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Biomedical subjects

M Araujo

Publications and source records attributed to M Araujo.

At least 19 recordsLinked to original sources
PubMed2000

Geometrical Description of Contact Line Fluctuations in Heterogeneous Systems with Controlled Wettability.

The understanding of contact line fluctuations in heterogeneous systems of controlled wettability is relevant to many industrial processes. Despite its importance, it is poorly understood. Here, we present results on an experimental study of fluid displacement on modified Hele-Shaw cells with surface defects as heterogeneities. The system wettability is controlled by defect surface coverage. Three different surface coverage regimes were studied. For each one, the morphology and deformation energy of the displacement front is determined. The width front is described in terms of two exponents, the roughness exponent (alpha) and the one that describes its growth (beta). In all cases, it is found that the width increases logarithmically in time up to a characteristic value, where a crossover to a saturation behavior is observed. The crossover time is a function of the surface coverage. For low coverage 0.51</=beta</=0.59 and 0.65</=alpha</=0.67. For medium and high coverage the values obtained for the exponents are similar to those of directed percolation. The deformation energy associated with the displacement front morphology makes it possible to identify the individual pinning role of the surface defects. Copyright 2000 Academic Press.

Journal Article↗
PubMed2000

A comparison of anaesthesia using remifentanil combined with either isoflurane, enflurane or propofol in patients undergoing gynaecological laparoscopy, varicose vein or arthroscopic surgery.

BACKGROUND: Anaesthesia comprising remifentanil plus isoflurane, enflurane or propofol was randomly evaluated in 285, 285 and 284 patients, respectively, undergoing short-procedure surgery. METHODS: Anaesthesia was induced with propofol (0.5 mg x kg(-1) and 10 mg x 10 s(-1)), and a remifentanil bolus (1 microg x kg(-1)) and infusion at 0.5 microg x g(-1) x min(-1). Five minutes after intubation, remifentanil infusion was halved and 0.5 MAC of isoflurane or enflurane, or propofol at 100 microg x kg(-1) x min(-1) were started and titrated for maintenance. RESULTS: Patient demography and anaesthesia duration were similar between the groups. Surgery was performed as daycases (52%) or inpatients (48%). The median times (5-7 min) to extubation and postoperative recovery were similar between the groups. Responses to tracheal intubation (15% vs 8%) and skin incision (13% vs 7%) were significantly greater in the total intravenous anaesthesia (TIVA) group (P<0.05). Fewer patients given remifentanil and isoflurane (21%) or enflurane (19%) experienced > or =1 intraoperative stress response compared to the TIVA group (28%) (P<0.05). Median times to qualification for and actual recovery room discharge were 0.5-0.6 h and 1.1-1.2 h, respectively. The most common remifentanil-related symptoms were muscle rigidity (6-7%) at induction, hypotension (3-5%) and bradycardia (1-4%) intraoperatively and, shivering (6-7%), nausea and vomiting postoperatively. Nausea (7%) and vomiting (3%) were significantly lower with TIVA compared with inhaled anaesthetic groups (14-15% and 6-8%, respectively; P<0.05). CONCLUSION: Anaesthesia combining remifentanil with volatile hypnotics or TIVA with propofol was effective and well tolerated. Times of extubation, postanaesthesia recovery and recovery room discharge were rapid, consistent and similar for all three regimens.

Adolescent↗
PubMed2000

Efficacy of a diagnostic strategy for patients with chest pain and no ST-segment elevation in the emergency room.

