Search PubMed⌕ Search

Biomedical subjects

A Rivero

Publications and source records attributed to A Rivero.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Multicenter study of the prevalence of type 2 human immunodeficiency virus infection in Spain (1990)].

BACKGROUND: HIV-2 is a new retrovirus which may produce AIDS and has been mainly described in individuals from West Africa. More than 400 cases have been reported in France and Portugal while in Spain very few cases of HIV-2 infection have been reported with few studies having been made concerning the prevalence of the disease. This multicentric study analyzes the prevalence of HIV-2 infection in subjects of different risk groups in Spain and evaluates the diagnostic efficacy of different methodologies. METHODS: The presence of HIV-2 antibodies was analyzed in 902 serum samples of high risk individuals collected in 1990 from: 386 drug addicts, 246 not drug addict prostitutes, 184 West Africans and 86 homo/bisexual individuals. These samples were from Barcelona, Sevilla, and Malaga. The detection of antibodies was carried out by enzymatic immunoanalysis (EIA), Western blot (WB) and an enzymoimmuno-dot (EID) designed with synthetic peptides. RESULTS: Positive serology only for HIV-2 was detected in 7 samples from African immigrants. Two drug addicts presented double reactivity HIV-1/HIV-2 in all the tests suggesting double infection. No prostitutes or homo/bisexual males were identified with positive serology for HIV-2. Cross-reactivity between HIV-1 and HIV-2 was more frequently detected in WB than in EID. Greater discordance was found in the results obtained by EIA, WB, and EID in the West Africans than in the analysis of the samples of native subjects. CONCLUSIONS: This study demonstrates that, for the time being, HIV-2 infection in Spain is rare although from among immigrants from endemic areas subjects with behavior to risk of transmission to the autochthonous population have been identified. The use of techniques designed with synthetic peptides may be of use to discriminate HIV-1 and HIV-2 infection in positive samples by enzymatic immunoanalysis (EIA) and Western blot which use a viral lysate as antigenic material.

Acquired Immunodeficiency Syndrome↗
PubMed1992

HIV-1 infection among non-intravenous drug user female prostitutes in Spain. No evidence of evolution to pattern II.

OBJECTIVES: To assess the prevalence of HIV-1 infection among non-intravenous drug user (IVDU) female prostitutes in Spain and to determine risk factors for HIV-1 infection in this population. DESIGN: Cross-sectional seroepidemiological study of 519 non-IVDU prostitutes. SETTING: Four university hospitals. METHODS: All participants completed a questionnaire and provided a serum sample. Serum samples were tested for antibodies against HIV-1, hepatitis C virus (HCV) and Treponema pallidum. RESULTS: Twelve out of the 519 (2.31%) participants were HIV-1-seropositive. HIV-1 infection was associated with the presence of both HCV and T. pallidum antibodies, multiple sex partners, longer history of prostitution, history of genital ulcers and anal intercourse. Condom use was associated with HIV-1 seronegativity. CONCLUSIONS: The prevalence of HIV-1 infection in non-IVDU prostitutes in Spain remains relatively low. Risk increases with a higher rate of sexual exposure and practices such as anal intercourse and unprotected coitus.

Adolescent↗
PubMed1992

Visceral leishmaniasis in HIV-1-infected individuals: a common opportunistic infection in Spain?

OBJECTIVE: To investigate the epidemiological, clinical and biological features of visceral leishmaniasis (VL) in patients with HIV-1 infection. DESIGN: Retrospective study. SETTING: Three university hospitals in southern Spain. PATIENTS: Forty-seven adult patients with VL and HIV-1 infection diagnosed between January 1986 and November 1991. RESULTS: Forty-five out of the 47 (96%) cases were diagnosed in the last 2 years. Fever (87%), hepatomegaly (74%), splenomegaly (72%) and pancytopenia (77%) were the most common presenting features. Most patients (79%) were strongly immunocompromised when VL was diagnosed, and were in stage IV of the Centers for Disease Control classification; 87% had a CD4 lymphocyte count < 200 x 10(6)/l. However, VL was the first severe infection diagnosed in 10 cases. Significant titres (> 1:40) of antileishmanial antibodies were detected by indirect immunofluorescence in five out of 16 (31%) cases only. Clinical response to the therapy was difficult to assess. Microbiological response was achieved in only 38% of the patients evaluated. CONCLUSIONS: Leishmaniasis is a relatively common infection in HIV-1-infected individuals in southern Spain. Its clinical picture is quite uniform and it can be the first opportunistic infection in individuals with HIV-1. In endemic areas, a high index of clinical suspicion should be maintained in order to avoid underdiagnosis of leishmaniasis.

AIDS-Related Opportunistic Infections↗
PubMed1992

Implementing total quality management in the Spanish health care system.

