Acute non-lymphoblast leukaemia presenting as a Guillain-Barré syndrome.
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Biomedical subjects
Publications and source records attributed to A Rodrigues.
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We present the case of 55-year old female patient with a rare malignant disease of the stomach associated with IgA deficiency. For its management the surgical, transfusional and renal support strategy required good coordination of pre, intra and post-operative care, and good articulation among the various sub-specialties. The patient experienced two severe anaphylactoid transfunctional reactions. Congenital IgA deficiency was detected with probable anti-IgA immunization associated with a metacrone adenocarcinoma of the stomach and nephrotic syndrome with renal failure. The transfusion methods utilized are discussed, and the results of the study aimed at detecting a compatible donor, with identical deficit, among family members are presented. In the absence of a national registry of donors with IgA deficiency, the prevention of these potentially dangerous reactions imposes a burden on the Service of Immuno-Hematherapy to take special measures on its own. This case points out the need to implement a blood bank with rare groups and IgA deficient blood, for homo/autologous transfusions.
Candida albicans is by far the most frequent agent of genital candidosis. We studied the prevalence of C albicans in normal asymptomatic women attending primary health care centers throughout Portugal. The overall prevalence of C albicans in the vaginal fluid of 1,004 women studied was 10.4%. Interestingly, the prevalence rates were lower (6.8%) in women taking combination oral contraceptives and higher (13.0%) in those using intrauterine devices.
Quercetin has been extensively studied in various short-term assays for genotoxicity. The patterns of genotoxicity of quercetin for different genetic endpoints are subject to a variety of factors (pH, antioxidants, metabolism) whose precise role in each test remains unclear. In the present study we report on the possible effect of oxygen-derived species on the activity of quercetin in the Ames assay and in the SOS chromotest. Our results seem to suggest that superoxide dismutase (SOD) does not account for the levels of mutagenicity detected in the presence of S9 or S100. The latter may, however, contain other factors of antioxidant defense which may prevent the oxidative degradation of quercetin. Since this degradation occurs at pH values above neutrality and the SOS-inducing activity is higher at pH 6.0, it is concluded that the response of quercetin in the SOS chromotest is due to quercetin itself at acidic pH. The SOS-inducing activity at pH 7.4 is enhanced by SOD, but it cannot be unambiguously concluded that this effect in the SOS chromotest might only be due to protection against the oxidative degradation of quercetin.
Biomimetic oxidative systems using tetraarylporphyrins, which can bind various metals, and exogenous oxygen donors have been extensively studied as models of the natural heme prosthetic group. Those systems were shown to catalyze oxidations in a manner consistent with cytochromes P-450 and usefully contributed to an understanding of the mechanisms of the cytochromes P-450-dependent reactions when using oxygen donors. The usage of those systems in mutagenicity studies showed that some promutagens could be activated to proximate mutagens. In the present work we report on the activation of benzo[a]pyrene, 3-methylcholanthrene, 7,12-dimethylbenz[a]anthracene; 2-aminofluorene, 2-acetylaminofluorene and the heterocyclic amine 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) to Ames assay mutagens using tetraphenylporphinatoiron(III) chloride and various oxygen donors, namely iodosylbenzene, cumene hydroperoxide, tert-butylhydroperoxide and H2O2. Our results demonstrate that IQ could be activated using any of the oxygen donors. However, a pattern of specificity for the oxygen donor could be identified. Polycyclic aromatic hydrocarbons displayed higher levels of mutagenicity with iodosylbenzene, whereas aromatic amines were preferentially activated when tert-butylhydroperoxide was used. For the heterocyclic amine IQ the higher responses were obtained using cumene hydroperoxide. The putative non-carcinogen pyrene and the controversial carcinogen quercetin were not activated irrespective of the oxygen donor used.
The following case is presented to illustrate the roentgenographic findings of a condition of interest to the radiologist and orthopaedic surgeon. Initial history, physical findings, and roentgenographic examinations are presented along with the final histologic and roentgenographic differential diagnosis.
