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Biomedical subjects

M C Ferreira

Publications and source records attributed to M C Ferreira.

At least 19 recordsLinked to original sources

Beyond prejudice as simple antipathy: hostile and benevolent sexism across cultures.

The authors argue that complementary hostile and benevolent components of sexism exist across cultures. Male dominance creates hostile sexism (HS), but men's dependence on women fosters benevolent sexism (BS)--subjectively positive attitudes that put women on a pedestal but reinforce their subordination. Research with 15,000 men and women in 19 nations showed that (a) HS and BS are coherent constructs that correlate positively across nations, but (b) HS predicts the ascription of negative and BS the ascription of positive traits to women, (c) relative to men, women are more likely to reject HS than BS, especially when overall levels of sexism in a culture are high, and (d) national averages on BS and HS predict gender inequality across nations. These results challenge prevailing notions of prejudice as an antipathy in that BS (an affectionate, patronizing ideology) reflects inequality and is a cross-culturally pervasive complement to HS.

Adult↗

Distally based fasciocutaneous flap of the calf for cutaneous coverage of the lower leg and dorsum of the foot.

Cutaneous injuries of the inferior third of the leg and dorsum of the foot represent a great challenge for plastic surgeons. The poor vascularization and subsequent poor healing encountered in these regions demand detailed knowledge of the local anatomy to select the best surgical alternative for each patient. In patients in whom local or free muscular flaps are not suitable, the fasciocutaneous flaps seem to be a good alternative. The distal pedicled fasciocutaneous flap of the calf was used to cover skin defects of the leg and foot in 22 patients. In 4 patients the authors designed an island flap to prevent a large defect in the donor area and to decrease the time of hospitalization and recovery of the patient. In a severe defect, the flap was used as a cross-leg flap. The results were satisfactory because the flap provided stable coverage for different defects with few complications. The island flap is a good option for achieving a better aesthetic result and can be used in select patients.

Foot Injuries↗

Total reconstruction of the alar cartilages with a partially split septal cartilage graft.

The alar cartilage is a unique structure that supports the tip of the nose, keeps the external valve open, and plays an important role in tip aesthetics. Very often the plastic surgeon needs to reconstruct this cartilage, as in secondary rhinoplasties when the lower lateral cartilage is overresected. Many authors have described cartilage grafts taken from the ear and septum, mounted and stitched in various manners, with some very good results. In patients with thin skin, though, any irregularity or distortion in the grafts becomes visible after a short time postoperatively. The authors present an alternative to reconstructing alar cartilage symmetrically using one graft. This graft is obtained by shaping septal cartilage in an "L" form, with a 135-deg angle (instead of a 90-deg angle) between its legs, and then splitting the smaller leg, obtaining a strut from the longer leg and two "lateral crura" from the shorter leg.

Cartilage↗

Evaluation of results in aesthetic plastic surgery: preliminary observations on mammaplasty.

Aesthetic plastic surgery has received wide public attention in the past few years. Expectations of patients regarding results have been exaggerated; the real place and medical importance of the procedures are still not clear because of a lack of more objective evidence. This study discusses the difficulties encountered related to the scientific evaluation of the aesthetic operations and proposes alternatives for assessment. A frequently performed procedure, reduction mammaplasty, is presented as an example, with its specific evaluation.

Adult↗

V--Y flap for perineal reconstruction following modified approach to vulvectomy in vulvar cancer.

OBJECTIVE: To evaluate a simple reconstructive procedure used in combination with a modified oncological approach to the treatment of invasive vulvar cancer. Local and systemic morbidity, length of hospital stay, local recurrence, and mortality were evaluated. METHODS: Between September 1995 and January 1997, 19 patients underwent radical vulvectomy and inguinal lymphadenectomy with a modified oncological approach. The modified approach consisted of a triple incision: two inguinal incisions, shorter and following force lines of the groin, and a third incision around the vulvar lesion. Vulvectomy included a 2-cm safety margin around the tumor, based on clinical examination and anatomical-pathological frozen sections of the specimen. This procedure was always followed by perineal reconstruction with V-Y flaps by the plastic surgery team. Median follow-up was 12 months. The complication rate and lengths of hospital stay were evaluated and compared with those in a similar group in which radical vulvectomy was performed associated with two long longitudinal incisions in the groin. The data were statistically analyzed. RESULTS: The perineal and inguinal dehiscence rates in group A (traditional approach) were 68.4% and 78.94%, respectively. The same rates in group B (modified approach), were 10.5% and 36.84%, respectively. Mean hospital stay was 39.5 days in group A (traditional) vs. 14.0 days in group B (modified). At 30 months' median follow-up, the rate of local recurrence in group A (traditional) was 42.0%; at 12 months' median follow-up, local recurrence in group B (modified) was 26.3%. CONCLUSIONS: In this study, the use of V-Y flaps in combination with a modified oncological approach significantly reduced local complication rates and lengths of hospital stay, while observing oncological principles.

