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Biomedical subjects

M Vives

Publications and source records attributed to M Vives.

At least 37 records · Page 2Linked to original sources

Elecsys CEA, PSA and AFP. Clinical results of a multicentre evaluation.

Three tumormarker assays, Elecsys CEA, PSA and AFP, have been evaluated in an international multicentre study to characterize their clinical performance and to verify the comparability with the corresponding tests of the Enzymun-Test product line and other methods. For each of the markers results were obtained from four laboratories. On the basis of 314 and 199 specimens respectively, (preliminary) reference ranges could be established for CEA and PSA. For the prostate marker, the age dependence of the antigen level could be clearly confirmed. Mean concentrations range between 0.51 ng/ml (< 40 years) and 3.57 ng/ml (> 70 years). Referring to CEA, 95th percentiles of 4.31 ng/ml and 2.69 ng/ml were elaborated for smokers and nonsmokers. In general, good to excellent correlations (r > 0.98) were found between the Elecsys and Enzymun-Tests. Regarding the systematic comparability of both systems, most of the slopes derived from the individual method comparison studies are within the +/- 10% range of the respective standardization results. The specific distribution pattern of the individual tumormarker values elaborated with sample material of known clinical background, reflects the well established categorization of different benign and malignant diseases according to their characteristic marker levels. Of utmost importance, however, is the excellent comparability of the Elecsys assays with the corresponding Enzymun-Tests and the FDA approved AIA 1200 tests from TOSOH in follow-up studies. Almost superimposable concentration curves guarantee that identical diagnostic information is derived from all three methods. Especially for PSA, a series of measurements on sera of prostatectomized patients proved the usability and clinical value of the test also for this particular indication. For either one of the Elecsys tests, the feasibility of using plasma as sample material was verified.

Adult↗

Nasopharyngeal colonization in Costa Rican children during the first year of life.

BACKGROUND: The establishment of the nasopharyngeal flora was followed in Costa Rican children from birth to 1 year of age. METHODS: Nasopharyngeal cultures were obtained at 1 (n = 413), 3 (n = 393), 6 (n = 376) and 12 months (n = 356) of age from children representative of the population in the Puriscal district. Weekly cultures were obtained from a subcohort of these children (n = 101). Mother-infant diads (n = 95) and preschool children (n = 208) attending day-care centers were also studied. RESULTS: The estimated proportion of colonized children in the population differed markedly depending on the frequency of culture. Quarterly cultures showed a slow increase in carrier rates from 3.9% for Haemophilus influenzae, 3.1% for Streptococcus pneumoniae and 6.5% for Moraxella catarrhalis at 1 month of age to 10.1% carrying H. influenzae and 19.4% carrying S. pneumoniae by the end of the first year. By quarterly culture the proportion of children colonized at least once was 36% for S. pneumoniae, 26% for H. influenzae and 28% for M. catarrhalis. In contrast weekly sampling showed that 95 to 100% of the children were colonized at least once during the first year of life with H. influenzae, S. pneumoniae or M. catarrhalis. Nasopharyngeal carriage of H. influenzae, S. pneumoniae and M. catarrhalis was low in the mothers, and very few mother-infant pairs carried identical bacteria at the same time. In contrast carrier rates were high in the siblings attending day care (H. influenzae 27.9%, S. pneumoniae 39.4%, both organisms 26.6%). Infants with siblings had significantly higher bacterial carriage at all ages than infants without siblings. CONCLUSIONS: Quarterly nasopharyngeal cultures showed that Costa Rican infants acquire their nasopharyngeal flora at a rate comparable with that for infants in developed countries and that siblings are an important source of the bacteria. Weekly samplings showed that virtually all children were colonized at least once during the first year of life.

Adult↗

Beta-cell function abnormalities in islets from an adult subject with nesidioblastosis and autoantibodies against the islet cells.

Human islets from an adult subject with nesidioblastosis were isolated and used to perform in vitro studies. Isolated nesidioblastotic islets showed an increased basal rate of insulin secretion (nesidioblastotic islets, 81.3 +/- 6.4 vs. control islets, from cadaveric organ normal donors, 10.2 +/- 0.9 microU/islet/90 min) without any further release with increasing glucose concentration. In addition, islets isolated from the pancreas with nesidioblastosis contained more insulin than control islets, 1,547.0 +/- 128.7 vs. 935.0 +/- 51.7 microU/islet, and the levels of insulin mRNA were also higher than those measured in controls. Interestingly, the serum of the subject with nesidioblastosis contained autoantibodies that stained brightly and selectively a population of islet cells whose distribution coincided with that expected of alpha cells. In summary, pancreatic islets in nesidioblastosis display beta-cell functional abnormalities. Moreover, the finding of antibodies against islet cells is a common feature in the serum of nesidioblastotic subjects; nevertheless, their pathological significance warrants further investigation.

