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Biomedical subjects

M Almeida

Publications and source records attributed to M Almeida.

At least 73 records · Page 4Linked to original sources

[Typing of human papillomavirus (HPV) in the male and female genitalia].

Diagnosis and typing of HPV was started in November 1990 at the Virology department of the National Health Institute, Lisbon. Eighty one samples from 70 patients were studied, 57 from women observed at the cervico-vulvar out patient unit of the Gynecology department of Sta Maria Hospital, Lisbon, and 13 from male contacts of some of these women. Forty nine women (86%) had colposcopic, histological or cytological evidence of HPV infection. Eleven men (85%) have clinical signs of infection and 2 (15%) had had sexual intercourse with infected partners with clinical evidence of infection. HPV DNA was detected in 43 patients (61%). Forty two were infected with HPV 6/11 (98%) and one with HPV 16 (2%). These preliminary results suggest that genital infection by HPV must also be considered a public health problem in the field of sexually transmitted diseases in Portugal.

Adolescent↗

Comparative growth of natural bacterial isolates on various lignin-related compounds.

Bacterial strains were isolated on the basis of their ability to proliferate in a minimal medium containing one of a series of lignin-related compounds as the sole carbon and energy source. These included the aromatic monomers guaiacol, vanillic and coumaric acids, a dimer and a trimer possessing the arylglycerol-beta-aryl ether linkage, anisoin, and both the ether-soluble and -insoluble fractions of kraft lignin. The growth of the strains on each of these compounds was measured. The results showed that the metabolic properties of the strains varied according to the structure of the carbon sources used for their selection. Spectrophotometric tracings of the culture medium during the log phase of growth of one of the strains on the beta-O-4 dimer revealed decomposition with the release of guaiacol.

Journal Article↗

X;Y translocation in an adolescent mentally normal phenotypic male with features of hypogonadism.

Cytogenetic studies on a 17-year-old phenotypic male, with short stature and clinical and hormonal features of hypogonadism similar to those of an XX male, revealed an X;Y translocation, karyotype, 46,Xt(X;Y)(p22;?p11?q11). He was H-Y antigen positive. X inactivation studies showed inactivation of the abnormal X in the majority of cells (60 to 70%) and inactivation of the normal X in the remaining cells. Gene marker studies, including Xg blood grouping, showed no anomalous segregation. This patient is the second reported male showing a positively identified X;Y tanslocation with no detectable free Y chromosome and provides further indirect evidence for an X-Y interchange in the aetiology of XX male sex reversal.

Adolescent↗

Correlation between plasma and cerebrospinal levels of imipramine.

This study measured the levels of imipramine hydrochloride and desipramine hydrochloride (desmethylimipramine) in the plasma and cerebrospinal fluid (CSF) in 11 depressed patients. The oral doses correlated significantly with the plasma levels irrespective of different diagnostic categories. The CSF levels varied significantly. In the endogenous depressive group the CSF levels were significantly higher in responders as compared to nonresponders. The CSF levels of the nonresponders in the endogenous depressive group, and of both responders and nonresponders in the schizo-affective groups, were similar.

Depression↗

Immunosuppression with antithymocyte globulin in renal transplantation: better long-term graft survival.

