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Biomedical subjects

J M Rubio

Publications and source records attributed to J M Rubio.

At least 37 records · Page 2Linked to original sources
PubMed2000

The use of PCR in the diagnosis of hyper-reactive malarial splenomegaly (HMS).

Between August 1997 and September 1998, 14 cases of hyper-reactive malarial splenomegaly (HMS) were diagnosed in the Instituto de Salud Carlos III in Madrid, Spain. These cases, from Equatorial Guinea and Cameroon, were identified using the diagnostic criteria established by Y. M. Fakunle in 1981: gross splenomegaly; high levels of anti-malarial antibodies; IgM in serum at least two standard deviations above the local mean; and clinical and immunological response to antimalarial treatment. Although malarial parasites were only detected in the Giemsa-stained blood films of four of the cases, these four and four others were found to have the DNA of such parasites in their blood when tested using a method based on a semi-nested, multiplex PCR. These result indicate that malarial parasitaemias may be more prevalent in HMS than is usually recognized.

Adult↗
PubMed2000

An open standard platform for interoperability of medical devices.

Patient care in Intensive Care Units and Operating Rooms requires sophisticated instrumentation for monitoring, treatment and control. A major technical problem is the communication between devices, since the connection of medical devices from different manufacturers has similar problems to the communication between people from different countries who do not share a common language. Several proprietary solutions have been developed by initiatives from well-known international companies. These proprietary, non-open solutions have not gained general acceptability and have failed to draw upon the immense resources for instrumentation development which are available in the industry. Consequently, a set of open European standards for Medical Device Intercommunication has recently been created (ratified 1999) to provide the ability to connect devices to each other freely and to exchange data between them. The development of such standards has lead to the design and implementation of a network platform over which those standards could be tested and validated. At the same time guidelines have been defined for the development and deployment of open solutions for any kind of medical device, including existing legacy devices. The design and testing of this open standards implementation is described in this paper.

Computer Communication Networks↗
PubMed1999

Amiodarone and "primary" prevention of sudden death: critical review of a decade of clinical trials.

Several trials have evaluated the role of amiodarone in decreasing mortality in patients at high risk of developing sudden death. Current evidence does not support the prophylactic use of amiodarone in myocardial infarction (MI) survivors with a depressed left ventricular function and/or frequent or complex ventricular ectopy. Some postinfarction trials (e.g., the Spanish Study of Sudden Death [SSSD]) found mortality rates in controls much lower than the expected figures. Other postinfarction trials--the European Amiodarone Myocardial Infarction Arrhythmia Trial (EMIAT) and the Canadian Amiodarone Myocardial Infarction Arrhythmia Trial (CAMIAT)--despite observing a 2-year mortality rate of about 15% as expected, could not demonstrate a significant reduction in mortality. Amiodarone decreases the risk of sudden death in postinfarction patients by about 35%. In patients with a history of heart failure and left ventricular dysfunction, evidence is not sufficiently strong to use amiodarone for prevention of sudden death. The 2 major trials on such patients, Group for the Study of Survival in Heart Failure in Argentina (Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina or GESICA) and the Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure (STAT-CHF), arrived at conflicting results. Meta-analyses have been performed to overcome the small sample size of these trials, with the aim of assessing the benefit of amiodarone on total mortality. Differences among the recruited populations make it difficult to extract clinically applicable conclusions from these overviews. Even accepting that amiodarone might decrease total mortality by 10%, it is difficult to identify the patients for whom such a beneficial effect applies. A practical consequence of amiodarone trials is that this drug can be used rather safely in patients with left ventricular dysfunction of any etiology as, in contrast to some class I agents, it does not increase mortality. Therefore, amiodarone is the drug of choice when antiarrhythmic drug treatment is indicated in patients with left ventricular dysfunction.

Aged↗
PubMed1999

Usefulness of seminested multiplex PCR in surveillance of imported malaria in Spain.

The use of a new PCR-based method for the diagnosis of malaria in the Spanish Malaria Reference Laboratory has promoted an increase in confirmed cases of malaria. From August 1997 to July 1998, a total of 192 whole-blood samples and 71 serum samples from 168 patients were received from the hospitals of the Spanish National Health System. Most of the patients came from west-central African countries (85%). This molecular method showed more sensitivity and specificity than microscopy, detecting 12.4% more positive samples than microscopy and 13% of mixed infections undetectable by Giemsa stain. Plasmodium falciparum was the main species detected, with 68% of the total positive malaria cases, followed by Plasmodium malariae (29%), Plasmodium vivax (14%), and Plasmodium ovale (7%), including mixed infections in all cases. This report consists of the first wide, centralized survey of malaria surveillance in Spain. The reference laboratory conducted the analysis of all imported cases in order to detect trends in acquisition. The use of a seminested multiplex PCR permitted confirmation of the origins of the infections and the Plasmodium species involved and confirmation of the effectiveness of drug treatments. This PCR also allowed the detection of the presence in Spain of primaquine-tolerant P. vivax strains from west-central Africa, as well as the detection of a P. falciparum infection induced by transfusion.

