Fungal flora of the normal human small and large intestine.
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Adolescent↗
Biomedical subjects
E Delgado
Publications and source records attributed to E Delgado.
Comparison of bag-valve-mask, manually triggered ventilator, and automated ventilator devices used while ventilating a nonintubated mannikin model.
OBJECTIVE: To determine whether there were differences in tidal volume (Vt), minute volume (MV), average mask leak per breath (ML), gastric insufflation (GI), and peak airway pressure (PAP) when ventilating a nonintubated mannikin with a bag-valve-mask (BV), manually triggered ventilator (MTV), and automated ventilator (AV). The authors' hypothesis was that there would be no differences among the devices for any of these variables. METHODS: This was a prospective in-vitro experimental model. A convenience sample of 19 emergency medical technicians (EMTs) ventilated a nonintubated mannikin-mechanical test lung model with the BV, MTV (flow rate 40 L/min; pressure relief 55 cm H2O), and AV (800 mL/breath; rate 12). Each subject, blinded to volume and pressure gauges, used each device for 2 minutes at both normal (0.1 cm H2O) and poor (0.04 cm H2O) compliances. Vt, MV, GI, and PAP were measured directly and ML was calculated. A survey was issued to the EMTs who participated in the study. Data were analyzed with repeated-measures ANOVA and the Bonferroni-Dunn multiple comparison test with alpha set at 0.05. RESULTS: At the normal compliance, PAP was higher for the BV than the MTV (p = 0.0001) and AV (p < 0.0001). MV was also greater with the BV than with the AV (p = 0.001). PAP was also higher at the poor compliance with the BV than with the MTV and AV (p = 0.008 and 0.013, respectively). The BV had a higher GI at this compliance (p < 0.0001) and a higher ML than the AV (p = 0.002). CONCLUSION: All three devices delivered similar volumes when used by EMTs, but the BV was associated with higher PAP, ML, and GI.
Adult↗
Reversal by medical treatment of endometrial hyperplasia caused by estrogen replacement therapy.
OBJECTIVE: Endometrial hyperplasia, an entity considered a precursor to endometrial carcinoma, frequently develops in women receiving unopposed estrogens. Progestins used concomitantly with estrogens can largely prevent endometrial hyperplasia and carcinoma. However, the ability of progestins to reverse endometrial hyperplasia induced by estrogens is less well recognized. The purpose of this study was to assess the medical reversal rate of endometrial hyperplasia that develops in women receiving unopposed estrogen replacement therapy (ERT). DESIGN: Review of recent literature (1990-2000). RESULTS: Based on four large series, more than 90% of endometrial hyperplasia caused by ERT can be reversed by medical treatment. Discontinuation of estrogen and oral administration of 10 mg/day of medroxyprogesterone acetate continuously for 6 weeks or cyclically for 3 months (2 weeks of each month) are the two regimens most widely used. Other progestins also have been shown to be effective. CONCLUSIONS: Progestins are highly successful in reversing endometrial hyperplasia caused by ERT.
Clinical Trials as Topic↗
Radiologic pelvic asymmetry in unilateral late-diagnosed developmental dysplasia of the hip.
Eighty-three cases of unilateral late-diagnosed (older than 4 months of age) developmental dysplasia of the hip (DDH) were studied to evaluate pelvic shape and innominate bone relationships in the initial anteroposterior radiograph. To be included, each initial radiograph had to have no lumbar pedicle rotation, lumbar scoliosis, gas shadows, or metallic protectors. Measurements were done using as reference a medial pelvic line, which divides the pelvis into two innominate bones. Lineal parameters were defined to assess pelvic radiologic shape; angular parameters defined the relationship between the ilium, ischium and pubis, and sacrum. Statistically significant differences were observed in most cases, and pelvis asymmetry was evident. The asymmetry was more obvious in cases in which the teardrop had a negative value and in low dislocations. Similar changes have been observed in experimental dislocation of the hip secondary to a triplane pelvic deformity. We suggest that similar alterations of pelvic shape occur in DDH, possibly secondary to growth disturbance in the triradiate cartilage.
