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Biomedical subjects

M C Ramos

Publications and source records attributed to M C Ramos.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Repetitive serum determinations of anticonvulsants in epileptic patients].

To evaluate complacence in chronic epileptic women we collected weekly 144 blood samples from 38 patients for antiepileptic drugs determination. All the patients were supposed to have uncontrolled seizures using phenobarbital, phenytoin or carbamazepine monotherapeutically. We found that 34% of the blood levels were below the standard normal range. Blood level with great weekly variations were interpreted as inadequate intake by the patient. We conclude that repetitive antiepileptic blood levels determination may elucidate if the patient has drug-resistant seizures or if the patient is not complacent to the drug therapy.

Adolescent↗
PubMed1992

The nurse-patient relationship: theme and variations.

The nurse-patient relationship traditionally has been thought central to professional practice. For several decades, nurse theorists have explored the communication processes which mediate clinical practice and the variously described outcomes of these processes. Yet while interpersonal skills and personal attributes have been considered integral to professional bonding, and while outcomes of the process are widely discussed, clinically based validation of theorized process components has not been definitively accomplished. To this end, 67 critical incidents concerning experienced clinicians' perceptions of their closest professional relationships were analysed. The perceived professional bond was demonstrated to be a cumulative process of attachment with three qualitatively different levels of involvement and two impasse states. The most intense levels of attachment were perceived to be the most beneficial by the nurses who described relationships characterized by mutuality and reciprocity. This level was not, however, achieved by all nurses in the sample. Implications of the perceived outcomes of the most intimate professional relationships were discussed.

Adult↗
PubMed1992

Comparison of daptomycin, vancomycin, and ampicillin-gentamicin for treatment of experimental endocarditis caused by penicillin-resistant enterococci.

Infections with enterococci that are resistant to multiple antibiotics are an emerging clinical problem. We evaluated the antibiotic treatment of experimental enterococcal endocarditis caused by two strains with different mechanisms of penicillin resistance. Enterococcus faecalis HH-22 is resistant to aminoglycosides and penicillin on the basis of plasmid-mediated modifying enzymes; Enterococcus raffinosus SF-195 is susceptible to aminoglycosides but is resistant to penicillin on the basis of low-affinity penicillin-binding proteins. Animals infected with strain HH-22 received 5 days of treatment with the following: no treatment; daptomycin (20 mg/kg of body weight twice daily [b.i.d.], intramuscularly [i.m.]), vancomycin (20 mg/kg b.i.d., intravenously), or ampicillin (100 mg/kg three times daily, i.m.) plus gentamicin (2.5 mg/kg b.i.d. i.m.). Although vancomycin was superior to ampicillin-gentamicin (P less than 0.01), daptomycin was significantly better than all other treatment regimens (P less than 0.01) in reducing intravegetation enterococcal densities, although no vegetations were rendered culture negative by this agent. Animals infected with strain SF-195 received 5 days of no therapy, ampicillin, ampicillin-gentamicin, vancomycin, or daptomycin (all at the dosage regimens described above). Daptomycin, vancomycin, and ampicillin-gentamicin each lowered intravegetation enterococcal densities significantly better than did ampicillin monotherapy or no treatment (P less than 0.01); moreover, these three treatment regimens rendered significantly more vegetations culture negative than did ampicillin monotherapy or no treatment (P less than 0.05). Serum daptomycin levels remained above the MICs and MBCs for both enterococcal strains throughout the 12-h dosing interval used in the study. Daptomycin and vancomycin were both active in vivo in these models of experimental enterococcal endocarditis caused by penicillin-resistant strains, irrespective of the mechanism of resistance. This activity correlated with the unique cell wall sites of action of these agents (binding to lipoteichoic acid and pentapeptide precursor, respectively) compared with the sites of action of beta-lactams (penicillin-binding proteins). Beta-Lactamase production by strain HH-22 precluded in vivo efficacy with ampicillin-gentamicin combinations. In contrast, this combination was active in vivo against strain SF-195, which exhibited intermediate-level penicillin resistance (MIC, 32 micrograms/ml), likely reflecting the ability of high-dose ampicillin to achieve enough binding to low-affinity penicillin-binding proteins to cause augmented aminoglycoside uptake.

