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Biomedical subjects

J Blanco

Publications and source records attributed to J Blanco.

At least 235 records · Page 13Linked to original sources
PubMed1994

The gynecologic contribution to intestinal obstruction in females.

This study was done to identify the cause of intestinal obstruction with particular emphasis on the gynecologic and perioperative related causes. All medical records from females with the discharge diagnosis "intestinal obstruction" from 1988 to 1991 at Columbia Presbyterian Medical Center were requested. The patient series consisted of the first 100 completed charts received. Forty-eight percent of those patients with intestinal obstruction had experienced a previous gynecologic or obstetric event that could account for the obstruction. Primarily, the gynecologist managed more than 20 percent of all female patients with intestinal obstruction. The most common causative factors contributing to intestinal obstruction were postoperative adhesions (59 percent) and tumor (17 percent). Fifty-six percent of the patients with intestinal obstruction associated with postoperative adhesions had a history of previous gynecologic and obstetric operation. Hysterectomy was the most common previously performed operation. In this series, cesarean section was less likely and myomectomy was more likely to cause subsequent intestinal obstruction than expected. Of 59 female patients with postoperative adhesions associated with intestinal obstruction, 31 had the original operative reports available for analysis. Eleven of these patients were taken to the operating room for management of the obstruction. In the nine patients who had surgical peritoneal closure in the original operation, the adhesions causing the obstruction were always to the site of reperitonealization. In the two patients in whom the peritoneum was left open, the adhesions causing obstruction were remote from the site of spontaneous reperitonealization. In an unselected patient series of intestinal obstruction, a history of previous gynecologic pathology is a significant factor contributing to the total number of instances of intestinal obstruction in females. Also, surgical peritoneal closure may result in an increase in the incidence of intestinal obstruction.

Adolescent↗
PubMed1994

[Yersinia enterocolitica infection with extraintestinal manifestations: case report and overview].

Five weeks after a four-day visit to Malta, a 39-year old white male German national developed septic temperatures of up to 40 degrees C, progressive jaundice and a pronounced hepatosplenomegaly. The initial examination showed a very sick, somnolent patient with jaundice, cyanosis, tachypnea and a markedly enlarged liver on both physical examination and sonography. The laboratory evaluation revealed a moderate leukocytosis, markedly accelerated ESR, poor liver function with strongly elevated gamma-GT and alkaline phosphatase levels. Primary antibiotic therapy consisted of doxycycline. Ultrasound examination of the liver four days after admission revealed multiple hypodense abscesses. On the sixth day after admission, gram-negative rods were first isolated from blood cultures; antibiotic therapy was switched to ofloxacin (2 x 400 mg/day) and amoxycillin (3 x 2 g/day) after sensitivity testing. As a result of treatment with this combination of antibiotics, the patient was free of fever 10 days after hospitalization; on the same day yersinia enterocolitica was isolated from the first blood cultures taken on admission. The diagnosis of non-enteric forms of yersinia infection can prove very difficult, especially if the serology is not clear cut and there are no immunological complications. A presentation including intermittent fever, moderate leukocytosis, strongly accelerated ESR and multiple hypodense abscesses in the liver should lead one to consider a non-enteric type of yersinia infection. Hepatic abscesses usually occur in patients who have an iron overload.

Adult↗
PubMed1993

Adenine nucleotides and adenosine metabolism in pig kidney proximal tubule membranes.

Exogenous adenosine triphosphate (ATP) added to brush-border membrane vesicles was rapidly degraded mainly to inosine according to the high ecto-nucleotidase activities in these vesicles. In the absence of phosphate, inosine was slowly transformed into hypoxanthine, and xanthine oxidase and dehydrogenase activities were not detected. The presence of ecto-adenosine deaminase and ecto-adenosine monophosphate (AMP) nucleotidase was shown. The ecto-adenosine deaminase was inhibited by deoxycoformycin and was also detected in rat renal brush-border membrane vesicles. Using orthovanadate, levamisole, and alpha, beta-methylene adenosine diphosphate as possible inhibitors, alkaline phosphatase was shown to be the main agent responsible for ecto-AMP nucleotidase activity. In pig renal basolateral membrane vesicles and in whole cell extracts from pig renal cortex, ecto-AMP nucleotidase was the limiting factor in ATP degradation. Comparing the ATP catabolism in the whole cell cortical extract with the catabolism in the same sample precleared of membranes, it was shown that ectonucleotidase activity is mainly bound to the membranous components. It is also shown that the whole cell extract of pig renal cortex has hypoxanthine phosphoribosyl transferase activity, and it seems probable that the rapid and specific formation of luminal inosine and its transport into the cell in competition with adenosine may start the purine salvage pathway through the synthesis of IMP from hypoxanthine.

