Biomedical subjects

E Molina

Publications and source records attributed to E Molina.

At least 37 records · Page 2Linked to original sources

PubMed2001

[Diagnosis of apical hypertrophic cardiomyopathy using contrast echocardiography].

Apical hypertrophic cardiomyopathy is a disease with clear electrocardiographic and echocardiographic characteristics. However, poor visualization of apical endocardial border is a limiting factor to diagnose apical hypertrophic cardiomyopathy by echocardiography. We present a case report of a patient with a characteristic electrocardiogram but poor apical endocardial border delineation. A contrast-enhanced echocardiography was performed to confirm the diagnosis of apical hypertrophic cardiomyopathy. We discuss the role of echocardiographic image enhancement with contrast to diagnose apical hypertrophic cardiomyopathy.

Aged↗

PubMed2001

Noncirrhotic portal hypertension.

Noncirrhotic portal hypertension represents a heterogeneous group of conditions that have distinct clinical and hemodynamic features that often help distinguish them from cirrhosis. [figure: see text] The sites of portal flow resistance may not be precisely localized to one area of the hepatic lobule and may extend beyond the site where the pathogenetic process began. Even in patients with portal hypertension caused by an increased flow, there may be subsequent development of increased resistance. The prognosis is variable; outcomes are better in patients with presinusoidal portal hypertension. A good understanding of the presentation of the various noncirrhotic conditions that cause portal hypertension will help determine the cause, the site of resistance, and the therapeutic plan. Ascites is not a feature of presinusoidal portal hypertension, whereas it may be the predominant feature in postsinusoidal portal hypertension.

Humans↗

PubMed2001

Novel local (fragment-based) topological molecular descriptors for QSpr/QSAR and molecular design.

Novel molecular descriptors based on local spectral moments of the bond matrix are defined. Mathematical expressions relating bond moments to linear combinations of structural fragments are derived. The novel descriptors are used to describe boiling points of alcohols producing a good QSPR model accounting for more than 98% of variance. A quantitative structure-reactivity model is obtained to predict the specific rate constant (log k) of the nucleophilic addition of mercaptoacetic acid to 2-furylethylene derivatives. The model accounts for more than 96% of the variance in log k. Two other models were also obtained by using molecular connectivity indices and total spectral moments of the bond matrix that account for <84% of the variance in this reactivity index. A model based on quantum chemical descriptors accounts for the same variance than that obtained with bond moments. The model based on local moments permitted to compute the contribution of different structural fragments to the reactivity, and a good relationship (r = 0.98) was obtained with these group contributions with Hammett sigma(p) constants for 21 groups.

Models, Molecular↗

PubMed2001

Quantitative structure-toxicity relationships using TOPS-MODE. 2. Neurotoxicity of a non-congeneric series of solvents.

Neurotoxicities of a series of solvents in rats and mice have been modeled by means of the TOPS-MODE approach. Two quantitative structure-toxicity relationship (QSTR) models were obtained explaining more than 80% of the variance in the experimental values of neurotoxicity of 45 solvents. Only one compound was detected as statistical outlier for these models. In contrast, previous models explained less than 60% of the variance in this property for 44 solvents. Finally, the contributions to neurotoxicity in rats and mice for a series of structural fragments were found. Structural characteristics of chlorinated fragments responsible for their different neurotoxicities were analyzed. The differences in neurotoxic behavior of some fragments in rats and mice were also analyzed, which could give insights on the toxicological mechanism of action of solvents studied.

Animals↗

PubMed2001

Benign and solid tumors of the liver: relationship to sex, age, size of tumors, and outcome.

