Search PubMed⌕ Search

Biomedical subjects

A Moreno

Publications and source records attributed to A Moreno.

At least 199 records · Page 11Linked to original sources
PubMed1998

The PROP1 2-base pair deletion is a common cause of combined pituitary hormone deficiency.

Combined pituitary hormone deficiency (CPHD) has an incidence of approximately 1 in 8000 births. Although the proportion of familial CPHD cases is unknown, about 10% have an affected first degree relative. We have recently reported three mutations in the PROP1 gene that cause CPHD in human subjects. We report here the frequency of one of these mutations, a 301-302delAG deletion in exon 2 of PROP1, in 10 independently ascertained CPHD kindreds and 21 sporadic cases of CPHD from 8 different countries. Our results show that 55% (11 of 20) of PROP1 alleles have the 301-302delAG deletion in familial CPHD cases. Interestingly, although only 12% (5 of 42) of the PROP1 alleles of our 21 sporadic cases were 301-302delAG, the frequency of this allele (in 20 of 21 of the sporadic subjects given TRH stimulation tests) was 50% (3 of 6) and 0% (0 of 34) in the CPHD cases with pituitary and hypothalamic defects, respectively. Using whole genome radiation hybrid analysis, we localized the PROP1 gene to the distal end of chromosome 5q and identified a tightly linked polymorphic marker, D5S408, which can be used in segregation studies. Analysis of this marker in affected subjects with the 301-302delAG deletion suggests that rather than being inherited from a common founder, the 301-302delAG may be a recurring mutation.

Alleles↗
PubMed1998

[Simplified technique for thoracic drainage in anterior surgery of scoliosis in the child].

The authors describe a technique of thoracic drainage after anterior surgery of the spine in a pediatric population. A comparative study of drainage using the standard chest tube in one group of patients and small multiperforated vacuum drainage do not show any difference in term of morbidity. As the modified drainage is best tolerated in term of pain, easier to take care of and costless, the authors recommand this technique in children when hermetic closing of the pleura is possible and in absence of air-leakage.

Adolescent↗
PubMed1998

Prostatic adenocarcinoma with cutaneous metastases overlying oestrogen-induced gynaecomastia.

Carcinoma of the prostate gland is the second most frequent malignancy in males, accounting for 17% of cancer in men; between a third and one-half of these patients will have distant metastases at onset, but rarely cutaneous. We now report a case of prostatic adenocarcinoma with such metastases involving the right nipple and periareolar skin, overlying an area of hormone-induced gynaecomastia.

Adenocarcinoma↗
PubMed1997

Salmonella lung involvement in patients with HIV infection.

STUDY OBJECTIVE: To determine the frequency, clinical features, and outcome of lung involvement in HIV-infected patients having nontyphoid strains of Salmonella bacteremia. DESIGN: A retrospective clinical study. PATIENTS AND SETTING: We studied the records of all HIV-infected patients with Salmonella bacteremia diagnosed at a university tertiary hospital from January 1987 to December 1995. RESULTS: Lung involvement was found in 18 (35.3%) of 51 HIV-infected individuals with Salmonella bacteremia. Six of 18 (33.3%) were diagnosed as having definite Salmonella pulmonary infection by isolation of Salmonella from respiratory specimens, while probable Salmonella lung disease was considered in two patients who developed lung abscesses without the identification of any pathogen. Predisposing factors for focal disease, such as prior lung disease or Salmonella serotype, were equally prevalent regardless of the presence of Salmonella pulmonary involvement. Cavitary infiltrates or abscess formation were seen in five of the eight patients. With the exception of one patient coinfected with Nocardia asteroides who died 1 month later, all patients were cured with antibiotic treatment. Superinfection with other pulmonary pathogens (10 cases, 56%) was more frequent than Salmonella pneumonia; the most frequent alternative diagnosis was Pneumocystis carinii pneumonia (5 cases, 28%), pyogenic bacterial infection (17%), and tuberculosis (11%). CONCLUSIONS: In HIV-infected patients with Salmonella bacteremia, lung involvement is frequent, although there were no significant factors to explain this association. Cavitary disease was the most common radiologic pattern, and focal lung disease due to Salmonella does not seem to be associated with a worse prognosis. Coinfection and superinfection with other respiratory pathogens are more common than isolated Salmonella lung disease, and therefore, additional diagnostic procedures must be considered in the evaluation of these patients.

