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Biomedical subjects

M Rodriguez

Publications and source records attributed to M Rodriguez.

At least 739 records · Page 41Linked to original sources
PubMedDate not supplied

[Current aspects of surgical management of patellar dislocation in the growth period with special reference to Goldthwait surgery].

RESEARCH QUESTION: The Goldthwait procedure is an operative treatment method for patellar dislocation in children which respects the growth plate. The aim of the study was to analyse the long term results of this procedure. METHODS: The results of 36 knees (26 children) operated on because of patellar dislocation according to the Goldthwait technique alone or in combination with other procedures (Krogius, patellar fixation) between 1941-1991 at Balgrist Clinic were analysed. Therefore, we used an own score. RESULTS: After a mean follow-up of 16 years (1.5 to 51 years) we found in 77.8% of the cases good and very good subjective results, and in 63.9% good and very good objective results. A recurrence of dislocation occurred in 36.1% of the cases. In 76.9% of these cases a reoperation was performed, of which only one case led to an acceptable final result. The operation results were unsatisfactory in the presence of condylar dysplasia with an angle of more than 160 degrees. The age at the time of surgery and the degree of patellar dysplasia had no effect on the outcome. The success was increased through the use of the Goldthwait procedure in conjunction with other techniques. Pathologic leg axis or severe arthrosis did not occur. CONCLUSION: In absence of significant condylar dysplasia the Goldthwait procedure combined with other techniques provides acceptable results. The technique alone is less efficient.

Adolescent↗
PubMedDate not supplied

[Lunate malacia and the Swanson endoprosthesis].

The etiology and the treatment of the aseptic necrosis of the lunate bone (M. Kienböck) is still today debated. In the literature we find more than twenty different procedures of treatment. Our follow-up of seven patients with Swanson Lunatum prosthesis showed subjectiv and functional good results whereas the radiological findings weren't satisfactory.

Adult↗
PubMedDate not supplied

Report from the CDC. Use of preventive health services by Hispanic/Latino women in two urban communities: Atlanta, Georgia and Miami, Florida, 2000 and 2001.

PURPOSE: During the 1990s, a 58% increase in the Hispanic/Latino population, fueled by the century's largest immigration wave and the highest fertility of any group, resulted in Hispanics becoming the largest U. S. minority group. To assess use of preventive services by Hispanics in Atlanta, Georgia, the largest Hispanic new destination, and Miami, Florida, the largest established Hispanic community in the Southeast, survey data were analyzed. METHODS: Miami-Ft. Lauderdale and Atlanta metropolitan area data from the 2000 National Health Interview Survey (NHIS) and from anonymous surveys conducted at health festivals in Miami and Atlanta in 2001 were analyzed. RESULTS: Female non-Hispanic white and black NHIS respondents were more likely than Hispanic counterparts to report annual household income >$20,000 (77.3%, 70.8% vs. 67.7%), usual source of healthcare (61.5%, 56.4% vs. 50.2%), or ever having had Pap screening (88.8%, 86.7% vs. 80.7%) or oral contraceptive use (55.7%, 59.7% vs. 33.7%). Miami-Ft. Lauderdale Hispanics were less likely than Atlanta respondents to be monolingual Spanish speakers, to lack usual source of healthcare, or to have less than 12 years of education. Of 295 female health festival respondents, the 160 Miami participants were more likely than Atlanta participants to have health insurance, monthly income >$1000, and prior Pap screening (p < 0.01) but less likely to have used contraception (p = 0.07). Most Hispanics felt they had inadequate healthcare; 15.0% reported being denied healthcare because of inability to pay. CONCLUSIONS: Low income, uninsured status, and language barriers were associated with lower use of preventive services among Hispanics in these Southeastern communities, particularly Atlanta, a new destination.

Adult↗
PubMedDate not supplied

Treatment of dermatomycoses with ketoconazole.

Forty patients (22 males and 18 nonpregnant females) with tegumentary mycoses were treated with ketoconazole (R41,400). The group included 39 patients with dermatophytoses and one with tinea versicolor. Ketoconazole was administered in one dose per day taken with water 2 hr before or after breakfast for one month; patients weighing < 30 kg received 100 mg of ketoconazole per day, whereas those weighing > 30 kg received 200 mg per day. Twenty-one patients had complete clinical and mycologic cure, two responded clinically but the last culture was positive, eight had partial improvement, and three had no improvement at all. In six cases the treatment was stopped (in one because of gastric intolerance). The main adverse effect of ketoconazole was nausea; only one patient had vomiting. The results indicate that ketoconazole is a safe and effective drug for treatment of dermatomycosis.

