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Biomedical subjects

M Gil

Publications and source records attributed to M Gil.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Prescription habits in a primary health care district: approach to an indication-prescription study].

OBJECTIVE: To analyse the profile of medical prescription and prescription habits in the most common illnesses in a Primary Health Care district. DESIGN: Descriptive crossover study. SETTING: Algeciras-La Línea (Cádiz) Primary Care district. MEASUREMENTS AND MAIN RESULTS: A randomised sample of clinical histories stratified by months was selected. This included 338 Paediatrics cases (< 8 years old) and 665 general medical cases (> 8). The therapeutic groups most commonly prescribed for the children were R (45.7%) and J (27.1%) The therapeutic groups most used among the > 8 group were C (17.9%), R (14.8%), N (14.7%) and A (14.3%). Hypertension was the most common chronic pathology in this group (8.9%), treated most often by ACEIs (44.9%). CONCLUSIONS: 1) In our ambit, the most widespread pathology signified the greatest consumption of therapeutic groups. 2) The indication-prescription analysis detected prescription habits that need to be watched: the use of antibiotics and expectorants/mucolytics in ARI and the use of fixed-dose combinations which are hard to justify. Prescription habits in Hypertension treatment and Hyperlipidaemia also merit a consensus analysis.

Adolescent↗
PubMed1998

MPK38 expression is upregulated in immature T cells activated by concanavalin A.

We have previously identified a cDNA clone from a murine teratocarcinoma PCC4 cDNA library, which we have termed MPK38 for murine protein kinase 38. MPK38 is a new member of the SNF1 serine/threonine kinase family. To understand the role of the MPK38 in thymocytes, we have investigated the level of MPK38 expression by Northern blot analysis. Interestingly, incubation of thymocytes at 37 degrees C resulted in the loss of the MPK38 transcript, however the transcript could be reinduced by treatment with Con A or PHA, but not with PMA and growth factors such as IL-2, IL-7, TGF-beta, TNF-alpha, and EGF. In addition, stimulation of mature T cells from the spleen with Con A failed to reinduce the MPK38 transcript, indicating a developmental regulation of MPK38 expression, whereas non-T cell populations significantly reinduced the transcript. These results suggest that MPK38 may play a functional role as one of the signal regulators in early T cell activation and, potentially, certain lineages of hematopoietic cell activation induced by Con A.

Animals↗
PubMed1998

Chronic immobilization stress appears to increase the role of dopamine in the control of active behaviour in the forced swimming test.

Previously, we have demonstrated that chronic exposure to immobilization (IMO) did not modify the influence of catecholamines on active behaviour of rats in the holeboard, but clearly increased the role of these amines in the forced swimming test (FST). In the present experiment, it was studied whether or not chronic IMO altered the role of dopamine in the two tests. Adult male Sprague-Dawley rats were left either undisturbed or subjected daily to 2 h of IMO stress for 12 days. On the following day, half of the rats were administered saline and the others the dopamine antagonist haloperidol (0.5 mg/kg). Then the rats remained undisturbed in the animal room (controls) or were subjected to acute IMO for 2 h. Finally, all animals were exposed consecutively to the holeboard (4 min) and the FST (5 min). In non-chronically stressed rats, acute IMO depressed behaviour in the holeboard but not in the FST. In chronic IMO rats the inhibitory effect of acute IMO on holeboard activity was slightly reduced as compared to controls. Acute IMO increased struggling in rats previously exposed to chronic IMO but did not alter struggling in non-chronically stressed rats. Whereas the inhibition caused by haloperidol treatment in the active behaviour of rats in the holeboard was not altered by chronic IMO, the inhibitory effect of haloperidol in the active behaviour of rats in the FST was greater after chronic IMO, particularly in rats also subjected to acute IMO. These data suggest that chronic IMO stress potentiates the role of dopamine in a specific behavioural task such as the FST and adds support to the previously published data demonstrating enhanced behavioural and neurochemical responses to dopamine-related drugs after chronic stress.

Animals↗
PubMed1998

Association between giardiasis and allergy.

