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Biomedical subjects

C A Moreno

Publications and source records attributed to C A Moreno.

12 recordsLinked to original sources
PubMed1999

Preclinical evaluation of a synthetic Plasmodium falciparum MAP malaria vaccine in Aotus monkeys and mice.

Multiple antigen peptides (MAPs) containing epitopes of the major surface protein of the malaria sporozoite, the circumsporozoite (CS) protein, have been shown in previous studies to elicit antibody-mediated protection against sporozoite challenge in experimental murine and simian hosts. For the preparation for a phase I trial of a P. falciparum (T1B)4 MAP, which contains T and B cell epitopes from the CS repeat region, pre-clinical immunogenicity and adjuvant formulation studies were carried out in mice and Aotus monkeys. The (T1B)4 MAP was found to be immunogenic in three different species of owl monkeys, Aotus nancymae, A. vociferans and A. nigriceps. Optimal antibody responses were obtained in A. nancymae immunized s.c. with (T1B)4 MAP emulsified in Freund's, in which peak titers of over 10(6) were obtained in individual monkeys. MAP immunized A. vociferans also developed high levels of anti-sporozoite antibodies, although the kinetics and the magnitude of the response differed from A. nancymae. (T1B)4 MAP adsorbed to alum (aluminum hydroxide), a formulation that is acceptable for human use, was less immunogenic in naive A. nancymae, as well as A. nigriceps. The injection of MAPs/alum, however, significantly enhanced antibody responses in sporozoite-primed monkeys, suggesting that the administration of the MAP vaccine may be an effective means to increase the low levels of antibody present in individuals living in malaria endemic areas. The addition of a co-adjuvant QS-21, a purified saponin, significantly increased the immunogenicity of the alum-adsorbed MAP in both mice and monkeys, providing a vaccine formulation suitable for phase I trials in human volunteers.

Alum Compounds↗
PubMed1996

Potential clinical implications of abnormal myocardial perfusion patterns immediately after reperfusion in a canine model: a myocardial contrast echocardiography study.

During myocardial infarction, lack of myocardial opacification after reperfusion has been associated with poor or no recovery of function. We have previously documented the presence of perfusion abnormalities after brief coronary occlusions without infarction and the absence of perfusion abnormalities after prolonged occlusions with infarction. To characterize myocardial perfusion patterns immediately after reperfusion, we studied 53 animals in two groups in a coronary occlusion-reperfusion model. Temporary occlusions (group 1, 15 minutes; group 2, 30 to 360 minutes) were performed, followed by reperfusion with and without dobutamine. Myocardial contrast echocardiography was performed with aortic root injections of sonicated 5% serum human albumin (Albunex) during each intervention. Group 1 dogs showed no evidence of myocardial infarction. In group 2, 26 of 40 dogs had infarctions. After reperfusion, no perfusion abnormalities were seen in 13 of 26 group 2 dogs with infarctions; perfusion abnormalities were identified after reperfusion in 2 of 13 group 1 and in 8 of 14 group 2 dogs without infarctions. In animals subjected to prolonged ischemia, the absence of perfusion abnormalities after reperfusion did not rule out the presence of necrosis. Similarly, in animals without infarction subjected to ischemia, the presence of a perfusion defect after reperfusion did not represent the presence of necrosis but an abnormal microvascular reserve. These results suggest that early after reperfusion, assessment of perfusion by myocardial contrast echocardiography has significant limitations in the evaluation of myocardial viability and salvage.

Animals↗
PubMed1993

AIDS-related risk behavior, knowledge, and beliefs among women and their Mexican-American sexual partners who used intravenous drugs.

OBJECTIVE: To assess the risk behaviors, knowledge, and beliefs regarding human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) among women and their sexual partners who were Mexican-American men who used intravenous drugs. DESIGN: Survey of male methadone users and their female sexual partners. PARTICIPANTS AND SETTING: Mexican-American male clients at a methadone clinic in Los Angeles, Calif, were consecutively recruited for the study. A method similar to partner contact tracing was used to identify female subjects. One hundred subjects, representing 50 male-female pairs of sexual partners, answered identical questionnaires. The responses from females were compared with those from their male partners. RESULTS: Seventy-four percent of the females disclosed that they used intravenous drugs, and 88% knew that their male partners were intravenous drug users. Of subjects who used intravenous drugs, 73% (27/37) of females and 88% (44/50) of males currently injected themselves and shared uncleaned needles. Seventy-six percent of females and 84% of males never used a condom during the previous year, and about 20% of both sexes had more than one sexual partner. Even though most of the females understood how HIV was transmitted and recognized themselves as at risk for AIDS, they continued to share needles unsafely and place themselves at risk for acquiring HIV infection through sex. CONCLUSION: This group of females and their male sexual partners engaged in multiple behaviors that may contribute to the further propagation of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Hispanic elders in Texas: implications for health care.

Hispanic elders are a large, rapidly growing subgroup of the Hispanic population in Texas. This population continues to suffer from a high incidence of non-insulin-dependent diabetes mellitus, with similar or lower rates of cardiovascular disease than non-Hispanic whites have. Barriers that may modify potentially effective diagnostic or appropriate treatment plans include communication problems, access issues, and use of informal health-care services. Knowledge and attention to these issues may improve compliance and decrease morbidity of this cohort. This article summarizes important information affecting the health of Hispanic elders in Texas and alerts practitioners to issues that may affect the care of their older Hispanic patients.

Aged↗
PubMed1989

Infant circumcision in an outpatient setting.

