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Biomedical subjects

M E Garcia

Publications and source records attributed to M E Garcia.

At least 37 records · Page 2Linked to original sources
PubMed1998

Transabdominal or totally extraperitoneal laparoscopic hernia repair?

Laparoscopic repair of inguinal hernias follows some principles that have already proven its efficiency, as a posterior approach and the prosthetic repair that allows a "tension-free" repair with consequent early return to work and low recurrence rate. To determine the most appropriate laparoscopic repair, we compared the transabdominal preperitoneal (TAPP) and the totally extraperitoneal (TEP) approach. Patients undergoing TAPP and TEP were compared regarding technical feasibility and difficulties, time until return to work and follow-up, including intraoperative and postoperative complications. Seventy-eight patients (108 hernias) were submitted to TAPP and 67 (100 hernias) were repaired through TEP. All data were analyzed by Yates-corrected chi-square test to qualitative analysis of each group and p < or = 0.05 was considered significant. Both procedures were indicated mainly for bilateral and/or recurrent hernias (68%). The operative time was shorter in TAPP (not statistically significant). Surgeons complained of more technical difficulties while performing the TEP approach (70% complaints of difficulty in TEP--four conversions to TAPP). There was no difference in hospital stay (mean of 30 h) and return to work (TAPP 7 days and TEP 5.5 days). Regarding the complication rate (TAPP = 20.5% and TEP = 13.5%; not significant), none were related to the pneumoperitoneum technique or its systemic effects. In the TAPP approach, two trocar site hernias occurred, and in the TEP approach, one severe cellulitis occurred, which was managed without surgical intervention. The mean follow-up period for each procedure was not the same, so the recurrence rates are not comparable statistically (rate of 1.85% in TAPP and 0 in TEP). Both techniques are safe and have the same advantages, but TAPP is easier: a better view of the anatomy is achieved, shortening the learning curve. We suggest that TAPP can be an adequate laparoscopic approach to groin hernias. A longer follow-up period and more cases are needed to determine recurrence rates.

Adult↗
PubMed1997

How safe is ERCP to the endoscopist?

BACKGROUND: Interventional techniques in endoscopy such as endoscopic retrograde cholangiopancreatography (ERCP) have greatly increased since laparoscopic cholecystectomy has become widespread; mainly these techniques deal with common bile duct stones. Fluoroscopy is usually employed, and chronic exposure to X-ray, in spite of the relative low dose, can lead to potentially unhealthy conditions such as malignancies like bone marrow and other solid cancers. A median of 18 years of life is lost per fatal cancer, including the time of latency since exposure. Nor should one forget benign condition such as cataracts that can lead to partial or complete blindness and which surely impair life's quality. METHODS: Simulated examinations were carried at the University Hospital (São Paulo, Brazil) using an anthropomorphic phantom in place of the physician. Four sets of dosimeters were placed in the forehead, neck, torso, and lower abdomen (with and without a lead apron) and standard ERCP fluoroscopic techniques were employed. RESULTS: The dose equivalents were calculated and compared to the recommended exposure doses of national and international boards of radiation protection. CONCLUSIONS: Based on the results found and compared to standards, working safely means: (1) A lead (0.5 mm thickness) apron is fundamental. Without it less than one ERCP\month should be performed. (2) With an apron, 23 examinations/month are allowed. (3) No thyroid protection grants only 19 exams/month. (4) Performing ERCP without lead glasses is hazardous to the eye, allowing only seven ERCPs monthly.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1997

Nasopharyngeal colonization in Costa Rican children during the first year of life.