From 1983 through 1997, our center diagnosed 130 cases of benign neoplasms: 27 with focal nodular hyperplasia (FNH), 25 with hepatic adenoma, 71 with cavernous hemangioma, and seven with mixed tumors of different diagnoses. Most often these lesions were seen in females [female-to-male ratio (f/m): 5.5/1]. Hepatic adenomas and mixed tumors were seen exclusively in females and FNH predominantly in females (f/m: 26/1). Hemangiomas, however, were not uncommon in men (f/m: 52/19) relative to the other tumors (P < 0.001). Furthermore patients with hemangioma were older (mean age: 49 years) whereas patients with hepatic adenoma, FNH, and mixed tumors were often younger (mean age: 33, 35, and 44 years respectively; P < 0.004). Oral contraceptive steroid use was related by 21 of 25 patients (84%) with hepatic adenoma, 22 of 26 (85%) females with FNH, five of seven (71%) females with mixed tumors, and 10 of 52 (19%) patients with hemangioma. Ninety-five of the 130 patients (73%) had one or more symptoms. There was no statistically significant correlation between symptoms and the size of the lesion, the final diagnosis, and whether there were solitary or multiple masses. Three of 25 (12%) with hepatic adenoma presented with rupture, and one of 27 (4%) with FNH had such a consequence. None of the hemangiomas presented with rupture or progressed to such a state. One patient with hepatic adenoma (4%) had a focus of malignancy. Surgical removal of benign tumors was performed in 82 of 130 patients (63%), and there was one operative mortality (1.2%) in a patient who had a caudate lobe FNH. The types of surgical procedures included segmentectomy (62%), lobectomy (34%), and trisegmentectomy (4%). In two of 84 patients who had undergone laparotomy resection was not technically possible. Resection is recommended in all cases of hepatic adenoma because of fear of rupture or associated focus of malignancy. FNH was not observed to undergo a malignant transformation and will rarely rupture. Surgery is only recommended for symptomatic hemangioma, and size of the lesion is not a criterion for excision.

Adenoma, Liver Cell↗

PubMed2000

A process for high yield and scaleable recovery of high purity eicosapentaenoic acid esters from microalgae and fish oil.

A low expense process is developed for recovering esterified eicosapentaenoic acid (EPA) from microalgae and fish oil. Over 70% of the EPA content in the esterified crude extract of microalgae were recovered at purities exceeding 90%. The recovery scheme utilizes either wet or freeze-dried algal biomass. The process consists of only three main steps: 1) simultaneous extraction and transesterification of the algal biomass; 2) argentated silica gel column chromatography of the crude extract; and 3) removal of pigments by a second column chromatographic step. Argentated silica gel chromatography recovered about 70% of the EPA ester present in the crude fatty ester mixture of fish oil, but at a reduced purity ( approximately 83% pure) compared to the microalgal derived EPA. The optimal loading of the fatty ester mixture on the chromatographic support was about 3% (w/w) but loadings up to 4% did not affect the resolution significantly. The process was scaled up by a factor of nearly 320 by increasing the diameter of the chromatography columns. The elution velocity remained constant. Compared to the green alga Monodus subterraneus, the diatom Phaeodactylum tricornutum had important advantages as a potential commercial producer of EPA. For a microalgal EPA process to be competitive with fish oil derived EPA, P. tricornutum biomass (2.5% w/w EPA) needs to be obtained at less than $4/kg. If the EPA content in the alga are increased to 3.5%, the biomass may command a somewhat higher price. The quality of microalgal EPA compares favorably with that of the fish oil product. Compared to free fatty acid, EPA ester is more stable in storage. Shelf-life is extended by storing in hexane. The silver contamination in the final purified EPA was negligibly small (<210 ppb).

Journal Article↗

PubMed2000

Capillary electrophoresis characterization of the casein fraction of cheeses made from cows', ewes' and goats' milks.

Casein fractions and their breakdown products in Iberico-type cheeses made from the milk of cows, ewes or goats were analysed by capillary electrophoresis in order to characterize them. The actions of plasmin and chymosin on caseins were evaluated by comparing the electropherograms of caseins from milk and from cheese, both with and without treatment with plasmin. Characteristic capillary electrophoresis patterns were obtained for cheeses made from the milk of each of the three species, and the main components were identified. Caprine para-kappa-casein and bovine beta-caseins, eluting at the first and at the last part of the electropherogram respectively, were found to be indicative of the presence of the milks of these species.

