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Biomedical subjects

A Luna

Publications and source records attributed to A Luna.

At least 19 recordsLinked to original sources
PubMed2007

Influence of motor symptoms upon the quality of life of patients with Parkinson's disease.

We studied the impact of various motor and nonmotor symptoms upon quality of life in patients with Parkinson's disease (PD). The study comprised 110 patients with PD (age: 68.6 years, course of the disease: 7.6 years). The Unified Parkinson Disease Rating Scale (UPDRS; I-IV) and Parkinson's Disease Questionnaire (PDQ-39) were recorded. We recorded the correlations between years of disease and UPDRS IV, as well as PDQ-39 and UPDRS I, II, III and IV. Introduction of all variables into a linear regression model showed that 3 variables accounted for 51% of the variance in PDQ-39. Mental condition, gait disorders and complications of dopaminergic drugs are the variables that most affect the quality of life of patients with PD.

Aged↗
PubMed2006

Usefulness of DNA quantification in diagnosis of hypertrophic cardiomyopathies A preliminary study.

Hypertrophic cardiomyopathies (HCM) are a frequent cause of sudden death in both young people and adults. Different cardiomyopathies can be distinguished according to the etiological agent and, although there are morphological differences too, alterations in the quantity of DNA in the cardiomyocytes may play an important role in their pathogenesis and evolution. To understand the characteristics and the behaviour of the DNA index in hypertrophic cardiomyopathies, we have studied thirty cases (10 primaries or essential, 10 hypertensives and 10 toxic) and compared the results with those obtained for 10 macroscopically normal hearts. The results showed that the different cardiomyopathies were statistically related with age, heart weight and ventricle thickness. The normal hearts showing a diploid DNA index, hypertensive cardiomyopathies (CM) hearts a tetraploid index and both toxic CM (1.1-1.9) and essential CM (>2) heart showing an aneuploid index. Statistically significant associations (p < 0.001) were observed when the DNA values were compared with the type of CM, the age, the thickness of both ventricles and the heart weight. Therefore, we think that the technique described may be of great help in the differential diagnosis of hypertrophic cardiomyopathies.

Adult↗
PubMed2006

Primary care confidentiality for Spanish adolescents: fact or fiction?

BACKGROUND: By providing healthcare to adolescents, a major opportunity is created to help them cope with the challenges in their lives, develop healthy behaviour and become responsible healthcare consumers. Confidentiality is a major issue in adolescent healthcare, and its perceived absence may be the main barrier to an adolescent seeking medical care. Little is known, however, about confidentiality for adolescents in primary care practices in Spain. OBJECTIVE: To ascertain the attitudes of Spanish family doctors towards the right of adolescents to confidentiality in different healthcare situations and in the prescription of treatment. METHOD: A descriptive postal questionnaire was self-administered by family doctors. RESULTS: Parents of patients under 18 years are always informed by 18.5% of family doctors, whereas parents of those under 16 years are informed by 38.8% of doctors. The patients are warned of this likelihood by 79.3% of doctors. The proportion of doctors supporting confidentiality for adolescents increases with the age and maturity of the patients, whereas workload and previous training has a negative effect. CONCLUSIONS: Spanish laws on adolescent healthcare are not reflected by the paternalistic attitude that Spanish primary care doctors have towards their adolescent patients. Doctors need to be provided with up-to-date and clinically relevant explanations on contemporary legal positions. In primary care, more attention should be paid to adolescents' rights to information, privacy and confidentiality. Doctors should be more aware of the need to encourage communication between teenagers and their parents, while also safeguarding their patients' rights to confidential care.

Adolescent↗
PubMed2005

Estimation of postmortem interval in real cases based on experimentally obtained entomological evidence.

Using the entomological evidence obtained in several forensic cases analyzed in our laboratory for comparison, we evaluated the results of an experimental study carried out in a semiurban setting to determine the structure of the sarcosaprophagous fauna from a Mediterranean region of SE Spain. In all, 18 orders of arthropods were collected. The summarized experimental results refer to the most important taxa for estimating the postmortem interval. Thus, the seasonal character of certain Diptera species, such as Phaenicia sericata, Calliphora vicina, Chrysomya albiceps and Musca domestica, is cited. Among the Coleoptera, the role of Dermestidae as a necrophagous species, and of Staphylinidae and Histeridae as necrophilous, or Cleridae, Tenebrionidae and Nitidulidae as omnivorous, as well as their appearance on the corpse, is described. Among the Hymenoptera, Formicidae were as the most abundant group, acting as omnivores and not apparently related to any particular decomposition stage. The real cases are discussed using data from the literature and the experimentally obtained results. In every case, the most relevant factors for estimating PMI are briefly discussed, mentioning, when possible, the relation with the experimental results. We confirm the significance of the experimental results because they seem to be applicable to actual forensic cases, the details of which enlarge our very little knowledge on the subject in the Iberian Peninsula. The importance of regional faunistic studies of the sarcosaprophagous arthropod community, the results of which may be applied to forensic practice, is mentioned.

