Search PubMed⌕ Search

Biomedical subjects

R Pujol

Publications and source records attributed to R Pujol.

At least 91 records · Page 5Linked to original sources
PubMed1996

Epidemiology of sarcoidosis in Catalonia: 1979-1989.

For the purpose of estimating the incidence rate and clinico-epidemiological characteristics of sarcoidosis in Catalonia (a country comprising the provinces of Barcelona, Tarragona, Lleida and Girona, with a total population of 6 million people), we did a retrospective study of new cases diagnosed in the country's qualified hospitals during 1979 and the three-year period from 1986 to 1988. The annual incidence rate in the province of Barcelona was 1.2/100,000 in 1979 and 1.5/100,000 in 1988. 245 cases were diagnosed in Catalonia in the three-year period covering 1986-88, the annual incidence rate being 1.36/100,000 inhabitants. We describe here the characteristics of this series of 245 cases (which is the first one representative of the whole of Catalonia), and compare them with those of other series published previously. We conclude that the incidence of sarcoidosis in our country is one of the lowest in Europe, with no significant variations observed over ten years. The most relevant clinico-epidemiological characteristics are its clear predominance in women (3:1), and the high frequency of Löfgren's syndrome (48% of cases), whose incidence is significantly higher in springtime.

Adolescent↗
PubMed1996

[Antiphospholipid antibodies and epilepsy in patients with systemic lupus erythematosus].

OBJECTIVE: To verify the possible relationship between the presence of antiphospholipid antibodies (APLA) and the presence of epileptic seizures in patients with systemic lupus erythematosus (SLE). METHODS: A total of 168 patients with SLE were studied. Fifteen patients had antecedents of epilepsy which were non attributable to a cause other than SLE. Epilepsy was diagnosed on clinical and electroencephalographic grounds. Antibodies to cardiolipin (CLa) and lupus anticoagulant (LA) were measured. RESULTS: Epileptic seizures were generalized in 13 and partial in two patients. The lupus anticoagulant was positive in 40% of patients with epilepsy compared to 32% in the control group; CLa IgG in 53.5% compared to 65.6%, and CLa IgM in 40% compared to 35.2%. Differences were never statistically significant. Neither when patients with moderate/high CLa levels were studied. Seven patients (40%) had some of the classical manifestations of antiphospholipid syndrome. CONCLUSIONS: No association was found between positive APLA and epilepsy in patients with SLE.

Adult↗
PubMed1996

[Bone mineral density in female patients with systemic lupus erythematosus treated with high glucocorticoid doses].

OBJECTIVE: To study the bone mineral density (BMD) in premenopausal women with systemic lupus erythematosus receiving glucocorticoids (GL) and at 6 months, when the dose of GL was decreased to a level below half of the initial dose. METHODS: Twelve premenopausal women with SLE were prospectively studied after initiating prednisone therapy at a dose > or = 0.5 mg/kg/day. A densitometric study was performed (Hologic 1000 QDR) of the lumbar spine and femoral neck. Levels of osteocalcine (BGP), catacalcine (PDN-21), testosterone in plasma and saliva, and dehydroepiandrosterone sulphate (DHEAS) were measured. Measurements were repeated after 6 months. RESULTS: The initial mean dose of prednisone was 40 +/- 10.2 mg/day (0.66 mg/kg/day) with an accumulated dose of 27.6 +/- 23 g. Lumbar and femoral BMD were 1 +/- 0.13 and 0.831 +/- 0.07 g/cm2, respectively. A significant increase was observed in BGP an adrogen levels studied after a 6 months when the dose of GL was decreased to a mean dose of 13.9 +/- 7.5 mg/day (0.23 mg/kg/day), whereas no differences were found in BMD values. In none of the two phases of the study were osteoporosis, correlations between BMD and BGP, between PDN-21 and androgens or with the accumulated or punctual doses of GL documented. CONCLUSIONS: No decrease in BMD was observed after 6 months of therapy with high doses of GL. In contrast, an increase in BGP and androgenic status was observed when the GL dose was decreased.

Adult↗
PubMed1995

[An evaluation of the clinical competence of a population of specialist physicians educated by the medical internship and residency system].

