Biomedical subjects

A Luna

Publications and source records attributed to A Luna.

At least 55 records · Page 3Linked to original sources

PubMed1999

Metal contamination in illicit samples of heroin.

We analyzed 198 illicit heroin samples from Andalusia (southern Spain) to determine the contents of various metals (cadmium, calcium, copper, iron, manganese and zinc) with a view to investigating a new aspect of the drug purity and the conditions under which the drugs are used by addicts. Calcium was found in 93.4% of the samples and always at high concentrations, which can be ascribed to adulteration of the heroin by addicts with thinners and excipients containing salts of this metal such as calcium bicarbonate. Also, all samples were found to contain variable amounts of zinc and substantial amounts of iron, probably because it is the most common metal found in metal containers used in the extraction of morphine from the opium poppy. Only cadmium and, to a lesser extent, zinc, copper, and iron, are among the metals detected in heroin that can increase the inherent toxicity of the drug while always taking into account the maximum values.

Cadmium↗

PubMed1998

Cardiac troponin I (cTn I) and the postmortem diagnosis of myocardial infarction.

In clinical practice several biochemical markers are used for the diagnosis of myocardial infarction. Because of its extremely high specificity for myocardial damage, cardiac troponin I (cTn I) is frequently used. The aim of this study was to evaluate the diagnostic efficacy of postmortem cTn I determinations in pericardial fluid and serum and to compare these results with other biochemical markers and with structural findings used to diagnose acute myocardial ischaemia. We studied 89 cadavers with a mean age of 51.38 +/- 2.04 (SD 19.27 years). Cases were allocated to 1 of 4 diagnostic groups depending on the probable intensity of myocardial damage and cause of death. In pericardial fluid we obtained statistically significant differences for the four biochemical parameters, while in serum myosin heavy chains and myoglobin showed statistically significant differences. The highest levels of biochemical markers in pericardial fluid were observed in subjects who had died from definite myocardial infarction.

Asphyxia↗

PubMed1998

Lipid peroxidation in lung tissue after chest trauma and correlation with the duration of the post-trauma survival period.

Blunt chest trauma is a frequently encountered cause of death in forensic pathology and one of the organs most likely to be affected are the lungs. Assuming that the victim survives the initial trauma, reperfusion processes take place, free radicals are formed and lipid peroxidation occurs. The aim of this study was to ascertain whether the length of the survival time is correlated with the extent of lipid peroxidation in the lung tissue following such ischaemia-reperfusion processes. A study of 470 samples taken from all five pulmonary lobes from 94 cadavers was carried out. Cases were allocated to different groups according to whether there was chest trauma and/or a known survival period. Lipid peroxidation was investigated by determining malondialdehyde (MDA) levels. The lowest mean level of peroxidation was found in control cases showing no evidence of chest trauma at autopsy and no apparent survival period. Our results suggest that the level of lipid peroxidation in lung tissue can be a reliable indicator of survival processes.

Adult↗

PubMed1998

Distribution of biochemical markers in biologic fluids: application to the postmortem diagnosis of myocardial infarction.

We evaluated the usefulness of postmortem determination of biochemical markers and the ratio of their concentrations in pericardial fluid and serum to diagnose acute myocardial necrosis. One hundred cadavers from routine necropsies were studied. Cases were allocated in diagnostic groups according to the cause of death. Myoglobin and myosin heavy chain concentrations and creatine kinase MB isoenzymes (CK-MB) activities were measured in serum and pericardial fluid. Ratios of the concentrations obtained in these fluids were calculated. Hematoxylin and eosin (H&E) and acridine orange stains were used for microscopy studies. Pericardial fluid-serum ratios of the concentrations of biochemical markers were significantly different. The ratio of the concentrations of myosin is the best indicator of wide-spread muscle damage or cardiac necrosis.

Adolescent↗

PubMed1998

The right to information for the terminally ill patient.

