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Biomedical subjects

L Miranda

Publications and source records attributed to L Miranda.

At least 37 records · Page 2Linked to original sources

Cerebral infarction in young women: analysis of 130 cases.

UNLABELLED: The aim of this study was to determine the risk factors and mechanism of cerebral infarction in young women. METHODS: We evaluated 130 consecutive women younger than 41 years of age with cerebral infarction and compared the risk factors with a control group of 122 healthy, age-matched women. RESULTS: The leading risk factors in patients with cerebral infarction were migraine (15%), tobacco use (15%), and oral contraceptive (OC) use (12%). Cerebral arteriograms were abnormal in 59% of patients (57 of 96). The causes of cerebral infarction were cardiac embolism in 36%, nonatherosclerotic vasculopathy in 25%, hematologic disorders in 8%, and migraine in 8%. The etiology could not be determined in 23% of patients. CONCLUSION: Migraine and OCs are independent risk factors for cerebral infarction in young women. The leading etiologies were rheumatic valve disease and nonatherosclerotic vasculopathy, hematologic disturbances, and migraine were responsible for a few cases.

Adolescent↗

[Abdominal pregnancy. Clinical case in surgical emergncy].

A clinical case of abdominal pregnancy observed during emergency laparotomy in a woman suffering for acute abdominal pain, is described. The difficulty of an ectopic pregnancy diagnosis and the catastrophic consequence of an missing diagnosis are underlined.

Abdomen, Acute↗

Isolation of the human PC6 gene encoding the putative host protease for HIV-1 gp160 processing in CD4+ T lymphocytes.

Production of infectious HIV-1 virions is dependent on the processing of envelope glycoprotein gp160 by a host cell protease. The protease in human CD4+ T lymphocytes has not been unequivocally identified, yet members of the family of mammalian subtilisin-like protein convertases (SPCs), which are soluble or membrane-bound proteases of the secretory pathway, best fulfill the criteria. These proteases are required for proprotein maturation and cleave at paired basic amino acid motifs in numerous cellular and viral glycoprotein precursors, both in vivo and in vitro. To identify the gp160 processing protease, we have used reverse transcription-PCR and Northern blot analyses to ascertain the spectrum of SPC proteases in human CD4+ T cells. We have cloned novel members of the SPC family, known as the human PC6 genes. Two isoforms of the hPC6 protease are expressed in human T cells, hPC6A and the larger hPC6B. The patterns of SPC gene expression in human T cells has been compared with the furin-defective LoVo cell line, both of which are competent in the production of infectious HIV virions. This comparison led to the conclusion that the hPC6 gene products are the most likely candidates for the host cell protease responsible for HIV-1 gp160 processing in human CD4+ T cells.

Amino Acid Sequence↗

Transport of acetic acid in Zygosaccharomyces bailii: effects of ethanol and their implications on the resistance of the yeast to acidic environments.

Cells of Zygosaccharomyces bailii ISA 1307 grown in a medium with acetic acid, ethanol, or glycerol as the sole carbon and energy source transported acetic acid by a saturable transport system. This system accepted propionic and formic acids but not lactic, sorbic, and benzoic acids. When the carbon source was glucose or fructose, the cells displayed activity of a mediated transport system specific for acetic acid, apparently not being able to recognize other monocarboxylic acids. In both types of cells, ethanol inhibited the transport of labelled acetic acid. The inhibition was noncompetitive, and the dependence of the maximum transport rate on the ethanol concentration was found to be exponential. These results reinforced the belief that, under the referenced growth conditions, the acid entered the cells mainly through a transporter protein. The simple diffusion of the undissociated acid appeared to contribute, with a relatively low weight, to the overall acid uptake. It was concluded that in Z. bailii, ethanol plays a protective role against the possible negative effects of acetic acid by inhibiting its transport and accumulation. Thus, the intracellular concentration of the acid could be maintained at levels lower than those expected if the acid entered the cells only by simple diffusion.

Acetates↗

Envelope V3 region sequences of Cuban HIV-1 isolates.

The origin of HIV-1 species, responsible for the AIDS epidemic in Cuba, is a subject that has been intensely debated. This study represents an initial attempt to shed light on this issue, through sequence analysis of the V3 regions of viruses isolated from 15 Cuban subjects. We now report that these viruses fall within three distinct, well-recognized groupings. These findings suggest that viruses of different sources are responsible for the HIV/AIDS epidemic in Cuba.

Acquired Immunodeficiency Syndrome↗

[Placenta praevia accreta and obstetric hysterectomy].