AIDS-Related Opportunistic Infections↗
PubMed1997

Effect of erythrocytes and prostacyclin production in the effect of fructose and sorbitol on platelet activation in human whole blood in vitro.

We analyzed the in vitro effects of sorbitol and fructose on platelet function. Sorbitol and fructose increased platelet aggregation induced with adenosine diphosphate (ADP) or collagen in whole blood, but had no effect in platelet-rich plasma. The concentration that increased basal aggregation by 50% with ADP as the inducer was 12.89 +/- 1.55 mmol/L for fructose, and 18.99 +/- 2.01 mmol/L for sorbitol. When collagen was the inducer, these concentrations were 15.02 +/- 0.98 mmol/L for fructose, and 12.94 +/- 1.57 mmol/L for sorbitol. Both sugars increased, in a concentration-dependent way, the proaggregatory effect of erythrocytes, and erythrocyte uptake of adenosine. Time to uptake of 50% adenosine was 2.1 +/- 0.3 min in control samples, 0.14 +/- 0.01 min in the presence of fructose, and 0.23 +/- 0.03 min with sorbitol. Both sugars reduced vascular prostacyclin synthesis, with 50% inhibitory concentrations of 26.48 +/- 1.97 mmol/L for fructose, and 39.53 +/- 2.81 mmol/L for sorbitol. Both sugars also increased arterial lipid peroxidation by 30% (sorbitol) and 23% (fructose). We conclude that these two sugars enhance platelet function and disrupt the thromboxane/prostacyclin ratio.

6-Ketoprostaglandin F1 alpha↗
PubMed1997

Clinical presentation and outcome of tuberculosis in kidney, liver, and heart transplant recipients in Spain. Spanish Transplantation Infection Study Group, GESITRA.

BACKGROUND: Tuberculosis is unusual in transplant recipients. The incidence, clinical manifestations, and optimal treatment of this disease in this population has not been adequately defined. The present study was undertaken to assess the incidence, clinical features, and response to therapy of Mycobacterium tuberculosis infection in solid-organ transplant recipients. METHODS: We evaluated retrospectively the incidence, clinical characteristics, diagnostic procedures, antituberculous treatment, clinical course, and factors influencing mortality in 51 solid-organ transplant recipients who developed tuberculosis after transplantation. We also reviewed the world literature on tuberculosis in solid-organ transplantation. RESULTS: The overall incidence of tuberculosis was 0.8%. The localization was pulmonary in 63% of the cases, disseminated in 25%, and extrapulmonary in 12%. Tuberculosis developed from 15 days to 13 years after surgery (mean, 23 months). In one third of the cases, diagnosis was not suspected initially, and in three cases, diagnosis was made at necropsy. Fever was the most frequent symptom, followed by constitutional symptoms, cough, respiratory insufficiency, and pleuritic pain. Fifteen patients (33%) developed hepatotoxicity during treatment; hepatotoxicity was severe in seven cases. Hepatotoxicity was higher in patients receiving four or more antituberculous drugs (50%) than in patients receiving three drugs (21%; P=0.03). Serum levels of cyclosporine decreased in the 26 patients under the simultaneous use of rifampin. Nine of them (35%) developed acute rejection, and five (56%) died, in comparison with 3 of 17 patients (18%) who did not develop rejection after the use of cyclosporine and rifampin (P=0.03). Although microbiological response was favorable in 94% of the 35 patients who completed 6 or more months of treatment, 16 other patients (31%) died before diagnosis or in the course of treatment. None of the patients treated for more than 9 months died as a consequence of tuberculosis, whereas the mortality rate was 33% among those treated for 6 to 9 months (P=0.03). Use of antilymphocyte antibodies or high doses of steroids for acute rejection before tuberculosis was associated with a higher mortality rate. CONCLUSIONS: M tuberculosis causes serious and potentially life-threatening disease in solid-organ transplant recipients. Treatment with at least three drugs during 9 months or more, avoiding the use of rifampin, appears to be appropriate.

Adult↗
PubMed1997

Purification, crystallization and preliminary X-ray diffraction studies of C-phycocyanin and allophycocyanin from Spirulina platensis.

