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Biomedical subjects

J A Moreno

Publications and source records attributed to J A Moreno.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Hypercoagulability status previous to total hip and knee arthroplasty: the contribution of rheumatoid arthritis].

PURPOSE: Starting from a status hypercoagulability previous to substitutive hip and knee surgery, the aim of this work was to investigate the influence of different osteoarthropatic pictures for which arthroplasty is indicated in the activation of the clotting cascade, rheumatoid arthritis (RA) being one of such pictures. PATIENTS AND METHODS: Of 79 patients suitable for prosthetic surgery of hip (53) and knee (26), the preoperative values of several markers, namely, D dimers (D-D), thrombin-antithrombin (TAT) complex, and F1 + 2 prothrombin fragment (F1 + F2) were assessed by enzymoimmunoasay. The mean age of the patients was 65.5 years, and their sex distribution was 50 women and 29 men. The indications for arthroplasty were as follows: osteoarthrosis (62), aseptic necrosis (11), RA (9), articular gout (2), previous fracture (2), more than one diagnosis overlapped in some cases. The results attained were compared with a control group comprised of 33 subjects (16 women and 17 men) with mean age similar to the patient's group (68.06 years). RESULTS: The D-D values in the patients suitable for hip arthroplasty and the TAT values in patients suitable for both types of surgery were significantly higher than those found in the control group (p = 0.012 and 0.01, respectively). The preoperative TAT levels of the RA patients were significantly higher (p = 0.025) than those found in the patients with the other surgical indications. CONCLUSIONS: Previously to the performance of arthroplasty, the patients show hypercoagulative marker values higher than those of age-matched controls. The significant rising of TAT found in RA patients is concordant with the literature, and this fact makes it advisable to include RA among the pathologic situations associated with hypercoagulability, as this is a common indication for substitutive hip and knee surgery with high risk of venous thromboembolic disease.

Aged↗
PubMed1997

Activation of arylamines to mutagenic product(s) by two in vitro plant systems.

Plant activation of three isomers of phenylenediamine o- m- and p-phenylenediamine, has been studied. Two in vitro plant systems have been used: Persea americana S117 with mixed-function oxidase (MFO) and peroxidase activities, and Zea mays S9 which contains only peroxidase activity. As genetic endpoint, the classical Salmonella tester strains. TA98 and TA100, their derivatives with high O-acetyltransferase levels (YG1024 and YG1029, respectively) and TA98/1.8-DNP6, deficient in this enzyme, have been assayed. Of the three isomers studied, only m-PDA was activated to mutagenic product(s) by both plant systems. This activation required the bacterial O-acetyltransferase activity to give frameshift mutagenic product(s), detected in TA98 and YG1024 strains. In all the assays the P americana system was more potent than the Z. mays system in activating m-PDA. A slight increase of the number of YG1029 revertants was detected when m-PDA was activated by P. americana, suggesting that this compound can be also converted into ultimate mutagenic product(s) that induce base-pair substitutions. m-PDA activation by Z. mays was dependent on the peroxidase activity of this system, but the activation produced by P. americana was totally dependent on MFOs, because a total inhibition of the mutagenic response was found when these activities were inhibited. In addition, the P. americana system was more potent in generating proximal mutagenic forms from m-PDA than S9 from non-induced rat liver, although S9 from Aroclor 1254-induced Sprague-Dawley male rats was the most potent system in the m-PDA activation. These results indicate that the P. americana system can be useful in determining the role of mixed-function oxidases in plant activation of xenobiotics.

Animals↗
PubMed1997

Prevalence and seasonal activity of Ixodes ricinus (Acari:Ixodidae) on domestic ruminants of the Basque country, Spain.

Ixodes ricinus on domestic ruminants was sampled through a natural year at several points in the Basque country, north Spain. The sampling points were comprised of the different natural regions, according to climate and vegetation, into which the region is commonly divided. Both the immature and adult stages were collected on cattle and sheep at five of the eight collecting points, namely in areas with a medium elevation, mild summers and a medium to high annual rainfall. The adults of this tick showed a bimodal pattern of activity in some areas, while in others the pattern was unimodal. It was concluded that, because of the adequate climate, I. ricinus is widely distributed in the Basque country, with geographically close populations adapted to different, local, changing conditions.

Animals↗
PubMed1997

UFT in combination as adjuvant therapy for breast cancer. Grupo Oncologico de Sevilla Seville, Spain.

