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Biomedical subjects

A Gil

Publications and source records attributed to A Gil.

At least 235 records · Page 13Linked to original sources
PubMed1993

X-linked agammaglobulinemia and gastric adenocarcinoma.

BACKGROUND: The incidence and mortality rate for cancer in patients with primary immunodeficiency diseases have increased greatly. Lymphomas constitute more than 50% of tumors identified in the Immunodeficiency Cancer Registry, but solid tumors are frequent in these patients, especially gastric carcinomas. In addition to immunologic impairment, other local conditions such as chronic atrophic gastritis with intestinal metaplasia and pernicious anemia, usually observed in these patients, may play an important role in the genesis of gastrointestinal tumors. METHODS AND RESULTS: This report describes a 23-year-old patient with X-linked agammaglobulinemia who had previously documented chronic atrophic gastritis with intestinal metaplasia, pernicious anemia, and parasitization with Giardia lamblia in whom an adenocarcinoma of the stomach developed. CONCLUSION: The authors believe that it may be useful to perform a periodic gastrointestinal evaluation for all patients with primary immunodeficiencies to establish early detection and treatment of these tumors.

Adenocarcinoma↗
PubMed1993

Interaction of polypyrimidine tract binding protein with the encephalomyocarditis virus mRNA internal ribosomal entry site.

Translation of encephalomyocarditis virus (EMCV) mRNA occurs in a cap-independent manner, requiring instead a cis-acting element termed the internal ribosomal entry site (IRES). Binding of a 57-kDa ribosome-associated protein (p57) to the EMCV IRES has been found to correlate with cap-independent translation. p57 has recently been reported to be very similar, if not identical, to the polypyrimidine tract binding protein (pPTB), a spliceosome-associated factor possibly involved in U2 snRNP/pre-mRNA complex formation of 3'-splice-site recognition. The interaction between purified pPTB and the EMCV IRES was characterized in this study using nitrocellulose filter binding and UV cross-linking assays. pPTB bound the EMCV IRES with high affinity (Kd = 40 nM at 25 degrees C, pH 5.5, 80 mM ionic strength). pPTB also bound strongly to RNA fragments containing either the 5'-end, 3'-end, or an internal stem-loop of the IRES. The binding properties of 16 RNA variants derived from the IRES revealed however that purified pPTB bound with less specificity than pPTB in a mixture of cytoplasmic HeLa cell polypeptides. The addition of HeLa extract to purified pPTB increased the binding specificity, suggesting that factors within the extract alter the binding specificity of pPTB. The binding of pPTB to the full-length IRES and three IRES-derived fragments was studied in detail. Complex formation was optimal at low pH and was driven entirely by entropy. As many as four ion pairs are formed upon binding, with electrostatic interactions accounting for approximately 35% of the total free energy of complex formation.

Base Sequence↗
PubMed1993

A cytoplasmic 57-kDa protein that is required for translation of picornavirus RNA by internal ribosomal entry is identical to the nuclear pyrimidine tract-binding protein.

Initiation of translation of the RNA genomes of picornaviruses such as poliovirus and encephalomyocarditis virus is cap-independent and results from interaction of ribosomes with a segment of the 5' noncoding region of these mRNAs termed the internal ribosomal entry site. Genetic and biochemical studies have previously shown that a 57-kDa cytoplasmic RNA-binding protein (p57) plays an essential role in this translation mechanism. We have now found that p57 shares physical, biochemical, and antigenic properties with the pyrimidine tract-binding protein (PTB), a nuclear protein that has been implicated in various processes involving pre-mRNA. These data indicate that p57 and PTB are the same protein. Purified recombinant PTB bound specifically to a bulged hairpin within the internal ribosomal entry site of encephalomyocarditis virus and had a much lower affinity for a mutated derivative of this hairpin and for unrelated RNAs. Immunodepletion of p57/PTB from a HeLa cell-free lysate inhibited translation of poliovirus and encephalomyocarditis virus mRNAs but had no effect on translation of beta-globin mRNA, confirming the essential role of p57 in translation by internal ribosomal entry.

Base Sequence↗
PubMed1993

[Neoplasms associated with human immunodeficiency virus infection. Study of the clinical course of 70 patients].

