paula marie Cruz - Academia.edu (original) (raw)
Papers by paula marie Cruz
European Journal of Internal Medicine, 2009
Introduction: A characteristic of the patients with heart failure (HF) is a decreased peripheral ... more Introduction: A characteristic of the patients with heart failure (HF) is a decreased peripheral blood flow by rest as well as by exercise. This is caused, at least in part, by a reduced vasodilator response of the peripheral vessels endothelium. Objectives: The purpose of our study is to correlate the morphological and structural changes of the endothelium with the splanhnic blood flow, estimated by measuring the resistance index in superior mesenteric artery (RI SMA) using Doppler ultrasonography. Methods: 25 small vessels biopsies from patients that underwent abdominal surgery (15 patients with HF, 10 controls) were examined by optical and electronically microscopy. The endothelial changes were quantified by using Masuda scoring. Before intervention we measured in all patients the RI SMA and systolic peak velocity of SMA, as well as flow mediated dilation (FMD) of brachial artery. Results: we noticed very high RI SMA in patients with HF vs. controls (0.85±0,16 vs. 0.763±0,10, p<0.003), but without correlation of this index with the reactivity of the brachial artery to hyperaemia. A very low FMD (FMD 2,48±6,55 vs. 10,85±17, p<0.0001) was associated with changes of Doppler IntroductionObjectivesMaterials & MethodsResultsDiscussion & ConclusionKeywordsKeywordsflow wave pattern in SMA, namely, the lack of protodiastolic reverse. Only 9 biopsies from patients with HF have revealed important endothelial changes and a high activity score (Masuda 2-3) was correlated with low values of FMD and high peak systolic velocities in SMA. Conclusions: the correlation between FDM, endothelial structural changes and the flow wave pattern in SMA could indicate important hemodynamic disturbance and extensive endothelial dysfunction in heart failure. RI SMA, peak velocities in SMA and the Doppler flow pattern in SMA could be usefully in monitoring the peripheral circulatory status in patients with HF.
Digestive Diseases and Sciences, 2006
Page 1. Digestive Diseases and Sciences, Vol. 51, No. 6 (June 2006), pp. 11361136 (C o 2006) DOI... more Page 1. Digestive Diseases and Sciences, Vol. 51, No. 6 (June 2006), pp. 11361136 (C o 2006) DOI: 10.1007/s10620-006-8022-y LETTER TO THE EDITOR ON THE COMPLEX AUTONOMIC CHANGES INVOLVED IN THE ...
AJP: Advances in Physiology Education, 2009
Current medical curricula devote scarce time for practical activities on digestive physiology, de... more Current medical curricula devote scarce time for practical activities on digestive physiology, despite frequent misconceptions about dyspepsia and dysmotility phenomena. Thus, we designed a hands-on activity followed by a small-group discussion on gut motility. Male awake rats were randomly submitted to insulin, control, or hypertonic protocols. Insulin and control rats were gavage fed with 5% glucose solution, whereas hypertonic-fed rats were gavage fed with 50% glucose solution. Insulin treatment was performed 30 min before a meal. All meals (1.5 ml) contained an equal mass of phenol red dye. After 10, 15, or 20 min of meal gavage, rats were euthanized. Each subset consisted of six to eight rats. Dye recovery in the stomach and proximal, middle, and distal small intestine was measured by spectrophotometry, a safe and reliable method that can be performed by minimally trained students. In a separate group of rats, we used the same protocols except that the test meal contained (99m)Tc as a marker. Compared with control, the hypertonic meal delayed gastric emptying and gastrointestinal transit, whereas insulinic hypoglycemia accelerated them. The session helped engage our undergraduate students in observing and analyzing gut motor behavior. In conclusion, the fractional dye retention test can be used as a teaching tool to strengthen the understanding of basic physiopathological features of gastrointestinal motility.
