Biomedical subjects

J J Silva

Publications and source records attributed to J J Silva.

18 recordsLinked to original sources

PubMed2003

[Anomalous insertion of the pectoralis minor muscle: ultrasound findings].

PURPOSE: With anomalous insertion of the pectoralis minor muscle, its distal fibers pass over the coracoid process instead of inserting on it, following sometimes a trajectory very similar to that of the coracohumeral ligament. The aim of this prospective study was to evaluate the frequency of detection of this anomalous insertion by ultrasonography. MATERIALS AND METHODS: Ultrasound demonstrated the abnormal insertion of the pectoralis minor muscle by directly visualizing its fibers slipping over the coracoid process during external and internal rotation of the humerus. Three hundred and three individuals underwent ultrasound of the shoulders (64,7% female, mean age of 45 years), for a total of six hundred and six shoulders; 30% (183/606) were symptomatic. RESULTS: An abnormal insertion was demonstrated in 9,57% of the examined shoulders (58/606), with a statistically significant predominance on the left side (12,2%) compared to the right side (6,9%), and of women (12,2%) compared to men (4,7%). CONCLUSION: Ultrasound demonstrated an abnormal insertion of the pectoralis minor muscle in 9,57% of 606 examined shoulders. There was a female and left side predominance and no significant correlation with symptoms.

Female↗

PubMed2001

Knee imaging after anterior cruciate ligament reconstruction.

An increasing number of reconstructions of the anterior cruciate ligament (ACL) are performed every year, due to both the increasing occurrence of sport related injuries and the development of diagnostic and surgical techniques. The most used surgical procedure for the torn ACL reconstruction is the use of autogenous material, most often the patellar and semitendinosus tendons. Magnetic resonance (MR) imaging and spiral-CT performed after arthrography with multiplanar reconstructions are the imaging methods of choice for post-operative evaluation of ACL ligamentoplasty. This paper provides a brief bibliographic and more extensive pictorial review of the normal evolution and possible complications after ACL repair.

Anterior Cruciate Ligament↗

PubMed2001

Somatic embryogenesis from flower explants of cocoa (Theobroma cacao L.).

Two types of flower explants, staminoides and petals, were used for in vitro induction of somatic embryos in cocoa. After 14 days in culture, we observed globular structures and callus formation on both types of explants. However, the better results were obtained on staminoides: 98.3% formed callus and 86.2% somatic embryos on Murashige and Skoog (1962) medium supplemented with sucrose, coconut water, 2,4-D, kinetin and agar.

Cacao↗

PubMed2000

Results of radiotherapy for epithelial skin cancer of the pinna: the Princess Margaret Hospital experience, 1982-1993.

PURPOSE: To assess the treatment outcome, late toxicity, and prognostic factors for radiotherapy (RT) of carcinoma of the pinna. METHODS AND MATERIALS: The charts of 313 patients treated between 01/82 and 12/93 were retrospectively reviewed. There were 334 lesions treated: 201 basal cell carcinoma (BCC), 122 squamous cell carcinoma (SCC), and 11 basosquamous carcinoma. RT was most commonly given by orthovoltage X-rays (278 lesions) or electrons (39 lesions). The most frequently used dose prescriptions were 35 Gy in 5 fractions (123 treatments with median field size = 4.9 cm(2)), 42. 5-45 Gy in 10 fractions (67 treatments with median field size = 10.5 cm(2)), and 50-65 Gy in 20-30 fractions (42 treatments with median field size = 81 cm(2)).2 cm. RESUL TS: The actuarial 2- and 5-year local control rates were 86.6% and 79.2 %. Multivariate analysis revealed two factors to be statistically signi ficant for increased local failure: tumor size > 2 cm (hazard ratio [HR] = 2.66, 95% confidence interval [CI] = 1.16-6.08), and a low biological effective dose (BED) (for each decrease of 5 BED units, HR = 1.76, 95% CI = 1.07-2.88). The 5-year actuarial rate of significant Grade 4 late toxicity was 7.3%. Factors statistically significant for this endpoint on univariate analysis were tumor size (p = 0.035), T-stage (p = 0.02), field size (p = 0.05), fraction size (p = 0.003), and BED (p = 0.05). CONCLUSIONS: RT is an eff ctive treatment option for epithelial skin cancer of the pinna. Large t umor size and low BED were independently statistically significantly ass ociated with increased local failure. Dose-fractionation schedules usin g fraction sizes < 4 Gy may reduce the risk of necrosis and ulceration, particularly for field sizes > 5 cm2.