BACKGROUND: A different epidemiologic pattern of the neoplasms associated to the human immunodeficiency virus (HIV) has been described in the Mediterranean area. The aim of the present study was to analyze the epidemiologic, clinical and evolutive characteristics of these patients. METHODS: A retrospective study of 74 neoplasms in 70 patients (15% of AIDS cases) was carried out. The following variables were analyzed: risk group, state of the infection (HIV), stage and type of tumor, immunohematologic data, opportunistic infections (OI), response to treatment, evolution and prognostic factors. RESULTS: Thirty-four Kaposi's sarcomas (SK) were diagnosed, 32 non Hodgkin's lymphomas (NHL), 4 Hodgkin's disease (HD), 2 seminomas, 1 cutaneous carcinoma and one undifferentiated tumor. Sixty-eight patients were males with a mean age of 32 years. The risk group was: homosexual (52%), drug abuse (24%), hemophilia (14%), and heterosexual contact (10%). The neoplasm was the first manifestation of HIV infection in 60% of the patients. Sixteen patients with SK were treated with chemotherapy (CMT), radiotherapy (RT) or interferon and stabilization of the disease was achieved in 50% of the cases. Twenty-six patients with NHL received treatment: 26 with CMT, 9 with RT and 4 with surgery. Complete remission was achieved in 27% and partial in 61% of the cases. Overall mortality was 56% and median survival 13 months. Most of the patients died due to progression of the tumor or infection. The prognostic factors associated to shortened survival were: advanced stage of AIDS, OI at the time of diagnosis of the tumor and a decrease in hemoglobin, total lymphocytes and CD4. CONCLUSIONS: The lower incidence of neoplasms among patients with acquired immunodeficiency disease and the differences in the distribution of the histologic types may be related with the demographic features of the risk groups in Spain. Survival is determined more by opportunistic infections than by the tumor itself.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Surgical wound infection: the risk factors and a predictive model].

BACKGROUND: The identification of the factors associated with infection of the surgical wound and the groups of patients with greatest risk of developing the same may aid in the elaboration of prevention strategies. METHODS: A prospective follow up study of a group of 1,143 patients admitted to general and digestive surgical departments in the Ramón y Cajal Hospital over a period of 7 months was carried out to determine the accumulated incidence of infection of the surgical wound and quantify the associated risk factors. A mathematical model was developed by logistic multiple regression analysis allowing the identification of groups of patients with high risk of infection which were internally evaluated posteriorly. RESULTS: Surgically intervened patients (70% of those admitted) developed a mean of 11 wound infections out of 100 patients. Five independent factors (age, surgical classification, length of intervention, presurgical stay, and presence of a central route) were associated to increased risk of infection. CONCLUSIONS: The factors associated with surgical wound infection identified in this study are related to the degree of wound contamination, the intrinsic risk of the patients and quality of health care. The model obtained is more efficient than the traditional surgical classification for the identification of groups of patients with high risk of infection.

Chi-Square Distribution↗
PubMed1993

Abnormal plasma polyunsaturated fatty acid pattern in non-active inflammatory bowel disease.

An abnormal plasma polyunsaturated fatty acid pattern (PUFA) (increased n3 and decreased n6 PUFA) has been reported in active inflammatory bowel disease (IBD). The possibility of a primary defect in the PUFA metabolism in IBD was hypothesised. The aim of this study was to assess plasma PUFA pattern in inactive inflammatory bowel disease and to ascertain whether patients who had had a colectomy and who were suffering from ulcerative colitis have a similar PUFA pattern than those patients with non-active ulcerative colitis and who had not had a colectomy. Plasma fatty acids were analysed by semi-capillary column gas-liquid chromatography in three groups of patients with inactive IBD (24 patients with inactive ulcerative colitis who had not had a colectomy, 15 patients with ulcerative colitis who had had a colectomy, and 27 patients with Crohn's disease). Plasma concentration and percentage of C22:6n3 and unsaturation index were significantly higher in patients with inactive ulcerative colitis without a colectomy and the Crohn's disease group (p < 0.0001) than in controls. Plasma concentration and percentage of C22:6n3 and the unsaturation index remained significantly higher, in both the operated and non-operated ulcerative colitis patients when compared with controls (p < 0.0001). These results suggest that in inactive IBD, an increased PUFA biosynthesis might be the cause of the high values of n3 compounds. These findings although seen in active disease, are more noticeable in remission because of the lack of artefactual factors (malnutrition, steroids, inflammation). In addition, persistence of high values in both groups of ulcerative colitis patients--that is, those who had had a colectomy and those who had not suggests the existence of a primary abnormality in the PUFA metabolism in IBD.

