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Biomedical subjects

C Almeida

Publications and source records attributed to C Almeida.

At least 19 recordsLinked to original sources

New strategies to screen for endocrine-disrupting chemicals in the Portuguese marine environment utilizing large volume injection-capillary gas chromatography-mass spectrometry combined with retention time locking libraries (LVI-GC-MS-RTL).

A new analytical strategy to screen for endocrine-disrupting chemicals (EDCs) in environmental matrices is presented. The strategy uses solid-phase extraction followed by large volume injection and capillary gas chromatography coupled to mass spectrometry combined with retention time locking libraries (SPE-LVI-GC-MS-RTL). Characterization of the proposed methodology (SPE-LVI-GC-MS) for selected classes of EDCs enabled high reproducibility and robustness at the ultratrace level. The RTL databases used allowed hundreds of non-target semivolatiles (i.e., pesticides, polycyclic aromatic hydrocarbons, polychlorinated biphenyls and other classes of suspected EDCs from a great number of unknown environmental matrices) to be simultaneously screened for in an easy, fast and remarkable manner. The application of the proposed methodology to real environmental samples demonstrated its remarkable selectivity and sensitivity at the ultratrace level. Screening assessments performed on water and sediment matrices from eight Portuguese estuaries and coastal waters identified EDC "hotspots." These EDCs mainly come from agricultural and a wide variety of industrial sources, and include pesticides and pesticide metabolites, phenolic derivatives and polycyclic aromatic hydrocarbons, which are included in the lists of priority substances published by international environmental agencies. The estuaries that contained relatively high levels of pesticides were Guadiana, Sado and Mondego, while Minho, Douro and Formosa showed enhanced levels of phenolic derivatives. Dibutyltin and tributyltin, selected as target compounds to be monitored by SPE-LVI-GC-MS in the selected ion monitoring mode, were shown to be widespread contaminants at trace levels in almost all of the sediment matrices assessed. The reliability of the proposed methodology undoubtedly makes it a valuable tool that could replace other analytical strategies currently used to screen for EDCs present in the environment at ultratrace levels.

Chemistry Techniques, Analytical↗

Comparative study of disc diffusion and microdilution methods in susceptibility testing of micafungin against Candida species.

OBJECTIVES: To compare the Clinical Laboratory Standards Institute CLSI M44-A disc diffusion (DD) and M27-A2 broth microdilution (MD) methods for determining the susceptibility of Candida spp. to micafungin (FK463). PATIENTS AND METHODS: A total of 355 clinical yeast isolates including 270 Candida albicans, 45 Candida glabrata, 24 Candida krusei, 11 Candida tropicalis and 5 Candida parapsilosis were studied. The MIC of micafungin was determined by following the CLSI M27-A2 guidelines (MD). Endpoints were defined as the lowest concentration of micafungin resulting in partial inhibition (IC(50)) of visual growth after 24/48 h of incubation at 35 degrees C. Final concentrations were 0.008-4 mg/L of micafungin. DD testing was performed using a CLSI M44-A document with 2.5 mug micafungin discs. Zone diameter endpoints were read after 24/48 h of incubation at 35 degrees C. Arbitrary breakpoints were 4 mg/L for MD and 15 mm for DD. RESULTS: The best correlation was observed when we read MD 48 h/DD 24 and 48 h (97%). When the reading was MD 24 h/DD 24 and 48 h the percentage of correlation was 95.2%. CONCLUSIONS: The DD method performs well for testing the susceptibility of Candida spp. to micafungin. More studies involving more Candida strains with elevated MIC values are needed.

AIDS-Related Opportunistic Infections↗

Prospective genetic screening decreases the incidence of abacavir hypersensitivity reactions in the Western Australian HIV cohort study.

Abacavir therapy is associated with significant drug hypersensitivity in approximately 8% of recipients, with retrospective studies indicating a strong genetic association with the HLA-B*5701 allele. In this prospective study, involving 260 abacavir-naive individuals (7.7% of whom were positive for HLA-B*5701), we confirm the usefulness of genetic risk stratification, with no cases of abacavir hypersensitivity among 148 HLA-B*5701-negative recipients.

Adult↗

Determination of steroid sex hormones in water and urine matrices by stir bar sorptive extraction and liquid chromatography with diode array detection.

