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Tepper Á, Vásquez Núñez J, Ramirez-Mahaluf JP, Aguirre JM, Barbagelata D, Maldonado E, Díaz Dellarossa C, Nachar R, González-Valderrama A, Undurraga J, Goñi J, Crossley N. Intra and inter-individual variability in functional connectomes of patients with First Episode of Psychosis. Neuroimage Clin 2023; 38:103391. [PMID: 37003128 PMCID: PMC10102560 DOI: 10.1016/j.nicl.2023.103391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023]
Abstract
Patients with Schizophrenia may show different clinical presentations, not only regarding inter-individual comparisons but also in one specific subject over time. In fMRI studies, functional connectomes have been shown to carry valuable individual level information, which can be associated with cognitive and behavioral variables. Moreover, functional connectomes have been used to identify subjects within a group, as if they were fingerprints. For the particular case of Schizophrenia, it has been shown that there is reduced connectome stability as well as higher inter-individual variability. Here, we studied inter and intra-individual heterogeneity by exploring functional connectomes' variability and related it with clinical variables (PANSS Total scores and antipsychotic's doses). Our sample consisted of 30 patients with First Episode of Psychosis and 32 Healthy Controls, with a test-retest approach of two resting-state fMRI scanning sessions. In our patients' group, we found increased deviation from healthy functional connectomes and increased intragroup inter-subject variability, which was positively correlated to symptoms' levels in six subnetworks (visual, somatomotor, dorsal attention, ventral attention, frontoparietal and DMN). Moreover, changes in symptom severity were positively related to changes in deviation from healthy functional connectomes. Regarding intra-subject variability, we were unable to replicate previous findings of reduced connectome stability (i.e., increased intra-subject variability), but we found a trend suggesting that result. Our findings highlight the relevance of variability characterization in Schizophrenia, and they can be related to evidence of Schizophrenia patients having a noisy functional connectome.
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Affiliation(s)
- Ángeles Tepper
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Intelligent Healthcare Engineering, iHEALTH, Santiago, Chile
| | | | | | - Juan Manuel Aguirre
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Daniella Barbagelata
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Elisa Maldonado
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Ruben Nachar
- Psychiatric Institute "Dr. José Horwitz Barak", Santiago. Chile
| | - Alfonso González-Valderrama
- Psychiatric Institute "Dr. José Horwitz Barak", Santiago. Chile; School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Juan Undurraga
- Psychiatric Institute "Dr. José Horwitz Barak", Santiago. Chile; Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Joaquín Goñi
- CONNplexity Lab. Purdue University. West Lafayette, Indiana USA
| | - Nicolás Crossley
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Intelligent Healthcare Engineering, iHEALTH, Santiago, Chile; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
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Calderón J, Flores P, Aguirre JM, Valdivia G, Padilla O, Barra I, Scoriels L, Herrera S, González A, Massardo L. Impact of cognitive impairment, depression, disease activity, and disease damage on quality of life in women with systemic lupus erythematosus. Scand J Rheumatol 2016; 46:273-280. [PMID: 27701937 DOI: 10.1080/03009742.2016.1206617] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To define the relative role of cognitive impairment, depression, disease activity, and disease damage in the decreased health-related quality of life (HRQoL) frequently observed in systemic lupus erythematosus (SLE) patients. METHOD We studied 101 Chilean female SLE patients and applied the 12-item Medical Outcomes Study (MOS) Short Form Health Survey version 2 (SF-12v2) to assess HRQoL and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive function. Analysis of covariance (ANCOVA) models included demographic and disease-related factors and cognitive function tests of sustained attention, memory, and executive function. RESULTS All measures of HRQoL were lower in the 101 female SLE patients compared to the women from the Chilean general population. HRQoL was associated with the following factors: (i) depression symptoms, which were detrimental to all components of the physical and mental HRQoL scores; (ii) executive dysfunction (spatial planning), which was associated with lower scores on role limitations due to physical health problems and emotional problems, and general health perceptions; (iii) higher activity and organ damage were deleterious to role physical, bodily pain, and physical summary scores; and (iv) higher damage also impacted physical function. Impairments in sustained attention and memory did not decrease the HRQoL. CONCLUSIONS Our results highlight the relevance of executive dysfunction to poor physical and mental health components of HRQoL in SLE together with depression, while disease activity and disease damage are associated with lower HRQoL physical components. The need for cognitive function evaluation and rehabilitation in SLE is indicated.
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Affiliation(s)
- J Calderón
- a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - P Flores
- a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - J M Aguirre
- a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - G Valdivia
- b Department of Public Health, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - O Padilla
- b Department of Public Health, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - I Barra
- c School of Medicine, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - L Scoriels
- d Institute of Biomedical Sciences , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
| | - S Herrera
- c School of Medicine, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - A González
- e Department of Clinical Immunology and Rheumatology, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.,f Centre for Ageing and Regeneration (CARE), Department of Molecular and Cell Biology, Faculty of Biological Sciences , Pontifical Catholic University of Chile , Santiago , Chile
| | - L Massardo
- e Department of Clinical Immunology and Rheumatology, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
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Massardo L, Bravo-Zehnder M, Calderón J, Flores P, Padilla O, Aguirre JM, Scoriels L, González A. Anti-N-methyl-D-aspartate receptor and anti-ribosomal-P autoantibodies contribute to cognitive dysfunction in systemic lupus erythematosus. Lupus 2014; 24:558-68. [DOI: 10.1177/0961203314555538] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 09/23/2014] [Indexed: 12/28/2022]
Abstract
Objective Autoantibodies against N-methyl-D-aspartate receptor (anti-NMDAR) and ribosomal-P (anti-P) antigens are potential pathogenic factors in the frequently observed diffuse brain dysfunctions in patients with systemic lupus erythematosus (SLE). Although studies have been conducted in this area, the role of anti-NMDAR antibodies in SLE cognitive dysfunction remains elusive. Moreover, the specific contribution of anti-P antibodies has not been reported yet. The present study attempts to clarify the contribution of anti-NMDAR and anti-P antibodies to cognitive dysfunction in SLE. Methods The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess a wide range of cognitive function areas in 133 Chilean women with SLE. ANCOVA models included autoantibodies, patient and disease features. Results Cognitive deficit was found in 20%. Higher SLEDAI-2K scores were associated with impairment in spatial memory and learning abilities, whereas both anti-NMDAR and anti-P antibodies contributed to deficits in attention and spatial planning abilities, which reflect fronto-parietal cortex dysfunctions. Conclusions These results reveal an association of active disease together with specific circulating autoantibodies, such as anti-NMDAR and anti-P, with cognitive dysfunction in SLE patients.
