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Toledo AF, da Silva AP, Poczynek M, Coelho MG, Silva MD, Polizel DM, Reis ME, Virgínio GF, Millen DD, Bittar CMM. Whole-flint corn grain or tropical grass hay free choice in the diet of dairy calves. J Dairy Sci 2020; 103:10083-10098. [PMID: 32952017 DOI: 10.3168/jds.2020-18514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/08/2020] [Indexed: 01/24/2023]
Abstract
Tropical grass hay feeding is related to improved ruminal health; however, it may decrease energy intake. On the other hand, whole-flint corn grain may be an alternative fiber source in the diet of dairy calves. Forty-two Holstein calves were used in a randomized block design, considering sex, birth date, and weight at 21 d of age, when the supply of whole-flint corn grain or tropical grass hay started. Three component-fed solid diets were compared: (1) starter concentrate only during the preweaning and starter concentrate with free choice of chopped Tifton-85 hay postweaning (SC), (2) starter concentrate with free choice of chopped Tifton-85 hay pre- and postweaning (SCH), and (3) starter concentrate with free choice of whole-flint corn grain pre- and postweaning (SCW). The animals were evaluated from 21 to 84 d of age. Calves were managed equally during the first 21 d, fed with 6 L/d of whole milk and a commercial starter concentrate (46% nonfiber carbohydrates, small particles, and pelleted) ad libitum. After that, milk feeding was reduced to 4 L/d until gradual weaning at 56 d of age. At 56 d of age, 4 animals per treatment were randomly chosen to be slaughtered for digestive tract weight evaluation and to collect tissue for histological analysis of the ruminal wall, duodenum, and cecum, whereas the other 30 animals were weaned and evaluated for a further 22 d when the SC diet also received hay ad libitum. Feed intake was measured daily. Weight gain and metabolic indicators of intermediate metabolism were evaluated weekly. Ruminal fluid was collected at wk 6, 8, 10, and 12 of age. The SCH diet increased the total and starter dry matter intake, and consequently, the average daily gain and body weight at 56 d of age. The SCW diet promoted an increase in propionate and decreased acetate-to-propionate ratio. Morphometric variables were affected by the SCH diet. The postweaning performance was unaffected by solid diets; however, the SCW diet decreased ruminal and fecal pH. Feeding hay, starting at 21 d of age, can stimulate early solid diet intake, promoting better performance and ruminal and intestinal development, when a highly fermentable and small particle pelleted starter is fed.
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Affiliation(s)
- A F Toledo
- Department of Animal Science, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil 13418-900
| | - A P da Silva
- Department of Animal Science, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil 13418-900
| | - M Poczynek
- Department of Animal Science, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil 13418-900
| | - M G Coelho
- Department of Animal Science, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil 13418-900
| | - M D Silva
- Department of Animal Science, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil 13418-900
| | - D M Polizel
- Department of Animal Science, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil 13418-900
| | - M E Reis
- Department of Animal Science, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil 13418-900
| | - G F Virgínio
- Department of Animal Science, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil 13418-900
| | - D D Millen
- Department of Animal Production, College of Technology and Agricultural Sciences, São Paulo State University (UNESP), Dracena, São Paulo, Brazil 17900-000
| | - C M M Bittar
- Department of Animal Science, Luiz de Queiroz College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil 13418-900.
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Look M, de Silva M, Ahn HJ, Austin Seabury A, Vegas JK, Kim C, Dillard A, Gonsalves J, Haumea S, Kaholokula JK. Cultural dance significantly improves hypertension management. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Hypertension (HT), uncontrolled blood pressure (>140/90 mmHg), is the leading preventable cause of premature death globally and a major risk factor for coronary heart disease, stroke, and other conditions. European and African regions have the highest prevalence rates at about 40% of adults. The U.S. has comparable rates and disturbing disparities in non-White minority groups. Native Hawaiians (NH), an indigenous U.S. population, are 70% more likely to have HT; 4 times more likely to have coronary heart disease or stroke than Whites. Hula, the cultural dance of NH, offers promise of a culturally responsive strategy for HT control.
We conducted a randomized clinical trial with a waitlist control to test the impact of a hula-based cultural dance intervention (CDI) on systolic blood pressure (SBP) in 263 NH with HT. All participants received HT education (e.g. diet, exercise, medication) during 3 1-hr sessions over 2 weeks, then randomly assigned to CDI (n = 131) or waitlist control (WC; n = 132). The CDI received 6 months of hula (2 1-hr sessions/week x 3 months, then 1 lesson/mth x 3 months with self-directed practice), with group activities to reinforce HT education. WC only received the initial HT education, then offered hula after the study. Assessments were done at 0-, 3- and 6-month, with 12-month for CDI only.
Baseline characteristics were balanced between groups, except for weight. Adjusting for weight and baseline SBP in intent-to-treat analysis, CDI achieved significant reductions (p < .05) in SBP (-15.3 mmHg; SE = 1.6) compared to WC (-11.8 mmHg, SE = 1.7). From 6 to 12 months, CDI maintained their SBP (mean change: 1.47 mmHg, SE = 1.26; p = .16) improvements at 12 months. CDI were more likely to achieve SBP reduction ≥ 10 mmHg than WC, 60% vs 48% (p = .03), respectively.
A CDI based on the NH cultural dance significantly improved HTN management in NH with uncontrolled SBP. Improvements were comparable to the best proven non-medication treatment of HT.
Key messages
Improving elevated blood pressure control with at-risk populations can be effectively and innovatively achieved by utilizing culturally responsive strategies, such as cultural dance interventions. Leveraging and aligning community strengths and health objectives leads to innovation and empowerment.
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Affiliation(s)
- M Look
- School of Medicine, University of Hawaii Medical School, Honolulu, USA
- Hālau Mōhala ʻIlima, Kaʻohao, USA
| | | | - H J Ahn
- School of Medicine, University of Hawaii Medical School, Honolulu, USA
| | | | - J K Vegas
- Waianae Coast Comprehensive Health Center, Waianae, USA
| | - C Kim
- Ke Ola Mamo, Honolulu, USA
| | - A Dillard
- Kula no na Poʻe Hawaiʻi, Honolulu, USA
| | | | | | - J K Kaholokula
- School of Medicine, University of Hawaii Medical School, Honolulu, USA
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Liu M, Kurimoto P, Zhang J, Niu QT, Stolina M, Dechow PC, Feng JQ, Hesterman J, Silva MD, Ominsky MS, Richards WG, Ke H, Kostenuik PJ. Sclerostin and DKK1 Inhibition Preserves and Augments Alveolar Bone Volume and Architecture in Rats with Alveolar Bone Loss. J Dent Res 2018; 97:1031-1038. [PMID: 29617179 DOI: 10.1177/0022034518766874] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Alveolar bone is a mechanosensitive tissue that provides structural support for teeth. Alveolar bone loss is common with aging, menopause, tooth loss, and periodontitis and can lead to additional tooth loss, reduced denture fixation, and challenges in placing dental implants. The current studies suggest that sclerostin and DKK1, which are established osteocyte-derived inhibitors of bone formation, contribute to alveolar bone loss associated with estrogen ablation and edentulism in rats. Estrogen-deficient ovariectomized rats showed significant mandibular bone loss that was reversed by systemic administration of sclerostin antibody (SAB) alone and in combination with DKK1 antibody (DAB). Osteocytes in the dentate and edentulous rat maxilla expressed Sost (sclerostin) and Dkk1 (DKK1) mRNA, and molar extraction appeared to acutely increase DKK1 expression. In a chronic rat maxillary molar extraction model, systemic SAB administration augmented the volume and height of atrophic alveolar ridges, effects that were enhanced by coadministering DAB. SAB and SAB+DAB also fully reversed bone loss that developed in the opposing mandible as a result of hypo-occlusion. In both treatment studies, alveolar bone augmentation with SAB or SAB+DAB was accompanied by increased bone mass in the postcranial skeleton. Jaw bone biomechanics showed that intact sclerostin-deficient mice exhibited stronger and denser mandibles as compared with wild-type controls. These studies show that sclerostin inhibition, with and without DKK1 coinhibition, augmented alveolar bone volume and architecture in rats with alveolar bone loss. These noninvasive approaches may have utility for the conservative augmentation of alveolar bone.
