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Biomedical subjects

R Gabriel

Publications and source records attributed to R Gabriel.

At least 73 records · Page 4Linked to original sources
PubMed1997

Prevalence of stroke in two samples (rural and urban) of old people in Spain. A pilot door-to-door study carried out by health professionals.

The aim of this study was to present the prevalence of stroke from a pilot study in old people. The urban site sample (Madrid) was made up of 397 subjects and the rural site sample (Arévalo, Avila) of 862 subjects. The study was performed with a door-to-door methodology. In the urban sample, the prevalence of stroke was 8.5% (CI 95% = 5.5-11.5%) and that of TIA was 2.1% (CI 95% = 0.6-3.6%). In the rural location the prevalence of stroke was 7.1% (CI 95% = 5.4-8.8%). This prevalence of stroke is higher than in other Spanish studies. These results need to be confirmed in a wider investigation.

Aged↗
PubMed1997

Clinicopathological features of Zimbabwean patients with sustained proteinuria.

OBJECTIVE: To describe clinico-pathological features of patients admitted with significant proteinuria. DESIGN: Hospital based prospective survey conducted from 1982 to 1987. SETTING: Paediatric and medical wards at both tertiary referral hospitals in Harare. SUBJECTS: 119 patients who presented with significant proteinuria were investigated. RESULTS: Of the primary nephritides, diffuse mesangial proliferative glomerulonephritis was the most common finding (25/119); IgM was the dominant or sole immunoglobulin identified in 17/25. Minor glomerular abnormalities were common (19/119); there were 11 patients with minimal change disease and this number accounted for 42% of the children aged three to 12 years who were nephrotic. This incidence is higher than previously reported from Africa. Diffuse membranous nephropathy was frequent (18/119); hepatitis B surface antigen was present in only five of these patients. Focal sclerosing glomerulo-sclerosis was as frequent as diffuse membranous nephropathy (18/119) and appeared to be idiopathic. Diffuse mesangiocapillary glomerulonephritis (membranoproliferative) was present in 15/119 patients; no causal association was made. CONCLUSION: The pattern of primary glomerulonephritis is described from 1982 to 1987. We describe a slightly higher number of patients with minimal change disease and minor glomerular abnormalities than previously reported and a surprisingly small number of patients with diffuse endocapillary glomerulonephritis. In common with other African series, no patient with IgA nephropathy was found.

Adolescent↗
PubMed1996

Loss of sequences 3' to the testis-determining gene, SRY, including the Y pseudoautosomal boundary associated with partial testicular determination.

The condition termed 46,XY complete gonadal dysgenesis is characterized by a completely female phenotype and streak gonads. In contrast, subjects with 46,XY partial gonadal dysgenesis and those with embryonic testicular regression sequence usually present ambiguous genitalia and a mix of Müllerian and Wolffian structures. In 46,XY partial gonadal dysgenesis gonadal histology shows evidence of incomplete testis determination. In 46,XY embryonic testicular regression sequence there is lack of gonadal tissue on both sides. Various lines of evidence suggest that embryonic testicular regression sequence is a variant form of 46,XY gonadal dysgenesis. The sex-determining region Y chromosome gene (SRY) encodes sequences for the testis-determining factor. To date germ-line mutations in SRY have been reported in approximately 20% of subjects with 46,XY complete gonadal dysgenesis. However, no germ-line mutations of SRY have been reported in subjects with the partial forms. We studied 20 subjects who presented either 46,XY partial gonadal dysgenesis or 46,XY embryonic testicular regression sequence. We examined the SRY gene and the minimum region of Y-specific DNA known to confer a male phenotype. The SRY-open reading frame (ORF) was normal in all subjects. However a de novo interstitial deletion 3' to the SRY-ORF was found in one subject. Although it is possible that the deletion was unrelated to the subject's phenotype, we propose that the deletion was responsible for the abnormal gonadal development by diminishing expression of SRY. We suggest that the deletion resulted either in the loss of sequences necessary for normal SRY expression or in a position effect that altered SRY expression. This case provides further evidence that deletions of the Y chromosome outside the SRY-ORF can result in either complete or incomplete sex reversal.

