Biomedical subjects

M Bravo

Publications and source records attributed to M Bravo.

At least 37 records · Page 2Linked to original sources

PubMed2000

Predictors of positive and negative appraisal among Cuban American caregivers of Alzheimer's disease patients.

OBJECTIVE: This study investigated predictors of positive (satisfaction) and negative (burden) appraisal among Cuban American (CA) caregivers of Alzheimer's disease (AD) patients. DESIGN: Cross-sectional study of AD patients and their family caregivers. SETTING: A university-affiliated outpatient memory disorders clinic. SUBJECTS: A convenience sample of 40 CA family caregivers of patients diagnosed with probable or possible AD according to NINCDS-ADRDA diagnostic criteria. MEASURES: AD patients: Mini-Mental State Examination (MMSE), Blessed Dementia Scale (BDS) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). Caregivers: Caregiving Burden Scale (CBS), Caregiving Satisfaction Scale (CSS), Perceived Emotional Support scale (PES) and the Short Form-36 Health Survey-General Health Index (GH). RESULTS: Appraised burden was predicted by increased patient behavioral pathology, female caregiver gender and lower levels of perceived emotional support. The association between older caregiver age and increased burden approached significance. Older caregiver age and higher levels of perceived social support were shown to predict appraised satisfaction. Post-hoc analyses also indicated that length of residence in the United States, a measure of acculturation, was not associated with positive or negative appraisal. CONCLUSION: Appraised burden and satisfaction represent important outcomes of dementia care that show relations with distinct factors among CA caregivers. It is clear that further research is warranted in order to ascertain the relationship of ethnicity or culture to the process and psychological consequences of dementia caregiving. Continued investigations into predictors of caregiving satisfaction are also recommended.

Activities of Daily Living↗

PubMed2000

Antibacterial activity of four dentin bonding systems.

The antibacterial action of bonding systems Gluma 2000, Syntac, Prisma Universal Bond 3, Scotchbond Multipurpose and Prime-Bond was tested against 32 strains of the caries-producing bacteria Streptococcus spp., Lactobacillus spp., Actinomyces spp., Porphyromonas spp. and Clostridium spp. An agar plate diffusion method was used with chlorhexidine as the positive control. Assays were performed in triplicate for each component (primer and adhesive) of the bonding systems. All the adhesives were found to inhibit bacterial growth but with differences in their spectra of action. The sum action of the Scotchbond Multipurpose components were most inhibitory and Prime-Bond was found to be the least effective system.

Anti-Bacterial Agents↗

PubMed2000

Category fluency test: normative data for English- and Spanish-speaking elderly.

Category fluency tasks are an important component of neuropsychological assessment, especially when evaluating for dementia syndromes. The growth in the number of Spanish-speaking elderly in the United States has increased the need for appropriate neuropsychological measures and normative data for this population. This study provides norms for English and Spanish speakers, over the age of 50, on 3 frequently used measures of category fluency: animals, vegetables, and fruits. In addition, it examines the impact of age, education, gender, language, and depressed mood on total fluency scores and on scores on each of these fluency measures. A sample of 702 cognitively intact elderly, 424 English speakers, and 278 Spanish speakers, participated in the study. Normative data are provided stratified by language, age, education, and gender. Results evidence that regardless of the primary language of the examinee, age, education, and gender are the strongest predictors of total category fluency scores, with gender being the best predictor of performance after adjusting for age and education. English and Spanish speakers obtained similar scores on animal and fruit fluency, but English speakers generated more vegetable exemplars than Spanish speakers. Results also indicate that different fluency measures are affected by various factors to different degrees.

Aged↗

PubMed2000

Depressive symptoms in Alzheimer's disease. An examination among community-dwelling Cuban American patients.

The authors examined the prevalence and clinical correlates of mood disturbance in 96 Cuban American (CA) Alzheimer's disease (AD) patients. Depression (Cornell Scale for Depression in Dementia score > or = 7) was evident in 39.6% of the participants and showed associations with comorbid psychosis, lower education, and decreased length of residence in the United States, a measure of acculturation. Mood disturbance was not related to age, gender, marital status, cognitive dysfunction, functional impairment, history of significant alcohol use, or coexisting medical conditions. The results of this investigation suggest that signs and symptoms of depression are common neuropsychiatric disturbances in CA AD patients residing in the community.