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Affiliation(s)
- M Liu
- 1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA
| | - P Kurimoto
- 1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA
| | - J Zhang
- 1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA.,Merck Research Labs, South San Francisco, CA, USA
| | - Q T Niu
- 1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA
| | - M Stolina
- 1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA
| | - P C Dechow
- 2 Baylor College of Dentistry, Texas A&M University, Dallas, TX, USA
| | - J Q Feng
- 2 Baylor College of Dentistry, Texas A&M University, Dallas, TX, USA
| | | | | | - M S Ominsky
- 1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA.,Radius Health Inc., Waltham, MA, USA
| | - W G Richards
- 1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA
| | - H Ke
- 1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA.,4 UCB Pharma, Slough, UK
| | - P J Kostenuik
- 1 Department of Cardiometabolic and Bone Disorders, Amgen Inc., Thousand Oaks, CA, USA.,Phylon Pharma Services, Newbury Park, CA, USA, and School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Lancman S, Barros JO, Silva MD, Pereira AR, Jardim TA. Interrelationship Between Organizational and Relational Aspects and the Return-to-Work Process: A Case Study with Nursing Professionals at a Teaching Hospital in Brazil. J Occup Rehabil 2017; 27:49-58. [PMID: 26868643 DOI: 10.1007/s10926-016-9631-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Introduction The process of returning to work, especially for individuals with labor restrictions, impacts work teams and interferes with the labor reinsertion process. In this study, we aimed to understand the impact of these situations on a nursing team from both organizational and relational perspectives. Methods We conducted a qualitative research study at a university hospital in the municipality of São Paulo using three strategies: documentary analysis; semi-structured interviews with pairs of workers returning to a labor situation; and a focus group with nursing managers. Results Medical leaves of absence overburden the employees who remain working. Regarding the return to work, the participants reported both positive and negative aspects. One positive aspect reported was that those who return to work contribute to the division of labor, generating solidarity and cooperation. The negative aspects reported were related to the return of workers with labor restrictions who do not fully resume their activities, consequently generating conflicts within the work teams that interfere with the reintegration processes. The supervisors reported difficulties reorganizing work on a broad scale and assessing the workers' diagnoses and symptoms and the workers themselves in terms of the necessity of their leaves and the validity of their labor restrictions. Conclusion The organization of labor and social relationships among peers and supervisors is a significant contributor to the success or failure of the work reintegration process and therefore should be considered. We aimed to address this issue by highlighting the complexity of the return-to-work process among health workers.
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Affiliation(s)
- S Lancman
- Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, Faculty of Medicine, University of São Paulo, Rua Cipotanea 51, São Paulo, 05360-160, Brazil.
| | - J O Barros
- Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, Faculty of Medicine, University of São Paulo, Rua Cipotanea 51, São Paulo, 05360-160, Brazil
| | - M D Silva
- Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, Faculty of Medicine, University of São Paulo, Rua Cipotanea 51, São Paulo, 05360-160, Brazil
| | - A R Pereira
- Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, Faculty of Medicine, University of São Paulo, Rua Cipotanea 51, São Paulo, 05360-160, Brazil
| | - T A Jardim
- Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, Faculty of Medicine, University of São Paulo, Rua Cipotanea 51, São Paulo, 05360-160, Brazil
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Brüggemann TR, Ávila LCM, Fortkamp B, Greiffo FR, Bobinski F, Mazzardo-Martins L, Martins DF, Duarte MMMF, Dafre A, Santos ARS, Silva MD, Souza LF, Vieira RP, Hizume-Kunzler DC. Effects of Swimming on the Inflammatory and Redox Response in a Model of Allergic Asthma. Int J Sports Med 2015; 36:e10. [PMID: 25958938 DOI: 10.1055/s-0035-1549904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- T R Brüggemann
- Internal Medicine, School of Medicine of University of São Paulo, São Paulo, Brazil
| | - L C M Ávila
- Physical Therapy, State University of Santa Catarina, Florianopolis, Brazil
| | - B Fortkamp
- Physical Therapy, State University of Santa Catarina, Florianopolis, Brazil
| | - F R Greiffo
- Research, Nove de Julho University - UNINOVE, São Paulo, Brazil
| | - F Bobinski
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - L Mazzardo-Martins
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - D F Martins
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - M M M F Duarte
- Department of Health Science, Lutheran University of Brazil, Santa Maria, Brazil
| | - A Dafre
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - A R S Santos
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - M D Silva
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - L F Souza
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - R P Vieira
- Research, Nove de Julho University, São Paulo, Brazil
| | - D C Hizume-Kunzler
- Physical Therapy, State University of Santa Catarina, Florianopolis, Brazil
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6
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Brüggemann TR, Ávila LCM, Fortkamp B, Greiffo FR, Bobinski F, Mazzardo-Martins L, Martins DF, Duarte MMMF, Dafre A, Santos ARS, Silva MD, Souza LF, Vieira RP, Hizume-Kunzler DC. Effects of Swimming on the Inflammatory and Redox Response in a Model of Allergic Asthma. Int J Sports Med 2015; 36:579-84. [PMID: 25837246 DOI: 10.1055/s-0034-1395588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In this study we hypothesized that swimming during sensitization phase could result in a preventive effect in mice with allergic asthma. Swiss mice were divided into 4 groups: Control and Swimming (non-sensitized), OVA and OVA+Swimming (sensitized). The allergic inflammation was induced by 2 intraperitoneal injections and 4 aerosol challenges using ovalbumin. Swimming sessions were performed at high intensity over 3 weeks. 48 h after the last challenge mice were euthanized. Swimming decreased OVA-increased total IgE, IL-1, IL-4, IL-5 and IL-6 levels, as well as the number of total cells, lymphocytes and eosinophils in bronchoalveolar lavage fluid, (p<0.05). Simultaneously, swimming also increased IL-10 and glutathione levels in the Swimming and OVA+Swimming groups (p<0.05). The levels of glutathione peroxidase and catalase were increased only in the Swimming group when compared to all groups (p<0.05). 21 days of swimming resulted in an attenuation of pulmonary allergic inflammation followed by an increase of glutathione levels in the OVA group. Swimming only increased the levels of glutathione peroxidase and catalase in non-sensitized mice (p<0.05). These data suggest that the pulmonary anti-inflammatory effects produced by 3 weeks of high-intensity swimming in this model of OVA-induced asthma may be, at least partly, modulated by reduced oxidative stress and increased IL-10 production.