PURPOSE: To evaluate the efficacy of a systematic model of care for patients with chest pain and no ST segment elevation in the emergency room. METHODS: From 1003 patients submitted to an algorithm diagnostic investigation by probability of acute ischemic syndrome. We analyzed 600 ones with no elevation of ST segment, then enrolled to diagnostic routes of median (route 2) and low probability (route 3) to ischemic syndrome. RESULTS: In route 2 we found 17% acute myocardial infarction and 43% unstable angina, whereas in route 3 the rates were 2% and 7%, respectively. Patients with normal/non-specific ECG had 6% probability of AMI whereas in those with negative first CKMB it was 7%; the association of the 2 data only reduced it to 4%. In patients in route 2 the diagnosis of AMI could only be ruled out with serial CKMB measurement up to 9 hours, while in route 3 it could be done in up to 3 hours. Thus, sensitivity and negative predictive value of admission CKMB for AMI were 52% and 93%, respectively. About one-half of patients with unstable angina did not disclose objective ischemic changes on admission. CONCLUSION: The use of a systematic model of care in patients with chest pain offers the opportunity of hindering inappropriate release of patients with ACI and reduces unnecessary admissions. However some patients even with normal ECG should not be released based on a negative first CKMB. Serial measurement of CKMB up to 9 hours is necessary in patients with medium probability of AMI.

Algorithms↗
PubMed2000

Chest pain in the emergency room. Importance of a systematic approach.

OBJECTIVE: To evaluate the efficiency of a systematic diagnostic approach in patients with chest pain in the emergency room in relation to the diagnosis of acute coronary syndrome (ACS) and the rate of hospitalization in high-cost units. METHODS: One thousand and three consecutive patients with chest pain were screened according to a pre-established process of diagnostic investigation based on the pre-test probability of ACS determinate by chest pain type and ECG changes. RESULTS: Of the 1003 patients, 224 were immediately discharged home because of no suspicion of ACS (route 5) and 119 were immediately transferred to the coronary care united because of ST elevation or left bundle-branch block (LBBB) (route 1) (74% of these had a final diagnosis of acute myocardial infarction [AMI]). Of the 660 patients that remained in the emergency room under observation, 77 (12%) had AMI without ST segment elevation and 202 (31%) had unstable angina (UA). In route 2 (high probability of ACS) 17% of patients had AMI and 43% had UA, whereas in route 3 (low probability) 2% had AMI and 7 % had UA. The admission ECG has been confirmed as a poor sensitivity test for the diagnosis of AMI ( 49%), with a positive predictive value considered only satisfactory (79%). CONCLUSION: A systematic diagnostic strategy, as used in this study, is essential in managing patients with chest pain in the emergency room in order to obtain high diagnostic accuracy, lower cost, and optimization of the use of coronary care unit beds.

Journal Article↗
PubMed2000

Chest pain in the emergency room. Importance of a systematic approach

OBJECTIVE: To evaluate the efficiency of a systematic diagnostic approach in patients with chest pain in the emergency room in relation to the diagnosis of acute coronary syndrome (ACS) and the rate of hospitalization in high-cost units. METHODS: One thousand and three consecutive patients with chest pain were screened according to a pre-established process of diagnostic investigation based on the pre-test probability of ACS determinate by chest pain type and ECG changes. RESULTS: Of the 1003 patients, 224 were immediately discharged home because of no suspicion of ACS (route 5) and 119 were immediately transferred to the coronary care united because of ST elevation or left bundle-branch block (LBBB) (route 1) (74% of these had a final diagnosis of acute myocardial infarction [AMI]). Of the 660 patients that remained in the emergency room under observation, 77 (12%) had AMI without ST segment elevation and 202 (31%) had unstable angina (UA). In route 2 (high probability of ACS) 17% of patients had AMI and 43% had UA, whereas in route 3 (low probability) 2% had AMI and 7% had UA. The admission ECG has been confirmed as a poor sensitivity test for the diagnosis of AMI (49%), with a positive predictive value considered only satisfactory (79%). CONCLUSION: A systematic diagnostic strategy, as used in this study, is essential in managing patients with chest pain in the emergency room in order to obtain high diagnostic accuracy, lower cost, and optimization of the use of coronary care unit beds.

Journal Article↗
PubMed2000

Chest pain in the emergency room. Importance of a systematic approach.

