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Biomedical subjects

M C Machado

Publications and source records attributed to M C Machado.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

[A new technique of intrahepatic cholangiodigestive shunt in the right lobe of the liver].

Intra-hepatic cholangiojejunostomy in the left liver lobe is a well standardized procedure. For the right lobe however this procedure may be tedious, difficult and followed by early and late complications. A new technique is described based on two principles: minimal sacrifice of hepatic parenchyma and establishment of latero-lateral cholangio-intestinal anastomoses. Five patients were submitted to this procedure and one of them is alive without jaundice three years after the operation. It's concluded that this technique can be indicated in cases of biliary obstruction in which the anastomoses of the left duct cannot be performed because of local changes and in cases with cholangitis.

Anastomosis, Roux-en-Y↗
PubMedDate not supplied

[Cholecystectomy in patients with sickle-cell anemia].

The surgical treatment of cholelithiasis in patients with sickle cell anemia is rather frequently followed by the operative complications. In order to study the influence of pre-operative factors and post operative complications, 31 consecutive patients distributed in two groups has been studied. In group I, all the patients have been operated by conventional procedures with 43.75% of complications. In group II, a more appropriated technique and a better metabolic control ensured a lower morbidity (6.67%). There was no pos operative death in this series. Pre operative bilirubin levels was the only condition associated with increased pos operative morbidity.

Adolescent↗
PubMedDate not supplied

[Differential diagnosis of cholestasis in pancreatic cancer and chronic pancreatitis].

The clinical, biochemical and radiological data of 25 patients with carcinoma of the head of the pancreas were compared with the same parameters of 25 patients with chronic pancreatitis producing cholestasis. History of alcohol abuse, pruritus and palpable gallbladder were the only clinical findings useful for the differential diagnosis. Plasma bilirubin levels were significantly higher in patients with malignancy (20.0 +/- 14.3 vs 2.5 +/- 2.4) but the course of the bilirubinemia was similar in the two groups after hospital admission. Preoperative ultrasound and cholangiography were usefull in differentiating both groups of patients. Sensibility of a point score based on significant differences was 100% for pancreatitis and 96% for malignancy.

Adult↗
PubMedDate not supplied

[Carcinoid tumor of the duodenal papilla].

Carcinoid tumor of the duodenal papilla is very rare. The authors report the case of a 17 years old male with a carcinoid tumor at this site in whom a partial pancreatoduodenectomy was performed and who is well and asymptomatic 13 years after the surgical intervention. A review of literature of this unusual condition and a discussion about the treatment are presented.

Adolescent↗
PubMedDate not supplied

[Influence of diet composition on the late course of acute pancreatitis. Experimental study in rats].

Acute pancreatitis was induced with sodium taurocholate 1% in two lots of rats fed during 21 days with diets that differed in lipid composition. Serum amylase, pancreatic tissue enzymes (trypsinogen, chymotrypsinogen and amylase), pancreatic tissue nucleotides (RNA and DNA) and biopsies for histological study were collected in normal pair fed animals, and in the experimental lots 1, 4, 7 and 15 days after AP was induced. ANOVA and Student t-test were used for the comparison of biochemical data (p less than 0.05). They showed that acute pancreatitis aggravated progressively until the fourth day independently of the regimen. On the 15th day, the histological and biochemical parameters reached normal values. The authors concluded that high lipidic diet was not the main factor responsible for progressive injury of the pancreas.

Acute Disease↗
PubMedDate not supplied

[Leiomyosarcoma of the inferior vena cava: report of a case].

Leiomyosarcoma of the inferior vena cava is a rare tumor. The authors report a case and discuss the clinical features, diagnosis and treatment of this disease. With recent advances in radiologic and surgical procedures an early diagnosis and radical resection might be possible, leading to a better prognosis or even to the cure of the condition.

Adult↗
PubMedDate not supplied

[Portal thrombosis: early complication of azygo-portal disconnection in the treatment of bleeding esophageal varices].

The authors studied 30 patients with bleeding from esophageal varices due to portal hypertension. They underwent the disconnection of portal and azygos veins and splenectomy. The immediate postoperative complications were: portal thrombosis in four patients (13.3%); subphrenic abscess in two (6.6%); pulmonary embolism in one (3.3%) and esophageal perforation in one (3.3%). The manifestations of portal thrombosis were ascites, and fever (without leukocytosis). One patient with portal thrombosis who had intractable ascite was submitted to peritoneovenous shunting.

Adolescent↗
PubMedDate not supplied

[Focal nodular hyperplasia of the liver observed in a patient undergoing prolonged therapy with ketoconazole].

