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Biomedical subjects

L Gonçalves

Publications and source records attributed to L Gonçalves.

At least 19 recordsLinked to original sources

Worm burdens in outbred and inbred laboratory rats with morphometric data on Syphacia muris (Yamaguti, 1935) Yamaguti, 1941 (Nematoda, Oxyuroidea).

Syphacia muris worm burdens were evaluated in the rat Rattus norvegicus of the strains Wistar (outbred), Low/M and AM/2/Torr (inbred), maintained conventionally in institutional animal houses in Brazil. Morphometrics and illustration data for S. muris recovered from Brazilian laboratory rats are provided for the first time since its proposition in 1935.

Animals↗

Helminth fauna of the golden hamster Mesocricetus auratus in Brazil.

Helminth fauna of conventionally maintained hamsters from institutional animal houses that supply the research community with laboratory animals and from an openly kept control group, randomly purchased in a pet shop in the State of Rio de Janeiro, were evaluated and compared. Necropsied animals from institutional suppliers were infected with the oxyurid nematodes Syphacia criceti and S. mesocriceti and with the cestode Rodentolepis nana; those from the pet shop were infected with S. mesocriceti and R. nana. These are the first morphometric data that are based on Brazilian samples of these species parasitizing hamsters. Mesocricetus auratus is a newly recorded host for S. criceti, previously recovered from Oryzomys subflavus and Calomys callosus in Brazil. The potential of pet and laboratory hamsters in the spreading of helminth infections to humans is also considered.

Animals↗

Malaria in São Tomé and Príncipe: parasite prevalences and vector densities.

A cross-sectional survey was carried out in 16 localities on the island of São Tomé and three on the island of Príncipe, at the end of the rainy season of 1997, to determine malaria prevalence and vector densities. Blood samples from 664 inhabitants of all ages were examined by optical microscopy (OM) and PCR. Mosquito collections were made by outdoor landing captures from 21:00-23:00 h. Great differences were found between OM and PCR readings. OM had a sensitivity of 66%, a specificity of 79% and failed to reveal any mixed-infections. Overall prevalence, determined by PCR, was higher in São Tomé (53%) than in Príncipe (35%). It was highest in children below 16 years-old. All four human Plasmodium species occurred in São Tomé but P. ovale was not detected in Príncipe. The human population was largely asymptomatic. Bednet users had lower prevalence than did non-users. The FOREST form of Anopheles gambiae s.s., identified by PCR and cytogenetics, was the only vector on the islands. The sporozoite rate in São Tomé, assessed by ELISA, was 0.5%. Parasite prevalence and vector densities were positively correlated in São Tomé, where malaria transmission must occur predominantly in the more populated coastal areas.

Adolescent↗

[Transient cortical blindness after cardiac catheterization in a post-surgical coronary patient].

Transient cortical blindness is a known complication after cerebral and vertebral angiography although is a rare complication following cardiac catheterization. In this report, we describe a seventy-six-year-old male patient who had cortical blindness after coronary bypass graft angiography. The development of cortical blindness, in this setting, appears to be an osmotic disruption of the blood-brain barrier which is selective for the occipital cortex. Other hypotheses, such as an immunological reaction to the contrast agent or a direct injection of dye into the vertebral artery system, were considered. The clinical outcome is usually favourable, with vision completely restored within 24-48 hours, as was the case of the patient described in the present report.

Aged↗

Adenoviral-mediated gene transfer induces sustained pericardial VEGF expression in dogs: effect on myocardial angiogenesis.

OBJECTIVE: Angiogenic peptides like VEGF (vascular endothelial growth factor) and bFGF (basic fibroblast growth factor) have entered clinical trials for coronary artery disease. Attempts are being made to devise clinically relevant means of delivery and to effect site-specific delivery of these peptides to the cardiac tissue, in order to limit systemic side-effects. We characterized the response of the pericardium to delivery of a replication-deficient adenovirus carrying the cDNA for AdCMV.VEGF165, and assessed the effect of pericardial VEGF165 on myocardial collateral development in a canine model of progressive coronary occlusion. METHODS: Ameroid constrictors were placed on the proximal left circumflex coronary artery of mongrel dogs. Ten days later, 6 x 10(9) pfu AdCMV.VEGF165 (n = 9). AdRSV.beta-gal (n = 9), or saline (n = 7) were injected through an indwelling pericardial catheter. Transfection efficiency was assessed by X-gal staining. Pericardial and serum VEGF levels were measured serially by ELISA. Maximal myocardial collateral perfusion was quantified with radiolabeled or fluorescent microspheres 28 days after treatment. RESULTS: In AdRSV.beta-gal-treated dogs, there was extensive beta-gal staining in the pericardium and epicardium, with minimal beta-gal staining in the mid-myocardium and endocardium. Pericardial delivery of AdCMV.VEGF165 resulted in sustained (8-14 day) pericardial transgene expression, with VEGF levels peaking 3 days after infection (> 200 ng/ml) and decreasing thereafter. There was no detectable increase in serum VEGF levels. Maximal collateral perfusion, a principal correlate of collateral development and angiogenesis, was equivalent in all groups. CONCLUSION: Adenoviral-mediated gene transfer is capable of inducing sustained VEGF165 expression in the pericardium; however, locally targeted pericardial VEGF delivery failed to improve myocardial collateral perfusion in this model.