Adult↗

A study of the post-burned restored skin.

The color of restored skin (RS) resulting from healing of partial skin thickness burns was analyzed. Comparisons within symmetric skin areas were performed between RS and healthy undamaged skin (HS), using spectrophotometry, in 118 subjects, 64 males, 54 females with an age range of 1-70 years. A total of 379 samples were analyzed. The CIE-1976 color system was adopted where L*, a* and b*, characterizes the sample color. L*, a* and b* values from restored and healthy skin were obtained and differences between them calculated. Age, sex, sun exposure and time span after burn were taken into account and the data was submitted to statistical analysis: Wilcoxon test for age and chi 2 for other variables. RS became darker: one year after the original burn; in subjects with sun exposure and in older subjects. Sex did not show any influence on brightness index. RS became more red in subjects with sun exposure; in older subjects; within the first six months after the burn. Sex did not show any influence on a* chromaticity axis. RS became more blue: in male subjects and within one year after the burn. Age and sun exposure did not yield any influence on b* chromaticity axis.

Adolescent↗

Bacteroides fragilis isolates compared by AP-PCR.

Bacteroides fragilis is a component of the normal intestinal flora and an important pathogen in nonintestinal endogenous infections. It has been associated with enteric infections and has already been detected in polluted water. In order to evaluate the genetic diversity of B. fragilis, a total of 31 isolates and two reference strains were examined. This collection included strains from nonintestinal infections [12], intestinal infections [5], intestinal microflora [10], aquatic environments [4], and the reference strains ATCC 25285 and ATCC 23745. DNA fingerprints were detected using two separate PCR reactions with different arbitrary primers. The computer-assisted system Taxotron (Institut Pasteur, Dr P. Grimont) was used to analyze the profiles obtained and dendrograms were generated. By using a distance of 0.65 as the threshold, two clusters (hereafter referred to as genotypes I and II) were defined. Strains of differents origins could be distributed into both genotypes. We were unable to detect any obvious correlation between a given genotype and the specific disease or the source of the corresponding strains.

Bacteroides fragilis↗

Production of bacteriocin by Bacteriodes fragilis and partial characterization.

The ability of Bacteroides fragilis strains, isolated from various sources, to produce bacteriocin was evaluated. All strains isolated from intestinal infections were producers in high levels and less susceptible to the others. Strains from other origins were found to produce bacteriocin at a medium level and they were variably susceptible. Some properties of one bacteriocin produced by the Bact. fragilis 079298-3 strain were analysed, providing evidence of its protein nature, with stability over a wide range of pH and retained inhibitory activity after heating. This variability seems to suggest that bacteriocin typing is a good method for this species.

Animals↗

Correction of eyelid anomalies in pachydermoperiostosis.

PURPOSE: Pachydermoperiostosis, or primary hypertrophic osteoarthropathy, is a rare disease, characterized by pachydermia, acropathy, and periostosis. The authors propose the surgical correction of the eyelid anomalies in one stage. METHODS: A 30-year-old patient with moderate blepharoptosis (3 mm) and increased vertical and horizontal dimensions of the upper eyelids underwent fusiform transverse excision of skin, orbicularis muscle, and tarsus; shortening of the levator palpebrae superioris apeoneurosis by 13 mm; and 8-mm-wide wedge excision. RESULTS: Histologic findings included hyperplasia of the tarso-conjunctival plate, obstructive cystic dilatation of the sebaceous glands, extensive fibrosis, and granulomatous reaction. Satisfactory functional and aesthetic results were observed after surgery. CONCLUSION: Upper eyelid anomalies in pachydermoperiostosis can be corrected in a single stage bilaterally with good results.

Adult↗

[Surgical treatment of blepharospasm. Report of 2 patients].

