Randomized trial of ondansetron, granisetron, and tropisetron in the prevention of acute nausea and vomiting.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
A Rodrigues
Publications and source records attributed to A Rodrigues.
Protection from cholera by adding lime juice to food - results from community and laboratory studies in Guinea-Bissau, West Africa.
Epidemiological studies have shown that food plays an important role in the transmission of Vibrio cholerae, and different foods have been incriminated in many epidemic outbreaks of cholera. Storing contaminated meals at ambient temperatures allows growth of V. cholerae. Some ingredients such as lime juice may inhibit the survival of V. cholerae in foods. During an epidemic caused by V. cholerae O1 in Guinea-Bissau in 1996, a case control study was conducted in the capital Bissau, the main affected region with an attack rate of 7.4%. Cases were hospitalized patients and controls were matched for area, gender and age. Lime juice in the sauce eaten with rice gave a strong protective effect (odds ratio [OR] = 0.31, 95% confidence interval [CI] = 0.17-0.56), and tomato sauce was also protective (OR = 0.36, 95% CI = 0.24-0.54). On the other hand, use of a bucket for storage of water in the house was associated with increased risk (OR = 4.4, CI = 2.21-8.74). Laboratory experiments to elucidate the inhibitory effect of different concentrations of lime juice on survival of V. cholerae in meals showed that V. cholerae thrives in rice with peanut sauce, but lime juice inhibited its growth. Since lime juice is a common ingredient of sauces, its use should be further encouraged to prevent foodborne transmission in the household during cholera outbreaks.
Adolescent↗
Class 1 integron-borne, multiple-antibiotic resistance encoded by a 150-kilobase conjugative plasmid in epidemic vibrio cholerae O1 strains isolated in Guinea-Bissau.
In the 1996-1997 cholera epidemic in Guinea-Bissau, surveillance for antimicrobial resistance showed the emergence of a multidrug-resistant strain of Vibrio cholerae O1 during the course of the epidemic. The strain was resistant to ampicillin, erythromycin, tetracycline, furazolidone, aminoglycosides, trimethoprim, and sulfamethoxazole. Concomitant with the emergence of this strain, we observed a resurgence in the number of registered cholera cases as well as an increase in the case fatality rate from 1.0% before the emergence of the multiple-drug-resistant strain to 5.3% after the emergence of the strain. Our study shows that the strain contained a 150-kb conjugative multiple-antibiotic resistance plasmid with class 1 integron-borne gene cassettes encoding resistance to trimethoprim (dhfrXII) and aminoglycosides [ant(3")-1a]). The finding of transferable resistance to almost all of the antibiotics commonly used to treat cholera is of great public health concern. Studies should be carried out to determine to what extent the strain or its resistance genes have been spread to other areas where cholera is endemic.
Anti-Bacterial Agents↗
[Clinical correlation of angiographic restenosis, isolated or associated with stress test variables, with a population that had stent implantation].
OBJECTIVE: We analyse the value of the clinical data, isolated or associated with the stress EKG (SEKG) variables, in the detection of angiographic restenosis (AR: lesion > 50%), in a group of patients (pts) submitted to coronary angioplasty (PTCA) with stenting. POPULATION AND METHODS: 105 patients were followed prospectively (male: 87%; age: 56 +/- 10); clinical evaluation was performed in the 1st, 3rd and 6th month, SEKG in the 4th month and recatheterization for angiographic control in the 6th month. The vascular risk factors, cause of admission, medication at discharge, angiographic and procedure characteristics were analysed. RESULTS: The most frequent vascular risk factors were hypertension (42%), smoking (64%), and dyslipidemia (52%); 30% had previous ischemic heart disease. The indication for PTCA was myocardial infarction (direct PTCA or residual ischemia) in 42% and angina in 59%. All patients were discharged with AAS and ticlopidine, 38% with beta-blockers, 59% with calcium channel blockers and 92% with nitrates. Thirty-eight percent had multivessel disease. They were submitted to dilatation with the implantation of 128 stents in 199 vessels. An intraaortic balloon pump was used in 13% and Abciximab in 47% of the procedures. In the recatheterization for angiographic control in the sixth month, 30 patients had angiographic restenosis (AR rate = 25.2%). In the clinical evaluation, 22 patients (20.9%) had angina, and 14 of them had angiographic restenosis (clinical restenosis rate = 13.3%). In the 16 asymptomatic patients with AR, 5 had positive SEKG. CONCLUSION: The presence of angina in a group of patients submitted to coronary angioplasty with stenting has a low sensitivity (54%), a good specificity (88%), a positive predictive value of 64% and negative of 83% in the detection of angiographic restenosis. The association with clinical data improves sensitivity (83%), with a decrease in specificity (61%).