Age Factors↗
Intraocular pressure variability in the anesthetized rat: a spectral analysis.
PURPOSE: Intraocular pressure (IOP) is a measure of the balance between the inflow and outflow of the aqueous humor, being in close relationship with the venous ocular blood flow. But the influence of the autonomic nervous system upon this variable is not well understood. One of the most frequently used mathematical tools for the evaluation of the autonomic nervous system in the frequency domain is the fast Fourier algorithm (FFT) applied to the analysis of heart rate (HR) and arterial blood pressure (BP). For these variables, a power spectrum has been built showing the major bands: very low frequency, lower frequency, and higher frequency (HF). The range of these bands depends on the animal species. In this study, the authors used FFT to analyze the variability of IOP in anesthetized rats. METHODS: BP and electrocardiogram were acquired at 2 KHz in all animals before and following muscle blockade and artificial ventilation at the same frequency as the spontaneous ventilation. Also, in this last condition, IOP was recorded before and after the application of atropine in the eye. RESULTS: Results show three bands in the IOP spectrum, a similar profile to those observed in the HR and BP spectra, with HF band modified after atropine application DISCUSSION: The discussion calls attention to the influence of the autonomic nervous system on IOP and suggests the possibility of clinical application of this methodology on diagnosis and therapeutic efficacy.
Animals↗
Improved conditions for extraction and amplification of human immunodeficiency virus type 1 RNA from plasma samples with low viral load.
OBJECTIVES: We attempted to define optimal conditions for amplification of low copy number HIV-1 RNA sequences in plasma samples, applying improved conditions for nucleic acid extraction and amplification. METHODS: Several methodologic parameters were evaluated, including methods of RNA extraction, volumes of plasma samples, proportion of extracted RNA used as a template for amplification, and reverse transcriptase-DNA polymerase enzyme combination employed in cDNA synthesis and polymerase chain reaction amplification. RESULTS: With this improved assay, we were able to obtain sufficient amounts of amplified material for direct sequencing in 97% of all plasma samples in our study, including 88% of samples with viral loads <80 copies/mL, 78% of samples with viral loads <50 copies/mL, and even 2 (67%) of 3 samples with <20 copies/mL. CONCLUSIONS: This procedure could be useful for testing resistance mutations in patients undergoing highly active antiretroviral therapy, in which the viral load is commonly <400 copies/mL, and even if it is <20 RNA copies/mL.
DNA Primers↗
Single- and multidrug resistance mutations to reverse transcriptase and protease inhibitors: human immunodeficiency virus type 1-infected patients from two geographical areas in Spain. Spanish Groups for Antiretroviral Resistance Studies.
OBJECTIVES: To describe the prevalence of genotypic resistance mutations, including single and multidrug resistance (MDR) to reverse transcriptase (RT) and protease (PR) inhibitors in treated and untreated patients from two geographical areas in Spain (Madrid and Galicia). STUDY DESIGN/METHODS: Resistance mutations to RT inhibitors were studied by line probe assay (LiPA) or by automated sequencing in 468 patients (Madrid, 268; Galicia, 200), and resistance mutations to PR inhibitors were studied by automated sequencing in 295 patients (Madrid, 85; Galicia, 210). RESULTS: The proportion of resistance mutations in treated and untreated patients results were higher by the LiPA method than by sequencing. By sequencing, we detected resistance mutations to nucleoside analogue RT (NRT) inhibitors and NRT inhibitors plus nonnucleoside RT (NNRT) inhibitors in 35.4% and 17.2% of treated patients, respectively. We also detected MDR to zidovudine plus lamivudine in 13.9% of treated patients from Galicia, in 1.7% from Madrid (p < 0.001), and in 1.5% of untreated patients from Galicia. Also, we detected MDR to NRT inhibitors in 3.8% and to NNRT inhibitors in 9.1%. We found resistance mutations to PR inhibitors in 38.1% of treated patients and in 0.9% of untreated patients. CONCLUSIONS: These findings reinforce the usefulness of testing for resistance mutations in some cases to evaluate their prevalence in a given population and in the follow-up of treated patients.
