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Biomedical subjects

G Navarro

Publications and source records attributed to G Navarro.

At least 19 recordsLinked to original sources

ASPP1, a common activator of TP53, is inactivated by aberrant methylation of its promoter in acute lymphoblastic leukemia.

We have analyzed the regulation and expression of ASPP members, genes implicated in the regulation of the apoptotic function of the TP53 tumor-suppressor gene, in acute lymphoblastic leukemia (ALL). Expression of ASPP1 was significantly reduced in ALL and was dependent on hypermethylation of the ASPP1 gene promoter. Abnormal ASPP1 expression was associated with normal function of the tumor-suppressor gene TP53 in ALL. The analyses of 180 patients with ALL at diagnosis showed that the ASPP1 promoter was hypermethylated in 25% of cases with decreased mRNA expression. Methylation was significantly higher in adult ALL vs childhood ALL (32 vs 17%, P = 0.03) and T-ALL vs B-ALL (50 vs 9%, P = 0.001). Relapse rate (62 vs 44%, P = 0.05) and mortality (59 vs 43%, P = 0.05) were significantly higher in patients with methylated ASPP1. DFS and OS were 32.8 and 33.7% for patients with unmethylated ASPP1 and 6.1 and 9.9% for methylated patients (P < 0.001 y P < 0.02, respectively). On the multivariate analysis, methylation of the ASPP1 gene promoter was an independent poor prognosis factor in ALL patients. Our results demonstrate that decreased expression of ASPP1 in patients with ALL is due to an abnormal methylation of its promoter and is associated with a poor prognosis.

Adaptor Proteins, Signal Transducing↗

Reliable quantification of hematopoietic chimerism after allogeneic transplantation for acute leukemia using amplification by real-time PCR of null alleles and insertion/deletion polymorphisms.

Increasing mixed chimerism (MC) after allogeneic stem cell transplantation (SCT) has been associated with a high risk of relapse in acute leukemia. We evaluated a new method for chimerism detection, based on the quantitative real-time PCR (qrt-PCR) amplification of null alleles or insertion/deletion polymorphisms (indels). All qrt-PCR assays with null alleles and indels attained a sensitivity of at least 10(-4), as well as good intra- and interassay concordance, and a high accuracy in experiments with cell mixtures. Informativeness was found in 80.3% of the 61 donor/recipient pairs tested. Nonrelapsed patients showed a progressive decrease in peripheral blood chimerism to values below 0.01% (complete chimerism (CC)). Bone marrow chimerism failed to reach CC more than 4 years after SCT. Increasing MC was observed prior to relapse in 88.2% of patients. Compared with conventional PCR amplification of variable number of tandem repeats, qrt-PCR predicted a significantly higher number of relapses (88.2 vs 44.4%) with a median anticipation period of 58 days. In conclusion, chimerism determination by qrt-PCR amplification of null alleles and indels constitutes a useful tool for the follow-up of patients with acute leukemia after SCT, showing better results than those obtained with conventional PCR.

Adolescent↗

Transcriptional silencing of the Dickkopfs-3 (Dkk-3) gene by CpG hypermethylation in acute lymphoblastic leukaemia.

DKK-3: is a newly characterised mortalisation-related gene and an antagonist of the Wnt oncogenic signalling pathway whose expression is decreased in a variety of cancer cell lines, suggesting that the Dkk-3 gene, located at chromosome 11p15.1, functions as a tumour suppressor gene. Although 11p15 is a 'hot spot' for methylation in acute lymphoblastic leukaemia (ALL), the role of Dkk-3 abnormalities has never been evaluated in this disease. We analysed CpG island methylation of the Dkk-3 promoter in six ALL cell lines and 183 ALL patients. We observed Dkk-3 hypermethylation in all cell lines and in cells from 33% (60/183) of ALL patients. Moreover, Dkk-3 methylation was associated with decreased Dkk-3 mRNA expression and this expression was restored after exposure to the demethylating agent 5-AzaC. Clinical features did not differ between hypermethylated and unmethylated patients. Estimated disease-free survival (DFS) and overall survival at 10 and 11 years, respectively, were 49.8 and 45.6% for normal patients and 10.5 and 15.1% for hypermethylated patients (P=0.001 and 0.09). Multivariate analysis demonstrated that Dkk-3 methylation was an independent prognostic factor predicting DFS (P=0.0009). Our data suggest that Dkk-3 methylation occurs at an early stage in ALL pathogenesis and probably influences the clinical behaviour of the disease.

Adaptor Proteins, Signal Transducing↗

Intrathecal IgG synthesis: marker of progression in multiple sclerosis patients.