C-phycocyanin and allophycocyanin from the green alga Spirulina platensis were isolated and crystallized by gel-acupuncture techniques. A novel two-step chromatographic procedure was used for purification. Blue hexagonal crystals were obtained by diffusing magnesium chloride into the protein solution for a week, followed by diffusion of PEG 6000 in order to complete the reduction of the solubility of the protein in the capillary tube used as a growth cell. In the case of allophycocyanin, crystals with a size of 0.4 x 0.3 x 0.3 mm were characterized by X-ray diffraction. They belong to space group P6(3)22 with unit-cell parameters a = b = 102.04, c = 131.22 A. The crystals of C-phycocyanin belong to either space group P6 or P6(3) with unit-cell constants a = b = 182.38, c = 60.87 A, alpha = beta = 90, gamma = 120 degrees. The crystals diffract beyond 2.4 and 2.5 A resolution, respectively, using a rotating anode as an X-ray source.

Journal Article↗
PubMed1997

Idiopathic biliary ductopenia in adults without symptoms of liver disease.

BACKGROUND: Idiopathic adulthood ductopenia is a severe cholestatic liver disease of unknown cause characterized by loss of the interlobular bile ducts in more than 50 percent of the portal tracts. In most reported cases, cirrhosis and liver failure develop. METHODS: We studied 24 adults with abnormal results on liver-function tests but no symptoms of liver disease. All had liver biopsies that showed a lack of bile ducts in many of the portal tracts. RESULTS: The 17 women and 7 men had a mean age of 41 years (range, 27 to 57). All were asymptomatic and had high serum gamma-glutamyltransferase concentrations (mean [+/-SD], 179 +/- 84 U per liter); 75 percent also had abnormal serum alanine aminotransferase concentrations. The proportion of portal tracts that had bile ducts was 62 +/- 7 percent (range, 55 to 78 percent). Three patients had a second liver biopsy three to nine years after the first; there were no changes over time. In four of the five patients treated with 600 to 900 mg of ursodiol two to three times daily, results of liver-function tests returned to normal. CONCLUSIONS: Idiopathic biliary ductopenia, with an apparently nonprogressive clinical course, can occur in adults who have no symptoms of biliary disease.

Adult↗
PubMed1997

[A study of 30 patients with bacteremia due to Campylobacter spp].

BACKGROUND: To get better knowledge about clinical and bacteriological features in Campylobacter spp. bacteremia. PATIENTS AND METHODS: Over a period of 8 years (1987-1994) we prospectively analyzed underlying diseases, predisposing factors, clinical manifestations, complications and outcome of patients with Campylobacter spp. bacteremia. The study took place in an urban third-level teaching hospital. Antibiogram was tested in all the strains isolated. RESULTS: We identified 30 cases of Campylobacter spp. bacteremia (26 due to C. jejuni and 4 due to C. fetus). Seventy-three percent of the patients were male and the mean age +/- SD of all the patients was 52 +/- 19 years. Ninety percent of patients had some kind of immunodepression related to immunosuppressive therapy or to underlying diseases, especially liver cirrhosis and HIV infection. All patients had fever and 40% complained of intestinal symptoms before bacteremia. Mortality rate in patients with C. jejuni bacteremia was 30.8% (8 patients) during the admission, the death was directly related to bacteremia in 11.5% (3 patients). In all the fatal cases C. jejuni was resistant to empirical antibiotherapy instituted. In contrast, none of the patients with C. fetus bacteremia died. We detected an increasing ciproflaxin resistance in C. jejuni strains during this period which reached to 75% in the last years. Antimicrobial susceptibility to erythromycin and aminoglucosids was kept in all the strains. CONCLUSIONS: Campylobacter spp. bacteremia has a remarkable mortality rate, probably related to immunosuppressive underlying diseases in affective patients. In our institution we detected an increasing fluoroquinolone resistance over the years while susceptibility to erythromycin and aminoglucosids was maintained.

Adult↗
PubMed1997

Evidence that mobile lipids detected in rat brain glioma by 1H nuclear magnetic resonance correspond to lipid droplets.

