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Biomedical subjects

A Otero

Publications and source records attributed to A Otero.

140 records · Page 8Linked to original sources
PubMed1981

[Polycystic renal disease in the adult associated with an incomplete form of Marfan's syndrome (author's transl)].

A case of polycystic renal disease of the adult associated to dissecting aneurysm of the ascending aorta with histological findings compatible with Marfan's syndrome is reported. A review of the literature discloses only one case of this association, although without cardiovascular abnormalities. Polycystic renal disease of the adult is associated with some frequency to aneurysms of the cerebral arteries and, occasionally, to aneurysms of systemic arteries (splenic and renal). On the other hand, the Marfan's syndrome presents the well known dysmorphic manifestations associated to cystic degeneration of certain organs (congenital pulmonary cystic disease and congenital renal cysts, amongst others), constituting the so-called secondary abnormalities. The association herein reported might be considered as casual, but could also represent simultaneous mutations due to a single mutagenic factor. This explanation is supported by the identical hereditary pattern and the fact that both diseases share some secondary abnormalities.

Adult↗
PubMedDate not supplied

Differential features between bipolar I and bipolar II disorder.

Although bipolar II disorder is generally viewed as a mild form of classic manic-depressive illness, recent investigations suggest that it could be a valid diagnostic category different from bipolar I in genetic, biological, clinical, and pharmacological aspects. Twenty-two patients fulfilling Research Diagnostic Criteria for the diagnosis of bipolar II disorder and 38 bipolar I patients were evaluated with the Schedule for Affective Disorders and Schizophrenia by two independent interviewers and compared. Bipolar II patients had significantly more previous episodes (P = .001), including both depressive (P = .003) and hypomanic (P = .006) switches, but had been hospitalized (P = .001) and presented psychotic symptoms (P < .001) less frequently. These results suggest that bipolar II disorder is less severe than bipolar I with regard to symptom intensity, but is more severe with respect to episode frequency.

Adult↗
PubMedDate not supplied

Analysis of respiratory syncytial virus in clinical samples by reverse transcriptase-polymerase chain reaction restriction mapping.

The aim of this study was to develop a polymerase chain reaction (PCR) for the detection of respiratory syncytial virus (RSV) genomes. The primers were designed from published sequences and selected from conserved regions of the genome encoding for the N protein of subgroups A and B of RSV. PCR was applied to 20 specimens from children admitted to the respiratory ward of "William Soler" Pediatric Hospital in Havana City with a clinical diagnosis of bronchiolitis. The PCR was compared with viral isolation and with an indirect immunofluorescence technique that employs monoclonal antibodies of subgroups A and B. Of 20 nasopharyngeal exudates, 10 were found positive by the three assayed methods. In only two cases, samples that yielded positive RNA-PCR were found negative by indirect immunofluorescence and cell culture. Considering viral isolation as the "gold standard" technique, RNA-PCR had 100% sensitivity and 80% specificity. RNA-PCR is a specific and sensitive technique for the detection of the RSV genome. Technical advantages are discussed.

Humans↗
PubMedDate not supplied

Antigenic and genetic characterization of twenty-six strains of human respiratory syncytial virus (subgroup A) isolated during three consecutive outbreaks in Havana city, Cuba.

Twenty-six human respiratory syncytial virus strains (subgroup A) isolated from three outbreaks in Havana City during the period 1994/95, 1995/96 and 1996/97 were analyzed to determine their antigenic and genetic relationships. Analyses were performed by monoclonal antibodies and restriction mapping (N gene) following amplification of the select region of the virus genome by polymerase chain reaction. All isolated strains were classified as subgroup A by monoclonal antibodies and they showed a restriction pattern NP4 that belonged to subgroup A. Thus the results obtained in this work, showed a close relation (100%) between antigenic and genetic characterization of the isolated strains in our laboratory. These methods permit the examination of large numbers of isolates by molecular techniques, simplifying the researchs into the molecular epidemiology of the virus.

Antibodies, Monoclonal↗
PubMedDate not supplied

[A validity study of continuous Doppler].

INTRODUCTION: Ultrasound is regularly used for the detection of carotid stenosis which can be treated surgically. This technique includes continuous Doppler, which together with study of blood flow in the orbit is very useful and should be used systematically, not only in certain cases. We present a study of the usefulness of this technique in our Cerebral Vascular Pathology Laboratory. PATIENTS AND METHODS: We selected 708 patients studied sequentially over 10 years with continuous Doppler and conventional angiography (gold standard). The data obtained independently with each technique were compared in order to establish the degree of concordance between them and the corresponding indicators of validity. Contingency tables were drawn up for different cut-off points corresponding to the different degrees of stenosis (50, 70 and 100%). The parameters for validity (sensitivity, specificity, predictive value and precision) were calculated in each case. RESULTS: The percentage coincidence of the two techniques was 91.95%. At the cut-off points there was a high degree of precision (> 94.35%). The specificity and negative predictive value of Doppler compared with angiography was over 95% and 96% respectively. CONCLUSIONS: The validity markers obtained in our laboratory support the technique using continuous Doppler as the ideal non-invasive diagnostic method for carotid stenosis and this means that its systematic use is to be recommended in patients with suspected extracranial carotid disease. Moreover, the low cost of the equipment used as compared with other more sophisticated techniques should lead to its more widespread use as a first-line diagnostic method in all Neurology departments.

