week. Moreover, he relapsed 3 months after completion of treatment for 1 year.

Adult↗
PubMed1997

Improvement in establishing the period of rubella virus primary infection using a mild protein denaturant.

A more precise determination of the date of primary rubella infection in pregnancy is obtained by application of the urea denaturation method. Two denaturation buffers containing 6 and 8 M urea were compared for the detection of rubella IgG avidity by enzyme immunoassay. The results demonstrate that IgG avidity detected by 6M urea increases more rapidly, from 16% on the third day to 51% on the 46th day after the rash, than that obtained by 8 M urea, from 13 to 36%. The specific rubella IgG avidity detected by 6 M urea denaturation buffer increased significantly in paired sera obtained at an interval of 15 days. The same samples did not show any significant increase of IgG avidity when an 8 M urea denaturation buffer was used. The use of a mild denaturant such as 6 M urea indicates the presumptive date of primary rubella infection in pregnancy within 2 months of sampling.

Acute Disease↗