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Biomedical subjects

C Muñoz

Publications and source records attributed to C Muñoz.

At least 127 records · Page 7Linked to original sources
PubMed1995

[Abundant erythroblastic islands in bone marrow aspirate in a case of polycythemia vera. Various considerations on this anatomo-functional structure].

Despite the initial description, more than 30 years ago, of an erythroblastic island (EI), little is known about the mechanisms of union and interaction between the different cells of this anatomical and functional bone marrow structure. The observation of entire Els is extremely uncommon in normal bone marrow aspirates because of their dispersion during spread. A case report is described in which a 73-year-old woman, diagnosed 20 years ago with polycythaemia vera, showed multiple Els in a bone marrow aspirate. Their immunophenotyping revealed deficiency of several integrins. The ultrastructural study indicated a marked erythroblastic rophalocytosis. A hypothesis is suggested in view of these observations.

Aged↗
PubMed1995

[Evaluation of the E test method in the antimicrobial sensitivity of Neisseria meningitidis to penicillin].

BACKGROUND: The E test (AB Biodisk, Solna, Sweden) is a rather new method for performing antimicrobial susceptibility test--their results are generated directly as MICs. Due to its simplicity, is available in nearly all laboratories. The present study evaluates the effectiveness of the E test for susceptibility studies of Neisseria meningitidis to penicilline. METHODS: The MICs of penicilline of 55 strains of Neisseria meningitidis, studied by E test and by microdilution method, were compared to those obtained by agar dilution using both Mueller-Hinton (MH) and Mueller-Hinton with a 5% of sheep blood (MH+S) as test culture bases. RESULTS: The concordance rate (+/- 1 log2 of dilutions) was 100% in all cases, except for the E test on MH+S which yielded a 98.2% value. The Pearson's correlation coefficients were 0.95 and 0.84 for the E test and 0.88 and 0.85 for microdilution, using MH and MH+S. Roughly 70% of strains were considered susceptible to penicillin using MH for the in vitro tests, whereas only 40% of them were so considered using MH+S. CONCLUSIONS: The E test can be considered a good alternative to agar dilution method when testing susceptibility of N. meningitidis to penicilline, and MH is the best culture base for these assays.

Bacteriological Techniques↗
PubMed1995

[Retrograde cerebral perfusion during circulatory arrest with deep hypothermia. A new technique for brain protection in surgery of ascending aorta and aortic arch].

Between May 1993 and August 1994, 15 patients (10 men) with type A aortic dissection (9 acute) had a replacement of the ascending aorta and/or aortic arch with circulatory arrest with profound hypothermia and retrograde cerebral perfusion. Mean circulatory arrest time was 47.5 min (range 23 to 68 min). Three patients (20%) died in relation to postoperative bleeding. No patient had a new neurologic damage related to surgery. Ten patients were awake and oriented before 24 hours of the operation and another one before 48 hours; 4 patients required more than 48 hours to be completely awake and oriented. Two patients were operated on with a recent stroke. One of them recovered without sequelae before hospital discharge and the other one had a major regression of his brain damage. Two other patients had emergency surgery because of cardiac tamponade and cardiogenic shock. Both of them had a satisfactory recovery. Six patients presented azotemia but only 2 of them needed dialysis. There was no case of Q wave infarction nor congestive heart failure in the perioperative period. Follow-up was 100% completed (12 patients) with a mean of 9.8 months (range 5 to 18 months). One patient died on the 10th postoperative month because of a late infectious process. Eight patients are in functional class I and 3 in II. Ten of them are back to their usual activities'. Although retrograde cerebral perfusion is a new surgical technique, it seems to be a very valuable complement for brain protection in ascending aorta and/or aortic arch surgery with circulatory arrest with profound hypothermia.

Aged↗
PubMed1994

[The usefulness of different markers in the diagnosis of advanced HIV infection].