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Affiliation(s)
- L Massardo
- Departamento de Inmunología Clínica y Reumatología, Facultad de Medicina
| | - M Bravo-Zehnder
- Departamento de Inmunología Clínica y Reumatología, Facultad de Medicina
- Centro de Envejecimiento y Regeneración, Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas
| | | | | | - O Padilla
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - L Scoriels
- Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, Brazil
| | - A González
- Departamento de Inmunología Clínica y Reumatología, Facultad de Medicina
- Centro de Envejecimiento y Regeneración, Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas
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Calderón J, Flores P, Babul M, Aguirre JM, Slachevsky A, Padilla O, Scoriels L, Henríquez C, Cárcamo C, Bravo-Zehnder M, González A, Massardo L. Systemic lupus erythematosus impairs memory cognitive tests not affected by depression. Lupus 2014; 23:1042-53. [DOI: 10.1177/0961203314536247] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Our aim was to assess the contribution of depression to cognitive impairment in patients with systemic lupus erythematosus (SLE). Methods Clinical features, education, age, and Hospital Anxiety and Depression Scale (HADS) were evaluated in 82 patients with SLE and 22 healthy controls, all Chilean women. The Cambridge Neuropsychological Test Automated Battery (CANTAB eclipseTM) assessing attention, spatial memory, and learning and executive function domains was applied. Cognitive deficit definition: a cut-off for definite impairment was defined as a score below -2 standard deviations in at least one outcome measure in two or more domains. ANCOVA with stepwise selection evaluated influences of health status (SLE or control), age, education, and HADS depression and anxiety scores on cognitive outcomes. To avoid overfitting, a shrinkage method was performed. Also, adjusted p-values for multiple comparisons were obtained. Results Cognitive deficit affected 16 (20%) patients, and no controls ( p = 0.039). Median HADS depression score in SLE patients was 6 (range 0–19) and in controls was 0 (0–19), p < 0.001). ANCOVA and shrinkage models showed that worse cognitive performance in sustained attention and spatial working memory tests was explained by the presence of SLE but not depression, whereas depression only affected a measure of executive function (I/ED Stages completed). Conclusion Depression has a limited role in cognitive impairment in SLE. Impairments in sustained attention and spatial working memory are distinctly influenced by yet-unknown disease-intrinsic factors.
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Affiliation(s)
- J Calderón
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - P Flores
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - M Babul
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - JM Aguirre
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - A Slachevsky
- Department of Neurological Sciences Oriente, Facultad de Medicina, Universidad de Chile, Chile
| | - O Padilla
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - L Scoriels
- Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, Brazil
| | - C Henríquez
- Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - C Cárcamo
- Department of Neurology, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - M Bravo-Zehnder
- Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - A González
- Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Chile
- Center for Aging and Regeneration, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - L Massardo
- Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Chile
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To-Figueras J, Phillips JD, Gonzalez-López JM, Badenas C, Madrigal I, González-Romarís EM, Ramos C, Aguirre JM, Herrero C. Hepatoerythropoietic porphyria due to a novel mutation in the uroporphyrinogen decarboxylase gene. Br J Dermatol 2011; 165:499-505. [PMID: 21668429 PMCID: PMC3818800 DOI: 10.1111/j.1365-2133.2011.10453.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hepatoerythropoietic porphyria (HEP) is a rare form of porphyria that results from a deficiency of uroporphyrinogen decarboxylase (UROD). The disease is caused by homoallelism or heteroallelism for mutations in the UROD gene. OBJECTIVE To study a 19-year-old woman from Equatorial Guinea, one of the few cases of HEP of African descent and to characterize a new mutation causing HEP. METHODS Excretion of porphyrins and residual UROD activity in erythrocytes were measured and compared with those of other patients with HEP. The UROD gene of the proband was sequenced and a new mutation identified. The recombinant UROD protein was purified and assayed for enzymatic activity. The change of amino acid mapped to the UROD protein and the functional consequences were predicted. RESULTS The patient presented a novel homozygous G170D missense mutation. Porphyrin excretion showed an atypical pattern in stool with a high pentaporphyrin III to isocoproporphyrin ratio. Erythrocyte UROD activity was 42% of normal and higher than the activity found in patients with HEP with a G281E mutation. The recombinant UROD protein showed a relative activity of 17% and 60% of wild-type to uroporphyrinogen I and III respectively. Molecular modelling showed that glycine 170 is located on the dimer interface of UROD, in a loop containing residues 167-172 that are critical for optimal enzymatic activity and that the carboxyl side chain from aspartic acid is predicted to cause negative interactions between the protein and the substrate. CONCLUSIONS The results emphasize the complex relationship between the genetic defects and the biochemical phenotype in homozygous porphyria.
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Affiliation(s)
- J To-Figueras
- Biochemistry and Molecular Genetics Department, Hospital Clinic, School of Medicine, IDIBAPS, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain.
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Ramos Paesa C, Marcilla F, López G, Hueso E, Pascual A, Aguirre JM. [Valuation of APRI and Forns models for non-invasive diagnosis of fibrosis in patients with hepatitis C in coinfected and non-coinfected with HIV]. ACTA ACUST UNITED AC 2008; 24:369-74. [PMID: 18020875 DOI: 10.4321/s0212-71992007000800003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND APRI and Forns (IF) index are noninvasive models consisting of routine laboratory data for the prediction of liver fibrosis in patients with chronic hepatitis C. The aim of our study was to confirm the value of these models to predict significant fibrosis in these patients and if they may decrease the need for performing liver biopsy specimens in coinfected and HIVnon-coinfected. PATIENTS AND METHOD We included 60 patients with chronic hepatitis C and histologic data, 33 were coinfected with HIV. Mild fibrosis (F0-F1) was found in 73% patients, severe fibrosis (F3-F4) in 23% and cirrhosis in 18.3%. We calculated and compared APRI and IF with the stage of liver fibrosis. RESULTS The APRI score < 0.5 or > 1.5 and IF < 4.2 or > 6.9, as predictors of mild or severe fibrosis, were only available in 53% and 49%. Neither laboratory nor APRI and IF were associated with liver fibrosis in non-coinfected patients. We only found association in HIV coinfected patients: severe fibrosis (F3-4) whit higher gammaglobulins [24.5% vs. 30% (p < 0.05)] and Gamma-GT levels [77 (46.5) vs. 32 (48.5) (p < 0.05)], and lower prothrombin time [72% vs. 91% (p < 0.05) ] and platelets.109 count [129 (40) vs. 170 (78) (p < 0.05)]; APRI was lower than 0.5 in 41.6% patients with mild fibrosis (F0-1) against none with severe (F3-4) (p < 0.05); specifity (E) of APRI < 0.5 for predicting mild fibrosis was 100%, but sensivity (S) was very low (41%), with a positive preditive value (VPP) of 100%, but a negative predictive value (VPN) also very low ( 36.3%). CONCLUSIONS Our study showed that these models don t avoid the need for liver biopsies. More than a half of patients are not appropriately classified according to findings on liver biopsy and S and VPN are very low. The combination of these index with gammaglobulins, Gamma-GT, AST, ALT and platelet levels and protrombine time, only may be an approach to degree of fibrosis or inflammation liver in HIV co-infected patients.
