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Machado C, Bochner R, Fiszon JT. Epidemiological profile of snakebites in Rio de Janeiro, Brazil, 2001-2006. J Venom Anim Toxins Incl Trop Dis 2012. [DOI: 10.1590/s1678-91992012000200012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Machado C, Estevez M, Gutierrez J, Prez-Nellar J, Olivares A. A network approach to assessing cognition in disorders of consciousness. Neurology 2011; 77:511; author reply 511-2. [PMID: 21810702 DOI: 10.1212/wnl.0b013e31821ea0bd] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Guimaraes M, Machado C. P1-25 Potential bias in HIV estimates using RDS sampling. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976c.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abreu D, Machado C, Fialho C, Drumond E. P2-348 Avoidable mortality in elderly people: using the Brazilian avoidable causes of death classification in three Brazilian cities (2003-2007). Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Settergren G, Machado C. Allow elective ventilation to recruit more organ donors. Acta Anaesthesiol Scand 2011; 55:340-3. [PMID: 21288217 DOI: 10.1111/j.1399-6576.2010.02386.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Transplantation surgery started >50 years ago and has developed into an established medical practice in many countries. We consider it positive if our dead body could be used as an organ or tissue donor. If transplanted, our organs confer other human beings with a longer and better life. There is, however, a relative lack of organs compared with the needs, and many potential recipients die while on the waiting list for transplantation.
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Machado C. S23-5 Diagnosis of brain death and other disorders of consciousness. Clin Neurophysiol 2010. [DOI: 10.1016/s1388-2457(10)60151-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cuspineda Bravo ER, Iturria Y, Praderes JC, Melie L, Valdés PA, Virues T, Machado C, Valdés Urrutia L. Noninvasive multimodal neuroimaging for Rasmussen encephalopathy surgery: simultaneous EEG-fMRI recording. Clin EEG Neurosci 2010; 41:159-65. [PMID: 20722352 DOI: 10.1177/155005941004100311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rasmussen syndrome is characterized by continuous partial seizures with progressive neurological/cognitive impairment. Currently the only effective treatment is surgery (hemispherectomy). The objective of our study is to detect the exact epileptogenic focus through the analysis of multimodal noninvasive and innocuous functional neuroimaging. The subject is a 5-year-old female patient with Rasmussen encephalopathy. Continuous and simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) was recorded. The sources of background and paroxysmal activity of EEG were computed by low resolution electromagnetic tomography (LORETA). Image analysis (SPM: statistic parametric mapping) was obtained for the areas where statistically significant differences in the fMRI BOLD response were computed, and the results from both techniques were compared. The main source of paroxysmal activity by EEG analysis was found in the anterolateral left hemisphere, with a significant increase in absolute and relative energies of slow frequency bands (theta-delta): Z > or = 3. The fMRI BOLD signal (basal vs. paroxysmal activity) was significantly different in the same region (t-test > or = 2.39). The generators of propagated paroxysmal activity were found in similar areas for both techniques. In conclusion, simultaneous EEG-fMRI recording allows the analysis of two harmless functional neuroimaging techniques separately and together in the same time period. In our case, it allowed the accurate delineation of epileptogenic foci and areas of spread with high spatiotemporal resolution, which is crucial for epilepsy surgery.
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Machado C, Perez-Nellar J, Rodríguez R, Scherle C, Korein J. Emergence from minimally conscious state: insights from evaluation of posttraumatic confusion. Neurology 2010; 74:1156; author reply 1156-7. [PMID: 20368639 DOI: 10.1212/wnl.0b013e3181d5df0d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cuspineda ER, Machado C, Virues T, Martínez-Montes E, Ojeda A, Valdés PA, Bosch J, Valdes L. Source analysis of alpha rhythm reactivity using LORETA imaging with 64-channel EEG and individual MRI. Clin EEG Neurosci 2009; 40:150-6. [PMID: 19715176 DOI: 10.1177/155005940904000306] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Conventional EEG and quantitative EEG visual stimuli (close-open eyes) reactivity analysis have shown their usefulness in clinical practice; however studies at the level of EEG generators are limited. The focus of the study was visual reactivity of cortical resources in healthy subjects and in a stroke patient. The 64 channel EEG and T1 magnetic resonance imaging (MRI) studies were obtained from 32 healthy subjects and a middle cerebral artery stroke patient. Low Resolution Electromagnetic Tomography (LORETA) was used to estimate EEG sources for both close eyes (CE) vs. open eyes (OE) conditions using individual MRI. The t-test was performed between source spectra of the two conditions. Thresholds for statistically significant t values were estimated by the local false discovery rate (lfdr) method. The Z transform was used to quantify the differences in cortical reactivity between the patient and healthy subjects. Closed-open eyes alpha reactivity sources were found mainly in posterior regions (occipito-parietal zones), extended in some cases to anterior and thalamic regions. Significant cortical reactivity sources were found in frequencies different from alpha (lower t-values). Significant changes at EEG reactivity sources were evident in the damaged brain hemisphere. Reactivity changes were also found in the "healthy" hemisphere when compared with the normal population. In conclusion, our study of brain sources of EEG alpha reactivity provides information that is not evident in the usual topographic analysis.
