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Biomedical subjects

J Reis

Publications and source records attributed to J Reis.

At least 19 recordsLinked to original sources
PubMed1998

Distribution of bismuth in the rat after oral dosing with ranitidine bismuth citrate and bismuth subcitrate.

Bismuth preparations are used world-wide for the management of peptic ulcer disease, for eradication of Helicobacter pylori, and in the prevention and treatment of diarrhoea. However neurological toxicity of bismuth has always been a major concern and evidence has been found of the absorption of bismuth. Recent studies have suggested that the absorption of bismuth increases when bismuth salts are used with ranitidine hydrochloride. The absorption and deposition of bismuth as a result of the use of the new drug ranitidine bismuth citrate have not been yet clarified. After 15 days of twice daily oral gavage with bismuth subcitrate, 13.7 mg kg(-1) day(-1) to eight rats, deposition of bismuth was found in all the tissues studied, especially the kidney (30.81 +/- 8.59 microg g(-1) dry weight). A similar pattern of distribution and tissue concentrations was found when bismuth subcitrate was given with ranitidine hydrochloride 8.6 mg kg(-1) day(-1) to another eight rats, although this combination resulted in lower brain levels (3.12 + 1.31 microg g(-1) dry weight) than after administration of bismuth subcitrate alone (4.77 +/- 0.97 microg g(-1) dry weight). When six rats were given ranitidine bismuth citrate by gavage at 22.8 mg kg(-1) day(-1) for 15 days, kidney levels were lower (4.24 +/- 1.75 microg g(-1) dry weight) and brain levels were below detection limits; the bismuth concentrations in the faeces from this group were also significantly lower (1603 +/- 104.0 microg g(-1) dry weight) than for the two other groups. After dosing with bismuth alone or in association with ranitidine hydrochloride, bismuth was detected in several organs and deposition was not influenced by gastric pH. Blood levels correlate poorly with organ deposition and brain deposition was not always associated with encephalopathy. After administration of ranitidine bismuth citrate, significantly lower concentrations of bismuth were found in the kidney and bismuth was not detectable in the brain, suggesting lower bismuth absorption. This was confirmed by higher levels in the faeces after dosing with ranitidine bismuth citrate. Thirty days after dosing with ranitidine bismuth citrate or bismuth subcitrate, bismuth could not be detected in any of the organs examined but could be found in the urine. In conclusion, bismuth was deposited in the kidney, brain, lung and liver of rats after oral dosing with bismuth subcitrate. After oral dosing with an equivalent amount of bismuth in the form of ranitidine bismuth citrate, significantly lower concentrations of bismuth were deposited in the kidney; in the brain bismuth was not detectable.

Administration, Oral↗
PubMed1998

[Free flaps in the reconstruction of head and neck. Clinical experience].

The reconstruction of head and neck defects, due to trauma, tumor resection or other, begins with a careful assessment of the patient and the respective defect. Ideally, it ends with the successful reconstructive procedure that optimally restores form and function to the patient. Free flaps have often been used as a last resort reconstructive option in the head and neck because of the need for added technical skill, a longer operating time and a perception of poor reliability. This study reviews our experience with forty-eight patients submitted to microvascular reconstructive procedures. Twelve different kinds of free flaps have been involved as the preferred choice for free flap reconstruction of a specific defect of the head and neck. The latissimus dorsi flap was used for scalp and skull reconstruction, whereas the serratus anterior or rectus abdominis free flaps were used for the reconstruction of complex defects of the middle third of the face. The radial forearm flap and the free jejunal transfer have become the preferred choices for intraoral and pharyngo-esophageal reconstruction, respectively. Good results were obtained with both functional and social rehabilitation. There were three flap losses probably due to thrombosis of the microvascular anastomosis. There was no surgical mortality. The indications for each free flap are discussed.

Adolescent↗
PubMed1998

[Cutaneous reconstruction at the leg and foot level. Experience in 277 clinical cases].

The authors present their clinical experience of leg and foot reconstruction with 227 clinical cases. Based on these cases the authors analyse the use of 18 musculocutaneous, 53 axial, 72 septocutaneous and 84 free flaps, totalling 29 different kinds of flaps performed. Although no definitive conclusions can be drawn about which are the best flaps for foot and leg reconstruction, the preferential options are pointed out.

