Biomedical subjects

B Bermejo

Publications and source records attributed to B Bermejo.

52 records · Page 3Linked to original sources

PubMed1993

Prevalence of Raynaud's phenomenon in a healthy Spanish population.

To determine the prevalence of Raynaud's phenomenon (RP) in Spain, we studied a working population of 988 men and 479 women. The overall prevalence of RP was 3.7%, with a 3.2% rate for men and 4.7% for women. There was a statistically significant association between Raynaud's phenomenon and a personal or familial history of perniosis, acrocyanosis or migraine among women. The age at onset was significantly lower in women. RP was classified as primary in 89% of the cases and as secondary in 11%. Examination by capillaroscopy revealed no significant differences between primary Raynaud cases and controls.

Adolescent↗

PubMed1992

Stable binding of the eukaryotic acidic phosphoproteins to the ribosome is not an absolute requirement for in vivo protein synthesis.

The genes encoding the four acidic ribosomal phosphoproteins have been inactivated in Saccharomyces cerevisae by recombination with truncated genes carrying different genetic markers. By crossing single haploid disruptants, strains harboring two simultaneously inactivated acidic protein genes were constructed. None of the six possible double disruptions was lethal, but the simultaneous inactivation of either YP1 alpha and YP1 beta(L44') or YP2 alpha(L44) and YP2 beta(L45) caused an important decrease in the cell growth rate. Ribosomes isolated from these slow-growing strains did not contain acidic proteins, not even the two polypeptides whose genes were still intact, although these proteins were present in the cell extracts and they seem to be able to form high-molecular weight protein complexes. Transformation of a slow-growing double transformant with a plasmid containing one of the disrupted genes restored the presence of the acidic proteins in the ribosomes and normal growth rates. The particles of the slow-growing strains were active in an in vitro amino acid polymerizing system, although their activity could be stimulated by the exogenous addition of the missing proteins. These results indicate that in the absence of either YP1 alpha and YP1 beta(L44') or YP2 alpha (L44) and YP2 beta(L45), the remaining acidic proteins are unable to interact with the ribosome in a stable manner, but that a strong interaction of these ribosomal components with the particle is not an absolute requirement for in vivo and in vitro protein synthesis.

Blotting, Southern↗

PubMed1992

Investigation of an outbreak of nosocomial infection due to a multiply drug-resistant strain of Pseudomonas aeruginosa.

A nosocomial outbreak of Pseudomonas aeruginosa infections which occurred in the Urology Service of a large city hospital was studied. A case-control methodology was used to analyse patients' characteristics and the main risk factors of all cases with a positive culture during the period between March 1987 and March 1988. The usefulness of factor analysis in the definition of a case was examined. There were 74 infections of which 35 (47.3%), had a nosocomial origin. The outbreak took place in December 1987, with a peak incidence of infections of 10.5%, compared with a 2.2% frequency during the preceding months (P less than 0.005). Six of the nine infections occurring in that month, were caused by strains resistant to ticarcillin and gentamicin. The epidemic cases had longer hospital stays than the non-epidemic cases (P less than 0.038) and occurred more frequently in a specific area of the hospital (P less than 0.001). The odds ratio for resistance to gentamicin was 15 (P less than 0.018) and that of resistance to ticarcillin, 127 (P less than 0.0001). Our results suggest that inaccurate case definitions may produce misleading conclusions. Factor analysis appears to be a useful analytical tool when defining a case.

Case-Control Studies↗

PubMed1990

[Hospital outbreak of salmonellosis with secondary cases].

Food poisoning by Salmonella in hospitals and other health care centers is not uncommon and occasionally results in high mortality rates. We report an outbreak of food poisoning that took place in June 1987 in a hospital. A staff relay was primarily affected, with an attack rate of 59.3%. The mean incubation period was 31.2 hours. The epidemiological evidence pointed to a rice with milk served as a dessert as the transmitting vehicle, although the contamination source could not be identified. Subsequently, 11 days after the start of the outbreak, 9 cases were identified among the patients cared for at the center, which were considered as secondary cases. The causative organism was Salmonella (serovariety enteritidis, phage type A). All the involved individuals had a favorable outcome. The transmission of the mentioned organism within the hospital milieu has not been previously reported. In food poisoning developing in health care centers, the exposed individuals should be extremely careful and absolutely conscious of the need for complying with hygienic rules. In our area, we recommend sick leave while symptoms persist or the culture of feces is positive.