Adolescent↗
PubMedDate not supplied

Posttraumatic stress symptoms, intrusive thoughts, loss, and immune function after Hurricane Andrew.

OBJECTIVE: To examine the impact of and relationship between exposure to Hurricane Andrew, a severe stressor, posttraumatic stress symptoms and immune measures. METHODS: Blood draws and questionnaires were taken from community volunteer subjects living in the damaged neighborhoods between 1 and 4 months after the Hurricane. RESULTS: The sample exhibited high levels of posttraumatic stress symptoms by questionnaire (33% overall; 76% with at least one symptom cluster), and 44% scored in the high impact range on the Impact of Events (IES) scale. A substantial proportion of variance in posttraumatic stress symptoms could be accounted for by four hurricane experience variables (damage, loss, life threat, and injury), with perceived loss being the highest correlate. Of the five immune measures studied Natural Killer Cell Cytotoxicity (NKCC) was the only measure that was meaningfully related (negatively) to both damage and psychological variables (loss, intrusive thoughts, and posttraumatic stress disorder (PTSD). White blood cell counts (WBCs) were significantly positively related with the degree of loss and PTSD experienced. Both NKCC (lower) and WBC were significantly related to retrospective self-reported increase of somatic symptoms after the hurricane. Overall, the community sample was significantly lower in NKCC, CD4 and CD8 number, and higher in NK cell number compared to laboratory controls. Finally, evidence was found for new onset of sleep problems as a mediator of the posttraumatic symptom-NKCC relationship. CONCLUSIONS: Several immune measures differed from controls after Hurricane Andrew. Negative (intrusive) thoughts and PTSD were related to lower NKCC. Loss was a key correlate of both posttraumatic symptoms and immune (NKCC, WBC) measures.

Adolescent↗
PubMedDate not supplied

Detection of human papillomavirus L1 protein in condylomata acuminata from various anatomical sites.

BACKGROUND AND OBJECTIVES: Though human papillomavirus (HPV) DNA can be detected in the majority of condylomata acuminata, the major capsid protein of HPV (L1 protein) can be detected in only 10% to 50% of lesions in immunohistochemical assays. GOAL OF STUDY: To evaluate the association between anatomic location of genital HPV infections and the ability to detect HPV L1 protein. METHODS: Condylomata acuminata from 49 male and 51 female patients were evaluated for L1 protein by immunohistochemistry. Thirty of these lesions were vulvar; 20 were cervical; 1 was vaginal; 45 were penile; and 4 were perianal. A quantitative analysis of L1-positive nuclei in the lesions was performed. RESULTS: L1 protein was detected in 20 (20%) of all lesions. L1 protein was detected in seven (35%) of the cervical lesions compared to nine (12%) of exophytic condylomata acuminata of males and females (P = 0.038). A statistically significant difference was noted between cervical and exophytic condylomata acuminata lesions (46.6 vs. 7.8) (P = 0.0006). No association between oral contraceptive use and L1 protein detection was found. CONCLUSIONS: The major capsid protein of HPV can be detected in condylomata acuminata of the uterine cervix more often, and in higher quantities, than in lesions of the vulva or penis. Further studies are needed to assess the effects of sex hormones and the anatomic location of the infection as they relate to transmission of HPV.

Biopsy↗
PubMedDate not supplied

Growth characteristics of nonmalignant cells in the ATP cell viability assay.

Over the last 5 years, the ATP cell viability assay (ATP-CVA) has been used to study the in vitro response of cell lines and fresh gynecologic human tumors to a variety of antineoplastic agents including chemotherapeutic agents, hormones and biological response modifiers. This assay measures light production as intracellular ATP interacts with the luciferin-luciferase complex. Quantitation of the light produced has been shown to directly correspond with the number of viable cells. A past criticism is that in the ATP-CVA, when applied to fresh tumor tissue, normal cells (fibroblasts, macrophages and lymphocytes) also produce ATP, and if present in sufficient numbers, could lead to errors in chemosensitivity testing results. This study was designed to evaluate the growth characteristics of various benign cells found in fresh tumors. The cells were studied under multiple plating conditions to show the relative increase or decrease of fractional ATP measured at different time points. We found that agar/McCoy underlayer and agarose-coated wells do not permit the growth of nonmalignant cells. In the culture conditions of the ATP-CVA, non-malignant cells do not contribute relevant ATP levels when treated samples are compared to controls on day 6. Therefore, results of the ATP-CVA in fresh tumors should not be affected.