Adenoviridae↗

Cardiac lymphatic dynamics after ischemia and reperfusion--experimental model.

ABSTRACT. The aim of the present study was to investigate the lymphatic cardiac circulation in an experimental model of ischemia plus reperfusion in mongrel dogs (Canis familiaris L). As radiotracer we used 0.2-0.25 ml (111 MBq) of 99mTc-Re2S7 colloid (+/-10 microm), injected subcapsullary below the second diagonal of the descending anterior ligated coronary artery with a special needle. A gamma-camera/Starport + DecStation were used for data acquisition. Four experimental groups with five animals each were established: G I = controls; G II = immediately after acute myocardial infarction (AMI); G III = late infarction (5 days after AMI); G IV = ischemia (90 min) + reperfusion. Four regions of interest (ROIs) were chosen: injection area (ZA), above (ZB), near right (ZD), and far right (ZC) from ZA. Mean disappearance times in ZA and dynamic parameters in the other ROIs were determined from activity/time curves drawn in each area, using homemade software. The results obtained seem to indicate that the methodology is appropriate to a detailed study of lymphatic drainage in pathological situations in animal models.

Animals↗

[Partial pericardectomy using videothoracoscopy].

OBJECTIVE: The aim of this study is to assess the validity of videothoracoscopy in the treatment of chronic pericardial effusions. STUDY PATIENTS: We studied 13 consecutive patients with chronic pericardial effusions and an indication for surgical treatment. The patients, 10 female and 3 male, had a mean age of 48 years (21-72 years). Eleven patients had recurrent pericardial effusion and two patients had anterior mediastinal masses of unknown etiology and a large pericardial effusion. METHODS: A videothoracoscopy was performed in every patient, under general anesthesia with a double-lumen endotracheal tube. The thoracic cavity was inspected, the pericardial effusion was drained and a partial pericardectomy was performed. RESULTS: There was no postoperative mortality or morbidity. Average duration of postoperative thoracic drain and postoperative stay were, 1.2 and 2.4 days respectively. Follow-up ranged from 1 to 48 months (mean 23.3 months). One patient died due to progression of his malignant disease. There were no cases of recurrent pericardial effusions. CONCLUSIONS: Video assisted pericardectomy is a safe technique that should be considered in the treatment of chronic pericardial effusions.

Adult↗

[Hypertrophic myocardiopathy: a sarcomere disease?].

The introduction of molecular biology in Cardiology opened a new era, in which the collaboration between geneticists, molecular biologists and cardiologists will allow the clinical application of Molecular Cardiology. In this review the new advances in the diagnosis and prognostic evaluation of patients with Hypertrophic Cardiomyopathy at the molecular level are discussed. We also present a summary of our current knowledge on the genetic bases and molecular mechanisms of this disease. Finally, some possibilities of the future clinical application of the data obtained by Genetic and Molecular Biology are shown. The Molecular Biology of Hypertrophic Cardiomyopathy expanded our horizons beyond the morphologic definitions, exposing the limitations of traditional concepts. However, we should not forget the potential drawbacks of these genetic tests, in order to anticipate and prevent the problems associated with their performance.

Cardiomyopathy, Hypertrophic↗

In utero percutaneous umbilical cord ligation in the management of complicated monochorionic multiple gestations.