Between 1989 and 1993, 409 evaluable patients with breast cancer have been treated with tegafur and uracil (UFT) in an adjuvant setting in two different trials. Data from both trials were reviewed in December 1995 after a mean follow-up of 5.09 +/- 1.1 years (range, 2.9 to 7.1 years). The aim of the first trial was to demonstrate the activity of UFT 400 mg/day for 6 months plus prednimustine 60 mg/m2 for 7 consecutive days, every 28 days in 6 cycles given orally (arm B). This scheme was compared with 6 cycles of cyclophosphamide 600 mg/m2, plus methotrexate 40 mg/m2, plus fluorouracil 600 mg/m2, every 4 weeks (arm A). In this study, 187 premenopausal women were evaluable, 96 in arm A and 91 in arm B, all of whom had positive axillary nodes. Although there were more younger patients in arm A than in arm B, prognostic factors were similar in both groups. Disease-free survival and overall survival were similar in both arms. However, some concern is raised by the low disease-free survival rate. The toxicity was mild (mainly nausea and vomiting and alopecia) and slightly worse in arm A. We believe that oral administration could be a useful alternative to the parenteral route. In the second trial, 222 evaluable patients received 20 mg/day of tamoxifen (Nolvadex) for 1 year (arm A), or the same dose of tamoxifen plus UFT 400 mg/day for 6 months. All patients were postmenopausal, and the characteristics of the tumors were the same as those in patients in the first trial. In arm A there were 109 patients and in arm B, 113. The groups were well balanced. The overall survival and the disease-free survival rates were equal in both arms, but were longer in arm B in the subset of patients with five or more axillary-involved nodes. The toxicity was negligible in both arms. We conclude that UFT/tamoxifen might be useful in postmenopausal patients with five or more involved nodes who are unable to follow a more aggressive schedule because of their age or low performance status.

Administration, Oral↗
PubMed1997

[Comparative study of 2 antithrombotic regimens in 75 patients with coronary endoprostheses].

PURPOSE: To compare systemic anticoagulation with antiaggregation in patients with coronary stent, with regard to subacute occlusion, mean hospital staying and haemorrhagic complications. PATIENTS AND METHODS: Seventy-five patients with coronary stent were treated with one of two different antithrombotic protocols. A group comprised of 34 patients (group A) received sodium heparin and acenocoumarin, plus acetylsalicylic acid (325 mg) and dipyridamole (225 mg). The remaining 41 patients (group B) were given antiplatelet agents, namely ticlopidine (125-250 mg) and aspirin (125 mg). RESULTS: One case of group A (2.9%) showed thrombosis due to stent occlusion. No thrombotic complications were seen in the patients with antiplatelet drugs. Haemorrhagic complications were present in 11 group A patients (32.3%), and blood transfusion was necessary in 3 of them. Hemorrhage was present in 9 cases of group B (21.8%), and none of them needed blood transfusion. The mean number of days to achieve INR > 2 was 3.06 (1-11) in group and 2.02 (1-5) in group B. CONCLUSIONS: Antiplatelet regimes appear as a good choice in coronary stent, in spite of the fact that the primary indication seems that of group A.

Acenocoumarol↗
PubMed1996

Inhibition of D-amino acid oxidase by alpha-keto acids analogs of amino acids.

The inhibition of D-amino acid oxidase by certain alpha-keto acids products of the reaction with D-amino acids, in particular alpha-keto acids that are analogs of the amino acids alanine, valine, leucine, phenylanaline, phenylglycine, tyrosine and tryptophan, is reported. All the alpha-keto acids assayed behaved as substrate competitive inhibitors of the enzyme. The relationship between the degree of inhibition and the structure of the inhibitor is discussed.

Amino Acids↗
PubMed1996

Parkinsonism in an HIV-infected patient with hypodense cerebral lesion.

A 49-year-old man presented with fever and parkinsonism. Examination of cerebrospinal fluid confirmed tuberculous meningitis. Cerebral computerized tomography scan revealed hypodense lesions and human immunodeficiency virus tests were positive. The patient's clinical picture and parkinsonism were improved with tuberculosis treatment.

AIDS-Related Opportunistic Infections↗
PubMed1996

Comparative study of propofol versus midazolam in the sedation of critically ill patients: results of a prospective, randomized, multicenter trial.

