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Biomedical subjects

M Cruz

Publications and source records attributed to M Cruz.

At least 37 records · Page 2Linked to original sources
PubMed2001

Compliance and costs in a case management model.

Case management (CM) team models are a well-established mode for delivery of mental health services to individuals with serious and persistent mental illnesses. Although numerous aspects of CM models have been investigated, a neglected component is compliance to outpatient appointments. This pilot, quality assurance study examined the relationship between compliance to psychiatric outpatient appointments and costs in an integrated service delivery system using CM for treating seriously and persistently mentally ill individuals. Two groups of participants were randomly selected based on a single compliance data point and examined using cross-sectional and longitudinal methods. Results revealed relatively high compliance rates that were significantly different between groups over time. However, no differences in costs for services over time, and no demographic variables predictive of noncompliance (i.e., age, miles from residence to site, ethnicity, diagnostic group, level of functioning) were identified. Implications for CM in public mental health integrated service delivery systems, and quality assurance studies are discussed.

Adult↗
PubMed2001

Implant-induced expansion of atrophic ridges for the placement of implants.

The applicability of endosseous implants is directly related to the topography and quality of the patient's residual bone. Several techniques have tried to expand the applicability through implant design alterations and surgical techniques for bone augmentation. This article describes an implant-induced bone expansion procedure that facilitates the placement of implants in atrophic alveolar ridges. This procedure expands the cortical plates of the alveolar ridges with or without fracture using wedge-shaped implants and the principles of guided tissue regeneration. The use of implants of larger diameters and the remodeling of the ridge external contour can be achieved with this procedure.

Alveolar Process↗
PubMed2001

The removal of bacteria by modified natural zeolites.

The removal effect of natural and modified zeolites containing different heavy metals (Ni2+, Zn2+, Fe3+ and Cu2+) on pure cultures of Escherichia coli and Staphylococcus aureus in a solid medium was evaluated in this work. These experiments were carried out in a continuous mode treating municipal wastewater. Faecal coliform species and Pseudomonas aeruginosa were identified. The rate constants of heavy metal lixiviation were determined using a first order kinetic model. The removal effect of modified natural zeolites in both a solid medium and in continuous mode showed an increased elimination of the bacterial population. The results established a decreasing order of the removal effect as follows: Cu2+ > Fe3+ > Zn2+ > Ni2+. The best performance of columns was obtained for inlet bacterial concentrations below 10(6) cells/100 ml. Most of the identified bacterial species were affected by copper modified zeolites, although Serratia marcescens presented the highest sensitivity and Klebsiella pneumoniae the greatest resistance.

Escherichia coli↗
PubMed2001

Tracking of oocyte dysmorphisms for ICSI patients may prove relevant to the outcome in subsequent patient cycles.

BACKGROUND: We determined whether oocyte dysmorphisms, especially repetition of specific dysmorphisms from cycle to cycle, had a prognostic impact on intracytoplasmic sperm injection (ICSI) outcome. METHODS: ICSI patients (n = 67) were grouped as follows: group 1 >50% phenotypically dysmorphic oocytes per cohort (cytoplasmic and extra-cytoplasmic dysmorphisms) with no repetition of a specific dysmorphism from cycle one to cycle two (36 cycles and 274 oocytes); group 2 >50% dysmorphic oocytes per cohort and repetition of the same dysmorphism from cycle one to cycle two (32 cycles and 313 oocytes); group 3 (control) <30% dysmorphic oocytes (33 cycles and 378 oocytes). RESULTS: In group 2 (repetitive), 47% of oocytes were observed to have organelle clustering versus 20.5% in group 1 and 17.3% in group 3 (P < 0.001). There was no difference between the groups in fertilization rates, cleavage rates or embryo quality. Embryos derived from normal oocytes were transferred in each group (57, 33 and 72% respectively). The clinical pregnancy and implantation rates in group 2 (3.1 and 1.7% respectively) were lower (P < 0.01, P = 0.005) than both group 1 (28 and 15% respectively) and group 3 (45.5 and 26.5% respectively). CONCLUSIONS: The low implantation rate in group 2, even though 33% of transferred embryos were derived from morphologically normal oocytes, suggests that repetitive organelle clustering may be associated with an underlying adverse factor affecting the entire follicular cohort.

