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Biomedical subjects

A Gil

Publications and source records attributed to A Gil.

At least 271 records · Page 15Linked to original sources
PubMed1991

[Angiothrombotic pulmonary granulomatosis in intravenous drug addicts].

Two cases of angio-thrombotic lung granulomatosis in intravenous drug addicts are described. This entity has been previously described in drug addicts who inject oral drugs intravenously. Talc, which is used in the preparation of several drugs, cotton and other substances provoke at lung vessels level, thrombotic phenomena with strange body granuloma formations. Depending on the predominating localization of these lesions, interstitial pneumonia or pulmonary hypertension can later occur, such is the case in one of our patients who had a fatal evolution in a short period of time.

Adult↗
PubMed1991

[Infection by Mucorales fungi].

Mucormycosis is a rare opportunistic fungal infection of immunosuppressed patients. We describe here 5 cases of mucormycosis: three with facial and eye involvement, one with lung involvement and one affecting skin and joints. All five patients had underlying diseases: diabetes, leukemia, lymphoma, neoplasia and AIDS. Four patients were treated with amphotericin B and also with surgical debridement. Infection could be controlled only in two patients. Both survived but with major sequelae. In two additional patients, death was directly related to the infection and the remaining patient was lost to follow-up.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Left ventricular hypertrophy and arrhythmia. An aspect of hypertensive cardiomyopathy].

Epidemiological data has established a relationship between left ventricular hypertrophy (LVH) and sudden cardiac death. This relationship is independent. The search for ventricular and atrial arrhythmias in hypertensives confirms a greater prevalence of these arrhythmias in patients with LVH. The mechanism of these arrhythmias is multifactorial: ischemia, subendocardial fibrosis, increased sympathetic tone, electrolyte disturbances, age, and hemodynamic changes may be arrhythmogenic substrates both at the ventricular and auricular levels. The relationship between LVH (marker or cause) and the detected arrhythmias remain obscure. The most sensitive markers of severity seem to be the ECG parameters (LVH with overload), echocardiographic mass (greater than + 20%) and septal thickness (greater than 12 mm). The evolution of arrhythmias with regression of LVH is unknown. Respect of electrolyte equilibrium would seem to be the only unquestioned therapeutic intervention.

Arrhythmias, Cardiac↗
PubMed1991

[Rhino-cerebral mucormycosis and hematological neoplasia].

Mucormycosis is a rare infection that occurs in immunocompromised patients. The rhinocerebral form presents in diabetics as a severe necrotizing sinusitis and is not frequent in patients with haematologic malignancies. Diagnosis requires direct examination and culture of biopsy specimens. Two patients with rhinocerebral mucormycosis and haematologic neoplasms (Non-Hodgkin's lymphoma and acute myeloblastic leukaemia) are described. Both patients had severe drug-induced neutropenia when the infection appeared. One patient died in spite of aggressive treatment with surgery and amphotericin.

Aged↗
PubMed1990

Association of antibodies against phospholipids with heart valve disease in systemic lupus erythematosus.

A prospective echocardiographic study was carried out on 132 consecutive patients with systemic lupus erythematosus (SLE) derived from three European university medical centres. The prevalence of valvular lesions in patients with SLE was 22.7% compared with 2.9% in a control group of 68 healthy volunteers. 50 SLE patients had antibodies against phospholipids. The prevalence of valve vegetations (8/50 [16%]) and of mitral regurgitation (19/50 [38%]) was significantly higher among the SLE patients with antiphospholipids than among those without (1 and 10/82 [1.2% and 12%], respectively). During follow-up of the patients with valvular lesions, haemodynamically significant clinical valve disease developed in 6 but surgery was required in only 1; 9 had cerebrovascular occlusions; and 7 died, although no death was due directly to the cardiac involvement. Thus, valvular heart disease, particularly affecting the mitral valve, is common in patients with SLE, and the presence of antibodies against phospholipids is associated with a higher prevalence of valvular abnormalities in these patients.

Adolescent↗
PubMed1990

[Drug surveillance for adverse reactions in patients with human immunodeficiency virus infection].

Human immunodeficiency virus (HIV) carrier patients experience several secondary effects with drugs, being mainly skin reactions and myelosuppression. Owing to this, close observation of patients is necessary with regard to therapeutic and prophylactic schedules. In this paper, we describe the secondary effects of zidovudine in 60 patients of groups III and IV from CDC. The main toxicity was found in bone marrow; with anemia in 50% and leukopenia in 53% of patients. Finally, the more frequent secondary effects of therapy for opportunist infections are analysed. A guide for identifying the drugs' secondary effects is also included, based on our experience and on a wide range of literature reviews.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Serum zinc, copper, and selenium levels in inflammatory bowel disease: effect of total enteral nutrition on trace element status.

