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Biomedical subjects

R Moreno

Publications and source records attributed to R Moreno.

At least 109 records · Page 6Linked to original sources
PubMed1998

[Experimental pulmonary emphysema in rats. Inflammatory phenomena and progression of lung damage].

BACKGROUND: Although the hamster model of elastase induced emphysema is well characterized, the rat model has received less attention. AIM: To evaluate the effect of a single intratracheal elastase dose on lung pathological changes of Sprague-Dawley rats. MATERIAL AND METHODS: Rats were injected with a single intratracheal elastase dose of 28 U/100 g body weight or saline and studied 7, 15, 30 and 365 days after injection. RESULTS: Forty percent of rats died in the first 48 hours after injection, six were sacrificed at 7 days, 6 at 15 days, 7 at 30 days and 12 at 365 days. Progressive centroacinar emphysema was found from day 7 after elastase, with a persistent inflammatory reaction in the vicinity of emphysematous areas. CONCLUSIONS: Present findings differ from the panacinar emphysema described in the hamster using a similar elastase dose.

Animals↗
PubMed1998

[Chlamydia pneumoniae in patients with acquired pneumonia in the Santiago of Chile community].

BACKGROUND: The prevalence of Chlamydia pneumoniae infection varies according to the population and geographic area studied. AIM: To evaluate the incidence of Chlamydia pneumoniae infection in Chilean subjects with community acquired pneumonia. PATIENTS AND METHODS: Between 1995 and 1997, patients with community acquired pneumonia attending two emergency rooms in Santiago, were studied. The diagnosis of Chlamydia pneumoniae infection was based on the detection of Chlamydia pneumoniae specific IgG antibody in samples from both the acute and convalescent phase, using an indirect microimmunofluorescent technique. Evidence of present infection was defined as seroconversion, a significant increase in the titer of the second sample and an initial titer equal or greater than 1/512. RESULTS: During the study period, 160 patients consulted and seven (six male), aged 54 +/- 27 years old, complied with the diagnostic criteria of present Chlamydia pneumoniae infection. These patients had no special clinical or radiological features. Five of seven patients improved without any specific treatment. CONCLUSIONS: Eight percent of this sample of patients with community acquired pneumonia had Chlamydia pneumoniae infection. This agent should be included in the design of empiric treatment schemes, although our results cast doubt on the pathogenic role of Chlamydia pneumoniae in pneumonia.

Chile↗
PubMed1998

Multi-Link Stenting in Acute Myocardial Infarction.

ACS Multi-Linkª stent is a stainless steel balloon expandable stents composed of 12 rings connected by multiple links giving a great flexibility and radial strength. Multi-Link stenting offers good clinical and angiographic results in patients with unstable and stable angina, but there are few reports about Multi-Link stent placement in acute myocardial infarction (AMI). In this study, the experience of Multi-Link stenting during primary PTCA is described. RESULTS: 38 Multi-Link stents were placed in the culprit vessel in 34 patients with AMI. Mean age was 67 +/- 14 years, 25 (74%) were male, 12 (35%) were in Killip class III or IV and 20 (59%) had multi-vessel disease. All 38 Multi-Link stents (100%) could be successfully delivered. Angiographic success was achieved in 32 patients (94%). After stenting, stenosis decreased from 95 +/- 9% to 9 +/- 5% (p < 0.001) and minimal lumen diameter increased from 0.2 +/- 0.5 to 2.9 +/- 0.5 mm (p < 0.001). One patient (3%) suffered a subacute thrombosis requiring a new PTCA, but no patient needed surgical revascularization. Seven patients (20.6%; 95% CI: 8.7Ð37.9%) died during hospitalization, 6 of whom were in cardiogenic shock at admission. Mortality in patients with and without cardiogenic shock at admission was 85.7% (95% CI: 42.1Ð99.6%) and 3.7% (95% CI: 0.1%Ð20.0%) respectively (p < 0.001). CONCLUSION: The Multi-Link stent offers good angiographic results in patients with AMI. The in-hospital mortality in patients without cardiogenic shock at admission is low.

