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J P Fernandes

Publications and source records attributed to J P Fernandes.

12 recordsLinked to original sources

Theoretical evaluation of the susceptometric measurement of iron in human liver by four different susceptometers.

This paper is an evaluation of liver iron quantification using a simulated magnetic susceptibility measurement in the hepatic region. Susceptometers having homogeneous and non-homogeneous magnetizing fields coupled with axial second-order and planar first-order gradiometric magnetic detectors were considered. The intensity of magnetic flux threading the detector coils was evaluated considering samples with volume and susceptibility equivalent to liver iron, tissue and lung air individually. These volumes were represented by cylindrical and spherical geometries. The main sources of error in quantifying iron overload in susceptometric measurement of hepatic tissue were evaluated for four configurations of the susceptometer.

Anemia, Iron-Deficiency↗

Short-term intensive consolidation therapy after all-trans retinoic acid in acute promyelocytic leukemia.

Complete remission induced by all-trans retinoic acid (ATRA) in acute promyelocytic leukemia is short lived, and several consolidation chemotherapy courses usually are given to reduce the relapse rate. To assess the value of short-term intensive consolidation, 38 patients with newly diagnosed acute promyelocytic leukemia entered a prospective study in which induction therapy with ATRA immediately was followed by a single course of mitoxantrone plus high-dose cytarabine (3 g/m2 every 12 hours, days 1-4), with no further treatment. Complete remission was achieved in 31 patients (81.6%) after a median time of 49 days of ATRA (to which chemotherapy was added at entry in 10 patients with leukocytosis). Thirty patients received the planned consolidation course. After a median follow-up of 36 months, four of these patients have relapsed and 24 are still in first complete remission, for an estimated disease-free survival of 75% at 60 months. The authors conclude that this single course consolidation of ATRA-induced remission provides excellent long-term control of acute promyelocytic leukemia.

Adult↗

Granulocyte-macrophage colony-stimulating factor in post-remission therapy of acute myeloid leukemia.

The impact on occult leukemia of GM-CSF as a sensitizing agent has not been studied. We treated 41 adult patients with de novo acute myeloid leukemia, 25 of whom achieved complete remission and were given 1 to 3 post-remission courses, each course including GM-CSF begun 4 days prior to chemotherapy and given until day 3. After a median follow-up of 32 months, the probability of remaining in continuous complete remission was 17% at 46 months. GM-CSF in this setting was not associated with an improved outcome, arguing against a priming effect.

Acute Disease↗

Candidemia in acute leukemia patients.

Fungal infections are an important cause of morbidity and mortality in patients with acute leukemia (AL). Candidemia, once rare, is now a common nosocomial infection because of the intensity of chemotherapy, prolonged neutropenia, administration of broad-spectrum antibiotics and use of central venous catheters (CVC). We retrospectively identified patients treated for AL from 6/86 to 6/95 who also had candidemia. We describe 28 patients (incidence 6.3%) with a median age of 39 years, 24 of whom were on remission induction and 4 on postremission chemotherapy. All patients had CVC and empiric antimicrobial therapy, 4 had been given prophylactic antifungal drugs, and 2 had parenteral nutrition. Neutropenia was profound (median leukocyte nadir 200/microliters, median duration 19 days). Candida was isolated in blood cultures 10 days (median) after the start of neutropenia. The clinical presentation included fever (100%), respiratory symptoms (71.4%), skin lesions (39.2%) and septic shock (17.8%). Amphotericin B was given to 17 patients and liposomal amphotericin to 5 patients. Infection resolved in 18 patients (64.2%). 10 of whom were in complete remission. Mortality from candidemia was 17.8% (5/28). In conclusion, fungal infections are responsible for death in a significant number of patients. In our series treatment success was related to its rapid onset and to the recovery of neutropenia.

Acute Disease↗

Diffuse leiomyomatosis of the esophagus: a case report and review of the literature.

A case of diffuse leiomyomatosis of the esophagus in a 21-year-old woman with a 5-year history of dysphagia is presented. The radiological appearance was that of achalasia, but at esophagoscopy, a diagnosis of an organic stricture of the lower end of the esophagus was made. During the operation a diffuse tumor involving the lower end of the esophagus, cardia, upper portion of the stomach, and the tail of the pancreas was found. The histological diagnosis was diffuse leiomyomatosis of the esophagus. The individual characteristics of the microscopic picture are described. Distal esophagectomy and total gastrectomy resulted in complete recovery of the patient. This is a very rare condition; only a dozen similar cases have been published before. The data of these patients are presented.

Adult↗

Reliability of serological methods for detection of leishmaniasis in Portuguese domestic and wild reservoirs.

A direct agglutination test (DAT) and an immunofluorescence technique (IFAT) were compared for detection of Leishmania infantum infection in 43 dogs and five foxes from Alto-Douro and Arrábida, two known endemic areas in Portugal. In four dogs with proved canine leishmaniasis, both DAT and IFAT showed positive readings (titres > or = 1:320 and > or = 1:128). Of 34 samples collected from apparently healthy dogs, ten were positive by both serological tests and eight were serologically positive by one test or the other. Three foxes out of five captured in this area, scored titres indicative of leishmaniasis in both DAT and IFAT. The concordance between DAT and IFAT in all collected samples (48) was 81.25%. Considering these and previous studies in the adjacent Mediterranean areas, the seroprevalence of L. infantum infection in the canine and vulpine populations appear to be of high magnitude.

Animals↗

[Quality control methods in sero-immunologic tests for infectious diseases].

The different quality control methods which should be used in seroimmunological assays for detection of antibodies in infectious disease are analyzed. The concepts of reliability, sensitivity, specificity, cut off, efficacy and predictive value are described, explained how they can be calculated and exemplified. The statistics which can be used for comparing results in different situations it is also referred.

Humans↗

Endoscopy in the upper G.I. bleedings.

From 388 patients with upper G.I. bleeding investigated by endoscopy, radiology or emergent surgery, one third bled from duodenal ulcer, one third oesophageal varices, and from the remain the most frequent were gastric ulcer (14%) and gastric cancer (9%). From a sample of 53 patients with liver cirrhosis, 66% bled from varices and 34% from other lesions. The proportion of patients who bled from oesophageal varices is higher under 60 yrs. The mortality was higher after 60 yrs, except when there was associated chronic liver disease or renal or cardio-respiratory failure. In this group of patients, near half in our series, the mortality is the same under and above 60 years.

Duodenal Ulcer↗