The study was designed to report our experience with in utero percutaneous umbilical cord ligation for selective feticide in pre-viable, abnormal, monochorionic multiple gestations. The selection criteria prior to offering percutaneous umbilical cord ligation included normal anatomy in the other fetus(es), normal karyotype and polyhydramnios, or uterine contractions. The procedure was performed under combined endoscopic and sonographic guidance. Fifteen patients were referred for evaluation and possible treatment. Two patients were excluded because of misdiagnosis. The mean gestational age at the time of the procedure was 21 weeks (range 16-25 weeks). There were ten acardiac twins, one discordant twin with acrania, and two cases of twin-twin transfusion syndrome with a hydropic twin. Percutaneous umbilical cord ligation was accomplished in 11/13 (84%) cases. An average of 8.5 weeks (range 0-18.5 weeks) was gained after percutaneous umbilical cord ligation, and five of 11 patients delivered at or after 30 weeks. Seven of 11 patients undergoing ligation procedures had living children. Premature rupture of membranes occurred within 3 weeks in 4/13 (30%) of cases. In utero fetal demise remote from the procedure occurred in three ligated patients undergoing ligation, in two of which intraoperative bleeding occurred. One fetus with cystic fibrosis died in the newborn period. Percutaneous umbilical cord ligation is an evolving alternative technique for the management of abnormal monochorionic multiple gestations. The advantages of percutaneous umbilical cord ligation over other approaches include complete extravascular interruption of the blood flow in all vessels of the cord. This may prevent postmortem feto-fetal hemorrhage or possible embolic phenomena that may result in death of the normal twin, as seen with intravascular techniques. Percutaneous umbilical cord ligation prior to spontaneous death of a co-twin may also avert the neurological and other complications that may occur in the surviving twin. Technological advances should decrease the observed complications and improve the success rate of the procedure.

Diseases in Twins↗

In utero endoscopic devascularization of a large chorioangioma.

Clinically significant chorioangiomas, i.e. those greater than 4 cm in diameter, are associated with an overall fetal loss rate of approximately 40%. Maternal complications may also be present. Most patients diagnosed with chorioangiomas have been managed expectantly. A patient with a large chorioangioma was referred to our institution, with a fetus that was hydropic and showed sonographic signs of over heart failure. Fetal anemia, marked erythropoiesis and hypoalbuminemia were documented on cordocentesis. The blood supply to the mass consisted of an artery and a vein of 9 mm in diameter. The vascular supply to the tumor was ablated via operative fetoscopy by suture ligation of the arterial supply, after subchorionic dissection of the vessel. The remaining blood supply was electrocoagulated with bipolar cautery. Although the procedure was technically successful, the fetus died on the 3rd postoperative day. This case illustrates ablation of the blood supply of placental chorioangiomas as a potential management alternative for those patients with large chorioangiomas. Early identification and treatment may result in a successful outcome.

Endoscopy↗

Prenatal sonographic diagnosis of Treacher Collins syndrome: a case and review of the literature.

We report the prenatal ultrasonographic diagnosis of a fetus with mandibulofacial dysostosis (Treacher Collins syndrome). Sonographic findings included: polyhydramnios, microcephaly, abnormal fetal facial features (slanting forehead, microphthalmos, micrognathia), and abnormal fetal swallowing. A review of the current literature pertaining to prenatal diagnosis of this condition is presented.

Adolescent↗

Risk stratification after myocardial infarction. Clinical evaluation before discharge.

Risk stratification after an acute myocardial infarction suffered a remarkable evolution in the last few years. These improvements were mainly related to the development of reperfusion strategies that changed radically the way we managed acute myocardial infarction. Risk stratification in the reperfusion era occurs in three according to time from admission: Phase I (first 24 hours), Phase II (days 2 to 5), and Phase III (predischarge). In the last years the development of new technologies permitted the study of areas not usually explored in risk stratification, as heart rate variability (autonomic system activation), and signal-averaged electrocardiogram (arrhythmia's substrate). However, risk stratification is an issue that is far from being closed, a lot of controversy still exists in some areas, and new frontiers are emerging in front of us.

Death, Sudden, Cardiac↗

How to evaluate the quality in a system of video-microscopy in the field of anatomic pathology.

The acquisition of a video microscope image is explained by the concept of modulation transfer function to describe the quality of a microscope which should target a sensor of a video camera to allow around 50 pairs of lines per mm with a good contrast in the video-monitor. Taking this into consideration, high aperture lenses, a microscope with infinity optics, a low power video adapter and a high quality camera must be used.

Humans↗

Telemedicine project in the Azores Islands.

Telemedicine projects and programmes began in Portugal only in 1992 with a telepathology programme in real time frozen section service. The main purpose and challenge of the telemedicine is to allow the access of a special and specific health care to populations as the 250,000 inhabitants of the Azores archipelago. We wish to start with telepathology, teledermatology, telecardiology, tele ORL, telepsychiatry, telematernal and foetal medicine in all islands of the archipelago, also connected with the Major University Centers in Lisbon. The system must be composed of a video conferencing station working in ISDN at 384 kb/sec connectors via a switch to the video camera applied to different video-cameras. Telemedicine improves the human, economical, social and cultural life quality to the people of the European, but depressed ultraperipherical region of Azores.

Azores↗