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Biomedical subjects

R Mora

Publications and source records attributed to R Mora.

83 records · Page 5Linked to original sources
PubMedDate not supplied

Calcium-dependent degradation of surfactant protein A by activated neutrophils due to serine proteases.

The effects of activated leukocytes on surfactant function and composition were examined to better define the mechanisms by which acute inflammation contributes to respiratory distress syndrome (ARDS). Peripheral blood leukocytes from healthy volunteers were incubated in vitro with surfactant for 4 hours: (1) in the absence of activation; (2) following activation by addition of phorbol myristate acetate (PMA); (3) following addition of PMA + FeCl2/EDTA; (4) PMA + FeCl2; (5) PMA + EDTA; (6) PMA + FeCl2 + superoxide dismutase (SOD) + catalase; (7) PMA + EDTA + serine or cysteine protease inhibitors. Surfactant was then repurified by sucrose gradient centrifugation, and function, phospholipid and protein composition, and extent of lipid peroxidation were assessed. PMA caused activation of leukocytes as detected by dichlorofluorescene assay. Lipid peroxidation (assessed by conjugated diene assay) was detected in all samples containing PMA. Abnormal function was noted in surfactant exposed to activated cells with 1 mM EDTA, whereas activation alone, or with FeCl2, had no effect. SOD + catalase prevented lipid peroxidation, but did not prevent leukocyte-mediated dysfunction, which was associated with a marked reduction in surfactant protein A (SP-A), but no detectable change in surfactant protein B (SP-B) or phospholipid composition. Serine protease inhibitors prevented SP-A degradation and dysfunction, whereas cysteine protease inhibitors had no protective effect. Addition of purified SP-A (5% w/w) to dysfunctional surfactant restored normal function, while SP-B/C mixture (3%) did not. Activated leukocytes cause surfactant dysfunction in vitro by serine protease-mediated degradation of SP-A, which occurs only in the presence of EDTA, and is prevented by addition of calcium. Although lipid peroxidation mediated by leukocyte release of free-radical products was also detected, surfactant dysfunction appears to be unrelated to this process.

Albumins↗
PubMedDate not supplied

[Autoimmune disease in primary antibody deficiencies].

BACKGROUND: Immunodeficiency and autoimmune phenomena may occur concomitantly in the same individual. Many immune deficiency syndromes, mainly humoral defects, are associated with autoimmune disorders. In the present study, we describe the frequency of autoimmune disorders in these patients. METHODS AND RESULTS: We performed a retrospective review of the medical records of a cohort of 152 patients with primary antibody deficiency in the Clinical Immunology Unit of the Gregorio Maranon University Hospital in Madrid: common variable immunodeficiency (CVID) (n = 35), IgA deficiency (n = 43), specific IgG subclass deficiency (n = 56), antibody deficiency with normal immunoglobulin (n = 14) and X-linked agammaglobulinemia (n = 4). Of the 152 patients with primary antibody deficiencies, autoimmune disorders were found in 35 (23 %). Autoimmune hematologic disease was found in 14 patients (9.2 %), autoimmune diseases of the gastrointestinal tract in eight (5.3 %), autoimmune endocrine diseases in six (3.9 %), autoimmune rheumatic diseases in six (3.9 %) and vitiligo in four. Autoimmune diseases were more frequent in CVID patients (37.1 %) than in those with selective IgA deficiency (25.5 %) or selective IgG subclass deficiency (12.5 %). Thirty-seven percent of autoimmune episodes occurred prior to the diagnosis of primary antibody deficiency. Sixteen patients (10.5 %) had autoantibodies without clinical data of an autoimmune disease. CONCLUSIONS: Primary antibody deficiencies have variable autoimmune manifestations. For early detection and appropriate treatment, autoimmune disease should be suspected in patients with immunodeficiency.

Adolescent↗
PubMedDate not supplied

[Prescription and costs of artificial nutrition before and after a new utilization protocol].