Base Sequence↗
PubMed1996

Fryns syndrome phenotype and trisomy 22.

Trisomy 22 was detected in a 32-week-old fetus born to an overweight mother with hypertension. Severe intrauterine growth retardation was associated with phenotypic manifestations of Fryns syndrome: diaphragmatic hernia, facial defects, and nail hypoplasia with short distal fifth phalanges. This is the second report of congenital diaphragmatic hernia in trisomy 22. This case demonstrates the importance of karyotyping malformed fetuses or newborns, even if a nonchromosome syndrome seems identifiable on clinical grounds. To date, at least 10 cases of Fryns syndrome have been reported without chromosome analysis.

Adult↗
PubMed1996

[Maternal complications from tocolytic treatment with beta-mimetics. Three cases of pulmonary edema].

We report three cases of pulmonary edema associated with prolonged intravenous tocolytic therapy with beta 2-adrenergic agonists among patients with multiple pregnancies. Although beta 2-adrenergic agonists may have direct myocardial side-effects, the underlying pathophysiologic mechanisms are mainly noncardiogenic. The most important one appears to be the fluid overload, related to amounts of fluids given intravenously and to direct result of beta-sympathomimetic therapy on renal excretion of sodium and water. Neonatal benefit of prolonged tocolytic therapy remains hypothetical. If this strategy is used, the prevention of cardiovascular adverse effects requires an intensive maternal supervision, especially in case of multiple pregnancy, the use of beta 2-adrenergic agonists in concentrated solution in order to reduce the amounts of fluids given intravenously, and the association with progesterone therapy which can reduce the infusion rate and the duration of tocolytic therapy.

Adrenergic beta-Agonists↗
PubMed1995

[Allogeneic bone marrow transplantation in chronic myeloid leukemia. The clinical results and risk factors in 70 patients].

BACKGROUND: The 10 year experience of a single center performing allogeneic bone marrow transplantation in 70 patients with chronic myeloid leukemia (CML) is analyzed. METHODS: Seventy patients transplanted for CML between November 1982 and October 1992 were evaluated. Fifty-two patients were in the first chronic phase (FC), 10 in an accelerated phase, 4 in blast crisis and 4 in the second chronic phase. The combination of cyclosporin and methotrexate was the most commonly used prophylactic schedule for graft versus host disease (GVHD) (60 cases) and T depletion was not performed in any case. The combination of cyclophosphamide (120 mg/kg) and total body irradiation was used in 48 patients with the remaining patients received busulfan (16 mg/kg) and cyclophosphamide (120 mg/kg). The estimation of survival was performed using the Kaplan-Meier limit product method. The prognostic factors influencing survival, disease free period and relapse were evaluated by Cox multivariate models of proportional risk. RESULTS: Actuarial survival at four years was 40% (95% Cl: 26-58%). Multivariate analysis selected variables associated with lower survival, the presence of acute GVHD (relative risk-RR-4.75), advanced disease phase (RR: 3.26) and age over 30 years (RR: 3.57). Eleven patients had relapsed. Multivariate analysis found the absence of chronic GVHD (RR: 5.3) and advanced phase (RR: 1.91) to be associated to a higher probability of relapse. In a separate analysis of the 48 patients transplanted in chronic phase who received cyclosporin and methotrexate, the disease free survival was longer for those under the age of 30 years (71.4% vs. 36%) without acute GVHD (68.8% vs. 39.6%) and those transplanted from a male donor (64.6% vs. 30%). CONCLUSIONS: Advanced phase of the disease, the presence of acute graft versus host disease and the age and female sex of the donor are the main factors associated to shorter survival in allogeneic bone marrow transplant for chronic myeloid leukemia. In contrast, the presence of chronic graft versus host disease decreases the possibilities of relapse.

Adolescent↗
PubMed1995

Feedback from luminosity horizontal cells mediates depolarizing responses of chromaticity horizontal cells in the Xenopus retina.

