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Biomedical subjects

F M Carvalho

Publications and source records attributed to F M Carvalho.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Clinical diagnosis versus autopsy].

Records from 910 autopsies performed at a university hospital in Salvador, Bahia, Brazil were examined in order to assess the accuracy of clinical diagnoses of the patients' underlying causes of death. This study found inaccurate clinical diagnoses in 31% of the cases. The overall rate of diagnostic error appeared to remain fairly stable from 1970 to 1982, being highest for older patients. Thirty-six percent of the 263 cancer deaths were incorrectly diagnosed, and a number of pathologies considered relatively easy to diagnose were not always correctly identified--the underlying cause of death being incorrectly diagnosed in many of the fatalities caused by such ailments as arterial hypertension, chronic obstructive lung disease, pneumonia/bronchopneumonia, and schistosomiasis. Quite aside from their direct medical implications, diagnostic errors of the magnitude observed in this and other studies seriously jeopardize the quality of vital statistics and such statistics' usefulness for improving public health.

Adolescent↗
PubMed1991

Clinical diagnosis versus autopsy.

Records from 910 autopsies performed at a university hospital in Salvador, Bahia, Brazil, were examined in order to assess the accuracy of clinical diagnoses of the patients' underlying causes of death. This study found inaccurate clinical diagnoses in 31% of the cases. The overall rate of diagnostic error appeared to remain fairly stable from 1970 to 1982, being highest for older patients. Thirty-six percent of the 263 cancer deaths were incorrectly diagnosed, and a number of pathologies considered relatively easy to diagnose were not always correctly identified. Quite aside from their direct medical implications, diagnostic errors of the magnitude observed in this and other studies seriously jeopardize the quality of vital statistics and such statistics' usefulness for improving public health.

Adolescent↗
PubMed1990

[Family income and child malnutrition in the coast of Camaçari, Brazil].

A study on malnutrition prevalence was carried out in a sample of 388 children, aged 0 to 5 years, living in the coast of Camaçari County, State of Bahia, Brazil. Prevalence of malnutrition indicated by low weight-for-age, degrees I, II and III--according to Gómez' criteria--was 62.1%. According to the criteria proposed by Waterlow, prevalence of malnutrition was 64.9%, 26.5% of stunted children, 20.7% of wasted, and 17.7% of stunted plus wasted children. The relationship between income and malnutrition became statistically significant when the per capita family income index was used, instead of the total family income index. Concerning the nature of malnutrition, it was observed that only stunting--in an inversely proportional fashion--was significantly associated with income. Prevalence rates of wasting or wasting plus stunting were not significantly associated with the per capita or with the total family income.

Body Constitution↗
PubMed1989

Repeated surveillance of lead poisoning among children.

In 1980, a survey of lead poisoning was carried out among 592 children aged 1 to 9 years living within 900 m of a lead smelter in Santo Amaro, Brazil. From 1980 to 1985, the lead smelter carried out a number of major improvements aimed at reducing environmental pollution. In January, 1985, a second survey was carried out among a sample of 250 children living in this same geographical area. The geometric mean of zinc protoporphyrin (ZPP) concentration in whole blood was 1.17 (standard deviation = 1.5) mumol l-1. Blood lead concentrations (PbB) determined in a subsample of 53 children had an arithmetic mean and standard deviation of 1.77 +/- 1.00 mumol l-1, with 22 children showing PbB greater than or equal to 1.68 mumol l-1. Twenty-nine (11.6%) of the 250 children lived in houses where the lead content of the soil was greater than 10,000 ppm, and they presented higher ZPP levels than the rest of the population. Children with the habit of pica for soil had elevated ZPP levels. Comparing the results from the 1980 and 1985 surveys, slight improvements in ZPP and PbB levels were observed. However, new cases of lead poisoning are still occurring in the area. The soil is highly contaminated by lead and represents a long-lasting risk factor for child intoxication.

Anemia↗
PubMed1989

Cadmium in hair of children living near a lead smelter in Brazil.

In a cross-sectional study, concentrations of cadmium in hair (CdH) were determined for 263 children aged 1-9 years, living less than 900 m from a lead smelter in Santo Amaro, Brazil. The mean CdH level was significantly higher when individuals with the following characteristics were considered: female, racial group "dark" or "medium", and children of lead workers. The mean CdH value did not vary significantly according to nutritional status or iron status or hair type. Hair Cd levels increased significantly in relation to an increase in cadmium concentration in soil. An increase of 0.024 ppm in mean CdH level was estimated for each 1 ppm increase in the cadmium concentration in soil. However, children with the habit of pica had only a slight increase in CdH levels, when compared with those without the habit. The marked variations observed in CdH levels suggest the possibility of using them as an epidemiological index in situations of intense environmental pollution.

Brazil↗
PubMed1987

Renal dysfunction in Brazilian lead workers.

