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Biomedical subjects

A L Gonçalves

Publications and source records attributed to A L Gonçalves.

At least 19 recordsLinked to original sources

Evaluation of an automated system for the identification and antimicrobial susceptibility testing of enterococci.

The performance of a new version of an automated system panel, the Positive Combo Panel Type 11 of MicroScan WalkAway 96 (WA96; Dade Behring) was evaluated and compared to that of reference methods for the identification and for antimicrobial susceptibility testing of the different enterococcal species. A total of 376 enterococcal isolates were tested. The MicroScan WA96 correctly identified 99.6% (266/267), 78.3% (18/23) and 68.6% (59/86) of Enterococcus faecalis, Enterococcus faecium and species other than E. faecalis and E. faecium, respectively. Although low probability of accurate identification was obtained for 37 (9.8%) strains, the system indicated that supplementary tests were necessary for precise identification of 8 (9.3%) among the 86 strains included in the non-faecalis/non-faecium group and of 3 (13.0%) among the E. faecium isolates. In comparison to the agar screening method, the percentage of agreement for detection of resistance markers by the automated system was 90.2% (37/41) for ampicillin, 90.6% (48/53) for high-level resistance to streptomycin (HLRS), 96.4% (80/83) for high-level resistance to gentamicin (HLRG), and 100% (14/14) for vancomycin. The results indicate that the MicroScan WA96 performed well for the identification of E. faecalis and typical E. faecium isolates, and for the detection of resistance to vancomycin and HLRG. However, the system still needs further improvement in order to provide reliable results for the characterization of the other enterococcal species, including atypical variants of E. faecium.

Autoanalysis↗

Effects of colectomy on gallbladder motility in patients with ulcerative colitis.

In order to gain insight into the possible mechanisms involved in gallstone formation in colectomized ulcerative colitis patients, we studied gallbladder motility by means of ultrasonography in three groups of subjects: controls (N = 40) and ulcerative colitis patients without (N = 30) and with (N = 20) colectomy. Impaired gallbladder emptying after a liquid fatty meal stimulus was observed in ulcerative colitis patients with colectomy compared with those obtained in ulcerative colitis patients without colectomy and controls (P = 0.001). The maximum percentage of gallbladder emptying also, was significantly lower (59.8%) than those seen in ulcerative colitis patients without colectomy (74.5%) and controls (77.8%) (P = 0.001). Diminished gallbladder emptying with ensuing stasis might be a contributory factor to the increased prevalence of gallstones in colectomized patients.

Adult↗

[Hypoxic-ischemic encephalopathy in newborn infants. Acute period and outcome].

Ninety four neonates with hypoxic ischemic encephalopathy HIE attended at the University of Ribeirão Preto since 1982 were studied in terms of the neurological alterations during the acute phase and outcome over a mean period of 47 months. From 43 newborns with HIE I, 40 recovered within 96 hours and 3 died. Among 40 infants with HIE II, 37.5% recovered within the first week, and the others continued abnormal beyond the 7th day. All 11 infants with HIE III died before the second month of life. The HIE I group had no motor sequelae. Among the HIE II group, 34.5% showed cerebral palsy and 17.7% neuromotor retardation. 80.0% of those with sequelae persisted abnormal beyond 7th day of life, during the acute phase of the HIE. Epilepsy occurred in 17.5% of cases with HIE grade II, only among those with neuromotor sequelae. The IQ test did not show statistically significant difference between the HIE I, II without motor sequelae and the control groups. The authors reaffirm the value of the findings in the acute phase of HIE on the outcome of these patients.

Acute Disease↗

Surfactant replacement therapy: a multicentric trial comparing two dosage approaches.

