Search PubMed⌕ Search

Biomedical subjects

A Oliveira e Silva

Publications and source records attributed to A Oliveira e Silva.

10 recordsLinked to original sources
PubMed2007

Liver transplantation from deceased donors serologically positive for Chagas disease.

The high mortality rates among patients waiting for liver transplantation has motivated the use of "marginal livers", among which are included livers from deceased donors serologically positive for Chagas disease (CD). The present work describes the outcome of orthotopic liver transplantation in six patients with severe liver disease (Child Pugh C), with livers from donors serologically positive for CD. Transplantations were performed from November 2000 to January 2005, and the patients received prophylactic treatment with benznidazole for 60 days, as a recommended by the Brazilian Consensus in Chagas Disease. The transplantation procedures presented no technical problems, and all the patients were discharged from hospital. Five of them did not present side effects demanding interruption of the prophylactic treatment. Four of the patients were clinically well over 1 year after transplantation (mean follow-up of 42.1 months), with negative serological results for CD. Two patients died, one of them 6 months post surgery of sepsis due to biliary complication and other one due to pulmonary (tuberculosis) complications. They were both serologically negative for CD. These results suggest that liver transplantation from CD donors, followed by benznidazole prophylactic treatment, is an important therapeutic alternative for severe liver disease.

Adult↗
PubMed2001

Appropriateness of emergency department visits in a Portuguese university hospital.

STUDY OBJECTIVE: There are no studies in Portugal supporting a common claim that most emergency department visits are inappropriate. The aim of this study was to determine the prevalence of and to evaluate factors associated with an appropriate ED visit in a major public hospital. METHODS: A cross-sectional prospective study was performed at a public university hospital ED. Data for demographic variables, duration of complaint, transfer from other medical sources, and previous medical care for the same complaints were collected by interviewing all patients who arrived at the ED within a consecutive period of at least 24 hours. Data for diagnostic tests, treatment performed, and final patient destination were collected by triage records review. An appropriate ED visit was defined by explicit criteria: interhospital transfer, patient death at the ED, hospitalization, and diagnostic tests or treatments performed. RESULTS: The study included 5,818 adult patients. The prevalence of an appropriate ED visit, by use of our criteria, was 68.7%. Sex was an effect modifier. According to this study, determinants of an appropriate visit for men and women were age 60 years or older and complaints of 24 hours or less and in women but not in men, retired from work and with arrival between midnight and 8 AM. CONCLUSIONS: In a university hospital in Oporto, the majority of ED visits were appropriate according to explicit criteria. Some variables may be associated with appropriateness of ED visits. A duration of the complaint 24 hours or less along with an arrival between midnight and 8 AM in women and age 60 years or older in men were the most important determinants.

Adult↗
PubMed1996

[Arterial hypertension in a patient with cardiac tamponade].

An elevated arterial pressure in cardiac tamponade, although not unusual might postpone the diagnosis of pericardial disease. We reported a case of cardiac tamponade, due to neoplastic infiltration of the pericardium, in which the diagnosis was first suspected by the presence of pulsus paradoxus. The patient presented cardiac tamponade and arterial hypertension simultaneously.

Cardiac Tamponade↗
PubMed1995

Splenic abscess.

Explore the source record for details and available documents.

Abdominal Abscess↗
PubMed1994

[Refractory heart failure in a 26-year-old woman with idiopathic hemochromatosis].

Idiopathic hemochromatosis, the most frequent inherited disease in Caucasians, is frequently undiagnosed. In this disorder, characterized by a continued inappropriated absorption of dietary iron, the clinical manifestations result from damage to those organ systems in which iron has been pathologically deposited, namely, the heart and the liver. Typically, hemochromatosis becomes clinically manifest in later life and in men more frequently than in women. This has been attributed to the extra loss of iron in women through menstruation and pregnancies. Removal of the excess iron by phlebotomy will prevent all of the complications of hemochromatosis of when begun early. In this paper, we report a case of a young woman with a eight years evolution of amenorrhea, cardiac failure, diabetes mellitus and increased pigmentation of the skin, associated with biochemical markers of iron overload. It is emphasized that hemochromatosis most be excluded in all patients with a unexplained cardiac failure.

Adult↗
PubMedDate not supplied

[Small hepatocellular carcinoma. New concepts on intrahepatic recurrence after hepatectomy in orthotopic liver transplantation].

Hepatocellular carcinoma is one of the most common cancers worldwide. Epidemiologic studies shows a striking correlation between areas where this tumor is prevalent and where hepatitis virus B and C are endemic, contaminations of food with mycotoxin aflatoxin B1, excessive alcohol intake, prolonged cigarette smoking, sexual hormones. Combination of chemical, physical, and genetic insults to individual hepatocytes involve changes in the genome transformed or neoplastic cell, depending to both the activation of oncogenes (e.g., ras) and the inactivation of tumor supressor genes (e.g., p53). Advances in radiologic techniques such as ultrasonography, computed tomography, angiography and dosages of tumor markers like alpha-fetoprotein offers still the best for diagnosis and screening for hepatocellular carcinoma. Then the diagnosis has become possible during the early stages, characterized to be a very well-differentiated tumour that has returned its preexisting liver structure, with a certain proportion have a multicentric origin. Hepatocellular carcinoma carries an extremely poor prognosis, with a median survival between 2-4 weeks, for those without treatment. Surgical resection are the only curative modality for this disease. In these patients two main patterns of intrahepatic recurrence after hepatectomy are defined, and depends on the growth of residual satellite tumours or synchronous and metachronous multicentric carcinogenesis. This evolution is estimated to be nearly 50%, with 5-year survival rate of nearly 30%. The presence of cirrhosis, satellite nodules, venous invasion, the absence of capsule formation and positive surgical margin (< or = 5 mm) were associated with higher intrahepatic recurrence rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Hepatocellular↗
PubMedDate not supplied

[Frantz tumor--report of 2 cases. Therapeutic approach and prognosis].

The authors report two rare pancreatic tumor cases (Frantz's tumor), which were in different evolutionary stages, emphasizing the complexity of a precise anatomopathologic diagnosis and an aggressive surgical approach, whenever possible because the excellent prognosis. They also discuss the clinical manifestation and histological origin, as well as the prognosis factors and a new approach for the liver metastasis.

Adolescent↗