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Biomedical subjects

C Miranda

Publications and source records attributed to C Miranda.

At least 37 records · Page 2Linked to original sources
PubMed2000

Clinical significance of polymicrobial versus monomicrobial bacteremia involving Pseudomonas aeruginosa.

The objective of this study was to examine the clinical significance of polymicrobial bacteremia involving Pseudomonas aeruginosa. Two hundred forty-eight episodes of Pseudomonas aeruginosa bacteremia, 43 of which were polymicrobic, were studied prospectively over a 6-year period. Three sets of blood cultures were obtained for each patient. Positive results for all three blood cultures were found more frequently in patients with polymicrobial infection, who were older than those with monomicrobial infection. Patients with polymicrobial bacteremia also were worse clinically and developed shock more frequently. Crude mortality was higher in patients with polymicrobial infection. A multivariate analysis revealed three variables significantly and independently associated with polymicrobial Pseudomonas aeruginosa bacteremia: higher age, poor clinical status of the patient, and positive results for all blood cultures obtained.

Adult↗
PubMed1999

Mercury contamination associated with artisanal gold mining on the island of Mindanao, the Philippines.

The Agusan River basin of eastern Mindanao, the Philippines, hosts several centres of artisanal gold mining, the most important of which, Diwalwal, is a significant gold producer in global terms. An investigation of the environmental impacts of artisanal mining in the Agusan system, with particular reference to mercury contamination, was initiated in 1995 following reports of several incidents of human Hg poisoning in the province of Davao del Norte. Results show drainage downstream of Diwalwal is characterised by extremely high levels of Hg both in solution (maximum 2906 micrograms/l) and in bottom sediments (> 20 mg/kg). Filtered surface water Hg levels exceed the WHO Drinking Water guideline and the US-EPA Water Quality Criteria for the Protection of Aquatic Life for a downstream distance of more than 14 km, including channel sections utilised for fishing and potable water supply. The Environment Canada sediment quality Hg Toxic Effect Threshold for the Protection of Aquatic Life is exceeded for a downstream distance of 20 km. Hair Hg data indicate that ballmill and CIP plant operators processing Hg contaminated tailings at eastern Mindanao's principal gold beneficiation centre, Apokon, may be subject to enhanced occupational Hg exposure. It appears that the wider population of this area has not been affected.

Geologic Sediments↗
PubMed1999

Effects of two types of pillows on bilateral sternocleidomastoid EMG activity in healthy subjects and in patients with myogenic cranio-cervical-mandibular dysfunction.

This study was conducted in order to determine the effects of two types of pillows on bilateral electromyographic (EMG) activity of the sternocleidomastoid muscles. The study was performed on 15 patients with myogenic cranio-cervical mandibular dysfunction (CMD) and 15 healthy subjects. EMG recordings at rest and during swallowing of saliva and maximal voluntary clenching were performed by placing surface electrodes on the right and left sternocleidomastoid muscles. EMG activity was recorded in the supine position and in the lateral decubitus position (according to each individual's normal resting habit), with their eyes closed and with the head supported by means of: 1. a Sleep Easy Pillow (Interwood Marketing Groups, Concord, Ontario, Canada) and 2. a Standard Pillow (INDUVET). In the lateral decubitus position a significantly higher contralateral than ipsilateral EMG activity at rest in the sternocleidomastoid muscles was observed with both types of pillows in all the sample studied (ANOVA and Duncan's Multiple-Range Test). Asymmetrical bilateral EMG activity in the lateral decubitus position with both types of pillows in healthy subjects and in patients with myogenic CMD, suggests that if this body posture is prolonged, it could be important in the genesis of sternocleidomastoid hyperactivity.

Adult↗
PubMed1999

[Pancreatic intubation by endoscopy in chronic calcifying pancreatitis].

