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Biomedical subjects

C Navarro

Publications and source records attributed to C Navarro.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Unsuccessful pericardiocentesis for cardiac tamponade during angiocardiography with nonionic contrast material.

Cardiac tamponade secondary to ventricular wall perforation is one of the possible complications of right-sided as well as left-sided cardiac catheterization. Ventriculography was performed on a patient with obstructive cardiomyopathy using a nonionic contrast medium. During the procedure, the right ventricle was accidentally perforated and the patient developed cardiac tamponade. Pericardiocentesis was unsuccessful and surgical drainage was needed after the patient developed progressive hemodynamic deterioration. At surgery, pericardial thrombus was found. We consider the reason for failure of pericardiocentesis was rapid coagulation of the extravasated blood in connection with nonionic contrast material.

Aged↗
PubMedDate not supplied

Prevalence of germline mutations of hMLH1, hMSH2, hPMS1, hPMS2, and hMSH6 genes in 75 French kindreds with nonpolyposis colorectal cancer.

Hereditary nonpolyposis colorectal cancer (HNPCC) is a syndrome characterized by familial predisposition to colorectal carcinoma and extracolonic cancers of the gastrointestinal, urological, and female reproductive tracts. This dominant disorder is caused by germline defects in one of at least five DNA mismatch repair (MMR) genes: hMLH1, hMSH2, hPMS1, hPMS2, and hMSH6 (GTBP). Germline mutations of hMSH2 and hMLH1 are also frequently identified in families not fulfilling all the Amsterdam criteria, thereby demonstrating that the involvement of these genes is not confined to typical HNPCC. To evaluate the respective involvement of the various MMR genes in typical and incomplete HNPCC syndromes, we have performed an analysis of the hMLH1, hMSH2, hPMS1, hPMS2, and hMSH6 genes in a large series of French kindreds (n=75) with colorectal tumors and/or aggregation of extracolonic cancers belonging to the HNPCC spectrum. Mutational analysis has been performed in all families, without preselection for the tumor phenotype. We have detected 26 pathogenic germline mutations of the hMLH1 and hMSH2 genes and several novel variants of the hPMS1, hPMS2, and hMSH6 genes. Our data confirm that, regardless of the type of families and the tumor phenotype, hPMS1, hPMS2, and hMSH6 germline mutations are rare in familial aggregation of colorectal cancers. Furthermore, they suggest that the presence of multiple primary malignancies in a single individual and the observation of extracolonic tumors in relatives of a colorectal cancer patient should be included among the guidelines for referring patients for genetic testing.

Adaptor Proteins, Signal Transducing↗
PubMedDate not supplied

[Sociodemographic differences in adherence to the Mediterranean dietary pattern in Spanish populations].

OBJECTIVES: Lower social classes tend to eat a less healthy diet. The aim of this study was to compare adherence to the Mediterranean dietary pattern among different demographic and social groups in the adult population. METHODS: A cross-sectional study was performed in southern and northern regions of Spain in healthy volunteers (15,634 men and 25,812 women), aged 29-69 years, who were members of the European Prospective Investigation on Cancer cohort in Spain. Nine groups of food were included in the definition of the Mediterranean diet: vegetables and garden products, fruits, pulses, cereals, red meat, fish, olive oil, milk and milk products, and wine. Two techniques were used in the analysis: comparison of the mean daily intake of each group and calculation of an overall score for all the foods according to educational level and original social class. RESULTS: Groups with the lowest educational levels consumed more cereals and pulses and lower quantities of vegetables, olive oil (women), milk and milk products (men). Wine consumption was positively associated with education in women and was negatively associated in men. Calculation of a score to measure overall adherence to the Mediterranean dietary pattern eliminated differences according to each food category. No variations were found according to educational level, but small differences were found in original social class. The adherence score was lowest in young adults and women and was slightly higher in the south than in the north of Spain. CONCLUSIONS: The results suggest that the Mediterranean dietary pattern is fairly uniform, at least in the adult population of the regions included in this study.

Adult↗
PubMedDate not supplied

[Physical sports activity in a representative sample of the population of Región de Murcia, Spain].