OBJECTIVE: To evaluate the efficiency of a systematic diagnostic approach in patients with chest pain in the emergency room in relation to the diagnosis of acute coronary syndrome (ACS) and the rate of hospitalization in high-cost units. METHODS: One thousand and three consecutive patients with chest pain were screened according to a preestablished process of diagnostic investigation based on the pre-test probability of ACS determinate by chest pain type and ECG changes. RESULTS: Of the 1003 patients, 224 were immediately discharged home because of no suspicion of ACS (route 5) and 119 were immediately transferred to the coronary care united because of ST elevation or left bundle-branch block (LBBB) (route 1) (74% of these had a final diagnosis of acute myocardial infarction [AMI]). Of the 660 patients that remained in the emergency room under observation, 77 (12%) had AMI without ST segment elevation and 202 (31%) had unstable angina (UA). In route 2 (high probability of ACS) 17% of patients had AMI and 43% had UA, whereas in route 3 (low probability) 2% had AMI and 7% had UA. The admission ECG has been confirmed as a poor sensitivity test for the diagnosis of AMI (49%), with a positive predictive value considered only satisfactory (79%). CONCLUSION: A systematic diagnostic strategy, as used in this study, is essential in managing patients with chest pain in the emergency room in order to obtain high diagnostic accuracy, lower cost, and optimization of the use of coronary care unit beds.

Aged↗
PubMed1999

Mutation distribution and CYP21/C4 locus variability in Brazilian families with the classical form of the 21-hydroxylase deficiency.

Deficiency of adrenal steroid 21-hydroxylase is the most common form of congenital adrenal hyperplasia and it is considered to be responsible for 90% of the disease. This paper describes for the first time the CYP21B mutation profile in Brazilian patients. We genotyped 41 families with at least one individual affected with the classical form of the 21-hydroxylase deficiency, representing 74 unrelated alleles. In order to characterize different disease-causing alleles, genotyping was performed by Southern blot analysis with three restriction enzymes, allele-specific oligonucleotide hybridization, and allele-specific PCR. Different alleles were distinguished by TaqI C4B RFLP, gene duplications or deletions of either CYP21A + C4B or CYP21B + C4B, large gene conversions and eight mutations that might have been introduced into CYP21B from CYP21A by microconversion events. At least one mutation was detected in 24 different disease-causing alleles, which represents about 85% of the affected alleles in those families. The frequency of the 30 kb deletion of CYP21B was lower than that described for Caucasians. The mutation Sp2 showed the highest frequency (24.65%) and was present mainly in salt-wasting patients, although it was also detected in some patients with the simple virilizing form of the disease. Conversely, I172N showed a frequency of 18.91% and was found mostly in patients affected with the simple virilizing form of the disease. Five other mutations were determined at low frequency, but CL6 was not found in any of the tested alleles.

Adrenal Hyperplasia, Congenital↗
PubMed1998

Neural induction in whole chick embryo cultures by FGF.

FGFs are well known as mesodermal inducers and they have been reported to have neural inducing and/or caudalizing activity in Xenopus. To evaluate the role of FGFs in neural induction and patterning of the nervous system in chick embryos, we have targeted the ectopic expression of these factors by applying FGF-soaked beads to extended primitive streak chick embryos developing in culture. The whole embryo culture system allows to directly assessing the neural inducing activity on nonneural ectodermal cells. Our results show that FGFs induce the production of ectopic neural structures in the epiblast cell layer which are independent of the endogenous neural tube. The induced neural plates express several neural positional markers (Otx-2, Krox-20, EphA4, EphA7, and cHox-B9), although they lack anterior neural markers such as BF-1. These effects are very likely to be exerted by the direct action of FGF on epiblast cells because we have found no evidence of the induction of an organizer-like activity or of the presence of new axial mesoderm induced by the growth factor. We conclude that FGFs can act as direct neural inducers and that this action is exerted independently from the axial mesoderm.

Animals↗
PubMed1998

Antigenic diversity of hepatitis B virus strains of genotype F in Amerindians and other population groups from Venezuela.