Adolescent↗
PubMed1993

Clinical and nutritional factors predictive of plasma lipid unsaturation deficiency in advanced liver cirrhosis: a logistic regression analysis.

AIM: To identify those clinical and nutritional factors associated with plasma lipid unsaturation deficiency in cirrhosis. METHODS: Fatty acid profiles of plasma phospholipids (PL) and cholesteryl esters (CE) were measured in 101 inpatients with advanced cirrhosis and in 44 age- and sex-matched healthy controls. Double-bond index (DBI) was calculated for each fraction and binarily categorized in each patient using the 5th percentile of the control group as the cut-off limit. The association of 12 routine clinical, biological, and nutritional variables with derangement of each DBI was multivariately assessed by means of stepwise logistic regression analysis. RESULTS: The DBI of PL and CE were below the 5th percentile of the control group in 60 and 68 of 101 cirrhotic patients, respectively. After multivariate analyses, the variables found to be independent predictors of impaired unsaturation were: 1) The presence of moderate/severe malnutrition (odds ratio: 1.3-8.0 (95% CI); p < 0.05) and serum tau-GT > 1 mukat/L (odds ratio: 0.2-1.0; NS) for plasma PL, and 2) the presence of moderate/severe malnutrition (odds ratio: 1.8-17.4; p < 0.05), serum bilirubin > 50 mumol/L (odds ratio 1.7-14.5; p < 0.05) and serum tau-GT > 1 mukat/L (odds ratio 0.1-1.1; NS) for CE. CONCLUSION: Malnutrition appears to be a major factor for impaired lipid unsaturation in advanced cirrhosis. Thus, the possibility of improving plasma lipid unsaturation in these patients by means of nutritional support should be further investigated.

Adult↗
PubMed1993

The relationship of drug use to suicide ideation and attempts among African American, Hispanic, and white non-Hispanic male adolescents.

This study presents self-report cross-sectional and longitudinal data on associations between drug use, suicide ideation, and attempts in a multiethnic sample of seventh- and eighth-grade male adolescents attending school in the greater Miami, Florida, area. African Americans had the highest prevalence of 6-month ideation (20.5%), and Haitians had the highest attempts (11.4%). For the total sample, tranquilizers had the highest odds ratio for ideation (3.4), and PCP for attempts (6.2). Psychoactive drug-use was consistently related to attempts among Hispanics, white non-Hispanics, and African Americans. Acculturation strains interacted with cocaine and crack to predict suicide attempts among Hispanic respondents.

Acculturation↗
PubMed1993

Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1,000 patients. The European Working Party on Systemic Lupus Erythematosus.

In the present study we have analyzed the prevalence and characteristics of the most relevant clinical and immunologic features in 1,000 patients with SLE. Several differences in the expression of the disease have been observed in relation to the patients' age at onset, sex, and autoantibody serology. The childhood-onset patients more often had malar rashes (55% vs 39%) and nephropathy (28% vs 15%) as presenting manifestations. During the evolution of the disease, these patients had an increased prevalence only of malar rash (79% vs 56%) and a lower prevalence of rheumatoid factor (6% vs 19%). The older-onset patients (age 50 or older) less often showed malar rash (21% vs 42%), arthritis (52% vs 71%), and nephropathy (3% vs 17%) as the first symptom. During the evolution of their disease, these patients had a decreased prevalence of malar rash (33% vs 60%), photosensitivity (29% vs 47%), arthritis (73% vs 85%), nephropathy (22% vs 41%), thrombosis (4% vs 15%), and anti-La antibodies (6% vs 20%), but an increased prevalence of sicca syndrome (33% vs 15%). Males more often had serositis (28% vs 16%) as a first symptom, but they presented with a lower prevalence of arthritis (74% vs 85%) during the evolution of the disease. The presence of ANA, a high titer of anti-dsDNA, rheumatoid factor, anti-ENA, and antiphospholipid antibodies also distinguished additional homogeneous SLE subsets of clinical significance.

Adolescent↗
PubMed1993

[Clinico-epidemiological study of botulism poisoning in La Rioja (1979-1990)].

