Search PubMed⌕ Search

Biomedical subjects

J Silva

Publications and source records attributed to J Silva.

At least 181 records · Page 10Linked to original sources
PubMed1990

[Rhythm profile in patients with psoriatic arthritis].

OBJECTIVE: To analyze the rhythmic profile in patients with psoriatic arthritis (PA). DESIGN: In order to evaluate the rhythmic profile of patients with PA, we have carried out ambulatory 24 hour ECG recordings in 22 patients presented consecutively to the Holter ECG laboratory. SETTING: Patients followed in a specialised rheumatology consultation, in Santa Maria Hospital. PATIENTS: We have studied 22 patients (pts), 10 male and 12 female, aged 49.8 +/- 8.4 years, presenting PA diagnosed in average 12.9 years before. A group of 36 individuals, 25 male and 11 female, aged 37 +/- 8 years and without disease, were used as control. RESULTS: All patients were in sinus rhythm with a mean heart rate of 71 +/- 6 (min - 51.5 +/- 7.0 and max - 130.3 +/- 15.0). In 8 (36.6%) there were sinus bradycardia less than 50/min and sinus tachycardia (greater than 120/min) in 15 patients (68.1%). Two patients (9%) presented supraventricular tachycardia and one had AV block. There were premature atrial systoles in 14 pts (63.6%), and ventricular arrhythmias in 9 (40.9%). In control group, there were sinus bradycardia in 16.6%, sinus tachycardia in 33.3%, premature atrial systoles in 33.3% and ventricular arrhythmias in 25% of them; in 11% there were conduction disturbances. CONCLUSIONS: a) Premature atrial systoles were the rhythm disturbance more prevalent. b) Patients with PA presented a significant higher incidence of sinus bradycardia and sinus tachycardia. c) Cardiac conduction disturbances were not frequent. d) Our results may suggest the presence of a subtle autonomic dysfunction in patients with psoriatic arthritis.

Adult↗
PubMed1989

Treatment of antibiotic-associated Clostridium difficile colitis with oral vancomycin: comparison of two dosage regimens.

PURPOSE: High-dose (500 mg orally four times daily) vancomycin is considered by many investigators to be the most effective treatment for antibiotic-associated Clostridium difficile colitis. However, a lower dosage of 125 or 150 mg given three or four times a day has become popular, has been shown to be effective, and is less expensive than the high-dose regimen. We therefore decided to compare two vancomycin dosage regimens in a randomized trial. PATIENTS AND METHODS: The study involved 46 hospitalized patients with serious underlying diseases complicated by C. difficile diarrhea or colitis. Patients were assigned (according to a table of random numbers) to treatment with either 125 or 500 mg of vancomycin orally four times daily for an average of 10 days. RESULTS: No significant differences in measurable responses to the two regimens were noted. There were no treatment failures. The mean duration of diarrhea after initiation of therapy was about four days, and almost all patients had no diarrhea after one week. The organism continued to be demonstrated in the stools of about 50 percent of patients for the first few weeks after completion of therapy, and nine (20 percent) patients developed a recurrence of their diarrheal illness. Vancomycin was well tolerated by all patients. CONCLUSION: Since the dose of 125 mg appeared to be as effective as the 500-mg dose, which is more expensive, the 125-mg dose is preferred when vancomycin is used in treatment of this disease, unless the patient is critically ill.

Administration, Oral↗
PubMed1989

Reconstitution of cytolytic alloreactivity with N-[4-[(4-fluorophenyl) sulfonyl]phenyl]acetamide (CL 259,763) in animals immunocompromised by cyclophosphamide.

A novel synthetic immunopotentiator, i.e. N-[4-[(4-fluorophenyl)sulfonyl]phenyl]acetamide (CL 259,763), was investigated for its potential in reconstituting the cell-mediated immune response of animals whose immunologic system had been severely depressed by cytoreductive agents. It was demonstrated that lymphocytes from mice which had received 300 mg/kg of cyclophosphamide (CY) immediately following antigen sensitization had a reduced capability of responding to alloantigens in mixed lymphocyte culture and failed to generate effective cytolytic T-lymphocytes (CTL) capable of destroying appropriate tumor target cells in a cytotoxicity assay. However, treatment of these immunocompromised animals with CL 259,763 produced a significant restoration of alloreactivity, as evidenced by an enhancement of the CTL response. Although effective doses of CL 259,763 ranged from 20 to 300 mg/kg, the optimal effect was observed at 75 mg/kg. Findings from a time course study indicated that the maximum restoration occurred when CL 259,763 was given to mice 2-5 days after, but not before or simultaneously with, CY treatment. Both the immunoimpairment by CY and its reversal by CL 259,763 appeared not to be antigen specific. The lessened immunoreactivity of CY-treated mice was explicable by the presence of suppressor cells in their spleens. These suppressors were able to adhere to plastic and resisted treatment with anti-Thy 1.2 antibody, indicating a macrophage characteristic. Flow cytometric analysis indicated a quantitative depletion of all T-lymphocytes, including Thy-1.2(+), Lyt-1(+), Lyt-2(+) and L3T4(+) subsets in the spleens of CY-treated mice; however, a population of Mac-1(+) cells was markedly expanded.(ABSTRACT TRUNCATED AT 250 WORDS)