Mobile lipids have been detected by proton nuclear magnetic resonance (NMR) in animal and human tumors (cultured cells, biopsies, and in vivo), but their origin and subcellular location are still unclear. They have been associated with malignancy, metastatic ability, drug resistance, and necrosis. We wanted to determine whether these lipids are located within plasma membrane microdomains or in lipid droplets for a C6 cell-induced rat glioma. NMR-visible mobile lipids were found in all subcellular fractions isolated from the rat tumor, except in the cytosolic supernatants. Transmission electron microscopy showed that lipid droplets were present in all subcellular fractions containing NMR-visible lipids and in the necrotic and perinecrotic areas of the tumor. The mean diameter of droplets isolated by flotation in the subcellular fractionation protocol was 0.97 microm (n = 682; droplet profile diameter range between 0.2 and 5.0 microm). The apparent diffusion coefficient for these lipids (46 +/- 17 microm2 s(-1) measured in vivo by proton spectroscopy was four orders of magnitude higher than would be expected if mobile lipids were inside plasma membrane microdomains. The combined results demonstrated that mobile lipids detected in vivo by proton NMR in the C6 rat glioma are located in large lipid droplets, associated with the necrotic process.

Animals↗
PubMed1997

Cognition and life: the autonomy of cognition.

In this paper we propose a philosophical distinction between biological and cognitive domains based on two conditions that are postulated to obtain a useful characterization of cognition: biological grounding and explanatory sufficiency. According to this, we argue that the origin of cognition in natural systems (cognition as we know it) is the result of the appearance of an autonomous system embedded into another more generic one: the whole organism. This basic idea is complemented by another one: the formation and development of this system, in the course of evolution, cannot be understood but as the outcome of a continuous process of interaction between organisms and environment, between different organisms, and, specially, between the very cognitive organisms. Finally, we address the problem of the generalization of a theory of cognition (cognition as it could be) and conclude that this work would imply a grounding work on the problem of the origins developed in the frame of a confluence between both Artificial Life and an embodied Artificial Intelligence.

Animals↗
PubMed1997

Use of albumin in two Spanish university hospitals.

OBJECTIVES: The aim of this study was to characterize the use of seralbumin, evaluating how appropriate its prescription is and what possible economic repercussions may result from inappropriate use. METHODS: We performed a prospective study that included all patients receiving albumin in two University Hospitals from October 1995 to March 1996. The reasons for albumin use were considered appropriate if they coincided with the recommendations of a panel of experts. RESULTS: During the study period, 197 patients received albumin and a total of 3208 50-ml vials (20%) were used. The internal medicine and gastroenterology services prescribed this drug the most often. The most frequent prescription motives were paracentesis in cirrhotic patients (25.9%), hypoalbuminemia (24.9%) and chronic handling of cirrhotic patients (18.6%). Only 16 prescriptions (8.1%) (corresponding to 315 vials, 9.8%) were considered appropriate. One cause of inappropriate prescribing was that colloid solutions had not previously been used in 56 (30.9%) of the 186 inappropriate prescriptions. During the study period, 74,306 ECUs were spent on inappropriate indications. CONCLUSIONS: The use of albumin in our centers is incorrect and has important economic repercussions. Some educational and informative measures must be established to change this situation.

Albumins↗
PubMed1997

High-resolution ultrasound associated with aspiration biopsy in the follow-up of patients with differentiated thyroid cancer.

OBJECTIVE: To assess the value of ultrasound in the follow-up of patients undergoing surgery for differentiated thyroid carcinoma. SUBJECTS: The study included 89 patients (70 women and 19 men) with differentiated thyroid carcinoma (76 papillary and 13 follicular cancer). METHODS: High-frequency ultrasound (US) was used in the evaluation of 89 subjects who underwent surgery for thyroid carcinoma. Fine-needle aspiration was performed in cases with positive US. In addition, determinations of thyroglobulin (Tgb) in serum, scintigraphy with (131)I, and cervical palpation were evaluated. We determined sensitivity, specificity, and overall accuracy for each of these diagnostic methods. RESULTS: Ultrasonography was positive in 22 subjects, 16 in the nodal area and 6 in the thyroid bed. Twenty-two subjects received fine-needle aspiration with US control; 13 (59%) of 22 were positive for cancer. The results of the US for detecting neoplastic disease showed a sensitivity of 65%, specificity of 86%, and overall accuracy of 82%. The overall accuracy for scintigraphy was 88% and for Tgb, 91%. CONCLUSION: We concluded that US can be included in the follow-up protocol for patients undergoing surgery for differentiated cancer of thyroid, as a valuable tool to localize the recurrence. This technique is particularly useful in the evaluation of patients who are found to have elevated Tgb levels.

