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Biomedical subjects

M L Fidalgo

Publications and source records attributed to M L Fidalgo.

16 recordsLinked to original sources

PSP toxins from Aphanizomenon flos-aquae (cyanobacteria) collected in the Crestuma-Lever reservoir (Douro river, northern Portugal).

The presence of paralytic shellfish poisoning (PSP) toxins in cultures of Aphanizomenon flos-aquae, isolated from the Crestuma-Lever reservoir, was found by reversed phase high performance liquid chromatography employing two isocratic elution systems for the separation of PSP toxins. With the first isocratic elution protocol, the presence of apolar toxins as saxitoxin, decarbamoyl saxitoxin and neosaxitoxin not detected. On the other hand, GTX4, GTX1 and GTX3 as well as Cs toxins were present either in the Aphanizomenon flos-aquae cells collected directly from the bloom or in the other toxic isolates priorly cultivated in laboratory conditions.

Bacterial Toxins↗

Occurrence of Salmonella spp in estuarine and coastal waters of Portugal.

The presence of Salmonella and its relationship with indicator organisms of fecal pollution, such as total coliforms, fecal coliforms and fecal streptococci, was studied at two marine zones in Portugal. Seventeen different Salmonella serotypes were isolated and identified, S. virchow was the most frequently isolated (21.6%). In addition, a high percentage (35.1%) was recorded for some Salmonella serotypes of clinical significance, namely S. enteritidis, S. infantis, S. typhimurium and S. virchow. In any of the samples from the two zones Salmonella was not detected in the absence of any of the indicator organisms. However, the incidence of Salmonella as a function of indicator concentration intervals established by the EEC standards was 0, 10 and 19.3% at guide values of total coliforms, fecal coliforms and fecal streptococci, respectively in the Faro samples (south of Portugal). In contrast, Salmonella incidence rates of 37.5, 36.4 and 33.3% were recorded at the corresponding guide values the Caminha samples (north of Portugal). No significant correlations (p>0.005) were obtained between Salmonella and the indicators at the sampling stations; however, total coliforms and fecal streptococci were the indicators most closely related to Salmonella in Caminha and Faro samples, respectively. Survival experiments in Escherichia coli, Enterococcus faecalis and S. typhimurium, using diffusion chambers, were performed to verify whether the lack of correlation between indicators and Salmonella was due to different inactivation rates in seawater. The results indicate that survival percentages of the three microorganisms tested were similar after 48 h of exposure to seawater.

Bathing Beaches↗

[Aortic valvular endocarditis caused by Brucella melitensis with initial acute myocardial infarction manifestation].

This is the case of a 31 year old man with Brucella aortic valvular endocarditis which first manifested itself clinically as an acute myocardial infarction (AMI). He subsequently developed an acute aortic regurgitation, which together with the ventricular disfunction secondary to the myocardial necrosis caused severe heart failure requiring aortic valve replacement and aortic coronary graft in a first operation. The patient's subsequent evolution was negative with congestive heart failure refractory to medical treatment. For this reason he was submitted to a second operation in which an orthotopic cardiac transplant was carried out with good results. The patient remains symptom-free and has returned to his work.

Adult↗

[Myocardial infarct during pregnancy. Treatment of the acute phase and of labor. Apropos a case and a review of the literature].

An acute myocardial infarction, is an infrequent complication in pregnant women. We present the case of a 29-years-old patient who suffered 2 acute myocardial infarction in relation with her two pregnancies. The first acute myocardial infarction occurred the third day after delivery, and the second, during the seventh month of the second pregnancy. In the latter, delivery was vaginal, with epidural anaesthesia. A coronary angiogram showed coronary arteries without significant narrowings, as well as an aneurysm of the left ventricle. A review of the literature published so far is made in the discussion.

Acute Disease↗

[Acute non-lethal complete occlusion of the left main coronary artery].

Myocardial infarction secondary to total obstruction of the left main coronary artery is an infrequent finding in clinical practice. Even though this disease usually results in high mortality rates, various cases have been described documenting survival after complete occlusion of the left main trunk. We present a patient who survived after a massive myocardial infarction due to total obstruction of the left main coronary artery. Orthotopic cardiac transplantation was subsequently performed with good results.

Acute Disease↗

APHE-1 and APHE-2, two new antimicrobial and cytotoxic antibiotics. II. Physico-chemical properties and structure elucidation.

Two new pyrazolo-isoquinolinone antibiotics, APHE-1 and APHE-2, have been isolated from the culture filtrate and mycelia of Streptoverticillium griseocarneum NCIMB 40447. Molecular formulae were established as C13H12N2O for APHE-1 and C14H14N2O for APHE-2, by elemental analysis, NMR and mass spectra. 2D NMR techniques (1H-1H COSY-45 and 1H-13C correlated spectroscopy) have been applied to establish their structures.

Anti-Bacterial Agents↗

[Ischemic cardiopathy in women].

Life expectancy in western women is 8 years larger compared to men. This is due to the higher incidence of ischemic heart disease in men at least before reaching 45 years of age. This may also be due to differences in blood lipoprotein levels, differences in smoking habits, use of hormonal contraceptives, plasma iron levels, parity and other risk factors also found in men. After menopause the difference in the incidence of ischemic heart disease progressively decreases, basically because of a decrease in estrogen secretion. However, the role of estrogen supplement treatment in this group of women in the prevention of ischemic heart disease has not yet been clearly defined. The objectives of this study are to review the risk factors involved in the development of ischemic heart disease in women, the changes brought about by menopause and the possible beneficial effects of supplemental estrogens in the postmenopausal period.

