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Biomedical subjects

M Correia

Publications and source records attributed to M Correia.

52 records · Page 3Linked to original sources
PubMed1990

[Arrhythmia in chronic respiratory insufficiency].

Ventricular arrhythmias are frequent in chronic pulmonary disease. Hypoxemia, right ventricular enlargement, associated left ventricular dysfunction and iatrogenic factors are potential determinants of the density and complexity of these arrhythmias. Its prognostic meaning in chronic pulmonary disease and its relationship with the elevated prevalence of sudden cardiac death in these patients, are not well known. Meanwhile, the therapeutic anti-arrhythmic strategy is dominated by the correction of the etiologic factors, namely continuous oxygen therapy which decreases ventricular arrhythmia and prolongs survival. Holter 24 hours monitoring is a useful diagnostic tool in management of these patients.

Arrhythmias, Cardiac↗
PubMed1981

Morphology of the veins draining the coronary sinus of the dog.

The morphology of the superficial cardiac veins draining the coronary sinus was investigated in 47 normal adult dogs, using the injection-corrosion-fluorescence technique. The veins pertaining to the left coronary territory all drain directly to the coronary sinus and include the following vessels: the great coronary vein and its tributaries, the left posterior atrial and ventricular veins. The veins pertaining to the right coronary territory include the posterior interventricular vein and the small cardiac vein. A comparison with the human pattern was made, particularly regarding the number of interventricular septal branches and it was suggested that such a reduction in number in the dog could be due to a take-over from the Thebesian veins in the venous drainage of the interventricular septum.

Animals↗
PubMed1975

Morphological study on the thebesian veins of the right cavities of the heart in the dog.

The authors studied 48 dog hearts, using the injection-corrosion-fluorescence method to study the topography of thebesian veins in all the walls of the cardiac cavities. The thebesian veins are small, situated deep in the myocardium, opening after a short course into the cardiac cavities, by small openings with diameters in general not exceeding 1 mm, known 'foraminula'. They have a centripetal course, while every other vein in the heart has a centrifugal one, to reach the subepicardial zone. In the heart of the dog five types of thebesian veins were served: arboriform, sinuous, brush-like, canaliculated and stellate. The thebesian veins are almost regularly found in every wall of the cardiac cavities. The authors also observed that they predominated in the right ventricle (81.24%) and in the right atrium (77.43%).

Animals↗
PubMedDate not supplied

Vasa vasorum changes following stent placement in experimental arterial stenoses.

PURPOSE: Experimental stenoses were created in canine aortae to compare the effects of stent placement and balloon angioplasty on the vasa vasorum. MATERIALS AND METHODS: A balloon-expandable Palmaz stent was placed in the proximal stenosis, and angioplasty was performed in the distal stenosis in each of eight dogs. Two dogs were killed at 4, 8, 12, and 18 months, respectively. Specimens were studied by means of microangiography, histology, scanning electronic microscopy, and Spalteholz technique. RESULTS: At up to 12 months, there was proliferation of the vasa vasorum and a rich plexus formed in each of the animals at each treated site. More vasa vasorum were seen after stent placement than after angioplasty. The new vessels were mainly venules located in the media. At 18 months, there was regression of the venules and the vasa vasorum distribution returned to baseline. CONCLUSION: The authors conclude that the effects of stents on the vasa vasorum are temporary.

Animals↗
PubMedDate not supplied

Changes in the vasa vasorum following percutaneous transluminal angioplasty in a canine model of aortic stenosis.

PURPOSE: To investigate the effects of percutaneous transluminal angioplasty on the vasa vasorum in dogs with experimentally created abdominal aortic stenoses. MATERIALS AND METHODS: Two stenoses were created in the abdominal aorta in each of 21 dogs. After 6 weeks, the more cephalic stenosis was dilated; the other stenosis served as an untreated control. Groups of three dogs were killed at 24 hours, 3 and 6 weeks, and 4, 8, 12, and 18 months after angioplasty. The aortae were studied by means of histologic examination, microangiography, scanning electron microscopy, and the Spalteholz technique. RESULTS: At nondilated stenoses, the vasa vasorum was interrupted in the outer adventitia and unchanged in the outer media. At dilated stenoses, the number of precapillary arterioles in the outer media progressively increased up to 8 months; thereafter, the number of precapillary arterioles began to decrease. At 18 months, the number was normal. CONCLUSION: Angioplasty brings about changes in the number of precapillary arterioles in the outer media of the aorta in our canine model of focal abdominal aortic stenosis.

