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Biomedical subjects

F Nunes

Publications and source records attributed to F Nunes.

At least 19 recordsLinked to original sources

Direct analysis of human blood (mothers and newborns) by energy dispersive X-ray fluorescence.

This work is an application of energy dispersive X-ray fluorescence (EDXRF) as analytical technique for trace element determination in human tissues. Potassium (K), calcium (Ca), iron (Fe), copper (Cu), zinc (Zn), bromine (Br), rubidium (Rb) and lead (Pb) were determined directly in blood samples from 66 mothers at delivery after full-term pregnancies. The corresponding 66 cord-blood samples of the newborns were also analysed, in order to find element correlations between maternal and newborn blood at birth. The studied samples were obtained from mothers aged between 15 and 39 years old, the gestational age being between 35 and 41 weeks and the newborns' weight between 2.310 and 4.310 kg. Samples were lyophilised and analysed without any chemical treatment. Very low levels of Pb were found both in maternal and fetal cord blood samples. Cu values ranged from 3 to 13 microg g-1, both for mothers and children. A correlation between Cu and Fe concentrations in maternal and fetal cord blood was found. Zn is considered as one of the key elements in newborn health. Concentrations between 10 and 40 microg g-1 were measured. A positive correlation between Br levels in mothers and children was observed. Positive correlations for mothers were observed between Zn and Rb as well as K and Fe. The corresponding correlations in fetal cord blood samples were not observed, however positive correlations were found between Ca and K; Cu and Fe. The mean concentrations for each element were similar in maternal and in fetal cord blood, except for Cu and Zn, being higher in maternal samples. No correlations between element concentrations and pathologies of the mothers were observed.

Adolescent↗

Domino liver transplant: influence on the number of donors and transplant coordination.

The shortage of organs forces coordinators to seek new forms of generating organs for transplantation of the increasing numbers of patients on waiting lists. A recent technique called sequential transplant or domino liver transplant (DLT) allows the transplantation of a patient with chronic liver disease by implantation of a full-size liver derived from a patient with familial amyloidosis polyneuropathy (FAP) who receives a cadaveric graft. Therefore, it is possible to transplant two patients with only one cadaveric liver. The present report illustrates the use of this technique for the first time in our country, thereby increasing the number of hepatic transplants by 25%.

Humans↗

Dermatomycoses caused by Nattrassia mangiferae in São Paulo, Brazil.

Nattrassia mangiferae formerly known as Hendersonula toruloidea, is a phaeoid coelomycete described by Nattrass in 1933. We report five cases of N. mangiferae infections in São Paulo, Brazil. This fungus was isolated from interdigital lesions on the feet in one patient, toenails in three cases and fingernails in the other one. The infections were initially considered to be caused by a dermatophyte. Although there are only a few cases described in the medical literature, the five cases reported suggest that N. mangiferae should be taken into consideration in the differential diagnosis of tinea pedis infections.

Adult↗

Trace elements determination by energy dispersive X-ray fluorescence (EDXRF) in human placenta and membrane: a comparative study.

This work is an application of energy dispersive X-ray fluorescence (EDXRF) as an analytical technique for trace elemental determination in human membrane and placenta and elemental concentrations correlations in both tissues. Whole samples were collected during the delivery from healthy mothers and full-term pregnancies. The age of the mother was between 25 and 40 years old, and the weight of the infants ranged from 2.56 to 4.05 kg. Samples were lyophilised and analysed without any chemical treatment. No significant differences in elemental content of placenta and membrane samples were observed except for Ca. Very low levels of Se, As and Pb were observed in all the analysed samples. Zn, considered as one of the key elements in newborn health, was not significantly different in the analysed samples, all of which originated from healthy mothers and healthy babies. The obtained values agree with the literature except for Ca, which is much higher in the studied samples.

Adult↗

Sensory organ generation in the chicken inner ear: contributions of bone morphogenetic protein 4, serrate1, and lunatic fringe.