A Total Quality Management Programme for the Spanish Health Care System was set in motion in 1986. The first phase of the programme covers three areas: (1) information sources, (2) training, (3) Total Quality activities, through a cascade of four coordinated projects. The first one defines a basic nucleus of patient information and established two national standards: (a) a minimum basic data set, (b) the use of an ICD-9-CM Spanish translation for codification of diagnoses and procedures. The second is an open demonstration project implementing these two standards in National Health Service hospitals and carrying out intensive training on ICD-9-CM codifiers. The third project encompasses two pilot studies on case-mix measurements systems and cost analysis framework. Through the fourth project concepts, methods and tools for Total Quality Management are developed, setting up specific working groups on clinical and organizational indicators for hospitals and primary health care.

Delivery of Health Care↗
PubMed1991

Lead-glazed ceramics as major determinants of blood lead levels in Mexican women.

The aim of this study was to determine the main contributors to blood lead levels in a population of women from middle to low socioeconomic status in the southwestern part of Mexico City. Within this area, the authors selected a random sample of 200 women. Age ranged from 21 to 57 years, with a mean of 36 years. Among 99 women who agreed to participate in this study, blood lead levels ranged from 1 to 52 micrograms/dL, with a mean of 10.6 micrograms/dL. Five percent of the women had a blood lead level over 25 micrograms/dL and 22% over 15 micrograms/dL. There was no significant trend in blood levels according to age. The main determinants of blood lead levels were higher socioeconomic status (presence of telephone in the house, t-test, p = 0.01) and using lead-glazed ceramics (LGC) to prepare food (t-test, p less than 0.005). There was a significant increasing trend in blood lead levels with increasing frequency of consumption of food prepared in LGC (test for trend, p = 0.0008). Among the dishes prepared in LGC, the main determinant was the consumption of stew. Time spent outdoors and consumption of tap water and of canned food were not important determinants of blood lead levels. The population attributable risk of high blood level (less than 15 micrograms/dL) due to the use of LGC was 58%. These findings demonstrate the major role of traditional pottery as a contributor to blood lead levels in this population and emphasize the need for interventions to produce lead-free pottery.

Adult↗
PubMed1991

[Single fiber electromyogram in myasthenia gravis and other neuromuscular diseases].

Single fibre electromyography (SFEMG) has been used to study neuromuscular transmission and the degree of reinnervation in patients with myasthenia gravis (MG) (n = 70); Lambert-Eaton syndrome (n = 3); myopathies (n = 8); motor neuron disease (n = 4) and peripheral neuropathies (n = 3) (Table 1). An automatic method was used to calculate neuromuscular jitter by means of a PC computer, a TECA TD 20 electromyograph and a jittermeter. Twenty pairs of potentials were selected from the extensor digitorum communis muscle for analysis using a trigger unit and a delay line. Mean jitter and percentage of pairs with normal and abnormal jitter were calculated (Figs. 1 and 2). MG patients showed pairs with normal (Fig. 3) and other with abnormal jitter and intermittent blocking (Fig. 4). Abnormalities were found in 72% of patients with ocular MG, in 95% with mild generalized MG, in 93% with moderate generalized MG and in 100% of severe MG cases (Table 2), (Fig. 5). There was a significant correlation between patient disability and jitter values (Fig. 6). The method was useful for the follow-up during immunosuppressant treatment (Fig. 7). Patients with other myopathies showed normal or mildly increased jitter and increased fibre density. The most common abnormality in patients with neurogenic conditions was increased fibre density, which ranged from 2.1 to 4.3 (Figs. 8 and 9). The method used showed high sensitivity for the detection of neuromuscular transmission defects. In some cases an abnormal jitter was found even before the appearance of transmission block and therefore it was possible to find abnormalities in clinically normal muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1990

Hemodynamic effects of continuous negative chest pressure ventilation in heart failure.

We have previously shown improved cardiac output (QT) with external continuous negative-pressure ventilation (CNPV) compared with continuous positive-pressure ventilation (CPPV) in dogs with low pressure pulmonary edema (1). The current study was done to determine if this effect was reversed in high pressure pulmonary edema. Seven supine, anesthetized dogs were fluid-loaded and treated with disopyramide (3.5 to 7.0 mg/kg) and propranolol (0.25 to 1.5 mg/kg). This produced a mean pulmonary wedge pressure (Ppaw) of 21.0 mm Hg on intermittent positive-pressure ventilation (IPPV). CPPV and CNPV were then alternated at 30-min intervals. Ventilators were matched for oxygen concentration, frequency, tidal volume (VT), and the increment in FRC (delta FRC) produced by a given positive (PEEP) or negative (NEEP) end-expiratory pressure. During 20 cm H2O of PEEP, QT values were significantly depressed from IPPV control values (2.13 +/- 0.2 versus 1.27 +/- 0.2 L/min, p less than 0.05) but not during CNPV with equivalent NEEP (1.66 +/- 0.2 L/min). Although arterial oxygen saturations were similar, mixed venous oxygen saturations were depressed by CPPV with PEEP of 15 and 20 cm H2O (67.9 +/- 3.8% during IPPV versus 54.1 +/- 4.9 and 51.9 +/- 5.8%, respectively, p less than 0.05 in both instances) but not during equivalent CNPV (59.9 +/- 4.3 and 58.7 +/- 4.5%). Despite potentially increased left ventricular afterload, external negative chest wall ventilation with NEEP does not appear to significantly depress QT compared with CPPV even when Ppaw is high and myocardial contractility is impaired.

