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Biomedical subjects

C Rey

Publications and source records attributed to C Rey.

At least 181 records · Page 10Linked to original sources
PubMed1995

Prevalence of infection by human T-cell leukemia virus types I and II in southern Spain.

To assess the spread of human T-cell leukemia virus (HTLV) type I and II in different population groups at potential risk of infection in Spain, a total of 756 subjects were studied: 453 belonging to groups at risk for retrovirus infection, 255 with diseases potentially linked to HTLV-I/II infection and 48 immigrants from endemic areas. An HTLV-I viral-lysate enzyme immunoassay (EIA) with a recombinant transmembrane envelope protein incorporated was used to screen serum samples. Reactive specimens were confirmed by Western blot strips spiked with recombinant proteins that differentiated HTLV-I from HTLV-II. Infection was then verified by the polymerase chain reaction (PCR). Serum samples from 19 of the 756 subjects analyzed (2.5%) were reactive for HTLV by EIA. One of these was from an intravenous drug user (IVDU) in whom HTLV-II infection was confirmed by Western blot and PCR; a specimen from another IVDU showed Western blot reactivity for both retroviruses, but PCR results were negative. Lastly, Western blot confirmed the presence of HTLV in one of the immigrant subjects. Western blot did not verify HTLV infection in the remaining 16 cases, indicating a high rate of nonspecific anti-HTLV reactivity when a second-generation EIA screening test was applied. These results suggest that HTLV is present in Spain among populations at high risk for HTLV, although at a very low rate and restricted to intravenous drug users and individuals immigrating from endemic areas.

Blotting, Western↗
PubMed1995

Emergence and clinical relevance of mutations associated with zidovudine resistance in asymptomatic HIV-1 infected patients.

The dynamics leading to the emergence of a zidovudine-resistant mutation at codon 215 of the reverse transcriptase coding region was investigated in a cohort of HIV-infected individuals who received early zidovudine therapy. Clinical implications and the role of the resistance mutation at codon 41 were also assessed. Thirty-eight initially asymptomatic HIV-infected patients with a CD4+ cell count above 400 cells/mm3 were followed for a mean period of 121 weeks (20 received zidovudine and 18 matching placebo). Specific mutations in the HIV-1 reverse transcriptase coding region conferring resistance to zidovudine were detected using a selective polymerase chain reaction. During the follow-up period a mutation at codon 215 was detected in eight (40%) of the individuals in the zidovudine group, and in two of these eight subjects, a mutation at codon 41 was found. During the study, disease progression occurred in seven of the eight (88%) patients with a mutation at codon 215, compared with 7 of 18 (39%) patients assigned to the placebo group and 3 of the 12 (25%) patients receiving zidovudine treatment who did not develop a 215-mutant strain (p < 0.05). At entry, none of the patients harbored MT-2 tropic virus. Therefore, the emergence of a zidovudine-resistant mutation at codon 215 is associated with subsequent disease progression in asymptomatic HIV-infected patients who receive zidovudine monotherapy. This association suggests that the mutation at codon 215 is involved in a loss of therapeutic efficacy and, therefore, patients should be monitored during treatment with zidovudine.

Adult↗
PubMed1995

Association between hepatitis C virus seroreactivity and HIV infection in non-intravenous drug abusing prostitutes.

Two hundred and ninety-four non-transfused prostitutes from Spain, who denied intravenous drug abuse, were tested for hepatitis C virus (HCV) antibodies. Seventeen (5.78%) of them were seropositive. Both in univariate and correspondence analyses, serological results for hepatitis C were associated with the HIV-1 serostatus (p < 0.001), number of sex partners (p < 0.05) and a history of genital ulcers (p < 0.05). In logistic regression analysis, hepatitis C seropositivity was associated only with HIV-1 infection (adjusted odds ratio = 13.6; 95% confidence interval = 3.3-55.2). These results show that hepatitis C seropositivity is associated with HIV-1 infection in female non-intravenous drug abusing prostitutes. These findings are also consistent with the hypothesis that HCV can be sexually transmitted with low efficiency.

Adult↗
PubMed1995

[Scimitar syndrome with anatomical or functional absence of the right pulmonary artery. Apropos of 4 cases].

