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Biomedical subjects

A Jorge

Publications and source records attributed to A Jorge.

At least 19 recordsLinked to original sources
PubMed2003

Local side effects observed among long-term users of norplant contraceptive implants.

The prevalence of local signs and symptoms related to the site of insertion of implants, and the association of these signs and symptoms with time of use, skin color and body mass index (BMI) was evaluated among users of the Norplant implant system. Three hundred and three Norplant users attending at the reproductive health clinic of PROFAMILIA in Santo Domingo, Dominican Republic, were asked if they had ever had any discomfort at the site/arm of implant insertion and the implant insertion area was examined and hyperpigmentation and hollowing of the surface was recorded. Half of the subjects reported either pain or paresthesia or both, in almost equal numbers, some time since insertion. Hyperpigmentation was observed in 35.6% and hollowing in 22.4% of the subjects. Report of pain and paresthesia was inversely associated to time of use and to BMI. Hyperpigmentation was directly associated to time of use and darker skin, and hollowing of the arm surface in the implants area with time of use and BMI. Local signs and symptoms were more frequent than previously reported, although they were of mild nature and appeared not to worry most of the users.

Adult↗
PubMed2003

Helicobacter pylori infection affects the expression of PCNA, p53, c-erbB-2 and Bcl-2 in the human gastric mucosa.

OBJECTIVE: Helicobacter pylori infection has been related to gastric carcinogenesis. This association is based on epidemiological data, pathological changes observed in the gastric mucosa, and chemical products from bacteria that may induce damage of DNA. In the present study we examined gastric endoscopic biopsies from patients with chronic gastritis, with and without H. pylori infection, and surgical biopsies from gastric cancer patients to evaluate whether this bacteria may induce changes in the expression of molecular markers associated with carcinogenesis. PATIENTS AND METHODS: the study involved 57 biopsies from the antral region of the stomach of patients with chronic gastritis and gastric cancer that were analyzed by immunohistochemistry. Molecular markers examined were: PCNA (Proliferating Cell Nuclear Antigen), p53, c-erbB-2, Bcl-2, and p21 H-ras. RESULTS: PCNA content of epithelial cells was significantly higher in H. pylori infected biopsies. Treatment aimed to eradicate H. pylori decreased the level of PCNA-positive cells in the group of patients that became H. pylori-negative as well as in H. pylori-positive patients. Nuclear p53 expression (used here as a surrogate marker for p53 mutation/inactivation) and c-erbB-2 expression were observed only in the group of patients that remained with the bacteria after treatment. A higher bcl-2 expression in lymphoid cells was observed in H. pylori-positive biopsies, and treatment did not change the expression of this protein. No significant expression of p21 H-ras was observed in the studied biopsies. CONCLUSION: this study suggests that H. pylori is involved in the induction of molecular changes that might predispose human gastric mucosa cells to pre-neoplastic and neoplastic events.

Adolescent↗
PubMed1997

[Purulent pericarditis. A 10-year retrospective study].

The authors carried out a retrospective study of 10 cases (ages below 11 years) with purulent pericarditis diagnosed and treated at the Coimbra Paediatric Hospital during a 10 year period (1 January 1985-31 December 1994). This study identified an average of 1 case per year, a low age group, low morbidity and nil mortality. Our results were due to early diagnosis and immediate aggressive medico-surgical managements, namely, systemic antibiotics covering the most common organisms during at least 3 weeks coupled with extensive pericardiocentesis associated with saline lavage.

Bacterial Infections↗
PubMed1993

[Endoscopic papillotomy and extraction of bile duct calculi in patients with gallbladder in situ and cholelithiasis].

Cholecystectomy with surgical papillotomy is a prolonged procedure with significant morbidity and mortality. In patient stay is usually extended. Occasionally the bad general conditions and the advanced age of the patients contraindicate surgical procedures. Eventually, the drainage of the biliary ducts is inevitable. For this reason, since 1983, we are performing the endoscopic papillotomy and extraction of stones from the bile duct in patients with choledocholithiasis and cholelithiasis. Cholecystectomy was performed only in cases with real necessity. Ninety one patients, 26 men and 65 women, between 25 and 82 years, have been submitted to this procedure in our department. Cholecystectomy was performed in 52 cases after 24 to 72 hours post-papillotomy. Due to acute cholecystitis 12 patients had to be operated after a period of 2 months to 2 years. No cholecystectomy was performed in 27 patients, they are still asymptomatic. Then were no mortality related to the method.

Adult↗
PubMed1993

[Effectiveness and safety of 150 mg vs 300 mg ranitidine twice a day in duodenal ulcer].

394 patients with endoscopically diagnosed duodenal ulcer were randomly allocated to treatment with ranitidine 150 bid o ranitidine 300 mg bid in a prospective double-blind multicenter trial conducted in seven LatinoAmerican countries. Endoscopy at 4 weeks showed complete ulcer healing en 171 of 196 patients (87.2%) treated with ranitidine 150 mg bid and 178 of 198 (89.9%) treated with ranitidine 300 mg bid. Both treatment regimens were equally effective at rapidly reducing the incidence of ulcer-related symptoms. It is possible that higher dosage regimen of ranitidine would be useful in patients with more severe duodenal ulcer disease.