OBJECTIVES: To compare the effectiveness, characteristics, duration of action, hemodynamic and biochemical effects, and side effects of propofol and midazolam used for continuous intravenous sedation of ventilated critically ill patients. DESIGN: Multicenter, prospective, randomized, nonblinded study. SETTING: Nine Spanish general intensive care units (ICUs). PATIENTS: Ninety-eight patients admitted to the ICU who were mechanically ventilated and required sedation for a minimum of 48 hrs. INTERVENTIONS: Propofol or midazolam was used for induction and maintenance of continuous intravenous sedation for a maximum of 5 days. The effectiveness of those two regimens was assessed according to their effects on ventilatory management and the presence of agitation. MEASUREMENTS AND MAIN RESULTS: In 93% of the patients studied, there was a medical cause necessitating mechanical ventilation. The mean (+/-SD) duration of sedation was 81 +/- 25 hrs and 88 +/- 27 hrs for the propofol and midazolam groups, respectively. The induction dose was 2.24 +/- 0.43 mg/kg over 318 +/- 363 secs for propofol, and 0.22 +/-0.07 mg/kg over 33 +/-29 secs for midazolam. The maintenance dose was 2.8 +/-1.1 mg/kg/hr for propofol and 0.14 +/- 0.10 mg/kg/hr for midazolam. There was no difference regarding the opiate and muscle relaxant requirements between the two groups. Sedation with propofol was more effective in achieving patient-ventilator synchrony than that with midazolam after the first hour of treatment (p < .01). Patients sedated with propofol awoke more rapidly and with less variability that those patients sedated with midazolam (23 +/- 16 mins vs. 137 +/- 185 mins, respectively, p < .05), particularly in those patients requiring deep sedation (27 +/- 16 mins vs. 237 +/- 222 mins, respectively, p < .01). No hemodynamic or biochemical changes were detected in any of the treatment groups. During induction, five patients in the propofol group and two patients in the midazolam group had hypotension. CONCLUSIONS: In this population of critically ill patients, propofol is an effective and safe alternative for sedation, with some advantages, such as short duration of action and high effectiveness over the conventional regimen with benzodiazepines and opiates.

Adolescent↗
PubMed1996

Significant increase in eradication rates of Helicobacter pylori infection with two consecutive dual therapies (omeprazole and amoxycillin or omeprazole and clarithromycin). A randomized study in 450 Spanish patients.

Helicobacter pylori infection is associated with peptic ulcer disease and chronic gastritis, and eradication of the microorganism markedly reduces the recurrence of peptic ulcer. However, a major problem is the choice of a treatment that is effective, has high eradication rate, and is well tolerated by patients. We evaluated the eradication of H. pylori infection in patients with chronic gastritis (CG), duodenal ulcer (DU), and gastric ulcer (GU) after two dual therapies (omeprazole with either amoxycillin or clarithromycin). Of 450 patients initially included in the study, 207 had CG, 187 DU and 56 GU, and all presented with H. pylori infection. Diagnosis was made from endoscope examination, biopsy samples, rapid urease test and 13C-urea breath test (UBT). H. pylori infection was considered to be present when two of the tests had positive results. All patients were randomized to one of two regimens: (A) omeprazole (20 mg b.i.d.) plus amoxycillin (750 mg t.i.d.) or (B) omeprazole (40 mg b.i.d.) plus clarithromycin (500 mg t.i.d.). The duration of each of the regimens was 2 weeks. Fifty-eight patients who showed H. pylori infection after the first treatment (27 with CG, 24 with DU, and 7 with GU) were allocated to a second therapy. H. pylori eradication was assessed by UBT, 6 weeks after the end of the therapies; positive values were those higher than 5 delta units. A second consecutive dual therapy of omeprazole plus an antibiotic (amoxycillin or clarithromycin) not used in the first therapy improved on the eradication rates obtained with the first regimen. The overall eradication rates were also higher, but no significant differences were found between amoxycillin and clarithromycin. The best results were obtained in those patients with GU.

Adult↗
PubMed1995

Borrelia burgdorferi sensu lato in ticks (Acari: Ixodidae) from two different foci in Spain.