Animals↗

PubMed2000

Homeostasis of REM sleep after total and selective sleep deprivation in the rat.

During specific rapid eye movement (REM) sleep deprivation its homeostatic regulation is expressed by progressively more frequent attempts to enter REM and by a compensatory rebound after the deprivation ends. The buildup of pressure to enter REM may be hypothesized to depend just on the time elapsed without REM or to be differentially related to non-REM (NREM) and wakefulness. This problem bears direct implications on the issue of the function of REM and its relation to NREM. We compared three protocols that combined REM-specific and total sleep deprivation so that animals underwent similar 3-h REM deprivations but different concomitant NREM deprivations for the first 2 (2T1R), 1 (1T2R), or 0 (3R) hours. Deprivation periods started at hour 6 after lights on. Twenty-two chronically implanted rats were recorded. The median amount of REM during all three protocols was approximately 1 min. The deficits of median amount of NREM in minutes within the 3-h deprivation periods as compared with their baselines were, respectively for 2T1R, 1T2R, and 3R, 35 (43%), 25 (25%), and 7 (7%). Medians of REM rebound in the three succeeding hours, in minutes above baseline, were, respectively, 8 (44%), 9 (53%), and 9 (50%), showing no significant differences among protocols. Attempted transitions to REM showed a rising trend during REM deprivations reaching a final value that did not differ significantly among the three protocols. These results support the hypothesis that the build up of REM pressure and its subsequent rebound is primarily related to REM absence independent of the presence of NREM.

Animals↗

PubMed2000

[New approach in the surgical treatment of the urogenital sinus].

The urogenital sinus is an embriological anomaly which consists on a common channel from the urethra and vagina. The major incidence is produced in the congenital adrenal hyperplasia's context. In certain occasions it can be associated to an imperforate anus, then the malformation is called a cloacal defect. There are multiple surgical techniques to correct this malformation and different therapeutical approaches (without surgery, surgery at one or various times, early or delayed surgery) being the newest one the total urogenital mobilization. The purpose of this work is to reflect our experience with this technique. We present seven girls with urogenital sinus (3 with congenital adrenal hyperplasia, 2 with a cloacal defect, and the other 2 associated to ambiguous genitalia). Five patients were operated in the first year of life. The outcome has been favorable, and the cosmetic and functional results have been very good. The surgical technique consists on posterior sagittal incision, it can be done transanorectal if necessary, the urethrovaginal union is achieved and both structures are mobilized together, connecting them to the perineum, as a single unit. We believe that the total urogenital mobilization is actually the surgical technique to be chosen in every of urogenital sinus, for being easier, allowing early realization (girls under 1 year old), correcting simultaneously other anomalies, reducing the complications (urethrovaginal fistula, vaginal structure, or acquired vaginal atresia); and the result is excellent.

Abnormalities, Multiple↗

PubMed1999

Cholesteatoma in a child with congenital ichthyosiform erythroderma.

A 7-year-old girl had non-bullous congenital ichthyosiform erythroderma (NBCIE) in treatment with retinoids. She also suffered continuous desquamation of the external ears, recurrent external otitis, chronic adenoiditis, tubaric dysfunction and intermittent episodes of otitis media and developed a cholesteatoma in her left ear. Chronic scaling disorders, such as NBCIE and other ichthyosis, can be entities at risk for the development of cholesteatoma in childhood.

Child↗

PubMed1999

Experience with staging laparoscopy in pancreatic malignancy.