Adult↗
PubMed2005

Balancing confidentiality and the information provided to families of patients in primary care.

BACKGROUND: Medical confidentiality underpins the doctor-patient relationship and ensures privacy so that intimate information can be exchanged to improve, preserve, and protect the health of the patient. The right to information applies to the patient alone, and, only if expressly desired, can it be extended to family members. However, it must be remembered that one of the primary tenets of family medicine is precisely that patient care occurs ideally within the context of the family. There may be, then, certain occasions when difficulties will arise as to the extent of the information provided to family members. OBJECTIVES: This study aimed to describe family doctors' attitudes to confidentiality and providing patient information to relatives as well as their justifications for sharing information. METHOD: A descriptive postal questionnaire was self-administered by family doctors. RESULTS: Of 227 doctors, 95.1% provided information to a patient's family and over a third (35%) disclosed information to others without prior patient consent. CONCLUSIONS: The findings reveal that family doctors should pay more attention to their patients' rights to information, privacy, and confidentiality, and reflect very carefully on the fine balance between this and the occasional need for the support and collaboration of family members in delivery of care. Emphasis should be placed on ethics and legal problems during undergraduate education and in-service training of doctors.

Attitude of Health Personnel↗
PubMed2005

Biochemical analysis and immunohistochemical determination of cardiac troponin for the postmortem diagnosis of myocardial damage.

Cardiac disease is the most common cause of sudden death in Western nations. In forensic practice there is a need for more sensitive diagnostic methods for the postmortem diagnosis of myocardial damage. The aim of this study was to analyse the diagnostic efficacy of biochemical markers in cadaver fluids in conjunction with histological studies and the immunohistochemical determination of cardiac troponin C (cTnC) and cardiac troponin T (cTnT) levels in myocardial tissue fixed in formol and included in paraffin. We studied 50 cadavers (43 males and 7 females) with a mean age of 47.5 years (SD 19.2; range 12 to 87 years). Cases were chosen according to the postmortem interval, cause of death, and circumstances of death. Pericardial fluid and serum were tested in duplicate for cardiac troponin I (cTn I), myoglobin and CKMB by immunoassay system using commercial kits. In myocardial tissue, histological studies were performed with hematoxylin and eosin (HE), Masson's trichrome staining and immunohistochemical techniques involving streptavidin-biotin-peroxidase were performed. The results pointed to statistically significant differences for all the biochemical markers in pericardial fluid. The highest levels were obtained in the group of cadavers who had died from myocardial infarction. The immunohistochemical expression of cTnC was detected in 86% of cases; it was strongly positive and usually diffuse. The expression of cTnT, was much less frequent (46% of cases) and less intense. It was concluded that the immunohistochemical determination of cTnC and cTnT levels in myocardial tissue may be used as an index of myocardium damage.

Adolescent↗
PubMed2004

Magnetic resonance imaging of intramuscular myxoma with histological comparison and a review of the literature.

OBJECTIVE: To evaluate the magnetic resonance (MR) features of intramuscular myxoma (IM) compared with its pathological findings. DESIGN: Two radiologists retrospectively reviewed records and imaging studies of patients with histologically proven IM. Two radiologists also analyzed by consensus all the MR studies (pre- and post-contrast T1-weighted and T2-weighted sequences) and a pathologist reviewed the available histological material. PATIENTS: Seventeen patients with 18 histologically proven IM were reviewed. Histological samples of 11 of these 18 tumors were available for pathological analysis. RESULTS: There were 14 women and three men, with a mean age of 58.9 years. IM involved predominantly the thigh (n=10). MR imaging showed well-circumscribed intramuscular masses, hypointense on T1-weighted and hyperintense on T2-weighted images. Eleven masses were homogeneous and seven slightly heterogeneous due to fibrous septa. Enhanced MR imaging demonstrated three different patterns: peripheral enhancement (n=1), peripheral and patchy internal enhancement (n=7) or peripheral and linear internal enhancement (n=4). Intratumoral cysts were detected in four masses. MR imaging showed the presence of a pseudocapsule (n=12), fat around the lesion (n=16) and peritumoral edema (n=16). Histologically, all the tumors were hypocellular, hypovascular and myxoid. Peripheral areas of collagenous fibers formed a partial capsule and IM often merged into surrounding muscular fibers. More cellular tumors and those with scanty myxoid stroma tended to show a more prominent internal enhancement. CONCLUSION: IM shows several recognizable MR features which suggest its diagnosis.

Adipose Tissue↗
PubMed2004

Diagnostic efficacy of biochemical markers in diagnosis post-mortem of ischaemic heart disease.

