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Biomedical subjects

J Marta

Publications and source records attributed to J Marta.

At least 19 recordsLinked to original sources
PubMed2006

Aspirin or anticoagulants in stenosis of the middle cerebral artery: A randomized trial.

BACKGROUND: We report the results of an open, randomized, multicenter trial that compared the efficacy of aspirin to oral anticoagulants (OA) for the prevention of vascular events in patients with symptomatic stenosis of the middle cerebral artery (MCA). METHODS: Participants were randomly assigned to receive 300 mg/day of aspirin or a dose of OA (target INR 2-3). The MCA stenosis was demonstrated by conventional angiography or by at least two noninvasive examinations. Patients had either transient ischemic attack or cerebral infarct (CI) attributable to the MCA stenosis within 90 days before inclusion. The primary endpoint was: nonfatal CI, nonfatal acute myocardial infarct, vascular death and major hemorrhage. The patients were followed-up for a minimum of 1 year and a maximum of 3 years. RESULTS: The study included 28 patients (14 in each treatment group); the average age was 67 +/- 9.9 years. Men constituted 68% of the patients. After a mean follow-up of 23.1 +/- 10.9 months, there were no recurrences of CI in both groups. No endpoint was reported in the aspirin group, but 2 patients in the OA group (14.3%) exhibited vascular events: 1 acute myocardial infarct and 1 intracerebral hemorrhage). However, this difference was not statistically significant (p = 0.48). CONCLUSIONS: Our study suggests that aspirin is the treatment of choice for the prevention of vascular events in patients with symptomatic MCA stenosis.

Aged↗
PubMed1998

Whose consent is it anyway? A poststructuralist framing of the person in medical decision-making.

This paper explores the value of a Poststructuralist psychoanalytic model of persons, or "Subjects," as an expanded frame for the question "Whose consent is it anyway?" The elaboration of the need for this expanded frame, its tenets and its value form the substance of the paper. This frame incorporates the emotional, linguistic, and socio-cultural dimensions that help restore patients and physicians to their full status as persons from their restricted status, in the current dominant theory and model, as unidimensional, rationalistic, medico-legally constructed players; emphasizes their interconnectedness; and, focuses broadly on responsibility as bearing consequences, and not only accountability. This frame does not deny the role and importance of cognition or rationality, it supplements them. It does not supplant rationality, but rather includes it in a view of the person that also includes those other human capacities which are not based on an ideal of pure reason.

Beneficence↗
PubMed1998

[The referral of hospitalized patients with cerebrovascular pathology. Where, when and why. A cross-sectional multicenter study of the referral of patients with ischemia and predisposing factors].

OBJECTIVES: Referral of patients with ictus on discharge from hospital is a daily problem for neurologists, both because of the suitability of one place or another for maximum recovery of the patient and because of the effect on average stay, complications and use of resources. The aim of this study was to determine where and when patients with ictus were referred and what factors affect whether a patient goes to one place or another. PATIENTS AND METHODS: A transversal multicentric study (3 months) using a questionnaire was sent to all Insalud hospitals in Aragon, recording data of 128 patients from four hospitals. There were questions on medical, functional, demographic and socio-economic factors which might affect referral. RESULTS: On discharge 20% of the patients did not return to their own homes. In 50% of the cases where patients went to a supporting hospital (SH) socio-economic factors were decisive and in 20% were the only cause. Referral to SH was related to functional state and type of ictus, need for nursing care or rehabilitation, age, sex, marital status and place of residence. CONCLUSIONS: Apart from clinical criteria, many socio-economic factors determine the need for referral of patients to one place or another.

Adult↗
PubMed1996

A linguistic model of informed consent.

The current disclosure model of informed consent ignores the linguistic complexity of any act of communication, and the increased risk of difficulties in the special circumstances of informed consent. This article explores, through linguistic analysis, the specificity of informed consent as a speech act, a communication act, and a form of dialogue, following on the theories of J.L. Austin, Roman Jakobson, and Mikhail Bakhtin, respectively. In the proposed model, informed consent is a performative speech act resulting from a series of communication acts which together constitute a dialogic, polyphonic, heteroglossial discourse. It is an act of speech that results in action being taken after a conversation has happened where distinct individuals, multiple voices, and multiple perspectives have been respected, and convention observed and recognized. It is more meaningful and more ethical for both patient and physician, in all their human facets including their interconnectedness.

Communication↗
PubMed1994

Vascular malformation of the cerebellopontine angle associated with "SUNCT" syndrome.

A 70-year-old man complained of two distinct types of unilateral headache during the past fifteen years. When the illness began, the pain was intermittent and short-lasting. In successive years, the crises appeared in clusters and lasted weeks to months. At present, the pain occurs daily, and is located on the right side, from the forehead supraorbitally to the temporal region. Some attacks last 30 sec and are accompanied by tearing, conjunctival injection, rhinorrhea and a subjective need to micturate. Other headaches last 1/2-1 h and are occasionally accompanied by local ipsilateral dysautonomic symptoms. Attacks of pain are provoked by movements of the trunk and neck. A vascular malformation in the right cerebellopontine angle was demonstrated on cranial CT and MRI, and by angiography.

