[Acute myocardial infarct in diabetic patients: a comparative study].
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Aged↗
Biomedical subjects
J Ribeiro
Publications and source records attributed to J Ribeiro.
A report of forty-four instances of pancreaticoduodenal resection in patients more than seventy years of age.
Between January 1970 and December 1990, 223 patients underwent pancreaticoduodenal resection for pancreatic or periampullary tumors. Forty-four of these patients were 70 years of age or older and 179 patients were less than 70 years of age. In the older group, 27 patients were operated upon after 1986. The overall operative mortality rate was 9.0 percent and 2.5 percent during the last five years. The overall operative mortality rate was 4.5 percent in patients more than 70 years of age and 10 percent in those less than 70 years of age. The overall operative morbidity rate was 35 percent; 36 percent in patients more than 70 years of age and 35 percent in those less than 70 years of age. Survival was related to tumor histologic factors. For carcinoma of the pancreas, the survival rate at five years was 17 percent in patients more than 70 years of age and 19 percent in patients less than 70 years of age. For the ampullary carcinoma, the survival rate at five years was 38 percent in patients more than 70 years of age and 45 percent in patients less than 70 years of age. It can be concluded that, in a selected group, age is not a limiting factor for pancreaticoduodenal resection.
Adult↗
Dormant liver metastases: an experimental study.
Experimental work was undertaken to evaluate whether intrahepatic recurrences, observed after resection of colorectal liver metastases in humans, could be due to the activation of dormant cancer cells already present within the liver at liver resection. About 250 cell aggregates (DHDK12 colon carcinoma cell line) were injected into the portal vein of 70 BD IX rats. Eight weeks later, 43 rats with no apparent liver metastases were divided randomly into three groups: group 1 (n = 15) served as control; group 2 (n = 15) were given cyclosporin A (10 mg kg body-weight-1 day-1) for 28 days; and group 3 (n = 13) underwent a 70 per cent hepatectomy. Twelve weeks after the injection of cells, when the animals were killed, 20 per cent of rats in group 1 had liver metastases, 80 per cent in group 2 (P less than 0.01) and 62 per cent in group 3 (P less than 0.05). Undetectable liver micrometastases may have been present at 8 weeks and had not developed until stimulation by cyclosporin A-induced immunosuppression or by liver regeneration after hepatectomy. A similar mechanism may occur clinically and explain some of the recurrences observed after resection of liver metastases.
Animals↗
Intrasplenic hepatocellular transplantation corrects hepatic encephalopathy in portacaval-shunted rats.
The aim of this work was to evaluate the effect of intrasplenic hepatocellular transplantation on hepatic encephalopathy in an experimental model of chronic liver failure induced by end-to-side portacaval shunt in the rat. Inbred male Wistar Furth rats were divided into three groups: rats subjected to portacaval shunt (n = 10), rats subjected to portacaval shunt and intrasplenic hepatocellular transplantation of 10(7) hepatocytes isolated from livers of syngeneic rats (n = 10) and sham-operated rats (n = 10). Behavior tests were performed in a blind fashion at 3 wk, at 2 mo and at 3 mo after surgery. Spontaneous activity and nose-poke exploration by individual rats were studied in automated open field boxes equipped with infrared cells. Each cell beam interruption was automatically recorded on a microcomputer and transformed into a score index (counts/hour). Plasma levels of amino acids, ammonia and total biliary acids were measured. Portacaval shunt rats showed reduced spontaneous activity and nose-poke exploration scores. Intrasplenic hepatocellular transplantation significantly increased spontaneous activity after 2 mo and improved nose-poke exploration after 3 wk. At 3 mo, spontaneous activity and nose-poke exploration in portacaval shunt/intrasplenic hepatocellular transplantation rats were not significantly different from those of sham rats. Increases in plasma ammonia levels after portacaval shunt were not corrected. Amino acid imbalance and bile acid concentration in plasma were partially corrected by intrasplenic hepatocellular transplantation. These data show that intrasplenic hepatocellular transplantation can correct the neurological symptoms of hepatic encephalopathy in an experimental model of chronic liver failure and suggest that intrasplenic hepatocellular transplantation might be of therapeutic interest in chronic liver failure.
Animals↗
Coma of vascular aetiology: evaluation and prognosis.