Adenocarcinoma, Follicular↗
PubMed1997

Nutritional and immunologic evaluation of patients with gastric cancer before and after surgery.

The main objective was to evaluate a patient's immunologic and nutritional status as a prognostic indicator of morbidity and mortality in patients with gastric cancer. A prospective clinical study carried out at the National Cancer Institute in Bogotá, Colombia. Our study group consisted of 40 patients with a diagnosis of gastric adenocarcinoma that was treated surgically. Blood samples were taken before and 5 d after surgery; mononuclear cell typing was done by flow cytometry allowing a bicolor analysis. Nutritional evaluation was obtained through measurement of albumin levels, average weight loss, and nutritional risk index (NRI). Half of the malignancies were localized to the middle and lower third of the stomach: stage I, 17.55%; stage II, 10%; stage III, 55%; and stage IV, 17.5%. Twenty subtotal gastrectomies, 11 total gastrectomies, 7 gastrojejunostomies, and 2 esophagogastrectomies with D1 and D2-D3 lymph node resection were performed. A postoperative morbidity of 22.5% and a mortality of 7.5% were observed. A preoperative cellular immunosuppression was identified, with a helper lymphocyte (CD4) to suppressor/cytotoxic lymphocyte (CD8) ratio of 1.38 normal value (NV > 1.5), which increased according to the stage of the disease. Patients who died presented with a significantly greater preoperative cellular immunosuppression than those who survived (P = 0.05). Postoperative mortality correlated significantly with hypoalbuminemia (P = 0.008). In those who died, weight loss was greater than in those who survived (P = 0.06). Patients with severe malnutrition had greater postoperative mortality according to the NRI. Severe preoperative cellular immunosuppression (CD4/CD8 < 1), hypoalbuminemia, weight loss, and severe NRI have a positive predictive value for mortality in patients with gastric cancer.

Adenocarcinoma↗
PubMed1997

Detection of hepatitis G virus from serum and liver of a patient with long-term liver dysfunction after autologous bone marrow transplantation.

Long-term effects after blood or bone marrow transplantation (BMT) are emerging as an important issue, as more patients are included in BMT programmes and as this procedure becomes more successful. Long-term liver dysfunction, mainly due to chronic graft-versus-host disease or hepatitis C virus infection, is a well-known complication. Nevertheless, the diagnosis of liver disease in this patient group is sometimes difficult and, despite adequate studies, it may remain undetected. A novel hepatitis-associated virus, hepatitis G virus (HGV), has recently been identified. The virus belongs to the Flaviviridae family and is known to be parenterally transmitted, although there is no clear evidence to implicate this agent in causing acute or chronic hepatitis. We report a patient who developed mild, but persistent, abnormalities in transaminases for 2 years after an autologous BMT. HGV RNA was detected in both serum and liver. HGV RNA persisted in serum for at least 8 months. No other known hepatitis virus was found. This report provides the first direct evidence of a patient with long-term liver abnormalities after a BMT in whom the only known hepatitis virus isolated was the HGV.

Adult↗
PubMed1997

Candidal meningitis in HIV-infected patients: analysis of 14 cases.

Five cases of candidal meningitis in human immunodeficiency virus (HIV)-infected patients have been diagnosed in our hospital. This article describes these cases and reviews another nine previously reported in the literature. Most patients (71%) had at least one well-known predisposing factor for candidiasis. Median CD4 cell count was 135/mm3. Headache and fever, in the absence of focal neurologic signs, were the predominant clinical features. The CSF analysis revealed mild pleocytosis and hypoglycorrachia, indistinguishable from those seen in tuberculous or cryptococcal meningitis. Twelve patients (92%) received amphotericin B for a median of 51 days, in combination with flucytosine in five cases. The overall mortality among treated patients was 31%. Although the risk of relapse of candidal meningitis is unknown, maintenance antifungal therapy was given to seven patients (63%), usually with fluconazole. Candida species must be kept in mind as a cause of chronic meningitis in HIV-infected patients who have a known predisposing factor.

AIDS-Related Opportunistic Infections↗