Aged↗
Primary angioplasty for acute myocardial infarction complicated by cardiogenic shock on admission.
AIM: To evaluate primary angioplasty results for the treatment of acute myocardial infarction complicated by cardiogenic shock on admission. POPULATION AND METHODS: Retrospective analysis of 11 consecutive patients with acute myocardial infarction complicated by cardiogenic shock (defined as systolic blood pressure below 80 mmHg and signs of hypoperfusion, despite volume expanders and/or vasopressors infusion) treated with primary angioplasty. Clinical characteristics, angiographic data, hospital outcome and follow-up were analysed. RESULTS: There were ten males (90.9%) with a mean age of 66 years. Eight patients had anterior wall myocardial infarction and three patients had inferior wall myocardial infarction, two of which with extension to the right ventricle. The mean time between symptom onset and angioplasty was 3.5 hours. Three patients had left main coronary artery occlusion; three patients had single vessel disease and five patients had multivessel disease. The angiographic success rate (open infarct-related artery and TIMI III flow) was 90.9% (ten patients). Stent implantation was performed in five patients. Abciximab was given in five patients. In-hospital mortality rate was 36.4% (four patients). The surviving patients had a mean ejection fraction of 43.1% on discharge. In a mean follow-up of 16.2 months, one patient had coronary artery bypass graft and one had stroke. CONCLUSION: Based on published data, our experience with this short series of cases shows that primary angiography should be regarded as a positive option for the treatment of acute myocardial infarction complicated by cardiogenic shock.
Aged↗
First do no harm: making oral rehydration solution safer in a cholera epidemic.
Oral rehydration solution (ORS) is lifesaving therapy for cholera and pediatric diarrhea. During a cholera epidemic in Guinea-Bissau, we evaluated the microbiologic quality of ORS prepared at a hospital and tested a simple intervention using special vessels for disinfecting tap water with bleach and for preparing, storing, and dispensing ORS. Few coliform bacteria and Escherichia coli were recovered from tap water; however, pre-intervention ORS contained numerous bacteria including E. coli and toxigenic Vibrio cholerae O1. In contrast, ORS samples from intervention vessels had few or no coliform bacteria, no E. coli, and no V. cholerae. Mean pre-intervention counts of coliform bacteria (3.4 x 10(7) colony-forming units [cfu]/100 ml) and E. coli (6.2 x 10(3) cfu) decreased significantly during the intervention period to 3.6 x 10(2) cfu and 0 cfu, respectively (P < 0.001). This simple system using bleach disinfectant and special storage vessels prevents bacterial contamination of ORS and reduces the risk of nosocomial transmission of cholera and other enteric pathogens.
Agglutination Tests↗
In vitro effect of fibrinogen on Candida albicans germ tube formation.
Pseudohyphae formation by Candida albicans blastoconidia, as seen in vaginal smears, is a phenotypical change commonly assumed to mean fungal invasiveness, i.e. not mere colonization. C. albicans forms germ tubes in vitro in the presence of serum. In our search for inhibitory components of germ tube formation, we decided to study fibrinogen. The inhibition of germ tube formation by clinical isolates of C. albicans was evaluated in the presence of serial concentrations of fraction I, type IV and fraction I, type Is of fibrinogen from bovine plasma. Fibrinogen showed a dose-dependent, pH-independent inhibitory effect on the germ tube formation by C. albicans.
