Sensitivity of the meiofaunal copepod Tisbe longicornis to K2Cr2O7 under varying temperature regimes.
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Animals↗
Biomedical subjects
J Silva
Publications and source records attributed to J Silva.
Internal thoracic artery atherosclerosis after coarctation repair in an adult.
We report a rare case of a patient with an unsuitable grossly atherosclerotic and extensively calcified right internal thoracic artery found during a coronary bypass grafting operation. He had undergone an aortic coarctation repair 35 years before, with long-term systemic hypertension previous to the operation and sustained after it. It is advisable to be alert to the possibility of atherosclerotic degeneration of the internal thoracic artery in these patients.
Aortic Coarctation↗
Iatrogenic mammary arteriovenous fistula caused by sternal wire.
Internal mammary arteriovenous fistulas are a rare complication of sternotomy. We present a case of a 64-year-old woman with a poststernotomy fistula between the left mammary vein and artery with formation of a pseudoaneurysm with subcutaneous extension. We describe the different imaging techniques that led to the diagnosis and the resolution of the fistula via endovascular embolization.
Arteriovenous Fistula↗
Isolation of a toxin B-deficient mutant strain of Clostridium difficile in a case of recurrent C. difficile-associated diarrhea.
Clostridium difficile-associated diarrhea (CDAD) recurs in approximately 15%-20% of patients after discontinuation of metronidazole or vancomycin therapy. Most recurrences are believed to be endogenous relapses due to the persistence of spores. However, there is evidence that reinfection with a different strain is a cause of recurrence. We report the case of a patient with a history of multiple episodes of C. difficile colitis. The patient, a 56-year-old female, has had 5 years of repeated recurrences, each shortly after discontinuing vancomycin therapy. During the course of these episodes, three isolates were cultured from her stools at different times. These isolates were analyzed for the presence of toxin A and B gene sequences and genotyped by means of arbitrarily primed polymerase chain reaction (AP-PCR). The original two isolates contained the toxin A and B genes, as determined by PCR, and were of the same AP-PCR type. During her last relapse, a C. difficile strain lacking at least a portion of the toxin B gene was isolated. AP-PCR analysis of this isolate showed a different DNA banding pattern from that of the previous isolates. A vancomycin susceptibility assay revealed a slight decrease in vancomycin activity as compared with that against the prior isolate. This case demonstrates two unique features: (1) recurrent infections can be due to reinfections and (2) toxin B mutants can possibly cause CDAD. This study also raises concerns about long-term vancomycin use and the development of resistance of C. difficile to vancomycin.
Bacterial Proteins↗
Iron supplementation in haemodialysis--practical clinical guidelines.
BACKGROUND: The aim of this prospective study was to test a new protocol for iron supplementation in haemodialysis patients, as well as to assess the utility of different iron metabolism markers in common use and their 'target' values for the correction of iron deficiency. METHODS: Thirty-three of 56 chronic haemodialysis patients were selected for long-term (6 months) i.v. iron therapy at 20 mg three times per week post-dialysis based on the presence of at least one of the following iron metabolism markers: percentage of transferrin saturation (%TSAT) <20%; percentage of hypochromic erythrocytes (%HypoE) > 10% and serum ferritin (SF) <400 microg/l. Reasons for patient exclusion were active inflammatory or infectious diseases, haematological diseases, psychosis, probable iron overload (SF > or =400 microg/l) and/or acute need of blood transfusion mostly due to haemorrhage and change in renal replacement treatment. RESULTS: More than half (51.8%) of the patients of our dialysis centre proved to have some degree of iron deficiency in spite of their regular oral iron supplementation. At the start of the study the mean haemoglobin was 10.8 g/dl and increased after the 6 months of iron treatment to 12.8 g/dl (P<0.0001). The use of erythropoietin decreased from 118 units/kg/week to 84 units/kg/week. The criterion for iron supplementation with the best sensitivity/specificity relationship (100/87.9%) was ferritin <400 microg/l. Patients with ferritin < 100 [microg/l and those with ferritin between 100 microg/l and 400 microg/l had the same increase in haemoglobin but other parameters of iron metabolism were different between the two groups. CONCLUSIONS: Routine supplementation of iron in haemodialysis patients should be performed intravenously. Target ferritin values should be considered individually and the best mean haemoglobin values were achieved at 6 months with a mean ferritin of 456 microg/l (variation from to 919 microg/l). The percentage of transferrin saturation, percentage of hypochromic erythrocytes and ferritin <100 microg/l, were not considered useful parameters to monitor routine iron supplementation in haemodialysis patients. No significant adverse reactions to iron therapy were observed.