BACKGROUND: The aim of our study was to assess the efficacy of endoscopic pancreatic stenting on pain and frequency of acute pancreatitis in patients with calcifying chronic pancreatitis. PATIENTS: Between 1987 and 1996, 70 patients underwent endoscopic management for calcifying chronic pancreatitis. RESULTS: Endoscopic stent placement was successful in 59 patients (85%). 46 patients were followed for a mean duration of 29 +/- 26.4 months after stent removal. The presence of pancreatic pseudocysts in 26 patients appeared to modify pain improvement rate but did not influence the decrease in the frequency of acute pancreatitis. An improvement of pancreatic pain occurred at the end of stenting and after removal of the stent in respectively 44% and 38% of the patients without pseudocysts and in 85% (P < 0.02) and 65% of the patients presenting with pancreatic pseudocysts. Before stenting, 43/70 (61%) patients had at least two episodes of acute pancreatitis. After removal of the stent, only 5/46 (11%) had one episode of acute pancreatitis. Improvement of weight loss and diabetes was observed in respectively 28 cases (52%), 7 cases (39%) at the end of pancreatic stenting and was still persisting in 21 (51%) and 5 cases (26%) after removal of the stent. CONCLUSION: After pancreatic stenting, the improvement of pain appears to be moderate in the absence of pancreatic pseudocyst. Nevertheless, the improvement of pain is maintained after stent removal. Moreover, the frequency of acute pancreatitis is significantly decreased after pancreatic stenting.

Adult↗
PubMed1998

Role of the TFG N-terminus and coiled-coil domain in the transforming activity of the thyroid TRK-T3 oncogene.

The thyroid TRK-T3 oncogene results from the fusion of the tyrosine kinase (TK) domain of NTRK1 (one of the receptors for the Nerve Growth Factor) on chromosome 1 to sequences of a novel gene, TFG, on chromosome 3. The 68 kDa TRK-T3 fusion oncoprotein displays a constitutive tyrosine kinase activity resulting in its capability to transform mouse NIH3T3 cells. The TFG portion of TRK-T3 contains a coiled-coil domain most likely responsible for the constitutive, ligand-independent activation of the receptor tyrosine kinase activity. We have previously shown that TRK-T3 oncoprotein forms, in vivo, complexes of three or four molecules. By mean of different experimental approaches, we show here that TRK-T3 activity depends on oligomers formation. In addition, the analysis of different TRK-T3 mutants indicates that the TFG coiled-coil domain and its N-terminal region are both required for the activation and the fully transforming activity of the TRK-T3 oncoprotein, although, most likely, they play a role in different steps of the transforming process. The deletion of the coiled-coil domain abrogates the oligomers formation leading to a constitutive activation; the deletion of the N-terminal region, although not affecting phosphorylation and complexes formation, abrogates transformation, thus suggesting a role in cellular localization and/or interaction with substrata.

3T3 Cells↗
PubMed1998

[Satellite remote sensing as a tool for the analysis of the occurrence of American cutaneous leishmaniasis in an urban area of southeastern Brazil].

INTRODUCTION: The occurrence of American cutaneous leishmaniasis in the region of the Paraiba valley and the Northern shore of the State of S. Paulo, Brazil, is studied by remote sensing satellite imagery and maps of the region. METHOD: The places where infections might have occurred were plotted on a false color composition made up of Landsat TM-3, 4 and 5 band images, the relevant vegetation (shrubs and trees) has been identified and correlations were sought for those areas seen as areas of risk for the disease and the environmental characteristics and their changes. The maps made it possible to add to the composite image the creeks and the contours of the tops of the large number of hills found in that region. RESULTS: An area is characterized which may prove to be a macro-habitat for vectors, reservoirs and etiological agents. The search for changes in the landscape and the evaluation of meteorological data has not yielded any possible additional risk factor. CONCLUSIONS: There is full correlation among the areas considered to present risk of infection and the presence of creeks and relevant vegetation (shrubs and trees).

Brazil↗
PubMed1998

Treatment of chronic Chagas' disease with itraconazole and allopurinol.