Animals↗
Hepatitis C virus genotypes and the influence of the induction of immunosuppression with anti-thymocyte globulin (ATG) on chronic hepatitis in renal graft recipients.
Hepatitis C virus (HCV) exhibits a dramatic genetic variability and several mechanisms of immunological response are unable to control hepatic and extrahepatic replication. Genotype 1 b is associated with more severe clinical manifestations and is less responsive to interferon. In addition, we have reported an increase of HCV RNA viral load after renal transplantation. Anti-thymocyte globulin (ATG) is supposed to increase viral replication and liver dysfunction in chronically infected renal graft recipients. We evaluated the genotype profile in HCV+ patients of our Renal Transplant Unit and studied the effects of ATG, as part of the induction of immunosuppression, on viral load and liver enzymes abnormalities. From 726 renal graft recipients, 104 patients, with a mean follow up of 3.9 +/- 2.9 years, were anti-HCV+ by ELISA II. HCV RNA was measured by quantitative PCR. We correlated the viral load and biochemical liver parameters with genotype, exposure to ATG as induction therapy, early acute rejection episode and the duration of infection. Of the 81 patients tested, 72% were viraemic and genotype 1 b was the predominant viral strain (66%). The majority of these patients (65%) were coinfected by two or more strains. There was no correlation between HCV RNA blood levels and liver enzymes. We did not find higher viral load with genotype 1 b infection (68 +/- 88 mEq/ml vs 75.8 +/- 123 mEq/ml in the others) nor with ATG induction therapy (43.5 +/- 71.3 mEq/ml vs 64.1 +/- 110.5 mEq/ml). Early acute rejection and longer follow up were not associated with higher levels of HCV RNA. The biochemical liver profile showed no relationship with the variables studied. We concluded that genotype 1 b is the predominant strain in our HCV+ population and there is a great prevalence of coinfection with several genotypes. Our results did not confirm a deleterious effect of the use of ATG as induction therapy in these HCV-infected patients. Prospective randomised studies with liver biopsy evaluation are needed to answer more fully the remaining questions about the best immunosuppressive therapy in renal graft recipients with chronic HCV infection.
Genotype↗
HTLV-I and -II infections in a nationwide survey of pregnant women in Guinea-Bissau, West Africa.
Explore the source record for details and available documents.
Female↗
Risk factors for cholera infection in the initial phase of an epidemic in Guinea-Bissau: protection by lime juice.
Previous studies of cholera transmission have been conducted in the middle or at the end of an epidemic. Since modes of transmission could be different in different phases of an epidemic, we initiated a case-referent study immediately after the first cases had been hospitalized in a recent cholera epidemic in Guinea-Bissau in West Africa in October 1994. The cases investigated were consecutive adult patients resident in the capital of Bissau who were admitted the the National Hospital during the first two weeks of the epidemic. Referents were matched for district, gender, and age. The study showed a protective effect of using limes in the main meal (odds ratio [OR] = 0.2, 95% confidence interval [CI] = 0.1-0.3) and having soap in the house (OR = 0.3, 95% CI = 0.1-0.8). Not eating with the fingers and using water from a public standpipe were also protective. No specific source or mode of transmission was identified. Thus, cholera control programs in Africa may have to emphasize general hygienic conditions and the use of acidifiers in food preparation.
Adolescent↗
Remnants of the right valve of the sinus venosus presenting as a right atrial mass on transthoracic echocardiography.
