Biomedical subjects

M C Machado

Publications and source records attributed to M C Machado.

At least 217 records · Page 12Linked to original sources

PubMedDate not supplied

[Effect of omeprazole administration on pancreatic content of enzymes in rats].

Gastric chloride acid plays an important role in pancreatic enzyme synthesis and secretion, mediated by cholecystokinin released in the duodenum. This study was designed to evaluate the influence of gastric acid suppression by omeprazole on pancreatic enzyme content. Eighteen male Wistar rats (180-220 g) were divided in two groups: I--control and II--omeprazole. Animals received by intraduodenal catheter 3 doses of 0.5 ml saline solution (NaCl 0.9%)--Group I or 5 mumol/Kg of omeprazole solution--Group II at 24 h intervals. All animals, after an overnight fasting period, were killed 3 h after the last dose. Serum amylase and pancreatic tissue content of protein, trypsinogen, elastase, lipase and phospholipase A2 were determinated. Omeprazole treated animals (group II) showed statistically significant lower levels of serum amylase and pancreatic trypsinogen content (P < 0.05). We believe that this effect is related with acid secretion suppression by omeprazole and that it may be mediated by cholecystokinin.

Animals↗

PubMedDate not supplied

[Surgical treatment of solitary liver cysts].

Solitary hepatic cysts an uncommon disease in the past, which incidental diagnosis is increasing with the advent of ultrasound and computed tomography, are nowadays very frequent. Cysts that reach massive proportions often become symptomatic and necessitate surgical intervention. Surgical wide unroofing technique is a simple procedure advocated for the treatment of symptomatic patients. Ten patients with solitary liver cysts were submitted to wide unroofing with good immediate and late results.

Adult↗

PubMedDate not supplied

Resection of a fibrolamellar carcinoma of the liver originating in the caudate lobe.

Liver tumors rarely arise in the caudate lobe and resection of such tumors is even more rare. Spigel's lobe resection, first described by Ton Thac Tung, is a very unusual operation and the technique has not been clearly established. Recently, successful resections of the caudate lobe of the liver have been reported. Since Edmonson's first report in 1956, fibrolamellar carcinoma of the liver (FLC) has been recognized as a distinct variant of hepatocellular carcinoma. It occurs, without sexual preference, primarily in adolescents and young adults. Usually, FLC is found in noncirrhotic livers and rarely associated with hepatitis B virus. This tumor presents a high resectability rate (48-100%) with a good prognosis and a mean survival of 68 months. We report a case of fibrolamellar carcinoma arising in the caudate lobe of the liver. Resection of the caudate lobe of the liver was carried out with no morbidity.

Adult↗

PubMedDate not supplied

[Neonatal screening of hemoglobinopathies in a population residing in Portugal].

The primary objective of newborn screening of hemoglobinopathies is the early identification of infants with sickle cell disease, as they are at increased clinical risk. Other goals include the identification of other types of clinically significant hemoglobinopathies and the detection of heterozygous carriers followed by the screening and counselling of family members. We performed a pilot study for the neonatal screening of hemoglobinopathies in 400 samples of cord blood taken from a maternity in Lisbon. We did not find any newborn with sickle cell disease. Six samples were from sickle cell heterozygotes, the respective families were studied and informed. We looked for the presence of alpha-thalassemia at birth in 100 consecutive samples of cord blood, by the presence of Hb Bart's, abnormal red blood cell indices and alpha-globin genotype. The results show an incidence of 10% of alpha-thalassemia (-alpha) carriers and 4% of triple alpha-globin gene carriers. The authors discuss the feasibility of neonatal screening of hemoglobinopathies in a Portuguese-speaking population consisting of a low prevalence of Hb S trait autoclonous group and a high prevalence immigrant minority.

Carrier State↗

PubMedDate not supplied

[Lung injury in acute pancreatitis. Influence of pancreatic enzymes reduction].

UNLABELLED: A previous report has show that cerulein in physiological doses reduces the rate mortality of pancreatitis by decreasing the enzyme content of the pancreas. Clinically detectable signs of lung injury develop in up to 50-70 percent of patients with acute pancreatitis. The aim of the present study was to assess the effect of acute reduction of pancreatic enzyme content on the pancreatitis pulmonary injury. Experimental haemorrhagic pancreatitis was induced by intraductal injection of 5 per cent sodium taurocholate in two groups of Wistar rats: group I (pancreatitis) and group II (pancreatitis after decreasing pancreatic enzyme content). Dye Evans blue was used to evaluate the lung injury. The degree of histologically observed lesions were similar in both groups, but the pulmonary lesion was smaller in group II than group I (p < 0.05). IN CONCLUSION: 1) pancreatitis' pulmonary lesion may be related with pancreatic enzymes that reach the blood stream and 2) the reduction of the pancreatic enzyme content has a beneficial effect on acute pancreatitis and reduces its pulmonary injury.

Acute Disease↗

PubMedDate not supplied

[Distal pancreatectomy with conservation of the spleen].

