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Biomedical subjects

J J de Oliveira

Publications and source records attributed to J J de Oliveira.

6 recordsLinked to original sources

[Diagnostic value of exercise testing in the diagnosis of silent myocardial ischemia in elderly patients with systolic hypertension].

PURPOSE: To evaluate the diagnosis value of exercise testing for silent myocardial ischemia in systolic hypertension of the elderly. METHODS: We compared 110 patients with systolic hypertension (group A) with 104 patients without hypertension (group B). They were submitted to an exercise test according to the Bruce protocol, between January/91 to December/94. Exercise was discontinued if target heart rate was achieved, or fatigue, dyspnea, severe arrhythmia, hypotension or significant ST segment depression > or = 2 mm/0.2 mV developed. RESULTS: Exercise testing showed ischemic ST depression in 22 (20%) of the elderly patients with hypertension systolic and 12 (11.5%) of control elderly patients. The exercise time was shorter in the hypertensives 7.1 +/- 2.9 min vs 8.8 +/- 2.5 min. The ST depression was greater in the hypertensives than the control group: 2.5 +/- 0.8 min vs 1.9 +/- 0.4 min. Also the duration or ischemic ST depression was longer in the hypertensive patients than the control group 5.4 +/- 2.8 min vs 3.4 +/- 1.9 min. CONCLUSION: Elderly hypertensive patients with systolic hypertension have more silent myocardial ischemia than elderly without hypertension. Among the elderly hypertensive patients there was a prevalence of silent ischemia that was 1.7 times higher than in the normotensive elderlies (20% vs 11.5% P < 0.003).

Aged↗

[Acute myocardial infarction occurring in a young man due to crack use].

The relation between cocaine use and cardiovascular disease has been well documented including coronary artery vasoconstriction, coronary thrombosis, accelerated atherosclerosis, myocarditis, cardiomyopathies and endocarditis. Cocaine use has reached epidemic proportions. Cocaine is the most commonly abused drug among young patients. We report the case of a 32-year-old male admitted to the emergency department with myocardial infarction secondary to an overdose of cocaine.

Adult↗

[Signs of myocardial ischemia associated with subarachnoid hemorrhage].

Electrocardiographic changes, left ventricular wall motion abnormalities, myocardial ischemia, myocytolysis and arrhythmias have been well documented in patients with cerebral bleed. These complications may be related to stimulation of autonomic nervous system and central nervous system. We report a case of a 38-year-old back woman without previous heart disease, taken to emergency unit with headache and subarachnoid Haemorrhage. One day after, she complained of retroesternal pain. An electrocardiographic tracing showed significant and diffuse ST-T wave abnormalities. The patient remained stable with no neurologic or cardiac deficits. She was treated with bed rest, nimodipine, isossorbide propranolol and is symptomless six months of follow-up.

Adult↗

[Arterial hypertension due to mercury intoxication with clinical and laboratorial syndrome simulating pheochromocytoma].

A 17-year-old boy was admitted to hospital because of severe hypertension (200/130 mmHg), headache, irritability, sweating, etc. Initial biochemical tests suggested pheochromocytoma, being treated with nifedipina, clonidina and propranolol. On reporting exposure to mercury vapour, he underwent twenty-four-hour urine screening and measurement of blood mercury which confirmed intoxication. The patient received courses of chelation therapy with dimercaprol (BAL) and penicillamine with remission of symptoms and normalisation of hypertension after 2 months. This case is relevant to current practice regarding similarity between mercury intoxication and hypertension secondary to pheochromocytoma.

English Abstract↗

[Psychiatric disorders in hospitalized patients with hematologic neoplasms].

We report the results of a year of regular psychiatric support in the Hematology Department (UTI-DH) at Santa Maria Hospital. During a six-month period, the total group of hospital inpatients suffering from leukemia, Hodgkin's disease or non-Hodgkin's lymphoma, were assessed, using a semi-structured interview. A prevalence of 30% of adjustment disorders (depression and/or anxiety) and 2% of organic mental syndromes was found employing the DSM-III-R diagnostic system. In the second six-month period only patients referred by their doctor and/or nurse were observed. The two rates are discussed. A lower prevalence was found if compared with other studies in cancer patients in general. Possible causes will be focussed. General problems related to the nature of the cancer were identified. The consequences of the omission of cancer diagnosis to patients are analysed. The communication between physician and patient which is often neglected irrespectively of the culture or country, is stressed.

Adolescent↗