BACKGROUND: The quality of physicians who have undergone resident official training (MIR) should logically be better than that of the remaining physicians who were not able to enter into this official training. The present study was designed with the aim of verifying this hypothesis. METHODS: A sample of physicians who underwent the MIR examination in 1982 and who upon passing the same were permitted to initiate the MIR training in 1983 was selected. The group was subdivided into MIR and no MIR and according to the specialty followed. When the physicians were practicing as specialists two types of surveys were carried out with one being by telephone and the other personal in which the personal characteristics, preparation for the MIR test, professional satisfaction and personal motivation were analyzed. The pharmaceutic prescriptions of both groups were analyzed according to indicators of the Servei Català de la Salut (Catalonian Health Service) and the opinion of colleagues of each of the members of each group was evaluated with another questionnaire. The written resolution of hypothetical clinical cases were given to each of the individuals included. A level of global competence defined as a percentage for the following components was identified using: curricular evaluation (10%), professional satisfaction (20%), personal motivation (10%), hypothetical case resolution (35%) and peer opinion (25%). RESULTS: The global competence of the physicians trained under the MIR system was greater than that of the no MIR group (p < 0.01). On analysis by sections the differences of greatest note were observed in the resolution of hypothetical cases (p < 0.0001), curricular evaluation (p < 0.0001) and the quality of pharmaceutical prescription (p < 0.0001). The differences were less of note in comparison of personal motivation (p < 0.02) and professional satisfaction (p < 0.02). No differences were observed in peer opinion. CONCLUSIONS: The professional quality of physicians trained by MIR who presented for the 1982 examination in Catalonia and practiced in medical specialties is greater than that of a comparable group with regard to professional practice.

Adult↗
PubMed1995

[The Kveim-Siltzbach test in sarcoidosis].

BACKGROUND: The Kveim-Siltzbach test has been widely used in the diagnosis of sarcoidosis. This reactive is currently available in the authors' hospitals. Previous experience with this test in the same centers was reviewed to know its diagnostic usefulness. The present is the first series described in Spain. METHODS: From 1977 to 1988 the Kveim-Siltzbach test was performed in 79 patients diagnosed or suspected of having sarcoidosis. The study was carried out as cooperation of the validation process of sarcoid spleen suspensions (lots K12, K12 1/2, K32, K41, K42, K42 1/2 and K50 of the Colindale antigen) prepared in the Standards Laboratory for Serological Reagents in the Royal Brompton Hospital in London. RESULTS: The results of test positivity were determined following the criteria established by Siltzbach. The global sensitivity of the Kveim-Siltzbach test was 78% (CI 95% = 67.8-86.9). Positivity ranged from 84% in subacute sarcoidosis to 61% in chronic sarcoidosis (p = 0.08). Likewise, it was higher in patients with radiologic stage I (84%) and II (81%) with respect to stage III (62%) or the cases with exclusive extrathoracic sarcoidosis (stage 0) (57%) (p = 0.11). No association was found between the Kveim-Siltzbach test positivity and the elevation in serum values of the angiotensin-converting enzyme (p = 0.575). CONCLUSIONS: In the present study the Kveim-Siltzbach test showed high sensitivity in the diagnosis of sarcoidosis. This fact, together with the high specificity observed in other studies, makes the test a very useful tool for the non-invasive diagnosis of sarcoidosis.

Acute Disease↗
PubMed1995

Synaptic connections and putative functions of the dopaminergic innervation of the guinea pig cochlea.

We report our findings in the guinea pig involving dopamine in postsynaptic regulation of the activity of glutamatergic inner hair cells (IHCs) and in protection of primary auditory neurons during transient ischemia. Seven days after intracochlear perfusion of 6-hydroxydopamine, no immunoreactivity to tyrosine hydroxylase (TH) was demonstrable within the organ of Corti. TH and aromatic amino acid decarboxylase were immunolocalized at an ultrastructural level within lateral olivocochlear varicosities synapsing with radial auditory dendrites postsynaptic to the IHCs. The D2 agonist piribedil induced a dose-dependent decrease in the amplitude of the compound action potential of the auditory nerve. Piribedil also prevented appearance of ischemia-induced swelling of the radial dendrites.

