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Biomedical subjects

M Oliveira

Publications and source records attributed to M Oliveira.

At least 55 records · Page 3Linked to original sources
PubMed1998

Sugar transport and glut transporter expression in a variety of human immunodeficiency virus-1 (HIV-1) chronically infected target cell lines.

In this study, sugar transport and the cellular content of the human Glut 1 and 3 glucose transporters were ascertained in uninfected and chronically HIV-infected Jurkat and H9 cell lines (T-cell lines) and U937 cells (a promonocytic cell line). Sugar transport was determined by monitoring 2-deoxy glucose uptake (2DG) and glut transporter content was determined by Western analysis. Although 'acute' HIV infection of H9 cells led to increased cellular transport activity and Glut 3 transporter content, chronic HIV infection exhibited no significant differences in sugar transport in any of the cell types investigated whether log or stationary phase cultures were employed. When uninfected and chronically HIV-infected cell lines were compared, all cell lines expressed the Glut 1 transporter, however, significant differences in Glut 1 transporter content were not observed. The Glut 3 transporter which could only be detected in the H9 cell line exhibited no differences in Glut 3 content in uninfected or chronically HIV-infected cells (2.1 +/- 0.6 versus 3.8 +/- 2.1 x 10(-3) arbitrary units/microgram protein). A trend towards lower amino acid uptake was seen in the chronically HIV-infected cells but this was not significantly different from uninfected cell cultures. The data indicate that: (1) glucose transport and the Glut 1 and 3 transporters are not increased in cells chronically infected with HIV-1 and (2) the expression of the Glut 3 sugar transporters is not the same in all target cells.

Biological Transport, Active↗
PubMed1998

Stepwise strategy on the cost of risk stratification after acute myocardial infarction: a retrospective simulation study.

Stratification of postinfarction patients at high risk of mortality and/or other adverse events can be improved by combining several prognostic markers. As the clinical impact of risk stratification has only recently emerged in prospective trials, there are a lack of data regarding the cost-effectiveness of multimarker strategies. This study performed a comprehensive search of a postinfarction database and simulated different risk stratification strategies involving left ventricular ejection fraction, signal-averaged electrocardiography, Holter monitoring, and heart rate variability, The parameters were assessed before discharge in 417 survivors of acute myocardial infarction followed-up for 1 year. Cardiac mortality was used as the clinical endpoint. A statistical computer model of a stepwise strategy using every feasible sequence of the four tests was used and, based on prices derived from European and American centers, the cost estimates of all possible combinations were compared. During the 1 year after myocardial infarction there were 24 cardiac deaths (5.8%). In all the population, 6% had all four tests positive (cardiac mortality 20%); 25% had at least three tests positive (cardiac mortality 12.5%); 58% had at least two tests positive (cardiac mortality 8.3%); and 92% presented with at least one test positive (cardiac mortality 6.3%). The cost of performing all the tests ranged between $398 and $1,887 for each patient. However, by selecting patients according to a step wise strategy, the costs ranged from $96 (> or = 1 test positive) to $510 (for the least expensive sequences of four tests positive). For each of the centers considered, the costs resulting from the risk stratification protocol were determined by the number of variables combined and sequences of tests adopted. Thus, a step wise strategy using the combination of all four parameters, starting with analysis of Holter variables and finishing with signal-averaged electrocardiography, appears to be the most appropriate and the least expensive approach for selecting patients at high risk of cardiac death.

Computer Simulation↗
PubMed1998

Childhood cutaneous mucinosis.

A case of childhood cutaneous mucinosis is described. This is a clinical condition that is rarely seen and has only recently been included in the group of primary mucinosis.

Adolescent↗
PubMed1998

[The influence of therapy (sympathomimetic amines versus vasodilators) in the indexes of ejection fraction derived from an analysis of Doppler aortic flow].

