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Biomedical subjects

S Gallego

Publications and source records attributed to S Gallego.

At least 37 records · Page 2Linked to original sources

Anesthetic efficacy of eutectic prilocaine-lidocaine cream in pediatric oncology patients undergoing lumbar puncture.

OBJECTIVE: To evaluate the efficacy of eutectic mixture of local anesthetics 5% (Emla) in reducing pain associated with lumbar punctures in children. DESIGN: Prospective, double-blind, randomized, placebo-controlled trial. SETTING: University pediatric hospital. PATIENTS: Eleven pediatric oncology patients (mean age 6.6 y, range 4-16) who underwent 31 lumbar punctures. MAIN OUTCOME MEASURES: The analgesic effect was measured by using two methods. The first was a 10-point visual analog scale reported by the patient and the second was an 8-point behavioral pain scale assessed by the nurse who applied the cream. RESULTS: Emla cream was associated with significantly lower pain scores than those with placebo as measured by the patient when the puncture was successful on the first attempt (2.0 +/- 1.6 Emla group, 3.8 +/- 1.9 placebo group; p < 0.05). CONCLUSIONS: The use of Emla cream may reduce pain substantially only in patients who undergo a successful lumbar puncture on the first attempt.

Adolescent↗

Spectral and cepstral properties of vowels as a means for characterizing velopharyngeal impairment in children.

This study investigated spectral differences in the phonation of vowels between a group of 21 children with velopharyngeal impairment and a paired control group of 42 subjects. The speech material was composed of the isolated vowels /a/, /i/, and /u/, a sustained vowel /a/, and four vowels included in spoken words: two nasals /in/ and /on/ in "dindon," and two orals /a/ and /o/ in "gâteau." A bottom-up discriminant function analysis indicated that the cepstrum coefficients and the linear-FFT were the most efficient tools in the test to classify the set of children. They were superior to the results obtained with the formant-representation of the vowels. The use of a perceptive scale (barks) did not improve the results. Discrimination over the total group showed percentages lower than those obtained when boys and girls were assessed separately. The best discriminating results were obtained with the /a/ of "gâteau" for the girls and with the isolated /i/ for the boys.

Case-Control Studies↗

Ipsilateral ABR with cochlear implant.

Ipsilateral ABR recording technique was developed with the MXM DIGISONIC DX10 cochlear implant, involving, firstly, setting of recording variables with regard to implant and ABR constraints, and, secondly, enhancement of recording quality by signal processing. The resulting recording quality then enabled us to characterize ABR latency, amplitude and wave reproductibility according to stimulus intensity and stimulation site (electrode stimulated). The findings agree with those of the literature on contralateral human and ipsilateral animal studies. Waves III and V amplitude increased with stimulus intensity. Waves III and V latency was insensitive to stimulus intensity or site. ABR quality diminished basally.

Cochlear Implants↗

Analytic importance of the coding features for the discrimination of vowels in the cochlear implant signal.

The present study considers the analytic importance of the excitation pulse features delivered by a Nucleus cochlear implant using the F0F1F2 strategy. Four cochlear implant patients and 10 speakers uttering two 48-item lists constructed from four basic French vowels participated in this study. Patterns were presented to the patients and played at the input of an acquisition system in order to record the pulse features. Confusion matrices obtained with the patients and with automatic recognition procedures were then compared in order to find out the best-matching models simulating the patients' performances, out of 255 possibilities. The automatic recognition was carried out according to fuzzy logic based on the elementary features of the pulses coding the vowels. Results show that the essential features strongly depended on the subject.

Adult↗

[Nephropathy in Schoenlein-Henoch purpura. Long-term developmental aspects in 55 cases].

Fifty five patients with Schöelein-Henoch nephropathy were reviewed. These patients were divided into five groups according to the clinical picture initially presented: 1. Hematuria with proteinuria. 2. Hematuria with nephrotic syndrome. 3. Isolated hematuria. 4. Hematuria, nephrotic syndrome and renal failure. 5. Proteinuria. From a histopathological point of view, they were classified into six groups according to ISKDC criteria. A strong correlation was found between clinical presentation and histological lesion. The worst prognosis corresponded to patients with nephrotic syndrome and renal failure, whose biopsy revealed more than 75% of glomeruli with epithelial crescents.