BACKGROUND: The role of diagnostic laparoscopy in the staging of abdominal malignancies is not well defined. METHODS: We retrospectively reviewed the usefulness of diagnostic laparoscopy as a staging procedure in pancreatic malignancy. This experience between February 1988 and May 1997 involves 109 cases of suspected or proven pancreatic malignancy. All laparoscopies were performed with the patient under conscious sedation and local anesthesia in an endoscopy suite. RESULTS: Of the 109 patients with pancreatic cancer, 45 (42%) had metastatic disease. The use of computed tomography (CT) alone revealed the existence of liver metastases in 10 of 109 (9%) patients, which were confirmed laparoscopically. The further use of laparoscopy identified metastases in 29 more cases: hepatic, 23; hepatic and peritoneal, 3; peritoneal and mesenteric, 1; and mesenteric, 2. CT in conjunction with laparoscopy therefore revealed metastatic liver, peritoneal, or mesenteric lesions in 39 of 109 (36%) patients with pancreatic cancer. After staging laparoscopy, 67 of 69 patients underwent laparotomy. Metastatic disease was identified at laparotomy in 6 more patients; however, only 4 of these patients had metastases to the liver whereas 2 had metastases to the peripancreatic lymph nodes. Therefore, in patients with pancreatic malignancy, the negative predictive value for the diagnosis of metastases to the liver, peritoneum or mesentery was 94% (61 of 65 patients). The positive predictive value of laparoscopy alone for the detection of metastatic disease to the liver, peritoneum, or mesentery was 88% (29 of 33 patients). Laparoscopy was successfully performed without complications in all patients with pancreatic cancer; however, one had a technically unsatisfactory examination. The overall rate of resectability after staging by imaging studies and laparoscopy was 57% (35 of 61 patients). CONCLUSIONS: In patients with a negative CT for metastases, laparoscopic identification of metastases avoided unnecessary laparotomy in 29 of 99 (29%) patients with pancreatic cancer. Staging laparoscopy is indicated in all cases of pancreatic malignancy before an attempt at a surgical cure.

Aged↗

PubMed1999

[The tilt-table test in assessing syncope of unknown origin: do differences exist between children and adults?].

BACKGROUND AND OBJECTIVES: Little is known about the differences between children and adults in the results of head-up tilt test. This study sought to investigate the potential differences concerning: a) the clinical profile and circumstances of spontaneous syncope; b) the overall diagnostic performance of the test, and c) the type of positive response obtained. MATERIAL AND METHODS: We studied 31 children and 123 adults with unexplained syncope. If baseline test (tilting at 70 degrees for 30 min) resulted negative, it was repeated under isoprenaline low-dose infusion. RESULTS: There were no differences in either clinical profile, except for severe traumatism more frequent in adults (25% vs. 3% in children; p < 0.05), or overall diagnostic performance (39% in children vs. 33% in adults; p = NS). However, the way the test rendered positive (via basal tilting in 92% of children vs. 50% in adults; p < 0.05) and the rate of cardioinhibitory response (42% in children vs 8% in adults; p < 0.01) were significantly different. CONCLUSIONS: In this study children, in contrast to adults, rarely have a positive response in tilting under isoprenaline infusion. They also present a much higher rate of cardio-inhibitory response than adults.

Adolescent↗

PubMed1999

Two-week dual vs. one-week triple therapy for cure of Helicobacter pylori infection in primary care: a multicentre, randomized trial.

BACKGROUND: One-week triple therapy has been suggested to be superior to two-week omeprazole-clarithromycin therapy for the cure of Helicobacter pylori infection. However, direct comparisons of the two treatments are scarce. AIM: To compare triple with dual therapy for H. pylori infection in the primary care setting. METHODS: One hundred and forty-five patients with duodenal ulcer and H. pylori infection were randomized to receive omeprazole 20 mg b.d. and clarithromycin 500 mg t.d.s. for 14 days (OC14 group, 69 patients) or omeprazole 20 mg b.d., clarithromycin 500 mg b.d. and amoxycillin 1 g b.d. for 7 days (OCA7 group, 76 patients). Eradication was evaluated by the 13C-urea breath-test. RESULTS: Intention-to-treat analysis showed a cure rate of 48% (95% CI: 36-60%) in the OC14 group, and 71% (95% CI: 59-80%) in the OCA7 group (P=0.0004). Per protocol analysis showed cure rates of 51% (95% CI: 38-63%, 33/65 patients) and 82% (95% CI: 70-90%, 54/66 patients), respectively (P=0.0001). There were no significant differences in compliance or side-effects. CONCLUSION: One-week twice-daily triple therapy is superior to 2-week dual therapy, but the cure rate in primary care was far below 90%.

