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Biomedical subjects

M Gomes

Publications and source records attributed to M Gomes.

At least 37 records · Page 2Linked to original sources
PubMed1995

Autologous blood donation in cardiac patients.

Despite the advantages of autologous blood transfusion, doubt still remains about its safety in cardiac patients. We report our experience with 439 cardiac patients who donated a total of 1692 units of blood before coronary, valvular, or congenital cardiac operations. During the collections, patients were continuously monitored with ECG, blood pressure, and heart rate. In 22 collections we observed vasovagal reactions, which represents an incidence of 1.3% of the total number of collections. The patients recovered quickly and only in 3 cases was volume replacement with saline needed. There were no other complications which could be related to the preoperative autologous donation program. We feel that, with careful selection of the patients and of the circumstances surrounding the collection of blood, autologous blood donation in cardiac patients is a safe and beneficial experience.

Adolescent↗
PubMed1994

The reliability of Hickman catheter blood for the assessment of activation markers of coagulation and fibrinolysis in patients with hematological malignancies.

We studied the reliability of Hickman catheter (HC) blood for the determination of activation markers of coagulation and fibrinolysis in 14 patients with hematological malignancies. 10 of 22 HC samples were contaminated with heparin, probably as a consequence of our institutional antithrombotic catheter care, and withdrawn from statistical analysis. Prothrombin activation fragment F1.2, thrombin-antithrombin III complexes, soluble fibrin, degradation products of fibrinogen and fibrin, total degradation products, alpha 2-antiplasmin and antithrombin III levels withdrawn from Hickman catheters did not differ significantly from peripheral venous blood samples. Fibrinogen levels were slightly but significantly higher in peripheral venous blood samples. We conclude that Hickman catheter blood gives reliable results for the determination of activation markers of coagulation and fibrinolysis in patients with hematological malignancies, but may be less useful in clinical practice due to frequent heparin contamination.

Adolescent↗
PubMed1994

Symptomatic identification of malaria in the home and in the primary health care clinic.

In endemic areas in the absence of microscopy, the WHO case definition of malaria is the presence or a history of fever without other obvious cause. Yet there is little empirical evidence on the accuracy, predictability and reliability of clinical signs and symptoms for diagnosing malaria within different endemic settings. Studying patients in endemic communities in the Philippines, we found that fever alone did not discriminate well for malaria. In contrast, a sequential occurrence of fever, chills and/or sweating, or a combination of all three symptoms was a good general predictor of the disease. However, the place of diagnosis and observation (home or clinic), age, and season affected the positive predictive values obtained. Specificities and positive predictive values were greatest (over 80%) for those at most risk--children under 9 years of age in highly endemic communities--and were most reliable when the diagnosis was made at home. Predictive values were also greatest during the season when childhood acute lower respiratory infections in the study area increase. The good predictability of clinical signs and symptoms for high-risk groups suggests that simple protocols can be developed for the management of malaria in endemic areas of the Philippines.

Adolescent↗
PubMed1993

Economic and demographic research on malaria: a review of the evidence.

The primary objective of malaria control is to reduce deaths and illness from the disease. Elimination of infection is far more difficult. However, in most developing countries where malaria is endemic, there are few reliable data on levels, differences and trends in malaria mortality, and its relative importance as a cause of death or illness in endemic communities. The large-scale efforts and resources being devoted to delivery of essential care to mothers and young children in most countries make it important to have a better understanding of the extent of cause-specific child mortality levels in different epidemiological conditions so that appropriate interventions can be targeted at high risk groups and properly evaluated according to their contribution to mortality reduction. As per capita resources necessary in relation to the scale of the problem remain scarce, governments are finding that they must use their available resources more efficiently in meeting their health objectives. In the case of malaria, there are far too few empirical data documenting the marginal costs and benefits of alternative interventions and their response to an expansion (or contraction) of services, and to the level of endemicity and distribution of disease. Equally important, the literature on private costs of malaria (treatment, transportation etc) provides incomplete guidance to gains from control unless the authors begin to examine the policy implications of their results; for example, in many countries there is accumulating evidence that private expenditures outweigh public expenditures on health. What effect does this mix have on infectious diseases like malaria where public sector expenditures on prevention are so important in affecting incidence?

Adolescent↗
PubMed1992

Compliance with diphtheria, tetanus, and pertussis immunisation in Bangladesh: factors identifying high risk groups.