We present the case of a 38-years-old tertipara at full term with a diagnosis by ultrasound of placenta previa who underwent elective cesarean under spinal anesthesia. After a difficult birth, anomalous adhesion of the placenta prevented its removal and caused massive hemorrhage of the placental bed and hypovolemic shock. Blood volume was restored and emergency hysterectomy under general anesthesia was effected, as bleeding and hemodynamic state were brought under control. Abnormal heart rhythm appearing after the operation responded to treatment; postoperative recovery was unremarkable. Placenta accreta is a rare complication of placenta previa. Given that massive obstetric hemorrhage is associated with significant mortality and morbidity, both maternal and fetal, the anesthesiologist must be aware of potential problems that might arise in cases of placental accreta so that readiness can keep risk to a minimum.

Adult↗

Health policy dilemmas related to high technology infertility services.

As cost containment in health care becomes an important concern, the costs and benefits of specific health care services will be more closely examined. The costs and benefits of one type of health care, high technology infertility services, are explored in this paper. These services may be particularly susceptible to cost containment since they are costly, raise ethical issues, and because they currently are provided to healthy individuals not experiencing life-threatening illness who can afford them.

Adult↗

[Annuloaortic ectasia: report of a case].

The authors describe a case of a patient with annuloaortic ectasia (AAE) and severe aortic regurgitation. The diagnostic was made by angiography. He was submitted to a Bentall's procedure; replacement of the ascending aorta by a conduit and of aortic valve by a mechanical prosthesis with reimplantation of coronary arteries into the conduit. The only complication was atrial fibrillation with fast ventricular response. Nowadays he is clinically well, in NYHA class I. The authors make some considerations about AAE, its surgical treatment and its results.

Aortic Diseases↗

Endothelial-derived relaxing factor released by endothelial cells of human umbilical vessels and its impairment in pregnancy-induced hypertension.

The principal objective of this study was to determine and compare the capability of human umbilical vessels of normal and pregnancy-induced hypertensive parturients to produce and to release the endothelial-derived relaxing factor. A bolus of bradykinin injected in the perfusion system of human umbilical vessels induces a release of a relaxant factor, detectable by bioassay, that is pharmacologically similar to the endothelial-derived relaxing factor. Human umbilical cords were collected from normal and pregnancy-induced hypertensive parturients. In the latter group the release of endothelial-derived relaxing factor is extremely reduced. In fact, in umbilical vessels collected from normal parturients, bradykinin at a dose of 20 pmol produces a release of endothelial-derived relaxing factor equivalent to a relaxation induced by 59.9 +/- 11.0 and 30.8 +/- 11.4 pmol of glyceryl trinitrate for the artery and vein, respectively. The same dose of bradykinin in umbilical vessels, collected from pregnancy-induced hypertensive parturients, produces a release equivalent to 6.6 +/- 2.2 and 5.7 +/- 3.5 pmol of glyceryl trinitrate equivalent for the artery and vein, respectively. Neither an increasing bolus of exogenous bradykinin or an infusion of superoxide dismutase or L-arginine was able to restore the production of endothelial-derived relaxing factor to normal levels. Our results indicate a probable alteration of endothelial cell numbers or an alteration of the enzymatic pathway, probably due to cytotoxic endogenous factors produced in pregnancy.

Animals↗

Changes in the Bishop score induced by manual nipple stimulation. A cross-over randomized study.

Bishop score changes, by a cross-over, randomized study, were evaluated in 60 primigravidas at term, not yet in labour, who performed nipple stimulation for 45 minutes three times a day for three days. Results showed that changes of Bishop score in the treated groups were statistically highly significant, in comparison to control groups. A greater frequency in the onset of labour was also remarked.

Adult↗

Action of a prostaglandin synthetase inhibitor on IUD associated uterine bleeding.

The Authors treated twenty-eight women using IUD, who suffered from increased menstrual blood loss and pelvic pain, with a prostaglandin synthetase inhibitor, Suprofen, in an attempt to reduce their symptomatology, in a double blind crossover study. The drug produced an important reduction of the menstrual blood loss and pains. These observations suggest that prostaglandins are involved in the etiology of excessive menstrual blood loss and pains, and that prostaglandin inhibitors may be useful for reducing these symptoms.

Clinical Trials as Topic↗

Outpatient treatment of prescription opioid dependence: comparison of two methods.

Outpatient treatment of 42 patients who presented with dependence upon prescription opioids was attempted by two different methods. The first group of 21 patients was treated by 21-day detoxification followed by psychotherapeutic counseling (D/C), and the next 21 patients were offered 21-day detoxification to be followed by opioid maintenance if detoxification was unsuccessful (D/M). Only 5 of 21 (23.8%) patients in the D/C group compared to 20 of 21 (95.2%) in the D/M group completed three weeks of treatment (P less than .001). On admission, no patient perceived that chronic pain due to a medical condition would be an impediment to withdrawal from opioids, but pain which was masked by opioid dependency and which emerged during detoxification proved to be an insurmountable barrier to total withdrawal in the majority of patients. Treatment of outpatients who presented with dependence upon prescription opioids was best provided in the study by opioid maintenance and adjunctive pain therapy.

Adult↗