Aged↗
PubMed1994

[Peripheral neuropathy and mixed cryoglobulinemia: clinical, neuro- physiological and pathological signs in a group of 12 patients].

This retrospective study involved a series of 12 patients with peripheral neuropathy and mixed type III cryoglobulinemia. The predominating symptoms were sensory. In patients with essential cryoglobulinemia, neuropathy most often presented as multiple mononeuropathy, while polyneuropathic forms were most common among those with secondary cryoglobulinemia. The absence of cryosensitivity was evident in secondary forms. Both neurophysiological and morphological examination revealed a predominance of axonal neuropathy. Two cases of demyelinating neuropathy were found among those with secondary cryoglobulinemia associated with monoclonal gammopathy. Although the vascular lesion was clearly demonstrable in muscle and skin tissue, this was not so in the nervous system.

Adult↗
PubMed1993

[Informed consent: a prerequisite for psychotherapy?].

Is it desirable to extend the practice of explicit informed consent to psychotherapy? Is it possible? How? This article offers preliminary answers to these questions following a literature review and reflection on the theory of informed consent and psychotherapy. It explores the advantages and the possibility of using explicit informed consent in place of the implicit consent obtained currently. Explicit consent for psychotherapy would be interactive, iterative, repeated and revokable. It would take into account specific characteristics of psychotherapy, such as the fact that it is a process rather than a procedure, its relative unpredictability, the active part the patient plays in treatment, and the importance of the unconscious, transference and counter-transference. It would have the advantages of respecting the patients' autonomy without sacrificing their well-being, of having meaning not only for medico-legal protocols but for the patient, and would improve satisfaction with and the efficacy of psychotherapy as a treatment modality. The proposed model provides direction for future research, both empirical and theoretical.

Countertransference↗
PubMed1987

Correlation of conformational changes in the acrosome stabilizing factor (ASF) with its biological activity.

The rabbit Acrosome Stabilizing Factor (ASF) is a glycoprotein synthesized in the corpus epididymis that reversibly decapacitates sperm. The effects of altering the conformation of ASF were evaluated by using a competitive enzyme-linked immunoabsorption assay (ELISA) with monoclonal antibodies that recognized either sequential or conformational determinants and/or an in vivo decapacitation assay. Heat denaturation (80 degrees C for 30 min) of affinity-purified ASF resulted in destruction of its native conformation concurrent with its loss of biological activity. Acid pH treatment of ASF also resulted in a conformational change in ASF, which caused a shift from the dimeric form (MW = 260,000) to the monomeric form (MW = 130,000). This manipulation allowed the biological activity of the monomeric form of ASF to be assayed separately from the dimer. The monomer was found to be biologically inactive. Proteolysis with trypsin or Staphylococcus-V8 treatment resulted in loss of the native conformation of the molecule, but Staphylococcus-V8 did not destroy the sequential determinant recognized in this analysis. This work indicates that conformation of the ASF macromolecule is important for its biological activity, and also provides a rapid means to evaluate potential decapacitation activity of purified ASF.

Animals↗
PubMed1984

Control of the humoral immune system within the rabbit oviduct.

Within the oviduct the maternal humoral immune system can react with the sperm on their way to fertilize the ovum and with preimplantation embryos which express paternal surface antigens. The embryo or sperm is destroyed by antibodies plus complement; thus control of the humoral immune system in the oviduct is advantageous. This paper confirms the absence of whole complement in the oviduct as determined by both in vivo and in vitro hemolytic assays. Further, it is established that there exists within oviductal fluid a concentration-dependent inhibition of complement activity. This inhibitor is heat labile and nondialyzable. Utilizing purification by Sephadex G-200 and ion-exchange chromatography, the complement inhibition was attributed to a family of sulfated glycoproteins secreted by the oviductal epithelium.

Animals↗
PubMedDate not supplied

[Validation of a model for the prediction of verbal semantic fluency].

INTRODUCTION: The diagnosis of dementia requires documentation of cognitive loss with respect to the patient's previous level. It would therefore be very useful to have models available which would predict the result expected in the tests normally used in the diagnosis of dementia. OBJECTIVE: To validate a model for prediction of the results of a test of semantic verbal fluency in persons with no dementia. PATIENTS AND METHODS: A model for the prediction of semantic verbal fluency deduced from a sample of 138 persons was applied to two other independent samples: the first of 86 persons from the same environment as the original sample and a second multicentric sample of 92 persons. The validity of the model was evaluated by residual analysis. RESULTS: No sex differences were seen between the samples, but there were differences regarding the other variables, including the observed and predicted verbal fluency. The residuals of the samples did not differ from each other nor vary from zero, but were normally distributed. CONCLUSION: The model proposed based on sociodemographic and clinical variables is valid and satisfactorily predicts the verbal fluency to be expected in each case.

Aged↗