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Biomedical subjects

C Benito

Publications and source records attributed to C Benito.

At least 37 records · Page 2Linked to original sources
PubMed1999

Colorectal resection and primary anastomosis in patients aged 70 and older: prospective study.

OBJECTIVE: To assess the differences in morbidity, mortality, and other immediate postoperative results of colorectal resection with primary anastomosis in relation to age. DESIGN: Prospective study. SETTING: District hospital, Spain. SUBJECTS: 316 consecutive patients who required colorectal resection with primary anastomosis between 1991 and 1995, 155 of whom were aged <70 years and 161 who were 70 years or more. MAIN OUTCOME MEASURES: Mortality, morbidity, and hospital stay. RESULTS: 116 patients aged <70 (75%) were American Society of Anaesthesiologists (ASA) grades I-II compared with 82 (51%) aged > or =70.33 of the younger patients (21%) and 49 of the older (30%) developed complications. The anastomotic leak rate was 14% (n = 21) in the younger group and 16% (n = 26) among those aged > or =70. Median hospital stay was 14 and 15 days, respectively (ranges 8-81 and 1-120). 4 died (3%) among those aged <70 compared with 17 (11%) in the older group (p = 0.009, chi square 6.9). Mortality for elective resections was 6% (15/263) compared with 11% (6/53) for emergencies. There were no significant differences in mortality according to ASA grade between age groups. CONCLUSIONS: People aged 70 or more are not a high risk group for colorectal resection and primary anastomosis as a result of their age alone. Mortality and morbidity depend more on ASA grade and whether the operation was elective or emergency.

Age Factors↗
PubMed1999

Intestinal obstruction in the elderly. Prognostic factors of mortality.

OBJECTIVES: To analyze mortality-related factors in elderly patients who were operated on for intestinal obstruction, and to determine whether advanced age worsened the morbidity and mortality rates. METHODS: In this prospective study we analyzed 188 patients older than 69 years who were operated on for intestinal obstruction. Group 1 consisted of 82 patients aged between 70 and 79 years, and group 2 consisted of 106 patients aged 80 years and older. We compared the distribution of clinical features and outcomes between the two groups, and determined factors related with mortality (chi-squared test with Yates' correction, Student's t test and multiple logistic regression analysis). RESULTS: The incidence of heart disease was 11% in group 1 and 35% in group 1 (p = 0.0003). There was no difference between the groups in any of the other factors analyzed. Univariate analysis identified as mortality-related factors perianesthetic risk (American Society of Anesthesiologists' Physical Status classification) (p = 0.0005), presence of metastases (p = 0.0001) and delay in surgery (t value = 3.043, p = 0.0027). CONCLUSIONS: Mortality due to surgery for intestinal obstruction in elderly patients is related to perianesthetic risk and delay in surgery. Older age does not increase the morbidity or mortality rates for this type of surgery.

Age Distribution↗
PubMed1998

TMJ static disk: correlation between clinical findings and pseudodynamic magnetic resonance images.

The aim of this study was to analyze the position and mobility of the temporomandibular joint (TMJ) articular disk by means of pseudodynamic magnetic resonance imaging (MRI) and to compare: clinical features, osseus and muscular degenerative changes, the different types of static and their signs and symptoms. The study was performed on 101 patients with clinical and MRI diagnosis of TMJ internal derangement with closed lock (permanent or episodic). On the MRI survey the following was evaluated: disk displacement, disk mobility, condylar translation, bone, and muscular fatty atrophy. Pain was more frequent in static disks (SD) than in mobile disks (MD) in all types of disk displacements (p < 0.01). Condylar translation was always lower in SD than in MD, independently from the position of the articular disk (p < 0.01). Localized sclerosis was more frequent in joints with SD. There were no statistically significant differences in the incidence of fatty atrophy considering disk mobility. The results of the study indicate that clinical diagnosis of closed lock with high frequency is related to the presence of a static disk. Clinical diagnosis of SD can be confirmed with a pseudodynamic MRI survey.