Cohort Studies↗
Prevalence of drug resistance mutations in B, non-B subtypes, and recombinant forms of human immunodeficiency virus type 1 in infected individuals in Spain (Galicia).
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Drug Resistance, Microbial↗
Detection and quantification of multiple drug resistance mutations in HIV-1 reverse transcriptase by an oligonucleotide ligation assay.
OBJECTIVES: To develop an assay for the early detection and quantification of minor human immunodeficiency virus-1 populations bearing multiple drug resistance (MDR) mutations. STUDY DESIGN/METHODS: The oligonucleotide ligation assay (OLA) is based on ligation of probe and detector oligonucleotides annealed to a polymerase chain reaction amplicon strand with detection by an enzyme immunoassay. In OLA-MDR, oligonucleotides were designed to detect MDR mutations. The method was validated with wild-type and MDR mutant clones mixed at different proportions. RESULTS: K103N mutants were detected as minor populations (5%-30%) by OLA in 6 of 18 samples from patients treated with nonnucleoside reverse transcription inhibitors and classified as wild type by sequencing. In one patient, the kinetics of the increase of MDR mutants could be followed in sequential samples, with K103N being detected earlier by OLA than by sequencing. Q151M mutants were detected as minor populations (13%-24%) by OLA but not by sequencing in 4 samples. CONCLUSIONS: Oligonucleotide ligation assay MDR exhibits higher sensitivity than sequencing for detection of minor MDR mutant populations.
Drug Resistance, Multiple, Viral↗
[Penetration route of the larva of Paragonium peruvianus in experimental animals].
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Animals↗
[The participation of hospital pharmacy services in enteral nutrition].
We present the results of a study done in the departments of hospital pharmacy of our country with the aim of knowing their participation in the use and clinical follow up of patients with enteral nutrition. 293 questionnaires were sent out, and 121 were filled out and returned (41.3%). The responses were classified into three groups, according to the number of hospital beds, considering > or = 1000 (large), 500-1000 (medium), and < or = 500 (small). The data were analyzed by means of a statistical program (R-Sigma Horus). 79% (68) of the small hospitals have a unitary dose drug dispensation system, and the Enteral Nutrition was distributed through this system in 53% (50) of them; only 29% (27) of them have a stock of these preparations on the wards. 93% (14) and 65% (54) of the large and small hospitals respectively, prefer the use of enteral nutrition as opposed to parenteral nutrition. 85% (11) of the large hospitals have protocols for the use of enteral nutrition, this being 62% (10) and 59% (47) in medium and small hospitals. The committees for artificial nutrition are present in 75% of the large hospitals, in addition to which, in 66% of these there is a nutritional support team. A pharmacist from the department of pharmacy participates in both multidisciplinary groups. If it is necessary to manipulate the enteral nutrition preparations, in 30% of the departments of pharmacy of the smaller hospitals, this is centralized, being done by personnel of the department itself; in 59% of them (19) there is a specific area for the elaboration, which is not the case in large hospitals. Drugs are mixed with the enteral nutrition in 25% (1), 12% (1), and 9% (4) of the large, medium and small hospitals respectively. There is great, active participation of the hospital pharmacists in the activities of the multidisciplinary nutritional support systems, although at the present time, the involvement of the departments of pharmacy in the centralization of the manipulation of the enteral nutrition is reduced. It is necessary therefore, to implement the development of enteral nutrition programs with a quality guarantee from the departments of pharmacy.
Enteral Nutrition↗