Adult↗
PubMed2001

Views of child sexual abuse in two cultural communities: an exploratory study among African Americans and Latinos.

This exploratory study investigates knowledge and ideas about child sexual abuse among African Americans and Latinos through focus group discussions. Participants defined and described child sexual abuse, acknowledged that it occurred in their communities, and expressed their sense that family risk factors, risky institutions, and offender propensities were its root causes. Latino participants identified cultural transitions as another contributor. Responses and conversational style differed somewhat by gender and cultural identity. The authors discuss implications for child sexual abuse prevention, intervention, and research.

Adult↗
PubMed2001

Neurological teleconsultation for general practitioners.

A neurology teleconsulting network was implemented between a university hospital in Lisbon and five nearby health centres. PCs equipped for videoconferencing were installed, connected by ISDN lines at 128 kbit/s. Fifty-three general practitioners (GPs) were surveyed. The survey showed that the GPs had difficulties in using computers, but they had definite intentions to use teleconsultation for neurology cases and 83% of the respondents stated that they would probably use the technique. During the study, 90 neurology teleconsultations took place over 55 weeks. The average consultation rate was 1.6 teleconsultations per week (SD 1.3, range 0-6). The conferences lasted 10-45 min. Longer teleconsultations were mainly due to technical difficulties in using computers on the part of users with a low level of computer literacy. The patients were 42 males and 46 females, with a mean age of 38 years (SD 20, range 1-84); two patients were discussed twice. The benefits consisted mainly of advice on patient medication, diagnosis and the prevention of unnecessary specialist consultations or laboratory examinations. Doctor-doctor teleconsultation allows the rapid resolution of queries which otherwise cause stress to patients and increase the cost and complexity of care.

Adolescent↗
PubMed2001

Stenting as first option for endovascular treatment of malignant superior vena cava syndrome.

OBJECTIVE: Endoprostheses were inserted in cancer patients with superior vena cava syndrome to assess their effectiveness as first-choice, initial treatment for relief of symptoms. SUBJECTS AND METHODS: Wallstent prostheses (n = 73) of various lengths (5-14 cm; median, 7 cm) and diameters (10-16 mm; median, 16 mm) were inserted in 52 cancer patients (51 men, 1 woman; age range, 44-78 years; mean, 63 years) who were diagnosed and confirmed by cavography or phlebography as having superior vena cava syndrome. A single stent was sufficient in 37 patients, two stents were required in 11, three stents in two, and four stents in another two patients. Contraindications for the procedure were severe cardiopathy or coagulopathy. RESULTS: Resolution of symptoms was achieved in all patients within 72 hr. At follow-up, six obstructions, one partial migration to the right atrium, two incorrect placements, and four stent "shortenings" were noted. All were successfully resolved by repeated stenting. Symptom-free survival ranged from 2 days to 17 months (mean, 6.4 months). At the time of this writing, eight patients are alive and have patent stents. The rest have died from their cancer. CONCLUSION: The Wallstent vascular endoprosthesis is an effective initial treatment in superior vena cava syndrome of neoplastic origin. Morbidity and complications are minimal. Clinical relief of symptoms is rapid; therefore, the Wallstent endoprosthesis is highly recommended as the first choice for palliative treatment of superior vena cava syndrome, especially because the clinical decision for subsequent chemotherapy or radiotherapy or surgery is not in any way prejudiced.

Adult↗
PubMed2001

Induction of matrix metalloproteinase-8 in human fibroblasts by basic calcium phosphate and calcium pyrophosphate dihydrate crystals: effect of phosphocitrate.

