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Biomedical subjects

J Romero

Publications and source records attributed to J Romero.

At least 37 records · Page 2Linked to original sources

Infections by Neisseria meningitidis serogroup X in Spain.

We describe an atypical presentation of bacteremia caused by N. meningitidis serogroup X. By multilocus sequence typing the isolate was characterized to the sequence type 2139, which is not related with the clonal complex recently isolated in Africa. Since 1984, only six cases of serogroup X N. meningitidis infections have been diagnosed in Spain. Nevertheless, after the application of the conjugated vaccine, attention should be paid to the emergence of infections caused by unusual serogroups of N. meningitidis.

Anti-Bacterial Agents↗

Osteonecrosis diagnosed on MR images of the knee. Relationship to reduced bone mineral density determined by high resolution peripheral quantitative CT.

PURPOSE: To evaluate if osteonecrosis diagnosed on MR images of the knee relates to reduced bone mineral density (BMD) and may be caused by an insufficiency fracture. MATERIAL AND METHODS: Thirty-two consecutive patients (8 men, 24 women; age range 27-82 years, mean 62 years) with MR findings of osteonecrosis of the femoral or tibial condyle were prospectively included. Trabecular and cortical BMD were measured with high resolution peripheral quantitative CT in the non-dominant distal radius and the tibia of the involved extremity. One tibia was not measured due to posttraumatic deformity. RESULTS: The mean trabecular BMD of the radius was 81% of the young-adult average peak BMD (range 19-160%). The mean cortical BMD in the radius was 86% (range 63-108%). The mean trabecular BMD in the tibia was 92% (range 28-160%). The mean cortical BMD in the tibia was 86% (range 49-132%). The values of the trabecular bone of the distal radius (tibia) were normal in 11 (15) patients, osteopenic in 12 (4), and osteoporotic in 9 (12), respectively. The cortical bone values of the distal radius (tibia) were normal in 12 (13) patients, osteopenic in 12 (12), and osteoporotic in 8 (6), respectively. CONCLUSION: Osteoporosis and osteopenia are commonly found in patients with osteonecrosis of the knee as diagnosed on MR images. This indicates that for some patients an insufficiency mechanism may be responsible for the MR findings. However, in the patients with normal bone density other reasons for osteonecrosis may be present.

Adult↗

Levator scapulae and rhomboid transfer for paralysis of trapezius. The Eden-Lange procedure.

Spinal accessory nerve palsy leads to painful disability of the shoulder, carrying an uncertain prognosis. We reviewed the long-term outcome in 16 patients who were treated for pain, weakness of active elevation and asymmetry of the shoulder and the neck due to chronic paralysis of the trapezius muscle, as a result of nerve palsy. Of four patients who were treated conservatively, none regained satisfactory function, although two became pain-free. The other 12 patients were treated operatively with transfer of the levator scapulae to the acromion and the rhomboid muscles to the infraspinatus fossa (the Eden-Lange procedure). At a mean follow-up of 32 years, the clinical outcome of the operatively treated patients was excellent in nine, fair in two, and poor in one patient, as determined by the Constant score. Pain was adequately relieved in 11 and overhead function was restored in nine patients. Pre-operative electromyography had been carried out in four patients. In two, who eventually had a poor outcome, a concomitant long thoracic and dorsal scapular nerve lesion had been present. The Eden-Lange procedure gives very satisfactory long-term results for the treatment of isolated paralysis of trapezius. In the presence of an additional serratus anterior palsy or weak rhomboid muscles, the procedure is less successful in restoring shoulder function.

Accessory Nerve Injuries↗

Bacterial 16S rRNA gene analysis revealed that bacteria related to Arcobacter spp. constitute an abundant and common component of the oyster microbiota (Tiostrea chilensis).