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Affiliation(s)
- T R Brüggemann
- Internal Medicine, School of Medicine of University of São Paulo, São Paulo, Brazil
| | - L C M Ávila
- Physical Therapy, State University of Santa Catarina, Florianopolis, Brazil
| | - B Fortkamp
- Physical Therapy, State University of Santa Catarina, Florianopolis, Brazil
| | - F R Greiffo
- Research, Nove de Julho University - UNINOVE, São Paulo, Brazil
| | - F Bobinski
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - L Mazzardo-Martins
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - D F Martins
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - M M M F Duarte
- Department of Health Science, Lutheran University of Brazil, Santa Maria, Brazil
| | - A Dafre
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - A R S Santos
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - M D Silva
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - L F Souza
- Department of Biological Science, Federal University of Santa Catarina, Florianopolis, Brazil
| | - R P Vieira
- Research, Nove de Julho University, São Paulo, Brazil
| | - D C Hizume-Kunzler
- Physical Therapy, State University of Santa Catarina, Florianopolis, Brazil
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7
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Silva MD, Ramalho M, Monteiro D. Communities of Social Bees (Apidae: Meliponini) in Trap-Nests: the Spatial Dynamics of Reproduction in an Area of Atlantic Forest. Neotrop Entomol 2014; 43:307-313. [PMID: 27193808 DOI: 10.1007/s13744-014-0219-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 04/05/2014] [Indexed: 06/05/2023]
Abstract
As most stingless bee species depend on preexisting cavities, principally tree hollows, nesting site availability may represent an important restriction in the structuring of their forest communities. The present study examined the spatial dynamics of stingless bee communities in an area of Atlantic Forest by evaluating their swarming to trap-nests. The field work was performed in the Michelin Ecological Reserve (MER) on the southeastern coast of the state of Bahia, Brazil. Seven hundred and twenty trap-nests were distributed within two forest habitats in advanced and initial stages of regeneration. The trap-nests were monitored between September 2009 and March 2011. Twenty-five trap-nests were occupied by five bee species, resulting in a capture ratio of 0.035 swarms/trap (approximately 0.14 swarms/ha), corresponding to 10 swarms/year (0.056 swarms/ha/year). According to previous study at MER, the most abundant species in natural nests were also the most common in trap-nests in the two forest habitats examined, with the exception of Melipona scutellaris Latreille. Swarms of higher numbers of species were captured in initial regeneration stage forests than in advanced regeneration stage areas, and differences in species compositions were significant between both habitats (p = 0.03); these apparent differences were not consistent, however, when considering richness (p = 0.14) and total abundance (p = 0.08). The present study suggests the existence of a minimum cavity size threshold of approximately 1 L for most local species of stingless bees and sustains the hypothesis of a mass effect of Tetragonisca angustula Latreille populations from surrounding disturbed habitats on the MER forest community in terms of propagule (swarm) pressure. Examining swarm densities with trap-nests can be a promising technique for comparative analyses of the carrying capacities of forest habitats for stingless bee colonies, as long as size thresholds of cavities for nesting are taken into consideration.
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Affiliation(s)
- M D Silva
- Lab de Ecologia da Polinizaçao, Instituto de Biologia, Depto de Botânica, Univ Federal da Bahia, Salvador, BA, Brasil.
- Instituto Federal de Educação, Ciência e Tecnologia Baiano, Governador Mangabeira, BA, Brasil.
| | - M Ramalho
- Lab de Ecologia da Polinizaçao, Instituto de Biologia, Depto de Botânica, Univ Federal da Bahia, Salvador, BA, Brasil
| | - D Monteiro
- Lab de Ecologia da Polinizaçao, Instituto de Biologia, Depto de Botânica, Univ Federal da Bahia, Salvador, BA, Brasil
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8
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Usagawa T, Look M, de Silva M, Stickley C, Kaholokula JK, Seto T, Mau M. Metabolic equivalent determination in the cultural dance of hula. Int J Sports Med 2013; 35:399-402. [PMID: 24203801 DOI: 10.1055/s-0033-1353213] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Ethnic minorities share an unequal burden of cardiometabolic syndrome. Physical activity (PA) has been shown to be an important factor for improving the outcomes of these diseases. While metabolic equivalents (METs) have been calculated for diverse activities, most cultural activities have not been evaluated. Hula, the traditional dance of Native Hawaiians, is practiced by men and women of all ages but its MET value is unknown. To our knowledge, this is the first scientific evaluation of energy expenditure of hula. 19 competitive hula dancers performed 2 dance sets of low- and high-intensity hula. METs were measured with a portable indirect calorimetry device. Mean and standard deviations were calculated for all the variables. A 2-way ANOVA was conducted to identify differences for gender and intensity. The mean MET were 5.7 (range 3.17-9.77) and 7.55 (range 4.43-12.0) for low-intensity and high-intensity, respectively. There was a significant difference between intensities and no significant difference between genders. This study demonstrates that the energy expenditure of both low- and high-intensity hula met the recommended guidelines for moderate and vigorous intensity exercise, respectively, and that hula can be utilized as a prescribed PA.
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Affiliation(s)
- T Usagawa
- Department of Native Hawaiian Health, University of Hawaii, Honolulu, United States
| | - M Look
- Department of Native Hawaiian Health, University of Hawaii, Honolulu, United States
| | - M de Silva
- Hālau Mōhala ‛Ilima, Hālau Mōhala ‛Ilima, Kailua, United States
| | - C Stickley
- Department of Kinesiology and Rehabilitation Science, University of Hawaii, Honolulu, United States
| | - J K Kaholokula
- Department of Native Hawaiian Health, University of Hawaii, Honolulu, United States
| | - T Seto
- Department of Native Hawaiian Health, University of Hawaii, Honolulu, United States
| | - M Mau
- Department of Native Hawaiian Health, University of Hawaii, Honolulu, United States
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9
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Paiva JB, Cavallini JS, Silva MD, Almeida MA, Ângela HL, Berchieri Junior A. Molecular differentiation of Salmonella Gallinarum and Salmonella Pullorum by RFLP of fliC gene from Brazilian isolates. Rev Bras Cienc Avic 2009. [DOI: 10.1590/s1516-635x2009000400009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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10
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Robertson R, Germanos MS, Li C, Mitchell GS, Cherry SR, Silva MD. Optical imaging of Cerenkov light generation from positron-emitting radiotracers. Phys Med Biol 2009; 54:N355-65. [PMID: 19636082 DOI: 10.1088/0031-9155/54/16/n01] [Citation(s) in RCA: 251] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Radiotracers labeled with high-energy positron emitters, such as those commonly used for positron emission tomography studies, emit visible light immediately following decay in a medium. This phenomenon, not previously described for these imaging tracers, is consistent with Cerenkov radiation and has several potential applications, especially for in vivo molecular imaging studies. Herein we detail a new molecular imaging tool, Cerenkov Luminescence Imaging, the experiments conducted that support our interpretation of the source of the signal, and proof-of-concept in vivo studies that set the foundation for future application of this new method.
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Affiliation(s)
- R Robertson
- Department of Imaging Sciences, Millennium Pharmaceuticals, Inc., Cambridge, MA 02139, USA
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Valdez Domingos FX, Azevedo M, Silva MD, Randi MAF, Freire CA, Silva de Assis HC, Oliveira Ribeiro CA. Multibiomarker assessment of three Brazilian estuaries using oysters as bioindicators. Environ Res 2007; 105:350-63. [PMID: 17658507 DOI: 10.1016/j.envres.2007.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2007] [Revised: 06/09/2007] [Accepted: 06/18/2007] [Indexed: 05/16/2023]
Abstract
Oysters have been largely employed as bioindicators of environmental quality in biomonitoring studies. Crassostrea rhizophorae was selected to evaluate the health status of three estuarine areas impacted by anthropogenic activities along the Brazilian coast, in three estuarine complexes, ranging in latitude from 7 to 25 degrees S. In each estuary three sites were sampled in Winter and in Summer: a site considered as reference, and two sites next to contamination sources. Condition index was similar at all sites and estuaries, with the highest values found for Itamaracá oysters in Summer. Necrosis, hyperplasia, mucocyte hypertrophy and fusion of ordinary filaments were the main histopathological lesions observed. Muscle cholinesterase activity was overall similar, but with a strong seasonal effect. Inhibition or activation of branchial total ATPase and Na,K-ATPase activities at the contaminated sites was observed. The health status of these estuarine areas is quite similar, and the combined use of biomarkers is recommended.
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Affiliation(s)
- F X Valdez Domingos
- Departamento de Biologia Celular, Universidade Federal do Paraná. CP. 19031, CEP 81531-990, Curitiba, PR, Brazil.