Adolescent↗

Wound coverage after modified hip disarticulation using a total adductor myocutaneous flap.

There are several options available for wound coverage after hip disarticulation and hemipelvectomy. Standard flaps for closure are not always available due to the 3-dimensional extent of the tumor and availability of satisfactory tissue for coverage. This article details a new coverage technique after a modified hip disarticulation using a total adductor myocutaneous flap in a patient with radiation induced osteosarcoma of the femur after Ewing's sarcoma. In this case, neither the commonly used posterior flap nor an anterior flap could be used because of the location of the tumor and the presence of radiation induced skin and soft tissue changes. The total adductor myocutaneous flap allowed for wide surgical margins, avoided soft tissue coverage using previously irradiated soft tissue flaps, and provided excellent coverage without requiring the use of free or pedicle based flaps.

Adult↗

A study of Light's criteria and possible modifications for distinguishing exudative from transudative pleural effusions.

STUDY OBJECTIVE: To determine the usefulness of modifying Light's criteria for the separation of pleural transudates from exudates. DESIGN: Retrospective review of patients who underwent a diagnostic thoracentesis during a 2-year period. SETTING: Community teaching hospital in Lleida, Spain. PATIENTS AND METHODS: Clinical records and pleural fluid characteristics of 230 consecutive patients with pleural effusion underwent a detailed review. Thirty-five of these patients were excluded from the analysis. As suggested recently by Romero et al, different cutoff levels for the criteria of Light et al were applied and their accuracies were calculated. RESULTS: Thirty-nine (20%) pleural effusions were transudates and 156 (80%) were exudates. The accuracy of the criteria of Light et al for identifying exudates was 94.7% (confidence interval, 91.6 to 97.9) in comparison to our own modified criteria (93.1%; confidence interval, 89.5 to 96.7) and the criteria suggested by Romero et al (92.6%; confidence interval, 88.9 to 96.3). These differences were not statistically significant. CONCLUSION: Changing the classic Light's criteria with different cutoff points offers no advantages for discriminating between transudative and exudative pleural effusions.

Adolescent↗

Deleterious effect of dithizone-DMSO staining on insulin secretion in rat and human pancreatic islets.

Dithizone (DTZ) is a selective stain for pancreatic islets which facilitates their identification, being of special interest in human islet isolation assessment. Nevertheless, there are few studies concerning its potential toxic effects on islet function. In our study, we have evaluated the effects of DTZ (dissolved in dimethyl sulfoxide [DMSO] 1% w/v) at three different concentrations (2, 10, and 100 micrograms/ml) on insulin response to glucose in human and rat islets. Likewise, we studied the effect of incubation time, in the presence of DTZ at the above-mentioned concentrations, on insulin release. Only when DTZ was employed at low concentrations and for a short period of incubation (10 min) was there no impairment of pancreatic islet function. Moreover, even at this low concentration, DTZ became deleterious for islet function when the incubation period with the dye was prolonged for 30 min. Culture (24 h) of previously stained islets produced a partial recovery of insulin response. In conclusion, our findings indicate (a) DTZ should not be employed to collect islets for functional studies because of its deleterious effect on beta-cell function, (b) DTZ's deleterious effects on beta-cell function should be considered if this dye is used to purify islets by fluorescence-activated cell sorting for transplantation.

Animals↗

Extinction of Vibrio cholerae in acidic substrata: contaminated fish marinated with lime juice (ceviche).

Millions of Vibrio cholerae O1 El Tor were rapidly eliminated when added to commercial ceviche prepared by marination of mahi-mahi fish in lime juice. Likewise, large masses of viable vibrios present in laboratory contaminated fish, were readily eliminated after immersion in lime juice, during the preparation of ceviche. The killing effect was evident within 5 min of exposure of vibrios to lime juice, with reductions of more than 99.9% of the initial bacterial mass. After 2 h of marination of fish with lime juice (the minimum recommended), no vibrios were detected in the lowest working dilutions (1:10, 1:100). The Vibrio mass eliminated by lime juice was 2 to 6 logarithms greater than the maximum infectious dose, and 4 to 8 logs greater than the minimum infectious dose to induce cholera El Tor. Also, the killing time was shorter than the elapsing time between preparing and serving food in homes or restaurants. The traditional marination of fish with lime juice or its addition to seafood and meals immediately before consumption, should be protected and promoted to prevent infection with cholera vibrios. In the face of an epidemic of cholera, consumption of ceviche prepared with lime juice would be one of the safest ways to avoid infection with V. cholerae.

