Search PubMed⌕ Search

Biomedical subjects

L Ferreira

Publications and source records attributed to L Ferreira.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Hemodynamic assessment after heart transplantation].

OBJECTIVE: Comparative analysis of the results of the hemodynamic evaluations performed at the preoperative period, during the first week and at the end of the first and second years, after orthotopic heart transplantation. DESIGN: Retrospective study of hemodynamic evaluation of patients submitted to orthotopic cardiac transplantation from April 1987 to April 1990. SETTING: Transplanted patients admitted at the cardiology and cardio-toracic surgery departments of the Hospital Santa Marta. PATIENTS: 15 patients (eleven males and four females) aged 21 to 55 years (mean = 33.3 +/- 10.5), with the preoperative diagnosis: dilated cardiomyopathy in 11, ischemic heart disease in three and hypertrophic cardiomyopathy in one patient. All the patients were on triple immunosuppressive therapy (cyclosporine A, azatioprine and prednisolone) at the time of the first week evaluation. Three of the eight patients evaluated at the end of the first year were with double immunosuppressive regimen (without steroids), seven at NYHA functional class I and one patient at class II. The three patients evaluated at the end of the second year were on triple immunosuppressive regimen and in class I. INTERVENTIONS: We considered, preoperatively (PrOp), at the first week (1W), and at the end of the first (1Y) and second (2Y) years: mean right atrial pressure (RA), systolic pulmonary arterial pressure (PAs), mean pulmonary arterial pressure (PAm), pulmonary capillary wedge pressure (PCW), mean systemic arterial pressure (SAm), cardiac index (CI), pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR). At 1Y and 2y there were also considered the left ventricular end-diastolic pressure (LVEDP) and the ejection fraction (Ej). RESULTS: (table; see text) The results found at 2Y were similar to those showed at 1Y. At 1Y and 2Y LVEDP and Ej were normal. CONCLUSIONS: A high prevalence of mild to moderate hemodynamic disturbances characterizes the early post-operative period in cardiac transplantation. Abnormal pressures on right atrium, pulmonary artery, pulmonary capillary wedge pressure, are found on a significant number of patients, and pulmonary and systemic vascular resistances are also elevated. However at the end of the first year there is a significant improvement compared with the first week. Normality is the hallmark of hemodynamic evaluation performed in transplant recipients at the end of the first and second years.

Heart Transplantation↗
PubMed1991

[Exercise test parameters after acute myocardial infarction. Relationship with coronary angiography].

OBJECTIVE: To analyze the relation between characteristics of symptom-limited treadmill exercise stress test, after acute myocardial infarction (MI) and coronariographic results (number of diseased vessels). Both tests were performed before hospital discharge. DESIGN: Retrospective study with comparative analysis between variable defined groups. POPULATION AND SETTING: From 232 patients interned in the department of Cardiology of Hospital de Santa Marta with a first acute MI, a population of 112 patients submitted to exercise stress test and coronary angiography before discharge were selected (aged 29 to 69 years). METHODS: Symptom-limited treadmill exercise stress tests were performed according to Bruce protocol, with no heart-rate limitation. The following parameters were analyzed: Stress test duration (DUR); Double product variation (varDP); Metabolic equivalent units (METS); Maximal heart rate (FCmax); Percentage of the maximal reached heart rate (% FCmax); Incidence of ST segment depression (InfST); Maximal ST segment depression (Max-InfST); Onset minute of ST segment depression (MinInfST); Heart rate at the onset of ST segment depression (FCInfST); Double product at the onset of ST segment depression (DPInfST); Recovery minute of ST segment depression (MinRInfST); Onset minute of angina (MinAng); Heart rate at the onset of angina (FCAng); Double product at the onset of angina (DPAng). RESULTS: Statistical significant differences were obtained between coronariographic groups concerning the following parameters: DUR: 1-vessel/3-vessel P = 0.02; VarDP: 1-vessel/3-vessel p = 0.008, 2-vessel/3-vessel p = 0.004; METS: 1-vessel/3-vessel p = 0.01. No differences were seen between anterior and inferior myocardial infarctions regarding all the stress test parameters. However in patients with anterior MI significant differences were obtained concerning the following variables: VarDP: 1-vessel/2-vessel p = 0.02; InfraST: 1-vessel/2-vessel p = 0.006, 1-vessel/3-vessel p = 0.03; MaxInfST: 1-vessel/2-vessel p = 0.01, 1-vessel/3-vessel p = 0.0006; Angina: 1-vessel/2-vessel p = 0.0005, 1-vessel/3-vessel p = .001. In inferior myocardial infarctions only the stress duration differed between 1-vessel and 3-vessel groups (p = 0.003). CONCLUSIONS: Symptom-limited treadmill exercise stress tests, safely performed in our institution, were an important method for post MI evaluation and allowed the diagnosis of a great number of patients with residual ischemia. Statistical significant differences were found in ergometric parameters, between coronariographic groups (defined by the number of diseased vessels), emphasising the importance of stress tolerance analysis.

