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Biomedical subjects

E Fernandez

Publications and source records attributed to E Fernandez.

324 records · Page 18Linked to original sources
PubMedDate not supplied

The impact of Title VII departmental and predoctoral support on the production of generalist physicians in private medical schools.

Although federal support for medical education comes from several sources, only 1 targets generalist education--Title VII of the Public Health Service Act. With governmental streamlining and downsizing, the federal investment in medical education should be evaluated. We tested the relationship between 2 Title VII authorities and presence of a medical school generalist training infrastructure, and the relationship between this infrastructure and generalist production. Based on our definitions for receipt of Title VII support, generalist infrastructure, and generalist production, we found that, for private schools, sustained receipt of Title VII funds directed for undergraduate medical education is positively associated with presence of family medicine departments, which is positively associated with higher rates of generalist production. Establishment and maintenance of family medicine departments in private schools and their generalist production are positively associated with Title VII support. Title VII support in public schools, the major generalist producers, has less of a unique measurable impact on generalist production.

Education, Medical, Graduate↗
PubMedDate not supplied

Relative contributions of life events versus daily hassles to the frequency and intensity of headaches.

This study investigated headaches parameters (frequency and intensity) in relation to (the number and severity of) two types of psychosocial stress: major life events (as assessed by a revised Social Readjustment Rating Scale) and minor daily hassles (as assessed by a revised Hassles Scale). Subjects were 261 volunteers reporting headache. Results revealed that both headache frequency and intensity were significantly predicted by daily hassles, in particular, the average severity of these hassles, but there was a negligible relationship between headache parameters and any of the life event measures. Furthermore, a significant relationship emerged between life events and daily hassles themselves. This fits with recent findings that life events (while exerting little direct effect on headache) may trigger a succession of hassles which culminate in headaches. Also, it is not the number of hassles, but the perceived severity of these hassles that best predicts headache frequency and intensity. Finally, though significant as predictors, daily hassles explained a small portion of the variance in headache, thus pointing to the host of other possible biological and psychosocial contributions to headache.

Adolescent↗
PubMedDate not supplied

Malignant fibrous histiocytoma of the spleen and chronic myelogenous leukemia. A case report.

We report a rare case of a patient with an intrasplenic malignant fibrous histiocytoma (MFH) and chronic myelogenous leukemia. The neoplasms were synchronous in their onset and evolution. The peculiarity of the primary site of the MFH, the genetic implications of multiple primary tumors in a single patient, and the controversy about the cell precursors of MFH are briefly outlined.

Adult↗
PubMedDate not supplied

Just 'doing the observations': reflective practice in nursing.

The first part of this article explores the development, definition, and design of reflective practice. In the second part the author relates an 'ordinary nursing' story--'10 minutes with Mr Kandinski'--and uses an existentialist framework for reflective analysis. Reflection on personal experience can expose something of the interrelationship of theory and practice, perhaps helping practitioners to improve their work. More importantly, reflective practice provides a means for nurses to reveal a more complete picture of the reality of nursing work to others.

Clinical Competence↗
PubMedDate not supplied

GH-IGF axis during catch up growth in small for gestational age (SGA) infants.

The hormonal profile in 47 small for gestational age (SGA) term newborns during their first year of life was studied. The newborns had a mean birth weight of 2290 +/- 230 g and a length of 45.5 +/- 2.0 cm, and they were followed up every month. Serum IGF-I, IGF-II, and urinary growth hormone (u-GH) concentrations were measured at 3 days of age and every 3 months during one year. Serum IGFBP-3 levels were measured at 3 and 6 months of age. Catch up growth (CUG) was defined as an increase in length z score greater than 1 SD between birth and 6 months of age. According to this definition, 27 infants (57.4%) experienced CUG. We compared the hormonal profile of the infants who demonstrated evidence of CUG [CUG(+)] with those who did not [CUG(-)]. Serum IGF-II levels were significantly higher in CUG(+) infants compared to CUG(-) infants at 3 months of age. We did not find any differences in serum IGF-I, IGFBP-3 and urinary GH between CUG(+) and CUG(-) infants at any time during the study.

Birth Weight↗
PubMedDate not supplied

Zoonotic cutaneous leishmaniasis due to Leishmania (Viannia) braziliensis associated with domestic animals in Venezuela and Brazil.

After outbreaks of cutaneous leishmaniasis in Solano State, Venezuela, 5% of the population had parasitized ulcers while after similar outbreaks in Mesquita, Rio de Janeiro State, Brazil, 9% had the disease. In these foci children, including some under six years of age, were affected. There was no significant difference in the occurrence of the disease according to sex or type of employment. In Solano, 3% of dogs and 28% of donkeys had parasitized lesions, while in Mesquita these indices were 19.8% and 30.8% respectively. The parasite from man, dogs and equines was identified as Leishmania (Viannia) braziliensis, by zymodeme and serodeme characterization. In these foci there is evidence suggesting that leishmaniasis is a zoonosis, possibly with equines and dogs as reservoirs, although both a wild enzootic cycle and the role of man as a source of infection can not be ruled out. Transmission is assumed to occur peridomestically by sandfly vectors such as Lutzomyia panamensis in Venezuela and Lutzomyia intermedia in Brazil. Information about the origin of these foci suggests that infected equines may be an important factor in the dissemination of the parasite in a peridomestic situation where these sandflies are abundant.