OBJECTIVES: We study the power of IgG synthesis value as a marker of disease activity in multiple sclerosis (MS). MATERIAL AND METHODS: Link index was calculated in 202 MS patients. Time between first, second and third attack and progression index (PI) were compared in patient with normal (NLI) high (HL) or very high Link index (VHLI). RESULTS: Secondary progressive (SP) patients had a higher LI than relapsing-remitting (RR) and primary progressive (PP) courses (1.10 +/- 0.5 for SP vs 0.86 +/- 0.5 for RR and 0.81 +/- 0.5 for PP, P=0.01 and 0.03, respectively). Having a HLI in MS RR and SP patients has no time effect in the development of the second and third attack. PI was higher in patients with VHIL (0.67 +/- 0.7) vs patients with NLI (0.42 +/- 0.4, P=0.008) and with HLI (0.39 +/- 0.3, P=0.001). CONCLUSIONS: This study confirmed that LI is a good marker of subsequent progression of MS.

Adult↗

Review of the utilisation of a university hospital in Barcelona (Spain): evolution 1992-1996.

BACKGROUND: To test the applicability of the appropriateness evaluation protocol (AEP) as a tool for reviewing hospital utilisation. To quantify and to compare the rate of inappropriate admissions and amount of in-hospital days, emphasising the main causes and factors in the hospital associated with inappropriateness during the studied periods of time. PATIENTS AND METHODS: Two retrospective studies were carried out, the first one in 1992, when 2048 clinical histories were analysed, and the second in 1996, with 1099 reviewed histories. The tool used for the evaluation of the level of hospital utilisation is the AEP. RESULTS: The proportion of admissions considered to be inappropriate was 25% (95% CI: 20.8-24.5) in 1992, and 16% (95% CI: 13.8-18.2) in 1996. Premature admission was the most frequent cause of inappropriateness in both periods. The logistic regression model built for the dependent variable admission showed the following variables to be associated to inappropriateness: scheduled admission (OR: 15; 95% CI: 10.8-20.7) and (OR: 10; 95% CI: 6-16.5), weekend admission (OR: 2; 95% CI: 1.3-1.2) and (OR: 2; 95% CI: 1.2-2.3), for 1992 and 1996, respectively. The rate of inappropriate in-hospital stays in 1992 was 29% (95% CI: 28.3-29.6), and 13.5% (95% CI: 12.7-14.3) in 1996. Hospital organisational problems were the main cause of inappropriate in-hospital days in 1992, and diagnostic/ therapeutical tests that could be performed ambulatorily ranked first in 1996. The logistic regression model built for the dependent variable in-hospital days had the following independent variables associated to its inappropriateness: discharge on weekdays (OR: 1.4; 95% CI: 1.2-1.8) and (OR: 0.6; 95% CI: 0.5-0.8) and length of stay (OR: 2; 95% CI: 1.8-2.4) and (OR: 2.4; 95% CI: 2.3-2.5), for 1992 and 1996 respectively, among other variables. CONCLUSION: Periodic checking of the utilisation levels with the application of methods such as the AEP will contribute towards adapting hospital management in the more competitive current setting.

Female↗

Multiresidue method for the rapid determination--in grape, must and wine--of fungicides frequently used on vineyards.

A rapid multiresidue gas chromatographic method for determining 17 fungicides in grapes, must and wine, widely used on vineyards, is described. A simple on-line microextraction method for isolation of fungicides was used. Nitrogen-phosphorus and electron-capture detection were used for the identification and quantitation of pesticides. For confirmation, mass spectrometic detection was used. Because of the high selectivity of both detection methods, no clean-up was necessary. The regression coefficients relating to linearity were at least 0.994. Recoveries from spiked grapes, must and wine samples ranged from 78 to 107% and relative standard deviations were not higher than 14%. Individual detection limits were in the range 0.02-0.1 ng. Limits of quantification varied from 0.01 to 0.05 mg/kg, smaller in all cases than the maximum residue limits set down by the legislations of Spain, France and Italy, the main wine-producing countries of the European Union. Only for fludioxonil and hexaconazole do the limits of quantification coincide with the maximum residue limits (0.05 mg/kg) established by the Spanish legislation.

Chromatography, Gas↗

Genotype and phenotype analysis of Friedreich's ataxia compound heterozygous patients.

