Biomedical subjects
Publications and source records attributed to M I Martins.
We present a case of a 53-year-old woman who developed an endometrioid adenocarcinoma six years after total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO), who was on estrogenic-only hormone replacement therapy (HRT).
Based on the experience of a teacher training program entitled Program for Continuing Education of Polytechnic Faculty (PAETEC) developed by the Escola Politécnica de Saúde Joaquim Vemâncio (EPSJV/FIOCRUZ), this article is intended to contribute to the discussion of alternatives for continuing vocational teacher education programs. In the search for new on-the-job teacher training models fostering interaction between the educational process and research activity, the experience employs a strategy based on the construction of an integrated methodology allowing teachers to reflect on their own practices and turn them into the object of their research.
The effect of perioperative blood transfusion on the survival of patients with colorectal cancer was evaluated in 128 patients undergoing curative surgery between 1980 and 1988. The following clinical and histopathological variables were also studied: age, sex, duration of symptoms, presence of intestinal obstruction, tumour site, extent of spread through the bowel wall, lymph node involvement, Dukes' stage, grade of differentiation, venous invasion and type of surgical procedure performed. The need for perioperative blood transfusion was unrelated to the stage of disease. In the transfused patients (n = 73) the 5-year recurrence-free survival, calculated by the Kaplan-Meyer technique, was 37% and in the non-transfused (n = 55) was 60% (P = 0.0027, Mantel-Cox). Similar differences were found in the comparison of the groups with (n = 68) and without (n = 60) transfusions on the day of operation. The deleterious effect of transfusion was evident in patients who received only one unit of blood (n = 19)--these had a 5-year survival rate of 45% compared those who had more than one unit of blood (n = 54) (5-year survival rate 35%) (P = 0.0062). With a multivariate analysis, using a Cox proportional hazard model, taking into account all the variables studied, a significant and independent effect on survival was found for lymph node involvement (beta coefficient = 3.97), blood transfusion (beta coefficient = 2.16) and extent of bowel wall spread (beta coefficient = 1.75).(ABSTRACT TRUNCATED AT 250 WORDS)
The authors present a global valuation of the psychological repercussion of the child produced by a cronic and genetic disease like mucopolissacaridosis. The A. describe also those repercussion on the family and the school of the child. Finally they point the actual therapeutic support of the child and his family and remarks the need or pedopsychiatric management.
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Leiomyoblastoma of the stomach is exceedingly rare. The authors report the case of a 69-year-old woman who presented with acute epigastric pain, anemia and weight loss. She was found to have a malignant leiomyoblastoma (epithelioid leiomyosarcoma) of the duodenum with lymph-node involvement. The clinical and pathological aspects of leiomyoblastoma of the gastrointestinal tract are reviewed, with emphasis on the distinctive, diagnostic histologic features. To the authors' knowledge, this is only the fourth reported case of leiomyoblastoma of the duodenum and the only case in which the tumour was malignant.
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BACKGROUND/AIMS: Helicobacter pylori (Hp) may affect the normal balance between gastric epithelial cell proliferation and epithelial cell death, interfering thus with the maintenance of gastric mucosa integrity. The aim of this study was to investigate the effect of Hp infection on cell proliferation index (PI) and apoptotic index (AI) in gastric epithelium of the antrum and corpus. METHODOLOGY: Prospective study in forty-one patients with functional dyspepsia (14 males, 27 females, average age = 54+/-16.1 years). Day one: upper digestive endoscopy with biopsies of the antrum and corpus, and a cytological smear of the antral area for AgNOR (argyrophilic nucleolar organizer region) analysis. Biopsies for the programmed tests were sent in separate labeled containers: to study AI (antibody anti-M30), PI (antibody anti-Ki 67) and histology (Sydney criteria and the detection of Hp). Detection of the AgNORs through the Giménez-Mas et al. technique, using Visilog-Microptic Software. Day two: a blood sample was drawn from each patient for the serologic detection of the status CagA and VacA, and a breath test was carried out with 13C-Urea. STATISTICS: SPSS program with the application of Student's t, chi-square and Fisher tests. RESULTS: 24 patients were Hp(+) and 17 Hp(-). The PI (Ki 67 and AgNORs) in the antral area was significantly increased in the Hp(+) patients. AI showed no significant difference in the subgroups Hp(+) and Hp(-). Both subgroups showed increased PI in the antrum and increased AI in the gastric corpus. There was significantly higher PI in CagA(+), without an increase in the AI. The AI was significantly higher in CagA(-), when compared with CagA(+). The VacA protein had no influence on PI and AI. Acute and chronic gastritis was more frequent and more severe in Hp(+) patients. This group lacked any correlation between the histological findings and the PI, but the opposite was the case between AI and the degree of cellular infiltration. CONCLUSIONS: In patients with functional dyspepsia, Hp infection induces an increase of PI, with significant presence in the antrum area, without the corresponding increase in AI. Cag A(+) promotes the increase of PI, and Cag A(-) promotes the increase of AI. The Vac A status has no influence on the PI or AI. The degree of cellular infiltration interferes with AI.
The authors present experimental results with a bovine "mammary" artery graft with a 6 months follow-up and histological study up to 3 months (Transmission and Scanning Electron Microscopy). They report a 100% patency in the 16 dogs operated on (there were 2 controls). Grafts used were 6 cm long, had a 4 mm diameter and were implanted as aorto-aortic bypass. Dinamic evolution of the pseudo-intima is described as thickening up to the 14th day, when it is "cleaned". These facts would be related with variation in the peripheral resistance and their objectives would be narrowing or widening the graft in order to accelerate or slow the flow speed, respectively. Factors related to Poiseuille's law (diameter, length, viscosity) are mentioned as important elements for the patency rate of long lengthened, thin-diametered grafts. Also, the electrical charge of the intima and the endothelial seeding are discussed.
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