Biomedical subjects

A G Almeida

Publications and source records attributed to A G Almeida.

3 recordsLinked to original sources

PubMed2001

[Prognosis of postoperative aortic dissection. Assessment with magnetic resonance].

OBJECTIVE: To evaluate operated type A aortic dissection by Magnetic Resonance Imaging (MRI), in order to detect long-term complications and identify prognostic indexes of evolution. DESIGN: Prospective study with a three-year period of follow-up. Prognosis evaluation. SETTINGS: Outpatient Clinic at Hospital de Santa Maria and Magnetic Resonance Imaging Center at Hospital da Cruz Vermelha. PATIENTS: A sample of 37 patients submitted to type A aortic dissection surgery, included sequentially, after exclusion of those with contraindication to MRI. METHODS: Initial evaluation (clinical and MRI study) at 3 to 4 months and at 1, 2 and 3 years after surgery. The mean follow-up time was 39.3 +/- 2.9 months. We evaluated the following complications over the aorta (aortic graft and five segments of residual aorta) and the aortic valve: aneurysm, pseudoaneurysm, rupture, re-dissection, progressive aortic valve regurgitation, reoperation and death. The prognostic indexes analysed were: presence of residual flap; false lumen patency; presence of re-entry points; false lumen to aorta dimension ratio; initial aortic dimension; increase of aortic dimension. RESULTS: All patients, with the exception of three that died, remained asymptomatic. COMPLICATIONS: Aneurysm was detected in 45.9% of patients, located in one or more segments; rupture occurred in three patients, preceded by aneurysm and pseudoaneurysm development; moderate or severe aortic regurgitation was detected in 47.8% of patients. Prognostic indexes: 1. Aneurysm development in each segment yeilded a significant association with: presence of residual flap in the same and other segments; higher initial dimension of the same and other segments, with the exception of the abdominal segment; higher increase in dimension of the same and other segments, with the exception of the abdominal segment; 2. Moderate or severe aortic regurgitation development showed a tendency to association with higher increase in dimension of proximal ascending aorta. 3. No association was found between aneurysm and aortic regurgitation development. CONCLUSIONS: Patients operated for type A aortic dissection had a high incidence of late complications which lead to reoperation and in some cases death. The presence of a residual flap, increased aortic dimensions and higher increase rate of aortic dimensions were associated with a complicated evolution. MRI was a very useful technique for long-term monitoring and to identify prognostic indexes of evolution.

Aortic Dissection↗

PubMed1998

[Hereditary fructose intolerance].

Hereditary fructose intolerance (HFI) is a rare autosomal recessive, metabolic disorder, that results from a deficiency of aldolase B (fructose-biphosphate aldolase) in the liver, kidney and intestine. Recent molecular studies have identified the mutation A149P in most European patients. We describe the first case of HFI with molecular analysis in a Portuguese child, presenting the same mutation of the aldolase B gene. The role of molecular studies in the diagnosis of HFI risk patients and their families is emphasized.

Alleles↗

PubMedDate not supplied

Future caries susceptibility in children with early childhood caries following treatment under general anesthesia.

PURPOSE: The purpose of this study was to assess the susceptibility of children to the future development of caries following comprehensive treatment for early childhood caries (ECC) under general anesthesia. METHODS: The patients selected for this retrospective study were identified by analyzing dental records of children receiving treatment at the Franciscan Children's Hospital & Rehabilitation Center, Boston, MA (FCH & RC). In total, 4,143 records were reviewed. Of these, ECC was diagnosed in 42 patients before their admission to the operating room. Thirty-one control children were selected randomly from the dental records reviewed at FCH & RC. The control group was initially caries-free. The caries status of the children diagnosed with ECC was evaluated and compared with the control group. Children in both groups were seen for recall at intervals of six to nine months over a two-year period. The carious lesions were recorded in two categories; new smooth surface caries (NSSC) and new pit and fissure caries (NPFC). RESULTS: Thirty-three of 42 (79%) ECC children compared to nine of 31 (29%) control children had detectable carious lesions at subsequent recall visits. Children with ECC demonstrated a mean number of 3.2 +/- 3.3 new carious lesions compared to a mean of only 0.8 +/- 1.6 carious lesions in the control group. These differences were statistically significant (t71 = 3.8; P < 0.001). In addition, of the 42 patients treated for ECC under general anesthesia, seven (17%) required retreatment under general anesthesia within two years following their initial full-mouth rehabilitation. The prevalence of NSSC in the ECC group was significantly higher than the control group (t71 = 3.5; P < 0.001). CONCLUSIONS: Despite increased preventive measures implemented for children who experienced ECC, this study concluded that this group of children is still highly predisposed to greater caries incidence in later years. These findings strongly suggest that more aggressive preventive therapies may be required to prevent the future development of carious lesions in children who experienced ECC.

Anesthesia, Dental↗