Adult↗

PubMed1990

[Chronic lead poisoning caused by wine consumption: an epidemiologic study].

An epidemiological study was carried out after the observation of a case of chronic lead poisoning so as to investigate its possible sources. An environmental evaluation was performed, including an analysis of the waters and wines consumed by the involved family; blood samples were obtained to assess lead levels in the consumers of the possibly implicated wines, with a comparative analysis of controls living in the same area. The study revealed that the source of the poisoning were the claret and white wines, which made soluble the lead when passing through the outlet tubes of the storage casks. The need for a greater surveillance of alimentary products by the corresponding authorities is emphasized.

Adult↗

PubMedDate not supplied

Amniotic fluid glucose and cytokines values in the early diagnosis of amniotic infection in patients with preterm labor and intact membranes.

OBJECTIVE: Our goal was to compare sensitivity, specificity, and predictive values of glucose and cytokines [interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF)] in amniotic fluid (AF) to detect an AF-positive culture. METHODS: Amniocentesis was performed on 113 patients with preterm labour (PTL) and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria, and for mycoplasmas. AF analysis included cytokines and glucose determinations. RESULTS: The prevalence of positive AF cultures was 11.5% (13/113). Anaerobic bacteria were isolated in 9 patients (69.2%). The glucose <16 mg/dl and cytokines values; IL-1 >640 pg/ml, IL-6 >55,000 pg/ml, IL-8 >1,000 pg/ml, TNF >672 pg/ml, were significantly correlated (P < 0.01) with AF culture result. Glucose had a sensitivity of 69.2% and a specificity of 96% for the prediction of positive AF culture. The sensitivity and specificity of the cytokines ranged from 61.5-53.4% and 79.8-8.99%, respectively. CONCLUSIONS: In the diagnosis of the AF-positive culture, glucose <16 mg/dl is more sensitive than cytokines.

Amniocentesis↗

PubMedDate not supplied

Prognostic assessment of uncomplicated first myocardial infarction by exercise echocardiography and Tc-99m tetrofosmin gated SPECT.

BACKGROUND: We evaluate the prognostic value of stress echo and gated single photon emission computed tomography (SPECT) after a first uncomplicated acute myocardial infarction. METHODS AND RESULTS: We used predischarge maximal subjective exercise echocardiography and gated SPECT with technetium 99m tetrofosmin to prospectively study 103 patients younger than 70 years with a first acute myocardial infarction. During a 12-month follow-up period, 2 patients died, 9 had heart failure, and 29 had ischemic complications (4 reinfarction and 25 angina). Predictive variables for heart failure in multivariate analysis were ejection fraction evaluated by echocardiography (odds ratio [OR] 8.5, P =.016) or by gated SPECT (OR 10.7, P =.009). Predictive variables for ischemic complications in multivariate analysis were less than 5 metabolic equivalents (METS) in exercise test (OR 5.2, P =.007) and greater than 15% ischemic extent in the polar map (OR 3.6, P =.04) of SPECT. CONCLUSIONS: Exercise echocardiography and Tc-99m tetrofosmin gated SPECT were predictive for heart failure, but exercise SPECT was the only test with predictive power for ischemic complications.

Echocardiography↗

PubMedDate not supplied

Interhospital observer agreement in interpretation of exercise myocardial Tc-99m tetrofosmin SPECT studies.