Anemia, Iron-Deficiency↗
Monte Carlo based method for conversion of in-situ gamma ray spectra obtained with a portable Ge detector to an incident photon flux energy distribution.
A Monte Carlo based method for the conversion of an in-situ gamma-ray spectrum obtained with a portable Ge detector to photon flux energy distribution is proposed. The spectrum is first stripped of the partial absorption and cosmic-ray events leaving only the events corresponding to the full absorption of a gamma ray. Applying to the resulting spectrum the full absorption efficiency curve of the detector determined by calibrated point sources and Monte Carlo simulations, the photon flux energy distribution is deduced. The events corresponding to partial absorption in the detector are determined by Monte Carlo simulations for different incident photon energies and angles using the CERN's GEANT library. Using the detector's characteristics given by the manufacturer as input it is impossible to reproduce experimental spectra obtained with point sources. A transition zone of increasing charge collection efficiency has to be introduced in the simulation geometry, after the inactive Ge layer, in order to obtain good agreement between the simulated and experimental spectra. The functional form of the charge collection efficiency is deduced from a diffusion model.
Barium Radioisotopes↗
Detection of Bacteroides fragilis enterotoxin gene by PCR.
Bacteroides fragilis constitutes about 1% of the bacterial flora in intestines of normal humans. Enterotoxigenic strains of B. fragilis have been associated with diarrheal diseases in humans and animals. The enterotoxin produced by these isolates induces fluid changes in ligated intestinal loops and an in vitro cytotoxic response in HT-29 cells. We developed a nested PCR to detect the enterotoxin gene of B. fragilis in stool specimens. After DNA extraction, a 367-bp fragment was amplified with two outer primers. The amplicon from this reaction was subjected to a second round of amplification with a set of internal primers. With these inner primers, a 290-bp DNA fragment was obtained which was confirmed as part of the B. fragilis enterotoxin gene by Southern blotting with a nonradioactive internal probe and a chemiluminescence system. By this approach, B. fragilis enterotoxin gene sequences were detected in eight known enterotoxigenic human isolates and nine enterotoxigenic horse isolates. No amplification products were obtained from DNA extracted from 28 nonenterotoxigenic B. fragilis isolates or B. distasonis, B. thetaiotaomicron, B. uniformis, B. ovatus, Escherichia coli, or Clostridium difficile. The sensitivity of this assay allowed us to detect as little as 1 pg of enterotoxin DNA sequences or 100 to 1,000 cells of enterotoxigenic B. fragilis/g of stool. Enterotoxin production of all isolates was confirmed in vitro in HT-29 cells. A 100% correlation was obtained between enterotoxin detection by cytotoxin assay and the nested PCR assay. This rapid and sensitive assay can be used to identify enterotoxigenic B. fragilis and may be used clinically to determine the role of B. fragilis in diarrheal diseases.
Animals↗
Susceptibility to new beta-lactams of enterobacterial extended-spectrum beta-lactamase (ESBL) producers and penicillin-resistant Streptococcus pneumoniae in Mexico.
The activities of several beta-lactam antimicrobial agents, aminoglycosides and ciprofloxacin, were determined against 62 clinical isolates of enterobacteria resistant to oxyimino cephalosporins (extended-spectrum beta-lactamase producers), collected during 1991 to 1993, and 16 penicillin-resistant invasive isolates of Streptococcus pneumoniae collected during 1994-1996. The numbers and percentages of susceptible enterobacterial strains to tested antibiotics were: imipenem 60 (97%), ciprofloxacin 57 (92%), cefepime 56 (90%), cefpirome 34 (55%), aztreonam 13 (21%), cefotaxime 7 (11%), ceftazidime 0 (0%), amikacin 11 (18%) and gentamicin 16 (26%). Despite the fact that these strains had never been exposed previously to cefepime or cefpirome, the susceptibility was 90% and 55%, respectively. No penicillin-resistant strains of S. pneumoniae were susceptible to cefotaxime, imipenem or cefepime. Only one strain was susceptible to ceftazidime and 4 (25%) were susceptible to cefpirome. Erythromycin showed the greatest activity with 12 (75%) susceptible strains.
Aminoglycosides↗
[Advances in the diagnosis and treatment of pancreatic carcinoma].