Ampicillin↗
PubMed1992

Effects of alginase on the natural history and antibiotic therapy of experimental endocarditis caused by mucoid Pseudomonas aeruginosa.

The exopolysaccharide (alginate) of mucoid strains of Pseudomonas aeruginosa is believed to be an important virulence factor. The ability of an alginate-deploymerizing enzyme (alginase) to modify the polymorphonuclear leukocyte (PMN)-directed and antibiotic-mediated phagocytosis and killing of mucoid P. aeruginosa was studied both in vitro and in vivo. In vitro, pretreatment of a mucoid P. aeruginosa strain (144MR) resulted in a significant enhancement of PMN phagocytosis and killing of the organism (P less than 0.05), to levels similar to that observed with its nonmucoid mate, strain 144NM. Moreover, alginase treatment of the mucoid strain 144MR caused a substantial removal of bacterial cell surface alginate as assessed by immunofluorescence staining with a murine monoclonal antialginate antibody. The experimental endocarditis model was used to evaluate the in vivo effect of alginase in modifying the course of a deep-seated pseudomonal infection caused by mucoid strain 144MR. In right-sided endocarditis, in which PMNs normally mediate spontaneous clearance of the organism from cardiac vegetations (A. S. Bayer, J. Yih, C. Y. Chiu, and C. C. Nast, Chemotherapy 35:278-288, 1989), the presence of the alginate exopolysaccharide on strain 144MR was associated with an inability to reduce intravegetation pseudomonal counts over a 13-day postinfection period; in contrast, right-sided vegetations infected with the nonmucoid strain 144NM underwent significant reductions in bacterial densities over this same time (P less than 0.05). Administration of alginase intravenously (i.v.) (750 enzyme units per day for 7 days) to animals with right-sided endocarditis caused by the mucoid strain 144MR was associated with a significant reduction in intravegetation pseudomonal counts (P less than 0.05), to levels similar to that seen with endocarditis caused by the nonmucoid strain. In left-sided endocarditis caused by mucoid strain 144MR, animals received either no therapy, amikacin (20 or 40 mg/kg twice a day for 7 or 14 days), or amikacin plus alginase (750 U/day [i.v.]). The coadministration of alginase for 14 days with the higher-dose amikacin regimen rendered more left-sided vegetations culture negative than those in animals receiving the antibiotic alone for 7 or 14 days (P = 0.001 and 0.056, respectively). These salutary effects of alginase in vivo were paralleled by the ability of the enzyme to remove the exopolysaccharide from the surface of mucoid pseudomonal cells within cardiac vegetations, as assessed by transmission electron microscopy.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1991

Premenstrual seizure increase: influence of age, duration of disease, seizure frequency, previous complaint of perimenstrual accentuation, EEG and CT scan findings.

UNLABELLED: We selected prospectively 80 mentally healthy women at menacme age, with chronic epilepsy and at least one seizure in the month preceding this study. They underwent four EEGs weekly. CT scan of the skull was done in 57 patients (71.25%). Seven patients were excluded because they had no seizures or menses. We registered 5630 seizures during 579 regular menstrual cycles over a 30 month period. RESULTS: there was a higher incidence of seizures in the premenstrual period (p less than 0.001); age did not influence the distribution of seizures during the menstrual cycle in the group studied; patients with 11 or more years of disease showed more accentuation of premenstrual seizures than patients with 10 or less years of disease; there was no relation between the patients frequency of seizures and the occurrence of premenstrual seizures; the patients impression of the incidence of seizures not related to menstruation was not confirmed; patients with abnormal skull CT scans had more accentuation of premenstrual seizures than patients with normal exams; patients with abnormal EEGs had more premenstrual seizures than patients with normal exams. Our findings suggest that the female sexual hormones alter cerebral excitability when there is an underlying structural pathology shown by CT scan or an electrical cerebral dysfunction revealed by EEG.

Adolescent↗
PubMed1989

Some ethical implications of qualitative research.

Traditional values in nursing dictate a high level of concern for the welfare of research participants. Initial attempts at setting minimal ethical standards stemmed from the quantitative approaches. As qualitative modalities are more widely used, nurses must become acutely aware of possible problems in study design and planning, the dangers of coercion and deception, threats to confidentiality and trust, implications of the emergent design, and providing for a new concept of informed consent. The new character of the research relationship is examined in light of possible strategies for protection of research participants while preserving the integrity of qualitative investigation.

