Biomedical subjects

F Martínez

Publications and source records attributed to F Martínez.

At least 19 recordsLinked to original sources

PubMed2006

A prospective trial comparing oocyte donor ovarian response and recipient pregnancy rates between suppression with gonadotrophin-releasing hormone agonist (GnRHa) alone and dual suppression with a contraceptive vaginal ring and GnRH.

BACKGROUND: Contraceptive treatment before gonadotrophin-releasing hormone agonist administration presents advantages in women with a tendency to hyper-response and simplifies donor-recipient treatment synchronization. This study compares response to gonadotrophin stimulation under hypophyseal suppression in oocyte donors with or without vaginal contraceptive pretreatment. METHODS: One hundred and ninety oocyte donors were recruited in a single centre and prospectively assigned to one of two treatment groups, according to the day of the week menstruation initiated: Group VC-, no prior vaginal contraceptive and Group VC+, prior vaginal contraceptive. RESULTS: VC+ patients presented a significantly higher cancellation rate, lower plasma estradiol levels and fewer follicles >12 mm on the day of hCG, versus the VC- group. Number of oocytes recovered was significantly lower in the VC+ group. All the cases of severe ovarian hyperstimulation syndrome (SOHSS) were in the VC- group. Pregnancy rates by embryo transfer to synchronic recipients were similar between VC+ and VC- (59.5 versus 57.9%, respectively). CONCLUSIONS: Vaginal contraceptive pretreatment resulted in a higher ovarian suppression, whereas SOHSS rate was lower than in donors who did not receive pretreatment. There were no differences in pregnancy rates between the two groups of synchronic oocyte recipients.

Adult↗

PubMed2006

Donor age and degree of HLA matching have a major impact on the outcome of unrelated donor haematopoietic cell transplantation for chronic myeloid leukaemia.

We analysed the outcome of 92 consecutive unrelated donor haematopoietic cell transplantations (UD-HCTs) performed in Spain to treat adult patients with CML in the first chronic phase (1CP). Patients' and donors' median age was 32 (15-49) and 36 (22-56) years, respectively. In all, 73 pairs (79%) matched for A, B+/-C and DRB1+/-DQB1 loci and 19 had > or =1 mismatch. Their probability of survival and disease-free survival at 4 years were 50 and 46%, respectively. Pretransplant factors associated with a better survival were patient age <25 years (P=0.035), donor age < or =36 years (P=0.012), use of cyclosporine since day -7 (P=0.001), and matching 8/8, 9/10 or 10/10 loci at allele level (P=0.003). In multivariate analysis only donor age (P=0.003; RR=3.1 (95% CI: 1.3-7.1)) and degree of HLA-matching (P=0.009; RR: 7.7 (95% CI: 1.8-33)) maintained their significance. The addition of these two variables to the EBMT prognostic score allowed an adequate risk assessment for patients receiving a UD-HCT during 1CP. Our analysis shows that in patients with a young and fully allele-matched donor, UD-HCT should be considered in the initial therapeutic algorithm due to its excellent outcome (92% survival at 2 years).

Adolescent↗

PubMed2006

A simple technique for shoulder arthrography.

PURPOSE: To present a systematic approach to teaching a technique for arthrography of the shoulder. Using an adhesive marker-plate with radiopaque coordinates, precise sites for puncture can be identified and the need for fluoroscopic guidance obviated. MATERIAL AND METHODS: Forty-six glenohumeral arthrograms were performed in 45 patients; in 1 case involving examination of both shoulders. The stages of the technique are described in detail, as are the fundamental aspects of achieving an effective glenohumeral injection. Pain intensity was measured in all patients using a verbal description scale. RESULTS: Shoulder arthrography was successful in all cases. Average time taken for the procedure was 7 min, with no difference in the respective times required by an experienced radiologist and a resident. The procedure was well tolerated by most patients, with slight discomfort being observed in a very few cases. CONCLUSION: The arthrographic technique used in this study is simple, safe, rapid, and reproducible, and has the advantage of precise localization of the site for puncture without need for fluoroscopic guidance. The procedure described in this study can be of help in teaching residents and can reduce the learning curve for radiologists with no experience in arthrographic methods. It also reduces the time of exposure to fluoroscopy.