Pancreatic carcinoma has a dismal prognosis. In the last years, great efforts have been made to improve diagnosis and preoperative staging of potentially curable carcinomas. Actually, the diagnosis of fairly small tumours is possible. Chemoradiation therapy protocols prior to pancreatectomy, aiming to improve survival, are currently being held. This therapy allows radiation to be distributed into well oxygenated cells before surgical devascularization. This procedure can be done with acceptable morbidity and mortality rates. In selected cases of irresectable carcinoma, surgical palliation allows a better quality of life. Pancreatoduodenal resection, along with other traditional oncological therapies, will continue to be the therapy of choice for patients with carcinoma of the head of the pancreas, without local or regional metastases. However, an intensive search for new therapeutic strategies, specially in the field of molecular biology, is being carried out.
Carcinoma↗
Quality care for cardiology patients.
To evaluate outcome measures in a cardiology unit, patient satisfaction was measured. Patients consistently related problems in two areas: pain management and the waiting period before their procedure. After a major system change, patient satisfaction increased 16% and 29% respectively.
Heart Diseases↗
Aging, hyaluronidase removal of the cumulus, and microinjection do not affect the sperm binding potential of human oocytes.
PURPOSE: We studied the influence of aging, hyaluronidase removal of the cumulus, and microinjection on the sperm binding potential of human oocytes under intact zona assay conditions to determine the safe use of unstored aged unfertilized ICSI oocytes on zona binding tests. Results were also compared with those for aged IVF oocytes under the same conditions. METHODS: To avoid the large variation in sperm binding scores, we compared the ratios of the number of sperm bound to nontreated versus to treated oocytes. Treated oocytes were those whose zonae were exposed to hyaluronidase, an agent that decreases sperm binding. Experimental groups were fresh oocytes, experimentally aged fresh oocytes, fresh oocytes whose cumulus was removed either mechanically or with hyaluronidase, aged ICSI oocytes, and aged IVF oocytes. RESULTS: Statistical analysis within and between groups showed that aging, previous insemination, cumulus removal by hyaluronidase, and microinjection did not affect the sperm binding potential of human oocytes. CONCLUSIONS: As the zona binding ability of fresh and unfertilized aged ICSI oocytes is similar, they can be used safely in zona assays.
Aging↗
Evolution of cerebral edema and its relationship with power in the theta band.
In previous papers we have proposed that in patients with space-occupying lesions, delta power was related with the volume of the lesion and theta power with the volume of the edema. In this report we analyze the evolution of 10 patients with space-occupying lesions in whom we measured the volume of the lesion and of the edema before and after treatment that produced changes in these volumes. EEGs were recorded in the leads of the 10-20 system referenced to linked earlobes. Delta and theta powers were calculated for voltage and current source densities (CSD) and compared with age-norms to compute conventional Z-maps. These maps provide probability statements about the deviation of observed values from the norm. Rank correlations between the change in the volume of the lesion before and after treatment and the change in Z-values before and after treatment were significant only in the delta band. However, rank correlations between the change in the volume of the edema and the change in EEG Z-values were only significant in the theta band. These correlations were higher for CSD than for voltage estimates. We also observed that the site of the lesion and of the edema was better represented by CSD maps than by voltage maps. These results are also in agreement with our previous reports, in which we observed more precise localization of brain lesions by CSD than by voltage estimates.
Adult↗
Pregnancy and birth after intracytoplasmic sperm injection with totally immotile sperm recovered from the ejaculate.
OBJECTIVE: To report the birth of two healthy children after intracytoplasmic sperm injection (ICSI) with totally immotile spermatozoa recovered from the ejaculate. DESIGN: Retrospective case report. SETTING: University-based hospital. PATIENT(S): Four couples in whom spermatozoa recovered from the ejaculate were totally immotile but presented normal vitality scores. INTERVENTION(S): Therapeutical IVF-ET attempts coupled with ICSI. MAIN OUTCOME MEASURE(S): Fertilization and pregnancy results after ICSI. RESULTS: With random sperm injection, 19 of the 36 injected oocytes showed normal fertilization and cleavage. One of four patients had a twin pregnancy that resulted in birth of two healthy children. CONCLUSION(S): In cases in which totally immotile ejaculated sperm present normal vitality scores, normal clinical outcomes can be achieved by using the usual random sperm selection during conventional ICSI.
Abortion, Spontaneous↗
A follow-up study of EEG coherences in children with different pedagogical evaluations.
