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Biomedical subjects

R Almeida

Publications and source records attributed to R Almeida.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Cerebral metastases. Review of a hospital population].

Cerebral Metastases are diagnosed in approximately 20-30% of patients with primary tumours. Because of the improvement of central nervous system imagining technology and of the newly effective therapeutic schemes, the incidence of this particular type of cerebral lesion tends to increase. In this retrospective study the authors review the patients admitted in the Neurology, Neurosurgery and Medicine departments and in the outpatient chemotherapy consultation, with a diagnosis of cerebral metastases. Sex and age, neurologic symptoms at presentation, neuroradiologic findings, primary tumour origin, treatment outcomes and prognosis were evaluated in this population.

Adult↗
PubMed1996

Effects of a chlorhexidine varnish on the gingival status of adolescents.

The purpose of this blind study was to determine the effect of a two-stage chlorhexidine varnish, after three months, on the gingival status of 11- to 15-year-old children attending a school in Rio de Janeiro, Brazil. Subjects participating in the study were randomly allocated to control (C) and treatment (T) groups, n = 53 and n = 57, respectively. All subjects were matched at baseline on age, salivary levels of mutans streptococci, and caries scores. After elimination of carious lesions, a prophylaxis was given to both groups. The chlorhexidine varnish was then painted on the entire dentition of Group T subjects only. Prior to caries elimination, and again after three months, the gingival index was used to assess the gingival status of study subjects. An average of 106.6 +/- 8.9 and 107.7 +/- 6.2 gingival sites per subject (four sites per tooth) in Groups C and T, respectively, were examined by the same calibrated examiner on two occasions. For statistical purposes, data were dichotomized [(0,1) (2,3)] for the gingival index. Independent t-tests and paired t-tests were used to analyze the data. The percentage of sites per subject with scores of two or three at the baseline were balanced between study groups (3.7 +/- 7.1 for T; 1.8 +/- 3.2 for C; p = 0.08). After three months, a statistically significant decrease in the average percentage of sites with scores of two or three was demonstrated in the T group (0.7 +/- 2.4, T, p < 0.0001; 1.3 +/- 3.0, C, p < 0.25). The authors concluded that the application of a chlorhexidine varnish significantly improved the gingival health of T subjects for up to three months. A significant improvement in the gingival health could not be demonstrated in the C group.

Adolescent↗
PubMed1995

[The semiology and classification of myoclonias].

Myoclonus can present itself in various distinct clinical contexts. The authors review the possible different types of myoclonus, as a single manifestation or included in a syndrome, based on a semiological and aetiological classification. Special emphasis is given to the group of progressive myoclonus epilepsies.

Epilepsies, Myoclonic↗
PubMed1995

[The neurochemical aspects of Alzheimer's disease].

Alzheimer's disease is one of the most severe and most common progressive neurodegenerative diseases of ageing. It accounts for a significant number of cases of senile dementia. It is a major health problem, considering the current increase in the geriatric population all over the world. The purpose of this article is to review the neurochemical and histopathological aspects of Alzheimer's disease as well as the most recent therapeutical advances in this area.

Alzheimer Disease↗
PubMed1994

[Mitochondrial encephalomyopathies].

Mitochondrial Encephalomyopathies are primary disorders of energy metabolism recently described. They are the result of mitochondrial abnormalities with a wide spectrum of syndromes implying a multisystemic but predominantly muscular and cerebral involvement. Biochemical, histological, imagiologic and clinical features of the three well known mitochondrial syndromes (MERRF, MELAS and KSS) are described, as well as the mitochondrial genetics and maternal inheritance pattern.

Energy Metabolism↗
PubMed1994

[Oculomotor paralysis. The perspective of a neuro-ophthalmology consultation].

Ocular paresis is a usual diagnosis in neuro-ophthalmologic consultation, and its aetiology is indeed a challenge. The authors studied 3400 records concerning this consultation, between 1982 and the third quarter of 1993. During this period 221 cases with ocular paresis were selected. During this retrospective study we point out the following items: the cranial nerve affected; the neuro-ophthalmologic semiology; the aetiology and clinical evolution, according to the age groups. From 221 cases selected, 111 were paresis from the VIth pair (50.2%), 88 from the IIIrd pair (39.8%), 14 multiple paresis (6.4%) and 8 paresis from the IVth pair (3.6%). The most frequent complaint was diplopia (> 90%). As far as the aetiological diagnosis is concerned, this was easier to establish in patients > 50 years of age. In this age group the most usual aetiology was vascular and traumatic pathologies. In younger patients the most frequent pathologies were traumatic and tumoral. The prognostic was better in the vascular group, the paresis recovery being > 50% in all other pathologies, except the tumoral one.

Adolescent↗
PubMed1993

[Movement disorders induced by neuroleptic therapy].

