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Biomedical subjects

J Lamberti

Publications and source records attributed to J Lamberti.

At least 19 recordsLinked to original sources
PubMed1999

Sequence variations in the Boophilus microplus Bm86 locus and implications for immunoprotection in cattle vaccinated with this antigen.

Cattle tick infestations constitute a major problem for the cattle industry in tropical and subtropical regions of the world. Traditional control methods have been only partially successful, hampered by the selection of chemical-resistant tick populations. The Boophilus microplus Bm86 protein was isolated from tick gut epithelial cells and shown to induce a protective response against tick infestations in vaccinated cattle. Vaccine preparations including the recombinant Bm86 are used to control cattle tick infestations in the field as an alternative measure to reduce the losses produced by this ectoparasite. The principle for the immunological control of tick infestations relies on a polyclonal antibody response against the target antigen and, therefore, should be difficult to select for tick-resistant populations. However, sequence variations in the Bm86 locus, among other factors, could affect the effectiveness of Bm86-containing vaccines. In the present study we have addressed this issue, employing data obtained with B. microplus strains from Australia, Mexico, Cuba, Argentina and Venezuela. The results showed a tendency in the inverse correlation between the efficacy of the vaccination with Bm86 and the sequence variations in the Bm86 locus (R2 = 0.7). The mutation fixation index in the Bm86 locus was calculated and shown to be between 0.02 and 0.1 amino acids per year. Possible implications of these findings for the immunoprotection of cattle against tick infestations employing the Bm86 antigen are discussed.

Amino Acid Sequence↗
PubMed1999

Liposomal prostaglandin E1 (TLC C-53) in acute respiratory distress syndrome: a controlled, randomized, double-blind, multicenter clinical trial. TLC C-53 ARDS Study Group.

OBJECTIVE: To evaluate the safety and efficacy of an intravenous liposomal dispersion of prostaglandin E1 as TLC C-53 in the treatment of patients with acute respiratory distress syndrome (ARDS). DESIGN: Randomized, prospective, multicenter, double-blind, placebo-controlled, phase III clinical trial. SETTING: Forty-seven community and university-affiliated hospitals in the United States. PATIENTS: A total of 350 patients with ARDS were enrolled in this clinical trial. INTERVENTION: Patients were prospectively randomized in a 1:1 ratio to receive either liposomal prostaglandin E1 or placebo. The study drug was infused intravenously for 60 mins every 6 hrs for 7 days starting with a dosage of 0.15 microg/kg/hr. The dose was increased every 12 hrs until the maximal dose (3.6 microg/kg/hr) was attained or intolerance to further increases developed. Patients received standard aggressive medical/surgical care during the infusion period. OUTCOME MEASURES: The primary outcome measure was the time it took to wean the patient from the ventilator. Secondary end points included time to improvement of the PaO2/FIO2 ratio (defined as first PaO2/FIO2 > 300 mm Hg), day 28 mortality, ventilator dependence at day 8, changes in PaO2/FIO2, incidence of and time to development/resolution of organ failure other than ARDS. RESULTS: A total of 348 patients could be evaluated for efficacy. The distribution of variables at baseline describing gender, lung injury scores, Acute Physiology and Chronic Health Evaluation II scores, PaO2/FIO2, pulmonary compliance, and time from onset of ARDS or from institution of mechanical ventilation to the first dose of study drug was similar among patients in the liposomal prostaglandin E1 (n = 177) and the placebo (n = 171) treatment arms. There was no significant difference in the number of days to the discontinuation of ventilation in the liposomal prostaglandin E1 group compared with the placebo group (median number of days to off mechanical ventilation, 16.9 in patients receiving liposomal prostaglandin E1 and 19.6 in those administered placebo; p = .94). Similarly, mortality at day 28 was not significantly different in the two groups (day 28 mortality, 57 of 176 (32%) in the liposomal prostaglandin E1 group and 50 of 170 (29%) in patients receiving placebo; p = .55). In contrast, treatment with liposomal prostaglandin E1 was associated with a significantly shorter time to reach a PaO2/FIO2 ratio of >300 mm Hg (median number of days to reaching a PaO2/FIO2 ratio >300 mm Hg: 9.8 days in the liposomal prostaglandin E1 group and 13.7 days in patients receiving the placebo; p = .02). Among the subgroups examined, time to off mechanical ventilation was significantly reduced in patients who received at least 85% of a full dose (i.e., > 45.9 microg/kg) of liposomal prostaglandin E1 (median number of days to discontinuation of ventilation, 10.3 in the liposomal prostaglandin E1 group and 16.3 days in patients receiving placebo; p = .05). The overall incidence of serious adverse events was not significantly different in the liposomal prostaglandin E1 (40%) or placebo-treated (37%) groups. Drug-related adverse events of all kinds were reported in 69% of the patients receiving liposomal prostaglandin E1 compared with 33% of the placebo group, with hypotension and hypoxia (occurring in 52% and 24% of the liposomal prostaglandin E1-treated patients, respectively, and 17% and 5% of the placebo-treated patients, respectively) being noted most frequently. CONCLUSIONS: In the intent-to-treat population of patients with ARDS, treatment with liposomal prostaglandin E1 accelerated improvement in indexes of oxygenation but did not decrease the duration of mechanical ventilation and did not improve day 28 survival.