Animals↗

Extinction of Vibrio cholerae in acidic substrata: contaminated cabbage and lettuce treated with lime juice.

Lime juice killed millions of Vibrio cholerae O1, El Tor, Inaba, present on cabbage and lettuce contaminated in the laboratory. The lethal effect was evident within 5 min of exposure to lime juice. No vibrios could be recovered at dilution 1:10 using alkaline peptone water (APW) and thiosulfate-citrate-bile salts-saccharose agar (TCBS). More than 99.9% of the initial inoculum was effectively destroyed. The number of vibrios killed by lime juice was 2 to 6 logarithms greater than the maximum infecting dose, and 4 to 8 logs greater than the minimum infecting dose for cholera El Tor. The time interval needed for killing was smaller than the usual waiting time for serving food in homes and restaurants. The addition of lime juice to non-acidic foods, beverages and water, is strongly recommended to prevent infection with cholera vibrios and other acid-sensitive microorganisms. This measure is particularly important for rural and slum populations in the tropics and subtropics.

Cholera↗

Prevalence of cardiovascular risk factors in rural and urban Costa Rica.

BACKGROUND: Coronary artery disease (CAD) is becoming more prevalent in developing countries, particularly in the urban areas, in contrast to the CAD mortality trends observed in some industrialized nations. METHODS AND RESULTS: We determined the prevalence of cardiovascular risk factors (hypertension, diabetes, smoking, obesity, total cholesterol greater than or equal to 240 mg/dl and greater than or equal to 200 less than or equal to 239 mg/dl, low density lipoprotein (LDL) cholesterol greater than or equal to 160 mg/dl and greater than 130 less than or equal to 159 mg/dl, and high density lipoprotein (HDL) cholesterol less than 35 mg/dl) in 222 men and 243 women from rural and urban areas of Puriscal, Costa Rica, using the American Cholesterol Education Program guidelines. Urban Puriscal men had a significantly (p less than 0.05) higher prevalence of borderline high-risk total cholesterol (26% versus 14%), borderline high-risk LDL cholesterol (21% versus 11%), smoking (32% versus 13%), and higher prevalence of low HDL cholesterol (34% versus 24%), hypertension (16% versus 13%), diabetes (4.5% versus 2.7%), obesity (21% versus 14%), and saturated fat intake greater than 15% of calories (14% versus 7%) than rural men from Puriscal. No significant differences between rural and urban women were found for any of the cardiovascular risk factors. Urban Puriscal residents were also more sedentary than rural Puriscal residents. CONCLUSIONS: These data indicate that modifiable risk factors are more prevalent in urban than in rural Puriscal, Costa Rica, particularly in men.

Adult↗

Reevaluation of autoantibodies to islet cell membrane in IDDM. Failure to detect islet cell surface antibodies using human islet cells as substrate.

Since their demonstration in 1975, ICSAs have been proposed as serological markers and pathogenic elements in IDDM. ICSAs are detected in the sera of most newly diagnosed IDDM patients by indirect IFL that uses viable preparations of rat islet or insulinoma cells as substrate, but they also can be detected by using human insulinoma or fetal islet cells. We have tried to demonstrate ICSAs in the sera of 31 newly diagnosed diabetic patients, including 6 positive samples on human fetal islet cells, which used their natural target for the first time: normal human islet cells. In spite of using different types of preparations of these cells (i.e., freshly dispersed cell suspensions, monolayer cultures, or dispersed islets after culture), ICSAs could not be detected by IFL under the UV microscope, nor by flow cytometry. In contrast, 9 of 29 of the sera gave a positive staining on the RIN rat insulinoma cells. In an attempt to establish whether the putative ICSA autoantigen is present in the surface of human islet cells in the diabetic pancreas, the insulitis microenvironment was emulated by exposing the islets to three types of stress: 1) cytokines (IFN-gamma and TNF-alpha); 2) heat shock; and 3) hyperglycemia. However, diabetic sera failed again to recognize membrane antigens on the islet cells after either of these treatments. Neither were islet cells from a newly diagnosed diabetic patient stained by its autologous serum (ICA titer > 80 JDF U). These results suggest that ICSA autoantigen is not expressed in the membrane of human islet cells and therefore raises doubts about their proposed pathogenic role.