PURPOSE: To assess the influence of inotropic IV therapy--dobutamine and/or dopamine--versus vasodilator therapy--nitroprusside, captopril or hydralazine--in aortic flow ejection phase indexes obtained by pulsed Doppler echocardiography. METHODS: In 17 patients admitted to the ICU (11 males, 62 +/- 14 years, 9 with ischemic cardiomyopathy and 8 with dilated cardiomyopathy, all in sinus rhythm), with congestive heart failure, and submitted to tailored therapy, 53 serial pulsed Doppler and hemodynamic evaluations were made as the therapy changed the hemodynamic and clinical status. Considering serial consecutive evaluations, a hemodynamic improvement was obtained only with inotropics in 13 (group A), and with vasodilators in only 15 (group B). The following ejection phase indexes were calculated from Doppler registers: average acceleration (AvAc) and ejection force (EFor), calculated according to the formula: Efor = 1.06 x Aortic Orifice Area x AvAc x Acceleration Velocity Time Integral. RESULTS: Arterial blood pressure increased in gr A (76.2 +/- 14.1 to 81.4 +/- 14.8 mm Hg, p < 0.05) and decreased in gr B (85.1 +/- 12.6 to 76.2 +/- 9.7 mm Hg (p < 0.05). In both groups there was a significant (p < 0.05) increase in cardiac output (CO)-from 3.9 +/- 1.1 to 4.9 +/- 1.4 L/min in group A, and from 3.9 +/- 1.2 to 4.4 +/- 1.2 L/min in group B. CO increased 18.7% in group A and 13.8% in group B (NS). There was a decrease in pulmonary capillary wedge pressure (PCWP) from 19.5 +/- 6.0 to 15.1 +/- 5.8 mm Hg in group A (p < 0.05), and from (16.9 +/- 5.7 to 12.1 +/- 4.6 mm Hg in group B (p < 0.05). PCWP decreased 19.7% in group A and 27.8% in group B (NS). Systemic vascular resistance (SVR) changed from 18.2 +/- 7.0 to 16.2 +/- 7.1 Wood U in group A (p < 0.05), and from 22.3 +/- 9.3 to 17.7 +/- 5.7 Wood U in group B (p < 0.05). In group A, AvAc increased-from 1347 +/- 611 cm.s-2 (p < 0.05), as did Efor-from 15.4 +/- 10.7 to 20.2 +/- 11.0 g.cm,s-2 (p < 0.05), whereas in group B there was no significant change in either AvAc-from 1337 +/- 284 to 1277 +/- 256 cm.s-2, or Efor-from 22.7 +/- 17.0 to 23.8 +/- 15.0 g.cm.s-2. CONCLUSIONS: Vasodilator therapy, although inducing hemodynamic changes similar to inotropics, does not alter the ejection phase indexes. Therefore, AvAc and Efor, in spite of being calculated from the aortic flow, are independent of the changes in PCWP and SVR and seem to reflect changes in inotropism in the clinical setting.

Captopril↗
PubMed1998

[Skin cancer].

The authors, using the Cancer Registry data of S. Antonio General Hospital in Oporto, selected the cancer cases from 1981 to 1993. Distribution according to age, sex, topography and morphology is presented. Seven point nine percent of the 12,124 cases mentioned in the Registry were skin cancers (n = 883). They were mostly on the face (56.8%), trunk (11.7%) and scalp and neck (7.7%). As for the type of tumour, 472 basaliomas, 231 squamous cell carcinomas and 63 melanomas were recorded. One may conclude that basaliomas and squamous cell cancers arise at a later age than melanomas; melanomas are more frequent on the lower limbs and on the trunk; squamous cell carcinomas are more frequent on the face and lips. Basalioma is more frequent on the face. These results are in accordance with those published internationally.

Adolescent↗
PubMed1998

[Therapeutic exhaustion in patients with an implantable cardioverter-defibrillator. Are there predisposing factors?].

UNLABELLED: In patients (pts) with implantable cardioverter-defibrillators (ICD), antitachycardia pacing (ATP) schemes may be used followed by a limited number of endocavitary shocks in the same episode of ventricular tachycardia (VT) with the potential risk of therapeutic exhaustion. OBJECTIVE: To assess the incidence of episodes of therapeutic exhaustion in a population of ICD carriers with ATP programmes and to attempt to determine their correlation with clinical variables. METHODS: Study of the episodes of VT treated by ICD in 8 patients (6 male; 2 female) with an average age of 56 +/- 17 years with a follow-up > 6 months. The underlying pathology was: ischemic heart disease-5 patients; arrhythmogenic dysplasia of the right ventricle-1 patient; hypertrophic cardiomyopathy-1 patient; and operated pulmonary valve stenosis-1 patient. The authors considered therapeutic exhaustion to be the occurrence of episodes in which VT persisted after the application of ATP and the maximum number of shocks. The patients with episodes of therapeutic exhaustion (group A-3 patients) were compared with the remaining patients (group B-5 patients) with regard to the following parameters: age; ejection fraction; previous myocardial infarction (pMI; cardiac frequency during VT (cfVT); number of episodes of non-maintained VT (NMVT) without therapeutic intervention; > 20% reduction of the VT cycle after ATP (VTATP); intensity of programmable shocks (Icho); and medication with anti-arrhythmia drugs (AA). RESULTS: In a total of 262 VT records (duration > 2.5 sec. after detection) with treatment by ICD during an average follow-up of 11 months, 6 episodes (2.3%) of therapeutic exhaustion were detected in 3 patients. Four of the episodes occurred in the same patient in a period of 4 hours, hospitalisation being necessary following syncope. In the other two cases, there were complaints of dizziness which subsided spontaneously a short time after the application of the last shock by the ICD. [table: see text] CONCLUSION: Therapeutic exhaustion occurred in about 2% of the VT treated with this population. The possibility of a high number of non maintained VT episodes being associated to a greater possibility of therapeutic exhaustion may have implications on ICD programming.