Adenine Nucleotides↗
PubMed1993

Serotypes and colonization factors of enterotoxigenic Escherichia coli isolated in various countries.

One hundred and six enterotoxigenic E. coli (ETEC) isolated from many geographical areas were serotyped and investigated for the presence of colonization factor antigens CFA/I and CFA/II, the expression of mannose-resistant haemagglutination (MRHA) and the levels of surface hydrophobicity. CFA/I was found in 6 (17%) of 36 LT+STa+ strains and in 15 (54%) of 28 STa+ strains; CFA/II was found in 16 (44%) of 36 LT+STa+ strains. None of 42 LT+ strains showed CFA/I or CFA/II. CFA/I was found in ETEC of serotypes O63:K-:H-, O78:K80, O128:K67 and O153:K:H45, whereas CFA/II was found in serotypes O6:H-, O6:K15:H16 and O6:K?:H40. Of the 69 CFA/I- CFA/II- ETEC strains, 9 (13%) showed MRHA with some of the seven erythrocyte species used and 21 (30%) were hydrophobic. Among the 21 hydrophobic strains CFA-negative we have detected: (i) 6 LT+ strains of serogroup O25 negative for MRHA, (ii) 5 strains O159 (4 LT+ and 1 LT+ STa+) also negative for MRHA, and (iii) 3 STa+ strains of serotype O27:K-:H7 that haemagglutinated calf and sheep erythrocytes when grown on Minca-Is. The 106 ETEC strains belonged to 20 different O serogroups. However, 77 (73%) were of one of nine serogroups (O6, O8, O25, O27, O78, O148, O153, O159 and O167). E. coli strains belonging to O6 and O153 groups predominated among ETEC isolated in Spain, O159 strains in the Central African Republic, O25 and O148 strains in Japan, and O15 and O78 strains in India.

Adult↗
PubMed1993

Papanicolaou smear screening augmented by a magnified chemiluminescent exam.

OBJECTIVES: Since the adequacy of screening for cervical cancer and pre-cancer with Papanicolaou smear alone has been questioned, a number of adjunctive tests have been evaluated. This study evaluated whether a magnified chemiluminescent visual screening exam can improve cervical screening when performed coincident with cytologic sampling. METHODS: Patients were evaluated using the Papanicolaou smear, magnified chemiluminescent visual exam (MCE) and colposcopy at 10 study centers. Screening with either Papanicolaou smear alone or in combination with MCE (Pap and MCE), was evaluated using colposcopy directed biopsy as the highest diagnostic standard. RESULTS: The Papanicolaou smear alone detected 9/29 (31%) of women with significant pathology (cervical neoplasia) on biopsy, whereas the combination of the Pap and MCE detected 24/29 (83%) of the women (P < 0.001). Patients in whom both tests results were negative (negative Pap and MCE) were extremely unlikely to harbor significant pathology (1% of those screened). Pap and MCE was especially helpful in the detection of low grade cervical lesions when compared with the Papanicolaou smear alone. CONCLUSIONS: These data indicate that MCE enhances the sensitivity of cervical screening. MCE appears to be particularly useful as a triage instrument in women with otherwise negative Papanicolaou smears. Further studies of cost effectiveness of this combined screening protocol using non-colposcopists is warranted.

Adolescent↗
PubMed1993

Haemolytic Escherichia coli strains isolated from stools of healthy cats produce cytotoxic necrotizing factor type 1 (CNF1).

A total of 159 Escherichia coli colonies isolated from the stools of 23 healthy cats were studied for production of alpha-haemolysin (Hly), enterohaemolysin (EntHly), cytotoxic necrotizing factors (CNF1 and CNF2), verotoxins (VT) and heat-labile enterotoxin (LT). Hly+CNF1+, Hly+CNF2+, Hly+VT+ and Hly+ E. coli colonies were isolated from 12 (48%), 1 (4%), 1 (4%) and 2 (8%) respectively of the cats sampled. None of the 159 E. coli colonies produced LT or EntHly. Nine of 12 Hly+CNF1+ strains from the cats belonged to serogroup O6 and eleven to serotypes (O4:K?:H5 or H-, O6:K13:H1, O6:K53:H-, O6:K53:H1, O6:K53:H7 and O6:K14:H31) found among Hly+CNF1+ E. coli that cause urinary tract infections and sepsis in humans. Furthermore, 10 Hly+CNF1+ strains from the cats expressed the mannose-resistant haemagglutination (MRHA) type III. By contrast, the majority of nontoxigenic E. coli strains were MRHA negative and belonged to different O groups. We conclude that cats are a important reservoir of Hly+CNF1+ E. coli strains that possess similar characteristics to strains that can cause extraintestinal infections in humans and that Hly+ E. coli from cats usually do not produce shiga-like toxins with cytotoxic activity on Vero cells.