BACKGROUND: Previous studies have indicated that there may be an association between infection by the intestinal protozoan Giardia lamblia and the expression of allergic disease. OBJECT: We evaluated a group of children who attended the Outpatient Clinic of the Children's Hospital in Caracas, Venezuela, a group in which both allergic disease and giardiasis were common. METHODS: We performed feces examination and measured total and specific serum IgE (immunoglobulin E) in these children. RESULTS: We found that 70% of the children infected with G. lamblia presented symptoms of allergy, in contrast to 43% of the non-Giardia parasitized group (P <.05). In addition, the G. lamblia parasitized children showed significantly higher levels of total serum IgE (1194 IU/mL) than the non-Giardia group (822 IU/mL) (P <.005). Children infected with G. lamblia showed higher levels of specific serum IgE antibody against food allergens compared both with the non-parasitized group (P <.0001) and children infected with parasites other than Giardia (P <.05). In contrast, IgE responses against the house dust mite Dermatophagoides pteronyssinus were similar in all the groups studied. CONCLUSIONS: These results reveal a clear relationship between giardiasis and allergy, possibly because infection by this protozoon enhances sensitization towards food antigens, due to increased antigen penetration through damaged intestinal mucosa.

Antibodies, Protozoan↗
PubMed1998

Epidemiology of peptic ulcer disease in cirrhotic patients: role of Helicobacter pylori infection.

OBJECTIVE: The aim of this study was to investigate the clinical and epidemiological factors associated with the appearance of peptic ulcer in patients with cirrhosis and, in particular, the role of Helicobacter pylori infection. METHODS: A total of 201 of 220 consecutive patients included in a prospective study that aimed to evaluate the effect of dietary intervention on cirrhotic complications and survival underwent upper gastrointestinal endoscopy. At entry, an epidemiological and clinical questionnaire was completed and the presence of peptic ulcer disease or esophageal varices at endoscopy was prospectively collected. Sera were obtained and stored at -70 degrees C until analyzed, being tested afterward for Helicobacter pylori antibodies using a commercial ELISA kit. RESULTS: Eleven of 201 patients had borderline anti-Helicobacter pylori IgG titers and were excluded from further analysis. In the remaining 190 patients, point prevalence of peptic ulcer was 10.5% and lifetime prevalence 24.7%. Multivariate analysis selected male sex (OR 2.3; 95%CI 1.09-4.89) and Helicobacter pylori seropositivity (OR: 1.7, 95%CI 1.02-2.81) as the variables independently related to peptic ulcer disease. CONCLUSIONS: Male sex and seropositivity for Helicobacter pylori are the major risk factors for peptic ulcer in cirrhosis.

Female↗
PubMed1998

Helical CT versus CT arterial portography in the detection of hepatic metastasis of colorectal carcinoma.

OBJECTIVE: The study is a prospective comparison of helical CT with nonhelical CT arterial portography (CTAP) in the detection of liver metastases from colorectal carcinoma, using surgical and histologic findings as the gold standard. SUBJECTS AND METHODS: Thirty-five patients with colorectal carcinoma and suspected liver metastases were prospectively examined with helical CT and CTAP before surgery. In nine cases, surgery was not performed. In the remaining 26 patients, imaging results were correlated with surgical and pathologic findings. Three radiologists prospectively assessed metastatic involvement with both techniques. The results were compared with pathologic and surgical findings on a lesion-by-lesion basis. In a second phase, three radiologists not directly concerned in the design of the study independently assessed metastatic involvement of the liver as revealed on helical CT and CTAP on a segment-by-segment basis with a five-level scale of confidence. Results were analyzed by receiver operating characteristic methods. RESULTS: The results of the histologic study disclosed 50 metastatic lesions. Helical CT had a sensitivity of 76% (38/50) and a positive predictive value of 90%. CTAP had a sensitivity of 74% (37/50) and positive predictive value of 69%. Receiver operating characteristic analysis revealed a greater area under the curve (Az index), 0.96, for helical CT than for CTAP (0.86). Differences were statistically significant (p < .001). CONCLUSION: Helical CT is superior to nonhelical CTAP in the detection of hepatic metastases from colorectal carcinoma.

Adult↗
PubMed1998

[The improvement of echocardiographic assessment of the left ventricle by the use of perflenapent and harmonic imaging].

