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Biomedical subjects

E Morales

Publications and source records attributed to E Morales.

At least 73 records · Page 4Linked to original sources
PubMed1999

Etiological characterization of 512 severely mentally retarded institutionalized patients in havana.

OBJECTIVE: To investigate etiological factors in severe mental retardation (SMR). METHODS: An etiological study is presented of 512 SMR patients in five specialized institutions in Havana. RESULTS: Prenatal, perinatal and postnatal causes were apparent in 58.0, 24.8 and 11.1% of the patients, respectively; infantile psychosis was determined in only 0.4%. The remaining 5.6% were classified as having SMR of undeterminable origin, i.e. patients with apparently normal pre-, peri- and postnatal histories who had neither dysmorphism nor affected first-degree relatives, and had a normal karyotype and metabolic screen. Among prenatal causes, genetic factors were the most frequent (82.8%), while environmental factors were apparent in only 5.3% of these cases. Of the cases with prenatal genetic etiology, chromosomal aberrations were present in 86.5% (Down syndrome 96.2% and 3.7% other chromosomal aberrations), monogenic disorders in 11.3% [neurocutaneous diseases (32.1%) and fragile X syndrome (25%) were the most frequent], and multifactorial disorders in 2.0%. Thirty-five patients (11.7%) presented multiple congenital anomalies of 'prenatal unknown' causes. The latter group may include unidentifiable chromosomal aberrations, uniparental disomy, de novo mutations and multifactorial or teratogenic factors. CONCLUSION: Accurate determination of the etiology of SMR is important not only for genetic counseling purposes, but also in identifying prenatal events which make infants more vulnerable to perinatal risk factors.

Journal Article↗
PubMed1999

[Chronic myeloid leukemia and non Hodgkin lymphoma in the same patient. Clinical case].

Chronic myeloid leukemia is a myeloproliferative disorder caused by a clonal disturbance of the trunk cell and the accumulation of granulocytic series in the marrow, blood and other organs. We report a 63 years old male, carrier of a chronic myeloid leukemia whose clinical condition was complicated by the appearance of a T cell lymphoma. He was subjected to chemotherapy, that reduced the size of adenopathies and improved his general condition. Further studies are required to determine if there is a relationship between these two clinical entities.

Humans↗
PubMed1999

First cigarette smoking experience among secondary-school students in Aden, Republic of Yemen.

The objectives of this study were first to estimate the prevalence of cigarette smoking among secondary-school students and then to identify and analyse the demographic, social and cultural risk factors associated with the first cigarette smoking experience. A sample comprising 1000 students was selected randomly. Results showed that 19.6% of the total sample smoked; 15.5% among females and 21.9% among males. Family and/or friends appeared to influence the first cigarette experience and thus prevention strategies should involve not only the students themselves but the home, school and social environments also.

Adolescent↗
PubMed1998

Association of thin basement membrane nephropathy with hypercalciuria, hyperuricosuria and nephrolithiasis.

BACKGROUND: Familial persistent microhematuria with normal renal function is the most common presentation of thin basement membrane nephropathy (TBMN). Gross hematuria episodes and loin pain attacks are other manifestations of the disease. On the other hand, it has been shown that hypercalciuria (HC) and hyperuricosuria (HU) can produce both gross or microscopic non-glomerular hematuria, in addition to their role in renal stone formation. METHODS: We studied the prevalence of HC, HU and nephrolithiasis in a group of 27 biopsy-proven TBMN as well as in 19 non-biopsied first-degree relatives with persistent microhematuria and 25 first-degree relatives without microhematuria. A group of 27 patients with IgA nephropathy (IgAN) and persistent microhematuria, and another group of 20 healthy subjects without known renal diseases were selected as control groups. RESULTS: Ten (37%) patients with TBMN and 8 (42%) relatives with microhematuria showed HC and/or HU at presentation; relatives without microhematuria, IgAN patients and normal controls showed a significantly lower prevalence of HC and HU. The prevalence of previous nephrolithiasis among TBMN patients (25%) was significantly higher than in IgAN patients (3%; P < 0.05). Family history of nephrolithiasis was recorded in 14 (51%) of the 27 TBMN families, in contrast with 2 of 27 (7%) with IgAN and 1 of 20 (5%) in normal controls (P < 0.05). The prevalence of nephrolithiasis, gross hematuria bouts and loin pain episodes among TBMN patients and microhematuric relatives showing HC and/or HU at presentation (44%, 44% and 27%, respectively) were significantly higher than those of TBMN patients and microhematuric relatives with normal calcium and uric acid urinary excretions (10%, 7% and 3%, respectively; P < 0.05). At the end of follow-up (8.8+/-4.1 years in TBMN patients and 9.1+/-4.2 years in relatives with microhematuria), all the cases maintained normal renal function. CONCLUSIONS: We found a high prevalence of HC, HU, and nephrolithiasis among TBMN patients and relatives with microhematuria. Our study also shows a significant relationship between the presence of HC and/or HU and the prevalence of nephrolithiasis, gross hematuria bouts and loin pain episodes.