Adenosine Triphosphate↗
PubMedDate not supplied

Significance of cytologically normal endometrial cells in cervical smears from postmenopausal women.

OBJECTIVE: To determine the significance of cytologically normal endometrial cells in cervicovaginal (CV) smears from postmenopausal women over age 55 years. STUDY DESIGN: From January 1995 to January 1998, 220 women had CV smears demonstrating cytologically normal endometrial cells. The menopausal status, hormone replacement therapy (HRT) and information related to subsequent CV smears and endometrial sampling within 12 months of the initial diagnosis was recorded. RESULTS: Eighty-one of the 220 cases (36.8%) had histologic sampling of the endometrium. Thirty-four of 81 (42%) showed no endometrial pathology. Endometrial pathology was identified in 28 of 81 (34%), of which 19 were endometrial polyps (23.4%), 4 were endometrial hyperplasia (4.9%), 4 were endometrial carcinoma (4.9%) and 1 was a leiomyoma (1.2%). Nineteen (23.4%) were insufficient for diagnosis. Ninety-one of 220 women were on HRT, and 129 were not. In the group without HRT, endometrial disease was identified in 22/51 (43%) cases as compared to 6/30 (20%) in the group with HRT (P < .001). Endometrial carcinoma was identified in three (5.8%) cases and one (3.3%) case without and with HRT, respectively. CONCLUSION: Although the finding of normal endometrial cells in Pap smears from postmenopausal women was without any clinical significance in the majority of women in this study, in a small number it was associated with endometrial hyperplasia and carcinoma. Women who were not on HRT had a higher incidence of endometrial pathology.

Aged↗
PubMedDate not supplied

Atypical squamous cells of undetermined significance in women over 55. Comparison with the general population and implications for management.

OBJECTIVE: To determine the significance of atypical squamous cells of undetermined significance (ASCUS) in patients 55 years or older. STUDY DESIGN: From January 1994, to January 1997, 8,175 cervicovaginal smears were obtained from patients 55 years or older (mean age, 64.8; range, 56-84) at University Hospitals of Cleveland. Ninety-six of these patients were diagnosed with ASCUS only or ASCUS with a qualifying statement on the smear. Patient records, follow-up cervicovaginal smears and biopsies were reviewed for a period of one to four years following the diagnosis of ASCUS. RESULTS: The incidence of ASCUS only or ASCUS with a qualifying statement for patients 55 years or older was 1.8%. The ASCUS:SIL ratio was 2.6:1. An estrogen stimulation test was recommended in two cases. Women older than 55 with ASCUS were three times more likely to be receiving hormonal replacement therapy than similar-aged women with normal cervicovaginal smears. Follow-up cervicovaginal smears or biopsies were obtained on 93 (80 cervicovaginal smears, 13 biopsies). The results were the following: LSIL (13), squamous carcinoma in situ (1) and ASCUS (53); the remainder of the cases were normal. In the patients who received a second diagnosis of ASCUS, follow-up cervi covaginal smears or biopsies revealed low grade dysplasia in six. CONCLUSION: Although the incidence of ASCUS and the frequency of underlying dysplasia is lower in postmenopausal women than the general population, there is still a real risk that a postmenopausal woman with ASCUS has underlying intraepithelial neoplasia. Therefore, these patients should be managed as is the general population.

Aged↗
PubMedDate not supplied

Peritoneal washing cytology of ovarian tumors of low malignant potential: correlation with surface ovarian involvement and peritoneal implants.

