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Biomedical subjects

L Flores

Publications and source records attributed to L Flores.

At least 37 records · Page 2Linked to original sources
PubMed1999

Usefulness of ambulatory blood pressure monitoring in pregnant women with type 1 diabetes.

OBJECTIVE: Pregnancy in type 1 diabetes is associated with an increased risk of developing pregnancy-induced hypertension (PIH). Ambulatory blood pressure monitoring (ABPM) has been used to screen for preeclampsia in nondiabetic pregnancy. To date, there are no data regarding ABPM during pregnancy in normotensive type 1 diabetic women. This study sought to establish blood pressure (BP) profiles for pregnant type 1 diabetic women using ABPM and determine whether the BP pattern can define a population at risk for developing PIH. RESEARCH DESIGN AND METHODS: ABPM was carried out for one 24-h period during each trimester--in the first trimester between weeks 7 and 12, in the second trimester between weeks 20 and 24, and in the third trimester between weeks 30 and 34--in 22 normotensive pregnant type 1 diabetic and 10 pregnant nondiabetic women. RESULTS: The incidence of PIH was fourfold greater in type 1 diabetic women than in control subjects. Diabetic women showed higher daily diastolic BP in the third trimester compared with nondiabetic pregnant women. Diabetic women who developed PIH in the third trimester showed significantly higher BP profiles throughout gestation than those who remained normotensive. Receiver operator characteristics curves for nighttime systolic BP showed the best predictive capacity for PIH, with a cutoff > 105 mmHg (85% sensitivity and 92% specificity). CONCLUSIONS: Our study confirms the early increase of BP in patients who will develop PIH and suggests that nighttime systolic BP >105 mmHg in the second trimester is a useful predictor of PIH. ABPM may be useful in screening for PIH in pregnant diabetic women.

Adolescent↗
PubMed1999

Gelatinase activity of matrix metalloproteinases in the cerebrospinal fluid of various patient populations.

We have studied the enzymatic gelatinolytic activity of matrix metalloproteinases (MMPs) present in cerebrospinal fluid (CSF) of samples obtained from 67 individuals, twenty-one nonneurological patients (considered controls) and 46 subjects with various neurological disorders e.g., vascular lesions, demyelination, inflammatory, degenerative and prion diseases. Biochemical characterization of MMPs, a family of neutral proteolytic enzymes involved in extracellular matrix modeling, included determination of substrate specificity and Ca+2 dependency, as well as the effects of protease inactivators, carboxylic and His (histidine) residue modifiers, and antibiotics. Whereas all CSF samples expressed MMP-2 (gelatinase A) activity, it corresponded in most cases (normal and pathological samples) to its latent form (proenzyme; pMMP-2). In general, inflammatory neurological diseases (especially meningitis and neurocisticercosis) were associated with the presence of a second enzyme, MMP-9 (or gelatinase B). Whereas MMP-9 was found in the CSF of every tropical spastic paraparesis patient studied, its presence in samples from individuals with vascular lesions was uncommon. Patients blood-brain barrier damage was ascertained by determining total CSF protein content using both, the conventional polyacrylamide gel electrophoresis procedure under denaturing conditions and capillary zone electrophoresis.

Enzyme Activation↗
PubMed1998

Insulin therapy in type 2 diabetic patients: effects on arterial blood pressure and endothelin-1 plasma levels.

