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Biomedical subjects

C Elias

Publications and source records attributed to C Elias.

At least 19 recordsLinked to original sources
PubMed2006

[Prolonged convulsions treated with buccal midazolam in a setting of mentally retarded patients with refractory epilepsy].

INTRODUCTION: Convulsive status epilepticus is a common major complication of epilepsy that results in high morbidity and mortality. Early treatment of prolonged seizures with rectal diazepam has been the method of choice in order to avoid this complication. However, several randomized trials in recent years suggest that buccal midazolam is as effective and safe as rectal diazepam. This study aims to seek further confirmation of the efficacy and safety of buccal midazolam in daily clinical practice. METHOD: Ten out of 73 adult epileptic patients who were residents in a center for people with severe encephalopathy were included. We recorded all seizures over a one-year period. Prolonged seizures, defined as a seizure lasting one minute or longer, were treated by placing buccal midazolam 5 mg (1 ml) between the lower lip and the gum. We administered a second dose of midazolam when the seizure lasted more than two minutes and a third dose of midazolam, or a combination of rectal diazepam 5 mg together with midazolam, as a rescue therapy when the seizure lasted for more than 3 minutes. Vital constants were monitored. RESULTS: We treated 52 prolonged seizures in 10 patients enrolled in the study. The treatment was effective with a single dose within two minutes in 80.7% of seizures. No cardiorespiratory complications were detected and no patients presented a convulsive status epilepticus. CONCLUSION: Buccal midazolam is effective and safe in the treatment of prolonged seizures and has the advantage of being a convenient and socially acceptable administration form.

Administration, Oral↗
PubMed2005

Measurement of perceived competence in Dutch children with mild intellectual disabilities.

BACKGROUND: Little research has been conducted on the perceived competence of children with mild intellectual disabilities (MID). One of the reasons for the marked absence of research appears to be the lack of reliable and clearly valid measurement instruments for this particular group of children. In the present study, it was examined whether a pictorial scale originally designed to measure perceived competence in typically developing children could successfully be used with children with MID. METHODS: The pictorial scale was administered to a group of 106 children with MID. The construct validity, reliability and stability of the scale were investigated. RESULTS: The results of the exploratory factor analyses and the confirmatory factor analyses supported the conceptual framework proposed. The construct validity was also supported by the pattern of intercorrelations between the subscales. The scale had adequate internal consistency and the stability analyses showed sufficient stability across a 4-month period. CONCLUSIONS: The findings show the psychometric properties of the pictorial scale to justify its use with children with MID.

Child↗
PubMed2001

Women's willingness to participate in microbicide trials in Northern Thailand.

To assess women's interests and concerns regarding participation in trials of microbicides in Chiang Rai, Thailand, we administered structured questionnaires. Before answering the questionnaire, women attended an educational session on microbicides and clinical trials. Of 370 participants, 82% correctly answered 8 or more of the 11 overall comprehension questions, indicating an adequate knowledge base among the women from which to answer questions about attitudes toward microbicide trials. The most common motivations for participating in a trial were "getting tested for HIV" and "doing something good for women's health." The greatest barrier to participation was women's fear that if they proposed use of a microbicide, their husbands might feel protected and thereby have more sex partners. Overall, 6.2% said they would be "definitely willing to participate," and 66.8% said they wanted to participate but wanted to think about it. Most women previously unacquainted with the concept of microbicides or clinical trial design displayed adequate knowledge of these subjects after the short educational session. If women's initial reactions are validated by actual willingness, surveys could prove valuable for selecting sites for microbicide trials, estimating enrollment rates, and tailoring trials to make them most acceptable to women.

Adult↗
PubMed2001

Acceptability research on female-controlled barrier methods to prevent heterosexual transmission of HIV: Where have we been? Where are we going?

Acceptability research is an important component of any product development process. As researchers move into a new, accelerated phase of vaginal microbicide development, it is important to take stock of the acceptability research conducted to date and determine future research priorities. In this paper, we review findings from acceptability research conducted to date in four categories: hypothetical product acceptability research, existing product research (spermicide acceptability studies), acceptability research within the context of clinical trials, and postmarketing acceptability research conducted around the female condom. Finally, we highlight areas where additional research is needed in light of recent progress in microbicide development and discuss a possible framework for the introduction and acceptability of new sexually transmitted disease (STD) prevention technologies.

Administration, Intravaginal↗
PubMed2000

Screening and syndromic approaches to identify gonorrhea and chlamydial infection among women.

