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Biomedical subjects

J Miranda

Publications and source records attributed to J Miranda.

At least 91 records · Page 5Linked to original sources
PubMed1981

Keratotic lesions of the oral epithelium.

Glycogen in the epithelium is interpreted as a sign of cell activity; its accumulation seems to take place gradually during cell migration. The oxido-reductase and hydrolytic enzyme-groups represent a sensitive indicator of changes in cell metabolism. The occurrence and intensity of glycogen, lactic and succinic dehydrogenases, NAD-cytochrome-c-reductase, alkaline and acid phosphatases were studied in 20 biopsy materials obtained from patients with keratotic buccal lesions. The results were compared with 20 biopsies from healthy oral mucosa. Variations were found in the localization and amount of glycogen, but no significant difference could be observed in the intensity of the oxido-reductase enzymes and alkaline phosphatase reactions. Acid phosphatase showed increased reactivity in most superficial layers of the keratinized epithelium.

Acid Phosphatase↗
PubMed1980

Scoliosis secondary to fractures of the transverse processes of lumbar vertebrae.

Fractures of the transverse processes of the lumbar vertebrae may be difficult to identify radiographically because they are often obscured by gas and feces. With unilateral fractures, there is often scoliosis convex to the side of the fractures. We propose that this may be due to the ineffective action of the ipsilateral quadratus lumborum muscle which inserts into the transverse processes. The unopposed action of the contralateral quadratus lumborum results in scoliosis convex to the side of the fracture(s). Awareness of this cause of scoliosis can help in differentiating it from scoliosis caused by other painful abdominal processes, and may aid in recognition of the fracture(s).

Adolescent↗
PubMed1977

Treatment of South American blastomycosis (paracoccidioidomycosis) with miconazole by the oral route: an on-going study.

Results are presented from 12 patients of both sexes, whose ages range from 34 to 65 years, observed over a period of 16 months and receiving miconazole treatment for South-American blastomycosis. Ten of them were being treated for the first time and the remaining 2 presented relapses after treatment with other chemotherapeutic agents. The blastomycotic lesions were localized in skin, mucosa, lung and lymphatics. The drug was administered orally, at a dosage of 1 g three times daily. One relapsing patient had his first daily oral dose replaced by an intravenous dose of 200 mg of miconazole diluted in 250 ml of glucose solution during the initial four weeks. The criterion for diagnosis was finding of the fungus in sputum and/or in the material collected through scrapings or biopsy of the lesions. All patients were treated in hospital until the cure was apparent, clinical examinations being conducted weekly and bi-weekly. Bi-weekly laboratory examinations were performed to evaluate the patient's tolerance to the drug. All treated patients presented complete healing of cutaneomucous lesions (mean time: 4 weeks) and involution of lymphatic and pulmonary features (mean time: 4 months). Two of them still presented palpable lymphatics after 5 months of treatment, in spite of the cure of mucosal and pulmonary lesions. Monitoring the progress of the cured patients was and is being carried out quarterly. Currently, this observation period ranges from three to 15 months. Nine patients are still returning and none have shown the reappearance of mycotic lesions. Diarrhoea was the only side-effect observed after a period of therapy, but it was easily controlled by specific medication (kaolin, pectin, &c.). In a single case the treatment was interrupted because of this symptom.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMedDate not supplied

Brain-stem auditory evoked potentials and brain death.

BAEP records were obtained from 30 brain-dead patients. Three BAEP patterns were observed: (1) no identifiable waves (73.34%), (2) an isolated bilateral wave I (16.66%), and (3) an isolated unilateral wave I (10%). When wave I was present, it was always significantly delayed. Significant augmentation of wave I amplitude was present bilaterally in one case and unilaterally in another. On the other hand, in serial records from 3 cases wave I latency tended to increase progressively until this component disappeared. During the same period, wave I amplitude fluctuations were observed. A significant negative correlation was found for wave I latency with heart rate and body temperature in 1 case. Two facts might explain the progressive delay and disappearance of wave I in brain-dead patients: a progressive hypoxic-ischaemic dysfunction of the cochlea and the eighth nerve plus hypothermia, often present in brain-dead patients. Then the incidence of wave I preservation reported by different authors in single BAEP records from brain-dead patients might depend on the moment at which the evoked potential study was done in relation to the onset of the clinical state. It is suggested that, although BAEPs provide an objective electrophysiological assessment of brain-stem function, essential for BD diagnosis, this technique could be of no value for this purpose when used in isolation.