Journal of Virological Methods, 2011
A new protocol for producing polyclonal antibody against hepatitis A virus (HAV) is described. Tw... more A new protocol for producing polyclonal antibody against hepatitis A virus (HAV) is described. Twenty hens were immunized three times with a commercial HAV vaccine and HAV from a cell culture with three types of adjuvants: CpG oligodeoxynucleotides (CpG-ODN), incomplete Freund's adjuvant and an alum adjuvant. In each of the last two booster inoculations, blood from the birds was collected and tested for HAV antibodies. Egg yolk was separated from egg white and immunoglobulin Y (IgY) antibody was then purified by polyethylene glycol 6000. The mean yield of total protein in yolk was 22.62 mg/mL. Specific activity of the antibody was tested using commercial ELISA, Western blotting, and in vitro neutralization assay demonstrating that anti-HAV IgY bound specifically. After the first immunization, birds immunized with HAV from cell culture plus incomplete Freund's adjuvant with/without CpG-ODN showed highest levels of anti-HAV IgY in serum (p < 0.05). Viral combination with CpG-ODN resulted in early response of anti-HAV serum in hens, reflecting the amount of IgY transferred to the egg yolk (p < 0.05). The results suggest that egg yolk may be a large scale source of specific antibodies against hepatitis A virus. Further applications of this method have yet to be tested.
Acta Otorrinolaringológica Española
Introduction Oncologic surgery leads to important defects and sequelae, as well as notable cosmet... more Introduction Oncologic surgery leads to important defects and sequelae, as well as notable cosmetic and functional alterations. In this aspect reconstructive surgery has an essential role, allowing more radical excision and lower associated functional and cosmetic morbidities. The aim of this study was to present and evaluate the experience and results of the reconstructive microsurgery unit in our centre's ENT department. Methods Retrospective study of procedures performed between 2006 and 2012. Results A total of 36 cases were reviewed. The primary tumour was found in the oropharynx (58%) in the majority of cases. In 5 cases the procedure was performed for reconstruction and fistula closure (4 pharyngostoma and 1 tracheoesophageal fistula). Failure from total necrosis was 16% (6/36). No associated mortality has been reported. The most common postoperative complications were wound dehiscence in 5 patients and pharyngostoma (fistula) in 5 cases. Prior radiotherapy significantly ...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014
ABSTRACT La fasciite nécrosante cervicale (FNC) est une entité rare caractérisée par une infectio... more ABSTRACT La fasciite nécrosante cervicale (FNC) est une entité rare caractérisée par une infection fulminante provoquant une nécrose extensive des tissus sous-cutanés et des plans fasciaux, et présentant des taux élevés de morbidité et de mortalité. L’origine de cette infection est généralement odontogène ou pharyngée, impliquant une flore mixte de micro-organismes. Les complications principales sont les infections descendantes et l’atteinte médiastinale. L’objectif de cette étude est d’examiner les cas traités dans notre service, et d’analyser le diagnostic et le traitement de la FNC.
European Annals of Otorhinolaryngology, Head and Neck Diseases, 2014
Objective: Necrotizing fasciitis in the cervical region is a rare entity, characterized by a fulm... more Objective: Necrotizing fasciitis in the cervical region is a rare entity, characterized by a fulminant infection that causes extensive necrosis of the subcutaneous tissue and fascial planes, with high mortality and morbidity rates. The origin is generally odontogenic or pharyngeal, involving a mixed flora of microorganisms. Descending infection and mediastinal involvement are usually associated and are the main complications. The aim of the present study was to review the cases treated in our department and analyze diagnosis and treatment, supplementing the understanding of the disease. Methods: A retrospective study was performed on the clinical records of patients admitted to our center between January 2005 and June 2010 with diagnosis of necrotizing cervical fasciitis. Results: Six clinical records were reviewed. The origin of the infection was mainly oropharyngeal and odontogenic, with a mixed flora of Prevotella, Peptostreptococcus and coagulase-negative Staphylococcus. All patients presented mediastinal involvement: superior mediastinitis in 4 patients and superior and postero-inferior mediastinitis in 2 cases. All patients underwent early drainage by bilateral cervicotomy with mediastinal drainage by a cervical approach in those with superior mediastinal affection, and associated thoracotomy, in a single surgical step, for postero-inferior mediastinitis. Temporary tracheotomy was performed in all cases. All received broad spectrum antibiotics, with a medium hospital stay of 37 days. There were no deaths reported. Conclusion: Concerning cervical necrotizing fasciitis, early diagnosis and surgical treatment associated to antibiotics and intensive medical care are essential to obtain a favorable outcome.