The prevalence of Borrelia burgdorferi sensu lato in several tick species was studied over a 2 year period in two ecologically different areas in Spain. One area was an endemic area for Lyme disease, with a number of autochthonous human cases and supported large populations of Ixodes ricinus on cattle and birds; the second area was characterized by the absence of I. ricinus together with the presence of foxes and their associated tick species. While I. ricinus was the main vector of B. burgdoreri in the endemic area (with a mean prevalence of 14% in adults and 51% in nymphs), adults of both Ixodes canisuga and Ixodes hexagonus had high rates of B. burgdorferi prevalence (30 and 28%, respectively) in the zone where I. ricinus was absent. Immatures of Ixodes frontalis were found to be carriers of the spirochete only in those zones where I. ricinus is present, suggesting evidence for reservoir competence in a tick-bird cycle.

Animals↗
PubMed1995

[Transtracheal catheter and liquid oxygen: 5 years of experience].

We studied clinical tolerance, complications, change in pulmonary function test results, arterial gasometrics, hemoglobin (Hb), 6 minute stress tests (6 wt) and subjective perception of dyspnea assessed on a visual analog scale (VAS) in a group of 18 patients (17 with obstructive disease and one with restrictive disease). These patients had previously been enrolled in a home oxygen therapy (HOT) program to deliver continuous oxygen therapy through nasal prongs, and had accepted portable oxygen therapy delivered by transtracheal catheter (TTC) from 1988 until 1993. Tolerance was good, there were no lethal complications of TTC, and excellent compliance with the prescribed HOT was achieved. Lung function test results worsened, while Hb and PaO2 improved and significant oxygen savings (50%) were achieved. The 6 wt test results had not worsened at the end of the first year but did so significantly at the end of the third year, in spite of a relative preservation of lung function. Dyspnea assessed on a VAS was not seen to worsen. We conclude that tolerance of the method was good and that no relevant complications occurred. HOT by TTC did not prevent worsening of bronchial obstruction. Oxygenation of patients was better, as shown by the decrease in Hb and the improvement in PaO2 at the end of the first year of monitoring. Changes in 6 wt showed that in order to achieve greater benefit from HOT by TTC, patients should follow a pulmonary rehabilitation program.

Aged↗
PubMed1995

[Congenital deficiency of factor Xii and spontaenous venous thrombosis treated with urokinase].

There is a well known relationship between factor XII deficiency and arterial and venous thrombosis. A new case of moderate factor XII deficiency associated to spontaneous deep vein thrombosis and treated with Urokinase is reported. The patient had a partial response to the treatment with Urokinase, with normal study of the fibrinolytic system. The deficiency was found in five relatives within the three generations studied. The genetic transmission had an autosomic dominant pattern. We feel that there is no relationship between the family history or the degree of factor XII deficiency and the risk of developing deep venous thrombosis.

Adult↗
PubMed1994

Using cuticular hydrocarbon composition to elucidate phylogenies in tick populations (Acari: Ixodidae).

Cuticular hydrocarbon composition is used to explain hypothetical phylogenies among sympatric and allopatric populations of Amblyomma cajennense, A. variegatum and Ixodes ricinus tick species. The method proposed here uses a parsimony analysis of endemicity by disjunct biochemical data (PAEDB) based in the pattern of cuticular hydrocarbons. The advantage of our approach is that information contained in fragments that are not conserved in all the individuals of a populations need not be discarded, and that only patterns of presence/absence are used. In such a way, PAEDB methodology provides a system which traces the pathway of a definite compound through populations, together with data of genetic relationships among specimens.

Animals↗
PubMed1994

[Tumors of the female urethra: difficulties in the early diagnosis].

There is no widespread agreement on the treatment of tumors of the female urethra due to their scant incidence. These are generally slowly growing tumors with no salient or specific symptoms and signs. They manifest late and can be misdiagnosed as urethral lesions mimicking a tumor, therefore a biopsy is warranted. For all the foregoing reasons, these tumors are diagnosed in the advanced stages, with a worse prognosis despite very aggressive therapies. Two such cases are described: one was a Grabstald stage C3 epidermoid carcinoma that was submitted to anterior pelvic exenteration and died at 6 months, and the other was a Grabstald stage D4 papillary adenocarcinoma that died a few days after a resection biopsy. Due to the lower incidence of urethral adenocarcinoma, we review the literature on this tumor type and highlight its greater predisposition to progression which carries a worse prognosis.

Adenocarcinoma, Papillary↗
PubMed1994

[Fibrinolytic system in patients with myocardial infarction and other coronary disease risk factors].