The standard diagnostic tools to identify sexually transmitted infections are often expensive and have laboratory and infrastructure requirements that make them unavailable to family planning and primary health-care clinics in developing countries. Therefore, inexpensive, accessible tools that rely on symptoms, signs, and/or risk factors have been developed to identify and treat reproductive tract infections without the need for laboratory diagnostics. Studies were reviewed that used standard diagnostic tests to identify gonorrhea and cervical chlamydial infection among women and that provided adequate information about the usefulness of the tools for screening. Aggregation of the studies' results suggest that risk factors, algorithms, and risk scoring for syndromic management are poor indicators of gonorrhea and chlamydial infection in samples of both low and high prevalence and, consequently, are not effective mechanisms with which to identify or manage these conditions. The development and evaluation of other approaches to identify gonorrhea and chlamydial infections, including inexpensive and simple laboratory screening tools, periodic universal treatment, and other alternatives must be given priority.

Algorithms↗
PubMed2000

Preliminary safety and acceptability of a carrageenan gel for possible use as a vaginal microbicide.

OBJECTIVE: We sought to determine the safety and acceptability of vaginal gel formulation PC-503 among low risk, abstinent women. The active ingredient was 2% pharmaceutical grade lambda carrageenan, a sulphated polymer that is generally recognised as safe by the US Food and Drug Administration. METHODS: 35 women in five sites applied 5 ml of the PC-503 gel vaginally once a day for 7 days while abstaining from sexual intercourse. Visual vaginal examinations were performed on days 1, 4, and 8. STI testing and vaginal pool Gram stain preparations were done on days 1 and 8. Participants were asked about product acceptability. RESULTS: 34 of the 35 women enrolled completed 7 days' use. Following product use, five reported mild symptoms including "bladder fullness," "genital warmth," or discomfort, and lower abdominal pain, and one had moderate pale yellow cervical discharge. Using the Nugent criteria, three women had bacterial vaginosis (BV) before and after use; three had BV before but not after, and two had BV after but not before. Most of the women found PC-503 to be pleasant or neutral in feel and smell and considered extra lubrication to be an advantage; however, one third found it to be messy. CONCLUSIONS: Vaginal use of PC-503 gel did not cause significant adverse effects in a small number of low risk, sexually abstinent women. Further testing in larger numbers of sexually active women is planned. A smaller volume of gel may be more acceptable to some women.

Anti-Infective Agents, Local↗
PubMed1997

Molecular cloning and functional characterization of a novel CC chemokine, stimulated T cell chemotactic protein (STCP-1) that specifically acts on activated T lymphocytes.

A novel human chemokine STCP-1 (stimulated T cell chemotactic protein) was isolated from an activated macrophage cDNA library. The chemokine has four cysteines positioned in a manner that identifies STCP-1 as a member of the CC chemokine family. The amino acid sequence shows 34% identity with RANTES. The gene consists of 3 exons and 2 introns with the position of intron/exon boundaries similar to that of RANTES. The gene is expressed as a 3.4-kilobase transcript on lymph node, thymus, and Appendix. STCP-1 induces Ca2+ mobilization in a small percentage of primary activated T lymphocytes, but on repeated stimulation the percentage of T lymphocytes that respond to STCP-1 increases. The chemokine STCP-1 does not induce Ca2+ mobilization in monocytes, dendritic cells, neutrophils, eosinophils, lipopolysaccharide-activated B lymphocytes, and freshly isolated resting T lymphocytes. Similarly, STCP-1, while acting as a mild chemoattractant for primary activated T lymphocytes, is a potent chemoattractant for chronically activated T lymphocytes but has no chemoattractant activity for monocytes, neutrophils, eosinophils, and resting T lymphocytes. As STCP-1 acts specifically on activated T lymphocytes, it may play a role in the trafficking of activated/effector T lymphocytes to inflammatory sites and other aspects of activated T lymphocyte physiology.

Amino Acid Sequence↗
PubMed1995

Transforming aids prevention to meet women's needs: a focus on developing countries.