Journal Article↗
PubMed1998

[Coastal Chilean populations: genetic markers in four locations].

BACKGROUND: Historical and anthropological data suggest the presence of descendents of Changos, Cuncos, Chonos and Yamanas, South American indian populations, in certain Chilean coastal villages. AIM: To assess the degree of South American indian admixture in Chilean coastal villages using protein markers, to complete the assessment of human biological diversity in Chile. SUBJECTS AND METHODS: ABO, Rh, MNS, Duffy and Kidd blood group systems were assessed in 47, 48, 55 and 24 individuals from Paposo, Carelmapu, Laitec and Ukika respectively. Phenotypic and gene frequencies were calculated. The degree of South American indian admixture was estimated from the ABO*O allele and Rh*dce haplotypes. RESULTS: High frequencies of ABO*O, Fy*a, Jk*b alleles, Dce and Ms haplotypes were found in all villages, consistent with the pattern expected for South American Aboriginal populations. The highest presence of South American indian admixture was present in Laitec with 80% and in Ukika with 74%. The figures for Paposo and Carelmapu were 60 and 65% respectively. CONCLUSIONS: According to South American indian admixture estimates, the genetic isolation of coastal populations is lower than that of inland subjects, suggesting that sea proximity facilitates gene flow.

Alleles↗
PubMed1997

Potassium collapses the deltaP in yeast mitochondria while the rate of ATP synthesis is inhibited only partially: modulation by phosphate.

Addition of increasing concentrations of K+ to yeast mitochondria in the presence of 0 to 400 microM phosphate and 200 microM Mg2+ led to uncoupled respiration and decreased protonmotive force (deltaP):at 0 K+ deltaP = 213 mV, negative inside, where deltapsi = 180 mV and deltapH = 33 mV, while at 20 mM K+ deltaP = 28 mV, where deltapsi = 16 mV and deltapH = 12 mV. In contrast, the synthesis of ATP resulted in smaller values for the Km and the Vmax in 400 microM Pi and increasing ADP: in 0 K+, Km = 18.6 microM and Vmax = 75.4 nmol (min x mg protein)-1, while in 20 mM K+, Km = 5.2 microM and Vmax = 46.0 nmol (min x mg protein)-1, i.e., when K+ depleted most of the deltaP, and at ADP concentrations below the Km, the rate of ATP synthesis was essentially the same as in the absence of K+. At saturating ADP, the rate of ATP synthesis in the presence of K+ was about 60% of the rate observed without K+. The synthesis of ATP by yeast mitochondria was inhibited by oligomycin or uncouplers. K+ had no effects on rat liver mitochondria. Adenylate kinase activity was much smaller in yeast mitochondria than in rat liver mitochondria and thus did not account for the synthesis of ATP observed in the presence of K+. The effects of K+ on the deltaP of yeast mitochondria were prevented by increasing concentrations of phosphate (1 to 4 mM). At 4 mM phosphate, the deltaP was always above 200 mV and the kinetics of ATP synthesis were as follows: 0 K+ Km = 10.0 microM and Vmax = 88.3 nmol (min x mg protein)-1. At 20 mM K+, Km = 7.4 microM and Vmax = 133 nmol (min x mg protein)-1.

Adenosine Triphosphate↗
PubMed1997

Evolution of the outgassing of comet Hale-Bopp (C/1995 O1) from radio observations.

Spectra obtained from ground-based radio telescopes show the progressive release of CO, CH3OH, HCN, H2O (from OH), H2S, CS, H2CO, CH3CN, and HNC as comet Hale-Bopp (C/1995 01) approached the sun from 6.9 to 1.4 astronomical units (AU). The more volatile species were relatively more abundant in the coma far from the sun, but there was no direct correlation between overabundance and volatility. Evidence for H2O sublimation from icy grains was seen beyond 3.5 AU from the sun. The change from a CO-driven coma to an H2O-driven coma occurred at about 3 AU. The gas outflow velocity and temperature increased as Hale-Bopp approached the sun.

