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Biomedical subjects

Y Juliano

Publications and source records attributed to Y Juliano.

At least 19 recordsLinked to original sources
PubMed2006

Phytate technetium-99m versus dextran 500 technetium-99m in the sentinel lymph node biopsy.

PURPOSE: To study which of the two most used radiopharmaceutical drugs for the sentinel lymph node (SLN) biopsy procedure (dextran 500 99mTc and phytate 99mTc) best defines the SLN and migrates less to other lymph nodes. MATERIAL AND METHODS: Thirty-two rats, separated into two groups, underwent lymphoscintigraphy examination with either dextran or phytate followed by sentinel (popliteal), lumbar, and inguinal lymph node biopsy. Radiation was detected with a gamma probe. RESULTS: The statistical study indicated count rates significantly higher in the SLN than in the other basins for both the dextran (P<0.01) and phytate groups (P<0.001). There was no statistically significant difference concerning SLN absorption in either group (P=0.2981). In the dextran group, migration occurred to 1.5 lymphatic basins with counting higher than 10% of that found in the SLN versus 0.8 in the phytate group (P=0.0023). Migration was thus higher in the dextran group (P=0.0207). CONCLUSION: There was no statistically significant difference between dextran and phytate in the SLN identification, but the phytate migrated to fewer lymphatic basins beyond the SLN and with less intensity.

Animals↗
PubMed2004

Prevalence of varicose veins and venous anatomy in patients without truncal saphenous reflux.

OBJECTIVES: To determine the prevalence and distribution of primary venous reflux in the lower limbs in patients without truncal saphenous reflux. DESIGN: Prospective cohort study. PATIENTS AND METHODS: One thousand and seven hundred and twelve patients with suspected venous disease were examined by duplex ultrasonography. Seven hundred and thirty-five patients had primary varicose veins with competent saphenous trunks. Limbs with truncal saphenous reflux, deep vein reflux or obstruction, previous injection sclerotherapy or vein surgery, arterial disease and inflammation of non-venous origin were excluded from further consideration. The CEAP classification system was used for clinical staging. Systematic duplex ultrasound examination was undertaken to assess the distribution of incompetent saphenous tributaries. RESULTS: The prevalence of primary reflux with competent saphenous trunks was 43%. Reflux of GSV calf tributaries was the most common. The majority of the limbs (96%) belonged to chronic venous disease classes C1 and C2 of the CEAP classification. CONCLUSIONS: Superficial venous reflux causing varicose veins in the presence competent saphenous trunks is very prevalent in this series in contrast to other studies, presumably reflecting differing patient populations. Our data clearly show that varicose veins may occur in any vein and do not depend on truncal saphenous incompetence. Careful duplex ultrasound evaluation allows the pattern of venous reflux to be established in this group of patient ensuring appropriate management of varices.

Adolescent↗
PubMed2004

Biochemical and morphological evaluation of ischemia-reperfusion injury in rat small bowel modulated by ischemic preconditioning.

The objective of this study was to evaluate the effect of ischemic preconditioning upon lesions produced by ischemia-reperfusion of the small intestine. Thirty EPM-1 Wistar rats were randomly distributed into three groups: ischemic preconditioning (IPC; n = 12), ischemia-reperfusion (I/R; n = 12), and control (C; n = 6). Laparotomy permitted isolation of the mesenteric artery for clamping. The animals were heparinized and hydrated. IPC was induced by: 10 minutes of ischemia followed by 10 minutes of reperfusion and then 50 minutes ischemia followed by another 30 minutes reperfusion. Group I/R was submitted to the same protocol except for the 20 minutes of preconditioning. Group C animals underwent only laparotomy for 100 minutes. After reperfusion small intestine fragments were examined histologically. Blood samples were obtained to measure LDH and lactate prior to euthanasia. Lactate values were significantly lower in the IPC as compared to I/R group, 39 versus 67 mg/dL, respectively (P < or =.05). However, neither IPC (grade 3) lesions of the mucosa versus I/R (grade 4) nor LDH values (PCI = 680, I/R = 873 U/L) were statistically different. Thus No morphological evidence of protection was observed following ischemic preconditioning.

Animals↗
PubMed2004

Repercussions of extensive small bowel resections in growing rats.