It has been proposed that the depolarizing responses of chromaticity horizontal cells (C-HCs) to red light depend on a feedback signal from luminosity horizontal cells (L-HCs) to short-wavelength-sensitive cones in the retinas of lower vertebrates. In this regard we studied the C-HCs of the Xenopus retina. C-HCs and L-HCs were identified by physiological criteria and then injected with neurobiotin. The retina then was incubated with peanut agglutinin, which stains red-but not blue-sensitive cones. Electron microscopic examination revealed that L-HCs contact all cone classes, whereas C-HCs contact only blue-sensitive cones. Simultaneous recordings from C-HC/L-HC pairs established that when the L-HC was saturated by a steady bright red light, C-HCs alone responded to a superimposed blue stimulus. In response to red test flashes, the C-HC response was delayed by approximately 30 msec with respect to the L-HC response. Isolated HCs of both subtypes were examined by whole-cell patch clamp. Both responded to kainate with sustained inward currents and to quisqualate or alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) with desensitizing currents from a negative holding potential; i.e., both have AMPA-type glutamate receptors. gamma-Aminobutyric acid or glycine opened a chloride channel in the L-HC, whereas the C-HC was unresponsive to either inhibitory amino acid. Since glycine has been shown to abolish selectively the depolarizing response of the C-HC, this finding and other pharmacological data strongly implicate the L-HC in the underlying circuit. Moreover, because the C-HC does not respond to gamma-aminobutyric acid, the neurotransmitter of the L-HC, by elimination, a feedback synapse from L-HC to blue cone is the most plausible mechanism for the creation of depolarizing responses in C-HCs.

Animals↗
PubMed1995

Primary application of three-dimensional ultrasonography to early diagnosis of ectopic pregnancy.

OBJECTIVE: Preliminary evaluation of three-dimensional (3D) imaging for early diagnosis of ectopic pregnancy. STUDY DESIGN: Twelve asymptomatic patients before six weeks of amenorrhea and with no feature of intrauterine nor of ectopic pregnancy at traditional bidimensional ultrasonography were considered. Laparoscopy showed ectopic pregnancy in 9 cases. RESULTS: 3D transvaginal ultrasonography preceding laparoscopy showed small ectopic gestational sac in 4 cases. Moreover the fallopian tube on the side of ectopic pregnancy could be imaged in all cases. This was possible because the fallopian tube was surrounded by a fine hypoechogenic border, an apparently specific feature which had not been reported previously. CONCLUSION: These preliminary data suggest that 3D ultrasonography is an effective procedure for early diagnosis of ectopic pregnancy in asymptomatic patients before six weeks of amenorrhea.

Fallopian Tubes↗
PubMed1995

[Low back pain and headache during immediate postpartum. Role of obstetrical epidural analgesia].

The rate of low back pain and headache following parturition seems to be higher in patients delivered under epidural analgesia. The aim of this study, performed in the immediate postpartum (up to 3rd day) and including 200 patients delivered vaginally, was to assess the incidence and the risk factors of low back pain and headache. A total of 31.5% of them complained of low back pain (LBP+) after parturition. They were significantly younger than those without low back pain (LBP-) (p < 0.03) and have had significantly more often epidural analgesia (p < 0.05). However, there were no statistically significant differences concerning weight, weight gain, parity, duration of labour and duration of epidural analgesia. The LBP+ patients complained significantly more often of cervical (p < 0.04) and low back pain (p < 0.02) during pregnancy, than the LBP-. In the immediate postpartum period, cervical and dorsal pain as well as headache occurred significantly more often in LBP+ than in LBP+ (p < 0.001). The intensity of low back pain during pregnancy (p < 0.006). Risk factors for postpartum LBP were epidural analgesia (OR = odds ratio = 6.59), LBP (OR = 6.50) and cervical pain (OR = 2.75) during pregnancy. The influence of epidural analgesia is questionable, as there was no difference between duration of labour and duration of epidural analgesia, if used, between the two groups. Patients for whom epidural analgesia was required are probably more susceptible to pain during pregnancy. Patients who suffered from postpartum headache (PPHDA+) were comparable to those who did not (PPDHA-).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Molecular approach to intrauterine growth retardation: an overview of recent data.