Animals↗
PubMed1990

[The prevalence of Borrelia burgdorferi antibodies in a population at risk].

Given the increasing interest in Lyme borreliosis in our community, and the lack of epidemiological studies in our country, we have considered convenient to analyze the presence of anti-Borrelia burgdorferi antibodies in a group of workmen who we have considered at high risk since they carry out their everyday work in an environment infested by ticks. Significant antibody titers (= or greater than 1/128) are found in 38% of cases versus 0% in the control group. The significance of these results in relation to the presence or not of compatible clinical manifestations and tick bites are studied.

Agricultural Workers' Diseases↗
PubMed1989

[Hodgkin's disease associated with infection by human immunodeficiency virus].

We present four patients with Hodgkin's disease and human immunodeficiency virus infection (HIV). Three patients were addicts to parenteral drugs. The disease was very advanced at the time of diagnosis, stage IVB in all cases. Histologic types were mixed cellularity in two cases, nodular sclerosis in one case and it was not typifiable in the remaining case. The disturbances of cell-mediated immunity that the patients presented were those of the acquired immunodeficiency syndrome (AIDS) as well as the infectious complications. Response to treatment was poor with a high incidence of bone marrow toxicity; three patients died during the first 3 months after the diagnosis (X = 7.3 months). We emphasize the necessity of considering different prognostic and therapeutic approaches for the HD in these patients in contrast with those of seronegative patients. We pose some questions suggested by the review of the literature and the data of this series.

Adult↗
PubMed1989

[Myocardial perfusion during exercise and rest in coronary patients. Evaluation with a thallium 201 analog (isonitrile-technetium 99 m)].

Isonitrile-technetium, a Thallium 201 analog, was used for myocardial perfusion imaging in 12 patients with known coronary heart disease. 10-40 mCu of the isotope were injected at maximal effort during a Bruce stress test. Imaging was performed using 3 projections immediately after exercise and 24 hr later, using a gamma camera attached to a computer. Myocardial necrosis was detected with a sensitivity of 89% and specificity of 63%. Corresponding figures for stress induced ischemia were 89% and 100%. Accurate localization of ischemia or necrosis was obtained in 70% of all cases, improving to 100% in cases of total artery occlusion. These results, similar to those reported in the literature, encourage the use of Tc labeled isonitrile for myocardial perfusion imaging whenever Thallium 201 is difficult to obtain.

Adult↗
PubMed1989

[Intrafamilial, non-sexual, transmission of the human immunodeficiency virus].

In order to evaluate the possibility of intrafamilial transmission of the human immunodeficiency virus (HIV), a serological follow up of 104 household family members of HIV seropositive subjects with whom they were not having sexual contacts (SC) was carried out. The coexistence of other risk factors in the studied subjects was excluded. Of the initial seropositive patients (SP), 87.5% showed clinical and immunological alterations that could be attributed to the HIV infection. 32.6% of the SC lived in poor sanitary conditions with their respective SP. 3.8% of the SC shared toothbrushes with the group 29.8% shared shaving blades and 81.7% shared combs o hair brushes. After a 12.35 +/- 5.42 month follow up, none of the SC seroconverted. The results obtained suggest that the possibility of HIV transmission to household family members of HIV infected subjects is extremely unlikely if not impossible.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Open cross-over comparison of tulobuterol and fenoterol in asthmatic adult patients.

The objective of this open randomized cross-over study was to compare the clinical efficacy and safety of a recently introduced beta-2 mimetic, tulobuterol, with fenoterol in asthma patients. The study length was four weeks with each drug, with a seven-day washout period between treatment courses. Spirometric tests were carried out every 14 days; laboratory tests and an electrocardiograph were performed at the beginning and end of each treatment course, and a daily diary of salbutamol aerosol use and adverse reactions was kept. Pulmonary function tests and registration of pulse rate and arterial pressure were performed on days 1, 14 and 28 of both treatment courses, before the morning dose and 3 h after administration of the drug. No statistically significant changes were detected in laboratory tests, pulse rate or arterial pressure. The only adverse reaction noted was transient tremor which appeared in three cases with tulobuterol and in two cases with fenoterol. Spirometric tests revealed increases in all parameters with both drugs, although in the comparison between groups no overall statistically significant differences were found. All patients required inhaled salbutamol with both of the drug treatments, and there was a significant increase (p less than 0.05) in its use during the fenoterol treatment course. With both tulobuterol and fenoterol, inhaled salbutamol was mainly used within 2 h before and 1 h after each dose. It is concluded that tulobuterrol (2 mg, twice daily) was at least as effective as fenoterol (2.5 mg, thrice daily), while its clinical effect was longer-lasting. It is doubtful, however, that it provides coverage for 12 h in the type of patients selected.

Adult↗