In this study the results of two different initial doses (Group A: 200 mg/kg--82 patients; Group B: 100 mg/kg--83 patients) of a porcine surfactant were compared in the treatment of neonatal respiratory distress syndrome. Main entry criteria were: birth weight between 700 and 2,000 grams, need of mechanical ventilation, FiO2 > or = 0.60 to obtain a PaO2 between 50 and 80 mmHg (PaO2/FiO2 < or = 133.3 mmHg) and less than 15 hours of postnatal age. Two further 100 mg/kg doses could be given in both groups at 12 hours interval if FiO2 was > 0.40. Birth weight (Group A: 1,231 +/- 281 g. and Group B: 1,324 +/- 355 g.), gestational age (Group A: 29.9 +/- 2.7 wk. and Group B: 30.6 +/- 2.6 wk.) and Apgar scores were similar in the two groups. Group A had a significantly higher mean PaO2/FiO2 ratio (p < 0.05) after 12 hours--178 (40-506) vs 133 (17-243) mmHg, before receiving a 2nd dose, after 24 hours--180 (17-431) vs 152 (39-360), and in the 3rd day--177 (40-333) vs 124 (24-249) and needed a lower FiO2 (p < 0.05) after 36 hours (0.47 +/- 0.20 vs 0.53 +/- 0.23) and on the 3rd day (0.51 +/- 0.23 vs 0.61 +/- 0.24). The mean peak inspiratory pressure was lower in Group A at 36 hours (17.5 +/- 4.5 vs 20.6 +/- 6.8) after the initial dose (p < 0.05). The time of exposure to high oxygen concentrations (FiO2 > or = 0.40) was lower in Group A--85 (3-643) vs 131 (3-672) hours; p < 0.05). Total amount of phospholipids given per patient was meanly 224 mg in Group A and 144 mg in Group B. Mortality was lower in group A but without significant difference (Group A: 17/82; Group B: 26/83). The analysis of the subgroup of babies with less than 1,500 gr. at birth showed a statistically significant difference in mortality (Group A: 15/70; Group B: 24/56; p < 0.02).

Biological Products↗

Iron from complex salts and its bioavailability to rats.

Complex iron compounds are being used as iron suppliers. Bioavailability of their iron was tested through several parameters. A biological iron prophylactic study in rats was simultaneously carried out with three of these iron complexes products: ferric orthophosphate, iron sodium EDTA and iron glycine chelate. Their iron biodisponibility was compared to that of ferrous sulfate. Five low iron diets were prepared according to AOAC method. Four of them were enriched to a level of 20 mg Fe/kg, with ferrous sulfate and the 3 iron complexes salts under study. These diets were offered to 5 groups of 6 weanling rats each in an iron prophylactic test. Food intake was measured during 5 weeks, weight checked weekly, blood and liver collected for analyses. Weight gain, hemoglobin, hematocrit, transferrin saturation, iron hemoglobin, biodisponibility and relative iron biological values were calculated. The prophylactic iron rat assay proved to be a feasible and practical model to test and compare iron salts biodisponibility. NaFeEDTA and iron aminochelate produced similar results as ferrous sulfate and their iron has a high biological value for the rats. Orthophosphate iron had lower biological value when compared to the reference standard ferrous sulfate and the other complex products studied.

Animals↗

Feeding premature infants banked human milk homogenized by ultrasonic treatment.

Premature neonates fed ultrasonically homogenized human milk had better weight gain and triceps skin-fold thickness than did a control group given untreated human milk (p < 0.01) and also had lower fat loss during tube feeding (p < 0.01). Ultrasonic homogenization of human milk appears to minimize loss of fat and thus allows better growth of premature infants.

Food Handling↗

[Longitudinal study of weight gain in premature infants from birth to the 6th post-term month].

The dynamics of weight gain were studied in 95 preterm adequate for gestational age infants between birth and their 6th post-term month. The infants were divided into 4 groups according to the number of weeks of gestation at birth, i.e., 33, 34, 35 and 36 weeks, respectively. To compare the results, weight gains were studied for each group of the same corrected ages up to the 64th week of post-menstrual age, corresponding to the 6th post-term month. Weight gain was small during the first 2 weeks of post-natal life but increased considerably over the subsequent weeks with an almost constant periodical increment (GRI) being maintained in all 4 groups during the first months of life. However, unit growth rate (UGR) reached its highest value during the first post-natal month and decreased a similarly in all 4 groups during the subsequent months, with values approximating to those reported for infants in developed countries.

Female↗

[Prevalence of breast feeding in low birth weight infants].