Adult↗
PubMed1990

[Influence of recipient auricular contraction on the left ventricle filling pattern of the transplanted heart studied with pulsed Doppler echocardiography].

OBJECTIVES: to evaluate the influence of recipient atrial contraction (RAC) timing on left ventricular filling pattern (LVFP), assessed by Pulsed Doppler, in orthotopic transplant recipients (OTR). STUDY DESIGN: prospective study of OTR. SETTING: patients (pts) submitted to orthotopic heart transplantation at Hospital de Santa Marta, from April/87 to March/89, in routine evaluation. PARTICIPANTS: nine pts, aged 21 to 55 years (mean = 32 +/- 11), 0.5 to 20 (mean = 7.4 +/- 6.9) months post-operatively. METHODS: in each pt 40 to 60 (mean 52) consecutive cardiac cycles were analysed; five groups (Gr.) were considered, according to RAC (P wave) position in the cardiac cycle: Gr. I--Early systole, GR. II--late systole, Gr. III--early diastole, Gr. IV--late diastole and Gr. V--absent. The following parameters were studied: peak early diastolic mitral flow velocity (Evel), peak late diastolic mitral flow velocity (Avel), ratio Evel/Avel, (E/A) and pressure half time (PHT). RESULTS: 1) Evel and E/A were significantly higher, Avel lower, and PHT shorter, in Gr II and III; 2) Avel was higher and E/A smaller in Gr. IV; 3) no statistically significant differences were found betwenn Gr. I and V, for any of the parameters analised. CONCLUSIONS: the timing of RAC significantly influences LVFP and it must be considered on Echo-Doppler analysis of diastolic function in OTR.

Adult↗
PubMed1990

[Biopsy of the right ventricle endomyocardium. Experience at the Santa Marta Hospital].

OBJECTIVE: To review the experience of Santa Marta Hospital in the right ventricle endomyocardial biopsy technique. DESIGN: Retrospective analysis of the results, diagnostic value and complications of the myocardial biopsies performed between April/87 and March/90. PATIENTS AND INTERVENTIONS: 255 biopsies were performed; 221 on 13 patients submitted to orthotopic heart transplantation (nine male and four female, aged between 21 and 55 years old), and the remaining on 34 patients (22 male and 12 female aged between 15 and 64 years old), mainly on cardiomyopathies. RESULTS: In 221 biopsies performed in heart transplant recipients, we found: 109 with no rejection, 21 with moderate rejection, 57 with mild rejection and only one case showed severe rejection. In this group six biopsies were considered inconclusive. In the group of patients not submitted to heart transplantation the histological findings were inespecific in the great majority of the cases. In the 255 procedures four complications were detected (1.56%), with no mortality; two hemopericardium with tamponade (0.78%), one pneumothorax and one atrial fibrillation. CONCLUSIONS: Endomyocardial biopsy essential for histological diagnosis of acute rejection following heart transplantation has revealed to be a save procedure with a small number of complications.

Adolescent↗
PubMed1990

[Flow in the entry chamber of the right ventricle: diastolic function indexes in a normal population].

OBJECTIVES: To define normal values of indexes of diastolic function of right ventricle by bidimensional pulsed doppler echocardiography. STUDY DESIGN: Prospective study of normal individuals. MATERIALS AND METHODS: Thirty normal subjects by physical examination, electrocardiographic, radiological and echocardiographic criteria, aged between 22-48 (mean 31.2 +/- 6.7) were evaluated. We determined 16 different indexes and correlated them with heart rate, age and body surface; 27% of cases owing to the poor quality of records, were excluded. RESULTS: Eight indexes were heart rate dependent and for their use is necessary the respective correction; none of them correlated with age or body surface. Areas determined under the curves of flow are very time consuming and require great accuracy determination. So, we had correlated areas with other different indexes in order to obtain other parameters to give us the same information on a easier and quickly way. E/A relation correlated with all areas relations. CONCLUSIONS: The indexes determined can be considered as normal standard in order to evaluate, by a non-invasive way, right ventricle diastolic function. Nevertheless, the great proportion of records of poor quality is a limitation of the method.