Adolescent↗
PubMed1998

[The application of the polymerase chain reaction technic for the detection of human papillomavirus sequences].

The polymerase chain reaction technique was applied to detect sequences of human Papillomavirus (HPV) by controls of cellular lines of cervical cancer and of tissues obtained through biopsy with a HPV-positive clinical diagnosis. A set of consensus oligonucleotides, which are complementary to a highly conserved region within the open reading frame E1 of the viral genome of HPV affecting the cervical mucosa, was used. With these primers it was possible to amplify DNA sequences corresponding to HPV 6 and 11, considered in the low risk group, and to HPV 16, 18, 31 and 33, included in the high risk group. The study of the sensitivity of the amplification technique showed a level of detection of 3,5 viral particles per each cellular diploid genome.

DNA, Viral↗
PubMed1997

Plasma tissue factor antigen levels in capillary whole blood and venous blood: effect of tissue factor on prothrombin time.

To measure the amount of tissue factor released during specimen collection and its potential effect of shortening the prothrombin time, we measured tissue factor and prothrombin time in twenty-three paired venous and capillary blood samples from anticoagulated patients and in ten paired samples from controls. We also compared venous prothrombin time determined by a plasma-based assay with venous and capillary prothrombin time determined with a whole blood assay. Venous specimens were obtained using a two-syringe technique; capillary specimens were obtained by fingerstick after wiping the first drop of blood. Plasma tissue factor was determined by an enzyme-linked immunoabsorbant assay. The patients' mean venous tissue factor (235 +/- 101 pg/ml) and capillary tissue factor (268 +/- 106 pg/ml) were higher than those of the controls (161 +/- 42 pg/ml and 187 +/- 63 pg/ml, respectively, P < 0.05). These differences disappeared after adjusting for age. Capillary tissue factor levels were higher than venous tissue factor (244 +/- 102 pg/ml vs. 213 +/- 93 pg/ml), with a mean difference of 31 pg/ml (P = 0.0001). In addition, whole blood prothrombin time was lower in the capillary than in the venous samples (17.7 +/- 5 sec vs. 18.3 +/- 5.4 sec, P = 0.004). However, there was no correlation between capillary-venous differences in tissue factor and capillary-venous differences in the whole blood prothrombin time. Whole blood capillary and venous prothrombin times highly correlated with the plasma-based venous prothrombin time (r = 0.98, P < 0.0001). These results demonstrate that obtaining blood by fingerstick does not result in a clinically significant release of tissue factor. In addition, we did not observe any interference of plasma tissue factor with the whole blood prothrombin time assay. A direct relationship between tissue factor and age was observed.

Adult↗
PubMed1996

Block of large conductance Ca(2+)-activated K+ channels in rabbit vascular myocytes by internal Mg2+ and Na+.