BACKGROUND: Scimitar syndrome is characterized by an anomalous pulmonary vein draining into the inferior vena cava and visible roentgenographically as a crescentic shadow of vascular density along the right border of the cardiac silhouette. The aim of this study is to report four cases associated with anatomical or functional absence of the right pulmonary artery. CASE REPORTS: Diagnosis of scimitar syndrome had been made in 4 patients aged 3, 10, 23 and 33 years. Pulmonary scintigraphy and/or CT scan detected the scimitar syndrome and the type of pulmonary and systemic vascularization. In all cases, the vascularization of the right lung did not originate from the pulmonary artery trunk but was supplied by systemic vessels arising from the abdominal aorta. The right pulmonary artery was vascularized a retro, against the stream, by the systemic vessels (two cases); alternatively, circulation into the right pulmonary artery resulted directly from the systemic vessels, this pulmonary artery being anatomically absent (two cases). Pulmonary arterial pressures were normal in all four cases and functional tolerance was good in three cases; repeated and severe hemoptysis required right pneumonectomy in the last patient. CONCLUSIONS: These four cases are compared to six other similar cases in the literature. Elegant and non invasive methods are now disposable to detect such a syndrome and to assess the type of pulmonary vascularization.

Child↗
PubMed1995

[Judicial and administrative consequences of reporting of adolescents in danger].

Adolescent victims of abuse or neglect are regularly reported to social agencies and legal authorities. However, decisions following reports often remain unknown, leaving the question of the reporting's relevance open. POPULATION AND METHODS--Forty-one consecutive written reports sent to child protective services were reviewed, and their content analysed. These services were then contacted by telephone, in order to gather information on outcome. RESULTS--Forty-one reports concerned 40 adolescents (32 girls, 8 boys); 36 of whom had been admitted to our adolescent medicine ward. The most common reason for admission was a suicide attempt (20 cases). Thirty-nine reports were destined to legal authorities, while two to social agencies. The reason for reporting was physical or sexual abuse in more than half of the cases. In twenty-five cases, the main request was a separation from the family. Eighteen adolescents were lost from our medical follow-up after reporting. Thirty-two reports to legal authorities had led to a hearing by a juvenile judge answered favorably in two-thirds of the cases, after a mean period of 26 days. All the subjects for whom a separation from the family was not requested in the report remained at home. CONCLUSION--A simple telephone call is enough to gather information about the following of reports and enables an evaluation of the relevancy of its requests. The interface between the health care and legal systems needs improving through better coordination. Pediatricians should be leaders in this field.

Adolescent↗
PubMed1995

[Acute liver failure caused by paracetamol: should treatment with N-acetylcysteine be prolonged?].

BACKGROUND: Some cases of paracetamol-induced acute hepatic failure may require liver transplantation but the present shortage of graft urges the search for an alternate therapeutic approach. CASE REPORT: A 17 year-old girl was admitted for sleepingness and vomiting after about 15 hours of voluntary but denied absorption of paracetamol. Plasma paracetamol concentration was 120 mg/l; factors VII+X level were 55% and factor V 106%. The patient was given IV N-acetylcysteine, 150 mg/kg/30 min, then 50 mg/kg/4 hours. Further decrease in facteur VII level led to pursue administration of N-acetylcysteine (total dose: 350 mg/kg/2 hours). While indication of liver transplantation was considered, clinical and laboratory findings definitely improved. CONCLUSIONS: N-acetylcysteine may be effective even if administered late. Repeated determination of factor VII could be a good means for managing such a severe condition.

Acetaminophen↗
PubMed1995

[Therapeutic compliance in adolescents with chronic disease].

In clinical practice, non-compliance is an often unrecognised or frustrating reality, which physicians find difficult to accept or deal with. Possible determinants of adolescents' level of compliance may be divided into demographic factors, patient and family characteristics, aspects of the illness and treatment regimen, and quality of the patient-doctor relationship. Compliance should be viewed as a reflexion of the experience of chronic illness as well as the expression of specific adolescent developmental issues. Practical guidelines are proposed.

Adolescent↗
PubMed1995

[Acute gastric dilatation with superior mesenteric artery syndrome in a young girl with anorexia nervosa].