Conventional resection of the body and tail of the pancreas usually involves splenectomy. There are evidence that spleen removal can lead to septic and hematological complications and should, therefore, be avoided when possible. Distal pancreatectomy with spleen conservation has been described by specialized centers with good results. This report describes our experience in 8 cases with conservation of the spleen during the resection of the body and tail of the pancreas. The technique has been applied in patients with pancreatic neuroendocrine tumors (n = 4), cystic tumors (n = 3) and cystic-papillary tumor (n = 1) with no complications and good late results in all cases.

Adolescent↗

PubMedDate not supplied

[Results of conventional cholecystectomy. Experience in a university hospital].

The experience with open cholecystectomy in an university affiliated hospital is documented in this report. We studied retrospectively 221 patients operated between 1987 and 1992, type of surgery, morbidity and mortality were analyzed. There were 171 (77.3%) cholecystectomy alone and 50 (22.7%) cholecystectomy with other biliary surgery (BS). Pulmonary, urinary and wound complications were the most common. Overall incidence of complications was 7.2%. For patients with cholecystectomy alone morbidity was 3.5% and for patients with BS morbidity was 20% (p < 0.002). There were no mortality in this group of patients.

Adolescent↗

PubMedDate not supplied

[Biliary fistula after elective conventional cholecystectomy].

The use or not of drainage after elective cholecystectomy has been recently studied, and we will discuss the real incidence of the subhepatic biliary collection and its clinical significance. In this sense, we studied 20 patients with a mean age of 45 years (4 male and 16 female), submitted to elective cholecystectomy according to selective techniques patterned by our group, where we realized ligature of all vessels of the gallbladder bed, and subhepatic drainage. These patients receibed 99 mTc-DISIDA at the moment we closed the abdomen, and in a period of 24 and 48 hours we studied its presence in the subhepatic bed and in the drainage material. All the patients had not post-operative complications and none biliary drainage or subhepatic collection scanned. We concluded that using our preconized techniques, the subhepatic drainage is unnecessary after elective cholecystectomy.

Adult↗

PubMedDate not supplied

[Bacterial translocation in acute pancreatitis. Experimental study in rats].

Ninety Wistar rats were studied to confirm if the intestinal tract is a source of infection in acute pancreatitis. Bacterial translocation to the mesenteric lymph nodes, pancreas, peritoneal cavity, and blood was determined at 6 h, 24 h, 48 h and 96 hours after induction of non lethal acute pancreatitis. Bacterial growing was present in 60% (6 h), 90% (24 h), 70% (48 h) and 40% (96 h) (p < 0.05) of the mesenteric lymph nodes. Live bacteria were recovered from 67% (6 h), 90% (24 h), 50% (48 h) and 40% (96 h) (p < 0.05) of the pancreas. Gram-positive bacteria translocate more frequently than Gram-negative bacteria in the early period (6 h). Lately (24-96 h), Gram-negative bacteria were much more frequently isolated (p < 0.05). The most common organism isolated was Escherichia coli. No overgrowth of cecal Gram-negative bacteria was found. It is concluded that bacterial translocation in acute pancreatitis is an early phenomena, initially caused by Gram-positive bacteria and lately by Gram-negative bacteria, and associated with the severity of pancreatic lesions.

Acute Disease↗

PubMedDate not supplied

Pyogenic liver abscess: the role of surgical treatment.

MATERIALS AND METHODS: We present an analysis of 48 patients with pyogenic liver abscess (PLA) that were treated according to a protocol between 1975 and 1993. In this period, 35 patients with PLA were treated by surgical drainage (SD). The indication for surgical treatment of the abscess were patients in septic conditions, underlying intra-abdominal surgical disease and the failure/contraindication of other therapeutic methods. Thirty-one patients were submitted to surgical treatment as the initial procedure and four patients unsuccessfully treated by percutaneous drainage, underwent SD. RESULTS: The surgical approach was indicated in patients with severe disease and presented 91.5% of good results, and a mortality rate of 8.5%. CONCLUSIONS: These results suggest that surgical treatment is a good alternative as a first step not only for the treatment of the primary cause of the abscess but also in septic patients with severe disease where a delay in adequate drainage, frequent in percutaneous management, can lead to high morbidity and mortality rates.

Adolescent↗

PubMedDate not supplied

[Protective effect of reduction of pancreatic enzyme content on the pulmonary disease induced by acute pancreatitis].

Lung injury develop in up to 50-70 percent of patients with acute pancreatitis. Cerulein in physiological doses reduces the rate mortality of pancreatitis by decreasing the enzyme content of the pancreas. In order to assess the effect of acute reduction of pancreatic enzyme content on the pancreatitis pulmonary injury, pancreatitis was induced in Wistar rats by intraductal injection of 5 per cent sodium taurocholate: group I, with pancreatitis; group II, pancreatitis after decreasing pancreatic enzyme content; group III, control group. Dye Evans blue was used to evaluate the lung injury. The pancreatitis pulmonary injury was smaller in group II than group I (P < 0.05) but it was similar to control group (group III). In conclusion, it is speculated that the reduction of the pancreatic enzyme content reduces the pancreatitis pulmonary injury by decreasing the quantity of pancreatic enzymes reaching the systemic circulation.

