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Biomedical subjects

E Fernandes

Publications and source records attributed to E Fernandes.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Circadian rhythm at the onset of symptoms in clinical cases of myocardial infarction. Our first five hundred cases].

Following previous studies, we conducted an inquiry into acute myocardial infarction in our ward (Medicine 2, St. John Hospital, Oporto) regarding the exact time of the onset of symptoms. The results now published are of the first five hundred cases. These results show three peaks of greater frequency in the onset of symptoms--morning, afternoon and evening, as well as a certain degree of nocturnal protection. Our intention is to continue this study.

Adult↗
PubMed1994

Endoscopic examination of the operated stomach: a review and a systematic approach.

The endoscopist examining a patient with a history of gastric surgery is expected to know details of the history, the present physical condition, and relevant laboratory results. Familiarity with the appropriateness or limitations of different types of fiberscopes in relation to the individual case, and knowledge of how to overcome common difficulties, is important. The preparation must address the particular characteristics of the case, and the endoscopist must be aware of contraindications, complications, and recommendations to be observed in special circumstances. Based on situations confronted in daily practice, the authors suggest a systematic approach to the examination of patients with a history of gastric surgery, and point to the importance of observing the following steps: measurement of the length of the greater curvature in the gastric stump, verification of artifacts and anatomic modifications and their repercussions, removal of symptomatic suture line or staples, dilatation of strictures, fragmentation of bezoars, exeresis of polypoid lesions, collection of tissue samples, and regular follow up of the patients.

Follow-Up Studies↗
PubMed1994

Helicobacter pylori: the link with gastric cancer.

Gastric cancer is the world's overall second most common cancer, and carries a bad prognosis. In the Correa model of gastric carcinogenesis, environmental factors (salt, nitrate, a lack of vitamin C and beta-carotene, bile reflux, bacterial overgrowth in atrophic gastritis with nitrosamine formation) are related to the evolution from normal gastric tissue through superficial gastritis, multifocal atrophic gastritis, intestinal metaplasia and dysplasia to carcinoma. The incidence of H. pylori decreases with progressing preneoplastic lesions. In several studies, the prevalence of H. pylori was elevated in patients with gastric cancer, with a trend for a higher prevalence in intestinal type gastric cancer vs diffuse type. Family members of patients with gastric adenocarcinoma have a higher H. pylori prevalence than controls; patients infected with H. pylori have more family members with gastric cancer. Several epidemiological studies showed a higher H. pylori prevalence in regions or populations with high gastric cancer risk vs low-risk populations. Large-scale studies in China and Europe showed a correlation between H. pylori seroprevalence and gastric cancer incidence and mortality. Three prospective nested case-control studies showed that infection with H. pylori increased the risk of further development of gastric adenocarcinoma, showing that H. pylori infection precedes the development of gastric cancer. Several pathways can be identified explaining the association between H. pylori and gastric adenocarcinoma. We showed that gastric cell proliferation is increased in parallel with inflammation. The ascorbic acid concentrating mechanism is abolished in gastritis. Ammonia, generated by H. pylori's urease, gives rise to gastric mucosal atrophy. We showed that salt increases the gastric cell proliferation only in H. pylori-infected individuals. The organism's toxin may play a role in gastric cancer. Besides H. pylori, other environmental factors are important in determining the gastric cancer risk. For instance, we showed that in Belgium, Maghreb immigrants have a high prevalence of H. pylori infection but a low prevalence of intestinal metaplasia and gastric cancer. Gastric lymphoma is rare (about 5% of all gastric tumours), but its incidence is steadily increasing. It was shown that H. pylori also increases the risk for low-grade as well as high-grade gastric lymphoma. Eradication of H. pylori has been shown to cure several cases of unequivocally proven gastric low-grade lymphoma.(ABSTRACT TRUNCATED AT 400 WORDS)

Helicobacter Infections↗
PubMed1994

[Refractory heart failure in a 26-year-old woman with idiopathic hemochromatosis].

Idiopathic hemochromatosis, the most frequent inherited disease in Caucasians, is frequently undiagnosed. In this disorder, characterized by a continued inappropriated absorption of dietary iron, the clinical manifestations result from damage to those organ systems in which iron has been pathologically deposited, namely, the heart and the liver. Typically, hemochromatosis becomes clinically manifest in later life and in men more frequently than in women. This has been attributed to the extra loss of iron in women through menstruation and pregnancies. Removal of the excess iron by phlebotomy will prevent all of the complications of hemochromatosis of when begun early. In this paper, we report a case of a young woman with a eight years evolution of amenorrhea, cardiac failure, diabetes mellitus and increased pigmentation of the skin, associated with biochemical markers of iron overload. It is emphasized that hemochromatosis most be excluded in all patients with a unexplained cardiac failure.

Adult↗
PubMed1992

Partial suppression of tumorigenicity in a human lung cancer cell line transfected with Krev-1.

A human non-small-cell lung carcinoma cell line, Calu-6 (from an anaplastic carcinoma), was transfected with the Ki-ras-related anti-oncogene Krev-1. Several transfectant lines were obtained that showed a reduced tumorigenicity in nude mice with respect to the parental and control transfected cell lines. This decrease was approximately 50% in tumor incidence at 4 wk after subcutaneous inoculation of the transfected cells. In addition, the volume of the Calu-6 revertant-derived tumors was three to 10 times smaller than that of the equivalent tumors produced by inoculation of the control cell line transfected with the neomycin-resistance gene. Krev-1--transfected cells that exhibited reduced tumorigenicity expressed Krev-1 mRNA and had variable numbers of copies of the Krev-1 gene. Moreover, Krev-1--transfected cells exhibited a more differentiated squamous epithelial morphology than the parental and control cell lines did. Moderately elevated levels of protein kinase C activity were detected in some revertant clones. Such activity correlated with the level of expression of Krev-1 mRNA in most cases. In summary, Krev-1 induced important morphological and biological changes in transfected Calu-6 cells that we interpreted as partial reversion of the malignant phenotype.