Essential blepharospasm can be approached by several types of treatment: clinical in which the most important is the botulinum toxin with advantages and limitations; and some options of surgical treatment. The surgical technique described by Gillum and Anderson offers an alternative to patients resistant to the clinical treatment or with secondary complications. Two cases are analysed. Myectomy of all accessible orbicularis oculi, procerus and corrugator superciliaris muscle associated with blepharoplastic surgery and frontal lifting was indicated due to poor answer to clinical treatment. The results were satisfactory and both patients returned to their normal activities.

Anti-Dyskinesia Agents↗

Treatment of the nasal hump with preservation of the cartilaginous framework.

Classically, nasal hump reduction is based on the partial resection of the cartilages and bones of the nose, as it was described by Joseph almost a century ago. The cartilaginous portion of the hump consists of a single unity formed by the two upper lateral cartilages and the septal cartilage. During hump reduction in the classic rhinoplasty, this structure is slashed in three pieces, which is the main cause of irregularities, shadows, and pinchings over the long-term results. Late follow-ups of the classical hump removal often show an inverted V-shaped shadow on the dorsum secondary to the destruction of the osseous-cartilaginous transition. The angle and relation between the septal and upper lateral cartilages are reduced, which may compromise the functional aspect. The destruction of the unique anatomy of the cartilaginous hump is one of the main causes of this functional and aesthetic sequela. Here, we present a technique that preserves the cartilaginous framework of the nasal hump by lowering it through the resection of a strip of septum, avoiding the problems described above.

Cartilage↗

The role of plastic surgery in congenital cutis laxa: a 10-year follow-up.

The clinical features and the plastic surgery management of a 23-year-old woman with cutis laxa are presented. Two rhytidectomies were performed in this patient within 1 year. The first was associated with a SMAS flap; the second employed a prehairline incision. The evolution of the aging facial appearance 10 years after the last face lift was evaluated and compared with the preoperative situation. Repeated face lifts seem to be an interesting way to manage patients with cutis laxa. Unlike patients with other disorders of the connective tissue, those with cutis laxa have no vascular fragility and heal well. The role of plastic surgery and the clinical features and timing for operation are reviewed and discussed.

Adult↗

Electrophoretic characterization of exposed outer membrane proteins in environmental and human Bacteroides fragilis strains.

Bacteriodes fragilis isolated from aquatic environment, from infectious process and from human feces were compared as to their outer membrane protein electrophoretic profiles after staining with Coomassie blue and reacting with antibodies prepared against whole-cell antigens of a reference strain from a clinical source. A marked homogeneity was found among the strains with these methodologies. The profiles of all strains obtained after radio-iodination of the intact cell showed qualitative similarity when compared with the profiles obtained by the other methods. Thus, these data allow us to suggest the designation of the peptides observed in the autoradiograms as surface-exposed proteins. Differences observed in the autoradiograms in the expression of bands mainly detected at a molecular weight of 28 in the commensal strain 118,310 defined previously as avirulent, in addition to a distinction in the titres of agglutination with the sera tested and lower reactivity in the immunoblotting assays, suggest a relationship of the B. fragilis surface architecture with the virulence potential as well as with the origin of the strain.

Agglutination Tests↗

Contraction and myofibroblasts in restored skin.

Myofibroblasts and the contraction of split skin-graft donor sites were studied in 18 patients. For each patient five samples were studied, taken on days 0, 14, 21, 28, and 35. On each occasion the extensions and densities of myofibroblasts were calculated. After the initial measurement, the subsequent extensions were expressed in percentages of the first, resulting in mean measurements of 100, 95, 97, 99, and 99%, respectively. The myofibroblasts in 10 dermic fields were counted under light microscopy at a magnification of 1000 marked with anti-alpha-smooth muscle actin antibodies using immunoperoxidase, resulting in the means of 0.2, 3.8, 1.3, 1.3, and 0.4, respectively. The contraction and the increase in density of myofibroblasts were transitory and significant in the samples measured on day 14, but in sample 35 neither of the variables was significantly different from the initial sample. These variables evolved concurrently, corroborating the hypothesis that myofibroblasts are responsible for the contraction.

Cell Count↗

Abdominal wall closure after selective aponeurotic incision and undermining.

