Ocular use of gentamicin and cephaloridine. I. Intraocular penetration.
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Aged↗
Biomedical subjects
E Fernandes
Publications and source records attributed to E Fernandes.
[Middle lobectomy for bronchiectasis: clinical case and review of the literature].
Over the past few years bronchiectasis, among the chronic lung diseases, has been the second most important after tuberculosis in terms of frequency and mortality. Although the incidence of the disease has been decreasing in recent years, the illness is currently of great surgical interest because of an upsurge of cases among people considered to be below the bread line. The authors present the clinical case and surgical treatment of a young adult with middle lobe bronchiectasis, with a 10-year primary IgG deficiency and severe bronchopneumonia requiring hospitalisation. Medical treatment, long regarded as the treatment of choice in this condition, has reduced the short-term morbidity of patients suffering from the disease, without affecting its ultimate mortality which is still very high today. The policy in the past to reserve surgery only for the most complicated cases or for patients not responding to medical treatment can now be considered obsolete, due to the reduced surgical risks (less than 1%) and to faster patient recovery. Further surgical indications are mono- or bilaterally located forms of the disease and failure to respond to medical treatment for more than 2 years. A review of the literature enables the authors to affirm that in the absence of randomised trials on the effectiveness of surgical vs medical treatment, it seems clear that surgical therapy is the best option, being curative and safe, with a high percentage of complete remission of disease and very low operative risks and mortality. It can therefore guarantee good quality of life, radically changing the prognosis which otherwise is fatal in 1/3 of patients suffering from this orphan disease.
Adult↗
Trabeculectomy: a reevaluation 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 an 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 patients with primary glaucoma treated with a Scheie procedure and 16.6 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 chambers 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) patients where endophthalmitis is a real concern, as in the 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.
Adolescent↗
[Single asymptomatic splenic metastasis of breast carcinoma: report of a clinical case].
The spleen is rarely involved from metastatic disease. Metastases from breast cancer are extremely rare although described in the Literature. The Authors report a case of a woman who had undergone to radical mastectomy for breast cancer nine years previously and admitted to the hospital because of a single splenic lesion shown by U.S. scan during the follow up.
Aged↗
Enzymatic transformation and binding of labeled 2,4,6-trinitrotoluene to humic substances during an anaerobic/aerobic incubation.
Organic pollutants are degraded in soil and simultaneously nonextractable residues are formed. However, proof is lacking that this fixation has a detoxifying effect. We investigated the transformation and binding of 2,4,6-trinitrotoluene (TNT) with catechol or soil humic acid as cosubstrates. Carbon-14-labeled TNT and its reaction products were quantified by radiocounting; extractable compounds were identified by high performance liquid chromatography (HPLC). Bound and extractable residues of 15N-labeled TNT and metabolites were studied by 15N nuclear magnetic resonance spectroscopy (15N NMR). Since TNT is not easily transformed under oxidizing conditions an anaerobic/aerobic treatment was used. Anaerobic microorganisms from cow manure were used to reduce TNT during the anaerobic phase and subsequently, a laccase from Trametes villosa was used in the aerobic phase to oxidatively couple the metabolites to humic matter. Seventy-four percent of TNT was immobilized with catechol as cosubstrate, but only 25% with humic acid. With catechol the main extractable component was TNT, while with humic acid it was mostly the metabolite 4-aminodinitrotoluene. For both co-substrates, the spectra of immobilized metabolites obtained by solid-state 15N-cross polarization magic angle spinning (CPMAS) NMR spectroscopy showed signals in the chemical shift region for protonated aromatic amino compounds. However, in the presence of catechol, an additional signal from nonextractable nitro groups was found, which could represent sequestered TNT. The partially reduced metabolites of TNT that formed nonextractable residues in humic acid are not likely to be remobilized easily and are thus regarded as detoxified.
Bacteria, Aerobic↗
[A sporadic case of legionnaire's disease in Oporto].
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Humans↗