Adult↗
PubMed1997

Modulation of stress protein (hsp27 and hsp70) expression in CD4+ lymphocytic cells following acute infection with human immunodeficiency virus type-1.

This study was designed to assess the impact of acute human immunodeficiency virus (HIV-1) infection on host intracellular expression of the heat shock family of stress proteins (hsps). Experimental conditions were established wherein CD4+ lymphocytic cell lines undergo a synchronous HIV-1 infection cycle. During the early phase of infection, HIV-1 mRNA expression was restricted to singly and multiply spliced subspecies, with no genomic viral RNA present until 30 hr following infection. In contrast, hsp27 and hsp70 mRNA transcription appeared as early as 3-8 hr following viral infection. No corresponding induction was observed in mock-infected cells. Notably, hsp27 and hsp70 mRNA transcripts were down-regulated by 24 hr, concomitant to the first appearance of full-length genomic HIV-1 mRNA. Hsp27 and hsp70 mRNA transcripts reemerged at end stages of the viral replicative cycle, coincident to virion release and CD4 cell death. Similarly, a transient induction of de novo hsp27 protein expression occurred between 12 and 24 hr. The generated hsp27 stress response was viral dose-related, suppressed by heat-inactivation of virus, and abrogated by neutralizing antibodies to HIV-1. Acute infection did not alter levels of hsp60, hsp70, and hsp90 protein synthesis. However, two-dimensional Western blot analysis did show the appearance of novel hsp70 homologues between 6 and 24 hr following infection. CEM.NKR, Jurkat, H9, and MT-2 cells showed similar patterns of viral-associated modulation of host hsp27 and hsp70 protein and RNA expression. Thus, host hsp27 and hsp70 stress pathways are selectively implicated in the HIV-1 viral life cycle.

Blotting, Northern↗
PubMed1997

Polypectomy and endometrial resection in postmenopausal patients.

STUDY OBJECTIVE: To evaluate the therapeutic efficacy of polypectomy associated with endometrial resection for the treatment of polyps in postmenopausal women. DESIGN: Prospective study (Canadian Task Force classification II-2). SETTING: Private urban hospital with facilities for endoscopic surgery. PATIENTS: Sixty-six women with endometrial polyps. INTERVENTIONS: Sixty-four of the 66 patients underwent polypectomy followed by endometrial resection. One patient had hysterectomy because endometrial biopsy showed serous papillary carcinoma. MEASUREMENTS AND MAIN RESULTS: No major complications were associated with the procedure. Histopathology showed hyperplasia in most polyps. One patient had a papillary uterine carcinoma in the polyp that was not detected by preoperative endometrial biopsy. The women were followed with transvaginal sonography for 1 year after surgery. CONCLUSION: Polypectomy followed by endometrial resection is a very low-risk procedure for postmenopausal patients. There was no recurrence after the first year in women who completed follow-up.

Aged↗
PubMed1997

[Guided anti-arrhythmia therapy by programmed ventricular stimulation. A case of arrhythmogenic dysplasia of the right ventricle].

Right ventricle dysplasia (RVD) is a rare clinical entity, described in young people, and a known cause of ventricular arrhythmias and sudden death. A genetic transmission has been suggested from the study of familial cases. The disease is characterized by a dilated right ventricle, cardiac infiltration with fatty tissue and focal fibrosis. Lymphoplasmocyte infiltrates are documented. The diagnosis is based on electrocardiography, echocardiography, magnetic resonance imaging and right ventricular endomyocardial biopsy. The authors report a case of a young woman with symptomatic ventricular tachycardia (VT) in whom the diagnosis of RVD was established. Programmed ventricular stimulation was used to reproduce the clinical VT and to test the efficacy of the anti-arrhythmic drug therapy. The diagnosis criteria and therapeutic options are discussed.

Adult↗
PubMed1997

[Mitral valve insufficiency caused by tendinous cord rupture and mitral valve aneurysm. Significance of the echocardiographic study].