Animals↗
PubMed1993

[Enterotoxigenic Escherichia coli K99+, serotype 08:K25, produce cytotoxic necrotizing factor CNF1 and alpha-hemolysin].

A total of 54 K99+ and/or F41+ Escherichia coli strains isolated of calves and piglets with diarrhoea in different countries were investigated for production of heat-labile (LT) and heat-stable (STa) enterotoxins, verotoxins (VT1 and VT2), cytotoxic necrotizing factors (CNF1 and CNF2), alpha-haemolysin (Hly) and enterohaemolysin (EntHly). Fifty-one (94%) strains were STa+, two (4%) were STa+CNF1+Hly+ and one (2%) was not toxigenic. The two STa+CNF1+Hly+ E. coli strains expressed the K99 intestinal colonization factor and belonged to serotype O8:K25. The majority of STa-producing E. coli were K99+ and F41+ and belonged to serotypes O9:K(A)35, O101:K(A)28 and O101:K(A)30. All enterotoxigenic strains assayed in this study were negative for expression of the Att25, Vir and B23 adhesins recently detected in E. coli that cause infections in calves.

Adhesins, Escherichia coli↗
PubMed1993

Toxic and adhesive properties of Escherichia coli strains belonging to classic enteropathogenic serogroups.

Twenty-three strains belonging to classic enteropathogenic Escherichia coli (EPEC) serogroups were investigated for the production of heat-labile (LT) and heat-stable (STa) enterotoxins, verotoxins (VT), cytotoxic necrotizing factors CNF1 and CNF2, alpha-haemolysin (Hly), necrosis and modification of permeability in rabbit skin, lethal activity to mice, mannose-resistant (MRHA) and mannose-sensitive (MSHA) haemagglutination, relative cell surface hydrophobicity and the expression of P fimbriae. Of 23 EPEC strains, 7 (30%) belonging to serotypes O18ac: H7 (Hly+), O20: H26 (lethal), O26: H- (Hly+), O44: H18 (Hly+), O55: H- (CNF2+, necrotic and lethal), O119: H27 (VT+ and Hly+) and O142: H6 (lethal) produced toxic factors. Seven (30%) of 23 EPEC strains were MRHA+, 17 (74%) were MSHA+ and only 2 possessed high hydrophobicity. Two strains belonging to serotypes O18ac: H7 and O44: H18 that showed MRHA type IVa were fimbriated when grown on CFA medium.

Animals↗
PubMed1993

[Toxic properties of enteroinvasive Escherichia coli].

Up to now enteroinvasive Escherichia coli (EIEC) has not been extensively studied for toxin production. We have investigated 15 EIEC strains belonging to ten representative serotypes (O28ac:H-, 029:H-, O112ac:H-, O124:H-, O136:H-, O143:H-, O144:H-, O152:H-, O164:H- and O167:H-) for their ability to produce enterotoxins (LT and STa), Shiga-like toxins (SLT-I and SLT-II), cytotoxic necrotizing factors (CNF1 and CNF2) and other toxic products with necrotic or lethal activity. None of these strains were toxigenic.

Animals↗
PubMed1993

Enterotoxigenic, verotoxigenic, and necrotoxigenic Escherichia coli isolated from cattle in Spain.

To assess the role of enterotoxigenic (ETEC), verotoxigenic (VTEC), and necrotoxigenic (NTEC) Escherichia coli in cattle with diarrhea, 1,524 colonies of E coli isolated from 197 calves with diarrhea and from 112 healthy controls were investigated for production of heat-labile and heat-stable enterotoxins, verotoxins, and cytotoxic necrotizing factors (CNF1 and CNF2). The ETEC were isolated from only 2 (1%) calves with diarrhea and from 5 (4%) healthy controls. In contrast, VTEC and NTEC that produced CNF2 were frequently identified. The VTEC were isolated from 18 (9%) calves with diarrhea and from 21 (19%) healthy cattle (P < 0.05), whereas NTEC that produced CNF2 were detected in 39 (20%) ill calves and in 38 (34%) controls (P < 0.01). Therefore, VTEC and NTEC that produced CNF2 were isolated significantly more frequently from healthy than diseased calves. Serogroups to which VTEC belonged differed considerably from the O groups involved with NTEC. Although, VTEC belonged to 18 serogroups, only 4 (O26, O103, O113, and O157) accounted for 56% (25 of 45) of verotoxigenic strains. The NTEC that produced CNF2 belonged to 26 serogroups; however, 64% (69 of 108) were from 6 serogroups (O1, O3, O15, O55, O88, and O123). Our results are compatible with cattle being a reservoir of VTEC that are pathogenic for human beings and with ETEC being an unusual cause of bovine colibacillosis in Galicia (northwestern Spain). Furthermore, results of this study indicate that VTEC and NTEC that produced CNF2 may be part of the normal intestinal flora of cattle.