Adult↗

PubMed2000

Optimal matchline blocking and matchline dosimetry for lymphoma patients.

Patient setup and geometrical factors can potentially lead to excessive spinal cord doses when treating lymphoma patients with matched mantle and para-aortic (PAN) fields. To ensure cord protection, partial transmission blocks are often used at the matchline. This study evaluates optimal placement of these blocks. Three patients were planned using a variety of mantle/PAN field geometries, including significantly different field lengths and isocenter vertical positions. Field matching in all cases was based on a standard gap calculation. Half-transmission blocks (HTB) were positioned on (a) both posterior fields, (b) both anterior fields, and (c) the posterior PAN field only. Doses were calculated with and without effects of setup uncertainty. HTB on both posterior fields yielded a lower maximum cord dose but slightly poorer target coverage than HTB on both anterior fields. HTB on the posterior PAN field alone resulted in a maximum cord dose similar to HTB on both anterior fields. Setup uncertainty decreased but did not eliminate the differences between block placement methods. HTB of sufficient size on both posterior fields ensures a maximum cord dose less than the prescription without significant compromise of target coverage.

Humans↗

PubMed1999

Seroprevalence of Chlamydia pneumoniae in Chile.

We used microimmunofluorescence to survey the prevalence of antibodies to Chlamydia pneumoniae in 403 serum samples from asymptomatic subjects aged 6 months to 89 y in Santiago, Chile. The results suggest that Chlamydia pneumoniae infection is endemic in Chile, with a seroprevalence of 60% which does not differ by gender.

Adult↗

PubMed1998

Cancer cluster among young Indian adults living near power transmission lines in Bom Jesus do Tocantins, Pará, brazil.

A case study was carried out to explore the occurrence of a cancer cluster in 1992 among young indian adults adults living in an Amazonian village near two 500 kV power transmission lines that began operating a decade ago. Current blood levels of DDT and organophosphorus pesticides and metal levels in hair samples were measured. Extremely low magnetic field exposure was determined during current daily activities carried out by the Indian villagers. Taking into account the cancer incidence rates in different Brazilian cities, the probability of the occurrence of this cluster by chance was considered remote (p< 0.003, Poisson distribution). High blood levels of p,p'-DDT (median levels ranging from 26 to 58 ppb) were observed. As a whole, this community showed a pattern of low exposure to organophosphorus pesticides, and high recent exposure was only observed in a few blood samples. Continuous exposure to extremely low electromagnetic fields originated in the power transmission lines (which reached 95.0 mG under the lines) was observed on several opportunities during daily activities carried out by Indian villagers. Further observational studies should evaluate the interaction between exposure to extremely low electromagnetic fields and prior exposure to tumor initiators in cancer development.

Adolescent↗

PubMed1997

Ursodeoxycholic acid in the treatment of cholestasis of pregnancy: a randomized, double-blind study controlled with placebo.

BACKGROUND/AIMS: Intense pruritus and the risk of stillbirths and premature deliveries justify the search for an effective pharmacologic treatment of intrahepatic cholestasis of pregnancy. This study was designed to test the efficacy of ursodeoxycholic acid in maternal pruritus, the biochemical abnormalities and the outcome of pregnancy, in patients with intrahepatic cholestasis of pregnancy of early onset. METHODS: Pregnant patients hospitalized in a secondary case-referral center with intense pruritus and abnormal serum levels of bile salts and aminotransferases, detected before week 33 of pregnancy, were randomly assigned to receive ursodeoxycholic acid, 1 g per day orally, or an identical placebo, until delivery, in a double-blind study. A 3-week trial period was chosen to compare drug and placebo effects. The follow-up was extended for 3 months after delivery. RESULTS: Twenty-four patients entered the trial; eight had deliveries before 2 weeks of treatment and one dropped out. The study was then completed in 15 patients: eight received ursodeoxycholic acid and seven placebo. No adverse effects were detected in the mothers or in their babies. After 3 weeks of treatment, patients receiving ursodeoxycholic acid (mean daily dose 16 mg/kg body weight) had a significant improvement in pruritus (p<0.02), in serum bilirubin (0.36+/-0.19 mg/dl (mean+/-SD) versus 0.95+/-0.48 in patients receiving placebo, p<0.01), in aspartate aminotransferase (52+/-42 IU/l vs 98+/-44, p<0.05) and in alanine aminotransferase (54+/-50 IU/l vs 229+/-154, p<0.01); serum total bile salts also tended to be lower in patients receiving ursodeoxycholic acid (26.3+/-33.7 micromol/l vs 55.0+/-44.8, p N.S.). Deliveries occurred at or near term in all mothers who received ursodeoxycholic acid (mean week of pregnancy: 38), while they occurred before week 36 of pregnancy in five patients who received placebo, including one stillbirth. All babies born alive had birth weights adequate for gestational age and they were thriving normally 3 months after delivery. CONCLUSIONS: Ursodeoxycholic acid is effective and safe in patients with intrahepatic cholestasis of pregnancy of early onset, attenuating pruritus and correcting some biochemical abnormalities in the mothers. Relevant aspects of fetal outcome were also improved in patients receiving ursodeoxycholic acid compared to placebo.

