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C Ortiz

Publications and source records attributed to C Ortiz.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Central venous catheter location by endocavitary ECG: an alternative to chest radiography].

BACKGROUND: The location of a central venous catheter is checked with a chest radiograph. Right endocavitary electrocardiography (ECG), a technique in which the catheter is connected to the ECG recorder wire to record ECG in DII, might be an alternate method to check the position of the catheter. When the catheter enters the right atrium, there is a large increase in the amplitude of P wave. The aim of this study was to compare the efficacy of endocavitary ECG against the chest radiography as a method to check the position of a central catheter, and to determine whether the ECG method can replace the radiological method. MATERIAL AND METHODS: One-hundred central catheters which location was checked by ECG and by chest X-ray entered the study. Efficacy of endocavitary ECG, delay between catheter insertion and radiological check, and the cost of the two methods were studied. RESULTS: Endocavitary ECG determined that de catheter was in a correct position in 80 cases and malpositioned in 20 cases. ECG check agreed with radiological check in 93 catheters. There were 4 false-positive and 3 false-negative cases. The efficacy of endocavitary ECG was 93% (sensitivity: 82%; specificity: 81%; positive predictive rate: 95%; negative predictive rate: 85%). Catheter location was checked immediately on insertion by ECG in all cases, while radiological check was delayed 32 +/- 25 min in the emergency department and 68 +/- 206 min in the admitted patients. The cost of the ECG method was less than that of the radiological method. CONCLUSIONS: The check of the position of a central venous catheter by endocavitary ECG is taster, cheaper, and of similar efficacy to the radiological method. Endocavitary ECG can replace chest X-rays to check the position of the catheter in more than 90% of cases.

Catheterization, Central Venous↗
PubMed1997

Role of ascorbate in the activation of NF-kappaB by tumour necrosis factor-alpha in T-cells.

The first product of ascorbate oxidation, the ascorbate free radical (AFR), acts in biological systems mainly as an oxidant, and through its role in the plasma membrane redox system exerts different effects on the cell. We have investigated the role of ascorbate, AFR and dehydroascorbate (DHA) in the activation of the NF-kappaB transcription factor in Jurkat T-cells stimulated by tumour necrosis factor-alpha (TNF-alpha). Here we show, by electrophoretic mobility shift assays, that ascorbate increases the binding of NF-kappaB to DNA in TNF-alpha-stimulated Jurkat cells. The ability of ascorbate to enhance cytoplasmic inhibitory IkBalpha protein degradation correlates completely with its capacity to induce NF-kappaB binding to DNA and to potentiate NF-kappaB-mediated transactivation of the HIV-1 long terminal repeat promoter in TNF-alpha-stimulated Jurkat cells but not in cells stimulated with PMA plus ionomycin. AFR behaves like ascorbate, while DHA and ascorbate phosphate do not affect TNF-alpha-mediated NF-kappaB activation. These results provide new evidence for a possible relationship between the activation of the electron-transport system at the plasma membrane by ascorbate or its free radical and redox-dependent gene transcription in T-cells.

Ascorbic Acid↗
PubMed1997

Greater incidence of hospitalized myocardial infarction among Mexican Americans than non-Hispanic whites. The Corpus Christi Heart Project, 1988-1992.

BACKGROUND: Since Mexican Americans have adverse patterns of risk factors for myocardial infarction relative to non-Hispanic whites, the incidence of myocardial infarction should be greater among Mexican Americans than among non-Hispanic whites. This expectation conflicts with reports generated from death certificate registries. METHODS AND RESULTS: Data regarding myocardial infarction attacks and incident events were collected for a 4-year period in the Corpus Christi Heart Project, a population-based surveillance project for hospitalized coronary heart disease events. For both women and men, Mexican Americans experienced greater hospitalization rates for both attacks and incident events than non-Hispanic whites. Age-adjusted attack rate ratios comparing Mexican Americans with non-Hispanic whites were 1.59 (95% CI, 1.05 to 2.41) and 1.31 (95% CI, 1.18 to 1.45) among women and men, respectively. Corresponding incidence ratios were 1.52 (95% CI, 1.28 to 1.80) and 1.25 (95% CI, 1.10 to 1.42). CONCLUSIONS: This is the first report documenting greater incidence of hospitalized myocardial infarction among Mexican Americans than among non-Hispanic whites, a biologically plausible finding given the risk factor patterns observed in the Mexican-American population. Public health planners and clinicians should be aware of the importance of myocardial infarction as a health problem in the Mexican-American population. Culturally appropriate prevention strategies should be developed for and tested in Mexican-American populations.

Adult↗
PubMed1997

Local cost sharing in Bamako Initiative systems in Benin and Guinea: assuring the financial viability of primary health care.