Three patients were referred for suspicion of intracardiac tumour on transthoracic echocardiography. In all patients, the mass appeared as a nonobstructive oval structure measuring approximately 12 x 4 mm, located near the posterior third of the interatrial septum in the right atrium in the apical four-chamber view. The characteristics of the mass were not those of a Eustachian valve or a Chiari network. Multiplane transesophageal echocardiography performed in each of these patients did not reveal a tumour but rather a fibrous band in the right atrium, extending from the inferior to the superior vena cava. These findings are consistent with remnants of the right valve of the sinus venosus. Inclusion of a persistent right valve of the sinus venosus in the differential diagnosis of a right atrial mass can alleviate concern and spare an unnecessary transesophageal examination when the typical transthoracic echocardiographic characteristics are identified.
Adult↗
Mutagenicity of kaempferol in V79 cells: the role of cytochromes P450.
The flavonol kaempferol is widely found in the diet and is directly mutagenic in some short-term tests, such as the induction of chromosomal aberrations in eukaryotic cells. The presence of exogenous metabolizing systems enhances its mutagenicity. We have evaluated the role of cytochromes P450 in the induction of chromosomal aberrations by kaempferol in V79 cells. The results obtained suggest that there is a time-dependent biotransformation of kaempferol to quercetin, by cytochromes P450, as assessed by high pressure liquid chromatography. Quercetin seems to contribute to the mutagenicity of kaempferol in the presence of microsomal metabolizing systems. On the other hand, the direct induction of chromosomal aberrations by kaempferol does not seem to depend on the production of reactive oxygen species.
Animals↗
Mechanisms of myricetin mutagenicity in V79 cells: involvement of radicalar species.
Myricetin is a flavonol that is widely distributed in edible plants and although it has been proved to be genotoxic in bacteria and to induce significant concentration-dependent nuclear DNA degradation concurrent with lipid peroxidation, very little is known about its mechanisms of genotoxicity. In this work we tried to evaluate the role of rat cytochromes P450 in the genotoxicity of myricetin and to study the role that radicalar species may have in its mutagenicity. The results obtained show that the genotoxicity of myricetin as assessed by the induction of chromosomal aberrations is not different in V79 cells lines genetically engineered for the expression of rat cytochromes P450 1A1, 1A2, and 2B1, compared to parental cell lines. We have also been able to show that reactive oxygen species resulting from the autooxidation of myricetin at pH values above neutrality have an important role in its mutagenicity. Therefore, under some conditions, myricetin can act as a prooxidant.
Animals↗
Outcome of renal graft recipients with hepatitis C virus infection.
Hepatitis C virus (HCV) is a major cause of posttransplantation chronic liver disease. The aim of this study was to evaluate the prevalence of HCV in renal transplant recipients and to investigate risk and prognostic factors. Of 427 renal transplants carried out between July 1983 and January 1993, we retrospectively studied 66 (15.5%) HBsAg-negative patients with anti-HCV detected by enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA). Patient and graft survivals were estimated. Anti-HCV positive patients had more time on hemodialysis and pretransplant blood transfusions (P = 0.0001) than did the seronegative population. In a mean follow-up of 52.3 +/- 27.7 months, 36 patients (54%) had biochemical evidence of liver disease, predominantly with a persistently high pattern of serum alanine aminotransferase (ALT). Pretransplantation ALT elevation was associated (P = 0.004) with chronic liver disease (CLD) in the graft recipient. None of the other variables studied predicted posttransplantation CLD. Liver failure occurred in two (3%) and was the cause of death in one of the patients. Death occurred in eight significantly more aged (P = 0.0001) patients, at 45.5 +/- 28.8 months posttransplant. In 50% of the cases, death was ascribed to sepsis. The biochemical pattern of HCV showed no predictive value for prognosis. The disease had no significant effect on the number of rejections or graft survival. The study revealed lower actuarial survival (P = 0.004) for HCV-positive patients in comparison with the seronegative population.
Adult↗
On the mechanisms of genotoxicity and metabolism of quercetin.