BACKGROUND: We sought to determine the degree of interhospital agreement in the interpretation of exercise myocardial technetium-99m tetrofosmin single photon emission computed tomography (SPECT). METHODS AND RESULTS: Five experienced hospital laboratories were asked to submit 2 sets of myocardial Tc-99m tetrofosmin SPECT images obtained in 150 patients undergoing coronary angiography: group A used a uniform color scale for all hospitals, and group B used the individual color scale in place at each hospital (uniform color scale, nonuniform color scale, and black-and-white scale). Thus a total of 300 images were interpreted by each center without knowledge of any other patient data. Angiographically significant coronary artery disease (< or =50% diameter stenosis) was present in 90 patients (60%). By a majority decision (3 or more centers), the sensitivity was found to be similar for groups A and B (82% and 84%, respectively), but the specificity was significantly higher for group A (87% vs 73%; P =.021). Four or all 5 of the centers agreed on abnormal or normal results of SPECT images in 87% of patients in group A (kappa 0.626) and in 78% of patients in group B (kappa 0.528). The kappa value of 0.617 was obtained for the uniform color scale, 0.467 for the uniform black-and-white scale, and 0.444 for the nonuniform color scale. Agreement on the left anterior descending artery territory (81% for group A and 78% for group B) was similar to that of the right coronary artery territory (79% for A and 75% for B) and to that of the left circumflex artery territory (91% for A and 85% for B). Agreement was similar in patients with 1-, 2-, and 3-vessel coronary artery disease (91%, 88%, and 86% for group A and 81%, 82%, and 82% for group B, respectively). CONCLUSIONS: In the interpretation of myocardial Tc-99m tetrofosmin SPECT images, good interinstitutional observer agreement was found, mainly when the uniform display method was adopted.

Adult↗

PubMedDate not supplied

Early results of the value of p53 in predicting survival in a homogeneous cohort of patients with invasive bladder cancer treated with a neoadjuvant carboplatin-based regimen (M-CAVI).

AIMS AND BACKGROUND: Several reports on prognostic factors for infiltrating-bladder cancer have given controversial results. We assessed the prognostic value of p53 nuclear overexpression together with known prognostic factors for survival in patients with invasive T2-4 N0 M0 bladder cancer treated with neoadjuvant chemotherapy. STUDY DESIGN: Thirty-five paraffinized tumor samples from initial transurethral resection of patients with bladder cancer were analyzed immunohistochemically to detect overexpression of p53 protein. Patients were treated with 3 to 4 cycles of neoadjuvant methotrexate, carboplatin, and vinblastine (M-CAVI) and then underwent radical cystectomy. Prechemotherapy, treatment, and postchemotherapy factors were analyzed for correlation with survival by univariate and multivariate analysis. Fifty-seven percent of tumors were positive for p53 protein, 71.5% had grade III-IV tumors, and 72% had organ-confined disease. The median follow-up was 20 months (range 5-71+). RESULTS: By univariate analysis, the significant pretreatment factors were initial tumor (T) stage (P < 0.0001) and the male sex (P = 0.03). Five postchemotherapy variables were found significant: surgery performed according to protocol (P = 0.003), overall clinical (P = 0.004), and overall pathologic (P = 0.02) response to therapy, postchemotherapy pathologic stage (P = 0.0002), and tumor status after surgery (P = 0.0006). By multivariate analysis, the initial prechemotherapy T stage was the only factor that demonstrated independent significance. CONCLUSIONS: Although the median follow-up of the study is still too short, in this group of patients treated with a neoadjuvant carboplatin-based regimen, a classical variable (prechemotherapy T stage) rather than p53 nuclear overexpression was an independent prognostic factor for survival. Further follow-up will be required to assess the value of p53 overexpression as a prognostic factor in invasive bladder cancer patients treated with neoadjuvant carboplatin-based chemotherapy.

Aged↗

PubMedDate not supplied

[Evolution of the prevalence of bedsores in the Hospital of Navarra].