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Coleman B, Hardman J, Coco A, Epp S, de Silva M, Crook J, Shepherd R. Fate of embryonic stem cells transplanted into the deafened mammalian cochlea. Cell Transplant 2006; 15:369-80. [PMID: 16970279 PMCID: PMC1810231 DOI: 10.3727/000000006783981819] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Spiral ganglion neurons (SGNs), the primary afferent neurons of the cochlea, degenerate following a sensorineural hearing loss (SNHL) due to lack of trophic support normally received from hair cells. Cell transplantation is emerging as a potential strategy for inner ear rehabilitation, as injected cells may be able to replace damaged SGNs in the deafened cochlea. An increase in the number of surviving SGNs may result in improved efficacy of cochlear implants (CIs). We examined the survival of partially differentiated mouse embryonic stem cells (MESCs), following xenograft transplantation into the deafened guinea pig cochlea (n=15). Cells were delivered directly into the left scala tympani via microinjection through the round window. Small numbers of MESCs were detected in the scala tympani for up to 4 weeks following transplantation and a proportion of these cells retained expression of neurofilament protein 68 kDa in vivo. While this delivery method requires refinement for effective long-term replacement of damaged SGNs, small numbers of MESCs were capable of survival in the deafened mammalian cochlea for up to 4 weeks, without causing an inflammatory tissue response.
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Affiliation(s)
- B Coleman
- Department of Otolaryngology, University of Melbourne, Level 2, Royal Victorian Eye and Ear Hospital, 32 Gisbome Street, East Melbourne, 3002, Australia.
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Russell AS, Maksymowych WP, de Silva M. Anti-cyclic citrullinated peptide antibodies in patients with rheumatoid arthritis treated with anti-tumour necrosis factor agents. Ann Rheum Dis 2005; 64:1807. [PMID: 16284357 PMCID: PMC1755309 DOI: 10.1136/ard.2005.040436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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de Silva M, Contreras M. M. de Silva and M. Contreras. Vox Sang 2004. [DOI: 10.1111/j.0042-9007.2004.572_13.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Engelfriet CP, Reesink HW, Judd WJ, Ulander VM, Kuosmanen M, Koskinen S, Rouger P, Morelati F, Tantalo V, Fujii T, de Haas M, van der Schoot CE, Overbeeke M, Koelewijn J, Bonsel G, Vrijkotte T, Zupańska B, Martin-Vega C, Parra Lopez R, de Silva M, Contreras M, Panzer S, Ulm B, Mayr WR. Current status of immunoprophylaxis with anti-D immunoglobin. Vox Sang 2004; 85:328-37. [PMID: 14633261 DOI: 10.1111/j.0042-9007.2003.364_1.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Silva MD, Contreras M. International Forum: 10. Vox Sang 2003. [DOI: 10.1111/j.0042-9007.2003.364_10.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- G Daniels
- Bristol Institute for Transfusion Sciences, Bristol, UK.
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Pagnano KBB, Silva MD, Vassallo J, Aranha FJP, Saad STO. Apoptosis-regulating proteins and prognosis in diffuse large B cell non-Hodgkin's lymphomas. Acta Haematol 2002; 107:29-34. [PMID: 11818669 DOI: 10.1159/000046626] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We evaluated the expression of apoptosis-regulating proteins (p53, Bcl-2, Bax, Bak and Mcl-1) in paraffin-embedded tissues of 33 patients with diffuse large B cell non-Hodgkin's lymphoma, and assessed the relationship of these proteins to clinical outcome and response to chemotherapy. Our results showed that p53 expression was an independent immunohistochemical parameter related to a poor prognosis in these lymphomas. Bcl-2, Bax, Bak and Mcl-1 proteins, though highly expressed in almost all cases were not associated with prognosis or response to treatment.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Apoptosis/genetics
- Biomarkers/analysis
- Female
- Humans
- Immunohistochemistry
- Lymphoma, B-Cell/chemistry
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/chemistry
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Membrane Proteins/metabolism
- Middle Aged
- Myeloid Cell Leukemia Sequence 1 Protein
- Neoplasm Proteins/metabolism
- Prognosis
- Proto-Oncogene Proteins/metabolism
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Retrospective Studies
- Survival Analysis
- Treatment Outcome
- Tumor Suppressor Protein p53/metabolism
- bcl-2 Homologous Antagonist-Killer Protein
- bcl-2-Associated X Protein
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Affiliation(s)
- K B B Pagnano
- Hematology Hemotherapy Center, State University of Campinas, Cidade Universitária Zeferino Vaz s/n, Campinas-SP, Brazil
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Abstract
A case of anti-Js(b) in pregnancy was associated with unexpectedly severe haemolytic disease of the newborn, requiring urgent exchange transfusion. Clinical signs of fetal distress were evident at 35 weeks of gestation in a sixth pregnancy. A Js(b+) baby from a previous pregnancy had been unaffected. This case report illustrates the difficulties of predicting severity on the basis of anti-Js(b) titre, and highlights issues relating to the problems of using reconstituted frozen red cells from the rare red cell bank for exchange transfusion.
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Affiliation(s)
- S Stanworth
- Reference Laboratory, Immunohaematology Department, North London Blood Centre, London, UK
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Jayasuriya N, de Silva M, Fernando D. Unusual case of obstructive jaundice. Ceylon Med J 2001; 46:158-9. [PMID: 12164040 DOI: 10.4038/cmj.v46i4.6474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Leal C, Henrique R, Monteiro P, Lopes C, Bento MJ, De Sousa CP, Lopes P, Olson S, Silva MD, Page DL. Apocrine ductal carcinoma in situ of the breast: histologic classification and expression of biologic markers. Hum Pathol 2001; 32:487-93. [PMID: 11381366 DOI: 10.1053/hupa.2001.24327] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Apocrine ductal carcinoma in situ (ADCIS) has been called a special type of ductal carcinoma in situ (DCIS) because the histologic grading is considered difficult using the classification schemes that have been proposed for common DCIS. However, ADCIS encompasses a spectrum of lesions with different morphologic aspects ranging from minimally atypical to overtly malignant. To define a classification scheme for ADCIS, 35 cases (22 pure and 13 associated with invasive carcinoma) were selected on the basis of conventional morphology on hematoxylin and eosin (H&E)-stained sections. Each case was assigned to 1 of 3 histologic grades (low, intermediate, and high) based on nuclear morphology and the presence of necrosis. In addition, the expression of hormone receptors p53, bcl-2, c-erbB-2, and Ki-67 was evaluated by immunohistochemistry, and the DNA ploidy was determined by image cytometry. Fifteen cases were classified as high histologic grade, 10 as low histologic grade, and the other 10 as intermediate grade. All but 4 cases, irrespective of grade, had the same hormonal immunophenotype: androgen receptor positivity (97.1%) and estrogen receptor and progesterone receptor negativity (94.3% and 97.1% respectively). Twenty-one cases (61.8%) showed p53 expression, and 47.1% of the cases were positive for c-erbB-2. The median positivity for Ki-67 was 5.2%. ADCIS has a unique morphologic and hormonal profile, distinct from common DCIS, deserving a specific classification. The proposed classification scheme allows for categorization of ADCIS according to the most important morphologic features already seen in common DCIS, ie, nuclear grade and necrosis. The expression of biologic markers other than hormonal receptors and bcl2 in ADCIS seems in general to be similar to that in common DCIS. Ki-67 and c-erbB-2 are expressed more frequently in intermediate and high histologic grade ADCIS.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Breast Neoplasms/chemistry
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Cell Nucleus/chemistry
- Cell Nucleus/pathology
- Coloring Agents
- DNA, Neoplasm/analysis
- Eosine Yellowish-(YS)
- Female
- Hematoxylin
- Humans
- Immunohistochemistry
- Ki-67 Antigen/analysis
- Mastectomy
- Middle Aged
- Necrosis
- Proto-Oncogene Proteins c-bcl-2/analysis
- Radiotherapy
- Receptor, ErbB-2/analysis
- Receptors, Androgen/analysis
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Tumor Suppressor Protein p53/analysis
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Affiliation(s)
- C Leal
- Department of Pathology and Epidemiology, Instituto Português de Oncologia, Centro Regional do Porto, Portugal
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Abstract
OBJECTIVE To study the pattern of injuries and some causative factors of three-wheeler related accidents. DESIGN Prospective descriptive study. SETTING Accident unit, Colombo South Teaching Hospital, Kalubowila. METHODS One hundred patients admitted to Colombo South Teaching Hospital with three-wheeler related accidents were interviewed, examined within 24 hours of admission and followed up by using a standard questionnaire. Detailed descriptions of the accident and the types of injuries were recorded. RESULTS 54 accidents took place during daytime 07.00 h to 19.00 h) and the passengers were the commonest victims (40%). Soft tissue injury was the commonest injury observed (75%). The second commonest type of injury was long bone fractures (21%). Toppling due to a sudden turn of the vehicle accounted for 30% of accidents. Of 28 drivers in the study group, 25 admitted breaking the handle-lock to increase the vehicle's turning angle. Toppling due to a sudden turn was identified as the cause of the accident in all those who had interfered with the handle-lock. At the time of the accident, 89% of the drivers and 28.1% of pedestrians were under the influence of alcohol. Alcohol was related to 67.4% of the night accidents. CONCLUSIONS Alcohol consumption was recognised as a major contributory factor, in particular for night accidents. A strong association was observed between mechanical alteration of the vehicle's handle-lock and the risk of accident. Introduction of legislation to prohibit handle-lock alteration and strict implementation of the law regarding driving under the influence of alcohol would help to reduce three-wheeler related accidents.
