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Biomedical subjects

José Soares

Publications and source records attributed to José Soares.

13 recordsLinked to original sources

Effect of off-road competitive motocross race on plasma oxidative stress and damage markers.

AIM: To analyse the effect of an off-road motocross heat on plasma levels of oxidative stress and damage, blood leucocyte counts and urine catecholamine concentration. METHODS: Plasma contents of total, reduced and oxidised (GSSG) glutathione, %GSSG, malondialdehyde (MDA), protein carbonyl and sulphydryl groups, total antioxidant status (TAS), uric acid, and blood neutrophil and lymphocyte counts were evaluated in 10 male top-level riders before, immediately after (0 h) and 1 h after a simulated competitive motocross race. 24-h urine adrenaline, noradrenaline and dopamine concentrations were also measured. RESULTS: The motocross heat resulted in an increase in plasma oxidative stress and damage (p<0.05). This was shown by a significant increase in %GSSG, TAS, MDA and carbonyls, and by a decrease in sulphydryl groups after the race. There was a significant increase in both plasma uric acid and urine catecholamine concentration after the race (p<0.05). Blood neutrophil counts increased at 0 and 1 h after exercise (p<0.05). Lymphocyte count increased from baseline to 0 h, although it decreased from baseline and 0 to 1 h after exercise (p<0.05). CONCLUSION: The data reinforce the marked metabolic and hormonal demands imposed by motocross, resulting in a condition of enhanced plasma oxidative stress and damage.

Adult↗

[Hematuria after ureteral-iliac aneurysm rupture].

OBJECTIVE: Ureteral-iliac artery fistula is a rare condition. We perform a bibliographic review and report a case of ureter-iliac artery fistula reviewing its major differential diagnosis. METHODS: This case-study describes a patient with massive hematuria that presented a ureter-iliac artery fistula secondary to spontaneous rupture of an internal iliac artery aneurysm. RESULTS: 86 -year-old male patient with history of previous surgery for aneurysm and ureteral catheterization. CONCLUSIONS: This difficult diagnosis should be thought of in a patient with massive macroscopic hematuria and previous vascular surgery. The treatment is always surgery.

Aged, 80 and over↗

[Penile abscess. Case report].

OBJECTIVE: To report one case of penile abscess, with special reference to diagnostic and therapeutic aspects. METHODS: One case of penile abscess is presented in a patient referred for penile swelling. RESULTS: During surgical exploration it showed to be a corpora cavernosum rupture with drainage of a small volume of purulent fluid. CONCLUSIONS: Penile abscess is uncommon. High frequency ultrasonography is a reliable diagnostic imaging method. We were able to incise the affected area of the corpus cavernosum and glans safely, and with appropriate antibiotics this patient was treated successfully.

Abscess↗

[Transperitoneal laparoscopic adrenalectomy: initial experience].

OBJECTIVES: Since the first published report in 1992, laparoscopic adrenalectomy has been widespread and it is now accepted as the standard treatment option in most of benign diseases of the adrenal gland. Aim of the present study is to describe our initial experience with laparoscopic adrenalectomy. METHODS: Between May 2001 and December 2005, 15 patients were submitted to laparoscopic adrenalectomy for benign diseases of the adrenal gland. We analyzed patients characteristics (sex, age, initial diagnosis), operative and perioperative results (operative time, blood loss, time to first oral intake) and complications. RESULTS: Mean operative time was 143 minutes. Blood loss was minimal. Mean hospital stay was 90 hours. There was no need for open conversion and complication rate was low. CONCLUSIONS: Laparoscopic surgery of the adrenal gland is a safe and effective option which offers quality of life benefits to the patients.

Adrenal Gland Diseases↗

[Tubulovillous adenocarcinoma of the renal pelvis. Case report].

OBJECTIVE: To present a case of tubulovillous renal pelvis adenocarcinoma. METHODS/RESULTS: An 81 year-old patient presented at Emergency Department with sepsis. CT scan showed a staghorn calculus with signs suggestive of pyonefrosis. A nephrectomy was performed and pathological exam revealed tubulovillous renal pelvis adenocarcinoma. CONCLUSIONS: Renal pelvis adenocarcinoma is a rare disease. It is usually accompanied by chronic urinary infections, on inflammatory state and staghorn calculi. The best therapeutic option is nephrectomy and the prognosis is poor.

