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Biomedical subjects

J Martins

Publications and source records attributed to J Martins.

34 records · Page 2Linked to original sources
PubMed1984

Advance prediction of transthoracic impedance in human defibrillation and cardioversion: importance of impedance in determining the success of low-energy shocks.

The purposes of this study were to evaluate a method that predicts transthoracic impedance in advance of defibrillating shocks in humans and to assess the importance of transthoracic impedance in low-energy defibrillation. Via defibrillator electrodes we applied 31 kHz current to the chest during the defibrillator charge cycle, before the defibrillating shock was actually delivered. The current flow was limited by transthoracic impedance; a microprocessor monitored the predischarge current flow and determined the predischarge impedance by calibration against known resistance values. Actual impedance to the defibrillating shock was also determined and compared with the predicted impedance. With this approach we predicted impedance in 19 patients who received 66 shocks for ventricular and atrial arrhythmias. Predicted impedance (y) correlated very well with actual impedance (x):y = .90x + 11.3; r = .97. To determine the importance of impedance in defibrillation and cardioversion, we prospectively gathered data from 96 patients who received shocks of various energies for ventricular or atrial arrhythmias. In patients with high transthoracic impedance (greater than 97 omega), low-energy shocks (less than or equal to 100 J) for ventricular defibrillation had only a 20% success rate as opposed to a 70% success rate for low-energy shocks in patients with low or average impedance (p less than .05). We conclude that transthoracic impedance can be accurately predicted in advance of defibrillation and cardioversion. This method permits the preshock identification of patients with high impedance in whom attempts to defibrillate with low-energy shocks are inappropriate.

Arrhythmias, Cardiac↗
PubMed1977

Retro-umbilical ectopic testicle: report of a case.

A case of a retro-umbilical ectopic testicle in a 13-year-old cryptorchid boy is reported. To our knowledge this has not been reported previously. There is no definite explanation for this highly aberrant ectopia. During the neonatal period the boy had an umbilical suppuration that required drainage. This may offer a possible explanation since the consequent healing process could have pulled the peritoneum upwards, dragging the testicle with it. Despite the high position of this testicle (and previous operation on the other side) it was easy to cross over both testes successfully to the heterolateral scrotum.

Adolescent↗
PubMedDate not supplied

Identifying environmental health priorities for a whole nation: the use of principal environmental exposure pathways in the Philippines.

This paper presents a novel approach to establishing environmental health priorities for a large society, based upon the concept of principal environmental exposure pathways (PEEPs). Principal environmental exposure pathways extend the concept of a causal pathway backward from health outcome to exposure, then to the industrial, transportation, commercial, or living conditions that gave rise to the pollution of interest. In the Philippines, where the method was developed and used, five PEEPs were identified: an urban air-pollution pathway; a community water-supply pathway; an urban solid-waste pathway; a rural "point-source" pathway; and a pathway whereby fertilizers and pesticides affect food, worker health, and rural water supplies. Characterizing the PEEPs involved pinpointing the populations at risk necessary to estimate the burden of morbidity and mortality related to each as well as identifying the health outcomes that were experienced by those exposed along each pathway or that they could be expected to experience; determining where adequate health-outcome information was available or absent; where exposure sources were or were not adequately identified; where there were significant gaps in agency responsibilities; where new data flows were needed; and where things could have been improved by improving inter-agency cooperation. The most important success of the PEEP method was to reduce the "problem of everything" in a complex country of 65 million people to a small and manageable number of priority environmental exposures.

Air Pollution↗
PubMedDate not supplied

[Iatrogenic traumatic lesions of femoral veins during varicose veins surgery].

Traumatic lesions of the femoral veins during varicose veins surgery are very uncommon and they raise several therapeutic difficulties. They occur in 1/1000 cases of varicose veins operated. The authors describe four cases of lesions of this type that were seen and treated for the last six years, probably because there was an increase in the number of varicose veins operated on in the Lisbon area. The authors discuss the surgical options and they concluded that these complications can be minimized with good anatomical and surgical skills, specially of the saphenous-femoral and saphenous-popliteal junctions.

Adult↗
PubMedDate not supplied

[Chronic hypoparathyroidism: review of 5 clinical cases].

In 5 patients with a long clinical evolution of tetany and/or convulsions and with documented hypocalcaemia and hyperphosphatemia, low or inappropriate values of parathormone were detected. Only two of the patients had a history of subtotal thyroidectomy and all presented with basal ganglia calcification, bilateral subcapsular cataracts and prolonged QTc interval in the ECG. After one month of oral therapy with calcium and calcitriol, the values of calcaemia and phosphatemia were in a near-normal range with the exception of a patient in which that normalization was much slower and only occurred after correction of magnesaemia. In this last patient statistical correlation between QTc interval in the ECG and the calcaemia was statistically significant (P less than 0.001). We conclude that the QTc interval can be a useful and accessible index in acute situations of symptomatic hypocalcaemia.

Adult↗
PubMedDate not supplied

[Depression and anxiety in general practice and family medicine consultation].

The aim of this work was to study depression and anxiety in outpatients of Family Practice, namely: definition of cases, caseness, point-prevalence, clinical features, correlations with social demographic factors and identification of risk groups for those psychological disorders. Therapeutic attitudes displayed by family practitioners were also evaluated. The results of the study reveal a high prevalence of depression in family medicine settings and a relative tendency of family doctors to underdiagnose case of depression. Such an evidence allows the authors to conclude that steps should be taken in order to provide training programs for family practitioners and to plan appropriate treatment programmes at public Health Centres.

Adolescent↗