Serum levels of zinc, copper, and selenium, and alkaline phosphatase activity were prospectively studied in 29 patients with inflammatory bowel disease. Fifteen patients had extensive active colitis (active colitis group). Seven patients had active, and seven cases inactive small bowel or ileocecal Crohn's disease (small bowel disease group). Ninety-three healthy subjects acted as controls. Serum trace element levels were considered in relation to vitamin A and E levels, nutritional parameters, the activity of the disease, and the recent intake of steroids. The effect of total enteral nutrition on serum trace elements was studied in seven cases. Serum zinc levels were lower and serum copper levels higher in the active colitis group than in controls (p = 0.0007, and p = 0.02, respectively). More than 50% of patients with active colonic or small bowel disease showed zinc levels below the 15th percentile of the control group. Serum zinc levels correlated with plasma vitamin A in acute colitis (r = 0.67; p = 0.006), and with both serum albumin concentration (r = 0.76; p = 0.002) and disease activity score (r = -0.67, p = 0.009) in patients with small bowel disease. The copper:zinc ratio was higher in the active colitis group than in controls (p = 0.002). In spite of the increase in serum albumin levels and the decrease in disease activity, serum zinc levels remained low after total enteral nutrition. The implications of the abnormal trace element status in patients with inflammatory bowel disease are discussed.

Adolescent↗
PubMed1990

Plasma fatty acid profile in advanced cirrhosis: unsaturation deficit of lipid fractions.

Fatty acid (FA) profile of plasma total lipids, phospholipids (PL), cholesteryl esters (CE), and triglycerides (TG) were measured in 101 patients with advanced liver cirrhosis and in 44 age- and sex-matched healthy controls. Plasma levels of lipidic phosphorus, esterified cholesterol, and TG also were measured, and the unsaturation index (UI) was calculated for each fraction. Total plasma concentrations of saturated FA, linoleate, and polyunsaturated FA (PUFA) were lower in cirrhotics than in controls. This profile was also found in plasma levels of PL- and CE-associated FA. No detectable amounts of C20:3n9 were found in cirrhotic patients. Percent FA distribution of lipid fractions showed a lower percentage of linoleate and PUFA and a higher relative amount of saturated and monoenoic FA in cirrhotics than in controls. As a consequence, the UI of PL and CE was diminished in liver cirrhosis. Linoleate and PUFA deficiency was more marked in CE than in PL, as shown by the number of patients with values below the 5th percentile of the control group, suggesting an attempt to maintain the unsaturation of PL as the most important component of cell membranes. Hepatic failure, poor essential FA intake, and malnutrition are some of the possible etiologic factors for PUFA deficiency in cirrhosis. Their relative contribution to plasma FA abnormalities, as well as the clinical and pathophysiological consequences of PUFA deficit in cirrhotic patients, requires further investigation.

Adult↗
PubMed1990

Changes in the fatty acid profiles of red blood cell membrane phospholipids in human neonates during the first month of life.

We have studied the changes in the fatty acid profiles of red blood cell membrane phospholipids in 47 infants who were exclusively fed human milk from birth to 1 month of life. Twenty blood samples were obtained from cord, 15 at 7 days and 12 at 30 days after birth. Membrane phospholipids were obtained from erythrocyte ghosts by thin-layer chromatography and fatty acid composition was determined by gas liquid chromatography. Phosphatidylcholine showed the most important changes during early life; stearic, w6 eicosatrienoic and arachidonic acids decreased whereas oleic and linoleic acids increased. In phosphatidylethanolamine, palmitic and stearic acid declined and oleic, linoleic and docosahexenoic acids increased with advancing age. Small changes were noted for individual fatty acids in phosphatidylserine. In sphingomyelin stearic acid increased from birth to 1 month and linoleic, arachidonic and nervonic acids decreased. Total polyunsaturated fatty acids of the w6 series greater than 18 carbon atoms increased with advancing age in phosphatidylethanolamine and decreased in choline and serine phosphoglycerides and in sphingomyelin. Long chain fatty acids derived from linoleic acid decreased in phosphatidylcholine but increased in ethanolamine and serine phosphoglycerides. The different behavior in the changes observed in fatty acid patterns for each erythrocyte membrane phospholipid may be a consequence of its different location in the cell membrane bilayer and specific exchange with plasma lipid fractions.

Analysis of Variance↗
PubMed1990

Low serum selenium concentration in a healthy population resident in Catalunya: a preliminary report.

