[Chronic disseminated intravascular coagulation in hepato-splenic schistosomiasis mansoni].
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Biomedical subjects
Publications and source records attributed to D R Borges.
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Considerations on a few aspects of postgraduate education in medicine are made: 1) Concept of stricto sensu of postgraduate study of the physician (who is an MD and seeks a second degree of doctor, that is, the PhD); 2) Importance of scientific initiation (to shorten stricto sensu postgraduation); 3) Features of the postgraduate program (that, having the objective of preparing a scientific investigator, has different characteristics of the graduation courses, of specialization or advanced courses, of the advisor (who must have a consistent line of research), of the doctor-to-be (who must develop his potential of creativity) and of the thesis to be prepared (which should generate a paper publishable in an indexed international journal).
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AIM: To study the hepatic clearance of a glycoprotein (rat plasma kallikrein) by the liver of rats with experimental decompensated cirrhosis. MATERIAL AND METHODS: Cirrhosis was induced by intragastrically administration of carbon tetrachloride 520 mg/kg/week, during 16-19 weeks. After this period, each liver was isolated, exsanguinated and perfused at 37 degrees C with 10nM rat plasma kallikrein (RPK). RESULTS: 58% of the animals died during the treatment and the remaining developed prostration, ascites, jaundice and bleeding; at the end of the treatment period serum aminotransferases were not altered and serum albumin decreased. The liver histology showed cirrhosis. RPK clearance rate of the cirrhosis group (5.4 +/- 0.9 pmol/g liver/10 min) was significantly lower (p < 0.05) than that of the control group (13.5 +/- 2.7 pmol/g liver/10 min). CONCLUSION: The development of cirrhosis is associated with a decreased hepatic clearance of a glycoprotein which endocytosis is mediated by a receptor.
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Hemostasis was studied in 18 patients with the hepato-intestinal form of Schistosomiasis mansoni and in 23 with the hepato-splenic form. Both groups are compared referring to alterations found. The relations between plasmatic coagulation factors and hepatocytic function tests are studied. In 6 patients the explorations were repeated after administration of hycanthone. In the patients with the hepato-splenic form, the presence of chronic consumptive coagulophathy was found. The coagulopathy disappeared either by treatment with heparine or by splenectomy. This observation points out the importance of splenomegaly in the development of chronic consumptive coagulopathy, and may be an important factor in indicating splenectomy in a patient with portal hypertension due to Schistosomiasis mansoni.