The chicken inner ear is a remarkably complex structure consisting of eight morphologically distinct sensory organs. Unraveling how these sensory organs are specified during development is key to understanding how such a complex structure is generated. Previously, we have shown that each sensory organ in the chicken inner ear arises independently in the rudimentary otocyst based on Bone morphogenetic protein 4 (Bmp4) expression. Here, we compare the expression of Bmp4 with two other putative sensory organ markers, Lunatic Fringe (L-fng) and chicken Serrate1 (Ser1), both of which are components of the Notch signaling pathway. L-fng and Ser1 expression domains were asymmetrically distributed in the otic cup. At this early stage, expression of L-fng is similar to Delta1 (Dl1), in an anteroventral domain apparently corresponding to the neurogenic region, while Ser1 is expressed at both the anterior and posterior poles. By the otocyst stage, the expression of both L-fng and Ser1 largely coincided in the medial region. All presumptive sensory organs, as identified by Bmp4 expression, arose within the broad L-fng- and Ser1-positive domain, indicating the existence of a sensory-competent region in the rudimentary otocyst. In addition, there is a qualitative difference in the levels of expression between L-fng and Ser1 such that L-fng expression was stronger in the ventral anterior, whereas Ser1 was stronger in the dorsal posterior region of this broad domain. This early difference in expression may presage the differences among sensory organs as they arise from this sensory competent zone.

Age Factors↗

Randomized comparison between intravaginal misoprostol and dinoprostone for cervical ripening and induction of labor.

OBJECTIVE: We sought to evaluate the efficacy and safety of intravaginal misoprostol and dinoprostone for labor induction. STUDY DESIGN: One hundred eighty-nine women with singleton term pregnancies and unfavorable cervices were randomly assigned to receive intravaginal misoprostol or dinoprostone. The outcome variables were change in Bishop score, time from application to active phase of labor and delivery, fetal and maternal morbidity, and the incidence of cesarean deliveries. RESULTS: The interval from application of the initial dose to the beginning of the active phase of labor was 9.8 +/- 5.8 and 14.2 +/- 10.2 hours (P <.01), and the interval from initial dose to delivery was 15.3 +/- 9.8 and 19.1 +/- 13.2 hours (P =.027) for the misoprostol and dinoprostone groups, respectively. There were no significant differences in Bishop score change, cesarean delivery rate, and the incidence of tachysystole, hypersystole, and hyperstimulation. No maternal and neonatal adverse effects were noted. CONCLUSION: Intravaginal misoprostol is more effective than intravaginal dinoprostone for labor induction in low-risk patients at term with unfavorable cervices.

Administration, Intravaginal↗

An audit of European training in obstetrics and gynaecology.

During 1997, The European Network of Trainees in Obstetrics and Gynaecology (ENTOG) circulated a questionnaire to audit training in Europe. Results describe number and gender in each country, access to training, duration of training, tutor/tutee scheme, logbooks, minimum curriculum, assessment, criteria for accreditation, training abroad, final examination, hospital inspection, subspecialty, academic training, and career progression. Quality of life is tried to address with questions relating to salary, working hours, maternity leave, annual leave and study leave. EBCOG has drawn up recommendations to try and achieve a standardisation of quality of training whilst fully understanding that complete standardisation of training is not a realistic possibility due to social, cultural and ethical differences. A repeat audit is planned after 3 years to close the feedback loop.

Education, Medical, Graduate↗

Induction of labor with intravaginal administration of misoprostol.

OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of intravaginal misoprostol for labor induction. METHODS: 110 singleton term pregnancies with or without rupture of membranes were enrolled. Fractionated doses of misoprostol were applied (50-100 microg), every 6 h until a maximum of three doses or beginning of labor. RESULTS: The average interval (+/- S.D.) from vaginal application to the beginning of active labor and to delivery were, respectively, 9.5 +/- 5.7 h and 14.8 +/- 9.5 h. Failed labor induction was observed in two cases (2%). Cesarean section rate was 14%. The incidence of tachysystole was 18% and hypersystole 4%, but these situations were associated with abnormal fetal heart rate pattern (hyperstimulation) in only 3%. No maternal side effects and neonatal adverse effects were noted. CONCLUSIONS: Intravaginal misoprostol administration with low doses is an effective and safe method for labor induction in term pregnancies, with or without rupture of membranes.

Administration, Intravaginal↗

Aeroallergens and work-related respiratory symptoms among office workers.