Adolescent↗

Adhesion molecules in human islet beta-cells. De novo induction of ICAM-1 but not LFA-3.

Understanding how T lymphocytes recognize beta-cell autoantigens is essential for the elucidation of the pathogenesis of insulin-dependent diabetes mellitus. The increased and ectopic expression of HLA class I and II molecules detected in human beta-cells may facilitate this interaction. T-lymphocyte recognition of surface antigens also involves adhesion accessory molecules: intercellular adhesion molecule 1 (ICAM-1) and lymphocyte function-associated antigen 3 (LFA-3). These molecules not only allow cell contact but can also provide costimulatory signals for T-lymphocyte activation. Levels of ICAM-1 and LFA-3 expression in normal human islet cells and regulation of their expression by cytokines interferon-gamma (IFN-gamma), tumor necrosis factor alpha (TNF-alpha), interleukin 1 beta (IL-1 beta), and IL-6 have been studied by two-color immunofluorescence staining of pancreatic cryostat sections and fluorescence-activated cell sorter analysis. Neither ICAM-1 nor LFA-3 could be demonstrated in sections or in fresh cell preparations, but after 18 h of culture, beta-, alpha-, and delta-cells expressed spontaneously moderate levels of ICAM-1 (but not LFA-3). IFN-gamma and TNF-alpha alone or in combination strongly enhanced this spontaneous expression of ICAM-1 in a time- and/or dose-dependent and additive manner but had no effect on LFA-3. An SV40-transformed islet cell line showed high basal levels of both ICAM-1 and LFA-3, but the response to cytokines followed the same pattern as primary cultures.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Surface↗

Inappropriate expression of HLA class II molecules in endocrine epithelial cells: the phenomenon, the new experimental data and comparison with animal models.

Physiologically, HLA Class II molecules are primarily expressed on immunoregulatory cells. In recent years, it has been shown that tissues affected by autoimmunity, including beta cells of 'diabetic' pancreases, 'inappropriately' express these glycoproteins. Cytokines are potent Class II inducers on a variety of cells but they exert a heterogenous effect when incubated with different human endocrine cells, i.e. thyroid cells are readily inducible, beta cells are much more resistant. The fine modulation of Class II expression by cytokines has been extensively studied and recent information on their action on endocrine cells is reported here. The possibility that distinct environmental factors from those postulated until now may be responsible for triggering the inappropriate expression of MHC molecules in epithelial cells in vivo is also emphasized. Despite several similarities between human Type I diabetes and spontaneous animal models of the disease, major differences still exist. Transgenic models have now been produced. However, even if they offer interesting new insights, they have not so far provided the decisive answer to explain the pathogenesis of human autoimmune diseases.

Animals↗

Low endemicity and low pathogenicity of rotaviruses among rural children in Costa Rica.

Rotaviruses were prospectively studied in 51 rural Costa Rican children from birth to two years. Samples of feces were collected weekly over a 33-month period. Rotavirus was detected in 45 (1.04%) of 4,317 fecal specimens; 39 infections were documented (an incidence of 0.5 infection per child-year), only five of which were associated with diarrhea (a pathogenicity of 12.8%). Secretory antibody in fecal extracts, detected in six of 39 infections, was short lived and did not protect against reinfection. Serum antibody was present in 69.6% of two-year-old children, but was not detected in 18.8% with documented infections. On the other hand, serum antibody was present in six of 14 children in whom rotavirus was not detected, thus increasing the overall incidence to 0.6 infection per child-year. The combination of prolonged breast-feeding, exposure to a lower infecting dose (compared with urban children), and a higher standard of hygiene than expected may explain the low incidence and low pathogenicity of rotavirus among these rural children.

Age Factors↗

Cryptosporidiosis in children from some highland Costa Rican rural and urban areas.

This report summarizes both a prospective study of diarrhea in cohorts of rural children in their natural ecosystem, and a vertical study of diarrheic urban children attending a hospital emergency service. Cryptosporidium oocysts were found in feces of 4.3% of the cases, while all controls were negative. No infection occurred in the first year of life among rural infants, contrasting with a 3% infection rate in children under 1 year of age in the metropolitan area. This could be attributed to intense and exclusive breast-feeding for several months in the rural area while in the urban area many infants are not breast-fed at all, or are weaned prematurely. No infection was found in wholly breast-fed infants. Diarrhea associated with Cryptosporidium was watery and without inflammatory cells. Dehydration was common in urban children, but was rapidly corrected by oral rehydration therapy, or by intravenous fluid therapy in some cases. Infections clustered in the warmer, rainy and humid months of the year.

Child, Preschool↗