Adolescent↗
PubMed1998

[Integration of multimodal medical images].

Multimodality analysis is becoming a required tool in medical practice due to the development of different image techniques and new imaging processing tools. This paper is a review of the basis of medical image integration, image fusion techniques, and their clinical applications, especially addressing our experience with brain tomographic studies in nuclear medicine and radiology.

Algorithms↗
PubMed1997

Enzyme-linked immunosorbent assay of autoantibodies against mitochondrial glycerophosphate dehydrogenase in insulin-dependent and non-insulin-dependent diabetic subjects.

The mitochondrial enzyme FAD-linked glycerophosphate dehydrogenase (mGDH) plays a key role in the recognition of glucose as a stimulus for insulin release from the pancreatic islet B-cell. In the present study, an ELISA procedure was used for the measurement of mGDH antibodies in both insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetic patients. Positive readings, exceeding the upper limit of the normal range, were recorded in 7 out of 12 IDDM patients, as distinct (P < 0.01) from 2 out of 12 nondiabetic subjects of comparable age. The study conducted in 41 NIDDM patients and 15 control subjects of similar age indicated that the incidence of mGDH-positive cases was not significantly different in the diabetic (4/41) and control (1/15) groups, the measurement of optical density in the positive cases barely exceeding the upper limit of the normal range. These findings indicate that the mitochondrial enzyme mGDH often acts as an antigenic determinant in IDDM, but not in NIDDM, patients.

Adolescent↗
PubMed1996

Immunodetection of mitochondrial glycerophosphate dehydrogenase (mGDH) by a polyclonal antibody raised against a recombinant mGDH fragment product.

The mitochondrial enzyme glycerophosphate dehydrogenase (mGDH) plays an essential role in the B-cell glucose-sensing device and its activity in islet homogenates is impaired in several animal models of type 2 diabetes. We have now developed a polyclonal antibody, raised against a recombinant mGDH fragment product, that could be used for the immunodetection of mGDH. Total RNA was isolated from rat pancreatic islets and used in the synthesis of cDNA. Specific primers were designed that corresponded to the FAD binding domain of mGDH. The PCR product was purified and cloned into an appropriate expression vector used for transformation of Escherichia coli cells. The fusion protein was extracted from the transformed cells, further purified, and used for immunization of rabbits. The antibody recognized a single band of 72 kDa in rat islets and testis. The recombinant mGDH product was also recognized as a single band with the expected 65-kDa reference. An ELISA procedure was designed for detection of antibodies against the recombinant mGDH fragment product. The availability of the mGDH antibody opens the way to a number of further applications such as immunocytochemis- try and mGDH quantification in biological material.

Animals↗
PubMed1996

The efficacy of individual computer heart rate indices in detecting acidemia at birth in growth-restricted fetuses.

OBJECTIVE: To determine the efficacy of individual fetal heart rate (FHR) indices, as determined by computer analysis of the FHR tracing, in detecting fetal acidemia at birth in growth-restricted fetuses. METHODS: The study population consisted of 38 growth-restricted fetuses at 26-37 weeks' gestation from pregnancies with abnormal uterine and/or umbilical artery Doppler velocimetry. The 1-hour FHR tracing was analyzed by computer within 4 hours of cesarean birth before the onset of labor. Umbilical artery cord blood was collected at birth, and pH was determined within 5 minutes of collection. RESULTS: On linear regression, the duration of episodes of low variation in minutes (r = -0.77, r2 = 0.59) and short-term (r = 0.72, r2 = 0.52) and long-term (r = 0.69, r2 = 0.47) variation in milliseconds were significantly related to umbilical artery pH at birth, and more so than the number of accelerations of ten (r = 0.57, r2 = 0.32) and 15 (r = 0.38, r2 = 0.14) beats per minute. There were significant differences in computer measurements of FHR accelerations and variation between the umbilical artery pH categories of acidemia (pH less than 7.20), preacidemia (7.20-7.25), and nonacidemia (greater than 7.25). Stepwise regression revealed that episodes of low variation best described the model for predicting umbilical artery pH at birth (P < .001), with no improvement provided by the addition of other computer-analyzed FHR characteristics. CONCLUSION: In this population of growth-restricted fetuses delivered by elective cesarean, the computer indices of duration of episodes of low variation and short-term and long-term variation were significantly associated with umbilical artery pH and predicted umbilical artery acidemia at birth.