Adult↗

PubMed1999

Fimbria-mediated enhanced attachment of nontypeable Haemophilus influenzae to respiratory syncytial virus-infected respiratory epithelial cells.

Respiratory syncytial virus (RSV) infection is known to predispose children to otitis media and sinusitis due to bacteria such as nontypeable Haemophilus influenzae (NTHI). In this study, we investigated the role of NTHI surface outer membrane protein P5-homologous fimbriae (P5-fimbriae) in attachment to RSV-exposed A549 epithelial cells. Analysis by fluorescence flow cytometry showed that a live P5-fimbriated NTHI strain (NTHIF+) attached to a higher proportion of RSV-exposed A549 cells than to control cells (mean, 68% for RSV versus 29% for control; P = 0.008), while attachment of the P5-fimbriae-deficient isogenic mutant strain (NTHIF-) was significantly lower than in control cells and rose only slightly following RSV exposure (mean, 17% for RSV versus 10% for control, P = 0.229). Attachment of NTHIF+ did not correlate with the amount of RSV antigen expressed by A549 cells. Furthermore, paraformaldehyde-fixed NTHIF+ also demonstrated an enhanced binding to RSV-exposed cells. Observations by transmission electronic microscopy showed that the mean number of bacteria attached per 100 RSV-exposed A549 cells was higher for NTHIF+ than NTHIF- (99 versus 18; P < 0.001). No intracellular bacteria were identified. UV-irradiated conditioned supernatants collected from RSV-infected A549 cultures (UV-cRSV) also enhanced the attachment of NTHIF+ to A549, suggesting the presence of a preformed soluble mediator(s) in UV-cRSV that enhances the expression of receptors for P5-fimbriae on A549 cells. In summary, RSV infection significantly enhances NTHI attachment to respiratory epithelial cells. P5-fimbria is the critical appendage of NTHI that participates in this attachment. In clinical settings, blocking of the P5-fimbria-mediated attachment of NTHIF+ by passive or active immunity may reduce the morbidity due to NTHI during RSV infection.

Antigens, Viral↗

PubMed1999

Mitochondrial DNA variation among Anopheles albimanus populations.

Barriers to gene flow between Pacific and Atlantic coast populations of Anopheles albimanus were reported in an earlier study of variation in the intergenic spacer of the nuclear ribosomal DNA. We examined the distribution of mitochondrial DNA haplotypes among A. albimanus populations to test for gene flow barriers with an independent genetic marker. A region of the NADH dehydrogenase subunit 5 gene was amplified by the polymerase chain reaction (PCR) in 1,105 mosquitoes collected from 16 locations in Guatemala and in single collections from Mexico, Honduras, Nicaragua, Costa Rica, Panama, Colombia, and Venezuela. The PCR products were tested for variation using single strand conformation polymorphism analysis and 45 haplotypes were detected. Haplotype frequencies did not vary between coasts in Guatemala. Populations within approximately 200 km of one another were panmictic. However, at distances > 200 km, FST and geographic distances were correlated suggesting that populations are isolated by distance.

Animals↗

PubMed1999

[Thyroid tumors in childhood].