Adolescent↗

Effects of vitamin D-3 on phosphate and calcium transport across and composition of skeletal muscle plasma cell membranes.

The effects of vitamin D-3 on calcium and phosphate transport in skeletal muscle plasma membranes were studied. Sarcolemma vesicles were isolated from vitamin D-deficient and vitamin D-treated (one week) chicks by sucrose density gradient centrifugation of a crude muscle plasma membrane fraction. Measurement of (Na+ + K+)-ATPase activity, cholesterol to phospholipid molar ratios and levels of intracellular marker enzymes showed a high degree of purification of the preparations. Administration of vitamin D-3 significantly increased active Ca2+ and phosphate uptake into the vesicles. The efflux of both ions from preloaded vesicles was only slightly altered by the sterol. Ca2+-ATPase activity was higher in sarcolemma from treated animals. This confirms that the effects of vitamin D-3 on calcium transport are related to the Ca2+ pump and not to the passive permeability properties of the membrane. No changes in the protein composition of vesicles from both experimental groups were observed. However, treatment with vitamin D-3 increased sphingomyelin and phosphatidylcholine concentrations. These changes in lipid structure may play a role in the effects of vitamin D-3 on transport characteristics of sarcolemma.

Animals↗

Modification by rumen of vitamin D-like activity of Solanum malacoxylon in rats.

The biological activity of aqueous extracts of Solanum malacoxylon (SM) and of extracts preincubated with ruminal fluid (SMRF) on calcium and phosphate metabolism in vitamin D depleted rats was compared. The responses in intestinal 32P and 45Ca absorption, measured in an isolated duodenal loop in situ after a single oral dose, were qualitatively similar to that of 1,25-OH2-vit.D3. However, the effects elicited by SMRF were significantly higher than those caused by SM. Both extracts were equally effective in promoting bone resorption when administered orally or subcutaneously. These results provide a basis to explain the greater effectiveness of SMRF to produce calcinosis in rats. The hypothesis is advanced that biologically active steroidal metabolites with predominant action on intestine, are formed during incubation with rumen.

Animals↗

A seroepidemiologic study of hepatitis A in Spanish children. Relationship of prevalence to age and socio-environmental factors.

Three child population groups from the Madrid area were studied for anti-HAV antibodies. Analysis was carried out with respect to age and socio-environmental factors. The population understudy was composed of 156 children, with ages ranging from 1 to 14 years; they were stratified in three socio-environmental groups (white-family unit, gypsy-family unit and orphanage), and also divided into subgroups according to age. As a whole, an age-related increase in prevalence was found. The overall seroprevalence by socio-environmental groups was: gypsy-family unit 63%, orphanage 46%, and white-family unit 23%. Significant differences between groups appeared from seven years on, being more marked among the eldest subgroups. Among the factors evaluated, hygienic-sanitary conditions and overcrowding influenced the high prevalence rate found in the gypsy-family unit subjects, whereas overcrowding appeared to be responsible for the higher prevalence in orphanage residents, as compared to white-family unit children.

Adolescent↗

[Helicobacter pylori eradication in patients with peptic ulcer after two treatment failures: a prospective culture-guided study].