OBJECTIVES: To analyse the attitudes of medical personnel towards terminally ill patients and their right to be fully informed. DESIGN: Self-administered questionnaire composed of 56 closed questions. SETTING: Three general hospitals and eleven health centres in Granada (Spain). The sample comprised 168 doctors and 207 nurses. RESULTS: A high percentage of medical personnel (24.1%) do not think that informing the terminally ill would help them face their illness with greater serenity. Eighty-four per cent think the patient's own home is the best place to die: 8.9% of the subjects questioned state that the would not like to be informed of an incurable illness. CONCLUSION: In our opinion any information given should depend on the patient's personality, the stage of the illness and family circumstances. Our study confirms that a hospital is not the ideal environment for attending to the needs of the terminally ill and their families.

Attitude of Health Personnel↗

PubMed1998

Informed consent. Evaluation of the information provided to patients before anaesthesia and surgery.

The procedure for obtaining informed consent is often poorly appreciated by patients. The aim of this paper is to evaluate the verbal information given as part of the informed consent process before anaesthesia and surgery. A total of 300 randomly chosen patients (141 male and 159 female) were asked their opinion between 1993 and 1995 at the University of Murcia Hospital (Murcia, Spain). One hundred and fifty of these patients received scheduled surgery and the other 150 received emergency surgery. In general, the patients were not happy with the information they had received concerning their pathology and treatment. Although they had signed the consent documents, the patients did not feel they had really understood the risks involved in the surgery they had undergone.

Adolescent↗

PubMed1998

[Preoperative information and informed consent in surgically treated patients].

OBJECTIVE: Providing information is an important part of the doctor-patient relationship. In hospital practice today, patients and/or their families are sometimes given seriously inadequate information. Our aim was to analyze the quality of information received by patients before anesthesia and surgery. PATIENTS AND METHODS: The opinion of 300 patients (141 men and 159 women) at Hospital Universitario "Virgen de la Arrixaca" (Murcia, Spain) was studied from 1993 to 1995. The sample was a stratified random one with sex and age as the classifying variables. Surgery was scheduled in 150 cases and emergency in 150. Mean age was 42.88 +/- 1.20 years (SD = 20.84; range 3-90 years). RESULTS: Patients were unfamiliar with risks of surgery and anesthesia in 19% and 18.3% of the cases, respectively. No information was received by 69.3% of patients regarding surgical risks and an even higher 75% of patients received no information on risks of anesthesia. In 3.6% of scheduled operations, neither patient nor family members were required to sign a consent from, though these cases involved patients under 18 years of age. For emergency surgery this percentage was 5.4%. Lack-of-information percentages are higher in operations requiring local or regional anesthesia. CONCLUSIONS: We must underline the poor quality of patient knowledge about medical procedures and the scarce information provided. Even fewer patients known about the risks of anesthesia. A patient's signing of an informed consent form does not correspond to real knowledge of the risks involved in the procedure.

Aged↗

PubMed1998

Bovine aortic endothelial cells express a variant of the very low density lipoprotein receptor that lacks the O-linked sugar domain.

The very low density lipoprotein (VLDL) receptor is a member of the low density lipoprotein supergene family of receptors in which differential splicing of mRNA has been reported. We present several lines of evidence showing that bovine aortic endothelial cells exclusively express a VLDL receptor isoform that lacks the O-linked sugar domain i) Western and receptor-associated protein (RAP) ligand blotting gave a single band of about 99 kDa in membrane extracts of bovine aortic endothelial cells (BAEC). ii) Screening of the BAEC cDNA library with the previously characterized human VLDL receptor cDNA as a probe gave several C-terminal-positive clones; all lacked the 84 nucleotides corresponding to exon 16. Polymerase chain reaction (PCR) confirmed that VLDL receptor cDNA encoding exon 16 was absent from the library. iii) Reverse transcription (RT)-PCR analysis of the BAEC mRNA using a pair of oligonucleotide primers that flank the deletion gave only one band of 136 nt. iv) Semiquantitative RT-PCR analysis showed that only the non-O-glycosylated variant was expressed in BAEC. Cell-binding studies with antibodies against the N-terminal domain showed that the BAEC VLDL receptor is present at the plasma membrane, suggesting that the non-glycosylated variant could be functional. In addition, RT-PCR performed in bovine tissues showed that the variant containing the O-linked sugar domain is preferentially expressed in heart, brain, and skeletal muscle, whereas the non-O-glycosylated spliced variant is found in all tissues analyzed. Taken together these results suggest that the differential splicing of the VLDL receptor is cell- and tissue-specific and that the functions of the receptor could depend on the cell type.