In forensic medicine, there is a need for more sensitive biochemical markers for the post-mortem diagnosis of acute myocardial infarction. A study of the distribution of biochemical markers in different fluids is of great significance in post-mortem diagnosis, because their distribution depends on the location of tissue damage and release kinetics. The aim of this study is to compare the sensitivities and specificities of creatine kinase-MB (CK-MB), myoglobin and cTnI in serum and pericardial fluid for the post-mortem diagnosis of acute myocardial infarction (AMI). We studied 188 cadavers selected during 1 year from medicolegal autopsies. The groups were as follows: (1) myocardial infarction (n = 52); (2) asphyxia (n = 59); (3) multiple trauma (n = 41); (4) natural deaths excluding myocardial infarction (n = 36). We obtained statistically significant differences in pericardial fluid for all the biochemical markers, the highest levels being obtained in the group of cadavers who had died from myocardial infarction. A common factor is the high negative predictive value found in biochemical markers, which is contrary to the findings obtained in clinical practice, when the percentages of sensitivity are very high.

Adolescent↗
PubMed2004

Studies on seasonal arthropod succession on carrion in the southeastern Iberian Peninsula.

A global study of the sarcosaprophagous community that occurs in the southeastern Iberian Peninsula during all four seasons is made for the first time, and its diversity is described with reference to biological indices. A total of 18,179 adults and, additionally, a number of preimaginal states were collected. The results for the main arthropod groups, and their diversity are discussed in relation to the season and decompositional stages. The results provide an extensive inventory of carrion-associated arthropods. An association between decomposition stages and more representative arthropod groups is established. With respect to the biological indices applied, Margalef's index shows that the diversity of the community increases as the state of decomposition advances, while Sorenson's quantitative index shows that the greatest similarities are between spring and summer on the one hand, and fall and winter, on the other.

Animals↗
PubMed2004

HCH and DDT residues in human placentas in Murcia (Spain).

Organochlorinated insecticides are ubiquitous toxicants that are transplacentally transferred from mother to fetus and are reported to produce adverse health effects in pregnant woman and neonates. To investigate hexachlorocyclohexane (HCH) and 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane (DDT) exposure in pregnant woman, a total of 102 placentas were analyzed by a gas chromatograph equipped with electron capture detector. Organochlorine residues were found in 69.6% of the samples. Lindane was detected in 24.5%, alpha-HCH in 2.9%, beta-HCH in 6.9%, p,p'-DDE in 44.1%, p,p'-DDT in 14.7% and p,p'-DDD in 10.8% of the samples. The pattern of dispersal by these substances in Murcia is similar to that described by different authors in other countries. Therefore, the past use of DDT and the present employment of lindane seem to be reflected in body tissues of the residents of this area.

Adult↗
PubMed2004

Morphological characterization of renal cell lines (BGM and VERO) exposed to low doses of lead nitrate.

The response to lead nitrate has been assessed in two cell lines of renal origin. The range of toxic concentrations was determined by Neutral Red assay after 24-h of exposure. Morphological changes in the Buffalo Green Monkey (BGM) and VERO cell lines after exposure to subcytotoxic doses (1.38 mM and 1.04 mM, respectively) equivalent to EC10 (effective concentrations 10%) of lead nitrate were evaluated at the ultrastructural level by transmission microscopy. The most notable finding in treated cells was the presence of inclusion bodies in the form of irregular granules of varying size in both cytoplasm and lysosomes. Cell membrane integrity was not affected. The number of phagolysosomes and myeline figures associated to the inclusion bodies was higher than in the control cultures. We conclude that the phagolysosomic mechanism fails to digest this metal ion and the BGM and VERO renal cell lines can be considered as useful tools for toxicological studies involving lead nitrate.

Animals↗
PubMed2004

Expression and significance of cell immunohistochemical markers (HHF-35, CD-31, Bcl-2, P-53 and apopDETEC) in hypertrophic cardiomyopathy.

There are several hypotheses concerning the pathogenesis of hypertrophic cardiomyopathy (genetic, ischaemic, immune, inflammatory and apoptosis induction). We have studied three types of cardiomyopathy in order to observe the expression and assess the significance of different immunohistochemical markers (muscular actin, CD-31, proliferation cell nuclear antigen -PCNA-, Ki-67, and markers related with programmed cell death, bcl-2, p-53 and apopDETEC). We studied different microscopic (haematoxylin-eosin and Masson's thrichrome) and immunohistochemical parameters (streptavidin-biotin-peroxidase and "in situ" hybridisation) of forty cases: ten each of hypertensive hypertrophic cardiomyopathy, essential hypertrophic cardiomyopathy, hypertrophic cardiomyopathy in patients treated with chemotherapy and morphologically "normal" hearts. Our findings point to an absence of structural marker expression (actin and CD-31) in cases of hypoxic damage. The distribution and intensity of apoptosis markers, a seen by "in situ" hybridisation were irregular, and the rest of the markers studied showed negative results, with the exception of acridin orange (a marker of hypoxic damage). In our opinion, the above immunohistochemical markers, especially actin and CD-31, could be used for differentiating hypoxic lesions in these three types of cardiomyopathy. Moreover, it is difficult to know the significance of the apoptosis markers, because the autolysis process produces cross reactions with false positive results. We think that there is a need for new studies on DNA breakdown processes during the post-mortem interval. To avoid autolysis problems the post-mortem material needs to be as fresh as possible.

