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Biomedical subjects

A L Gomes

Publications and source records attributed to A L Gomes.

7 recordsLinked to original sources

Non-progressive leukoencephalopathy with bilateral temporal cysts.

We report two cases of a peculiar leukoencephalopathy with temporal cysts. Both patients have a non-progressive neurological disorder with mental retardation, microcephaly and sensorineural deafness although clinical differences between them may reflect a different aetiology. The metabolic disorders with white matter involvement and the recently described leukoencephalopathies (Van Der Knaap disease, 'vanishing white matter disease') were excluded based on clinical, biologic and imaging findings. Cytomegalovirus infection is a likely possibility in the first case although the magnetic resonance imaging picture is only partially similar to previously reported cases. Our patients are strikingly similar to the patients reported by Deonna et al. and Olivier et al. We discuss the clinical and imaging findings in our patients and the differential diagnosis considering the known disorders of the white matter in childhood.

Central Nervous System Cysts↗

Risk factors for breast cancer among pre- or post-menopausal women in Belo Horizonte, Brazil.

BACKGROUND: Much controversy has been generated about pre- and post-menopausal breast cancer patients and investigators have sought to identify whether risk factors differ between these two groups. In Brazil, breast cancer is an important cause of death among women and there are few analytical studies concerning pre- or post-menopausal comparisons. METHODS: A case-control study was carried out at the Federal University Hospital, Belo Horizonte, Brazil, to determine if selected socio-economic and reproductive risk factors for breast cancer differed between pre-menopausal and post-menopausal women. Cases were 300 women with breast carcinoma and controls were 600 women with other benign diseases matched for age and date of diagnosis, admitted to the same hospital during the same period (1978-1987). Univariate and multivariate conditional logistic regression analyses were performed. RESULTS: Multivariate analysis showed no differences in breast cancer risk in pre- and post-menopausal women (risk factors were similar in direction and magnitude). Occupation, irregular menstrual cycles, parity, history of breast cancer in at least one first-degree female relative, and oral contraceptive use had similar associations in both groups. CONCLUSIONS: The present study indicates that breast cancer diagnosed before and after menopause has a similar risk profile.

Adult↗

[Lateral sinus thrombosis].

Lateral sinus thrombosis has become a rare complication of the ear in the developed world with the widespread use of antibiotics. The classic clinical picture is often modified by previous antibiotic treatment, which difficult diagnosis and treatment. The authors present the case of a seven year old female who, after an acute left otitis media, treated and later complicated with mastoiditis, presented headaches, neck pain, papilledema and binocular diplopy. Etiologic investigation lead to the diagnosis of left lateral sinus thrombosis. Anticoagulation was started with heparin followed by dicumarinics. This treatment was maintained during eight months. At the moment, the child has no symptoms, with no papilledema or repercussions on visual acuity. The diagnosis of lateral sinus thrombosis and the need for a selection of complementary studies is discussed. A protocol treatment, based on data from a review of the literature, is suggested.

Anti-Bacterial Agents↗

[Moyamoya disease. Its clinical picture, diagnosis and new therapies].

Moyamoya disease is a chronic cerebral vasculopathy that leads to a slow progressive narrowing and occlusion of the principal arteries responsible for the anterior circulation of the brain. It causes a cerebrovascular insufficiency with the development of multiple anastomoses between internal and external carotid arteries. The diagnosis is based on the peculiar appearance in angiography. Although rare, it is not possible to omit it in the differential diagnosis of ischemic vascular accidents in children. The authors describe a case of a eight year old female caucasian whose diagnosis was suspected by means of the non invasive technique of angiographic magnetic resonance imaging and confirmed by angiography. Based on this case, the main aspects of the disease are described, with particular emphasis on clinical features, diagnosis and treatment.

Brain↗

A case-control study of risk factors for breast cancer in Brazil, 1978-1987.

BACKGROUND: There are still controversies regarding the role of many risk factors assessed for breast cancer worldwide. In Brazil, it represents a major cause of death among women but yet few analytical studies have been published to date. METHODS: The association of selected factors with breast cancer was assessed in a case-control study of 300 women, aged 25-75 years, treated at the Federal University Hospital, Belo Horizonte, Brazil, from 1978 to 1987. In all, 300 cases with diagnosed breast carcinoma were compared with 600 controls matched on age and date of diagnosis. Socio-economic, demographic and reproductive factors were analysed. RESULTS: Multiple logistic regression analysis showed the following factors to be independently associated with increased risk of breast cancer: a) monthly family income (odds ratio [OR] = 1.69, 95% confidence interval [CI]: 1.18-2.42); b) being a housewife (OR = 2.86, 95% CI: 1.83-4.47; c) parity of less than six deliveries and nulliparous women (OR = 5.06, 95% CI: 3.01-8.52 and OR = 2.42, CI: 1.64-3.59, respectively); d) history of breast cancer among first degree female relatives (OR = 9.35, 95% CI: 3.22-27.14); and e) oral contraceptive use (OR = 1.81, 95% CI: 1.15-2.85). Irregular menstrual cycle (OR = 0.44, 95% CI: 0.25-0.75) was associated with breast cancer as a protective effect. CONCLUSIONS: The study has confirmed most risk/protective factors previously demonstrated elsewhere in the world and provides clear documentation of breast cancer epidemiology in Brazil.

Adult↗

Acute infantile thalamic necrosis.

An acute encephalopathy of infancy presenting as seizures and coma following a presumably infectious disease with the distinctive finding of thalamic necrosis was recently described. The authors report a similar case in an 11-month-old infant, and discuss its possible pathogenesis.

Female↗