Adolescent↗
PubMed1998

[Bioartificial liver].

Fulminant hepatic failure remains without satisfactory medical treatment and with a mortality rate of nearly 90%. Liver transplantation is the only chance to save these patients. However, there is a shortage of donors and many patients die before transplantation. It is thus necessary to develop a liver support system to help maintain patients alive, neurologically intact until an organ becomes available for transplantation, or ideally until hepatic regeneration. Early systems had only a depuration function, but now these systems include hepatocytes to replace most hepatic functions.

Cell Transplantation↗
PubMed1998

[Revascularization and reimplantation of the upper extremity. 15-year-experience with 114 cases].

Progress in micro or macro replantation has resulted in higher survival rates of formerly amputated parts. More amputated digits or limbs survive because the time of ischemia can be exceeded by using cold storage or perfusion. Homo or heterodigital vessel transposition, expanded indications for vein graft interposition, as well as heterotopic transplantation allow for extremity preservation even in crush injuries, and in disastrous multiple amputations combined with contusion or avulsion. Secondary reconstruction with regard to bone defects, tendon repair, and eventual nerve grafting have to be aspired, finally leading to an improvement of functional results in daily and leisure activities as well as in early professional readaptation. A total of 114 microvascular extremity replantations/revascularizations with a survival rate of 77.2% were followed for an average of 15 years.

Accidents, Occupational↗
PubMed1997

[Reimbursement budgets and treatment demands require cost saving--a short operations day as a possible solution in the hospital].

BACKGROUND: Implementation of case related budgeting (similar to diagnosis related groups) has forced hospitals into more cost efficient management particularly with respect to surgery. Efforts to increase efficiency are concentrated on the labor intensive organization of the surgical ward. Operations of short duration are a major focal point. An analysis of the organizational structure of our hospital showed that significant improvement in operating theater management and utilization can be achieved in order to improve efficiency. A new pilot project was tested for economic efficiency. METHODS: On eleven specified surgery days (129 patients) only short operations with a duration of less than 20 min were allowed (tonsillectomy, adenectomy, etc.). On each day 15 operations were performed in one operating room with two anesthesiology teams and one surgery team. This type of "short-operation day" was compared with a "regular" surgery day with two operating rooms, two anesthesiology teams, and two surgery teams. Efficiency, complication rates, economic outcome, and patient satisfaction were assessed. RESULTS: Due to reduction of staff and a more efficient organization, we were able to reduce the costs for staff and the operating theater maintenance from DM 378,20 to DM 243,90 for each operation. Additionally, only one operating room was required instead of two. Complication rates (postoperative bleeding) were lower than before and patient acceptance and satisfaction was remarkable. CONCLUSIONS: Economic efficiency of short operations could be increased by organizational restricturing. The quality of the operations and the patients' satisfaction did not decrease.

Adolescent↗
PubMed1997

Using behavioral theory in computer-based health promotion and appraisal.

This article explores how behavioral theory can facilitate the development, implementation, and evaluation of health promotion software packages intended to influence personal health practices and/or assess health risks. Current behavioral theories and models are reviewed, and their relevance to developing health promotion software is discussed. A series of six steps is suggested for developing and evaluating health promotion and appraisal software within a behavioral theory framework. These steps should help to facilitate direct application of the theory-based process to health promotion software development.

Behavioral Sciences↗
PubMed1997

Interactive multimedia software design: concepts, process, and evaluation.

This article provides the health educator with a review of the design and construction of computer-based health education materials. Specifically, this review considers questions of instructional objectives as defined in the field of instructional design, a body of expertise not often deployed in the area of health education. It discusses in some detail the computer materials development process, associated documentation, and the range of personnel required. This article also briefly updates discussion of the costing process, and current costs for multimedia hardware and authoring software. The review touches on, but does not synthesize, emerging possibilities with the Internet.

Computer-Assisted Instruction↗
PubMed1997

Male and female adolescents' perceived interpersonal communication skills according to history of sexual coercion.