Behavioral Research↗
PubMed1989

Detection and characterization of antigens from Taenia solium cysticercus in cerebrospinal fluid.

Dot-ELISA and standard-ELISA were used to detect T. solium cysticercus antigens in cerebrospinal fluid for the diagnosis of neurocysticercosis. The results indicate that both assays are sensitive, specific and economically adequate for the diagnosis of this disease. Using SDS-PAGE, electroblotting and dot-ELISA we have found that the antigen is a protein with a molecular weight of 66,000 daltons.

Adult↗
PubMed1987

Adopting an evolutionary lens: an optimistic approach to discovering strength in nursing.

Appropriately, the state of the art of nursing is in constant review. Philosophy of science, particularly the work of Thomas Kuhn, has traditionally provided the criteria upon which these introspective evaluative processes are based. More recent developments in philosophy of science have introduced alternative models, such as Toulmin's evolutionary model, which might yield a more cogent, optimistic assessment of theoretical progress within nursing. Specific shortcomings of Kuhn's model and possible advantages of one evolutionary model are explored with comparative outcomes presented. Evidence of emerging evaluative criteria within nursing is also explicated.

Human Development↗
PubMed1987

Effect of ultraviolet light irradiation on viability and aflatoxin production by Aspergillus parasiticus.

The effect of ultraviolet light irradiation (254 nm) on both the viability and the aflatoxin-producing ability of the fungus Aspergillus parasiticus NRRL 2999, a good aflatoxin-producing strain, was studied. This strain showed noticeable resistance and irradiation for more than 10 min was necessary to reduce survival to under 10%, while the white mutants were more susceptible (5 min of irradiation reduced survival to under 1%). Induction of mutants with complete loss of aflatoxigenicity was rare and only 3 of the 1463 survivors tested were aflatoxinless.

Aflatoxins↗
PubMed1987

Detection of Cysticercus cellulosae antigens in cerebrospinal fluid by dot enzyme-linked immunosorbent assay (Dot-ELISA) and standard ELISA.

The dot enzyme-linked immunoassay and standard enzyme-linked immunoassay were used to detect Cysticercus cellulosae antigens in cerebrospinal fluid of patients suffering with neurocysticercosis. Using the dot enzyme-linked immunoassay, 10 of 17 patients (59%) were positive at a reciprocal titer of 128 (range 128-1,024). In the standard assay, 13 of 17 (77%) were positive (range 128-512). Specificity was 100% in both assays using 48 cerebrospinal fluids from patients with various central nervous system infections. The quantification of antigens in cerebrospinal fluid using standard assay and photometric readings showed a range of 17 to 138 ng/ml. The results indicate that both assays are sensitive, specific, and economical for the diagnosis of neurocysticercosis.

Adult↗
PubMed1985

Cytogenetic findings in a human malignant melanoma metastatic to the brain.

Cytogenetic analysis by G-banding of direct and preparations of a malignant melanoma metastatic to the brain in vitro showed a pseudodiploid modal chromosome number, including five marker chromosomes, one of which was an i(6p). These results agree with those recently reported about the preferential involvement of chromosome #6 in malignant melanoma.

Brain Neoplasms↗
PubMed1985

[Polyradiculoneuritis and malaria: report of a case].

Case report of a patient who three weeks after a Plasmodium falciparum malaria presented the Guillain-Barré syndrome. There was a severe type of polyradiculoneuritis with tetraplegia and involvement of several cranial nerves (VI, VII, IX, X) evolving to death. The Guillain-Barré syndrome has been considered a immune disorder with several eliciting antigenic stimuli. The case suggests that protozoan may be one these antigenic factors.

Acute Disease↗
PubMed1984

Treatment of neurocysticercosis with flubendazole.

Thirteen patients with neurocysticercosis were studied and treated with flubendazole. Diagnostic procedures included computerized tomography (CT) and enzyme-linked immunosorbent assay. In 12 cases treatment with the drug led to clinical improvement. CT showed that some cysts regressed in size, and in two patients they disappeared. The treatment also lowered the antibody levels. The drug was well tolerated and no allergic reaction or other side effects were observed.

Adult↗