Adenocarcinoma↗

Endurance training attenuates doxorubicin-induced cardiac oxidative damage in mice.

BACKGROUND: There is a lack of studies reporting the influence of DOX treatment on chronically exercised animals. This study intended to determine the effect of endurance swimming training on cardiac muscle tolerance to in vivo DOX-induced damage, analyzing the levels of oxidative stress markers, the response of antioxidant system and the expression of 60 and 70 kDa heat shock proteins (HSP). METHODS: Forty-four Charles River CD1 male mice were randomly assigned to either non-trained placebo (NT+P) and non-trained DOX (NT+DOX) or trained placebo (T+P) and trained DOX (T+DOX). Twenty-four hours after completion of a 14-week training, cardiac ventricles were extracted for biochemical assays of oxidative stress and damage markers, antioxidant enzymes and HSPs. RESULTS: DOX treatment per se (single 20 mg kg(-1) dose), administrated 24 h after the last exercise bout, elevated (p<0.05) plasma cardiac troponin I (cTnI), HSP60, % oxidized glutathione, thiobarbituric acid reactive substances and carbonyl groups and reduced -SH groups. However, training induced a significant increase (p<0.05) on total and reduced glutathione (GSH), HSP60 expression, and decreased the rise of plasma cTnI as well as cardiac carbonyl groups contents in DOX hearts, when compared to NT+DOX mice. Although catalase activity of T+DOX was significantly higher than T+P, no changes were observed in the activities of superoxide dismutase, glutathione peroxidase and glutathione reductase. Neither DOX nor training induced significant variations in HSP70. CONCLUSION: Training improved myocardial tolerance to DOX-induced damage. It is likely that the improvement in responses to DOX was related to training-induced increases in GSH and HSP60.

Animals↗

Germline MUTYH (MYH) mutations in Portuguese individuals with multiple colorectal adenomas.

Germinal mutations in the base excision repair (BER) gene MUTYH (MYH) have recently been described in association with predisposition to multiple colorectal adenomas and cancer. In contrast to the classic dominant condition of familial adenomatous polyposis (FAP) due to germinal mutations in the APC gene, the MYH polyposis is an autosomal recessive disease. The identification of individuals affected by MYH polyposis brings new and important implications for the diagnostic, screening, genetic counseling, follow up and therapeutic options in these patients. In this study, screening for germinal mutations in the MYH gene was performed in 53 Portuguese individuals with multiple colorectal adenomas or classic adenomatous polyposis, in whom no mutation had been identified in the APC gene. The results revealed the presence of biallelic germline MYH mutations in 21 patients. In addition, we here report 3 mutations (c.340T>C [p.Y114H]; c.503G>A [p.R168H]; and c.1186_1187insGG [p.E396fsX437]) which, to our knowledge, have not been previously described.

Adenoma↗

Doppler flow evaluation can anticipate abnormal left lung perfusion after transcatheter closure of patent ductus arteriosus.

AIMS: Coil protrusion into the left pulmonary artery (LPA) has been described after transcatheter closure of the patent ductus arteriosus (PDA). The possible impact of such a finding in lung perfusion has not been completely clarified. We evaluated Doppler flow velocities and lung perfusion in patients submitted to that procedure. METHODS: After transcatheter closure of PDA with coils, 70 patients (mean age 8.6+/-3.4 years) were followed for a period of 3.6+/-0.9 years (range 2.1-5.9) and compared to 22 controls. Peak flow velocities and coil protrusion were assessed by Doppler echocardiography. A Doppler velocity index (DVI) was calculated by the difference between the LPA and right pulmonary artery (RPA) peak flow velocities relative to the pulmonary trunk (PT) expressed in percentage, as follows: DVI=(LPA velocity - RPA velocity)/PT velocity x 100. Lung scintigraphy was performed using (99m)Tc-labelled macro-aggregated albumin. RESULTS: Device protrusion was observed in 94% of the patients, 10% of whom presented abnormal left lung perfusion. Peak LPA velocity and DVI were significantly greater in patients (p=0.001) and correlated negatively with left lung perfusion values (R(2)=0.21 and R(2)=0.65, respectively). A cut-off value of 50% for the DVI showed high sensitivity and specificity for reduced lung perfusion. CONCLUSION: Impaired left lung perfusion may appear following transcatheter closure of PDA with coils and the determination of DVI may anticipate such alteration.