Four hundred four patients with chronic Chagas' disease were treated with itraconazole (6 mg/kg of body weight/day for 120 days), allopurinol (8.5 mg/kg of body weight/day for 60 days), or with a placebo of pure starch. Patients were monitored over a period of four years by clinical examination, serology, xenodiagnosis, hemoculture, and electrocardiogram. Drug tolerance was good, with only four treatments discontinued due to side effects that subsided after suspension of treatment. Parasitologic cure was evident in 44% of the those treated with allopurinol and 53% of those treated with itraconazole, and the electrocardiographic evaluation showed normalization in 36.5% and 48.2%, respectively, of patients with chronic or recent cardiopathy.

Adolescent↗
PubMed1997

Oral lichen planus: epidemiology, clinical characteristics, and associated diseases.

Oral lichen planus (OLP) is a chronic inflammatory disease, the cause of which remains unknown. In the last few years, significant advances have been made in understanding the mechanisms involved in the pathogenesis of the disease. Data on HLA markers for OLP vary depending on the population studied. OLP is a disease primarily of adults (50 to 55 years of age) and predominantly affects women. Any site in the oral cavity may be involved, but the buccal mucosa and gingiva are the most common sites. OLP can have different clinical presentations, with the reticular, erosive, and atrophic types being the most commonly reported. OLP has been reported to be associated with different medical conditions such as diabetes, hepatitis C infection, liver disease, and oral cancer. With the exception of oral cancer, there are not good data to support such associations. The question that remains to be answered is why we see a higher prevalence of oral carcinoma in patients with OLP. The relative prevalence from our series was 1.2%. Therefore, we believe patients with OLP have a higher risk for oral cancer and should be monitored for malignant transformation once a year.

Adult↗
PubMed1997

Oral lichen planus: topical and systemic therapy.

The treatment of oral lichen planus (OLP) remains a real challenge for clinicians who deal with this patient population and thus with diagnosis of this disease. Most treatment failures are attributable to improper diagnosis. Therefore, before a patient is started on therapy, a biopsy must be done and the diagnosis established. Most patients with OLP are asymptomatic, and once the diagnosis is established, patients need to be seen once a year to monitor their disease. However, when OLP is symptomatic, it can interfere with the patient's everyday life, making it difficult to work and to eat. The most symptomatic forms of the disease are the erosive and atrophic types. Often, systemic therapy is the only way to control the acute presentation of the disease. The most effective treatment modality to control the signs and symptoms of the disease is short courses of systemic steroids (prednisone) and topical high-potency corticosteroids. Other forms of therapy include the use of cyclosporine (topical) and retinoids, both systemic (etretinate) and topical (tretinoin). However, there is no one single standard protocol proven effective with either systemic retinoids or topical cyclosporine. Results so far are controversial and not very encouraging. One aspect clinicians must remember when designing treatment protocols for erosive OLP is the chronic course of the disease and its recalcitrant nature. These factors mean that treatment has to be long, and the onset of adverse side effects from long-term therapy must be taken into account. Alternate-day treatment protocols, low doses, and adjunct therapy all should be considered when a new agent is being considered for treating erosive OLP.

Administration, Topical↗
PubMed1997

Nontyphoidal salmonella intracranial infections in HIV-infected patients.

Salmonella focal intracranial infections are unusual in human immunodeficiency virus (HIV)-infected patients. Six such infections have been reported in the world literature. We report a case of salmonella subdural and epidural cerebral empyema with concomitant osteomyelitis of the frontal bone. Such a complication in the course of salmonellosis is reported for the first time. In previously published case reports, four patients had brain abscess and two had subdural empyema. Salmonella typhimurium was isolated from two patients, and different serotypes were recovered from the others. All patients had advanced HIV disease, and all but two had had opportunistic infections before the diagnosis of salmonella intracranial infection. Surgical drainage combined with systemic antibiotic therapy resulted in the recovery of four of five patients. No regression of the lesions occurred in one patient treated only with antibiotics for multiple cerebral abscesses.

AIDS-Related Opportunistic Infections↗
PubMed1997

Endocarditis caused by nonhemolytic group B streptococcus.