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López M, Aguirre JM, Cuevas N, Anzola M, Videgain J, Aguirregaviria J, Castro A, de Pancorbo MM. Use of cytological specimens for p53 gene alteration detection in oral squamous cell carcinoma risk patients. Clin Oncol (R Coll Radiol) 2004; 16:366-70. [PMID: 15341441 DOI: 10.1016/j.clon.2004.03.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS Recurrence and multifocal nature are two important characteristics of oral squamous cell carcinoma. Leukoplakia is the most frequent pre-cancerous oral lesion and, in most cases, it is not possible to predict malignant capacity. The objective of this study is to identify p53 alterations in cells taken from the oral cavity of at-risk patients. MATERIALS AND METHODS The following samples were collected from 34 patients with oral leukoplakia with and without previous carcinoma: oral rinse, a brush swabbed over the lesions and hair roots. Mutational analysis of the p53 gene was performed by single-strand conformation polymorphisms and confirmed by DNA sequencing. RESULTS We detected 11 mutations in p53 gene in oral cytological specimens. These alterations were observed only in brush cytology samples in patients without previous carcinoma, and in both samples (rinse and brush) in patients with previous carcinoma. Three of these patients had disease recurrence. CONCLUSION This non-invasive technique may be useful in the follow-up of at-risk patients, and introduces new possibilities to analyse molecular markers before malignant lesions are clinically apparent.
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Affiliation(s)
- M López
- Buccal Medicine, Department of Stomatology, Faculty of Medicine and Odontology, University of the Basque Country EHU, Leioa, Spain
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Aguirre JM, Bagán JV, Rodriguez C, Jimenez Y, Martínez-Conde R, Díaz de Rojas F, Ponte A. Efficacy of mometasone furoate microemulsion in the treatment of erosive-ulcerative oral lichen planus: pilot study. J Oral Pathol Med 2004; 33:381-5. [PMID: 15250828 DOI: 10.1111/j.1600-0714.2004.00213.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a frequent immunological chronic disease, having different clinical forms: asymptomatic and symptomatic. Symptomatic OLP has been palliated with topical corticosteroids with different levels of efficacy and safety. The purpose of this pilot phase II clinical trial was to determine the efficacy of mometasone furoate microemulsion upon the symptoms and signs of erosive-ulcerative OLP. METHODS Forty-nine patients with clinical and histologically confirmed erosive-ulcerative OLP were enrolled in this study (36 women and 13 men). Their average age was 56.4 years (from 28 to 78). The treatment consisted of 0.1% mometasone furoate microemulsion mouthwash three times a day over 30 days. Pain, erythema and ulceration were assessed after 15 and 30 days of treatment. The data was processed and statistically analysed by student's t-test for paired samples. RESULTS Mometasone caused a statistically significant reduction in pain (3.58 vs. 0.65, P = 0.0000). Treatment significantly reduced the surface area of erythema (155.2 vs. 21.9 mm(2), P = 0.0001) and ulceration (30.7 vs. 7.3 mm(2), P = 0.0000). None of these patients suffered severe adverse effects. CONCLUSIONS Mometasone furoate microemulsion is a safe and effective therapy in the treatment of symptomatic erosive-ulcerative OLP.
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Affiliation(s)
- J M Aguirre
- Medicina y Patología Bucal, Medicina Preventiva y Salud Pública, Facultad de Medicina y Odontología, Universidad del País Vasco/EHU, Spain.
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Eguia A, Aguirre JM, Echevarria MA, Martinez-Conde R, Pontón J. Gingivostomatitis after eating fish parasitized by Anisakis simplex: a case report. ACTA ACUST UNITED AC 2003; 96:437-40. [PMID: 14561968 DOI: 10.1016/s1079-2104(03)00264-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Anisakis simplex (AS) is a nematode that may be encountered as a parasite in various kinds of seafood. Human beings may accidentally acquire AS larvae by eating raw or undercooked seafood. In addition to human parasitization (anisakiasis), this nematode can induce allergic reactions. AS-related diseases are frequent, especially in those countries with a high level of fish consumption and with traditions of eating raw or undercooked seafood. To our knowledge, this is the first report of gingivostomatitis secondary to the ingestion of fish with AS parasites.
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Affiliation(s)
- A Eguia
- Departamento de Estomatología, Universidad del País Vasco/EHU, Leioa, Vizcaya, Spain
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López M, Aguirre JM, Cuevas N, Anzola M, Videgain J, Aguirregaviria J, Martínez de Pancorbo M. Gene promoter hypermethylation in oral rinses of leukoplakia patients—a diagnostic and/or prognostic tool? Eur J Cancer 2003; 39:2306-9. [PMID: 14556921 DOI: 10.1016/s0959-8049(03)00550-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Leukoplakia is the most frequent oral precancerous lesion and shows a variable rate of malignant transformation. We hypothesised that the detection of molecular alterations, like the promoter hypermethylation of DNA, in oral cytological samples from patients at risk of developing primary or recurrent tumours could be a valuable diagnostic and prognostic tool in the management of these lesions. Two groups of patients with differing risks of developing oral squamous cell carcinoma (OSCC) were analysed. DNA was extracted from the oral rinse of each patient. The methylation status of the p16, p14 and MGMT gene promoters was determined using a methylation-specific polymerase chain reaction (MSP). Methylation of p16 and MGMT was observed in 44 and 56% of the oral samples, respectively. Only 12% of the cases showed p14 methylation. DNA hypermethylation was more frequent in patients with previous OSCC. DNA promoter hypermethylation is frequent during early oral carcinogenesis and even more so in the later stages. MSP using oral rinses is a non-invasive and highly sensitive technique which could be used to monitor patients with precancerous and cancerous oral lesions.
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Affiliation(s)
- M López
- Department of Zoology and Cellular Biology, Faculty of Pharmacy, University of the Basque Country/EHU, 48940, Vitoria-Gasteiz, Spain
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Lopez-Martinez M, Anzola M, Cuevas N, Aguirre JM, De-Pancorbo M. Clinical applications of the diagnosis of p53 alterations in squamous cell carcinoma of the head and neck. Med Oral 2002; 7:108-20. [PMID: 11887018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Alteration of the p53 tumor suppressor gene implies an extremely high risk of developing malignancy, and mutation of the gene is one of the most frequent genetic changes found in human cancer. Squamous cell carcinoma of the head and neck (SCCHN) shows a high incidence of p53 tumor suppressor gene alterations; the latter therefore appears to play an important role in the pathogenesis and progression of such neoplasms. The loss of p53 protein activity may be due to many p53 gene mutations or to the action of certain viruses that infect the oral cavity. Local recurrence is the most common cause of mortality after SCCHN surgery; in this sense, p53 gene mutations have been observed in tissue adjacent to the tumor, and constitute a good prognostic marker of tumor recurrence. The analysis of p53 tumor suppressor gene alterations in SCCHN affords important information on the diagnosis, prognosis and treatment of affected patients - such alterations representing an indicator in high risk patients of the convenience of applying more aggressive adjuvant therapies.
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Affiliation(s)
- M Lopez-Martinez
- Departamento de Z y Dinamica celular Facultad de Farmacia Universidad de Pais Vasco Paseo de la Universidad 7 01006 Vitoria, GASTEIZ.
