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Biomedical subjects

M R de Freitas

Publications and source records attributed to M R de Freitas.

At least 19 recordsLinked to original sources

Three-dimensional evaluation of skeletal and dental asymmetries in Class II subdivision malocclusions.

The objective of this study was to determine if any significant differences existed with regard to dental and skeletal asymmetries between subjects with Angle Class II subdivision malocclusions and subjects with normal occlusions. The sample consisted of 30 subjects in each of the 2 groups. Each possessed a full complement of permanent teeth, including first molars. The average age of subjects was 15.76 years in the Class II subdivision group and 22.42 years in the normal occlusion group. Measurements were obtained with the use of submentovertex, posteroanterior, and corrected oblique cephalometric radiographs. In the submentovertex radiographs, symmetry was assessed by measuring the relative differences in the spatial positions of dental and skeletal landmarks between the right and the left sides in both anteroposterior and transverse dimensions. Coordinate systems were used to represent the mandible, cranial floor, and the maxilla. In the posteroanterior radiographs, symmetry was assessed similarly by measuring the relative differences in the spatial positions of dental and skeletal landmarks between the right and the left sides. In the corrected oblique radiographs, symmetry was assessed by measuring the differences in size of dental and skeletal structures between the right and the left sides. Variables were analyzed with multivariate logistic regression analysis. The results demonstrated that the primary contributor to the differences between the 2 groups was the distal positioning of the mandibular first molars on the Class II side in patients whose mandibles showed no unusual skeletal or positional asymmetries. A secondary contributor was the mesial positioning of the maxillary first molars on the Class II side. Furthermore, the posteroanterior radiographic analysis showed that the more frequent distal positioning of the mandibular molars on the Class II side, compared with the mesial positioning of the maxillary molars on that side resulted in mandibular dental midline deviation to the Class II side more frequently than the maxillary dental midline to the opposite side.

Adolescent↗

[Understanding the sexuality of HVI-1 carriers].

The objective of the present investigation was to identify the sexual difficulties experienced by persons in an HIV-1 crisis. This is a study of a descriptive nature based on the Theory of Crisis. The sample consisted of 5 patients with HIV-1 followed up clinically in a town in the hinterland of the state of São Paulo. Semistructured interviews were tape recorded and transcribed. Data were analyzed according to MEIHY (1996) and BARDIN (1994). We conclude that the subjects presented a negative adaptation with respect to sexual, social and emotional difficulties. The results indicate the need for effective nursing interventions with persons in an HIV-1 crisis.

Female↗

[Sexual problems experienced by women in HIV-1 crisis].

This descriptive study was based on the assumptions of qualitative investigation methods and on the Crisis Theory formulated by CAPLAN (1966). The objective of the study was to identify the sexual problems experienced by women undergoing an HIV-1 crisis. Data were collected through a semi-structured interview recorded by the method of FREITAS et al. (1992) and analyzed by the method of MEIHY (1996). Authors concluded that these women maintained themselves unbalanced using negative coping mechanisms. Thus, authors believe that it would be possible to help them using adequate nursing actions such as educational and guidance actions, but mainly by actions directed to the needs of patients undergoing an HIV-1 crisis.

Adaptation, Psychological↗

[Contribution to the understanding of the sexuality of partners of people with permanent colostomy].

The general purpose of the present investigation was to describe the sexual interactions involving colostomized individuals, aiming at understanding this experience. The authors aimed also at identifying the mode regarding sexual procedures used by colostomized individuals and the possible effects of colostomy on these procedures. Therefore, a semi-structured interview, recorded or not, was applied to partners of colostomized subjects. The interviews were transcribed and analyzed according to the content analysis technique. Authors divided the results in 39 subcategories with 4.361 speech units that were gathered in three main categories. The category I "Precedence of the crisis" included 4 subcategories with 113 (36.67%) speech units. The category II "Crisis" comprised 17 subcategories with 1599 (36.67%) speech units and Category III "Crisis' Results" comprehended 18 subcategories with 2649 (60.74%) speech units. Data were validated by an expert on content analysis and the conclusion was that the main concern of health professionals is to keep subjects with a definitive colostomy alive, providing orientations focussing on the stoma, its care and gastrointestinal function. The speech of partners showed a clear presence of post-crisis results, representing a great danger to their general and sexual integrity and to their general and sexual adaptation on a short, medium and long-term basis.

