Jose Medina - Academia.edu (original) (raw)

Papers by Jose Medina

Rehabilitación, 2009

Introducción: El objetivo del trabajo es describir las características del Programa de Raquialgia... more Introducción: El objetivo del trabajo es describir las características del Programa de Raquialgia del Hospital de San Juan, aplicado en un Centro de Salud del área sanitaria, y hacer una valoración de la eficacia del mismo en el tratamiento del dolor de espalda crónico. Material y métodos: Se incluyeron 192 pacientes afectos de cervicalgia, dorsalgia y/o lumbalgia, durante el periodo de enero 03 a enero 05. El programa se desarrolló en 6 sesiones colectivas de 2 meses de duración. En consulta individual inicial y final, se completaron los tets de escala visual analógica (EVA) del dolor, un cuestionario de compresión de conceptos biomecánicos y un test de valoración adaptado, con las siguientes variables: valoración subjetiva del control postural y valoración objetiva del control postural. Con la finalidad de valorar la efectividad de la técnica, se envió una encuesta postal anónima a 160 pacientes, que habían seguido el programa. Resultados y discusión: El programa mejora el dolor raquídeo a través de la EVA en un 27.2% y a través del test de valoración adaptado en un 31.4%. También se mejoró en la comprensión de conceptos biomecánicos en un 13.1%. Estas mejorías encontradas fueron estadísticamente significativas (p < 0.001). El nivel educacional de los sujetos estudiados se correlacionó de forma estadísticamente significativa (p = 0.0038) con la diferencia obtenida en el cuestionario de comprensión de conceptos. Los pacientes con una mayor adhesión a la aplicación práctica de posturas fueron los que lograron una mayor reducción del dolor de espalda, aunque estas diferencias no alcanzaron significación estadística.

To determine the hemodynamic and clinical effects of long-term positive inotropic stimulation on ... more To determine the hemodynamic and clinical effects of long-term positive inotropic stimulation on the myocardium, we treated 31 patients with severe chronic heart failure with oral amrinone (600 mg daily) and performed invasive hemodynamic studies during shortand long-term treatment with the drug. Stroke volume and stroke work indexes increased markedly during the first 48 hr of therapy (p < .01) but returned to pretreatment values after 2 to 10 weeks; upon drug withdrawal, both variables deteriorated rapidly to values significantly lower than those observed before treatment with amrinone (p < .01), despite similar values for left ventricular filling pressure, mean arterial pressure, and systemic vascular resistance. This pattern of response indicated that progression of the underlying heart disease had occurred during treatment with amrinone and contributed importantly to its failure to produce long-term benefits. Progression of left ventricular dysfunction was associated with a progressive increase in heart rate and plasma renin activity and a decline in serum sodium concentration. Clinically, amrinone therapy was complicated by sustained symptomatic ventricular tachycardia in four patients, worsening myocardial ischemia in four patients, and worsening congestive heart failure in eight patients, all of whom had been stable before entry into the study; only three of the 31 patients improved clinically. Ten patients died during the first 2 weeks of treatment, and 16 (52%) were dead within 3 months, a mortality rate twice as great as that seen during comparable trials with vasodilating drugs. Although noncardiac adverse effects were frequent, they were not the primary reason for drug failure. In conclusion, long-term therapy with amrinone may accelerate progression of left ventricular dysfunction, exacerbate myocardial ischemia, and provoke life-threatening ventricular tachyarrhythmias, thereby shortening survival in patients with severe chronic heart failure. Prolonged administration of inotropic drugs may achieve short-term gains at the expense of long-term detrimental effects on the myocardium.

Progresos de Obstetricia y Ginecología, 2005

Paciente de 74 años, remitida a la consulta de ginecología de nuestro hospital por tumoración pél... more Paciente de 74 años, remitida a la consulta de ginecología de nuestro hospital por tumoración pélvica de unos 12 cm. La paciente refiere dolor crónico en fosa ilíaca izquierda que aumenta en los últimos meses. La ecografía abdominal muestra una formación quística de 116 × 96 mm, de contenido denso sin tabiques ni papilas. Los marcadores tumorales fueron negativos. Se practica histerectomía y doble anexectomía, y el estudio anatomopatológico informó de endometrioma de ovario izquierdo.