OBJECTIVE: To evaluate factors associated with non-compliance with having second vaccination against diphtheria, tetanus, and pertussis in a treatment centre in Dhaka to determine which children were most at risk of not completing immunisation. DESIGN: Cohort study of infants given first dose of the vaccine and followed up six weeks later to ascertain compliance with having second dose. Factors associated with non-compliance were evaluated. SETTING: Dhaka treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh. SUBJECTS: 136 unimmunised children aged 6 weeks to 23 months who lived within reach of the treatment centre. At time of the six week follow up 16 of the children could not be traced and seven had died. INTERVENTIONS: All children received their first dose of the vaccine. In each case health education workers had informed the mother about the value of immunisation, and she was given clear instructions to bring the child back after four weeks for the second dose. MAIN OUTCOME MEASURE: Rate of non-compliance with advice to return child for second vaccination. RESULTS: 46 of 113 children (41%) received the second dose of the vaccine. Factors most closely associated with mothers' failure to comply with the second dose were lack of education and low income. Children whose mothers knew most about immunisation at first interview were more likely to have their second dose. CONCLUSIONS: Preventive health care services such as immunisation are appropriately offered in treatment centres, but compliance among children varies with socioeconomic status and mother's education. Further research should be aimed at ways to make health education more effective among uneducated parents.

Bangladesh↗
PubMed1991

DNA sequence of the nucleoside triphosphate phosphohydrolase I (NPH I) of the Choristoneura biennis entomopoxvirus.

The DNA sequence of an open reading frame (ORF) corresponding to a Choristoneura biennis entomopoxvirus putative late gene was determined. Residing within an 8-kp EcoRI viral genomic fragment, this ORF is 1944 nucleotides long, encoding a basic protein (pI 9.83) with a predicted molecular weight of 76,000 Da. Computer analysis indicates a 36.4% homology between this ORF and the vaccinia nucleoside triphosphate phosphohydrolase I (NHP I) gene, with substantially greater homology (60%) in two domains believed to be involved in ATP binding. The entomopoxvirus ORF contains 78% AT residues; and like other poxvirus late genes, it possesses the conserved TAAAT motif at the 5' terminus of the gene.

Amino Acid Sequence↗
PubMed1991

Left ventricular function after total correction of tetralogy of Fallot.

Conflicting data are available concerning left ventricular (LV) function in patients after total correction of tetralogy of Fallot (TOF). The response to afterload stress determined by methoxamine challenge and the peak systolic blood pressure-end-systolic volume relationship were evaluated echocardiographically in 20 postoperative TOF patients (age range 9 to 15 years, mean 12 +/- 2). All patients were without significant residual shunts or pulmonary stenosis. Results were compared with those in 10 control subjects (age range 9 to 15 years, mean 11 +/- 2). The TOF group had higher mean end-diastolic (76.9 +/- 14.4 vs 66.2 +/- 7.2 ml.m-2 P less than 0.05) and mean end-systolic (36.7 +/- 8.5 vs 29.6 +/- 3.9 ml.m-2, P less than 0.05) volumes than controls. Stroke volume index (SVI) and LV ejection fraction were similar in the two groups. In normal subjects, methoxamine caused a decrease in SVI in seven out of 10 patients and a mild increase in three; the mean value of SVI at rest was not significantly different from the mean value at peak pressor effect (36.5 +/- 4.4 vs 35.9 +/- 4.0 ml.m-2, P = NS). In the TOF group, methoxamine induced a reduction in SVI in all patients; the mean value of SVI at peak pressor effect was significantly lower than the mean value at rest (31.3 +/- 5.4 vs 40.2 +/- 6.9 ml.m-2, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Chemotherapy: principles in practice--a case study of the Philippines.

This paper reports on the principles that form the basis of chemotherapy and examines the operational considerations that affect their practice in a developing country like the Philippines, where malaria endemicity is synonymous with difficult topography, poor public health infrastructure, and alternative means of obtaining medication. The practice of using microscopic diagnosis for radical treatment is followed routinely and uniformly. Where policy dictates that all fever cases be screened, the result is an overload of the system and a corresponding delay in the slide-examination rate which makes such microscopic diagnosis cease to serve as a basis for prompt radical treatment and control in transmission.

Animals↗