AIM: To determine the effectiveness of a third, culture-guided, treatment of H. pylori infection after two unsuccessful attempts. PATIENTS AND METHODS: Forty-two consecutive patients with a diagnosis of peptic ulcer were included in an open prospective and multicenter study. After two unsuccessful attempts at eradication (demonstrated by positive urea breath test), all patients underwent endoscopy and H. pylori infection was confirmed by urease test, histology and culture (Pylori-Agar, Bio Merieux, France). Antibiotic susceptibility to metronidazole, amoxicillin, tetracycline and clarithromycin was defined by E-test. Thirty-nine patients received a two-week quadruple culture-guided therapy defined by the protocol, which considered sensitivity data and previous allergies to antibiotics (one culture was contaminated, one patient refused treatment and one was allergic to tetracycline and amoxicillin and was resistant to metronidazole and clarithromycin). Compliance was monitored by pill counting and eradication was defined as a negative urea breath test six weeks after the end of treatment. RESULTS: Sensitivity data were obtained in 41 patients. Intention-to-treat analysis revealed that overall eradication was achieved in 60% (24/40). Eighteen strains (43.9%) were resistant to metronidazole, 21 (51.2%) were resistant to clarithromycin and 8 (19.5%) were resistant to both drugs. None of the strains were resistant to amoxicillin or tetracycline. We used mainly two kinds of quadruple therapy in the 39 patients. Despite good compliance with treatment based on omeprazole (20 mg/12 h), bismuth subcitrate (120 mg/6 h), tetracycline (500 mg/4 h) and clarithromycin (500 mg/ 12 h) (OBTC) eradication was achieved in only 9 of 19 patients (47.4%; CI: 24.4-71.1) (one patient failed to attend the urea breath test). Nineteen clarithromycin-resistant patients received amoxicillin (1,000 mg/12 h) instead of clarithromycin (OBTA) and this treatment was effective in 14 (73.7%; CI: 48.8-90.9). Eradication was achieved in one patient who was allergic to amoxicillin and resistant to clarithromycin and metronidazole and who received ciprofloxacin (500 mg/8 h) instead of clarithromycin (OBTCipro). No clinical factors associated with eradication failure were found. CONCLUSIONS: Despite the use of two-week, high-dose, quadruple and culture-guided combinations of drugs, a third treatment was frequently unsuccessful. The lowest eradication rate was obtained in patients with H. pylori strains sensitive to all antibiotics; therefore, we believe that other factors could influence eradication rates. New prospective and randomized studies are needed in this subgroup of patients to find effective treatments.

Adult↗

Improving survival of medulloblastoma: results in two groups of patients.

This retrospective study compares the results obtained in 56 children with medulloblastoma treated with two different protocols at our center between 1975 and 1990. Since 1985 we have been enrolled in the medulloblastoma SIOP II protocol in which we have entered 27 patients. These patients from the SIOP group (SG) and the 29 children treated before 1985, the historical group (HG). When the two groups were compared for age and sex distribution, no differences were found; however, prognostic factors were worse in the HG than in SG: 21 versus 15 T3-T4 and 13 versus 8 high-risk, respectively. The relapse rate was 63% for the HG and 39% for the SG. Five-year disease-free survival was 31% for the HG and 56% for the SG (p = 0.037). Five-year survival was 52 and 70%, respectively (p = 0.055). When SG and HG were compared by stratifying for tumor size, surgical resection and the risk variable, better disease-free survival was obtained in SG than in HG. In a multivariate analysis, the HG and the high-risk proved to be variable independent predictors of poor survival. We observe an increase in survival in our patients with medulloblastoma.

Brain Neoplasms↗

Immunofluorescence assay reactivity patterns of serum samples presenting indeterminate Western blot results for antibodies to HIV-1 and HTLV-I/II in Cordoba, Argentina.

Serum samples (n: 110) from blood donors and high risk individuals from Cordoba, Argentina with indeterminate HIV-1 and HTLV-I/II Wb profiles were studied for specific antibodies to HTLV-I/II and HIV-1 by indirect immunofluorescence assay (IFA) and for the presence or absence of HIV-1 and HTLV-I/II specific bands by Wb. This study was carried out in order to characterize their putative reactions with HIV-1 and HTLV-I/II proteins and to resolve the retrovirus infection status of these individuals. Results indicated that blood donors sera displaying indeterminate HIV-1 or HTLV-I/II Wb patterns were not immunoreactive to HTLV-I/II and HIV-1 on IFA. However, a high rate of indeterminate HIV-1 and HTLV-I/II Wb samples from high risk individuals had positive HTLV-I/II and HIV-1 IFA results respectively. Our study supports the growing evidence that HTLV-HIV indeterminate seroreactivity in low risk population is due to a cross reaction against nonviral antigens, and in high risk populations the indeterminate samples show serological cross-recognition between HIV-1 proteins and HTLV-I/II proteins on Wb. These results point out the necessity to investigate the HTLV-I/II reactivity in indeterminate HIV-1 samples and vice versa in order to confirm the diagnosis. Finally, this study shows the potential usefulness of IFA in elucidating the status of HIV-1 and HTLV-I/II infection of individuals with indeterminate Wb profiles, thus enabling resolution of retrovirus infection status.