OBJECTIVE: To evaluate the possible effect of short- and long-term insulin treatment on arterial blood pressure (BP) and endothelin-1 (ET-1) plasma levels in type 2 diabetic patients. RESEARCH DESIGN AND METHODS: Seven type 2 diabetic patients with secondary failure to oral hypoglycemic drugs (SFOH) were studied. Twenty-four-hour arterial BP monitorization (Spacelabs 90207) was performed before initiation of insulin treatment (time 0), 6 days after (time 1) and 1 year later (time 2). Moreover, ET-1 plasma levels were measured. RESULTS: Insulin treatment did not produce any variation in systolic (124.3 +/- 11.6; 120.7 +/- 7.9; 127.0 +/- 13.4 mmHg) and diastolic (72.8 +/- 5.9; 71.5 +/- 3.4; 71.8 +/- 5.2 mmHg) 24-h BP monitorization at times 0, 1 and 2, respectively. The systolic and diastolic day/night differences did not change in the three times studied. Neither were significant differences observed in ET-1 plasma levels. CONCLUSIONS: In patients with SFOH, insulin treatment did not induce any short- or long-term increase in BP or any variation in plasma ET-1 levels.

Aged↗
PubMed1998

Simultaneous intestinal leishmaniasis and mycobacterial involvement in a patient with acquired immune deficiency syndrome.

Gastrointestinal involvement is reported in approximately 50% to 93% of patients with human immunodeficiency virus. It is frequently the result of coinfection with several microorganisms. Selective Leishmania intestinal involvement presents with atypical symptoms for visceral leishmaniasis, and may appear as a relapse or as the first manifestation of the disease. The authors present a patient with acquired immune deficiency syndrome who has a history of treated leishmaniasis and gastrointestinal infection by showed Mycobacterium avium intracellulare (MAI). After the new onset of abdominal pain, an intestinal biopsy showed the presence of both MAI and Leishmania in duodenum. Intestinal infection by Leishmania must be included in the differential diagnosis in patients with a previous history of leishmaniasis or travel to an endemic area.

AIDS-Related Opportunistic Infections↗
PubMed1997

Objectification of functional improvement after nonoperative care.

STUDY DESIGN: In this article, the authors review the three broad categories of measures that have been used to objectify functional improvement after nonoperative care of painful spinal disorder patients-physical, psychological, and socioeconomic. For each of the three categories, the major measures used are discussed, as well as research relating to the efficacy of the measures. OBJECTIVE: To point out the many differences that still exist among research studies regarding which functional outcome measures to use and when to use them. SUMMARY OF BACKGROUND DATA: During the past few decades, it has been made abundantly clear that painful spinal disorders, particularly when associated with work disability and/or financial benefits, result from a complex interaction of medical, psychological, and social factors. This has resulted in frequent confusion regarding what constitutes the primary roots of the disabling process. Currently, a more comprehensive biopsychosocial perspective of chronic pain and disability has emerged that has significant implications for diagnostic and treatment philosophies of practitioners. METHODS: Identifying the measures frequently used to address the important biopsychosocial factors, and evaluating their relative benefits and drawbacks. RESULTS AND CONCLUSIONS: It is demonstrated that there has been an overall trend in recent years toward using more objective, quantifiable instruments, encompassing the physical, psychological, and socioeconomic parameters of outcomes research in painful spinal disorders. These changes will certainly improve the ability of researchers to tease out which factors tap more directly into such tissue as physical impairment, as well as create greater uniformity of measures that will permit direct comparisons between studies.

Activities of Daily Living↗
PubMed1997

The Genome Sequence DataBase version 1.0 (GSDB): from low pass sequences to complete genomes.

The Genome Sequence DataBase (GSDB) has completed its conversion to an improved relational database. The new database, GSDB 1.0, is fully operational and publicly available. Data contributions, including both original sequence submissions and community annotation, are being accomplished through the use of a graphical client-server interface tool, the GSDB Annotator, and via GIO (GSDB Input/Output) files. Data retrieval services are being provided through a new Web Query Tool and direct SQL. All methods of data contribution and data retrieval fully support the new data types that have been incorporated into GSDB, including discontiguous sequences, multiple sequence alignments, and community annotation.

Animals↗
PubMed1997

Localization and postoperative follow-up of a bronchial carcinoid tumor causing Cushing's syndrome by 111In-DTPA labelled octreotide scintigraphy.