Although matrix metalloproteinase-8 (MMP-8) was regarded as the exclusive product of the neutrophils, recent studies have shown that it is also expressed in articular chondrocytes, rheumatoid synovial fibroblasts and endothelial cells. Our aim was to determine the expression of MMP-8 in human fibroblasts (HF) by reverse transcription/polymerase chain reaction (RT/PCR). Northern and Western blotting methods and MMP-8 activity assay. We have shown the expression of MMP-8 in HF and its dose-dependent upregulation by basic calcium phosphate (BCP) and calcium pyrophosphate dihydrate (CPPD) crystals which are markers of severe joint degeneration in osteoarthritis. These effects require new protein synthesis and are reversed by phosphocitrate (PC). The results also show that this fibroblast MMP-8 is distinct from the neutrophil MMP-8 and from the fibroblast MMP-1. These results indicate that MMP-8 may play a significant role in the pathogenic effects of the crystals in osteoarthritis.

Anti-Bacterial Agents↗
PubMed2001

[Motivation to quit smoking among ex-smoker university workers and students].

BACKGROUND: In Chile, 10% of deaths in adults are directly attributed to smoking. AIM: To identify intrinsic and extrinsic motivations to quit smoking among a group of subjects that quitted without external help. MATERIAL AND METHODS: The motivations to quit smoking were measured using the 20 items Reasons for Quitting Scale (RFQ), in 145 ex smokers (80 students and 65 workers at The University of Conception). The scale identifies intrinsic motivations in the categories health and self control and extrinsic motivations in the categories immediate reinforcement and social pressure. RESULTS: Factorial analysis with orthogonal rotation of the 20 items of the scale, suggested an optimal solution with five factors, that had a maximal impact of 0.43 and explained the motivations in up to a 66% of workers and 65% of students. The factors with the greater impact were the items of immediate reinforcement, social pressure and self control. The category health had only a 6% influence in the modification of smoking habits. CONCLUSIONS: The most important motivations to quit smoking in this sample were an immediate reinforcement, social pressure and self control. The analysis of motivations will help to orient smoking cessation programs.

Adolescent↗
PubMed2001

Seroprevalence of Schistosoma mansoni in Puerto Ricans with inflammatory bowel disease.

BACKGROUND: The etiology of Inflammatory Bowel Diseases, Crohn's disease (CD) and ulcerative colitis (UC), is unknown. These diseases have a higher incidence in industrialized countries and their pathogenesis involves an over-reaction of the immune system. A genetic factor is believed to predispose to the development of chronic inflammation in response to an unidentified stimulus. Exposure to infections in childhood may modulate future immune responses. Parasitosis, particularly Schistosomiasis, stimulate Th2 immune responses. It has been hypothesized that the absence of these parasitic infections, as seen in economically developed countries, favors a Th1 response that may result in the clinical appearance of Crohn's disease later in life. OBJECTIVE: To determine the prevalence of Schistosoma mansoni antibodies in Puerto Ricans with Inflammatory Bowel Disease and controls. METHODS: Serum from 92 Puerto Ricans with IBD and 106 controls was screened for S. mansoni adult microsomal antigens (MAMA) using the FAST:ELISA assay. Those positive were confirmed with an enzyme-linked immunoelectrotransfer blot test. RESULTS: Seven serum samples (3 UC and 4 controls) were positive for S. mansoni antibodies. There was no significant difference between groups in gender, municipality of origin or seroprevalence of Schistosomiasis. The control group was slightly older than the IBD group. CONCLUSIONS: Our study did not demonstrate an inverse relation between Schistosomiasis and IBD. However, the decreasing prevalence of Schistosomiasis in the general population of Puerto Rico may account for this result.

Adult↗
PubMed2000

Quality of rearing practices as predictor of short-term outcome in adolescent anorexia nervosa.