OBJECTIVE: To study the effects of extensive intestinal resection on growing rats, with regard to animal weight and histomorphometry of the remaining small intestine. METHODS: Forty growing rats were allocated according to the extent of small intestine resection: 60%, 70%, 80%, or 90%. The animals were weighed every week and observed for 30 days. Following sacrifice the remaining small intestine was resected, fixed in 10% formol for 24 hours, embedded in paraffin, and stained using hematoxylin and eosin. The histological changes in the remaining small intestine were assessed for the length and thickness of villi, the thickness of the muscle layer, and the number of intestinal glands. RESULTS: All growing rats showed a fall in body weight, although it was more significant with the largest intestinal resection (80% and 90%). Villus length and muscle thickness increased after 30 postoperative days in all rats, but the number of intestinal glands remained unaltered. CONCLUSION: Growing rats with greatest resection of small intestine (80% and 90%) had better intestinal adaptation and slower recovery of body weight.

Animals↗
PubMed2003

Effect of lung resection and sham surgery on the frequency of infection in alloxan-diabetic rats.

The present study was carried out in order to determine the effect of lung resection on the frequency of infections in alloxan-diabetic rats. Adult female Wistar rats were injected with alloxan (40 mg/kg, iv) to induce diabetes mellitus (group D; N = 45) or with vehicle (1.0 ml/kg, iv) to be used as controls (group C; N = 45). Thirty-six days after receiving alloxan both groups were randomly divided into three subgroups: no operation (NO; N = 15), sham operation (SO; N = 15), and left pneumonectomy (PE; N = 15). The rats were sacrificed 36 days after surgery and their lungs were examined microscopically and macroscopically. The occurrence of thoracic wall infection, thoracic wall abscess, lung abscess and pleural empyema was similar in groups D and C. In contrast, the overall infection rate was higher (P<0.05) in the diabetic rats (SO-D and PE-D subgroups, but not in the NO-D subgroup). Considering that the overall infection rate was similar in the SO-D and PE-D subgroups, we suggest that surgery but not pneumonectomy was related to the higher prevalence of infection in diabetic rats.

Alloxan↗
PubMed2003

Anthropometry and body composition in ethnic Japanese and Caucasian adolescent girls: considerations on ethnicity and menarche.

OBJECTIVE: This study aimed to compare the various anthropometric and body composition parameters based on the ethnicity and the absence or presence of menarche. DESIGN: A cross-sectional study with incomplete sampling, using the subject as the evaluation unit. SUBJECTS: The final sample of 550 subjects was composed of 122 Japanese and 179 Caucasian premenarcheal adolescents, and 72 Japanese and 177 Caucasian postmenarcheal adolescents. METHODS: The variables of body composition were measured through the following methods: bioelectrical impedance analysis, near-infrared interactance (NIR), Slaughter cutaneous skinfold equations and body mass index. Weight, height and sitting height were also evaluated. RESULTS: The Japanese pre- and postmenarcheal girls presented lower weight and height values when compared with the Caucasian girls. In general, the Japanese premenarcheal girls presented less fat and fat-free mass than the premenarcheal Caucasian girls. This fact was demonstrated through NIR results. Conversely, the Japanese postmenarcheal adolescents accumulated more fat than their Caucasian counterparts. However, significant differences were solely encountered in the values of cutaneous skinfold percent body fat. With regard to menarche, it was verified that, regardless of ethnicity, all the anthropometric and body composition variables reached higher values among postmenarcheal adolescents when compared with premenarcheal adolescents. CONCLUSION: Different results of weight and height between the ethnic groups may bring back the discussion concerning separate growth curves for different ethnic groups. The results of the body composition analysis indicated high adiposity levels among postmenarcheal adolescents.

Adipose Tissue↗
PubMed2001

Anatomic study of the tricuspid valve in children.

We performed an anatomic study of the right atrioventricular valve in children under one year of age using a conservative method of dissection of the heart valve. The main aspects studied were the number of cusps and their morphometric characteristics, such as the width of the base and the depth of the cusps. Other parameters studied were the number of papillary muscles, number of tendinous cords, and diameter of the fibrous ring and the last one were divided in three regions, anterior, posterior and septal for localization of cusps. Our results showed that the number of cusps varied from two to four. Three cusps was the commonest finding and the fourth cusp, if present, was classified as anterolateral in location. The anterior and septal cusps had bases bigger than those of the posterior and anterolateral cusps; the septal cusp was deeper than the others; and the number of tendinous cords was greater for the anterior and septal cusps than for the posterior and anterolateral cusps. In addition, the posterior region showed great variability: in 35.7% it was occupied by undeveloped valve tissue and the posterior valve in these cases was located anteriorly.

Cadaver↗
PubMed2001

Comparison of the body mass index to other methods of body fat evaluation in ethnic Japanese and Caucasian adolescent girls.