Adult↗
PubMed1990

[Flow in the entry chamber of the left ventricle. Changes with age].

OBJECTIVES: To evaluate the influence of aging in the parameters of the left ventricle diastolic function, using 2D-Doppler echocardiography. STUDY DESIGN: Prospective study of normals subjects. MATERIAL AND METHODS: They were studied 38 normals subjects aged between 23-70 years divided in two groups: group A--20 subjects aged less than 45 years (34.5 +/- 6) and group B--18 subjects aged greater than 45 years (55.7 +/- 8.4); we registered the left ventricle inflow flows by 2D-pulsed Doppler Echocardiography and analyzed the following indexes: E and A Velocities, E/A ratio, relations of areas under the curves of flow, E Area/Total Area (EAr/TAr), A Area/Total Area (AAr/TAr), 33% Area/Total Area (33Ar/TAr), 50% Area/Total Area (50Ar/TAr) and A Area/E Area (AAr/EAr). RESULTS: E Vel and E/A ratio are significantly higher in the group A (p less than 0.001), both decreasing with aging, respectively r = -0.71 and r = 0.63; on the other way, the relative contribution of atrial systole to the left ventricle diastolic filling is significantly higher in the group B(ArA/ArT p less than 0.001; AAr/EAr p less than 0.001), increasing significantly with aging, r = 0.64 and r = 0.69, respectively. CONCLUSIONS: There is an increasing of atrial contribution to the left ventricular diastolic filling in the elderly, so in comparative studies it must be used control groups with the same age.

Adult↗
PubMed1988

[Hypereosinophilic syndrome. Clinical case].

We report the case of a 16 years old girl with hypereosinophilic syndrome, presenting with fever, abdominal pain, skin lesions and peripheral neuropathy, which responded successfully to treatment with prednisone.

Adolescent↗
PubMed1985

A double-blind trial comparing mianserin and maprotiline in depressed inpatients.

The antidepressant effects and side effects of mianserin and maprotiline were assessed in a double-blind trial in 62 inpatients (34 men and 28 women; mean age, 43.6 years) with primary depressive illness. For the first week of the trial, 32 patients received 30 mg/day of mianserin and 30 patients received 75 mg/day of maprotiline; for the next three weeks, the dosage of each drug was doubled. According to scores on the Hamilton Psychiatric Rating Scale for Depression, administered on days 0, 7, 14, 21, and 28, the antidepressant effects of the two drugs were virtually identical. Results of electrocardiographic and vectorcardiographic recordings and other measurements indicated that by day 28 the QRS duration was significantly longer (P less than 0.05) in the maprotiline group. On days 14 and 28, mean systolic blood pressure was significantly higher (P less than 0.05) in the maprotiline group. By day 28, the incidence of anticholinergic side effects--constipation and dry mouth--was significantly higher (P less than 0.05) in the maprotiline group. Although maprotiline's effects on heart functions never reached clinical significance, its anticholinergic side effects could be bothersome, especially to older patients.

Adolescent↗
PubMedDate not supplied

The efficacy of the D2 and 5-HT2 antagonist risperidone (R 64,766) in the treatment of chronic psychosis. An open dose-finding study.

After a wash-out period of 1 week, 20 patients suffering from schizophrenia were treated for 4 weeks in an open dose-finding study with a new serotonin-dopamine antagonist risperidone. All patients completed the trial. The mean daily dose of risperidone was 4.6 mg (range 2-10 mg) at completion. Risperiodone had a rapid onset of action: a highly significant decrease of the total BPRS score (Brief Psychiatric Rating Scale) was already noticed at the end of the second week. This decrease was found in all BPRS factors after 4 weeks. In spite of the withdrawal of antiparkinson medication at selection, a clear decrease of EPS (extrapyramidal symptoms), assessed on the Simpson and Angus Scale, was observed. The Global Therapeutic Impression agreed to the BPRS scores, showing a highly significant improvement after 2 weeks of treatment. Risperidone was very well tolerated, only mild side effects were reported. Vital signs, electrocardiographic parameters and laboratory values remained normal during the trial. This study indicates that risperidone can be an effective and well-tolerated alternative in the treatment of chronic schizophrenia, combining an antipsychotic activity, a beneficial effect on anergia and anxiety depression and a low EPS-inducing profile.

Adult↗
PubMedDate not supplied

[Lung cancer and women].