BACKGROUND: The aim of the present study was to evaluate botulinic poisoning requiring hospital admission in La Rioja (Spain) during one decade from a clinical-epidemiologic point of view. METHODS: Chart records from patients admitted to the departments of Internal Medicine, Neurology, the ICU, and the Neurophysiology and Preventive Medicine files of the reference hospital between 1979 and 1990 were retrospectively reviewed. RESULTS: Fifteen cases were identified. Home preserves of vegetables were most frequently the foods responsible for the poisoning. The presentation as a sole case constituted half of this series. The most frequent symptomatology was neuro-ophthalmologic and digestive. All the cases were type B. Neurophysiologic studies were compatible with the diagnosis in all the cases in which they were performed. Two cases (13.3%) required intensive care and death occurred in one (6.6%). CONCLUSIONS: a) The habit of home preserves was responsible for the presentation of botulism in this environment. b) Early diagnosis was based on complementary clinical tests together with the neurophysiologic study. c) The mild forms were most frequent. Death in this series was 6.6%.

Adolescent↗
PubMed1992

Beat-to-beat morphologic variability of the electrocardiogram for the evaluation of chest pain in the emergency room.

The value of electrocardiographic, morphologic variability in the early diagnosis of acute myocardial infarction (AMI) and myocardial ischemia was evaluated in 49 nonselected patients presenting to the emergency room with chest pain. High-resolution electrocardiography was used to determine the morphologic variability of consecutive electrocardiographic complexes, and the ratio of the variance of the QRS onset to that of the entire electrocardiogram was calculated. A final diagnosis of AMI was confirmed in 8 patients, acute coronary insufficiency in 8, angina pectoris in 19, and a noncardiac origin for chest pain in 14. Patients with AMI had a significantly higher beat-to-beat electrocardiographic morphologic variability of the QRS onset (1.4 +/- 0.2) than did those with acute coronary insufficiency (1.1 +/- 0.2), angina pectoris (0.9 +/- 0.1) or noncardiac chest pain (0.8 +/- 0.1) (p < 0.05). The sensitivity of the clinical presentation, typical electrocardiographic changes and creatine phosphokinase levels for the diagnosis of an acute ischemic event on admission to the emergency room was 62, 25 and 37.5%, respectively. Relative variance of the QRS onset of > 0.86 had a sensitivity of 75% and a specificity of 61% for diagnosing an acute ischemic event. Logistic regression of these variables showed that the QRS onset relative variability is an independent predictor for an acute ischemic event. It is concluded that an increased beat-to-beat electrocardiographic variability in patients with AMI is present on admission to the emergency room and may assist in establishing the diagnosis in this setting.

Adult↗
PubMed1992

[Treatment of esophageal candidiasis with fluconazole in acquired immunodeficiency syndrome. Comparative study of 2 therapeutic schemes].

BACKGROUND: To evaluate the efficacy and pharmacological safety of 2 therapeutic trials with fluconazole in candida esophagitis in AIDS patients. METHODS: A total of 75 episodes of candida esophagitis in 70 AIDS patients were included in an open prospective study. In group I 36 patients were included who received 200 mg of fluconazole orally the first day followed by 100 mg daily for 4 weeks. In group II (34 patients) the length of treatment was reduced to 10 days with the same daily doses. Therapeutic response was evaluated by esophagoscopy, biopsy and fungal culture. RESULTS: The protocol was completed at 68 episodes with a cure being obtained in all but 2 patients in group II. No significant differences in clinical response were found between the 2 groups. The incidence of oropharyngeal colonization at the end of treatment was greater in patients from group I than from group II (43% vs 11%). Fluconazole was well tolerated in all the patients. A slight alteration of the hepatic enzymes was observed in 29 cases (40%) with a lower incidence in the shorter time group (p less than 0.001), however, treatment was discontinued only in 1 patient because of severe asymptomatic hepatic dysfunction to which a relation with the drug is unclear. CONCLUSIONS: Fluconazole in an efficient and safe agent in the treatment of candida esophagitis in AIDS patients. A 10 day treatment is a useful as longer treatment and has a lower risk of adverse effects.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[An epidemiological study of arterial pressure in a schoolchild population].

AIM: To know the prevalence of high blood pressure in childhood. DESIGN: Epidemiological transversal study. SITE. School population, level community. POPULATION: A population of 566 children of 6, 10 and 13 years old of Madrid public schools. MEASUREMENTS AND RESULTS: The blood pressure measure was registered two times according to the WHO's guidelines. We considered the first sound as systolic blood pressure and the fifth auscultatory phase as diastolic blood pressure. Considering as hypertensive those subjects whose blood pressure are higher than percentile 95 for their age and sex, the total prevalence of systolic hypertension was 5.8% and the total prevalence of diastolic hypertension was 1.4% in both genders. We realized that systolic hypertension prevalence is higher in males for all ages and its is also higher than the results offered by similar studies. It doesn't happen the same thing in the diastolic hypertension prevalence which we found that the measurements registered in males are higher than females but in contrast with other studies we found similar prevalence. CONCLUSIONS: We need to identify early the presence of higher blood pressure with the purpose of to prevent in time.