Animals↗
PubMed1995

Cyclophosphamide-induced synaptonemal complex damage during meiotic prophase of female Rattus norvegicus.

The reproductive system can be especially sensitive to the toxic, carcinogenic or mutagenic effects of alkylating agents. However, since studies of such effects on germ cells are complex, their analysis has been frequently overlooked. In humans, occupational or therapeutic exposure to cyclophosphamide has been associated with male (azoospermia) and female (ovarian failure) sterility or infertility. In this work, we have studied the effect of cyclophosphamide on the formation of the synaptonemal complexes in female rat fetuses. Our results indicate that cyclophosphamide administered at 16 days of gestation, when most germ cells are in a proliferative stage in the female rat, significantly increases the frequency of synaptonemal complex and nucleolar fragmentation in a dose-dependent way.

Animals↗
PubMed1995

Effects of a dopaminergic agonist in the guinea pig cochlea.

This study investigates the role of dopamine, a putative lateral efferent neurotransmitter/modulator, in cochlear physiology and physiopathology. Cochlear potentials were recorded in guinea pigs after intracochlear perfusion of increasing doses (0.1-1 mM) of piribedil, an agonist of the D2/D3 receptors. A dose-dependent reduction in the amplitude of auditory nerve compound action potential (CAP) was observed, predominantly at high-intensity tone-burst stimulations, and without significant effect on CAP threshold. There was no variation of cochlear microphonic and summating potential. When 1 mM piribedil was perfused into the cochlea during continuous 130 dB SPL pure tone exposure (6 kHz, 15 min), CAP threshold shifts were significantly less than in control animals with artificial perilymph-perfused cochleas. No dendritic damage was observed, although there was evident hair cell damage. Similarly, radial dendrites were clearly protected against ischemia-induced damage when 1 mM piribedil was applied prior to a 10-min ischemia. These results suggest that dopamine modulates the activity of radial afferent fibers via D2/D3 receptors. The protective effect of piribedil during acoustic trauma or ischemia suggests that this modulation corresponds to a prevention of excitotoxicity due to dysfunction of inner hair cell neurotransmission.

Acoustic Stimulation↗
PubMed1995

Lipid metabolism and apolipoprotein E phenotypes in patients with xanthelasma.

PURPOSE: To know the prevalence and types of dyslipidemia associated with xanthelasma. PATIENTS AND METHODS: One hundred fifteen patients with xanthelasma and 105 age-matched control subjects without xanthelasma were evaluated in a cross-sectional study. Univariate and multivariate comparisons of lipid variables (including total cholesterol; triglycerides; very-low-, low-, and high-density lipoprotein cholesterol [VLDL-C, LDL-C, and HDL-C, respectively]; cholesterol of high density lipoprotein [HDL] subfractions 2 and 3 [HDL2-C and HDL3-C]; apolipoprotein (apo) A-I and B; and apo E phenotypes) and nonlipid coronary risk factors were made between patients with and without xanthelasma. RESULTS: Patients with xanthelasma had higher levels of cholesterol, LDL-C, and apo B, and lower levels of HDL2-C than control subjects. The prevalence of the apo E4/E3 phenotype was higher in cases than in controls (P < 0.05). Patients with xanthelasma had a higher prevalence of personal and familiar history of cardiovascular disease and were more overweight than control subjects. A stepwise discriminant analysis disclosed an independent association of xanthelasma with lower HDL-C, HDL2-C, and HDL3-C levels in men, and with higher total cholesterol and lower HDL2-C levels in women. CONCLUSIONS: Xanthelasma appears to be associated with qualitative and quantitative abnormalities of lipid metabolism that may favor lipid deposition in the skin and arterial wall. The findings support the notion that xanthelasma is a marker of dyslipidemia, and underline the need to determine a full lipid profile in these patients to detect those potentially at increased risk of cardiovascular disease.

Adult↗
PubMed1995

Synaptic regeneration and functional recovery after excitotoxic injury in the guinea pig cochlea.