Adjuvants, Immunologic↗
PubMed1989

Clostridium difficile in the intensive care unit: management problems and prevention issues.

Several patients hospitalized in our 12-bed medical ICU were found to have Clostridium difficile associated colitis. Stool cultures of all patients identified eight cases (three culture positive, and five culture and cytotoxin positive), seven of which were geographically and temporarily clustered within a 2-wk period. At least one patient appeared to contract the disease after hospitalization and in the absence of antibiotic therapy or other known major risk factors. The outbreak highlights the problem of C. difficile in the ICU. We believe that a heightened awareness of the multiple risk factors and preventive measures, along with consideration of possible nosocomial transmission, will be necessary to prevent or arrest future clusters of cases in the ICU. The diagnosis of one patient with this infection in a unit should prompt a review of all other patients within the unit.

Aged↗
PubMed1989

Update on pseudomembranous colitis.

These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from transcriptions, they are prepared by Homer A. Boushey, MD, Professor of Medicine, under the direction of Lloyd H. Smith, Jr, MD, Professor of Medicine and Associate Dean in the School of Medicine. Requests for reprints should be sent to the Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA 94143.

Enterocolitis, Pseudomembranous↗
PubMed1988

Restoration of cytolytic T-lymphocyte response with a new immunopotentiator, N-(4-[(4-fluorophenyl)sulfonyl]phenyl)acetamide (CL 259, 763), in mice.

The immunorestorative characteristics of a novel synthetic immunomodulator, N-(4-[(4-fluorophenyl)sulfonyl]phenyl)acetamide (CL 259, 763), has been investigated in several experimental models. In one situation, the compound was shown to enhance the induction of a cytolytic T-lymphocyte response to the murine MBL-2 leukemia implanted in its syngeneic host in which only a minimal reactivity to the tumor is normally displayed. In a Vaccinia virus model, the compound similarly augmented the lytic activity of cytolytic T-lymphocyte to virus-infected targets in not only viral antigen-primed but also cyclosporin A-impaired mice. Likewise, the alloreactive cytolytic T-lymphocyte activity was recovered in animals immunocompromised by inoculation with murine plasmacytomas or cytoreductive anticancer drugs, such as cyclophosphamide and 5-fluorouracil. Thus, the present findings suggest that CL 259,763 is effective in potentiating the immune response to weak antigens as well as in restoring alloreactivity by sparing the immunotoxicity associated with the administration of cytotoxic drugs and the growth of neoplasms.

Adjuvants, Immunologic↗
PubMed1988

Clostridium difficile as a nosocomial pathogen.

Patients admitted to a 19-bed floor with intermediate nursing care were studied for the onset of Clostridium difficile-associated diarrhoea during a six-month period (181 calendar days) in 1986-87. All admitted patients were reviewed weekly and followed after discharge from the study unit to other inpatient services. Multiple items in the environment of five patients' rooms were sampled bacteriologically for the presence of C. difficile weekly during the study period. Three of the rooms were selected for study because of a higher prevalence of C. difficile associated diarrhoea in the prior three years and two were selected because no cases had been discovered previously in these rooms ('control rooms'). Nine of 521 patients admitted to this unit developed C. difficile diarrhoea (1.73 cases/100 patients admitted) versus 0.30/100 patients admitted to all other sites in our hospital (24 of 7970 other patients). This represented respectively 3.91 cases per 1000 patient days on this floor versus 0.37 patients/1000 patient days throughout the hospital. Seven of the C. difficile diarrhoea cases were associated with stay in the C. difficile associated rooms, versus two cases in the two 'control rooms'. C. difficile was isolated from the toilet seats, bedpan hopper, night stands or food trays. Of some 1955 cultures taken, only 1.9% overall were positive for C. difficile.