Adult↗
PubMed1991

Choledochoduodenal fistulas.

In 2,012 ERCP studies reviewed in the period between 1976 and 1989, we observed 14 choledochoduodenal fistulas found in the upper portion of the papilla of Vater. Two fistulas occurred spontaneously due to necrosis of the duodenal wall caused by stones located in the distal common bile duct above the sphincter of the papilla. In these two cases the stones were removed endoscopically. The twelve remaining cases were iatrogenic, caused during surgical papillotomy which resulted in a false tract. All patients showed raised AP and gamma GT. Eight had acute cholangitis, 7 were jaundiced, there was one case each of acute pancreatitis and chronic recurrent pancreatitis. Nine patients had stones located in the distal common bile duct. In eight cases it was possible to cannulate the papillary opening and do a papillotomy thereby connecting the fistulous orifice with the opening of the papilla. The other patient was treated surgically. Two patients had papillary stenosis. One was successfully treated with papillotomy through the papillary opening. In the other, the fistulous orifice was joined with the papillary opening using a diathermy scalpel. This patient suffered a posterior duodenal wall perforation. One patient with acute pancreatitis and common bile duct stones distal to the fistula improved with papillotomy and stone removal. The patient with chronic recurrent pancreatitis without lithiasis refused any form of treatment.

Ampulla of Vater↗
PubMed1991

[Determination of the neurotransmitters 5-hydroxytryptamine, noradrenaline, and dopamine in gastroduodenal mucosa. Clinical and histologic correlation].

We have studied the concentrations (pg/mg) of Neurotransmitters 5-hydroxytryptamine (5HT), Noradrenaline (NA) and Dopamine (DA) at mucosa normal and with different degrees of chronic inflammation mucosa of fundus (F), antrum (A) and duodenum (D) in 21 patients. We correlated the concentration of the neurotransmitters with each other, all of them in each region and with clinics, indirect of motility and histologic parameters. The average for 5HT in F: 940.2 +/- 457.4; in A: 787.5 +/- 407.0; in D: 601.6 +/- 272.0; for NA in F: 217.5 +/- 138.7; in A: 228.4 +/- 126.5; in D: 245.7 +/- 118.6 for DA in F: 50.7 +/- 32.2; in A: 46.3 +/- 31.5; in D: 53.0 +/- 45.6. The statistical analysis showed a significant correlation of DA concentration with lymphoplasmocytic infiltrated in Duodenum (r = 0,94). not any other parameter had significative relation with the neurotransmitters variations. We established that the variations of the neurotransmitter concentrations of the antrum mucosa are more associated with the duodenum than with the gastric fundus.

Adult↗
PubMed1990

[Endoscopic treatment of acute pancreatitis of biliary etiology].

23 patients with acute biliary pancreatitis were treated with endoscopic papillotomy and extraction of bile duct stones. 12 suffered on an acute moderate and 11 on an severe pancreatitis in the classification of Glasgow. The patients were between 45 and 92 years old. 19 had an evolution without complications, 2, who also had an acute cholangitis, had a slow but good evolution. 2 died due to a septic shock and cardio-respiratory failure.

Aged↗
PubMed1988

Primary sclerosing cholangitis.

Thirty patients, 18 males and 12 females, with PSC have been studied between 1972 and 1986. In nine PSC was associated with ulcerative colitis (30%), in 4 with Crohn's disease (13%) and 17 were free of any chronic bowel disease. Four of these 17 were siblings. Alkaline Phosphatase, Gamma GT, total bile acids and 7-alpha-hydroxilated bile acids were elevated in all patients. In 14 patients plasma and urinary copper as well as ceruloplasmin were studied, showing the copper in all cases and ceruloplasmin in 10 cases elevated, 4 were normal. By means of cholangiography alterations of the extrahepatic ducts, the intrahepatic ducts, and both the intra- and extrahepatic ducts were seen in 13%, 27% and 40% of the cases, respectively. Alterations of the pancreatic duct were observed by pancreatography in 21% of cases. 40% of the PSC-patients had also a Sjögren's syndrome, while 3% were associated with diabetes mellitus Type I and II, psoriasis and red lichen planus, iridocyclitis and hepatic hemangioma.

Adult↗
PubMed1987

Anti-delta antibody in various HBsAg positive Argentine populations.