Cochlear ischemia and acoustic trauma result in an immediate hearing loss accompanied by the complete disruption of the terminal dendrites of primary auditory neurons postsynaptic to the sensory inner hair cells (IHCs). This synaptic uncoupling, due to an acute glutamate (IHC neurotransmitter) excitotoxicity process, can be mimicked by glutamate agonists. Thus, we have followed over a 5-day period the responses of guinea-pig cochleas to a local application of 200 microM AMPA. This application immediately results in a destruction of all postsynaptic endings of the auditory nerve, resulting in a total loss of cochlear potentials. Twenty-four hours after this excitotoxic injury, the inner hair cells were contacted by repaired postsynaptic dendrites and the cochlear potential had partially recovered. This process of neo-synaptogenesis was completed and the potentials were fully restored at 5 days post exposure. As shown by in situ hybridization, an up-regulation of NMDA and metabotropic glutamate receptors in the primary auditory neurons occurred during this process of recovery. This process of neo-synaptogenesis and functional recovery probably accounts for restoring hearing after temporary losses due to excitotoxic-related pathologies.

Animals↗
PubMed1995

[Herpes-zoster virus infection in patients with systemic lupus erythematosus].

The prevalence of infection with VZV in 145 patients with SLE was investigated, with a mean follow-up of 7.6 years; its relationship with different variables, particularly with therapy of the underlying disease, was analyzed. Twenty episodes of VZV infection in 19 patients were diagnosed (13.1%). In no case was the therapeutic regime changed nor was worsening of SLE observed. There was neither dissemination of herpes nor superinfection. An increase in the number of VZV infections was observed in patients with SLE under corticosteroid therapy (p = 0.04) and particularly when drug administration was on a daily basis (p = 0.00006). Cytotoxic agents also favored the infection (p = 0.0014). VZV infection is of a benign nature in SLE and its emergence is favored by immunosuppressive agents. The risk is lower if corticosteroid administration is on alternate days. There is no need to decrease therapy for SLE.

Female↗
PubMed1995

Splenomegaly in sarcoidosis: a report of 16 cases.

The reported frequency of splenomegaly in sarcoidosis has ranged from 1% to 40%. Splenomegaly has been associated with clinical evidence of more extensive extrathoracic sarcoidosis. In a previous study, we reported that splenomegaly was associated with a poor outcome of the disease. The aim of the present study was to describe the characteristics of the sarcoidosis patients with splenomegaly seen at our institution. Of 284 sarcoidosis patients, followed up at our hospital, 16 (5.6%) had splenomegaly on physical examination. These patients showed other extrathoracic manifestations as well, and all but two showed intrathoracic involvement. Eleven patients received corticosteroid therapy. Splenectomy was done in three patients, but the natural history of their sarcoidosis remained unaltered two years after diagnosis. The results of this study disclosed that patients with splenomegaly had evidence of extensive pulmonary and extrathoracic sarcoidosis with a poor prognosis in spite of steroid therapy.

Adolescent↗
PubMed1994

Effects of ototoxins on quinuclidinyl benzylate binding in the rat cochlea.

Ototoxins inhibit the muscarinic receptor-activated inositol phosphate synthesis in the rat cochlea. In order to study this inhibitory mechanism, we investigated the effects of the ototoxins ethacrynate, cisplatin, HgCl2 and neomycin on [3H]quinuclidinyl benzylate binding to muscarinic receptors in adult and 12-day-old rat cochleas. The results are similar whatever the age: at concentrations that inhibit the inositol phosphate synthesis, ethacrynate is without effect. Neomycin only reduces [3H]quinuclidinyl benzylate binding at concentrations in the millimolar range. Cisplatin and HgCl2 block the binding in a dose-dependent way. These results suggest that the block of the transduction system by cisplatin and HgCl2 is due to direct interactions with muscarinic binding sites. Moreover, considering these data together with previous results, ethacrynate and neomycin may affect the phosphoinositide signalling pathway at targets including phosphoinositides and G proteins.

Animals↗
PubMed1994

Excitatory amino acid antagonists protect cochlear auditory neurons from excitotoxicity.