In this study, stir bar sorptive extraction and liquid desorption followed by high performance liquid chromatography with diode array detection (SBSE-LD-HPLC/DAD) were combined for the simultaneous determination of nine steroid sex hormones (estrone, 17alpha-estradiol, 17beta-estradiol, 17alpha-ethynylestradiol, diethylstilbestrol, mestranol, progesterone, 19-norethisterone and norgestrel) in water and urine matrices. During the method development, it has been demonstrated that equilibrium time, ionic strength and back extraction solvents are the most important parameters to control, for determining the nine-hormones in water matrices, in which stir bars coated with 126 microl of polydimethylsiloxane were used. Assays performed on 30 ml water samples spiked at 10 microg/l levels under optimised experimental conditions, yielded recoveries ranging from 11.1+/-4.9% (17beta-estradiol) to 100.2+/-10.4% (mestranol), showed that the methodology is well described by the octanol-water partition coefficients (K(PDMS/W) approximately K(O/W)) for the latter, while pronounced deviations to the theoretical efficiency (K(PDMS/W) not equal K(O/W)) were observed for the remaining hormones. From calibration studies, a good analytical performance for all hormones was attained, including a suitable precision (2.1-17.1%), low limits of detection (0.3-1.0 microg/l) and an excellent linear dynamic range (1.25-50.0 microg/l). Assays on environmental water and urine matrices showed recovery yields in worthy good agreement with the spiking level (10 microg/l), and suitability for profiling low microg/l levels of natural hormones in urine samples taken from pregnant women. The present methodology is easy, reliable and sensitive at the trace level, only requiring a low sample volume, showing to be a good analytical alternative to routine quality control for environmental and biomedical laboratories.

Chromatography, High Pressure Liquid↗

Current provision of rheumatology education for undergraduate nursing, occupational therapy and physiotherapy students in the UK.

OBJECTIVES: Rheumatological conditions are common and all health professionals (HPs) therefore need sufficient knowledge and skills to manage patients safely and effectively. The aim of this study was to examine current undergraduate education in rheumatology for HPs in the UK. METHODS: A questionnaire was sent to curriculum organizers and clinical placement officers for all undergraduate courses in adult nursing, occupational therapy (OT) and physiotherapy (PT) in the UK to ascertain the nature and amount of rheumatology theory and clinical exposure provided. RESULTS: Of the 47 adult nursing, 26 OT and 30 PT undergraduate courses surveyed, 85-90% responded. Overall, rheumatology teaching is 5-10 h over 3 yr. Nursing students receive moderate/in-depth teaching on rheumatoid arthritis (RA) in only 52% of courses (OT 91%, PT 96%) and on osteoarthritis (OA) in 63% (OT 91%, PT 92%). Clinical experience of RA is probably/definitely available in only 56% of nursing courses (OT 72%, PT 88%), with similar results in OA. Overall, nursing students receive the least rheumatology exposure, particularly in psychosocial issues and symptom management, while PT students receive the most. OT students have limited opportunities for clinical exposure to psychosocial and joint protection issues. Use of local rheumatology clinical HP experts is variable (18-93%) and cross-disciplinary exposure is limited (0-36%). Many educators consider their rheumatology training to be insufficient (nursing 50%, PT 42%, OT 24%). CONCLUSIONS: Rheumatology training for undergraduate HPs is limited in key areas and often fails to take advantage of local clinical expertise, with nursing students particularly restricted. Clinical HP experts should consider novel methods of addressing these shortfalls within the limited curriculum time available.

Allied Health Occupations↗

Evaluation of disk diffusion method for determining posaconazole susceptibility of filamentous fungi: comparison with CLSI broth microdilution method.

The disk diffusion method was evaluated for determining posaconazole susceptibility against 78 strains of molds using two culture media in comparison with the CLSI (Clinical Laboratory Standards Institute) broth microdilution method (M38-A). A significant correlation between disk diffusion and microdilution methods was observed with both culture media.

Antifungal Agents↗

A comparative study of the disc diffusion method with the broth microdilution and Etest methods for voriconazole susceptibility testing of Aspergillus spp.