Coronary Disease↗

The value of exercise testing in patients with coronary artery spasm.

To analyze the usefulness of a single exercise test to predict the presence of fixed obstructive coronary artery disease in patients with active coronary spasm, 91 consecutive patients with angiographically proven symptomatic coronary artery spasm who had performed a symptom-limited exercise test within the week before diagnostic coronary angiography were studied. Coronary angiography revealed significant coronary obstructions in 61 patients (67%). According to the type of angina, the prevalence of significant coronary stenosis was 53% for patients with angina at rest, 68% for those with effort angina, and 92% for those with mixed angina. Exercise-induced ST segment elevation was present in eight patients (9%), ST segment depression was seen in 37 patients (41%), and no ST abnormalities in 46 (50%). There was not a significant relationship between the ST segment response to exercise and the clinical variables assessed except for coronary anatomy. Abnormal exercise test results were significantly more frequent in patients with significant coronary obstructions than in those without significant coronary occlusions (62% versus 23%; p less than 0.01). ST elevation was not useful to predict the presence of fixed coronary lesions. However, ST depression strongly suggested the presence of underlying coronary lesions with a sensitivity of 54%, a specificity of 87%, and a positive predictive value of 89%. Using this criterion, 65% of the patients were correctly classified. The results indicate that despite the functional component of ischemia in patients with coronary spasm, ST segment depression with exercise is still a highly specific sign with a high positive predictive value for the presence of significant coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Ambulatory heart catheterization. Initial experience].

Development of cardiovascular surgical techniques and more recently, balloon angioplasty, has resulted in a dramatic increase in the number of cardiac catheterizations performed. Previously, the usual policy was to admit the patient to the hospital for several days. Various series of patients submitted to ambulatory cardiac catheterizations have revealed that this procedure con be performed safely, with a potential reduction in hospital and patients costs, better utilization of medical beds and good image quality. In this study we present our initial experience in this kind of outpatient procedure.

Adult↗

[Contraceptives and ischemic cardiopathy].

The incidence of myocardial infarction is higher in women that use oral contraceptives. The most important pathophysiologic mechanisms are: a) modification of coronary risk factors: the pill produces an elevation of both serum cholesterol and trygliceride levels, increase of blood pressure and decompensation of diabetes mellitus; b) blood coagulation disorders: oral contraceptives increase platelet aggregation and fibrinogen blood levels, therefore they have a considerable thrombogenic capacity. At this moment there are several update publications concerning this matter; however most of the mechanisms involved in the increase of coronary heart disease in this specific group still remain unclear.

Arteriosclerosis↗

[Antiphospholipid syndrome and cardiovascular disease].

Recurrent thrombosis, abortion and thrombocytopenia are the most frequent manifestation of antiphospholipid syndrome, which usually presents antibodies against some anionic phospholipids. A few years ago, this syndrome was considered as a manifestation of systemic lupus erythematosus; nowadays it is classified as an isolated systemic lupus erythematosus; nowadays it is classified as an isolated autoimmune disease. Hypotheses have been proposed to explain the origin of antiphospholipid antibodies, including infectious and autoimmune diseases with high titles of anticardiolipin antibodies. Genetic factors have also been involved. Laboratory tests of choice for the detection of anticardiolipin antibodies are RIA and ELISA tests; there are some structural differences among them depending on the underlying disease. Hypercoagulability and recurrent thrombosis are the main features of this entity; ischemic heart disease is in this context of outmost importance. Despite the lack of any clinically demonstrated association between antiphospholipid syndrome and ischemic heart disease, there are many "in vitro" studies that support this possibility.

Autoantibodies↗

[Dysautonomic syncope. Diagnosis and treatment].

Inappropriate activation or disbalance of vasomotor reflexes may have a close relationship with the pathogenesis of disautonomic syndromes, a frequent underlying cause of recurrent syncope. A combined approach of meticulous historical data, physical examination and selected laboratory procedures may delineate the most common causes of recurrent syncope. Tests of autonomic function may be particularly helpful in the diagnosis of this entity. They include some non-invasive maneuvers such as stimulation of carotid sinus, Valsalva maneuver or tilt-table test. Therapy for this syndrome includes pharmacologic agents, surgical and radiotherapeutic maneuvers and atrioventricular sequential pacing. In this work we will present an overall formulation of the diagnostic evaluation and a therapy approach of the patient presenting with this complaint.

Carotid Sinus↗

[Current use of anti-hemostatics in ischemic cardiopathy].

Antihemostatic drugs are widely used in the treatment and prevention of ischemic heart disease. Fibrinolytic agents are prescribed in the early phase of acute myocardial infarction, to reduce its size and improve survival. Their use in unstable angina is still controversial. Anticoagulants have substantial benefit in myocardial infarction, unstable angina and primary prevention of coronary disease. Finally, antiplatelet agents are used in stable and unstable angina, myocardial infarction and high risk patients.

Angina, Unstable↗

[The threat syndrome of the anterior descending coronary artery].

Some patients with unstable angina develop a deep T-wave inversion in ECG leads V1 to V4. It has been suggested that this special ECG pattern is associated with a severe stenosis of the left anterior descending (LAD) coronary artery. We have studied 73 of this patients. All of them had an LAD involvement, nearly always as severe atherosclerotic plaque and in 5% of the cases due to non-atherosclerotic alterations (milking or spasm). Angioplasty was performed in 33% and bypass surgery in 61%. In both cases the immediate results were good (0% and 4% respectively in-hospital mortality) as well as the outcome (12% restenosis and 0% late mortality respectively). The ECG signs disappeared in the year after.

Angina Pectoris↗