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Biomedical subjects

A Moreira

Publications and source records attributed to A Moreira.

47 records · Page 3Linked to original sources
PubMedDate not supplied

Is Helicobacter pylori infection associated with chronic idiopathic urticaria?

BACKGROUND: Chronic idiopathic urticaria (CIU) is one of the most frequent skin diseases, however its causes remain unknown in the vast majority of cases. There is increasing evidence for systemic effects of gastric Helicobacter pylori infection, which may result in extra gastrointestinal disorders. Although CIU can result from several causes, a possible relationship between chronic urticaria and Helicobacter pylori has been recently suggested. OBJECTIVE: The aim of this study is to determine the prevalence of Helicobacter pylori infection in a series of patients with CIU, and measure the effectiveness of eradication therapy on the skin disease. METHOD: We assess Helicobacter pylori infection by 13C urea breath test (UBT) in 21 CIU patients. Amoxicillin, clarithromycin, and omeprazole were given to infected patients for seven days. The results of therapy were assessed by urea breath test one month after therapy. Urticaria and gastrointestinal symptoms were assessed on enrolment and for six months after eradication. RESULTS: Prevalence of Helicobacter pylori infection was of 71.4 % (15/21). There were no differences concerning age (31.83 vs. 33.82 years) and duration of symptoms (38.40 vs. 35.38 months) in patients with respectively positive and negative UBT. Helicobacter pylori eradication rate was of 80 % (12/14). Three patients had clinical improvement with total resolution of urticaria starting immediately after eradication therapy, being able to completely withdrawn antihistamine and corticosteroids therapy without complaints. In relation to the rest of the patients, these three had smaller duration of urticaria disease (14.3 vs. 43.7 months; p = 0.038) and greater titters in the UBT results (42.39 vs. 25.81; p = 0.073). DISCUSSION: Although some authors found convincing evidence of the involvement of Helicobacter pylori as one possible cause of chronic urticaria, our results have failed to confirm the existence of this etiological association. The most remarkable finding was that those patients who had clinical remission of disease were the ones with greater UBT titters suggesting a role for the amount of colonization by Hp in the pathogenesis of urticaria disease.

Adult↗
PubMedDate not supplied

[Brain stem ischemia in a boy with resistance to C activated protein and elevated lipoprotein A].

INTRODUCTION: Activated protein C resistance is the most common hereditary coagulation abnormality. In the majority of cases it results from a point mutation Arg506-->Gln of the factor V gene, and characterized by a poor anticoagulant response to activated protein C. CLINICAL CASE: We report the clinical case of a 6-year-old obese boy, who presented with acute hemiparesis. A cerebral MRI revealed an area of infarction in the left hemiprotuberance. Further investigation identified activated protein C resistance (heterozygosity for factor V Leiden) and elevation in lipoprotein (a). His mother also had factor V Leiden mutation. Prophylaxis with acetylsalicylic acid was instituted with favorable evolution. CONCLUSIONS: This mutation, isolated, is usually asymptomatic, unless other risk factors coexist. Although venous thromboembolism seems to be the main clinical manifestation, recent reports consider that activated protein C resistance is also a risk factor for arterial thrombosis and stroke in children. We reinforce the need for systematic and thorough evaluation of etiology and risk factors in cases of stroke in children.

Activated Protein C Resistance↗
PubMedDate not supplied

[Iatrogenic vascular injuries].

Iatrogenic vascular injuries include an extremely broad group of lesions with multiple etiology and polymorphic manifestations. We present a series of 44 patients with iatrogenic vascular lesions that result from arterial and venous catheterizations and surgical interventions. The arterial catheterization for coronariography and arteriography and orthopaedic surgery were the agents that most frequently caused vascular injury. Arterial and venous reconstructive surgery were the predominant treatment procedures. In our series, morbidity and mortality were 4.6% and 2.3%, respectively.

Adolescent↗
PubMedDate not supplied

[Kikuchi and Fujimoto disease].

We present a case of Kikuchi and Fujimoto's disease (KFD), revealed by malar rash, fever, arthritis and lymphadenopathy, suggesting Systemic Lupus Erythematosus (SLE). The relation between KFD and SLE is not yet completely understood and remains complex. There are few cases with a lupus-like presentation and the histopathologic features may be insufficient to confirm the KFD diagnosis definitively. The clinical presentation, the IgM deposits at the dermal-epidermal transition in the Lupus Band Test, and the presence of anticardiolipin antibody emphasises the relationship between these two entities and does not exclude the possibility of evolution to SLE, which makes the prognosis doubtful.

Adult↗
PubMedDate not supplied

[Psychiatric nursing and modern nursing in Rio de Janeiro: a history lesson].

The present study is the result of an essay written for the discipline Research Laboratory of Nursing History. It refers to the interest and struggle of the Brazilian Association of Nursing (ABEN), in the 1940s, in Rio de Janeiro, to make professionals of this area aware of the need of the inclusion of nursing in the psychiatric field in Rio de Janeiro. Our objective is to present the difficulties of this insertion, although the beginnings and the regulation of the nursing profession in Brazil started in a school of nursing, in the Psychiatric Hospital of Rio de Janeiro. In order to present the difficulties for this inclusion, we analyzed the documents that prescribed the regulation of the nursing profession, in the psychiatric area of the hospital mentioned above. Results indicate that standards established by Anna Nery Nursing School were broken, since psychiatric assistance was denied by this school until 1949, while the Nursing School Alfredo Pinto provided this kind of care since 1890. It is important to point out the strategic and historical role of ABEn as the coordinator and motivator of discussions regarding the course of the nursing profession.

Brazil↗
PubMedDate not supplied

[Acute thyroiditis].

We review the pathophysiology, clinical features and therapy of acute thyroiditis. Four cases are reported stressing the role of fine needle aspiration for the diagnosis of this clinical entity.

Acute Disease↗
PubMedDate not supplied

[The risk factors for breast cancer: a case-control study].

In western countries, female breast cancer is a major cause of death. Many risk factors for breast cancer have been identified, but the magnitude of the risks is clearly different between high and low risk areas. In this hospital-based case-control study we evaluated risk factors for female breast cancer in 158 women with breast cancer and 131 controls. Cases presented a later age at first birth and a lower median number of pregnancies. The risk of breast cancer increased with increasing age at first birth, particularly for women with lower parity. After controlling for other variables the risk significantly decreased with abortion history (OR = 0.5, 95% CI: 0.3-0.7) and oral contraception (OR = 0.5, 95% CI: 0.3-0.9). Premenopausal and postmenopausal women presented different risk factors. Among premenopausal cases the risk was lower for parous women (OR = 0.1, 95% CI: 0.0-0.7) and higher for those with a positive family history (OR = 4.5, 95% CI: 1.3-16). Compared to controls, postmenopausal cases only presented a significantly lower rate of abortions (OR = 0.2, 95% CI: 0.1-0.4). The present study shows that these women can be regarded as belonging to an intermediate risk population.

Aged↗