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de Morais GP, Lopes A, Machado C, Santos E, Pelicano N, Martins D. Wellens syndrome--the forgotten pattern. Rev Port Cardiol 2009; 28:641-644. [PMID: 19650577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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Machado C, Rodríguez R, Caiballo M, Korein J, Sanchez-Catasus C, Pérez J, Leisman G. Brain Anatomy, Cerebral Blood Flow, and Connectivity in the Transition from PVS to MCS. Rev Neurosci 2009; 20:177-80. [DOI: 10.1515/revneuro.2009.20.3-4.177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Machado C, Lin KC, Kuo JR, Greer DM, Varelas PN, Haque S, Wijdicks EF. VARIABILITY OF BRAIN DEATH DETERMINATION GUIDELINES IN LEADING US NEUROLOGIC INSTITUTIONS. Neurology 2008; 71:1125; author reply 1126. [DOI: 10.1212/01.wnl.0000334352.27463.49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Percegona L, Bignelli A, Adamy A, Machado C, Pilz F, Meyer F, Hokazono S, Riella M. Early Graft Function in Kidney Transplantation: Comparison Between Laparoscopic Donor Nephrectomy and Open Donor Nephrectomy. Transplant Proc 2008; 40:685-6. [DOI: 10.1016/j.transproceed.2008.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bottcher-Luiz F, Acquaro C, Machado C, Carvalho A, Pinotti M, Cecilio Sahium R, Blanco E, Teixeira L. Maintenance of breast cell lines with malignant phenotype and progenitor cells properties. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70504-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Percegona L, Bignelli A, Adamy A, Pilz F, Chin E, Meyer F, Hokazono S, Riella M, Machado C. Hand-Assisted Laparoscopic Donor Nephrectomy: Comparison to Pure Laparoscopic Donor Nephrectomy. Transplant Proc 2008; 40:687-8. [PMID: 18454987 DOI: 10.1016/j.transproceed.2008.03.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Acevedo AM, Montero M, Rojas-Sanchez F, Machado C, Rivera LE, Wolff M, Kleinberg I. Clinical evaluation of the ability of CaviStat in a mint confection to inhibit the development of dental caries in children. THE JOURNAL OF CLINICAL DENTISTRY 2008; 19:1-8. [PMID: 18500152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The aim of the present study was to determine if a sugarless mint containing CaviStat (an arginine bicarbonate calcium carbonate complex) is capable of preventing the development of dental caries in the primary molars and first permanent molars of 10 1/2- to 11-year-old Venezuelan children. METHODS Two-hundred children were entered into this one-year study who showed the following: (i) age between 10 1/2 and 11 years; (ii) first and second primary molars still present; (iii) sound primary molars or early caries lesions in any of these teeth; and (iv) at least some caries in the primary or permanent teeth as evidence of caries activity. Out of the 200 children initially selected, 195 finished and provided complete data. Children entered into the study were examined and then randomly divided into two groups (A and B), with distribution performed on the basis of the DMFS levels of the first permanent molars. All subjects were examined visually by a single examiner using good artificial light, mirror, and probe. Group A received a sugarless confection containing CaviStat (BasicMints); Group B received a sugarless mint control that contained all ingredients except for the CaviStat. Packaging and appearance of both types of mints were identical, except for their A and B designations. RESULTS Mean differences in DMFS, defs, and DMFS + defs scores between Groups A and B were determined. In the first permanent molars and some early erupting premolars and second molars, the data showed 75.6% fewer caries in Group A than in Group B children after six months, and 50.7% fewer after 12 months. Corresponding defs scores showed reduced development of dental caries in deciduous molars of 76.7% after six months and 131.3% after 12 months. Combined DMFS and defs scores showed 76.2 and 74.8% fewer caries lesions at six and 12 months, respectively. As exfoliation of primary molars occurred during the study period (approximately equal in the two groups), a proportion correction was made to allow for caries score reductions due to lesions lost because of such exfoliation. When this was done, the results at the end of the study still showed larger caries reductions in Group A than in the Group B subjects, and statistical analyses showed these differences were still highly significant (p < 0.001). Noncavitated caries lesions in the first permanent molars were also determined. These showed once again less caries development in Group A than in Group B subjects, and did so at both six and twelve months (57.0 and 52.4%, respectively). Levels of statistical significance at these times were p = 0.013 and 0.005. CONCLUSION It was evident from this clinical trial that mint confections containing CaviStat are able to inhibit both caries onset and caries progression. As a result, one can conclude that CaviStat mint confection technology is a simple and economical means for reducing substantially one of the most prevalent diseases in these children.