Adult↗

PubMed2006

Perioperative intravenous iron preserves iron stores and may hasten the recovery from post-operative anaemia after knee replacement surgery.

In unilateral total knee replacement (TKR), perioperative blood loss, low transfusion thresholds and short hospital stay result in patients being discharged with low haemoglobin (Hb). We assessed the effects of perioperative administration of intravenous iron, with or without erythropoietin, plus a restrictive transfusion threshold (Hb < 80 g L(-1)) both on transfusion rate and recovery from post-operative anaemia. TRK patients received iron sucrose (2 x 200 mg per 48 h, iv) (Group IVI, n = 129). Patients with admission Hb < 130 g L(-1), also received erythropoietin (1 x 40 000 IU, sc) (Group EPO, n = 19). Perioperative clinical and laboratory data were obtained. Mean Hb loss was 36 g L(-1), but only seven patients were transfused (5%). Pre-operatively, 66 (45%) patients did not have enough stored iron to compensate Hb loss. At post-operative day 30, only 15% were anaemic, 70% of Hb loss and 92% of pre-operative Hb were recovered and ferritin increased by 73 microg L(-1) (P < 0.01), although erythropoietic response was higher in patients receiving erythropoietin (P < 0.05). No adverse effects of iron sucrose or erythropoietin were witnessed. This protocol seems to reduce allogeneic blood transfusion rate and may hasten the recovery from post-operative anaemia in TKR patients, without depleting iron stores. Further studies are needed to ascertain which patients may benefit of extended intravenous iron and/or erythropoietin administration.

Aged↗

PubMed2006

Recombinant X chromosome in a prenatal diagnosis.

The prenatal cytogenetic study of an amniotic fluid sample of a 39-year-old female showed one X chromosome with a fragment of extra material in the short arm. The G-band pattern suggested that the extra material could be the long arm of an X chromosome. Several complementary studies were performed in order to better clarify the origin of the material. These studies included parental karyotypes, microsatellite typing and comparative genomic hybridization (CGH). The results obtained allowed us to conclude that the derivative chromosome arose de novo as a recombinant X chromosome with duplication of Xq and partial deletion of Xp. Once informed, the parents decided to continue with the pregnancy, after which a healthy girl was born with no apparent disorders.

Adult↗

PubMed2005

The treatment of mice with Lactobacillus casei induces protection against Babesia microti infection.

In this study, we report that administration of Lactobacillus casei confers protection to mice against the intracellular protozoan Babesia microti. Mice treated with L. casei orally or intraperitoneally were inoculated 7 days later with an infectious dose of B. microti. Mice treated with lactobacilli showed significant reduction in the percentage of parasitized erythrocytes (PPE) compared to untreated mice. When mice were inoculated intraperitoneally with L. casei 3 or 0 days before challenge with B. microti, the PPE was significantly lower compared to untreated mice and there were no differences between treated mice and mice immune to B. microti infection. When mice treated with live or dead L. casei were compared to mice inoculated with Freund Complete Adjuvant before a B. microti infection, a significant reduction of PPE was observed. These results show the protective effect of L. casei administered to mice against a B. microti infection and suggest that it might act by stimulating the innate immune system.

Administration, Oral↗

PubMed2005

Heavy metal speciation and phytotoxic effects of three representative sewage sludges for agricultural uses.

The environmental impact of sewage sludges depends on the availability and phytotoxicity of their heavy metal. The influence of representative sludges (dewatered anaerobic, pelletization, and composted sludge) on the availability of heavy metals, and their effects on seed germination were compared. The total heavy metal concentrations were below the maximum permitted for land-applied waste and the differences among them were small. The DTPA-extracted metal concentrations were rather different. The sequential extraction of the compost showed a slight increase in Cd and Cu availability, and a decrease in the availability of Fe, Mn, Ni and Zn. Pelletization increased the availability of Ni and slightly reduced that of Cr. The dewatering sludge led to greater availability of Cr and Mn but reduced the concentration of Cd. The three different sludges also affected seed germination and root elongation in different ways. The most serious adverse effects were caused by the dewatered sludge extract.

Agriculture↗

PubMed2005

Activity and resistance of iron-containing amorphous, zeolitic and mesostructured materials for wet peroxide oxidation of phenol.

