Search PubMed⌕ Search

Biomedical subjects

L Prieto

Publications and source records attributed to L Prieto.

At least 37 records · Page 2Linked to original sources
PubMed2002

Sentinel node localization in patients with non-palpable breast cancer.

The aim of this study was to demonstrate that radionuclide sentinel node detection can be applied to patients with non-palpable breast cancer. One hundred and ten consecutive women with unilateral breast cancer were studied. Group 1 was made up of 80 patients with palpable breast cancer (mean age, 58 years) and group 2 of 30 patients with non-palpable breast cancer detected mammographically (mean age, 55 years). Tc-nanocolloid (111 MBq) was injected peritumorally in palpable tumours, and in the tumour area (ultrasound guided) in non-palpable tumours. At 2 h post-injection, anterior and lateral scintigrams were obtained from patients in the supine position. The location of the sentinel node was marked on the patient's skin. Patients with non-palpable tumours were moved to the surgery room 3 h later, and those with palpable tumours 24 h later. The histopathological study included three haematoxylineosin sections and immunochemistry. All patients underwent axillary lymphadenectomy. The sentinel node was detected in 67 cases (84%) in group 1 and in 28 cases (93%) in group 2. In four patients (5%) in group 1 and two patients (7%) in group 2, no axillary sentinel node was detected in the surgical bed, although it had been seen in scintigraphy. In nine patients (11%) in group 1, neither scintigraphic nor surgical detection was successful. Skip metastasis was seen in six cases (10%) of palpable tumours and in one case (4%) of non-palpable tumours. It can be concluded that non-palpable breast tumours cannot be considered an exclusion criterion for sentinel node localization and biopsy. Ultrasonography-guided injection, followed by scintigraphic and surgical detection of the sentinel node, may help in the management of patients with non-palpable breast tumours.

Adult↗
PubMed2002

Airway obstruction induced by inhaled acetaldehyde in asthma: repeatability relationship to adenosine 5'-monophosphate responsiveness.

Inhaled acetaldehyde and adenosine 5'-monophosphate (AMP) cause bronchoconstriction in asthmatics by a mechanism believed to involve histamine release from airway mast cells. This study investigates the repeatability of the acetaldehyde challenge and the relationship between airway responsiveness to acetaldehyde and AMP. To this end, we examined the effect of inhaled acetaldehyde on airway tone in comparison with either methacholine or AMP in 16 asthmatics. Furthermore, the repeatability of the acetaldehyde challenge was assessed in 14 subjects with mild asthma. The response to each bronchoconstrictor agent was measured by the PC20 (provocative concentration required to produce a 20% fall in FEV1). The geometric mean (range) PC20 values were 3.1 mmol/l (0.5-46.0 mmol/l) for methacholine, 883.1 mmol/l (190.7-1816.1 mmol/l) for acetaldehyde, and 50.1 mmol/l (3.2-1152.1 mmol/l) for AMP. Thus, acetaldehyde was 18-fold less potent than AMP in causing bronchoconstriction. A similar correlation was observed between PC20 acetaldehyde and either PC20 AMP (r = 0.58, p = 0.02) or PC20 methacholine (r = 0.56, p = 0.02). The challenge procedure with acetaldehyde was moderately repeatable (coefficient of repeatability = +/- 1.4 doubling concentrations, intraclass correlation coefficient = 0.64). We conclude that inhaled acetaldehyde is less potent than AMP in causing bronchoconstriction in asthma, and that the response to inhaled acetaldehyde is repeatable. Furthermore, the present data lends indirect support to the suggestion that acetaldehyde responsiveness and AMP responsiveness are not identifying the same alterations in the airways.

Acetaldehyde↗
PubMed2001

Endogenous glutamate-taurine interaction in striatum and nucleus accumbens of the freely moving rat: studies during the normal process of aging.