Acculturation↗

PubMed1999

[Survival and the quality of life in extrahospital cardiorespiratory arrest].

BACKGROUND: There are few data in Spain on out-of-hospital cardiac arrest and the efficacy of emergency systems. The objectives of the present study were to evaluate an emergency system, comparing survival at hospital discharge according to the origin, cardiac or non-cardiac, of cardiac arrest in out-of-hospital critically ill patients, and to describe the quality of life of the survivors. PATIENTS AND METHODS: Prospective study on 282 patients treated during 1995 and 1996 by ICU ambulances units of the Andalusian Public Health Emergency Company (061) in Granada, Almería and El Ejido-Poniente (Spain). The Utstein style was followed, gathering the mortality at different times up to 6 months after hospital discharge and the origin (cardiac/non-cardiac) of the arrest. Quality of life 6 months after discharge was collected among survivors. RESULTS: Advanced cardiopulmonary resuscitation (CPR) was applied to 176 (62.4%) patients. The survival rate to discharge was 4.9% for patients with cardiac etiology (7/142 x 100) and 5.9% for those with non-cardiac etiology (2/34 x 100), with non-significant differences between the two groups. An optimal quality of life in all domains, except for pharmacological dependence in seven, was found in the eight survivors 6 months after hospital discharge. CONCLUSIONS: The origin (cardiac/non-cardiac) of out-of-hospital cardiac arrest is not associated with survival at hospital discharge. The survivors exhibit an optimal quality of life 6 months after discharge.

Aged↗

PubMed1999

Regulation of expression of avirulence gene avrRxv and identification of a family of host interaction factors by sequence analysis of avrBsT.

Resistance in tomato line Hawaii 7998 as well as in several nonhost plants to Xanthomonas campestris pv. vesicatoria tomato strain (XcvT) is mediated in part by the avirulence gene avrRxv. Analysis of growth of wild-type and avrRxv deletion strains indicates that avrRxv plays a crucial role in the ability of XcvT 92-14 to induce resistance on Hawaii 7998. We used avrRxv reporter gene fusions and Northern (RNA) blot analysis to test several growth environments for inductive potential. We found that avrRxv is constitutively expressed at high levels and that growth in planta, in tobacco conditioned medium, and in hrp-inductive medium XVM2 did not affect the high levels of expression. In addition, hrp structural and regulatory mutant backgrounds had no effect. We mutated the bipartite plant inducible promoter (PIP)-box sequence and found that avrRxv activity appears to be independent of an intact PIP-box element. We present the sequence of the avrRxv homologue called avrBsT and align the six AvrRxv host interaction factor family members including mammalian pathogen virulence factors YopJ and YopP from Yersinia spp. and AvrA from Salmonella typhimurium, and open reading frame Y4LO with unknown function from the symbiont Rhizobium sp.

Amino Acid Sequence↗

PubMed1999

The Spanish Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS): reliability and concordance with clinical diagnoses in a Hispanic population.

OBJECTIVE: The study reports the process of translation into Spanish and adaptation to the Hispanic culture of the Alcohol Use Disorder and Associated Disabilities Schedule (AUDADIS). This instrument is a structured diagnostic interview schedule specifically developed for the assessment of substance-related disorders and their comorbid disorders and disabilities. METHOD: A random sample (N = 169) of adults from a primary health care clinic in Puerto Rico was selected. The test-retest reliability of the instrument was examined across time and across interviewers, and the validity was assessed by comparing computer-derived diagnoses obtained through the administration of lay interviewers with best estimate diagnoses given by board-certified psychiatrists. RESULTS: For most diagnoses and symptoms studied, as well as for most of the alcohol consumption measures, the test-retest reliability of the Spanish AUDADIS was consistent with results reported in other national and international studies using this instrument. Good to excellent test-retest reliability was obtained for the diagnoses of alcohol dependence and major depression. Similarly, good to excellent agreement was obtained between the lay administered AUDADIS and best estimate diagnoses for most diagnostic categories, with the exception of dysthymia. As in other studies, the reliability and validity of the substance abuse category was poor. When agreement for this category was estimated independent of lifetime dependence, both the reliability and validity coefficients were considerably improved. CONCLUSIONS: The Spanish AUDADIS generally demonstrates good to excellent levels of reliability and validity that are comparable to findings reported for this instrument in other national and international studies.

