Search PubMed⌕ Search

Biomedical subjects

C Lemos

Publications and source records attributed to C Lemos.

At least 19 recordsLinked to original sources

Comparative study of basiliximab treatment in lung transplantation.

OBJECTIVE: This study compared the incidence of acute or chronic rejection and adverse events in lung transplant patients receiving induction basiliximab versus controls not receiving treatment. MATERIALS AND METHODS: Basiliximab was administered to 15 patients with impaired renal function, advanced age, or high surgical risk, (group I). The mean age was 48.9 years; nine were double-lung and six single-lung grafts. They were compared to 13 lung transplants performed in 2001 (mean age 43.6 years, 11 double lung and two single lung [group II]). RESULTS: The incidence of acute rejection was 13.3% in group I versus 38.5% in group II (P = .19, OR 4.06), with chronic rejection in 20% and 38.5% of cases, respectively (P = .4, OR 2.5). No significant differences were observed in the incidence of infections or malignancies. Nor were there any direct adverse events due to the administration of the drug. The estimated 2-year survival was 80% for group I and 54% for group II (P = .14). CONCLUSIONS: Basiliximab has a trend to reduce the rate of acute and chronic rejection in lung transplant recipients, with no increased incidence of infections or malignancies. The 2-year survival for patients treated with basiliximab was better than the control group, despite including high risk transplant patients.

Adult↗

The effect of a series of organic cations upon the plasmalemmal serotonin transporter, SERT.

The aim of this work was to test the effect of a series of organic cations upon the activity of the plasma membrane serotonin transporter (SERT). The experiments were performed using the JAR cell line that constitutively expresses high levels of SERT, and rat intestine, whose mucosal epithelial cells also express SERT. Initial rates of (3)H-serotonin ((3)H-5HT; 200 nM) uptake were not changed by some of the organic cations tested (guanidine, N-methylnicotinamide, choline, atenolol, caffeine and theophylline), but were slightly (15-30%) inhibited by some other organic cations, at the highest concentrations tested (thiamine (3 mM), cimetidine (1 mM) and tetraethylammonium (3 mM)). On the other hand, some other organic cations reduced, in a concentration-dependent manner, uptake of (3)H-5HT by JAR cells (IC(50)s of 0.3, 1.3, 5.4, 89.3, 460 and 748 microM for quinidine, verapamil, propranolol, amiloride, nicotine and clonidine, respectively). Quinidine, clonidine and amiloride seem to be competitive inhibitors of (3)H-5HT uptake, whereas verapamil, nicotine and propranolol appear to be uncompetitive or non-competitive inhibitors. Moreover, quinidine, verapamil and propranolol trans-inhibited (3)H-5HT uptake, whereas clonidine, nicotine and amiloride were devoid of effect. Finally, these six organic cations were able to significantly increase the serosal-to-mucosal apparent permeability (P(app)) to (3)H-5HT of rat jejunum, ileum and colon. In conclusion, human and rat SERT-mediated transport is inhibited by several distinct organic cations, some of which are therapeutic agents or drugs of abuse. Knowledge on which organic cations interfere with SERT-mediated transport of 5HT will have major implications in tissues where 5HT plays important physiological roles (eg. central nervous system, intestine and placenta).

Analysis of Variance↗

New features of rubella in Spain: the evidence of an outbreak.

In most of western Europe the rubella vaccine coverage is high. However, prior to the introduction of the vaccine in Latin America, rubella susceptibility in women of childbearing age was 10-25%. Forty one (93%) countries in Latin America have adopted the rubella vaccine since 2002. The adult immigrant population in Spain constitutes a group of susceptibles. In February 2003, the Madrid Community Measles Elimination Plan detected an increase in rubella notifications in women who had been born in Latin America. A descriptive study was undertaken to characterise the outbreak. A confirmed case was a person with fever or rash and a positive IgM serology, and living in Madrid, between 1 December 2002 and 31 March 2003. The secondary attack rate (SAR) per household was calculated. A total of 19 cases of rubella were identified, 15 were confirmed and 4 were probable cases. Fourteen (73.7%) cases were women at childbearing age. The mean age was 25.1 years. One pregnancy was diagnosed with a voluntary termination. Eleven (57.9%) cases were from Ecuador. The mean time of residence in Spain was 41 months. None of the cases or the 54 (78.3%) household contacts had been vaccinated against rubella. The SAR was 9.1%. This study showed the spread of rubella in the susceptible Latin American Community that is resident in Madrid. The interventions proposed were a vaccination programme towards immigrants, a health education campaign to prevent congenital rubella, and a health professional training programme case management.

Adolescent↗

Severe hereditary spherocytosis and distal renal tubular acidosis associated with the total absence of band 3.

Absence of band 3, associated with the mutation Coimbra (V488M) in the homozygous state, caused severe hereditary spherocytosis in a young child. Although prenatal testing was made available to the parents, it was declined. Because the fetus stopped moving near term, an emergency cesarean section was performed and a severely anemic, hydropic female baby was delivered. She was resuscitated and initially kept alive with respiratory assistance and hypertransfusion therapy. Cord blood smears revealed erythroblastosis, poikilocytosis, and red cells with stalk-like elongations. Band 3 and protein 4.2 were absent; spectrin, ankyrin, and glycophorin A were significantly reduced. Renal tubular acidosis was detected by the age of 3 months. Nephrocalcinosis appeared soon thereafter. After 3 years of follow-up the child is doing reasonably well on a regimen that includes regular blood transfusions and daily bicarbonate supplements. The long-term prognosis remains uncertain given the potential for hematologic and renal complications. (Blood. 2000;96:1602-1604)

Acidosis, Renal Tubular↗

[Congenital cyst adenomatoid malformation of the lung].