Clínica e Investigación en Ginecología y Obstetricia, 2006

Pneumonia is the most frequent cause of severe nonobstetric infection in pregnant women. All infe... more Pneumonia is the most frequent cause of severe nonobstetric infection in pregnant women. All infectious diseases in pregnant patients can affect both the mother and fetus, contributing to morbidity and mortality. The physiological and hormonal changes that take place in pregnancy predispose pregnant women to pneumonia. Pregnant women with pneumonia are at greater risk for premature delivery and for giving birth to low birthweight neonates.

A group of studies was carried out on a compacted Red Ferralitic soil, with the aim of evaluating... more A group of studies was carried out on a compacted Red Ferralitic soil, with the aim of evaluating the influence of inoculation frequency with arbuscular mycorrhizal fungi (AMF) on rizobacteria population and its effect on yield of diverse crop sequences. Therefore, four field experiments were developed in a randomized block design repeated during two years; three different crops were alternated,

Proceedings of the National Academy of Sciences, 2003

Mycobacterium bovis is the causative agent of tuberculosis in a range of animal species and man, ... more Mycobacterium bovis is the causative agent of tuberculosis in a range of animal species and man, with worldwide annual losses to agriculture of $3 billion. The human burden of tuberculosis caused by the bovine tubercle bacillus is still largely unknown. M. bovis was also the progenitor for the M. bovis bacillus Calmette-Gué rin vaccine strain, the most widely used human vaccine. Here we describe the 4,345,492-bp genome sequence of M. bovis AF2122͞97 and its comparison with the genomes of Mycobacterium tuberculosis and Mycobacterium leprae. Strikingly, the genome sequence of M. bovis is >99.95% identical to that of M. tuberculosis, but deletion of genetic information has led to a reduced genome size. Comparison with M. leprae reveals a number of common gene losses, suggesting the removal of functional redundancy. Cell wall components and secreted proteins show the greatest variation, indicating their potential role in host-bacillus interactions or immune evasion. Furthermore, there are no genes unique to M. bovis, implying that differential gene expression may be the key to the host tropisms of human and bovine bacilli. The genome sequence therefore offers major insight on the evolution, host preference, and pathobiology of M. bovis.

Mitochondrial DNA, 2000

The original strategy used in the Sulfolobus solfatnriciis genome project was to sequence non ove... more The original strategy used in the Sulfolobus solfatnriciis genome project was to sequence non overlapping, or minimally overlapping, cosmid or lambda inserts without constructing a physical map. However, after only about two thirds of the genome sequence was completed, this approach became counter-productive because there was a high sequence bias in the cosmid and lambda libraries. Therefore, a new approach was devised for linking the sequenced regions which may be generally applicable. BAC libraries were constructed and terminal sequences of the clones were determined and used for both end mapping and PCR screening. The PCR approaches included a novel chromosome walking method termed "paired-PCR". 21 gaps were filled by BAC end sequence analyses and 6 gaps were filled by PCR including three large ones by paired-PCR. The complete map revealed that 0.9 Mb remained to be sequenced and 34 BAC clones were selected for walking over small gaps and preparing template libraries for larger ones. It is concluded that an optimal strategy for sequencing microorganism genomes involves construction of a high-resolution physical map by BAC end analyses, PCR screening and paired-PCR chromosome walking after about half the genome sequence has been accumulated.

Microbiology, 1997

ABSTRACT

Microbiology, 1997

The nucleotide sequence of 17.3 kbp downstream of addA (98") on the Bacillus subtilis chromosome ... more The nucleotide sequence of 17.3 kbp downstream of addA (98") on the Bacillus subtilis chromosome was determined. Twenty putative ORFs were identified. Three of them coincided with known B. subtilis genes, addA, sbcD and wprA. The product of four other ORFs showed similarity to SbcC of Clostridium perfringens, CotH of B, subtNs, 2-hydroxyhepta-2,4-d iene-1,7-d iodate isomerase of Methanococcus jannaschi and a putative ORF of Pseudomonas syringae. In addition, a sequence of 7.6 kbp downstream of citG (189") was analysed. Among 10 putative ORFs identified, two coincided with known genes, c i s and mrgA, whilst three showed homology with X86780, a sensory protein kinase of Streptomyces hygroscopicus, an alkaline phosphatase regulatory protein and a hypothetical protease, YyxA, of B. subtilis.