Child, Preschool↗
PubMed1999

Semi-nested, multiplex polymerase chain reaction for detection of human malaria parasites and evidence of Plasmodium vivax infection in Equatorial Guinea.

A semi-nested, multiplex polymerase chain reaction (PCR) based on the amplification of the sequences of the 18S small subunit ribosomal RNA (ssrRNA) gene was tested in a field trial in Equatorial Guinea (a hyperendemic focus of malaria in west central Africa). The method uses a primary PCR amplification reaction with a universal reverse primer and two forward primers specific for the genus Plasmodium and to mammals (the mammalian-specific primer was included as a positive control to distinguish uninfected cases from inhibition of the PCR). The second amplification is carried out with the same Plasmodium genus-specific forward primer and four specific reverse primers for each human Plasmodium species. The PCR amplified products are differentiated by fragment size after electrophoresis on a 2% agarose gel. Four villages from three regions of the island of Bioko (Equatorial Guinea) and two suspected Plasmodium vivax-P. ovale infections from the hospital of Malabo were tested by microscopy and PCR. The PCR method showed greater sensitivity and specificity than microscopic examination and confirmed the existence of a focus of P. vivax infections in Equatorial Guinea suspected by microscopic examination. It also provided evidence of several mixed infections, mainly P. falciparum and P. malariae, the two predominant species causing malaria in Equatorial Guinea.

Animals↗
PubMed1998

Exopolysaccharide II production is regulated by salt in the halotolerant strain Rhizobium meliloti EFB1.

The halotolerant strain Rhizobium meliloti EFB1 modifies the production of extracellular polysaccharides in response to salt. EFB1 colonies grown in the presence of 0.3 M NaCl show a decrease in mucoidy, and in salt-supplemented liquid medium this organism produces 40% less exopolysaccharides. We isolated transposon-induced mutant that, when grown in the absence of salt, had a colony morphology (nonmucoid) similar to the colony morphology of the wild type grown in the presence of salt. Calcofluor fluorescence, proton nuclear magnetic resonance spectroscopy, and genetic analysis of the mutant indicated that galactoglucan, which is not produced under normal conditions by other R. meliloti strains, is produced by strain EFB1 and that production of this compound decreases when the organism is grown in the presence of salt. The mutant was found to be affected in a genetic region highly homologous to genes for galactoglucan production in R. meliloti Rm2011 (expE genes). However, sequence divergence occurs in a putative expE promoter region. A transcriptional fusion of the promoter with lacZ demonstrated that, unlike R. meliloti Rm2011, galactoglucan is produced constitutively by EFB1 and that its expression is reduced 10-fold during exponential growth in the presence of salt.

Base Sequence↗
PubMed1997

Effect of glucose administration during the estrous cycle on serum hormone profiles, mRNA for steroidogenic enzymes, and breeding performance of ewes.

Thirty mature Debouillet ewes were used to examine effects of exogenous glucose on endocrine, ovarian, and reproductive responses. Treatments were administered from d 5 through 15 of a normal estrous cycle (d 0 = estrus). Fifteen ewes received daily i.p. injections containing 100 mL of saline (.9%, control), and 15 ewes received daily i.p. injections containing 50 g of glucose (100 mL of 50% dextrose). Ovaries were removed from five ewes per group on d 15, and luteal mRNA encoding steroidogenic enzymes and follicular fluid progesterone (P4) were determined. Serum glucose in treated ewes increased rapidly after injection and remained elevated (P < .01) for 4 h after treatment on d 10 and 14 compared with control values. Serum insulin concentration was also greater (P < .01) after glucose treatment on d 10 and 14, but serum growth hormone concentration was similar (P > .10) in both groups on these days. Serum LH concentration and pulsatility were not altered by glucose injection (P > .15). Serum P4 remained elevated longer (P < .05) during the estrous cycle in treated than in control ewes. Corpora lutea from treated ewes also had more (P < .10) mRNA encoding for cytochrome P450 side-chain cleavage enzyme, but mRNA for 3 beta-hydroxysteriod dehydrogenase/delta 5- delta 4 isomerase and follicular fluid P4 were similar (P > .40) between groups. Glucose-treated ewes conceived later (P < .10) and produced fewer lambs (P < .10) than did controls. These data indicate that exogenous glucose and(or) the subsequent increased serum insulin resulted in ovarian changes associated with elevated luteal P4 production.