Animals↗
PubMed1992

Establishment of three categories of P-fimbriated Escherichia coli strains that show different toxic phenotypes and belong to particular O serogroups.

Eight hundred and nineteen strains of Escherichia coli isolated in Spain between 1986 and 1991 from extraintestinal infections and feces of healthy controls were investigated for expression of P-fimbriae using a particle agglutination test. Among strains causing urinary tract infections, sepsis and other extraintestinal infections, P-fimbriae were found in 31% (130/420) (P < 0.001), 25% (30/118) (P < 0.001) and 12% (11/92) (P < 0.5) respectively. In contrast, only 7% (14/189) of faecal isolates from healthy individuals carried P-fimbriae. According to two more common toxic markers detected in this study (alpha-haemolysin and cytotoxic necrotizing factor type 1), P-fimbriated E. coli strains were grouped into three categories: haemolysin+cytotoxic necrosing factor+ (Hly+CNF1+) (68/185; 37%), haemolysin+cytotoxic necrosing factor- (Hly+CNF1-) (61/185; 33%) and Hly-CNF1- (56/185; 30%). The 185 P-fimbriated strains belonged to 17 different O serogroups. However, 148 (80%) were of one of six serogroups (O1, O2, O4, O6, O7 and O18). The most frequent serogroups determined in the Hly+CNF1+ strains were the O4 and O6 (53/68; 78%), in the Hly+CNF1- strains it was the O18 (27/61; 44%) and in the Hly-CNF1- strains the O1, O2 and O7 (41/56; 73%). The majority (160/185; 86%) of P-fimbriated E. coli expressed the mannose-resistant haemagglutinin type IVa.

Bacterial Toxins↗
PubMed1992

Serogroups of Escherichia coli strains producing cytotoxic necrotizing factors CNF1 and CNF2.

The serogroups of 396 necrotizing Escherichia coli of human and bovine origin isolated in Spain between 1979 and 1991 have been determined. The 270 cytotoxic necrotizing factor strains belonged to 22 different O serogroups; however, 84% (226 of 270) were of one of seven serogroups (O2, O4, O6, O14, O22, O75 and O83). Although necrotizing E. coli producing cytotoxic necrotizing factor 2 belonged to 28 different serogroups, only six of them (O1, O3, O15, O55, O88 and O123) accounted for 60% (76 of 126) of cytotoxic necrotizing factor 2 strains. Furthermore, only 3% (4 of 126) of cytotoxic necrotizing factor 2 strains belonged to serogroups most common among strains producing cytotoxic necrotizing factor 1. The majority of necrotizing E. coli producing cytotoxic necrotizing factor 1 were obtained from human extraintestinal infections, whereas cytotoxic necrotizing factor 2 strains were isolated from stools of healthy and diarrhoeic calves.

Animals↗
PubMed1992

Bovine Escherichia coli of serotypes O55:H4 and O55:H21 which produce CNF2 express P fimbriae and Vir surface antigen, respectively.

We have characterized the toxic and adhesive properties of Escherichia coli strains producing the second type of cytotoxic necrotizing factor (CNF2) and belonging to the classic enteropathogenic serogroup O55. Bovine CNF2 strains of serotype O55:H4 express P fimbriae as do pyelonephritic Escherichia coli that cause infections in humans. In contrast, strains of serotype O55:H21 which produce CNF2 from bovine origin possess the Vir surface antigen. One human strain of serotype O55:H- was positive for production of CNF2, but was negative for the two adhesive factors and for mannose-resistant haemagglutination.

Animals↗
PubMed1992

Enterotoxigenic and necrotizing Escherichia coli in human diarrhoea in Spain.