Consideration of the abnormal regulation of fetal growth leading to intrauterine growth retardation must take account of the fundamental differences between the regulation of growth before and after birth. The significance of endocrine regulators of growth differs greatly in utero. During the first trimester of pregnancy, embryonic growth might be controlled at the level of the individual organs by nutrient supply and by locally active growth factors. Later, fetal growth depends essentially upon materno-placental cooperation in delivering nutrients to the fetus. Therefore the major role of hormones in fetal growth is to mediate utilization of available substrate. Fetal growth seems to be regulated by fetal insulin, IGF-1 and certainly IGF-2, while growth hormone has only a secondary role to play. In late gestation, placental size and fetal growth rate are well correlated, pointing to a key role of the placenta in the regulation of fetal growth. It is therefore of importance to understand the molecular mechanisms involved in regulating placental development and endocrine functions. TGF alpha and EGF might play a major role as suggested by the modulation of their receptors with placental development, and by the specific alterations of epidermal growth factor receptors in intrauterine growth retardation. In addition, human placenta secretes specifically placental growth hormone. The concentration of placental growth hormone is significantly decreased in sera of pregnant women bearing a fetus with intrauterine growth retardation.

Embryonic and Fetal Development↗
PubMed1995

Early single dose therapy with ofloxacin for empirical treatment of acute gastroenteritis: a randomised, placebo-controlled double-blind clinical trial.

This study is a double-blind, placebo-controlled, randomised clinical trial to evaluate the clinical and microbiological efficacy and safety of single dose ofloxacin for acute diarrhoea. Eligible patients were 16 years of age or older with a history of acute diarrhoea lasting no more than 48 h; 117 patients were randomised and 97.4% (114/117) were evaluable for efficacy. Of these, 58% were suspected to have ingested contaminated foods. Enteric pathogens were isolated in 61.5% of the patients, Salmonella enteritidis being reported in 87.5%. The patients received either a single 400 mg dose of ofloxacin, or placebo. The average duration of diarrhoea was 2.56 +/- 2.21 days in the ofloxacin group and 3.41 +/- 2.5 in the placebo group (P = 0.117). The average duration of fever was 0.63 +/- 0.95 days in the ofloxacin group and 1.05 +/- 0.96 in the placebo group (P = 0.02). Symptoms remained unchanged for more than 48 h in only 7% of the patients who received ofloxacin, compared with 12% in the placebo group (P = 0.485). Only 32% of patients in the ofloxacin group remained culture positive after 48 h compared with 59% in the placebo group (P = 0.0018). These represent a relative risk reduction (RRR) for stool clearance of 45.5% and absolute risk reduction (ARR) of 27% (95% Cl, 8-44.7), with a number of patients needed to treat (NNT) of 3.7 (95%, 2.7-11.3). After 15 days, 23.3% of patients in the ofloxacin group had a positive culture compared with 28.9% in the placebo (P = 0.63). This represents an RRR of 19%, an ARR of 5.6% and a NNT of 17.8. Adverse events in the ofloxacin group were observed in only one patient who reported headache and in one patient in the placebo group who developed a rash. In summary, empirical treatment with a single dose of ofloxacin in acute diarrhoea did not reduce the intensity or duration of symptoms (except possibly length of fever). It was notable however that stool cultures became negative for S. enteritidis by 48 h, with no relapse after 2 weeks of follow-up.

Acute Disease↗
PubMed1995

["Prune belly" syndrome. Etiopathogenesis and prenatal diagnosis. A case report].

Prune belly syndrome was diagnosed early in the antenatal period. Renal function was evaluated on the basis of bladder puncture results performed at 18 weeks gestation due to urethral atresia, suggesting a possible pathogenesis mechanism. Recent pathogenic data and the relationship with antenatal diagnosis are discussed.

Abortion, Therapeutic↗
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↗