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Biomedical subjects

A Fernandes

Publications and source records attributed to A Fernandes.

132 records · Page 8Linked to original sources
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[Unsustained ventricular tachycardia and accelerated idioventricular rhythm--clinical and electrocardiographic features].

OBJECTIVE: To compare clinical and electrocardiographic characteristics of Nonsustained Ventricular Tachycardia (NSVT) and Idioventricular Accelerated Rhythm (IVAR). MATERIAL AND METHODS: We studied 155 patients, 113 men and 42 women, with mean age 54 +/- 14 retrospectively, of these, 108 had NSVT and 47 IVAR. The arrhythmias were defined as follows: NSVT-more than 3 ventricular consecutive beats with an heart rate superior to 110 b/m and lasting less than 30 s.; IVAR-3 or more ventricular consecutive beats with an heart rate equal or superior to 50 and lower than 110 b/m, lasting less than 30 s. We evaluated clinical data (symptoms, functional class and anti-arrhythmic therapy), electrocardiographic data (rhythm, changes in conduction and repolarization) and ventricular function (with ECO, Radionuclide Angiography or Ventriculography). In the Holter recording (ECG-H), we analysed the presence of associated ventricular arrhythmias, their electrocardiographic characteristics (number of episodes, number of beats per episode, previous arrhythmia rate, morfology, regularity) and the relations of the arrhythmia with symptoms. RESULTS: Analysis of underlying pathology showed in both groups, the importance of coronary artery disease (44.5% vs 40%) followed by valvular heart disease (24% vs 27.6%) and cardiomyopathy (22.2% vs 17%) respectively to NSVT and IVAR. Only in the NSVT group there were patients without cardiac pathology (3.6%). Comparing with one control group of our department, this distribution was substantially different (p less than 0.0001). All IVAR episodes were assympthomatic compared with 90% of NSVT. Ventricular premature beats were found in all NSVT patients and in 90% of IVAR patients, and were frequent (greater than 10/h) in 79% and 60%, couplets in 84% and 53% respectively (ns). The previous rate of the arrhythmia was 85.3 +/- 20 b/m in NSVT against 68.7 +/- 14 in IVAR (p less than 0.0001). We found left ventricular disfunction in 60% of NSVT patients and in 63.7% in IVAR patients, being serious in 35% and 39% respectively. The follow-up was of 18.5 months (1-72) and posterior evolution showed 14.8% and 17% of deaths with no relation to the arrhythmia, although in NSVT the number of complexes and episodes were related with the ventricular disfunction (p = 0.02 and p = 0.05). CONCLUSION: Both arrhythmias appeared in patients with similar clinical and arrhythmic setting and identified a population with structural cardiopathy, bad function and poor outcome.

Adult↗
PubMedDate not supplied

[Alcoholism in an industrial population: diagnosis, prevalence and conditioning factors].

The pattern of alcohol consumption has been studied among 92 males, workers in a factory of the Lisbon area. In this population there were three groups of ethanol consumers: I--non consumers, 6%; II--medium, up to 80g/day, 68%; III--heavy consumers, more than 80g/day, 26%. Another group (IV) was considered, for reference, with 23 patients with heavy alcoholism in the outpatients of an alcoholic addicts clinic. Besides the clinical questionnaire and medical examination, the following methods have been used and analysed: brief MAST; Le Gô, Mean Corpuscular Volume (MCV), serum glutamic oxalacetic Trasaminase (SGOT), and gama-glutamyl transpepticlase (gamma GT). The mean ethanol consumption in group IV was significantly higher than in group III (p less than 0.005), and in group III higher than in group II (p less than 0.001). Group IV demarked itself form group III due to a higher prevalence of symptoms of physical dependence (p less than 0.001), and of consumption of tranquilizers (p less than 0.01). In group III the sensitivity of brief MAST has been only 8.5% and of Le Gô 13%. An increased MCV was found in 20% of individuals in group I, 4.9% in group II, 20% in group IV. The SGOT was normal in groups I and II, and increased in 8.7% of group III and 30.4% of group IV (p less than 0.05). The gamma GT was normal in group I and abnormal in 4.7% of group IV (p less than 0.01). In conclusion, approximately 25% of the workers have an excessive ethanol consumption.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Semiologic considerations and clinical significance of magnetic resonance in 11 intracranial aneurysms].

The author's experience with high-field Magnetic Resonance (Signa, 1.5 T, G.E.) in 11 cases of intracranial aneurysms (6 presenting as space lesion and 5 with symptoms of rupture) is reported. Spin-echo, gradient-echo and GRASS (fast-scan or flip-angle) sequences have been used and results compared with those of CT-scan and angiography. Magnetic Resonance findings, relating to blood flow and oxidation of haemoglobin (within the lumen, in the wall and at the periphery of the aneurysm) were interpreted from the point of diagnosis and surgical planning. The authors concluded that Magnetic Resonance should be considered as a routine investigation for intracranial aneurysms particularly when it is suspected that they might be voluminous and/or thrombosed.

Adolescent↗
PubMedDate not supplied

[Clear cell hepatocellular carcinoma].

A case of a 62 year old white patient with mild dyspeptic symptoms and nodular hepatomegaly is presented. The histologic examination of a liver biopsy revealed a hepatocellular carcinoma clear cell variant. There were no signs of chronic hepatic failure. The disease showed an indolent clinical behaviour, thus the beginning of chemotherapy was delayed until clinical deterioration was obvious. Clinical improvement was obtained with adriamycin. A review of the literature on this rare histologic variant of hepatocellular carcinoma is made.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Clear cell meningioma variant and clinical aggressiveness.

The few reports about clear cell meningiomas (CCM) point to an inordinate clinical aggressiveness despite their histological benignity. We studied 5 CCM aiming to assess their clinicopathological, cytometric, and ultrastructural features. Two patients were females and 3 males, with a mean age of 36 years. Two tumors were spinal, one of the cerebral convexity, one of the tentorium-clinoid region, and one of the base of the skull. The first 3 were totally removed and have not recurred for a mean follow-up time of 40 months. The tentorium-clinoid and the skull base tumors had radical subtotal and partial resections, and recurred after 16 and 1.5 months, respectively. All tumors but one, a non-recurrent one, presented no signs of histological anaplasia. The proliferative capacity, as assessed by MIB-1 staining index (SI), of recurrent tumors was slightly higher than that of those tumors that did not recur. All cases showed DNA diploid pattern. Amianthoid-type fibers were disclosed on ultrastructural study. CCM arose in patients younger than those with other variants of meningioma, the spinal canal and the posterior fossa were the common sites. Finally, intracranial tumors were linked to an aggressive behavior.

Adult↗