OBJECTIVE: To estimate the prevalence of intense physical activity according to age and sex in the region of Murcia, Spain, and to analyze its association with major demographic and socioeconomic determinants and other cardiovascular risk factors. METHODS: Survey of a representative sample of the population aged between 18 and 65 years from Murcia was performed using multistage random sampling with definition of the sample quotas. A total of 3091 individuals were surveyed. The frequency and duration of intense physical sports activity during the two weeks prior to the survey was obtained using a validated questionnaire. Information was also collected on socioeconomic variables, smoking, blood pressure, weight and height and a blood test was performed to determine plasma lipids. Intense or vigorous physical activity (> or = 6 Metabolic Equivalents [MET]) was measured in kcal/day and reduced to hours/week to give three categories: no vigorous physical activity, less than 2 hours/week, and 2 hours/week or more. RESULTS: Overall, 17.8% (95% CI: 16.6-19.0) of the adult population of the region of Murcia performed intense physical activity for > or = 2 hours/week. The figures were twice as high in men (23.1%; 95% CI: 21.0-25.2) than in women (12.5%; 95% CI: 10.9-14.1). In the logistic regression analysis, a higher frequency of intense physical activity was associated with age, level of education and employment situation. In men it was also associated with occupation and residence in urban areas. CONCLUSIONS: During the study period, one in five adults in the region of Murcia took intense physical sports activity with a frequency and duration that were compatible with the prevention of episodes of coronary ischemia.

Adolescent↗
PubMedDate not supplied

Phase III randomized pilot study comparing interferon alpha-2b in combination with radiation therapy versus radiation therapy alone in patients with stage III-B carcinoma of the cervix.

This randomized pilot study was designed to determine whether the addition of interferon alpha-2b to standard radiation therapy offered an advantage in loco-regional control and survival over radiation therapy alone in a homogeneous group of patients with stage IIIB carcinoma of the cervix. Thirty-six patients were treated with a combination of interferon alpha-2b plus radiation therapy, and 38 patients were treated with radiation therapy alone. Patients with evidence of ureteral obstruction were excluded from the study. Evaluation of loco-regional response was determined by pelvic examination, cervical cytology, biopsies and CT scans when indicated. Survival time was measured from initiation of treatment to date of death or last follow-up. Patient characteristics were comparable between both study arms. The objective complete response rate was 67% in the combined therapy group and 55% in the radiation alone group (P = 0.454). With a median follow-up of 17 months for all patients and 31 months for live patients, 50% of the combined group survived vs. 39.5% of the radiation alone group (P = 0.424). We conclude that the addition of interferon alpha-2b to standard radiation therapy did not significantly improve loco-regional response or survival, although such a trend was noted. We encourage the design of a larger randomized study with sufficient power to detect meaningful differences to prove whether the tendency observed in the present investigation holds any promise to improve the outcome of these patients.

Adult↗
PubMedDate not supplied

Preoperative risk factors associated with mortality in lung biopsy patients with interstitial lung disease.

The objective of this study was to evaluate the risk factors associated with mortality in interstitial lung disease patients. We performed a retrospective study of 722 consecutive patients submitted for lung biopsy during the 1986-1990 period. Twenty-two (3%) died within the 30 days following surgery. Forty-four patients who survived after the surgery for the same time span were randomly chosen as control group. Dyspnea at rest was present in 18/44 of surviving group (SG) and in 18/22 of the nonsurviving group (NSG) (OR 6.5, 95% CI 1.8-22.4,p = .001). Systemic diseases (i.e., diabetes, systemic arterial hypertension)were mainly present in the NSG (OR 7.2, 95% CI 2.3-22.8, p < .001). The SG displayed significantly less respiratory insufficiency with a PaO2 of 52.2 + 8.4 versus 38.5 i 9.4 mm Hg, and PaCO2 of 28.8 i 4.5 versus 38.5 +/- 9.2 mm Hg, respectively (p < .001). Likewise, the SG exhibited a PaCO2/PaO2 ratio of 0.5 - 0.1, while in the NSG it was of 1 +/- 0.4 (p < .001), showing a sensitivity of 84% and specificity of 93% for mortality. Multiple logistic regression analysis for these variables showed that log likelihood was still significant for PaCO2 > 34 mm Hg, PaO2 <48 mm Hg, and comorbid diseases. Logistic regression analysis of these three variables showed the greatest sensitivity and specificity (84 and 750/0,respectively) for prediction of mortality. However, the strongest association was found when PaCO2/PaO2 ratio was analyzed alone (OR 21,073,CI 95% 28-15,946,357, p < .005). These data suggest that PaCO2/PaO2 ratio appears to be a predictor of mortality in this subset of patients. Its prospective use has reduced early mortality after surgery less than 1% in the last decade.

Adult↗
PubMedDate not supplied

[Dystrophin and dystrophin-associated proteins. Their evaluation at the neuromuscular pathology laboratory].