3-Hydroxysteroid Dehydrogenases↗
PubMed1997

Chronic alcoholism decreases polyunsaturated fatty acid levels in human plasma, erythrocytes, and platelets--influence of chronic liver disease.

The effect of chronic ethanol ingestion on fatty acid composition of plasma, erythrocyte and platelet phospholipids and on plasma 6-keto-PGF1alpha was studied. Two groups of alcoholic subjects, one of them with chronic liver disease, were studied and compared to a control group of healthy subjects. Linoleic acid was not affected by alcoholism but its larger metabolites arachidonic acid (20:4n6) and docosatetraenoic acid (22:4n6) tended to be lower in erythrocytes and platelets of both groups of alcoholic patients; the decrease was more marked in the presence of chronic liver disease. Docosahexaenoic acid (22:6n3) was markedly decreased in plasma, erythrocytes and platelets obtained from alcoholic patients with chronic liver disease. Plasma levels of 6-keto-PGF1alpha, a metabolite of prostacyclin (PGI2), remained unchanged. We conclude that chronic ethanol ingestion induces important changes in long-chain polyunsaturated fatty acids, mainly in platelets, and that these changes are exacerbated when patients suffer from chronic liver disease.

Alcoholism↗
PubMed1996

Current role and future perspectives for radiofrequency catheter ablation of postmyocardial infarction ventricular tachycardia.

The most common substrate for ventricular tachycardia (VT) is a postmyocardial infarction (MI) scar. Radiofrequency catheter ablation (RFCA) in post-MI VT faces clinical, electrophysiologic, anatomic, and methodologic difficulties not found in many other human tachycardias. The pathophysiologic understanding of post-MI VT is incomplete; this influences the process of selecting RFCA target sites, which is time consuming, demands catheter stability, and has low sensitivity and predictive value for VT interruption by RF current. Improving and simplifying the methodology of RFCA in post-MI VT is badly needed. We review the pathophysiology of post-MI VT from the data reported on endocardial, epicardial, and intramural ventricular mapping obtained either intraoperatively or in a Langendorff perfused set-up in hearts from transplanted patients. From these studies we conclude that (1) some post-MI VT cases are not amenable to RFCA (reentry around the scar, VT having a subepicardial or deep intramural substrate, or a wide, extensive, subendocardial intrascar area of slow conduction); and (2) searching for the endocardial exit is advantageous for selecting the RFCA targets. We also comment on a new self-reference mapping catheter that allows the recording of high gain, noise-free, unfiltered and filtered unipolar signals as well as unipolar pacing. Among the unresolved issues in these patients is the meaning of fast nonclinical VT induced after successful RFCA of the clinical VT, which may explain why a substantial number of these patients still receive an implantable cardioverter-defibrillator.

Catheter Ablation↗
PubMed1996

Folate absorption in the jejunum of chronic ethanol-fed rats: in vivo studies.

This study sought to determine the intestinal in vivo absorption of folic acid and methyltetrahydrofolate (MTHF) by jejunum surface at different times, after 20 weeks of 30% ethanol ingestion. The absorption results were compared with the data of control rats. In general after ethanol treatment jejunal folic acid absorption was higher than in control rats. When the folic acid concentrations in the perfusion medium were 0.5 microM an increase at later times in ethanol-fed rats was found. At 1 microM the folic acid absorption values were significantly higher at the earlier time. When the concentration assayed was 2.5 microM, significant modifications were only seen at 30 min. Results of MTHF absorption by jejunum of ethanol-fed rats were similar to absorption values of control rats. No significant differences between both groups were found. The results obtained in the present work suggested a different absorptive behavior of both substrates and a different effect of ethanol on folic acid and MTHF absorption in the jejunum.

Alcoholism↗
PubMed1996

Folate absorption in the caecum of chronic ethanol-fed rats: in vivo studies.

This study was designed to determine the intestinal in vivo absorption of folic acid and methyltetrahydrofolate (MTHF) by the caecum surface at different times after 20 weeks of 30% ethanol ingestion. The absorption results were compared to the data of control rats. Chow and fluid consumption and body weight were significantly lower in ethanol-fed rats. The absorption of folic acid and MTHF by the caecum surface (pmol/cm2) was generally decreased in ethanol-fed rats at all concentrations assayed with respect to control animals (except for absorption of 0.5 and 2.5 microM folic acid at 15-min intervals). The results obtained in the present work also suggest a different absorptive behaviour of folic acid and MTHF in the caecum under the influence of chronic alcohol ingestion.