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Abstract
Oral and pharyngeal cancer is an entity constituted by a group of tumours that arise in several heterogeneous anatomical sites, and for this reason it is difficult to establish comparisons. The aim of the study was to describe the characteristics of oropharyngeal cancer in the Basque Autonomous Community (BAC), to learn the incidence rate and to establish comparisons. Data of cases are from the Basque Country Cancer Registry for the period 1986-1994, and the methodology used is descriptive. We included 2548 cases, and the sex ratio was 7.4:1. Diagnosis was made by histology in most cases (99%). The crude incidence rate was 24.1/100,000 population for men and 3.1/100,000 for women. Higher incidence rates were found in the tongue (6.6), lip (5.8) and oropharynx (4.9). No variation was found in the incidence during the period. In comparison with other Spanish registries, there is a high incidence in men of cancer in the oral cavity. The results obtained show the characteristics of oral and pharyngeal cancer in the BAC and its magnitude, highlighting the importance of future preventive actions.
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Affiliation(s)
- M I Izarzugaza
- Departamento de Sanidad del Gobierno Vasco, Scio de Registros e Información Sanitaria, C/Donostia-San Sebastian 1, 01010 Vitoria-Gasteiz, Basque Country, Spain.
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Martínez-Conde R, Aguirre JM, Burgos JJ, Rivera JM. Clinicopathological factors in early squamous cell carcinoma of the tongue and floor of the mouth, in Biscay (the Basque Country, Spain). Med Oral 2001; 6:87-94. [PMID: 11500624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
OBJECTIVES A study is made of the main clinicopathological factors in squamous cell carcinoma (SCC) of the tongue and floor of the mouth in the province of Vizcaya (Biscay) (The Basque Country, Spain), and their relation to patient prognosis. DESIGN A retrospective study was made of 40 patients with early (clinical stage I/II) SCC of the tongue and floor of the mouth. A previously designed protocol was used to record the clinical and histopathological data, which were subjected to descriptive and comparative bi- and multivariate statistical and survival analyses. RESULTS There were 34 males and 6 females, with a mean age of 55.7 years (range 33-81). In 23 cases the SCC was located in the tongue, and in 17 cases in the floor of the mouth. The average tumor diameter was 2.6 cm; 65% of the neoplasms were ulcerated. The mean clinical course was 3.4 months, with an average tumor growth rate or velocity of 268 (Evans formula). Thirty-four patients were smokers and 33 consumed alcohol. All SCC of the floor of the mouth, and all regional recurrences, were diagnosed in smokers and drinkers. Survival at 5 years was 65%. Well differentiated SCC were diagnosed in 52.5% of cases. The average histological malignancy grade was 1.96, and was higher in males, tongue malignancies, T2 lesions, tumors with growth velocities above 200, and in recurrent neoplasms. CONCLUSIONS Early SCC of the tongue and floor of the mouth in Vizcaya affects mainly male smokers and drinkers of alcohol under the age of 60 years. A relationship is observed between the histopathological findings (particularly invasion mode and stage) and patient prognosis.
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Affiliation(s)
- R Martínez-Conde
- Departamento de Estomatología Universidad del País Vasco E.H.U. Leioa 48940 Vizcaya
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14
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Aguirre JM, Martinez-Conde R, Tánago JG, Rivera JM. Cystic lymphoid hyperplasia in the parotid gland in HIV infection: report of 2 cases. J Oral Maxillofac Surg 2000; 58:1176-80. [PMID: 11021718 DOI: 10.1053/joms.2000.9585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J M Aguirre
- Department of Stomatology, Hospital of Cruces, Osakidetza, University of the Basque Country EHU, Spain.
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15
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Carreño MC, Toledo MA, Aguirre JM, Aranda MT, Fischer J. Enantioselective Generation of Benzylic Stereocenters Mediated by a Remote Sulfoxide This work was supported by the Dirección General de Investigación Científica y Técnica (Grants PB98-0062 to M.C.C. and PB98-0078 to J.L.G.R.). Angew Chem Int Ed Engl 2000; 39:2736-2737. [PMID: 10934410 DOI: 10.1002/1521-3773(20000804)39:15<2736::aid-anie2736>3.0.co;2-m] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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16
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Affiliation(s)
- R Carlos
- Servicio de Diagnóstico Clínico y Patológico, Facultad de Medicina, Universidad Francisco Marroquin, Guatemala C.A
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17
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Abstract
Four cases of the lesion first described as superficial mucocele by Eveson in 1988 are reported. All of the lesions developed in adult women; two of the women had concurrent oral lichen planus. The mucoceles were found on the soft palate, the buccal mucosa, and the upper and lower labial mucosa. The etiologic factors and pathogenesis of this lesion are discussed.
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Affiliation(s)
- A Bermejo
- Universidad de Murcia, Medicina Bucal, Spain
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18
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Aguirre JM, Echebarria MA, Ocina E, Ribacoba L, Montejo M. Reduction of HIV-associated oral lesions after highly active antiretroviral therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88:114-5. [PMID: 10468448 DOI: 10.1016/s1079-2104(99)70124-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Jiménez-Sáenz JM, Aguirre JM, Velilla J, Lezcano MA, Alvarez R, Zubiri ML. [Cutaneous nodules and arm paresthesia]. Enferm Infecc Microbiol Clin 1998; 16:199-200. [PMID: 9646566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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20
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Aguirre JM, Echebarría MA, Martínez-Conde R, Rodriguez C, Burgos JJ, Rivera JM. Warthin tumor. A new hypothesis concerning its development. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85:60-3. [PMID: 9474616 DOI: 10.1016/s1079-2104(98)90399-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Warthin tumor is the second most common benign parenchymal salivary neoplasm. The purpose of this study was to evaluate the histopathologic features of Warthin tumor to determine whether a developmental pattern could be identified. STUDY DESIGN Seventy-nine Warthin tumors in 63 patients (62 male and 1 female; average age, 58.62 years) were examined. All cases were histopathologically classified and morphometrically analyzed with an Optomax system to measure the proportions of lymphoid tissue and cystic cavities. RESULTS The predominantly epithelial type (21% of all cases) of Warthin tumor was associated with a mean patient age at diagnosis of 53 years, a mean evolution time of 2.8 months, an average size of 1 cm, and a mean lymphoid component of 10%. In the case of the classical type (61% of all cases), the mean patient age at diagnosis was 58 years, the mean evolution time 9 months, the average size 2.4 cm, and the mean lymphoid component 40%. For the predominantly lymphoid type (18% of all cases), these values were, respectively, 62 years, 11 months, 2.8 cm, and 74%. The mean size of the classical and lymphoid tumors (79% of the Warthin tumors) was significantly greater (p < 0.0001) than the mean size of the epithelial type (21% of the Warthin tumors). A positive correlation between tumor size and evolution time was found. CONCLUSION Our results suggest that the Warthin tumor initially develops as an adenomatous epithelial proliferation followed by lymphocytic infiltration.