The thyroid pathology in the paediatric population represents 5% of the total and 1.2% only thyroid pathology correspond to the infantile solitary thyroid nodules. Most of them are asymptomatic and as only sign an increase of volume is observed in the neck. Always we have to ask about the family history because the possibility of medullary carcinoma related with multiple endocrine neoplasias should be investigated (a patient of our series). The thyroid tumor represents 0.5% of all the tumors and of these 10% is in younger than 21 years old. We present 13 patients with thyroid pathology that have required surgical treatment, since 1983 to 1997. Five papillary carcinomas (ages: 7 to 14 years old) that started with a cervical nodule, normal thyroid function and a case of medullary carcinoma, in a multiple endocrine neoplasia (MEN II 2A). In the 5 cases of carcinoma papillary we were carried out total thyroidectomy and later on, postoperative ablative dose of 131I was administered. In the case of the girl with medullary carcinoma was carried out a total tumorectomy and lymph node excision. Finally, seven patients with nodule thyroid were thyroid benign tumors (benign 6 adenomas and 1 cyst colloid, ages: 8 to 15 years old). In all of them we were carried out total surgical excision of the thyroid nodules. Our protocol of study of nodule thyroid includes: 1) thyroid gammagraphy to know the intensity of reception of the isotope; 2) cervical ultrasound; and 3) biopsy or cytopathology of fine needle aspiration of the thyroid gland in children that it dissuades to base the surgical strategy on this test.

Adenoma↗

PubMed1999

[Sigmoid neovagina: apropos of 2 cases].

The presence of ambiguous external genitals can be related with a number of nosologic entities. We can find the female form with hypertrophic clitoris and vaginal hypoplasia in a wide variety of phenotype presentations. We have two young girls with ambiguous external genitals, where we notice hypertrophic clitoris and vaginal hypoplasia, with the diagnosis of mixed gonadal dysgenesis and androgen insensitivity syndrome (Morri's Syndrome). They have been operated several times: gonadectomy, genitoplasty, vaginoplasty and mammoplasty. We have made a neovagina, using a segment of sigma and preserving the walls of the former vagina. The surgical technique we used, consisted in the abdominoperineal descent of the segment of sigmoid colon and anastomosis with the back wall of the former vagina and the perineum; after that, we split the intervaginal septum, linking these two structures and reaching a lonely introitus vaginae. The hormonal treatment for the girl with mixed gonadal dysgenesis with estrogen and progestogen induces normal menstruations; we only use estrogen for the patient with Morri's Syndrome. The histology showed that there were dysgenetic gonads in one of the patients and testicular tissue without gonadal elements. Both girls have had a good evolution, with no problems and an excellent aesthetic and functional result.

Adolescent↗

PubMed1999

[Extracorporeal respiratory assistance (ECRA): initial experiences in Spain].

UNLABELLED: The attendance respiratory extracorporeal (AREC) is an oxygenation form for membrane extracorporeal with flow tidal and veno-venous cannula described by Chevalier et al. in 1990. We present our clinical experience so much with AREC in system veno-venous flow tidal as veno-arterial. From october of 1997 until the present time we have treated three patients by means AREC, in two patients with veno-venous system and in one veno-arterial. In all the cases bomb Collin-Cardio has been used with bladder for flow tidal and membrane of oxygenation of 0.8 m2, being inserted a system of alternative clamp of the branches of the circuit. The system AREC has been used in two patients with congenial diaphragmatic hernia, right in a case and left in the other one. The gestational age was of 38 and 36 weeks with a weight of 3,200 and 2,900 grams. Both patients were remitted from other centers by failure of the conventional treatment. In both cases the indication of AREC was the sharp deterioration of the general state with failure of the conservative treatment, being the previous oxygenation index of 109 and 112. The third patient precised veno-arterial AREC for ventricular failure during the correction of the congenital heart disease, this patient was 5 month old and the weight was 5,000 grams. The duration of AREC in the cases of congenital diaphragmatic hernia was of 14 and 10 days. In a patient the diaphragmatic hernia was corrected at the 55 hours of being in AREC. In the second case the hernia had been surgical corrected in another center. The exit of AREC in both cases carries out after a discreet improvement of the lung function. Both patients died at the 24 and 48 hours of the decannulation for cerebral hemorrhage and respiratory failure. The third patient stayed stable in veno-arterial AREC during 4 days, with hemodynamic support of 130 ml/kg/min, retiring the support to present absence of cerebral activity. CONCLUSIONS: With the derived limitations of the extreme severity of the treated cases and the current phase of beginning of the AREC team, we think that it is a useful and available technique in our country, for the handling of patient with cardiorespiratory failure while waiting for improvement of their base pathology.

Age Factors↗