Adolescent↗

Planar myocardial perfusion imaging for evaluation of patients with acute chest pain.

BACKGROUND: Rest single-photon emission computed tomographic (SPECT) perfusion imaging identifies acute myocardial ischemia in patients with chest pain in the emergency department; however, the costs are high and radioisotopic services are usually not available 24 h a day. Planar imaging through a portable gamma camera may be useful in this setting. However, planar imaging might be associated with less predictive values in comparison with a gated SPECT imaging. We sought to evaluate rest planar myocardial perfusion imaging for evaluation and triage of patients with suspected acute cardiac ischemia. METHODS: Patients within 6 h of chest pain onset and nondiagnostic electrocardiograms (ECGs) underwent planar myocardial perfusion imaging. Studies showing perfusion defects were considered suggestive of acute coronary syndromes. The results of planar scintigraphy were compared with the clinical diagnosis and outcomes. All patients were followed up and monitored for the occurrence of major cardiac events 120 days after hospital discharge. RESULTS: 71 patients underwent scintigraphy. Twenty-one (30%) patients had acute coronary syndromes, 15 (21%) had major cardiac events (8 had myocardial infarction and 7 underwent myocardial revascularization). Planar scintigraphy demonstrated perfusion defects in 21 patients, 16 (76%) patients with acute coronary syndromes, 12 (80%) patients who had major cardiac events and in 7 (88%) patients with myocardial infarction. The negative predictive value of planar scintigraphy was 90% for diagnosis of acute coronary syndromes and 94% for detecting major cardiac events. CONCLUSION: Early planar myocardial perfusion imaging allowed rapid and accurate risk stratification of emergency departments patients with possible myocardial ischemia and nondiagnostic ECGs.

Chest Pain↗

Oxidative stress in humans during and after 4 hours of hypoxia at a simulated altitude of 5500 m.

BACKGROUND: High-altitude hypoxia may induce oxidative stress in humans. However, the effect of acute, severe, and non-acclimatized short-term hypobaric hypoxia exposure in humans has not been described. Additionally, little is known regarding the confounding role of reoxygenation in the extent of oxidative stress and damage markers in hypoxia. Our goals were to analyze the effect of of hypobaric hypoxia and reoxygenation on plasma oxidative stress and oxidative damage. METHODS: There were six male volunteers exposed to a simulated altitude of 5500 m (52.52 kPa) in the INEFC-UB hypobaric chamber over 4 h and returned to sea level (SL) in 30 min. Data were collected at baseline SL at 1 h and 4 h of hypoxia at 5500 m and immediately after return to sea level (RSL). RESULTS: Elevated scores of acute mountain sickness (13) and significant changes in arterial oxygen saturation (97.5 +/- 0.5; 53.3 +/- 1.9; 97.1 +/- 0.3%, p < 0.05 at SL, 4 h, and RSL, respectively) were observed. Significant reductions (p < 0.05) on total glutathione (TGSH) content were measured from SL and 1 h vs. 4 h and RSL. The percentage of oxidized glutathione (%GSSG) as an indicator of redox oxidative changes increased significantly (SL vs. 1 h; 1 h vs. 4 h, and RSL). Lipid peroxidation (TBARS), protein oxidation (SH protein groups), and total antioxidant status (TAS) followed the redox changes suggested by the glutathione system throughout the protocol. CONCLUSIONS: Hypobaric hypoxia increased the burden of plasma oxidative stress and damage markers all through the hypoxia period. However, no additional changes were observed with reoxygenation at the end of the reoxygenation period.

Acute Disease↗

Magnification chromoendoscopy for the diagnosis of gastric intestinal metaplasia and dysplasia.