Carbon↗
PubMed1997

Determining whether acute myocardial infarction in patients with previous coronary bypass grafting is the result of narrowing of a bypass conduit or of a native coronary artery.

The relation between electrocardiographic changes and the infarct-related coronary artery was studied in 76 patients with acute myocardial infarction 77 +/- 49 months after coronary artery bypass surgery in a retrospective series. When the infarct-related coronary artery was a graft, the electrocardiogram showed ST elevation and new Q waves less often; although the infarction was smaller, these patients presented a worse in-hospital prognosis.

Anastomosis, Surgical↗
PubMed1997

Outcome prediction in intensive care: results of a prospective, multicentre, Portuguese study.

OBJECTIVE: To compare the performance of the New Simplified Acute Physiology Score (SAPS II) and Acute Physiology and Chronic Health Evaluation (APACHE) II in an independent database, using formal statistical assessment. DESIGN: Analysis of the database of a multicentre, prospective study. SETTING: 19 intensive care units (ICUs) in Portugal. PATIENTS: Data for 1094 patients consecutively admitted to the ICUs were collected over a period of 4 months. Following the original SAPS II and APACHE II criteria, the analysis excluded patients younger than 18 years of age, readmissions, acute myocardial infarction, burns, patients in the post-operative period after coronary artery bypass surgery, and patients with a length of stay in the ICU of less than 24 h. The group analysed comprised 982 patients. INTERVENTIONS: Collection of the first 24 h admission data necessary for the calculation of SAPS II, APACHE II, Therapeutic Intervention Scoring System (TISS), Simplified TISS, organ system failure and basic demographic statistics. Vital status at discharge from the hospital was registered. MEASUREMENTS AND RESULTS: In this cohort, discrimination was better for SAPS II than for APACHE II (SAPS II: area under the receiver operating characteristic curve 0.817, standard error 0.015; APACHE II: 0.787, 0.015; p < 0.001); however, both models presented a poor calibration, with significant differences between observed and predicted mortality (Hosmer-Lemeshow goodness-of-fit tests H and C, p < 0.001). In a stratified analysis, this study was unable to demonstrate any definite pattern of association between the poor performance of the models and specific subgroups of patients except for the most severely ill patients, where both models overestimated mortality. CONCLUSIONS: SAPS II performed better than APACHE II in this independent database, but the results do not allow its use, at least without being customised, to analyse quality of care or performance among ICUs in the target population.

APACHE↗
PubMed1997

Validation of the simplified therapeutic intervention scoring system on an independent database.

OBJECTIVE: To evaluate the performance of the Simplified Therapeutic Intervention Scoring System on an independent database and determine its relation with the Therapeutic Intervention Scoring System in the quantification of nursing workload in intensive care. DESIGN: Analysis of the database of a multicenter prospective Portuguese study. SETTING: 19 intensive care units (ICUs) in Portugal. PATIENTS: Data on 1094 patients consecutively admitted to the ICUs were collected during a period of 3 months. METHODS: Collection of the data necessary for the calculation of the Therapeutic Intervention Scoring System (TISS-76) and the Simplified Therapeutic Intervention Scoring System (TISS-28) during the first 24 h in the ICU. Basic demographic statistics and all the variables necessary for the computation of the Simplified Acute Physiology Score II were also collected. Vital status at discharge from the hospital was registered. Regression techniques, Pearson's correlation and paired sample t-test were used. Results are presented as mean +/- standard deviation except when stated otherwise. Reliability was evaluated by the use of intraclass correlation coefficients in a 5% random sample. MEASUREMENTS AND RESULTS: After exclusion of all the patients with missing data, 1080 patients were analysed. The overall mean TISS-28 (29.82 +/- 10.64) was significantly lower than the mean TISS-76 (31.14 +/- 11.95). Both systems showed very significant differences between ICUs (p < 0.001). The correlation between the two was good, with TISS-28 explaining 72% of the variation of TISS-76 (r = 0.85, r2 = 0.72). The relation between the two systems was TISS-28 = 6.22 + 0.85 TISS-76. In this cohort, reliability of data collection was very high, with intraclass correlation coefficients greater than 0.90 for both systems. CONCLUSIONS: TISS-28 was validated on this independent population. The results indicate that TISS-28 can replace TISS-76 for the measurement of the nursing workload in Portuguese ICUs.