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Affiliation(s)
- J M Aguirre
- Department of Stomatology, Hospital de Cruces, Vizcaya, Spain
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21
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Abstract
OBJECTIVE The incidence and distribution of enamel defects among patients with celiac disease were examined. STUDY DESIGN The oral cavity was explored in 137 patients with celiac disease (mean age 16.2 years; age range 5 to 68 years) and in 52 control patients (mean age 19.8 years; age range 5 to 64 years). Permanent dentition enamel defects were recorded, along with their number and locations. The decayed, missing, and filled teeth index rates were also established, and an investigation was made of the human leukocyte antigens among the patients with celiac disease. The results obtained were analyzed with the chi-squared test, statistical significance being regarded for p < or = 0.05. RESULTS Enamel defects were observed in 72 (52.5%) of the patients with celiac disease (52 patients had systematic defects) and in 22 (42.3%) of the control patients (9 patients had systematic defects). Systematic defects were significantly more common in the celiac disease group. In the patients with celiac disease, 72.2% were symmetrical, compared with 40.9% of the defects in the control patients. The incisors were the most frequently affected teeth, the extent of involvement being significantly greater in the celiac disease group. In patients with celiac disease, DR7, DR3, and DQ2 were the most commonly observed human leukocyte antigens. The mean decayed, missing, and filled teeth index rates were 4.8 and 6.2 in the celiac disease group and the control group, respectively. CONCLUSIONS Enamel defects are common among patients with celiac disease. They tend to be bilateral and symmetrical, and they are chronologically distributed. The lesions affect mainly the incisors and the molars. Patients with such characteristics should be evaluated for possible celiac disease.
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Affiliation(s)
- J M Aguirre
- Departamento de Estomatología, Universidad del País Vasco/E.H.U., Bilbao, Vizcaya, Spain
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22
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Zalba B, Lausín S, Rojo A, Arazo P, Fernández A, Aguirre JM. [An epidemiological and social study of 127 patients with AIDS IN Aragon]. Aten Primaria 1997; 19:159-64. [PMID: 9264634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To evaluate the profile epidemiology and social of the patient with AIDS in our environment and the direct relation with primary care. DESIGN A descriptive, analytic and retrospective study. SETTING The study was carried out in the Miguel Servet Hospital in Zaragoza. PARTICIPANTS Patients with AIDS between January 1991 and june 1993 and who fulfilled the requisite diagnostic criteria. MEASUREMENTS AND MAIN RESULTS Out of the 127 patients studied, 74.8% were male and the age was 20 to 30 years old. The transmission mechanism was blood way in drug addicts in 63.8% and heterosexual way in 14.8%. It was socioeconomic problems in 40.94%, and 69.23% of them were drug addicts. The familiar support were proved in 29.13% and had relation with primary care only 15.74%. CONCLUSIONS An increase of the incidence of AIDS is observed, prevailing men between 31-40 years old. The heterosexual way transmission is increasing, but the blood way in drug addicts is more frequently. The majority presents socioeconomic problems and they haven't familiar support.
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Affiliation(s)
- B Zalba
- Servicio de Enfarmedades infecciosas, Hospital Miguel Servet, Zaragoza
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23
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Delgado W, Aguirre JM. [Oral mycoses in the AIDS era]. Rev Iberoam Micol 1997; 14:14-22. [PMID: 15482019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
The present advancement and generalization of oral mycosis is probably due to different factors associated to the progress and development of the countries and the presence of medically compromised patients and immunosupressor therapies. From all these mycoses, oral candidosis is the commonest, but histoplasmosis and paracoccidioidomycosis are also important. The main clinicopathologic and therapeutic features of those oral diseases are reviewed in this paper.
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Affiliation(s)
- W Delgado
- Facultad de Estomatología, Universidad Peruana Cayetano Heredia, Lima, Perú
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24
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Abstract
The cytological patterns associated with the atrophic and hyperplastic forms of denture stomatitis (DS) were studied in 94 patients with DS and 33 controls. Forty percent of patients with DS and 30% of patients in the control group had a positive culture for Candida. When compared to the smears from the control group patients, the smears from patients with DS presented a higher amount of: i) cytological cellular material; ii) fungal cells; iii) cells of the intermediate and parabasal types; iv) cells of the intermediate type with a positive culture for Candida; and v) polymorphonuclear leukocytes, preferentially in association with a positive culture for Candida. Conversely, smears from the control group showed a higher percentage of cells of the superficial type than those of the patients with DS. Although no specific changes in the DS-affected mucosa have been observed by cytology, we consider that this is a useful, easy and inexpensive technique that gives important information about the inflamed mucosa it can be used in the treatment and control of these patients.
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Affiliation(s)
- J M Aguirre
- Departamento de Estomatologiá, Facultad de Medicina y Odontología, Universidad del País Vasco, Bilbao, Vizcaya, Spain
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25
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Lipperheide V, Quindós G, Jiménez Y, Pontón J, Bagán-Sebastián JV, Aguirre JM. Candida biotypes in patients with oral leukoplakia and lichen planus. Candida biotypes in leukoplakia and lichen planus. Mycopathologia 1996; 134:75-82. [PMID: 8981773 DOI: 10.1007/bf00436868] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Prevalence of yeasts in 35 leukoplakia and 34 oral lichen planus patients was compared with that observed in persons without oral diseases. Serotype and morphotype were determined on Candida albicans isolates. Yeasts were isolated from the oral cavity specimens of 43.7% of the patients. C. albicans (serotype A) was the predominant species (76% in leukoplakia, 88.2% in lichen planus and 60.8% in healthy persons). Sixteen morphotypes were encountered on malt extract agar, being 732, 733, 734, 753 and 754 the most frequently found. Morphotypes SP1N and SP1Y were the most common on Sabouraud-trypheniltetrazolium agar (68.4% of the isolates from leukoplakia and 73.3% from lichen planus, but only 46.6% of the isolates from healthy oral mucosa showed SP1N morphotype). Presence of oral lesions was associated with a marked reduction in the yeast species and C. albicans biotypes, suggesting that C. albicans and particularly some of its biotypes, show a high potential of adaptation to the changes associated with the development of oral leukoplakia and lichen planus.
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Affiliation(s)
- V Lipperheide
- Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Odontología, Universidad del País Vasco (UPV-EHU), Bilbao, Spain
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26
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Salcedo A, Echevarría P, Molinero E, Sagastagoitia D, Aguirre JM, Iriarte MM, Laka Mugarza JP. [Risk factors in stable coronary disease. Relationship with ischemic threshold and prognostic implications]. Med Clin (Barc) 1996; 106:372-7. [PMID: 8637276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND To assess the clinical evolution, in a 5-year follow-up, of the development of acute coronary syndromes, in patients with angina clinically stable, establishing its relationship with the ischemic threshold (IT) and the main modifiable cardiovascular risk factors. PATIENTS AND METHODS 120 patients, 86 males (71%), with an age of 57 +/- 8 years, with stable angina. The presence of smoking, hypercholesterolemia, hypertension and diabetes mellitus was evaluated. We performed exercise testings (baseline and after vasodilator drugs) in the beginning, in order to characterize the IT (which was fixed in 72 patients and variable in 48). The later group underwent exercise testing each term during the first year of follow-up. Lesion at least of 70% in a main coronary vessel was required as inclusion criteria. The development of acute myocardial infarction (AMI), unstable angina pectoris and cardiac death was recorded. Cox's hazard function analysis and multivariant analysis were applied. RESULTS 106 patients (88%) had one or more risk factors (40% hypertension, 43% hypercholesterolemia, 22% diabetes mellitus and 56% were smokers or ex-smokers). A significant association was shown between male gender and smoking and diabetes mellitus and female gender. 6 cardiac deaths, 8 AMI and 9 unstable angina were recorded. Within the 72 patients with fixed IT, 12.5% (9) suffered some acute syndrome. In the 48 with variable IT, in the 30 who continued in it, 20% (6) developed acute coronary pathology and in the 18 who modified their IT to fixed, the prevalence was 44.5% (8). Patients with modification of IT to fixed had a higher risk of acute coronary syndrome in the follow-up (p < 0.01) and the presence of hypertension and hypercholesterolemia allowed the prediction of modification of the IT. CONCLUSIONS The prevalence of cardiovascular risk factors in the stable coronary artery disease is high (88%); male gender is associated smoking and female gender to diabetes mellitus. The presence of hypertension and hypercholesterolemia are associated to modification in the IT in patients with variable threshold, allowing the detection of a subgroup of high risk for the development of acute coronary pathology.