Alternative Splicing↗

PubMed1997

Epidemiology of suicide in elderly people in Madrid, Spain (1990-1994).

The progressive aging of the population as a whole, the frequent appearance of degenerative diseases, and the greater frequency of suicide among persons older than 65 years than in younger age groups, are worrisome issues that deserve investigation. The aim of this study was therefore to analyze different epidemiological and social factors that influence suicide behaviour in elderly subjects in Madrid (Spain) during a 5-year period from January 1990 to December 1994. Post-mortem reports on all deaths that were examined at the Institute of Forensic Medicine in Madrid were studied. All cases of suicide in subjects aged > or = 65 years during these years (N = 461) were studied through the autopsy records and information from the coroner's inquest. Variables corresponding to demographic, clinical and interpersonal factors, method of suicide, scene of death, season, month and time of suicide were registered. In both sexes, jumping from a height was the most frequent method (63.6%). Family members had noted symptoms of depression in almost half of the cases (49.5%). Coexisting physical disorders were present in 68.9% of the subjects. Health care professionals have an important role to play in-suicide prevention.

Aged↗

PubMed1997

Environmental exposure and distribution of lead in four species of raptors in Southeastern Spain.

The purpose of this study was to monitor exposure to lead in four species of raptors in Southeastern Spain (Murcia Region). Samples of liver, kidney, brain, blood, and bone from two species of diurnal raptors (European kestrel (Falco tinnunculus) and European buzzard (Buteo buteo)) and two species of nocturnal raptors (Eagle owl (Bubo bubo) and Little owl (Athene noctua)) were obtained during 1994. Relationships were found between size and age of the birds, the nearness to areas of human activity and lead concentrations in tissues. The lead distribution pattern reveals that the bone is the principle organ for accumulation (0.62-43 mg/Kg, dry weight), followed by the kidney (0.03-0.66 mg/Kg, wet weight), and liver (0. 017-0.05 mg/Kg, w.w.), and to lesser extent, the brain (0.013-0.223 mg/Kg, w.w.). This distribution pattern indicates that raptors in Southeastern Spain were exposed to environmental low lead levels continuously over an extended period of time. Correlations between lead in bone and lead in soft tissues were higher in European buzzards (r = 0.87-0.95) and Eagle owl (r = 0.71-0.86) than those found in European kestrels (r = 0.53-0.58) and Little owls (r << 0). However, correlations between lead concentrations in soft tissues and in blood were high (r = 0.85-0.99).

Animals↗

PubMed1997

[Language and aphasias].

INTRODUCTION AND OBJECTIVE: Approximately 400,000 years ago men started to use language. Initially it was probably poor with few phonemes. With social evolution it became more complex, with the appearance of new phonemes and a more complete grammatical structure. The current concept of the processing of language dates, with little change, from the nineteenth century. DEVELOPMENT: With the birth of phrenology language began to be studied. This lead to the hypothesis of Wernicke, with two main areas joined by the fasciculo arcuato, which is still held to be valid with modifications by Gerchwind and Damasio, amongst others. Important advances in the study of language are due to Chomsky and his transformational grammar. This supports the universal structure of language, since one learns it following genetically determined laws. Language has three main aspects: creativity which makes both the transmitter and the receiver active participants in communication, the form from which words are constructed and the content of the message. Aphasia is an alteration in the comprehension and understanding of language, which may be the clinical expression of many different aetiologies. They help us to localize the lesion topographically. They are divided depending on the clinical signs, into motor or Broca's aphasia, in which understanding is conserved but the patient uses a language with poor grammatical structure, although the semantic content is acceptable: sensitive or Wernicke's aphasia, with inability to understand and language which is fluid but unintelligible; conduction aphasia due to limitation in the transmission of impulses from Wernicke's area to that of Broca, with acceptable understanding and fluid language and the trans-cortical aphasias where the main characteristic is indemnity of the capacity of repetition. CONCLUSIONS: The aphasias, as the expression of an alteration of language are an important support in the topographical localization of lesions, even before these can be shown on computerized tomography.