To explore the bacterial microbiota in Chilean oyster (Tiostrea chilensis), a molecular approach that permits detection of different bacteria, independently of their capacity to grow in culture media, was used. Bacterial diversity was assessed by analysis of both the 16S rDNA and the 16S-23S intergenic region, obtained by PCR amplifications of DNA extracted from depurated oysters. RFLP of the PCR amplified 16S rDNA showed a prevailing pattern in most of the individuals analyzed, indicating that a few bacterial species were relatively abundant and common in oysters. Cloning and sequencing of the 16S rDNA with the prevailing RFLP pattern indicated that this rRNA was most closely related to Arcobacter spp. However, analysis by the size of the amplified 16S-23S rRNA intergenic regions revealed not Arcobacter spp. but Staphylococcus spp. related bacteria as a major and common component in oyster. These different results may be caused by the absence of target for one of the primers employed for amplification of the intergenic region. Neither of the two bacteria species found in large abundance was recovered after culturing under aerobic, anaerobic, or microaerophilic conditions. This result, however, is expected because the number of bacteria recovered after cultivation was less than 0.01% of the total. All together, these observations suggest that Arcobacter-related strains are probably abundant and common in the Chilean oyster bacterial microbiota.

Animals↗

Fatty acid amide hydrolase localization in the human central nervous system: an immunohistochemical study.

Recent discoveries have opened new fields for research on the biochemistry and pharmacology of cannabinoids. Among them, and most importantly, are the characterization and molecular cloning of central and peripheral cannabinoid receptors as well as the isolation of the first putative endogenous ligands that bind to them, anandamide and 2-arachidonylglycerol. The enzyme that degrades these so-called "endocannabinoids" is an integral membrane protein, fatty acid amide hydrolase. Its distribution and biochemistry in rat brain suggest that it plays a critical role in the regulation of the endocannabinoid system. However, few data exist regarding its distribution and mechanism of action in human tissues. To that end, we have studied its cellular distribution in the human central nervous system by immunohistochemistry. Using an affinity-purified antibody, we report that fatty acid amide hydrolase is localized to specific and well-delimited cell populations, including cortical pyramidal neurons, subcortical white matter astrocytes, striatal and striatoefferent projecting neurons, hypothalamic and midbrain nuclei, granular and molecular layers of the cerebellum, Purkinje neurons, dentate cerebellar nucleus, inferior olivary nuclei and others. This distribution resembles that of the central cannabinoid receptors as well as that of the enzyme distribution in the rat brain. In summary, the cellular localization of the degradative enzyme of the endogenous cannabinoid ligands in human central nervous system reveals its presence on both neuronal and glial elements and shows a significant overlapping with that of central cannabinoid receptors, mainly in areas related with motor control, confirming the notion that the endocannabinoid system plays a critical role in the control of movement.

Adult↗

Prior aspirin use in unstable angina patients with modified plasma inflammatory markers and endothelial nitric oxide synthase in neutrophils.

BACKGROUND: Prior use of aspirin in patients with acute coronary syndrome has been associated with a lower incidence of acute myocardial infarction. The aim of this study was to explore if prior aspirin therapy in unstable angina (UA) patients could modify systemic inflammatory markers such as interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha) and intercellular adhesion molecule-1 (ICAM-1) and the expression of endothelial nitric oxide synthase (eNOS) in neutrophils. MATERIALS AND METHODS: Unstable angina was defined as transient S-T segment changes without significant increases in CK and CK-MB. We studied 50 consecutive patients admitted to hospital within 24 h after the onset of chest pain. The number of patients with prior aspirin was significantly higher (n = 32) than those not taking aspirin (n = 18) on admission. RESULTS: Plasma levels of IL-6 and ICAM-1 were significantly increased in the UA patients when compared with the healthy control volunteers (n = 20) used as a reference for normal values. Plasma levels of both IL-6 and ICAM-1 were reduced in patients taking aspirin. There were no differences in the plasma levels of TNF-alpha between the UA patients and the control volunteers. The eNOS protein expression was also higher in neutrophils from the UA patients taking aspirin than in those not taking aspirin. CONCLUSION: Patients taking aspirin before UA showed a lower systemic inflammatory response and higher eNOS protein expression in their neutrophils

Aged↗

Treatment of conjunctival lymphomas by beta-ray brachytherapy using a strontium-90-yttrium-90 applicator.