Mitral valve aneurysm is a rare complication that may occur in a myxomatous valve. We report the case of a 73 year old male patient with severe mitral regurgitation and heart failure-class IV NYHA. Echocardiography showed perforation of an aneurysm of the anterior leaflet of the mitral valve associated with rupture of tendinous cords of the posterior mitral leaflet. Diagnosis was made by transthoracic echocardiography and confirmed by transesophageal echocardiography. The patient was urgently operated with success and a mitral valve prosthesis was implanted.

Aged↗
PubMed1996

Influence of coronary lesions morphology on treadmill exercise stress testing after acute myocardial infarction.

OBJECTIVES: To evaluate the influence of infarct related artery lesion morphology on the exercise stress test performed after a first myocardial infarction. METHODS: We reviewed coronary angiography and the exercise stress test performed before discharge from hospital in 105 consecutive patients (91.4% male, mean age 49.6 +/- 9.2 years) with first acute myocardial infarction. Complex coronary lesions were defined by the presence of one of the following characteristics: ulcers, thrombus, shoulders, irregularities and eccentricity. According to either the existence or absence of complex coronary lesions, two groups were considered: Group I--42 patients with complex coronary lesions, and Group II--47 patients without these characteristics in coronary angiogram. Sixteen pts (14%) were excluded because the infarct related artery was occluded or existence of complex lesions in other coronary artery not related to the infarct. Left ventricular systolic function was analyzed using the "CASS score". Exercise stress test performed between the 10th and the 15th day after myocardial infarction, using Bruce protocol, were reviewed. The following parameters were analyzed: exercise time, number of metabolic equivalent units (METS), maximal heart rate attained, double product variation and number of patients with significant ST segment depression and/or angina. RESULTS: No statistically significant differences between the two groups were obtained as far as age, sex, left ventricular function, number of diseased vessels and lesions severity. From the analysis of ergometric parameters we did not find any difference between the two groups of patients about exercise time (Group A--8.37 +/- 2.6 versus (vs) Group B 8.38 +/- 3.18), METS (Group A--8.22 +/- 2.87 vs Group B--8.13 +/- 2.97), maximal heart rate (Group A--88.2% vs Group B--87.5%) and double product variation (Group A--14547 +/- 5492 vs Group B--14553 +/- 5387). However, the number of ischemic response (defined by usual criteria of St-segment depression and/or angina) was significantly greater in patients with complex coronary lesions (ST--segment depression: Group A--26 pts vs Group B--19 pts, p < 0.05/Angina: Group A--16 pts vs Group B--4 pts, p < 0.001). Thus, complex coronary lesions are related to a high incidence of residual ischemic phenomena detected by electrocardiographic exercise stress test performed on predischarge period of acute myocardial infarction. Further studies will be necessary to show the prognostic value of particular angiographic characteristics found in coronary plaques.

Adult↗
PubMed1996

[Significance of the exercise test in the assessment of graft patency after myocardial revascularization with arteries only].

UNLABELLED: Although treadmill exercise testing (TET) has been used to identify ischaemia and determine clinical prognosis after myocardial revascularization, considerable controversy remains on its role in the detection of obstructive lesions of the arterial grafts. AIM: To assess the value of TET in determining the patency of arterial conduits after coronary bypass surgery with complete revascularization. METHODS: Twenty five patients - 21 men and 4 women; age 53.7 +/- 8.7 years - submitted to complete myocardial revascularization exclusively with arterial conduits (CABG-A), undergoing coronary angiography and a symptomlimited TET (Bruce protocol) within 9 months after CABG-A. Angiograms were visually classified in 2 groups (Group I - conduits without lesions, n = 14; Group II > 50% stenosis or occlusion of > or = 1 conduit, n = 11). Clinical characteristics and the following parameters of the TET were compared: total exercise time (ETime); metabolic equivalents (METS); % of predicted maximal heart rate (% MHR); exercise-induced ST depression (decreases ST); and occurrence of angina. The arterial conduits used were: left internal mammary artery -24-; right internal mammary artery -11-; gastroepiploic artery -14-. RESULTS: There were no differences in age, gender, left ventricular systolic function, severity of coronary artery disease, and number of conduits per patient. Group I attained superior values for the following parameters: ETime (p < 0.01) and METS (p < 0.01). Among Group II there were more patients with angina (p = 0.03). Fourteen patients exceeded 8 METS (11 from Group I and 3 from Group II - p = 0.002-). There was no statistical difference among the number of patients with ST depression during exercise. CONCLUSIONS: After CABG-A the exercise tolerance seems to be related with the patency of the conduits and may play an important role in the detection of graft abnormalies. On the contrary, exercise-induced ST depression had low specificity in detecting obstructive lesions of the conduits.

Coronary Artery Bypass↗