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Affiliation(s)
- M de Silva
- Department of Surgery, Faculty of Medical Sciences, University of Sri Jayawardenepura, Nugegoda
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Abstract
It is known that a vein graft provides a good microenvironment for axon regeneration in motor peripheral nerves, but the use of artery graft for regeneration of sensory nerves is controversial. We sectioned the saphenous nerve and repaired it by using heterologous inside-out and standard artery graft techniques in rats. After 4, 12, and 20 weeks, the graft and the distal stump were observed under electron microscopy. In each period studied, the pattern, diameters, and thickness of the myelin sheaths of the regenerated axons were measured in the graft and distal stump. There was capillary invasion in both the graft and distal stump, especially in the inside-out artery graft group. Regenerated nerve fibers were prominent in both heterologous artery grafts 4 weeks after the surgical procedures. Conversely, in the distal stump, regenerated nerve fibers were observed only after 12 weeks. In both the inside-out artery graft and standard artery graft, no statistical difference in the diameters and thickness of the myelinated fibers after 20 weeks was observed.
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Abstract
A major difficulty in staging and predicting ischemic brain injury by magnetic resonance (MR) imaging is the time-varying nature of the MR parameters within the ischemic lesion. A new multispectral (MS) approach is described to characterize cerebral ischemia in a time-independent fashion. MS analysis of five MR parameters (mean diffusivity, diffusion anisotropy, T2, proton density, and perfusion) was employed to characterize the progression of ischemic lesion in the rat brain following 60 minutes of transient focal ischemia. k-Means (KM) and fuzzy c-means (FCM) classification methods were employed to define the acute and subacute ischemic lesion. KM produced an estimate of lesion volume that was highly correlated with postmortem infarct volume, independent of the age of the lesion. Overall classification rates for KM exceeded FCM at acute and subacute time points as follows: KM, 90.5%, 94.4%, and 95. 9%; FCM, 82.4%, 90.6%, and 82.6% (for 45 minutes, 180 minutes, and 24-120 hours post MCAO groups). MS analysis also offers a formal method of combining diffusion and perfusion parameters to provide an estimate of the ischemic penumbra (KM classification rate = 70.3%). J. Magn. Reson. Imaging 2000;12:842-858.
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Affiliation(s)
- R A Carano
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts 01609, USA
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Tilakaratne A, Soory M, Ranasinghe AW, Corea SM, Ekanayake SL, de Silva M. Effects of hormonal contraceptives on the periodontium, in a population of rural Sri-Lankan women. J Clin Periodontol 2000; 27:753-7. [PMID: 11034123 DOI: 10.1034/j.1600-051x.2000.027010753.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Women using hormonal contraceptives can be considered to be a 'risk group' for periodontal disease, due to prolonged, sustained serum levels of oestrogens and progesterone. This investigation aims to study the effects of hormonal contraceptives on periodontal tissues. METHODS 32 women using hormonal contraceptives for less than 2 years, 17 for 2-4 years and a matched control group of 39 non-users were selected for the study. They were clinically examined for plaque levels (plaque index: PLI), gingival condition (gingival index: GI) and loss of periodontal attachment (LA). RESULTS Contraceptive users of less than 2 years and 2-4 years duration (n=32, n= 17 respectively) and non-users (n=39) had similar oral hygiene levels; yet the contraceptive users had a significantly higher level of gingival inflammation, compared to the non-users (p<0.001; 1-way ANOVA). Usage of hormonal contraceptives for 2-4 years (n= 17) caused a significantly higher LA (p<0.001) compared to that of controls (n=39). CONCLUSIONS Usage of contraceptive preparations containing oestrogen and progesterone resulted in hormonal changes similar to those seen in pregnancy, associated with increased prevalence of gingivitis. There was significantly higher LA with prolonged usage of hormonal contraceptives, compared with controls.
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Affiliation(s)
- A Tilakaratne
- Department of Periodontology, Faculty of Dental Sciences, University of Peradeniya, Sri-Lanka
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Tilakaratne A, Soory M, Ranasinghe AW, Corea SM, Ekanayake SL, de Silva M. Periodontal disease status during pregnancy and 3 months post-partum, in a rural population of Sri-Lankan women. J Clin Periodontol 2000; 27:787-92. [PMID: 11034128 DOI: 10.1034/j.1600-051x.2000.027010787.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this investigation was to study the effects of pregnancy on the periodontium, in a rural population of Sri-Lankan women. METHODS The study group consisted of 47 pregnant women and 47 non-pregnant women who served as matched controls. All subjects were examined for plaque (plaque index: PLI), gingival condition (gingival index: GI) and loss of periodontal attachment (LA) levels, 4 x during the study, at 3-monthly intervals. RESULTS Despite similar scores for plaque levels in both pregnant and non-pregnant women, the GI of pregnant women was significantly increased, during the 1st and 2nd trimesters compared to the controls (p<0.01, 2-way ANOVA). During the 3rd trimester, GI was further increased (p<0.001), but dropped at 3 months post-partum. Values for LA did not show significant differences from that of controls, during any of the stages of pregnancy. CONCLUSIONS The results of this study show that pregnancy had an effect only on the gingivae and not on periodontal attachment levels. The effects of oestrogen and progesterone could give rise to a more florid response to the irritant effects of plaque, resulting in severe gingivitis.