Bronchial carcinoid tumor is the most frequent occult source of ectopic ACTH-dependent Cushing's syndrome, but its initial localization may be very difficult, as well as its postoperative follow-up. We here present the case of a 21-year-old man with Cushing's syndrome and biochemical findings suggesting an ectopic source of ACTH (lack of inhibition of cortisol after overnight 8-mg dexamethasone suppression test, and lack of response to h-CRH challenge). Chest CT-scan showed a node adjacent to the left lung hilium whose nature was confirmed by uptake of 111Indium-DTPA labelled octreotide scintigraphy. Surgical resection of the tumor consisted in an upper lobectomy of the left lung. Microscopic examination identified a typical carcinoid tumor. After surgery pituitary-adrenal function normalized and a second scintigraphy offered additional data on the absence of tumor remnants.

Adrenocorticotropic Hormone↗
PubMed1996

Susceptibility-weighted MR for evaluation of vasodilatory capacity with acetazolamide challenge.

PURPOSE: To investigate cerebral vasodilatory capacity by acetazolamide challenge in healthy subjects and in patients with chronic occlusive cerebrovascular disease by using susceptibility-weighted gradient-echo MR imaging. METHODS: Eight patients with chronic occlusive cerebrovascular disease and four healthy volunteers were studied with susceptibility-weighted MR imaging before and after intravenous administration of 1000 mg of acetazolamide. Signal intensities were measured as a function of time in several regions of interest defined on anatomic images. In all patients with chronic occlusive cerebrovascular disease, acetazolamide challenge and resting regional cerebral blood flow were also evaluated with single-photon emission CT (SPECT). RESULTS: In healthy volunteers, signal intensities began to increase 3 to 4 minutes after acetazolamide administration, with a continuous increase during the subsequent 10 minutes. The effect lasted for approximately 45 minutes after administration. In patients with chronic occlusive cerebrovascular disease, signal changes on susceptibility-weighted MR images of occluded areas with normal vasodilatory capacity on SPECT images did not differ from signal changes of nonocclusive areas. In those patients with changes that reflected diminished vasodilatory capacity, the MR images showed a lower percentage of signal changes after acetazolamide administration than those in normally perfused areas. CONCLUSION: Susceptibility-weighted MR imaging offers an alternative method for estimating vasodilatory capacity.

Acetazolamide↗
PubMed1996

[Reye syndrome evaluated by 99mTc-ECD SPECT: a case report].

We report a three-year-old boy with Reye syndrome evaluated by 99mTc-ECD SPECT. On acute stage, 99mTc-ECD brain SPECT disclosed diffuse high uptake in the cerebral cortex in spite of normal findings on brain X-ray CT. These lesions changed to general low uptake on the chronic state and multiple high intensity areas were shown on T2 weighted MRI image. Such a change of cerebral tracer uptake was considered to reflect the neuropathological change of Reye syndrome. 99mTc-ECD SPECT was a useful modality to diagnose Reye syndrome complementary.

Brain↗
PubMed1996

[The quantitative regional cerebral blood flow measurement with autoradiography method using 123I-IMP SPECT: evaluation of arterialized venous blood sampling as a substitute for arterial blood sampling].

The purpose of this study is validation of calibrating a standard input function in autoradiography (ARG) method by one point venous blood sampling as a substitute for that by one point arterial blood sampling. Ten and 20 minutes after intravenous constant infusion of 123I-IMP, arterialized venous blood sampling from a dorsal vein were performed on 15 patients having ischemic cerebrovascular disease. And arterial blood sampling from radial artery was performed 10 min after 123I-IMP infusion. The mean difference rates of integrated input function between calibrated standard input function by arterial blood sampling at 10 min and that by venous blood sampling were 4.1 +/- 3% and 9.3 +/- 5.4% at 10 and 20 min after 123I-IMP infusion, respectively. The ratio of venous blood radioactivity to arterial blood radioactivity at 10 min after 123I-IMP infusion was 0.96 +/- 0.02. There was an excellent correlation between ARG method CBF values obtained by arterial blood sampling at 10 min and those obtained by arterialized venous blood sampling at 10 min. In conclusion, a substitution by arterialized venous blood sampling from dorsal hand vein for artery can be possible. The optimized time for arterialized venous blood sampling was 10 min after 123I-IMP infusion.