The authors have done a revision of 450 patients admitted during the last 3 years to the emergency service of the Hospital de S. José with the diagnosis of CVA. In this retrospective study were included the patients of greater than or equal to 3 degree of the RLS/85 coma scale, the diagnostic being confirmed by CAT, angiography and/or autopsy, and simultaneously evaluated by the Glasgow coma scale. The studied population was grouped into: SAH; ICH with or without ventricular drowning, cerebellar haematoma, brainstem haematoma, ischaemic CVA. The factors of vascular risk: diabetes and hypertension, the age of the patients and coma level were correlated with the degree of cerebral disability of discharge in all patients. The following factors are clearly related with bad prognosis: coma of degree greater than or equal to 4 in the RLS/85 scale; ischaemic aetiology; intraventricular haemorrhage.
Adult↗
[Tetanus. A review of 54 cases].
Tetanus continues to be a frequent illness with a high rate of mortality which mainly affects the elderly. In view of this, 54 cases treated in the ICU between 1983 and 1991 were studied. The clinical support with mechanical ventilation and the use of new drugs, which allowed for a more satisfactory sedation and muscular relaxation, and which permitted the control of the autonomic overactivity, were the most determinant factors in the reduction of mortality verified in the late years of our practice.
Adolescent↗
In vitro antibacterial effect of chlorhexidine added to glass-ionomer cements.
The aims of the present study were to investigate the antibacterial properties of glass-ionomer cements containing different concentrations of chlorhexidine and the possible release of chlorhexidine from the compound. Chlorhexidine gluconate or diacetate was mixed with glass-ionomer cements and tested in vitro against strains of Lactobacillus casei and mutans streptococci. A spectrophotometric test was used to monitor the release of chlorhexidine from the mixture. In a broth culture test, the higher the concentrations of chlorhexidine in the mixture, the longer the time of antibacterial effect on Streptococcus mutans and the greater the tendency of the material to deteriorate. Agar diffusion tests revealed bacterial inhibition in a dose-response manner. The tested bacterial strains were similarly inhibited and the antibacterial properties decreased with time. A minor portion of added chlorhexidine was released from the cement. The deterioration of the cements indicates that the material could be useful as a varnish-like chlorhexidine carrier.
Acrylic Resins↗
[Hepatocyte transplantation. Treatment of hepatic encephalopathy. An experimental study in the rat].
The aim of this work was to assess the effect of intrasplenic liver cell transplantation (ILCT) on hepatic insufficiency induced by a terminolateral portocaval shunt (PCS) in rats. Thirty syngenic Wistar Furth rats were divided up into three groups: (a) rats with PCS (n = 10); (b) rats with PCS then ILCT of 10(7) liver cells isolated from the livers of syngenic rats (n = 10); (c) operated control rats (n = 10). Double-blind behavior tests were carried out two weeks, two months and six months after surgery. The spontaneous motor activity and the exploring activity of each rat were studied in automated cages fitted with infrared diodes. Each interruption of the infrared beam was automatically recorded by a computer and converted into an activity score (number/hour). The spontaneous motor activity and the exploring activity were poor in the rats with PCS. The ILCT significantly increased the spontaneous motor activity and the exploring activity 2 months and 3 weeks after transplantation, respectively. Three months after transplantation, the spontaneous motor activity and the exploring activity in the PCS/ILCT group were not significantly different from those of the control rats. This study shows that ILCT can correct the neurological signs of hepatic encephalopathy in an experimental model of chronic hepatic insufficiency, and suggests that ILCT may produce therapeutic benefits in chronic hepatic insufficiency.
Animals↗
Growth and body proportions in congenital adrenal hyperplasia.
Total height, sitting height, and subischial leg length were measured in 27 patients (19 girls and eight boys aged 4.3-21.1 years) with congenital adrenal hyperplasia to determine the influence of chronic hyperandrogenaemia on body proportions. Proportions were normal in 24 patients with classical congenital adrenal hyperplasia who had received steroid treatment since birth, but one of three patients with non-classical (late onset) congenital adrenal hyperplasia had a disproportionately large trunk. Eleven patients with classical congenital adrenal hyperplasia had completed growth, of whom seven had height standard deviation (SD) scores for chronological age less than zero, and one had extremely short stature (SD score -3.25). In 13 patients who were still growing, nine had height SD scores for chronological age of less than zero despite having mean (SD) advances in bone age over chronological age of 1.64 (1.68) years. Height SD scores for bone age were less than 0 in all 13 patients, indicating a loss of height despite advanced skeletal maturation. Doses of glucocorticoid that permit mild chronic or intermittent hyperandrogenaemia also seem to be associated with mild growth retardation. An adult height below average may be an inevitable consequence for many patients with congenital adrenal hyperplasia receiving conventional glucocorticoid treatment.
Adolescent↗
Body proportions in Turner's syndrome.