American Journal of Otolaryngology, 2014
Osteomas are benign lesions of the lamellar bone that within the temporal region are common in th... more Osteomas are benign lesions of the lamellar bone that within the temporal region are common in the external ear canal. Osteomas of the middle ear are extremely rare and until now there are only 14 reported cases. They usually present with conductive hearing loss while others are asymptomatic and diagnosed incidentally.
Acta Otorrinolaringológica Española, 2014
Cómo citar este artículo: Moya-Martínez R, et al. Tic convulsivo doloroso como manifestación de d... more Cómo citar este artículo: Moya-Martínez R, et al. Tic convulsivo doloroso como manifestación de dolicoestasia y aneurisma vertebrobasilar. Acta Otorrinolaringol Esp. 2014. http://dx.
Otolaryngology - Head and Neck Surgery, 2002
DISCUSSION Middle ear tumors are a rare entity. Among these, the adenoma has been of many controv... more DISCUSSION Middle ear tumors are a rare entity. Among these, the adenoma has been of many controversies concerning its origin; it can have both neuroendocrine and epithelial differentiation. Recent studies have demonstrated that these findings relate to different ...
Acta Otorrinolaringológica Española, 2014
Parálisis facial; Reanimación facial; Colgajo muscular libre microvascularizado gracilis
Acta Otorrinolaringológica Española, 2014
ABSTRACT Introduction Oncologic surgery leads to important defects and sequelae, as well as notab... more ABSTRACT Introduction Oncologic surgery leads to important defects and sequelae, as well as notable cosmetic and functional alterations. In this aspect reconstructive surgery has an essential role, allowing more radical excision and lower associated functional and cosmetic morbidities. The aim of this study was to present and evaluate the experience and results of the reconstructive microsurgery unit in our centre's ENT department. Methods Retrospective study of procedures performed between 2006 and 2012. Results A total of 36 cases were reviewed. The primary tumour was found in the oropharynx (58%) in the majority of cases. In 5 cases the procedure was performed for reconstruction and fistula closure (4 pharyngostoma and 1 tracheoesophageal fistula). Failure from total necrosis was 16% (6/36). No associated mortality has been reported. The most common postoperative complications were wound dehiscence in 5 patients and pharyngostoma (fistula) in 5 cases. Prior radiotherapy significantly influenced the increase in the overall incidence of complications (P < 05). Conclusions Reconstructive surgery currently plays an important role in surgery for head and neck cancer. The radial forearm flap is a safe, reliable method for reconstruction of most defects in the ENT field. This type of intervention provides greater autonomy and safety in surgical oncology.
Acta Otorrinolaringológica Española, 2014
Journal of Wildlife Diseases, 2013
We investigated the exposure of jaguar (Panthera onca) populations and domestic carnivores to sel... more We investigated the exposure of jaguar (Panthera onca) populations and domestic carnivores to selected viral infections in the Cerrado, Amazon, and Pantanal biomes of Brazil. Between February 2000 and January 2010, we collected serum samples from 31 jaguars, 174 dogs (Canis lupus familiaris), and 35 domestic cats (Felis catus). Serologic analyses for antibodies to rabies virus, canine distemper virus (CDV), feline immunodeficiency virus (FIV), and for feline leukemia virus (FeLV) antigen were conducted. The jaguars from Cerrado and Pantantal were exposed to rabies virus, while the jaguars from the Pantanal and the dogs from all three areas were exposed to CDV. Two cats from the Amazonian site were antigen-positive for FeLV, but no jaguars had FeLV antigen or FIV antibody. Canine distemper and rabies viruses should be carefully monitored and considered potential threats to these jaguar populations. Currently FIV and FeLV do not appear to represent a health threat for jaguar populations in this area. Domestic dogs and cats in these areas should be vaccinated, and the movement of domestic animals around protected areas should be restricted.