The fourth in a series of five, this article presents and analyses data on cost recovery and community cost-sharing, two key aspects of the Bamako Initiative which have been implemented in Benin and Guinea since 1986. The data come from approximately 400 health centres and result from the six-monthly monitoring sessions conducted from 1989 to 1993. Community involvement in the financing of local operating costs in the two national scale programmes is also described. In Benin and Guinea, a user fee system generates the community financed revenue with the aim of covering local operating costs including drugs. Health worker salaries remain the responsibility of the government and donor funding covers vaccine and investment costs. Village health committees manage and control resources and revenue. The community is also involved in decision making, strategy definition and quality control. In Benin in 1993, community financing revenue amounted to about US$0.6 per capita per year and generally covered all local recurrent non salary costs except vaccines and left a surplus. Although total costs and revenues were slightly lower in Guinea for the same period, over-all user fee revenue (around US$0.3 per capita per year) covered local recurrent costs (not including salaries or vaccines). A comparison of costs and revenue between regions and individual health centres revealed important differences in cost recovery ratios. In Benin, some centres recovered more than twice the local costs targeted for community financing. Twenty-five per cent of centres in Guinea did not manage to cover their designated local recurrent costs. The longitudinal analysis showed that the level of cost recovery remained stable over time even as preventive care (and especially EPI) coverage rose significantly. To better understand the most important characteristics affecting cost recovery levels, best performing health centres in terms of cost-recovery levels in 1993 were compared to worst performing centres. This analysis showed that the size of the target population of the health centre is a key determinant of cost-recovery in both countries. In addition, in Guinea the utilization of curative care linked to geographical access and in Benin the average revenue per case linked to the number of deliveries proved to be additional factors of importance. In best performing centres, financial viability improved over time in both countries between 1990 and 1993. Finally, the implications of these conclusions for the planning of health centre revitalization in West Africa are discussed.

Benin↗
PubMed1997

Affordability, cost-effectiveness and efficiency of primary health care: the Bamako Initiative experience in Benin and Guinea.

Since 1986 two West African countries, Benin and Guinea, have been actively reorganizing their peripheral health systems according to strategies subsequently called the "Bamako Initiative". Two preceding articles described the strategies implemented and the increased effectiveness of primary health care (PHC) witnessed over a period of six years. This article presents an analysis of cost and coverage data from biannual monitoring sessions between 1988 and 1993 in approximately 200 health centres in Benin and 214 in Guinea. In order to assess affordability, the total and per capita recurrent costs for operational health centres are analysed and then compared. The cost analysis reveals a mean total cost per health centre per year of slightly over US+11,000 in Benin and nearly US+9,000 in Guinea. The median cost per capita per year is approximately US+1.0 in Benin and between US+0.60 and US+0.80 in Guinea. Comparisons of these costs between regions, health centres and over time (as coverage levels evolved) show very little variation in either country. Cost-effectiveness is estimated by allocating these costs to immunization, antenatal and curative care and comparing them to the coverage achieved with these interventions. First, the cost-effectiveness of the Bamako Initiative (BI) system as a whole is analysed. The cost per fully vaccinated child is calculated at US+10.9 in Benin and US+8.8 in Guinea. The cost per woman receiving at least three antenatal visits is US+7 in Benin and US+4.7 in Guinea. For curative care, cost per full treatment is US+1.6 in Benin and half this amount in Guinea. Cost-effectiveness is variable between regions, health centres reveals that these differences in cost-effectiveness are mainly caused by the coverage levels achieved, since total costs are relatively stable. Finally the efficiency of drug management and prescriptions as well as of outreach for the expanded programme of immunizations (EPI) is estimated by relating specific drug and outreach activities costs to the number of beneficiaries. The average cost of drugs per treatment is around US+0.5 in Benin and around US+0.3 in Guinea. Cost analysis of outreach activities undertaken for EPI in Guinea revealed a similar average cost per child completely vaccinated for health centres with different intensities of outreach (approximately US+10) and an additional cost per child vaccinated attributable to outreach of US+1-2.

Benin↗
PubMed1997

Purification and characterization of a cytotoxin from Enterobacter cloacae.

Leukotoxic activity was assayed in clinical isolates of Enterobacter cloacae. Two strains were selected out of 38 by their greater hemolytic activity in blood agar plates. Leukotoxin was purified by salt precipitation, dialysis, chromatography by gel filtration, and high pressure liquid chromatography (HPLC). Human leukocytes, when incubated with purified E. cloacae toxin, showed high percentages of death and lysis, with time and dose dependence. The chromatographic profile of gel filtration presented three protein peaks and toxic activity was detected in the second peak. After HPLC, leukotoxin coeluted with the hemolytic activity and both activities were detected only after 2-mercaptoethanol treatment. Coomassie-stained sodium dodecyl sulfate--polyacrylamide gels showed a single band. This band was estimated to represent a protein of 13300 Da on the basis of both sodium dodecyl sulfate-polyacrylamide gel electrophoresis and gel filtration chromatography.

