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Biomedical subjects

C Martins

Publications and source records attributed to C Martins.

100 records · Page 6Linked to original sources
PubMedDate not supplied

Menkes' kinky hair syndrome: ultrastructural cutaneous alterations of the elastic fibers.

Menkes' kinky hair syndrome is associated with the defective functioning of several copper-dependent enzymes due to impaired copper absorption, transport, or metabolism. Lysyl oxidase is a copper-requiring enzyme that catalyzes the oxidative deamination of lysyl residues linking two adjacent chains of tropoelastin polypeptides into an insoluble network. Elastin of the connective tissue is the responsible protein for the elastic properties of the skin. We report transmission electron microscopy findings concerning elastic fiber alterations of the skin in three patients with Menkes' syndrome. The reticular dermis showed marked changes in the elastic fibers with a paucity of the central amorphous component while retaining normal microfibrillary material. These ultrastructural observations, to the best of our knowledge, are reported for the first time in skin from these patients and may be readily interpreted in terms of a specific biochemical defect in elastogenesis.

Child, Preschool↗
PubMedDate not supplied

[Leprosy. Comparative study of old and new patients].

Leprosy represented, until a few decades ago, an important public health problem in mainland Portugal. According to the data of the General Directorate of Primary Health Care, the incidence and prevalence rates of the disease have been decreasing progressively and in a significant way during the last years. In view of the fact that it is an endemic disease in regression, we decided to estimate if there were significative changes in the clinical manifestations of the new cases. Therefore, we carried out a comparative study based on the clinical data of 18 patients (13 males and 5 females) with Leprosy who were being followed up in the Dermatology Clinics of Coimbra University Hospital. We differentiated two groups: patients with the diagnosis of the disease before 1990 (old patients), and those diagnosed after 1990 (new patients). The first group had only 8 subjects while the second group had the other 10. We recorded the patients' age, sex, nationality and residence, age at the onset of the disease, number of cases that began before the age of 20, clinical manifestations (according to Ridley and Jopling's classification), and the presence of incapacity determined by the consequences of the disease. We carried out the Student's-t test to appreciate some of the study parameters. We verified that the old patients were on average 11 years younger than the new patients. Leprosy in new patients occurred 11 years later than in the old patients and this difference was statistically significant after the Student's-t test (p < 0.05). Almost one half of the new cases (4 patients in 10) were possible cases of leprosy brought from Brazil, while all the old individuals had an autochthonous origin. The multibacillary forms were predominant in both groups, representing 89% of all patients. The frequency of handicaps was similar in both groups. Although it is based on a small number of patients, our study suggests that the clinical and epidemiological manifestations of leprosy have been changing significantly in the last years and that the changes observed in the form of presentation of the new cases are consistent with the present epidemiological situation. Our study also seems to suggest an increase in the importance of leprosy imported by immigrants from leprosy endemic countries. We point out that this phenomenon, as in the case of AIDS, can theoretically create the conditions for a recrudescence of leprosy, as currently observed with tuberculosis.

Adult↗
PubMedDate not supplied

Evaluation of the analgesic activity of an ethanol extract of Miconia fallax.

A significant analgesic effect was observed after oral administration of an ethanol extract of Miconia fallax to mice, evaluated using chemical (writhing test) and thermal (hot plate test) stimuli. The extract showed a significant effect compared to control in both algesimetric models, suggesting that it was efficient in increasing the pain threshold.

Africa↗
PubMedDate not supplied

[Primary aneurysms of carotid bifurcation: surgical management].

From 1980 to 2005, eight patients, four male and four female, age range between 33 to 86 years (average 55.2) with the diagnosis of primary aneurysm of the carotid bifurcation, underwent surgical management. Patients with postendarterectomy pseudo-aneurysms (also rotulated as "secondary") were excluded from the study, due to different pathogenic, clinical and therapeutic features. Four aneurysms were degenerative by nature, occurring in the older patients of the series. Some other etiologies include arterial fibrodysplasia, brucellosis, Behçet's disease and penetrating wound of the neck. All patients underwent the surgical resection of the aneurysm, followed by reestablishment of the carotid continuity in 6 cases; two patient had a definite ligation of the internal and external carotid artery, respectively. There was no operative mortality nor significant morbidity. From 1 to 25 years after the operation, three patients died for different reasons, two were lost for follow up and the remaining three are found alive and well. The main features of clinical presentation, etiology, diagnosis and surgical management of this entity are presented and discussed and compared with similar experiences reported in the international literature.