BACKGROUND: Acute gastric dilatation is a rare complication of anorexia nervosa which may be fatal in case of gastric perforation. Superior mesenteric artery syndrome may be associated with gastric dilatation. CASE REPORT: A 14 year-old girl was admitted suffering from severe anorexia nervosa. Shortly after admission, she complained of abdominal pain related to a bulimic episode a few days before, followed by nausea and vomiting. Distended abdomen and tachycardia suggested acute small-bowel obstruction. A diagnosis of acute gastric dilatation with superior mesenteric artery syndrome was suspected on X-ray examination and confirmed by esophagogastrography after gastric evacuation. The patient improved rapidly under total parenteral nutrition. Upper gastrointestinal study repeated 10 days later showed normal stomach. CONCLUSIONS: Small-bowel obstruction in anorexia nervosa first evokes acute gastric dilatation, and a perforation has to be ruled out by esophagogastrography. Association with superior mesenteric artery syndrome is possible; it does not necessarily lead to surgery.

Acute Disease↗
PubMed1995

Hydroxyl groups in bone mineral.

The question of whether the apatite crystals of bone contain hydroxyl groups was explored using magic angle spinning, proton nuclear magnetic resonance spectroscopy, and resolution enhanced Fourier transform infrared spectroscopy. The powdered bone samples were heated at 300 degrees C in air, in CO2 at 4 bar atmosphere, and at 300 degrees C in air and subsequently at 300 degrees C in CO2, to eliminate the effects of water tightly bound to the crystals and to prevent the degradation of carbonate groups and the elimination of potentially present OH groups. Results confirm earlier findings that bone apatite crystals do not contain detectable amounts of hydroxyl ions.

Animals↗
PubMed1995

Metabolism of alpha-ketoisocaproic acid in isolated perfused liver of cirrhotic rats.

To determine the hepatic fate of alpha-ketoisocaproate (KIC) in cirrhosis, six groups of isolated rat livers were perfused with 0, 0.5, 1 (with or without alpha-[1-14C]KIC), 2, and 5 mM KIC; control livers from healthy rats were studied in parallel under similar conditions. KIC was rapidly removed by the normal livers, whereas uptake was lower in the cirrhotic livers at all concentrations tested (at 2 mM, 4.04 +/- 0.33 vs. 6.32 +/- 0.58 mumol/min; P < or = 0.05). The transamination pathway, evaluated by leucine exchanges, was more important in the cirrhotic livers (25.4 vs. 6.8% in controls at 2 mM). The incorporation of alpha-[1-14C]KIC in proteins of cirrhotic liver was increased compared with controls (0.25 +/- 0.04% of alpha-[1-14C]KIC was incorporated in proteins excreted in perfusate vs. 0.20 +/- 0.04 in controls; P < or = 0.05). In addition, a line of evidence suggests that glutamine rather than glutamate is the N donor for leucine synthesis from KIC. The decarboxylation pathway evaluated by beta-hydroxybutyrate production and by 14CO2 release from alpha-[1-14C]KIC was reduced, respectively, by 40-85% (according to KIC dose) and by 24% at 90 min in cirrhotic livers compared with healthy livers. These results indicate a dramatic modification of KIC metabolism in the cirrhotic liver; its uptake by the liver is decreased and its incorporation into proteins is increased via an enhancement of transamination to leucine, probably as a consequence of an inhibition of branched-chain keto acid dehydrogenase.

Animals↗
PubMed1995

Renin, kallikrein and prostaglandin renal systems in normotensive boys with and without a family history of essential hypertension.

BACKGROUND: The role of the kidney in the development of essential hypertension is subject of debate. METHODS: We compared the renin, kallikrein and prostaglandin renal systems in two groups of normotensive boys, aged 7-16 years, with different degrees of risk for future hypertension: 27 had parents with essential hypertension and 12 had normotensive parents. Supine, standing and post-exercise plasma renin activity as well as levels of urinary kallikrein and prostaglandin E2 before and after exercise were measured. RESULTS: The ratio of post-exercise plasma renin activity (ng/ml/h) to 24 h urinary sodium excretion (mEq/kg/day) was lower in children with hypertensive parents (mean +/- SEM 1.86 +/- 0.24 compared with 3.62 +/- 0.94, P = 0.02). The boys with hypertensive parents had a lower ratio of urinary kallikrein to creatinine before (0.70 +/- 0.13 compared with 1.54 +/- 0.36, P = 0.01) and after exercise (0.80 +/- 0.13 compared with 1.35 +/- 0.23, P = 0.03). The ratio of urinary prostaglandin E2 to creatinine levels did not differ between the groups before or after exercise. CONCLUSION: The plasma renin activity response to exercise and urinary kallikrein excretion were decreased in boys at increased risk of future essential hypertension. These early abnormalities in the renin and kallikrein renal systems may be associated with the development of essential hypertension.