We analyzed the impact of antithymocyte globulin (ATG) in renal transplantation. We retrospectively studied 1217 recipients performed from July 83 to December 03. ATG-Fresenius-S (ATG-F) was used for induction therapy in 492 patients (40.4%; group I) and compared with group II, 725 patients (59.6%), without antilymphocyte induction. Groups were comparable in terms of recipient gender and race distribution; time on dialysis; cause of renal disease; number of human leukocyte antigen (HLA) mismatches; donor age, gender, and creatinine; and cold ischemia time. Patients with ATG-F were younger (35.8 +/- 13.8 vs 38.9 +/- 12.5 years, P < .001), more frequently hypersensitized (10% vs 3%, P < .001), and had more second transplants (15.7% vs 5.8%, P < .001). The incidence of acute rejection episodes was lower among ATG-F patients (23.6% vs 32.1%, P = .004). Admission time and incidence of delayed graft function (DGF) were similar in the two groups. Graft survival at 1, 5, 10, and 15 years was 88.9%, 80.7%, 71.3%, and 64.9% in group I and 86.4%, 77.4%, 60.7%, and 48.4% in group II (P = .003). The difference in patient survival over the same follow-up did not reach statistical significance. Multivariate analysis showed that the risk of graft failure was higher for those who did not receive ATG-F (HR = 1.51; 95% CI, 1.14 to 2.00; P = .004). Donor age and DGF were also independent predictors of graft failure. Our results showed a better long-term graft survival among patients who received ATG-F, despite their higher immunological risk. The absence of induction with ATG-F, donor age, and DGF were independent risk factors for graft failure.

Antilymphocyte Serum↗

Conversion to sirolimus in a population of kidney and kidney-pancreas transplant recipients.

INTRODUCTION: Calcineurin inhibitors (CI) are associated with nephrotoxicity that might reduce long-term graft survival. We report our experience with sirolimus (SRL) conversion among a population of kidney and kidney pancreas transplant recipients. METHODS: Thirty transplant recipients (6 women, 24 men; age 41 +/- 10.5 years old) were converted to SRL therapy at 25.97 +/- 32.5 months after transplantation. Indications for conversion were: intolerance to mycophenolate mofetil (n = 13), diabetes mellitus (n = 3), CI nephrotoxicity (n = 11), CI nephrotoxicity with chronic allograft rejection (n = 2), and side effects of azathioprine (n = 1). Follow-up after conversion is 3 to 45 months. RESULTS: No significant changes were observed in the 3 months postconversion in renal function, hematological profile, and mean arterial blood pressure. In contrast there was a significant increase in cholesterol values (pre: 198.7 +/- 49.4, versus post 221.2 +/- 60.8, P = .018). At a follow-up of 15.2 +/- 9.9 months after conversion two patients (6.7%) died with functioning allograft (one because of infection and one to myocardial infarct) three kidney allografts (10.7%) have been lost: two chronic rejection; one infection. In two patients SRL therapy was discontinued (one infection, one refractory edema). Neither significant change in renal function nor episodes of acute rejection were observed. CONCLUSIONS: Conversion to SRL was safe. There was no deterioration in renal function nor episodes of acute rejection. There was a significant increase in cholesterol values after conversion. The size of the sample and the time of follow-up may have determined our results.

Adult↗

[Imperforate syringocele of the Cowper's glands laparoscopic treatment].

OBJECTIVES: The authors present a clinical report of an imperforate syringocele diagnosed on a male patient and treated by laparoscopic surgery. MATERIAL AND METHODS: A forty-four year old patient attends the emergency room with acute urinary retention. With a former history of mild obstructive voiding symptoms, he presented, at rectal examination, a bump on the left rectal wall. This patient also underwent urethrocistoscopy, sonography and retrograde urethrography. To establish the diagnose, Computerized Tomography (CT) scan and MRI were used. RESULTS: The syringocele marsupialization by laparoscopic surgery, allowed the resolution of the clinical problem, with a good outcome. The patient was discharged 48 hours after surgery, with no need of a vesical catheter. A six month follow-up showed no recurrence. CONCLUSIONS: The syringocele is a rare deformity which usually is asymptomatic. Of acquired or congenital etiology, it can be classified in four different morphological types: simple, perforate, imperforate and ruptured. The most frequent treatment is the marsupialization of the syringocele by endoscopic surgery, leaving a broad opening of the cavity to the urethra. Some authors recommend an open surgery excision, specially in the presence of an abscess. The laparoscopic approach becomes a minimally invasive alternative with good therapeutically outcome. In the incidentally discovered asymptomatic patients, an expectant approach is the correct approach.

