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Biomedical subjects

P Monteiro

Publications and source records attributed to P Monteiro.

8 recordsLinked to original sources

Apocrine ductal carcinoma in situ of the breast: histologic classification and expression of biologic markers.

Apocrine ductal carcinoma in situ (ADCIS) has been called a special type of ductal carcinoma in situ (DCIS) because the histologic grading is considered difficult using the classification schemes that have been proposed for common DCIS. However, ADCIS encompasses a spectrum of lesions with different morphologic aspects ranging from minimally atypical to overtly malignant. To define a classification scheme for ADCIS, 35 cases (22 pure and 13 associated with invasive carcinoma) were selected on the basis of conventional morphology on hematoxylin and eosin (H&E)-stained sections. Each case was assigned to 1 of 3 histologic grades (low, intermediate, and high) based on nuclear morphology and the presence of necrosis. In addition, the expression of hormone receptors p53, bcl-2, c-erbB-2, and Ki-67 was evaluated by immunohistochemistry, and the DNA ploidy was determined by image cytometry. Fifteen cases were classified as high histologic grade, 10 as low histologic grade, and the other 10 as intermediate grade. All but 4 cases, irrespective of grade, had the same hormonal immunophenotype: androgen receptor positivity (97.1%) and estrogen receptor and progesterone receptor negativity (94.3% and 97.1% respectively). Twenty-one cases (61.8%) showed p53 expression, and 47.1% of the cases were positive for c-erbB-2. The median positivity for Ki-67 was 5.2%. ADCIS has a unique morphologic and hormonal profile, distinct from common DCIS, deserving a specific classification. The proposed classification scheme allows for categorization of ADCIS according to the most important morphologic features already seen in common DCIS, ie, nuclear grade and necrosis. The expression of biologic markers other than hormonal receptors and bcl2 in ADCIS seems in general to be similar to that in common DCIS. Ki-67 and c-erbB-2 are expressed more frequently in intermediate and high histologic grade ADCIS.

Adult↗

[Headache of cervical origin].

It has been known for many years that headaches can originate from abnormalities in the neck. However, their clinical pictures were never sufficiently systematized, at least not enough to allows for research on their pathogenesis. In 1983 Sjaastad et al. described a group of patients with a very uniform and stereotyped headache. Attacks of mild, longlasting, unilateral head pain without side-shift, occurred every few weeks. The headache could be provoked by neck movements, such as extension, rotation or lateral flexion, as well as by external pressure on the neck, eventually spreading to the ipsilateral orbito-frontal-temporal or facial areas. The denomination Cervicogenic Headache (CC) was proposed. Its pathophysiology is presently unknown. The C2 and occipital nerve blockages eliminate the pain. The authors present a typical CC case and make some comments on its clinical picture, pathophysiology, and treatment.

Adult↗

[Early left ventricular dysfunction in acute myocardial infarct. Evaluation using imaging methods].

A patient admitted in a Coronary Care Unit with an acute anterior myocardial infarction, is presented. He had initially normal left ventricular function and, on the 11th day he had, suddenly, an acute pulmonary edema. The reason for this episode was detected through imaging techniques--echocardiography and isotopic studies, and consisted on infarct expansion with early evolution for apical aneurysm. Contrast angiography confirmed the presence of a huge aneurysm and two vessels disease. Tallium Scintigraphy showed reversible ischemia beyond necrotic areas. The patient was submitted to aneurysmectomy and received three aorto-coronary bypass. He is now doing well, in class I, NYHA. The discussion emphasizes the actual role of imaging techniques in the diagnosis of infarct expansion and early functional aneurysm. We discuss the prognostic of infarct expansion and the importance of perfusion studies on defining areas of myocardium in jeopardy, enabling a better surgical approach.

Echocardiography↗

[Analysis of mutations in the BRCA1 gene in patients with cancer of the breast and/or the ovary in Portugal].

Germline mutations in the BRCA1 gene confer an increased susceptibility to breast and ovarian cancer. Approximately 460 distinct mutations were founded scattered throughout the whole gene. However, several mutations were detected repeatedly in individuals of the same ethnic origin. There are no systematic studies concerning mutations in BRCA1 gene in Portugal. The aim of this study is to identify mutations inh this gene in patients with breast and/or ovarian cancer of Portuguese origin. Thirty-three cases of breast cancer and 3 of ovarian cancer were selected according to early age of onset and family history. Mutation screening of this gene was done by Protein Truncation Test (PTT) and Fragment analysis. Two de novo mutations were identified: 1) A frameshift mutation localised in exon 11 of BRCA1, was identify by the two techniques in an ovarian cancer case. Direct sequential revealed a deletion of 4 nucleotides (3444delAAAT); 2) An alteration in intron 18 (IVS 18 + 80delT) was observed in a breast cancer case. This is probably the first description of mutations in a series of patients with breast and/or cancer in the Portuguese population. The mutations identified in this study have not been previously described in other populations according to the Breast Cancer Information Core web site.

Breast Neoplasms↗

[Tuberculosis and hypercalcemia].

The authors present a case of disseminated tuberculosis in a patient under dialysis with endstage renal disease. Fever, nocturnal sweating, anorexia, asthenia, ascites, lymph node involvement and granulomatous involvement of the bone marrow were observed. In the twenty nine months of renal failure which preceded the beginning of the tuberculosis, serum calcium levels were normal or low-normal and there was a secondary hyperparathyroidism. During that period the patient was treated with calcium carbonate and calcitriol. At the onset of tuberculosis, serum calcium levels rose above normal. Treatment with calcium and calcitriol was withdrawn but hypercalcemia remained unchanged. Serum concentration of parathormone fell significantly. Antituberculosis drugs were started. The resolution of active tuberculosis was accompanied by normalization of serum calcium levels and by elevation above normal of serum concentration of parathormone.

Adult↗