INTRODUCTION: The rates of incidence and prevalence of patients with sores in hospital are indicators of nursing care quality. The aim of this study is to evaluate such prevalence in the last two years (1997-1998), comparing the patients with sores, the evaluation of the risk of developing sores, and the factors associated with their development. MATERIAL AND METHODS: A transversal study was made, in which the subjects under study were all of the patients hospitalised in the Hospital of Navarra on the day set for the study. The study gathers the variables of sex, age, unit of hospitalisation, date of admission and date of the study, presence and number of sores, their development in or outside the hospital, evaluation of risk on admission and evaluation of risk on the day of the study (according to the modified Braden scale). RESULTS: The prevalence of patients with sores was 8.9 per 100 patients hospitalised in 1997 and 5.1 in 1998. The difference is statistically significant with a value of p=0.025. Age, the classification of patients within those of risk, and the time of hospital stay are factors related to the development of sores. CONCLUSIONS: The factors associated with the development of sores detected in the study lead us to be more attentive in our vigilance of the patients that show them. The follow up of the prevalence and incidence of bedsores in hospitals is an instrument that makes it possible to continue improving understanding, prevention and treatment of such lesions in patients.

English Abstract↗

PubMedDate not supplied

Malignant tumors of the minor salivary glands. Retrospective study on 59 cases.

Minor salivary glands cancer account for 2-4% of head and neck cancer, 10% of all oral cavity cancer and 15-23% of all salivary glands cancer (1). There is a remarkable variation in clinical presentation, behavior and histology of those neoplasms. The incidence of malignancy is around 52-60% (2-4) Several classifications of salivary gland tumors have been presented, but for the present study we have utilized the WHO classification of 1992 (5). We present the results of a review of our experience with those malignancies, considering prognostic factors as histopathology, tumor grade, clinical staging, age and sex, primary location, regional and distant metastasis.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

[Comparative study of the efficacy and tolerance of propofol and thiopental in induction and in continuous perfusion with neuroleptanesthesia].

We have studied 40 ASA I/II patients aged from 18 to 65 years undergoing otorhinolaryngologic surgery of 40-100 minutes of duration. Patients were randomly assigned to two groups. Anesthesia in group I was induced with thiopental, 4 mg/kg and maintained with N2O at 66% and a variable perfusion of fentanyl. In group II, anesthesia was induced with propofol, 2.5 mg/kg and maintained with a perfusion of 6-12 mg/kg/hour and an initial perfusion of fentanyl, 4 micrograms/kg/hour. Loss of consciousness occurred in 37.49 +/- 9.78 seconds in group I and in 46.25 +/- 12.62 seconds in group II, with no significant differences. Two minutes after induction, propofol group presented a significant decrease in systolic blood pressure of - 12 mm Hg and both groups presented comparable increases in systolic blood pressure and heart rate during intubation. Five minutes later, systolic blood pressure regained normal values. Maintenance in group II was achieved in a proper fashion with a mean propofol consumption of 9.5 +/- 2.6 mg/kg/hour and fentanyl consumption of 4.94 +/- 2.22 micrograms/kg/hour whereas in group II, with N2O at 66%, the amount of fentanyl required was 6.85 +/- 2.95 micrograms/kg/hour, which was significantly higher. Eye opening from the time of interruption of anesthetics was achieved at 6.6 +/- 3.2 minutes in group I and 12.44 +/- 6.34 in group II. Consciousness was regained at 11.25 +/- 3.96 and 16.87 +/- 6.95 minutes, respectively. Pain on injection occurred in 15% with propofol and in 10% with thiopental. No patient presented major complications nor phlebitis after administration of the anesthetic.

Anesthesia, General↗

PubMedDate not supplied

[Nutrition in the first 100 liver transplants performed at the Hospital General Vall d'Hebrón].

The orthotopic liver transplant (OLT) is a therapeutic alternative in the terminal stages of liver pathology. It is a surgical procedure which is being used on a steadily increasing basis. In our Hospital, a OLT program was started in 1988. Coinciding with the one hundredth OLT, we have gathered, retrospectively the methods of nourishing these patients, as well as the possible connections existing between the nutritional support system and the time spent by these patients in the intensive care unit on one hand, and the mortality presented on the other hand. Parenteral nutrition (PN) was the initial nutritional support system most used by the patients in our unit. Those patients needing PN as the primary nutritional support system, presented significantly longer stays in the ICU and a tendency towards higher mortality than did those who required another type of nutrition as the primary nutritional support system. In 21% of the patients, the PN could, possibly, have been avoided. Oral nutrition (ON) was the next most frequent method of primary nutritional support, and the most frequent method as far as global nutrition, with enteral nutrition (EN) being used in very few cases.

