Biomedical subjects
Publications and source records attributed to H A Oliveira.
We report the case of a 57 years-old woman presenting polymyositis associated to HTLV-I infection without clinical signs of involvement of the central and peripheral nervous system. Pathophysiologic aspects of muscular involvement in HTLV-I infection are discussed.
HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) has been described in practically all regions of Brazil. The authors present eight clinically defined cases of HAM/TSP, as being the first reported in Sergipe (Northeastern Brazil). All of them were confirmed through ELISA in two examinations, although only two were confirmed by Western Blot. According to clinical/laboratorial investigation protocol, all patients presented involvement of the pyramidal tract with minimal sensory loss and sphincter alteration. The authors call the attention for the endemicity of HTLV-I in the region, whose prevalence amongst blood donors is significant (0.43%).
The authors present one case of Wernicke's encephalopathy in a patient with obstructive pyloric syndrome caused by gastric adenocarcinoma, without previous history of alcoholism or malnutrition. They comment on the importance of physiological aspects of thiamine as a co-enzyme of transketolase and pyruvate-decarboxilase in the metabolic pathway for ATP production and the possibility of existing an interaction between genetical and environmental factors in the onset the symptoms. They draw attention for the clinical diagnosis, which should be precocious for the therapy with thiamine to be effective, especially in patients without previous history of alcoholism or malnutrition.
A retrospective study of poliomyelitis in Sergipe, Northeast of Brazil, is presented by the authors. The study was divided in three periods, taking in consideration the notification rate of positive cases and emphasizing the period from 1979 to 1989 through the study of 159 consecutive cases. The following information was gathered for each case: sex, age, origin, former immunization status and clinical development. Also evaluated were annual incidence, relationship of incidence/vaccinal coverage and geographic distribution. Comments were made about the change in the wild poliovirus circulation (P1 to P3) and about epidemiological outbreaks occurred in 1984 and 1986, and problems related to the lack of immunity in children with complete vaccinal scheme. Poliomyelitis was considered to be controlled in the State of Sergipe but the necessity of maintenance of effective epidemiological vigilance for all cases of acute and flabby paralysis in children under 14 years is emphasized.
The authors report three cases of persistence of primitive trigeminal artery with no evidence of a relationship between its presence and any specific clinical syndrome. They discuss embryological aspects and establish the correlation between the presence of this malformation and other intracranial pathologies, such as "tic douloureux" and morphologic alteration of the circle of Willis. A critical review of the literature is also presented.
The author describes one case of congenital inclusion dermoid cyst located over the region of the anterior fontanel in an adult patient aged 24 years. The question of racial prevalence is discussed and considerations on the incidence of these cysts in adult patients are made based on the review of cases previously reported in the literature.
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A case of extracranial espontaneous pneumatocele, diagnosed and operated on with good results is reported. The authors comment about the physiopathology, emphasizing as principal cause the alteration in the development of the petroscamous fissure, that makes the air going from them to the Eustachian tubes reaching the median ear and the mastoid cells which will suffer a constant pressure resulting in this way a progressive increase of the pressure followed by rupture and propagation of the air to the subaponeurotic space. A review of cases previously described has been made.
Given that chagasic patients in the indeterminate form of this disease, can have abnormal motility of the digestive tract and immunologic abnormalities, we decided to assess the frequency of peptic disease and Helicobacter pylori (Hp) infection in these individuals. Twenty-one individuals, 13 males and 8 females, mean age 37.6 +/- 11.1 years, were examined. Biopsies of the duodenum, antrum, lesser and greater gastric curvature and esophagus were performed. The endoscopic findings were of chronic gastritis in 20 (95.2%) patients, duodenal ulcer in 3 (14.3%), gastric and duodenal ulcer in 3 (14.3%), gastric ulcer alone in 1 (4.8%), esophagitis in 5 (23.8%), and duodenitis in 5 (23.8%). The diagnosis of infection by the Hp was done by the urease test and histologic examination. Hp infection was found in 20 (95.2%) individuals: in 20 out of them in the antrum, in 17 in the lesser curvature, and in 17 in the greater curvature. Hp was not found in the esophagus and duodenum. The only individual with no evidence of infection by Hp was also the only one with normal endoscopic and histologic examinations. The histologic examinations confirmed the diagnoses of gastric ulcer as peptic, chronic gastritis in 20 patients, duodenitis in 14, and esophagitis in 9. In this series the patients had a high frequency of peptic disease, which was closely associated with Hp infection.