The present situation regarding the breast feeding of children born with a weight of 2,500 grammes or less (LWB) at the Hospital das Clínicas of the Medical School of the Universidade de S. Paulo in Ribeirão Preto (Brazil) was studied. The study was descriptive and the data were obtained through a longitudinal follow-up carried over the period from October 1985 to September 1986 inclusive. Of the 222 children included in the study, 30 (13.5%) infants were not breastfed. Thus the incidence of breast feeding among this population was of 86.5%. At 3 months 62.5% of these infants were still being breastfed. At 6 months this figure fell to 38.5% and only 25.0% were still being breast-fed at the end of 12 months. The average duration of breast feeding for the 192 children that had started it was of 4 months. An association was found between the level of literacy of the mothers and the duration of breast feeding. Birthweight was found to be associated with the incidence and duration of breast feeding in general, as well as with the incidence of exclusive breast feeding. These data are considerably lower than recent figures obtained from the populations of well-developed countries, especially than those of Finnish infants born with a weight of less than 1.500 g. Action programmes involving the community and/or the Institution must be implemented in order to improve these figures.

Adult↗

Serum immunoglobulin levels and incidence of infection during the first year of life in full-term and preterm infants.

IgG, IgM, and IgA concentrations from birth to 12 months of age, and the incidence of acute infectious processes were determined in 25 full-term and in 26 preterm infants by the single radioimmunodiffusion technique in a prospective study. Infants born at term showed significantly higher IgG levels than preterm babies up to 2 months of age (P less than 0.05) and the frequency of preterm babies with one or more acute infectious episodes during the same period of time was higher, mainly owing to pulmonary, oral mucosa, and ocular infections. The frequency of children with six or seven infectious episodes was also higher in the preterm group (P less than 0.05). IgM and IgA levels did not differ between groups. Even though preterm infants did not show serious bacterial disease or inability to produce antibodies, the incidence of infectious processes was higher in this group up to 2 months of age, a period during which serum IgG levels were lower than in the group of children born at term.

Female↗

Total nitrogen and electrolyte levels in colostrum and transition human milk.

The objective of this research was to study the composition of human milk in terms of protein levels and levels of the electrolytes sodium, potassium, calcium, magnesium, phosphorus and chloride in colostrum 48-72 hours post-partum, and in the transition milk (96 +/- 9 hours, 120 +/- 9 hours and 144 +/- 9 hours post-partum) of mothers who had fullterm and pre-term deliveries. The mothers were kept in the hospital with the objective to control a few important lactation parameters such as exercising or resting conditions, sleep, nutrition and suckling stimulation. Only low socioeconomic level mothers took part in the study. The initial period of lactation was studied because this is the time when secretion suffers rapid changes, going from colostrum to transition milk, and then to mature milk. The results observed for the different times and for the two groups were compared both within and between groups. No significant differences were obtained for any of the comparisons, except for transitory oscillations in potassium, calcium, chloride and phosphorus levels observed within groups. In general, it can be said that there was no variation between colostrum and transition milk for the mothers who delivered at full term or pre-term. No differences were found either when the groups were compared at the different times post-partum. This means that, under the conditions used in this study, milk did not vary as its type naturally changed (from colostrum to transition milk) for the two groups and that the levels of the constituents studied also remained unchanged when studied as a function of full-term or pre-term delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Colostrum↗

Serum vitamin B12 levels in parturients, in the intervillous space of the placenta and in full-term newborns and their interrelationships with folate levels.

Serum vitamin B12 levels were determined in a group of 51 parturients as well as in their babies and placentas. The results obtained showed that newborns had 2.3 times higher vitamin B12 levels than their mothers and that the concentrations of this vitamin in the intervillous space of the placenta was 1.3- and 3.2-fold those encountered in the blood of newborns and mothers, respectively. These findings indicate that vitamin B12 accumulation by the placenta may represent an important factor in providing sufficient amount of this essential nutrient to the fetus. The relationship between folate and vitamin B12 concentration in the maternal, fetal and placental sera was also investigated. The highly significant correlation coefficient encountered and significantly higher serum folate concentrations in the group of parturients who received vitamin B12 supplementation during pregnancy indicate a close metabolic interrelationship between vitamin B12 and folate.

Female↗

Serum and red blood cell folate levels in parturients, in the intervillous space of the placenta and in full-term newborns.

