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Biomedical subjects

J Barros

Publications and source records attributed to J Barros.

16 recordsLinked to original sources

Giant liponecrotic pseudocyst after breast augmentation by fat injection.

A case in which a growing and painful mass developed in the breast 10 months after fat injection following trochanteric and abdominal liposuction is described. Treatment included lumpectomy and breast reconstruction in a second stage by bilateral subpectoral augmentation mammaplasty with textured gel-filled prostheses. Histologic examination revealed a liponecrotic pseudocyst. The development of pseudocysts and microcalcifications after breast autologous fat injection is a complication that warns against using this technique for breast augmentation.

Adipose Tissue

Patient satisfaction with emergency house calls.

STUDY OBJECTIVES: To identify determinants of patient satisfaction with emergency house calls and to assess the properties of a satisfaction measurement questionnaire. DESIGN: Patient survey, combined with routinely collected information on the circumstances of the house call. SETTING: Emergency house calls provided by an independent emergency care organization (ECO) in Geneva, Switzerland. PARTICIPANTS: Consecutive sample of 389 patients (67% response rate). MAIN OUTCOME MEASURE: Patient satisfaction. PREDICTOR VARIABLES: patient age and sex, type of medical problem, time of visit, waiting time, duration of visit, perceived effectiveness of treatment. RESULTS: The satisfaction questionnaire was easy to administer. Factor analysis identified 3 separate dimensions of satisfaction, which pertained to the visit itself, to access and to general attitude toward the ECO. Validation tests were consistent with expectations. In multivariate analysis, older patient age and greater perceived treatment effectiveness predicted independently all satisfaction scales. Presence of a mixed physical and mental problem reduced satisfaction with the visit itself only, a delay between the phone call and the visit exceeding one hour reduced satisfaction with access and worsened the attitude toward the ECO. CONCLUSION: The instrument used to measure patient satisfaction with emergency house calls performed well. Overall levels of satisfaction were high. Perceived effectiveness of treatment was the strongest correlate of patient satisfaction. Monitoring of patient satisfaction in emergency settings may contribute to improvements of quality of care.

Adolescent

Genetic epidemiology of familial amyloidotic polyneuropathy (FAP)-type I in Póvoa do Varzim and Vila do Conde (north of Portugal).

Familial amyloidotic polyneuropathy (FAP-type I) was first described in Portugal by Andrade in 1952, a time when 54 among 64 patients (belonging to 25 families) originated from Póvoa do Varzim or its surrounding districts. Since then, a total of 1,233 patients, belonging to 489 pedigrees (so far unrelated), have been diagnosed at Centro de Estudos de Paramiloidose, Porto, Portugal. Although age-of-onset showed a wide range (17 to 78 years), 87% of these 1,233 patients developed symptoms before 40 years of age (mean 33.5, SD 9.4 years). Among all patients, 432 belong to 140 families originating from the area of Póvoa do Varzim/Vila do Conde, 330 of whom lived in that area at the time of diagnosis; age-of-onset was, on average, lower than in the overall group of patients (mean 31.1, SD 6.7 years), and no patient had onset after 57 years (versus 3.3% in the global sample). As in previous studies, women were found to have a later onset (33.7) than men (29.0) years. In 1991, the crude prevalence rate was 90.3 x 10(-5) (one in every 1,108 inhabitants), and the frequency of gene carriers was estimated to be 186 x 10(-5) (one in every 538); about 48.4% of these carriers had manifested symptoms by 1991. Female patients had a significantly higher number of children (mean 3.7, SD 2.6) than male patients (mean 2.7, SD 2.1) and the length of their reproductive period (mean 8.4, SD 5.8 yr) was also greater than for men (mean 5.6, SD 4.4 yr). Altogether, the 122 patients who ever reproduced contributed 457 children to the next generation, a mean fertility of 3.7. Further studies using a control groups may answer the question of whether this is the result of a specific high fertility of these patients or just their belonging to a population in natural expansion.

Adult

[Primary sternal hemangiosarcoma].

We describe a 22-year-old man with a bone mass in the middle and lower third of the sternum with no signs of respiratory deterioration. After biopsy by incision established a diagnosis of hemangiosarcoma, appropriate resection and repair of the thoracic wall was scheduled. An adequate amount of tissue for analysis must be obtained to allow choice of a surgical technique that will assure the best prognosis in malignant tumors of the sternum and assignation of the most appropriate mechanical ventilation procedure.

Adult

Heparin cofactor II in diabetic patients.

Levels of heparin cofactor II (HCII) activity and antigen and electrophoretic pattern were studied both in normal subjects and in type I diabetic patients with high and normal levels of glycosylated haemoglobin. There was a significant reduction in HCII activity (83 +/- 7%) in patients with high levels of glycosylated haemoglobin compared with controls (95 +/- 17%; P < 0.001). However, plasma HCII antigen levels were not decreased in these patients.

Adult

The prevalence of diabetic retinopathy in northwest Spain. An epidemiological study of diabetic retinopathy in Galicia. I.

The prevalence of retinopathy was studied in a group of 1179 diabetic patients attending 11 diabetologic centres in Gallica (Northwest of Spain). The age of the patients was 61.7 +/- 13.8 years, 43.8% were males and 56.2% females. The patients had had diabetes from 8.4 +/- 7.5 years, 30.4% were being treated with insulin, and 69.6% with oral antihyperglycaemics. 16.1% were aged under 40 years at onset as against 83.9% aged over 40 years. The prevalence of retinopathy was 44.7, in the whole group. Stepwise multiple regression analysis identified treatment time since onset and age at onset as the factors affecting prevalence, which was 61.8% in the insulin-treated subgroup vs 37% among those treated with oral antihyperglycaemics (p < 0.0001). The prevalence of proliferative diabetic retinopathy was 5.8% in the whole group.

Adolescent

Body dysmorphic disorder and aesthetic surgery: case report.

The appearance of psychiatric disorders among plastic surgery patients is well-known, and its frequency is higher than in other surgical branches. There is evidence that these patients may suffer from body dysmorphic disorder (BDD), a mental disorder characterized by excessive concern about some imaginary or slight physical defect, causing significant clinical discomfort, social deterioration, and losses in other important areas of the individuals' activity. We present a typical case of BDD and discuss diagnostic criteria and the proper attitude the plastic surgeon should adopt toward this kind of patient.

Antidepressive Agents