In this study, renal function of 52 workers of a primary lead smelter located in Northeast Brazil was compared to a reference group of 44 otherwise similar workers of a paper mill. Renal dysfunction, defined by a serum creatinine level greater than or equal to 1.5 mg/dl, was found in 17 (32.7%) workers at the lead smelter, the exposed group, but in only 1 (2.3%) individual from the reference group. Workers from the exposed group also showed significantly higher mean serum uric acid levels. Renal dysfunction of workers from the exposed group was statistically associated with duration of the employment at the smelter and with age, but not with the levels of lead and zinc protoporphyrin in blood and delta-aminolevulinic acid in urine. The two groups presented similar rates of arterial hypertension. However, arterial hypertension was much more strongly associated with renal dysfunction in the lead workers.

Adult↗
PubMed1986

Cadmium concentrations in blood of children living near a lead smelter in Bahia, Brazil.

A prevalence study of cadmium absorption was carried out among 396 children aged 1 to 9 years living at less than 900 m from a primary lead smelter in Santo Amaro City, northeast Brazil. Geometric mean and geometric standard deviation of cadmium concentrations in blood (CdB) were 0.087 and 2.5 mumole/liter, respectively, ranging from 0.004 to 0.511 units. Ninety-six per cent of these children presented CdB higher than 0.0089 mumole/liter (or 1.0 microgram/liter) which is usually taken as a reference level. Higher CdB levels were significantly associated with shorter distance from child's home to smelter chimney, residence time in the area greater than 7 months, racial groups Light and Medium, and heavy infection by hookworm. The variation in CdB levels was not associated with child's age, nutritional status, iron status, family per capita income, blood lead level, being a child of a lead worker, the habit of pica, and contamination of child's peridomiciliar environment by smelter dross.

Absorption↗
PubMed1984

Multiple causes of anaemia amongst children living near a lead smelter in Brazil.

A prevalence study of anaemia was carried out amongst children, aged one to nine years, living near a lead smelter in Santo Amaro City, Northeast Brazil. It was found that the variation in haemoglobin levels was significantly associated with malnutrition and with the interaction between malnutrition and iron deficiency, but not with lead poisoning, iron deficiency, or hookworm infection, having allowed for the effects of age, area of residence, family per capita income and race. The effect of the interaction between malnutrition and iron deficiency on haemoglobin levels was most prominent amongst children aged one year and amongst those living in the most deprived area. The lack of demonstrable interaction between lead poisoning and iron deficiency in the causation of anaemia amongst these children is discussed.

Anemia↗
PubMed1983

Lead poisoning and hookworm infection as multiple factors in anaemia.

A retrospective study was carried out in a rural area of north-eastern Brazil, to search for interactions between biological and chemical agents present in the environment as causes of anaemia. A lead smelter situated in a hookworm endemic area provided the opportunity to look at the effect of this double exposure in relation to laboratory defined anaemia, by comparing the odds ratios in different subgroups of 109 "cases" and 107 "controls". The subgroup with both hookworm infection and chronic lead poisoning--measured by the concentration of delta-ALA excreted in urine--had an odds ratio of developing anaemia five times greater than individuals with neither. Although a synergistic effect could not be demonstrated, the additive effect of the two conditions placed this group in a higher risk category.

Anemia↗
PubMedDate not supplied

Squamous cell vulvar carcinoma associated with Fanconi's anemia: a case report.

Fanconi's anemia (FA) is a rare autosomal recessive syndrome associated with a strong predisposition to cancer, particularly squamous cell carcinoma (SCC) of various organs. A few cases of lower genital tract neoplasia have been described. We present a 14-year-old black girl with an advanced squamous cell vulvar carcinoma treated with cisplatin chemotherapy plus radiation therapy. The patient died because of fungal sepsis. Polymerase chain reaction (PCR) was positive to human papillomavirus (HPV)-16. Vulvar carcinoma is a very rare condition in teenagers, but the association of Fanconi's anemia and SCC of many sites is common. Vulvar carcinoma when associated with Fanconi's anemia is a great treatment challenge.

Adolescent↗
PubMedDate not supplied

Endometrial damage in acute salpingitis.

Histologic and bacteriologic analyses of endometrium were performed before and on day 15 after minocycline treatment of 20 patients with acute salpingitis. Endometritis was diagnosed in 15 patients before and in nine after treatment. Neisseria gonorrhoeae was recovered from the cervix and endometrium of seven patients but was not isolated after treatment. Chlamydia trachomatis was recovered from the cervix of eight, and from the endometrium of three patients, two of whom had negative cervical cultures. After treatment C. trachomatis was recovered from the cervix of three patients, although two of them had taken aluminum hydroxide for gastric symptomatology during minocycline treatment. Culture of an endometrial specimen revealed no growth of C. trachomatis. The histologic study revealed plasma cell infiltrates in specimens from patients who had cultures positive for C. trachomatis. The results showed that although endometritis is an important manifestation of acute salpingitis, there is no correlation between severity of endometritis and degree of tubal damage.