Adolescent↗
PubMed1995

[The efficacy of iodine prophylaxis in the prevention of endemic goiter in the southwestern area of Asturias].

The aim of the present work was to assess the prevalence of the endemic goiter in Asturias southwestern area (46,000 inhabitants; 6,638 in school age), after 10 years of iodized salt introduction in diet. 317 schooling children were randomly chosen (stratified by age, sex and geographic area). We evaluated thyroid gland size and urinary iodine excretion (microgram of iodine per gram of creatinine = I/C). Previously, studies of infantile population suggested a 63% of prevalence. Our results indicate a decrease to 16.4% of endemic goiter prevalence. Nevertheless, the success of iodine prophylaxis was heterogeneous and not good in some case: point out Ibias population with a prevalence of 48.5% (2,000 inhabitants and 353 in schooling). Remainder population was prevalences between 6.9% and 19.8%. The mean of urinary iodine excretion increased to I/C = 106 (previously I/C = 53). The smallest index I/C become to Ibias population = 78. (p < 0.01 and p < 0.05 with regard to Cangas del Narcea and Tineo population respectively). Only 2 of the 52 cases of goiter were hypothyroidism (but because of autoimmune thyroiditis). We conclude that iodine prophylaxis with salt was effective generally, in order to diminish the endemic goiter in the area.

Adolescent↗
PubMed1995

[Agenesis of the pulmonary valves. Experience over 20 years].

Absent pulmonary valve is a rare cardiac malformation, usually associated with a tetralogy of Fallot. It features aneurysmal dilatation of the pulmonary arteries which may compress the bronchial tree and lead to respiratory distress. The experience of our group over a 20 year period (20 patients) is reported. The diagnosis was usually made in the neonatal period in the presence of cardiomegaly and a systolic and diastolic murmur at the left sternal border. The diagnosis was made at antenatal echocardiography in 2 cases. Ten patients were not operated and 4 of them died in the neonatal period of respiratory distress and 2 others of extracardiac causes. Three children are on the waiting list for surgical correction and the remaining child is asymptomatic. The other 10 cases were operated with a minimum closure of the ventricular septal defect and widening of the pulmonary tract. The latter procedure was performed with an infundibulo-pulmonary patch (6 cases) and insertion of a pulmonary valve (4 patients) (monocusp patch in 3 cases, pulmonary heterograft in one case). Eight patients underwent a reduction procedure of the pulmonary arteries to relieve branchial compression. Of those who were operated, two died during follow-up: the first of complete atrioventricular block and the second of infectious endocarditis of the stenosed pulmonary heterograft. These results show that reduction procedures of the pulmonary arteries are promising approaches which should improve the future prognosis of young patients with respiratory distress. The need for insertion of a pulmonary valve remains debatable.

Aneurysm↗
PubMed1995

[Transposition of great vessels with position anomaly of the atrioventricular valves or chordae: echocardiographic aspects and surgical correlations].

The authors report the echocardiographic appearances of 27 cases of transposition of the great arteries (TGA) with ventricular septal defect (VSD) (including the Taussig-Bing malformation) complicated by displacement of one or both atrioventricular valves and/or chordae tendinae diagnosed between September 1985 and September 1994. An anatomical repair was performed in 21 cases and allowed accurate correlation of the echocardiographic and peroperative findings; a cavo-bipulmonary conduit or a palliative procedure was performed in 6 cases. The cases were classified in 3 groups: group I: 16 children with isolated tricuspid valve abnormalities; group II: 7 cases of mitral valve straddling; group III: 4 cases of displacement of both atrioventricular valves and/or their chordae. The cases of group I were divided into 3 subgroups: subgroup Ia with insertion of the tricuspid chordae on the infundibular septum (7 cases); subgroup Ib with isolated overriding of the tricuspid valve (2 cases); subgroup Ic straddling with or without overriding of the tricuspid valve (7 cases). In all three groups, there were 10 cases of straddling of the tricuspid and 11 cases of straddling of the mitral valve: 9 type A, 3 type B and 9 type C of Tabry's classification. Echocardiography misdiagnosed one case of type A straddling of the tricuspid valve for a type A overriding and straddling of the mitral valve. The ventricular septal defect was situated in the admission septum in the 10 cases of straddling of the tricuspid; in the 11 cases of straddling of the mitral valve the chordae passed through the superior anterior part of the interventricular septum.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1995

Preoperative evaluation of the probability of common bile duct stones. French Association for Surgical Research.