We report a case of bacterial endocarditis caused by nonhemolytic group B streptococcus (GBS) in a 67-year-old man with no predisposing risk factors. Nonhemolytic GBS strains rarely cause illness and are usually detected in perinatal infections. We believe this to be the first reported case of endocarditis caused by a nonhemolytic strain of GBS.

Aged↗
PubMed1997

Chromosome 1 rearrangements involving the genes TPR and NTRK1 produce structurally different thyroid-specific TRK oncogenes.

The NTRK1 gene in the q arm of chromosome 1 encodes one of the receptors for the nerve growth factor and is frequently activated as an oncogene in papillary thyroid carcinomas. The activation is due to chromosomal rearrangements juxtaposing the NTRK1 tyrosine kinase domain to 5'-end sequences from different genes. The thyroid TRK oncogenes are activated by recombination with at least three different genes: the gene coding for tropomyosin and TPR, both on chromosome 1,and TFG on chromosome 3. In a previous study, we showed that two tumors carrying the TPR/NTRK1 rearrangement contained structurally different oncogenes named TRK-T1 and TRK-T2. In this paper, we report (1) the cDNA structure of TRK-T2, (2) evidence that TRK-T2 is generated by different rearrangements in two thyroid tumors, and (3) a detailed analysis of the three different TPR/NTRK1 rearrangements. With molecular studies based on Southern blot hybridization, cloning, and sequencing, we show that all the rearrangements are nearly balanced, involving deletion, insertion, or duplication of only few nucleotides. In one case, an additional rearrangement involving sequences derived from chromosome 17 was detected.

Base Sequence↗
PubMed1997

[Inflammatory pseudotumor of the spleen].

A case of inflammatory pseudotumor of the spleen in a 69-year-old woman who was studied for elevated globular sedimentation rate is presented. The lesion was observed on echography as a mixed solid-cystic mass. Magnetic resonance showed a slight decrease in signal intensity in potentiated T1 sequences and a heterogenic mass with high signal areas in T2 images and protonic density. Splenectomy was performed and histopathologic study demonstrated an inflammatory pseudotumor of 10 cm in its greatest size. Two year follow up was satisfactory. On review of the literature only 34 cases of inflammatory pseudotumors have been previously published. Half of the cases presented during the 6th and 7th decades of life, with women being the most frequently affected. Inflammatory pseudotumors of the spleen are benign lesions which should be considered in the differential diagnosis of splenic masses. Since diagnosis cannot be made preoperatively, and a malignant tumor is almost always suspected, splenectomy should be performed.

Aged↗
PubMed1996

The effects of acetyl-L-carnitine and sorbinil on peripheral nerve structure, chemistry, and function in experimental diabetes.

Nerve conduction velocity (NCV) increased with age in nondiabetic male Wistar rats for the first 26 weeks of life. The NCV of animals made hyperglycemic at age 6 weeks by administration of streptozotocin (STZ) also increases, but at a slower rate. Animals with 4 weeks of hyperglycemia and reduced NCV treated with an aldose reductase inhibitor (sorbinil) or a short-chain acyl-carnitine (acetyl-L-carnitine [ALC]) daily for 16 weeks showed an improvement in NCV. Morphometric studies of tibial nerves collected from animals after 20 weeks of hyperglycemia (age 26 weeks) showed a consistent reduction in the width of the myelin sheath and little change in axon area. The number of large myelinated fibers (>6.5 microns) found in nerves collected from hyperglycemic animals was less than the number found in nondiabetic animals. Treatment of hyperglycemic rats with either sorbinil or ALC was associated with increased NCV, myelin width, and large myelinated fibers. The apparent metabolic effect of these agents was similar for fatty acid metabolism, but different for polyol pathway activity. We conclude that in animals hyperglycemic long enough to slow NCV, sorbinil and/or ALC treatment reduces the functional, structural, and biochemical changes associated with hyperglycemia that occur in the myelin sheath.

Acetylcarnitine↗