Adolescent↗
PubMedDate not supplied

[Study of non-participation in the breast cancer screening program in the city of Valencia (Spain)].

AIM: To determine the reasons for non-participation of women in a breast cancer screening program. METHODS: We performed an observational, cross-sectional study in women who were invited to participate in the breast cancer screening program in the city of Valencia and who failed to attend. The women were interviewed in their homes through a questionnaire consisting of 25 questions grouped as follows: knowledge of the program, reasons for nonparticipation, attitudes or beliefs and characteristics of the interviewees (socioeconomic and educational variables and age). A descriptive analysis was performed. Differences in the characteristics of women were evaluated through bivariate analysis. Multivariate analysis was performed through logistic regression. RESULTS: A total of 783 addresses were used, 411 questionnaires were completed and 361 were analyzed. The 50 questionnaires used in the pilot study were excluded because, as a consequence of this study, the questionnaire had been modified. Most of the women (93.4%) (CI: 90.3-95.7) remembered having an appointment. The main reason for not attending was being screened in another health service in 48.8% (CI: 43.6-53.9), followed by various personal reasons in 16.1% (CI: 12.3-19.9) and inability to keep the appointment at the specified time in 15.5% (CI: 11.8-19.2). Comparison of women in the middle and upper social classes with those in the lower classes revealed important differences. Middle and upper class women had a higher probability of knowing about the program and of being on hormone replacement therapy (HRT) and the most frequent reason for non-attendance was attendance at another program run by another health service. In lower class women the reasons for non-attendance were fear, not believing the program to be important to health and inability to keep the appointment at the specified time. In the multivariate analysis, the variables that entered the model were HRT, social class and education. Thus, middle or upper class women undergoing HRT and with secondary or higher education had a higher probability of being screened. CONCLUSIONS: The profile of non-participating women belongs on the one hand to those in the middle or upper social classes, undergoing HRT and being screened by other health services and, on the other, to a group of women of low social class, whose reason for non-participation is fear and timetable difficulties.

Aged↗
PubMedDate not supplied

A comparison of miconazole, ketoconazole and fluconazole in their effects on temperature-dependent growth and thermal death in Candida albicans.

A strain of Candida albicans isolated from human sputum exhibited an associative temperature profile, with the initial maximum temperature = 42 degrees C, the final maximum temperature = 38 degrees C, and the minimum temperature of thermal death = 33 degrees C, showed a decrease in its cardinal temperatures and a reduction in the specific rates of growth and thermal death throughout the novel temperature ranges in the presence of either 25 microM of miconazole, ketoconazole or fluconazole. In the concentration range 0-30 microM, each drug concertedly depressed the kinetic and energetic parameters of growth, with lesser variation on the specific glucose transfer rate. The overall effect of miconazole was the greatest (up to one order of magnitude), while that of fluconazole was the least.

Antifungal Agents↗
PubMedDate not supplied

Intervention for minor depression in primary care patients.

This study examines the effectiveness of an intervention for minor depression in primary care patients. One hundred fifty public care medical patients were randomly assigned to either an 8-week cognitive-behavioral course intended to help them use pleasant activities, constructive thinking, and interpersonal relationships to improve mood or a control condition. Assessments were completed at postintervention, 6 months, and 1 year. The results support the effectiveness of the intervention. Persons with minor depression assigned to the intervention experienced reductions in depressive symptomatology, which persisted through the 1-year follow-up. In addition, the intervention lowered the somatic symptomatology that was associated with minor depression. Finally, those with minor depression who received the intervention missed fewer appointments with their primary care provider during the following year than did those with minor depression who received no intervention. The results from this preliminary evaluation suggest that interventions addressing minor depression in medical patients are feasible and are effective in reducing both depressive symptomatology and associated problems.

Adolescent↗
PubMedDate not supplied

A prototype beam delivery system for the proton medical accelerator at Loma Linda.

