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Biomedical subjects

A Morales

Publications and source records attributed to A Morales.

At least 145 records · Page 8Linked to original sources
PubMed1997

[Myopathy caused by inhibitors of hydroxymethylglutaryl-coenzyme A reductase].

INTRODUCTION: Hydroxymethylglutaryl-Coenzyme A (HMG-CoA) Reductase inhibitors are a group of drugs widely used for hypercholesterolemia. They are known to originate side-effects on muscles but with a very low incidence of myopathy. CLINICAL CASE: We present two cases of myopathy induced by HMG-CoA reductase inhibitors. They are two women, who were on 20 mg daily of lovastatin and 30 mg daily of simvastatin and consulted due to weakness, myalgia and a rise in blood levels of muscle enzymes. Both of them recovered completely a few weeks after withdrawal of the drugs. COMMENTS: Usage of this group of drugs is wide. Their side effects are rare but it is important to remember their capacity to induce a myopathy, usually reversible upon withdrawal of the drug.

Electromyography↗
PubMed1997

[Stiff-man syndrome. Presentation of a new case].

INTRODUCTION: The stiff-man syndrome (SPR) is a rare neurological condition characterized by the presence of marked, involuntary rigidity of the axial muscles and limbs, together with intense painful muscle spasms which characteristically occur following external stimuli such as sudden noises, brusque movements or emotional stimuli. Symptoms are markedly improved by sleep and by diazepam. The aetiology is unknown, although it is associated with certain auto-immune disorders, particularly diabetes mellitus (DM) and others such as thyroid disease, vitiligo, pernicious anaemia, adrenal insufficiency, etc. The presence of high titres of glutamate-decarboxylase (GAD) antibodies seems to indicate an auto-immune aetiology. CLINICAL CASE: We describe a 59 year old woman who complained of an illness starting seven years previously with progressive pain and contractions of the dorso-lumbar muscles, which later spread to the cervical and abdominal muscles and to the upper limbs. From the time of onset, there were exacerbations of the condition following external stimuli. Also there was generalized vitiligo and whilst this progressed, DM developed (which finally required insulin to control it). On EMG there was continuous muscular activity and absence of muscle relaxation. The presence of high titres of anti-nuclear antibodies, gastric parietal cell antibodies and anti-GAD was very marked. There was a spectacular response to treatment with diazepam, with progressive improvement although ever increasing dosage was required. CONCLUSIONS: A new case of the 'stiff-man' syndrome is presented and aspects of aetiopathology and treatment are reviewed.

Anticonvulsants↗
PubMed1997

"H" reflex as a measure of subclinical uremic polyneuropathy in children with chronic renal failure.

Uremic polyneuropathy (UPNP) is a serious complication of chronic renal failure (CRF) in adults; however, its prevalence is unknown in the pediatric population. An easy-to-perform maneuver for its detection in children is the evaluation of "H" reflex. The objective of this study was to validate the usefulness of the "H" reflex maneuver for the diagnosis of UPNP in pediatric dialysis patients for CRF. Thirty-seven CRF patients were paired with healthy controls by age and sex. The patients were being treated with dialysis or one of its variants. Information was obtained regarding diagnosis, duration, and control of dialysis. Neurological examination was performed, conduction velocities in sensory and motor nerves were measured, and "H" reflex elicited bilaterally. Peripheral polyneuropathy was determined by the presence of at least two nerves with alterations in latency and/or conduction velocities. It was found that 59.4% (22/37) of the children with CRF treated with dialysis developed UPNP, 17 with ambulatory peritoneal dialysis, and 5 with hemodialysis. There was no difference in diagnosis, duration of dialysis, or control of the same in these patients from other CRF patients who did not have UPNP. All patients were clinically asymptomatic. "H" reflex showed a sensibility of 44%, a specificity of 87%, a predictive value positive of 66%, and a predictive value negative of 76%, when measured to 28 msec. With a 30 msec duration specificity rises to 95%. UPNP presents asymptomatically in pediatric patients. "H" reflex is an adequate screening test for the selection of pediatric patients to be tested further.

Adolescent↗
PubMed1997

Comparison of the response to the recombinant vaccine against hepatitis B virus in dialyzed and nondialyzed children with CRF using different doses and routes of administration.