Acidosis↗
PubMed1996

The significance of transvaginal ultrasonographic evaluation of the cervix in women treated with emergency cerclage.

OBJECTIVE: Our purpose was to determine whether perioperative transvaginal ultrasonographic evaluation of the incompetent cervix treated with emergency cerclage is predictive of pregnancy outcome. STUDY DESIGN: Twenty-nine women who underwent emergency cerclage at 16 to 26 weeks of gestation had transvaginal ultrasonographic evaluation of the cervix within 48 hours before and after surgery and at least three times thereafter until 28 weeks of gestation. The following measurements were obtained: (1) funnel width, (2) funnel length, (3) endocervical canal length, (4) the distance between the internal and external os, (5) upper cervix (length of closed endocervical canal above the cervical cerclage), (6) lower cervix (endocervical canal length below suture), and (7) cervical index (1+ Funnel length/Endocervical canal length). Values are reported as the median in millimeters, and statistical analysis was performed by use of the Mann-Whitney U test, Wilcoxon signed-rank test, Spearman rank correlation, 2 x 2 contingency tables, and multiple regression analysis with significance set at p < 0.05. RESULTS: Cerclage procedures resulted in significant improvement in postoperative median measurements of funnel width (15 vs 4.0 mm, p < 0.0001), funnel length (29 vs 3 mm, p < 0.0001), and endocervical canal length (2 vs 27 mm, p < 0.0001). There was a significant relationship between gestational age at delivery and the following measurements: preoperative funnel width (r = -0.51, p = 0.007), postoperative endocervical canal length (r = 0.39, p = 0.04), length of the lower cervix (r = 0.39, p = 0.038), and the cervical index (r = -0.39, p = 0.038). An upper cervical length < 10 mm was a good predictor of delivery before 36 weeks of gestation, sensitivity 85.7% (12/14), specificity 66.7% (10/15), positive predictive value 70.6% (12/17), negative predictive value 83% (10/12), and Fisher's exact p = 0.008. Postoperatively all patients had upper cervical lengths < 10 mm by 28 weeks of gestation. Preoperative digital assessments of cervical dilatation before surgery did not correlate with gestational age at birth (r = -0.031, p = 0.36). CONCLUSIONS: In cases of cervical incompetence treated with emergency cerclage, perioperative transvaginal ultrasonographic assessment of the cervix reveals that the procedure results in improved ultrasonographic status of the cervix and that the ultrasonographic cervical findings before and after surgery correlate with pregnancy outcome.

Adolescent↗
PubMed1996

Sonography in the evaluation of the cervix during pregnancy.

Sonographic techniques have been developed to study the biometry and behavior of the cervix during pregnancy which have led to a better understanding of the pathogenesis of pregnancy loss and preterm birth. Nomograms have been developed for singleton and twin gestations, and associations between cervical sonographic characteristics and various adverse pregnancy outcomes have been observed. The new concept of 'relative' cervical incompetence suggests that the cervix may be an independent contributor to preterm birth. The incorporation of cervical sonography in management schemes for the prevention of pregnancy loss or preterm delivery has the potential to impact favorably on perinatal outcome.

Cervix Uteri↗
PubMed1996

[Percutaneous femoro-porto-jugular venovenous shunt in orthotopic liver transplantation].