1. We studied the biophysical properties of single large conductance (> 200 pS in symmetrical K+ pipette and bath solutions) Ca(2+)-activated K+ (BKca) channels of rabbit portal vein and coronary arterial smooth muscle cells using the cell-attached and inside-out variants of the patch-clamp technique (at 22 degrees C). 2. The unitary conductance of BKca channels recorded in cell-attached patches with K+ concentrations in the range 5.4-140 mM was significantly lower than that predicted on the basis of the conductance measured in inside-out patches with symmetrical K+ pipette and bath solutions (140 mM) and the constant field equation. In cell-attached patches from cells bathed in depolarizing medium (140 mM) with 5.4 mM K+ in the pipette solution, BKca channels were difficult to detect on the physiological range of membrane potentials (approximately -50 mV). Unitary currents were smaller at all voltages in the range -50 to 0 mV and the i-V relationship exhibited strong inward rectification at potentials > 0 mV. These channels were unequivocally identified as BKca channels due to their sensitivity to caffeine (10 mM) and iberiotoxin (20 nM), and their non-stationary kinetic properties. 3. Exposure of the cytoplasmic side of excised patches to [Mg2+] in the range 0-15 mM produced two effects on BKca channel activity: the slope conductance and open probability were reduced and enhanced, respectively, in a concentration-dependent manner by this cation. The Mg(2+)-induced reduction in conductance exhibited weak voltage dependence. 4. Application of 20 mM Na+ to the internal face of BKca channels recorded in the inside-out configuration produced a flickery block at potentials > or = +20 mV resulting in reduced unitary current amplitudes and strong inward rectification of the i-V relationship. Exposure of inside-out patches to a combination of 20 mM Na+ and 2 mM Mg2+ further reduced unitary current amplitude to a level similar to the algebraic sum of the effect of each cation in isolation. 5. We conclude that Ca(2+)-dependent K+ channels of vascular smooth muscle cells display a lower unitary conductance when recorded under physiological conditions than that previously estimated on the basis of their behaviour in excised membrane patches. Our data indicate that the decreased permeation through BKca channels may be partly attributed to block by intracellular Mg2+ and Na+, which appear to interact with distinct binding sites along the inner side of the pore.

Animals↗
PubMed1996

A cAMP regulated K+-selective channel from the sea urchin sperm plasma membrane.

Ion channels are deeply involved in sperm physiology. In sea urchin sperm cyclic nucleotide levels increase during quimotaxis and in the acrosome reaction (AR). Although cyclic nucleotides are second messengers known to directly or indirectly modulate ion channels, it is not clear how they modulate sperm responses to the egg outer layer. Here, we describe a cAMP regulated K+-selective channel from sea urchin sperm plasma membranes fused into planar bilayers that may have a role during sea urchin sperm quimotaxis and/or the AR. Its single channel conductance in 100 mM KCl is 103 pS. In bi-ionic experiments, the channel displayed a K+/Na+ permeability ratio (PK+/PNa+) of approximately 5. Thus, in sea water its reversal potential would be approximately -13 mV and channel opening would depolarize spermatozoa. The channel has low open probability (Po = 0.8 +/- 0.2% at 0 mV applied voltage) and weak voltage dependence. Channel activity is reversibly up-regulated by cAMP in the cis bilayer side, but not by cGMP. This modulation followed a single Langmuir isotherm with an apparent kd of 200 microM. At this concentration the channel open probability at 0 mV increased up to 11- fold. TEA+ blocked the channel only from the trans side. Also Ba2+ in trans blocked the channel in a voltage-dependent manner.

Animals↗
PubMed1996

Protein requirements of infants and children: growth during recovery from malnutrition.