In patients with chronic renal failure (CRF), parenteral transmission of the hepatitis B virus (HBV) is common. The response to the recombinant vaccine is 50%-80% of seroprotection. Therefore, to improve seroprotection, different strategies such as dose augmentation, vaccination at the predialysis stage, subcutaneous application, and using interleukin were tried, with unsatisfactory results. In children, there are no studies demonstrating the efficacy of the vaccine. The aim of this study was to evaluate the efficacy of the recombinant vaccine in children with CRF, in late as well as early phases, through the quantification of antibodies against the surface antigen in response to different doses of the vaccine against HBV. There were 103 patients who were assigned to three groups: (1) 25 patients with CRF in the early phase (undergoing pharmacological treatment only); (2) 67 patients with CRF in the late phase (treatment with peritoneal dialysis or hemodialysis); (3) 11 patients with CRF in the early phase (undergoing low-dose pharmacological treatment only). The antibodies against the serum antigen (HBsAg) were measured by the aEIA method. Urea, creatinine, and creatinine clearance were measured at 0, 2, and 12 months. In our seroprotection results we observed that group 1 and 3 developed earlier seroconversion (50% first month). In patients undergoing dialysis the seroconversion happened in 91% at month 13, but with lower concentration than group 1 and/or group 3 (p < 0.05). In conclusion, there is a better response in predialysis patients. The levels of antibodies are similar in groups 1 and 3 (with small doses), which are similar to the complete doses for an efficient immunity in children with chronic renal failure.

Adolescent↗
PubMed1996

Successive negative contrast in one-way avoidance: effect of thiopental sodium and chlorpromazine.

The successive negative contrast effect on one-way avoidance was induced by shifting rats from a large reward (30 s spent in the safe compartment after completion of the avoidance response, pre-shift phase) to a small reward (1 s, post-shift phase). Under these conditions, the previously learned avoidance response deteriorated (negative contrast) when compared to a control group for which 'safe time' remained constant throughout the experimental situation (1 s). Thiopental sodium at a dose of 5 or 10 mg/kg, but not at 1, 2, 15 or 20 mg/kg i.p., abolished the negative contrast effect, and did not affect performance of the one-way avoidance task. Similar results were found when rats were treated with diazepam (1 mg/kg i.p.). Chlorpromazine at a dose of 0.5 or 1 mg/kg i.p. did not affect negative contrast, although at higher doses (2 or 3 mg/kg) there was an increase in the number of trials needed to reach the criterion for learning the avoidance response. This increase was evident in both pre-shift and post-shift phases, although only in the experimental situations involving a low level of reinforcement (1 s in the safe compartment). On the basis of these results, we tentatively suggest that the successive negative contrast effect in one-way avoidance in rats can be considered a useful pharmacological animal model for research into anxiety.

Animals↗
PubMed1996

Subarachnoid hemorrhage simulating myocardial infarction.

We describe a patient with a subarachnoid hemorrhage that presented with electrocardiographic evidence of transmural myocardial infarction. The patient was found to have normal coronaries and on autopsy revealed generalized myocytolysis with no evidence of transmural myocardial infarction. This case illustrates the value of acute coronary angiography in patients with altered mental status and suspected myocardial infarction.

Adult↗
PubMed1996

Treatment of refractory interstitial cystitis.

Interstitial cystitis is the most therapeutically frustrating condition of the urinary tract. The vast array of treatments available clearly indicates that none is particularly effective. As the majority of patients fail to experience a significant and prolonged response to standard treatments, new options are frequently being developed. These include the oral administration of cimetidine, the intravesical use of hyaluronic acid and BCG, and total cystectomy with the formation of a continent urinary diversion. Unfortunately, the acceptance of many new treatments is based on incomplete evaluation, and this has resulted in a confusing array of disparate alternatives. Effective and durable treatment will not be available until the nature of the disease is better understood and the mechanisms of action of current therapies are elucidated.

Adjuvants, Immunologic↗
PubMed1996

Survival of potentially pathogenic human-associated bacteria in the rhizosphere of hydroponically grown wheat.

Plants may serve as reservoirs for human-associated bacteria (H-AB) in long-term space missions containing bioregenerative life support systems. The current study examined the abilities of five human-associated potential pathogens, Pseudomonas aeruginosa, Pseudomonas cepacia, Staphylococcus aureus, Streptococcus pyogenes and Escherichia coli, to colonize and grow in the rhizosphere of hydroponically grown wheat, a candidate crop for life support. All of these bacteria have been recovered from past NASA missions and present potential problems for future missions. The abilities of these organisms to adhere to the roots of axenic five-day-old wheat (Triticum aestivum L. cv. Yecora rojo) were evaluated by enumeration of the attached organisms after a one hour incubation of roots in a suspension (approximately 10(8) cfu ml-1) of the H-AB. Results showed that a greater percentage of P. aeruginosa cells adhered to the wheat roots than the other four H-AB. Similarly incubated seedlings were also grown under attempted axenic conditions for seven days to examine the potential of each organism to proliferate in the rhizosphere (root colonization capacity). P. cepacia and P. aerogiunosa showed considerable growth, E. coli and S. aureus showed no significant growth, and S. pyogenes died off in the wheat rhizosphere. Studies examining the effects of competition on the survival of these microorganisms indicated that P. aeruginosa was the only organism that survived in the rhizosphere of hydroponically grown wheat in the presence of different levels of microbial competition.