BACKGROUND: The aim of this study was to define the reproducibility and accuracy of magnification chromoendoscopy for the diagnosis of lesions associated with gastric cancer (intestinal metaplasia and dysplasia). METHODS: A total of 136 patients with previously diagnosed lesions and 5 gastrectomy specimens were studied. Endoscopic examination was performed with a magnification endoscope after methylene blue (1%) spraying. According to differences in color and mucosal pattern, groups and subgroups of endoscopic images were defined, and biopsies taken (n = 462). Five endoscopists were asked to classify individually 2 endoscopic images per subgroup on 2 separate occasions. RESULTS: Three groups of endoscopic images were defined: nonmetaplastic, nondysplastic mucosa (I); metaplastic mucosa (II); and dysplastic mucosa (III). Ten subgroups were defined according to pit pattern: round small (IA), round and tubular small (IB), coarse round (IC), and course round pits with a straight pit (ID); blue irregular marks (IIA), blue round and tubular pits (IIB), blue villi (IIC), and blue small pits (IID); and loss of clear pattern, with depression (IIIA) or with slight elevation (IIIB). The kappa statistic for intraobserver agreement on the classification of endoscopic images in groups was 0.86; for interobserver agreement, it was 0.74. For classification into subgroups, kappa values ranged from 0.48 to 0.78. For 85% of the areas classified endoscopically as Group I (n = 146), no mucosal lesions or gastritis was described at histologic examination; for 83% of those in Group II (n = 198), intestinal metaplasia was found. Subgroups IIA and IIB were more often associated with complete intestinal metaplasia (62%), and IIC and IID with incomplete metaplasia (67%); in Group III (n = 118), dysplasia was diagnosed histopathologically in 33%. For the diagnosis of dysplasia, specificity was 81% (95% CI [77%, 85%]) and negative predictive value 99% (95% CI [99%, 100%]). CONCLUSIONS: Gastric endoscopic patterns with chromoendoscopy and magnification seem reproducible and valid for the diagnosis of lesions associated with gastric cancer. This procedure may improve the follow-up of individuals at high-risk of gastric cancer, at least for the exclusion of severe lesions.

Color↗

Exercise and cardiac oxidative stress.

Cardiac muscle is frequently affected by many stimuli responsible for loss of cell homeostasis, including physical exercise. While exercise has been presented as a recommended activity for health reasons, it also provides favorable conditions for additional production of reactive oxygen species. These compounds are associated with fundamental mechanisms of cell metabolism but are also related to the etiology and pathophysiology of some cardiac diseases. Cardiac muscle tissue has a high oxidative metabolic rate and relatively low activity of the main antioxidant enzymes, which could enhance its susceptibility to oxidative injury after acute exercise. However, physical training could be considered an important stimulus for the different antioxidant systems like glutathione and those related to the activity of some important antioxidant enzymes in myocardial protection such as superoxide dismutase and glutathione peroxidase. Endurance training seems to induce up-regulation in some antioxidant defenses, protecting cardiac muscle in potentially harmful situations that induce additional oxidative stress. Nevertheless, the mechanisms related to this cross-tolerance effect of training are not yet well understood.

Animals↗

[Clinical, multicentric, and open study to evaluate the efficacy of and tolerance to sildenafil in patients with erectile dysfunction].

Erectile dysfunction (ED), defined by the Impotence-NIH Consensus Conference as the "persistent inability to achieve and/or maintain erection sufficient for satisfactory sexual activity" affect more than 100 million men worldwide, at particular severity levels. The global prevalence of ED is estimated to affect about 10%, but has been found to increase significantly with age (39% in men 40 years of age and 67% at 70 years of age). In men aged 40 to 70 years, the severe ED prevalence increased of three folds, 5 to 15%. In order to evaluate the efficacy and tolerance of sildenafil, it was conducted a national open, multicentre study on a portuguese population affected by ED. Subjects under ambulatory treatment were recruited in Psychiatry/Sexology Clinical units and Urology/Andrology. The results of the study carried out on a group of 62 men with ED, demonstrate that sildenafil was effective in the recovering of erectile function, increasing the number of attempts to sexual activity and improving their success rates (mainly in severe dysfunction). Fifty one patients treated with sildenafil, at the end of the study referred a global improvement in their erections (92.2%). Doses of 50 mg and 100 mg sildenafil were used and were well tolerated and also effective in the treatment of this pathology (70% and 69% respectively). Being this study a flexible dose one and taking into consideration that the final dose used was found the more suitable to the patients, can be concluded that 43.1% of the patients elected dose of 50 mg whereas 56.9% elected the maximum prescribed dose of 100 mg. Over and above global efficacy experimented by patients, a significant improvement in the sexual activity with partners was occurred. These results make possible a final conclusion--in the studied patients group affected by Erectile Dysfunction, aside from associated somatic pathology, sildenafil use provided a remarkable clinical profit, in what concerns global efficacy, by erectile function mechanisms improvement, concerning patients sensitivity of improvement, occurring in the major part of them, being these of high importance to the lifting up of their self-esteem.

Adult↗