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Affiliation(s)
- A Tilakaratne
- Faculty of Dental Sciences, University of Sri-Lanka, Peradeniya
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Engelfriet CP, Reesink HW, Garratty G, Knight R, de Silva M, Contreras M, Overbeeke MA, Porcelijn L, Lin M, So CC, Schmidt-Melbye AC, Heier HE, Sokol RJ, Booker DJ, Stamps R, Barbolla L, Zamora C, Hernández-Jodra M, Goldman M, Long A, Décary F. The detection of alloantibodies against red cells in patients with warm-type autoimmune haemolytic anaemia. Vox Sang 2000; 78:200-7. [PMID: 10838523 DOI: 10.1159/000031181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Li F, Silva MD, Liu KF, Helmer KG, Omae T, Fenstermacher JD, Sotak CH, Fisher M. Secondary decline in apparent diffusion coefficient and neurological outcomes after a short period of focal brain ischemia in rats. Ann Neurol 2000; 48:236-44. [PMID: 10939575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
This study was designed to characterize the initial and secondary changes of the apparent diffusion coefficient (ADC) of water with high temporal resolution measurements of ADC values and to correlate ADC changes with functional outcomes. Fourteen rats underwent 30 minutes of temporary middle cerebral artery occlusion (MCAO). Diffusion-, perfusion-, and T2-weighted imaging was performed during MCAO and every 30 minutes for a total of 12 hours after reperfusion (n = 6). Neurological outcomes were evaluated during MCAO, every 30 minutes for a total of 6 hours and at 24 hours after reperfusion (n = 8). The decreased cerebral blood flow during MCAO returned to normal after reperfusion and remained unchanged thereafter. The decreased ADC values during occlusion completely recovered at 1 hour after reperfusion. The renormalized ADC values started to decrease secondarily at 2.5 hours, accompanied by a delayed increase in T2 values. The ADC-defined secondary lesion grew over time and was 52% of the ADC-defined initial lesion at 12 hours. Histological evaluation demonstrated neuronal damage in the regions of secondary ADC decline. Complete resolution of neurological deficits was seen in 1 rat at 1 hour and in 6 rats between 2.5 and 6 hours after reperfusion; no secondary neurological deficits were observed at 24 hours. These data suggest that (1) a secondary ADC reduction occurs as early as 2.5 hours after reperfusion, evolves in a slow fashion, and is associated with neuronal injury; and (2) renormalization and secondary decline in ADC are not associated with neurological recovery and worsening, respectively.
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Affiliation(s)
- F Li
- Department of Neurology, U Mass Memorial Health Care and University of Massachusetts Medical School, Worcester 01605, USA
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Abstract
There is controversy over how hormonal conditions influence cerebral physiology. We studied pattern-shift visual evoked potentials (PS-VEP), brain stem auditory evoked potentials (BAEP) and short-latency somatosensory evoked potentials (SSEV) in 20 female volunteers at different phases of the menstrual cycle (estrogen phase, ovulatory day and progesterone phase). Statistical analysis showed decreased latencies for P100 (PS-VEP), N19 and P22 (SSEV) waves in the progesterone phase compared with the estrogen phase. There was no significant difference between the estrogen and the ovulation day values. Comparing the three above stages, there were no significant differences in the brainstem auditory evoked potentials. The reduction of the latencies of the potentials generated in multisynaptic circuits provides the first consistent neurophysiological basis for a tentative comprehension of human pre-menstrual syndrome.
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Affiliation(s)
- L A Resende
- Department of Neurology and Psychiatry, Faculty of Medicine of Botucatu, State University of São Paulo, Brazil
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Li F, Liu KF, Silva MD, Omae T, Sotak CH, Fenstermacher JD, Fisher M, Hsu CY, Lin W. Transient and permanent resolution of ischemic lesions on diffusion-weighted imaging after brief periods of focal ischemia in rats : correlation with histopathology. Stroke 2000; 31:946-54. [PMID: 10754004 DOI: 10.1161/01.str.31.4.946] [Citation(s) in RCA: 162] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The early ischemic lesions demonstrated by diffusion-weighted imaging (DWI) are potentially reversible. The purposes of this study were to determine whether resolution of initial DWI lesions is transient or permanent after different brief periods of focal brain ischemia and to evaluate histological outcomes. METHODS Sixteen rats were subjected to 10 minutes (n=7) or 30 minutes (n=7) of temporary middle cerebral artery occlusion or sham operation (n=2). DWI, perfusion-weighted imaging (PWI), and T(2)-weighted imaging (T(2)WI) were performed during occlusion; immediately after reperfusion; and at 0.5, 1.0, 1.5, 12, 24, 48, and 72 hours after reperfusion. After the last MRI study, the brains were fixed, sectioned, stained with hematoxylin and eosin, and evaluated for neuronal necrosis. RESULTS No MRI or histological abnormalities were observed in the sham-operated rats. In both the 10-minute and 30-minute groups, the perfusion deficits and DWI hyperintensities that occurred during occlusion disappeared shortly after reperfusion. The DWI, PWI, and T(2)WI results remained normal thereafter in the 10-minute group, whereas secondary DWI hyperintensity and T(2)WI abnormalities developed at the 12-hour observation point in the 30-minute group. Histological examinations demonstrated neuronal necrosis in both groups, but the number of necrotic neurons was significantly higher in the 30-minute group (95+/-4%) than in the 10-minute group (17+/-10%, P<0.0001). CONCLUSIONS Transient or permanent resolution of initial DWI lesions depends on the duration of ischemia. Transient resolution of DWI lesions is associated with widespread neuronal necrosis; moreover, permanent resolution of DWI lesions does not necessarily indicate complete salvage of brain tissue from ischemic injury.
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Affiliation(s)
- F Li
- Departments of Neurology, UMass Memorial Health Care, Worcester, MA 01605, USA.
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Abstract
OBJECTIVE Ischemic lesions seen on diffusion-weighted imaging (DWI) are reversible if reperfusion is performed within minutes after the onset of ischemia. This study was designed to determine whether acute reversibility of DWI abnormalities is transient following brief temporary focal brain ischemia and to characterize the temporal evolution of in vivo ischemic lesions. METHODS Eight rats were subjected to 30 minutes of temporary middle cerebral artery occlusion and underwent diffusion-, perfusion-, and T2-weighted MRI during occlusion; immediately after reperfusion; 30, 60, and 90 minutes after reperfusion; and 12, 24, 48, and 72 hours after reperfusion. Average apparent diffusion coefficient (ADCav) values and the cerebral blood flow index (CBFi) ratio were calculated in both the lateral caudoputamen and overlying cortex at each time point. The size of the in vivo ischemic abnormalities was calculated from the ADCav and the T2 maps. Postmortem triphenyltetrazolium chloride (TTC) staining was used to verify ischemic injury. RESULTS Both the CBFi ratio and ADCav values declined significantly in the two regions during occlusion. The CBFi ratio recovered immediately after reperfusion and remained unchanged over 72 hours. However, ADCav values returned to normal at 60 to 90 minutes and secondarily decreased at 12 hours after reperfusion as compared with those in the contralateral hemisphere. The extent of the in vivo ischemic lesions maximized at 48 hours and was highly correlated with TTC-derived lesion size. CONCLUSIONS Acute recovery of initial ADCav-defined lesions after reperfusion is transient, and secondary ADCav-defined lesions develop in a slow and delayed fashion.
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Affiliation(s)
- F Li
- Department of Neurology, UMass Memorial Health Care and University of Massachusetts Medical School, Worcester 01605, USA.
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Affiliation(s)
- M de Silva
- New Children's Hospital, Westmead, Sydney, NSW.
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de Silva M. Prevalence of Helicobacter pylori infection in patients with functional dyspepsia. Ceylon Med J 1999; 44:118-9. [PMID: 10675995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To investigate the prevalence of Helicobacter pylori infection in patients with functional dyspepsia. DESIGN Prospective descriptive study. SETTING Surgical unit, Base Hospital, Panadura. PATIENTS 67 patients with persistent symptoms suggestive of functional dyspepsia but no clinical, endoscopic or ultrasonographic evidence of peptic, biliary, pancreatic or malignant disease. METHODS Upper gastrointestinal endoscopy and two antral mucosal biopsies were performed in all patients and the rapid urease test (CLO test) was done to detect H pylori status. All patients gave informed consent. RESULTS Of the 67 patients (32 males) with a mean age of 45 years (35 to 70 years), only 2 patients (2.9%) were found to be positive for H pylori infection. CONCLUSION Incidence of H pylori infection was found to be very low in patients with functional dyspepsia.