Bacterial Proteins↗
PubMed1996

Women and Mexican Americans receive fewer cardiovascular drugs following myocardial infarction than men and non-Hispanic whites: the Corpus Christi Heart Project, 1988-1990.

Mortality following myocardial infarction (MI) is greater among women than men and among Mexican Americans than non-Hispanic whites. Because therapy can affect mortality following MI, we examined differences in discharge therapy among these groups. Data regarding discharge therapy of 982 patients in the Corpus Christi Heart Project showed that women received fewer cardiovascular drugs than men, and Mexican Americans received fewer cardiovascular drugs than non-Hispanic whites. In multivariate analysis adjusting for age, cigarettes smoking, diabetes, hypertension, congestive heart failure, and serum cholesterol, the odds ratio for receipt of cardiovascular medications was 0.51 (95% CI: 0.28-0.93) for women versus men and 0.62 (0.3-1.15) for Mexican Americans versus non-Hispanic whites. Beta-blockers were prescribed rarely. Thus, treatment differences between ethnic and gender groups were observed following MI. Further research is needed to determine both the reasons for these differences and the extent to which these differences contribute to the observed survival patterns following MI.

Adult↗
PubMed1996

Bacteremia due to Acinetobacter baumannii: epidemiology, clinical findings, and prognostic features.

The number of nosocomial infections caused by Acinetobacter baumannii has increased in recent years. During a 12-month study, there were 1.8 episodes of A. Baumannii bacteremia per 1,000 adults admitted to a hospital in Seville, Spain. Seventy-nine patients were included in the study. A. baumannii bacteremia occurred after a mean (+/- SD) hospitalization of 18 +/- 20 days. In all cases the infections were acquired nosocomially; 71% wee acquired in intensive care units. Ampicillin/ sulbactam was found to be the most active agent against A. baumannii. The common source of the bacteremia was the respiratory tract (32 cases [71%]). Twenty patients (25%) had septic shock, and 24 (30%) had disseminated intravascular coagulation (DIC). Treatment with imipenem or ampicillin/sulbactam was most effective (cure rates, 87.5% and 83%, respectively). The deaths of 27 patients (34%) were related to A baumannii bacteremia. The presence of DIC (odds ratio [OR] = 116.4; P < .0001) and inappropriate antimicrobial treatment (OR = 15.2; P < .01) were independently associated with mortality. We conclude that most A. baumannii isolates are multiresistant and that nosocomial A. baumannii bacteremia may cause severe clinical disease that is associated with a high mortality.

Acinetobacter↗
PubMed1996

Childcare needs of female street vendors in Mexico City.

This article reports on strategies developed by female street vendors (vendedoras ambulantes) in Mexico City to ensure the care of their young children in the absence of a specific and operational government policy to fulfil this need. The information concerning child care and health was gathered by a survey of 426 street traders selected by multi-stage random cluster sampling in four of the administrative districts (delegaciones politicas) of Mexico City during 1990. It was found that, as mothers of young children, street vendors most frequently looked after their children personally on the street or left them with other members of the family. Related factors were availability of alternative child care providers in the family, the age of the children and working conditions of the mother. Children who remained on the streets with their mothers suffered more frequently from gastro-intestinal diseases and accidents than the national average. The incidence of acute respiratory diseases, however, was similar in the cases of maternal care in the street and care by family members in another environment. Existing public health measures show a greater concern for the health of food consumers than that of workers in this area. Current public policy seeks to regulate street vending activities and to concentrate traders in ad hoc areas and facilities. Our research results document the need for actions that can contribute to an improvement in the care and health conditions of these young children.

Child Care↗
PubMed1995

[Advances and challenges in health economics].

Health economics is a specialized field of economic science that applies the economic perspective to the fields of health, the medical-industrial complex and health services. A brief review of the evolution of this speciality by subject, as well as the level achieved assessed in terms of generation, diffusion, reproduction and application of its specialized knowledge, is presented.

Economics↗
PubMed1994

[Teaching of health economics in Mexico: 5-year experience].

Teaching strategies for a new specialty constitute a challenge to ensure the rapid development of human resources for the purpose of supporting these activities. In the health economics field a plan was applied for coping with the needs of teaching activities in the field. The activities developed in the plan are presented in this paper, included under the following items: A. Theoretical organization of the contents of the subject. B. Organization of contents according to the students' needs. C. Support given to teachers. D. The whole strategy also includes: academic interchange, technical advisory services, dissemination of results through meetings, publications and academic organizations. E. Median term agenda: Human resources; Financial resources; Teaching strategies; Interaction between health services and decision makers; and Collaborative network.

