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Biomedical subjects

E Rocha

Publications and source records attributed to E Rocha.

At least 73 records · Page 4Linked to original sources
PubMed1997

Hypodiploidy and 22q11 rearrangements at diagnosis are associated with poor prognosis in patients with multiple myeloma.

Our aim was to evaluate the clinical use of cytogenetic analysis as a prognostic factor in the outcome of newly diagnosed multiple myeloma (MM) patients. The present series includes 111 newly diagnosed MM patients treated with one of three standard-dose regimens or autologous transplantation over an 8-year time interval. As expected, the presence of an abnormal karyotype (39% of patients) correlated with poor prognosis (progression rate 63% v 47%, P = 0.042), shorter event-free (EFS, P = 0.014) and overall (OS, P = 0.005) survival. Two distinct cytogenetic abnormalities were the most significant variables that influenced EFS and OS in the univariate analysis. The presence of hypodiploid karyotypes or rearrangements of band 22q11 were associated with higher progression rate (P = 0.001) and shorter EFS (P < 0.024) and OS (P < 0.004). The median EFS and OS for patients with hypodiploidy was 4 and 7 months respectively. Multivariate analysis showed that absence of hypodiploidy was the most favourable prognostic variable for OS (P = 0.022) followed by stage < or = IIA, serum calcium < or = 2875 micromol/l, and absence of abnormalities 22q. The data suggest that the presence of hypodiploid karyotypes and rearrangements on 22q11 band show a higher progression rate and shorter survival in MM patients.

Adult↗
PubMed1997

The increase of plasminogen activator inhibitor activity is associated with graft occlusion in patients undergoing aorto-coronary bypass surgery.

Early graft occlusion is a common complication in patients undergoing aorto-coronary bypass surgery. Both mechanical and haemostatic factors play a role in the pathogenesis of thrombotic occlusion. Several studies have demonstrated a relationship between fibrinolytic activity and venous or arterial thrombosis. We undertook this study to evaluate the possible contribution of the fibrinolytic system to postoperative occlusion in patients undergoing aorto-coronary bypass graft (CABG). A venous occlusion (VO) test was performed preoperatively in 82 patients undergoing revascularization procedures. Before and after VO the euglobulin fibrinolytic activity and tissue type plasminogen activator (t-PA) activity and antigen were measured. Plasminogen activator inhibitor (PAI) activity and antigen and fibrinogen were also assessed in the preocclusion sample. An angiography performed 10d postoperatively showed graft occlusion in 23% of patients. Patients with graft occlusion had significantly higher preoperative PAI activity than patients without occlusion (P < 0.001). Reduced fibrinolytic response and t-PA capacity was also observed in the group of patients with graft occlusion (P < 0.03 and P < 0.02 respectively). We found a reduced preoperative fibrinolytic response, mainly related to high plasma PAI activity in patients with postoperative graft occlusion. These results suggest that increased PAI activity might have a predictive value for early thrombosis in patients undergoing CABG.

Angina Pectoris↗
PubMed1997

Early gestational hemolytic uremic syndrome: case report and review of literature.

Hemolytic uremic syndrome (HUS) is a rare condition which most frequently follows gastrointestinal or respiratory infection episodes in young children, but it can also occur in other settings such as the postpartum period and during use of drugs such as oral contraconceptives, immunosuppressors, and antineoplastics. In early pregnancy, however, its frequency is thought to be very low. The authors report a case of a 30-year-old woman who developed HUS early in her first pregnancy. She had persistent aqueous diarrhea from the beginning of the pregnancy. At the 21st week she developed hypertension which in 2 weeks was followed by seizures, oliguria, and acute pulmonary edema despite intensive medical efforts to control her blood pressure. Surgical intervention for fetal delivery was performed. The patient was initially kept on continuous hemodialysis (CVVHD) followed by an alternate-day conventional hemodialysis schedule. A peripheral blood analysis showed a microangiopathic hemolytic anemia with thrombocytopenia; blood coagulation tests were completely normal. A brain CT scan and an abdominal MRI showed no major abnormalities. HUS was confirmed by a percutaneal kidney biopsy, performed at the 21st day of anuria. Techniques for identification of verotoxin-producing E. coli were not available. Renal function did not recover and the patient has been undergoing regular maintenance hemodialysis for a year.

