Biomedical subjects
Publications and source records attributed to C Araújo.
The uterine inversion is a rare but serious pathology of the delivery. We describe two cases of uterine inversion of secondary and quaternary degree; the first had a delay diagnosis and the second having a return after the manual replacement, finishing both on surgical resolution. The authors describe the causal factors, the diagnosis and the therapeutic of uterine inversion.
The essential oils from aerial parts of Melissa officinalis, Lavandula angustifolia, Salvia officinalis, and Mentha piperita were analyzed by gas chromatography and gas chromatography-mass spectrometry. Their antimicrobial activities were evaluated against five food spoilage yeasts, Torulaspora delbrueckii, Zygosaccharomyces bailii, Pichia membranifaciens, Dekkera anomala, and Yarrowia lipolytica. Saccharomyces cerevisiae was also used as a reference. The oils were preliminarily screened by a disc diffusion technique, with the most active being the oil from M. officinalis. MICs were determined by the broth dilution method, and the main components of the oils were also tested by this method. The essential oil of M. officinalis at 500 microg/ml completely inhibited the growth of all yeast species. The main component of the oil of M. officinalis is citral (neral plus geranial) (58.3%), which showed a marked fungitoxic effect, contributing to its high activity.
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This is a case report of a 29-year-old white female patient with Kikuchi's disease, presenting fever, polyarthritis, lymph gland enlargement, anemia, leucopenia with a relative lymphocytosis, altered liver function tests and circulating immune complexes. A literature review is made with emphasis on the etiology, clinical course and pathogenesis of this illness.
The purpose of the present study was to investigate the role of platelet-activating factor (PAF, 1-O-hexadecyl-2-acetyl-sn-glyceryl-3-phosphorylcholine), a phospholipid mediator synthesized by endothelial and smooth muscle cells, in the modulation of vascular tone and blood pressure. In pentobarbitone-anaesthetised rabbits, unloading of the carotid sinus baroreceptors by a bilateral carotid artery occlusion elicited a reflex rise in arterial pressure which was markedly potentiated by pretreating the animals with the PAF receptor antagonists WEB 2086 [3-4-(2-chlorphenyl)-9-methyl-6H-thieno-3,2f-1,2,4-triazolo-4, 3 a-1,4-diazepin-2-yl-(4-morpholinyl)-I-propanone; 2, 5 or 10 mg kg-1, i.v.] or BN 52021 (ginkgolide B; 0.1, 0.3 or 1.0 mg kg-1, i.v.). The increases in systemic vascular resistance induced by noradrenaline (30 micrograms kg-1, i.v.) or by the central activation of the sympathetic nervous system with glutamate (1 mg kg-1, intracerebroventricular) were also significantly potentiated in animals pretreated with WEB 2086 (5 mg kg-1, i.v.). In contrast, pretreatment with the cyclooxygenase inhibitor indomethacin (3 mg kg-1, i.v.) did not affect the haemodynamic actions of noradrenaline, thus excluding the possibility that prostacyclin may modulate the potentiating effect. To further confirm that PAF is released during systemic vasoconstriction, the cardiovascular PAF receptors were desensitized by the daily administration of PAF (3 micrograms kg-1, i.v.) for seven days. This procedure significantly reduced the intensity and duration of the hypotensive response to a subsequent PAF injection (3 micrograms kg-1, i.v.). In desensitized animals, the hypertensive response to bilateral carotid artery occlusion was potentiated to the same extent as in the animals treated with PAF receptor antagonists. Inhibition of PAF biosynthesis by pretreatment of the animals with the phospholipase A2 inhibitor mepacrine (5 mg kg-1, i.v.) also enhanced the increase in blood pressure elicited by carotid artery occlusion. We conclude that PAF is involved in the acute but not basal modulation of vasomotor tone and, hence, arterial pressure, probably by a negative feedback mechanism triggered by important increases in the vascular tone.