Using microdialysis, the effects of endogenous glutamate on extracellular concentrations of taurine, in striatum and nucleus accumbens of the awake rat during the normal process of aging were investigated. The glutamate uptake inhibitor L-trans-pyrrolidine-2,4-dicarboxylic acid (PDC) was perfused through the microdialysis probe to increase the endogenous concentration of glutamate. Young (2-4 months), middle aged (12-14 months), aged (27-32 months) and very aged (37 months) male Wistar rats were used. PDC (1, 2 and 4 mM) produced a dose-related increase of extracellular concentrations of glutamate and taurine in striatum and nucleus accumbens in all groups of age. Increases of glutamate, but not of taurine, decreased during aging in striatum. In nucleus accumbens there were no age-related changes in the increases of glutamate and taurine induced by PDC. In all age groups, increases of extracellular taurine were significantly correlated with increases of extracellular glutamate. However, when these taurine-glutamate correlations for all groups of age were compared, no statistical differences were found. These results show first that a decrease in the increases of glutamate produced by the glutamate reuptake inhibitor in striatum, but not in nucleus accumbens, is produced by age; second that glutamate-taurine interaction in striatum and nucleus accumbens does not change during the normal process of aging.

Aging↗
PubMed2001

Estrogen modulates norepinephrine-induced accumulation of adenosine cyclic monophosphate in a subpopulation of immortalized luteinizing hormone-releasing hormone secreting neurons from the mouse hypothalamus.

A subpopulation of luteinizing hormone-releasing hormone (LHRH)-producing cells that express the intermediate filament protein vimentin and the neuronal marker neurofilament 145, but not neurofilament 200 nor glial fibrillary acidic protein, has been isolated from GT1-7 cultures. These cells express the mRNA encoding estrogen receptor alpha (ERalpha) and respond to physiological concentrations of 17beta-estradiol (E2) by reducing the accumulation of cyclic adenosine monophosphate induced by norepinephrine, but not that induced by direct activation of adenylate cyclase. These results indicate that the activity of LHRH-producing neurons may be directly modulated by estrogen. In addition, they are suggestive of an estrogen-dependent desensitization of the beta-adrenoceptor in these cells.

Animals↗
PubMed2001

Performance of a perceived health measure in different groups of the population: a comprehensive study in Spain.

The metric properties of health-related quality of life measures are typically evaluated on selected samples and assumed to hold across different population groups. We assessed the extent to which the measurement properties of the Spanish version of the Nottingham Health Profile (NHP) were stable across sociodemographic, clinical and geographical characteristics. We collected information from all available studies using the NHP in Spain (1986-1995), and obtained data from 9419 individuals. We examined data completeness and distribution, as well as reliability and construct validity. The percentage of missing dimensions was lower than 5%, but increased with age and poor health status. Large ceiling effects in scores were observed for social isolation and energy dimensions, being largest for younger ages and individuals reporting "very good/good" health. Reliability was higher than 0.7 in all population groups considered, except for social isolation and energy dimensions in some subgroups. Mean NHP scores correlated with self-rated overall health (r = 0.48), but they varied substantially by age among those rating their health as "very good/good." We conclude that NHP is adequate for all Spanish populations. Nevertheless, some caution is needed because the reliability of dimension scores is not sufficient for individual purposes. And also, because a non-negligible high ceiling effect renders the instrument inefficient to measure changes over time among healthy populations.

Adult↗
PubMed2001

Glutamate-glutamine cycle and aging in striatum of the awake rat: effects of a glutamate transporter blocker.

This study investigated the effects of aging on the actions of a specific glutamate reuptake blocker, L-trans-pyrrolidine-2, 4-dicarboxylic acid (PDC), in extracellular glutamate and glutamine in striatum of the awake rat. Microdialysis experiments were performed on young (2-3 months), middle-aged (12-14 months), aged (27-32 months) and very aged (37 months) male Wistar rats. Local infusion of PDC (1-4 mM) in striatum increased the dialysate concentration of glutamate and decreased dialysate concentration of glutamine in all the age-groups. In young rats, decreases of dialysate glutamine were correlated with increases of dialysate glutamate. The same profile glutamine/glutamate as in young rats was found in middle-aged, aged and very aged rats, which suggests that the action of glutamate on the glutamate-glutamine cycle in striatum of the awake rat is not modified as a consequence of aging. We also found a significant correlation between the increases of glutamate produced by PDC and the basal dialysate concentration of glutamine, a relationship that did show a significant change with age. Although the significance of this latter finding remains to be elucidated, it may be important to understand the changes in glutamate-glutamine cycle during aging.

ATP-Binding Cassette Transporters↗
PubMed2001

Relationship between airway sensitivity to adenosine 5' monophosphate and the shape of the concentration-response curve to methacholine in subjects with allergic rhinitis.