BACKGROUND: The establishment of the nasopharyngeal flora was followed in Costa Rican children from birth to 1 year of age. METHODS: Nasopharyngeal cultures were obtained at 1 (n = 413), 3 (n = 393), 6 (n = 376) and 12 months (n = 356) of age from children representative of the population in the Puriscal district. Weekly cultures were obtained from a subcohort of these children (n = 101). Mother-infant diads (n = 95) and preschool children (n = 208) attending day-care centers were also studied. RESULTS: The estimated proportion of colonized children in the population differed markedly depending on the frequency of culture. Quarterly cultures showed a slow increase in carrier rates from 3.9% for Haemophilus influenzae, 3.1% for Streptococcus pneumoniae and 6.5% for Moraxella catarrhalis at 1 month of age to 10.1% carrying H. influenzae and 19.4% carrying S. pneumoniae by the end of the first year. By quarterly culture the proportion of children colonized at least once was 36% for S. pneumoniae, 26% for H. influenzae and 28% for M. catarrhalis. In contrast weekly sampling showed that 95 to 100% of the children were colonized at least once during the first year of life with H. influenzae, S. pneumoniae or M. catarrhalis. Nasopharyngeal carriage of H. influenzae, S. pneumoniae and M. catarrhalis was low in the mothers, and very few mother-infant pairs carried identical bacteria at the same time. In contrast carrier rates were high in the siblings attending day care (H. influenzae 27.9%, S. pneumoniae 39.4%, both organisms 26.6%). Infants with siblings had significantly higher bacterial carriage at all ages than infants without siblings. CONCLUSIONS: Quarterly nasopharyngeal cultures showed that Costa Rican infants acquire their nasopharyngeal flora at a rate comparable with that for infants in developed countries and that siblings are an important source of the bacteria. Weekly samplings showed that virtually all children were colonized at least once during the first year of life.

Adult↗
PubMed1997

Antimicrobial sensitivity in microorganisms isolated from canine otitis externa.

It is important to test the antimicrobial sensitivity of the aetiological agents of otitis externa before starting treatment in order to prevent the development of antibiotic resistance in the microorganisms. In this study the sensitivity patterns in bacteria and yeasts isolated as aetiological agents from otitis externa were analysed. Antifungal and antibacterial activity tests were done using the automated system ATB Fungus and the classic diffusion test respectively. The azole compounds had the greatest antifungal properties, while beta-lactams had the strongest antibiotic activity. This study reflects the increasing importance of sensitivity tests in chronic otitis externa due to the increasing antimicrobial resistances in bacteria and yeasts. If it is necessary to initiate an empiric treatment before the results of the antimicrobial test, the application of miconazole or econazole for yeasts and oxacillin or amoxicillin-clavulanic acid against bacteria is recommended.

Amphotericin B↗
PubMed1996

Microbiological diagnoses of chronic otitis externa in the dog.

The microbiological characteristics of otic exudates from 26 dogs with chronic otitis externa was studied with special reference to the implication of yeasts in the aetiology of the disease. A high frequency of yeasts and Staphylococcus aureus were isolated, alone or in association. In reference to the yeasts, there was a clear predominance of the genus Candida (48% of the total yeasts). Malassezia (Pytirosporum) represented only 3% of the isolates. It can be concluded that yeasts have an important role in the pathogenicity of this disease. For the microbiological diagnosis of otitis externa, we recommend the simultaneous use of Columbia/5% Sheep Blood Agar and Sabouraud-Dextrose without antibiotic addition, the use of 37 degrees C as the incubation temperature and direct microscopic observation of the sample before culture.

Animals↗
PubMed1995

Purification and amino acid sequence of the insecticidal neurotoxin Tx4(6-1) from the venom of the 'armed' spider Phoneutria nigriventer (Keys).

An insecticidal peptide referred to as Tx4(6-1) was purified from the venom of the spider Phoneutria nigriventer by a combination of gel filtration, reverse-phase fast liquid chromatography on Pep-RPC, reverse-phase high performance liquid chromatography (HPLC) on Vydac C18 and ion-exchange HPLC on cationic columns. Tx4(6-1) is highly toxic to house flies. At levels of 0.5 ng/house fly it caused excitatory symptoms immediately after intrathoracical injection. However, in mice injections of 0.03 mg of the toxin intracerebroventricularly resulted in no apparent symptoms of intoxication. These results demonstrate that Tx4(6-1) of P. nigriventer has no toxicity for mice, and suggest that it is a specific anti-insect toxin. The mol. wt (5244.6) and purity of the toxin were determined by desorption mass spectroscopy. The complete amino acid sequence of this toxin was established by direct automated Edman degradation and manual 4-N,N'-dimethylaminoazobenzene-4'isothiocyanate/phenyl-isothiocyanate microsequence analyses of peptides obtained from digests with various proteases. The protein contains 48 amino acids including 10 Cys and 6 Lys. The N-terminal and C-terminal residues were Cys. The Tx4(6-1) sequence differs from that of previously characterized neurotoxins found in the same and other venom spiders, but exhibited sequence similarities in the location of the Cys residues.

Amino Acid Sequence↗
PubMed1994

HIV infection presenting as renal polyarteritis nodosa.