The epidemiology of lung cancer has changed in the last years in several countries all over the world. In the 19th century, the lung cancer was rare but it incidence increase drastically during the 20th century, and the tendency is to continue in the 20th century. Actually the lung cancer's incidence and mortality are higher in the developed countries, especially in Europe and Unites States of America, with a increasing in the women incidence. These geographic differences and gender differences are related with smoking habits. Women begin to smoke earlier and have more difficulty to stop, because of problems related with obesity; they have more sensibility to the carcinogens and the risk of lung cancer is 1.5 times higher than the men with the same habits. Adenocarcinoma is the more frequent histological type in young people, in the total of the women and in non-smokers. Many factors since tobacco, home and professional pollution, nutritional, associated diseases even genetic and hormonal factors have been investigated to define its influence in development in women lung cancer. It specificity in women with lung cancer is the common problem for the medical people to treat this disease (pathology).The literature about this problem is not clear, and is necessary to advance with many studies in this area with the objective to clarify this important question.

Air Pollution, Indoor↗
PubMedDate not supplied

[The neuropathological findings in the acquired immunodeficiency syndrome (AIDS): a review of 138 cases].

This is an autopsy study performed in a retrospective fashion to determine the incidence of diseases that could affect the central nervous system in AIDS. For this purpose, 138 autopsies of patients with AIDS performed at the "Hospital de Clínicas de Porto Alegre", Brazil, between January/85 and December/90 were studied. All the brains were evaluated macroscopically and microscopically mainly through hematoxylin-eosin staining and if necessary special techniques like PAS, Grocott, Giemsa and Ziehl-Nielsen were done. Results have revealed 29 (21%) cases with cerebral toxoplasmosis; cryptococcosis in 17 (12%); tuberculosis in two (1%) and one case (0.7%) of candidiasis. Besides these inflammatory lesions, 15 (10%) presented vascular lesion; 8 (6%) had gliosis and 7 (5%) cases had suggestive findings of HIV encephalopathy. We can conclude that the CNS is a important target affected by AIDS and that cerebral toxoplasmosis is the principal disease in the CNS in AIDS patients.

AIDS Dementia Complex↗
PubMedDate not supplied

[The sensitivity and specificity of the clinical, serological and tomographic diagnosis of Toxoplasma gondii encephalitis in the acquired immunodeficiency syndrome (AIDS)].

Toxoplasmic encephalitis (TE) is among the most common neurologic affections and it is the most prevalent cause of intracerebral mass lesions in AIDS patients. All patients with AIDS hospitalized at the Hospital de Clínicas de Porto Alegre between May/85 and December/91 (516 cases) had their files revised to determinate TE prevalence, serology, sensitivity and specificity of the computed tomography (CT) brain scan, clinical findings and serology to make its diagnosis. The prevalence on CT was 13% (presumptive diagnosis). Blood serology and cerebrospinal (CSF) serology to toxoplasma were positive respectively in 65% and 49%. Autopsies of 125 patients were also revised with a prevalence of 22% (definite diagnosis). CT scan had 65% of sensitivity and 82% of specificity. Sensitivity and specificity of serology on blood was respectively 95% and 30%, while the cerebrospinal fluid (CSF) serology had 77% of sensitivity and 56% of specificity. The following clinical findings were considered: fever (sensitivity = 92%; specificity = 56%), neurological focal signs (sensitivity = 59%; specificity = 82%) and headache (sensitivity = 41%; specificity = 69%). We conclude that, based on the high serology sensitivity and high CT scan specificity, they constitute an useful approach to make TE diagnosis.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Tc45, a dimorphic Trypanosoma cruzi immunogen with variable chromosomal localization, is calreticulin.

We demonstrate that Tc45, a polypeptide described as an immunogenetically restricted Trypanosoma cruzi antigen in mice, is calreticulin, a dimorphic molecule encoded by genes with variable chromosomal distribution. Previously we showed that IgG from A.SW (H2s) mice immunized with T. cruzi trypomastigotes or epimastigotes and sera from infected humans recognize Tc45, a 45 kD parasite polypeptide. Herein we describe the cloning, sequencing, and expression of the Tc45 gene. A 98% homology in the deduced amino acid sequence was found with a T. cruzi calreticulin-like molecule and 41% with Leishmania donovani and human calreticulin. In the T. cruzi CL Brener clone and in the Tulahuén strain, the gene is located in two and four chromosomes, respectively. Calreticulin was detected in several T. cruzi clones, in the Tulahuén strain, and in T. rangeli, displaying alternative 43 and 46 kD forms.

Amino Acid Sequence↗
PubMedDate not supplied

[Nursing records].

Explore the source record for details and available documents.

Ethics, Nursing↗
PubMedDate not supplied

[Nursing thinking].

Explore the source record for details and available documents.

Nursing Theory↗