OBJECTIVE: The aim of this study was to assess the body mass index (BMI) and its relationship with other methods of body fat evaluation in pre- and post-menarcheal, Japanese and Caucasian female adolescents, using two different cut-off points for obesity: 28% and 30%. DESIGN: A cross-sectional study with incomplete sampling, using the subject as the evaluation unit. SUBJECTS: A total of 436 Japanese and Caucasian female adolescents in two age groups: 10-11 (pre-menarcheal adolescent); and 16-17 (post-menarcheal adolescents). METHODS: For the BMI the cut-off point for thinness was set at the 5th percentile of the BMI distribution of the NCHS reference population and the cut-off point for overweight and obesity was set at the 85th percentile. Body composition was assessed using foot-to-foot bioelectrical impedance analysis (BIA), near-infrared interactance (NIR) and Slaughter skinfold equations (SKI). The statistical comparison of the methods was performed using the kappa agreement test and the McNemar disagreement test. RESULTS: In the 10- and 11-y-old girls, the BMI was considerably and significantly correlated with the other methods. The major agreements were: in Japanese adolescents BMI x NIR=82.3% (cut-off point of 28%), BMI x BIA=85.7% (cut-off point of 30%); in Caucasian adolescents BMI x NIR=80.7% (cut-off point of 28%), BMI x BIA=87.4% (cut-off point of 30%). The disagreement above the diagonal between BMI x NIR was higher within the two groups for both the cut-off points, revealing that the girls identified as obese by the BMI were considered eutrophic by NIR. In the 16- and 17-y-old adolescents, the BMI demonstrated low or no correlation with the other methods. Furthermore, it presented disagreements below the diagonal, revealing that the BMI identified fewer obese subjects than the other methods. CONCLUSION: Among the 10- and 11-y-olds, the BMI presented a good correlation with the other methods, independent of ethnicity. The BMI can therefore be used in place of these methods, although it may underestimate obesity. Among the 16- and 17-y-olds, the BMI presented low or no agreement with the other methods, suggesting that it is probably not a suitable index for this age-group in studies focusing on the identification of obesity. In such cases the choice of one of the other methods, depending on availability, cost or technical experience, may represent a better approach.

Adipose Tissue↗
PubMed2001

[Incidence of ventilator-associated pneumonia in patients using open-suction systems and closed-suction systems: a prospective study -- preliminary data].

This a randomized clinical trial in which 20 patients were prospectively evaluated for the incidence of ventilator-associated pneumonia (VAP), of whom 12 received endotracheal suctioning by an open-suction method and 8 by a closed-suction method. Differences in the incidence of VAP was not significantly different (p = 0.4) between closed and open suctioning. Differences in Acute Physiology and Chronic Health Evaluation II, duration of entubation, and the use of steroids were all not significant. All patients in the study used H2 antagonist and a nasogastric tube. Proceeding with the study will involve a sample increase with a possible change in the results.

Female↗
PubMed2001

Effect of sequential intermittent pneumatic compression on both leg lymphedema volume and on lymph transport as semi-quantitatively evaluated by lymphoscintigraphy.

Sequential Intermittent Pneumatic Compression (SIPC) is an accepted method for treatment of peripheral lymphedema. This prospective study evaluated the effect in 11 patients of a single session of SIPC on both lymphedema volume of the leg and isotope lymphography (99Tc dextran) before SIPC (control) and 48 hours later after a 3 hour session of SIPC. Qualitative analysis of the 2 lymphoscintigrams (LS) was done by image interpretation by 3 physicians on a blind study protocol. The LS protocol attributed an index score based on the following variables: appearance, density and number of lymphatics, dermal backflow and collateral lymphatics in leg and thigh, visualization and intensity of popliteal and inguinal lymph nodes. Volume of the leg edema was evaluated by measuring limb circumference before and after SIPC at 6 designated sites. Whereas there was a significant reduction of circumference in the leg after SIPC (p<0.05), there was no significant difference in the index scores of the LS before and after treatment. This acute or single session SIPC suggests that compression increased transport of lymph fluid (i.e., water) without comparable transport of macromolecules (i.e., protein). Alternatively, SIPC reduced lymphedema by decreasing blood capillary filtration (lymph formation) rather than by accelerating lymph return thereby restoring the balance in lymph kinetics responsible for edema in the first place.

Adult↗
PubMed1999

Severity and prognosis in intensive care: prospective application of the APACHE II index.