OBJECTIVE: The activity of voriconazole against Aspergillus spp. (n = 77) was tested by the Etest, disc diffusion and the NCCLS M38-A methods. METHODS: Four Rhizomucor spp. isolates were included to study the suitability of the three susceptibility testing methods to detect isolates resistant to voriconazole. The disc diffusion method performed on Mueller-Hinton agar (Difco) supplemented with 2% glucose and Methylene Blue (0.5 mg/L) gave zone diameters with very clear border edges. RESULTS: The disc diffusion method showed excellent correlation with the Etest and the NCCLS methods. CONCLUSION: On the basis of our results, it appears that the disc diffusion test is a useful method for testing the activity of voriconazole against Aspergillus spp.

Antifungal Agents↗

Whole-body Tc-99m sestamibi scintigraphy in the follow-up of differentiated thyroid carcinoma.

PURPOSE: This study evaluated the potential of Tc-99m sestamibi whole-body scan (WBMIBI) as an alternative to whole-body I-131 scan (WBI) for the follow-up of patients with differentiated thyroid carcinoma. MATERIALS AND METHODS: We evaluated 99 consecutive patients with differentiated thyroid carcinoma who had total or nearly total thyroidectomy followed by an ablative dose of I-131 (86 women, 13 men; mean age, 44 +/- 12 years). WBMIBI was performed and serum thyroglobulin (TG) levels were obtained at least 6 months after I-131 treatment. All persons were receiving levothyroxine therapy. RESULTS: From the total of 110 studies performed, WBMIBI and TG were in agreement in 96% and discordant in 4%. From the 27 crossed studies (WBMIBI x TG) with at least one abnormal result, 16 were compared with WBI. In four cases, the WBI did not reveal functioning thyroid tissue when both TG and WBMIBI indicated tumoral activity. In one case of pulmonary metastasis confirmed by chest radiographs, with a normal TG value, the results of both WBMIBI and WBI were positive. CONCLUSIONS: WBMIBI should be considered as a scintigraphic method in the follow-up of differentiated thyroid carcinoma. This technique can show the sites of tumoral activity with optimal image resolution, particularly in those with abnormal TG and negative WBI results, and it is a potentially valuable tool in patients with anti-TG antibodies. The WBI in patients having ablation should be reserved only for therapy planning.

Adenocarcinoma, Follicular↗

Health sector reform in Brazil: a case study of inequity.

Health sector reform in Brazil built the Unified Health System according to a dense body of administrative instruments for organizing decentralized service networks and institutionalizing a complex decision-making arena. This article focuses on the equity in health care services. Equity is defined as a principle governing distributive functions designed to reduce or offset socially unjust inequalities, and it is applied to evaluate the distribution of financial resources and the use of health services. Even though in the Constitution the term "equity" refers to equal opportunity of access for equal needs, the implemented policies have not guaranteed these rights. Underfunding, fiscal stress, and lack of priorities for the sector have contributed to a progressive deterioration of health care services, with continuing regressive tax collection and unequal distribution of financial resources among regions. The data suggest that despite regulatory measures to increase efficiency and reduce inequalities, delivery of health care services remains extremely unequal across the country. People in lower income groups experience more difficulties in getting access to health services. Utilization rates vary greatly by type of service among income groups, positions in the labor market, and levels of education.

Brazil↗

[Physicians and health care: state, market or regulation? A false issue]

A cost crisis in the health care sector has focused discussion on health care services and an assessment of the results of investments in the health sector, underlining the importance of medical doctors as key actors in this area. This article reviews the main analytical approaches to professionalism in the last decade and discusses the most recent paradigmatic shifts. New approaches have emerged for correlating the medical division of labor (contained in specialized fields which are becoming more and more fragmented) with structural and historical changes in the professional market, as well as the collective action developed by these interest groups in their relationship to the state. These approaches, more closely linked to political economy, have made important contributions to this debate, because they allow for a questioning of the kind of ideological polarization contained in health care reform proposals aimed at a withdrawal of the state and the rule of the market (with no analytical justification), in addition to shifting regulation to a position outside the historically mutable dynamics between the state, health care providers, and clients of the health care sector and the public policy arena.

Journal Article↗

[Risk of transmission of cholera by fish products: regional perspective in South America].

