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Biomedical subjects

M C Silva

Publications and source records attributed to M C Silva.

At least 19 recordsLinked to original sources
PubMed1995

From Carper's patterns of knowing to ways of being: an ontological philosophical shift in nursing.

Carper's 1978 article in the premiere issue of Advances in Nursing Science encouraged nurses to consider four fundamental patterns of knowing. Through illustrations from literature and the performing arts, the authors address Carper's patterns of knowing in the context of an emerging philosophical shift. First, they critique the major strengths and limitations of the article. Next, they explore an emerging philosophical shift in nursing from Carper's epistemological focus to ontological reflections on ways of being. Finally, they discuss the significance of the emerging philosophical shift and the ways of being for the science-art of nursing.

Cognition↗
PubMed1992

Testing of nursing theory: critique and philosophical expansion.

The authors first critique Silva's 1986 article in Advances in Nursing Science entitled "Research Testing Nursing Theory: State of the Art." They specifically focus on her evaluation criteria for the empirical testing of nursing theory and then develop evaluation criteria for three alternative approaches to theory testing in nursing. In addition, they describe how philosophy in general, and epistemology in particular, affect testing of nursing theory. Finally, they raise philosophical issues and state conclusions related to the testing of nursing theory within the discipline and practice of nursing.

Cognition↗
PubMed1991

Anorectal electromanometry in the diagnosis of neuronal intestinal dysplasia in childhood.

The diagnosis of neuronal intestinal dysplasia (NID) is currently established by histochemical procedures. From October 1, 1981, until July 31, 1990, we submitted a total number of 737 patients under 15 years of age with several distinct colonic and anorectal disorders, to clinical, radiological, electromanometrical, histochemical and histological evaluation. 573 had a clinical diagnosis of chronic constipation, and in 38 of these NID could be demonstrated by histochemical examination. Motivated by our own findings with the anorectal electromanometry in these patients we performed a double-blind prospective study to find out if there are any particular and pathognomonic manometric parameters of NID in childhood. 80% of our patients with NID diagnosed prospectively since April 1st, 1986, had a relaxation of the internal anal sphincter which was not proportional to the volume of rectal distention. Anorectal hyperexcitability was also present in these patients, whereas a statistically highly significant (p less than 0.01) increase of the amplitude of anorectal fluctuations (7.27 +/- 1.12 mmHg) as compared to the values measured in our own patients with functional chronic constipation (2.87 +/- 0.33 mmHg) could be demonstrated. Considering only those patients who simultaneously presented all of the above mentioned electromanometric criteria (e.g. non-proportional relaxation of the internal anal sphincter, anorectal hyperexcitability, increased amplitude of anorectal fluctuations) without an increase of the anorectal pressure profile, we could demonstrate that the correlation between the electromanometric diagnosis of NID and the final histochemical diagnosis was 100%. Nevertheless, under these conditions, 30% (9 out of 30) of patients with NID were not recognized electromanometrically because they had been excluded as false negative cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Autoimmune phenomena in the elderly].

We analyzed sera from 102 subjects older than 65 years of age with no clinical evidence of autoimmune disorders, inflammatory diseases or pharmacological interventions. Positive titers for antinuclear antibodies were found in 18.6%, anti-smooth muscle fibre in 16.6%, and rheumatoid factor in 11.8%. These values were significantly higher than those of a control group of healthy younger adults (p < 0.0001). Anti mitochondrial antibodies were present in 1% (NS). Thus, a greater proportion of autoimmune phenomena is demonstrated in the elderly.

Age Factors↗
PubMed1991

Null allele in a human polymorphism restricted to the placenta: call for a search.

The identification of a null allele in a human genetic system restricted to the placenta is a great challenge for two reasons: the impossibility of carrying out family studies and the unviability of sample recollections because the placenta itself is a disposable universe. Thus, in addition to reporting the finding of a null phenotype of placental alkaline phosphatase in a dark mulatto newborn from a black mixed population of Bahia, Brazil, here we present other evidence for the presence of the ALPP*Q0 allele with considerably high frequency in this population.

Alkaline Phosphatase↗
PubMed1990

Radioimmunoassay of carboxyl and amino terminal fragments of parathyroid hormone for the evaluation of secondary hyperparathyroidism in chronic renal failure.