The objective of this study was to determine differences in airway sensitivity to adenosine 5'-monophosphate (AMP) between allergic rhinitis subjects with plateau and those without evidence of plateau on the concentration response curves to methacholine. A total of 51 adults (38 subjects with allergic rhinitis and 13 healthy controls) were challenged with increasing concentrations of methacholine and AMP. The methacholine challenge was terminated when there was a 40% or more decrease in forced expiratory volume in 1 sec (FEV1), whereas the AMP challenge was stopped when FEV1 had fallen by more than 20%. A plateau for methacholine was detected in all 13 healthy controls and in 27 patients with allergic rhinitis (AR-plateau group), whereas 11 subjects with allergic rhinitis did not exhibit a plateau (AR-non-plateau group). The median (range) PC20 AMP (provocative concentration required to produce a 20% fall in FEV1) value for the AR-non-plateau group was 44.0 mg ml(-1) (3.3-400.0), compared with 400.0 mgml(-1) (12.1-400.0) in the AR-plateau group (P=0.03) and 400.0 mgml(-1) in the healthy control group (P=0.007). The proportion of subjects who showed bronchoconstriction in response to AMP was higher in the AR-non-plateau group (73%) than in the AR-plateau group (30%) (P=0.03). However, three subjects with allergic rhinitis who had normal sensitivity to methacholine and plateau showed bronchoconstriction in response to AMP. We conclude that, in subjects with allergic rhinitis, the absence of plateau on the concentration response curves to methacholine is associated with a higher prevalence and degree of bronchoconstriction in response to AMP. However, the two bronchoconstrictor stimuli were not identifying the same abnormalities of the airways.

Adenosine Monophosphate↗
PubMed2001

Gamma probe sentinel node localization and biopsy in breast cancer patients treated with a neoadjuvant chemotherapy scheme.

The aim of this study was to analyse the accuracy of scintigraphic and gamma probe sentinel node (SN) localization in breast cancer patients who have been submitted to neoadjuvant chemotherapy (NC). Seventy-six patients with single breast cancer were included in the study, and were classified into two groups. Group 1 consisted of 40 women who had received NC, and Group 2 consisted of 36 women who did not receive NC. All patients received 111 MBq (3 mCi) of 99Tcm-nanocolloid in 3 ml, by peritumoural injection. Anterior and lateral thoracic scans were obtained 2 h post-injection. The following day (18-24 h post-injection) the patients underwent surgery and sentinel nodes were localized by using a gamma probe. Complete axillary lymph node dissection was performed in all patients. Histological analysis included haematoxylin-eosin in all cases and immunohistochemistry in 10 cases. In Group 1, SNs were localized in 36/40 patients, histological analysis was performed in 34 and there were four false negatives (22%). In Group 2, SNs were localized in 32/36 patients, histological analysis was performed in 29 and there were two false negatives (9%). Predictive negative values were 78% and 90% in Groups 1 and 2, respectively. In summary, sentinel node localization in breast cancer patients submitted to previous neoadjuvant chemotherapy is less accurate than in patients who do not receive this therapy. The procedure is not sufficiently accurate to localize the sentinel node, thus it cannot be recommended in these patients.

Adult↗
PubMed2001

Neonatal screening program for congenital adrenal hyperplasia: adjustments to the recall protocol.

OBJECTIVE: To evaluate the influence of gestational age (GA) and birth weight (BW) on 17 alpha-OH-progesterone (17-OHP) levels with respect to their impact on the recall rate of neonatal screening programs for congenital adrenal hyperplasia (CAH). PATIENTS AND METHODS: In June 1997 we began a pilot screening program for CAH measuring 17-OHP using a fluoroimmunoassay method (DELFIA) on dried blood spots. Until September 1999, 24,153 babies were screened. Among them, we analyzed the levels of 17-OHP in 1,313 samples from healthy preterm babies (23-36 weeks) and 1,500 term babies (>37 weeks), grouped according to GA and BW. All preterm babies underwent another sampling in their 2nd week of life. RESULTS: 5 CAHs were detected. The 30-nmol/l cutoff limit for 17-OHP in blood corresponded to the calculated 99th percentile in term newborns, while in preterm babies higher levels were found. GA and BW correlated inversely with 17-OHP levels. CONCLUSION: GA and BW were useful tools to adjust cutoff levels, obtaining a significant reduction in follow-up testing and psychological stress for families. The high false-positive recall rate in preterm babies can be substantially lowered with adjusted GA and/or BW criteria.