The adw4 subtype of hepatitis B virus (HBV) belongs to a unique genomic group (genotype F) representing the original HBV strains from the New World. Data regarding the prevalence of this subtype among HBV carriers in South America are, however, scarce, and those concerning HBV genotype F are based on only a few samples from Latin America. In this study, serum samples were obtained from 141 hepatitis B surface antigen (HBsAg) carriers from Amerindians and urban populations from Venezuela. The HBsAg subtype was identified with monoclonal antibodies in 105 samples, and the HBV genotype was identified by reverse-phase hybridization with DNA fragments in 58 samples. The adw4 subtype was highly prevalent in the population studied (75%); among the Amerindians, the prevalence was 97%. The adw2 subtype was also present (10%), while other subtypes (ayw3 and ayw4) were only occasionally found. The HBV subtype was associated with the expected genotype in most cases (80%), and thus genotype F was highly prevalent. Sequencing of viral strains that gave genotypes unpredicted by the HBsAg subtyping confirmed seven of them as belonging to not previously described genotype-subtype associations: namely, adw2 and ayw4 within genotype F.

Amino Acid Substitution↗
PubMed1998

The expression and regulation of chick EphA7 suggests roles in limb patterning and innervation.

Eph receptors and their ligands, the ephrins, have been implicated in early patterning and axon guidance in vertebrate embryos. Members of these families play pivotal roles in the formation of topographic maps in the central nervous system, the formation of brain commissures, and in the guidance of neural crest cells and motor axons through the anterior half of the somites. Here, we report a highly dynamic expression pattern of the chick EphA7 gene in the developing limb. Expression is detected in discrete domains of the dorsal mesenchyme from 3 days of incubation. The expressing cells are adjacent to the routes where axons grow to innervate the limb at several key points: the region of plexus formation, the bifurcation between dorsal and ventral fascicles, and the pathway followed by axons innervating the dorsal muscle mass. These results suggested a role for EphA7 in cell-cell contact-mediated signalling in dorsal limb patterning and/or axon guidance. We carried out experimental manipulations in the chick embryo wing bud to alter the dorsoventral patterning of the limb. The analyses of EphA7 expression and innervation in the operated wings indicate that a signal emanating from the dorsal ectoderm regulates EphA7 in such a way that, in its absence, the wing bud lacks EphA7 expression and shows innervation defects at the regions where the gene was downregulated. EphA7 downregulation in the dorsal mesenchyme after dorsal ectoderm removal is more rapid than that of Lmx-1, the gene known to mediate dorsalisation in response to the ectodermal signal. These results add a new gene to the dorsalisation signalling pathway in the limb. Moreover, they implicate the Eph receptor family in the patterning and innervation of the developing limb, extending its role in axon pathfinding to the distal periphery.

Animals↗
PubMed1997

Novel expression gradients of Eph-like receptor tyrosine kinases in the developing chick retina.

Eph-like receptor tyrosine kinases have recently been identified as critical components in the development of the retinotectal system. Complementary gradients of receptors and ligands in the retina and tectum, and within the retina itself, have previously been described. Here, we present a novel centroperipheral gradient of expression for one member of this family of receptors, Cek9, suggesting that retinal patterning and axon guidance during the establishment of retinotectal projections may involve coordinate mapping along three axes. Furthermore, we show matching gradients of two cytoplasmic kinases, compatible with their putative involvement in the intracellular signaling pathways used by these receptors in the retina. We also demonstrate a dorsal to ventral expression gradient for Cek11, an Eck-like receptor, the Eph subclass previously suggested to specify positional information along the temporonasal axis.

Animals↗
PubMed1997

The expression of chick EphA7 during segmentation of the central and peripheral nervous system.

We have isolated a novel chick Eph-related receptor that corresponds to the EphA7 gene. Within the nervous system, EphA7 expression is restricted to prosomeres 1 and 2 in the diencephalon and all the rhombomeres in the hindbrain during segmentation stages. Later on, a superimposed pattern appears that correlates with the formation of several axonal tracts. In the somitic mesoderm, the expression correlates with segmentation and the guidance of both neural crest and motor axons through the sclerotomes.

Animals↗
PubMed1996

Differential cellular response after glutamate analog hippocampal damage.