Cancer Epidemiology Biomarkers & Prevention, 2006

Osteosarcoma is a rare malignancy of largely unknown etiology. Although there is no consistent ev... more Osteosarcoma is a rare malignancy of largely unknown etiology. Although there is no consistent evidence for an association between fluoridation and cancer, some concerns remain about osteosarcoma. As part of the design of a collaborative study, bone samples were collected to allow for an evaluation of the association between osteosarcoma risk and individual fluoride exposure measured by levels of fluoride in bone. In this report, we provide the results of pilot experiments to consider issues that arose during the study design and to assess the reliability of the bone assays. Correlations of fluoride levels between normal bone near the affected area and iliac crest bone were strong and positive. The day-to-day laboratory analysis of fluoride in human and deer jaw bone yielded acceptable average coefficients of variation below 10% and an overall estimate of 5%. The intraclass correlation (ICC) is of particular importance to epidemiologists because it indicates the effect of measurement error on study results. Here, the estimated ICC is 0.86, and the estimated downward bias is only 14%. Hence, the ICC is strong enough so that the estimates of the relative risk will suffer little attenuation from lab measurements.

Acute pyelonephritis is one of the most common medical disorders of pregnancy. The incidence of p... more Acute pyelonephritis is one of the most common medical disorders of pregnancy. The incidence of pyelonephritis is 1-2% during pregnancy. An Acute Respiratory Distress Syndrome could appear as an infrecuent complication. Analysis of clinical laboratory and terapeutic parameters of each patient is the goal to stablish an early diagnosis of the syndrome. Close monitoring and vigorous treatment can prevent maternal

Cerebral venous thrombosis is an uncommon disease during pregnancy. The etiology is unknown in 25... more Cerebral venous thrombosis is an uncommon disease during pregnancy. The etiology is unknown in 25-40% of cases. Risk factors are infectious diseases, pregnancy, puerperium, dehydration, oral contraception use, hypercoagulative states, tumors, and traumatisms. We present a case of cerebral venous thrombosis and discuss the importance of performing a complete neurological examination in pregnant women presenting with abnormal neurological symptoms. With

Rehabilitación, 2009

Introducción: El objetivo del trabajo es describir las características del Programa de Raquialgia... more Introducción: El objetivo del trabajo es describir las características del Programa de Raquialgia del Hospital de San Juan, aplicado en un Centro de Salud del área sanitaria, y hacer una valoración de la eficacia del mismo en el tratamiento del dolor de espalda crónico. Material y métodos: Se incluyeron 192 pacientes afectos de cervicalgia, dorsalgia y/o lumbalgia, durante el periodo de enero 03 a enero 05. El programa se desarrolló en 6 sesiones colectivas de 2 meses de duración. En consulta individual inicial y final, se completaron los tets de escala visual analógica (EVA) del dolor, un cuestionario de compresión de conceptos biomecánicos y un test de valoración adaptado, con las siguientes variables: valoración subjetiva del control postural y valoración objetiva del control postural. Con la finalidad de valorar la efectividad de la técnica, se envió una encuesta postal anónima a 160 pacientes, que habían seguido el programa. Resultados y discusión: El programa mejora el dolor raquídeo a través de la EVA en un 27.2% y a través del test de valoración adaptado en un 31.4%. También se mejoró en la comprensión de conceptos biomecánicos en un 13.1%. Estas mejorías encontradas fueron estadísticamente significativas (p < 0.001). El nivel educacional de los sujetos estudiados se correlacionó de forma estadísticamente significativa (p = 0.0038) con la diferencia obtenida en el cuestionario de comprensión de conceptos. Los pacientes con una mayor adhesión a la aplicación práctica de posturas fueron los que lograron una mayor reducción del dolor de espalda, aunque estas diferencias no alcanzaron significación estadística.