Adult↗

Prognosis in patients with left bundle branch block and normal dipyridamole thallium-201 scintigraphy.

BACKGROUND: The presence of complete left bundle branch block (LBBB) is commonly associated with a poorer prognosis, especially in patients with coronary artery disease (CAD). In the general population with suspected CAD and normal intraventricular conduction, a normal dipyridamole-thallium scintigraphy is a strong marker of a favorable outcome. OBJECTIVE: Our objective was to assess the prognosis in patients with LBBB and a normal dipyridamole thallium-201 scintigram. POPULATION AND METHODS: Patients with complete LBBB and normal myocardial perfusion on dipyridamole SPECT thallium-201 scintigraphy performed in our center for suspected CAD between 1988 and 1995 were monitored for clinical events. RESULTS: Sixty-nine patients (36 women and 33 men) with a mean age of 59 years (range 56 to 61) were monitored for a mean period of 33 months (range 25 to 35). During this period, 4 patients had unstable angina, 2 of whom underwent myocardial revascularization. There were no deaths or myocardial infarction. All events occurred at least 2 years after the thallium-201 scintigraphy. CONCLUSION: The presence of a normal myocardial perfusion with dipyridamole thallium-201 scintigraphy in this group of patients with suspected CAD and LBBB was associated with a very good prognosis, a low rate of clinical events occurring only 2 years after the myocardial scintigraphy, and no hard events.

Bundle-Branch Block↗

Pouchitis: extracolonic manifestation of ulcerative colitis?

Pouchitis is the most frequent complication of ileal pouch-anal anastomosis for treatment of ulcerative colitis. There are several possible explanations. Among them, we focus on the one that considers pouchitis as an extracolonic manifestation of ulcerative colitis. The aim of this study was to investigate the association between pouchitis and extra-intestinal manifestations (EIM), which are frequent in these patients. Sixty patients underwent restorative proctocolectomy with an ileal J pouch (IPAA) from September 1984 to December 1998. Pouchitis was defined by clinical, endoscopic, and histologic criteria. The following extra-intestinal manifestations were studied: articular, cutaneous, hepatobiliary, ocular, genitourinary, and growth failure. Thirteen patients, of which 10 were female (76.9%), developed one or more episodes of pouchitis. Twelve patients of this group (92.3%) presented some kind of extra-intestinal manifestation, 4 pre-operatively (exclusively), 2 post-operatively (exclusively), and 6 both pre- and post-operatively (1.7 per patient). Twenty patients (42.7%) of the 47 without pouchitis did not present extra-intestinal manifestations; 10/35 (28. 5%) of females had pouchitis, compared to 3/35 (12.0%) of men. Pouchitis was more frequent among females, though not statistically significant. EIM increases the risk of pouchitis. Pouchitis is related to EIM in 92.3 % of cases, corroborating the hypothesis that it could be an extracolonic manifestation of ulcerative colitis.

Colitis, Ulcerative↗

[Sanitary battles and scientific clashes: Emilio Ribas and yellow fever in Sao Paulo].

Emilio Ribas, an administrative physician and sanitarian from Sao Paulo, was an advocate of the microbiological conception during the long period when he directed the Servico Sanitario de Sao Paulo (1898-1917). This article offers a brief analysis of his stance in the flight against yellow fever during the early 20th century, considered a highlight of his career. The scientists and professionals linked to this sanitary agency in Sao Paulo found themselves in a tense, unstable work environment, where experimental proof played an important role in corroborating new medical-sanitary conceptions and practices. The article takes a close look at the medical experiments on yellow fever directed by Emilio Ribas and conducted at Sao Paulo's Hospital de Isolamento in 1902-03. It examines these same studies in an effort to better understand how the significance of yellow fever was transformed and to explore its implications regarding the history of public health in Sao Paulo.

Brazil↗