OBJECTIVE: We sought to determine the association between office workers' respiratory tract symptoms and immediate skin test reactions with exposure to fungal and house dust mite aeroallergens at their work sites. METHODS: An initial prevalence survey was conducted among 1102 full-time workers in six mechanically ventilated, air-conditioned, nonindustrial buildings in downtown Montreal. Detailed environmental measures of 214 subjects' work sites were determined. Half of the workers reported frequent work-related respiratory tract symptoms on the initial survey. Participants simultaneously underwent allergy skin prick testing and completed a second self-administered questionnaire. RESULTS: Contaminant levels were low and not associated with symptoms in the great majority of workers. For approximately 17% of workers, symptoms were associated with exposure to total concentrations of house dust mite allergen greater than 1 microg/gm floor dust (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.3, 19.5]) or to detectable airborne Alternaria allergens in their offices (OR, 3.3; 95% CI, 1.2, 9.4 and in the ventilation system supplying their offices (OR, 3.9; 95% CI, 1.6, 9.6). Workers with positive skin test reactions to Alternaria extract were exposed at their work site to airborne Alternaria allergen (OR, 4.4; 95% CI, 1.4, 14.5) and cited significantly more respiratory symptoms on both questionnaires. Detection of airborne Alternaria allergen at work sites was significantly associated with detection in the ventilation system (OR, 4.0; 95% CI, 1.4,10.9); this was in turn associated with lower efficiency filters. CONCLUSIONS: Potentially avoidable exposure to aeroallergens accounted for symptoms in a small subgroup of office workers with frequent work-related respiratory tract symptoms.

Adult↗

The expression domain of two related homeobox genes defines a compartment in the chicken inner ear that may be involved in semicircular canal formation.

Homeobox-containing genes encode a class of proteins that control patterning in developing systems, in some cases by acting as selector genes that define compartment identity. In an effort to demonstrate a similar role for such genes during ear development in the chicken, we present a detailed expression study of two related homeobox-containing genes, SOHo-1 and GH6, using in situ hybridization. At otocyst stages the two genes define a broad lateral domain of expression, which may represent a developmental compartment. Three-dimensional computer reconstructions of SOHo-1 expression at these and later stages revealed that the lateral domain becomes progressively restricted to the three semicircular canals. Thus, SOHo-1 and GH6 are among a small group of markers for a specific structural component of the inner ear. The gene expression domain initially includes the sensory regions of the semicircular canals, known as the cristae ampullaris, but none of the other four sensory organs which were recognizable by BMP4 expression during early morphogenesis (stages 19-24). Significantly, two of the sensory organs (the superior and posterior cristae) were found at the limits, or boundaries, of the SOHo-1/GH6 expression domain, suggesting that compartment boundaries may be involved in specifying sensory organ location as well as identity. Maintained expression at the boundaries may aid in specifying the location of canal outgrowth. These concepts are presented as a formal model which emphasizes that patterning information could be provided at the boundaries of gene expression domains in the inner ear.

Animals↗

Second primitive malignant tumour in patients with gynaecological cancer.

OBJECTIVE: The purpose of this study was to characterise the occurrence of multiple primitive gynaecological malignant neoplasias, restricted to the genital tract and breast or associated with other organs, and to detect which types of association are most frequent concerning location, histology and staging. POPULATION AND METHODS: The records of patients with gynaecological cancer at the Portuguese Institute of Oncology--Lisbon Centre, between 1986 and 1993 were used in this study. RESULTS: Of the 10,746 women with gynaecological cancer, 91 (0.8%) were found to have a second primitive malignant neoplasia. Of these neoplasias, 64% (58 cases) were also located at a gynaecological site. The most frequent associations were endometrium/breast (13 cases), bilateral breast (12 cases) and ovary/endometrium (11 cases). The majority of primitive multiple gynaecological tumours were synchronous. Regarding gynaecological cancer and non-gynaecological cancer, in 28 cases (31%), the most common non-gynaecological location was the colon/rectum. Five patients had triple tumours. CONCLUSION: Although these situations are relatively rare the possibility of multiple primitive cancers should be considered with the presence of malignant tumours in two or more organs. This distinction between multiple primitive or metastatic cancers could be important for treatment as well as prognosis.

Breast Neoplasms↗

Exposure to varying levels of contaminants and symptoms among workers in two office buildings.

OBJECTIVES: We hypothesized that exposure to contaminants would be associated with symptoms reported by office workers. METHODS: In two mechanically ventilated office buildings in. Montreal, the outdoor air supply was manipulated for 6 weeks, while symptoms were reported and environmental parameters were measured at multiple sites. RESULTS: Contaminant concentrations varied considerably, in part related to experimental changes in outdoor air supply. Eye symptoms were reported with higher dust and with higher concentrations of nitrogen dioxide. Mucosal symptoms were increased with higher TVOCs, higher nitrogen dioxide, and higher total contaminant load. Systemic symptoms were associated with higher dust levels. CONCLUSIONS: Symptoms reported by the workers were associated with increased concentrations of several contaminants and a summary measure of all contaminants.

Air Pollution↗

Increased oxyradical production during reoxygenation of perfused rat liver. Signal versus injury.