In order to improve the quality of prescription and reduce expenditure, the artificial nutrition department has designed a new usage protocol: justification sheet, table of indications for parenteral nutrition (PN), nutritional assessment, etc. The Pharmacy Department is in charge of the follow-up of this programme and maintaining the database derived from it. Comparing the data for the year before (1996) and after (1998) implementation of this programme, we can see that as a result 9 patients/day switched from total parenteral nutrition by central administration to hypocaloric peripheral nutrition, with the prevalence of the former dropping to 1.4% of admissions and 2% of stays. The share of enteral nutrition (30.6%) and hypocaloric peripheral nutrition (27.8%) increases in the overall expenditure on artificial nutrition, with a reduction in the total parenteral nutrition (41.6%). The costs of parenteral nutrition per admission and stay are reduced by 39.3% and 33.5%, respectively, to 1,625 and 183 pesetas. This represents a saving of 16.5 million pesetas. The expenditure on PN elements declines by two percentage points to 2.2% of pharmaceutical expenditure. As an additional benefit, it is possible to identify each of the clinical situations which give rise to this indication and to allocate costs by diagnosis and department. Together with the containment of expenditure, it has been possible to increase the participation of everyone in the rational use of clinical nutrition thus highlighting its interdisciplinary nature.

Costs and Cost Analysis↗
PubMedDate not supplied

[Adaptation of the clinician-administered rating scale for mania].

INTRODUCTION: There is no mania rating scale properly adapted in Spain, and it's a true problem in research. METHODS: The adaptation process has been the following one: The authors start from CARS-M of Altman et al. First the carry out the translation and back translation which was revised by the author of the scale. Then they fullfill some previous training with video filming and lastly they apply the scale to a group of 24 patients. RESULTS: The Clinician-Administered Rating Scale for Mania (CARS-M) shows good psychometric proprieties among those its internal consistency of the scale, the interobservers reliability, and the item-total correlation. These results are lightly worse in the psychoticism sub-scale. CONCLUSIONS: This rating scale for mania show itself as a useful instrument in clinic and research.

Bipolar Disorder↗
PubMedDate not supplied

In vitro study of low density lipoprotein--collagen interaction.

Possibility of LDL--collagen complex formation was investigated in vitro by biochemical assay and electron microscopy. Types I and III collagen isolated from bovine thoracic aorta were incubated with human low density lipoproteins (LDL) at physiological ionic strength, pH and temperature. Biochemical quantification showed that 10-20 micrograms LDL (cholesterol) were bound per 100 micrograms collagen, binding of type III being slightly more pronounced (17%) than that of type I (11%). Binding was in inversely proportional to the extent of fibrillation. The increase of ionic strength and pH reduced the binding, indicating the electrostatic nature of the interaction. These observations suggest a possible trapping mechanism of LDL in the extracellular matrix by means of collagen, which may be relevant for the development of the atherosclerotic lesions.

Arteriosclerosis↗
PubMedDate not supplied

[Study of sinus node function and atrioventricular conduction in patients with chagas disease (author's transl)].

In order to detect possible abnormalities in sinus node function and atrio-ventricular conduction, one hundred and fourty three chagasic patients were subjected to electrophysiologic and pharmacologic studies. These patients were placed in four categories based on the their clinical, hemodynamic and angiographic characteristics. The chagasic patient without cardiac involvement (group IA), had no detectable abnormalities. Ten percent of those patients with early myocardial damage (group IB), had impaired sinus node automaticity. In three percent, the autonomic innervation was also altered and four percent had abnormally prolonged atrio-ventricular conduction. Among chagasic patients with abnormal EKG'S without heart failure (Group II), 45% had impaired sinus node automaticity, autonomic innervation was altered in 12%, and atrio-ventricular conduction was prolonged in 37%. Sinus node automaticity was impaired in 22% of those patients with abnormal EKG'S and heart failure (Group III). Autonomic innervation was altered in 33%, and atrio-ventricular conduction was prolonged in 47%. We conclude that over half of our patients with abnormal EKG'S will eventually require permanent pacing. Therefore, in these chagasic patients sinus node function and atrioventricular conduction should be routinely studied.

Adult↗