The tissue response after brain damage implicates the cellular "activation" of astrocytes and microglia. This glial response is referred as reactive gliosis. Using immunohistochemical markers, we have analyzed the neuronal and glial response to some neurotoxic-induced lesions. We have compared the effects of two glutamate analogs, AMPA and kainic acid, with those of traumatic injury. Our data showed that the time-course of appearance, the relative contribution of and the behavior of reactive astrocytes and microglial cells were clearly different after AMPA or kainic acid administration. The immunoreactivity associated with microglia response, with respect to the immunoreactivity associated with reactive astrocytes, was higher after AMPA damage than after kainic acid treatment. In both cases, however, glial cells were more abundant than after traumatic lesions. Interestingly, the CA1 pyramidal neurons affected by AMPA and some cortical neurons affected by traumatic injury responded with an overexpression of amyloid precursor protein, whereas no neuronal response was detected after the kainic acid treatment. Our data suggest that the gliotic response is highly specific to the type of insult and heterogeneous depending on the brain area affected.

Animals↗
PubMed1995

The effect of flap management and bioresorbable occlusive devices in GTR treatment of degree III furcation defects. An experimental study in dogs.

The present experiment on guided tissue regeneration had 2 objectives namely: (i) to study if an improved anchorage of the soft tissue flaps during the initial healing period after membrane placement would reduce the tendency for soft tissue recession and allow for healing of also large furcation defects; (ii) to determine if the use of biodegradable membranes in GTR procedures may promote new attachment formation in degree III furcation defects. 2 experiments were performed which included 5 and 8 dogs each. In each animal, the 3rd premolar of the left or right side of the mandible was selected as test site using the contralateral tooth as control. 2 months prior to the start of the experiment, the 2nd and 4th premolars in each side of the mandible were extracted. The extractions were performed to create a large edentulous space mesial and distal to the 3rd premolar. During GTR therapy the incisions prepared in this edentulous region were used to allow proper suture retention and flap stability during the initial phase of healing. In study 1, furcation defects (degree III) were prepared and subsequently treated according to GTR using e-PTFE membranes in the test and no membrane in the control site. In study 2, a bioresorbable membrane (Resolut) was installed in the test and an e-PTFE membrane in the control sites. The non-resorbable membranes were removed after 30 days. The animals were sacrificed 5 months after reconstructive surgery, biopsies were harvested, sectioned and analyzed histologically for new connective tissue attachment and bone.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Process↗
PubMed1995

Localization of NADPH-diaphorase activity in the human visual cortex.

The present report describes the activity of NADPH-diaphorase (NADPHd) in area 17 of autopsied normal human visual cortex. Four human brains from autopsy tissue (4-8 h postmortem) were fixed by immersion in 4% paraformaldehyde in 0.1 M sodium phosphate buffer, pH 7.2-7.4, or in 10% formalin for 24 h. NADPHd histochemistry was done using the malic enzyme indirect method. The neuropile pattern of enzyme activity presented a clear six-layer appearance. Cell morphology and the laminar distribution of 73 NADPHd-positive neurons are described. All neurons found in area 17 of human cortex were sparsely spiny or smooth cells, located in all cortical layers except layer 4c. Quantitative analysis of the branching pattern of the dendritic tree was carried out. A symmetrical pattern was observed with no particular dendritic bias except for a few white matter and layer 1 cells. Larger dendritic fields were found in white matter cells when compared to the other cortical layers. Comparison of cell densities for gray and white matters showed that 85% of the NADPHd-positive neurons were located in the white matter. NADPHd was colocalized with nitric oxide synthase which produces nitric oxide, a short-life neuromediator implicated in synaptic plasticity, neuroprotection, and neurotoxicity. Thus, the spatial distribution of the NADPHd cells is important for posterior functional studies of the neuromediators in the brain.

Aged↗
PubMed1995

Just another look at delegation.

Twenty-first century health care is a given. Delegation to and by the professional nurse may well be one empowering tool that will strengthen the scope of 21st century professional practice. Nurses as leaders can make it happen.

Forecasting↗