Agraphia↗

PubMed1996

Purge-and-trap method for the determination of styrene in urine.

A purge-and-trap method for biological monitoring of styrene in urine was developed. Sorbent tubes packed with Tenax TA were used to trap styrene vapour purged from urine. Thermal desorption-gas chromatography was used for sorbent tubes analysis. The detection limit (0.70 micrograms/1), linearity range, recovery (> 94% for spiked urine samples) and repeatability for urine from occupational exposed workers show the suitability of the method for the determination of styrene in urine. One specific advantage of this method is the possibility of storage of the charged sorbent tubes during long periods of time without a significant loss of styrene. This approach can be used, with slight modifications, for urinary determination of several others organic contaminants commonly present in occupational exposures.

Adsorption↗

PubMed1996

Effect of the ACE inhibitor ceronapril on cerebral blood flow in hypertensive patients.

OBJECTIVE: To assess the effect of the angiotensin-converting enzyme inhibitor ceronapril on cerebral blood flow (CBF) in patients with moderate hypertension. DESIGN: Patients received chlorthalidone 25 mg for 4 weeks, and if diastolic blood pressure remained in the range of 100-115 mm Hg, they were given titrated doses of ceronapril (10-40 mg/d based on blood pressure response) in addition to chlorthalidone for 9 weeks. SETTING: Outpatient research clinic. SUBJECTS: Eligible patients had moderate essential hypertension (diastolic blood pressure 100-115 mm Hg) assessed when the patients were receiving no medications. Thirteen patients were entered into the study; 1 withdrew for reasons unrelated to the study drug. Twelve patients (11 men, 1 woman; mean age 52 y) completed the study. INTERVENTION: Ceronapril, given with chlorthalidone. MAIN OUTCOME MEASURES: CBF measurements were taken at the start and end of ceronapril therapy using intravenous 133Xe; blood pressures were determined weekly. RESULTS: Mean arterial blood pressure decreased from 130 +/- 4 to 120 +/- 7 mm Hg after 4 weeks of chlorthalidone administration, and fell further to 108 +/- 8 mm Hg after an additional 9 weeks of combined chlorthalidone-ceronapril therapy (p < 0.05). CBF fell from 44 +/- 15 to 34 +/- 5 mL/min/100 g during the 9 weeks of combined therapy (p = 0.05). No adverse effects consistent with decreased CBF were observed. The decrease in CBF was not linearly correlated with the change in systemic blood pressure, but was strongly correlated (r = -0.937; p < 0.001) with the initial CBF. CONCLUSIONS: The decrease in mean arterial blood pressure was not associated with a decrease in CBF. Patients with high CBF may be predisposed to a decrease in CBF when treated with ceronapril and chlorthalidone.

Aged↗

PubMed1996

[Atypical internuclear ophthalmoplegia in a patient with subacute lymphocytic meningitis].

The local expression of tuberculous meningitis has an high incidence. They respond to a Koch bacillus direct lesion or vasculitis disease. The clinic implication of ocular movement is frequent and usually answers to a nervous trunk direct injury. Exceptionally the clinic expression of the oculomotor disturbance is due to a conjugate ocular tract or nucleus damage. The posterior internuclear ophthalmoplegia is a well-known manifestation and correspond with a dwindle of the medial longitudinal fasciculus electrical transmission and lies in falling of the medial rectus to move synchronously with the contralateral rectus on attempted lateral gaze to either side. In such a case the medial longitudinal fasciculus is damaged between the sith nerve nucleous below and the opposite third nerve nucleus above. A patient with AIDS B3 category who presents right internuclear ophthalmoplegia and right eye vertical conjugate gaze impairment with left vertical nystagmus due to a paramedial mesencephalic stroke as debut of a linfocitary subacute meningitis is present.

Adult↗

PubMed1996

Application of dimorphism in teeth to age calculation.