Serum selenium levels were determined in 92 healthy subjects [40 men, 52 women; mean age 33.5 +/- 1.6 (s.e.m.) years, range 16-71 years] living in the province of Barcelona, Catalunya, Spain. Only well-nourished individuals with unremarkable clinical history, normal blood chemistry and haematological tests were selected. The subjects were divided into 6 age groups for each sex. Serum samples were analysed using a modification of the standard electrothermal graphite furnace atomic absorption spectrophotometry method to shorten the procedure while maintaining its accuracy. A significant correlation (y = -1.31 + 1.51 x; r = 0.9967, P less than 0.001) was observed between our method and the standard assay method. The mean serum selenium concentration was 60.39 micrograms/l, 95 per cent CI 53.35-67.45 micrograms/l. There were age- but no sex-group differences (P less than 0.001). This result is similar to that found in countries whose low selenium levels have been related to an increased risk of some disease states. Clinical and health implications of this suboptimal selenium status are discussed.

Adolescent↗
PubMed1989

[Adverse reactions to drugs as a reason for consulting the emergency service of a general hospital].

The reports from the emergency service of La Paz General Hospital were daily reviewed for 4 months to investigate the number of consultations which, on the judgement of the physician on care, were due to adverse reactions to drugs. An overall number of 11,326 patients consulted. In 438 (3.9%) it was considered that the consultation was due to one or more definite, likely or possible adverse drug reactions. In 69 patients (15.8%), the reactions were considered to be severe, and 54 (12.3%) required admission; 59 reactions (13.4%) were moderate, and 310 (70.8%) were mild. The most common localizations were the skin and its appendages (37.7%) and gastrointestinal tract (25.3%). The most commonly implicated pharmacologic groups were analgesic and non-steroidal anti-inflammatory drugs (33.6%) and antimicrobials (22.1%). The incidence of adverse reactions was significantly higher in women (4.4% vs 3.3% in males, p less than 0.01). Depending on the age groups (14-29, 30-59, greater than or equal to 60 years) the incidence of nonallergic adverse reactions was significantly higher in patients aged 60 years or more (1.5%, 2%, 2.9%; chi 2 = 15.2, gl = 2, p less than 0.001). In presumably allergic adverse reactions, the incidence was significantly higher among those under 30 years (2.9%, 2.2%, 0.5%; chi 2 = 50.2; gl = 2, p less than 0.0001). The incidence of severe adverse reactions was significantly higher in patients over age 60 years (0.2%, 0.6%, 1.2%, chi 2 = 29.2, gl = 2, p less than 0.001). In 32% of cases the adverse reactions might have been prevented.

Adolescent↗
PubMed1989

Cerebrovascular disease and antiphospholipid antibodies in systemic lupus erythematosus, lupus-like disease, and the primary antiphospholipid syndrome.

PURPOSE AND PATIENTS AND METHODS: Antiphospholipid antibodies, lupus anticoagulant antibodies to cardiolipin, and a false-positive result on testing for syphilis have been linked to thrombotic vascular occlusions, particularly in patients with systemic lupus erythematosus (SLE) or lupus-like disease, i.e., patients not fulfilling four American Rheumatism Association criteria for the classification of SLE. The clinical and serologic features of 35 patients with cerebrovascular disease (strokes/transient ischemic attacks) who demonstrated antibodies to phospholipids are presented. Complete histories were obtained from all 35 patients, and all underwent routine physical examinations, radiography, electrocardiography, computed tomographic brain scanning, and immunologic studies. Psychometric tests were performed in nine patients. RESULTS: The strokes were often multiple and were followed by multi-infarct dementia in nine patients. Of particular interest were 10 patients in whom the presence of antiphospholipid antibodies was the major and often the sole immunologic disturbance present. Several of these patients were antinuclear antibody-negative, and the antinuclear antibodies, when present, were usually of a low titer (1:40 to 1:160). These patients conform to a group classified as having a primary antiphospholipid syndrome. CONCLUSION: Antiphospholipid antibodies are strongly associated with cerebrovascular occlusions in patients with SLE as well as in those with lupus-like disease and the primary antiphospholipid syndrome. All patients with any of these conditions who present with vascular events should be screened for these antibodies, as their occurrence may have a bearing on future therapy.

Adult↗
PubMed1989

Molecular heterogeneity of steroid sulfatase deficiency: a multicenter study on 57 unrelated patients, at DNA and protein levels.

