[Diagnosis of HIV infection in primary care].
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HIV Infections↗
Biomedical subjects
C Santos
Publications and source records attributed to C Santos.
Proteins P1, P2, and P0, components of the eukaryotic ribosome stalk. New structural and functional aspects.
The eukaryoic ribosomal stalk is thought to consist of the phosphoproteins P1 and P2, which form a complex with protein PO. This complex interacts at the GTPase domain in the large subunit rRNA, overlapping the binding site of the protein L11-like eukaryotic counterpart (Saccharomyces cerevisiae protein L15 and mammalian protein L12). An unusual pool of the dephosphorylated forms of proteins P1 and P2 is detected in eukaryotic cytoplasm, and an exchange between the proteins in the pool and on the ribosome takes place during translation. Quadruply disrupted yeast strains, carrying four inactive acidic protein genes and, therefore, containing ribosomes totally depleted of acidic proteins, are viable but grow with a doubling time threefold higher than wild-type cells. The in vitro translation systems derived from these stains are active but the two-dimensional gel electrophoresis pattern of proteins expressed in vivo and in vitro is partially different. These results indicate that the P1 and P2 proteins are not essential for ribosome activity but are able to affect the translation of some specific mRNAs. Protein PO is analogous to bacterial ribosomal protein L10 but carries an additional carboxyl domain showing a high sequence homology to the acidic proteins P1 and P2, including the terminal peptide DDDMGFGLFD. Successive deletions of the PO carboxyl domain show that removal of the last 21 amino acids from the PO carboxyl domain only slightly affects the ribosome activity in a wild-type genetic background; however, the same deletion is lethal in a quadruple disruptant deprived of acidic P1/P2 proteins. Additional deletions affect the interaction of PO with the P1 and P2 proteins and with the rRNA. The experimental data available support the implication of the eukaryotic stalk components in some regulatory process that modulates the ribosomal activity.
Amino Acid Sequence↗
[A study of peripheral neural conduction, motor and sensory, in diabetic patients treated with hyperbaric oxygenation].
INTRODUCTION: There are some occlusive disorders in the vasa nervorum and metabolic changes disminishing oxygen liberation by erytrocites at the capillary blood vessels, and these disturbances lead to endoneural microhypoxia. Hyperbaric oxygen reverts hypoxia in the diabetic neuropathy. OBJECTIVE: We studied motor and sensitive peripheric neuroconduction in nine diabetic patients, with distal symmetrical polyneuropathy, during normoglycemia. Four of them were insulin dependent and five were non insulin dependent. PATIENTS AND METHODS: The electrophysiological studies were done before treatment with hyperbaric oxygen, in a week, three and six months later. The abnormal electrophysiological parameters detected in diabetics were terminal latencies (enlarged), velocities of conduction (slowed) and distal amplitudes of compound action potentials (reduced). RESULTS: Neither distal latencies nor distal amplitudes and conduction velocities in peroneal nerve showed significative changes in the statistical analysis. We observed slower conduction velocities in the motor fibers of the median nerve in the examination performed six months after treatment. There was an increase of distal latency and retardation of the velocity of conduction six months later after treatment in the sensitive fibers of median nerve, whereas the amplitudes of sensitive action potentials decreased progressively. These changes suggest large diameter peripheral fibers didn't receive benefit with hyperbaric oxygen treatment. CONCLUSIONS: In all patients disappeared all symptoms of dysesthesias, paresthesias, distal pains and cramps in the legs and arms, suggesting functional changes in small unmyelinated fibers which we can't test with conventional techniques to prove it.
Adult↗
Two recent cases of tertiary syphilis.