We reviewed the outcome of the 10 patients (13 eyes) with localized, biopsy-proven, low-grade lymphoma of the conjunctiva treated at our Department between 1988 and 1997. All patients were treated by beta-ray brachytherapy using a bidirectional 90Sr-90Y ophthalmic applicator (Applicator SIA 2, Amersham plc). Total doses, prescribed at the surface of the applicator, varied between 40 Gy and 80 Gy. With a median follow-up of 78 months (range: 14 to 146 months), seven patients remained with no evidence of relapse (67.5% 10 year disease free survival). Local control was achieved in 10 out of 13 eyes (76.9%). Two of the three local relapses were marginal. One of these three patients also developed a metachronous lymphoma in the contralateral conjunctiva. These three patients underwent a second course of brachytherapy with 90Sr/90Y and remained free of second relapse 109, 68 and 33 months after salvage therapy. No cases of systemic relapse were observed. Late (LENT-SOMA) complications were of grade 2 in five eyes, of grade 3 in one eye and of grade 4 in one eye. Late complications of grade 2 or higher were observed in one out of five patients (20%) treated with doses lower or equal to 50 Gy and in six out of eight patients (75%) treated with doses higher than 50 Gy (P=0.086). Our data indicates that beta-ray brachytherapy was ultimately able to control most conjunctival lymphomas but carried a risk of late complications and marginal relapses that was possibly higher than the rates reported for other radiotherapy techniques.

Adult↗

Characterization of paint samples used in drinking water reservoirs: identification of endocrine disruptor compounds.

Several migration tests are performed from various epoxy paint samples that, according to the regulation, can be used in food reservoirs such as drinking water reservoirs. The level of the organic compounds capable of producing migrations to water with special attention to endocrine disruptor compounds (EDCs) are identified and estimated by closed loop-stripping analysis (CLSA) and liquid-liquid extraction (LLE) methods coupled with gas chromatography (GC)-mass spectrometry (MS). Bisphenol A, a strong endocrine disruptor, is found in all migration experiments. Its concentration level reaches between 0.02 and 0.03 mg/cm2. The higher concentration corresponds with benzylic alcohol, which is used as a solvent and curing agent in epoxy paint. Other EDCs identified in the migration tests are phthalates, 4-nonylphenol, and t-butylphenol. The main non-EDCs identified are solvents, antioxidants, and rubber-like compounds. No great differences are found in the use of metallic plates or concrete slabs for migration experiments; only additional compounds related with the pretreatment of the concrete wall have been identified, too. In the study of a drinking water sample the same organic compounds identified in the migration test is not seen. This is probably because of the dynamic situation in a drinking water reservoir. Finally, a GC profile of a direct epoxy paint analysis is shown. The main peak identified is bisphenol A diglycidyl ether, monomer, and an active principle of the polymerization of epoxy resins based on bisphenol A. In addition, we report the recoveries of a selected group of EDCs using CLSA and LLE methods coupled with GC-MS.

Endocrine Glands↗

Heterogeneity of Helicobacter pylori cag genotypes in experimentally infected mice.