Folates, essential nutrients for man, are especially important during gestation. Serum and red blood cell folate levels were measured in 51 parturients and in their respective placentas and concepts, with the objective to further elucidate the mechanisms of folate transfer from mother to fetus. The interrelationships between the three compartments with respect to folate levels were also studied (Tab. I). Serum and red blood cell folates were measured by radioimmunoassay in samples of venous blood from the mother, from the intervillous space of the placenta, and from the umbilical cord. Higher folate levels were detected in newborns than in their mothers both in serum (3.9 times) and red blood cells (2.3 times). Serum folate levels were higher in the intervillous space of the placenta than in newborns (1.3 times) or mothers (4.5 times) Fig. 1, 2). These data suggest that the placenta concentrates folates, thus offering high concentrations of this vitamin to the fetus. It is possible that folate-binding proteins existing in the placenta participate in the mechanism of folate concentration in this organ. However, despite the existence of a transfer mechanism that benefits the fetus, a significant positive correlation was observed between serum folate levels of mothers, newborns and placentas.

Chorionic Villi↗

Evaluation of plasma tocopherols in relation to hematological indices of Brazilian infants on human milk and cows' milk regime from birth to 1 year of age.

A study was carried out to evaluate the effects of a human milk and cows' milk regime on plasma tocopherols and hematological status of 176 Brazilian infants from birth to 12 months of age. Plasma total tocopherols and the ratio of tocopherols/total lipids were significantly higher (p less than 0.01) for breast-fed infants than for cows' milk-fed infants at all ages. Hydrogen peroxide-stimulated erythrocyte hemolysis was greater for cows' milk-fed infants than breast-fed infants; the difference was statistically significant (p less than 0.01) at 3, 6, and 9 months of age. Among the hematological indices examined, Hb levels were significantly higher (p less than 0.01) for the breast-fed infants at 3 and 12 months, while the reticulocyte counts were significantly higher for the cows' milk-fed infants at all ages; hematocrit values more or less remained similar for both groups. It is concluded from these results that although a human milk regime is ideal as compared to a cow's milk regime for maintaining adequate vitamin E status during the 1st year of early life, there may be other influencing factors besides vitamin E to explain such differences in the hematological indices of the breast-fed and cows' milk fed-Brazilian infants.

Animals↗

[Congenital tuberculosis]

OBJECTIVE: Considering the rarity and the significance of early diagnosis for planning appropriate treatment, a case of congenital tuberculosis is reported.CASE REPORT: After a prolonged stay in the Neonatal Intensive Care Unit (NICU) of a male pre-term infant without improvement, the diagnosis of tuberculosis was suspected when his mother underwent thoracotomy for valve replacement due to a subacute endocarditis. At this time, multiple pleural granulomas were detected and the diagnosis of tuberculosis was confirmed by histology. His mother seldom went to the NICU to see the baby and she was rarely very close to him in these occasions. After tuberculosis therapy, the baby gradually improved. CONCLUSION: Among the possible ways of transmission, the reported case was probably transmitted by aspiration of contaminated amniotic fluid in utero or at the time of delivery.

Journal Article↗

[Clinical aspects of children presenting specific IgM antibodies to cytomegalovirus by immunofluorescent test].

Clinical data observed in 25 children presenting IgM specific antibodies to cytomegalovirus (CMV) by immunofluorescent test are reported. The children were grouped by the presented clinical picture in: neonatal hepatitis, mononucleosis syndrome,pneumonitis, neurologic disease, ocular abnormalities, and thrombocytopenic purpure. Clinical aspects of CMV infection were analyzed and compared with data reported in the literature. CMV infections can involve multiple organs and this viral disease must to be considered on differential diagnosis of many infectious diseases.

English Abstract↗

[Surfactant replacement therapy: a multicentric trial comparing two dosage approaches].

This is an interim analysis of a multicentric trial that took place in 7 Neonatal Units to compare two initial doses of exigenous pulmonary surfactant (100 mg/kg and 200 mg/kg of phospholipids)by using a porcine surfactant for the treatment of very severe Hyaline Membrane Disease. The initial higher dose produced better oxigenation of arterial blood, reducing the time in high oxygen concentrations,while retreatments were necessary in less than half of the infants receiving 200 mg/kg as initial dose. The protocol of this study allowed the administration of additional doses only when FiO(2) was equal or greater than 0.40 instead of > 0.21, as in a large study recently published, where the same initial doses were given. This resulted in more than 40% reduction in the amount of surfactant administered,with apparently similar clinical outcome.

English Abstract↗