Curriculum↗
PubMed1994

'Double-head' antlers in red deer Cervus elaphus ssp. in which the antler cores survived the death of the cortex.

An unusual case of spike antlers in male red deer is described in which the antler core apparently survived the partial mineralization of the cortex in the first rut and then in the next year supported a new, "antleroma-like" growth. On one side of the antler beam a "separation gap" developed between the living core and the dead cortex. On the opposite side a new growth of antler tissue was observed; this was made of spongious bone which in some areas partially resembled peruke-like growth and in others resembled antler "pearls". This new tissue, which developed probably in the second antler cycle, grew in the right antler from the base to the apex but in the left antler it was limited to the lower portion of the beam. This new tissue might still have been covered with velvet when the deer was shot. It is speculated that hypoandrogenism or partial lack of testosterone receptors was responsible for the survival of the antler core and the subsequent proliferation of new antler tissue in the following year.

Androgens↗
PubMed1992

Glucosylenamines as glycosyl acceptors: synthesis of gentiobiosylenamines.

The preparation of 2,3,4-tri-O-benzyl- (3), 2,3,4-tri-O-acetyl- (4), and 2,3,4-tri-O-benzoyl-N-(2,2-diethoxycarbonylvinyl)-6-O-trityl-beta- D-glucopyranosylamine (5) is described. The reaction of 3-5 with 2,3,4,6-tetra-O-acetyl-alpha-D-glucopyranosyl bromide yields 2,3,4-tri-O-benzyl- (9), 2,3,4-tri-O-acetyl- (10), and 2,3,4-tri-O-benzoyl-N-(2,2-diethoxycarbonylvinyl)-6-O-(2,3,4,6-tet ra-O- acetyl-beta-D-glucopyranosyl)-beta-D-glucopyranosylamine (11), respectively. 2,3,4-Tri-O-benzyl- (6), 2,3,4-tri-O-acetyl- (7), and 2,3,4-tri-O- benzoyl-N-(2,2-diethoxycarbonylvinyl)-beta-D-glucopyranosylamine (8) are also described.

Carbohydrate Sequence↗
PubMed1992

[Risk factors for the heterosexual transmission of HIV from man to woman: a Spanish multicenter study].

BACKGROUND: The aims of this study were to estimate the rate of heterosexual transmission of HIV in a population of intravenous drug users (IVDU), as to well as to identify the possible risk factors associated. METHODS: One hundred thirty heterosexual couples were analyzed in which the male was seropositive for the human immunodeficiency virus (HIV) with the only possible risk factor for the companion being the sexual intercourse with the case index. RESULTS: The rate of global transmission estimated was 16% (confidence interval of 95% = 10-22.4%). The risk factors significantly associated to HIV transmission were: case index of over 30 years of age (OR = 3.1), clinical status IV (OR = 4.1), less than 0.8 x 10(8) lymphocytes/I (OR = 7), antecedents of sexually transmitted disease (STD) in the woman (OR = 4), and the practice of anal intercourse (OR = 3.1). In the multivariate analysis only the clinical status of the case index and the STC antecedents of the woman were statistically significant (p less than 0.05). CONCLUSIONS: In this study some of the classical risk factors for the heterosexual transmission of HIV have been confirmed, and the importance of decreasing the prevalence of STD in the IVDU collective in Spain has been corroborated to lower heterosexual transmission and, indirectly the vertical transmission of AIDS.

Chi-Square Distribution↗
PubMed1992

Improved detection of antibodies to hepatitis C virus in dialysis patients using a second-generation enzyme immunoassay.

We tested serum samples from 99 patients undergoing maintenance hemodialysis for hepatitis C virus (HCV) antibodies using a first-generation, licensed anti-HCV enzyme immunoassay (EIA) and a second-generation anti-HCV EIA that detect three gene products c100-3, NS3, and core. Specimens that were repeatedly reactive by either or both screening assays were further evaluated by testing with supplemental EIAs and a dot blot immunoassay. There was 87.9% agreement between the licensed HCV EIA and the HCV EIA second generation. HCV EIA Second Generation detected 10 more positive specimens than HCV EIA, for an increase in detection from 33.3% (33/99) to 43.4% (43/99). We conclude that HCV EIA Second Generation improves detection of HCV infection in hemodialysis patients.

Adult↗
PubMed1992

Isolation and identification of xochitloldione and isoxochitlolone from Cnidosculus urens.

Major components of MeOH extracts from the plant roots of Cnidosculus urens purified by cc and tlc and crystallization were lupeol acetate and the previously unreported compounds isoxochitlolone [1] and xochitloldione [2], which were identified through mass, ir, nmr, and uv spectroscopy and X-ray crystallography. In preliminary testing, isoxochitlolone has been found to be active against Escherichia coli and Staphylococcus aureus.

Anti-Bacterial Agents↗