Mutagenic activity was monitored during the time course of the vinification process of a Portuguese red wine using the Ames assay. Dependence upon faecalase treatment for detection of mutagenicity was evaluated concurrently with HPLC analysis of the flavonoids rutin and quercetin. Rutin (quercetin-o-3-rutinoside) is liberated from the grapes during the first 10 days of the process and is hydrolysed as the vinification process proceeds. This explains the levels of the free quercetin in the wine and mutagenicity in the absence of faecalase treatment. Mutagenicity in the presence of faecalase during the first 26 days of the process correlates with the levels of rutin, and in the absence of faecalase the highest mutagenic activity detected (160th day) coincides with the highest level of free quercetin. Our results do not rule out the possibility that other mutagens are present in wines, in particular oxidative-type mutagens.
Extracellular adenosine is transported into chromaffin cells by a high-affinity transport system. The action of adenosine receptor ligands was studied in this cellular model. 5'-(N-Ethylcarboxamido)adenosine (NECA), an agonist of A2 receptors, activated adenosine transport. Km values for adenosine were 4.6 +/- 1.0 (n = 5) and 10.2 +/- 3.0 microM (n = 5) for controls and 100 nM NECA, respectively. The Vmax values were 66.7 +/- 23.5 and 170.2 +/- 30 pmol/10(6) cells/min for controls and 100 nM NECA, respectively. The A1 agonist N6-cyclohexyladenosine, the A1 antagonist 8-cyclopentyl-1, 3-dipropylxanthine, and the A1-A2 antagonist 1,3-dipropyl-8-(4-[(2-aminoethyl)amino]-carbonylmethyloxyphenyl)- xanthine did not significantly modify the adenosine transport in this system. Binding studies done with [3H]dipyridamole, a nucleoside transporter ligand, did not show changes in either the number or affinity of transporter sites after NECA treatment. This ligand can enter cells and quantifies the total number of transporters. The binding studies with [3H]-nitrobenzylthioinosine, which quantifies the plasma membrane transporters, showed a Bmax of 19,200 +/- 800 and 23,200 +/- 700 transporters/cell for controls and 100 nM NECA, respectively. No changes in the KD were obtained. The effects of NECA were not mediated through adenylate cyclase activation, because its action was not imitated by forskolin.
In an examiner blind positive/negative controlled 6-month study, the efficacy of supragingival irrigation with 0.06% chlorhexidine gluconate on the marginal and subgingival microflora in naturally occurring gingivitis was evaluated. The 222 patients enrolled in the study were assigned to one of four groups: Group 1: Once daily irrigation with 300 ml water followed by irrigation with 200 ml 0.06% chlorhexidine gluconate (experimental); Group 2: Twice daily rinsing with 15 ml 0.12% chlorhexidine (positive control); Group 3: Once daily irrigation with 500 ml water (irrigation control) and Group 4: Sodium fluoride dentifrice for normal oral hygiene only (negative control). All groups received the same sodium fluoride dentifrice for tooth brushing. All patients received a supra- and subgingival oral prophylaxis after baseline examination and at the end of the investigation. Plaque samples were analyzed from 105 patients at baseline, 93 patients at 3 months and 88 patients at 6 months. The 6-months results demonstrated that, when compared with tooth brushing alone, adjunctive supragingival irrigation with 0.06% chlorhexidine gluconate was most effective by significantly reducing (P less than or equal to 0.008) both log10 CFU and % of Gram-negative anaerobic rods and black-pigmented Bacteroides. Chlorhexidine rinse also significantly (P less than or equal to 0.008) reduced log10 CFU of black-pigmented Bacteroides at 6 months. Both chlorhexidine regimens significantly (P less than or equal to 0.008) increased the % of Gram-positive facultative cocci compared to water irrigation at 3 months. Water irrigation had a limited effect on any of the assessed bacterial groups (log10 CFU and %).(ABSTRACT TRUNCATED AT 250 WORDS)
The authors report a case of lupus vulgaris in a 22-year-old female patient occurring three months after BCG vaccination, with a period of evolution of two months. The Mantoux intradermoreaction (1 U) was strongly positive, and no acid-fast bacilli were found in the lesion, either by direct analysis or by culture in a Lowenstein medium. The histopathological findings confirmed the diagnosis. Prescribed treatment with isoniazid and rifampicin for three months resulted in complete healing on the sixth month.