Colostomy↗

Nickel hypersensitivity reaction before, during, and after orthodontic therapy.

Nickel is a strong biological sensitizer and consequently may induce a delayed hypersensitivity reaction (type IV immune response). Because nickel is a component of the majority of the orthodontic alloys, the objectives of this cross-sectional study were to determine the prevalence of nickel hypersensitivity reaction before, during, and after orthodontic therapy with conventional stainless steel brackets and wires; to evidence the induction of this reaction by the orthodontic appliances; and to characterize the nickel hypersensitive persons. Nickel patch tests and a questionnaire were used to evaluate the hypersensitivity to this metal. The total sample consisted of 170 patients, 105 females and 65 males, from the orthodontic department at Bauru Dental School, University of São Paulo. They were divided into three groups as follows: A (n = 60), patients before the beginning of orthodontic therapy; B (n = 66), patients currently undergoing orthodontic treatment, and C (n = 44), patients who had undergone orthodontic treatment previously. The chi-square test (chi2) showed an allergic reaction in 28.3% of the total sample with 23% female and 5.3% male. This indicated a gender difference (chi2 = 10.75, p < 0.001). There was a positive association between nickel hypersensitivity and previous personal allergic history to metals (chi2 = 34.88, p < 0.0001) as well as with the daily use of metal objects (chi2 = 11.95, p < 0.0005). There was no statistically significant difference in the prevalence of contact dermatitis among the three groups (chi2 = 0.39, p = 0.848). This suggests that orthodontic therapy with conventional stainless steel appliances does not initiate or aggravate a nickel hypersensitivity reaction.

Adolescent↗

[Ulnar nerve palsy in leprosy without skin changes: biopsy of the superficial branch of the ulnar nerve in the hand].

Leprosy is one of the most common diseases of peripheral nerves in the world. In Brazil it is particularly frequent, being a major health problem. In tuberculoid leprosy the ulnar nerve is the most common affected nerve. Sometimes there are no skin changes. In these cases in spite of nerve thickening only the nerve biopsy is capable to make a specific diagnosis. We performed a biopsy in the dorsal sensory branch of the ulnar nerve in the hand in 17 patients with ulnar palsy with thickening of the nerve in the elbow, without skin changes. The pathological findings consisted mainly of: loss of fibers (14 cases), inflammatory infiltration (13), fibrosis (12), demyelination and remyelination (9), presence of granuloma (6) and presence of bacilli (5 cases). We conclude that in case of ulnar nerve palsy in leprosy without skin changes, the biopsy of the dorsal sensory branch of this nerve in the hand is a good procedure for the diagnosis of leprosy.

Adolescent↗

[Charcot-Marie-Tooth disease. Clinical study in 45 patients].

Charcot-Marie-Tooth (CMT) disease is the commonest inherited peripheral neuropathy. The clinical study of 45 patients with CMT is presented. They were derived from Antonio Pedro Hospital of Universidade Federal Fluminense in Niteroi, RJ, Brazil. Such patients could be divided by the motor conduction velocity in two types: a demyelinating form or type I (11 cases) and an axonal form or type II (34 cases). The disease was inherited as an autosomal dominant trait in 23 patients and as an autosomal recessive trait in 7 cases. In 15 patients the disorder was sporadic. The age of onset was in most of our cases before the 20 years. All of them had distal weakness in lower limbs. 38.2% had also distal weakness in upper limbs. 80% had distal wasting of the lower limbs and 50% had distal wasting of upper limbs. The tendon reflexes were absent in 64% in lower limbs and in 28% in upper limbs. The sensitive impairment in the distal regions of the extremities was mild in most patients. We found enlargement of peripheral nerves in 7 patients of type I. Pes cavus was present in 21 cases and scoliosis in 7. We found postural tremor of hands in 6 patients. In 9 cases there were rare features as mental retardation, trigeminal nevralgia, optic atrophy, deafness and calf enlargement. In most of our cases the clinical course was very slow progressive. A greater severity was seen in our sporadic cases.