Iron-containing materials have been prepared following several strategies of synthesis and using different silica supports (amorphous, zeolitic and mesostructured materials). Activity and stability of these materials was evaluated on the wet peroxide oxidation of phenol under mild reaction conditions (100 degrees C, air pressure of 1MPa and stoichiometric amount of hydrogen peroxide for the complete mineralisation of phenol). Their catalytic performance was monitored in terms of phenol and total organic carbon (TOC) conversions, by-products distribution (aromatics compounds and carboxylic acids) and degree of metal leached into the aqueous solution. The nature and local environment of iron species is strongly dependent on the synthetic route, which dramatically influences their catalytic performance. Crystalline iron oxide species supported over mesostructured SBA-15 materials have demonstrated to be the most interesting catalysts for phenol degradation according to its high organic mineralisation, low sensitivity to leaching out and good oxidant efficiency.

Carbon↗

PubMed2005

Iron affects the structure of cell membrane molecular models.

The effects of Fe(3+) and Fe(2+) on molecular models of biomembranes were investigated. These consisted of bilayers of dimyristoylphosphatidylcholine (DMPC) and of dimyristoylphosphatidylethanolamine (DMPE), classes of phospholipids located in the outer and inner moieties of cell membranes, respectively. X-ray studies showed that very low concentrations of Fe(3+) affected DMPC organization and 10(-3)M induced a total loss of its multilamellar periodic stacking. Experiments carried out with Fe(2+) on DMPC showed weaker effects than those induced by Fe(3+) ions. Similar experiments were performed on DMPE bilayers. Fe(3+) from 10(-7)M up to 10(-4)M had practically no effect on DMPE structure. However, 10(-3)M Fe(3+) induced a deep perturbation of the multilamellar structure of DMPE. However, 10(-3)M Fe(2+) had no effect on DMPE organization practically. Differential scanning calorimetry measurements also revealed different effects of Fe(3+) and Fe(2+) on the phase transition and other thermal properties of the examined lipids. In conclusion, the results obtained indicate that iron ions interact with phospholipid bilayers perturbing their structures. These findings are consistent with the observation that iron ions change cell membrane fluidity and, therefore, affect its functions.

Calorimetry, Differential Scanning↗

PubMed2005

Perioperative stimulation of erythropoiesis with intravenous iron and erythropoietin reduces transfusion requirements in patients with hip fracture. A prospective observational study.

BACKGROUND AND OBJECTIVES: Patients undergoing surgery for hip fracture (HF) often receive perioperative allogeneic blood transfusions (ABT) to avoid anaemia. However, concerns about the adverse effects of ABT have prompted the review of transfusion practice and the search for a safer treatment of perioperative anaemia. MATERIALS AND METHODS: We prospectively investigated the effect of a blood-saving protocol of perioperative iron sucrose (3 x 200 mg/48 h, intravenously) plus erythropoietin (1 x 40,000 IU, subcutaneously) if admission haemoglobin level < 130 g/l, on transfusion requirements and postoperative morbid-mortality in patients with HF (group 2; n= 83). A parallel series of 41 HF patients admitted to another surgical unit within the same hospital served as the control group (group 1). Perioperative blood samples were taken for haematimetric, iron metabolism and inflammatory parameter determination. RESULTS: This blood-saving protocol reduced the number of transfused patients (P < 0.001), the number of transfused units (P < 0.0001), increased the reticulocyte count and improved iron metabolism. In addition, the blood-saving protocol also reduced the rate of postoperative infections (P = 0.016), but not the 30-day mortality rate or the mean length of hospital stay. CONCLUSIONS: The blood-saving protocol implemented seems to reduce ABT requirements in patients with HF, and is associated with a lower postoperative morbidity. The possible mechanisms involved in these effects are discussed.

Aged↗

PubMed2005

Mortality in Spain during the heat waves of summer 2003.

The effect of the elevated temperatures on mortality experienced in Europe during the summer of 2003 was observed in several countries. This study, carried out in Spain, describes mortality between 1 June and 31 August and evaluates the effect of the heat wave on mortality. Observed deaths were obtained from official death registers from 50 provincial capitals. Observed deaths were compared with the expected number, estimated by applying a Poisson regression model to historical mortality series and adjusting for the upward trend and seasonality observed. Meteorological information was provided by the Instituto Nacional de Meteorologia (National Institute of Meteorology). Spain experienced three heat waves in 2003. The total associated excess deaths were 8% (43 212 observed deaths compared with 40 046 expected deaths). Excess deaths were only observed in those aged 75 years and over (15% more deaths than expected for the age group 75 to 84 and 29% for those aged 85 or over). This phenomenon (heat-associated excess mortality) is an emerging public health problem because of its increasing attributable risk, the aging of the Spanish population and its forecasted increasing frequency due to global warming. The implementation of alert and response systems based on monitoring of climate-related risks, emergency room activity and mortality, and strengthening the response capacity of the social and health services should be considered.