The Pawtucket (Rhode Island) Heart Health Program is designed to effect a community-wide change in heart disease morbidity and mortality by reducing smoking prevalence and other behavioral risks for this disease. The initial emphasis of the Pawtucket Heart Health Program was on the development of risk factor programs within specific churches, work sites, and other organizations in the community. At the end of 9 months of programming, however, only one organization had elected to begin a stop-smoking program. Given the community smoking prevalence of 43.4%, it was decided that larger-scale interventions would be required if a significant public health impact was to be realized. Therefore, a community-wide campaign was mounted to recruit as many participants as possible into the "Up in Smoke" cessation program. A lottery was attached to this program, with the contingency based on program attendance rather than cessation per se. One hundred three participants, including residents of neighboring communities, enrolled in three Up in Smoke lottery groups. At a 3-month follow-up, only 11 (7%) of smokers from the Up in Smoke lottery reported that they were not smoking (10% of those actually contacted). For a variety of reasons, the "Quit and Win" approach was later adopted by the Pawtucket Heart Health Program as the primary smoking intervention. One month after the end of the contest, 20% of those contacted reported not smoking. The percentage of quitters for the Up in Smoke program increased while the Quit and Win rate decreased over longer periods of follow-up. These and other data were compared with those of participants of a screening program conducted concurrently. Lotteries in general and face-to-face recruitment in large crowds were shown to be effective recruiting methods for large-scale smoking cessation programs.
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Many self-reported measures of health status, attitudes, and knowledge used by clinicians and researchers suffer from a variety of shortcomings, including limited empirical justification, excessive complexity, assessments of nonmodifiable historic or hereditary factors, and limited utility for public health program planning. The Health Attitudes and Behavior Scale is an instrument designed to overcome many of these shortcomings and direct public health professionals toward more efficacious interventions. One hundred sixty-four subjects responded to true-false and Likert scale items related to health beliefs, attitudes, and behavioral practices. A principal component analysis of the Likert items yielded six components, tentatively labeled (a) Lack of Social Support, (b) Hurdles to Health, (c) Health Attitudes/Weight Concerns, (d) Positive Environment, (e) Disease Concerns, and (f) Time and Work Pressure. Analyses of these scales using coefficient alpha indicated adequate internal consistency for each of them. These scales were then related to demographic variables of age, educational level, sex, and marital status. Next, these scales were correlated with individual true-false items reflecting self-reported behavioral practices or health histories. A component analysis of the true-false items yielded four principal components labeled (a) Organizational Health Concerns, (b) Smoking and Exercise Concerns, (c) Coronary and Weight Concerns, and (d) Blood Pressure and Risk Factor Programs. Finally, a cluster analysis yielded six typical profiles reflecting different levels of the original six components. Of interest is the fact that the Lack of Social Support and Time and Work Pressure scales had a very limited integration into the overall patterns. The assumption that organizational and environmental factors can have an important impact on health was supported. The need for further research in this area is also discussed.
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Three intratesticulary inoculated bovines revealed to be susceptible to experimental paracoccidioidomycosis. The experimental infection was self limited with no tendency to dissemination during a follow up period of five months. The histopathologic lesions characterized by granulomatous inflammatory foci, associated or not to necrosis, were found in the testicles, spermatic cords and testicular tunicae. In some of both lesions types the yeast cells of P. brasiliensis were present. The experimental infection did not cure in a follow up period of five months. The immunological response either cellular or humoral were delayed in relation to what happens in other animal species. The three experimentally infected bovines were utilized for some standardization of the paracoccidioidin intradermic test. A type and dose of an antigen which gives a clear reading for the positive tests was determined. The humoral responses were detected mainly by the complement fixation reaction. It was not possible to demonstrate humoral antibodies by the agar immunodiffusion test.
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In identical laboratory conditions, some differences in the endogenous relative activity (mul O2/mg protein/ml/h) were determined by the addition of succinate and alpha-keto-glutarate to the mitochondrial-rich-fraction from heart and both parts of the adductor muscle in oyster (Crassostrea rhizophorae) and from heart and adductor muscle in clams (Lucina pectinatus).