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Biomedical subjects

A Medeiros

Publications and source records attributed to A Medeiros.

10 recordsLinked to original sources

[The healthy life].

This study is based on a comparison of the habits and opinions of a group of pupils on entering the Damaia Preparatory School (5th and 6th years of education) and of the same group on leaving this School. Its aim is to contribute towards an adequate education for health at school in order to promote healthy living habits. The study was based on the comparison of data obtained from two random samples, chosen from the same group of pupils when entering (n1 = 36 out of a total of 368) and leaving (n2 = 32 out of a total of 164) the above mentioned school. The collection of data was carried out by means of a multiple-choice questionnaire given to a total of 532 pupils. The results demonstrated that the frequencies have changed in the following way: a) bathing has increased; b) tea drinking has decreased; c) the image of the teacher as a smoker has become less frequent; d) the number of pupils who have tried alcoholic beverages has increased; e) mother's smoking habits have increased. The other trends that were found in the study showed that there were no significant changes in either the behaviour or opinions that had been studied.

Adolescent

[Acute pancreatitis. An analysis of 91 consecutive cases (1988-1991) with a brief review of the literature)].

Acute pancreatitis (AP) remains a subject of great controversy from the standpoint of its aetiology, pathogeny and treatment. We present a study of 91 patients with AP consecutively admitted to a surgical ward. 50 Women and 41 men with a mean age of 59 +/- 19 years were treated. The aetiology of AP was attributed to gallstones in 54 patients, alcohol in 22, ERPC and trauma; in 14 patients the aetiology was considered idiopathic. The most frequent signs and symptoms were pain, vomiting, abdominal tenderness, jaundice and fever. The mean number of Ranson's prognostic criteria was 3 +/- 1.5 and 29 patients (31%) had more than three. Initial management was conservative in 84 patients (92.3%) and seven were operated on admission (acute abdomen in four, septic shock in two and common duct obstruction in another). Mortality rate was 11% (n = 10) and in 24 patients (26.3%) there were complications of AP. Most of the patients (80%) began oral feeding a week after admission. The mean number of Ranson's criteria of patients deceased was 5.4 +/- 1.6 and of those who survived was 2.8 +/- 1.3 (p < 0.001). Follow-up of patients allowed us to see that in five (5.5%) there was a relapse of AP.

Acute Disease

[Priapism].

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Humans

[Automatic, implantible cardioverter-defibrillator in a patient with chronic Chagas cardiopathy and sustained ventricular tachycardia].

We studied a 48 years old woman, with chronic Chagasic cardiopathy, manifested with cardiomegaly, heart failure and syncope, due to a sustained ventricular tachycardia (SVT) of two different configurations (left bundle branch block and right bundle branch block). During electrophysiological testing, both types of ventricular tachycardia were reproduced. Successful ablation therapy of the right branch of His was performed due to suspicion of the bundle branch reentrant tachycardia, with a left bundle branch block. The patient continued to show SVT episodes, now with right bundle branch block pattern. Cardioverter Defibrillator was implanted. We report this case due to the rare frequency of Chagas' disease, where it could be a cause of heart disease, since the existence of the parasite (trypanosoma cruzi) and its vector (Triatoma) has been identified in some rural and suburban zones in the state of Aguascalientes, Mexico.

Chagas Cardiomyopathy

[Complete congenital heart block. Its natural history and evolution].

This study describes the natural history and evolution of 67 patients with congenital auriculoventricular heart block admitted in the Instituto Nacional de Cardiología "Ignacio Chávez", Mexico, D.F. from 1944 to 1998. There were 35 (52%) females and 32 (47%) males, with mean follow up period of 93.7 +/- 104 months. Most of the patients were without structural cardiovascular disease (90%). The most frequent symptoms were dyspnea and syncope. Electrocardiograms showed a ventricular heart rate of 42.2 +/- 9 beats/minute. 85.7% of patients had a supra-Hisian complete heart block. In 31% of patients a pacemaker was implanted because syncope. Overall mortality was 4.4% and malignant ventricular arrhythmias were the principal contributors. Risk factors for mortality identified in this study were junctional escape rhythm lower than 50 beats/minute, inappropriate chronotropic response during exercise, R-R interval prolongation at night, enlargement of cardiac chambers, depressed left ventricular ejection fraction and prolonged QT interval. In all of these conditions we recommend permanent pacemaker implantation.

Adolescent

[A complete atrioventricular block during exertion].

Exercise-induced atrioventricular (AV) block in patients with normal electrocardiogram at rest is uncommon. We report the clinical features of two patients with AV block during treadmill test. The first patient was a woman of 54 years of age with presyncope on exercise. She developed complete AV block during exercise testing without evidence of ischemic myocardial disease. Electrophysiologic study documented distal AV block. The second patient was a man 31 years old who developed angina and third-degree AV block with depression of ST segment during treadmill test. Myocardial perfusion study suggested ischemic heart disease. He received anti-ischemic drugs with improvement of symptoms. A control exercise testing demonstrated normal AV conduction and electrophysiologic study was normal. In the first case, exercise AV block was probably due to abnormal His Purkinje conduction system refractoriness to autonomic modulation, while in second case AV block was secondary to ischemic heart disease. Third-degree AV block at exercise can be present in patients without conduction system abnormalities at rest. Exercise-induced infra-Hisian AV block must be treated with pacing until ischemic heart disease has been ruled out.

Adult

Bioprosthetic endocarditis due to Cryptococcus neoformans.

Fungal prosthetic endocarditis continues to be a lethal complication of cardiac valve replacement. We describe a patient with culture-proved Cryptococcal endocarditis and myocarditis whose non-regurgitant xenograft aortic prosthesis was successfully replaced urgently upon the occurrence of new 1st degree A-V block in the third postoperative week. Operative intervention, including vigorous debridement of the aortic root, is effective in postoperative prosthetic fungal infections involving the myocardium. The patient described herein is now infection-free, with a non-regurgitant valve, one and one-half years following operation.

Adult