The authors report two cases of Congenital Cyst Adenomatoid Malformation diagnosed by ultrasound in the 24th and 27th weeks of pregnancy. The pregnancies had no other problems until their term and deliveries were normal. Surgical resection of the malformation was made on the 8th day of life in one child and on the 11th day in the other. After 2 years, the first child shows a good evolution in weight and height, without lung pathology. After 2 months, the other child also shows a similar condition.

Child, Preschool↗

[Traumatic aortic valve insufficiency].

The traumatic aortic valvular insufficiency (TAVI), through less frequent after a non-penetrating thoracic traumatism, is a serious entity with a very reserved prognosis. So it must be suspected in every patients with signs or symptoms of de novo heart failure post-traumatism. The transthoracic echocardiography and eventually transesophageal echocardiography have a fundamental role in the confirmation of the diagnosis. The clinical picture of traumatic aortic regurgitation is quickly evolutionary and the non efficacy of medical therapy has placed the valvular substitution surgery as the best succeeded treatment. With the advent of the aortic valve repairing surgery some TAVI cases has been submitted to this procedure. Nevertheless, the development of residual aortic regurgitation in these situations, usually requiring later valvular replacement surgery, make the aortic valvuloplasty a controversial surgical technique. The AA describe a recent clinical case of aortic regurgitation after a non-penetrant thoracic traumatism, discussing the aspects connected with physiopathology, diagnosis and therapy. The singularity of this case was based on the fact that the initial clinical diagnosis had been prejudiced by the context of a polytraumatism and there had been a time free of symptoms between the traumatism and the beginning of the symptomatology of left ventricular failure. Even though the identification of the problem allowed an intensive treatment of this serious situation that ended with the replacement of the aortic valve by mechanical aortic prosthesis, with the patient's total recovery.

Accidents, Traffic↗

[Frequency of pregnant HBsAg carriers in a Brazilian community].

In view of the benefits of immunoprophylaxis among newborns of mothers who are seropositive for hepatitis B virus (HBV) surface antigen (HBsAG), these women must be correctly identified so that this measure can be instituted in Brazil. The research reported here studied 7992 women who gave birth in the Hospital das Clínicas of the Ribeirão Preto School of Medicine, University of São Paulo (HCFMRP-USP), Brazil, in order to determine the rate of serum reactivity of HBsAg and other markers of HBV infection among these women, and also to evaluate the risk factors for this infection. Serum reactivity for HBsAg was determined by means of an immunoenzymatic test (ELISA) carried out in two stages: the first with an incubation period of 2 hours (screening), and the second with an incubation period of 18 hours (confirmation) for those samples that were positive in the screening test. The markers anti-HBsAg, HBeAg, anti-HBcAg, and anti-HBeAG were tested in the samples that were confirmed positive. The screening test found 1.05% (95% CI: 0.84 - 1.30) of the samples to be positive for HBsAg. However, only 0.95% (95% CI: 0.75 - 1.19) were confirmed positive, the percentage being significantly higher among patients whose pregnancies had ended in abortion (1.84%) than among those who had given birth (0.84%) (X2, Yates correction = 7.76; P < 0.005). Risk factors for HBV infection could be identified for only 27.6% of the study subjects, based on their recall and reporting. Of the women with confirmed positive samples, 21.3% also were positive for HBeAG, indicating that these patients ran a greater risk of transmitting the virus vertically. These results underline the need for specific serologic studies in the final stage of pregnancy in order to offer the maximum benefit of neonatal immunoprophylaxis.

Brazil↗

[Myocardial infarct in a young man with normal coronary vessels: apropos of a clinical case treated with streptokinase].

The authors report a case of a 31 year old young man who suffered acute myocardial infarction and was subjected to early treatment with streptokinase. The immediate follow-up showed a complete recanalization of the infarct-related vessel, without any identifiable obstructive lesion on coronary arteriography. Related to this angiographic finding, common in myocardial infarction in the young adult, the authors debate the implicated mechanisms, focusing essentially in the relation endothelium-platelets-vasomotricity. The issue of cigarette smoking as a risk factor and its possible pathogenic implication, even in the absence of atherosclerotic plaque, is also approached.

Adult↗

Malignant osteoblastoma.

The clinical, radiographic and pathological features are described of eight cases of a bone tumour which we propose to classify as "malignant osteoblastoma". It presents the characteristics of genuine osteoblastoma but of an aggressive pattern, with more abundant and often plump hyperchromatic nuclei, greater nuclear atypia, and numerous giant cells of osteoclastic type. This rare tumour is regarded as the malignant counterpart of osteoblastoma and appears to be only locally aggressive. It should be separated from conventional osteosarcoma not only because of its peculiar histological pattern, but also because of its different clinical and radiological features and better prognosis. Thus seven of the eight patients were alive and free of disease from one and a half to eleven years after the initial surgical treatment, which in only two cases included amputation. Excision or block resection is the preferred method of treatment.

Adolescent↗