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Biomedical subjects

M M Linhares

Publications and source records attributed to M M Linhares.

9 recordsLinked to original sources
PubMed2004

Risk factors for the development of posttransplantation diabetes mellitus in simultaneous pancreas and kidney recipients.

We sought to determine the risk factors involved in the development of posttransplantation diabetes mellitus (PTDM) following simultaneous pancreas and kidney transplantation. Correlations were sought between tacrolimus (FK-506) levels/dose 2-hour capillary glucose (CG) and glycosylated hemoglobin (HbA(1c)), cyclosporine (CSA) levels/dose with HbA1c, 2-hour CG with prednisone dose and body mass index (BMI) and PTDM. Four patients (9.3%) developed PTDM. Three treated with FK-506 had altered 2-hour CG at 3 months after transplantation; 1 prescribed CSA displayed diabetes diagnosed after 1 year. There was no statistically significant difference among HbA(1c) values and FK-506 (P =.18) or CSA (P =.81) doses or FK-506 (P =.53) and CSA (P =.54) levels. In contrast, there was a statistically significant relationship between elevated 2-hour CG (> or =200 mg/dL) and daily prednisone dose (9.7 mg vs. 16.2 mg; P =.003). There was no correlation between 2-hour CG and FK-506 dose (P =.084) or FK-506 levels (P =.075). The greater BMI correlated with an increased risk of PTDM (21.25 +/- 3.13 kg/m(2) vs 24.67 +/- 2.38 kg/m(2); P =.034). Two-hour CG may be a useful tool to screen the diabetogenic effects of corticosteroids. A BMI increase should be discouraged due to the risk of PTDM.

Adolescent↗
PubMed2004

Simultaneous pancreas-kidney transplantation: infectious complications and microbiological aspects.

OBJECTIVE: The purpose of this study was to describe the clinical and microbiological characteristics of the infectious complications among simultaneous pancreas-kidney transplantations (SPKT). MATERIALS AND METHODS: Among the first 45 SPKT the mean age was 34 years (range, 21 to 49) and the mean duration of follow-up 13 months (range, 2 to 27 months). RESULTS: Twenty-three patients (51%) presented at least one to three episodes (1.7 mean) of infectious complications that needed hospitalization. The etiology of the infections included 71% bacterial (44% gram-negative rods and 27% gram-positive cocci), 16% viral (12% from CMV and 4% from Herpes sp) and 13% fungal (8% by Candida sp and 4% by others fungus). Wound and urinary infections were most frequent, occurring in 22% and 28% of the patients, respectively. All patients who were submitted to vesical drainage developed infections in contrast a rate of only 44% among patients undergoing enteric drainage. CONCLUSION: Infectious complications are the main cause of morbidity and mortality following simultaneous pancreas-kidney transplantation, especially with vesical drainage. The use of enteric drainage combined with administration of broad spectrum prophylactic antibiotics is recommended.

Adult↗
PubMed2004

Magnetic resonance cholangiography in the diagnosis of biliary complications after orthotopic liver transplantation.

OBJECTIVE: The aim of our study was to evaluate the role of magnetic resonance cholangiography (MRC) in the diagnosis of biliary tract complications (BC) after orthotopic liver transplantation (OLT). MATERIALS AND METHODS: Among 21 OLT patients who underwent routine follow-up MRC using a breath-hold T2-weighted turbo spin-echo sequence with half-Fourier acquisition (HASTE), 5 had an elevated serum alkaline phosphatase level. Diagnostic confirmation was obtained with endoscopic retrograde cholangiography (ERC) (n = 11), surgery (n = 3), or clinical and laboratory follow-up of at least 1 year (n = 8). RESULTS: In 13 patients, no abnormality of the biliary tract was detected using MRC. In 8 patients, anastomotic strictures were diagnosed, 7 of which were confirmed at surgery or using ERC. One patient with normal findings at MRC and abnormal liver function test results was found to have a stricture at ERC. All patients with normal MRC and liver function tests had 1 year of uneventful follow-up and were considered true-negative cases. We found that MRC had 87.5% sensitivity, 92.3% specificity, 87.5% positive predictive value, 92.3% negative predictive value, and 90.4% accuracy for the diagnosis of BC. CONCLUSION: MRC is a valuable examination to detect BC after OLT. It provides useful information for planning interventional procedures.

Cholangiography↗
PubMed2000

Selective removal of nitrogen from quinoline and petroleum by Pseudomonas ayucida IGTN9m.