European Journal of Internal Medicine, 2009
Introduction: A characteristic of the patients with heart failure (HF) is a decreased peripheral ... more Introduction: A characteristic of the patients with heart failure (HF) is a decreased peripheral blood flow by rest as well as by exercise. This is caused, at least in part, by a reduced vasodilator response of the peripheral vessels endothelium. Objectives: The purpose of our study is to correlate the morphological and structural changes of the endothelium with the splanhnic blood flow, estimated by measuring the resistance index in superior mesenteric artery (RI SMA) using Doppler ultrasonography. Methods: 25 small vessels biopsies from patients that underwent abdominal surgery (15 patients with HF, 10 controls) were examined by optical and electronically microscopy. The endothelial changes were quantified by using Masuda scoring. Before intervention we measured in all patients the RI SMA and systolic peak velocity of SMA, as well as flow mediated dilation (FMD) of brachial artery. Results: we noticed very high RI SMA in patients with HF vs. controls (0.85±0,16 vs. 0.763±0,10, p<0.003), but without correlation of this index with the reactivity of the brachial artery to hyperaemia. A very low FMD (FMD 2,48±6,55 vs. 10,85±17, p<0.0001) was associated with changes of Doppler IntroductionObjectivesMaterials & MethodsResultsDiscussion & ConclusionKeywordsKeywordsflow wave pattern in SMA, namely, the lack of protodiastolic reverse. Only 9 biopsies from patients with HF have revealed important endothelial changes and a high activity score (Masuda 2-3) was correlated with low values of FMD and high peak systolic velocities in SMA. Conclusions: the correlation between FDM, endothelial structural changes and the flow wave pattern in SMA could indicate important hemodynamic disturbance and extensive endothelial dysfunction in heart failure. RI SMA, peak velocities in SMA and the Doppler flow pattern in SMA could be usefully in monitoring the peripheral circulatory status in patients with HF.
Digestive Diseases and Sciences, 2006
Page 1. Digestive Diseases and Sciences, Vol. 51, No. 6 (June 2006), pp. 11361136 (C o 2006) DOI... more Page 1. Digestive Diseases and Sciences, Vol. 51, No. 6 (June 2006), pp. 11361136 (C o 2006) DOI: 10.1007/s10620-006-8022-y LETTER TO THE EDITOR ON THE COMPLEX AUTONOMIC CHANGES INVOLVED IN THE ...
AJP: Advances in Physiology Education, 2009
Current medical curricula devote scarce time for practical activities on digestive physiology, de... more Current medical curricula devote scarce time for practical activities on digestive physiology, despite frequent misconceptions about dyspepsia and dysmotility phenomena. Thus, we designed a hands-on activity followed by a small-group discussion on gut motility. Male awake rats were randomly submitted to insulin, control, or hypertonic protocols. Insulin and control rats were gavage fed with 5% glucose solution, whereas hypertonic-fed rats were gavage fed with 50% glucose solution. Insulin treatment was performed 30 min before a meal. All meals (1.5 ml) contained an equal mass of phenol red dye. After 10, 15, or 20 min of meal gavage, rats were euthanized. Each subset consisted of six to eight rats. Dye recovery in the stomach and proximal, middle, and distal small intestine was measured by spectrophotometry, a safe and reliable method that can be performed by minimally trained students. In a separate group of rats, we used the same protocols except that the test meal contained (99m)Tc as a marker. Compared with control, the hypertonic meal delayed gastric emptying and gastrointestinal transit, whereas insulinic hypoglycemia accelerated them. The session helped engage our undergraduate students in observing and analyzing gut motor behavior. In conclusion, the fractional dye retention test can be used as a teaching tool to strengthen the understanding of basic physiopathological features of gastrointestinal motility.
