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Biomedical subjects

L Leal

Publications and source records attributed to L Leal.

8 recordsLinked to original sources
PubMed2006

Nutritional status after intestinal transplantation in children.

INTRODUCTION: The management of children receiving small bowel grafts involves potentially life-threatening complications that affect their nutritional status. The aim of this paper was to define these factors and their influence on nutritional outcome. PATIENTS AND METHODS: Patients with intestinal failure (IF) who received an isolated small bowel transplantation (SBT) or small bowel/liver transplantation (SBLT) at our hospital during the last 6 years were reviewed for weight Z-score, biochemical nutritional parameters, total parenteral nutrition (TPN) weaning, catheter-related sepsis, rejection and steroid treatment. RESULTS: Twenty patients, 11 females and 9 males, received a SBT or a SBLT and survived the postoperative period; in the present study we only included 11 children with follow-up periods longer than 1 year. Seven males and 4 females with a mean age of 4.5 years (range, 1 to 20 years) received 6 SBLT and 5 SBT. Nine (82%) were weaned from TPN to an amino-acid or peptide enteral formula during the first 6 months after surgery. During the first year there was a significant increase in total protein from 5.11 +/- 1.8 mg/dl to 6.1 +/- 1.5 mg/dl (p < 0.05) and an increase in albumin from 3.8 +/- 0.9 mg/dl to 4.5 +/- 1.1 mg/dl (p < 0.05). There was an increase in weight Z-score in 9 patients (82%) during the first year. Mean Z-score improved from - 2.6 +/- 1 at transplant to - 1.0 +/- 0.6 (p < 0.05) after 1 year. Three patients (27.2%) had at least one rejection period, which was treated with steroids alone or in combination. Mean weight Z-score 1 year after surgery was - 0.9 +/- 0.6 for patients without rejection and - 1.24 +/- 0.8 for those with at least one rejection episode treated with steroids (p > 0.1). Four patients (36%) had at least one catheter-related sepsis episode. Mean weight Z-score 1 year after surgery was - 1.01 +/- 0.6 for patients without catheter-related sepsis and - 1.24 +/- 0.8 for those with at least one catheter-related sepsis episode (p > 0.1). CONCLUSIONS: There was a significant improvement in weight Z-score and biochemical nutritional parameters 1 year after receiving a small bowel graft. No influence of steroids or catheter-related sepsis on children's nutritional status was noted 1 year after surgery, although this point will need further evaluation.

Adolescent↗
PubMed2001

Neurochemical characterization of traumatic brain injury in humans.

Trauma is the leading cause of death in individuals between the ages of 1 and 44 years. And, in the case of severe head injury mortality can reach as high as 35-70%. Despite this fact, there has been little progress in the development of effective pharmacological agents to protect brain injured patients. To date, there is little data on the mechanisms involved in neuronal cellular insult after severe head injury, especially in humans. Glutamate acts both as a primary excitatory neurotransmitter and a potential neurotoxin within the mammalian brain. Evidence indicates that hyperactivity of the glutamate system contributes to neuronal death in brain trauma. Also, in animal models of neurotrauma, this neural injury is followed by gliosis which has been linked to the severity of brain injury. To investigate the glutamate system in brain trauma, we carried out [3H]glutamate and [3H]MK801 (a noncompetitive NMDA-receptor antagonist) binding and [3H]glutamate uptake assays in human cerebral cortex preparations obtained from severely brain injured and control victims. Additionally, to investigate gliosis following brain injury, we performed GFAP immunohistochemistry. There were no significant differences in [3H]glutamate binding (affinity or density of sites) between the control and head injured groups. In contrast, cerebral cortical [3H]MK801 binding revealed both a significant increase in the density of sites (Bmax) and a decrease in the dissociation constant (Kd) in the head injured group when compared to controls. There were no significant differences in [3H]glutamate uptake between groups. The injured brains presented an increased number of GFAP-positive astrocytes and more intense GFAP reaction in comparison to control brains. In the context of traumatic brain injury, our results encourage further investigation into compounds capable of selective modulation of NMDA receptor subtype in humans while also therapeutically manipulating glial cell responses following brain trauma.

Adolescent↗
PubMed1998

Ouabain induces apoptosis on PHA-activated lymphocytes.

Apoptotic cell death plays a critical role in immune system homeostasis, and c-myc protooncogene deregulated expression is a component of this programmed genomic response. Pharmacological intervention and modulation of peripheral lymphocytes apoptosis would have important implications. The present results indicate that ouabain, a specific inhibitor of Na+K(+)-ATPase, promotes an increased expression of c-myc mRNA, and induces apoptosis in PHA-stimulated lymphocytes. Furthermore, this ouabain-induced apoptosis cannot be counteracted by the addition of exogenous IL-2.

Apoptosis↗
PubMed1992

The teacher's role in facilitating memory and study strategy development in the elementary school classroom.

The efforts of 69 elementary school teachers to instruct children in cognitive processing activities were observed. Although the teaching of such activities was relatively infrequent, it varied by grade (occurring more often in grades 2-3 than in higher or lower grades) and by the content of instruction. Teachers of grade 4 and above more often provided rationales for the use of cognitive strategies than did teachers of younger children. In a second study, children of three achievement levels were selected from classrooms in which teachers varied in their use of suggestions regarding cognitive processes. Subsequent to training in the use of a memory strategy, children's performance on a maintenance trial was evaluated: Among average and low achievers, those whose teachers were relatively high in strategy suggestions showed better maintenance and more deliberate use of the trained strategy than did children whose teachers rarely made strategy suggestions. The role of school experience in the development of children's memory skills is discussed.

Achievement↗
PubMedDate not supplied

The relationship between gender, symptoms of bulimia, and tolerance for stress.

University students completed a questionnaire that included a measure of bulimia and a measure of tolerance for stress. Women reported significantly more symptoms of bulimia and a lower tolerance for stress than did men. Women in their first year on campus reported significantly more symptoms of bulimia than those not in their first year. For both women and men, a greater number of bulimic symptoms was associated with lower levels of stress tolerance. The present results suggest that women in their first year on campus should be targeted in intervention and prevention activities for eating disorders and that the relationship between disordered eating and stress is the same for both women and men.

Adaptation, Psychological↗
PubMedDate not supplied

Coralline hydroxyapatite bone graft substitutes.

The authors present a review of the various bone grafts currently available with special attention to coral bone grafts. Several of the benefits of coralline hydroxyapatite bone graft substitutes, such as safety and biocompatibility, will be addressed in this article, part of an ongoing investigation of coral bone grafts used in triple arthrodesis procedures. To date, eight cases have been performed. In seven cases, granular chips were employed to pack the subtalar joint. The final case, presented in this article, represents a 26-year-old male who, 2 years previously, sustained a calcaneal fracture with resultant shortening along the lateral column. A coralline hydroxyapatite block was used at the calcaneocuboid joint to achieve distraction. Clinically, the patient is progressing well at 10 months postoperatively. Radiographically, one can still clearly appreciate the margins of the bone graft at 5 months.

Adult↗