Contrast echocardiography and harmonic imaging (HI) are promising new modalities applied in order to obtain improved visualisation of the left ventricle. Perflenapent (EchoGen, Abbott) is a new generation echocardiographic contrast agent that crosses the pulmonary capillary bed and produces long-term ventricle opacification. Our aim was to assess the left ventricle endocardial visualisation after perflenapent infusion and HI technique. We studied a pilot group of 10 patients (mean age 52.5 +/- 7.6, mean weight 76.9 +/- 10.1 kg, one female) with previously obtained sub-optimal non-contrast echocardiograms. Perflenapent was injected intravenously at dosis 0.05 ml/kg. Echocardiography was performed before perflenapent injection and during the time between injection and LV image disappearance. Images were assessed using four-point scale, 0 standing for the poorest and 3 for excellent visualisation. Perflenapent produced full chamber opacification in all pts. Contrast effect was observed for 550-15824 sec and myocardial enhancement was seen for 176-2116 sec after i.v. administration. After perflenapent administration, endocardial border was significantly better visible than before (1.9 +/- 0.57 vs. 2.9 +/- 0.31, p < 0.001). No hemodynamic effects were noted, as assessed by oxygen saturation, blood pleasure and heart rate. A mild, transient somnolence was seen in one pt. Perflenapent improved left ventricular function diagnostic capabilities, and provided enhanced visualisation of the myocardium.

Adult↗
PubMed1998

[Correction of social inequalities in health: reform of primary health care as a strategy].

OBJECTIVES: To evaluate the impact of a policy to define priorities for the reform of primary health care services among small areas according to health and social indicators. DESIGN: Qualitative study of the changes in the provision of primary health care services after a priority setting exercise based in social and a health indicators. SETTING: The city of Barcelona (Catalonia, Spain). PARTICIPANTS: The 66 basic health areas in which the city is divided for health care planning. INTERVENTION: Areas are ranked according to their health and social indicators, giving greater priority to those areas with unfavorable indicators for the development of the reform of primary health care services and a associated allocation of resources. RESULTS: Although at first new investments were determined by preexisting processes based in opportunity criteria, clear changes are observed. Three years after, there are improvements in the provision for services in all priority areas, or they are in the midst of change. CONCLUSIONS: In a context of tightening resources and of resistance to change, it is possible to introduce objective criteria to set priorities to improve primary health care services selectively in areas with most unfavorable indicators. This process has the capacity to overrun obstacles and resistances.

Health Care Reform↗
PubMed1998

Rat liver genesine: a biochemical approach.

Genesine, the naked autoglucosylating protein involved in glycogen biosynthesis, was partially purified from rat liver and some of its biochemical properties were characterized. Its activity was strongly activated by Mn2+ and two-pH optimums were obtained. UDP-14C-Glc was the preferred glucosyl donor substrate, but also UDP-14C-Xyl was. It was additionally found that more than one glucose was transferred to the protein or to that alpha1,4 glucan already linked to the protein from UDP-Glc. Glucose, maltose, xylose and UDP were inhibitors of genesine activity.

Animals↗
PubMed1997

Cloning and expression of a cDNA encoding a novel protein serine/threonine kinase predominantly expressed in hematopoietic cells.

We have isolated a cDNA clone of a new member of protein serine/threonine kinases, MPK38, from a cDNA library constructed from the murine teratocarcinoma PCC4 cell line by the polymerase chain reaction. MPK38 was transcribed as an approx. 2.5 kb mRNA encoding for a protein of 643 amino acids. N-terminus of MPK38 contains the kinase catalytic domain which exhibits approximately 60% protein sequence identity with the SNF1 serine/threonine kinase family. The MPK38 cDNA directs the in vitro translation of two protein species of approx. 70 and approx. 50 kDa, which appear to result from an internal initiation of translation. MPK38 was predominantly expressed in thymus and spleen, but was not detectable in kidney, liver, and muscle in the adult tissues. In addition, MPK38 was apparently expressed in T lineage cells and a macrophage/monocyte cell, but was not detectable in a B cell line and an embryonic cell line. However, a low level of MPK38 transcript was detectable in a mast cell line after a longer exposure. Furthermore, MPK38 gene product showed the kinase activity which was assessed by immune complex kinase assay. Thus, MPK38 gene product seems to play an important role in signal transduction of certain lineages of hematopoietic cells.