Adult↗
PubMed1997

[Risk factors for cerebrovascular stroke in a cohort of hypertensive patients].

OBJECTIVES: To identify stroke risk factors in hypertensive patients and the probability of stroke in relation to those risk factors and follow-up. STUDY DESIGN: A cohort study (patients with high blood pressure). MATERIAL AND METHODS: 707 hypertensive patients were studied (Hypertension Register) in what concerns stroke incidence until 1992 (n = 126), considering one case per individual. The following variables were analysed: age, sex, body mass index (Quetelet), systolic and diastolic blood pressure, heart rate, types of hypertension (JNC-IV), left ventricular hypertrophy, changes in ST segment and T wave (Minnesota Code), fundi, angina pectoris, heart failure, central nervous (neurological) disturbances, antihypertensive treatment, smoking, serum potassium, serum sodium, blood urea, creatinine, uric acid, blood sugar, diabetes and cholesterol, in the initial record. Individually, in relation to the control of hypertension, the subjects were classified according to the casual recording of normal blood pressure, the absence of drug treatment, diastolic pressure > 114 mmHg and, at the end of 1992, according to survival, causes of death and follow-up. Stroke risk factors have been identified by multivariate analysis (Cox regression model). The survival probability (without stroke) was defined by Kaplan-Meier method. RESULTS: It was possible to maintain the epidemiological surveillance, from 1975 to 1992, of 598 cases. From those, 109 hypertensive patients were victims of at least one episode of non transient cerebral ischaemia, during their follow-up of 10.5 years. From the characteristics studied, only five were identified at risk factors. The adjusted relative risks and confidence intervals (95% CI) were the following: age: 1.08 (1.06-1.10); diastolic pressure > 114 mmHg: 1.96 (1.32-2.91); neurological disturbances 4.64 (2.99-7.2); diabetes: 2.57 (1.62-4.05) and left ventricular hypertrophy: 1.34 (1.13-1.58). CONCLUSIONS: As far as stroke is concerned: a) Age, diabetes, a casual measurement of diastolic blood pressure > 114 mmHg and left ventricular hypertrophy (electrocardiogram) were the risk factors identified; b) Prevention should include blood pressure and diabetes control, although this disease has shown more risk than a casual measurement of severe hypertension; c) Its occurrence, in this model, has only partly been explained, therefore it has become necessary to deepen the study of the risk profile.

Adult↗
PubMed1997

[Angina pectoris. The extent of the problem].

Angina pectoris is analysed according to the principal data of its social repercussion: frequency, gravity, chronicity, diagnostic and treatment complexity, treatment costs and genetic factor extension. Some data of the national literature defining the dimension of the problem are given and a comparative study with other diseases and other countries is made. In conclusion, the need to develop epidemiological studies of adequate dimension is supported, mostly to better define frequency of the disease (prevalence and incidence) since the hospital and the mortality data are not enough. However, from the available data, it is expected that the prevalence of ischemic heart disease, of which the angina is a frequent clinical manifestation, will increase as well as the economic costs. In fact, the costs will be the consequence of scientific and technological development and of the increasing search for health by the population can services.

Angina Pectoris↗
PubMed1997

[Prevalence of hypercoagulation conditions in patients with thrombosis in Northern Navarra].