One thousand five hundred and seventeen HBsAg carriers from different cities of Argentina were studied for the presence of anti-Delta antibody (anti-HDV) in their sera. One thousand one hundred and sixty-eight were volunteer blood donors and 349 were patients with liver disease. Different liver diseases were diagnosed by clinical, biochemical, and histological parameters. Among blood donors, 16 (1.4%) were positive for the antibody and none was Delta-antigen positive. In 130 patients with acute hepatitis, one (0.77%) was positive for anti-HDV, as well as three (2.22%) out of 135 patients with chronic active hepatitis (CAH), and three (5.77%) out of 52 patients with cirrhosis (C). No anti-HDV positive was found among seven fulminant hepatitis (FH) cases. The presence of HBeAg and anti-HBe was studied in anti-HDV positive sera; eleven (69%) volunteer blood donors were anti-HBe positive, and five (31%) were HBeAg positive. HBeAg was positive in the three CAH cases, and in one out of three C Cases with anti-HDV positive. Hepatitis Delta antigen was also positive in the hepatocytic nuclei in the three patients with C and two of the three CAH cases. The present results show that Delta infection is rare among blood donors in Argentina. A small variation without statistical significance could be found within different geographical areas. Among patients with HBsAg related liver disease, the presence of HDV markers was also low.

Adolescent↗
PubMed1982

[Sclerosing treatment of esophageal varices].

Sixty-five patients with hepatic cirrhosis and esophageal varices were subjected to endoscopic sclerotherapy. Twelve patients were treated in the intervals between hemorrhages; 43 patients were treated after their first hemorrhage. The rate of survival in a 5 to 26 month period was 82%.

Esophageal and Gastric Varices↗
PubMed1982

[Determination of cholic and sulfolithocholic acids in various hepatopathies].

The conjugated cholic acid (glycocholic acid) (GC) in the serum and the conjugated sulfolithocholic acid (sulfolithoglycocholic acid (SLGC) in 35 aggressive chronic hepatitis (HCA), 22 cirrhosis, 11 primary biliary cirrhosis (CBP), 11 pruritus of pregnancy and in 20 normal controls were determined. The control group revealed a mean value of GC of 21 micrograms % with a dispersion of +/- 14 micrograms % and for SLGC of 36 micrograms % with a dispersion of +/- 9 micrograms %. The frequency of the alteration of GC and SLGC in the cases of chronic hepatitis was low (14% and 9%) as well as in the cirrhosis (23% and 14%). In the pruritus of pregnancy the values reached 64% and 45%. On the other hand, the values were significantly elevated in CBP (100% and 90%) (p.001 and p.006). The absolute values in the various pathologies revealed mean values which were different but with a very wide dispersion that prevented us from seeing any relation between those absolute values and the different diseases. The alteration in the metabolism of biliary acids in the hepatic pathology was manifested by the postprandial determination of GC and SLGC in 20 HCA in whom the frequency of abnormal values rose from 14% and 9% on fasting to 60% and 45% prandially.

Chronic Disease↗
PubMed1980

[Effect of chenodeoxycholic acid in cholesterol lithiasis].

Chenodesoxycholic acid (CDCA) was administered to 60 patients with radiolucent lithiasis and also to 2 patients with functioning gallbladder and radiopaque stone. The lithiasis disappeared completely in 27 patients while in 14 patients there was a decrease in the size of the stones from 30 to 70% as compared to the size of the previous ones. Treatment was successful in about 68,33% of cases. Only one patient had severe diarrhea which led to interruption of treatment. A transient increase of SGOT and SGPT was observed in 7 patients (11,29%) and there was an increase of GT in 4 patients (6,45%). These enzymes returned to normal with no change of treatment. 48 patients had hepatic biopsy before and during treatment, but no histologic abnormalities were found. Two patients were operated upon at 9 and 17 months after starting treatment due to bile-pancreatic crisis. Of the 27 patients who had complete remission of lithiasis, 12 of them were given 500 mg/day CDCA and another twelve 500 mg every other day. None of the two groups revealed recurrence of lithiasis. Two of the patients who were given only 500 mg twice a week revealed multiple small-sized lithiasis 7 and 9 months after dissolution. A patient who had interrupted treatment completely revealed a recurrence of lithiasis after 10 months.

Adult↗
PubMed1979

[Percutaneous cholangiography with the Chiba method (author's transl)].

In 92 patients with cholestasis a percutaneous cholangiography was performed. The bile duct could be visualized in 75 cases (81.5 percent). When the bile ducts were dilatated, the investigation succeeded in 94 percent, whereas in patients with normal bile ducts the rate was 65 percent. Complications occurred only in 2 cases. In one patient surgery was necessary due to biliary peritonitis. In another patient a discrete hemobilia without clinical symptoms could be found during laparotomy.

Adult↗
PubMed1979

[Ultrastructure of the liver in patients with cholesterol stones receiving chenodesoxycholic acid (author's transl)].

The ultrastructure of the liver was investigated in 5 normal persons and 10 patients with cholesterol stones. In the patients numerous intramitochondrial crystals could be found; precipitated cholesterol-digitonin complexes were found as well in the canaliculi, the sinus and the pericanalicular areas. 5 patients received chenodesoxycholic acid (10 mg/kg/day); liver biopsies taken 3 and 6 months after start of treatment did not show any more the changes described above.

Chenodeoxycholic Acid↗