The tension required to pull the anterior and the posterior rectus sheaths toward the midline was studied in 20 fresh cadavers at two levels: 3 cm above and 2 cm below the umbilicus. The quotient of the force used to mobilize the aponeurotic site to the midline and its resulting displacement was called the traction index. These indices were compared in three situations: (1) prior to any aponeurotic undermining, (2) after the incision of the anterior rectus sheath and the undermining of the rectus muscle from its posterior sheath, and (3) after additionally releasing and undermining the external oblique muscle. A significant decrease in aponeurotic resistance was observed after each dissection. The anterior sheath showed higher resistance to traction compared with the posterior sheath on both levels. No statistical difference was noted in the comparison of the values of the aponeurosis above and below the umbilicus. These results suggest that these procedures are effective in assisting in the closure of abdominal wall defects because these maneuvers decrease substantially the tension required for advancement of the aponeurotic edges.

Abdominal Muscles↗

Midfacial advancement by bone distraction for treatment of craniofacial deformities.

Craniofaciostenosis is often associated with midfacial hypoplasia and has been treated traditionally using Le Fort advancement osteotomies and bone grafts. The surgical procedure requires a prolonged operating time, several osteotomies with a significant blood loss, and wide surgical exposure. According to the principles of bone lengthening, we performed midfacial advancement by bone distraction in 4 patients with midfacial hypoplasia to reduce the operative time and complication rate. In 2 patients with Crouzon's syndrome we performed a Le Fort III osteotomy and placed the distraction device behind the malar eminence and screwed it on the temporal bone bilaterally. In the other 2 children, with Apert's syndrome, we performed frontal advancement and remodeling before placing the device during the same surgery behind the malar bone without any midfacial osteotomy. It appears to us that patients with more severe deformities will need surgical procedures to offer more satisfactory results. In these patients, distraction is an initial therapy to reduce the severity of the deformity, making it possible to effect a better treatment afterward.

Acrocephalosyndactylia↗

Influence of stress conditions on Bacteroides fragilis survival and protein profiles.

Bacteroides fragilis strains isolated from different sources, i.e. 1 strain (AA1) from an aquatic environment, 1 strain from normal flora (118310) and the type strain (ATCC 25285) originally isolated from clinical material, were analysed for both cell envelope proteins composition and surviving under oxidative stress starvation. All strains examined showed a similar survival response when cultured in drinking water with a ten-fold decrease in viable counts per day during the 7 days of analysis. The outer membrane protein (OMP) profiles of all strains were quite similar during the stress period as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). However, the periplasmic proteins of the strain 118310 showed two protein bands at 48 and 58 kDa, respectively, that were absent in the strains AA1 and ATCC 25285 during the incubation period in potable water. Whole cells and periplasmic 35S-labelled proteins from bacteria cultured in drinking water showed a significant increase in proteins at 16, 18, 24, 26, 35, 48, and 58 kDa and 18, 22, 24, 48, 58, and 70 kDa, respectively, in all strains when compared to cells grown in BHI-PRAS media as detected by autoradiography following SDS-PAGE. These data suggest that B. fragilis may have a synthesis mechanism that allows them to adapt to adverse environments.

Bacterial Outer Membrane Proteins↗

Comparison of extraction methods and detection systems in the gas chromatographic analysis of volatile carbonyl compounds.

High-resolution gas chromatography (HRGC) with electron-capture detection (ECD), nitrogen-phosphorus detection (NPD), flame ionization detection (FID) or with mass spectrometry-selected ion monitoring (MS-SIM) was used in the analysis of volatile carbonyl compounds. Eighteen carbonyl compounds that are typically produced during lipid peroxidation were derivatized quantitatively with pentafluorophenylhydrazine (PFPH) at room temperature, to afford their corresponding water-insoluble hydrazones. These derivatives were extracted into non-polar phases by means of either liquid-liquid extraction (LLE) (hexane) or solid-phase extraction (SPE) on 3 ml C18 octadecyl-bonded phase cartridges. Detection limits of 10(-14) and 10(-12) mol/ml per aldehyde were achieved with the ECD and MS-SIM systems, respectively. The effects of extraction conditions on sensitivity and recovery were determined by performing parallel HRGC-ECD and HRGC-MS-SIM analyses of pentafluorophenylhydrazones of the eighteen compounds under study. Recoveries of 51.4-78.9 +/- 1.2-4.5 and 80.9-98.3 +/- 1.0-3.5% were obtained with LLE and SPE, respectively. The method was applied to the analysis of the volatile carbonyl compounds in various heated vegetable oils (corn, palm or sunflower) and to the analysis of volatile aldehydes in human urine.

Adult↗