Acridine Orange↗
PubMed2003

Application of postmortem lipid peroxidation in heart tissue to the diagnosis of myocardial damage.

The response by the myocardial tissue to injury may be manifested as macroscopical or microscopical lesions or, following an ischemia-reperfusion process, by the formation of reactive oxidant substances (ROS) which, in turn, may increase lipid peroxidation levels in myocardial tissue. The aim of this study was to determine whether the levels of lipid peroxidation in myocardial tissue from subjects who had died from different causes are related to cardiac lesions of ischemic or traumatic aetiology. We studied 825 hypostasis-free samples taken from the myocardial tissue of 75 cadavers. In all cases, a survival period was known to have existed. Lipid peroxidation in myocardial tissue was estimated by the colorimetric determination of malondialdehyde. The highest levels of tissue peroxidation were observed in the group of subjects who died from myocardial infarction. We observed a statistically significant correlation between the extent of peroxidation and the presence of myocardial damage of ischemic or traumatic aetiology. In our study, lipid peroxidation was associated with myocardial injury. The data suggest that the extent of lipid peroxidation in myocardial tissue may be used as a reliable indicator of myocardial damage in support of data obtained by conventional microscopy.

Adolescent↗
PubMed2003

Placental lead and outcome of pregnancy.

Prenatal exposure to lead produces toxic effects in the human fetus, including an increased risk of preterm delivery, low birth weight and impaired mental development. Since we believe that placental lead could be a good biomarker for fetal exposure, we assessed the relation of placental lead to intrauterine fetal growth and some adverse outcomes of pregnancy. Low concentrations of lead were found in the population studied (N, 89; mean, 113.4 ng/g dry tissue; S.D., 58.0). The cases were divided into two groups based on delivery outcome. In the group of placentas from premature rupture of membranes and preterm labor (gestational age <or=37 weeks), higher lead levels were recorded than in the placentas from term pregnancies. The proportion of abnormal pregnancy outcome in the group of placentas with lead concentrations above 120 ng/g was 40.6 versus 8.8% in placentas below this concentration. Higher placental lead levels, in general, were not related to smaller weight, head and abdominal circumference or shorter length at birth.

Adult↗
PubMed2003

Placental cadmium and lipid peroxidation in smoking women related to newborn anthropometric measurements.

Smoking during pregnancy is known to be harmful for fetal growth, and cigarette smoke is the major source of cadmium exposure in the general population. Some authors suggest that cadmium accumulated in placenta may be the main cause of the decreased fetal growth shown by infants born to smoking mothers. The aim of our study was to assess any relationship between smoking during pregnancy, placental cadmium levels, placental lipid peroxidation, and anthropometric measurements of newly born babies. The mean values of placental cadmium were significantly higher in smoking mothers, who also produced offspring with reduced neonatal weight, length, head and abdominal circumferences. Lipid peroxidation correlated negatively with birth weight and abdominal circumference. Our results suggest that the cadmium accumulated in placenta is not the reason for reduced fetal growth in smoking mothers and that placental peroxidation is not enhanced by smoking, although the outcome of pregnancy seems to be negatively influenced by lipid peroxidation.

Adult↗
PubMed2003

Morphological characterisation of BGM (Buffalo Green Monkey) cell line exposed to low doses of cadmium chloride.

Morphological changes in the Buffalo Green Monkey (BGM) cell line after exposure to a subcytotoxic dose (0.062 mM, equivalent to EC(10)-effective concentration 10%) of cadmium chloride have been evaluated. Cells were exposed for 24 h and the effects observed at the ultrastructural level by transmission and scanning microscopy. Using transmission electron microscopy, the most notable findings in treated cells were the presence of intranuclear inclusion bodies and thin intracytoplasmic granules associated to myelin figures and the presence of apoptotic bodies. Other morphological alterations included cell vacuolisation and a reduced cytoplasm volume, condensation of the mitochondria and a decreased number of cytoplasmic organelles, except lysosomes and autophagic vacuoles, which increased in number. Scanning electron microscopy pointed to a cell with a disrupted perinuclear region and a decrease in the number of surface microvilli. We conclude that the BGM cell line may be considered an useful tool for toxicological studies involving cadmium.

Animals↗