Our aim was to assess whether the Helicobacter pylori population recovered from experimentally infected mice show heterogeneity in cag genotypes. Wild-type FVB/N mice were challenged with strain Hp1 and sacrificed 8 weeks later. Direct PCR on gastric tissue was performed using primers for glmM and cagA, and for these two genes and for cagE and virB11 using DNA from the infecting and the emerging strains. The gastric tissues of two of five mice were PCR+ for glmM but not cagA. For the infecting strain, the PCRs for all four genes studied were strongly positive, but the sweeps from the emerging strains from both mice gave weaker signals for cagA and cagE. Examination of single colonies showed reduced or absent signals for cagA and cagE in relation to glmM and virB11. Serial dilution PCR of sweep isolates from the mice showed a 10- to 100-fold decrease in cagA signal compared to the infecting strain. The decrease of cagA and cagE, but not virB11, amplification and lack of cagA hybridization in Southern blots indicates a selective loss of the right half of the cag island during murine infection. This phenomenon is consistent with host-induced adaptive changes of cag genotype in the population of colonizing H. pylori cells.

Animals↗

Model-independent source imaging using two-pion correlations in (2 to 8)a GeV Au+Au collisions.

We report a particle source imaging analysis based on two-pion correlations in high multiplicity Au+Au collisions at beam energies between 2A and 8A GeV. We apply the imaging technique introduced by Brown and Danielewicz, which allows a model-independent extraction of source functions with useful accuracy out to relative pion separations of about 20 fm. The extracted source functions have Gaussian shapes. Values of source functions at zero separation are almost constant across the energy range under study. Imaging results are found to be consistent with conventional source parameters obtained from a multidimensional Hanburg-Brown-Twiss analysis.

Journal Article↗

Expression of an endothelial-type nitric oxide synthase isoform in human neutrophils: modification by tumor necrosis factor-alpha and during acute myocardial infarction.

OBJECTIVES: The purpose of this study was to determine whether human neutrophils express an endothelial-type nitric oxide synthase (eNOS), and to study the effect of tumor necrosis factor-alpha (TNF-alpha) on its expression. BACKGROUND: Several studies have demonstrated the presence of a constitutively expressed nitric oxide svnthase (NOS) in neutrophils. Cardiovascular disease is characterized by increased levels of plasma TNF-alpha, a cytokine that has demonstrated eNOS messenger ribonucleic acid (mRNA) destabilization in cultured endothelial cells. METHODS: Neutrophils were obtained from healthy volunteers and from patients with acute myocardial infarction (AMI). RESULTS: Human neutrophils express eNOS mRNA and eNOS protein. Stimulation of neutrophils with TNF-alpha decreased eNOS protein expression by reducing eNOS mRNA stabilization. In the present study, we also show that the cytosol of human neutrophils contains proteins that bind to a specific region within the 3'-untranslated region (3'-UTR) of eNOS mRNA. Tumor necrosis factor-alpha increased the binding of the cytosolic proteins to the 3'-UTR of eNOS mRNA. Simvastatin reduced the TNF-alpha-related binding activity of neutrophil cytosolic proteins to eNOS mRNA, which was associated with its protective effect on eNOS protein expression. The in vivo reproduction of the in vitro findings was performed in neutrophils obtained from patients with AMI and showed a diminished expression of eNOS protein, which was associated with increased binding of the cytosolic proteins. CONCLUSIONS: These observations demonstrate that human neutrophils express eNOS, which is downregulated by TNF-alpha and during AMI. This effect is associated with increased binding of neutrophil cytosolic proteins to the 3'-UTR of eNOS mRNA.

Adult↗

Dislocation of the polyethylene inlay due to anterior tibial slope in revision total knee arthroplasty.

We report a case of dislocation of the polyethylene inlay in revision total knee arthroplasty. Eight days after revision arthroplasty due to a previous infection, the polyethylene inlay of a PCL- retaining cemented total knee arthroplasty dislocated at about 80 degrees of flexion on the CPM machine. Lateral X-ray examination revealed an anterior slope of the tibial cut of 5 degrees. Correction of the tibial slope to a posterior tibial slope of 7 degrees reduced the forces on the posterior aspect of the inlay and no redislocation occurred. The mechanisms causing tibial inlays to dislocate in TKA are analyzed and discussed.