1. Some parameters of calcium and phosphorus metabolism and the radioimmunoassay of plasma concentrations of both the carboxyl (COOH) (residues 53-84) and amino (NH2) terminal (residues 1-34) fragments of parathyroid hormone (PTH) were measured to evaluate secondary hyperparathyroidism in 68 patients with chronic renal failure (CRF), 34 of whom were on hemodialysis therapy. 2. The upper limits of the normal values for serum PTH-NH2 and PTH-COOH concentrations were 28 and 146 pmol/l, respectively. Patients with mild CRF (plasma creatinine (CRp) 1.2-2 mg/dl) had normal mean serum total calcium, low mean serum phosphorus, undetectable plasma levels of PTH-NH2 (less than 10 pmol/l), slightly elevated mean plasma PTH-COOH concentration and normal fractional excretion of phosphorus (FEP). Patients with moderate CRF (CRp 2.1-4 mg/dl) had normal mean serum concentrations of both total calcium and phosphorus, and elevated mean levels of both plasma PTH-COOH and PTH-NH2 associated with increased FEP. Patients with end-stage CRF (CRp greater than 4 mg/dl) and those on hemodialysis had elevated mean serum phosphorus levels and decreased mean serum total calcium concentrations compared with those with mild and moderate CRF, and more pronounced increases in both mean plasma PTH-COOH and PTH-NH2. 3. The logarithm of plasma PTH-NH2, but not PTH-COOH, concentration correlated positively with FEP and serum phosphorus concentration and negatively with total serum calcium concentration, while the logarithms of both PTH-NH2 and PTH-COOH levels correlated positively with CRp.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Intratumoral aromatase as a prognostic factor in human breast carcinoma.

Intratumoral aromatase activity (AA) was measured in 145 samples of human primary breast carcinoma using the tritiated water release assay which quantifies the tritium lost to water during the aromatization of 1 beta-[3H]androstenedione to estrone. Significant AA was detected in 91/145 (63%) tumors. The possibility of a relationship between AA and a variety of clinical prognostic factors such as estrogen receptors, menopausal status, site, size, and histological grade of tumor was investigated. Possible relationship with time to relapse, overall survival, and survival of patients after relapse were also studied to determine whether intratumoral AA itself was of any prognostic value. There was no relationship between AA and tumor size, site, nodal status, menopausal status or estrogen receptors. However there was a significant correlation between AA and histological grade with an excess of AA-positive tumors having high grade (P = 0.03). There was no significant relationship between AA and overall survival (P greater than 0.1), but there was a marginal inverse correlation between AA and time to relapse (P less than 0.1). A statistically significant correlation was found between AA and survival of patients after relapse (P less than 0.05).

Aromatase↗
PubMed1988

Controlled trial of enalapril and hydrochlorothiazide in 200 hypertensive patients.

In a multicenter, multinational study, 200 patients with essential hypertension were treated with a fixed dose of Enalapril (E) 20 mg/day after a 2- to 4-week placebo period. All had diastolic blood pressure (DBP) 100 to 120 mm Hg at the end of the placebo period. They were then given E for 6 weeks. If DBP after this was greater than 90 mm Hg they were randomized double-blind to added therapy with hydrochlorothiazide (H) either 25 mg/day (E + H 25) or 12.5 mg/day (E + H 12.5) or placebo (E + P) for 4 weeks. Blood pressure was measured approximately 24 hours after taking the medication. In the whole group, BP fell from 171/107 to 156/97 mm Hg during monotherapy with E (P less than 0.001). Sixty-six patients reached DBP less than or equal to 90 mm Hg on E alone. Of the remainder, 42 were randomized to E + P. In these, BP fell by 5.9/3.4 mm Hg (P less than 0.05). Forty-two patients received E + H 12.5 and BP fell by 9.0/6.9 mm Hg (P less than 0.001). Forty-one patients received E + H 25 and BP fell by 5.6/6.3 mm Hg (P less than 0.05/0.01). The proportion of patients who reached DBP less than or equal to 90 mm Hg was 26% in the E + P group, 48% in the E + H 12.5 group (P less than 0.05 compared to E + P group), and 38% in the E + H 25 group. There were no other significant differences between the E + H 12.5 and E + H 25 groups except that S-potassium fell significantly (-0.2 mmol/L) in E + H 25. Both regimens were remarkably well tolerated. It can be concluded that H 12.5 mg/day potentiates the effect of Enalapril 25 mg/day at least as well as H 25 mg/day and better than placebo.

Adult↗
PubMed1988

Follow-up of the antibody response to measles vaccine in a rural area of Guinea-Bissau.

One hundred and fourty-four children who either were already immune or had been successfully immunized against measles were reexamined after 16 months. All still had circulating Elisa antibodies at a clearly detectable level. Titres were higher in the group of children stated to have had measles prior to the immunization. None of the children had measles after immunization. Boostering by the wild virus may have occurred, whereas no evidence of a booster effect from the vaccine was found. About one third of the children were underweight. Plasmodium falciparum parasitaemia rate, and also its seasonality, varied with the location of the child's homestead. Even children exposed to mesoendemic P. falciparum malaria and moderate malnutrition can be successfully immunized with a conventional live attenuated measles vaccine from 8 months of age, which probably results in a lasting protection.

Antibodies, Viral↗