OBJECTIVE: To correlate the cytologic diagnoses of peritoneal washings (PWs) with histologic findings of ovarian tumors of low malignant potential (LMP). METHODS: PW cytology from 90 patients with histologically confirmed ovarian tumors of LMP were reviewed and correlated with histologic findings. RESULTS: In 90 LMP tumor patients who underwent PW, cytologic diagnoses were reported as positive in 30 (33%) cases, atypical in 5 (6%) cases and negative in 55 (61%) cases. On review of the five atypical cases, three were reclassified as negative and two as positive. Peritoneal washings were positive in 20 (33%) of 60 patients with serous LMP tumors, 12 (44%) of 27 patients with mucinous LMP tumors and none of 3 patients with mixed LMP tumors. The presence of positive cytology was highly indicative of surface ovarian involvement or peritoneal implants in completely staged or selectively biopsied patients (P < .0001). Of 60 (67%) patients who had a staging laparotomy, positive PWs were seen in 3 (75%) of 4 cases with surface involvement only, 13 (94%) of 14 cases with peritoneal implants only, 3 (100%) of 3 cases with both peritoneal implants and ovarian surface involvement, and 9 (23%) of 39 cases without evidence of surface involvement or peritoneal implants. PWs were positive in 4 (13%) of 30 cases without staging laparotomy. CONCLUSION: PW cytology is a sensitive indicator of peritoneal dissemination of ovarian tumors of LMP. In addition, PWs will detect a high percentage of patients with subclinical intraperitoneal extension of such tumors and should be used routinely in the staging of ovarian tumors of LMP.

Female↗
PubMedDate not supplied

Capsaicin's effect on rat nasal mucosa substance P release: experimental basis for vasomotor rhinitis treatment.

Substance P (SP) is one of several neuropeptides found in nasal mucosa. It exists primarily in sensory afferent neurons, which are best demonstrated by immunohistochemical staining. These substance P-like immunoreactive (SPLI) nerve fibers are unmyelinated C fibers, which connect to the trigeminal ganglion and the spinal trigeminal nucleus. They are found around vessels and seromucinous glands in the submucosa. When the nasal mucosa receives a noxious stimulus, SP is released and acts orthodromically as a comediator of nasal pain, while antidromically it induces vasodilatation, plasma extravasation, mucosal edema, and rhinorrhea. Its antidromic effects have been implicated in vasomotor rhinitis and can be blocked by topical intranasal capsaicin application. Wolf and others have demonstrated in human subjects that vasomotor rhinitis can be blocked up to 1 year by a series of intranasal capsaicin applications. It has not yet been demonstrated that nasal mucous SP levels following noxious nasal stimulus change after intranasal capsaicin pretreatment. Consequently a project was designed to determine whether intranasal capsaicin pretreatment would affect nasal substance P release measured in nasal secretion. Nasal secretion SP levels were measured before and after noxious nasal stimulus in controls and in capsaicin pretreated rats. The difference in measured nasal secretion SP levels were significant (p < 0.05).

Administration, Intranasal↗
PubMedDate not supplied

Ultrastructure of multiple sclerosis.

The electron microscopic features of 11 stereotaxic brain biopsies that demonstrated inflammatory primary demyelination consistent both morphologically and clinically with multiple sclerosis are addressed. Degeneration of inner oligodendroglial loops and uniform widening of inner myelin lamellae antedated complete destruction of myelin sheaths. Perivascular lymphocytes, macrophages, and plasma cells were in intimate contact with myelin sheaths. Astrocytes proliferated even away from demyelinated areas. In areas of chronic, established demyelination, oligodendrocyte numbers were greatly decreased, and fields of completely demyelinated axons were seen among astrocytic processes. Axonal injury, evidenced by the formation of axonal swellings, was apparent in maximally affected areas. At the edge of acute lesions with demyelinated axons, oligodendrocytes were preserved morphologically. Thinly myelinated axons indicative of central nervous system-type remyelination by oligodendrocytes were observed primarily at the edges of plaques. An unusual inclusion observed in presumed macrophages was "polelike" bodies 0.04- to 0.7-microns thick. Linearly arrayed, their presumably proteinaceous crystalline substance was moderately electron-dense. Many were membrane-bound and appeared to arise from the endoplasmic reticulum. We conclude that disturbance of the myelinating function of oligodendrocytes may be a critical event in the pathogenesis of multiple sclerosis.

Axons↗
PubMedDate not supplied

Outbreak of human monkeypox, Democratic Republic of Congo, 1996 to 1997.