To determine the hemodynamic and clinical effects of long-term positive inotropic stimulation on ... more To determine the hemodynamic and clinical effects of long-term positive inotropic stimulation on the myocardium, we treated 31 patients with severe chronic heart failure with oral amrinone (600 mg daily) and performed invasive hemodynamic studies during shortand long-term treatment with the drug. Stroke volume and stroke work indexes increased markedly during the first 48 hr of therapy (p < .01) but returned to pretreatment values after 2 to 10 weeks; upon drug withdrawal, both variables deteriorated rapidly to values significantly lower than those observed before treatment with amrinone (p < .01), despite similar values for left ventricular filling pressure, mean arterial pressure, and systemic vascular resistance. This pattern of response indicated that progression of the underlying heart disease had occurred during treatment with amrinone and contributed importantly to its failure to produce long-term benefits. Progression of left ventricular dysfunction was associated with a progressive increase in heart rate and plasma renin activity and a decline in serum sodium concentration. Clinically, amrinone therapy was complicated by sustained symptomatic ventricular tachycardia in four patients, worsening myocardial ischemia in four patients, and worsening congestive heart failure in eight patients, all of whom had been stable before entry into the study; only three of the 31 patients improved clinically. Ten patients died during the first 2 weeks of treatment, and 16 (52%) were dead within 3 months, a mortality rate twice as great as that seen during comparable trials with vasodilating drugs. Although noncardiac adverse effects were frequent, they were not the primary reason for drug failure. In conclusion, long-term therapy with amrinone may accelerate progression of left ventricular dysfunction, exacerbate myocardial ischemia, and provoke life-threatening ventricular tachyarrhythmias, thereby shortening survival in patients with severe chronic heart failure. Prolonged administration of inotropic drugs may achieve short-term gains at the expense of long-term detrimental effects on the myocardium.

Progresos de Obstetricia y Ginecología, 2005

Paciente de 74 años, remitida a la consulta de ginecología de nuestro hospital por tumoración pél... more Paciente de 74 años, remitida a la consulta de ginecología de nuestro hospital por tumoración pélvica de unos 12 cm. La paciente refiere dolor crónico en fosa ilíaca izquierda que aumenta en los últimos meses. La ecografía abdominal muestra una formación quística de 116 × 96 mm, de contenido denso sin tabiques ni papilas. Los marcadores tumorales fueron negativos. Se practica histerectomía y doble anexectomía, y el estudio anatomopatológico informó de endometrioma de ovario izquierdo.

Clínica e Investigación en Ginecología y Obstetricia, 2006

Pneumonia is the most frequent cause of severe nonobstetric infection in pregnant women. All infe... more Pneumonia is the most frequent cause of severe nonobstetric infection in pregnant women. All infectious diseases in pregnant patients can affect both the mother and fetus, contributing to morbidity and mortality. The physiological and hormonal changes that take place in pregnancy predispose pregnant women to pneumonia. Pregnant women with pneumonia are at greater risk for premature delivery and for giving birth to low birthweight neonates.

A group of studies was carried out on a compacted Red Ferralitic soil, with the aim of evaluating... more A group of studies was carried out on a compacted Red Ferralitic soil, with the aim of evaluating the influence of inoculation frequency with arbuscular mycorrhizal fungi (AMF) on rizobacteria population and its effect on yield of diverse crop sequences. Therefore, four field experiments were developed in a randomized block design repeated during two years; three different crops were alternated,

Proceedings of the National Academy of Sciences, 2003

Mycobacterium bovis is the causative agent of tuberculosis in a range of animal species and man, ... more Mycobacterium bovis is the causative agent of tuberculosis in a range of animal species and man, with worldwide annual losses to agriculture of $3 billion. The human burden of tuberculosis caused by the bovine tubercle bacillus is still largely unknown. M. bovis was also the progenitor for the M. bovis bacillus Calmette-Gué rin vaccine strain, the most widely used human vaccine. Here we describe the 4,345,492-bp genome sequence of M. bovis AF2122͞97 and its comparison with the genomes of Mycobacterium tuberculosis and Mycobacterium leprae. Strikingly, the genome sequence of M. bovis is >99.95% identical to that of M. tuberculosis, but deletion of genetic information has led to a reduced genome size. Comparison with M. leprae reveals a number of common gene losses, suggesting the removal of functional redundancy. Cell wall components and secreted proteins show the greatest variation, indicating their potential role in host-bacillus interactions or immune evasion. Furthermore, there are no genes unique to M. bovis, implying that differential gene expression may be the key to the host tropisms of human and bovine bacilli. The genome sequence therefore offers major insight on the evolution, host preference, and pathobiology of M. bovis.