17-alpha-Hydroxyprogesterone↗
PubMed2001

Estrogen modulates alpha(1)/beta-adrenoceptor- induced signaling and melatonin production in female rat pinealocytes.

Nocturnal rise in pineal melatonin output is due to the night-induced acceleration of noradrenergic transmission and alpha(1)- and beta-adrenoceptor activation. In addition, in female animals, cyclic oscillations in circulating levels of sex steroid hormones are accompanied by changes in the rate of pineal melatonin secretion. To investigate whether estrogen directly affects pineal adrenoceptor responsiveness, pinealocytes from 21-day-old ovariectomized rats were exposed to physiological concentrations of 17beta-estradiol (17beta-E(2)) and treated with noradrenergic agonists. Direct exposure to 17beta-E(2) reduced alpha(1)/beta-adrenoceptor-induced stimulation of melatonin synthesis and release. This effect was mediated by an estrogen-dependent inhibition of both beta-adrenoceptor-induced accumulation of cAMP and alpha(1)-adrenoceptor-induced phosphoinositide hydrolysis. Furthermore, estrogen reduced transient Ca(2+) signals elicited in single pinealocytes by alpha(1)-adrenoceptor activation or by potassium-induced depolarization. In the case of beta-adrenoceptor responsiveness, neither forskolin- nor cholera toxin-induced accumulation of cAMP were affected by previous exposure to 17beta-E(2). This indicates that estrogen effects must be exerted upstream from adenylylcyclase activation, and independent of modifications in G protein expression, therefore suggesting changes in either adrenoceptor expression or receptor-effector coupling mechanisms. Since estrogen effects upon adrenoceptor responsiveness in pineal cells was not mimicked by 17beta-E(2) coupled to bovine serum albumin and showed a latency of 48 h, this effect could be compatible with a genomic action mechanism. This is also consistent with the presence of two estrogen receptor proteins, alpha- and beta-subtypes, in female rat pinealocytes under the present experimental conditions.

Action Potentials↗
PubMed2001

Bronchoconstriction induced by inhaled adenosine 5'-monophosphate in subjects with allergic rhinitis.

Adenosine and its related nucleotide, adenosine 5'-monophosphate (AMP) induce bronchoconstriction in asthmatics, probably caused by histamine release from airway mast cells. The objective of this study was to determine the effect of inhaled AMP on lung function in subjects with allergic rhinitis. A total of 52 adults (28 subjects with allergic rhinitis, 14 asthmatics and 10 healthy subjects) were challenged with increasing concentrations of AMP and methacholine. Airflow was assessed after each concentration and the response to each bronchoconstrictor agent was measured by the provocative concentration required to produce a 20% fall (PC20) in forced expired volume in one second (FEV1). All 14 asthmatics, 10 subjects with allergic rhinitis and none of the healthy controls were hyperresponsive to AMP. Subjects with allergic rhinitis had higher prevalence of hyperresponsiveness to AMP than healthy controls (p=0.038). Although the prevalence of hyperresponsiveness for methacholine and for AMP in subjects with allergic rhinitis was similar (39% and 36%, respectively), four subjects had hyperresponsiveness to methacholine but not to AMP, whereas three subjects had hyperresponsiveness to AMP but not to methacholine. To conclude, inhaled adenosine 5'-monophosphate causes airway narrowing in a significantly higher proportion of subjects with allergic rhinitis than healthy volunteers. Furthermore, methacholine and adenosine 5'-monophosphate hyperresponsiveness are not detected in the same individuals with allergic rhinitis, thus suggesting that responsiveness to the two bronchoconstrictor stimuli is not reflecting the same abnormalities of the airways.

Adenosine Monophosphate↗
PubMed2001

Immediate post-operative balloon dilatation of neonatal long segment stenosis of the descending thoracic aorta.

During surgical repair of a neonatal coarctation it was recognized that this was a rare, previously undescribed form of stenosis of the entire descending thoracic aorta. A few hours after the end-to-end surgical repair, the child underwent successful balloon angioplasty, involving the entire descending thoracic aorta, and in which we intentionally avoided the surgical site.