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Affiliation(s)
- A Salcedo
- Sección de Cardiología Hospital de Galdakao, Vizcaya
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27
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Affiliation(s)
- R Martinez-Conde
- Department of Stomatology, University of the Basque Country E.H.U., Vizcaya, Spain
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28
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Fernández Revuelta A, Arazo Garcés P, Aguirre JM, Zalba Etayo B, Lausin Marín S. [An epidemiological study of pulmonary tuberculosis in inpatients]. Aten Primaria 1995; 15:297-304. [PMID: 7734687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To evaluate the profile of the patient admitted to hospital with pulmonary tuberculosis and the clinical-radiological signs and symptoms of the illness. DESIGN A descriptive, retrospective study. SETTING The study was carried out in the Miguel Servet Hospital in Zaragoza. PATIENTS AND OTHER PARTICIPANTS Patients over 14 who were admitted for pulmonary tuberculosis between 1985 and june 1990 and who fulfilled the requisite diagnostic criteria. MEASUREMENTS AND MAIN RESULTS Out of the 423 patients studied, 75.17% were male. Average age of the whole sample was 45.9. 31% were retired. 55% (232 cases) had factors predisposing to tuberculosis. The 12% were infected by HIV (human immunodeficiency virus). The most common presentation symptoms were coughing and the radiological semeiology of condensation. In 22.7% there was extrapulmonary tubercular infection, most commonly in ganglia. Delay in diagnosis was over three months in 19.8% of the cases. CONCLUSIONS Tuberculosis is a common illness in our ambit and particularly affects those patients with underlying pathology. Given that there are still important delays in diagnosis, doctors need to be highly aware of the possibility.
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29
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Ara JR, Cía P, Arribas JL, Aguirre JM, de Juan F, Marco Tello A. [Clinico-epidemiologic study of bacterial meningitis in Aragon]. Med Clin (Barc) 1994; 103:611-4. [PMID: 7996917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The aim of the present study was to know the incidence, etiology, prognostic factors and rate of mortality of bacterial meningitis in Aragón (Spain). METHODS The clinical records of all the patients with bacterial meningitis seen in the hospitals in Aragón (Spain), from 1985 to 1988 inclusive were reviewed. RESULTS The mean of the annual rates of incidence for Aragón (Spain) was 7.52/100,000 inhabitants. In patients under the age of 15 years the most frequent etiologies were Neisseria meningitidis (59.0%), Haemophilus influenzae (13.7%) and Streptococcus pneumoniae (9.4%); the global rate of mortality was 3.5% similar to that of sequelae. In those over the age of 14 years, the most frequent etiologies were N. meningitidis (33%), S. pneumoniae (18.4%) and Staphylococcus spp. (13.6%); the rate of global mortality was 19.5% and that of sequelae 10.8% with resistance of S. pneumoniae to penicillin and/or ampicillin in 45.5% of the cases in children and in 26.3% in adults. No significant evolutive differences related with the existence of resistances or the administration of antibiotics prior to lumbar punction were observed in any of the age groups. CONCLUSIONS N. meningitidis is the main etiologic agent in Aragón in both children and adults. The greatest rates of mortality and sequelae were observed in the youngest and oldest age groups with a similar relation being seen in infection by gramnegative bacilli and S. pneumoniae, thus making these patients to be considered as being at high risk.
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Affiliation(s)
- J R Ara
- Servicios de Neurología, Hospital Miguel Servet, Zaragoza
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30
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Bagán JV, Aguirre JM, del Olmo JA, Milián A, Peñarrocha M, Rodrigo JM, Cardona F. Oral lichen planus and chronic liver disease: a clinical and morphometric study of the oral lesions in relation to transaminase elevation. Oral Surg Oral Med Oral Pathol 1994; 78:337-42. [PMID: 7970595 DOI: 10.1016/0030-4220(94)90065-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Serum transaminase levels (serum glutamic-oxaloacetic transaminase or serum glutamic-pyruvic transaminase) were found to be altered in 40 (21.39%) of 187 patients with oral lichen planus. The patients with oral lichen planus who had altered transaminase levels were on average older than those without liver disorders and exhibited a higher percentage of erosive lesions (p < 0.05) and tongue involvement. Histologically, no statistically significant differences were noted in the extension of inflammatory infiltration or in connective tissue density; nevertheless, the latter was greater in patients without altered transaminase levels. Finally, among those patients with altered liver test results and erosive lichen planus, serum glutamic-oxaloacetic transaminase and serum glutamic-pyruvic transaminase levels were found to be higher than levels in those patients without erosions. This indicates that behavior of the oral lesions is more aggressive as the degree of liver alteration increases. We emphasize that of the 40 patients with altered transaminase levels (all later proved to reflect chronic hepatitis through complementary diagnostic methods), 28 had hepatitis C virus infection.
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Affiliation(s)
- J V Bagán
- University General Hospital, Valencia University, Spain
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31
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Escobedo JA, Gil D, Pascual A, Aguirre JM. [Cutaneous infection caused by Mycobacterium chelonae after self-injection of insulin using a jet injector]. Enferm Infecc Microbiol Clin 1994; 12:274-5. [PMID: 8049299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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32
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Martínez RM, Figueras MP, Ramos C, Sanjuán F, Aguirre JM. [Campylobacter jejuni and HIV infection]. Enferm Infecc Microbiol Clin 1994; 12:90-4. [PMID: 7912110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the characteristics of the Campylobacter jejuni infection in HIV positive patients. DESIGN We report all cases appeared in our hospital between September 1991 and October 1992 with: HIV infection, chronic diarrhoea and C. jejuni in stool culture. Epidemiologic factors, other opportunist infections, immunologic situation, clinical symptomatology, antibiotic sensitivity and evolution are recorded. RESULTS Six patients, 4 men and 2 women, with an average age of 38 years were recorded. They have different risk factors (drug abusers, sexual behaviour and haemophilia). Chronic liver disease and other opportunist infections of the gastrointestinal tract were the most important facts in past history. CD4 count were directly related with the severity of the illness. Quantitative or qualitative disorders of B lymphocytes or immunoglobulins were not found. All of term suffered from chronic diarrhoea with fever in four of them and bacteremia in 2 patients. First generation cephalosporins resistance in one occasion. A good evolution occurred in 3 patients, another had a relapse and bacteremia appeared in 2 patients whose CD4 count were lower of 100/mm3, have AST, ALT changes and other concomitant gastrointestinal infections. CONCLUSION C. jejuni infection of the gastrointestinal tract results in chronic diarrhoea with a higher incidence than expected in HIV positive patients. The severity is directly related with CD4 count, and the existence of concomitants infections of the gastrointestinal tract or chronic liver disease. Antibiotic resistance to macrolide is possible, especially in chronic and severe forms.