Adult↗

PubMed1995

Appearance of resistance to beta-lactam antibiotics during therapy for Streptococcus pneumoniae meningitis.

A young boy had meningitis caused by Streptococcus pneumoniae that was relatively resistant to penicillin and susceptible to cefotaxime. After 10 days of therapy with penicillin and cefotaxime, fever recurred and a second lumbar puncture revealed a pneumococcus that was resistant to all beta-lactam antibiotics. We now add vancomycin to empiric third-generation cephalosporin therapy for meningitis in children when gram-positive cocci are seen on the cerebrospinal fluid smear.

Cefuroxime↗

PubMed1991

[Active rheumatoid arthritis: effect of dietary supplementation with omega-3 oils. A controlled double-blind trial].

We evaluated the effect of dietary supplementation with eicosapentaenoic acid in 8 patients with active rheumatoid arthritis. An appropriate placebo was given in a randomized double blind fashion to 8 control subjects. After 12 weeks of therapy a significant improvement in prehensile function was detected in patients receiving active treatment, other clinical parameters remaining unchanged. No significant side effects were detected. A larger trial may help define a possible therapeutic role for omega-3 fatty acids in patients with rheumatoid arthritis.

Adult↗

PubMed1991

[ABO materno-fetal incompatibility in the newborn infant: clinical usefulness of Coombs test and elution for the study of hemolytic disease].

A decision to establish early treatment for hemolytic disease in the newborn is usually based upon results of the Coombs test. In order to evaluate a possible advantage of using the Elution test to help in the diagnosis of the hemolytic state, samples of cord blood from 197 consecutive newborns with ABO incompatibility were studied. Hemolysis occurred in 41. Each test (Coombs and Elution) was positive in 26 patients, for a total of 35 positive results and a combined sensitivity of 85%. False positives occurred in 24 of 156 patients with Coombs test and in 30 for the Elution test. Thus, combined results of both test would have suggested a need for phototherapy in 72 of 197 patients when in fact it was needed for only 41. Conversely, 13 patients with hemolytic disease were missed by both tests. The negative predictive value of both tests combined was 95% which is useful for clinical practice.

Coombs Test↗

PubMed1986

Reactivity of E. coli-derived trans-activating protein of human T lymphotropic virus type III with sera from patients with acquired immune deficiency syndrome.

Randomly sheared DNA fragments from HTLV-III proviral DNA were cloned into an E. coli open reading frame (ORF) expression vector. The inserted ORF DNA was expressed in E. coli transformants as a polypeptide fused to the lambda CI protein at the amino terminus and to beta-galactosidase at the carboxyl terminus. The reactivity of the recombinant peptides with antibodies from sera of AIDS patients was determined by the Western blot technique. The coordinates of the DNA inserts of the immunoreactive clones were then determined by DNA sequencing. A clone, ORF 628, was found to contain a short DNA segment located between the sor and env genes (nucleotide positions 5367 to 5597), a region previously thought to be noncoding. Inspection of the DNA sequences of this clone and of other HTLV-III isolates revealed the presence of a small ORF located between nucleotide position 5411 and 5625, capable of encoding a polypeptide of 72 amino acids. The biosynthesis of the polypeptide of ORF 628 initiates from an ATG codon within the HTLV-III insert. The fusion protein of ORF 628 was partially purified by affinity chromatography on CH Sepharose 4B coupled to a beta-galactosidase ligand, and tested against a panel of sera from AIDS patients by Western blot analysis. Approximately 35% of the sera from patients with AIDS or ARC contained antibodies reactive with the peptide. The DNA region spanned by ORF 628 is now thought to be the major functional element of the trans-activator gene, tat.

Acquired Immunodeficiency Syndrome↗

PubMed1986