BACKGROUND: The aim of this study was to evaluate the usefulness of different markers to diagnose advanced infection by the human immunodeficiency virus (HIV) (AIDS or CD4 lymphocyte < 0.2 x 10(9)/L), establish the degree of correlation and define markers of advanced infection in primary health care. METHODS: Clinical, hematological, biochemical, cellular, serological and immunological variables were analyzed in 146 patients diagnosed for the first time with HIV infection. The patients were classified into three stages: A (II, III, CDC-1987), B (IV-A, IV-C2) and C or advanced (IV-C1, IV-D). The following data were compared: the results in the three stages, the degree of correlation, the specificity and sensitivity to the diagnosis of AIDS. Two multiple logistic regression models were established: the first for all the variables and the second for only those available in primary health care. RESULTS: All the markers except the triglycerides, IgG, IgM, and beta 2-microglobulin presented significant differences in the stages (p < 0.05). With the exception of the CD3+, CD4+ and CD8+ lymphocytes (r > or = 0.6 or -0.6) the remaining variables were independent. The decrease in CD4+ and the increase in neopterin were very sensitive markers (> 95%) but only hyperamylasemia demonstrated a specificity greater than 95% for the diagnosis of advanced infection. Oropharyngeal candidiasis (OR = 4.80) and the CD4+ lymphocyte (OR = 0.99) had the greatest weight in the first model. In the second model the most significant markers were weight loss (OR = 4.41), a decrease in lymphocytes (OR = 7.65) and an increase in IgA (OR = 5.82) with p < 0.01 and a predictive value of 85.16%. CONCLUSIONS: The presence of weight loss, lymphocyte count < 1 x 10(9)/L and an increase in IgA may be used in primary health care to diagnose advanced infection by the human immunodeficiency virus. Asymptomatic hyperamylasemia with no apparent cause suggests advanced infection.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Factors involved in the hypertensive patient non-compliance with treatment].

BACKGROUND: It is impossible to evaluate the therapeutic efficacy in hypertension without knowing the compliance of the treatment. The lack of compliance does not allow therapeutic efficacy to be achieved. This study evaluates possible factors involved in the non compliance of treatment in hypertensive patients and the characteristics defining the non compliant patient. METHODS: The control technique was tablet counting. The study was carried out in 157 hypertensive patients belonging to the Centro de Carrús (Elche-Alicante, Spain). RESULTS: 53.3% of the sample were shown to follow the therapy. 45.2% of patients not fulfilling the treatment believed that they were doing it correctly. Non compliance was found to be associated to the following factors: hypertensive patients of older age (p = 0.0054), low cultural level (p = 0.0027), bad knowledge of the disease (p = 0.0166), recent or lengthy knowledge of the disease (p = 0.00677), presence of other associated chronic diseases (p = 0.003), bad control of blood pressure (p = 0.0108), receiving more than two drugs for treatment (p = 0.0071), carrying out more than two medication intakes per day (p = 0.00309), saying that the diet is not well followed (p = 0.0187) and performing other associated pharmacologic treatments (p = 0.0024). CONCLUSIONS: Non compliance is a very frequent fact in patients with hypertension. Knowledge and evaluation of the factors involved in non compliance allows identification and intervention in patients who do not take the medication.

Adult↗
PubMed1994

Regulation of ICAM-3 (CD50) membrane expression on human neutrophils through a proteolytic shedding mechanism.

The regulation of the cell surface expression of ICAM-3 (CD50) was investigated in human neutrophils. Immunofluorescence flow cytometry analysis revealed a remarkable and very rapid down-regulation of the ICAM-3 cell surface expression upon neutrophil activation with stimulating agents such as phorbol myristate acetate (PMA) or calcium ionophore. A similar low expression of ICAM-3 was observed on neutrophils from patients undergoing hemodialysis with cell-activating cellulosic membranes. Internalization assays with 125I-labeled anti-ICAM-3 monoclonal antibody (mAb) suggested that ICAM-3-down-regulation was due to antigen release from the cell surface towards the outer milieu, rather than to antigen internalization. Immunoprecipitation studies confirmed this down-regulatory effect, and revealed the presence of ICAM-3 in cell-free supernatants from activated neutrophils. Furthermore, the presence of a soluble form of ICAM-3 with a range of concentrations of 0-296 ng/ml in the plasma from healthy human volunteers was detected by using a two-site mAb radioimmunoassay. A proteolytic mechanism likely accounts for this process since protease inhibitors virtually abrogated the PMA-induced down-regulation of ICAM-3. Functional studies showed that anti-ICAM-3 mAb were able to trigger homotypic neutrophil aggregation both before and after ICAM-3 down-regulation, indicating that the fraction of ICAM-3 molecules remaining on the neutrophil surface upon activation are still capable of sustaining cell adhesion. In contrast, the loss of L-selectin (CD62L) on activated neutrophils was almost complete, thus leading to an impairment of L-selectin-mediated neutrophil-endothelial cell adhesion. These results indicate that ICAM-3 is released to the medium upon neutrophil stimulation and that both ICAM-3 and L-selectin have a role in the neutrophil adhesive phenomena.