Antibiosis↗
PubMed1996

A computer program for quantification of SH groups generated after reduction of monoclonal antibodies.

Reduction of disulfide bonds to sulfhydryl (SH) groups for direct radiolabeling of antibodies for immunoscintigraphic studies of colorectal and other cancers continues to be of considerable research interest. We have developed a general strategy and a versatile computer program for the quantification of the number of SH per molecule of antibody (Ab) generated after the treatment of monoclonal antibodies (MAbs) with reducing agents such as 2-mercaptoethanol (2-ME), stannous chloride (SnCl2), dithiothreitol (DTT), dithioerythritol (DTE), ascorbic acid (AA), and the like. The program we describe here performs an unweighted least-squares regression analysis of the cysteine standard curve and interpolates the cysteine concentration of the samples. The number of SH groups per molecule of antibody in the 2-mercaptoethanol and in the other reducing agents was calculated from the cysteine standard curve using Ellman's reagent to develop the yellow color. The linear least-squares method fit the standard data with a high degree of accuracy and with the correlation coefficient r of 0.999. A program has been written for the IBM PC compatible computer utilizing a friendly menu to interact with the users. The package allows the user to change parameters of the assay, to calculate regression coefficients slope, intercept and its standard errors, to perform statistical analysis, together with detailed analysis of variance, and to produce an output of the results in a printed format.

Animals↗
PubMed1996

Micromethod for quantification of SH groups generated after reduction of monoclonal antibodies.

A simple, rapid, and reproducible micromethod for quantification of sulfhydryl (SH) groups generated after reduction of monoclonal antibody (MAb) disulfide bonds with 2-mercaptoethanol (2-ME) is described. The number of SH groups per molecule of antibody in the 2-ME and in the other reducing agents was calculated from the cysteine standard curve using Ellman's reagent to develop the yellow color. Results were plotted as absorbance at 405 nm vs. cysteine concentration (microgram/mL). After subtraction of the background due to Ellman's reagent, a straight-line relationship passing through the origin was obtained. Absorption spectrum of the yellow products was controlled, and no significative differences were found between optical density at 412 nm and 405 nm. Using a small quantity of antibody in the order of 37 micrograms, the lowest detection limit for cysteine quantification was 0.03 microgram. An excellent linear correlation was found between both cysteine concentration and absorbance (r = 0.999), and the mean value of the relative error in the quantification of cysteine from samples was 2.8%. A statistical Student t-test showed an excellent linearity and parallelism between cysteine standard and samples.

Animals↗
PubMed1996

Mycobacterium cell wall: an alternative to intravesical bacillus Calmette Guerin (BCG) therapy in orthotopic murine bladder cancer.

PURPOSE: The antitumor effect of intravesical mycobacterium cell wall (MCW) therapy on orthotopic and heterotopic bladder tumors in the mouse was assessed with magnetic resonance imaging (MRI). MATERIALS AND METHODS: The live bacillus Calmette Guerin (BCG) organism was replaced with a cell wall extract derived from the outer capsule of Mycobacterium phlei. This alternative form of intravesical therapy was used with the aim of reducing the toxicity associated with the live mycobacterium organism without compromising efficacy. Response to multiple doses of intravesical MCW and BCG was assessed in mice with established MBT-2 tumors after transurethral tumor implantation. RESULTS: Serial MRI of BCG-treated mice revealed significant tumor regression. The MR images correlated well with the corresponding histology of the whole mount bladder sections. Treatment with MCW also resulted in significant inhibition of tumor growth compared with control untreated animals (p < 0.05) although the antitumor effect was less pronounced than that of live BCG. Treatment was well tolerated in the MCW group with no apparent ill effects. Flow cytometric (FCM) analysis of bladder washings with phenotype-specific monoclonal antibodies revealed predominantly a CD3+ T cell infiltrate in the control and BCG-treated as well as the MCW-treated mice. The CD4+ (helper/inducer) subset of T cells predominated over the CD8+ (suppressor/cytotoxic) subset in both the BCG- and MCW-treated animals, and the CD4+/CD8+ ratio in both of the treated groups differed significantly from that of the control untreated groups. CONCLUSION: Intravesical MCW appears to invoke a similar inflammatory response in the mouse bladder mucosa as the live BCG organism and retains an antitumor action. It deserves further evaluation as a potential antitumor agent against bladder cancer. A Phase II clinical trial is now underway.