Clostridium↗
PubMed1988

The metabolism of N-acetyl-3,5-dimethyl-p-benzoquinone imine in isolated hepatocytes involves N-deacetylation.

3,5-Dimethyl-N-acetyl-p-benzoquinone imine (3,5-dimethyl-NAPQI) was cytotoxic to isolated hepatocytes from Sprague Dawley rats at levels between 200 and 300 microM. It rapidly oxidized intracellular glutathione within 10 sec, with the formation of oxidized glutathione. The cytotoxicity of 3,5-dimethyl-NAPQI could be prevented over a 3.5-hr period with the carboxylesterase inhibitor bis(p-nitrophenyl) phosphate, indicating that cytotoxicity involved N-deacetylation. The N-deacetylated product could be trapped with glutathione as 3-(glutathion-S-yl)-4-amino-2,6-dimethylphenol in 3,5-dimethyl-NAPQI-treated hepatocytes but not in hepatocytes pretreated with bis(p-nitrophenyl) phosphate, indicating that N-deacetylation activity had been inhibited. 3,5-Dimethyl-NAPQI was readily N-deacetylated by rat liver microsomes, in contrast to 3,5-dimethylacetaminophen. The latter was also not cytotoxic to hepatocytes at up to 2 mM. The N-deacetylated product 4-amino-2,6-dimethylphenol rapidly underwent autoxidation to form 2,6-dimethylbenzoquinone imine and was highly cytotoxic to hepatocytes at 200-300 microM. The latter reacted with glutathione to give the above conjugate and no glutathione oxidation occurred. Dithioerythritol (2 mM) added at 10, 20, and 30 min after 3,5-dimethyl-NAPQI delayed but did not prevent cytotoxicity. Dithioerythritol also resulted in the partial restoration of GSH, presumably as a result of reduction of protein mixed disulphides. The mechanism of cytotoxicity of 3,5-dimethyl-NAPQI therefore appears to be a result of a combination of oxidative stress and deacetylation resulting in arylation.

Acetylation↗
PubMed1987

Internalization and re-expression of antigens of human melanoma cells following exposure to monoclonal antibody.

Modulation of the surface membrane of human Sk-Mel-28 melanoma cells by monoclonal antibody (MoAb) 96.5 recognizing p97 determinants was examined using direct radioimmunoassay and indirect fluorescent antibody-staining techniques. It was determined that the majority of 111In-labeled antibody that remained associated with cells after a 24-hr incubation at 37 degrees C had been internalized because MoAb 96.5 was no longer visible on the cell surface. A second treatment of these cells with the same antibody 24 hr later not only increased the cell-associated radioactivity, reflecting an increase of total antibody bound, but also rendered these cells membrane immunofluorescent again, indicating the re-expression of surface antigens. Autoradiographs of the electrophoretically analyzed membrane components of Sk-Mel-28 cells further demonstrated the appearance of newly synthesized 97-kDa proteins that were immunoprecipitable with MoAb 96.5. Taken together, the present findings suggest that p97 antigens undergo endocytosis in Sk-Mel-28 cells following exposure to MoAb 96.5. However, the same antigens were regenerated and expressed on the cell surface within a period of 24 hr. The re-expression of tumor cell surface antigen following initial internalization of the MoAb-antigen complex may have implications for diagnosis and therapy.

Antibodies, Monoclonal↗
PubMed1987

Isolation and partial characterization of 2-microns yeast plasmid as a transcriptionally active minichromosome.

Yeast cell extracts from 2-microns-containing strains (cir+) showed higher transcriptional activity than their corresponding isogenic sets (cir0). These extracts were used to purify transcriptionally active 2-microns minichromosomes in a sucrose gradient. Minichromosomes were transcribed in vitro and, employing hybridization techniques, the RNA synthesized was shown to present 2-microns-specific sequences. This model system should permit the direct study of transcriptionally active eucaryotic chromatin.

Chromosomes↗
PubMed1987

The experimental pathogenicity in Swiss mice of various strains of Nocardia isolated in soil of Tucumán (Argentina).

The isolation of Nocardia pathogenic for man in soil of Tucumán revealed the convenience of undertaking a study of their virulence, to evaluate any potential danger it may imply. Thirty three strains were studied: 28 N. brasiliensis, 3 N. asteroides and 2 N. caviae by inoculating albino Swiss mice into the footpads and intraperitoneally. The results obtained revealed the existence of Nocardia of variable aggresiveness in the soil of Tucumán.

Animals↗
PubMed1987

Relationship of chemical structures of anthraquinones with their effects on the suppression of immune responses.