We present a clinical case of a 33 years old young male, gypsy, intravenous drug abuser with heroine and cocaine and AIDS diagnosis. The clinical anamnesis was mainly fever and systolic heart murmur in a clinical scenario of AIDS. The two-dimensional echocardiographic study was clearly diagnostic of an hypertrophic obstructive cardiomyopathy of the left ventricle. This study showed also the presence of multiple vegetations of the mitral, aortic and pulmonic valves in a clinical setting of an acute Streptococcus Viridans infective endocarditis. In this case report we discuss the incidence of this type of multiple cardiac lesions and particularly the presence of this specific pathogenic agent in this high risk group of patients with intravenous drug abuse and systemic immunosuppression. We pointed out the rarity of these findings of left side valvular vegetations associated with this type of cardiomyopathy and the different factors related to infective endocarditis.
In the geographic distribution of HIV-2, it is known that this infection is most prevalent in West Africa. Since 1986 we have studied seropositive and seronegative clusters, in Guinea-Bissau with follow-ups in 1988, 1989, 1990 and 1991. Analysis of the results show the high incidence of this infection. 8.51% of the 4,372 people of the general population studied were seropositive, showing the high predominance of HIV-2 infection. Only 4 cases were exclusively reactive to HIV-1 and a slow evolution of HIV-1 infections. In the seroconversions of HIV-2 infections the antibodies appeared first to the core components and secondly to the surface glycoproteins. Some of the laboratory parameters affected in the evolution of the infection include a gradual increase in immunoglobulins and a decrease in CD4 lymphocytes and in the CD4/CD8 ratio. A comparison of these variations in HIV-2 infected people, with or without cross-reactivity to HIV-1, reveals that they are much more evident in exclusively HIV-2 positive people. This fact can indicate that the variants responsible for the cross-reactions are less pathogenic and phylogenetically less developed.
The first clinical case described in Portugal of a human infection by Rhodococcus equi in a 35 year-old HIV1 seropositive i.v. drug user is presented. The patient was admitted to hospital due to clinical and radiological suspicion of tuberculosis. While in hospital, a Rhodococcus equi cavitated lung infection was diagnosed. By applying a triple antibiotic therapy with erythromycin, rifampin and teicoplanin along with surgical excision of the lower lobe of the right lung, we were able to clinically resolve the pulmonary infection. A brief review of Rhodococcus equi infections, especially those associated to HIV1 infected individuals is also presented with particular emphasis on the therapeutic approach.
Cutaneous cytomegalovirus (CMV) infection has been observed in a variety of nonspecific skin lesions. Because of this fact, its diagnosis is rare and frequently accidental. The presence of the virus has also been observed in apparently normal skin, from both a clinical and histological point of view. In this context, skin biopsy and immunohistochemistry are often the first means of diagnosis of systemic CMV infection. In 180 skin biopsies carried out on HIV patients in the Infectious and Parasitic Diseases Unit, typical histopathological findings of CMV infection in a nonspecific skin lesion were observed in only one patient. Although the patient showed no extracutaneous manifestations at this time, she died soon after this diagnosis. Because of this fact, we review the literature and discuss the difficulties and implications of the diagnosis of cutaneous CMV infection in AIDS patients.
The authors describe a case of disseminated Herpes-Zoster (VZV) in an HIV 1 positive patient with AIDS. Hyperkeratotic characteristics, acyclovir resistance and sensitivity to foscarnet of cutaneous lesions are the most important features of this example. From the casuistics of the department, the authors describe two similar cases and review the medical literature with emphasis on etiopathogenic, diagnostic and therapeutic factors of lesions caused by DNA Virus in immunocompromised hosts.
The management of 50 AIDS patients by traditional hospital admission (25 cases) and outpatient clinics (25 cases) was studied between August and November 1995 in the Department of Infectious and Parasitic Diseases of the Federal University Hospital. The most costly items of expenditure were hospital services and consumable materials. Comparison of costs was complicated by differences in clinical status of the patients in the two groups. The choice of treatment was much more dependent on clinical status than on sociodemographic factors. Traditional hospital admission tended to be associated with the poorest patients. The rationalization of care based on cost-benefit analysis requires much future work.