BACKGROUND: To determine the prevalence of hypercoagulability states in patients with thromboembolic disease in Septentrional Navarra. PATIENTS AND METHODS: 74 patients were studied (13 female, mean age [+/- SD] 43.5 +/- 13.9 years, range 22-81) with: deep venous thrombosis (DVT) with or without pulmonary embolism (PE) in 15 patients; ischemic stroke (IS) in 20 patients and; myocardial infarction (MI) in 39 patients. Antithrombin III, C protein (CP), plasminogen, plasminogen activator inhibitor (PAI), total S protein (TSP), free S protein (FSP), lupus anticoagulant (LA) and anticardiolipin antibodies (ACA) type IgG were determined in all patients. RESULTS: The prevalence of hypercoagulability state was 27% in patients with thromboembolic disease; 26.6% in patients with PE (20% with ACA and 6.6% with CP deficiency); 30% in patients with IS (15% with ACA, CP deficiency in 5%, FSP deficiency in 5%, and PAI raising in 10%) and in the 25.6% of patients with MI (15.3% with ACA, 2.5% with CP deficiency, 2.5% with TSP and FSP deficiency and PAI raising in the 7.6%). CONCLUSIONS: In Septentrional Navarra population with thromboembolic disease the presence of hypercoagulable states is high. In our study, the most common hypercoagulable state was the presence of ACA, followed by PAI raising and by the CP deficiency.

Adult↗
PubMed1996

Development and clinical application of a new ELISA assay to determine plasmin-alpha2-antiplasmin complexes in plasma.

Plasmin-alpha2-antiplasmin complexes (PAP) are considered good markers of fibrinolytic activation in vivo. The presence of neoantigens in these complexes offers the possibility to develop specific immunoassays to determine PAP levels. We have developed a sensitive PAP purification method in vitro by adding urokinase to fresh plasma followed by affinity chromatography to lysine-sepharose and elution with epsilon-aminocaproic acid. This material, characterized by SDS-PAGE and Western blotting, was used to raise monoclonal antibodies (MoAbs). We describe a new enzyme linked immunosorbent assay (ELISA) to quantify PAP complexes in plasma. The assay follows the sandwich principle and is based on two MoAbs, CPL12 and CPL15, that bind to the modified alpha2-antiplasmin moiety and the plasmin moiety of the complex respectively. The calibration curve was constructed with definite concentrations of purified PAP. The lower limit of the assay is 75 ng/ml and the variation coefficients are 3.5% (intra-assay) and 10-6% (interassay). A mean value of 573.5+/-131.4 ng/ml was obtained from PAP concentration in a healthy population (n = 30). Significantly higher PAP levels were observed under diverse clinical conditions in which fibrinolysis is activated: clinical sepsis, acute myocardial infarction (AMI), malignancy, diabetes, pregnancy, elderly people and thrombolytic therapy. From our results we conclude that this ELISA is suitable to measure in vivo plasma PAP levels.

Antibodies, Monoclonal↗
PubMed1996

Do microglia arise from pericytes? An ultrastructural and distribution study in the rat cerebellar cortex.

Both pericytes and microglia are dark cells that may present similar ultrastructure as well as organization of the rough endoplasmic reticulum cisternae; in addition, images that suggest pericytes being released from the basal lamina compartment, some of them looking like forms of perivascular microglia, may be found. Anatomical articulations between pericytes and microglia are observed. A distribution analysis reveals that, in the considered five neocerebellar cortical strata, the percentage of pericytes preponderates over the percentage of microglia; furthermore, there is a highly statistically significant linear trend between the percentages of pericytes and of microglia in connection with their distribution along the cortical strata. This study suggests that, in rat cerebellar cortex, microglia may arise from pericytes. It is also hypothesized that astroglia have an active role in releasing pericytes from the vascular wall.

Animals↗
PubMed1995

Evaluation of the fibrinolytic system in full-term neonates.

Plasminogen activity and antigen, euglobulin fibrinolytic activity, tissue-type plasminogen activator activity and antigen urokinase-type plasminogen activator antigen, plasminogen activator inhibitor-1 activity and antigen, plasminogen activator inhibitor-2 antigen, tissue-type plasminogen activator/plasminogen activator inhibitor complexes, alpha 2-antiplasmin, histidine-rich glycoprotein, and fibrinogen/fibrin degradation products were measured in blood samples taken from the umbilical vein of 100 healthy full-term newborns. Results were compared with a control group of 30 healthy adults. The overall fibrinolytic activity assessed on fibrin plates was significantly increased (P < 0.002). We also observed high tissue-type plasminogen activator activity levels (P < 0.001), whereas urokinase-type plasminogen activator antigen levels were lower than in adults. There was a significant reduction in plasminogen activity and antigen (P < 0.0001), plasminogen activator inhibitor-1 activity (P < 0.05), alpha 2-antiplasmin (P < 0.0001), and histidine-rich glycoprotein (P < 0.0001), whereas plasminogen activator inhibitor-2, tissue-type plasminogen activator/plasminogen activator inhibitor complexes and fibrinogen/fibrin degradation products did not differ between groups. We conclude that in the newborn there is increased fibrinolytic activity, mainly due to increased plasminogen activators and reduced fibrinolysis inhibition, without systemic fibrinolysis and fibrinogenolysis.

Adult↗
PubMed1995

Prolonged shedding of amantadine-resistant influenzae A viruses by immunodeficient patients: detection by polymerase chain reaction-restriction analysis.

Consecutive A (H3N2) influenza virus isolates from 2 influenza virus-infected immunodeficient patients treated with amantadine were examined using a novel polymerase chain reaction (PCR)-restriction analysis for resistance to this antiviral compound. The data indicate that immunodeficient patients may shed resistant viruses for prolonged periods and with different drug resistance mutations present at different times. This PCR-restriction technique allows rapid detection of amantadine- or rimantadine-resistant strains.

Adult↗
PubMed1995

Detection of enteroviruses and rhinoviruses in clinical specimens by PCR and liquid-phase hybridization.

A sensitive method based on PCR followed by liquid-phase hybridization for detection of enterovirus and rhinovirus RNAs in clinical specimens and cell culture supernatants is described. RNA was extracted from stool samples, throat swabs, nasopharyngeal aspirates, cerebrospinal fluid, urine, and plasma with a commercial phenol-guanidinium-chloroform reagent and purified on a polysulfone membrane, on which the reverse transcriptase reaction was also done. Two sets of oligonucleotide primers from the 5' noncoding region of picornaviruses were selected for DNA amplification of 153-bp (enterovirus) and 120-bp (rhinovirus) regions. Double-stranded amplicons were digested into single strands with T7 gene 6 exonuclease and quantitated by an assay using a europium-labeled probe, streptavidin- and biotinylated probe-coated microtitration wells, and time-resolved fluorometry. The sensitivity of the assay was about one template molecule when purified coxsackievirus A9 RNA was used. All enterovirus prototype strains, except echoviruses 22 and 23, and clinical isolates grown in cell culture or suckling mice were strongly positive by the enterovirus PCR-hybridization, as were selected prototype strains and untyped isolates of rhinoviruses by the rhinovirus PCR-hybridization. In a series of 100 clinical specimens tested, the results for 92 agreed with virus culture results. The detection method described will be useful in etiopathogenic studies on enteroviruses and rhinoviruses.

Animals↗
PubMed1995

Age changes in cerebellar oligodendrocytes: the appearance of nuclear filaments and increase in the volume density of the nucleus and in the number of dark cell forms.

A qualitative and quantitative ultrastructural study (volume density of the nucleus and cell countings) on age-related changes occurring in neocerebellar oligodendrocytes of the granular layer was carried out in female albino rats aged 2-24 months. Taking into account the cytological features, two types of oligodendrocytes could be discerned, designated as Type I and Type II. Observations showed that, from 18 months onwards, the appearance of bundles of nuclear filaments running throughout the euchromatin areas are common occurrence in Type II oligodendrocytes. The lowest and highest mean volume density of the nucleus is achieved, respectively, at 2 months (50.67%) and at 21 months (64.93%); the analysis of variance of the parameter with ageing displays a most statistically significant result. There is also a positive and linear correlation between the volume density and age. The percentage of Type I oligodendrocytes (out of the total of counted oligodendrocytes) predominates from 2 to 15 months; after being even at 18 months, the percentage of Type II oligodendrocytes preponderates at 21 and 24 months. Although oligodendrocytes are capable of undergoing mitosis, it is concluded that they are prone to morphological changes with ageing, a warning that the physiology of oligodendrocytes may be eventually affected.

Animals↗