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Biomedical subjects

M Jorge

Publications and source records attributed to M Jorge.

13 recordsLinked to original sources
PubMed2000

[Sertraline. Adverse effects due to the superposition of serotonic and malignant neuroleptic syndromes].

A 57 year-old man chronically treated with 50 mg daily of sertraline was admitted to the emergency room with mental status changes, rigidity, seizure activity and autonomic instability. He was rapidly transferred to the Intensive Care Unit. Laboratory determinations revealed increases in serum enzymes, prevailing creatine phosphokinase with a peak level by the third day of 35,000 Ui/L. Initial low serum sodium (10 mEq/L) was attributed to inadequate antidiuretic hormone secretion. Supportive care included discontinuation of sertraline and lorazepam administration. Mental status, and rigidity returned to baseline within 60 hours. Differential diagnosis between the neuroleptic malignant syndrome and the serotonin syndrome could not be determined accurately because of the striking overlap of signs and symptoms of both syndromes.

Antidepressive Agents↗
PubMed1998

[Radiotherapy-induced pemphigus].

The authors report the clinical case of a woman exposed to ionizing radiotherapy, for the treatment of breast carcinoma, in whom a pemphigus lesion developed within the area of irradiation. This is, to the authors' knowledge, the 14th case of ionizing radiation-induced pemphigus.

Aged↗
PubMed1997

Nature of drug resistance and predictors of multidrug-resistant tuberculosis among patients seen at the Philippine General Hospital, Manila, Philippines.

SETTING: This study was conducted at the University of the Philippines--Philippine General Hospital (UP-PGH), Manila, Philippines. OBJECTIVES: To determine the nature of drug resistance among patients with pulmonary tuberculosis (PTB), and to establish clinical predictors of drug-resistant tuberculosis. DESIGN: Descriptive, prospective study. METHODS: Patients with positive culture for Mycobacterium tuberculosis were interviewed regarding past history of anti-tuberculosis treatment, BCG vaccination, chest X-ray and family contact. M. tuberculosis isolates from 299 patients were tested for susceptibility to rifampicin, isoniazid (INH), ethambutol and streptomycin using the submerged disc proportion method. Pyrazinamide (PZA) susceptibility test was done with standard laboratory powder in 7H10 media. RESULTS: Of the 299 M. tuberculosis isolates, 17% were fully susceptible to the 5 primary drugs and 54% were resistant to 2 or more drugs (multidrug resistant TB [MDR-TB]). Initial drug resistance rate was high with ethambutol (39%) and INH (17%). Previous history of anti-tuberculosis treatment was significantly associated with MDR-TB (Odds Ratio [OR] 2.44, 95% confidence interval). Incomplete anti-TB treatment taken for longer than 3 months increased the likelihood of MDR-TB (OR 4.6, P < 0.0001). CONCLUSION: The high rate of MDR-TB was associated with previous anti-tuberculosis treatment. The chance of developing MDR-TB was significantly increased when inadequate prior treatment was given for more than 3 months.

Adolescent↗
PubMed1992

Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients.

Falls in gastric intramucosal pH (pHi) are associated with morbidity and mortality in patients admitted to intensive-care units (ICU). We tested the hypothesis that ICU outcome can be improved by therapy guided by changes in pHi and aimed at improving systemic oxygen availability. We studied 260 patients admitted to ICUs with APACHE II scores of 15-25. After insertion of a gastric tonometer, each patient was randomly assigned to a control or protocol group within the admission pHi category (normal = 7.35 or higher; low = below 7.35). The control groups were treated according to standard ICU practices. The protocol groups received, in addition, treatment to increase systemic oxygen transport or to reduce oxygen demand, whenever the pHi fell below 7.35 or by more than 0.10 units from the previous measurement. The protocol was used, because pHi fell, in 67 (85%) of the protocol group with normal pHi on admission. There were no significant differences between protocol and control groups in demographic characteristics, admission blood gases or haemoglobin concentration, number or type of organ system failures, or the intensity of ICU care. For patients admitted with low pHi, survival was similar in the protocol and control groups (37% vs 36%), whereas for those admitted with normal pHi, survival was significantly greater in the protocol than in the control group (58% vs 42%; p less than 0.01). Therapy guided by pHi measurements improved survival in patients whose pHi on admission to ICU was normal. pHi-guided resuscitation may help improve outcome in such patients by preventing splanchnic organ hypoxia and the development of a systemic oxygen deficit.