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Affiliation(s)
- R M Martínez
- Servicio de Medicina Interna, Hospital Miguel Servet, Zaragoza
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Abstract
The diastereoisomeric 2-benzyl-1,2-diphenylindan-1-ols were prepared and subjected to deoxygenation reactions under a variety of conditions to obtain 2-benzyl-1,2-diphenylindan. The stereochemistry of these compounds has been characterized on the basis of chemical and spectroscopic evidence.
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Aguirre JM, Rodriguez E, Ruiz de Azua E, Urrengoetxea J, Faus JM, Caso R, Iriarte M. Segmentary coronary reserve in hypertensive patients with echocardiographic left ventricular hypertrophy, gamma-graphic ischaemia and normal coronary angiography. Eur Heart J 1993; 14 Suppl J:25-31. [PMID: 8281959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Stress thallium scintigraphies are frequently positive in patients with systemic hypertension (SHT), especially in the presence of left ventricular hypertrophy (LVH). In order to determine whether positive thallium perfusion scans in patients with LVH secondary to SHT and normal coronary angiographies are due to segmentary reduction of coronary reserve (CR), we have studied 10 out of 60 consecutive cases of SHT with echocardiographic LVH, using intracoronary Doppler. We compared coronary blood flow velocity at rest and post-papaverine (PP), and CR in at least two major coronary vessels, always including the one corresponding to the ischaemic segment. In the vessel with the least CR at rest, a new determination of CR was made under intracoronary nitroglycerin. A group of five normal patients acted as controls. The mean CR of the controls and patients, respectively, was 6.2 +/- 1.4 vs 2.7 +/- 0.9 (P < 0.001). In patients with positive thallium perfusion scans, the coronary arteries corresponding to the ischaemic segments had less CR (2.5 +/- 0.6) than arteries from non-ischaemic segments (3.4 +/- 1, P < 0.05). These differences were greater when the ischaemia was anterior. There was no correlation either between CR and left ventricular mass (r = 0.23) or rest coronary blood flow velocity (r = 0.07). Only one patient exhibited functional behaviour indicating reduced CR; this rose from 1.9 to 7.5 after nitroglycerin 300 micrograms. In conclusion, CR determined by intracoronary Doppler and papaverine shows segmentary differences both in normal patients and in patients with LVH and normal coronary angiograms. This could be the cause of segmental ischaemia detected by means of radionuclide stress tests.
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Affiliation(s)
- J M Aguirre
- Division of Hemodynamics, Hospital Civil de Basurto, Bilbao (Bizkaia), Spain
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35
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Gutiérrez AI, Martín I, Ramos C, Aguirre JM, Arazo P. [Ulcerative colitis and HIV infection]. Enferm Infecc Microbiol Clin 1993; 11:210-3. [PMID: 8099812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
UNLABELLED FUNDAMENTAL: The difficulties to raise to a correct diagnosis in patients with human immunodeficiency virus infection and diarrhea, and the few cases reported of ulcerative colitis in the context of HIV infection. OBJECTIVE Description of 2 cases of ulcerative colitis in patients with HIV infection and the possibility of immunopathogenic relationship between them. MATERIAL AND METHODS The clinic history of the patients, the anatomopathological diagnosis after the colon biopsy and the determination of CD4 cells. RESULTS In case 1 the low level of CD4 cells didn't stop the aggressivity of ulcerative colitis. However, in both cases there was a good evolution of colitis after treatment although AIDS. CONCLUSION It is necessary to study more cases of inflammatory bowel disease in patients with HIV infection to determine the influence of the level of CD4 cells in the enteropathy's evolution.
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Affiliation(s)
- A I Gutiérrez
- Unidad de Infecciosos, Hospital Miguel Servet, Zaragoza
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36
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Gutiérrez A, Martín I, Ferrer E, Torrón C, Aguirre JM. [Treatment with intravitreous ganciclovir in cytomegalovirus retinitis associated with AIDS]. Enferm Infecc Microbiol Clin 1992; 10:629-30. [PMID: 1337981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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37
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Martín I, Ramos C, Gutiérrez A, Arazo P, Aguirre JM. [HIV infection and chronic brucellosis]. Enferm Infecc Microbiol Clin 1992; 10:566-7. [PMID: 1489809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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38
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Ramos C, Arazo P, Aguirre JM, Alvarez G, Aísa ML, Gonzalo C, Ferreria V. [Sclerosing cholangitis and AIDS]. Rev Clin Esp 1992; 190:79-81. [PMID: 1561443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Bile tract pathology in AIDS has been described as an incomplete biliary obstructive syndrome and acalculous cholecystitis. Most reported cases have been associated to bile ducts infection by Cytomegalovirus (CMV) and/or Cryptosporidium. We present a case of sclerosing cholangitis and acalculous cholecystitis in an AIDS patient in whom Cryptosporidium was identified in the cholecystectomy sample and this same agent together with Candida Albicans in bile. We highlight the need to suspect this pathology in HIV infected patients who present a bile obstruction picture and/or cholecystitis, the possible etiological role of Candida Albicans, which has not been previously described, as well as the increasing association of bile pathology and AIDS.
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Affiliation(s)
- C Ramos
- Unidad de Enfermedades Infecciosas, Hospital Miguel Servet, Zaragoza
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39
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Abstract
Although there are four possible racemates of the 1-ethyl-2-methyl-3-arylindans ( α, β, γ and δ, only three ( α, β and γ) have been synthesized or obtained from propenylbenzenes with acid reagents. Now we present a synthetic route for the preparation of the δ racemates (r-1-ethyl-t-2-methyl-t-3-arylindans), and 13C n.m.r. chemical shifts for the four racemates .
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40
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Povar J, Aguirre JM, Arazo P, Franco JM, Alvarez G, Ara JR, Lomba E. [Brucellosis with nervous system involvement]. An Med Interna 1991; 8:387-90. [PMID: 1768748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cases of brucellosis with involvement of the nervous system which was diagnosed in the Miguel Servet Hospital during the period 1985-1987 are retrospectively studied. The total quantity of affected patients of brucellosis was 132. Of this quantity, 9 patients (6.8%) had neurological complications under the following clinical forms: epidural abscess (2), meningoencephalitis (1), meningitis (2), encephalitis (1), myelitis (1) and polyradiculitis (2). The most important epidemiological and clinical characteristics are analysed, pointing out the diagnostic difficulties we found when the neurological manifestations are predominant in the brucella infection.