Analysis of Variance↗
PubMed1997

Nine equivalents of nursing manpower use score (NEMS).

OBJECTIVES: To develop a simplified Therapeutic Intervention Scoring System (TISS) based on the TISS-28 items and to validate the new score in an independent database. DESIGN: Retrospective statistical analysis of a database and a prospective multicentre study. SETTING: Development in the database of the Foundation for Research on Intensive Care in Europe with external validation in 64 intensive care units (ICUs) of 11 European countries. MEASUREMENTS AND RESULTS: Development of NEMS on a random sample of TISS-28 items, cross validation on another random sample of TISS-28, and external validation of NEMS in comparison with TISS-28 scored by two independent raters on the day of the visit to the ICUs participating in an international study. Multivariable regression techniques, Pearson's correlation, and paired sample t-tests were used (significance at p < 0.05 level). Intraclass correlation, rate of agreement, and kappa statistics were used for interrater reliability tests. The TISS-28 items were reduced to NEMS (9 items) in a random sample of 2000 records; the means of the two scores were no different: TISS-28 26.23 +/- 10.38, NEMS 26.19 +/- 9.12, NS. Cross-validation in a random sample of 996 records; mean TISS-28 26.13 +/- 10.38, NEMS 26.17 +/- 9.38, NS; R2 = 0.76. External validation on 369 pairs of TISS-28 and NEMS has shown that the means of the two scores were no different: TISS-28 27.56 +/- 11.03, NEMS 27.02 +/- 8.98, NS; R2 = 0.59. Reliability tests have shown an "almost perfect" interrater correlation. Similar to studies correlating TISS with Simplified Acute Physiology Score (SAPS)-I and/or Acute Physiology and Chronic Health Evaluation II scores, the value of NEMS scored on the first day accounts for 30.4% of the variation of SAPS-II score. CONCLUSIONS: NEMS is a suitable therapeutic index to measure nursing workload at the ICU level. The use of NEMS is indicated for: (a) multicentre ICU studies; (b) management purposes in the general (macro) evaluation and comparison of workload at the ICU level; (c) the prediction of workload and planning of nursing staff allocation at the individual patient level.

Cluster Analysis↗
PubMed1997

Enzyme-linked lectinsorbent assay measures N-acetyl-D-glucosamine in matrix of biofilm produced by Staphylococcus epidermidis.

An enzyme-linked lectinsorbent assay (ELLA) was developed for quantification of in situ biofilm produced by Staphylococcus epidermidis in polystyrene 96-well tissue culture plates with phosphatase-labeled wheat germ agglutinin (WGA) as a specific probe for the GlcNAcbeta-1,4n component of exocellular matrix material (EMM) that is responsible for intercellular adhesion and accumulation. The ELLA and the modified Christensen dye assay were used to test 13 laboratory strains of coagulase-negative staphylococci and 10 clinical isolates of S. epidermidis. Four biofilm-positive laboratory strains of S. epidermidis were positive by both tests, and six biofilm-negative strains were negative by both. One strain of S. hemolyticus was positive by the ELLA only. Two of the 10 clinical isolates of S. epidermidis were positive by both assays, two were negative by both, and the remaining were positive by the ELLA only. The ELLA was objective, reproducible, specific, sensitive, and useful for screening strains for their capacity to adhere to plastic, produce EMM, and form biofilm.

Acetylglucosamine↗
PubMed1997

Impact of different customization strategies in the performance of a general severity score.