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Machado C, Korein J, Ferrer Y, Portela L, García MDLC, Chinchilla M, Machado Y, Machado Y, Manero JM. The Declaration of Sydney on human death. JOURNAL OF MEDICAL ETHICS 2007; 33:699-703. [PMID: 18055899 PMCID: PMC2598225 DOI: 10.1136/jme.2007.020685] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2007] [Accepted: 06/18/2007] [Indexed: 05/19/2023]
Abstract
On 5 August 1968, publication of the Harvard Committee's report on the subject of "irreversible coma" established a standard for diagnosing death on neurological grounds. On the same day, the 22nd World Medical Assembly met in Sydney, Australia, and announced the Declaration of Sydney, a pronouncement on death, which is less often quoted because it was overshadowed by the impact of the Harvard Report. To put those events into present-day perspective, the authors reviewed all papers published on this subject and the World Medical Association web page and documents, and corresponded with Dr A G Romualdez, the son of Dr A Z Romualdez. There was vast neurological expertise among some of the Harvard Committee members, leading to a comprehensible and practical clinical description of the brain death syndrome and the way to diagnose it. This landmark account had a global medical and social impact on the issue of human death, which simultaneously lessened reception of the Declaration of Sydney. Nonetheless, the Declaration of Sydney faced the main conceptual and philosophical issues on human death in a bold and forthright manner. This statement differentiated the meaning of death at the cellular and tissue levels from the death of the person. This was a pioneering view on the discussion of human death, published as early as in 1968, that should be recognised by current and future generations.
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Cuspineda E, Machado C, Galán L, Aubert E, Alvarez MA, Llopis F, Portela L, García M, Manero JM, Avila Y. QEEG prognostic value in acute stroke. Clin EEG Neurosci 2007; 38:155-60. [PMID: 17844945 DOI: 10.1177/155005940703800312] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of our study is to determine the predictive value of QEEG in patients suffering from an acute ischemic cerebral stroke. Twenty-eight patients were studied within the first 72 hours of clinical evolution of middle cerebral artery territory ischemic stroke. Thirty-seven QEEG recordings were obtained: 13 in the first 24 hours after cerebral stroke onset, 9 between 24-48 hours and 15 between 48-72 hours. Absolute Energies (AE) were the QEEG selected variables for statistical analysis: first, AE Z values were calculated using the Cuban QEEG norms, then the maximum and minimum AE Z values were selected within each frequency band and total power. The medians of the five neighboring Z values were also chosen. Regression models were estimated using the RANKIN scores as dependent variables and the selected QEEG variables as independent, then outcome predictions at hospital discharge and 3 months later were calculated. Percentages of concordance and errors between the estimated and real outcome scores were obtained. Alpha and theta AE were the best predictor for short-term outcome and delta AE for long-term outcome. We conclude that QEEG performed within the first 72 hours of ischemic stroke might be a powerful tool predicting short- and long-term outcome.
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Machado C, Korein J, Aubert E, Bosch J, Alvarez MA, Rodríguez R, Valdés P, Portela L, Garcia M, Pérez N, Chinchilla M, Machado Y, Machado Y. Recognizing a mother's voice in the persistent vegetative state. Clin EEG Neurosci 2007; 38:124-6. [PMID: 17844939 DOI: 10.1177/155005940703800306] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We studied an 8-year-old boy after a near-drowning left him in a vegetative state (VS) for 4 years before the study. Findings fulfilled all clinical criteria for the diagnosis of VS. The purpose of this study was to investigate whether there was significant differential activation of the brain in response to hearing his mother's voice compared with the voices of unknown women. The data were assessed using quantitative electric tomography (QEEGt), a technique that combines anatomical information of the brain by MRI with EEG patterns to estimate the sources of the EEG within the brain. We found significant differences for EEG frequencies from 14-58 Hz, with a peak at 33.2 Hz (gamma band). The 3D reconstruction showed that these statistical differences were localized in the lateral and posterior regions of the left hemisphere. No significant differences were found between unknown women vs. basal conditions. These results demonstrate recognition of the mother's voice and indicate high-level residual linguistic processing in a patient meeting clinical criteria for VS. These findings launch new ethical and practical implications for the management of VS patients.