Animals↗
PubMed1992

[Treatment of arterial hypertension in the elderly].

The AA. try to evaluate the therapy of arterial hypertension in the elderly. With the present day data, they think it is advisable to make it but with some limitation--the J curve on diastolic arterial blood pressure (85 mmHg) and situations that may lead to modifications of therapy, such as troubles of rhythm, gout, diabetes mellitus, hyperlipidemia and perfusion deficiencies of lower limbs. OPAL concept (Old People With Active Life styles) recommends an individualized establishment of therapy instead of standard techniques to try the minimal trouble to a good quality of life for the patient.

Age Factors↗
PubMed1991

Preperitoneal approach for hernia repair: clinical application in pediatric urology.

The preperitoneal approach for inguinal hernia repair rarely is indicated in children. However, we report on its clinical usefulness for children in whom the perivesical space must be exposed, such as during surgical repair of bladder exstrophy, ureterocele and ureteral reimplantation. This approach allows for a true high ligation of the hernia sac, and the repair is safe, fast and effective.

Child↗
PubMed1991

Bracken as a risk factor in digestive tract tumors: state of the art.

The present knowledge of the risks of exposure to bracken fern (Pteridium aquilinum) is presented. The history of research on bracken toxicity is reviewed, covering the animal observations and chemical analysis, and focusing on the carcinogenic effects in various animal species and on the nature and biological properties of the known carcinogens. The implications of human exposure to bracken are inferred, the possible ways of contamination are discussed, and the existing epidemiological studies are commented. Bracken contribution to digestive tract tumors is deduced, and the need of further research on the plant toxicity and detailed epidemiological investigations with the exposed population is stressed.

Animals↗
PubMed1985

Lymphoid hypophysitis in a patient with lymphoid thyroiditis, lymphoid adrenalitis, and idiopathic retroperitoneal fibrosis.

We describe the autopsy findings in a 24-year-old woman with a clinical picture of pituitary and adrenal insufficiency which had its onset shortly after a normal pregnancy and delivery of a normal infant, two years before the mother's death. There were heavy lymphocytic infiltrations of the adenohypophysis, thyroid, and adrenals as well as diffuse retroperitoneal fibrosis with numerous perivascular lymphocytic infiltrates. It is concluded that lymphoid hypophysitis probably represents the hypophyseal counterpart of other endocrine autoimmune disorders and that immune mechanisms may also play a role in the pathogenesis of the so-called idiopathic retroperitoneal fibrosis.

Adrenal Glands↗
PubMed1980

Value of graduated compression stockings in deep venous insufficiency.

The effect on elastic stockings on ambulatory venous pressure was investigated in 22 limbs with deep venous insufficiency. The failure of some elastic stockings to reduce the ambulatory venous pressure in some limbs is due to the lack of graduated compression, which is caused by ankle-calf disproportion--narrow ankles and wide calves. This can be recognised by using the pressure-girth profile and corrected by specially made stockings with increased tension at the ankle. A pressure-girth profile established for each stocking enabled the exact compression exerted by the stocking along the length of each limb to be determined. Elastic stockings exerting a graduated compression between ankle and calf induced a reduction in the ambulatory venous pressure in all but one limb. The greater the degree of graduated compression between ankle and calf exerted by the stocking, the greater the fall in ambulatory venous pressure. This may explain the beneficial effect of compression in limbs with venous ulceration.

Ankle↗
PubMed1975

Trabeculectomy: a re-evaluation after three years and a comparison with Scheie's procedure.

Seventy-one patients with glaucoma needing surgical correction had either a peripheral iridectomy with a thermal sclerostomy or a trabeculectomy utilizing a modification of Watson's technique in which the scleral flap was closed tightly with sutures. Results of surgery were analyzed at intervals up to and including three years following the surgical procedure. The success of the operations was judged both in terms of the effect on intraocular pressure as well as on the visual ability of the eye. Since the surgeon's aim is to lower intraocular pressure to a particular level, not simply to an arbitrary level that facilitates statistical analysis, the control of the disease was graded in terms of how completely the operative procedure fulfilled the goal set by the surgeon at the time the decision to operate was made. While this method of grading success introduces a subjective element, a more valid assessment of the true value of the surgery may be obtained. The results suggest that the Scheie procedure lowers pressure to a lower level and for a longer duration than does the trabeculectomy (mean intraocular pressure three years postoperatively was 12.3 mm Hg in cases of primary glaucoma treated with a Scheie procedure and 16 mm Hg in those with trabeculectomy with a sutured scleral flap). In this study the long-term visual result was apparently no different with the Scheie procedure and trabeculectomy. Trabeculectomy causes fewer flat anterior changes than the Scheie procedure. The degree of pressure lowering in trabeculectomy is directly related to the amount of postoperative filtration. The relative indications for trabeculectomy include: (1) malignant glaucoma in the other eye; (2) chronic angle closure glaucoma where an iridectomy is considered insufficient; (3) "high pressure glaucoma" where pressure below 20 mm Hg is not essential; (4) low inflow glaucoma in which persistent flat anterior chambers may be expected following routine filtration surgery; and (5) cases where endophthalmitis is a real concern, as in the very young, those remote from medical care and those with poor personal hygiene. Trabeculectomy gives such poor results in secondary glaucoma that the procedure is probably relatively contraindicated. Trabeculectomy is a valuable operation, but not the final solution to glaucoma surgery. It should be chosen with full recognition of its specific advantages and disadvantages.

Administration, Topical↗