Adolescent↗

PubMedDate not supplied

[The nutrition of liver transplant patients in an intensive medicine service comparing the years 1989 and 1992].

We examined the possible changes undergone in the form of feeding post liver-transplant patients admitted to our Intensive Care Unit (ICU), comparing 1989 and 1992. As biological nutritional parameters, we reviewed blood lymphocyte values and albumin prior to the transplant, immediately after, seven days following and on discharge from the ICU. In the two periods studied, we assessed the features of the nutritional support received by these patients (type and chronology). We found that, in 1992, parenteral nutrition (in significant form, p = 0.04) and oral diet (as trend, p = 0.06) was initiated earlier than in 1989. We noted a tendency to change the overall nutritional pattern, with an increase seen in 1992 in oral diet and a reduction in parenteral nutritional when compared to the 1989 period. In 1992, 24% of patients received oral diet as a first nutrition as against none in 1989. These data must be correlated with the time in the Intensive Medicine Service and the tendency to reduce mortality, even though transplant patients in 1992 were significantly older than in 1989, while their selection and the base pathology altered the pattern of these patients.

Adolescent↗

PubMedDate not supplied

[Energy requirement in patients after liver transplantation].

We have made a study of the energy requirements of liver transplant patients in the immediate post-operative phase, by comparing different methods. A study of energy use was made with indirect Calorimetry (IC), of calculation of Resting Energy Expenditure (REE) according to Fick's formula modified by Liggett, and of the calculation of basal energy Expenditure (BEE) applying Harris-Benedict's equation (HB). The correlation between the REE calculation using indirect calorimetry and that of BEE using Harris-Benedict (r = 0.7567) did not give a correction factor, applied to the Harris-Benedict formula) (REE by IC/BEE), which was uniform for all patients, oscillating as it did between 1.0 and 1.8. We found no correlation between REE by IC and that calculated using the modified Fick method, nor between the modified Fick method and BEE as calculated by Harris-Benedict. Our conclusion is that, with the IC method as reference to evaluate energy use, the Harris-Benedict calculation appears to be more reliable than that using the modified Fick equation and that, in the group of patients studied, and given the individual variations in the REE ratio calculated by IC and the BEE calculated by HB, we were unable to find a suitable correction factor for them all. IC is therefore the ideal method for evaluating energy use in critical patients in the ICU.

Basal Metabolism↗

PubMedDate not supplied

Node-negative breast cancers with p53(-)/HER2-neu(-) status may identify women with very good prognosis.

BACKGROUND: The contribution of p53 and HER-2/neu to the management of node-negative breast cancer (NNBC) could be improved by combining their results. MATERIAL AND METHODS: We studied paraffin-embedded primary tumors for p53 (BP-53-12-1) (n=57) and HER2/neu (pAB1) (n=63) from NNBC patients. The results were grouped in a negative (p53(-)/neu(-)) versus a positive group (one or both overexpressed). The association between both groups (negative and positive) and clinicopathologic parameters, S-phase fraction and DNA ploidy, and patients' outcome, was analyzed. RESULTS: In 28% of the tumors p53 was overexpressed, and HER2/neu in 11%. Sixty-five percent (37 out of 57) were p53(-)/neu(-), and 35% overexpressed one (31.5%) or both (3.5%) oncoproteins. Significant correlations were found between p53(-)/neu(-) tumors and age greater than 50 (p=0.003), S-phase fraction lower than 7 (p=0.03), and positive estrogen receptor contents (p=0.049). Actuarial 5-year disease-free and overall survival for p53(-)/neu(-) tumors were 88% and 97%, respectively, versus 50% and 66%, for tumors overexpressing one or both oncoproteins (p=0.004).

Age Factors↗