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Affiliation(s)
- J Povar
- Unidad de Enfermedades Infecciosas, Hospital Miguel Servet, Zaragoza
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41
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Salcedo A, Molinero E, Echevarría MP, Aguirre JM, Arzubiaga J, Iriarte MM. [Prognostic significance of the electrocardiographic coronary reserve in stable angina]. Rev Esp Cardiol 1991; 44:99-105. [PMID: 2068364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We've studied the prognostic significance of the electrocardiographic coronary reserve, evaluated by seried effort tests, in patients with stable angina and proved coronary disease. Seventy-three patients with stable angina, who performed 2 exercise tests (basal and after vasodilator therapy) were included. It's considered variable reserve when in the second test the ST-descent improves greater than or equal to 1 mm for equal or higher double product (43 patients) and fixed reserve when it doesn't (30 patients). All of them underwent to coronariography study. The exercise test was seried each term during the first year. Clinical follow-up lasted 3 years and we considered cardiac events: myocardial infarction, unstable angina, surgery, PTCA or death. Patients with fixed reserve had higher maximal ST-descent (2.5 +/- 0.7 vs 1.9 +/- 0.6; p less than 0.05), lesser effort-time (359 +/- 144 vs 430 +/- 112; p less than 0.05), and more severe coronary disease (score: 3.5 +/- 1.5 vs 2.4 +/- 0.8; p less than 0.01) as compared with variable reserve group. Unfavorable clinic evolution was similar in both groups (44.3% in the fixed reserve group and 34.8% in the variable reserve group). We verified that 92.3% of patients with variable reserve who didn't modify its character in a year had good evolution; 76.4% of patients who changed to fixed reserve had unfavorable evolution (significant association, p less than 0.01). We conclude that in patients with variable reserve, the periodic evaluation of the reserve character has important prognostic implication.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Salcedo
- Sección de Cardiología, Hospital de Galdakao
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42
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Ara JR, Pina MA, Aguirre JM, Arazo P. [Neurological complications due to cryoagglutinins in psittacosis]. Rev Clin Esp 1990; 187:376-7. [PMID: 2091128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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43
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Ramos C, Arazo P, García Aranda A, Franco JM, Samperiz P, Aguirre JM, Muñoz JR. [Ungual pigmentation in patients with AIDS treated with zidovudine]. Rev Clin Esp 1990; 187:94. [PMID: 2152548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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44
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Arazo P, Muñoz JR, Aguirre JM, Mur M, Pascual A, García Aranda A, Rubin de Celis C. [Spleen abscess]. An Med Interna 1990; 7:144-6. [PMID: 2103770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
3 cases of splenic abscess (SA), all of them with similar clinical findings; abdominal pain, liver and splenic enlargement and leukocytosis, are presented. The diagnosis was suspected by abdominal ultrasound and confirmed by CTR. We focused the interest on the etiopathogenesis, diagnosis and the rareness of the bacteria isolated: Salmonella group D (two cases) and Bacteroides Fragilis.
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Affiliation(s)
- P Arazo
- Departamento de Medicina Interna, Hospital Miguel Servet, Zaragoza
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45
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Arribas JL, Navarro JF, Hernández MJ, Muniesa MP, Sarasa J, García JR, Arazo P, Sarría J, Aguirre JM. [Brucellosis at a tertiary hospital. Retrospective epidemiologic study of 166 cases]. Enferm Infecc Microbiol Clin 1989; 7:126-30. [PMID: 2490679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The epidemiologic polls concerning 166 cases of brucellosis are retrospectively analyzed; the cases are registered by the Preventive Medicine Service of Miguel Servet Hospital for five years (1980-1985). Most of our cases are of recent evolution, although 55% began to give symptoms more of 2 weeks ago and 30% more of 1 month ago. A clear annual increase of the number of cases, fundamentally of the male sex and patients coming from the rural areas, is observed. The percentage of cases in men (73.5%) is almost three times as those in women (26.5%), and the most numerous groups are the 20-29 interval age group and olders above 60. There is a small percentage of people with a professional risk factor (30.1%), which rise, slightly, for the ones who told of contact with cattle (39.2%) and rose up to 53.6% for the ones who consumed non controlled dairy products. However, in 23% of men and 40.9% of women the existence of some risk factors was unknown.
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46
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Soriano E, Gatell JM, Aguado JM, Aguirre JM, Arazo P, Arribas JL, Barros C, Cartón JA, Gurgui M, Jiménez E. Ceftriaxone monotherapy for severe bacteremic infections. Spanish Ceftriaxone Study Group. Chemotherapy 1989; 35 Suppl 2:27-32. [PMID: 2612237 DOI: 10.1159/000238736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We tested the efficacy of a single daily dose of ceftriaxone (active ingredient of Rocephin) for the treatment of severe bacteremic infections in 125 non-neutropenic adult patients. A single daily dose of ceftriaxone ranging from 1 to 4 g was given. Surgical procedures were performed if needed. Seventy-six (60.8%) were males and bacteremia was nosocomially acquired in 45 (36%). Microbiologically proven bacteremia was demonstrated in all patients. The most common microorganisms isolated were Escherichia coli (46 episodes), Streptococcus pneumoniae (17 episodes), Klebsiella pneumoniae, and Haemophilus influenzae, Serratia marcescens, Salmonella sp., and Staphylococcus aureus (9, 7, 6, 6, respectively). The urinary tract was the source of the bacteremia in 45 cases (36%), and the lower respiratory tract in 33 (26.4%). Mean duration of treatment was 10.8 days (range 3-21 days). One hundred and six patients (84.8%) recovered completely, 11 (8.8%) improved, but needed an alternative antibiotic treatment. An alternative treatment was also given to a patient whose condition had initially deteriorated. Seven patients (5.6%) died. Death was directly related to the infection in 2 cases. Three patients (2.4%) developed a superinfection, and 5 (4%) a severe (1 case) or mild (4 cases) adverse effect. In summary, a single daily dose of ceftriaxone proved to be useful for the treatment of selected severe bacteremic infections.
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47
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Iriarte MM, Aguirre JM, Molinero E, Sagastagoitia D, Arzubiaga J, Martínez Fernández J, Bóveda J, Peña N, Urrengoetxea J. [Usefulness of exertion test to predict transient ambulatory myocardial ischemia]. Rev Esp Cardiol 1988; 41:523-33. [PMID: 3231859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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48
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Abstract
A case of chondroma of the tongue in a 53-year-old male is reported. A review of the literature is presented.
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Affiliation(s)
- J M Aguirre
- Department of Oral Medicine, School of Stomatology, University of Basque Country, Spain
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49
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Abstract
Idiopathic paralysis of the palate in childhood is an entity of unknown cause which resolves spontaneously and which affects mainly male children in their second and third years. Viral and vascular hypotheses have been proposed in order to explain its genesis. The authors report a case of this rare illness.
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Affiliation(s)
- M A Crovetto
- Department of ENT, Basurto Hospital, E.U.E., University of Basque Country, Lejona, Viscaya, Spain
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50
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Olaz F, Bóveda J, de Juan E, Azcona MS, Aguirre JM, Urrengoetxea J, Iriarte M. [Quantification of coronary disease using myocardial gammagraphy with thallium-201 in exertion and redistribution. Advantages of computerized analysis]. Rev Esp Cardiol 1987; 40:164-8. [PMID: 3628910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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