OBJECTIVE: To evaluate the adequacy of protein intakes now recommended as safe for infants and toddlers. METHODS: Subjects were recovering malnourished infants, age 5.3 to 17.9 months, length age (LA) 2.5 to 6.4 months, weight age (WA) 1.5 to 5.2 months, weight/length (W/L) 78% to 100% of National Center for Health Statistics data; and toddlers age 11.4 to 31.6 months, LA 6.1 to 17.9 months, WA 3.9 to 12.0 months, W/L 79% to 99%. Infants were assigned at random to formulas with 5.5%, 6.7%, or 8.0% energy as 60:40 whey:casein protein. The 5.5% was based on FAO-WHO-UNU safe protein and average energy for ages 2.5 to 6.0 months. Toddlers received 4.7% (recommended for 6 to 18 months), 6.4%, or 8.0%. Identical concentrations (weight/kcal) of other nutrients were maintained; intakes were adjusted weekly to reach, in 90 days, the 50th percentile of weight for a LA 3 months greater than the initial one. RESULTS: Infants consumed 125 +/- 11 (SD), 116 +/- 10, and 126 +/- kcal and 1.7 +/- 0.1, 1.9 +/- 0.2, and 2.5 +/- 0.3 g protein kg-1 . d-1; gained 2.4 +/- 0.7, 2.9 +/- 0.7, and 2.6 +/- 0.5 months in LA, and reached a W/L of 105 +/- 5, 103 +/- 6, and 105 +/- 5% of reference. Sum of four fat-folds (sigma FF) grew 13.1 +/- 6.9, 10.4 +/- 4.8, and 11.7 +/- 5.3 mm to 32.5 +/- 5.2, 31.7 +/- 4.7, and 30.5 +/- 5.5 mm; arm muscle areas (AMA) 57%, 51%, 70% to 1004 +/- 109, 1017 +/- 110, and 1004 +/- 116 mm2, still low; arm fat areas (AFA) 93%, 66%, and 93% to higher-than-normal 598 +/- 105, 610 +/- 101, and 541 +/- 116 mm2. Regression of intake on weight gain estimated energy for maintenance + activity to be 81.0 +/- 7.5 (SEM) kcal . kg-1 . d-1, and cost of gain (storage + metabolic cost) as 7.6 +/- 1.7 kcal/g, with no significant effect of % protein. Toddlers consumed 107 +/- 9, 103 +/- 12, and 105 +/- 10 kcal and 1.3 +/- 0.1, 1.6 +/- 0.2, and 2.1 +/- 0.2 g protein . kg-1 . d-1, gained 3.3 +/- 0.7, 2.9 +/- 0.6, and 3.3 +/- 0.7 months in LA; to a W/L of 102 +/- 1, 102 +/- 3, and 101 +/- 4%. Sigma FF grew 9.2 +/- 4.0, 7.4 +/- 4.3, and 6.0 +/- 3.8 to 28.9 +/- 5.2, 30.5 +/- 3.7, and 27.0 +/- 2.7 mm; AMA 31%, 33%, and 34% to 1121 +/- 115, 1124 +/- 110, and 1117 +/- 120 mm2; AFA 53%, 44%, and 45% to higher-than normal 578 +/- 106, 636 +/- 99, and 569 +/- 68 mm2. Cost of maintenance + activity was 70.8 +/- 3.8 (SEM) kcal . kg-1 . d-1, that of weight gain 9.7 +/- 1.35 kcal/g, with no effect of % protein. CONCLUSIONS: Within age groups, there were no significant protein-related differences in growth. In both infants and toddlers, high-energy intakes resulted in mild obesity, with lean body mass still deficient. Protein intakes two SD below the means in the lowest protein/energy cells, 1.5 g . kg-1 . d-1 for infants and 1.1 g times kg-1 . d-1 for toddlers, should still be safe for nearly all children of comparable biological ages.

Adipose Tissue↗
PubMed1995

Least restrictive measures: alternatives to four-point restraints and seclusion.

Following the review and discussion of alternative measures in the use of four-point restraints and seclusion on an acute psychiatric inpatient unit, the staff increased the use of "least restrictive" measures with aggressive patients. This involved increased attention to escalating behavior and using alternatives. Although early recognition did not guarantee success in every situation, patients were included in making choices and being in control of which option to take. When staff became more knowledgeable about the use of alternatives, they were more comfortable offering patients choices and did not wait until restraints and seclusion were necessary. It was beneficial to review the rationale for the use of seclusion and restraints with both patients and staff. Specific approaches for early recognition and intervention focused on verbal control, limit setting, and decreased stimulation. It is important that staff have a clear understanding of their range of treatment strategies from most to "least restrictive" measures during stressful times when patients become confused, angry, or frightened and may lose control. Patients must be made aware of their choices during this cycle and understand the consequences of their behavior. Planning educational inservice programs for staff to address this content and share approaches to specific situations can be effective. Staff debriefing following an incident is crucial to discuss reactions to the use of restraints and seclusion and to plan for the use of alternative measures in the future. All patients need a chance to express themselves. As staff we must take time to stop, look, and listen. We must be aware of our own thoughts and feelings and think of choices. What are the ¿least restrictive¿ measures? We need to work with patients in considering a range of measures without taking unnecessary risks or disregarding issues. We must work with our patients so that we all can learn a valuable lesson. Why not give our patients a chance?

Adult↗
PubMed1995

Dopaminergic influence on the cardiovascular response to exercise in normotensive and hypertensive subjects.

