Biomedical subjects

J Yunes

Publications and source records attributed to J Yunes.

At least 19 recordsLinked to original sources

PubMed2000

[Renal cell carcinoma associated with renal angiomyolipoma and renal cortical adenoma].

OBJECTIVE: To report a case of renal cell carcinoma associated with renal angiomyolipoma and renal cortical adenoma and discuss the possibility of a hereditary etiology. METHODS: A 64-year-old patient with a tumor in the right kidney underwent right renal nephrectomy. The pathological findings revealed a clear cell renal carcinoma, two cortical angiomyolipoma and a renal cortical adenoma. The literature on these three coincident renal tumors is reviewed. RESULTS: The association of these three renal tumors is rare and is usually seen in patients with tuberous sclerosis. CONCLUSIONS: Renal angiomyolipoma is a benign tumor frequently associated with Bourneville's disease or tuberous sclerosis, a disorder of autosomal dominant transmission. Familial evidence of renal cell carcinoma has been previously reported, as in von Hippel-Lindau disease. It has been suggested that heredity may play an important role in the association of renal cell carcinoma and other renal tumors.

Adrenal Cortex Neoplasms↗

PubMed1999

[Fournier's gangrene. Our experience over 10 years. A review of the literature].

OBJECTIVE: To report our experience over the last 10 years with Fournier's gangrene, an extensive fulminant infection of the perineoscrotal region, and to review the literature. METHODS: The medical records of 9 patients with Fournier's gangrene that had been diagnosed from January 1988 to December 1997 were reviewed. Patient age, etiology and predisposing factors, microbiological findings, duration of hospital stay, treatment and outcome were analyzed. RESULTS: The mean age of the patients was 53.8 years (range 43-71). The source of the gangrene was perirectal (22.22%), urinary (66.66%) and cutaneous (11.11%). Predisposing factors included diabetes mellitus, alcoholism, malnutrition and low socio-economic status. All patients were treated with surgical debridement and broad-spectrum antimicrobial therapy. Two patients underwent delayed reconstructive surgery. Cystostomy was performed in 100% of the cases. Two patients died from severe sepsis. CONCLUSIONS: Necrotizing fasciitis of the perineum and genitalia is a severe condition with a high morbidity and mortality. Good management is based on aggressive debridement, broad-spectrum antibiotics and intensive supportive care.

Adult↗

PubMed1994

[Cleft lip and palate: case-control study].

This study relates to a case-control analysis for the purpose of verifying the association between oral clefts and possible risk factors. The analysed variables were: place of mother's residence (urban/rural), pollution, parental diseases, mother's diseases during the first four months of pregnancy, intake of drugs related to this period, heredity, smoking habits, alcohol consumption and X-ray examinations during pregnancy or X-ray examinations prior to pregnancy. There were 450 cases of clefts of whom 354 had a cleft lip with or without cleft palate and 96 had a cleft palate. The relative risk (RR) for each variable by was estimated points and at a 95% of confidence interval and multivariate analysis was applied. As regards cleft lip with or without cleft palate, the risk factors are heredity (RR = 4.96), epilepsy in the mother (RR = 2.39) and the intake of drugs such as anti-inflammatory substance in the first four months of pregnancy (RR = 2.59). Related to cleft palate, the risk factors are heredity (RR = 2.82) and pollution (RR = 2.58).

Brazil↗

PubMed1994

[The decentralization and municipalization of health services in Säo Paulo, Brazil].

The health system in Brazil has undergone profound changes since the 1980s. In the state of São Paulo, the processes of decentralization to the municipio and regional levels, as well as integration of health services, began in 1983. This study describes the strategies adopted by the Ministry of Health of the state of São Paulo to implement these processes and create 65 regional health offices, and discusses the role of these offices in the new unified health system. It is concluded that decentralization has resulted in increased local government participation in financing the health system, that production of medical and community health services has grown, and that health indicators have improved.

Brazil↗

PubMed1994

Children's health in the developing world: much remains to be done.

The principal causes of ill-health and mortality among children in the developing countries are outlined and the prospects for improvement through the provision of education, health services, adequate nutrition, clean drinking-water, sanitation and other basic needs are discussed.

Child Welfare↗

PubMed1993

[Mortality from violent causes in the Americas].

With a view to assembling information to aid in decision-making with regard to prevention policies, a study of mortality from violent causes and its trends in the countries of the Americas was carried out. The study focused on persons under 24 years of age and utilized information from 1980 and 1986 taken from the data base of the Pan American Health Organization. The causes of death were grouped in accordance with the International Classification of Diseases, Ninth Revision. Accidental deaths were separated from intentional deaths by means of the following classification: traffic accidents, other accidents, homicides, suicides, and "unknown causes." The information on violent deaths was compared with information on deaths from infectious diseases during the same period. The results indicate that in 1986, 517,465 deaths from violent causes were recorded in the 28 countries of the Region. Violent deaths as a proportion of total deaths ranged from 3.7% in Jamaica to 26.8% in El Salvador. It was observed that between 1980 and 1986 traffic accidents and "other accidents" tended to diminish but there was a moderate increase in suicides. Homicide rates varied markedly between the countries. In the under-1 and 1-4 year age groups, the highest rates corresponded to "other accidents," except in Chile, where among children aged 1-4 the largest proportion of deaths were attributed to "unknown causes." Comparative analysis of deaths from violent causes and from infectious diseases in the population aged 0-24 years showed that the former increase whereas the latter decrease as age increases. The study pointed up the need to promote further research on these phenomena in order to develop appropriate prevention strategies.

Accidents↗

PubMed1993

Mortality from violent causes in the Americas.

This article provides an assessment of 1986 mortality from violent causes in the Americas. Directed at assisting with development of preventive public health measures, it employs data available in the PAHO data base to focus on the under-25 year age group, compare mortality from violent causes with mortality from infectious and parasitic diseases, and evaluate the relative role of motor vehicle traffic accidents, other accidents, suicide, homicide, and deaths from unknown causes in mortality from violent causes. The study uses the classification of causes presented in the International Classification of Diseases, Ninth Revision. The results show that 517,465 deaths from violent causes were registered in 28 countries and political units of the Americas in 1986, mortality from these causes ranging from 19.3 deaths per 100,000 inhabitants in Jamaica to 125 in El Salvador. Examination of available 1980-1986 data from five countries points to steady increases in mortality from violent causes in Brazil and Cuba that began respectively in 1983 and 1984. Assessment of male and female 1986 mortality from these causes in nine countries showed male mortality to be substantially higher, the lowest male:female ratio (in Cuba) being 1.9:1. Among infants, infectious and parasitic disease mortality was greater than mortality from violent causes in most countries. However, from age 1 to the study's 25-year cutoff, mortality from violent causes was found to exceed infectious and parasitic disease mortality in most countries and to play an especially large role in deaths among those 19-24 years old. Data from eight countries suggested that accidents other than motor vehicle traffic accidents were accounting for much of the mortality from violent causes among infants and the 1-4 year age group in 1986, while motor vehicle traffic accidents rivaled other accidents in importance among the older (5-9, 10-14, 15-19, and 19-24) age groups. It appears that the information presented could prove of considerable use in developing policies designed to reduce morbidity and mortality from violent causes (1).

Adolescent↗

PubMed1992