Veno-venous bypass (VVB) by the percutaneous introduction of cannulas in the right internal jugular vein during liver transplantation may reduce the complications derived from the classical method of axillary vein dissection. The results and complications observed over a two and a half year period in 126 consecutive patients submitted to liver transplantation in whom preparation for femoral-portal-jugular veno-venous bypass was carried out are reported. Twelve complications (9.5%) were observed in the 126 patients. All the complications were due to jugular cannulation and were divided as follows: in 7 patients (5.5%) some of the guide introductions were unsuccessful following multiple punctures; in 2 patients (1.6%) the right carotid artery was punctured; 2 hemothorax (1.6%) were observed and one pneumothorax (0.8%). Forty patients required veno-venous bypass. The blood flows obtained during VVB were suffice in all the cases with a mean +/- standard deviation of 2.21 +/- 0.44 l/min-1. The technique of femoral-portal-jugular veno-venous bypass is a good alternative to the classical method of the axillary approach. It has advantages such as in the speed of installation of VVB and the utility of the large jugular vein during the remainder of the surgery for rapid fluid transfusions. Although the number of complications is low, they may be important thereby hindering intra management and post operative of the patients.

Adult↗
PubMed1995

Pancreatic islet GLUT2 glucose transporter mRNA and protein expression in humans with and without NIDDM.

GLUT2 glucose transporter mRNA has been shown to be underexpressed in pancreatic islets of numerous animal models of non-insulin-dependent diabetes mellitus (NIDDM). It has been proposed that this molecular defect contributes to the pathogenesis of diabetes, although information concerning the expression of GLUT2 in human pancreatic islet tissue is lacking. In contrast to the high abundance of GLUT2 in rat islets, human islets were found to express distinctly low levels of this glucose transporter mRNA and protein. Thus, a sensitive competitive reverse transcription-polymerase chain reaction assay was developed to quantify human GLUT2 mRNA. We obtained pancreases from 4 human organ donors with previously diagnosed NIDDM and 11 nondiabetic donors and found no significant differences in GLUT2 mRNA between the two groups. GLUT2 mRNA was 0.24 +/- 0.08 amol/micrograms RNA (mean +/- SE) in pancreases from humans with diabetes and 0.27 +/- 0.06 amol/microgram RNA in those without this diagnosis. Similarly, human pancreatic islet GLUT2 protein was measured by immunoblot and found to be present at similar levels in two individuals with diabetes relative to six control samples. These results thus demonstrate the existence of species differences in the abundance of islet GLUT2 mRNA and protein. Furthermore, the analysis of islet GLUT2 in a small sample of human organ donors with and without diabetes raises the possibility that decreased beta-cell GLUT2 may not represent a widespread feature of humans with NIDDM.

Base Sequence↗
PubMed1995

MR imaging and CT of central nervous system tuberculosis in the patient with AIDS.

CNS TB represents a disease that complicates AIDS with an increasing incidence in endemic areas as well as in developed countries in those patients who have some risk factors such as intravenous drug abuse. Although TB infection of the CNS in AIDS patients may follow a rapidly progressive course, the imaging findings otherwise are similar to those of the nonimmunosuppressed population. Meningeal enhancement, hydrocephalus, parenchymal granulomata, and infarcts are seen frequently and are often observed in combination with one another. Nevertheless, the differential diagnosis in AIDS patients must include other opportunistic infections and primary or metastatic lymphoma of the CNS. Spinal TB usually is seen in the form of epidural abscess secondary to tuberculous spondylitis, although it may be seen in isolation of spinal column involvement. The differential diagnosis includes spinal lymphoma or pyogenic abscess formation. Radiculomyelitis or isolated spinal cord tuberculomata are much less frequently observed and can be suspected on imaging only if there is concomitant evidence of the classic findings of intracranial TB.

AIDS-Related Opportunistic Infections↗
PubMed1994

Progressive supranuclear palsy and corticobasal ganglionic degeneration: differentiation by clinical features and neuroimaging techniques.