The authors report on a 44 year old man presenting focal nodular hyperplasia of the liver associated with prolonged ketoconazole therapy in the absence of known intake of either estrogens of androgens as well as of any factor that could cause hyperproduction of estrogens. It seems possible the existence of an etiopathogenic relationship between prolonged ketoconazole therapy and focal nodular hyperplasia of the liver since ketoconazole inhibits steroidogenesis and can also increase the estradiol-testosterone ratio (E/T). This hormonal alteration is known to play an important role in the pathogenesis of several hepatic neoplasms, including focal nodular hyperplasia.

Adult↗
PubMedDate not supplied

[Splenic abscess: report of 8 cases and review of the literature].

Eight patients with splenic abscess are reported. Etiological factors were sepsis, mainly due to endocarditis. Diagnosis was made by ultrasonography and computed tomography scans. Splenectomy was performed in four cases, transcutaneous drainage in three and abscess puncture in one case. Mortality was 12.5% (1/8). Since the introduction of US and CT scans early diagnosis and treatment was possible by which the mortality decreased.

Abscess↗
PubMedDate not supplied

[A hyperlipidic diet and acute pancreatitis: experimental study in rats].

After acute pancreatitis was induced, the residual pancreatic tissue contents were evaluated in two series of rats fed with diets that differed in the lipidic composition: 1--high lipid and balanced protein diet; 2--balanced diet. Total protein, nucleic acids, trypsinogen, chymotrypsinogen were quantified in the pancreatic tissue; amylase activity was measured in the pancreatic tissue and serum under the following conditions: 1--in rats fed "ad libitum" (groups CB and CL); 2--in rats submitted to a fast of 30 hs (groups JB and JL) and 3--twenty-four hours after acute pancreatitis was induced (group B and L). The results obtained were statistically compared among groups with the same kind of diets, using ANOVA and the Tukey test. Student t-test was used to compare the same parameters among similar groups with different diets (p less than 0.05). In comparison with the groups under same regimen it was verified that the pancreatic enzymes content didn't change in fasting groups, but did in PA groups. It was also found that trypsin was increased in all groups, RNA/DNA decreased and total protein increased in AP group in rats fed with hyperlipidic diet. It is concluded that high lipid intake can aggravate pancreatic injury.

Acute Disease↗
PubMedDate not supplied

[Surgical treatment of ascites and pleural effusion in patients with chronic pancreatitis].

Pleural effusion and ascites are now recognized as possible complications of chronic pancreatitis. Diagnosis of these conditions can be made by the finding of high amylase levels in the pleural or ascite fluid. Out of 31 of our patients with this complications 19 had ascites, 10 pleural effusions and two both pleural effusion and ascites. In 19 patients, presenting poor clinical conditions, the treatment was external drainage. Remaining patients were treated by internal drainage or resection. Eight out of the 19 patients treated by external drainage and one of the 13 patients with internal drainage had to be reoperated. There was no mortality. Though external drainage is followed by high incidence of reoperations this technique should be used in patients with poor conditions.

Adult↗
PubMedDate not supplied

[The management of acute pancreatitis in pregnancy--the coadjuvant role of parenteral feeding].

Acute pancreatitis in pregnancy is not a frequent condition: only a few hundred cases have been published in the literature. Its diagnosis can be misguided by clinical manifestations of the pregnancy itself, and by the delay in ordering the required diagnostic tests. These facts may contribute to the serious prognosis of this disease, which in the past had a mortality of up to 20%. The treatment recommended is conservative. A surgical intervention in the event of biliary lithiasis is best to be postponed till after delivery. Parenteral alimentation can be helpful because of its effects in the promotion of pancreatic rest with simultaneous improvement of the nutritional conditions of the mother and the fetus.

Acute Disease↗
PubMedDate not supplied

[Etiology of chronic pancreatitis in São Paulo: a study of 407 cases].

The etiology of chronic pancreatitis was investigated in 407 patients: 381 (93.6%) had a history of heavy alcoholic ingestion (average = 295.3 +/- 171.3 g of ethanol) during a time of 19.2 +/- 8.0 years: five patients (1.0%) had familial background of pancreatitis, two (0.5%) had the obstructive form, and two (0.5%) presented history of malnutrition. In 18 patients (4.4%) it was not possible to determine the etiology. Patients with the alcoholic form started the alcohol abuse at the age of 19.4 +/- 6.0 years. A careful dietetic inquiry showed that patients with chronic pancreatitis lived on a diet which was significantly richer in protein than that of patients of the control group (p less than 0.01). Attention is called to the high incidence of chronic alcohol abuse in patients with chronic pancreatitis.

Adolescent↗
PubMedDate not supplied

[Echographic study of cystadenoma and cystadenocarcinoma of the pancreas].

The ultrasonographic aspects of cystadenomas and cystadenocarcinomas of the pancreas were studied in 14 patients. The tumors were cystic, solid or of mixed type. The ultrasonographic differences between the benign and malignant lesions are discussed, as well as changes concerning the splenic vein and biliary system. Ultrasonography is of help for the differential diagnosis of cystic tumors of the pancreas and for indication of the best therapeutic procedure.

Adult↗