Adult↗
PubMed1998

Separation of omphalopagus twins: unique reconstruction using syngeneic cryopreserved tissue.

Omphalopagus twin girls were admitted for evaluation of possible separation and repair at age 7 days. Prenatal sonographic diagnosis occurred late in the third trimester and was followed by cesarean section delivery shortly thereafter. Results of extensive evaluation over the next 7 days including x-rays, computed tomography and ultrasound scan of the head and torso, and cardiac catheterization showed: the gastrointestinal tracts were separate and normal, the livers were joined but had separate biliary and vascular systems, and the hearts were separate with vastly different anatomy and function. One twin (twin A) had a normal heart with a small insignificant VSD. Twin B had a single ventricle, an incompetent A-V valve, stenotic pulmonic valve, ASD, PDA, and congenital heart block. Hemodynamic support of twin B was almost entirely from twin A. The vascular communications between the two consisted of a major connection between the internal mammary arteries and large arterial and venous connections traversing the joined livers. Because of continued deterioration of twin B, separation was undertaken at age 15 days. The separation included dividing the liver and the multiple large vascular connections. Two teams then reconstructed each twin separately. Twin B began showing signs of cardiac decompensation shortly after separation in spite of placement of a pacemaker, pulmonary artery banding, and ligation of the PDA. Cardiac function rapidly deteriorated and she died. Tissue from her chest wall was cryopreserved and placed in the tissue bank. Twin A underwent closure of her abdomen, and received a temporary bovine pericardial patch over the chest defect. She subsequently underwent placement of a graft of twin B's rib cage to bridge the bony chest defect and skin flap closure. She is presently taking a normal diet and thriving at home at age 18 months. The use of cryopreserved tissue from a syngeneic source provides a unique method of reconstruction in this situation.

Abdomen↗
PubMed1993

Changes in sexual behavior following radiation therapy for cervical cancer.

Twenty-one women with cervical cancer Types I and II, treated by radiation were evaluated by comparing periods before cancer and after therapy in order to identify changes in sexual behavior; if so, whether they attributed the changes to therapy, or whether other factors were associated with being sexually dysfunctional or non-dysfunctional. Data were obtained through administration of a sexual behavior questionnaire, personal interviews and review of medical records. Statistically significant changes were found: decreased frequency of masturbation and intercourse, decreased frequency of orgasm through non-coital sexual activities, less satisfaction with sex, and less enjoyment of intercourse. The majority believed that changes were due to radiation therapy and reflected decreased feelings of self-esteem, sex desirability and attractiveness. Most of the women believed that cancer could be transmitted through intercourse. Women who did not follow advice regarding use of vaginal dilators and did not resume their pre-illness level of sex were more likely to develop physical and sexual changes. The subjects' need for sexual counselling concerning the effect of the illness and treatment on relationships with partners was strongly evident. Suggestions for preventing undesirable physical and psychological changes, and guidelines for counselling are provided.

Attitude to Health↗
PubMed1991

Follow-up status of patients with angiographically normal coronary arteries and panic disorder.

Cardiology patients with normal coronary angiography demonstrate continuing and substantial social, health, and work disability. We hypothesized that the diagnosis of panic disorder would mark those for whom continuing disability is most likely. We interviewed 72 such patients at the time of their normal angiogram, and then again an average of 38 months later. Those with panic disorder (n = 36) demonstrated significantly more disability at follow-up than did the other study patients. We conclude that those patients with normal angiograms who have panic disorder are more disabled than those who do not have panic disorder. Panic disorder in psychiatric samples has been shown to be highly treatable. Therefore, early identification and treatment of panic disorder in this group is likely to minimize the suffering associated with this condition.