Journal of Virological Methods, 2011
A new protocol for producing polyclonal antibody against hepatitis A virus (HAV) is described. Tw... more A new protocol for producing polyclonal antibody against hepatitis A virus (HAV) is described. Twenty hens were immunized three times with a commercial HAV vaccine and HAV from a cell culture with three types of adjuvants: CpG oligodeoxynucleotides (CpG-ODN), incomplete Freund's adjuvant and an alum adjuvant. In each of the last two booster inoculations, blood from the birds was collected and tested for HAV antibodies. Egg yolk was separated from egg white and immunoglobulin Y (IgY) antibody was then purified by polyethylene glycol 6000. The mean yield of total protein in yolk was 22.62 mg/mL. Specific activity of the antibody was tested using commercial ELISA, Western blotting, and in vitro neutralization assay demonstrating that anti-HAV IgY bound specifically. After the first immunization, birds immunized with HAV from cell culture plus incomplete Freund's adjuvant with/without CpG-ODN showed highest levels of anti-HAV IgY in serum (p < 0.05). Viral combination with CpG-ODN resulted in early response of anti-HAV serum in hens, reflecting the amount of IgY transferred to the egg yolk (p < 0.05). The results suggest that egg yolk may be a large scale source of specific antibodies against hepatitis A virus. Further applications of this method have yet to be tested.
Acta Otorrinolaringológica Española
Introduction Oncologic surgery leads to important defects and sequelae, as well as notable cosmet... more Introduction Oncologic surgery leads to important defects and sequelae, as well as notable cosmetic and functional alterations. In this aspect reconstructive surgery has an essential role, allowing more radical excision and lower associated functional and cosmetic morbidities. The aim of this study was to present and evaluate the experience and results of the reconstructive microsurgery unit in our centre's ENT department. Methods Retrospective study of procedures performed between 2006 and 2012. Results A total of 36 cases were reviewed. The primary tumour was found in the oropharynx (58%) in the majority of cases. In 5 cases the procedure was performed for reconstruction and fistula closure (4 pharyngostoma and 1 tracheoesophageal fistula). Failure from total necrosis was 16% (6/36). No associated mortality has been reported. The most common postoperative complications were wound dehiscence in 5 patients and pharyngostoma (fistula) in 5 cases. Prior radiotherapy significantly ...
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014
ABSTRACT La fasciite nécrosante cervicale (FNC) est une entité rare caractérisée par une infectio... more ABSTRACT La fasciite nécrosante cervicale (FNC) est une entité rare caractérisée par une infection fulminante provoquant une nécrose extensive des tissus sous-cutanés et des plans fasciaux, et présentant des taux élevés de morbidité et de mortalité. L’origine de cette infection est généralement odontogène ou pharyngée, impliquant une flore mixte de micro-organismes. Les complications principales sont les infections descendantes et l’atteinte médiastinale. L’objectif de cette étude est d’examiner les cas traités dans notre service, et d’analyser le diagnostic et le traitement de la FNC.
European Annals of Otorhinolaryngology, Head and Neck Diseases, 2014
Objective: Necrotizing fasciitis in the cervical region is a rare entity, characterized by a fulm... more Objective: Necrotizing fasciitis in the cervical region is a rare entity, characterized by a fulminant infection that causes extensive necrosis of the subcutaneous tissue and fascial planes, with high mortality and morbidity rates. The origin is generally odontogenic or pharyngeal, involving a mixed flora of microorganisms. Descending infection and mediastinal involvement are usually associated and are the main complications. The aim of the present study was to review the cases treated in our department and analyze diagnosis and treatment, supplementing the understanding of the disease. Methods: A retrospective study was performed on the clinical records of patients admitted to our center between January 2005 and June 2010 with diagnosis of necrotizing cervical fasciitis. Results: Six clinical records were reviewed. The origin of the infection was mainly oropharyngeal and odontogenic, with a mixed flora of Prevotella, Peptostreptococcus and coagulase-negative Staphylococcus. All patients presented mediastinal involvement: superior mediastinitis in 4 patients and superior and postero-inferior mediastinitis in 2 cases. All patients underwent early drainage by bilateral cervicotomy with mediastinal drainage by a cervical approach in those with superior mediastinal affection, and associated thoracotomy, in a single surgical step, for postero-inferior mediastinitis. Temporary tracheotomy was performed in all cases. All received broad spectrum antibiotics, with a medium hospital stay of 37 days. There were no deaths reported. Conclusion: Concerning cervical necrotizing fasciitis, early diagnosis and surgical treatment associated to antibiotics and intensive medical care are essential to obtain a favorable outcome.