Adult↗

PubMed1999

[Systemic fibromuscular dysplasia. Supra aortic and renal artery involvement].

We report a 39 years old male presenting with an intense hemicrania pain in the tract of the carotid artery and Claude Bernard Horner syndrome. The patient had also a high blood pressure. Magnetic resonance imaging demonstrated a left carotid artery fibrodysplastic disease. Conventional angiography of 4 cerebral vessels showed a dissection of the left carotid artery and fibromuscular dysplasia of the left vertebral artery. Renal angiography showed a stenosis and occlusion of renal artery with radiological exclusion of right kidney. On the left side there was a stenosis and occlusion of segmental branches. The diagnostic importance of Claude Bernard Horner syndrome and the need to study renal artery involvement when carotid dissection is accompanied with high blood pressure, is highlighted.

Adult↗

PubMed1999

[Prolonged electroencephalographic and video monitoring an experience from a military Chilean hospital].

BACKGROUND: Cerebral activity must be registered for prolonged periods in certain clinical situations that are not resolved with conventional electroencephalography. AIM: To report the experience with prolonged electroencephalographic and video monitoring at a Neurology Department, of a Military hospital in Santiago. PATIENTS AND METHODS: A retrospective analysis of patients referred for continuous electroencephalographic and video monitoring between 1991 and 1996. Three hundred thirty six patients, aged 3 months to 60 years old, were studied in the period and in 244, there was information about the diagnosis, treatment and evolution. RESULTS: Monitoring was performed in an outpatient basis in 84% of subjects and lasted between 2 and 7 hours. One hundred ten patients were epileptics, 77 patients had a suspicion of epilepsy, 13 patients had possible pseudoseizures and 33 patients had miscellaneous diagnoses. In 154 patients, electroencephalographs recorded during wakefulness, somnolence and spontaneous dream, were normal. Intercritical recordings with epileptic activity were obtained in 76 patients and in 30 of these, critical epileptic activity was also recorded, not always associated to clinical manifestations. Unspecific electroencephalographic alterations were recorded in 14 patients. CONCLUSIONS: Prolonged electroencephalographic and video monitoring can be useful for patients with complex neurological problems.

Adolescent↗

PubMed1999

[Rhinocerebral mucormycosis. Report of four cases].

We report four diabetic patients (one male) aged 64, 63, 61 and 77 years old with rhinocerebral mucormycosis. Three had an acute and one a chronic form of the disease. The chronic form was diagnosed with a biopsy of the nasal cavity. Three patients received amphotericin but all died. The diagnosis of the disease must be suspected in diabetics or patients with some type of immune depression.

Aged↗

PubMed1999

[Detection of beta thalassemia by the technique of refractory amplification of mutation systems (ARMS-PCR)].

beta Thalassemia (Thal) mutations were studied in DNA from 80/159 patients with hemolytic anemia and high levels of Hb A2 by the amplification refractory mutation system technique (ARMS-PCR). This method detects point mutations and insertions or deletions of just a few nucleotides in the beta globin gene by the polymerase chain reaction of allele-specific priming. In 43/80 patients with different clinical presentations of beta Thalassemia and 37/80 compound heterozygous for hemoglobinopathies and beta Thalassemia the most frequent mutation found was the -29 (of African origin), followed by the CD39 (of Mediterranean origin) and in a lower frequency also was found the -88, the IVSI-6 and the IVSI-110. We conclude that this technique is an useful approach in determining the beta thalassemia mutations in population surveys, because it allows to make a differential diagnosis between beta Thalassemia minor and individuals with high levels of Hb A2. It helps to clarify the diagnosis of patients with structural hemoglobinopathies that also presents high levels of Hb A2.