Tertiary syphilis is now a rare disease in Europe, mainly as a result of occasional antibiotherapy for concomitant infections. However early syphilis is rising in USA and Germany, and it is necessary to maintain an high level of knowledge and suspicion to achieve a diagnosis in the tertiary stage of the disease. In this report two patients with benign tertiary syphilis are described. The first one is a 55-year-old female with erythemato-violaceous annular scaling plaques on the right buttock and scapula and on both thighs, which had a negative and then a low VDRL titer. The second case is a 33-year-old mentally handicapped female with erythematous plaques, with psoriasiform scaling in the trunk and well defined crusted ulcers on the face, which also had negative VDRL. Biopsy of the skin lesions revealed plasmocytic infiltrate with endothelial swelling without granulomas and with negative silver stains in both patients. The investigation for cardiovascular and neurological involvement was negative in both patients. Diagnosis of tertiary syphilis can be difficult as clinical pictures can be misleading, similar to other granulomatous diseases, and serological titers can be low or negative. We recall the necessity of ruling out neurological and cardiac involvement in this stage of syphilis. These cases are reported as a reminder of the possibility of syphilis, so that new cases are not misdiagnosed and mistreated as other diseases.
Adult↗
[Smoking cessation].
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Abortion, Spontaneous↗
[Prevalence of cutaneous lesions in Freixo de Espada à Cinta].
Incidence or prevalence studies on cutaneous lesions in general populations are not available. The community observed by the authors (Freixo de Espada à Cinta, North-Eastern Portugal) is relatively closed. A pre-tested questionnaire for socio-demographic and clinical information was used and a physical observation was conducted in January and February 1994 by the Dermatology Team of Santo António General Hospital, Oporto. The analysis was supported by independent tests (Pearson and Fisher chi 2, Student-t, Mann-Whitney and Kruskall-Wallis). The Spearman correlation coefficient was also used. The results indicated that 51.9% of 1000 subjects analysed were in phototype III. Concerning specific pathologies, the following percentages were observed: melanocytic nevi 81.2; hemangiomas 26.5; androgenetic alopecia 20.5; deshydrotic eczema 12.7; seborrheic keratosis 11; solar keratosis 9.6; acne vulgaris 9.5; seborrheic dermatitis 6.9; superficial mycosis 6.4; other dermatitis 5.5; vascular spiders 4.4; vulgar psoriasis 1.9; vulgar warts 1.5; pediculosis and scabiosis 1.2.; herpes simplex 0.9; impetigo 0.7; tumours (neoplasias) 0.7; dysplastic nevi 0.6; urticaria 0.3. More than nine nevi were counted in 50% of the subjects observed. A difference was observed (p < 0.05) concerning the presence of nevi, mycosis, hemangiomas, non-specific dermatitis, vascular spider and solar keratosis according to sex. The females had more nevi in number than males (Mann-Whitney, p = 0.03). According to age there was a difference concerning the presence of nevi, superficial mycosis, deshydrotic eczema, seborrheic dermatitis, acne, psoriasis, tumours, hemangiomas, non-specific dermatitis, vascular spider, solar keratosis (with linear augmentation by age) and seborrheic keratosis. Nevi increased with ageing (Rs = 0.10 p < 0.001) and a greater number were observed in age groups 0-9 and 60 or more years. Acne was observed in 9.4% of the females and 9.7% of the males, 46.2% in the 15-29 year-old age group. This study indicated that the population had a mean of nine nevi. Psoriasis was similar to that mentioned in other studies: about 1% in the United States of America. Atopic dermatitis (5.5%) is below the values for the northern population (> = 15%), but above that indicated for the English and American population. Nevertheless, the values of the present study were higher than those in the latter populations, when children until seven years old were considered. The Freixo de Espada à Cinta population above 60 years had solar keratosis in 30.6%, a value three times higher than the previous decade (10.9%); reference values were not found. Contrary to the literature, an association was not established between phototype and solar keratosis. Cutaneous tumours were observed in 0.7% of the cases.
Adolescent↗
[Organization of family labor and fertility in rural Mexico].
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Agriculture↗
Sleep-related breathing disorders in amyotrophic lateral sclerosis.