Antigens, CD↗
PubMed1994

Strict glycemic control in women with pregestational insulin-dependent diabetes mellitus.

OBJECTIVE: To determine the efficacy of strict glycemic control in women with pregestational insulin-dependent diabetes mellitus (IDDM). METHODS: The records of 62 pregnant women with pregestational IDDM who had attended the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Virgen de las Nieves General Hospital, Granada, Spain, between 1982 and 1992, were reviewed. The women had received several daily doses of a mixture of rapid action (regular) and intermediate action insulin with the aim of keeping preprandial glucose levels lower than 95 mg/dl and postprandial glucose levels lower than 120 mg/dl. Perinatal outcomes were compared with those of a control group consisting of 96 randomly selected, normal, pregnant women who gave birth at approximately the same time. RESULTS: Mean glycemic profile in the first assay at an insulin dose of 33.1 +/- 15.9 IU/day was 153.7 +/- 52.3 mg/dl and the HbA1c was 7.7 +/- 2.3%. In the last assay before delivery patients received an insulin dose of 68.2 +/- 30.7 IU/day and had a mean glycemic profile of 94.4 +/- 18.1 mg/dl and an HbA1c of 5.9 +/- 1.4% (P < 0.001 for all parameters). The perinatal mortality of newborn infants of the diabetic mothers was 48 per 1000, and 11.3 per 1000 had some congenital malformations. CONCLUSIONS: Our results verify that strict glycemic control decreases the elevated perinatal mortality normally suffered by IDDM patients. However, if it is to reduce the number of congenital malformations, it must be initiated before the early gestational stages.

Adult↗
PubMed1994

Genotoxic evaluation of eugenol using the bone marrow micronucleus assay.

Eugenol, a widely used chemical in clinical dentistry, was evaluated for genotoxicity using the bone marrow micronucleus (Mn) assay in mice. Three doses (100, 400 or 600 mg/kg) were administered intraperitoneally (i.p.). The animals were killed 30 h post-treatment and the frequency of Mn in 1000 polychromatic erythrocytes (PCE) was determined. Corn oil and methyl methanesulfonate (MMS) were used as negative and positive controls, respectively. Only 400 and 600 mg/kg doses showed significant induction of Mn. We also studied the effect of eugenol at different recovery times (24, 30 or 48 h) with a dose of 400 mg/kg. A positive Mn response was seen at all three post-treatment times, but the differences between them were not significant. For treatment and control groups, the cytotoxicity was in the normal range, measured as the ratio of PCE/NCE (normochromatic erythrocytes).

Animals↗
PubMed1994

Nested polymerase chain reaction for detection of Legionella pneumophila in water.

A highly sensitive nested polymerase chain reaction (PCR) method was evaluated for detection of Legionella pneumophila in water. Two sets of primers homologous to the coding region of the L. pneumophila macrophage infectivity potentiator (mip) gene were used. Even when starting from minute amounts of L. pneumophila DNA, the double PCR products were readily detected by direct visualization in ethidium-bromide-stained agarose gels. The method was tested on 34 potable water samples from a hospital building and compared with standard culture isolation. L. pneumophila was isolated in only twelve samples, whereas, by nested PCR, 19 samples were positive, 12 of them coincidental with culturing. These results indicate that nested PCR permits detection of L. pneumophila in samples where culturing fails, with the advantage of a rapid turnaround time, simplicity and the ability to detect non-culturable cells, fulfilling the requirements of sensitivity and specificity for routine use in an environmental laboratory.

Blotting, Southern↗
PubMed1994

Depressed immune response in malnourished rats correlates with increased thymic noradrenaline level.