A follow-up study on EEG coherence values was carried out with 46 school-age children divided into three pedagogical groups considering their reading and writing abilities (normal subject and children with mild and with serious reading-writing problems). EEGs were recorded at rest, with eyes closed in 15 referential derivations that gave 105 possible coherence values. Coherence was calculated after the elimination of the average reference. Repeated Measure ANOVAs were calculated to evaluate the effects of time, sex, reading-writing problems and their interactions. The second EEG recordings were taken 2-3 years after the first. The results revealed significant increase of coherence values during the time lapse studied, consisting of an increase of frontal coherences in all bands, with the exception of the theta band. The most numerous changes occurred in the alpha band. Very few differences in coherence values were observed between the two EEG recordings by pedagogical groups and by sex suggesting a similar but not igual maturation of coherences of boys and girls and of the three pedagogical groups, in this age range studied. These findings suggests an abnormal coherence development for the reading disabled group, as well as different coherence maturation for boys and girls in this time lapse studied.
Child↗
Co-metabolism and microbial growth in the biodegradation of alkylbenzenesulphonates.
Two organisms, CCMI507 and CCMI852, degrading undecylbenzenesulphonate (LAS) by the ortho- and meta-cleavage pathways were studied in cultures where glucose was used as carbon and energy source. CCMI507 (ortho-pathway) started the degradation of LAS at the beginning of the culture development in parallel with glucose utilization. The degradation followed a steady profile of degradation until 77% of LAS was degraded in the culture containing initially 5 mg l-1 of the compound and 81% in the cultures containing initially 10 and 20 mg l-1 of LAS, after 72 h fermentation. The organism CCMI852 (meta-pathway) started degrading the compound only after 20 h, when 75% of glucose was spent and well within the stationary-phase. After 72 h fermentation the level of degradation by CCMI852 varied from 70% (5 mg l-1 of LAS) to around 75% (10 and 20 mg l-1 of LAS).
Benzenesulfonates↗
Antimicrobial susceptibilities of equine isolates of Clostridium difficile and molecular characterization of metronidazole-resistant strains.
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Animals↗
Isolation of various genotypes of Clostridium difficile from patients and the environment in an oncology ward.
The epidemiology of Clostridium difficile-associated diarrhea (CDAD) is not well defined in nonepidemic situations because precise biotyping techniques have only recently become available. Arbitrarily primed polymerase chain reaction (AP-PCR) was used to determine strain identity of C. difficile isolates recovered on our oncology ward, at an incidence rate of 0.84%. Twenty-one strains of C. difficile, which were grouped into 18 different AP-PCR types, were isolated from patients' specimens. Forty-two C. difficile isolates recovered from the environment (33 toxigenic and 9 nontoxigenic) represented 9 different AP-PCR types. The most commonly found type, a toxigenic strain accounting for 29% of the environmental isolates, was widespread throughout the ward. None of the environmental types were found among the isolates from patients. Three patients' isolates were of the same AP-PCR type, and two of these patients had occupied neighboring rooms at the same time. The diversity of C. difficile isotypes suggests that endemic nosocomial CDAD is not necessarily clonally spread.
California↗
Developmental changes in calcium content of ultrastructurally distinct subcellular compartments of preimplantation human embryos.
The ultrastructural localization of mobilizable Ca2+ in different subcellular compartments of human oocytes and preimplantation embryos was studied using the potassium-pyroantimonate technique and transmission electron microscopy; the specificity was confirmed by chelation experiments and X-ray microanalysis. In unfertilized oocytes, Ca2+ was detected in small vesicles beneath the plasma membrane as well as in other forms of smooth endoplasmic reticulum (SER) and in mitochondria but not in cortical granules. In pronuclear zygotes and blastomeres of cleaving embryos, Ca(2+)-rich vesicles were no longer present close to the plasma membrane, and the entire periphery was poor in Ca(2+)-containing organelles which, however, were abundant in the perinuclear region. The uneven Ca2+ loading of SER and mitochondria from the pronuclear stage onwards suggests that Ca2+ release from both these types of organelle contributes to the embryonic Ca2+ signals. During mitosis, less Ca2+ was detected with organelles, but the antimonate reaction product was more abundant in the cytosol. These data suggest that, in addition to different forms of SER, mitochondria also act as a source of mobilizable Ca2+ in preimplantation human embryos. The previously described developmental and cell cycle related changes in the characteristics of Ca2+ signals are associated with the redistribution and structural reorganization of these organelles.
Antimony↗