Aged↗
PubMed1987

Gentamicin dosage regimen based on serum creatinine concentration.

In order to avoid gentamicin toxicity trough serum concentrations when drug monitoring is not available, a correction factor for serum creatinine was calculated and evaluated. In a first group of 35 patients under aminoglycoside treatment with variable serum creatinine (SCr) values, the regression plot of SCr concentrations versus half-life (T1/2) values was established: log T1/2 = log 2.28 + 1.45 log SCr, r = 0.90, p less than 0.01. A second group of 18 patients was treated with doses of 1.0 mg/kg of gentamicin. Dose intervals equivalent to 3 T1/2 were daily adjusted. The T1/2 was calculated from SCr according to the relationship established for the patients of the first group. All the patients studied maintained trough levels within the therapeutic range.

Adult↗
PubMed1986

Analysis of EMG measurements during bicycle pedalling.

Activity of eight leg muscles has been monitored for six test subjects while pedalling a bicycle on rollers in the laboratory. Each electromyogram (EMG) data channel was digitized at a sampling rate of 2 kHz by a minicomputer. Data analysis entailed generating plots of both EMG activity regions and integrated EMG (IEMG). For each test subject, data were recorded for five cases of pedalling conditions. The different pedalling conditions were defined to explore a variety of research hypotheses. This exploration has led to the following conclusions: Muscular activity levels of the quadriceps are influenced by the type of shoes worn and activity levels increase with soft sole shoes as opposed to cycling shoes with cleats and toeclips. EMG activity patterns are not strongly related to pedalling conditions (i.e. load, seat height and shoe type). The level of muscle activity, however, is significantly affected by pedalling conditions. Muscular activity bears a complex relationship with seat height and quadriceps activity level decreases with greater seat height. Agonist (i.e. hamstrings) and antagonist (i.e. quadriceps) muscles of the hip/knee are active simultaneously during leg extension. Regions of peak activity levels, however, do not overlap. The lack of significant cocontraction of agonist/antagonist muscles enables muscle forces during pedalling action to be computed by solving a series of equilibrium problems over different regions of the crank cycle. Regions are defined and a solution procedure is outlined.

Bicycling↗
PubMed1985

A method for biomechanical analysis of bicycle pedalling.

This paper reports a new method, which enables a detailed biomechanical analysis of the lower limb during bicycling. The method consists of simultaneously measuring both the normal and tangential pedal forces, the EMGs of eight leg muscles, and the crank arm and pedal angles. Data were recorded for three male subjects of similar anthropometric characteristics. Subjects rode under different pedalling conditions to explore how both pedal forces and pedalling rates affect the biomechanics of the pedalling process. By modelling the leg-bicycle as a five bar linkage and driving the linkage with the measured force and kinematic data, the joint moment histories due to pedal forces only (i.e. no motion) and motion only (i.e. no pedal forces) were generated. Total moments were produced by superimposing the two moment histories. The separate moment histories, together with the pedal forces and EMG results, enable a detailed biomechanical analysis of bicycle pedalling. Inasmuch as the results are similar for all three subjects, the analysis for one subject is discussed fully. One unique insight gained via this new method is the functional role that individual leg muscles play in the pedalling process.

Adult↗
PubMedDate not supplied

[Conservative treatment of breast cancer. Experience of the Consultation Group of Breast Oncology of the Santa Maria Hospital].

Since 1983, the Oncology Breast Group Consultation of the H.S.M. has been practicing a Conservative Treatment in women with early stage breast carcinoma. So far, 61 women stages I and II, were submitted to Conservative Treatment, which consists of limited Surgery, followed by Radiotherapy. 20 patients had performed associated systemic therapy, because they presented axillary positive lymphnodes. 10 of there were pre-menopause and they had performed Chemotherapy and the other 10 were post-menopause receiving Hormonotherapy. Of the 61 patients that constitute this series, two had local failure; two had hepatic metastasis and another two had secondary neoplasms. The remaining 55 are in good condition. In 54 patients with follow-up superior to 3 month oesthetical evaluation revealed excellent results in 26 cases, good in 24, medium (fair) in 6, middling in one and bad in 4. Follow-up varies between 3 months and 6 years, and it is not possible to present results of 5 years survival because almost all patients have a follow-up of less than 2 years.

Adult↗