Depressed immune response is well documented in protein-calorie malnutrition (PCM). Also, central and peripheral noradrenaline (NA) activities have been reported to be increased in malnourished animals. Since increases in central and peripheral NA may inhibit immune function, it is possible that malnutrition-induced immunodepression could be mediated by noradrenergic hyperactivity. To address this hypothesis the effect of malnutrition on cell-mediated immune response, as well as on NA levels of the median eminence, spleen and thymus was studied in PCM rats. Decreased lymphoproliferative response and IL-1 production by mononuclear macrophages was observed in PCM. Besides, increased NA concentration was detected in thymuses of PCM rats, while unchanged levels of this neurotransmitter were observed in median eminence and spleen. These data suggest a positive correlation between malnutrition-induced immunodepression and sympathetic noradrenergic activity in thymus, an organ implicated in immune cell differentiation during early development.

Animals↗
PubMed1994

Carbohydrate-lipid interactions during gestation and their control by insulin.

1. During the first two thirds of gestation, coinciding with a minimal accretion by the conceptus, the mother is in an anabolic state which is supported by her hyperphagia and the more efficient conservation of exogenous nutrients when she eats. During this phase maternal fat deposits are accumulated thanks to the enhancement in adipose tissue lipogenic and glycerologenic activity. In contrast, in the latter part of gestation, the rapid fetal growth is sustained by the intense transfer of nutrients from maternal circulation. 2. Glucose is quantitatively the most abundant of the several substrates that cross the placenta and despite increased maternal gluconeogenesis this transfer is responsible for the maternal tendency to hypoglycemia. This causes a switch to a net catabolic state which is especially evident in the net breakdown of fat depots. 3. Enhanced release of adipose tissue lipolytic products, free fatty acids (FFA) and glycerol, facilitates the liver synthesis of triglycerides and their later release into circulation associated to very low-density lipoprotein (VLDL). Glycerol is also used as an important gluconeogenic substrate and FFAs are broken down through beta-oxidation for ketone body synthesis. Flow through these pathways becomes increased when food is withheld and this actively contributes to the availability of fuels to the fetus which becomes partially preserved from maternal metabolic insult. Increased liver production of VLDL-triglycerides and decreased extrahepatic lipoprotein lipase contribute to exaggerated maternal hypertriglyceridemia which, besides being a floating metabolic reserve for emergency conditions such as starvation, constitutes an essential substrate for milk synthesis around parturition in preparation for lactation. 4. While the maternal anabolic tendencies found during the first two-thirds of gestation seem to be facilitated by hyperinsulinemia in the presence of a normal responsiveness to the hormone, it is proposed that most of the metabolic changes taking place during the last third of gestation seem to be caused by the insulin-resistant state which is consistently present at this stage, since its reversion caused by sustained exaggerated hyperinsulinemia also reverts several of these metabolic adaptations.

Adipose Tissue↗
PubMed1994

[Validity of epidemiologic criteria in the detection of hypertension].

We wish to find out the quality of the diagnostic test commonly used in epidemiological studies to detect hypertension, and in so doing, we study the validity of epidemiological criteria in the detection of hypertension (diagnostic test) and compare the diagnostic thresholds of the World Health Organization (WHO) and the Joint National Committee (JNC). Two methods of detection for arterial hypertension are used in this study of 674 people. One is population-based (mobile unit), and the other is opportunistic sampling. (systematic measurements of blood pressure in medical consultations). As a test of certainty, clinical confirmation is performed. The methodology of Haynes and Sackett is used in the validation study. The epidemiological criteria obtains a sensibility of 90.4 percent and a specificity of 94.4 percent with the diagnostic thresholds of WHO, and a sensibility of 97 percent and a specificity of 81.2 percent with those of JNC, which are defined as effective methods of screening in the detection of hypertension. The excess prevalence of HBP obtained using the diagnostic criteria of WHO is 4.5 percent (that is to say of 12.2 percent of the cases of hypertension found by the epidemiological criteria, that figure decreases to 7.7% percent with clinical confirmation). With the JNC criteria, it is 14.5 percent (from 34.1 percent, it goes to 19.6 percent). This excess can be used to adjust numbers found in epidemiological studies to their real values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