Aged↗
PubMed1993

Exercise countermeasure protocol management expert system.

Exercise will be used primarily to countermeasure against deconditioning on extended space flight. In this paper we describe the development and evaluation of an expert system for exercise countermeasure protocol management. Currently, the system includes two major subsystems: baseline prescription and prescription adjustment. The baseline prescription subsystem is designed to provide initial exercise prescriptions while prescription adjustment subsystem is designed to modify the initial prescription based on the exercised progress. The system runs under three different environments: PC, SUN workstation, and Symbolic machine. The inference engine, baseline prescription module, prescription adjustment module and explanation module are developed under the Symbolic environment by using the ART (Automated Reasoning Tool) software. The Sun environment handles database management features and interfaces with PC environment to obtain physical and physiological data from exercise units on-board during the flight. Eight subjects' data have been used to evaluate the system performance by comparing the prescription of nine experienced exercise physiologists and the one prescribed by the expert system. The results of the validation test indicated that the performance of the expert system was acceptable.

Analysis of Variance↗
PubMed1993

Incompatibility of Isovue 370 and papaverine in peripheral arteriography.

Complete thrombotic occlusion of the arterial blood flow in the upper extremity was produced after mixture of Isovue 370 (iopamidol) and papaverine hydrochloride during routine angiography. Bolus and then continuous infusion of urokinase failed to dissolve the thrombus. The patient required a surgical thrombectomy and recovered uneventfully. This case report demonstrates that caution should be exercised when Isovue 370 and papaverine are used in angiography.

Angiography↗
PubMed1992

Daughters caregiving for Hispanic and non-Hispanic Alzheimer patients: does ethnicity make a difference?

This study assessed Cuban-American Hispanic and White non-Hispanic daughters who were major caregivers for their mothers suffering from Alzheimer's Disease. Although patients in both ethnic groups did not differ in their level of cognitive and functional impairment, Cuban-American Hispanic patients were significantly more likely to be living in their daughters' homes while the White non-Hispanic patients resided in institutional settings. Caregivers were equivalent in their knowledge and utilization of community services, but Cuban-American daughters were significantly more aware of financial aid resources. Cuban-American patients were significantly more depressed than their White non-Hispanic counterparts with daughters showing similar but nonsignificant trends. The impact of cultural factors on caregiving is discussed.

Activities of Daily Living↗
PubMed1990

Hemodynamic function in dogs with chronic obstructive jaundice: effects of radiocontrast medium.

Chronic obstruction of the biliary tract alters circulatory function. The effects of radiocontrast medium (iothalamate meglumine) on systemic and renal hemodynamics were studied in normal dogs and dogs with chronic common bile duct ligation (CBDL). After intravenous injection of radiocontrast, cardiac output and stroke volume were not altered in normal and CBDL dogs; arterial pressure was stable in normal dogs but decreased significantly in CBDL dogs and was accompanied by reduced systemic vascular resistance. In normal and CBDL dogs the renal hemodynamic responses to radiocontrast medium were characterized by initial vasoconstriction (independent of renal renin release) and later vasodilation. This vasodilatation in CBDL dogs was particularly striking as it occurred despite reduced renal perfusion pressure and the augmented renin-angiotensin system. Inhibition of prostaglandin synthesis with indomethacin in CBDL dogs abolished both the hypotensive and the renal vasodilator responses to radiocontrast medium. We conclude that enhanced prostaglandin activity contributes to the labile hemodynamic function noted in obstructive jaundice.

Animals↗