Friedreich's ataxia is caused by mutations in the FRDA gene that encodes frataxin, a nuclear-encoded mitochondrial protein. Most patients are homozygous for the expansion of a GAA triplet repeat within the FRDA gene, but a few patients show compound heterozygosity for a point mutation and the GAA-repeat expansion. We analyzed DNA samples from a cohort of 241 patients with autosomal recessive or isolated spinocerebellar ataxia for the GAA triplet expansion. Patients heterozygous for the GAA expansion were screened for point mutations within the FRDA coding region. Molecular analyses included the single-strand conformation polymorphism analysis, direct sequencing, and linkage analysis with FRDA locus flanking markers. Seven compound heterozygous patients were identified. In four patients, a point mutation that predicts a truncated frataxin was detected. Three of them associated classic early-onset Friedreich's ataxia with an expanded GAA allele greater than 800 repeats. The other patient associated late-onset disease at the age of 29 years with a 350-GAA repeat expansion. In two patients manifesting the classical phenotype, no changes were observed by single-strand conformation polymorphism (SSCP) analysis. Linkage analysis in a family with two children affected by an ataxic syndrome, one of them showing heterozygosity for the GAA expansion, confirmed no linkage to the FRDA locus. Most point mutations in compound heterozygous Friedreich's ataxia patients are null mutations. In the present patients, clinical phenotype seems to be related to the GAA repeat number in the expanded allele. Complete molecular definition in these patients is required for clinical diagnosis and genetic counseling.

Adult↗

Serum endothelial adhesion molecules levels correlate with lesion burden in multiple sclerosis patients treated with interferon beta-1b.

The levels of serum-soluble intracellular adhesion molecule-1 and soluble endothelial-leukocyte adhesion molecule-1, and the Gadolinium-enhanced T1-weighted MRI were studied in a group of patients with relapsing-remitting multiple sclerosis treated with interferon beta-1b and compared to a non-treated control group. The levels of serum-soluble intracellular adhesion molecule-1 and soluble endothelial-leukocyte adhesion molecule-1 increased, after three months treatment, as compared to baseline and the non-treated MS patients. A significant correlation was found in the treated group between serum-soluble endothelial-leukocyte adhesion molecule-1 and the lesion area in the Gadolinium-enhancing (T2 weighted scan) MRI.

Adult↗

Evolution of chlorpyrifos, fenarimol, metalaxyl, penconazole, and vinclozolin in red wines elaborated by carbonic maceration of Monastrell grapes.

The influence of the different steps involved in the wine-making process on the disappearance of chlorpyrifos, fenarimol, metalaxyl, penconazole, and vinclozolin in red wines elaborated by carbonic maceration of Monastrell grapes was studied. The initial levels of the residues in grapes ranged from 0.28 mg/kg (penconazole) to 1 mg/kg (chlorpyrifos). Ten days after the beginning of maceration, the compound that had decreased least was chlorpyrifos (83% of initial value remaining), whereas metalaxyl, the least persistent of the residues, had decreased to 49% of its initial value. In the free-run juice, on the other hand, the highest percentage remaining corresponded to metalaxyl (10%) and the lowest to chlorpyrifos (0. 1%). After pressing, the percentages of initial values eliminated in pomace varied from 82.7% for chlorpyrifos to 17.7% for metalaxyl, whereas in the press juice the opposite was the case (37% metalaxyl and 2% chlorpyrifos remaining). In finished wine, there were residues of all the pesticides, with the exception of chlorpyrifos, metalaxyl (21%) being the most persistent. The percentages eliminated in the lees varied from 1.5 to 2.5% of the initial value.

Carbonic Acid↗

Effect of muscle mass and intensity of isometric contraction on heart rate.

The purpose of this study was to determine the effect of muscle mass and the level of force on the contraction-induced rise in heart rate. We conducted an experimental study in a sample of 28 healthy men between 20 and 30 yr of age (power: 95%, alpha: 5%). Smokers, obese subjects, and those who performed regular physical activity over a certain amount of energetic expenditure were excluded from the study. The participants exerted two types of isometric contractions: handgrip and turning a 40-cm-diameter wheel. Both were sustained to exhaustion at 20 and 50% of maximal force. Twenty-five subjects finished the experiment. Heart rate increased a mean of 15.1 beats/min [95% confidence interval (CI): 5.5-24.6] from 20 to 50% handgrip contractions, and 20.7 beats/min (95% CI: 11.9-29.5) from 20 to 50% wheel-turn contractions. Heart rate also increased a mean of 13.3 beats/min (95% CI: 10.4-16.1) from handgrip to wheel-turn contractions at 20% maximal force, and 18.9 beats/min (95% CI: 9. 8-28.0) from handgrip to wheel-turn contractions at 50% maximal force. We conclude that the magnitude of the heart rate increase during isometric exercise is related to the intensity of the contraction and the mass of the contracted muscle.

Adult↗

Homozygosity for the protein S Heerlen allele is associated with type I PS deficiency in a thrombophilic pedigree with multiple risk factors.