Aged↗

PubMed2005

[Anesthetic management for thoracoscopic repair of type I esophageal atresia with continuous-flow single-lung ventilation].

We describe a continuous flow mode of ventilation for repair of type I esophageal atresia in an infant. This type of atresia is defined by distal stenosis of the esophagus with a proximal blind pouch and no connection to the tracheobronchial tree. In traditional repair procedures the surgical approach is by thoracotomy, but newer videoassisted thoracoscopic techniques have introduced novel challenges to ventilatory mechanics in these low-weight infants. The literature contains little discussion of the anesthetic management or respiratory mechanics of these patients. Trying to maintain adequate tidal volume and oxygenation while thoracoscopic maneuvers take place increases the risk of barotrauma. Single-lung ventilation with a continuous flow respirator was effective in the case we report.

Abnormalities, Multiple↗

PubMed2004

The stability of 2-acetoxy-4-trifluoromethylbenzoic acid (Triflusal) in micellar pseudophase.

The new platelet antiaggregant Triflusal or 2-acetoxy-4-trifluoromethylbenzoic acid presents a structural analogy to acetylsalicylic acid (ASA). Alkaline hydrolysis of triflusal was studied in the presence and absence of cationic micelles of N-cetyl-N-ethyl-N,N-dimethylammonium bromide (CDEABr) at different KOH concentrations and different temperatures (25, 30, and 37 degrees C) using a spectrophotometric method. The influence of potassium bromide concentration upon alkaline hydrolysis at 25 degrees C is also discussed. At constant [KOH] pseudofirst-rate constant (k(obs)) decreased with increasing [CDEABr] at concentrations greater than the CMC and also decreased with increasing [KBr] at constant [KOH] and [CDEABr]. To explain the effect of cationic micelles of CDEABr upon alkaline hydrolysis, the pseudophase ion exchange model was used. The values of the micellar properties such as the critical micelle concentration, the degree of micellar ionization and the neutralized fraction of the head group obtained by conductivity measurements were determined previously.

Algorithms↗

PubMed2004

Budd-Chiari syndrome caused by membranous obstruction of the inferior vena cava associated with coeliac disease.

Ten cases of Budd-Chiari syndrome associated with coeliac disease have been reported in the literature, most of them in North African subjects. Supporting this association, we report a new case in a young Spanish Caucasian man in whom the cause of the syndrome was the membranous obstruction of the inferior vena cava, an infrequent cause of Budd-Chiari syndrome in Western countries. A percutaneous balloon angioplasty was performed, with satisfactory outcome.

Adult↗

PubMed2004

[Variants of the anterior circle of Willis. Anatomic and angiografic correlation and its implications in the surgery of intracranial aneurysms. (Acigos anterior cerebral artery, median artery of the corpus callosum and accessory middle cerebral artery)].

It is worlwide accepted that in almost 60% of cases, anatomical variants in the Circle of Willis can be found. Some of them are associated with vascular malformations such as aneurysms. The knowledge of these anatomical variants is of vital importance when facing surgery, being the aims to preserve arteries in unusual localisations, which when injured can determine invalidating sequelae. The authors have reviewed 192 cerebral hemispheres, finding three variants in the anterior Circle of Willis: Azigos anterior cerebral artery; Median artery of the corpus callosum and accessory middle cerebral artery. The authors make an anatomical description of the findings, their angiographical correlation, and describe the influence of these changes during surgery of aneurysms in the involved regions.

Angiography↗

PubMed2004

Minimal residual disease in neuroblastoma: to GAGE or not to GAGE.

