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M J Brito

Publications and source records attributed to M J Brito.

20 records · Page 2Linked to original sources

[Structural changes in pulmonary vessels and coronary arteries in hypoplastic left heart syndrome].

In order to correlate gross morphological features with pulmonary and coronary vasculature changes in hypoplastic left heart syndrome (HLHS) 15 heart-lung necropsy specimens from neonates were analysed. Histology of left atrium wall, lung vessels with pulmonary arteriolar disease morphometric grading, study of intra and extra pulmonary wall veins and coronary arteries were recorded. Classic HLHS was observed in 11, and DORV with mitral atresia in 4, the foramen ovale (FO) being the only left atrium outflow tract in all. All specimens had increased % of thickness and muscular extension of arterioles and increased wall thickness of pulmonary veins, but severer arteriolar and venous changes with left atrium fibrosis were noticed in 8 specimens with either closed FO (3 cases) or mean FO diameter (d) of 5 mm when compared with specimens with mean FOd of 9 mm. Coronary arteries histology disclosed in 4 of 8 specimens with opened but hypoplastic mitral valve, intima proliferative changes with lumen narrowing, not observed in 7 specimens with mitral valve atresia. We concluded that in HLHS closed or restrictive FO and permeable mitral valve may predispose neonates to respiratory complications, right ventricle abnormal function and arrhythmias, specially after cardiac surgery.

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[A resurgence of rheumatic fever. New causes or old attitudes?].

Bearing in mind that in the last years there has been an increase in rheumatic fever episodes, the authors evaluate the cases recently observed in the department. The data of 3 children born and living in Portugal, the first known outbreak of rheumatic fever observed between June 93 and March 94, were examined. One case presented polyarthritis, another polyarthritis and carditis and the third chorea and carditis. In just one case was the diagnosis of rheumatic fever considered in the beginning, and over-all, failures in the diagnosis and treatment of tonsillitis, and in echocardiographic diagnosis were detected. In view of these examples, the authors conclude that the increasing incidence and morbidity of rheumatic fever is more probably due to forgetfulness of old attitudes than to new causes. Delay in the diagnosis and errors in secondary prophylaxis may influence long term results.

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