Base Sequence↗

PubMed1998

Measurement of risk for mental disorders and competence in a psychiatric epidemiologic community survey: the National Institute of Mental Health Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study.

This paper describes the implementation of the National Institute of Mental Health Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study's goals of measuring risk factors and competence. The emphasis is on the development and testing of the measures. Relevant constructs for measurement of risk and competence in relation to psychopathology were selected and pilot tested prior to the field trials. A structured interview was developed and field tested using lay interviewers. Using the full sample from the field trials (n = 1285 caretaker-youth pairs), sample means, standard deviations, internal consistencies, parent-youth agreement, and associations with childhood disorder were computed. Descriptive statistics reveal a range of scores and means consistent with norming samples, when available, Internal consistencies were moderate to high. Parent-youth agreement on factual items was excellent and on scales was consistent with the literature. Several strong associations were found between risk factors and disorder, although most were related to disorder in general and not specific to a diagnostic category. This instrument provides a means of obtaining data that will be useful to researchers conducting epidemiologic and clinical studies designed to contribute to the understanding of mental disorders in children and adolescents, including nosology, risk factors, context, adaptive functioning, and treatment.

Adolescent↗

PubMed1998

The Apache III prognostic system: customized mortality predictions for Spanish ICU patients.

OBJECTIVE: To customize the Acute Physiology and Chronic Health Evaluation (APACHE) III mortality equation for Spanish admissions to the intensive care unit (ICU) and evaluate its discrimination and calibration. DESIGN: Prospective multicenter inception cohort study. SETTING: 86 ICUs located in all regions of Spain. PATIENTS: 10,929 adult patients selected by a systematic sampling method. All types of critical care patients were included, including coronary bypass patients, but excluding those with burn injury, those admitted for pacemaker implants, patients under 16 years of age, and patients with length of ICU stay < 6 h. MEASUREMENTS AND RESULTS: Data collection in the first 24 h after patient admission included: APACHE III score, treatment location prior to ICU admission, and main ICU admission diagnosis. Using these variables, a model for predicting hospital mortality was constructed, adapted to Spain, and its discriminating ability was assessed by the area below the ROC curve, which was 0.83. The model was validated using the jacknife method and the area below the receiver operating characteristic (ROC) curve for the cross-validated predictions was 0.82. The percentage of patients correctly classified at 0.50 risk of death was 82.3%. Model calibration was evaluated by analysis of the agreement between the observed and cross-validated predicted mortality using the Hosmer-Lemeshow test, which gave a value of (H) 12.27, with no statistical significance, i.e., good calibration. CONCLUSIONS: We have customized the APACHE III mortality prediction system for the Spanish population. This adapted model has demonstrated the requisite validation, calibration, and discrimination for its use among Spanish critical care patients.

APACHE↗

PubMed1998

G2 repair in Nijmegen breakage syndrome: G2 duration and effect of caffeine and cycloheximide in control and X-ray irradiated lymphocytes.

Lymphocytes from a patient with the Nijmegen breakage syndrome (NBS/NBS) and his parents (NBS/+) have been analyzed to identify possible disturbances in chromosomal G2 repair. The study included the determination of G2 duration and the analysis of the chromosomal aberration frequencies in lymphocytes with/without caffeine and cyclohexemide (CHM) treatments during G2, under control and X-irradiated conditions. Under control conditions, NBS/NBS lymphocytes showed that the basal chromosomal damage as well as the damage detected in G2, with caffeine treatment, and the G2 duration were higher than cells from an age-matched control. In X-irradiated NBS/NBS lymphocytes, the basal and G2 chromosome aberration frequencies were higher than in the controls; however, no significant differences in G2 duration were detected between these two type of cells. Under X-irradiated conditions, NBS/+ lymphocytes showed that while the level of chromosomal damage in G2 and the duration of this cell cycle phase were similar to the control cells, the frequency of unrepaired chromosomal lesions was higher than in the control lymphocytes. No significant differences in chromosomal damage and G2 duration were detected in NBS/+ lymphocytes compared to the control cells, under control conditions. CHM treatment, which induces an increase in G2 duration, decreased the basal spontaneous and X-ray induced chromosome aberration frequency in NBS/NBS and NBS/+ lymphocytes. These results suggest that NBS lymphocytes might be affected by some disturbances in their ability to extend the G2 duration, which may be influencing their DNA repair efficiency in this phase of the cell cycle.