Sleep-related breathing events in patients with amyotrophic lateral sclerosis (ALS) have been reported in small case series, but the association with the clinical presentation--with (B) or without (nonB) bulbar symptoms--or the relevance for prognosis have not been investigated. We retrospectively analyzed sleep studies of 114 (46 nonB) ALS patients, aged 54 +/- 11 years. Respiratory function was better in nonB patients: forced vital capacity was 76 +/- 20% vs 55 +/- 23% in the bulbar group (p < 0.001); PaCO2 41 +/- 5 vs 44 +/- 6 mm Hg p < 0.05. The mean apnea/hypopnea index (AHI) was higher in nonB patients (22 +/- 12 vs 15 +/- 16 events per hour- p < 0.05); in this group 21 out of 46 patients (46%) had more than 20 events/hour versus 14 out of 68 (21%) in the nonB group (p < 0.005). On the contrary the oxygen desaturation index (ODI) was similar (10 +/- 11 vs 9 +/- 12 events per hour, p = NS). Most events had a central genesis and obstructive events were usually erratic, except in 7 patients (6 in group B) who had more than 10 obstructive events/hour. Data were stratified in three groups: with a disease duration below 1 year (< 1 yr), between 1 and 2 years (1-2 yr), and more than 2 years (> 2 yr). The occurrence of sleep-related respiratory disorders decreased with the increase of disease duration (23 +/- 15; 18 +/- 14; and 16 +/- 15 events per hour respectively), the decrease being significantly lower in the > 2 yr group than in the < 1 yr (p < 0.05). Again ODI was similar in the three groups. In conclusion the present study shows that sleep-related breathing events are more common than previously described in ALS patients, particularly in the first year following onset of the disease. Obstructive events occur rarely, although the prevalence of obstructive sleep apnea is higher than predicted, particularly when bulbar symptoms are present. Patients without bulbar signs show a higher prevalence of central events. The progressive decrease of events with the increase of disease duration could be due to a progressive weakness of respiratory muscles, but it could also suggest an independent role for nocturnal events which could be linked to a worse prognosis or to a more rapid decay of clinical status.
Adult↗
[Comparative study of peridural anesthesia with bupivacaine alone and combined with fentanyl during vaginal delivery].
Two groups of primiparous women with single fetus in cephalic presentation were prospectively randomized at the end of pregnancy to receive epidural analgesia with 0.25% bupivacaine, either single (n = 102) or associated with 0.05 mg of phentanyl (n = 102). Phentanyl significantly reduces the period of development of analgesia and increases the interdose period. The quality of analgesia is significantly better when fentanyl is associated with bupivacaine. The evolution of delivery (dilatation and expulsion) and the perinatal results (cord pH and vitality of the newborn as assessed by the Apgar test) were similar in both groups. We conclude that the association of phentanyl with bupivacaine has advantages for epidural analgesia during delivery, as the quality of analgesia is improved, its duration is prolonged and there are no adverse effects on the evolution of delivery or on the newborn.
Adult↗
[Acanthosis nigricans and cancer of the stomach].
A case of a 44 years old patient with inoperable gastric adenocarcinoma and exuberant lesions of Acanthosis Nigricans is described. He died nine months after the diagnosis, having experienced disappearance of the cutaneous manifestations after the cytostatic treatment done. The literature about Acanthosis Nigricans is reviewed and the importance of precocious search of associated malign disease is stressed. It was demonstrated by immunocytochemistry, positivity to NSE (neuron specific enolase) and ACTH, in the patient gastric tumour cells which allows them to be classified as neuroendocrine cells. It is suggested that Acanthosis Nigricans is a manifestation of a para-endocrine syndrome.
Acanthosis Nigricans↗
Treatment of gonorrhea with thiamphenicol: a study of 4,500 male patients.
In an eight-year study of thiamphenicol, 4,500 male patients with previously untreated, acute, uncomplicated gonococcal urethritis were selected for treatment with this drug. Gonococcal urethritis was diagnosed in all instances by microscopic examination of gram-stained urethral smears. In ambiguous cases, specimens were cultured on modified Thayer-Martin medium. All patients initially received a single oral dose of 2.5 g of thiamphenicol. This regimen resulted in clinical recovery within 24-48 hr in 4,028 patients (89.5%). The remaining 472 patients received a second regimen consisting of a single intramuscular injection of 750 mg of thiamphenicol followed 6 hr later by a single oral dose of 2.5 g; 462 (98%) of these patients recovered. Altogether, the two regimens produced a recovery rate of 99.8%. The drug was well tolerated both gastrointestinally and hematologically; blood tests performed for 2,000 patients showed no hematologic changes.
Acute Disease↗
[Synadelpho-ureterostomy: Indications].
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Child↗