A series of 37 anthraquinones were evaluated for their ability to inhibit the induction of cytolytic T-lymphocytes in a mixed lymphocyte culture system, useful as a preliminary screen for immunosuppressive agents. These compounds were also tested for their ability to prevent the production of antibody in mice. It was demonstrated that 1,4-bis [(2-aminoethyl)amino]-5, 8-dihydroxy-9,10-anthracenedione dihydrochloride (AEAD, 2) derived from mitoxantrone (MX, 1) by removing hydroxyethyl groups from both side chains was extremely active in depressing immune responses in vitro and in vivo. Four additional anthraquinones related to AEAD were also identified to share similar suppressive activity. They include a Schiff base, 1,4-dihydroxy-5,8-bis[[2-[(3-pyridinylmethylene)amino]ethyl]amino] -9,10-anthracenedione; a dimer with N-terminals methylated, 1,1-[ethylenebis (iminoethyleneimino)]-bis [5,8-dihydroxy-4-[(2-methylamino-ethyl)amino] anthraquinone tetrahydrochloride; an oxazolidine, 1,4-dihydroxy-5,8-bis [[2-(2-propyl-3-oxazolidinyl)ethyl]amino] anthraquinone; and its polymeric oxazolidine, poly [5,8-dihydroxy-1,4-anthraquinonyleneiminoethylene-3,2-oxazolidine- diyltrimethylene-2,3-oxazolidinediylethyleneimino]. These compounds may warrant further consideration as candidates for the treatment of refractory autoimmune diseases and in organ transplantation.

Animals↗
PubMed1987

Induction of epidermal and hepatic ornithine decarboxylase by a Prudhoe Bay crude oil.

Application of a Prudhoe Bay crude oil (PBCO) to the backs of mice caused a rapid induction of epidermal ornithine decarboxylase (ODC). A maximum induction of over 60-fold was seen at 6 hr after application of 50 microliters of PBCO. Concurrently, epidermal putrescine levels were elevated 4.7-fold over controls. Intraperitoneal administration of PBCO led to a 15-20-fold increase in hepatic ODC activity but to a 45% decrease in the renal enzyme activity. Maximum induction of ODC was seen at 12 hr following the administration of 4 ml/kg body wt of PBCO. Hepatic putrescine levels were elevated 34-fold over controls. Pretreatment of mice with the protein synthesis inhibitor cycloheximide abolished both epidermal and hepatic ODC induction.

Animals↗
PubMed1987

Pyogenic liver abscess. Diagnostic and therapeutic strategies.

A retrospective review of 26 adult patients admitted to University of California, Davis, Medical Center (UCDMC) with pyogenic liver abscess (1980-1986) was performed to ascertain the impact of rapid diagnosis and percutaneous drainage. Ultrasonographic examinations and computed tomography (CT) scans were highly sensitive and noninvasive imaging modalities. Sixteen patients had solitary abscesses and seven had multiple microscopic abscesses. The median time interval from admission to diagnosis and therapy was 2 and 3 days, respectively. Origin of the abscess was determined in 22 patients, the biliary tree being the most common source. Medical therapy was successful in three patients with microabscesses but failed in two. Nine patients had percutaneous drainage; two required repetitive percutaneous catheter placement, and two proceeded to surgical drainage. Twelve patients had surgical drainage; one required repetitive surgical drainage. Postdrainage complications were minimal in all groups. Overall mortality role was 11.5% (two patients). Deaths were related to delay in diagnosis, gram-negative sepsis at presentation, and biliary origin of the abscess.

Adult↗
PubMed1987

Therapy of relapsing Clostridium difficile-associated diarrhea and colitis with the combination of vancomycin and rifampin.

Seven patients with multiple bacteriologic and symptomatic relapses of Clostridium difficile-associated diarrhea and/or colitis were treated with vancomycin and rifampin in combination. Diarrhea and abdominal pain promptly resolved in all, and neither C. difficile nor its toxin could be recovered from their stools shortly after therapy. However, stools of all patients subsequently became culture-positive for C. difficile and occasionally had demonstrable cytotoxin. Except in one instance following oral antibiotic use, all patients remained free of symptoms. Resistance to either vancomycin or rifampin was not encountered. Biotyping of isolates with clostridial bacteriophages and bacteriocins suggested true relapse with the same organism in all patients studied, rather than reinfection with another strain. Vancomycin and rifampin in combination appear to be useful in the therapy of relapsing antibiotic-associated diarrhea due to C. difficile.

Adult↗