We present a case of renal vasculitis (polyarteritis nodosa) in a 36-year-old female prostitute having undetected HIV infection (AIDS-related complex) and chronic B-hepatitis. The pathogenesis and significance of the association between these entities are reviewed.

AIDS-Related Opportunistic Infections↗
PubMed1994

Entrapment of cisplatin into biodegradable polyalkylcyanoacrylate nanoparticles.

The entrapment of cisplatin into biodegradable colloidal systems (polyalkylcyanoacrylates) was studied. Nanoparticles were characterized in terms of relevant parameters for organ distribution in vivo, such as particle diameter and particle size distribution, determined by correlation photon spectroscopy and transmission electron microscopy. Association efficiency was also evaluated by Plasma Emission Spectrophotometry. The ability of surfactants (sodium lauryl sulphate and poloxamer 188), and dextrans of various molecular weights, to improve the binding of the drug to polyalkylcyanoacrylates was also studied. The dextran content in nanoparticles, as determined by polarimetry, increases with the molecular weight of the polysaccharide. The highest value of association efficiency of cisplatin to nanoparticles was obtained in the presence of dextran 70 with sodium lauryl sulphate (0.08%) as stabiliser.

Absorptiometry, Photon↗
PubMed1993

Physical and functional characterization of the ColS8 plasmid.

The restriction map of the 5.1-kb colicinogenic plasmid ColS8 is reported. Transposon-insertion mutagenesis has been carried out to investigate the location of the various functional regions of this plasmid. Twenty-six independent ColS8::Tn1 insertions and six different deletion mutant plasmids were isolated, and the locations of the insertions and deletions were determined. The mapping of the transposon-insertion sites, together with characterization of the phenotypes of these mutants, permitted the localization of the regions of DNA involved in colicin production, colicin S8 immunity and mobilization by other plasmids. There is a polar effect in some mutants in which single insertions result in the non-expression of all three functions. In minicell preparations, the ColS8 plasmid directed the synthesis of colicin S8 (60 kDa) and a 14-kDa immunity protein. One deletion mutant with a colicin-less phenotype can synthesize colicin S8 in minicells, which placed the DNA region involved in colicin release between the colicin production and immunity regions. Both the 60-kDa and 14-kDa proteins are expressed from pColS8 in maxicell preparations.

Colicins↗
PubMed1993

Solubility and stability of sterigmatocystin in different organic solvents.

In the present work we studied the solubility of sterigmatocystin (ST) in different organic solvents and the stability of these solutions during cold and frozen storage. ST was more soluble in chloroform and in pyridine. In cold storage ST was more stable in chloroform after both 7 and 30 days. In pyridine, ST was stable on day 7 but not on day 30. In frozen storage, 90% recovery was achieved only in chloroform. We conclude that chloroform is the most suitable organic solvent of those studied to solubilize and store standard solutions of ST.

Drug Stability↗
PubMed1990

Development and validation of the situational appetite measures.

Based on a system to categorize high-risk situations for relapse in addictive disorders, instruments were developed to assess cue strength and self-efficacy relevant to weight loss attempts. Two versions of the Situational Appetite Measure (SAM) were developed, one to assess urges to overeat in selected situations and the other to assess self-efficacy in controlling urges to overeat. In a sample of college student dieters and enrollees in commercial diet centers, the measures were found to be highly correlated, such that as consummatory urges increased, self-efficacy to control overeating decreased. High-risk situations were represented by five relatively distinct and reliable subscales: relaxation, food present, hunger, reward, and negative feelings. Low cue strength and high self-efficacy for controlling overeating in situations involving negative feelings predicted weight reduction among female dieters in treatment. The multidimensional nature of the SAM allows for differential prediction of eating behavior across situations.

Adult↗
PubMed1990

A fine-grained analysis of the role of self-efficacy in self-initiated attempts to quit smoking.

The relation between self-efficacy ratings and smoking behavior was explored among 36 people who were trying to quit smoking on their own. Ss self-monitored high-risk situations, coping efforts to withstand the temptation to smoke, and self-efficacy in coping with similar temptations for 4 weeks after quitting. Self-efficacy ratings were significantly related to the outcome of these situations, with Ss reporting higher efficacy ratings after situations in which they did not smoke as opposed to those in which they did smoke. Self-efficacy was predictive of smoking outcome, but there was considerable intersubject variability in the strength of the relation between efficacy and smoking behavior. Both efficacy and previous smoking behavior predicted smoking outcome equally well, however.