We assessed the utility of GAGE gene expression as a marker of minimal residual disease (MRD) in neuroblastoma. The GAGE gene family shows a high degree of homology (>90%), clustering into two subgroups. GAGE-1, -2, and -8 form one subset, almost identical among themselves, while GAGE-3 to -7 constitute the other subset. The entire GAGE family (GAGE-1-8) was studied by RT-PCR followed by Southern blotting to increase both the sensitivity and specificity of the technique. Surprisingly, expression of GAGE was detected in 59% of peripheral blood samples from normal controls (20/35) as well as in a similar proportion from neuroblastoma patients with localized disease (stages 1 and 2). The study of GAGE-1, -2, and -8 with specific primers lowered this percentage to 28% (10/35), of which only two (6%) showed a high level of expression (directly visualized after RT-PCR). We conclude that GAGE genes can show a variable, usually low level of illegitimate expression in normal blood cells, and therefore their use as MRD markers should be taken with caution.

Antigens, Neoplasm↗

PubMed2004

[MIBI and parathyroid gland function in secondary hyperparathyroidism].

The role of the double phase parathyroid scintigraphy with MIBI in the primary hyperparathyroidism has been well studied. The present work analyzes the benefit of this image technique in the diagnosis and therapeutic approach to uremia associated hyperparathyroidism. We studied 18 dialysis patients with clinical and analytical data of hyperparathyroidism. All of them were receiving treatment with i.v. vitamin D. We carried out two scintigraphic studies, the first under basal conditions (without changes in treatment) and the second one, a week later after the stimulation of the parathyroid gland through the cessation of the treatment with vitamin D and phosphorus binders, and the use of a low-calcium dialysate. In the basal study, fourteen patients had a positive uptake test in at least one of the four glands. These patients had significantly higher PTHi levels than those with a negative scintigraphic study. After the stimulation test, we found a statistically significative rise in PHTi (644 vs 979 p < 0.001) and phosphorus levels (5.8 vs 7.3; p < 0.01), a slight fall in calcium levels (p = NS) and a statistically significative increment in the score of scintigraphic captation (5.5 +/- 4.5 vs 6.8 +/- 5; p < 0.05). We found a statistically significative correlation between the PTHi level and the score of scintigraphic uptake, in the basal study (r = 0.6, p < 0.01) and after stimulation (r = 0.6, p < 0.01). The only variable associated with the scintigraphic uptake was PTHi, justifying 31.1% of the variance in the first study and 32.7% in the second. In conclusion, the MIBI scintigraphic is a useful exploration in the uremic patient with hyperparathyroidism, as it predicts the functional state of the parathyroid glands according to uptake intensity. The stimulation test could be useful in planning therapy, but some of its characteristics need to be established, such as the precise time to reach the maximum level of parathyroid stimulation.

Acetates↗

PubMed2003

Effects on run-off water quantity and quality of urban organic wastes applied in a degraded semi-arid ecosystem.

Biosolids and composted municipal solid wastes were surface-applied (0 and 80 Mg ha(-1)) to a degraded soil in a semi-arid environment to determine their effects on the quantity and quality of run-off water. Three and 4 years after application, a simulated rainfall was performed (intensity=942.5 ml min(-1) and kinetic energy=3.92 J m(-2)) on 0.078 m(2) plots using a portable rainfall simulator. The run-off from the different treatment plots was collected and analysed. The type of treatment was highly related to infiltration, run-off and sediment production. The biosolid-treated plots showed the minimum value of total run-off, maximum time to the beginning of run-off and maximum run-off ratio (the relationship between total rainfall and run-off). The MSW-treated plots showed values intermediate between biosolid-treated plots and control plots. Soil losses were also closely related to treatment type. Control plots showed the maximum sediment yield, MSW-treated plots showed intermediate values, and biosolid plots the minimum values for washout. The concentrations of NH(4)-N and PO(4)-P in the run-off water were significantly higher in the treated plots than in control plots. The highest PO(4)-P value, 0.73 mg l(-1), was obtained in the soil treated with biosolids; NO(3)-N concentration also increased significantly with respect to the control and MSW treatments. NH(4)-N concentrations of 15.6 and 15.0 mg l(-1) were recorded in the soils treated with biosolids and MSW, respectively, values approximately five times higher than those obtained in run-off water from untreated soil. However, the concentrations of all these constituents were lower than threshold limits cited in water quality standards for agricultural use. With the exception of Cu, all trace metals analysed in the run-off water were below detection limits.

Conservation of Natural Resources↗