Adult↗
PubMedDate not supplied

[Carotid artery surgery in extracranial occlusive disease and cerebral ischemia. Early and late results].

Carotid artery surgery became an established procedure for the treatment of cerebrovascular insufficiency associated with carotid artery stenosis and for the prevention of Stroke. 180 patients were consecutively treated because of occlusive disease of the carotid arteries: 152 (84%) had TIA's or reversible deficits, 11 (6.1%) had strokes with partial recovery, 16 (8.8%) asymptomatic carotid disease and 1 patient (0.5%) had global cerebral ischemia. The severity of occlusive disease was assessed by ECHO-DOPPLER, with or without colour mapping and by angiography: 21 had minimal lesions (less than 20%), 58 stenosis between 21-75%, 92 stenosis between 76-99% and 7 had complete occlusion of the carotid artery; 2 patients had aneurysmal disease 196 operations were performed; early mortality (less than 30 days) was 2.2% (4/180) and neurological morbidity 1.6% (3/180), the operative risk being 3.8%. Longterm results were assessed during a follow-up period extending to 132 months and were assessed by life-table analysis. Survival was 52.5%, 79.3% of the patients were fully asymptomatic during the follow-up but 89.2% were stroke-free, the incidence of stroke being 0.97%/year. These results compare favorably with data available from the natural history and confirm the efficacy of carotid artery reconstructive surgery for the prevention of stroke.

Adult↗
PubMedDate not supplied

[Doppler flowmetry of feto-maternal circulation: III --Absent and reverse diastolic flow in the umbilical artery].

Twelve cases of extreme umbilical blood flow impairement (8 cases with loss of end-diastolic blood flow and 4 cases with reversed flow) found among 658 pregnancies studied by continuous Doppler between April 1st 1989 and March 31st 1990, are reported. The findings were associated to intra-uterine growth retardation (92%), maternal hypertensive disease (50%) and perinatal death (33%); fetal Trisomy 21 was the sole problem in one of the cases with absent end-diastolic frequencies. Our results are discussed and compared to similar data reported recently. Clinical management is proposed, according to umbilical blood flow patterns, length of gestation and underlying clinical situations.

Blood Flow Velocity↗
PubMedDate not supplied

[Verrucous herpes zoster in AIDS patients].

The authors describe a case of disseminated Herpes-Zoster (VZV) in an HIV 1 positive patient with AIDS. Hyperkeratotic characteristics, acyclovir resistance and sensitivity to foscarnet of cutaneous lesions are the most important features of this example. From the casuistics of the department, the authors describe two similar cases and review the medical literature with emphasis on etiopathogenic, diagnostic and therapeutic factors of lesions caused by DNA Virus in immunocompromised hosts.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Programms of community psychiatry].

Three main resources in all Health Care Programs are classified into three groups: The Psychiatric Hospital. It is a strictly hierarchical organization, where decisions are made at the top of the pyramid, and authority flows down administrative channels. Tasks are clearly defined, and so are responsibilities. The Therapeutic Community. It is a non-hierarchical group, with the goal of re-socializing disturbed individuals. It stresses group and individual responsibilities, aiming at learning new patterns of interaction. All members, patients and personnel alike, are equal members sharing full responsibilities, including decisions concerning the group and/or the individuals. Joining the group, leaving it, or dismissing a member, are all joint decisions. The underlying theory assumes therapeutic potentialities for a group with those special requirements, and for each of its members, regardless of its roles. The Programs of Community Psychiatry. All resources of large population groups are oriented and origanized into comprehensive community programs. All physical facilities are co-ordinated into a network. Personnel is recruited, whenever possible, using the human resources within the same community. All actions, at all scales, are organically co-ordinated in order to maximize benefits and minimize efforts and expenses. All three systems collide substantially, because of their radically different conceptions, grounds and operating requirements. Their many conflicts are analyzed in detail, assessing their consequences on the efficacity of services. A general conclusion is drawn on the valuable data emerging from the application of different systems simultaneously, allowing for future further evaluations. The author stresses that all three systems must be analyzed within a much broader socio-economical framework, and taking into account additional difficulties emerging from: a) great social distance between patient and therapeutic team, impeding exchanges; b) politically unstable climate for officials in charge of mental health policies; c) lack of psychological and technical fitness and heterogeneity of training affecting most mental health workers and agents.

Community Psychiatry↗