Arthroplasty, Replacement, Knee↗

Scapular neck fracture--the influence of permanent malalignment of the glenoid neck on clinical outcome.

A scapular neck fracture is considered unstable if it is associated with an ipsilateral clavicular fracture or an acromioclavicular (AC) joint dislocation. Currently, it is recommended that stabilization of a disrupted shoulder girdle must be achieved through open reduction and internal fixation of the clavicular fracture or by reduction of the AC joint, without addressing the scapular neck. However, if the displaced glenoid neck is not simultaneously reduced, malalignment of the glenoid neck may persist. The purpose of this retrospective study was to analyze the effect of associated shoulder girdle injury on glenoid displacement and the influence of glenoid malalignment on clinical outcome. Nineteen patients with scapular neck fractures were reviewed clinically and radiologically at a mean of 8 years (range 2-21 years) after injury. None of them has developed nonunion of the scapular neck, and only one showed radiological signs of mild degenerative joint disease. The glenopolar angle (GPA), which assesses the rotational malalignment of the glenoid about an anteroposterior axis perpendicular to the scapular plane on plain X-rays was measured less than 20 degrees in six patients. Three of them had sustained an associated clavicular fracture or AC joint dislocation. The other 3 patients had permanent severe malalignment of the glenoid neck in the absence of an associated shoulder girdle injury. Five patients with GPA less than 20 degrees complained of moderate or severe pain, whereas of the 13 patients with mild or no glenoid rotational displacement or medial displacement alone, 11 patients had no or mild pain, and only 2 had moderate or severe pain (P = 0.0095). Five patients presented with reduced activities of daily living, 4 of them had severe glenoid rotational displacement (P = 0.0173). Loss of motion was found in only 2 patients, and both had a severely displaced glenoid neck (P = 0.088). In conclusion, severe displacement of the glenoid neck may occur with or without associated fracture of the clavicle or dislocation of the AC joint and can be identified as a GPA less than 20 degrees. Scapular neck fractures with such malalignment have a less favorable long-term outcome compared with otherwise comparable cases with absence of glenoid malalignment as measured with the glenopolar angle.

Adult↗

Effects of fish farm loadings on seagrass (Posidonia oceanica) distribution, growth and photosynthesis.

The spatial extent and timing of the impact of fish farms on the distribution and performance of a Posidonia oceanica meadow were examined in an embayment of the south-eastern coast of Spain (Hornillo Bay, Murcia). Changes in seagrass distribution were determined using available seagrass mapping (from 1988, i.e., before the onset of aquaculture activities and 1998) and by successive sampling in 1994 and 1998. Environmental variables (light attenuation coefficient, water-column dissolved nutrients and organic content of sediments) together with plant performance (shoot biomass, leaf growth rate, photosynthetic activity, carbohydrate reserves, the number of leaves per shoot, epiphyte loads and herbivore pressure) were measured in plants affected by organic discharges, and were compared with those found in reference healthy plants over an annual growth cycle. Since the onset of fish farm activity, 11.29 ha of P. oceanica meadow has been completely lost and 9.86 ha significantly degraded, thus resulting in a total affected area which accounts for about 53% of the former meadow, or 7-fold the fish farming area. Unequal propagation of seagrass die-off or degradation reflects the relevance of local factors such as depth and hydrodynamism on the true extent of fish farm impact. Water transparency decreases and dissolved nutrient and organic content of sediments increases in the vicinity of cages compared to distant reference stations, thus supporting the notion of environmental gradients caused by the organic release from cages, which spreads outwards. Shoot size, leaf growth rate and the number of leaves per shoot in plants close to the fish farm decreased. Moreover, low leaf growth and low rhizome carbohydrate concentration (always relative to that found in an undisturbed area) indicated carbon budget imbalances. Since light reduction in the affected area was only modest (31% of light reaching the sea surface, while at the same depth this figure was 39% at the reference site), and light availability was well above the minimum requirement estimated for this species, neither this factor nor epiphyte overgrowth (epiphyte load was lower in the affected area) seem to explain such carbon imbalances or the observed meadow regression. Alternatively, the high herbivore pressure found in the affected zone suggests that overgrazing is one of the main causes of decreasing shoot sizes and hence of carbon imbalance, reduced growth and shoot mortality. The impact of fish farms on seagrasses, therefore, seems to be highly variable and depends on complex interactions between a large number of processes.

