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Biomedical subjects

R Gabriel

Publications and source records attributed to R Gabriel.

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

[Sirenomelia. Review of nosology and a case report].

We report a case of sirenomelus observed at 21 weeks amenorrhoea with oligoamnios. This syndrome results from an anomaly during the fourth week of gestation perturbing development of the lower limbs and the pelvis. Normal differentiation of the sexual organs, urinary tract and terminal intestine is interrupted. Recent progress in embryopathology has led to identification of a caudal regression syndrome but the aetiology remains unknown as is the nature of the relationship with VATER association.

Abortion, Therapeutic↗
PubMed1995

[Ultrasonic signs of fetal toxoplasmosis. Review of the literature].

OBJECTIVE: Evaluate the frequency and discuss the mechanisms and the prognostic value of sonographic anomalies observed during the surveillance of seroconversion for toxoplasmosis during pregnancy. METHODS: Cases of seroconversion during pregnancy were collected from 6 teams working with similar protocols. There were 2,168 seroconversions. We focused on ultrasound anomalies reported. RESULTS: Ultrasound anomalies were reported in 48 cases including the 168 fetuses with proven contamination (fetal blood or amniotic fluid sample), i.e. 2.2% (48 cases out of 2,168) of the seroconversions and 28% (48 cases out of 168) of the contaminated fetuses. There were multiple lesions in 44% of the cases. Brain calcifications had been found in utero in 44% of the newborns with such anomalies. No case of microcephalia was reported. Isolated hepatomegalia (4 cases) was not an indication for medical abortion. Isolated ascitis can regress after antiparasite treatment (2 cases). Medical abortions were performed in 51% of the cases (34 cases out of 66) on the basis of ultrasound findings. CONCLUSION: Ultrasound examination is reliable but can only detect late, constituted and often irreversible lesions. Nevertheless, this examination can help in deciding on medical abortion.

Abortion, Therapeutic↗
PubMed1995

Prevention of AIDS and living together with an HIV-infected patient.

In Brazil, approximately 45 thousand cases had been reported until the end of 1993, with an estimated 50% underreport. According to the Ministry of Health, until the year 2,000 from 2 to 8 million Brazilians citizens will be infected with HIV. The basic aspect of the educational campaigns regarding AIDS does not refer only to information on forms of transmission and prevention measures, but also attempts to fight against the mystification and the enormous resistance of the public to definitely accept the fact that transmission does not occur by simple means such as having a drink from the same glass, independently of its socioeconomic and cultural level. In addition to the lack of information, prejudice and discrimination appear strongly rooted in the population to the point of a tendency of social and effective rejection of the HIV-infected patient. Fighting against prejudice, against which there is also no vaccine, is a task as gigantic as fighting against the virus. For both, investments in education of and information to the population in general, is very important. Development of a software which would fulfill the function of explaining, and providing the correct information about AIDS, would be extremely valuable for any part of the society and could also be used as a complementary element by health professionals. The objective was to develop an interactive software in order to demonstrate prevention measures and universal precaution in AIDS; to inform about the necessary care to people that are living together an HIV-infected patient. To develop this software with animation and elucidating text regarding AIDS for the general population, we are using the Storyboard live to be run in Windows environment.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Prolonged intravenous ritodrine therapy: a comparison between multiple and singleton pregnancies.

To compare multiple and singleton pregnancies in the treatment of threatened preterm delivery with prolonged intravenous ritodrine, 32 women with multiple pregnancy (26 twins, 6 triplets, 70 fetuses, 30.3 +/- 3.5 weeks) and 51 women with singleton pregnancy (31.3 +/- 2.6 weeks) admitted for threatened preterm delivery without rupture of the membranes were the subjects of a retrospective study of obstetric data, perinatal outcome and maternal adverse effects. Significance was assessed by chi 2 test and Student's t test. Multiple pregnancies were associated with a marked increase in the duration of tocolysis (17.2 +/- 17.3 vs. 7.6 +/- 8.1 days, P < 0.01), incidence of delivery before 37 weeks (87.5 vs. 35.3%, P < 0.01) and incidence of maternal cardiovascular complications (34.4 vs. 4.0%, P < 0.01), including three cases of pulmonary edema. The incidences of delivery before 32 weeks (12.5 vs. 7.8%) and of neonatal death (2.9 vs. 0%) were not significantly different in the two groups. Multiple pregnancies dramatically increased the incidence of maternal adverse effects of prolonged intravenous ritodrine therapy. Neonatal benefit is questionable and was difficult to establish since it was not a randomized study.

