Biomedical subjects

Alex Augusto Silva

Publications and source records attributed to Alex Augusto Silva.

7 recordsLinked to original sources

PubMed2006

[Manometric evaluation of upper esophageal sphincter in patients with indeterminate form of Chagas' disease].

The objective was to study the disorders of upper esophageal sphincter in 37 patients with indeterminate clinical form of Chagas' disease. Eighty (48.6%) patients with synchronic waves were found. The average maximum pressure value of the upper esophageal sphincter was significantly higher in the synchronic group. Subjects with indeterminate clinical form of Chagas' disease may have functional disorders demonstrated by an increase in the pressure of the upper esophageal sphincter.

Chagas Disease↗

PubMed2006

Evaluation of cytokines (MIG, IFN-gamma, TNF-alpha, IL-4, IL-5, and IL-10) during the different evolutive phases of chagasic esophagopathy.

The production of cytokines (MIG, IFN-gamma, TNF-alpha, IL-4, IL-5, and IL-10) was studied in 39 individuals, including 28 with chagasic esophagopathy and 11 nonchagasic patients with gastroesophageal reflux disease. A sandwich enzyme immunoassay employing monoclonal antibody pairs specific for each cytokine was used. IFN-gamma and MIG production was significantly higher in patients with megaesophagus compared to control. Furthermore, in the absence of stimulation TNF-alpha levels were lower in the chagasic group than in the control group. In addition, significantly lower TNF-alpha levels were observed for the advanced form of the disease compared to the nonadvanced form. These results support the hypothesis that, although patients with advanced phase of megaesophagus present low number of CD4+ T lymphocytes, PBMC from this patients are able to respond up specific antigen stimulation.

Adult↗

PubMed2005

[Secondary sclerosing cholangitis in a patient with acquired immunodeficiency syndrome treated by common hepatic duct plasty by the laparoscopic route].

We report the case of a patient with obstructive jaundice caused by sclerosing cholangitis secondary to acquired immunodeficiency syndrome. In acquired immunodeficiency syndrome-related cholangiopathy, patients present with right upper quadrant or epigastric pain, fever, diarrhea and characteristic biliary alterations. The patient was submitted to transverse plasty of the common hepatic duct by laparoscopic route.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Evaluation of the response of cortisol, corticotropin and blood platelets kinetics after laparoscopic and open cholecystectomy.

PURPOSE: To compare the behavior of serum cortisol and ACTH levels and platelet kinetics after laparoscopic and open cholecystectomy. METHODS: In this prospective study, 31 patients with symptomatic cholelithiasis submitted to elective cholecystectomy, 17 by the laparoscopic route and 14 by the open route, were compared. Peripheral blood samples were collected on admission of the patient, during anesthetic induction, and 2, 6, 12, 24 and 48 hours after the surgical incision. Platelets were counted in hematoxylin-eosin-stained specimens under a light microscope at 100x magnification. Cortisol and ACTH were measured by chemiluminescence. RESULTS: Cortisol and ACTH levels showed a significant increase (p < 0.05) within the first hours after surgery compared to preoperative values. At 2 hours, a significantly higher cortisol concentration was observed in the laparoscopic group compared to the open surgery group (p = 0.0365). A return to basal levels during the later postoperative periods (24 and 48 hours) was only observed for ACTH, while serum cortisol continued to be elevated during the same period, being significantly higher in the open surgery group than in the laparoscopic group (p24 = 0.0248 and p48 = 0.032). Different platelet response curves were obtained for the two groups, but their levels were normal at all times studied. No significant difference (p > 0.05) between the post- and preoperative periods was observed for either group. CONCLUSION: A hormonal response was observed for both procedures studied, but the surgical stress was higher and longer lasting in open surgery compared to the laparoscopic approach. However, no significant variation in platelet kinetics in response to tissue injury was observed between the two procedures.

Adrenocorticotropic Hormone↗

PubMed2002

Excluded-loop hepatojejunal anastomosis with use of laparoscopy in late management of iatrogenic ligature of the bile duct.

Although the procedures adopted for bile duct surgery are routine, serious complications occasionally occur. This article reports the authors' experience in managing an iatrogenic ligature of the bile duct. The patient in this case had undergone open cholecystectomy and had significant jaundice in the early postoperative period. During the investigation, a complete ligature of the common hepatic duct was discovered. An anastomosis of the common hepatic duct with an excluded jejunum loop was performed with use of laparoscopy. Periodic follow-up continuing until 30 months after surgery showed the patient was asymptomatic, and ultrasonography, percutaneous transhepatic cholangiography, and cholangioresonance findings were normal. We consider the procedure feasible and technically advantageous when done with the assistance of laparoscopy.

Adult↗

PubMedDate not supplied

[Manometric and radiologic aspects of Chagas' megaesophagus: the importance to its surgical treatment].

This study analyzed the radiologic and manometric findings of 43 patients suffering from chagasic megaesophagus with positive tests for Chagas' disease. There was a significant reduction in the high pressure levels of the body of the esophagus related to the stage of the disease: stage I/II--42.9 mmHg; stage III--23.6 mmHg; stage IV--15.6 mmHg. It was observed that 5 (35.7%) stage III patients had high pressure levels below 20 mmHg and presented advanced megaesophagus and these underwent a subtotal esophagectomy following esophagogastroplasty instead of cardiomyotomy with anti-reflux valve. The manometric study in stage III patients with chagasic megaesophagus was considered helpful to indicate which surgical procedure would be best for these patients.

Chagas Disease↗

PubMedDate not supplied

[Microflora in chagasic megaesophagus].

Chagasic patients with megaesophagus were submitted to an endoscopy of the upper digestive tract and the samples were collected with special instruments under sterilized conditions. One of the four samples collected was from the stase liquid and the other three samples were collected from fragments of the esophageal mucosa at one, three and five centimeters from the esophageal-stomach transition (Z line). The samples were analyzed by the Microbiology and Pathologic labs for the identification of microorganisms. After that, the results were correlated with the degree of mega esophagus according to Ferreira-Santos. We observed that the incidence of pathogenic microorganism is very high in megaesophagus, with no relation with the degree of dilatation making the surgery for the treatment of this affection potentially contaminated. There was no significant difference concerning the positivity of the culture relating to the degree of esophagus dilatation.

Adult↗