Fourteen subjects (normotensive, hypertensive) were studied at the Vargas Hospital of Caracas. They were treated with placebo (2 periods), domperidone, a peripheral dopaminergic blocker, at the daily oral dose of 40 mg, and metoclopramide, a central and peripheral dopaminergic blocker, at the daily oral dose of 40 mg. All placebo and active drug periods lasted 1 week. Cardiovascular hemodynamic parameters (blood pressure, heart rate) were measured before, during and after submitting subjects to treadmill exercise according to the Bruce's protocol. Metoclopramide decreased significantly heart rate before and during exercise stress and systolic blood pressure during stage 1 exercise in normotensive subjects. Domperidone decreased significantly heart rate before and during exercise stress, and systolic blood pressure during stage 3 exercise in hypertensive subjects. Neither heart rate nor blood pressure were changed significantly after 8 minutes resting period post exercise. Our results suggest the existence of an excitatory modulatory influence of dopaminergic influence during exercise over the sympathetic activity.

Adult↗
PubMed1995

Metoclopramide blocks bromocriptine induced antihypertensive effect in hypertensive patients.

Two groups of patients with essential hypertension were studied at the Vargas Hospital of Caracas. The first group of 9 patients under placebo treatment for 1 week received a single 2.5 mg oral dose of bromocriptine. Cardiovascular and biochemical parameters including arterial pressure, heart rate, plasma renin activity, and plasma aldosterone levels were evaluated during the 6-hour period before and after the administration of drugs. The second experimental design was as follows: 9 patients received 30 mg metoclopramide daily (divided in 3 doses) for 1 week. At the end of the period a single oral dose of 2.5 mg of bromocriptine was given to each patient. The cardiovascular and biochemical parameters were also determined. Bromocriptine reduced both systolic and diastolic arterial pressure. The peak antihypertensive effect was shown 3 hours after administration of the drug, but the reduction of arterial pressure lasted approximately 6 hours. At the same time bromocriptine reduced plasma aldosterone levels and plasma renin activity. This reduction persisted 6 hours after its administration. Metoclopramide reversed the antihypertensive effect of bromocriptine and its effect on aldosterone secretion and plasma renin activity. We conclude from these findings that bromocriptine acts as an antihypertensive agent by stimulating DA2 dopaminergic receptor, the dopaminergic receptor involved in aldosterone and renin secretion is possibly DA2.

Aldosterone↗
PubMed1994

Detection of human papillomavirus by nonradioactive hybridization.

The presence of the human papillomavirus (HPV) DNA sequence in cervical smears of women with cervical intraepithelial neoplasia (CIN) was investigated through dot blot using a nonradioactive method based on the principle of enhanced chemiluminiscence. From 154 samples examined, 59 (38.3%) had HPV-related sequences determined by dot-blot hybridization; among these, 18 samples (11.68%) reacted either to HPV 6/11 or to HPV 16/18 probes, 20 (12.98%) reacted to only HPV 16/18, and 21 (13.63%) reacted exclusively to HPV 6/11. The relative sensitivity of the method was controlled comparing the results of both tests with those obtained by Southern blot in 32 samples. The risk of HPV positivity was increased in women who first had intercourse at an early age and in patients with CIN II or III. Both associations were significant at the 95% confidence interval (CI). An increased risk of HPV positivity was also associated with patient's age at diagnosis, education levels, number of sexual partners, and use of oral contraceptives, but none of these factors were significant at 95% CI. Other risk factors for cervical cancer, such as the number of pregnancies or cigarette smoking, were not found to be associated with HPV infection and indicate that the association of these factors with cervical cancer probably is independent of HPV infection. Even if HPV is the major risk factor for CIN, this also supports a multifactorial model of cervical cancer etiology with an increased risk of HPV infection.

Adult↗
PubMed1994

Meaning of touch to hospitalized Puerto Ricans with cancer.

This ethnographic study was undertaken to elicit the meaning of nurse's touch for hospitalized Puerto Rican patients with cancer. The key informants were eight cancer patients at a tertiary 12-bed oncology research unit in Puerto Rico. Data gathering methods included participant observation and several ethnographic interviews during a month period. Content analysis was used to identify pattern of behavior and meaning. Analysis of the field notes and interviews was done to search for domains. Theme analysis was used in the search for the relationship among domains. In the analysis of the patient interviews, two types of touch were identified: procedural and affective touch. The predominant theme about perception of nurse's touch was that of conveying confidence. Confidence was related to the patient's increase in positive expectation as much as the possibility of recovery from the cancer illness. The confidence theme was represented by two domains: the enhancement of the abilities of the patient for coping and through the acceptance of the patient as a person during their illness experience.

Adaptation, Psychological↗