Animals↗

Renal vascular injuries.

Even today, most renal vascular injuries result in loss of renal function. Kidney salvage is not possible because of late diagnosis and the presence of severe associated injuries. Physical exam and basic laboratory tests are not sensitive; thus, a high index of suspicion is required. Repair should be attempted for all solitary kidneys and for patients sustaining bilateral injuries. All viable kidneys should be revascularized in order to increase the chances of obtaining adequate functional renal tissue. In the event that revascularization is not feasible, nephrectomy can be performed at a later time, if hypertension develops. In some cases, delayed return of function is possible, but in most cases the kidney will atrophy without producing hypertension. Most importantly, maintaining a high index of suspicion, prompt diagnostic evaluation, and judicious treatment can optimize outcome lowering the significant morbidity and mortality of renal vascular injuries.

Humans↗

Lipophilic extractives in process waters during manufacturing of totally chlorine free kraft pulp from eucalypt wood.

The chemical composition of lipophilic extractives from process waters throughout a totally chlorine free (TCF) bleaching sequence after kraft pulping of eucalypt wood has been studied. These compounds are among the most problematic wood constituents for both TCF and zero liquid effluent (ZLE) processes, since they tend to accumulate in circuits resulting in the formation of the so-called pitch deposits causing serious problems in the pulp and paper industry. Pitch deposits collected at different parts of the pulp mill were also characterized and their composition compared with that of lipophilic compounds in process waters and Eucalyptus globulus wood. The identification of these compounds from process waters, wood and pitch deposits was performed by gas chromatography and gas chromatography-mass spectrometry using short- and medium-length high temperature capillary columns. Sterols, sterol esters, steroid ketones and steroid hydrocarbons were the main compounds identified. These chemical species arise from eucalypt wood extractives that survive the pulping and are released from pulp into the process waters during the bleaching process. Finally, they can deposit in pulp and on different parts of the mill or remain suspended in process waters being discharged in effluents.

Chromatography, Gas↗

[Results of a psychotherapeutic program for smoking after 12 months of follow-up].

OBJECTIVE: To compare the efficacy of psychological counseling for smokers in a cessation program in comparison with treatment based only on providing information about damage caused by tobacco and advice for quitting, and to determine the reasons patients started to smoke. PATIENTS AND METHODS: We studied 249 patients who came to a preliminary interview; 226 began treatment for smoking cessation. The average level of dependence, quantified the Fagerstrom test was 7.26 +/- 1.85 points. Two treatment groups were formed: the first patients seen made up the control group (n = 37), which received information about the dangers of tobacco and strategies for quitting, and the psychological counseling group (n = 189). Follow-up examinations were performed three, six and twelve months after treatment, with abstinence checked by measurement of CO in exhaled air. Only patients with CO levels less than 5 ppm (particles per million) in exhaled air were considered non-smokers. RESULTS: Most patients of both sexes named social pressure as the reason for starting to smoke. The rate of abstinence in the information and strategies group was 8.1% at all three follow-up visits, whereas the rate was 37%, 25.4% and 24.3% at three, six and twelve months, respectively, in the group receiving counseling. The differences between the two groups were significant at all visits. CONCLUSIONS: Social pressure is the main reason for starting to smoke. We observed a success rate of 24.3% after one year of follow-up after psychological treatment only, a rate that was significantly higher than that of the group that received only information. We believe that psychological counseling is an effective alternative for smokers who want to quit.

Adult↗