Adult↗
PubMed1987

Situational factors and behavioral self-predictions in the identification of clients at high risk to drop out of psychotherapy.

Two hundred and eight adults who requested outpatient treatment at a community mental health center were asked to complete brief questionnaires immediately prior to and after their first therapy session. Questionnaires contained items that pertained to self-predicted length of stay in psychotherapy, situational barriers to regular attendance, and past behavior in similar situations (e.g., appointment-keeping with other health care professionals). Therapists also were asked to make predictions with regard to client length of stay. Questionnaire data were analyzed via a series of double cross-validated multiple regression and discriminant function equations, and results indicated that client and therapist predictions of length of stay in therapy were the most stable and consistent correlates of attendance behavior.

Adult↗
PubMed1979

Surgical treatment of recurrent primary malignant tumor of the left atrium.

A young woman presented with a tumor in the left atrium resembling a left atrial myxoma. After simple excision of the tumor the diagnosis of primary malignant fibrous histiocytoma of the heart was made. A course of radiation therapy was given. Four subsequent recurrences were treated by cardiotomy and resection of the left atrial wall. At the third, fourth, and fifth operations fulguration of the left atrial wall was performed. Subsequent chemotherapy failed to control the tumor. The patient was admitted 6 weeks after the last resection and died. Postmortem examination revealed a large recurrent tumor obstructing the left atrium with no metastases. The clinical course, cardiac catherization data, and postmortem examination are presented. Palliation was achieved by repeated resection of a radiation-resistent primary sarcoma of the heart.

Adult↗
PubMed1978

Malignant fibrous histiocytoma of the heart presenting as an atrial myxoma.

A 37-year-old woman presented with signs and symptoms suggestive of mitral stenosis and insufficiency. Subsequent evaluation demonstrated a left atrial tumor which was suspected clinically and at the time of initial surgery to be an atrial myxoma. Histologic examination revealed that the tumor was actually a malignant fibrous histiocytoma. Despite near total removal at surgery and subsequent radiotherapy, the tumor recurred within six months in the left atrium. Re-excision was followed by a third recurrence in the same site.

Adult↗
PubMed1978

Complete common atrioventricular canal in infancy--surgical repair and postoperative hemodynamics.

Fourteen infants with complete common atrioventricular canal (CCAVC) underwent open heart surgery under deep hypothermia and circulatory arrest. There were three operative deaths and two late deaths. Postoperative studies performed in seven of the nine survivors revealed nearly normal hemodynamics. There were no residual shunts, and excellent mitral valve function was observed in six patients. In one patient, residual mitral regurgitation was noted. The pulmonary artery pressures and pulmonary vascular resistances were normal except in one who had severe pulmonary vascular obstructive disease before surgery. The mean left ventricular end-diastolic volume changed from 175 +/- 24% (SEM) before surgery to 106 +/- 7% after surgery (P less than 0.01). The corresponding right ventricular end-diastolic volume changed from 166 +/- 16% to 102 +/- 19% (P less than 0.025). Left ventricular ejection fraction was mildly decreased before and after surgery (0.63 +/- 0.02). Surgical repair of CCAVC is possible during the first year of life, with likely normalization of cardiac size and function. Unsatisfactory results related to pulmonary vascular obstruction may be anticipated if repair is delayed much beyond the first year.

Atrioventricular Node↗
PubMedDate not supplied

Adjuvant and immunostimulating properties of the recombinant Bm86 protein expressed in Pichia pastoris.

The cattle tick Boophilus microplus has remained a latent problem to the cattle industry. The recombinant vaccine GAVAC against the cattle tick has proved its efficacy and, conveniently, combined with the use of chemicals could be the solution to this problem. As this vaccine is based in the recombinant concealed antigen Bm86, it has to be given periodically to the animal to maintain an adequate level of antibodies. Some other commercially available vaccines for cattle also have to be given periodically, which creates the possibility of combining vaccines for cattle. In an attempt to evaluate the possible interactions of the Bm86 with other vaccine antigens, a potent stimulatory effect was demonstrated of the recombinant Bm86 on the humoral immune response to the recombinant Hepatitis B surface antigen in mice, and to the inactivated Infectious Bovine Rhinothraqueitis virus in cattle. These results make the Bm86 antigen expressed in Pichia pastoris a good candidate for combining vaccines for cattle because of its dual role, immunogen and adjuvant.

Adjuvants, Immunologic↗