Adolescent↗

Tapia's syndrome caused by Paracoccidioidis brasiliensis.

Tapia's syndrome is due to extracranial involvement of the XIIth nerve and the recurrent laryngeal branch of the Xth nerve. There is ipsilateral paralysis of vocal cords, soft palate and tongue. The main causes are parotid and other tumors or injuries to the high neck. We describe here a Brazilian female patient who presented with a lesion in the nasal mucosa, and soon after had dysphagia and dysphonia. Examination revealed paralysis of the soft palate, vocal cords and tongue ipsilaterally. Microscopic examination of the lesion in the nasal mucosa revealed the presence of the fungus. The patient was treated with sulfonamide and ketoconasol.

Adult↗

[Cytomegalovirus encephalo-myelo-radiculitis in acquired immunodeficiency syndrome].

A 30 year-old male, with the acquired immune deficiency syndrome (AIDS) presented with rapidly progressive flaccid paraplegia and sphincter incontinence. Cerebrospinal fluid examination showed elevated protein and pleocytosis. Death occurred 2 months after the onset of neurological signs. Post-mortem examination showed inflammatory necrotic lesions, relatively sparing the axons and predominantly involving the roots of the cord. Numerous cytomegalovirus (CMV) inclusion bodies were found in the necrotic lesions, in the subarachnoid spaces and in Schwann cells. CMV encephalitis and involvement of the 3rd cranial nerves were also observed. Only 8 well-documented clinico-pathological cases of acute CMV myeloradiculitis, which all presented as progressive cauda equina syndrome, have been reported until now in AIDS patients.

Acquired Immunodeficiency Syndrome↗

[Hypoglycemic polyneuropathy: report of a case with insulinoma].

A case of a young man who presented symptoms and clinical signs of polyneuropathy that occurred in connection with recurrent hypoglycemic episodes is reported. The hypoglycemia was probably caused by a pancreatic islet tumor. There were symmetric weakness and wasting of hands and feet, absent tendon reflexes and 'glove and stocking' loss of sensation. Electromyographic studies showed denervation potentials with slight reduction of nerve conduction velocities. Sural nerve biopsy studied by optic and electronic microscopy showed axonal degeneration without signs of demyelination or remyelination. There are only 30 similar cases reported in the literature. According to experimental findings, the authors believe that glucopenia is the mechanism responsible for the development of the neuropathy, and that at present time there is no evidence for a direct insulin effect.

Adenoma, Islet Cell↗

[Association of myopathies and alcoholic cardiomyopathy: clinical, electroneuromyographic and histopathologic study of the skeletal muscle in 10 cases of alcoholic cardiomyopathy].

Myocardial and skeletal muscle impairment caused by alcohol has been thoroughly studied. Nevertheless, the simultaneous involvement of those tissues by ethanol has not been broached in medical literature. We have studied ten patients undergoing alcoholic cardiomyopathy. They were subjected to a detailed neurological examination, muscle enzymes serum level determinations, electromyography, and muscle biopsy with analysis of the tissue by usual histological techniques and by electron microscopy. Only one of ten patients exhibited proximal weakness and atrophy of the lower limbs, the electromyographic and histological findings correlating with the clinical feature of the chronic muscle disease due to alcohol consumption. The electromyographic findings included muscle disease in eight patients, neuron disease in one patient and no changes at all in the tenth patient. In one patient only, the skeletal muscle proved normal when examined by conventional histological techniques. In the other nine patients there were several minimal changes, such as the proliferation of nuclei beneath the sarcolemma, atrophy of fibers, hyalinization, vacuolation, loss of muscle fiber striae, and atrophy of groups of fibers. Electron microscopy demonstrated the following changes in nine patients: intracellular edema, dissociation of myofilaments, alteration of the Z line, changing in the shape and increase in the number of mitochondria, thickening of sarcolemma, and vacuolation and increase of the glycogen granules. Since all patients exhibited skeletal muscle injury, we concluded that there is a close relation between alcoholic cardiomyopathy and skeletal muscle disease.

