Biomedical subjects

J Viegas

Publications and source records attributed to J Viegas.

4 recordsLinked to original sources

PubMed1992

[Benign pleural effusion caused by asbestos exposure].

The Authors present the first case described among us of benign pleural effusion of an asbestotic origin. They stress the importance of thoracoscopy (pleuroscopy) in the diagnosis of this situation. Attention is drawn to the fact that asbestotic lesions and asbestotic bodies have been found in the lung and, in particular, in the parietal pleura as well. They emphasize the fact that exposure to asbestos was not realized by the patient, which made the clarification of the situation more difficult. It was a CT scan that showed the signs suggestive of exposure to asbestos which raised the diagnostic suspicion. They conclude that every patient with a pleural effusion must be thoroughly questioned about exposure to asbestos. Even if the exposure is accepted, they consider that one should proceed to a pleuro-pulmonar biopsy by thoracoscopy. This biopsy allows demonstration of the characteristic histopathological lesions and rule out other etiologies, namely malignancy and tuberculosis. They suggest that these patients must be highly motivated to stop any smoking and kept under periodic surveillance.

Adult↗

PubMed1992

[Multiple myeloma. An unusual case].

We describe the case of a 75 year old male patient, hospitalized because of sudden paraplegia. The radiological tests performed, revealed degenerative changes of the entire vertebral spine, osteolytic lesions of the seventh cervical and first two thoracic vertebrae, and lacunar lesions of the others. The erythrocyte sedimentation rate, total proteins and its electrophoretic study, as well as quantification of serum immunoglobulins were found to be normal. Regardless of these results, we continued our investigation in order to diagnose or exclude multiple myeloma (MM), which was confirmed by serum and urinary immunoelectrophoresis, that revealed monoclonal gammopathy IgG, K with low value of serum IgG and very high urinary values of Bence Jones K, and by the histological analysis of the necropsy material. In conclusion, we report a case where the probability of an alteration of the controlling immunological mechanisms must be considered. We suggest that there is a heavy chain suppression of the malignant clone, that would explain its very low value in peripheral blood. These findings associated to the absence of light chains in serum, have lead to a particular laboratorial expression of this myeloma.

Aged↗

PubMed1991

First clinical experience with isradipine in the treatment of hypertension in Portugal.

The efficacy and safety of isradipine and nifedipine retard were compared in 51 patients with mild-to-moderate essential hypertension. A 4-week placebo run-in period was followed by an 8-week course of treatment. Patients were randomly allocated to either isradipine 1.25 mg twice daily (n = 24) or nifedipine 20 mg twice daily (n = 826); dosages were doubled if blood pressure was not normalized [diastolic blood pressure greater than or equal to 90 mm Hg) after 4 weeks of active treatment. Systolic/diastolic blood pressures were significantly reduced (p less than 0.01/p less than 0.01) by isradipine from 162/103 to 145/89 mm Hg, and by nifedipine from 162/104 to 143/88 mm Hg. Normalization rates were 79% with isradipine and 67% with nifedipine. It was necessary to double the dosage in seven of the patients taking isradipine and in three of those taking nifedipine; the mean final dosages were 1.63 mg and 22.4 mg twice daily, respectively. Heart rate did not change significantly with either treatment. There were drug-related adverse events in five patients (21%) taking isradipine (2 edema, 2 headache, 2 palpitations, 1 flushing) and in eight (30%) of those taking nifedipine (5 edema, 2 headache, 1 palpitations). Therapy was withdrawn in one patient in the isradipine group (1 headache) and two patients in the nifedipine group (1 edema, 1 headache). We conclude that isradipine is a highly effective and well tolerated antihypertensive agent.

Adult↗

PubMedDate not supplied

[Lupus pancreatitis].

We report the case of a sixteen year old female patient, admitted to a general hospital due to fever, poliarthritis, malar rash and vasculitis. Diagnostic studies confirmed the existence of Systemic Lupus Erythematosus. Shortly after admission, the patient was transferred to an intensive care unit due to severe acute pancreatitis. In spite of its infrequency, the diagnosis of acute pancreatitis must always be considered whenever a patient with SLE presents abdominal pain. The authors emphasise the importance of an early diagnosis of this rare complication, with high mortality rates, and present a brief review of the international literature.

Acute Disease↗