Human monkeypox is a zoonotic smallpox-like disease caused by an orthopoxvirus of interhuman transmissibility too low to sustain spread in susceptible populations. In February 1997, 88 cases of febrile pustular rash were identified for the previous 12 months in 12 villages of the Katako-Kombe Health Zone, Democratic Republic of Congo (attack rate = 22 per 1,000; case-fatality rate = 3.7%). Seven were active cases confirmed by virus isolation. Orthopoxvirus- neutralizing antibodies were detected in 54% of 72 patients who provided serum and 25% of 59 wild-caught animals, mainly squirrels. Hemagglutination-inhibition assays and Western blotting detected antibodies in 68% and 73% of patients, respectively. Vaccinia vaccination, which protects against monkeypox, ceased by 1983 after global smallpox eradication, leading to an increase in the proportion of susceptible people.

Adolescent↗
PubMedDate not supplied

Influence of an interdisciplinary diabetes specialist team on short-term outcomes of diabetes at a community health center.

OBJECTIVE: To assess the effect on short-term diabetes outcomes of intervention with an interdisciplinary diabetes specialist team at a primary-care community health center in East Harlem, New York City. METHODS: An interdisciplinary diabetes specialist team, consisting of a diabetologist, a bicultural certified diabetes nurse-educator, and a nutritionist, attended weekly clinics at a primary-care community health center in East Harlem. Emphasis was placed on communicating in the patient's primary language and providing nutritional counseling, diabetes education, and diabetes management. After 1 year, a retrospective review of medical records for patients seen by the diabetes team was performed to assess the influence of this intervention on performance of home glucose monitoring (HGM), frequency of hypoglycemia, and changes in diabetes treatment regimens. Of 70 patients referred to the diabetes team by their primary-care providers, 50 underwent follow-up for at least 6 months and were included in the statistical analysis. RESULTS: Of the 50 study patients, 94% had type 2 diabetes, with a mean duration of 11.2 years. Eighty-two percent were Hispanic, and 18% were Afro-American. The mean age was 54.6 years. Microvascular complications were present in 44%, and macrovascular complications were present in 22%. HGM was done by 13 patients (26%) before and 33 patients (66%) after diabetes team intervention (P<0.001). Before intervention by the diabetes team, 14 patients (28%) were having episodes of unrecognized hypoglycemia. Unrecognized hypoglycemia resolved after intervention in all but two patients with type 1 diabetes (P<0.001). Before intervention, diabetes treatment was dietary in 6 patients, a sulfonylurea in 19, and insulin in 25; after intervention, 5 patients had dietary management of their diabetes, 14 were taking a sulfonylurea, and 31 were receiving insulin (P<0.05). CONCLUSION: Providing access to an interdisciplinary diabetes specialist team at the site of primary care had a beneficial effect on short-term diabetes outcomes in inner-city Hispanic and Afro-American patients with diabetes. Providing specialty care in the primary-care setting may be one model for improving the quality and long-term outcomes of diabetes care, particularly in high-risk populations.

Journal Article↗
PubMedDate not supplied

Reduced peptide bond pseudopeptide analogues of neurotensin.

Pseudopeptide analogues of the C-terminal hexapeptide of neurotensin (H-Arg-Arg-Pro-Tyr-Ile-Leu-OH) were obtained by replacing each peptide bond by the reduced peptide bond CH2NH. The resulting analogues were then examined for their ability to inhibit binding of labeled neurotensin to new-born mouse brain membranes and for stimulation of guinea pig ileum contraction. Replacement of the Ile12-Leu13, Tyr11-Ile12, Pro10-Tyr11 and Lys9-Pro10 peptide bonds resulted in about 2000-, 3400-, 200- and 3400-fold losses, respectively, in binding affinity and 400-, 750-, 250- and 300-fold losses, respectively, in biological activity. Replacement of both Arg8 and Arg9 by lysine led to an analogue exhibiting the same pharmacological profile as the C-terminal hexapeptide of neurotensin. Interestingly, replacement of the Lys8-Lys9 peptide bond by the CH2NH bond produced an analogue exhibiting the same affinity for neurotensin receptors, but 10 times more potent in stimulating guinea pig ileum contraction. N-terminal protected analogues (by the Boc group) showed decreased potency as compared with their amino-free corresponding compounds.

Amino Acid Sequence↗