Cholera returned to South America in January 1991, after almost a century of absence. The hygienic status of the countries affected, aggravated by economic and political difficulties, allowed the disease to spread rapidly. In Peru, fishery products were incriminated from the outset, although without conclusive evidence. However, epidemiological and laboratory findings in other countries have confirmed the transmission of the disease by these products. The authors discuss the effects of the recent cholera epidemic on the trade and consumption of fishery products in countries of South America. The actual risk of cholera transmission by food and in particular by the consumption of fishery products is discussed, and a basis for conducting an accurate evaluation of these risks is proposed. Finally, the authors summarise the measures recommended to prevent the transmission of cholera by fishery products.

Animals↗

Enzyme purification with aqueous two-phase systems: comparison between systems composed of pure polymers and systems composed of crude polymers.

The main drawback when using aqueous two-phase systems for macromolecule purification is the high cost of most polymers used. The purification of an enzyme, alcohol dehydrogenase, from a crude extract of Saccharomyces cerevisiae was tested in systems composed of poly(ethylene glycol) and a crude hydroxypropyl starch or Reppal PES 100, a purified fraction of hydroxypropyl starch. Purification factors measured for the enzyme were very similar in both systems (between 0.8 and 1.4 for both systems in the upper phase). However, systems composed of Reppal PES present a greater recovery of enzyme, between 77% and 100% versus 60% and 100%, while systems composed of crude hydroxypropyl starch exhibit a larger delta log K for the tested ligand, 1.26 versus 0.81.

Alcohol Dehydrogenase↗

[The quality of life after tubal ligation].

OBJECTIVE: To analyse the attitude, physical and psychological repercussions of sterilisation on Portuguese women in order to determine their quality of life. PROJECT: Retrospective study of women submitted to sterilisation between 1988 and 1991, by means of a questionnaire mailed in June 1992. LOCATION: Family planning clinic, S. Francisco Xavier Hospital, Lisbon. POPULATION: Between 1988 and 1991, 540 women were sterilised at the Gynaecology/Obstetrics Department of S. Francisco Xavier, 308 of which were included in the study (women who were sterilised with a pathology which might interfere with the results and those who were sterilised during a caesarean section, post partum or post abortion were excluded). MAIN DETERMINATIONS: Descriptive and demographic data taken from the clinical files and the results of a mailed questionnaire with eleven groups of questions on their attitudes, opinions and behaviour as well as gynaecological and sexual complaints, all with regard to sterilisation. RESULTS: 106 women (34.5%) replied to the mailed questionnaire. An overwhelming majority felt satisfied (97.1%) and well informed (98%) regarding sterilisation. Sexual satisfaction and coital frequency improved or remained the same in 92.1% of the women and a slightly lower number (85.3%) stated that their sexual interest had improved or remained the same. All the women stated that the sexual interest of their partners had not diminished. The symptoms which were most frequently referred to as being worse or which had recurred were alterations in the menstrual cycle (43.1%), dysmenorrhea (16.7%) and mastodynia (16.7%). CONCLUSION: The majority of women (3/4) presented good or very good results in terms of quality of life.

Adult↗

Intercomparison of techniques available at INETI in the analysis of two IAEA candidate research materials.

Under contract with the IAEA, the epiphytic lichen Evernia prunastri was collected to prepare a multielement lichen reference material for quality assurance of environmental studies. An intercomparison run on trace and minor elements in this candidate research material (IAEA-336) was organized in which six analytical groups of the National Institute of Engineering and Industrial Technology (INETI) took part. INAA, PIXE, XRF, AAS, and ICP-ES were applied. The results obtained by different methods are compared, and their complementarity is discussed. As a quality control, the IAEA cabbage research material (IAEA-359) was analyzed. The results agree quite well with the estimated values given by the IAEA.

Environmental Monitoring↗

Tuberculosis infection in urban adolescents: results of a school-based testing program.

In 1986-87 a pilot tuberculosis (TB) skin testing program was introduced for seventh and tenth grade students in the Boston (Massachusetts) public schools. The 8.9 percent tuberculin positivity rate in tenth grade students was significantly higher than the 5.1 percent rate found in seventh graders. A majority of those who were skin test positive were born outside the United States. These results suggest that tuberculin testing in an urban school setting may identify a significant number of candidates for TB preventive therapy, particularly among tenth grade students and those who are foreign-born.

Adolescent↗