Argentina↗

Clinical relevance of molecular markers in neuroblastoma: results from a single institution.

Neuroblastomas, the most common extracranial solid tumors in children, present an extremely heterogeneous behaviour that can be explained in part by their genetic abnormalities. Thirty-four patients treated at the Pediatric Oncology Unit, Hospital Vall d'Hebron from 1993 to 1997 were prospectively studied to determine the relative prognostic impact of a number of clinical and molecular factors. The factors studied were: ploidy, MYCN and 1p status, and TRK-A expression, in addition to age, stage and histology. Their impact on prognosis was analyzed. In univariate analysis, advanced stage, unfavorable histology, diploidy, MYCN amplification, and 1p deletion were identified as adverse prognostic factors; TRK-A expression was associated with favorable prognosis. After multivariate analysis, only MYCN amplification proved to be an independent adverse prognostic factor (p=0.03), whereas TRK-A expression identified a subset of good-prognosis patients (p=0.003).

Age Factors↗

[Evaluation of commercial equipment used in blood banks in Córdoba for the detection of anti-HTLV-I/II antibodies].

In order to assess the efficiency of currently used screening tests, Abbott HTLV-I/HTLV-II EIA, Vironostika HTLV-I/II Organon Teknika, Particle Agglutination (PA) assay Serodia Fujirebio Inc. (Tokyo, Japan) for HTLV-I/II antibody detection in blood donors samples, a panel of 100 sera from different blood banks of Córdoba city were studied. An "in house" indirect immunofluorescence assay (IFA) was used as reference test. The correlation rates were: 66% for Abbott HTLV-I/HTLV-II EIA, 97% for Vironostika HTLV-I/II Organon Teknika EIA and 99% for PA Serodia. Vironostika HTLV-I/II Organon Teknika EIA and PA Serodia assay proved to be more reliable for HTlV-I/II antibody screening in blood donors from Córdoba, yielding a very low rate of false positive results as compared with Abbot HTLV-I/HTLV-II EIA.

Argentina↗

[HTLV-I/II seroprevalence and risk factors associated with infection in a blood donor population in Córdoba, Argentina].

In this study we have determined the seroprevalence of infections by HTLV-I/II in the blood donor population from the city of Córdoba. A total of 5476 blood donor sera were screened for HTLV-I/II antibodies by particle agglutination assay (PA) (SERODIA HTLV-I, Fujirebio INC, Tokyo, Japan). The reactive sera samples were confirmed by an "in house" indirect immunofluorescence assay (IFA). 14 out of 5476 blood donors studied were PA reactive and were confirmed positive by IFA, showing a prevalence of 0.26% (95% confidence interval: 0.126%-0.394%). All the positive samples, except one, met the criteria for HTLV-I. Although one HTLV-I infected donor was an intravenous drug abuser and two donors were born in highly endemic areas for HTLV-I, no specific risk factors were identified among the others. The demonstration that HTLV-I circulates in blood donor population of Córdoba, points out that the systematic screening of blood for HTLV-I/II antibodies must be implemented in the blood banks, in an attempt to prevent the spread of infections with this oncogenic virus in Argentina.

Adolescent↗

[Absence of HTLV-I/II virus circulation in blood donors from the provinces of Santa Fe and Santiago del Estero].

In the present study, we evaluated the seroprevalence of HTLV-I/II infection among the blood donors in Santa Fe and Santiago del Estero provinces. A total of 1327 serum samples from blood donors from Rafaela blood bank of Santa Fe province and 3382 serum samples from blood donors from Dr Edgar Bouzon blood bank of Santiago del Estero province were studied. The antibody screening was done by particle agglutination assay (PA) (SERODIA, Fujirebio Inc., Tokyo, Japan) or by enzyme immuno assay (EIA) (Abbott HTLV-I/HTLV-II EIA, Abbott, Germany). The "in house" indirect immunofluorescence assay (IFA) and Western blot (Bioblot HTLV Biokit, Barcelona, Spain) were used as confirmatory assays. All the samples resulted negative for specific antibodies against HTLV-I/II. These results suggest that HTLV-I/II are not circulating in low risk populations in these provinces or that the prevalences of infection would be lower than that reported by blood banks in other provinces of Argentina.

Adult↗