Adult↗

[Intracranial arachnoid cyst associated with subdural hygroma: report of a case].

A case of a 10-year-old boy with a congenital arachnoid cyst in the right middle cranial fossa is reported. The symptoms were precipitated by head injury of moderate intensity, occurred some days before the beginning of the clinical picture. The computerized tomography has demonstrated the existence of a simultaneous right fronto-parietal subdural hygroma that was responsible for the intracranial hypertension syndrome. The influence of the cyst in the hygroma formation has been suggested. The mechanisms of growth, the etiology, clinical aspects, the diagnostics and the surgical treatment of the arachnoid cysts are discussed.

Arachnoid↗

[Familial myasthenia gravis: report of 2 brothers].

The familial form of myasthenia gravis is a relatively rare condition, occurring in about 3.4 per cent of myasthenic patients. Two familial cases with ocular myasthenia gravis are reported. They had a third brother who died probably with the same disease. Their parents are cousins. The authors made a brief approach of genetic, clinical, statistical and therapeutic aspects of the disease.

Adult↗

[Necrotizing myelopathy and neoplasms: clinico-pathological report of 2 cases].

Two clinico-pathological cases of necrotic myelopathies with a distant malignancy are presented. The first patient had histiocytic medullary reticulosis and the second one had a renal cell carcinoma. The authors referred to other similar cases found in the literature. In both patients the pathological features in the spinal cord were similar to the other cases reported, but in their first case they found an intense inflammatory reaction and hyperplasia of astrocytes into bizarre giant forms. The cause of necrotizing myelopathy associated with neoplasms remain unknown. The authors think that the presence of inflammatory reaction and the changes in the astrocytes in their first case are consistent with the effects of a virus.

Humans↗

[Infiltration of central nervous system and meninges in lymphomas with leukemic conversion].

The cases of four patients with lymphoma with leukemic conversion, who exhibited neoplastic infiltration of the central nervous system and of the meninges are reported. The anatomo-pathologic study showed the presence of small nodules of leukemic cells, in two patients. The other two patients had clinical improvement after the use of metotrexate by spinal route so that the anatomopathologic study of their CNS and meninges showed no abnormality.

Adolescent↗

[Mucolipidosis type II. Report of 2 suggestive cases].

The clinical and laboratorial study of two brothers with gargoylism is reported. The examination of the urine showed normal findings of mucopolysaccharides. The authors made differential diagnoses with others mucolipidoses and concluded that mucolipidose type II should be considered in any patient with gargoylism.

Adolescent↗

[Internal carotid artery thrombosis in the course of rheumatic disease. Report of a case].

The case of a 21 years old man with hemiplegia and hyperthermia of sudden onset is reported. The angiographic study showed thrombosis of the distal portion of the internal carotid artery. Laboratorial studies revealed positive rheumatic tests. The authors think that the rheumatic arteritis may be responsible for this ischemic cerebral accident. Differential diagnosis with the embolic accidents caused by the rheumatic disease is discussed.

Adult↗

[Multiple neuropaty caused by giant cell arteritis. Clinico-pathological report of a case].

The case of a 67 years old woman with giant cell arteritis and neuritis multiplex is reported. The diagnosis was based on the microscopic appearances of temporal artery biopsy specimens. The authors described the involvement of peripheral nerves in this disease and made differential diagnosis with polyarteritis nodosa. There was also hemorragic infarction of the brain without giant-cells in brain vessels. It is concluded that this diagnosis should be considered in any elderly patient with peripheral neuropathy.

Aged↗