Acute Disease↗

PubMedDate not supplied

Primary extranodal non-Hodgkin lymphoma of the extrahepatic bile duct mimmicking Klatskin tumor.

This report describes one case of primary non-Hodgkin lymphoma of the extrahepatic biliary tree. The main symptom was obstructive jaundice. Cholangiography demonstrated stricture of the bile duct which resembled the appearance of cholangiocarcinoma. The surgical approach allowed complete ressection. The histopathological analyses showed a centrocitic-centroblastic follicular non-Hodgkin lymphoma. She underwent chemotherapy, developed severe bone marrow hypoplasia, but 48 months after surgery, the patient is doing well.

Adult↗

PubMedDate not supplied

[How our pediatric services work].

The results of a questionnaire sent by the College of Pediatrics of the Portuguese Doctors Association (Ordem dos Médicos) to the pediatric departments all over the country are presented. From the answers of fifty-one services, physical conditions, equipment, human resources, assistancial and scientific activities developed are characterized.

Child↗

PubMedDate not supplied

[Hepatic dysfunction in myoglobinuric acute renal failure (rhabdomyolysis)--experimental study in rats].

Liver damage as a consequence of rhabdomyolysis (RM) has not been well established on clinical and experimental grounds. Hepatic dysfunction was then investigated in rats 24 h after induction of acute renal failure with glycerol. Forty male Wistar rats (220-270 g) were dehydrated for 24 h and were divided in two group: GI experimental group (n = 14)-50% glycerol was injected (10 ml/Kg, one-half of the dose in each hindlimb muscle) and GII control group (n = 26)-animals received injection of saline solution. Twenty-four hours after the glycerol or saline injection all the animals were killed. Serum urea, creatinine, transaminases (AST, ALT) and CK were measured and significantly high values were obtained in experimental animals. Arterial blood pressure was measured and remained within normal levels in both groups. Hepatocyte mitochondrial respiratory function was estimated polarographically with determination of oxygen consumption without ADP (Basal respiration-State 4) and in the presence of ADP (Activated respiration-State 3). In experimental group (GI) there was significant low values of oxygen consumption in state 3, decrease of respiratory control rate and in ADP/O ratio (p < 0.05). Histological studies of the liver revealed a periportal necrosis and centrilobular degeneration. These studies suggested that hepatic dysfunction is an additional complication of glycerol-induced rhabdomyolysis. The pathogenesis and clinical implications of these abnormalities are discussed.

Alanine Transaminase↗

PubMedDate not supplied

[Physiopathology of lung injury in acute pancreatitis].

Clinically detectable signs of lung injury develop in up to 50-70 percent of patients with acute pancreatitis. Despite that, the physiopathology of the lung injury associated with acute pancreatitis is unclear so far. Pulmonary edema is the main respiratory complication in acute pancreatitis. Increased permeabilities of the pulmonary endothelial and alveolar epithelial barriers are the causes of the pulmonary edema. Several factors have been regarded as the cause to pulmonary edema: release of pancreatic-derived proteolytic enzymes, oxygen-free radicals, phospholipase A2, free fat acids, tumor necrosis factor, platelet activating factor, arachidonic acid metabolites and pulmonary embolization. Understanding lung injury physiopathology enables physicians to a better therapeutic approach of the patients with acute pancreatitis. The aim of this paper is to expose the theories that explain the pancreatic-derived lung injury.

Acute Disease↗

PubMedDate not supplied

[Early adenocarcinoma of the duodenum--report of a case].

The early duodenal carcinoma is a very rare type of neoplasia, usually asymptomatic, its surgical treatment remains a controverse issue. In the present case an early duodenal carcinoma was incidentally found at the pathological specimen after a gastrectomy with BII reconstruction for a gastric adenoma unressectable by endoscopy. The patient is now alive for two years, without evidence of recurrence on follow-up.

Adenocarcinoma↗

PubMedDate not supplied

[Laparoscopic treatment of duodenal obstruction in a patient with pancreatic cancer].

We present a case report of laparoscopic gastrojejunostomy in a patient with duodenal obstruction from unresectable cancer. We performed an side-to-side intracorporeal gastrojejunostomy using endoscopic stapling devices. The patient had no morbidity and he was discharge on fourth postoperative day. Laparoscopic gastric bypass is an alternative to open procedure in well selected cases.

Anastomosis, Surgical↗

PubMedDate not supplied

[Video laparoscopic splenectomy in a patient with splenomegaly due to hereditary spherocytosis: report of two cases].

We present a case report of laparoscopic splenectomy in two patients with congenital spherocytosis. A 23-year-old man and a 25-year-old woman with splenomegaly due to congenital spherocytosis underwent laparoscopic splenectomy. Their postoperative course was uncomplicated and they were discharged on the second and fourth postoperative day, respectively.

Adult↗