Neuroleptics are drugs frequently used in clinical psychiatric and neurologic daily practice. They share the ability to block postsynaptic dopamine D2 receptors in the Central Nervous System. Their potency is directly proportional to that block. Movement disorders are the most frequent and important adverse effects induced by these antipsychotic drugs. This work will highlight some of the essential aspects of distinct neuroleptic-induced movement disorders.

Antipsychotic Agents↗
PubMed1992

Relapsing illness due to Rochalimaea henselae in immunocompetent hosts: implication for therapy and new epidemiological associations.

Two previously healthy, immunocompetent men had persistent Rochalimaea henselae bacteremia with clinical relapses after courses of antibiotics to which the isolates were ultimately demonstrated susceptible in vitro. Both had sustained tick bites prior to their illnesses, thus demonstrating an association not previously identified, although suspected. The first patient had relapsing fever, constitutional symptoms, and an episode of aseptic meningitis despite therapy with amoxicillin, then with doxycycline, and then with ceftriaxone. Thereafter, he spontaneously became asymptomatic during a span of 2 months of persistent bacteremia. Finally, after 2 weeks of therapy with ceftriaxone plus gentamicin, followed by 4 weeks of therapy with oral ciprofloxacin, his bacteremia was cured. The second man had relapsing fever and constitutional symptoms after courses of tetracycline, then of chloramphenicol, and then of doxycycline. He became permanently asymptomatic after serial 2-week courses of chloramphenicol and erythromycin. The greater efficacy of lysis-centrifugation blood cultures in the recovery of R. henselae was noted.

Adult↗
PubMed1992

Lymphadenopathy associated with Leishmania braziliensis cutaneous infection.

Lymph node involvement by Leishmania during human cutaneous leishmaniasis was reported more than 90 years ago, but the importance of certain Leishmania strains in such dissemination remains largely speculative. We have examined 36 consecutively untreated cutaneous leishmaniasis patients early in their disease; 66.7% had enlarged lymph nodes. Patients with enlarged lymph nodes had higher anti-Leishmania immune responses than patients without such involvement, both at the IgG antibody level (mean +/- SD optical density at 492 nm = 0.163 +/- 0.089 versus 0.098 +/- 0.086; P = 0.009) and in skin test responses (12.4 +/- 10.2 mm versus 5.7 +/- 7.3; P = 0.03). Thirteen (62%) of 21 lymph node cultures and 16 (53%) of 30 cultures from cutaneous sites were positive for Leishmania. Eleven of 13 isolates from lymph nodes were characterized by a panel of monoclonal antibodies, and all were typed as L. braziliensis. Our findings stress the importance of L. braziliensis as an agent involved in the early invasion of the lymphatic system.

Adolescent↗
PubMed1991

Genetic diversity among toxigenic and nontoxigenic Vibrio cholerae O1 isolated from the Western Hemisphere.

Multilocus enzyme electrophoresis was used to examine genetic relationships among and between toxigenic and non-toxigenic isolates of Vibrio cholerae O1 obtained from patients and the environment in the US Gulf Coast and surrounding areas. A total of 23 toxigenic and 23 non-toxigenic strains were examined. All the toxigenic and 7 of the non-toxigenic strains had the same alleles at 16 enzyme loci, whereas the balance of the nontoxigenic strains had 9 distinct combinations of alleles. This study suggests that all of the toxigenic strains belong to a single clone, and that while some of the non-toxigenic isolates were related, most were of diverse origin.

Alleles↗
PubMed1991

Leishmaniasis in Bahia, Brazil: evidence that Leishmania amazonensis produces a wide spectrum of clinical disease.

One hundred fourteen Leishmania isolates from patients with different clinical forms of leishmaniasis in the State of Bahia, Brazil, were characterized by indirect radioimmune binding assay using specific monoclonal antibodies (serodeme analysis). Seventy-five of these isolates were also analyzed by enzyme electrophoresis, based on 11 enzyme loci; parasite species were compared, according to their characteristic zymodemes, to those of WHO Leishmania reference strains. All isolates could be classified into one of three species: Leishmania amazonensis (n = 40), L. braziliensis (n = 39) or L. chagasi (n = 35). The most interesting information obtained from this study is the realization that L. amazonensis is capable of producing a wide spectrum of disease in humans. Infection with this parasite was associated with many different clinical presentations, including cutaneous leishmaniasis [CL] (20/49 cases), mucocutaneous leishmaniasis [MCL] (5/13 cases) and, of special note, visceral leishmaniasis [VL] (11/46 cases), as well as four cases of post kalaazar dermal leishmaniasis [PKDL]. In situ tissue parasite characterization, by immunoperoxidase assay and employing anti-L. amazonensis amastigote monoclonal antibodies, confirmed the infection with this species in two cases of CL, one case of DCL, one case of MCL and one case of PKDL. Our results also demonstrate the difficulty of parasite differentiation based on clinical grounds, since at least L. amazonensis infection can be associated with all types of leishmanial diseases, and different Leishmania species may be associated with indistinguishable clinical presentations. Since leishmanial parasites may vary in their biological behavior or in their response to treatment, it is important that their identification be made by reliable methods.