BACKGROUND: Studies of family relationships in anorexia nervosa have produced conflicting results. Some authors claim that family factors are related to short-term outcomes. METHODS: Perceived rearing practices, as measured by the EMBU (Egna Minnen Betraffande Uppfostran: 'My memories of Upbringing') were examined in a sample (N = 158) of adolescents with anorexia nervosa and compared with the perceptions of adolescents (N = 159) from the general population. A further comparison was made between the groups of patients with good and bad short-term outcomes. Logistic regression analysis was performed to evaluate the predictive value of different variables on short-term outcome. RESULTS: Overall, small differences were observed in the perceptions of rearing practices as expressed by the controls and the anorexic patients. Patients with bad short-term outcome perceived more rejection and control-overprotection from both parents than those with good outcome. In the logistic regression analysis only Rejection from father and the EAT (Eating Attitudes Test) total score gave independent prediction of treatment response. CONCLUSIONS: Taken as a whole, these results do not support the idea of altered rearing practices in anorexic patients, at least in young patients with a short evolution of the disease. Perceived rearing practices, especially 'rejection', appear to have an appreciable effect on the short-term outcome.

Adolescent↗
PubMed2000

Subacute thyroiditis during treatment with combination therapy (interferon plus ribavirin) for hepatitis C virus.

Autoimmune thyroiditis has been frequently reported during interferon monotherapy for hepatitis C, but there are few reports concerning subacute thyroiditis. Recently, combination therapy of IFN plus ribavirin has become the preferred therapeutic schedule for chronic hepatitis C. Similarly to interferon monotherapy, there are no reports concerning subacute thyroiditis during combination therapy. We described four episodes of subacute thyroiditis occurring in three patients during antiviral combination therapy. All patients had symptoms compatible with hyperthyroidism, which could be misdiagnosed as IFN side-effects. The antiviral treatment was continued in all three patients and thyroid function increased progressively with pharmacological treatment for hyperthyroidism. We concluded that subacute thyroiditis may be a complication of combination antiviral therapy and should be investigated in patients presenting with compatible symptoms, in order to differentiate from IFN side-effects.

Adult↗
PubMed2000

Respiratory-related evoked potentials in children with life-threatening asthma.

Respiratory-related evoked potentials (RREPs) have been elicited by inspiratory occlusion and recorded over the somatosensory cortex. The first positive peak (P(1)) amplitude has been correlated with the magnitude of inspiratory loads. Since children with life-threatening asthma (LTA) have a decreased perceptual sensitivity of inspiratory loads, we hypothesized that a subpopulation of patients with LTA have an impaired ability to sense mechanical loads, and that these patients would have an abnormal RREP. The RREP was recorded from C(Z) -C(3) and C(Z) -C(4) in three groups: LTA asthmatic, control asthmatic, and nonasthmatic children. Two inspiratory-interruption occlusions trials and a control trial were recorded. All the evoked potentials were analyzed after the averaged control trial was subtracted from the averaged occlusion trials. The RREP P(1) peak was observed in all 14 nonasthmatic children and in 14 of 15 control asthmatic children. The RREP was absent in 6 of 11 patients with LTA. When present, there were no between-group significant differences in P(1) peak latency or amplitude. These results demonstrate that the RREP elicited by inspiratory occlusion is present bilaterally in nonasthmatic and asthmatic children. There is a subpopulation of LTA children in which inspiratory occlusion fails to elicit the P(1) peak of the RREP, suggesting an altered neural processing of inspiratory load information.

Adolescent↗
PubMed2000

A proposal to declare neurocysticercosis an international reportable disease.

Neurocysticercosis is an infection of the nervous system caused by Taenia solium. It is the most important human parasitic neurological disease and a common cause of epilepsy in Africa, Asia, and Latin America, representing enormous costs for anticonvulsants, medical resources and lost production. Neurocysticercosis is a human-to-human infection, acquired by the faecal-enteric route from carriers of intestinal T. solium, most often in areas with deficient sanitation. Intestinal tapeworms cause few symptoms, but adult taeniae carried by humans release large numbers of infective eggs and are extremely contagious. Ingestion of poorly cooked pig meat infested with T. solium larvae results in intestinal taeniosis but not neurocysticercosis. With a view to hastening the control of taeniosis and neurocysticercosis we propose that neurocysticercosis be declared an international reportable disease. New cases of neurocysticercosis should be reported by physicians or hospital administrators to their health ministries. An epidemiological intervention could then be launched to interrupt the chain of transmission by: (1) searching for, treating and reporting the sources of contagion, i.e. human carriers of tapeworms; (2) identifying and treating other exposed contacts; (3) providing health education on parasite transmission and improvement of hygiene and sanitary conditions; and (4) enforcing meat inspection policies and limiting the animal reservoir by treatment of pigs. We believe that the first step required to solve the problem of neurocysticercosis is to implement appropriate surveillance mechanisms under the responsibility of ministries of health. Compulsory notification also has the major advantage of providing accurate quantification of the incidence and prevalence of neurocysticercosis at regional level, thus permitting the rational use of resources in eradication campaigns.