Adjuvants, Immunologic↗
PubMed1996

Surgical treatment of penile veno-occlusive dysfunction: is it justified?

OBJECTIVES: Veno-occlusive dysfunction is a commonly diagnosed cause of impotence. Surgical removal of the intermediate (deep dorsal vein and its tributaries) venous system of the penis has been advocated as an effective treatment but recurrence of the dysfunction is common after a few months. We studied prospectively the first 100 cases of veno-occlusive dysfunction undergoing surgical treatment at our institutions. METHODS: One hundred consecutive patients undergoing penile venous ligation surgery were evaluated. All patients had a comprehensive workup prior to therapy. Surgery involved excision of the intermediate venous drainage. Short-term results were investigated by personal interview, and long-term outcome was determined by separate telephone interview of patients and their partners when available. RESULTS: Short-term success (3 months) was 62%, and long-term success (45 months) was 31%. Historical factors, preoperative testing results, and histologic assessment of the surgical specimens were not found to be helpful in predicting outcome. CONCLUSIONS: Despite the mediocre long-term results of the surgical procedure and lack of preoperative predictive factors, we believe that venous leak surgery could be offered to well-selected patients in whom the only other available alternative would be a prosthetic device.

Adult↗
PubMed1996

Quality of life in children with well-controlled epilepsy.

In our pediatric neurology clinic, we noticed that some of the children and adolescents with well-controlled epilepsy seemed to have difficulty in school, social and family life situations. We postulated that having epilepsy and needing to take daily antiepileptic drugs caused occasional problems in these areas. A questionnaire assessing self concept, home life, school life, social activities and medication issues was developed to explore this issue. Sixty patients with mild epilepsy from our pediatric neurology clinic were surveyed. With an age range of 8-18 years, the mean age of the participants was 12.38 years (SD = 2.93). Thirty-five were females and 25 were males. Twenty had generalized tonic-clonic, 7 absence, 30 partial with motor symptoms, 2 partial with sensory symptoms and 1 unspecified type. Preliminary data indicate statistically significant correlations (p < .05) between children's concerns about seizure activity and self-perceived academic and social difficulties. A simple tool like this questionnaire can be used to help nurses assess quality of life issues in children and adolescents with epilepsy.

Adaptation, Psychological↗
PubMed1996

AgNOR mark epithelial foci in malignant transformation in hamster cheek pouch carcinogenesis.

Hamster cheek pouch mucosa is an accepted model of oral carcinogenesis. We herein examined the value of morphometric evaluation of silver-stained nucleolar organizer regions (AgNOR) in the detection of epithelial foci in malignant transformation following dimethyl-1,2-benzanthracene-induced carcinogenesis of hamster cheek pouch. AgNOR-related parameters were analyzed at different stages of the process of carcinogenesis (control epithelium, epithelium with no unusual microscopic features, "dysplastic" epithelium, exophytic and endophytic carcinomas). Morphometric evaluation of AgNOR revealed incipient cellular alterations which were not evident in routine preparations and contributed to the characterization of different stages of carcinogenesis in this model.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1996

Amplified ELISA to detect autoantibodies to N-glycolyl-GM3 ganglioside.

Numerous immunochemical methods are now available for the detection of antibodies to gangliosides. An amplified ELISA method for detection of autoantibodies to NGcGM3 ganglioside in the sera of patients with various type of renal diseases was developed. IgM antibodies were found in 39 out of 53 sera of patients using 30 normal healthy blood donor as a negative control. For human IgG conjugate no reactivity to NGcGM3 was seen in the sera. Positive ELISA results were confirmed by TLC-immunostaining using GM3, NGcGM3, NGcGM2 and Standard bovine gangliosides (GM1, GD1a, GD1b and GT1b). All sera were also assayed for reactivity with GM3 in ELISA to determine the line specificity of these antibodies. Based on these results, a protocol for a sensitive and reproducible amplification ELISA system for serum anti-NGcGM3 antibodies in patients with renal or other diseases is presented. The ELISA method described here in appear to be useful adjunt to measure antiNGcGM3 antibodies in sera of patients with various type of renal or other diseases.

Autoantibodies↗