Abnormalities, Multiple↗

PubMed1998

[Deep venous cerebral thrombosis. Report of one case].

We report a 39 years old female presenting with headache, progressive clouding of sensorium and long pathway deficit signs. Brain CAT scan showed a process involving basal ganglia, thalami and Herophilus press. A thrombosis of this vessel was suspected. The first magnetic resonance imaging was informed as a diffuse inflammatory process compatible with an encephalitis. The patient aggravated and a second magnetic resonance imaging demonstrated a partial thrombosis of sinus rectus, Galenus vein, Herophilus press and both internal cerebral veins. Intravenous heparin was started with a progressive recovery of the patient. Two months later she had an almost complete recovery with a persistent mild right brachial paresis and a memory deficit for recent events.

Adult↗

PubMed1998

[Myxoma and antiphospholipid antibody syndrome].

We report a 26 years old female with a Cerebral Palsy as a consequence of a perinatal vascular accident. She was admitted in August 1996 with a left hemiplegia due to a right M1 median artery thrombotic occlusion, as demonstrated by magnetic resonance imaging angiography. Transesophagical bi-dimensional echocardiography showed a right atrial myxoma and ruled out the persistence of an oval foramen. The study of coagulation disorders lead to the diagnosis of a primary antiphospholipid syndrome. We postulate that interleukin-6 produced by the myxoma could trigger an immunological reaction leading to the primary antiphospholipid syndrome.

Adult↗

PubMed1998

[Listeria monocytogenes rhomboencephalitis. Clinical case].

We report a previously healthy 44 years old female, that presented with mild clouding of consciousness, a left cerebellar syndrome, involvement of V, X and XII left cranial nerves and an alteration of epicritic sensitivity in the left half of the body. Cerebrospinal fluid had inflammatory features. Cerebrospinal fluid and blood cultures were positive for Listeria monocytogenes. Magnetic resonance imaging disclosed a rhomboencephalitis. Antibiotics were started and the clinical condition of the patient improved progressively. After three months of follow up, the patient is notably recovered and there is a regression of hyperintense lesions of the brainstem in the magnetic resonance imaging. The diagnosis of Listeria monocytogenes infection must be born in mind in the presence of a rhomboencephalitis.

Adult↗

PubMed1997

Effect of pulmonary lymphatic obstruction on rabbit urine flow.

1. The effects of pulmonary lymphatic obstruction on urine flow, sodium and potassium excretion were examined on anaesthetized, artificially ventilated New Zealand White rabbits. Pulmonary lymphatic obstruction was produced by raising the pressure in a pouch created from the right external jugular vein. The experiments were performed on two groups of rabbits (non-hydrated and hydrated). 2. Pulmonary lymphatic obstruction caused a significant increase in urine flow in both groups of rabbits. After release of the obstruction, the urine flow returned to basal values. Urine flow (ml (10 min)-1) for both groups was initial control, 5.3 +/- 0.9; lymphatic obstruction, 8.9 +/- 1.0; final control, 6.2 +/- 0.7 (means +/- S.E.M.; n = 21, P < 0.025). 3. The increase in urine flow was not accompanied by significant changes in concentration of sodium and potassium in urine. Sodium excretion increased significantly only in the hydrated rabbits. 4. The increase in urine flow was abolished by bilateral cervical vagotomy and by renal nerve sectioning. Cooling the cervical vagi to 8 degrees C also abolished the response. 5. Pulmonary lymphatic obstruction did not produce any significant change in heart rate, mean arterial blood pressure, mean right atrial pressure and peak airway pressure. 6. These findings suggest that obstructing the lymph drainage from the lung results in a reflex increase in urine flow. The afferent pathway for this reflex resides in the myelinated fibres of the vagi and the efferent pathway in the renal nerves. The rapidly adapting receptors of the airways are likely to be the receptors involved.

Animals↗