Biomedical subjects

F Castro-Sousa

Publications and source records attributed to F Castro-Sousa.

6 recordsLinked to original sources

PubMed2005

Is prophylactic colectomy indicated in patients with MYH-associated polyposis?

OBJECTIVES: The MYH gene has recently been associated with multiple colorectal tumours. It participates in the DNA base-excision-repair, avoiding mutations in other genes, namely the APC and Ki-ras. Recently, biallelic MYH mutations have been described in patients with attenuated polyposis and in 7.5% with classic polyposis and no detectable APC mutation. The aim of this study was to analyse the incidence of germ-line MYH mutations in selected Portuguese families recorded in a hereditary tumour registry and to evaluate the risk of colorectal cancer in this syndrome. PATIENTS AND METHODS: Nineteen APC mutation negative patients, 13 presenting attenuated polyposis and 6 with classic familial adenomatous polyposis (> 100 adenomas), were screened for germline biallelic MYH mutations. RESULTS: Biallelic germline mutations in MYH were identified in 9 of the attenuated polyposis and in one of the classic polyposis patients. The mean age at the clinical diagnosis was 50.6 years (from 35 to 69 years); six were men and four women. Five patients belonged to families with affected siblings; three showed evidence for vertical transmission and two had no evidence for familial transmission of the disease. No extra-colonic manifestations were reported. All patients had surgical resections: five total colectomies, four reconstructive proctocolectomies and one left hemicolectomy. Eight patients had associated malignant degeneration: three T3N+, four T3N0 and one T1N+. In the follow-up two patients died due to tumour recurrence. CONCLUSION: A large frequency of biallelic MYH mutations (69%) was found in APC mutation negative patients belonging to families with attenuated polyposis; the highest percentage was observed in families presenting evidence for horizontal transmission of the disease. The high percentage of degeneration found in these patients suggests that colonoscopy with polypectomies is not sufficient and prophylactic colectomy is recommended. The identification of MYH associated polyposis is important to evaluate the level of risk, particularly for the siblings.

Adenomatous Polyposis Coli↗

PubMed2001

Dissociation between vasodilation and Leishmania infection-enhancing effects of sand fly saliva and maxadilan.

In this study, the ability of maxadilan and Lutzomyia longipalpis salivary gland lysate to enhance the infection of CBA mice by Leishmania major and of BALB/c mice by L. braziliensis was tested. No difference was observed between sizes of lesion in CBA mice infected with L. major and treated or not with salivary gland lysate or maxadilan, although they were injected in concentrations that induced cutaneous vasodilation. Although parasites were more frequently observed in foot pads and spleens of animals treated with maxadilan than in the animals treated with salivary gland lysate or saline, the differences were small and not statistically significant. The lesions in BALB/c mice infected with L. braziliensis and treated with maxadilan were slightly larger than in animals that received Leishmania alone. Such differences disappeared 14 weeks after infection, and were statistically significant only in one of two experiments.

Animals↗

PubMed1997

[Changes in lung function after cholecystectomy--open versus laparoscopic cholecystectomy].

Impairment of respiratory function after open cholecystectomy may cause atelectasis and hypoxemia. Clinical experience shows evidence for easier recovery after laparoscopic operation. Postoperative respiratory function using spirometric tests was assessed in 50 patients with simple symptomatic cholecystolithiasis submitted either to open or laparoscopic cholecystectomy and revealed less impairment of respiratory function in the laparoscopic group.

Cholecystectomy↗

PubMed1996

Laparoscopic surgery for duodenal ulcer: first results of a multicentre study applying a personal procedure.

Between January 1991 and February 1995 data were gathered on 136 patients operated on in 14 surgical centres. All patients underwent posterior truncal vagotomy (PTV) and anterior linear gastrectomy (ALG) for chronic duodenal ulcer. Recurrence and repeated bleeding were the main indications for surgery. An antireflux technique was simultaneously carried out in 17 patients, while 13 underwent cholecystectomy. There were no peroperative complications or deaths, and the mean duration of operation was 65 (range 25-180) min. Immediate postoperative morbidity rate was 2.9 per cent, with a mean hospital stay of 3.1 (range 2-13) days. A total of 131 patients were evaluated between 6 and 33 (mean 25) months after operation. Of these, 126 (96.2 per cent) were graded as Visick I or II. Four (3.0 per cent) were Visick III, and one patient (0.8 per cent) was considered Visick IV. Gastric function studies were performed in 45 patients before and after operation, with a maximum acid output reduction of 83 per cent 3 months after the operation. Laparoscopic PTV with ALG constitutes a simple, efficient, rapid and safe method in the treatment of patients with chronic duodenal ulcer.

Adult↗

PubMed1993

Effect of perioperative blood transfusions on survival of patients after radical surgery for colorectal cancer.

The effect of perioperative blood transfusion on the survival of patients with colorectal cancer was evaluated in 128 patients undergoing curative surgery between 1980 and 1988. The following clinical and histopathological variables were also studied: age, sex, duration of symptoms, presence of intestinal obstruction, tumour site, extent of spread through the bowel wall, lymph node involvement, Dukes' stage, grade of differentiation, venous invasion and type of surgical procedure performed. The need for perioperative blood transfusion was unrelated to the stage of disease. In the transfused patients (n = 73) the 5-year recurrence-free survival, calculated by the Kaplan-Meyer technique, was 37% and in the non-transfused (n = 55) was 60% (P = 0.0027, Mantel-Cox). Similar differences were found in the comparison of the groups with (n = 68) and without (n = 60) transfusions on the day of operation. The deleterious effect of transfusion was evident in patients who received only one unit of blood (n = 19)--these had a 5-year survival rate of 45% compared those who had more than one unit of blood (n = 54) (5-year survival rate 35%) (P = 0.0062). With a multivariate analysis, using a Cox proportional hazard model, taking into account all the variables studied, a significant and independent effect on survival was found for lymph node involvement (beta coefficient = 3.97), blood transfusion (beta coefficient = 2.16) and extent of bowel wall spread (beta coefficient = 1.75).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMedDate not supplied

Laparoscopic surgery for duodenal ulcer: first results of a multicenter study applying a personal procedure.

BACKGROUND/AIMS: First results from 14 different centers applying a personal procedure for the treatment of duodenal ulcer by laparoscopic surgery. METHODOLOGY: One hundred and thirty-six patients were operated on in 14 surgical centers between January 1991 and February 1995. All patients underwent posterior truncal vagotomy (PTV) and anterior linear gastrectomy (ALG) for chronic duodenal ulcer. RESULTS: The mean duration of operation was 65 min (range: 25-180) and there were no peroperative complications or deaths. Immediate post-operative morbidity rate was 2-9%, with a mean hospital stay of 3-1 days (range: 2-13). A total of 131 patients were evaluated between 6 and 33 months (mean: 25) after operation. Of these, 126 (96.2%) were graded as Visick I or II. Four (3.0%) were Visick III, and one patient (0.8%) was considered Visick IV. Gastric function studies were performed in 45 patients before and after operation, with a maximum acid output reduction of 83% 3 months after the operation CONCLUSIONS: Laparoscopic PTV with ALG constitutes a simple, efficient, rapid and safe method in the treatment of patients with chronic duodenal ulcer.

Adult↗