CONTEXT: The performance of each ICU needs to be assessed within the overall context of medical care, as well as by the institution which the ICU forms part of. Evaluation mechanisms in the field of intensive care have been developed that are recognized worldwide within the scientific literature. OBJECTIVE: To study outcomes from groups of critical patients and to compare their actual and estimated mortality rates. DESIGN: Prospective study of patients' outcomes. SETTING: A tertiary care unit for a period of 13 months (anesthesiology intensive care unit at the Escola Paulista de Medicina). PARTICIPANTS: 520 patients selected according to sex, age and nature of hospitalization. DIAGNOSTIC TEST: The modified APACHE II prognostic index was applied in order to assess clinical severity and anticipation of mortality in three groups who had non-surgical treatment, emergency surgery and elective surgery. MAIN MEASUREMENTS: The APACHE II index. RESULTS: The application of this index allowed patients to be stratified and expected death risks for both subgroups and the entire sample population to be calculated. The observed mortality rate was greater than the expected rate (28. 5% versus 23.6%, respectively), with a statistically significant difference. The standardized mortality rate was 1.20. Patients who obtained scores above 25 presented a significant outcome towards death. The most severe and worst evolving cases were, in decreasing order: non-surgical, emergency surgical and scheduled surgical patients; the actual general mortality rate was higher than the expected one. CONCLUSIONS: The use of the APACHE II index made it possible to stratify critical patient groups according to the severity of their condition.

APACHE↗
PubMed1998

Effects of tamoxifen on the breast in the luteal phase of the menstrual cycle.

OBJECTIVES: The effect of tamoxifen on cyclic mastalgia and on chemoprophylaxis against breast cancer is little known, mainly due to the difficulties in studying the normal human gland. We proposed to evaluate the mitotic index and the nuclear volume of the lobule of women medicated with tamoxifen only during the luteal phase of the menstrual cycle in order to observe the effect of tamoxifen on the normal human mammary gland. METHODS: Twenty-four premenopausal women with fibroadenoma diagnosed via biopsy were studied. The phase of the cycle was determined by the date of menstruation and serum progesterone level in the luteal phase (> or = 3 ng/ml). The patients admitted to the study and were given written informed consent to participate in the investigation, which was previously approved of by the hospital Ethics Committee. Patients were divided at random into two groups: Group I consisted of 12 untreated women (control) and Group II consisted of 12 patients treated with 20 mg/day tamoxifen for 10 consecutive days beginning on the 13th day of the menstrual cycle. In both groups, the patients were submitted to biopsies of the nodule and of a 1-cm3 fragment of adjacent mammary parenchyma between the 23rd and 26th day of the cycle. The mitotic index (number of mitoses/1000 nuclei counted) and mean nuclear volume (mean of 10 nuclear volumes for each case) were measured. RESULTS: No mitosis was observed in Group II. There was a reduction in the mean nuclear volume in Group II (Mann-Whitney test). CONCLUSIONS: Tamoxifen, when administered only during the luteal phase of the menstrual cycle, significantly reduces the nuclear volume and mitotic activity of the epithelium. This data demonstrates an antagonistic action of tamoxifen on estrogen even when administered for short periods of time.

Adult↗
PubMed1998

[Cardiorespiratory response during exercise in heart transplant recipients. Comparative ergoespirometric analysis with normal health subjects].

PURPOSE: To evaluate the cardiorespiratory response of heart transplant (HT) recipients. METHODS: Nine HT recipients (GI) underwent ergospirometric tests and were compared to 9 apparently healthy, sedentary subjects with similar sex, age, weight and height (GII). All were male patients aging 48 +/- 12 years, in functional class I (NYHA) an average of 23 +/- 21 months after HT. They were receiving cyclosporin, azathioprine, prednisone, dipyridamole and antihypertensive drugs. The tests were symptom-limited and they were interrupted due to exhaustion. RESULTS: During peak exercise, GI had a significantly lower physical performance related to lower VO2, VE, VEO2, HR, endurance time and work load. At the anaerobic threshold, VO2, endurance time and work load levels were also significantly lower in GI. The physical performance was similar between the groups in the 40W load. CONCLUSION: The cardiorespiratory performance in GI was significantly lower at peak exercise and similar to GII in the 40W load, showing the HT benefits cardiac patients during usual activities.

Exercise Test↗
PubMed1996

Facial nerve electroneurography. Variability in normal subjects.