Since ischemic damage in the brain is linked to glutamate excitotoxicity, the effects of an acute exposure to glutamate, alpha-amino-3-hydroxy-5-methyl-4-isoxazole proprionic acid (AMPA) or N-methyl-D aspartate (NMDA) on the radial dendrites were compared with those occurring after a severe cochlear ischemia. Glutamate and AMPA, but not NMDA, produced a drastic swelling restricted to the radial dendrites below the inner hair cells (IHCs). At a concentration of 20 microM AMPA, a full electrophysiological recovery could be observed in some cochleas after washing the drug out. A prior perfusion of 6-7-dinitroquinoxaline-2,3-dione (DNQX, 50 microM) prevented the 25 microM AMPA-induced dendritic swelling. No protective effect of D-2-amino-5-phosphonopentanoate (D-AP5) could be observed. In the same way, ischemia (5-40 minutes) resulted in a clear swelling of the radial dendrites. While D-AP5 had no protective effects, 50 microM DNQX protected most of the radial dendrites from the ischemia-induced swelling, excepting those contacting the modiolar side of the IHCs. Finally, 50 microM DNQX + 50 microM D-AP5 resulted in a nearly complete protection of all the radial dendrites. Altogether, these results suggest that the acute swelling of radial dendrites primarily occurs via AMPA/kainate receptors. However, in radial dendrites contacting the inner hair cells on their modiolar side, NMDA receptors may be also involved.

2-Amino-5-phosphonovalerate↗
PubMed1994

Multiple liver abscesses due to Yersinia enterocolitica discloses primary hemochromatosis: three cases reports and review.

We report three cases of multiple liver abscesses due to Yersinia enterocolitica that led to previously unknown diagnoses of primary hemochromatosis. Y. enterocolitica is an iron-dependent bacterium that relies entirely on exogenous iron for growth. A review of the literature with use of MEDLINE (National Library of Medicine, Bethesda, MD) disclosed 35 cases of Y. enterocolitica liver abscesses; 21 (60%) of these cases were associated with hemochromatosis. In 11 of the remaining 14 cases, two common manifestations of hemochromatosis, diabetes mellitus and cirrhosis of the liver, also were present; these findings were significant. Finally, we emphasize that when iron overload cannot be documented at the time of diagnosis of the liver abscess, long-term follow-up for determination of increasing iron stores is mandatory. With this approach, most manifestations of hemochromatosis in asymptomatic patients can be prevented.

Adult↗
PubMed1993

Localisation of functional muscarinic receptors in the rat cochlea: evidence for efferent presynaptic autoreceptors.

In the rat cochlea, the activation of muscarinic receptors stimulates the hydrolysis of phosphoinositides but the importance of this muscarinic effect is still unknown. In order to find out about the role of the muscarinic receptors in the cochlea, we examined their functional distribution within this organ. This was achieved by measuring the formation of [3H]inositol phosphates induced by carbachol (1 mM) in two regions of the cochlea: the modiolus and the organ of Corti. At both sites, carbachol enhanced the accumulation of inositol phosphates in an atropine-sensitive way. These stimulations were completely antagonised by 4-diphenylacetoxy-N-methyl piperidine methiodide (1 microM) but unchanged by pirenzepine (1 microM). In cochleas depleted of outer hair cells by a treatment with amikacin, the carbachol-induced formation of inositol phosphates is not altered with respect to control, undamaged cochleas. Conversely, when the medial cholinergic axons which form synapses with the outer hair cells are destroyed by the section of the crossed olivocochlear bundle the carbachol-stimulated inositol phosphates response is reduced by 35% in the organ of Corti. This section has no effect in the modiolus, despite the degeneration of some modiolar fibers. Our results show that functional muscarinic receptors are distributed both in the organ of Corti and in the modiolus. These two structures contain presumably the same class of cholinoceptor. The effects of selective destruction clearly demonstrate that a population of muscarinic receptors is located on presynaptic membranes at the level of the medial axon-outer hair cell contacts. They also point to spiral ganglion neurons and/or the Schwann cells as sites for the functional cholinoceptors in the modiolus.

Amikacin↗