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Gutierrez J, Lestayo Z, Mustelier R, Machado C. FC15.1 Reduced blink reflex habituation in patients with early-staged amyotrophic lateral sclerosis. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Percegona LS, Meyer F, Machado C, Bignelli AT, Riella MC, Santos LS. Hand-Assisted Laparoscopic Nephrectomy in Living Donors. Transplant Proc 2006; 38:1870-1. [PMID: 16908309 DOI: 10.1016/j.transproceed.2006.06.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hand-assisted laparoscopic nephrectomy (HLN) in living donors is a minimally invasive surgical modality that uses classic laparoscopic techniques either combined or not with the use of the surgeon's hand as a support tool during renal dissection maneuvers. The purpose of this study was to describe the initial experience with HLN technique in renal donors. Among 58 hand-assisted laparoscopic nephrectomies, the left kidney was removed in 39 donors (67%) and the right in 19 (33%). Surgery time ranged from 55 to 270 minutes (mean 156.9 +/- 49.5). Warm ischemia time ranged from 2 to 11 minutes (mean 4.38 +/- 2.31 min), with an estimated mean blood loss during the intraoperative period of 268 mL. Conversion to open surgery was required for four (6.8%) patients due to a vascular lesion. Upon graft evaluation, we observed immediate diuresis in 56 (96.3%) cases, with a mean serum creatinine on postoperative day 7 of 1.74 +/- 1.61 mg/dL. Renal vein thrombosis requiring graft removal occurred in one (1.7%) patient. Lymphocele was observed in three recipients (5.1%), and urinary leakage due to ureteral necrosis in three cases (5.1%). HLN for living donors is a safe procedure and an effective alternative to open nephrectomy. In this series, the procedure displayed low morbidity after surgery, providing a good morphological and functional quality of the graft for the recipient.
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Ghanbari H, Hassunizadeh B, Manyam H, Dandamudi R, Cunningham D, David S, Machado C. We-P13:330 Association between plasma myeloperoxidase levels and metabolic syndrome. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81683-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zulian F, Athreya BH, Laxer R, Nelson AM, Feitosa de Oliveira SK, Punaro MG, Cuttica R, Higgins GC, Van Suijlekom-Smit LWA, Moore TL, Lindsley C, Garcia-Consuegra J, Esteves Hilário MO, Lepore L, Silva CA, Machado C, Garay SM, Uziel Y, Martini G, Foeldvari I, Peserico A, Woo P, Harper J. Juvenile localized scleroderma: clinical and epidemiological features in 750 children. An international study. Rheumatology (Oxford) 2005; 45:614-20. [PMID: 16368732 DOI: 10.1093/rheumatology/kei251] [Citation(s) in RCA: 258] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Juvenile localized scleroderma (JLS) includes a number of conditions often grouped together. With the long-term goal of developing uniform classification criteria, we studied the epidemiological, clinical and immunological features of children with JLS followed by paediatric rheumatology and dermatology centres. METHODS A large, multicentre, multinational study was conducted by collecting information on the demographics, family history, triggering environmental factors, clinical and laboratory features, and treatment of patients with JLS. RESULTS Seven hundred and fifty patients with JLS from 70 centres were enrolled into the study. The disease duration at diagnosis was 18 months. Linear scleroderma (LS) was the most frequent subtype (65%), followed by plaque morphea (PM) (26%), generalized morphea (GM) (7%) and deep morphea (DM) (2%). As many as 15% of patients had a mixed subtype. Ninety-one patients (12%) had a positive family history for rheumatic or autoimmune diseases; 100 (13.3%) reported environmental events as possible trigger. ANA was positive in 42.3% of the patients, with a higher prevalence in the LS-DM subtype than in the PM-GM subtype. Scl70 was detected in the sera of 3% of the patients, anticentromere antibody in 2%, anti-double-stranded DNA in 4%, anti-cardiolipin antibody in 13% and rheumatoid factor in 16%. Methotrexate was the drug most frequently used, especially during the last 5 yr. CONCLUSION This study represents the largest collection of patients with JLS ever reported. The insidious onset of the disease, the delay in diagnosis, the recognition of mixed subtype and the better definition of the other subtypes should influence our efforts in educating trainees and practitioners and help in developing a comprehensive classification system for this syndrome.
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