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N Santana

Publications and source records attributed to N Santana.

8 recordsLinked to original sources

[Giant thymolipoma].

Thymolipoma is an uncommon benign tumor (accounting for 2% to 9% of thymus tumors). We present the case of a 26-year-old man who sought medical attention for left-sided pleural pain of 3 months duration. Computed tomography showed a mass in the left side of the chest occupying both the anterior mediastinum and the left pleural cavity. This mass caused lung collapse and mediastinal shift. Magnetic resonance imaging revealed a large fatty tumor and transthoracic biopsy with radiological guidance confirmed the diagnosis. The tumor was resected through a left thoracotomy. No postsurgical complications occurred and the histopathological diagnosis was thymolipoma.

Adult↗

[Mediastinoscopy in the diagnosis of mediastinal disease. An analysis of 181 explorations].

To validate our experience with standard cervical mediastinoscopy (SCM) and extended cervical mediastinoscopy (ECM) to diagnose mediastinal nodes and masses, we studied 181 patients between January 1992 and February 2001. SCM and ECM were indicated for diagnostic staging of nodes related to bronchogenic carcinoma (Group I) or of mediastinal masses (Group II). An SCM was performed in all cases to explore the paratracheal region (2R, 2L, 4R, 4L, 7, 10R and 10L); in 21 additional cases, an ECM was performed to explore the aortopulmonary window or the subaortic region (area 5) and the para-aortic region (area 6). In Group I, the sensitivity of SCM was 93.6% and specificity was 100%; the positive predictive value (PPV) was 100%, the negative predictive value (NPV) was 82.8%, and the diagnostic yield was 95.1%. The sensitivity of ECM was 91% and specificity was 100%; PPV was 100%, NPV 93.3% and yield was 96%. In Group II, the sensitivity was 93.3%, specificity 100%, PPV 100%, NPV 81.2% and diagnostic yield 94.8%. The sensitivity of ECM in this group was 80%, specificity was 100%, PPV 100%, NPV 66.7% and yield 85.7%. A 2.7% complication rate was observed, with one case of bleeding after injury to the superior vena cava, one tracheal lesion, one recurring paralysis and two cases of surgical wound infection. The mean postoperative stay was 36 hours and mortality was zero. We conclude that SCM is highly specific for the evaluation of mediastinal node involvement in bronchogenic carcinoma and it is the approach of choice when a diagnosis of lesions located in the mid-mediastinal region has not been reached. ECM is a valid, safe alternative to anterior mediastinotomy for staging nodes and masses occupying para-aortic zones or the aortopulmonary window, with good diagnostic yield, low morbidity and absence of mortality.

Adenocarcinoma↗

Hepatitis C virus genotypes in a northeastern area of Brazil.

We used a reverse transcription-polymerase chain reaction (RT-PCR) to obtain the genotypes of circulating hepatitis C virus (HCV) in patients from a Gastro-Hepatology Unit in the city of Salvador (Bahia State) in northeastern Brazil. Viral RNA was detected in 83 (65.4%) of 127 anti-HCV seropositive serum samples. Positivity was significantly associated with alterations in levels of aspartate aminotransferase and alanine aminotransferase (P < 0.05). Genotyping of HCV was performed by RT-PCR using genotype-specific primers from the core region: 24.1% were infected with subtype 1a, 38.6% with 1b, 3.6% with 2, 21.7% with 3a, and 12.0% with a mixed genotype. There was no difference in genotype distribution when compared with results from other Brazilian locations. Surprisingly, the high frequency of genotype 3 in Brazilian samples continues to be different from that reported around the world and warrants further investigation.

Adolescent↗

[Recurring invasive thymoma of the diaphragm].

Diaphragmatic recurrence of a thymoma is rare. We report the case of a 70-year-old woman who underwent transternal thymectomy and adjuvant radiation therapy, and who was admitted four years later with recurrence of the thymoma in the left hemidiaphragm with infiltration of the inferior ipsilateral pulmonary lobe. The thymoma was excised along with the left hemidiaphragm, chest wall and three ribs and an atypical segmentectomy of the left lower lobe was performed. The hemidiaphragm was reconstructed and the chest wall was repaired with synthetic mesh. Surgery was complemented with radiotherapy.

Aged↗

Effects of tamoxifen on serum lipid and apolipoprotein levels in postmenopausal patients with breast cancer.

Serum lipids and apolipoprotein levels were measured in twenty postmenopausal women with primary breast cancer, before and three months after tamoxifen therapy (10 mg twice a day). Tamoxifen caused a significant reduction in total serum cholesterol (10%; P < 0.02), and in low-density lipoprotein cholesterol (17%; P < 0.01), and a significant 47% increase in the subclass 2 of the high density lipoprotein cholesterol (P < 0.01). In addition, tamoxifen caused a 16% increase in apolipoprotein A-I, a 12% decrease in apolipoprotein B (P < 0.05), and a 37% reduction in the serum concentration of lipoprotein (a) (P < 0.01). These results show that tamoxifen brings about an important improvement in serum lipid profile.

Aged↗

[Myasthenia gravis associated with carcinoma of the thymus. A report of three cases].

INTRODUCTION: Although the association between benign neoplasias of the thymus and myasthenia gravis is well known, with greater predominance of squamous thymomas over other histological types, carcinoma of the thymus is only exceptionally associated with auto immune disorders. CASE REPORTS: We present three patients with myasthenia gravis associated with carcinoma of the thymus. They were three men aged between 38 and 73 years. Clinical features of myasthenia were generalized in two cases and ocular only in the third. Antireceptor antibodies to acetylcholine and anti striped muscle antibodies were present in all three patients. Repetitive stimulation was abnormal in two of the three cases. On CAT of the thorax there was a tumour of the thymus with the radiological characteristics of a benign thymoma in two of the patients and data suggesting an invasive thymoma in the third. In all three cases the diagnosis of carcinoma of the thymus was made on the post operative histological findings. CONCLUSIONS: The association of carcinoma of the thymus with myasthenia gravis in our series of cases was probably due to chance. We consider that this association is exceptional since the histological characteristics of carcinoma of the thymus do not favour the development of auto immunity.

Adult↗