Steroid sulfatase (STS) deficiency is the biochemical defect of X-linked ichthyosis (XLI), one of the most common X-linked disorders. We studied 57 European unrelated patients affected by STS deficiency. Twenty-eight patients were from Italy, 24 from the United Kingdom, 4 from The Netherlands, and 1 from Denmark. In two families XLI was associated with Kallmann syndrome (hypogonadotropic hypogonadism and anosmia). STS enzymatic activity was profoundly deficient in all cases. Direct DNA analysis, using cDNA and genomic probes from the STS gene and linked regions, demonstrated heterogeneity of the molecular defect. Forty-eight patients (84%) showed a deletion of the STS gene. In 44 cases the deletion also involved the STS flanking locus DXS237. In 1 patient a partial deletion of the STS gene was detected and in 9 patients no evidence of deletion was found. Locus DXS31 (probe M1A), previously mapped to Xp22.3-pter, was not deleted either in 24 patients with X-linked ichthyosis or in two families with X-linked ichthyosis associated with Kallmann syndrome. Consequently, the following loci order could be suggested: telomere--DXS31--(DXS237, STS)--Kallmann--centromere. Immunoblotting experiments, performed using anti-STS polyclonal antibodies, revealed the absence of cross-reacting material to STS in all cases tested, including 4 patients without evidence of deletions.

Arylsulfatases↗
PubMed1989

Protection of Peruvian children against rotavirus diarrhea of specific serotypes by one, two, or three doses of the RIT 4237 attenuated bovine rotavirus vaccine.

A randomized placebo-controlled double-blind field trial of RIT 4237 attenuated rotavirus vaccine in Lima, Peru, evaluated the protection against diarrheal illness by one, two, or three doses of vaccine. There were 391 children, 2-18 months old, studied for the occurrence of diarrhea during the 18 months after vaccination. Three doses of the vaccine provided 40% protection against any diarrheal illness associated with rotavirus alone but 58%-75%; protection against the more severe rotaviral illnesses. The vaccine appeared to be more efficacious when it was administered to children in the first year of life. Three doses provided up to 89% efficacy against more severe diseases due to serotype 1 rotavirus, and one dose also afforded significant protection. The protection was lower, even with three doses, against serotype 2 rotavirus. This vaccine trial has provided important insights on how such trials should be conducted and on the serotype-specificity of protection from rotavirus infection. Future vaccines should be able to protect against severe disease caused by all rotavirus serotypes and must work in developing countries where rotavirus is the most important cause of diarrheal mortality.

Antibodies, Viral↗
PubMed1989

120 hours simultaneous infusion of cisplatin and fluorouracil in metastatic breast cancer.

Thirty-six patients with metastatic breast cancer, 23 with documented progression of the disease after first-line chemotherapy (CAF or CMF) and 13 without prior chemotherapy, were treated with a simultaneous 120-h infusion of cisplatin (CDDP) and 5-fluorouracil (5-FU). Objective response was demonstrated in 19 patients (52.7%), stable disease in 7 patients (19.4%) and progression of the disease in 10 patients (27.7%). Similar response rate was observed according to tumor site (soft tissues, 50%; bone, 52%; lung, 63%; liver, 55%; and pleura and peritoneum, 42%) and previous treatment (previous chemotherapy, 48%; previously untreated, 61%). Median duration of response was 8 months. Toxicity was characterized by stomatitis and myelodepression and required dose adjustments in 30% of patients. CDDP and 5-FU infusion deserve further investigation because it appeared to have substantial activity in this preliminary study in metastatic breast cancer.

Adult↗
PubMed1989

Definition of an efficient synthetic poly(A) site.

We constructed and analyzed a synthetic poly(A) (SPA) site that was based on the highly efficient poly(A) signal of the rabbit beta-globin gene. By use of the SPA, we demonstrate that the minimum sequences required for efficient polyadenylation are the AATAAA sequence and a GT/T-rich sequence with the correct spacing of 22-23 nucleotides between them. When placed downstream of the poly(A) site of the human alpha 2-globin gene, the SPA is used exclusively. We predict that the SPA, with its more extensive GT/T-rich sequence, is a more efficient poly(A) site than alpha-globin. Also, we compared the use of the SPA when it is placed either in the exon 3 or intron 2 of the rabbit beta-globin gene. When in the exonic position, SPA is used 10-fold more than the regular poly(A) site of rabbit beta-globin. In contrast, when it is in the intronic location, no detectable use of SPA is observed; however, the deletion of the donor site of intron 2 reactivates the intronic positioned SPA. These results indicate that the splicing of intron 2 in the rabbit beta-globin gene occurs ahead of polyadenylation and have important implications for termination of transcription. Polyadenylation, although required for termination of transcription, is not sufficient; therefore, additional termination signals for RNA polymerase II must exist.

Animals↗