Biomedical subjects
M Coutinho
Publications and source records attributed to M Coutinho.
[Cardiopulmonary stress: control of the function of frequency variable pacemaker systems].
Based on the linear relationship between cardiac output and oxygen uptake direct breath-to-breath gas exchange measurements during exercise allow accurate determinations of cardiopulmonary function. We used cardiopulmonary exercise testing to assess the physiologic benefit of rate response VVIR pacing in 17 patients with chronotropic incompetence. 13 patients had an activity-rate-response pacemaker, two patients had a temperature-controlled pacemaker and two patients a respiratory-dependent system. Exercise testing was performed with the pacemaker, either programmed to fixed rate VVI or to rate variable VVIR pacing. All patients were exercised on a bicycle using a ramp protocol with 10 to 20 watts/min increments. