Biomedical subjects

E Rodriguez

Publications and source records attributed to E Rodriguez.

At least 109 records · Page 6Linked to original sources

PubMed1997

PCR detection of sequences similar to the AS-48 structural gene in bacteriocin-producing enterococci.

Three oligonucleotide primers, specific for the structural gene of antimicrobial peptide AS-48, were used to study the distribution of sequences similar to this gene in 15 independently isolated bacteriocin-producing Enterococcus strains by semi-nested PCR. Eight of 10 Ent. faecalis strains and three of five Ent. faecium strains gave a positive result in both reactions of the semi-nested PCR. These findings indicate that bacteriocins produced by many enterococcal strains are very closely related or even identical to peptide AS-48.

Bacteriocins↗

PubMed1997

CT-guided core-needle biopsy in omental pathology.

PURPOSE: To assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology. MATERIAL AND METHODS: We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n = 2) or diffuse (n = 23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n = 15), laparoscopic biopsy (n = 3), endoscopic biopsy (n = 1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n = 6). The final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. The CT-guided biopsies were performed with 1.0-1.8-mm Surecut core-needles. RESULTS: In 16 patients, the final diagnosis was metastatic adenocarcinoma--with the primary tumor sites in the ovary (n = 3), stomach (n = 1), appendix (n = 2), and unknown (n = 10). In the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n = 16) or cytological (n = 8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. In differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications. CONCLUSION: CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology.

Actinomycosis↗

PubMed1997

Vaginal colonization or infection with Candida albicans in human immunodeficiency virus-infected women during pregnancy and during the postpartum period. Women and Infants Transmission Study Group.

We evaluated the relationship between immunologic status and vaginal colonization or infection with Candida albicans for 605 women enrolled in a multicenter, prospective cohort study of mother-to-infant transmission of human immunodeficiency virus type 1 (HIV-1). A low CD4+ lymphocyte level (< 14% vs. > or = 14%, which corresponds to an absolute count of approximately 200 x 10(6)/L) was associated with a two- to fivefold increased likelihood of vaginal colonization (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.01-5.19) and vaginal candidiasis (OR, 3.08; 95% CI, 1.21-7.71) during pregnancy and during the postpartum period (OR, 2.98; 95% CI, 1.51-5.88 and OR, 5.45; 95% CI, 1.73-16.6, respectively). These associations persisted in multivariate logistic regression analyses. No associations with CD8+ lymphocyte levels or CD8+ CD38+ or other lymphocyte subset levels were found after adjustment for CD4+ cell level and other covariates. However, postpartum (but not antepartum) antibiotic use and pregnancy were also associated with vaginal colonization and candidiasis (P < or = .001 for each). Vaginal candidiasis was not associated with an increased risk of mother-to-infant transmission of HIV-1; however, a related, more inclusive variable, clinical vaginitis or vaginosis of any etiology at the last antepartum visit, was associated with mother-to-infant transmission (OR, 1.92; 95% CI, 1.07-3.43). These findings emphasize the complex, multifactorial nature of vaginal candidiasis and highlight the need for safe and effective treatment and prevention strategies for women with advanced HIV infection.

Adult↗

PubMed1997

Role of epicardial pacing wire cultures in the diagnosis of poststernotomy mediastinitis.

Mediastinitis after cardiac surgery is difficult to diagnose in many cases. The transitory epicardial pacing wires used after surgery are placed in the mediastinum, so the culture of these wires could be useful for the diagnosis of this disease. To test this hypothesis, we routinely cultured the epicardial pacing wires of 565 patients undergoing extracorporeal circulation. Wires were removed on the 7th to 9th postoperative day under sterile conditions and were cultured with routine techniques used for the culture of venous catheters. Mediastinitis developed in 16 patients, and Staphylococcus aureus was the most common pathogen (81.25%). We had 103 positive and 462 negative cultures. There were 458 true-negative, 12 true-positive, 91 false-positive and 4 false-negative results. For mediastinitis in general, epicardial pacing wire culture has a sensitivity of 75%, specificity of 83.4%, positive predictive value of 11.6%, and negative predictive value of 99.1%. For Staphylococcus aureus mediastinitis, epicardial pacing wire culture has a sensitivity of 84.6%, specificity of 95.8%, positive predictive value of 32.3%, and negative predictive value of 99.6%. We conclude that a sterile culture of the epicardial pacing wires strongly contradicts a diagnosis of postsurgical mediastinitis.

Cardiac Surgical Procedures↗

PubMed1997

Comparison of statistical indicators for the automatic detection of 80 Hz auditory steady state responses.

OBJECTIVE: To evaluate, using receiver operation characteristic (ROC) curves, the performance of several statistical indicators in the objective detection of 80 Hz steady state auditory evoked responses. DESIGN: Steady state auditory evoked responses elicited by amplitude modulated tones of 500 and 1000 Hz, were obtained in 16 normal adults. Recordings were made at intensities ranging from 80 to 30 dB SPL and without stimulation. Four statistics: coherence synchrony measure, circular T2, a new variant of Hotelling T2 (labeled HT2) and a test for hidden periodicity (F test) were calculated. The statistics were compared using ROC curves and bootstrapping techniques. Two outcome measures were considered: behavioral threshold prediction and averaging efficiency. RESULTS: All indicators were highly accurate to detect a response (8 to 9 dB above mean behavioral threshold for the 1000 Hz and 14 to 16 dB for the 500 Hz carrier). Responses could be reliable detected after averaging about five individual epochs of long duration. No statistically significant differences were evidenced though in their capability to predict behavioral threshold or their averaging efficiency. CONCLUSIONS: Despite the more adequate statistical properties of some of these indicators no significant differences were found in their performance. Thus all of these indicators could be recommended for automatic detection of 80 Hz auditory steady state responses.

Adolescent↗

PubMed1997

To treat or not to treat: issues in decisions not to treat older persons with cognitive impairment, depression, and incontinence.

OBJECTIVES: To examine decisions not to treat problems identified during outpatient geriatric assessment, particularly problems of cognitive impairment, depression, or urinary incontinence. DESIGN: A descriptive study using patients' medical charts and survey data and interviews with clinical staff. SETTING: Four hospital-based, ambulatory, geriatric assessment clinics in Allegheny Country, PA. PARTICIPANTS: The sample comprised 128 older adults, recruited to a randomized, controlled clinical trial, who had problems associated with cognitive impairment, depression, or urinary incontinence. RESULTS: Although treatment was recommended for most of the problems relating to cognitive impairment, depression, and/or incontinence experienced by this group, slightly more than one-third of cognitive impairment and depression problems and nearly one-half of incontinence did not receive treatment recommendations. Treatment rates varied considerably by condition and combination of comorbidity. Decisions not to treat are classified into six categories: patient or family refused treatment, the assessment was not completed, an intervention was already in place, concurrent problems or comorbities might have interfered with treatment, there was no documented diagnosis or there was a documented consideration and rule out of the problem, or no documented reason. CONCLUSION: Outpatient geriatric assessment units are designed to deal with the multiple problems experienced by their geriatric patients, and they identify successfully most problems presented by their frail constituents. However, identification of the patient's problems is only the first step in the assessment process and does not necessarily lead to either a documented diagnosis or to a treatment recommendation. Multiple social, cultural, environmental, and medical factors complicate the assessment process and, hence, the decision clinicians face when they decide whether to make recommendations to treat. These clinicians must weigh all medical and non-medical factors, including the patient's receptivity to treatment, when prioritizing the problems they deem to be treatable and making recommendations to treat.

Aged↗

PubMed1997

Molecular typing of Aspergillus fumigatus strains by sequence-specific DNA primer (SSDP) analysis.

A PCR typing method has been developed and tested to investigate the polymorphism of clinical strains of Aspergillus fumigatus. Firstly, the DNA fragments from random amplified polymorphic DNA (RAPD) patterns of nine epidemiologically and geographically non-related monosporal strains of A. fumigatus were cloned and sequenced. The pairs of five sequence-specific DNA primers (SSDP), characteristic of the 5' and 3' extremities of the RAPD products, were then used in high stringency PCR to type 43 clinical strains of A. fumigatus from 13 patients, according to the presence or absence of a single amplified band. This original approach, which uses the advantages of PCR, has made it possible to overcome the difficulties resulting from the low stringency amplification. The SSDP analysis of 51 A. fumigatus strains (9 unrelated monosporal strains and 43 clinical strains from 13 patients) can be classed into 22 different types with a high reproducibility and a high level of discrimination (D = 0.96). The results suggest that seven lung transplant patients with necrotizing aspergillosis, bronchitis aspergillosis and bronchial colonization were infected by multiple strain genotypes, whereas three patients with invasive aspergillosis seem to have been infected by a single strain.

Aspergillosis↗

PubMed1997

Murine macrophage elastolytic activity induced by Aspergillus fumigatusstrains in vitro: evidence of the expression of two macrophage-induced protease genes.

The interaction between Aspergillus fumigatus conidia and murine macrophages of various origins was investigated. Cocultures were carried out between A. fumigatus strains and freshly isolated murine pulmonary alveolar macrophages or two murine macrophage cell-lines: murine alveolar cell-line MALU and murine astrocytoma cell-line J774. By measuring the variation of elastolytic activity in the coculture supernatants with two elastin substrates, we demonstrated that either viable or fixed A. fumigatus or C. albicans yeasts or nonspecific particles induced significant macrophage elastolytic activity. The effect of A. fumigatus supernatant or the purified A. fumigatus galactomannan suggested also the possible involvement of this polysaccharide in macrophage-protease gene expression, release, and activity in invasive aspergillosis. The effect of inhibitory compounds demonstrated the potential implication of a macrophagic metalloprotease and a macrophagic cysteine protease. RNA analysis allowed us to demonstrate the induction of expression of two macrophagic protease genes in stimulated macrophages. Two distinctive mechanisms appeared to be implicated in macrophage protease induction: nonspecific phagocytosis in the earliest times of the coculture and (or) specific galactomannan recognition after its gradual release by the mycelium.

Animals↗

PubMed1997

The potential role of unemployment benefits in shaping the mental health impact of unemployment.

This study looks at the association between formal systems of support (unemployment compensation or welfare) and mental health outcomes during periods of unemployment. It assesses whether unemployed persons not receiving unemployment benefits are at greater risk of reporting depression and suffering ill-health than those receiving some kind of unemployment compensation, independent of total household income. The authors performed a secondary analysis of data collected in the National Survey of Families and Households, 1987-1988. Outcome measures included an index of depression and perception of health status. Multiple regression analyses were used. The unemployed receiving unemployment compensation or benefits from other entitlement programs did not report significantly higher depression relative to the employed. Rather, the study found a significantly higher index of depression among unemployed persons receiving welfare benefits or no benefits, even after controlling for total household income and previous employment/unemployment history. Thus unemployment compensation may play an important role in ameliorating the impact of unemployment on depression. By contrast, means-tested benefits may not be sufficient to reduce the risk for reporting depression and suffering ill-health in comparison with the full-time employed. The implications of the findings are discussed in terms of social policy development.

Adaptation, Psychological↗

PubMed1997

Synthesis and characterization of a new bile acid and platinum(II) complex with cytostatic activity.

With a view to using bile acids as shuttles for delivering platinum-related cytostatic drugs to the liver, a cholylglycine(CG)-derivative of platinum(II) has been synthesized. The complex, named Bamet-H2, was characterized by elemental analysis, FT-IR, NMR, FAB-MS, and UV spectroscopy. The results indicate the following composition: C52H84N2O12ClNa Pt(II). Conductivity data suggest that the complex behaves as a sodium salt (1:1) of a complex of Pt(II) bound to one cl-, one bidentate CG moiety, and another monodentate CG moiety, i.e., Na[Pt(CG-O,N)(CG-O)Cl]. The compound is highly soluble (up to 10 mM) in water, ethanol, methanol, DMF, and DMSO. Bamet-H2 was stable in solution (either water or 150 mM NaCl solution), as measured by HPLC, up to 24 h. At this time, more than 90% of the platinum present in water or saline solutions was found to be Bamet-H2. Cytostatic activity against L1210 murine leukemia cells was found. This characteristic was stronger against rat hepatocytes in primary culture. Isolated in situ rat livers were perfused for 40 min with a recirculating medium containing 1 microM Bamet-H2, CG, or cisplatin. Uptake and excretion into bile were much greater for Bamet-H2 than for cisplatin, but less than for CG. Liver content was higher for Bamet-H2 than for cisplatin or CG. The results point to the potential usefulness of Bamet-H2 in the antitumoral therapy of neoplasias derived from liver parenchymal cells.

Animals↗

PubMed1997

Clinical event monitoring at the University of Pittsburgh.

Although the literature on event monitoring is extensive, it does not cover all issues that we encountered while developing an event monitor at our institution. We had to resolve issues related to event detection, scalability, what topics were suitable for asynchronous decision support, and overlap of efforts of other groups at the institution attempting to improve quality and lower cost of care. In this paper, we describe our experience deploying CLEM, the clinical event monitor at the University of Pittsburgh with emphasis on these topics.

Academic Medical Centers↗

PubMed1997

Effect of human newborn BCG immunization on monocyte viability and function at 3 months of age.

SETTING: Immune response induced by BCG vaccination seems to reflect the development of T-cell immunity and monocyte activation. Participants were recruited from a large prospective study in infants from a suburb in Santiago, Chile. OBJECTIVE: To determine whether newborn BCG immunization changes the innate ability of cultured monocyte-macrophages to ingest and kill virulent mycobacteria in the absence of lymphocytes. DESIGN: The study population consisted of 15 three-month-old, tuberculin-positive infants immunized with BCG (Japanese) at birth, 13 randomly-selected, age-matched tuberculin-nonreactive infants in whom BCG immunization was postponed until one year of age, and five BCG-immunized, tuberculin-reactive adults. Adherent cells were cultured for 48 h. Monocyte-macrophage viability and number and viability of intracellular Mycobacterium tuberculosis bacilli were assessed after an additional 2 h and 4 and 7 days of incubation. RESULTS: There was no difference in the mean number of adherent cells present after 48 h among the three study groups. Adherent cells from BCG-immunized infants and adults had a significantly higher viability after 7 days in culture than adherent cells from non-immunized infants. The percentage of cells ingesting M. tuberculosis and the number of bacilli per cell after 2 h and 4 days was significantly higher in immunized infants and adults than in non-immunized infants. However, there was no evidence for increased killing of mycobacteria by cells from immunized infants and adults. CONCLUSION: These results suggest that BCG vaccination increases monocyte viability and the uptake of M. tuberculosis without enhancing the ability to kill ingested M. tuberculosis in the absence of lymphocytes.

Adult↗

PubMed1996

Cloning of the Penicillium minioluteum gene encoding dextranase and its expression in Pichia pastoris.

The DEX gene encoding an extracellular dextranase was isolated from the genomic DNA library of Penicillium minioluteum by hybridization using the dextranase cDNA as a probe. Comparison of the gene and cDNA sequences revealed that the DEX gene does not contain introns. Amino acid sequences comparison of P. minioluteum dextranase with other reported dextranases reveals a significant homology (29% identity) with a dextranase from Arthrobacter sp. CB-8. The DEX gene fragment encoding a mature protein of 574 amino acids was expressed in the methylotrophic yeast Pichia pastoris by using the SUC2 gene signal sequence from Saccharomyces cerevisiae under control of the alcohol oxidase-1 (AOX1) promoter. Over 3.2 g/l of enzymatically active dextranase was secreted into the medium after induction by methanol. The yeast product was indistinguishable from the native enzyme in specific activity and the N-terminus of both proteins were identical.

Amino Acid Sequence↗

PubMed1996

Treating major depression in primary care practice. Eight-month clinical outcomes.

BACKGROUND: We studied whether standardized treatments of major depression whose efficacy was established with psychiatric patients are equally effective when provided to primary care patients, and whether standardized treatments are more effective than a primary care physician's usual care. METHODS: A randomized controlled trial was conducted, in which primary care patients meeting DSM-III-R criteria for a current major depression were assigned to nortriptyline (n = 91) or interpersonal psychotherapy (n = 93) provided within well-structured parameters, or a physician's usual care (n = 92). The main outcome measures were degree and rate of improvement in severity of depressive symptoms and proportion of patients recovered at 8 months. RESULTS: Severity of depressive symptoms was reduced more rapidly and more effectively among patients randomized to pharmacotherapy or psychotherapy than among patients assigned to a physician's usual care. Among treatment completers, approximately 70% of patients participating in the full pharmacotherapy or psychotherapy protocol but only 20% of usual care patients were judged as recovered at 8 months. CONCLUSIONS: Pharmacotherapy and psychotherapy effectively treat major depression among primary care patients when provided within specific parameters and for the full acute and continuation phases. Treatment principles recommended by the Depression Guideline Panel of the Agency for Health Care Policy and Research are supported.

Adult↗

PubMed1996

Invertase secretion in Hansenula polymorpha under the AOX1 promoter from Pichia pastoris.