Body proportion was studied in Turner's syndrome by measurement of standing an sitting heights in relation to chronological and bone age. The mean standard deviation score for standing height was -3.8. Disproportionate growth of the legs was not a major determinant of short stature, either before or after oestrogen replacement.
Adolescent↗
The lymphatic vessels of the lung: morphological study.
The authors studied the anatomical structures of the pulmonary lymphatic vessels in the dog and in man using injection techniques and macro- and microangiographic and histological methods. The results show that injection in the basal lobes is easier than in the apical lobes. The dog, an animal with a thin pleura, has a very dense superficial lymphatic network, like man. The superficial and the deep lymphatic vessels are connected through the pleural septa.
Animals↗
[Vertebral arteriovenous fistula of congenital origin. Report of one case (author's transl)].
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Arteriovenous Malformations↗
Spectinomycin in gonorrhoea.
Of 104 male and nine female patients with uncomplicated acute gonorrhoea who were treated with spectinomycin (males 2 g., females 4 g.), two patients (one male and one female) were considered to be treatment failures. No conclusions can be drawn from the small numbers of female patients investigated. Of the 104 male patients, 93 were followed for 2 weeks or more, giving a failure rate of 1-1 per cent. The drug was well tolerated. Sensitivity tests were carried out on 44 strains of N. gonorrhoeae; 42 strains were sensitive to 2-5 mug./ml. spectinomycin and all strains were sensitive to 5 mug./ml.
Adolescent↗
Sexually transmitted diseases. 1.
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Sexually Transmitted Diseases↗
Sexually transmitted diseases. 2.
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Chancroid↗
Hepatocellular carcinoma: incidental finding in cirrhotic explanted livers.
INTRODUCTION: Cirrhosis predisposes to the development of hepatocellular carcinoma (HCC), demanding that these patients undergo follow-up with imaging methods for the early detection of neoplastic nodules. Morphologic study of the explanted livers allows identification of lesions not detected pre-operatively. OBJECTIVE: To assess the frequency and to characterize the HCC found incidentally at pathological evaluation of explanted cirrhotic livers. MATERIAL AND METHODS: Thirty patients had HCC diagnosed in explanted cirrhotic livers. The livers were sectioned at intervals of 0.5 cm. Each detached nodule was selected for microscopic study according to size, color and/or consistency. Retrospective analysis of the clinical records was performed comparing available data from various imaging methods. RESULTS: In 11 patients, 16 HCC had previously been identified in the explants by one or more imaging methods. In the other 19 explanted livers (63.3%), HCC was incidentally found. All HCC identified in 9 patients and some of them in 10 patients were incidentally found, varying from microscopic focuses to 2 cm diameter lesions. They varied from only one (5 cases) to multiple nodules (7 cases). DISCUSSION: Imaging methods may underestimate the number of HCC in cirrhotic livers. Histological study is an essential tool that can early detect tumor nodules not previously detected by imaging methods. In our study, although small, multicentric HCC were identified, illustrating the multifocal nature of the hepatic carcinogenesis. Future studies must correlate these findings with patient outcomes. CONCLUSION: Characterization of explanted cirrhotic livers for HCC is important for previously known and incidentally found lesions.
Biopsy↗
Association between overweight and early sexual maturation in Portuguese boys and girls.
OBJECTIVE: The purpose of this study was to examine the relationship between sexual maturation (SM), and the prevalence of overweight among boys and girls. SUBJECTS AND METHODS: The sample of this cross-sectional study included 819 children and adolescents (382 boys and 437 girls), aged 10-15 years old randomly selected from 30 schools in the Porto region. Anthropometrical measurements (body height, weight and skinfolds thickness) were determined by standard anthropometrical methods. Body mass index (BMI) was calculated from the ratio weight/height(2) (kg/m(2)). The sum of tricipital and subscapular skinfolds (TriSub) was also used. Physicians collected data on Tanner stages during physical examination. Subjects were grouped using the quartiles of the decimal age adjusted for Tanner stages of SM and gender. RESULTS: The prevalence of overweight was higher in early maturing boys (30.5%) and early maturing girls (32.7%). The late maturers presented a lower prevalence (p < 0.05) of overweight (20.3% boys and 18.3% girls). Logistic regression analysis illustrates that early maturing is associated with an increased risk for overweight or obesity for boys (OR: 1.87 and 95% CI: 0.99-3.50) and girls (OR: 2.14 and 95% CI: 1.12-4.07), when compared with the boys and girls of the fourth quartile (p < 0.05). CONCLUSIONS: We conclude that there is an association between early SM and the prevalence of overweight in both genders.
Adolescent↗