We conducted a retrospective evaluation of 442 infant circumcisions performed in an ambulatory setting. Procedures done with the Gomco clamp (Gomco Division, Allied Health Care, Buffalo, NY) and the Plastibell device (Hollister, Inc, Libertyville, Ill) were compared with respect to the frequency of complications. The overall complication rate was 6.8%. Bleeding requiring action by a physician occurred in 3.4% of cases and was significantly more common with the Gomco clamp than with the Plastibell device (p less than 0.05). There were no statistically significant differences between the two methods in the rate of infection or other complications. The rate of complications is comparable to previous studies of inpatient circumcision.

Ambulatory Surgical Procedures↗
PubMed1989

Analysis of resident and attending physician interactions in family medicine.

Clinical teaching does not fit neatly into traditional teaching-learning models. The interaction between a resident and an attending physician is of particular interest because it has several functions including education, supervision, socialization, and quality control. The purpose of this study was to observe, classify, and record verbal teaching and learning behaviors in the resident-attending physician interaction. During a 12-month period, 125 observations of resident-attending physician interactions were recorded; the average length of the interactions was 4.27 minutes. The six most frequent resident verbal behaviors compared by postgraduate year level did not vary significantly. Only one of the six most frequent attending physician verbal behaviors varied significantly. In the average interaction of about 4 minutes, three fourths of the interaction was on patient care issues, leaving little time for teaching. There are many unanswered questions about the resident-attending physician interaction and its contribution to the training of a physician.

Family Practice↗
PubMed1989

Utilization of medical services by single-parent and two-parent families.

The purpose of this study was to examine the influence of family structure on the utilization of health care services. Data from the Family Health Utilization Survey, a six-month prospective study, showed that when confounders were controlled using a multiple regression model, being in a single-parent family was predictive of a statistically significant increase in overall utilization of ambulatory health care services. There were no differences between single-parent and two-parent families in rates of hospitalization or emergency room visits. There was a trend toward a higher rate for obtaining telephone advice by the single-parent families and a higher rate of after-hours care among the two-parent families. Single-parent families were also more likely to feel they needed care but did not obtain it. Differences that exist in the health care utilization patterns of single- and two-parent families should be considered in assessing health care needs of families.

Adolescent↗
PubMed1988

Frequency of cardiac contusion in nonpenetrating chest injury.

Seventy-five patients with nonpenetrating chest injuries were evaluated with electrocardiography, cardiac enzyme determination, 2-dimensional echocardiography and radionuclide ventriculography to document the incidence of cardiac abnormalities. Although the electrocardiograms showed ST-T wave changes in 25 patients (33%), sensitivity (47%) and specificity (79%) for echocardiographic and radionuclide abnormalities were poor. Cardiac enzymes were abnormal in 10 patients (13%), sensitivity for echocardiographic or radionuclide abnormalities, or both, was 29% and specificity 90%. Wall motion abnormalities were detected in 11 patients (18%) by radionuclide studies and in 3 patients (6%) by echocardiography. A pericardial effusion was present in 5 patients (10%). Two patients (4%) died of noncardiac causes; neither had wall motion abnormalities. This study documents the favorable outcome of patients with blunt chest injuries and does not suggest that echocardiography or radionuclide studies should be performed routinely on such patients.

Adolescent↗
PubMedDate not supplied

Benefits of reducing the cardiac cycle-triggering frequency of ultrasound imaging to increase myocardial opacification with FSO69 during fundamental and second harmonic imaging.

BACKGROUND: Recent work has shown significant enhancement in myocardial contrast intensity with brief ultrasound pulsing gated to a discrete portion of the cardiac cycle over conventional 30 Hz imaging. We hypothesized that limiting ultrasound imaging to less than every cardiac cycle would further intensity the myocardial echo-contrast effect. We therefore sought to determine the best pulsing frequency for ultrasound imaging to achieve optimal myocardial perfusion after the intravenous administration of FSO69 using fundamental and second harmonic imaging. METHODS AND RESULTS: In 13 male mongrel dogs, myocardial contrast opacification was determined while varying the cardiac cycle-triggering frequency of ultrasound imaging after intravenous injections of FSO69. Resulting myocardial echo-contrast intensities with a cardiac cycle-triggering frequency of every beat during end-diastole were compared with those with a cardiac cycle-triggering frequency of every third and fifth beat. Myocardial opacification, measured by background-subtracted peak intensity and visual scoring, was significantly greater when ultrasound imaging was triggered to every third and fifth beats compared with every beat. These benefits were seen with imaging in both the fundamental and second harmonic modes. Optimal myocardial opacification with FSO69 was achieved with injections as low as 0.1 ml, a dose that produced significant acoustic shadowing in only 24% of the injections. The degree of myocardial opacification was not significantly affected when the images were acquired during end-systole or end-diastole. CONCLUSIONS: Electrocardiogram-gated ultrasound imaging to every third or fifth cardiac cycle greatly improves myocardial opacification compared with imaging each cardiac cycle. This benefit was increased twofold to threefold with the use of second harmonic imaging as compared with fundamental imaging.

Albumins↗
PubMedDate not supplied

The prevalence of selected chronic diseases among the Mexican-American elderly: data from the 1982-1984 Hispanic Health and Nutrition Examination Survey.

Although the Mexican-American elderly represent a large and rapidly growing subgroup of the ethnic aged, national prevalence data of major chronic diseases among this population are sparse. Data based on physical examinations from three older groups of the southwestern portion of the 1982-1984 Hispanic Health and Nutrition Examination Survey (HHANES) were reviewed to determine rates of hypertension, diabetes mellitus, arthritis, and heart disease. The results show a higher prevalence of diabetes and lower prevalence of heart disease and hypertension when compared with the general population, coinciding with data from previous studies. Findings for the prevalence of arthritis varied widely from other studies, however, and proportions were lower than expected. Further research on arthritis in the Mexican-American elderly is necessary to determine whether protective mechanisms that may lead to a lower prevalence of this disease exist in this ethnic subgroup.

Age Factors↗