[Complications of transvenous pacemakers. Considerations apropos of 2 necropsy cases].
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Biomedical subjects
Publications and source records attributed to M A Lopes.
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Generation of epidemiological data on perinatally-transmitted infections is a fundamental tool for the formulation of health policies. In Brazil, this information is scarce, particularly in Northeast, the poorest region of the country. In order to gain some insights of the problem we studied the seroprevalence of some perinatally-transmitted infections in 1,024 low income pregnant women in Salvador, Bahia. The prevalences were as follow: HIV-1 (0.10%), HTLV-I/II (0.88%), T.cruzi (2.34%). T.pallidum (3.91%), rubella virus (77.44%). T.gondii IgM (2.87%) and IgG (69.34%), HBs Ag (0.6%) and anti-HBs (7.62%). Rubella virus and T.gondii IgG antibodies were present in more than two thirds of pregnant women but antibodies against other pathogens were present at much lower rates. We found that the prevalence of HTLV-I/II was nine times higher than that found for HIV-1. In some cases such as T.cruzi and hepatitis B infection there was a decrease in the prevalence over the years. On the other hand, there was an increase in the seroprevalence of T.gondii infection. Our data strongly recommend mandatory screening tests for HTLV-I/II, T.gondii (IgM), T.pallidum and rubella virus in prenatal routine for pregnant women in Salvador. Screening test for T.cruzi, hepatitis and HIV-1 is recommended whenever risk factors associated with these infections are suspected. However in areas with high prevalence for these infections, the mandatory screening test in prenatal care should be considered.
One thousand seven hundred and eight chronic chagasic post-mortem examinations studied from a total of 4690 autopsies performed at our Institution. Two hundred and seventy-three chagasic had megas. Megacolon was the most frequent, followed by megaesophagus. Megacolon associated with megaesophagus was the third most common finding. Our data are discussed and compared with the literature. Megacolon and megaesophagus were more prevalent in man, as shown by other workers. Higher parasitemia perhaps could explain this finding.
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Pemphigus vulgaris is an uncommon mucocutaneous disease caused by autoantibodies against desmosomal antigens. It affects mainly middle-aged adults, and juvenile cases are rare. The authors present a case of pemphigus vulgaris in adolescence and review the literature. A 16-year-old girl showed oral and cutaneous lesions suggestive of pemphigus vulgaris. Histopathology and direct immunofluorescence of the oral mucosa confirmed the diagnosis and systemic steroid therapy was efficient in controlling the disease. The recognition of the oral lesions of pemphigus by the clinician, its early diagnosis, and prompt therapy are essential for a favorable prognosis.
Dental anomalies are an important issue and dentists should be able to manage these conditions. Often, treatment is not necessary; however, some abnormalities may affect the esthetics or function of teeth and can lead to other problems. This case report presents an unusual case of alteration in shape affecting the left lower canine in a 34-year-old woman.
Proliferative verrucous leukoplakia (PVL) is a particularly aggressive form of oral leukoplakia that is resistant to treatment and presents a high risk of recurrence and malignant transformation. This article describes the microscopic and clinical characteristics of one case of PVL, which initially presented as hyperkeratosis with mild dysplasia and posteriorly developed multifocal areas and verrucous carcinoma despite treatment.
An experiment was undertaken to determine the intra- and interexaminer reliability of a paraspinal skin temperature differential instrument. Nineteen pain-free female chiropractic college students participated as subjects for the investigation. Three separate areas of the spine (C4-T2, T4-T8 and L2-L5) were examined for concordance between two examiners. Additionally, intraexaminer reliability was tested by having each examiner repeat the scanning procedure. Concordance for whether a temperature differential existed in a particular area was evaluated with the Kappa statistic. Kappas ranged from 0.034 to 0.6591 and were all statistically significant (p less than 0.05). This represented slight to moderate reliability in the area C4-T2 and substantial agreement in the region T4-T8. The lumbar region could not be evaluated with the Kappa statistic due to limited variation. Following agreement for a positive finding in a given area, the numerical ratings were evaluated for agreement with the intraclass correlation coefficient (ICC). The first observation between examiners indicated fair agreement (ICC = 0.2756, p = 0.0478). The second observation between examiners had substantial agreement (ICC = 0.6402, p = 0.042). Intraexaminer agreement was moderate for one examiner (ICC = 0.5078, p = 0.0016). The other examiner showed an excellent level of agreement (ICC = 0.8588, p less than 0.001) between observations.
This is a review of 4.690 necropsies and 24.209 surgical pathology specimens describing the association between megacolon chagasic and malignant tumors of the large bowel. The prevalence of malignant tumors of the large bowel was not higher in megacolon.
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