Acute Disease↗
PubMedDate not supplied

Müllerian adenosarcoma of the uterus with sarcomatous overgrowth following tamoxifen treatment for breast cancer.

Müllerian adenosarcoma with sarcomatous overgrowth presented by a 52-year-old female patient after adjuvant tamoxifen treatment for breast carcinoma is described. The diagnosis was made on histological basis after curettage and complementary total hysterectomy with bilateral salpingo-oophorectomy. The immunohistochemical study showed high expression of estrogen receptors in the epithelial component of the lesion and irregularly positive findings in the stroma. The proliferative activity evaluated by Ki-67 immunoexpression was higher in the stroma than the epithelium. Some of the stromal cells showed rhabdomyoblastic differentiation. The association of tamoxifen use and development of mesenchymal neoplasms is discussed.

Adenosarcoma↗
PubMedDate not supplied

Conization, frozen section examination, and planned hysterectomy in the treatment of high-grade cervical intraepithelial neoplasia.

PURPOSE: We tested the role of frozen section examination of the cone specimen in the evaluation of the resection margin status and to rule out invasion in patients with high-grade cervical intraepithelial neoplasia. METHODS: Twenty-five patients with cervical intraepithelial neoplasia underwent conization followed by frozen section examination and planned hysterectomy. The results of the definitive paraffin exam were compared with frozen section examination. RESULTS: In the evaluation of the margins by frozen section examination, 16 patients (64%) had positive cone margins and 9 (36%) had negative margins. The definitive paraffin examination of margin status was concordant in all the cases. Intraoperative diagnosis of invasion was made in 5 cases, and 1 of these was microinvasive. Among the remaining 20 cases, we detected 2 additional microinvasive carcinomas after paraffin study, so the diagnosis of the frozen section examination was concordant with the paraffin sections in 23/25 cases (92%). Two cases of microinvasive carcinoma were diagnosed as cervical intraepithelial neoplasia by frozen section examination and had less than 2 mm stromal invasion. CONCLUSIONS: In high-grade cervical intraepithelial neoplasia, frozen section examination can provide immediate and precise evaluation of the cone margin status in high-grade cervical intraepithelial neoplasia. It can identify frank invasion and permit adequate treatment in a one-stage procedure. In early microinvasive disease, frozen section examination fails to detect the area of invasion but reliably detects clear resection margins.

Adult↗
PubMedDate not supplied

[Intervertebral disk disease among oil drilling workers].

A cross-sectional study among 1,026 oil drilling workers in Northeast Brazil found a prevalence rate of 5% for intervertebral disk disease, varying from 1.8% (activities without heavy lifting) and 4.5% (occasional lifting) to 7.2% (routine lifting). Disease prevalence was 10.5% among drilling workers with more than 15 years in the industry and 11.3% among those over 40 years of age. Prevalence ratio (PR) for the association between working in oil drilling operations and intervertebral disk disease was 2.3 (95% CI: 1.3-4.0). Retrospective information about exposure was collected to minimize the healthy worker survival effect. Using information on current occupation instead of occupational life history would cause an underestimated PR of 1.1 (95% CI: 0.6-1.9). Logistic regression showed results similar to the tabular analysis. Neither confounding nor interaction was evident. Growth of the Brazilian oil industry and recent changes in the work force contract and management, involving changes in risk management and health control, indicate a need for prompt ergonomic intervention in order to control intervertebral disk disease among oil drilling workers.

Adult↗
PubMedDate not supplied

[Lead poisoning: Zinc protoporphyrin in blood of children from Santo Amaro da Purificação, Bahia, Brazil].

A cross-sectional epidemiological study has investigated lead poisoning among all the 101 children aged 1 to 5 years, living at less then 500 m from a lead smelter which has been operating since 1960 in Santo Amaro da Purificação, State of Bahia, Brazil. Lead poisoning was evaluated by determining the concentrations of zinc protoporphyrin (ZPP) in whole blood. Results were compared with those obtained from 98 children of the same age range, in a nursery from Salvador, capital of the State of Bahia. In Santo Amaro, ZPP geometric mean was 65.5 mg/dl (geometric S.D. = 1.7), much higher, therefore, than the normal threshold of 30 microg/dl recommended by the CDC-USA. A child was excluded from statistical analyses because of very high ZPP level: 789 mg/dl. In Salvador, ZPP geometric mean was 31.0 mg/dl (geometric SD = 1.6). "Extremely elevated" ZPP levels (above 156 mg/dl) were observed in 8% of the children from Santo Amaro and in none (0%) of the children from Salvador, this statistical difference being highly significant. Anaemia was present among 35.0% of the children from Santo Amaro and among 25.5% of those from Salvador. One year-old children showed the highest levels of ZPP and anaemia. No marked statistical association was found between ZPP levels and anaemia. Lead contamination of this children population remained in a permanently high level during, at least, the period from 1980 to 1992. In December, 1993 the lead smelter has definitively ceased its industrial activities in Santo Amaro da Purificação.

English Abstract↗