Alcoholism↗
PubMed1994

Comparative effects of intestinal absorption of folic acid and methyltetrahydrofolic acid in chronic ethanol-fed rats.

This study concerns in vivo folic acid and methyltetrahydrofolic acid (MTHF) absorption by the whole intestinal surface after 20 weeks of 30% ethanol ingestion in drinking water. The results were compared with control rats fed ad libitum. The total intestinal serosal areas were similar in ethanol-fed and control rats. Significant increases in intestinal length, and decreases in tissue wet and dry weights were found in ethanol-fed rats. Serum folic acid concentrations were significantly less in the animals which had ingested ethanol than in the control rats. Intestinal folic acid absorption was significantly increased at lower substrate concentrations (0.5 and 1 microM), while no difference was observed at 2.5 microM in the ethanol-fed rats. Folic acid absorption relative to tissue wet weight showed significant increases at all tested concentrations in the ethanol-fed rats. Intestinal MTHF absorption showed no significant changes at 0.5 microM MTHF concentration, and an increase was observed in the absorption values at 1 and 2.5 microM concentrations in the ethanol-fed rats. When expressed as tissue wet weight, MTHF absorption values in ethanol-fed rats increased at 1 and 2.5 microM but did not differ at 0.5 microM substrate concentrations. The above results indicate compensatory responses in the folic acid and MTHF intestinal absorption after chronic ethanol ingestion. These effects are observed when the whole intestinal surface is evaluated.

Animals↗
PubMed1993

Presence of highly repetitive DNA sequences in Tribolium flour-beetles.

Digestion of genomic DNA from seven species of Tribolium (Coleoptera) with Sau3AI, TaqI and ClaI restriction enzymes shows the presence of remarkable amounts of highly repetitive DNA sequences in these species. In Tribolium freemani the sequences are tandemly repeated with a satellite monomer of 166 bp, A-T rich (70.5 per cent), representing 31 per cent of the total genome and located in centromeric chromosome areas as demonstrated by in situ hybridization. The sequence has the potential to form secondary structures such as stems or cruciforms due to the presence of frequent inverted repeats. Tribolium castaneum, T. anaphe and T. madens show homologous sequences to T. freemani satellite DNA but T. confusum, T. audax, T. brevicornis and other tenebrionid beetles, such as Tenebrio molitor and Misolampus goudoti, do not. A phylogenetic dendrogram, based on the homology and abundance of highly repetitive sequences deduced by dot-blot hybridization, chemotaxonomic and karyological characters, is proposed for the seven studied species of Tribolium.

Animals↗
PubMed1992

Comparative study of single-dose cefotaxime and multiple doses of cefoxitin and cefazolin as prophylaxis in gynecologic surgery.

In this comparative, randomized, multicenter trial, 273 patients scheduled for gynecologic surgery were studied: 87 received a single 1-g dose of cefotaxime 30 minutes before surgery; 81 were given a 1-g dose of cefoxitin 30 minutes before surgery and 1 g every 6 hours for 24 hours after surgery (total dose 4 g); and 105 received a 1-g dose of cefazolin 30 minutes before surgery, followed by 1 g every 8 hours for 48 hours (total dose 6 g). Patients who received cefotaxime had a significantly lower incidence of postoperative fever compared with those treated with cefoxitin or cefazolin (p < 0.01). The incidence of positive urinary cultures was lower in the cefotaxime and cefazolin groups when compared with the cefoxitin group (p < 0.01 and p < 0.05, respectively). The results of this study confirm the efficacy of cefotaxime as prophylaxis in surgical infections and demonstrate that single-dose cefotaxime is more effective than a four-dose regimen of cefoxitin.

Adolescent↗
PubMed1988

Autopsy as quality assurance in the intensive care unit.

A prospective study of 100 autopsies was carried out. The clinical and pathologic diagnoses were made independently by intensivists and pathologists; at the end of the study, the differences were determined. There were seven Class I errors (which if detected before death, would probably have led to a change in management that might have resulted in cure or prolonged survival), six of these relating to the basic disease and one to the cause of death. Class II errors occurred in 15 patients, ten relating to the basic disease and five to the cause of death. In 61% of the patients, the major and minor diagnoses coincided. In 77% of the patients, the major diagnoses coincided. No relationship was found between the incidence of Class I and Class II errors and the length of the patients' stay in the ICU.

Adolescent↗