Adolescent↗
PubMedDate not supplied

Menierè's disease: is it a bilateral disease?

BACKGROUND: Bilateral Meniere's disease (MD) is still controversial due to different criteria used to assess the involvement of the primarily affected ear and the contralateral one. We evaluated the percentage of bilateral forms in 49 patients with MD. METHODS: 49 patients with (MD) were studied. All were selected according to the following requirements: history, tonal audiometry, glycerol test, Auditory Brainstem Response (ABR), vestibular examination. Magnetic Resonance (MR) was performed in 14 patients. RESULTS: A raised hearing threshold in the contralateral ear was found in 23 patients, but only 7 (14.3%) fulfilled the requirements to be considered affected by bilateral MD. The delay of occurrence in the contralateral ear was 7 years (from 5 to 12 years). Submillimeter Magnetic Resonance is determinant for differential diagnosis with Meniere-like syndromes. CONCLUSIONS: A conservative approach in surgical treatment of unilateral Meniere's disease is recommended because of the possibility of evolution in a bilateral form, that can occur even after 10 years from the onset of the disease.

Adult↗
PubMedDate not supplied

[Yeast diversity in Bulnesia retama and Larrea divaricata canopies and associated soils].

Bush like vegetation dominates arid environments, and there is nutrients accumulation under shrub canopies and relatively unfertile soils between vegetal patches areas. Plants are one of the most common habitats for yeasts. There are many reports about yeasts inhabiting different plant components. Nevertheless, there are no reports about yeasts associated with Zygophyllaceae, an important shrub family of the Argentinean Province of Monte. The objective of this work was to analyzed yeast biodiversity of Bulnesia retama and Larrea divaricata canopies and associated soils, at Medanos Grandes of Caucete, San Juan, Argentina. Eighty seven (87) isolated yeasts were identified. From B. retama canopy and associated soil was observed a larger taxonomical diversity respect to L. divaricata. Nine (9) and ten (10) species were isolated from canopy and associated soil of B. retama, respectively. From L. divaricata canopy were 4 species and 3 species from its associated soil isolated. Identified genera were: Candida, Debaryomyces, Dekkera, Saccharomyces, Torulaspora, Sporidiobolus and Pichia. Fourteen (14) species were found at all microenvironments.

Argentina↗
PubMedDate not supplied

[Design of a vaccination campaign against hepatitis b virus].

Plans for a vaccination campaign among the health care personnel at the "Valle del Nalón" Hospital are discussed. For this purpose, first of all, the serological testing to determine the markers as compared to the VHB was done using the ELISA technique, and in following, the vaccine based on genetic engineering, ENGERIX BR was provided, initially according to the criteria established to this effect by law, and then from a less restricted view, according to the principles which are given in the text. We have observed that 14.74% of the workers in our town have some positive marker priori to the vaccination and that 1.81% are carriers. The level of tolerance was that of 45.79%, said level being related to the professional group in question and the service in which they work, differences obtained in both cases being statistically quite significant (p less than 0.0001).

Hepatitis B↗
PubMedDate not supplied

Family history and the risk of liver, gallbladder, and pancreatic cancer.

The relationship between family history of selected neoplasms in first-degree relatives and the risk of pancreatic, liver, and gallbladder cancer was investigated using data from a case-control study conducted in northern Italy on 320 histologically confirmed incident cases of liver cancer, 58 of gallbladder cancer, 362 of pancreatic cancer, and 1408 controls admitted to the hospital for acute, nonneoplastic, nondigestive tract disorders. Significant associations were observed between family history of hepatocellular carcinoma and primary liver cancer [relative risk (RR) = 2.4; 95% confidence interval (CI), 1.3 to 4.4], between family history of pancreatic cancer and pancreatic cancer (RR = 3.0; 95% CI, 1.4 to 6.6), and between family history of gallbladder cancer and gallbladder cancer (RR = 13.9; 95% CI, 1.2 to 163.9). The elevated risk of liver cancer associated with family history was not materially modified by adjustment for tobacco, alcohol, and personal history of cirrhosis and hepatitis (RR = 2.9; 95% CI, 1.5 to 5.3). Similarly, the risk for pancreatic cancer did not appreciably change after allowance for tobacco, alcohol, dietary factors, and medical history of diabetes and pancreatitis (RR = 2.8; 95% CI, 1.3 to 6.3). This pattern of risk would support the existence of a genetic component in the familial aggregation of liver and pancreatic cancer. In terms of population attributable risk, approximately 3% of the newly diagnosed liver and pancreatic cancers would be related to this familial component.

Aged↗