Enrichment culture experiments employing soil and water samples obtained from petroleum-contaminated environments succeeded in the isolation of a pure culture possessing the ability to utilize quinoline as a sole nitrogen source but did not utilize quinoline as a carbon source. This culture was identified as Pseudomonas ayucida based on a partial 16S rRNA gene sequence, and the strain was given the designation IGTN9m. Examination of metabolites using thin-layer chromatography and gas chromatography-mass spectrometry suggests that P. ayucida IGTN9m converts quinoline to 2-quinolinone and subsequently to 8-hydroxycoumarin. Resting cells of P. ayucida IGTN9m were shown to be capable of selectively removing about 68% of quinoline from shale oil in a 16-h treatment time. These results suggest that P. ayucida IGTN9m may be useful in petroleum biorefining for the selective removal of organically bound nitrogen from petroleum.

Biodegradation, Environmental↗
PubMedDate not supplied

Carcinosarcoma of the liver: a case report.

Primary hepatic carcinosarcoma is a rare malignant hepatic tumor containing both carcinomatous and sarcomatous elements. A 40-year-old man referred to our liver transplant team because of hepatic cirrhosis was on the waiting list, having undergone all liver tests, ultrasonography, and with normal serum alpha fetoprotein markers every 6 months to search for a tumor. He underwent a liver transplantation without complication. The pathologic findings of the original liver indicated carcinosarcoma. We have reviewed the literature on this subject.

Adult↗
PubMedDate not supplied

[Study of preoperative risk factors for bacteriobilia in patients with acute calculosis cholecystitis].

OBJECTIVE: to determine an association between the preoperative clinical status and the result of bile and gallbladder wall cultures. MATERIAL AND METHODS: 28 variables regarding history, physical examination and labatorial assessment in 38 patients with acute calculosis cholecystitis submitted to urgency surgery were prospectively studied during a 19-month period, between November 1995 and May 1997. Cultures for aerobic and anaerobic agents from both the gallbladder wall and the bile were performed, in three different culture media (BACTEC 9240, BHI and HEMOBAC). RESULTS: bacteria were isolated in at least one culture medium, in 68.2% of the patients. At univariate analysis, five preoperative factors were identified as predictors of bactibilia: over 55 years of age, a greater than 0.4 degrees C difference in the axillary-rectal temperature, a greater than 12.000 cels/m3 blood leukocyte count, a greater than 75% neutrophil percentage and a greater than 4% rod neutrophil percentage. Owing to the small sample size, statistical significance of the series could not be noted by logistic regression, although a trend to preoperative determination could be observed in 98% of the subjects with positive culture, by means of the model based on age and percentage of rod neutrophil. By analyzing predictive factors jointly, it was noted that patients with more than one predictive factor have a significantly greater possibility to yielding positive culture when compared to those with up to one predictive factor for bactibilia. CONCLUSIONS: We concluded that, in patients with acute calculosis cholecystitis, bactibilia may be predicted yet at the preoperative period, by using simple and easily obtained data.

Acute Disease↗
PubMedDate not supplied

Surgical resection of traumatic spleen cysts by laparoscopy.

Surgical resection of traumatic cysts by means of laparoscopy in two female patients is reported. The patients had sustained severe trauma in the left upper quadrant, were symptomatic and developed large splenic cysts found by computerized tomography, with an average diameter of 8.5 cm. Both patients were submitted to puncture and capsule removal by means of videolaparoscopy and diathermy; splenic parenchyma was preserved and the cyst's bed drained. No intra or postoperative complications occurred. After an average 21 months postoperative follow-up, both patients are symptom-free and no late recurrences were found on tomographic studies. The advantages of this technique over others that have been reported are the preservation of splenic parenchyma, its easy performance and efficient relief of symptoms, as well as being minimally invasive, associated with minimal postoperative pain, shorter length of hospital stay, and no early recurrences.

Abdominal Injuries↗
PubMedDate not supplied

Spontaneous hematoma of the rectus abdominis sheath: a review of 177 cases with report of 7 personal cases.

Hematoma of the rectus abdominis muscle sheath is a little known and rarely diagnosed condition, in spite of its definite clinical setting and treatment. It is very important to the surgeon, as it may be mistaken frequently for acute inflammatory abdominal conditions and should be considered in the differential diagnosis of intra-abdominal tumors. The literature on 177 cases of non-traumatic hematomas of the rectus abdominis muscle sheath is reviewed, including seven personal cases reported by the authors. Its epidemiology, pathogenesis, clinical features, diagnostic examinations and treatment are discussed.

Adult↗