A variable energy proton accelerator was commissioned at Fermi National Accelerator Laboratory for use in cancer treatment at the Loma Linda University Medical Center. The advantages of precise dose localization by proton therapy, while sparing nearby healthy tissue, are well documented [R. R. Wilson, Radiology 47, 487 (1946); M. Wagner, Med. Phys. 9, 749 (1982); M. Goitein and F. Chen, Med. Phys. 10, 831 (1983)]. One of the components of the proton therapy facility is a beam delivery system capable of delivering precise dose distributions to the target volume in the patient. To this end, a prototype beam delivery system was tested during the accelerator's commissioning period. The beam delivery system consisted of a beam spreading device to produce a large, uniform field, a range modulator to generate a spread out Bragg peak (SOBP), and various beam detectors to measure intensity, beam centering, and dose distributions. The beam delivery system provided a uniform proton dose distribution in a cylindrical volume of 20-cm-diam area and 9-cm depth. The dose variations throughout the target volume were found to be less than +/- 5%. Modifications in the range modulator should reduce this considerably. The central axis dose rate in the region of the SOBP was found to be 0.4 cGy/spill with an incident beam intensity of 6.7 x 10(9) protons/spill. With an accelerator repetition rate of 30 spills/min and expected intensity of 2.5 x 10(10) protons/spill for patient treatment, this system can provide 50 cGy/min for a 20-cm-diam field and 9-cm range modulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Equipment Design↗
PubMedDate not supplied

Evidence-based care for depression in managed primary care practices.

This paper evaluates whether externally designed, evidence-based interventions for improving care for depression can be locally implemented in managed care organizations. The interventions were carried out as part of a randomized trial involving forty-six practices within six diverse, nonacademic managed care plans. Based on evaluation of adherence to the intervention protocol, we determined that local practice leaders are able to implement predesigned interventions for improving depression care. Adherence rates for most key intervention activities were above 70 percent, and many were near 100 percent. Three intervention activities fell short of the goal of 70 percent implementation and should be targets for future improvement.

Depressive Disorder↗
PubMedDate not supplied

Diagnosis of Helicobacter pylori: comparison of an urease test, histological visualization of curved bacteria and culture.

Helicobacter pylori was investigated in 189 patients for culture, microscopic visualization of campylobacter-like organisms (CLO) and a ten minute urease test. In 136 (72%) the bacteria was isolated, and in 98 of them CLO were histologically detected. Specificity, sensitivity, positive and negative predictive values of microscopic visualization of CLO were: 0.77, 0.73, 0.97 and 0.51, respectively; 98 culture-positive patients were urease test positive. Specificity, sensitivity, positive and negative predictive values of the urease test were: 0.83, 0.72, 0.92 and 0.54, respectively. Comparing the urease test with culture of H. pylori combined with microscopic visualization of CLO, its specificity, sensitivity, positive and negative predictive values were: 0.95, 0.71, 0.98 and 0.48, respectively. Probably, these values are not real, since bacteria different from H. pylori could be misclassified as CLO.

Clinical Enzyme Tests↗
PubMedDate not supplied

[Evaluation of a social and environmental indicator used in the identification of lymphatic filariasis transmission in urban centers].

The concept of a "socially organized space" supported by new analytical techniques and mapping of health events has guided innovative methodological developments in public health interventions. This study aimed to evaluate a social/environmental indicator constructed with a scoring methodology to stratify areas in the city of Olinda by different levels of risk for Bancroftian filariasis transmission. The study mapped areas and the location of sample households and identified all residents ages 5 to 65 years as part of the parasitological survey. Among the 3,232 individuals who had blood samples taken, 42 were microfilaremic (1.3% prevalence). Global statistical analysis of filarial case distribution has suggested spatial clustering. Some 85.7% of positive individuals resided in the two strata with the highest transmission risk. The high sensitivity of the proposed indicator for predicting the places where the vast majority of filariasis cases occurred justifies its use in planning and implementing interventions.

Adolescent↗
PubMedDate not supplied

[Hepatitis B among health workers].

BACKGROUND: Hepatitis B virus (HBV) infection is one of the infectious diseases whose elimination or eradication is possible. However, it is still a serious problem among health workers who are an important risk group to acquire this infection. OBJECTIVE: To focus the problem of the HBV infection among health workers in terms of the risks and prevention alternatives, showing effective strategies to this effect. DATA SOURCE: Analysis of related publications through the MEDLINE system and the review of scientific journals, both in English and Spanish. SYNTHESIS OF INFORMATION: An available and effective vaccine against HBV exist more than 10 years ago. Some national hospitals have demonstrated the prevalence of HBV infection in apparently healthy staff, which evidences that it is an occupational problem. The vaccination of this risk group has proved to reduce the HBV infection in several centers in different countries, in addition to the cost-effectiveness of this measure. CONCLUSION: HBV infection constitutes a significant problem in our country considering its intermediate high endemic rate. No effective measures for its control have been taken, despite the availability of effective vaccines and strategies for the control and prevention of this disease, not to mention their economic benefits.

Aged↗