Adult↗
PubMedDate not supplied

[Effect of folic acid supplementation on total homocysteine levels in hemodialysis patients].

UNLABELLED: Hyperhomocysteinemia is an independent risk factor for cardiovascular mortality in ESRD, but about 80% of total homocysteine (tHcy) is bound to albumin (alb). We have tried, prospectively, to reduce tHcy levels by using folic acid (f.a.) and vitamin B6 (P.P.) supplementation. All patients on HD, not receiving f.a. or P.P. and all new patients, after their third month on HD, were supplemented with f.a. 5 mg/48 hours p.o and P.P. 40 mg/week. We determined folate, P.P. (RIA), vit. B12, KTV, residual renal function (KRU), PCRn, alb and tHcy levels (HPLC). 80 patients, age 62.6 +/- 13.6 years, time on HD 16.2 +/- 25.1 months, all dialysed with AN69 or PPMA, and bicarbonate, were included. The prevalence of hyperhomocysteinemia was 84.4%, and P.P. deficit was present in 32%, with folate in the low normal range. At the beginning of the study, before supplementation, tHcy was negatively correlating only with folate (r = -0.336) (p = 0.01), and not with P.P., vitamin B12, age, albumin, KTV, KRU or PCRn. 58 patients received six months of supplementation, with normalization of P.P. levels, a significant increase of folate (7.25; I.C = 95% confidence intervals: 6.45, 8.05 vs 61.29; I.C.: 44.47, 78.11) (p < 0.001), and decrease of tHcy (24.1; IC: 21.5, 26.3 vs 19.9; I.C: 17.5, 22.4) (p < 0.05). 33 patients have received 12 months of supplementation, but in spite of a continued increase of folate (100.78; I.C: 74.81, 126.74) (p < 0.001), only 3 have normal levels of tHcy; correlating directly tHcy with albumin (r = 0.56) (p = 0.001), that had increased compared to the beginning of the study (3.39; I.C. 3.29, 3.49 vs 3.50; I.C: 3.37, 3.63) (p < 0.05). CONCLUSION: After f.a. and P.P. supplementation, though initially tHcy is reduced, this response is short lived, and tHcy directly correlates with albumin levels. Good nutrition associated with HD adequacy, in absence of B vitamin deficits, seems to be the best determinant of tHcy levels rather than its removal by dialysis tHcy levels should be interpreted taking into account the serum albumin.

Aged↗
PubMedDate not supplied

[Cavernous haemangioma of the small bowel: an uncommon cause of intestinal obstruction].

Cavernous haemangioma of the small bowel is a vascular, benign and infrequent tumour, similar in both sexes and more typical from the third decade onwards. Its most common clinical manifestation is a chronic anaemia secondary to intestinal bleeding, other causes are intestinal obstruction and perforation. Preoperational diagnosis is difficult and the treatment of choice is surgical resection.

Aged↗
PubMedDate not supplied

[The referral system: a study on relations between general practitioners and specialists].

BACKGROUND: To describe the general practitioners referral patterns. There is special emphasis in the delay between the referral and the first consultation with the specialist. Also we consider other aspects of the coordination between both levels of care. METHODS: Cross-sectional study upon 8.095 referrals from 242 spanish doctors. RESULTS: The referral rate was 6.63%, higher in the 15-44 age group and also for men. We find a huge variability in the referral rates among doctors. The referral rates are higher to surgical specialties. The mean delay between referral and specialist appointment was 11 days. The general practitioners didn't receive communication from the specialists in 23.5 of the referrals. CONCLUSIONS: A considerable range of referral rates has been identified. There is a poor continuity and coordination in the patient care.

Adolescent↗
PubMedDate not supplied

[Bipolar II disorder: course and suicidal behavior].

INTRODUCTION: Bipolar II disorder seems to be more than a mild form of classic manic-depressive illness. Differences with bipolar I concern genetic, biological, clinical and pharmacological aspects. Nevertheless, studies on suicidal behavior in both groups have resulted in inconsistent results PATIENTS AND METHOD: Twenty-two patients fulfilling Research Diagnostic Criteria for the diagnosis of bipolar II disorder and 38 bipolar I were evaluated with the Schedule for Affective Disorders and Schizophrenia by two independent interviewers, and compared. RESULTS: Bipolar II patients had significantly more previous episodes (p = 0.001), including both depressive (p = 0.003) and hypomanic switches (p = 0.006), but had been hospitalized (p = 0.001) and presented psychotic symptoms (p < 0.001) less frequently. CONCLUSIONS: There were no significant differences between both groups regarding suicidal behavior variables. These results suggest that bipolar II disorder is less severe than bipolar I regarding symptoms intensity, but more severe with respect to episodes frequency, and that suicide attempts rates are not useful to discriminate between both groups.

Adolescent↗