Angioplasty, Balloon↗
PubMedDate not supplied

[Transesophageal echocardiography. Experience at the Pulido Valente Hospital (the first 50 cases)].

UNLABELLED: The use of echocardiography is increasingly important in the evaluation of cardiac patients. METHODS: The results of the First fifty examinations of the Department of cardiology (Hospital de Pulido Valente). We evaluate the contribution of the T-E-E on the therapeutic decisions of these patients. RESULTS: The clinical condition for which T-E-E were particularly appropriate were: embolism detection, evaluation of Mitral valvular regurgitation and prosthetic function, detection of vegetations in patients with suspicion of bacterial endocarditis, detection of intracardiac shunts. The examines were conclusive in 88% of the patients.

Adult↗
PubMedDate not supplied

Evaluation of the effect of sulphametoxazole and trimethoprim in patients with Machado-Joseph disease.

The treatment of Machado-Joseph disease (MJD) has so far been purely symptomatic. Encouraged by previous publications reporting some improvement in spasticity and gait in two patients with MJD treated with sulphamethoxazole and trimethoprim (Bactrim), we carried out a double-blind, placebo controlled cross-over trial in eight patients. Three kinds of parameters were used to evaluate the treatment effect: subjective performance, neurological examination and timed tests. The results showed that Bactrim had a beneficial effect on gait and coordination and that it would be worthwhile undertaking other trials, taking into account the great clinical variability of MJD.

Adult↗
PubMedDate not supplied

[Inter-hospital transfer in pediatrics].

We present the results of a prospective study of the technical and human characteristics of the transport of children transferred from other Hospitals to our PICU. During eight months of 1994, 153 children were transferred and 138 included in our study. Their ages varied between one month and fourteen years and the majority (60%) were males. 67% of the patients transferred required Pediatric specialties and 30% required surgical specialties. Accidents were the most common pathology (40%), followed by neurologic, respiratory and infectious situations (15% each) The most frequently used means of transport was an ambulance, in 88% of the cases. Only 12% of these were medically equipped and 10% had CPR material available. In 23% of the transports the patient was accompanied by both a nurse and a medical doctor. In 25% by a nurse only and in 14% by a medical doctor. None of them had training in transport medicine. The length of the transport varied between 30 min. and 14 h, with a mean of 2h. Ten patients had major complications during transfer. Their CCS on arrival at the PICU was > or = 3 in 55% of the cases. Based on these results we discuss the obvious need for a Pediatric Transport System in our country.

Adolescent↗
PubMedDate not supplied

Regional diastolic function in hypertrophic cardiomyopathy: a tissue Doppler echocardiographic study.

BACKGROUND: Tissue Doppler echocardiography (TDE) is a recent ultrasonic technique. One of its potential clinical uses is the assessment of regional diastolic function. OBJECTIVES: To compare left ventricular global diastolic function with interventricular septum regional diastolic function in patients with hypertrophic cardiomyopathy with different levels of global diastolic dysfunction. METHODOLOGY: 10 normal subjects (group 1), eight hypertrophic cardiomyopathy patients with abnormal relaxation (group 2) and 12 patients with hypertrophic cardiomyopathy with restrictive pattern (group 3) on the mitral inflow profile (pulsed wave Doppler) were studied. Each patient performed an M-mode color; TDE of the basal septum in the four chamber view. Velocities during the rapid filling phase (RF), and during atrial contraction (AC) were measured and RF/AC ratio calculated in each patient. RESULTS: While in normal subjects (group 1) the RF/AC ratio was always higher than 1, in patients with hypertrophic cardiomyopathy patients with different levels of global diastolic dysfunction (groups 2 and 3), the RF/AC ratio was always lower than 1 (velocities during atrial contraction always higher than during rapid filling), despite the level of global diastolic dysfunction. CONCLUSIONS: A ratio between myocardial velocities during the rapid filling phase and during atrial contraction lower than one (RF/AC < 1) is a tissue Doppler echocardiography index of regional diastolic dysfunction, independently of the severity of global diastolic dysfunction.

Adult↗
PubMedDate not supplied

[Nosocomial infection in a pediatric intensive care unit].

