Biomedical subjects
F Macedo
Publications and source records attributed to F Macedo.
Pericardial effusions in two boys with chronic granulomatous disease.
Pericardial involvement in chronic granulomatous disease (CGD) is very rare. We present two children with known CGD and pericardial effusions in whom no microbial cause for the effusions was found.
[Stress echocardiography with dobutamine. Analysis of a personal experience].
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Lisinopril and diltiazem reduce left ventricular mass without changing blood pressure in normotensive subjects with exaggerated blood pressure response to exercise.
OBJECTIVE: To determine whether high left ventricular mass may be reduced by antihypertensive drugs in normotensives with exaggerated blood pressure response to exercise as it occurs in hypertensive patients. DESIGN AND METHODS: Randomized, single blind, controlled parallel study evaluating the influence of placebo; lisinopril 20 mg/day, diltiazem 180 mg/d for 5-6 months on left ventricular mass (LVM), evaluated by echo and on "casual" and 24-h ambulatory blood pressure (24-h BP) in normotensive subjects with exaggerated blood pressure response to exercise (Group I) and in weight--and age--matched mild-moderated hypertensive patients (Group II), all with high left ventricular mass. PATIENTS: Placebo, lisinopril and diltiazem, were administered for 5-6 months in respectively 8+9+9 subjects of Group I and 8+9+10 patients in Group II. RESULTS: Placebo did not change either LVM index or 24-h BP values in Group I and Group II. Diltiazem and lisinopril reduced LVM index in both Groups I and II but 24-h BP values were only reduced in Group II. Lisinopril appeared to be more potent than diltiazem on LVM regression. Slopes of LVM index regression were not different between Groups I and II for each drug. Drug-induced changes of LVM index did not correlate with blood pressure changes. CONCLUSIONS: Drug-induced regression of LVM may be achieved in man (Group I) without any reduction of blood pressure. This may be explained by interference with growth-promoting systems other than with cardiac unloading. Also, the similar pattern of LVM regression that was observed in both Groups I and II suggests that similar underlying mechanisms may be involved in the LVH regression in these two populations.
[Isolated right ventricular myxoma: report of a clinical case].
A clinical case of a 14 years old white female with asthenia and easy fatigue of two months duration is presented. The two-dimensional echocardiography study has identified a tumorous and homogeneous mass filling completely the right ventricle. During the cardiac surgery and with the help of extemporaneous biopsy the real nature of the tumor was confirmed-cardiac myxoma. In this report the authors discuss the incidence of cardiac tumors and particularly cardiac myxomas and point out the rarity of isolated myxomas in the right ventricle.
Total parenteral nutrition by central venous catheter complicated by right atrial septic thrombus.
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[Infectious endocarditis. A form of the presentation of Marfan's syndrome--a clinical case].
The Marfan syndrome is a heritable disease with an autosomal dominant inheritance. Its prevalence is four to six per 100,000 people. It appears to be caused by mutations in a single fibrillin gene on chromosome 15. In its classic form, the Marfan syndrome is associated with abnormalities of the eye, aorta, skeleton, lungs and central nervous system. We describe a case of Marfan syndrome, previously undiagnosed, admitted to the hospital because of persistent fever, caused by an infective endocarditis followed by an acute aortic regurgitation. The purpose of this paper is to increase the awareness of this disorder among clinicians in order to prevent the potentially lethal complications, mostly cardiovascular, that could be avoided by a correct management.
Higher left ventricle mass in normotensives with exaggerated blood pressure responses to exercise associated with higher ambulatory blood pressure load and sympathetic activity.
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Evaluation of left ventricular function after acute myocardial infarction. Two-dimensional echocardiography versus radionuclide angiography. Study of 50 patients.
Two-dimensional echocardiography and gated blood radionuclide angiography was performed in 50 patients (mean age 51.3 years; 48 men and 2 women) after acute myocardial infarction, before discharge from the hospital. The aim of this study was to compare the wall motion score, determined by two-dimensional echocardiography (2DE), with the ejection fraction obtained by radionuclide angiography (RNA). The correlation between the results obtained by 2DE and RNA was good (r = 0.75; p less than 0.0001). We conclude that 2DE is a powerful diagnostic tool for the evaluation of left ventricular function.
The echocardiographic mitral valve prolapse. Two-dimensional and Doppler study of 100 cases.
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Left ventricular diastolic function evaluated by apexcardiography on patients with myocardial infarction.
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[American tegumentary leishmaniasis in the northeastern state of São Paulo-Brazil].
An outbreak of American Cutaneous Leishmaniasis (ACL) occurring in the Northeast region of São Paulo state in 1992 is described. After the notification of the 12 human cases, a skin test survey of the local population was carried out in a rural area of the Itupeva municipality. The survey consisted of 144 interviews and 100 clinical examinations using the Montenegro skin test (MST). A prevalence of 34% positive MST was encountered. The predominant species of sandflies captured both in domestic and nearby areas of secondary vegetation were L. intermedia, L. whitmani and L. migonei. The presence of L. longipalpis in the nearby area of secondary vegetation was also registered.
[Value of ventricular geometry in the evaluation of direct ventricular pressure].
OBJECTIVE: To determine the echocardiographic end-systolic ventricular geometry value in evaluating right ventricular systolic pressure (RVSP). MATERIAL AND METHODS: We studied prospectively 68 patients (mean age = 6.0 +/- 5.0 years), submitted to cardiac catheterization for cardiac disorders not involving left ventricular (LV) outflow tract obstruction, within 24 hours after two-dimensional echocardiographic (2D echo) examination. 2D echo evaluation of RVSP was performed using end-systolic LV transverse orthogonal diameters (TDR). The LV transverse orthogonal diameters (antero-posterior and supero-inferior) were measured on a parasternal short-axis image, at the tips of papillary muscles. 2D echo semi-quantitative evaluation of RVSP was tested correlating TDR with hemodynamic RVSP/LV systolic pressure (LVSP) ratio--group 1. We also used regression equation derived from the first 35 patients to quantify RVSP in the last 33 patients--group 2. In these cases, systolic systemic arterial pressure measured by sphygmomanometry was taken as LVSP. RESULTS: The TDR ranged from 1.0 to 2.1 (mean = 1.5 +/- 0.3) and the RVSP/LVSP ratio from 0.3 to 1.7 (mean = 0.7 +/- 0.4). All patients with RVSP/LVSP greater than or equal to 65% have TDR greater than or equal to 1.3 and when RVSP less than or equal to 35 mmHg we always obtained TDR less than or equal to 1.2. The correlation between 2D echo estimated and catheter measured RVSP shows, for group 1, r = 0.88 and y = 1.1X-0.88 and, for group 2'. r = 0.88. CONCLUSION: In the absence of LV systolic obstruction, TDR is a reliable non invasive method in evaluating the RVSP.