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Biomedical subjects

M Guimarães

Publications and source records attributed to M Guimarães.

7 recordsLinked to original sources
PubMed2003

Alpha-blocker therapy can be withdrawn in the majority of men following initial combination therapy with the dual 5alpha-reductase inhibitor dutasteride.

OBJECTIVES: The Symptom Management After Reducing Therapy (SMART-1) study examined the combination of the dual action 5alpha-reductase inhibitor (5ARI) dutasteride, and alpha(1)-blocker tamsulosin, followed by withdrawal of tamsulosin in men with symptomatic BPH. METHODS: 327 BPH patients were randomised to 0.5mg dutasteride and 0.4 mg tamsulosin for 36 weeks (DT36) or 0.5 mg dutasteride and 0.4 mg tamsulosin for 24 weeks followed by dutasteride and tamsulosin matched placebo for the remaining 12 weeks (DT24+D12). Patients' assessment of their symptoms, IPSS at weeks 24, 30, and drug safety were evaluated. RESULTS: 77% of DT24+D12 patients felt the same/better at week 30 compared with week 24 (changes in IPSS were consistent with this finding). Of those subjects with an IPSS <20 who changed to dutasteride monotherapy at week 24, 84% switched without a noticeable deterioration in their symptoms. In the 27% of men with severe baseline symptoms (IPSS >or=20) who had withdrawal of tamsulosin therapy at week 24, 42.5% reported a worsening of their symptoms compared with 14% in the DT36 group. The regimens were well tolerated. CONCLUSIONS: Dutasteride can be used in a 24-week combination with tamsulosin, to achieve rapid onset of symptom relief in patients at risk of underlying disease progression. This symptom relief is maintained in the majority of patients after the alpha(1)-blocker is removed from the combination. Patients with severe symptoms may benefit from longer-term combination therapy.

Adrenergic alpha-Antagonists↗
PubMed1999

Extra-adrenal phechromocytoma and renal cell carcinoma--an unusual case of tumour synchronism.

We report an unusual case of tumour synchronism combining an extra-adrenal pheochromocytoma and a renal cell carcinoma in a 48-year-old male. The most usual forms of presentation are described in accordance with their clinical significance. We emphasize the diagnostic importance of specific biochemical studies and the accurate anatomical localization of extra-adrenal chromaffin tissue by magnetic resonance imaging (MRI) and scintigraphy with 131 Iodine-methyliodobenzylguanidine (131I-MIBG). Surgical excision was the treatment of choice after the institution of adequate preoperative cardiovascular management. Pertinent features of the natural history of these tumours are described in accordance with their different embryological origin.

Carcinoma, Renal Cell↗
PubMed1997

Desensitization of bladder sensory fibers by intravesical capsaicin has long lasting clinical and urodynamic effects in patients with hyperactive or hypersensitive bladder dysfunction.

PURPOSE: Capsaicin was used to treat symptomatic patients with hyperactive or hypersensitive bladders. MATERIALS AND METHODS: Capsaicin solution (1 mM.) was instilled into the bladder of 16 patients with spinal hyperreflexia, bladder instability or hypersensibility. RESULTS: Frequency decreased in 14 patients and continence was achieved in 10 of 14 incontinent cases. Mean first desire to void and maximal cystometric capacity increased significantly. These effects lasted for 6 to 12 months and were renewed following repeat treatment. CONCLUSIONS: Bladder afferent desensitization with capsaicin is promising in patients with motor or sensory bladder dysfunction, although initial pungency might limit its use.

Administration, Intravesical↗
PubMed1986

[Cerebrovascular disorders in Uberlandia: I. Mortality].

We have analyzed 1361 death certificates, during the year of 1982 in Uberlandia (Brazil), all deaths of residents and not deathbirths. In 47% the deaths were assisted by a physician and the cause of death proved. The first basic cause of death found was cardiovascular diseases (23.3%). The second, infectious diseases particularly Chagas' disease (14.9%) and the third traumatic lesions and poisonings (14.4%). Cerebrovascular diseases were the seventh basic cause of death (6.5%) but the third most related disease at the death certificates (12.7%). It is important to stress that the mortality index change considerably if we consider the disease as a basic cause of death or in more than one position in the death certificate. For instance in Uberlandia the index for CVD was 30 and 63/100.000 inab/year, respectively. The carriers of arterial hypertension presented CVD related at death certificate 10 times more than in the not carriers of hypertension.

Adolescent↗
PubMedDate not supplied

[Renal-cell carcinoma. The basic concepts].

This article includes brief discussions of renal parenchymal neoplasms. The authors summarise epidemiological data and natural history of these lesions, the most relevant histopathologic characteristics, the classification of renal tumors, as well as outcome and the basic principles of treatment and follow-up. The staging systems, survival and prognostic factors in renal cancer are also reviewed. Special attention is given to the detection and earlier diagnosis of renal tumours because of the wider use of sonography and CT scanning. Although this has improved the cure rate of renal cell carcinoma, it has also increased the detection of all types of renal masses, benign and malignant, including those that require surgery and those that do not.

Carcinoma, Renal Cell↗
PubMedDate not supplied

[Progressive multifocal leukoencephalopathy. Role of imaging in its diagnosis. Perspectives].

We review five cases of Progressive Multifocal Leukoencephalopathy (PML), confirmed by biopsy in three cases and by LCR JC virus research by PCR (polymerase chain reaction) in two cases. We analysed the lesions and different forms of imagiological presentation, concerning location, mass effect, contrast enhancement and progress, and emphasize the importance of some atypical patterns. Reference is also made to the role of imaging in its diagnosis and new techniques, such as Spectroscopy and Transfer Magnetization, to avoid brain biopsy.

Adult↗