Adult↗
PubMed1994

Placenta percreta with bladder invasion: surgical strategy to avoid massive blood loss.

Placenta percreta with bladder invasion is a rare complication of pregnancy, causing life-threatening hemorrhage. We report two further cases. In the second case we opted for a specific surgical guideline based on immediate ligature of both the hypogastric arteries before hysterectomy. This approach resulted in considerably less blood loss than is usually reported.

Adult↗
PubMed1994

Alteration of epidermal growth factor receptor in placental membranes of smokers: relationship with intrauterine growth retardation.

OBJECTIVE: The study of a possible alteration of epidermal growth factor receptor in placental membranes of smokers was performed. STUDY DESIGN: We investigated the binding capacity and the autophosphorylation of epidermal growth factor receptor in membranes of 33 term placentas from smokers and nonsmokers with appropriate-for-gestational-age or small-for-gestational-age babies. RESULTS: The binding capacity of epidermal growth factor receptor was similar in the four subgroups of placental membranes. In contrast, epidermal growth factor receptor autophosphorylation was impaired in the membranes from smokers relative to those from nonsmokers. This decrease was significant (p < 0.001) in the membranes from smokers with small-for-gestational-age babies. Insulin receptor phosphorylation was similar in the four groups. CONCLUSION: Intrauterine growth retardation in women who smoke is associated with an alteration of placental epidermal growth factor receptor bioactivity and suggests that the regulatory role of epidermal growth factor in placental growth and differentiation is defective in this setting.

Epidermal Growth Factor↗
PubMed1994

Alterations of human placental epidermal growth factor receptor in intrauterine growth retardation.

We studied human placental microvillous EGF receptor (EGFR) and its relationship with maternal and placental features in 14 cases of intrauterine growth retardation. Placental EGFR phosphorylation was significantly decreased or absent in 12 cases of small for gestational age neonates, as shown by SDS-PAGE, autoradiography, and scanning analysis. Specific [125I]EGF binding and Scatchard plots of the binding data showed a decreased number of EGFR in 6 of the 12 cases, with a mean maximal binding capacity of 1.09 +/- 0.32 pmol/mg for high affinity sites (mean control value = 2.30 +/- 0.23 pmol/mg). Most of the hypertensive women and smokers belonged to this subgroup. In three of the remaining six cases of small gestational age placentas with low EGFR phosphorylation, there was no maternal pathology or significant parenchymatous placental lesions. Five showed a 175-kD EGFR species when probed by [125I]EGF cross-linking and Western blotting with RK2 and C-Term, two polyclonal anti-EGFR antibodies, suggesting abnormal transduction of the EGF-induced signal. The sixth placenta yielded a single 145-kD EGFR band consistent with an abnormal EGFR structure; Western blot analysis showed no immunoreactive band. In conclusion, maternal and placental pathologies in intrauterine growth retardation are associated with various alterations of placental EGFR, pointing out the importance of EGFR ligands in the regulatory pathway of placental and fetal growth.

Binding Sites↗
PubMed1994

[Multicenter register of index cases of dementia. A study by the Spanish Neurological Society's dementia group].

We report the objectives and case registration methods used by neurologists belonging to the Spanish Neurological Society's dementia group (GERMICIDE). Forerunners of the present project are also described. The group's principal aim, which is to determine the distribution of dementia in the "neurological" environment is pursued by enrolling consecutive index cases (new presentations) arriving at 18 Spanish neurological units over a period of 2 years. A standard protocol was used to study the patients and final diagnoses were agreed upon in keeping with international criteria for dementia and the main neurological diseases (DSM-III-R, CDR and others). A second objective is to study risk factors for the main etiological groups of dementia (Alzheimer's disease and vascular dementia) and to follow each patient in the cohort until death in order to assess the course of disease and its biological markers. The series will be large, as there are already over 800 cases listed in the coordinating centre even though the period of enrollment has not ended.