Animals↗
PubMed1990

Brain tumours in south Brazil: a retrospective study of 438 cases.

All brain tumours diagnosed since 1967 in a University Hospital in the Southern region of Brazil were reviewed and clinical information concerning age, sex, symptoms and evolution were analysed. 88.1% of tumours were primary neoplasms and the rest secondary deposits. There was a male predominance and the second and fifth decades of life were the most affected. The main presenting symptoms were headache, vomiting, hemiparesis, loss of vision and epilepsy. The commonest tumour was of astrocytic origin (36.3%) amongst which the malignant ones, including glioblastoma multiforme, predominated. These tumours were frequent in the cerebral hemispheres (31.3%), particularly in the frontal lobes. The time of evolution from the beginning of the clinical manifestations until the first hospital admission was also studied. The authors discuss the clinical and pathological observations in relation to other large series analysed in the literature.

Adolescent↗
PubMed1987

Evaluation of long-term results of homograft and heterograft valves in extracardiac conduits.

Between 1971 and 1982, 249 patients received right heart extracardiac conduits. The 173 patients who survived 30 days were reviewed retrospectively; 72 had antibiotic-sterilized aortic homografts, 97 had xenografts of various types, and four had valveless tubes. Reoperation for conduit obstruction was required as early as 13 months after the original operation, but actuarial analysis showed no differences in overall performance of homograft and heterograft conduit groups with respect to late death or survival free of conduit obstruction. More important risk factors for late death or the need for reoperation were the severity of the underlying cardiac lesions and the influence of early postoperative complications. When analyzed statistically, the performance of conduits bearing homografts was disappointing, influenced sometimes by complications in the Dacron extension tubes. Repairs dispensing with conduits entirely should be evaluated.

Actuarial Analysis↗
PubMedDate not supplied

Glomerular hyperfiltration in insulin-dependent diabetes mellitus: no evidence for enhanced activity of the renin-angiotensin-aldosterone system.

Glomerular hyperfiltration is a characteristic functional abnormality in insulin-dependent diabetes mellitus (IDDM) patients, but the underlying mechanisms remain controversial. Supine and ambulant plasma renin activity (PRA) and aldosterone were measured in ten IDDM patients with normal glomerular filtration rate (GFR), in ten IDDM patients with elevated GFR and in ten nondiabetic controls. Basal and stimulated PRA or aldosterone did not differ significantly between the three groups. These results suggest that in insulin-dependent diabetes the glomerular hyperfiltration is not causally related to hyperactivity of the renin-angiotensin-aldosterone system.

Adult↗
PubMedDate not supplied

Simultaneous pancreas-kidney transplantation: five-year results from a single center.

We report the 5-year results of our simultaneous pancreas-kidney transplantation (SPKT) program, started on May 2, 2000. Forty-two SPKT were performed on 42 type I diabetic patients with chronic renal failure. The procedure was performed with enteric diversion and vascular anastomosis to the iliac vessels. Immunosuppressive protocol included antithymocyte globulin, tacrolimus, mycophenolate mofetil, and steroids. The 24 women and 18 men had a mean age of 33.5 +/- 6.3 years and mean 22.8 +/- 14.2 years time of diabetes evolution. Forty patients had been on dialysis for 34.3 +/- 24.1 months, and two were preemptive transplantations. Acute rejection episodes were treated in eight patients (19.1%): in three cases they affected both organs; in two only the kidney was affected; and the other three were pancreas graft rejections. The incidence of postoperative complications requiring re-operation was 42.9%, mostly pancreas graft related. Two patients died, one due to cardiovascular disease; the other was transplant related. Three kidney grafts were lost, and the causes were immunologic, thrombosis, and patient death. Pancreas graft loss occurred in seven patients: thrombosis (n = 3); infection (n = 3); immunologic (n = 1). The patients with surviving grafts were doing well, with normal kidney and pancreas function: serum creatinine = 0.89 +/- 0.15 mg/dL; fasting blood glucose = 79 +/- 16 mg/dL; HbA1c = 4.7 +/- 1.1%. The 1-year patient, kidney, and pancreas survival rates were 97.3%, 94.6%, and 83.8% and 5-year values, 91.7%, 89.2%, and 78.7%, respectively. In conclusion, these results are similar to the most recent UNOS/IPTR reports, leading us to consider our experience with SPKT very positive.

Adult↗
PubMedDate not supplied

[Iatrogenic vascular injuries].

Iatrogenic vascular injuries include an extremely broad group of lesions with multiple etiology and polymorphic manifestations. We present a series of 44 patients with iatrogenic vascular lesions that result from arterial and venous catheterizations and surgical interventions. The arterial catheterization for coronariography and arteriography and orthopaedic surgery were the agents that most frequently caused vascular injury. Arterial and venous reconstructive surgery were the predominant treatment procedures. In our series, morbidity and mortality were 4.6% and 2.3%, respectively.

Adolescent↗