Abnormalities, Multiple↗
PubMed2001

Rasch measurement in the Assessment of Growth Hormone Deficiency in adult patients.

The Assessment of Growth Hormone Deficiency in Adults (AGHDA) questionnaire was previously designed, translated and validated in several European countries to evaluate the impact of the disease on Quality of Life. This study aimed to test the metric properties of the Spanish version by means of Rasch analysis. A sample of 356 consecutive adult patients with untreated GHD was included in the study. Patients responded to the questionnaire at baseline and 12 months apart. Answers were analyzed following the dichotomous logistic response model. Parameter estimates, model-data fit and separation statistics were computed. The invariance of the item parameters across time was tested in the follow-up. Rasch results were additionally employed to ascertain score changes through the calculation of the Reliable Change Index (RCI). Items varied in severity from 8.3 -16.8 units (SE= 0.4-0.5) and fit to define a unidimensional variable. The item separation index (SI)(5.2) indicates a good and reliable (0.9) separation of items along the variable that they define. Moreover, results showed the AGHDA conforms to the model expectation of item parameter invariance between administrations. The substantial (2.3) and reliable (0.8) person SI also suggests the sample was well targeted by the questionnaire. According to the RCI, 84% of the patients did not show a significant transition in their measures. Results denote the items of the AGHDA succeeded in defining a scale characterized by the interval-level of its measures, suggesting the questionnaire could be a useful complement of the clinical evaluation of GHD patients at both group and individual level.

Adult↗
PubMed2000

Isolated small intestinal atresias in Latin America and Spain: epidemiological analysis.

Stenosis, atresia, or absence of part of the duodenum, jejunum, or ileum are generally considered small intestinal atresias (SIAs). SIAs occur as isolated defects, in combination with other unrelated congenital anomalies, or as part of syndromes. We performed an epidemiological study of infants with isolated SIAs using data from two large congenital defects registries, one from Latin America (ECLAMC) and the other from Spain (ECEMC). The overall prevalence of SIAs is similar in both programs, being 1.32 per 10,000 livebirths in Spain and 1.29 per 10.000 livebirths in Latin America. Our results suggest that infants with isolated SIAs are characterized epidemiologically on the basis of shorter gestational age and low birthweight, an association with twinning, the parents are more frequently consanguineous, and their pregnancies are more frequently complicated by vaginal bleeding. The results also suggest an association between some maternal infections and ileal atresia. The fact that these characteristics have been observed in children with these types of anomalies occurring in different geographical areas and populations supports the conclusion that these characteristics are causally related to these defects.

Adult↗
PubMed2000

Differences in airway responsiveness to acetaldehyde and methacholine in asthma and chronic bronchitis.

Inhaled acetaldehyde may induce bronchoconstriction in asthmatic subjects and provides a new method to investigate airway responsiveness. The objective of the study was to determine whether acetaldehyde was a more specific stimulus than methacholine in differentiating asthma from chronic bronchitis with or without airflow limitation. Bronchial provocation challenges with methacholine and acetaldehyde were performed in 62 asthmatics and in 59 smokers with chronic bronchitis (32 with chronic bronchitis alone and 27 with chronic bronchitis and coexisting chronic obstructive pulmonary disease (COPD)). The response to both bronchoconstrictor agents was measured by the provocative concentration required to produce a 20% fall in forced expiratory volume in one second (FEV1; PC20). The two types of challenge yielded a similarly high level of sensitivity (100% for methacholine and 92% for acetaldehyde) in revealing airway hyperresponsiveness in asthma. However, bronchoprovocation with acetaldehyde yielded considerably greater specificity (95%) than bronchoprovocation with methacholine (24%) in separating asthma from chronic bronchitis. In subjects with asthma, methacholine and acetaldehyde responsiveness were weakly but significantly correlated (r=0.42, p=0.001) but no correlation was found between airway responsiveness to acetaldehyde and baseline FEV1 (r=0.13, p=0.33). These findings suggest that the demonstration of bronchoconstriction in response to acetaldehyde may be a more specific test than methacholine in the differentiation of asthma from chronic bronchitis. Furthermore, methacholine and acetaldehyde hyperresponsiveness are not reflecting the same pathophysiological process in the airways.

Acetaldehyde↗