PURPOSE: To evaluate the fibrinolytic system function in survivors of acute myocardial infarction (AMI) and to appreciate the differences between patients with history of diabetes and/or dyslipaemia and those without such history. PATIENTS AND METHODS: A series comprised of 101 patients (83 men and 18 women) surviving six months after AMI and with mean age of 61.7 +/- 8.5 years was studied. Previous history of type II diabetes mellitus was present in 22 cases, while 42 others had some type of dyslipaemia (16, hypertriglyceridaemia; 15, hypercholesterolaemia; 11 both). Of the patients with diabetes mellitus, 14 had also dyslipaemia (5, hypertriglyceridaemia; 6, hypercholesterolaemia; 3, both conditions). The rates of plasminogen-activator inhibitor (PAI-1), fibrinogen, plasminogen, and alpha-2-antiplasmin, along with the venous occlusion test to determine tissular plasminogen activator (t-PA), both functional and antigenic, before and after venous occlusion, were tested in all cases. The studies were performed at the moment of AMI and 6 months later. RESULTS: PAI-1 concentration during AMI in the patients with some concurrent lipid anomaly showed significant differences with respect to the patients without any such associated disease (p < 0.001). The patients with history of dyslipaemia had significant increase of PAI-1 (p < 0.001) with respect to those without such history. Those patients with associated diabetes showed significantly increased PAI-1 concentration with regard to those without it, both in the acute phase and 6 months later (p < 0.05); significant increase was also found when comparing the patients with diabetes and dyslipaemia with those ones with only diabetes or dyslipaemia (p < 0.05). A significant increase of PAI-1 level (p < 0.001) was found in the 6-month study in the dyslipaemia patients with respect to non-dyslipaemic, and similar findings appeared with respect to diabetics and non-diabetics (p < 0.05). The 14 patients with both disorders showed increased values when compared with those having only one associated impairment (p < 0.05). When comparing the PAI-1 rates at AMI and 6 months later in the patients with dyslipaemia or diabetes, statistically significant decrease could be noted (p < 0.05 and p < 0.01, respectively). Before venous occlusion, t-PA was significantly increased in diabetic or dyslipaemic patients (p < 0.05) and in the patients with both conditions (p < 0.01). CONCLUSIONS: Patients with AMI and abnormalities of the lipidic or glycaemic metabolism have fibrinolytic dysfunction on the basis of an increase of the main inhibitor of the fibrinolytic system and a decreased release of tissular plasminogen activator. Those patients with both metabolic abnormalities have a deeper fibrinolytic hypofunction, with higher PAI-1 concentration.

Aged↗
PubMed1994

[Evaluation of the fibrinolytic system in myocardial infarction].

PURPOSE: To evaluate the main components of the fibrinolytic system in patients suffering of acute myocardial infarction (AMI), both in the acute phase and once this has been overcome. PATIENTS AND METHODS: Components of the fibrinolytic system (i.e., PAI-1, t-PA, fibrinogen, plasminogen, and alpha 2-antiplasmin) were determined in 100 patients with AMI. The studies were performed at AMI and 6 months later, and the findings were compared with those of a control group of 30 people matched with regard to age and sex with the patient group. The statistical analysis of the results was made with the BMPD pack, using Student's t test for comparing quantitative variables and the matched test for paired samples. RESULTS: At the acute phase the patients showed significant increase of PAI-1 (p < 0.001) and fibrinogen (p < 0.05) concentrations. Plasminogen and alpha 2-antiplasmin rates were lower than in the control group (p < 0.01 and p < 0.005, respectively). In the 6-month study after AMI, significant increase of PAI-1 was found with respect to the control group (p < 0.001). There were also significant differences in the initial PAI-1 rates and the 6-month test (p < 0.05), whereas the increased fibrinogen rates persisted (p < 0.01). Increased antigenic t-PA was found in the patient group before venous occlusion (p < 0.001). Thus, 54 patients (54%) had hypofibrinolysis, due to increased PAI-1 in 41 cases (41%), impaired t-PA release in 13 cases (13%) and both causes in 12 cases (12%). CONCLUSIONS: Fibrinolytic hypofunction was found in this study during the acute phase of myocardial infarction, which was still present six months later, and was due to increased PAI-1 rates in the majority of the cases.

Aged↗