To assess the extent of overlap between clinically diagnosed patients with progressive supranuclear palsy (PSP) and corticobasal ganglionic degeneration (CBGD) we compared clinical scores for rigidity, bradykinesia, supranuclear gaze abnormalities, hemineglect and limb apraxia, postural instability, neck rigidity, and limb dystonia in 15 patients with a degenerative rigid-akinetic syndrome at presentation and at follow-up 3 to 120 months later. Only the presence of hemineglect, usually in combination with limb apraxia, was a reliable and early clinical factor for discriminating between these two conditions. These symptoms were present at admission in all 4 CBGD patients but not in any of the 11 PSP patients either at presentation or later during serial examinations. Though supranuclear ophthalmoplegia, neck rigidity, and postural instability were already observed in most CBGD patients at presentation, their scores remained low compared to those for PSP patients over the longterm. CT-scans and MRI were helpful in supporting clinically-based diagnoses made at presentation in that the vast majority of the PSP patients exhibited various degrees of midbrain atrophy and 50 percent of the CBGD patients exhibited asymmetric pericentral cortical atrophy.

Aged↗
PubMed1994

Once-a-month administration of intravenous pentamidine to patients infected with human immunodeficiency virus as prophylaxis for Pneumocystis carinii pneumonia.

We reviewed the charts of 52 patients infected with human immunodeficiency virus (HIV) who received at least three consecutive doses of intravenous pentamidine as prophylaxis for Pneumocystis carinii infections. Pentamidine isethionate was administered intravenously over 60-90 minutes once a month, at a dosage of 4 mg/kg, in 250 mL of 5% dextrose in water. During 387 months of administration of primary prophylaxis to 37 patients, no cases of P. carinii pneumonia were observed. During 200 months of administration of secondary prophylaxis to 15 patients, only one case of P. carinii pneumonia was diagnosed (6.0 cases per 100 patient-years). Side effects associated with the intravenous pentamidine were mild and did not necessitate withdrawal of the drug. Once-a-month administration of intravenous pentamidine is a valid alternative as prophylaxis for P. carinii pneumonia for patients who are intolerant of sulfonamides.

Adult↗
PubMed1993

Rapid identification of Triticeae genotypes from single seeds using the polymerase chain reaction.

An easy and quick protocol has been developed for DNA analysis via PCR. Single cereal endosperm or small leaf pieces can be separately processed in several PCR reactions. The resultant PCR patterns are equivalent to those obtained with standard DNA extraction protocols using either specific or random primers. Intra- and inter-specific variability can be detected. This method allows the analysis of a large number of individuals in early stages prior to the plant sowing.

DNA↗
PubMed1993

[Malignant fibrous histiocytoma of the pancreas].

Malignant fibrous histiocytoma (MFH), a frequent sarcoma in retroperitoneal mesenchimal tissues, has also been reported, although in a few cases, in digestive viscera. We present a case of a primary MFH of the pancreas in a 37-year-old male, treated with a 90% distal pancreatectomy, plus external and intraoperative radiotherapy over the tumoral bed, and polychemotherapy. Response to treatment was poor, with early local recurrence, liver and bone metastases and a survival of 7 months. Only 4 other cases of MFH of the pancreas have been reported. We analyze these 5 cases: they have been usually diagnosed in young adults, with vague symptoms and large tumoral masses without jaundice. Local recurrence seems to be frequent; they develop liver metastases rather than lung metastases. Even when they are resectable, the anatomical relations of the pancreas with vital vascular structures make broad resection difficult, and local recurrences frequent. Analysis of these five reported cases of MFH of the pancreas, allows to expect a local recurrence rate higher than 50% and a 5-year-survival rate lower than 30% due to distant metastases. Only radiotherapy seems to play a role as an adjuvant treatment after surgery for pancreas and other retroperitoneal sarcoma as it significantly increases survival.

Adult↗