Despite general agreement on the importance of oxyradicals in mediating "reperfusion" injury, the precise event(s) mediated by increased free radical production remain unclear. In this study we describe for the first time a model of unenhanced chemiluminescence of isolated perfused rat liver demonstrating a marked increase in oxyradical production after reoxygenation. Using aspartate aminotransferase and purine nucleoside phosphorylase release as measures of liver injury, there was no direct link between oxyradical production and hepatic injury. However, there was an abrupt increase in neutrophil chemotaxis activity in the perfusate at the time of reoxygenation with a subsequent decrement, following the pattern of oxyradical production. These data suggest that free radical formation during hepatic reperfusion may mediate signal transduction, as opposed to direct cell injury, as a primary mechanism of action.

Animals↗

The effect of varying levels of outdoor-air supply on the symptoms of sick building syndrome.

BACKGROUND: The sick building syndrome is the term given to a constellation of symptoms reported by workers in modern office buildings, hypothesized to occur when the supply of outdoor air is reduced, because of the accumulation of contaminants arising from within the building. We undertook this study to determine the effect of changing the supply of outdoor air in four office buildings on the symptoms reported by workers and their perception of the indoor environment. METHODS: Within each of three consecutive two-week blocks, the ventilation systems in each building were manipulated, in random order, to deliver to the indoor environment an intended 20 or 50 ft3 (0.57 or 1.4 m3) of outdoor air per minute per person for one week at a time. Each week, the participants, unaware of the experimental intervention, reported symptoms and the indoor environment was thoroughly evaluated. RESULTS: Of 1838 eligible workers in the four buildings, 1546 (84 percent) participated in the study. The supply of outdoor air averaged 7 percent and 32 percent in the ventilation systems and 30 and 64 ft3 (0.85 and 1.8 m3) per minute per person in the work sites at the lower and higher ventilation levels, respectively. These changes in the supply of outdoor air were not associated with changes in the participants' ratings of the office environment or in symptom frequency (crude odds ratio, 1.0; 95 percent confidence interval, 0.9 to 1.1). After work-site measures of ventilation, temperature, humidity, and air velocity were included in the regression analysis, the adjusted odds ratio was also 1.0 (95 percent confidence interval, 0.8 to 1.2). CONCLUSIONS: Increases in the supply of outdoor air did not appear to affect workers' perceptions of their office environment or their reporting of symptoms considered typical of the sick building syndrome.

Adult↗

Relation of airway responsiveness to duration of work in a dusty environment.

Health selection within a workforce has been found in several industries and appears to be more pronounced in dustier occupations. In this study of airway disease among workers exposed to asbestos and man made mineral fibres, 215 of 246 construction insulators 50 years old or less and currently working in the Montreal area were examined. Spirometry was completed successfully in 214 workers without known asbestosis and 207 underwent methacholine bronchoprovocation testing. Airway responsiveness was expressed as PC15, the concentration of methacholine causing a 15% fall in the forced expiratory volume in one second (FEV1). Exposure to asbestos and synthetic mineral fibre dust was estimated from the total hours of work in the trade since first employment. After the effect of age, height, and pack years of smoking had been taken into account, no relation was found between hours of work and any indices obtained from the forced expiratory manoeuvre (FEV1/FVC, MMF). After the effect of airway calibre (FEV1/FVC), age, and pack years of cigarette consumption had been taken into account, airway responsiveness decreased as the total hours of work in the trade increased. These findings suggest that workers with greater levels of airway responsiveness are more sensitive to exposure in a dusty workplace and in consequence are less likely to continue. In studies of workforces a survivor effect of this nature will tend to weaken the relation between lung function abnormality and occupational exposure.

Adult↗

Clinical prediction of airways hyperresponsiveness.

We tested the ability of chest physicians to detect increased airways responsiveness (IAR) in patients presenting with symptoms suggestive of asthma. Physicians ordering bronchial provocation tests for diagnostic purposes were asked to predict the clinical probability (based on the patient's history, examination, and spirometry) of IAR (defined by a PC20 for FEV1 less than or equal to 8 mg/ml of histamine). Presenting symptoms in the 38 subjects aged 16 to 78 years included cough, wheeze, dyspnea, chest tightness, and recurrent colds. There was no association between IAR and clinical probability dichotomized as less than or equal to 50 percent or greater than 50 percent (p = .16, Fisher test). The association was no stronger using only subjects in whom the clinical prediction was greater than 67 percent or less than 33 percent. If knowledge of the level of airway reactivity would influence subsequent patient management (eg, prescription of antiasthmatic therapy), then its clinical prediction should not be relied upon.

Adult↗