American Journal of Otolaryngology, 2014
Osteomas are benign lesions of the lamellar bone that within the temporal region are common in th... more Osteomas are benign lesions of the lamellar bone that within the temporal region are common in the external ear canal. Osteomas of the middle ear are extremely rare and until now there are only 14 reported cases. They usually present with conductive hearing loss while others are asymptomatic and diagnosed incidentally.
Acta Otorrinolaringológica Española, 2014
Cómo citar este artículo: Moya-Martínez R, et al. Tic convulsivo doloroso como manifestación de d... more Cómo citar este artículo: Moya-Martínez R, et al. Tic convulsivo doloroso como manifestación de dolicoestasia y aneurisma vertebrobasilar. Acta Otorrinolaringol Esp. 2014. http://dx.
Otolaryngology - Head and Neck Surgery, 2002
DISCUSSION Middle ear tumors are a rare entity. Among these, the adenoma has been of many controv... more DISCUSSION Middle ear tumors are a rare entity. Among these, the adenoma has been of many controversies concerning its origin; it can have both neuroendocrine and epithelial differentiation. Recent studies have demonstrated that these findings relate to different ...
Acta Otorrinolaringológica Española, 2014
Parálisis facial; Reanimación facial; Colgajo muscular libre microvascularizado gracilis
Acta Otorrinolaringológica Española, 2014
ABSTRACT Introduction Oncologic surgery leads to important defects and sequelae, as well as notab... more ABSTRACT Introduction Oncologic surgery leads to important defects and sequelae, as well as notable cosmetic and functional alterations. In this aspect reconstructive surgery has an essential role, allowing more radical excision and lower associated functional and cosmetic morbidities. The aim of this study was to present and evaluate the experience and results of the reconstructive microsurgery unit in our centre's ENT department. Methods Retrospective study of procedures performed between 2006 and 2012. Results A total of 36 cases were reviewed. The primary tumour was found in the oropharynx (58%) in the majority of cases. In 5 cases the procedure was performed for reconstruction and fistula closure (4 pharyngostoma and 1 tracheoesophageal fistula). Failure from total necrosis was 16% (6/36). No associated mortality has been reported. The most common postoperative complications were wound dehiscence in 5 patients and pharyngostoma (fistula) in 5 cases. Prior radiotherapy significantly influenced the increase in the overall incidence of complications (P < 05). Conclusions Reconstructive surgery currently plays an important role in surgery for head and neck cancer. The radial forearm flap is a safe, reliable method for reconstruction of most defects in the ENT field. This type of intervention provides greater autonomy and safety in surgical oncology.
Acta Otorrinolaringológica Española, 2014
Journal of Wildlife Diseases, 2013
We investigated the exposure of jaguar (Panthera onca) populations and domestic carnivores to sel... more We investigated the exposure of jaguar (Panthera onca) populations and domestic carnivores to selected viral infections in the Cerrado, Amazon, and Pantanal biomes of Brazil. Between February 2000 and January 2010, we collected serum samples from 31 jaguars, 174 dogs (Canis lupus familiaris), and 35 domestic cats (Felis catus). Serologic analyses for antibodies to rabies virus, canine distemper virus (CDV), feline immunodeficiency virus (FIV), and for feline leukemia virus (FeLV) antigen were conducted. The jaguars from Cerrado and Pantantal were exposed to rabies virus, while the jaguars from the Pantanal and the dogs from all three areas were exposed to CDV. Two cats from the Amazonian site were antigen-positive for FeLV, but no jaguars had FeLV antigen or FIV antibody. Canine distemper and rabies viruses should be carefully monitored and considered potential threats to these jaguar populations. Currently FIV and FeLV do not appear to represent a health threat for jaguar populations in this area. Domestic dogs and cats in these areas should be vaccinated, and the movement of domestic animals around protected areas should be restricted.