The multifactorial character of thrombotic disease is shown in a Spanish pedigree in which the propositus, with recurrent deep vein thrombosis, inherited the factor V R/Q506 mutation, the prothrombin 20210G/A variant and type III Protein S deficiency. Among 14 relatives carrying one or two of these three risk factors, thrombosis is present in a heterozygote for R/Q506 and in another for 20210G/A, who also had slightly positive antiphospholipid antibodies. Type I PS deficiency was also found in a young asymptomatic woman. PROS1 analysis showed coexistence of type III and type I PS deficiency to be associated with heterozygosity and homozygosity, respectively, for the P460 or PS Heerlen allele of the S/P460 variant. Analysis of PS values in this and other pedigrees segregating this variant revealed that not only free but also mean total PS levels are slightly but significantly lower in the SP460 heterozygotes than in the SS460 homozygotes. These findings strongly suggest a role of the P460 variant in the expression of the PS deficient phenotype.

Adult↗

Determination of chlorpyrifos, penconazole, fenarimol, vinclozolin and metalaxyl in grapes, must and wine by on-line microextraction and gas chromatography.

A rapid gas chromatographic method for determination of residue levels of one insecticide (chlorpyrifos) and four fungicides (penconazole, fenarimol, vinclozolin and metalaxyl) in grapes, must and wine is described. An on-line microextraction method was used. The matrix, once extracted with a mixture of acetone-dichloromethane (1:1, v/v) was filtered and concentrated. Electron-capture detection for chlorpyrifos, penconazole, fenarimol and vinclozolin and mass-selective detection in the selected-ion monitoring mode for metalaxyl were utilised. No clean-up was necessary because there were no interferences in the area of interest of the chromatogram. Linearity of both detectors, in the range 0.02-2 ng/microliter, was checked. In all cases, the correlation coefficient was the same or superior to 0.997. Recoveries from spiked grapes, must and wine ranged from 78% to 101% (fortification level, 0.1-1 mg/kg). Limits of determination were between 0.01 mg/kg for metalaxyl and 0.001 mg/kg for vinclozolin.

Alanine↗

Evolution of residual levels of six pesticides during elaboration of red wines. Effect of wine-making procedures in their dissappearance.

The effect of wine-making procedures on the concentrations of six pesticides (chlorpyrifos, penconazole, fenarimol, vinclozolin, metalaxyl, and mancozeb) in red wines has been studied. During maceration stage (4 days), the percentage remaining of chlorpyrifos, penconazole, and metalaxyl was approximately 90%, whereas that of fenarimol, vinclozolin, and mancozeb is somewhat smaller (74-67%). The residual levels found in pressed must were </=20%, except for metalaxyl (69%). From the whole concentration of chlorpyrifos in must, 85% is eliminated from the racking step; clarification (bentonite plus gelatin) eliminates 43% of the product found in the decanted wine, and with filtration, all of the residue is eliminated. Penconazole and mancozeb are retained on the lees in proportions of 43 and 31%, respectively. The eliminated percentage of vinclozolin after racking is 29%, whereas clarification and filtration reduce its proportion in the wine to 33 and 28%, respectively. Finally, fenarimol and metalaxyl are eliminated in smaller proportion with the realization of these processes.

Pesticide Residues↗

Effect of pesticide residues on the aromatic composition of red wines.

The influence of pesticide residues on the aromatic composition (major and minor volatiles) of red wines made from Vitis vinifera (Monastrell var.) was studied by comparing the concentration of aromas in wines made from grapes subjected (or not) to phytosanitary treatment with chlorpyrifos, fenarimol, mancozeb, metalaxyl, penconazole, and vinclozolin, according to the agricultural practice of the area. The analytical determination of the major volatiles was made by gas chromatography using a flame ionization detector, while the minor volatiles were determined by adsorption-thermal desorption gas chromatography using a mass selective detector. There were significant differences between the ethyl acetate, methanol, isobutanol, and diethylacetal levels of the control wine and that containing chlorpyrifos residues, although only the ethyl acetate exceeded the olfactory threshold. With regard to the minor volatiles, significant differences were detected in the concentrations of some esters, aldehydes, and acids. However, only isoamyl acetate exceeded the olfactory threshold in wines containing residues of chlorpyrifos, fenarimol, and vinclozolin.

Chlorpyrifos↗

DQB1*0602 confers genetic susceptibility to multiple sclerosis in Afro-Brazilians.

We studied the distribution of the HLA-DRB1, -DQA1 and -DQB1 alleles in 44 Afro-Brazilian patients with multiple sclerosis and 88 controls. Although no significant differences were found between the patients and controls for the DRB1 and DQA1 alleles, the HLA-DQB1*0602 allele was positively associated with multiple sclerosis (45.0% vs. 17.0%, Pc=0.024, RR=3.31). The positive extended haplotypes for DQB1*0602 were more frequent in patients than controls, although the differences were not statistically significant in any of them. These results in Afro-Brazilians are in line with other studies which have found DQB1*0602 to be associated with the disease in the absence of the DRB1*1501 allele. We therefore think that the association with the disease in this ethnic group is more allelic than haplotypic.

Alleles↗