Enterotoxigenic Escherichia coli (ETEC) strains of serotype 0153: K-:H45 CFA/I+ STa+ were associated with two outbreaks of neonatal diarrhoea that occurred in two different hospitals of Madrid, in one of which several children died. Two other outbreaks were associated with ETEC strains of serotypes 0159: K-:H21 (LT+) and 0159: K-:H4 (LT+ STa+) without CFA/I and CFA/II colonization factors. Necrotizing E. coli (NTEC) strains of serotype 06:K13, producing the cytotoxic necrotizing factor CNF1 and alpha-haemolysin, were also associated with two outbreaks of neonatal diarrhoea that occurred in a hospital in Madrid and in a hospital in Talavera de la Reina. The results of the characterization of some ETEC and NTEC strains isolated from sporadic cases of diarrhoea are also discussed.

Adult↗
PubMed1992

Evaluation of indexes predicting the outcome of ventilator weaning and value of adding supplemental inspiratory load.

OBJECTIVE: To assess the diagnostic accuracy of several measured and calculated indexes for early prediction of weaning outcome, and to study the value of supplemental inspiratory load in improving the accurate prediction of successful weaning. DESIGN: Prospective study. SETTING: ICU of a University Hospital. PATIENTS: Thirty consecutive patients under prolonged mechanical ventilation and without chronic obstructive pulmonary disease (COPD). INTERVENTIONS: Forty weaning trials were performed. Data were recorded at 15, 30 (adding inspiratory flow resistance), 60 and 120 min. MEASUREMENTS AND MAIN RESULTS: The threshold values and the accuracy of three indexes were determined: Inspiratory airway occlusion pressure at 0.1 sec. (P01) to maximum inspiratory pressure ratio (P01/MIP), inspiratory effort quotient (IEQ), and the ratio of respiratory frequency to tidal volume (F/Vt). All three were useful predictors for weaning success with a diagnostic accuracy between 82%-87%. At 15 min of spontaneous breathing, a P01/MIP ratio < 0.14 predicts weaning success with a sensitivity of 82% and specificity of 83%. In our group of patients no reintubation was necessary. The application of mechanical inspiratory load significantly increased P01 values (3.16 +/- 1.22 to 3.60 +/- 1.19, p < 0.001). The degree of the P01 increase did not provide prediction of weaning outcome. CONCLUSIONS: a) P01/MIP, IEQ and F/Vt ratio were accurate, early predictors of weaning outcome. b) The addition of a moderate mechanical inspiratory load did not enhance the diagnostic accuracy of P01 measurements. c) In our patients, a period of two hours seemed to be sufficient for development and detection of weaning failure.

Adult↗
PubMed1992

Characterization of adenosine receptors in brush-border membranes from pig kidney.

1. The adenosine receptors from pig kidney proximal tubules have been studied in membrane vesicle preparations derived from either luminal (brush-border membranes-BBM-) or basolateral (BL) sides. There was a substantial amount of A2-like NECA binding in both preparations, but the A1 subtype of adenosine receptors was not found in either BBM or BL membranes. The use of [3H]-CGS21680 which is a more specific ligand for A2a receptors revealed true adenosine receptors in the BBM. 2. The kinetic parameters for [3H]-CGS21680 binding to pig renal BBM were: Bmax = 1.48 pmol mg-1 protein and Kd = 150 nM. In the presence of Gpp(NH)p the affinity decreased (Kd = 220 nM), whereas the addition of Mg2+ induced a marked increase in affinity (Kd = 83 nM). These equilibrium constants are higher than those found for the A2a adenosine receptors present in pig brain striatal membranes (Kd = 12 nM), and are close to those found in rat renal BBM (Kd = 90 nM). 3. The order of potency of agonist and antagonists was not consistent with the presence of either A1 or A2 receptors, but it was very similar to the agonist order of potency for the A3 receptor subtype. Furthermore, the blockade of the [3H]-CGS21680 binding by both cholera and pertussis toxin further supports the view that the subtypes present in BBM are neither A1 nor A2. 4. Overall the results suggest the presence in BBM of an A3 receptor, or of a new subtype of adenosine receptor, which is linked to G proteins sensitive to both cholera and pertussis toxins.

Adenosine↗
PubMed1992

In vitro studies of activities of some antifungal agents against Candida albicans ATCC 10231 by the turbidimetric method.

Different criteria (the drug concentration which inhibited 50% of growth [IC1/2], the lowest drug concentration at which growth was just less than 30% of that in a positive control well [IC30], the visual inhibitory concentration [ICv], and the minimum fungicidal concentration [MFC]) were applied to study the effects of some antifungal agents against Candida albicans. Amphotericin B, flucytosine, and bifonazole produced total growth inhibition. Clotrimazole, itraconazole, ketoconazole, and miconazole produced partial growth inhibition. The values of IC1/2 and IC30 were similar for all agents and avoided the problems of partial inhibition; the values of ICv and MFC were higher than those of IC1/2 and IC30.

Antifungal Agents↗