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Li F, Carano RA, Irie K, Tatlisumak T, Silva MD, Pschorni U, Sotak CH, Fisher M. Neuroprotective effects of a novel broad-spectrum cation channel blocker, LOE 908 MS, on experimental focal ischemia: a multispectral study. J Magn Reson Imaging 1999; 10:138-45. [PMID: 10441016 DOI: 10.1002/(sici)1522-2586(199908)10:2<138::aid-jmri5>3.0.co;2-g] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Thirty-four rats undergoing 90 minutes of temporary middle cerebral artery occlusion were randomly and blindly assigned to vehicle or (RS)-(3,4-dihydro-6, 7-dimethoxyisoquinoline-1-gamma1)-2-phenyl-N,N-di-2-(2, 3, 4-trimethoxyphenyl)ethyl acetamide (LOE 908 MS; 0.5 mg/kg) i.v. bolus at 30 minutes after arterial occlusion followed by a 5 mg/kg/hr i.v. infusion for 3.8 hours (n =17/group). Perfusion-, diffusion- and T(2)-weighted magnetic resonance imaging was performed before treatment and repeatedly after treatment. Multispectral analysis was used to define ischemic abnormalities. The size of the ischemic abnormalities, including the ischemic core and penumbra, was not different between the two groups before treatment. However, a significant difference in ischemic lesion size was detected beginning 1.5 hours after treatment. The size of the ischemic core was significantly smaller in the treatment group, while the size of the ischemic penumbra was similar in the two groups at 85 minutes after arterial occlusion. Postmortem infarct size at 24 hours was significantly smaller in the drug-treated group than in the placebo group. These results demonstrate that LOE 908 MS can reduce ischemic lesion size, which is probably attributable to inhibition of expansion of the ischemic core. J. Magn. Reson. Imaging 1999;10:138-145.
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Affiliation(s)
- F Li
- Department of Neurology, UMass Memorial Health Care and University of Massachusetts Medical School, Worcester, Massachusetts 01605, USA.
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Brown GR, Silva MD, Thompson PA, Beutler B. Lymphoid hyperplasia, CD45RBhigh to CD45RBlow T-cell imbalance, and suppression of Type I diabetes mellitus result from TNF blockade in NOD-->NOD-scid adoptive T cell transfer. Diabetologia 1998; 41:1502-10. [PMID: 9867218 DOI: 10.1007/s001250051097] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Sustained antibody-mediated inhibition of tumor necrosis factor (TNF) activity offers protection against Type I (insulin-dependent) diabetes mellitus in non-obese diabetic (NOD) mice. The mechanism of this effect, however, has remained obscure: TNFalpha might be required for the development of specific immune responses to islet antigens or it could directly participate in destruction of beta cells. In this study, autoimmune destruction of beta cells was initiated in NOD-severe combined immunodeficient (scid) mice by transfer of NOD splenic T-cells to induce diabetes. The blockade of TNFalpha activity was achieved during a narrow window of time after transfer. Transient inhibition of TNFalpha greatly reduced the number of islet lymphocytes and the incidence of diabetes in recipients of prediabetic NOD spleen cells. Protection extended beyond the interval of effective TNF blockade. Furthermore, the protective effect was only observed if cells were obtained from 6-week-old donors. The suppression of autoimmunity was reversible in the context of adoptive transfer as indicated by the transfer of splenocytes from the primary recipient to a second NOD-scid host led to a diabetic outcome. The blockade of TNFalpha was accompanied by a considerable increase in spleen size and doubling of the total splenocyte count, suggesting that TNFalpha might normally eliminate a transplanted T-cell subset within the recipients. Further analysis showed an increase in the absolute count of CD4 + T cells and pronounced distortion of the CD45RBhigh to CD45RBlow ratio, with a relative augmentation in the CD45RBlow count in the spleen. TNFalpha appears to regulate the number and subtype distribution of a transplanted T cell population.
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Affiliation(s)
- G R Brown
- Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, 75235, USA
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Abstract
A pilot teleradiology project was conducted between the Royal Alexandra Hospital for Children in Camperdown, central Sydney, and Nepean Hospital in Penrith, about 48 km away. Over three months 575 paediatric radiographs were transmitted at full resolution. The results demonstrated that it was possible to transmit paediatric chest images of diagnostic quality in a reliable and secure manner. Mean transmission time per image was 3.26 min using ISDN, which was considered to be acceptable. Costs were calculated in terms of transmission, equipment, maintenance and staff components. The cost per image transmitted would vary from A$80 for 2500 images per year to A$34 for 10,000 images per year. The experience of the pilot study suggested that more widespread introduction of high-quality paediatric telemedicine in Australia would be feasible. Adoption of the technique would have major implications for paediatric health care, including potential improvements in patient management due to quicker diagnosis and earlier intervention, and potential savings through avoiding transfer of some emergency cases.
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Affiliation(s)
- B L Crowe
- Health Technology Division, Australian Institute of Health and Welfare, Canberra, Australia.
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Resende LA, Matarazzo AT, Kimaid PA, Silva MD. Reconsiderations about the clinical importance of the sympathetic skin response. Electromyogr Clin Neurophysiol 1997; 37:463-468. [PMID: 9444485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Over the last few years, neurologists have been showing increasing interest in the study of the sympathetic skin response (SSR). In the present report we describe a simple method that permitted us to determine a wide variation of SSR in response to different stimuli such as respiration, deglutition, blinking, skeletal movements, biting, auditory or light stimuli, vocalization, and sphincter contraction. These results raise doubts about the role of SSR as a complementary diagnostic method.
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Affiliation(s)
- L A Resende
- Department of Neurology and Psychiatry, Faculty of Medicine of Botucatu, UNESP, Brazil
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41
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Abstract
We present an infant who was exposed to warfarin throughout pregnancy and has warfarin embryopathy. When the child was examined radiologically at 20 months areas of calcification were visible in the septal and alar cartilages of the small external part of the nose. The location of this ectopic calcification is consistent with that seen in an animal model of the warfarin embryopathy. It supports the hypothesis that warfarin interferes with the prenatal growth of the cartilaginous nasal septum by inhibiting the normal formation of a vitamin K-dependent protein that prevents calcification of cartilage. The child also had severe abnormalities of the cervical vertebrae and secondary damage to the spinal cord. Cervical vertebral anomalies are a relatively common finding in the warfarin embryopathy and in the related Binder syndrome.
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Affiliation(s)
- A M Howe
- Department of Anatomy and Histology, University of Sydney, NSW, Australia
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Resende LA, Silva MD, Kimaid PA, Schiavão V, Zanini MA, Faleiros AT. Compression of the peripheral branches of the sciatic nerve by lipoma. Electromyogr Clin Neurophysiol 1997; 37:251-5. [PMID: 9208220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The authors report two female patients with chronic sensitive and motor findings in lower limbs caused by compression of distal branches of sciatic nerve by lipoma. Similar cases were not described on literature. Nerve conduction studies allowed to localize the exact site of compression. At surgery, lipomas compressing the deep peroneal nerve (case 1) and the posterior tibial nerve (case 2) were observed. Histologic studies of tumors confirmed the diagnoses.