Amino Acid Sequence↗
PubMed1997

Seroprevalence and epidemiology of Helicobacter pylori infection in patients with cirrhosis.

BACKGROUND: Helicobacter pylori infection is the major pathogenic factor for peptic ulcer disease. Its epidemiology is not fully known; few data are available in patients with chronic liver disease. AIMS: To investigate the seroprevalence and factors associated with Helicobacter pylori infection in a series of liver cirrhosis patients. METHODS: Two hundred and twenty consecutive patients were prospectively included in a study aimed to evaluate the effect of dietary intervention on cirrhosis complications and survival. At inclusion, an epidemiological and clinical questionnaire was completed. Sera were obtained and stored at -70 degrees C until analyzed. They were tested for Helicobacter pylori antibodies using a commercial ELISA kit. RESULTS: Eleven out of 220 patients had borderline anti-Helicobacter pylori IgG titers. Of the remaining 209 patients, 105 (50.2%) showed positive titers of Helicobacter pylori IgG. Univariate analysis showed that Helicobacter pylori infection was more frequent in older patients, those born outside Catalonia, and in patients with a low educational level. Past ethanol consumption and current smoking correlated negatively with Helicobacter pylori infection. Multivariate analysis selected age (OR 3.1. 95% CI 1.46-6.45), educational level (OR 2.2. 95% CI 1.18-4.2) and alcohol consumption (OR 0.7. 95% CI 0.45-0.99) as the variables independently related to Helicobacter pylori infection. CONCLUSIONS: Helicobacter pylori infection in cirrhosis has the same epidemiological pattern as in the general population. Suggestions that the etiology or the severity of the liver disease could be related to Helicobacter pylori infection were not confirmed by our study.

Adult↗
PubMed1997

Manual nucleofragmentation and endothelial cell loss.

PURPOSE: To compare corneal endothelial cell loss with two cataract surgery techniques: manual nucleofragmentation performed with the Keener nucleus divider and planned extracapsular extraction. SETTING: Department of Ophthalmology "Memorial Cristóbal Garrigosa," Hospital de l'Esperança, Universitat Autònoma de Barcelona, Spain. METHODS: Contact specular microscopy was performed before and 8 weeks after surgery in 51 patients who had been prospectively randomized into 2 groups: 26 patients had manual nucleofragmentation (NF) with the Keener divider and 25, planned extracapsular cataract extraction (ECCE). The analyzed parameters were preoperative and postoperative endothelial cell density and variations in cell size (polymegethism) and cell shape (pleomorphism). The results were compared and statistically analyzed. RESULTS: The mean percentage of endothelial cell loss in the NF group was 11.08% and in the ECCE group, 9.86%. This difference was not statistically significant. Postoperative variation in cell shape and size did not differ significantly between the two groups and was fairly constant. CONCLUSION: The percentage of endothelial cell loss that occurred with manual NF using the Keener nucleus divider was similar to the one that occurs with other cataract surgery techniques. The small variation detected in postoperative endothelial morphology suggests that this endothelial cell population is stable.

Aged↗
PubMed1997

Endoscopic sphincterotomy for choledocholithiasis: a prospective single-center study on the short-term and long-term treatment results in 483 patients.