OBJECTIVE: To describe the main techniques used to detect skeletal muscle proteins and to discuss the results regarding the new classification of limb-girdle muscular dystrophies. MATERIAL AND METHODS: Over three hundred muscle biopsies with a suspected diagnosis of muscular dystrophy were immunostained for dystrophin, dystrophin-associated proteins, spectrin and utrophin. In one hundred and twenty of them, Western blot for different proteins was performed. RESULTS: Duchenne muscular dystrophy showed negative immunostaining and Western blot for dystrophin and dystrophin-associated proteins, and overexpression of utrophin. In Becker muscular dystrophy there is an abnormal dystrophin immunolabelling and molecular weight. Sarcoglycanopathies present decreased sarcoglycans and normal dystrophin. In some forms of congenital muscular dystrophy there is absence of merosin and alpha 2-laminin, with variable results on Western blot analysis. CONCLUSION: The immunohistochemical analysis of several cytoskeletal and transmembrane proteins as well as Western blot analysis, are necessary to elaborate a correct diagnosis of dystrophinopathies, sarcoglycanopathies and the different forms of congenital muscular dystrophy [REV NEUROL 1999; 28: 154-8].

Biopsy↗
PubMedDate not supplied

Vascular endothelial growth factor and hypertrophic osteoarthropathy.

OBJECTIVE: Hypertrophic osteoarthropathy (HOA) is characterized by the coexistence of digital clubbing and periosteal proliferation of the tubular bones. Localized vascular proliferation associated with platelet/endothelial cell activation are recognized features of this syndrome. Current knowledge suggests that HOA develops from the presence in the systemic circulation of one or more growth factors that are normally inactivated in the lungs. The nature of these purported growth factors has not yet been identified. Vascular endothelial growth factor (VEGF) has several features that may fit in with the pathogenesis of HOA. The objective of our study was to measure serum and plasma levels of VEGF in different groups of patients with HOA. METHODS: We studied 24 patients with HOA; of these, in 12 the HOA was secondary to cyanotic congenital heart disease and in 7 to lung cancer, while 5 represented primary cases. As controls we studied 28 individuals without HOA; of these, 12 were apparently healthy individuals, 7 had cyanosis secondary to chronic obstructive pulmonary disease, and 9 had lung cancer. ELISA was used to measure serum and plasma levels of VEGF. RESULTS: Plasma levels of VEGF were significantly higher in the patients with primary HOA (median 46.2; range 19.4-398.8 pg/ml) and in those with lung cancer-HOA (median 75.5; range 24.6-166.7), compared to healthy controls (median 7.4; range: 0-26.1), p < 0.05. Serum VEGF levels were higher in patients with lung cancer and HOA (median 411.4; range 164.2-959.5 pg/ml) compared with lung cancer patients without HOA (median 74.5; range 13.2-205.4), p < 0.001. CONCLUSIONS: Patients with primary HOA and those with HOA and lung cancer have increased circulating levels of VEGF. This cytokine may play a role in the pathogenesis of HOA.

Adult↗
PubMedDate not supplied

[Resistance to penicillin and other antimicrobials in 301 clinical isolates of Streptococcus pneumoniae].

BACKGROUND: The aim of this study was to assess the susceptibility to penicillin of Streptococcus pneumoniae clinical strains and to analyze the association between penicillin resistance and cefotaxime and cefixime activity in S. pneumoniae isolates with decreased sensitivity to penicillin. METHODS: 301 S. pneumoniae clinical strains were isolated from patients during 1995-1996. Susceptibility to penicillin, cefotaxime, cefepime, erythromycin, chloramphenicol, tetracycline, cotrimoxazole and ciprofloxacin were studied. RESULTS: 38.2% isolates were penicillin-susceptible and 61.8% were penicillin-resistant; 20.6% showed high-level resistance. Resistance rates to erythromycin, chloramphenicol, tetracycline, cotrimoxazole and ciprofloxacin were, respectively, 30.9, 30.2, 40.9, 66.4, and 13.3% overall, and 54.8, 54.8, 61.3, and 93.5% in the 62 strains with high-level resistance to penicillin. Strains resistant to cefotaxime and cefepime were 13.9 and 14.9%, respectively. MIC50 and MIC90 for cefotaxime and cefepime in penicillin-resistant strains were 0.5 and 1 mg/ml. CONCLUSIONS: A high proportion of S. pneumoniae isolates showed resistance to penicillin, in agreement with other Spanish reports. Moreover, resistance to penicillin was significantly associated (p < 0.001) with resistance to erythromycin, chloramphenicol, tetracycline and cotrimoxazole, but not with ciprofloxacin. MIC50 and MIC90 for cefotaxime and cefepime were similar, and lower than those for penicillin in penicillin-resistant pneumococci strains.

Adolescent↗