Mitochondrial DNA, 2000

The original strategy used in the Sulfolobus solfatnriciis genome project was to sequence non ove... more The original strategy used in the Sulfolobus solfatnriciis genome project was to sequence non overlapping, or minimally overlapping, cosmid or lambda inserts without constructing a physical map. However, after only about two thirds of the genome sequence was completed, this approach became counter-productive because there was a high sequence bias in the cosmid and lambda libraries. Therefore, a new approach was devised for linking the sequenced regions which may be generally applicable. BAC libraries were constructed and terminal sequences of the clones were determined and used for both end mapping and PCR screening. The PCR approaches included a novel chromosome walking method termed "paired-PCR". 21 gaps were filled by BAC end sequence analyses and 6 gaps were filled by PCR including three large ones by paired-PCR. The complete map revealed that 0.9 Mb remained to be sequenced and 34 BAC clones were selected for walking over small gaps and preparing template libraries for larger ones. It is concluded that an optimal strategy for sequencing microorganism genomes involves construction of a high-resolution physical map by BAC end analyses, PCR screening and paired-PCR chromosome walking after about half the genome sequence has been accumulated.

Microbiology, 1997

ABSTRACT

Microbiology, 1997

The nucleotide sequence of 17.3 kbp downstream of addA (98") on the Bacillus subtilis chromosome ... more The nucleotide sequence of 17.3 kbp downstream of addA (98") on the Bacillus subtilis chromosome was determined. Twenty putative ORFs were identified. Three of them coincided with known B. subtilis genes, addA, sbcD and wprA. The product of four other ORFs showed similarity to SbcC of Clostridium perfringens, CotH of B, subtNs, 2-hydroxyhepta-2,4-d iene-1,7-d iodate isomerase of Methanococcus jannaschi and a putative ORF of Pseudomonas syringae. In addition, a sequence of 7.6 kbp downstream of citG (189") was analysed. Among 10 putative ORFs identified, two coincided with known genes, c i s and mrgA, whilst three showed homology with X86780, a sensory protein kinase of Streptomyces hygroscopicus, an alkaline phosphatase regulatory protein and a hypothetical protease, YyxA, of B. subtilis.

Cancer Epidemiology Biomarkers & Prevention, 2006

Osteosarcoma is a rare malignancy of largely unknown etiology. Although there is no consistent ev... more Osteosarcoma is a rare malignancy of largely unknown etiology. Although there is no consistent evidence for an association between fluoridation and cancer, some concerns remain about osteosarcoma. As part of the design of a collaborative study, bone samples were collected to allow for an evaluation of the association between osteosarcoma risk and individual fluoride exposure measured by levels of fluoride in bone. In this report, we provide the results of pilot experiments to consider issues that arose during the study design and to assess the reliability of the bone assays. Correlations of fluoride levels between normal bone near the affected area and iliac crest bone were strong and positive. The day-to-day laboratory analysis of fluoride in human and deer jaw bone yielded acceptable average coefficients of variation below 10% and an overall estimate of 5%. The intraclass correlation (ICC) is of particular importance to epidemiologists because it indicates the effect of measurement error on study results. Here, the estimated ICC is 0.86, and the estimated downward bias is only 14%. Hence, the ICC is strong enough so that the estimates of the relative risk will suffer little attenuation from lab measurements.

Acute pyelonephritis is one of the most common medical disorders of pregnancy. The incidence of p... more Acute pyelonephritis is one of the most common medical disorders of pregnancy. The incidence of pyelonephritis is 1-2% during pregnancy. An Acute Respiratory Distress Syndrome could appear as an infrecuent complication. Analysis of clinical laboratory and terapeutic parameters of each patient is the goal to stablish an early diagnosis of the syndrome. Close monitoring and vigorous treatment can prevent maternal

Cerebral venous thrombosis is an uncommon disease during pregnancy. The etiology is unknown in 25... more Cerebral venous thrombosis is an uncommon disease during pregnancy. The etiology is unknown in 25-40% of cases. Risk factors are infectious diseases, pregnancy, puerperium, dehydration, oral contraception use, hypercoagulative states, tumors, and traumatisms. We present a case of cerebral venous thrombosis and discuss the importance of performing a complete neurological examination in pregnant women presenting with abnormal neurological symptoms. With