Adult↗
PubMed1993

Meconium aspiration and otitis media in children.

Meconium-stained amniotic fluid was recently reported to be significantly correlated with a higher incidence of otitis media during infancy. In order to verify this connection, a case-control study was performed on 71 pairs of infants, with and without meconium aspiration, matched for gestational age, birth weight and sex. Data were collected by questionnaire or telephone, the response rate being 88.7%. No significant difference in incidence of otitis media between the two groups was observed. This study demonstrated that newborns with meconium aspiration are not at greater risk for otitis media in the 1st year of life.

Case-Control Studies↗
PubMed1993

Neuropathic calcaneal tuberosity avulsion fractures.

Avulsion of a calcaneal tuberosity can be the initial presentation of a neuropathic fracture. Neuropathic fracture should be investigated in patients who appear without a history of significant indirect or direct trauma. Neuropathic fractures should always be considered in patients with diabetes mellitus. The diagnosis of neuropathic calcaneal tuberosity avulsion fracture alters the prognosis and treatment of this injury. Two cases of bilateral fracture avulsions are reported to emphasize problems in diagnosis and treatment.

Calcaneus↗
PubMed1993

[An analysis of research projects on primary care presented to the Fondo de Investigación Sanitaria during 1991].

DESIGN: Observational cross-sectional study. SETTING: Proposals on primary health care (domain, functions and activities) identified among a total of the 1412, belonging to all topics, submitted to the Fondo de Investigación Sanitaria during the 1991 exercise. INTERVENTIONS: Proposals were classified according the degree of quality in the methodological fulfillment, pointed out those accepted for grant by the Technical Evaluation Committees. MEASUREMENTS AND RESULTS: 55 proposals about Primary Health Care were identified which account for 3.8% of the all proposals submitted. The degree of topic pertinence was very high with hypothesis and objectives well set out. There was a poor fulfillment of the methods and plan of action. Those projects with a very good fulfillment were accepted in a 90% of the cases. CONCLUSIONS: The reviewed proposals shaw a good pertinence in the research on primary health care. We could notice a growing portion of researchers well trained with exigent methodological criteria. However, it remains a majority of proposals with poor methodological fulfillment which could easily be improved by increasing research training and expert support. Some advices are offered for the elaboration of research projects.

Health Services Research↗
PubMed1993

[Amniocentesis to study the fetal karyotype before 16 weeks of amenorrhea. Prospective study comparing it with conventional amniocentesis].

In a prospective study, we compared early amniocentesis (13-15 weeks of amenorrhea, n = 67) with conventional amniocentesis (16-20 weeks, n = 105). Early amniocentesis was not associated with complications and cell culture was possible in every case. Sampling failures were more frequent (4.5% vs 0.9%, p = 0.057), but had no deleterious effects and this rate can probably be reduced with experience. The mean time required for karyotyping was only slightly longer: 17.0 (SD 2.8) days vs 15.8 (SD 2.0) days (p < 0.01). These results agree with other recent studies suggesting that early amniocentesis is a simple and safe method which can be performed several weeks before conventional amniocentesis.

Adult↗
PubMed1992

Gastroschisis: what part can the obstetrician play?

In order to assess the contribution of antenatal diagnosis to the management of gastroschisis, the antenatal and postnatal data from 24 cases of gastroschisis observed between 1974 and 1990 were re-examined. The frequency of antenatal diagnosis (29%), polyhydramnios (21%), atresia of the small intestine (29%), length of pregnancy (36.6 +/- 2 weeks of amenorrhea), proportion of cesarean sections (21%), birth weight (2230 +/- 430 g) and the Apgar score after 5 min (9.0 +/- 1.5) were comparable to findings reported elsewhere. The overall mortality rate for the period studied was high (41%), and was not influenced by any antenatal parameter or by the mode of delivery; its recent fall (P = 0.01) is explained by the development of therapeutic methods. These results are consistent with other recent studies and suggest that antenatal diagnosis does not enable an accurate assessment of the prognosis to be made and has no major influence on the mortality rate in gastroschisis.

Abdominal Muscles↗