Adolescent↗
PubMed1992

The cytochrome composition of the meat spoilage bacterium Brochothrix thermosphacta: identification of cytochrome a3-and d-type terminal oxidases under various conditions.

Brochothrix thermosphacta, grown in batch culture in a yeast-dextrose broth, at temperatures from 30 degrees C to 10 degrees C, contained diverse membrane-bound respiratory cytochromes. Under conditions of moderate aeration, cytochromes of the a-, b- and d-type were detected at all growth temperatures, but the proportions changed as a function of temperature, with the spectra of cells grown at 10 or 15 degrees C being dominated by a-type cytochrome(s). Cytochrome a3 was detected by its reactions with CO and cyanide in cells from all growth conditions. An additional cytochrome a, which was not cyanide-reactive, was also detected, suggesting the presence of an aa3 oxidase complex. Cytochrome d was cyanide- and CO-reactive, but not detectable in photodissociation spectra, presumably because of the very rapid recombination of CO at the sub-zero temperatures used. Decreasing the oxygen transfer rates to batch cultures resulted in enhanced expression of cytochrome d and changed the proportion of the aa3-type oxidase that could be attributed to ligand-binding cytochrome a3; at the lowest oxygen transfer rates, no cytochrome a was detected, suggesting the presence of a cytochrome ba3 terminal oxidase complex. Intact cells showed no evidence of a c-type cytochrome and no haem C was detected in membrane preparations. After growth at 10 degrees C, the cytochrome composition of B. campestris was essentially identical to that of B. thermosphacta. The multiplicity of putative terminal oxidases in B. thermosphacta is discussed.

Carbon Monoxide↗
PubMed1992

Malnutrition-related polyunsaturated fatty acid changes in plasma lipid fractions of cirrhotic patients.

Cirrhotic patients have both impaired liver function and nutritional derangement. In fact, the prevalence of protein-energy malnutrition (PEM) is very high in these patients. The aim of the present study was to elucidate whether the nutritional status in cirrhosis could be an additional factor that would affect levels of plasma lipids. Plasma lipid phosphorus, cholesterol, and triglycerides (TG), and fatty acid profiles in plasma and plasma fractions were determined in 50 healthy subjects and 92 patients with liver cirrhosis. The cirrhotic patients were prospectively included in three groups according to the result of nutritional assessment: group 1 (n = 38), acceptable nutritional status (including well-nourished and mildly malnourished patients); group 2 (n = 29), moderate PEM; and group 3 (n = 25), severe PEM. The main findings of this study were that the decrease in plasma cholesterol and linoleic, dihomo-gamma-linolenic, and arachidonic acid levels of cirrhotic patients was related to the degree of PEM. Cholesteryl esters (CE) appeared to be the most sensitive indicator of lipid changes in cirrhosis. We consider that the role of malnutrition in the changes observed for polyunsaturated fatty acid (PUFA) profiles in plasma lipids of cirrhotic patients may be of major importance, since severe malnourished subjects exhibited the lowest levels of those compounds. Dietary supplementation of both essential fatty acids (EFA) and long-chain PUFA in adequate amounts to the cirrhotic patient might be of importance in the management of the disease.

Aged↗
PubMed1992

Changes in liver microsome lipids and plasma fatty acids induced by dietary orotate in the weanling rat.

1. Dietary orotate produced a decrease in total plasma fatty acids which was reflected in low values of saturated, monounsaturated and polyunsaturated fatty acids longer than 18 carbon atoms of the n-6 series. The relative content of saturated fatty acids in microsomes of animals fed orotate was also decreased. 2. Rat liver delta-9 desaturase activity was lower in the group fed orotate. However, delta-6 desaturase activity did not show significant differences between the groups. 3. Microsomal cholesterol content was lower in rats fed orotate than in controls but phospholipid phosphorus contents were similar. These results suggest a direct effect of dietary orotate on the key enzymes which regulates cholesterol liver metabolism.

Animals↗