A DNA fragment containing a transcription regulating region of the alcohol oxidase (AOX1) gene from the methylotrophic yeast Pichia pastoris was used in the construction of a vector for the expression of heterologous proteins in the methylotrophic yeast Hansenula polymorpha. We used this vector to clone the SUC2 gene from Saccharomyces cerevisiae into H. polymorpha yeast. The culture conditions for invertase production using a fed-batch culture were studied. More than 1.5 x 10(3) U/ml of biologically active invertase (1 g/l) were secreted to the cellular periplasmic space. The fermentative process was scaled up to 50 l. Invertase produced from H. polymorpha was glycosylated, but it contained significantly less carbohydrate than protein produced by S. cerevisiae. Using the Western-blot technique, it was observed that invertase secreted from H. polymorpha and invertase secreted from S. cerevisiae showed common antigenic determinants.

Alcohol Oxidoreductases↗

PubMed1996

Validity of random urines to quantitate proteinuria in children with human immunodeficiency virus nephropathy.

Accurate assessment of proteinuria in pediatric patients infected with the human immunodeficiency virus (HIV) is limited by constraints imposed by timed urine collections and low creatinine excretion in very ill patients with low muscle mass. We therefore sought to validate the use of random urine specimens to quantitate total protein and creatinine excretion in a population of 236 HIV-positive children. A mathematical derivation for estimating urine volume (V) was constructed. The accuracy of the final calculation [V = 832 (kL/Ucr)BSA] (where k = constant, L body length, UCr urine creatinine and BSA body surface area) was tested by regression analysis comparing the calculated and measured volume of 31 urines from ambulatory HIV-negative patients. The correlation coefficient was highly significant (r = 0.77, P < or = 0.0001). The relationship was also applied to 23 timed urine specimens from HIV-positive patients with similar significance (r = 0.87, P < 0.0001). A regression analysis of measured proteinuria against the urine protein: creatinine ratio (Upr/Ucr) in these same urines from the HIV-positive patients yielded a significant relationship both in the linear (r = 0.95, y = 0.4x) and the logarithmic regression (r = 0.97, y = x + 0.4). These data support the use of random Upr/Ucr ratios to estimate daily proteinuria in HIV-infected pediatric patients despite low creatinine excretion rates. The previously accepted values continue to apply, with Upr/Ucr < or = 2.0 considered normal and > 2.0 representative of nephrotic proteinuria.

Adolescent↗

PubMed1996

Severe Guillain-Barré syndrome in childhood treated with human immune globulin.

Thirteen children with severe Guillain-Barré syndrome were treated with human immune globulin. Patients received a mean total dose of 1.9 gm/kg of human immune globulin for 2 or 5 days. To evaluate the relationship between the response to human immune globulin and electrodiagnostic findings, we compared the clinical outcome of 3 groups of children. The first group consisted of 9 children with electrophysiologic evidence of a mean amplitude of the compound motor action potentials larger than 10% of the lower limit of normal. The second group of 4 children had inexcitable motor nerves. Children in the second group required longer periods to improve one functional grade (mean 67.3 days vs 18.8 days) and to reach grade 2 (219 days vs 32.7 days). Moreover, children in the second group were more disabled after 3 and 6 months, and they all remained with distal atrophy and weakness after 7 months of follow-up. Furthermore, the outcome of children in the second group was no different from that of a historic control of 5 untreated children with severe Guillain-Barré syndrome and similar electrophysiologic findings. Human immune globulin treatment in children with severe Guillain-Barré syndrome is safe, easy to administer, and does not increase the number of relapses. Nevertheless, it does not seem to benefit children with low mean compound motor action potential amplitude.

Child↗

PubMed1996

Regulation of pulp cell matrix metalloproteinase production by cytokines and lipopolysaccharides.

Little information is currently known regarding the effects of cytokines and lipopolysaccharides (LPS's) on matrix metalloproteinase (MMP) production by pulp cells in vitro. In this study, human pulp cells (HPC's) and clonal rat pulp cells RPC-C2A were treated with interleukin (IL)-1 alpha, IL-1 beta, tumor necrosis factor (TNF)-alpha, and LPS for 24 h. Conditioned medium and cell lysates were collected and analyzed by gelatin zymography. RPC-C2A cells treated with IL-1 beta and TNF-alpha displayed elevated levels of MMP's in conditioned medium fractions. LPS's at increasing concentrations had a similar effect. HPC's treated with either cytokines or LPS's had no change in the pattern of MMP's produced or secreted in either cellular or conditioned medium fractions. These studies indicate that the effects of cytokines and LPS's on pulp cells are not identical for cells from different species and requires further investigation to clarify these variations.

Animals↗