UNLABELLED: Patients in intensive care units (ICU) are 3 to 4 times more prone to nosocomial infection (NI) than patients in general wards owing to the severity of their pathology and the frequent use of invasive procedures. The aim of this study was to establish the incidence of NI in an ICU and the associated risk factors. PATIENTS AND METHODS: During 18 months, all patients with severity scores III and IV (Clinical Classification System) were studied, (n = 575). The admissions were mainly due to accidents (24.7%), neurological (19.1%), surgical (17.2%), respiratory (11.1%) and infectious (7.0%) disease. The mean duration of stay was 2.4 days. The mortality was 5.2%. The evaluation protocol of these patients included determination of the PRISM score, registration of every invasive procedure and daily search for clinical and laboratory signs of infection. NI was defined according to the criteria of the Centers for Disease Control. Both the intrinsic and extrinsic risk factors were analysed and in the statistical analysis the null hypothesis was rejected at the significance level of p < 0.05. RESULTS: The incidence of NI was 7.6%. The infections occurred in the respiratory tract in 20 patients, bloodstream in 8, genito-urinary tract in 2, central nervous system in 2, skin in 2, gastrointestinal tract in 2, eyes in 1 and surgical wound in 1. There were isolates in 60.6%. The mean duration of stay was longer in patients with NI (9.8 versus 1.9). The factors most closely associated with NI were higher PRISM scores, malnutrition, immunodeficiency failure of 2 or more organs, administration of antibiotic since admission or corticosteroids and simultaneous use of 3 or more invasive procedures. The risk of pneumonia was significantly increased in patients with mechanical ventilation and all the patients with bacteremia had central venous catheters. The mortality was higher in the group with NI (18.2%) than in the group without NI (4.4%). CONCLUSIONS: The incidence of NI is acceptable in our ICU. The most frequent location was the respiratory tract (52.6%). The pathogens most frequently isolated in this ICU were Gram negative rods. The risk of NI increased in more debilitated patients with more severe disease who were administered antibiotic or corticosteroids and submitted to more invasive procedures.

Adolescent↗
PubMedDate not supplied

[Heart disease induced by mediastinal radiotherapy in Hodgkin's disease: report of a clinical case].

As the number of adults surviving radiation therapy for Hodgkin's disease increases, the long-term clinical sequelae of such treatment is becoming increasingly more evident. Mediastinal radiation has been linked to acute and chronic pericarditis (with or without pleural effusion), coronary artery disease, myocardial fibrosis, valvular dysfunction and arrhythmias. The AA describe a case of a young patient with evidence of significant valvular disease following mediastinal irradiation, and review the radiation-induced cardiotoxicity, discussing aspects concerned with pathophysiology, diagnosis and therapy.

Adult↗
PubMedDate not supplied

[The cerebrovascular stroke unit: the concept and its utility].

Patients suffering from stroke within a geographically defined area should be admitted to hospital early, treated by an organised multidisciplinary group and provided with a period of rehabilitation whenever necessary. All stroke units should, essentially, have the characteristics of the units assessed in aleatory clinical trials. Patients treated in stroke units have a lower mortality rate, less dependence and less need for long-term hospitalisation, without a systematic increase in the use of resources (in terms of hospitalisation time). Admission to stroke units should not be restricted to age, sex or stroke severity. The stroke units should be adapted to the existing conditions and resources in each hospital. They should be built progressively, with the knowledge that they do not use more of the existing resources, and should be fundamentally based on health care organisation.

Cerebrovascular Disorders↗
PubMedDate not supplied

[Therapeutic recommendations. Secondary prevention of cerebral vascular accident].

The guidelines for secondary stroke prevention, graded following available scientific evidence, are presented. Stroke and TIA are defined and the indications for referral established. Basic assessment of stroke patients should include laboratory evaluation, ECG, brain CT, ultrasound examination of the extracranial vessels for events in the carotid distribution, and transthoracic or transesophageal echocardiogram if cardioembolism is suspected. The pharmacological and non-pharmacological reduction of blood pressure and serum cholesterol, stopping smoking and reducing alcohol intake are general measures recommended for secondary stroke prevention, together with healthier life-style changes (eating a Mediterranean type diet and performing regular moderate physical exercise). Concerning antithrombotic therapy, oral anticoagulants are recommended for patients with atrial fibrillation and other high to medium emboligenic cardiac risk conditions. Antiplatelet drugs are recommended for all other survivors of an ischemic cerebral event. Aspirin (75-325 mg/day) is the drug of choice. Alternative antiplatelet agents are clopidrogrel, ticlopidine, dipiridamol or triflusal. They can be used in patients with intolerance or contraindication to aspirin or in high-risk subjects. Endarterectomy of the symptomatic carotid is an additional procedure recommended for patients with ischemic stroke or TIA and carotid stenosis > 80% on the side of the symptomatic cerebral hemisphere.

Antihypertensive Agents↗