As currently conceived, the global AIDS prevention strategy consists primarily of three interrelated tactics: (1) encouraging people to reduce their number of sexual partners; (2) promoting the widespread use of condoms; and (3) treating concurrent STDs in populations at risk of HIV. This three-pronged attack, however, is inadequate for meeting the protection needs of many of the world's women. Disproportionately poor and with little power to negotiate the terms of sexual encounters, women often cannot avail themselves of these life-saving strategies. Women need both a new commitment to addressing the underlying inequities that heighten their risk, and new technologies that provide them with a means of HIV protection within their personal control. This article makes the case for restructuring AIDS prevention by describing the growing risk of HIV infection faced by women throughout the world, examining the serious limitations of the contemporary AIDS prevention strategy in meeting women's needs, and exploring how new approaches--including a shift toward a more 'community organizing' approach to AIDS prevention--could help women exert more control over their sexual and reproductive lives.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Spermicides and barrier contraception.

The contraceptive failure rate of condoms varies from 2 to 13%, depending on the study population, yet it is the contraceptive method with the greatest capacity to protect against sexually transmitted diseases (STDs) and AIDS. Breakage and slippage during intercourse are important causes of failure, and individual behavior leading to consistent and correct use is the most important factor in condom effectiveness. Female-controlled barrier methods may actually prevent more STDs than condoms, because of their more consistent use. Using the diaphragm continuously and without spermicide was well accepted and effective in preventing pregnancy in one study. The female condom appears to have a contraceptive effectiveness close to that of other vaginal methods. It is likely that it also protects against STDs and AIDS. Nonoxynol-9 appears to have a protective effect against some STDs and the data concerning the protective effect of spermicides containing nonoxynol-9 against HIV is conflicting, yet suggests some protection, especially if products are used with relatively low frequency that avoids dose-dependent vaginal irritation. New spermicides which could also protect against viral infection without affecting epithelial cells are currently being studied.

Acquired Immunodeficiency Syndrome↗
PubMed1993

The effect of trauma and confinement on functional health and mental health status of Cambodians living in Thailand-Cambodia border camps.

OBJECTIVE: To assess the long-term impact of trauma and confinement on the functional health and mental health status of Cambodian displaced persons living on the Thailand-Cambodia border. DESIGN: Household survey of 993 adults randomly selected from household rosters. Household sample selection by multistage area probability sample. SETTING: Site 2, the largest Cambodian displaced-persons camp on the Thailand-Cambodia border. PARTICIPANTS: Adults 18 years of age and older selected at random within households; 98% of eligible persons selected agreed to participate. RESULTS: From 1975 through 1979 (Khmer Rouge regime), more than 85% reported lack of food, water, shelter, and medical care, brainwashing, and forced labor; 54% reported murder of a family member or friend; 36% reported torture; 18% reported head injury; and 17% reported rape or sexual abuse. During the refugee period between 1980 and 1990, 56% reported lack of food or water, 44% reported lack of shelter, 28% reported lack of medical care, 24% reported brainwashing, and 8% reported torture. Since 1980, reports of murder of a family member, head injury, and rape/sexual abuse have decreased to 5%. Reports of experiencing combat situations and shelling attacks have remained consistent between the two time periods, approximately 44% and 30%, respectively. From 1989 to 1990, 25% reported experiencing lack of food or water, and 5% to 10% reported serious injury, combat, and shelling conditions. More than 80% said they were in fair or poor health, felt depressed, and had a number of somatic complaints despite good access to medical services. Fifty-five percent and 15% had symptom scores that correlate with Western criteria for depression and posttraumatic stress disorder, respectively. Fifteen percent to 20% reported health impairments limiting activity, and moderate or severe bodily pain. Despite reported high levels of trauma and symptoms, social and work functioning were well preserved in the majority of respondents. CONCLUSIONS: Reports of extensive trauma, poor health status, and depressive symptoms of this population are of concern in predicting future morbidity and mortality. The health and mental health needs of Cambodian displaced persons and their impact on social and economic behavior should be addressed now that the Cambodians have been repatriated.

Adult↗
PubMed1985

Placebo therapy for postmenopausal osteoporosis.

Eighteen postmenopausal osteoporotic (PMO) women on placebo therapy were followed for 1 year. Serial measurements of calcium balance and kinetics, bone histomorphometry, photon absorptiometry, and radiogrammetry were obtained. Few significant changes in balance and kinetics or bone histology were seen in these women over time. Photon absorptiometry and radiogrammetry of the femoral cortex showed a significant annual bone loss however. When compared with premenopausal and healthy postmenopausal women, the annual bone loss in those with PMO was significantly greater. The ability of balance studies, photon absorptiometry, and radiogrammetry to predict the magnitude of this bone loss was similar. Finally, there was an illustration of the use of the estimated variance provided by this study for estimating sample size for future studies.

Aged↗