Adolescent↗
PubMed2000

Thyroid disease in HCV carriers undergoing antiviral therapy with interferon plus ribavirin.

High prevalence of thyroid autoantibodies, with or without overt thyroiditis, has been described in hepatitis C patients, particularly in those undergoing alpha-interferon treatment. The aim of this study was to describe the frequency and clinical outcome of thyroid disease in a cohort of HCV carriers before and during combination therapy with interferon plus ribavirin. Between May, 1997, and May, 1999, 111 previously untreated (naive) patients were treated with a-interferon plus ribavirin for 6 or 12 months. Of those, 67 (60%) patients were male and 44 (40%) female. Thyroid function was evaluated in all patients by testing free T4, TSH and antiTPO within 30 days prior to treatment, 90 days after treatment was initiated, and 6 months after treatment was concluded. Abnormal thyroid tests were observed in 4 (3.6%) patients--1 male and 3 female--before the onset of antiviral treatment. Three patients were already undergoing T4 replacement due to Hashimoto thyroiditis and 1 patient had positive antiTPO with normal free T4 and TSH. All 4 patients completed the treatment regime for HCV, but required hormone replacement. Among the patients with a normal thyroid function test prior to treatment (107 cases), 5 (4.6%) developed thyroid test abnormalities; 2 patients had hypothyroidism due to autoimmune thyroiditis; 1 patient became positive for antiTPO antibodies but thyroid function remained normal, and 2 patients had subacute thyroiditis. Four of these patients (80%) were female and 1 was male (20%). A family history of thyroid disease was strongly predictive of thyroid abnormalities during antiviral treatment. In conclusion, there is a low prevalence of thyroid function abnormalities in HCV carriers with no prior antiviral treatment. Family history of thyroid disease reinforces the special attention to thyroid abnormality development before considering antiviral therapy. Subacute thyroiditis during combination therapy was observed, but its pathogenesis is still unknown. Evaluation of thyroid function during and after antiviral treatment is strongly recommended because thyroid related symptoms can be easily misinterpreted as medication side effects.

Adult↗
PubMed2000

[Smoking among academics, non-academics and students of the Universidad de Concepción].

BACKGROUND: Effective smoking cessation campaigns require as baseline, precise estimations of smoking habits in different populations. AIM: To assess the prevalence of smoking in academic, non-academics workers and student of the University of Concepción. MATERIAL AND METHODS: In a random and stratified sample of 272 workers (including academics) and 1146 students, a previously validated, self administered questionnaire about smoking was applied. Daily smoking was defined as smoking seven or more cigarettes per week and occasional smoking as smoking less than seven cigarettes per week. RESULTS: The prevalence of smoking was 23% among academics, 34% among non-academic workers and 44% among students. Nineteen percent of men and 16% of women were occasional smokers; 23% of men and 25% of women were daily smokers. Students started smoking at 15 +/- 2 years old and workers did so at 18 +/- 3 years old. The greater influence about smoking came from parents. Workers from the administrative services and from the natural sciences faculty had the higher prevalence of the habit. The total annual cost of smoking was $33,000,000 (US$62,000). CONCLUSIONS: The prevalence of smoking at the University of Concepción is higher among students than workers. Quitting programs are urgently needed.

Adolescent↗