BACKGROUND AND STUDY AIMS: Endoscopic sphincterotomy (EST) is the method of choice for the treatment of choledocholithiasis. The aim of the present study was to assess the impact of various prognostic factors on the short-term and long-term results of EST. PATIENTS AND METHODS: Data from 483 EST procedures carried out due to choledocholithiasis without concomitant neoplasms or hepatic cirrhosis, and without subsequent bile duct surgery, were analyzed prospectively. The 324 patients (67%) who agreed to take part in the follow-up examinations and fulfilled the inclusion criteria for the study were divided into four groups, depending on the presence of the gallbladder or cholecystolithiasis prior to EST and on the time of diagnosis, and were prospectively followed up by physical examination laboratory tests, abdominal ultrasound, and endoscopic retrograde cholangiography examinations to evaluate the short-term and long-term outcomes. RESULTS: EST was successful in 95.7% of cases. Early complications were noted in 6.8% of cases. No early complications were seen in the group after cholecystectomy with a T-tube present, whereas this rate was highest in the group with concurrent choledocholithiasis and cholecystolithiasis (six of 48, 12.5%). Recurrent choledocholithiasis was observed in 5.6% of the cases overall. This rate was at its lowest in patients with choledocholithiasis alone, and was highest in the group with concurrent choledocholithiasis and cholecystolithiasis. Among the latter patients, the highest rates of papillary stenosis, chronic pancreatitis, and cholangitis were also observed, the latter complication being noted only in cases of recurrent common bile duct stones. CONCLUSIONS: EST is a relatively safe and effective procedure in the treatment of choledocholithiasis. The best prognostic factor is the presence of choledocholithiasis alone. Concurrent choledocholithiasis and cholecystolithiasis carry a more adverse prognosis, and in these cases cholecystectomy should be considered after EST.

Abdominal Pain↗
PubMed1997

Posterior tibial tendon dysfunction as a cause of acquired flatfoot in the adult: value of magnetic resonance imaging.

Dysfunction of the posterior tibial tendon is the most common cause of acquired flatfoot in adults; despite this, the condition is not commonly recognized. We report three cases with flatfoot secondary to spontaneous tendon rupture, in whom magnetic resonance imaging (MRI) was a helpful non-invasive technique to confirm the suspected diagnosis. This disabling entity, and the usefulness of MRI in the diagnosis and planning the appropriate treatment, are reviewed.

Diagnosis, Differential↗
PubMed1997

[Endoscopic polypectomy in the large bowel--the pathologist's view].

Colonoscopy remains the main diagnostic tool in colorectal diseases. Endoscopic polypectomy is a routine therapeutic method for colorectal adenomas, but its yield must be verified histologically. Complete endoscopic and histologic resection of an adenoma is regarded as a sufficient method of its treatment. Some early colon cancers can also be managed endoscopically, providing that strict histologic criteria are fulfilled. It is the duty of clinicians to supply pathologists with all the clinical data on the patient and to properly mark the resected specimen. Pathologists must understand the therapeutic technique, its limits, and provide physicians with a detailed histopathological report that includes not only a proper histological assessment of the resected tissue, but also a comment on completeness of the neoplasm resection. This article should help both clinicians and pathologists to benefit from the potential of histological examination.

Adenoma↗
PubMed1996

Transforming growth factor-beta1 inhibits human keratinocyte proliferation by upregulation of a receptor-type tyrosine phosphatase R-PTP-kappa gene expression.

We studied regulation of a receptor-type tyrosine phosphatase R-PTP-kappa gene expression in a human keratinocyte cell line, HaCaT. Addition of TGF-beta 1 to the HaCaT cells markedly induced the expression of R-PTP-kappa mRNA in a time- and dose-dependent manner. The induction of R-PTP-kappa mRNA expression was observed at a dose as low as 0.02 ng/ml TGF-beta1 and reached a peak at 2 ng/ml TGF-beta 1 after 6 h treatment. The TGF-beta 1-induced R-PTP-kappa mRNA expression was suppressed by sodium orthovanadate, a tyrosine phosphatase inhibitor, and H7, a serine/threonine kinase inhibitor, but not by genistein, a tyrosine kinase inhibitor. In addition, the inducing effect is not dependent on de novo protein synthesis. Taken together, these results suggest that TGF-beta 1 inhibits the human keratinocyte proliferation in vitro, possibly through induction of R-PTP-kappa gene expression.

Cell Division↗
PubMed1996

Giant cavernous hemangioma of the liver: atypical CT and MR findings.

The CT and MR appearance of giant cavernous hemangiomas can be confusing, and some atypical radiographic findings have been described. We report the CT and MR features of a giant cavernous hemangioma of the liver with atypical presentation. CT showed a large hypodense geographical lesion involving the majority of the liver and multiple scattered peripheral lesions. The T2-weighted MR images revealed a huge hyperintense lesion with multiple satellite nodules.

Biopsy, Needle↗