Twenty normal individuals were submitted to facial nerve electroneurography using different techniques in order to determine the most accurate to obtain the latencies and amplitudes of the compound muscle action potentials (CMAP) of the facial muscles. First of all it was determined in which muscle or muscle group highest amplitude CMAP could be recorded with the lowest variability between sides and in test-retest. Different techniques were studied in order to determine which could give the best results. This was shown to be an arrangement of bipolar surface electrodes fixed to a plastic bar. The records with higher amplitude where obtained from the nasolabial fold muscles. Therefore 65 normal volunteers were examined using this technique and recording the potentials obtained over the nasolabial fold muscles. Normal values were determined (latency lower than 4.5 ms and amplitude larger than 2 mV--95% confidence limits).

Action Potentials↗
PubMed1996

[Powdered milk enriched with iron and ascorbic acid as an intervention measure for treating iron deficiency anemia in children seen at a Basic Health Care Unit].

This study was undertaken to verify the influence of the use of iron and Vitamin C fortified powdered whole milk on the hemoglobin levels of 238 children, aged 6 to 18 months, seen at a Basic Health Care Unit in the State of São Paulo. The powdered milk was fortified with 9 mg of iron (ferrous sulfate) and 65 mg of Vitamin C for each 100 g of powder. 4 kg/month were distributed to children under one year and 2 kg/month to those over one year of age. Clinical, anthropometric and hematological (hemoglobin level measurements) evaluations were performed at the onset of the study and at three month intervals after the beginning of the supplementation. At the end of the trial, there was still enough milk available to extend the intervention for a group of 39 children who had presented the worst evolution in the first six months. At the onset of the study, 72.6% of the children presented anemia. After 3 and 6 months, these percentages had decreased to 38.9% and 18.5%, respectively. Among the children that were followed-up for 9 months, their were only 2.5% who presented anemia at the end of the intervention. The highest prevalences were found in the 6 to 12 months age group and the best results in the 10 to 18 month group. There was intrafamilial dilution of the milk in 30.7% of the cases. With or without intrafamilial milk sharing, there were significant decreases in anemia occurrences with no differences between the two groups. The use of fortified milk did not affect the children nutritional condition. This study permitted the conclusion that the fortification of foodstuffs, besides being the method of election for the prevention of iron deficiency, is an excellent alternative for the treatment of and recovery from iron deficient anemia in children under two years of age.

Anemia, Iron-Deficiency↗
PubMed1995

Short latency median nerve somatosensory evoked potential (SEP): increase in stimulation frequency from 3 to 30 Hz.

Somatosensory evoked potentials were obtained by electrical stimulation of the median nerve in 10 normal subjects at 3 and 30 Hz. At the higher rate of stimulation, a reduction was observed in amplitudes and prolongation of latencies of the N9, N/P13 and N20 components as well as increase of the interpeak latency N9-N/P13. A significant increase between the onsets of the N11 and N20 components was also seen; however, no significant increase of the N/P13-N20 interpeak latency was observed. Analysis suggested that an important reason for this last finding was related to the fact that in some cases different fast frequency components (FFC) determined the N20 peak in the different situations. It was further observed that, in those cases in which at least 3 peaks in the fast frequency components were detected (7/10), a significantly different increase in latency between the first and the third peaks was noted. A possible thalamo-cortical generation of the FFC is discussed.

Adolescent↗
PubMed1995

Comparison of three different schedules of vaccination against hepatitis B in health care workers.

Health care workers (HCW) are a group at risk for hepatitis B virus (HBV) infection; as a result, vaccination is recommended. However, elevated cost of the vaccination schedule is one of the limiting factors to this approach. Our aim in this study was to evaluate alternative schedules for vaccination against hepatitis B, in order to obtain safe immunization with reduced costs. We studied 300 HCW, randomized to be submitted to one of three vaccination schedules against hepatitis B: Group A--three doses of 20 micrograms i.m. (n = 103); Group B--first dose i.d. (2 micrograms), second and third doses i.m. (20 micrograms) (n = 97); Group C--first and second doses i.d. (2 micrograms), third dose i.m. (20 micrograms) (n = 100). All individuals received recombinant vaccine at 0, 1 and 6 months. After the first dose, there was no difference among the three schedules, either in terms of anamnestic response or in seroconversion rate. After the second dose, there was statistical difference among the three schedules (A > B > C), in terms of seroconversion rates. After the third dose, seroconversion rates were 92.2% in Group A and 92.8% in group B; geometric mean titers (GMT) in Group B (789.6 UI l-1) were similar to group A (1248.0 UI l-1). Group C presented a seroconversion rate of 78% and a GMT of 323.0 UI l-1, both statistically inferior to other schedules. We concluded that the schedule applied in Group B had similar results when compared to schedule A, with estimated savings of 30% in vaccine costs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