Quercetin has been the subject of numerous studies on its genetic toxicity and carcinogenicity. Despite its well-proven genetic damaging activity for various genetic end-points (reverse mutations, induction of SOS functions, induction of sister chromatid exchanges, chromosomal aberrations and micronuclei), the mechanisms of genetic damage by quercetin remain, by and large, unknown. The present study aims to further extend the observations on the possible active oxygen species mediated DNA-damaging activity of quercetin and the role of cytochrome P450-dependent metabolism on the genotoxicity of quercetin. The results reported in this work show that quercetin can produce the OH. radical, as assessed by deoxyribose degradation in the presence of Fe3+/EDTA (ethylenediaminetetraacetic acid), and that it induces strand breakage in isolated plasmidic DNA (pUC18). The data support the hypothesis that the production of OH. is mediated by H2O2. The results with genetically engineered V79 cells expressing rat cytochromes 1A1, 1A2 and 2B1 failed to demonstrate metabolism of quercetin, as indicated by the fact that neither an enhancement nor a decrease in the genotoxicity of quercetin was observed. Results obtained on the pH dependence of the induction of chromosomal aberrations by quercetin in V79 cells show that, as the pH value of the medium is increased to 8.0, there is a significant increase in the number of aberrant cells, as expected if oxygen radicals are responsible for the formation of chromosomal aberrations.
Animals↗
Comparison of the radiochemical behaviour and biological efficacy of three 99mTc-HIG preparations.
The aim of the present study was to evaluate whether the different methodologies used for human polyclonal immunoglobulin (HIG) preparation can affect the radiochemical purity of 99mTc-HIG and its binding affinity to infection sites. Three intravenous immunoglobulin preparations, beta-propiolactone treated, hydrochloric acid/pepsin treated, and an unmodified HIG molecule were studied. The HIG preparations were analysed by size-esclusion HPLC. The UV chromatogram profiles obtained showed some percentage of polymeric and dimeric fractions in all of them. The three HIG studied were directly radiolabelled via 2-mercaptoethanol reduction. Lyophilized kits containing 1 mg of HIG and a small amount of MDP(Sn) solution were prepared and then radiolabelled by adding pertechnetate-99m. The radiolabelled products, evaluated by ITLC, showed high radiochemical purity and in vitro stability. Biodistribution studies were performed in mice with an infection in the right thigh induced by the im administration of a single isolate of S. aureus, in order to compare the ability of 99mTc-HIG to detect an infectious focus. This study suggests that any damage during immunoglobulin treatment can influence the in vivo behaviour of 99mTc-HIG.
Animals↗
Gas chromatographic-mass spectrometric method for measuring stable isotope enrichments of underivatized cortisol from small plasma volumes.
Isotope dilution methods utilizing quantification of stable enrichment by mass spectrometry has been used recently to determine cortisol production rates in humans. Studies of steroid production and utilization rates require frequent blood sampling, and while stable isotopes are safe for pediatric and perinatal use, the required blood volumes may be problematic using published methodologies. We have developed methods to isolate and quantify the plasma enrichment of cortisol with its stable isotope, [9,12,12-2H3]cortisol using a simple four-step isolation procedure and gas chromatography-mass spectrometry. Isolation is semi-quantitative, but reproducible (mean recovery; 51.5 +/- 5.4% coefficient of variation) and the method does not require derivation. In human studies, this method can determine plasma enrichments between 1 and 10 mol% at plasma concentrations of 2 micrograms/dl or more; only 1 ml of plasma is required. The concentrations of labelled cortisol added to plasma are low (0.2-0.5 micrograms/dl) and are not expected to interfere with the sensitive hypothalamic-pituitary-adrenal feedback system. We conclude that reproducible quantification of stable cortisol isotope enrichment can be achieved from small plasma volumes.
Chromatography, Thin Layer↗
Abdominal wall mass in a pregnant woman.
Abdominal fibromatosis should be considered in female patients of childbearing age who present with a mass arising from the abdominal musculature, particularly if the mass becomes evident during or immediately after gestation. Magnetic resonance imaging, with its multiplanar imaging capabilities, is useful in characterizing soft tissue tumors and in defining the extent of tumor involvement of adjacent structures.
Abdominal Muscles↗