BACKGROUND: This study was done to determine if certain criteria could predict the presence of common bile duct stones in patients with symptomatic gallstones. It was hoped that patients could be identified in whom intraoperative cholangiography was unnecessary. STUDY DESIGN: One hundred seventy-five patients, from 15 surgical centers, were prospectively enrolled. For each patient, the preoperative score (Huguier score) previously published was calculated according to clinical and ultrasound data: age, diameter of the common bile duct, diameter of the smallest gallstone, history of biliary colic, and acute cholecystitis. All patients underwent an open cholecystectomy and an intraoperative cholangiography. The absence or presence of a common bile duct stone was evaluated during the operation, if necessary, after an instrumental investigation of the common bile duct. RESULTS: Ultrasound was not interpretable in eight (5 percent) of 175 patients. Final analysis was made from the charts of the 167 remaining patients. Thirty (18 percent) had common bile duct stones. When the score was equal to or greater than 3.5, the risk of having a common bile duct stone was 24 percent (27 of 111). When the score was less than 3.5, this risk was 5 percent (three of 56). CONCLUSIONS: Huguier's score is well assessed and can be safely used. Intraoperative cholangiography could be avoided in 33 percent of patients when the score is less than 3.5 (56 of 167).

Age Factors↗
PubMed1994

A unique protonated phosphate group in bone mineral not present in synthetic calcium phosphates. Identification by phosphorus-31 solid state NMR spectroscopy.

The detailed chemical composition and microstructure of freshly deposited bone mineral, and how these properties change with maturation of the mineral, have been studied intensively and still remain controversial. For example, current analytical technology is inadequate for the unambiguous characterization of the monohydrogen phosphate ions in bone mineral. Using a differential cross polarization/magic angle spinning solid state nuclear magnetic resonance spectroscopy technique, we suppress the dominant orthophosphate (PO4-3) signal to reveal the spectra of the minor phosphate constituents. This method depends upon differences in the cross polarization time constants for phosphorus-31 nuclei in protonated and non-protonated phosphate ions. It is now possible for the first time to directly measure both the proportion of acid phosphate (HPO4-2) as well as the parameters which characterize its isotropic and anisotropic chemical shift. In bone from three species at several developmental stages, we have found a single type of acid phosphate species, identical in all of the specimens examined. The phosphorus-31 isotropic chemical shift of this acid phosphate group in bone mineral corresponds precisely with that of acid phosphate in octacalcium phosphate, and not with that of brushite. In contrast, the bone acid phosphate anisotropic chemical shift parameters are close to those of brushite, and differ significantly from those of octacalcium phosphate. The orthophosphate resonances of bone mineral, synthetic hydroxyapatite and synthetic octacalcium phosphate share identical chemical isotropic shifts, and similar chemical shift anisotropies. The implication of these results is that the intimate structure of the acid phosphate group in bone mineral is unique, and that none of the common synthetic calcium phosphates accounts well for all of the observed solid state phosphorus-31 NMR properties of bone mineral.

Animals↗
PubMed1994

Purification and characterization of glutathione peroxidase from human blood platelets. Age-related changes in the enzyme.

Platelet glutathione peroxidase (GPx) is known to play a pivotal role in controlling the level of lipid hydroperoxides, especially those resulting from the 12-lipoxygenase activity. GPx was purified from the cell cytosol by more than 700-fold using an exchange chromatography, FPLP, gel filtration and covalent fixation. Isoelectric focusing revealed a peak activity at pH 5.1. The molecular mass of the enzyme was found between 90 and 100 kDa by gel filtration, and was approximating at 23 kDa by SDS-PAGE. A polyclonal antibody raised against commercial bovine erythrocyte GPx recognized the human platelet enzyme. It is concluded that human platelet GPx is likely a homotetramer of 92 kDa as described for most other sources. We have also found that the decreased platelet GPx activity observed in platelets from elderly people is associated with a lower content of the immunoreactive enzyme.

Adult↗