The objective of this study was to determine which teeth provide the most reliable data for use in age estimation. We studied 170 teeth from the anterior region (central and lateral incisors, and canines) and used an image analysis technique to analyse a number of morphometric features in thin sections of tooth. Our results showed root translucency to be the variable most clearly related to the subject's age, and the canine teeth to provide the most reliable information on this variable.

Adolescent↗

PubMed1995

Usefulness of myosin in the postmortem diagnosis of myocardial damage.

In some situations the postmortem diagnosis of myocardial infarction is made difficult by the brief course of the fatal episode or by interferences caused by autolysis. In such cases, biochemical indices may provide a useful adjunct to morphological studies. Myosin is the main component of the contractile apparatus of muscle cells, so its determination may well be useful to evaluate myocardial injury. The purpose of the present study was to establish the diagnostic efficacy of postmortem myosin heavy chain determinations using monoclonal antibodies and to compare this data with structural findings used to diagnose acute myocardial ischaemia. We studied 105 cadavers with a mean age of 61.63 +/- 2.21 years. Cases were allocated to 1 of 7 diagnostic groups depending on the probable intensity of myocardial damage and cause of death. The highest serum and pericardial fluid values of myosin heavy chains were seen in subjects who showed morphological evidence of myocardial ischaemia. Mean pericardial fluid/serum ratios differed significantly between subjects with and without observable signs of heart damage.

Analysis of Variance↗

PubMed1995

Creatine kinase BB and neuron-specific enolase in cerebrospinal fluid in the diagnosis of brain insult.

Cerebrospinal fluid (CSF) markers provide useful information about the extent of brain damage. These biochemical indices may also be used when postmortem histopathological examination does not confirm antemortem brain insult. Seven biochemical parameters--creatine kinase (CK), creatine kinase BB isoenzyme (CK-BB), lactate dehydrogenase (LDH), gamma-glutamyltransferase, aldolase, leucine aminopeptidase (LAP), and neuron-specific enolase (NSE)--were analyzed in CSF from 82 cadavers. Case studies were categorized into one of four diagnostic groups. There were 15 cases of head trauma, 23 of hypoxia (hangings, carbon monoxide, and drug poisonings), 23 sudden cardiac death, and 21 miscellaneous cases. The degree of craniocerebral trauma was graded. In CSF there was a statistically significant correlation between the severity of craniocerebral trauma and levels of CK, CK-BB, aldolase, LDH, and LAP. CSF CK-BB [median U/L (range)] for the groupings of head trauma, hypoxia, sudden cardiac death, and miscellaneous were, respectively, 873 (1-12,100), 26 (2-2,780), 16 (1-42), and 18 (0-2,780). Corresponding CSF CK levels were 9,370 (28-67,842), 101 (18-36,840), 180 (10-29,622), and 264 (17-26,556). There were no statistical significant differences among the NSE concentrations in the four diagnostic groups. The testing of biochemical markers could be a reliable indicator of the degree of brain insult in support of morphological studies.

Adolescent↗

PubMed1995

Biochemical assessment of acute myocardial ischaemia.

AIMS: To evaluate the efficacy of biochemical parameters in different fluids in the diagnosis of myocardial infarction of different causes, analysed after death. METHODS: The myoglobin concentration and total creatine kinase (CK) and creatine kinase MB isoenzyme (CK-MB) activities were measured in serum, pericardial fluid, and vitreous humour from seven diagnostic groups of cadavers classified according to the severity of myocardial ischaemia and cause of death. Lactate dehydrogenase (LDH) and myosin were measured only in serum and pericardial fluid, and cathepsin D only in pericardial fluid. Routine haematoxylin and eosin and acridine orange staining were used for microscopy studies of heart tissue. RESULTS: In pericardial fluid there were substantial differences between the different groups with respect to CK, CK-MB, and LDH activities and myosin concentrations. The highest values were found in cases with morphological evidence of myocardial ischaemia. CONCLUSIONS: Biochemical parameters, which reach the pericardial fluid via passive diffusion and ultrafiltration due to a pressure gradient, were thus detectable in this fluid earlier than in serum in cases with myocardial ischaemia. These biochemical parameters may be of use for ruling out myocardial ischaemia in those controversial cases in which reliable morphological findings are lacking.

Adolescent↗