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Affiliation(s)
- L A Resende
- Service of Neurology, São Paulo, State University, Brazil
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Angunawela P, de Silva M. Spontaneous rupture of a liver cell adenoma. Ceylon Med J 1997; 42:42-3. [PMID: 9164033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- P Angunawela
- Department of Pathology, Faculty of Medicine, Colombo
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Affiliation(s)
- M de Silva
- Royal Alexandra Hospital for Children, Wesmead, Sydney, Australia
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Abstract
The severity of hemolytic disease of the fetus or newborn can be assessed with certainty only by measurement of fetal parameters. However, these invasive procedures are not without risk for the fetus. Most erythrocyte antibodies do not cause significant hemolytic disease of the fetus or newborn and various assays are available to assist obstetricians in predicting the likely effect of maternal alloantibodies on fetal erythrocytes. Initially, immunohematologic tests are performed on maternal serum to identify antibodies with a potential for causing hemolytic disease of the fetus or newborn. Antibody concentration is measured by indirect antiglobulin technique titration, or where possible (for anti-D or -c), by quantitation. When used consecutively throughout pregnancy, these tests will reveal a trend that helps to predict the likelihood of hemolytic disease of the fetus or newborn. Functional assays (antibody-dependent cell-mediated cytotoxicity and chemiluminescence) are probably superior to serologic tests for predicting hemolytic disease of the fetus or newborn. Unfortunately, the assays do not reflect accurately the in vivo conditions for a given patient. Knowledge of the immunoglobulin subclass can help to assess the hemolytic potential of maternal antibody, but quantitative measurement of subclasses is still experimental. Diagnostic testing should be approached in a structured manner, commencing with simple serology, followed, in selected cases, by more complex functional assays and indirect fetal tests to identify those fetuses at greatest risk. This approach will enable direct fetal tests to be undertaken only when there is strong suspicion of severe hemolytic disease of the fetus or newborn.
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Macedo CS, Silva MD, Spadella CT, Breim LC, Capeletti S, Mercadante MC, Hernandes D, Macedo AR. Effect of long-term treatment with insulin and/or acarbose on glomerular basement membrane thickening in alloxan-diabetic rats. Braz J Med Biol Res 1996; 29:1329-35. [PMID: 9181105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Acarbose is a competitive inhibitor of the intestinal alpha-glycosidases, that can delay absorption of intestinal carbohydrates causing their malabsorption. In the present paper we studied the effects of insulin, acarbose and their association on glomerular basement membrane thickening in alloxan-diabetic rats. Twenty-five male and female Wistar rats, approximately 3 months old at the beginning of the experiment, were assigned randomly to each of five experimental groups: normal control rats, alloxan-diabetic control rats, alloxan-diabetic rats treated with acarbose, alloxan-diabetic rats treated with insulin, and alloxan-diabetic rats treated with insulin plus acarbose. Alloxan was administered in a single i.v. dose of 442 mg/kg body weight. Insulin was given subcutaneously at doses of 18 to 30 IU/kg corrected daily on the basis of glycosuria and ketonuria. Acarbose was given mixed with rat chow in a dose of 50 mg/100 g chow. Body weight, water and food intake and diuresis, as well as blood and urine glucose were determined after 1, 3, 6, 9, and 12 months of treatment. Glomerular basement membrane (GBM) thickening was determined by electron microscopy at the same times. Clear clinical and laboratory signs of severe diabetes, with blood glucose levels above 200 mg/dl and urine glucose above 3000 mg/dl, were observed in all alloxan-diabetic control rats, in all periods of follow-up, whereas administration of insulin or acarbose reduced the blood glucose levels of treated groups. The most satisfactory control of blood and urine glucose was observed in animals treated with both insulin and acarbose. However, diarrhea was observed in diabetic rats treated with acarbose associated or not with insulin. GBM thickening was correlated with age in all groups. Beginning at six months after diabetes induction, the GBM of untreated diabetic rats was significantly thicker (mean +/- SEM, 4.446 +/- 0.45 mm) than that of normal rats (2.977 +/- 0.63mm). Both insulin and acarbose prevented GBM thickening and their combination induced thickening similar to the age dependent thickening observed for normal rats of the same age. We conclude that acarbose when combined with insulin may be a good option in the control of diabetes and its renal complications.
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Affiliation(s)
- C S Macedo
- Departamento de Pediatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, SP, Brasil
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Sener RN, Jones AO, Roebuck DJ, de Silva M. Midline interhemispheric fusion associated with atypical callosal dysgenesis: a mild type of holoprosencephaly. Australas Radiol 1996; 40:357-9. [PMID: 8826753 DOI: 10.1111/j.1440-1673.1996.tb00421.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We report the imaging findings in a 3 year old girl with a mild form of holoprosencephaly. The malformation is of interest because it may contribute to our understanding of brain development. The relatively mild clinical features are emphasized.
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Affiliation(s)
- R N Sener
- Department of Radiology, Ege University Hospital, Bornova, Izmir, Turkey
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Abstract
Until 1943, blood-grouping tests were performed mainly on glass slides or tiles but, following the description of the antiglobulin test, tube techniques became widespread. With increasing workloads and pressure to be ever more cost-efficient, other 'reaction vessels' such as microplates have been developed for blood-group serological testing. The indirect antiglobulin test has been shown to be the most effective and reliable method for detecting clinically significant antibodies. As a result, this test has been developed, for example by the introduction of enhancement media such as low-ionic-strength saline and polyethylene glycol. However, the problems and inconvenience associated with the labelling and washing of large numbers of tubes were not overcome until the introduction of the solid-phase antiglobulin test and the newer microtubes containing gel or glass microbeads. These techniques are now replacing the conventional tube tests, but they too have their own limitations. There is still no single technique that will detect all clinically significant red-cell antibodies. Therefore, the safe transfusion of red cells that would survive optimally in the recipient depends not on a single test but on a series of tests and procedures, such as correct patient identification, blood-grouping, antibody-screening and compatibility-testing.
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de Silva M, MacArdle B, McGowan M, Hughes E, Stewart J, Neville BG, Johnson AL, Reynolds EH. Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy. Lancet 1996; 347:709-13. [PMID: 8601999 DOI: 10.1016/s0140-6736(96)90074-4] [Citation(s) in RCA: 189] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The medical treatment of childhood epilepsy is largely influenced by clinical trials in adult patients. We know of only one randomised comparative trial (of two drugs) in newly diagnosed childhood epilepsy. We have undertaken a long-term, prospective, randomised, unmasked, pragmatic trial of the comparative efficacy and toxicity of four standard antiepileptic drugs used as monotherapy in children with newly diagnosed epilepsy. METHODS Between 1981 and 1987, 167 children aged 3-16 years, who had had at least two previously untreated tonic-clonic or partial seizures, with or without secondary generalisation, were randomly allocated treatment with phenobarbitone, phenytoin, carbamazepine, or sodium valproate. The protocol was designed to conform to standard clinical practice. Efficacy was assessed by time to first seizure after the start of treatment and time to achieving 1-year remission. FINDINGS The overall outcome with all four drugs was good. 20% of children remained free of seizures and 73% had achieved 1-year remission by 3 years of follow-up. We found no significant differences between the drugs for either measure of efficacy at 1, 2, or 3 years of follow-up. The overall frequency of unacceptable side-effects necessitating withdrawal of the randomised drug was 9%. This total included six of the first ten children assigned phenobarbitone; no further children were allocated this drug. Of the other three drugs, phenytoin (9%) was more likely to be withdrawn than carbamazepine (4%) or sodium valproate (4%). INTERPRETATION Our data will inform choice of drug and outcome with four of the standard drugs available for newly diagnosed tonic-clonic or partial seizures with or without secondary generalisation in children.
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Affiliation(s)
- M de Silva
- Department of Neurology, King's College Hospital, London
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de Silva M, Knight R, Devenish A, Fleetwood P, Contreras M. ACP Broadsheet No 145--Investigation of patients with autoimmune haemolytic anaemia and provision of blood for transfusion. J Clin Pathol 1996; 49:187. [PMID: 8655696 PMCID: PMC500363 DOI: 10.1136/jcp.49.2.187-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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