Adaptation, Psychological↗
PubMed1989

[Infection in severe neutropenia: analysis of 140 episodes].

We analyzed infections complicating 140 episodes of severe neutropenia in 86 patients. The underlying diagnosis was acute leukemia in 64, lymphoma in 12 and isolated cases of bone marrow aplasia, agranulocytosis, dysmyelopoiesis and solid tumors. No fever developed in 35 (25%) episodes. No cause for the fever was identified in 40% of the remaining episodes. Clinical evidence of an infection was present in 20%, with positive bacteriologic findings in 27%. Respiratory infection (16%), pneumonia (11%) and sepsis (10%) were the most common infectious processes. Infectious agents isolated were gram negative bacilli (72%), gram positive cocci (19%) and fungi (9%). The association of amikacin and carbenicillin or cephalosporins proved to be superior to gentamycin-penicillin (p less than 0.01). 16 patients died for an overall mortality of 11%. Pneumonia and infection by K pneumoniae or C albicans were associated to a poorer prognosis.

Anti-Bacterial Agents↗
PubMed1982

Mode of action of colicin S8.

The mode of action of colicin S8 has been studied and compared with that of other colicins. Two minutes after the addition of colicin S8 to bacteria a considerable proportion of the colicin is inaccessible to trypsin. Treatment of bacteria with colicin S8 renders them more sensitive to lysis by sodium dodecyl sulphate and also inhibits motility. Like colicins K and E1, colicin S8 provokes lysis of bacteria superinfected with bacteriophage T4. Colicin S8, unlike colicin E2, prevents replication of bacteriophage T4. The incorporation of isoleucine or uracil into bacteria is inhibited by colicin S8 but, unlike colicins K and E1, the effect is multiplicity-dependent. A rapid method of titration of colicin S8 is described. The results are discussed with emphasis on the possible rearrangements at the bacterial surface and the possibility that there is more than one type of specific receptor for colicin S8.

Bacteriolysis↗
PubMed1981

Serum trypsin levels in acute pancreatic and non-pancreatic abdominal conditions.

Serum trypsin levels have been estimated by radioimmunoassay in 26 healthy controls (248 +/- 94.9 micrograms/l; mean +/- s.d.), 12 patients with chronic renal failure (1100 +/- 584 micrograms/l), 34 with acute pancreatitis (1399 +/- 618 micrograms/l) and 23 with acute non-pancreatic abdominal conditions. Mean serum trypsin in acute pancreatitis and in chronic renal failure was significantly higher than in control group (P less than 0.001). Serum trypsin levels were well above the upper limit of normality in all patients with acute pancreatitis and in all but one with chronic renal failure. Serum trypsin was markedly raised in one patient with a traumatic haemoperitoneum and in one of the 11 with peptic ulcer perforation, and moderately raised in 3 of the 6 with acute cholecystitis. Determination of serum trypsin seems to be a specific test for acute pancreatitis, provided renal failure has been excluded. However, the authors suggest it should be prospectively measured in a larger series of acute non-pancreatic abdominal conditions.

Acute Disease↗
PubMed1981

Effect of vanadate on renal tubular function in rats.

Orthovanadate (VO4) has been shown to cause a marked natriuresis in rats. This has been ascribed to its inhibitory action on renal Na-K-ATPase activity. Because virtually all nephron segments possess Na-K-ATPase activity the administration of VO4 should alter renal tubular transport along the entire nephron. To examine this possibility, adult rats were anesthetized and infused with VO4 (10 mumol.kg body wt-1.h-1 i.v.). This dose had no effect on glomerular filtration rate, effective renal plasma flow, and blood pressure, whereas urine flow and sodium and water excretion rose markedly. Potassium excretion remained unaltered. VO4 depressed only maximal bicarbonate and glucose reabsorption without causing a glucose or bicarbonate "leak" at normal levels of blood glucose or bicarbonate. In acutely thyroparathyroidectomized rats VO4 produced a striking phosphaturia, not accompanied by an increase in nephrogenous cAMP excretion. Both free water clearance in Brattleboro rats and free water reabsorption in normal rats was significantly depressed by VO4. These data demonstrate that VO4 depresses tubular reabsorption in proximal and distal nephron segments. We conclude that VO4 exerts its effect on tubular function by inhibition of Na-K-ATPase activity.

Animals↗