OBJECTIVE: To compare the impact of two different customization strategies in the performance of the admission Mortality Probability Model II (MPM II0) using formal statistical assessment. DESIGN: Analysis of the database of a multicenter, multinational, prospective cohort study, EURICUS-1, involving 89 intensive care units (ICUs) from 12 European countries. SETTING: Eighty-nine ICUs from 12 European countries. PATIENTS: Data from 16,060 patients consecutively admitted to 89 ICUs from 12 European countries were collected during a 4-month period. In accordance with original MPM II0 criteria, the following patients were excluded from analysis: patients <18 yrs of age; patients considered readmissions; patients with acute myocardial infarction or burns; and patients in the postoperative period recovering from coronary artery bypass surgery. A total of 10,397 patients were analyzed. INTERVENTIONS: Collection of the data necessary for the calculation of MPM II0 and basic demographic statistics. Vital status at hospital discharge was registered. Two new logistic regression equations were developed to relate MPM II0 to mortality after splitting the database into development and validation samples, the first with the original logit of MPM II0 as an independent variable (first-level customization), and the second with all 15 original variables (second-level customization). Discrimination (area under the receiver operating curve), Hosmer-Lemeshow goodness-of-fit tests H and C, and observed/expected mortality ratios were evaluated in both samples and within relevant subgroups. MEASUREMENTS AND MAIN RESULTS: The discriminative capability of the models was only slightly affected by customization (0.810 vs. 0.803), remaining lower than in the original description of the MPM II0 (0.824). Calibration improved, with Hosmer-Lemeshow goodness-of-fit tests H and C showing a good fit of the models. However, the formal evaluation of discrimination, calibration, and observed/expected mortality ratios across relevant subgroups appeared to be poor in some groups. CONCLUSIONS: In this ICU patient database, second-level customization was more effective than first-level customization in improving the overall goodness-of-fit of MPM II0 and should probably be chosen as the preferential strategy to improve the fit of a model when the sample size is large enough. However, second level customization had only a slight impact on discrimination. Its effects on the uniformity of fit are insufficient to overcome the problems that can arise when the model is applied in populations in which the case-mix is distinct from the population where it was originally developed.

Adult↗
PubMed1997

Strain increases airway smooth muscle contractile and cytoskeletal proteins in vitro.

Mechanical stress contributes to lung development and the progression of some lung diseases, although its effects on individual lung cells are unknown. Because increased airway smooth muscle (ASM) is found in lung diseases where abnormal stress is present, we determined if strain (change in resting length) causes ASM hypertrophy independently of other in vivo influences. Cultured canine ASM cells were subjected to two levels of cyclic deformational strain for 14 days and compared with nonstrained cells by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting. Cells subjected to 16-30% strain demonstrated increases in total cellular protein, myosin, myosin light chain kinase (MLCK), and desmin, whereas the cellular contents of actin, vimentin, and tubulin were similar. Changes in myosin appeared mostly due to the smooth muscle isoform, whereas nonmuscle myosin was unchanged. The increases in myosin and MLCK were disproportionate to increases in total protein, suggesting selective changes in contractile proteins. These relative increases in content of proteins were not as pronounced with 0-16% strain, suggesting a graded response. These data suggest that strain per se can increase the contractile proteins of ASM cells independently of other in vivo factors and modulates cultured cell phenotype to a more differentiated state, since it increases smooth muscle-specific proteins, such as smooth muscle myosin isoforms and desmin.

Animals↗
PubMed1997

The underreporting of deaths of American Indian children in California, 1979 through 1993.

OBJECTIVES: This study linked birth and death certificates to determine misclassification of deaths of American Indian children in California. METHODS: Birth records for 1979 to 1993 were matched with mortality records through a computerized system. RESULTS: The number of deaths to American Indians was estimated to be three to four times greater than that reported on death certificates. Children in urban counties and those who died before 1987 were more likely to be misclassified. CONCLUSIONS: California death certificates identify less than one third of the deaths among American Indian children. Adjusting for racial misclassification provides a more accurate accounting of child mortality among American Indians.

Adolescent↗