This report summarizes the experience of 61 female adolescents recruited through a private adolescent family planning clinic, and 183 9th through 12th-grade adolescents recruited from a private suburban high school regarding their experiences with dating relationships, sexual communication skills, and psychological status. The samples were predominantly white and middle to upper income. Perceptions of interpersonal communication skills were analyzed according to gender, clinic versus school, and history of sexual coercion. The adolescents were generally confident that they could assert their own preferences and stand up to other regarding sexual issues with the exception of the small group of high school males reporting having had experienced sexual coercion. This group (N = 20) expressed difficulty in talking to their partners about safer sex, getting their partner(s) to listen to them, or turning down alcohol or drugs prior to having sex. These boys were also more likely to report missing classes or having other kinds of trouble with school, to be concerned about use of alcohol and drugs, and about feeling unpopular. None of the female groups had this profile of communication and emotional problems. Implications for preventive education programming on interpersonal skills and sexuality are considered.

Adaptation, Psychological↗
PubMed1996

An assessment of lower back pain in young adults: implications for college health education.

A convenience sample of 243 undergraduates completed a 36-item questionnaire on their knowledge about back care and exercise patterns before they attended lectures and a workshop on back mechanics. At the workshop, the students were individually evaluated for posture, hamstring flexibility, hip flexor flexibility, back and abdominal strength, and lifting technique. Twenty-nine percent of the students reported that they experienced no back pain; 71% experienced lower back pain 1 to 5 days a week. The majority were neglectful of their posture, lifting and carrying techniques, and scored fair-to-poor on the hamstring flexibility test, possibly foreshadowing back problems in later life. The majority of respondents were unsure of what exercises to do for back care. Within the subgroup of students who claimed they were knowledgeable about exercise, more than 50% were performing ineffective and potentially harmful exercises. The results underscored the potential worth of health education on back care offered through didactic instruction and experiential workshops.

Adult↗
PubMed1995

Sweat secretion, stratum corneum hydration, small nerve function and pruritus in patients with advanced chronic renal failure.

Sweat secretion, stratum corneum hydration and small nerve fibre function were measured in 40 patients with advanced chronic renal failure (CRF), using pilocarpine iontophoresis, electrical capacitance and a thermal sensory analyser which measures the thresholds of warm and heat pain sensation. Correlations were sought between these parameters, and the presence and severity of pruritus and skin xerosis were compared with 45 healthy control subjects. The mean sweat secretion and stratum corneum hydration of CRF patients were significantly lower than in controls. Thirteen patients had pathological thresholds to warm sensation on the foot, and eight on the hand. None had pathological thresholds to heat-pain. The presence of pruritus did not correlate with any of the following: xerosis, stratum corneum hydration, sweat secretion or the results of thermal testing.

Aged↗
PubMed1995

[Neurologic manifestations following accidental exposure to pyralene and its thermal degradation products].

After five young women were exposed to pyralene and its thermal degradation products all developed a rich functional syndrome which could be explained by the traumatic effect of the accident. Nevertheless, in 3 of the women, abnormal somesthetic evoked potentials were observed including 2 with neurological lesions detectable radiologically. Polychlorobiphenyl derivates are toxic for the peripheral nervous system as has been observed in several recent exposure situations. Inversely, any effect on the central nervous system is still under debate.

Accidents, Occupational↗
PubMed1994

Halux pulp composite graft in nipple reconstruction.

We present a nipple reconstruction method that uses a composite graft of a constant halux's prominence. This technique, which has advantages over nipple reconstruction with toe pulp free grafts, has produced good results.

Female↗
PubMed1994

Consumer attitudes towards computer-assisted self-care of the common cold.

Knowledge of colds and flu and attitudes towards use of computers for self-care are compared for 260 young adult users and 194 young adult non-users of computer-assisted self-care for colds and flu. Participants completed a knowledge questionnaire on colds and flu, used a computer program designed to enhance self-care for colds and flu, and then completed a questionnaire on their attitudes towards using a computer for self-care for colds and flu, and then completed a questionnaire on their attitudes towards using a computer for self-care for colds and flu, perceived importance of physician interactions, physician expertise, and patient-physician communication. Compared with users, non-users preferred personal contact with their physicians and felt that computerized health assessments would be limited in vocabulary and range of current medical information. Non-users were also more likely to agree that people could not be trusted to do an accurate computerized health assessment and that the average person was too computer illiterate to use computers for self-care.

Adult↗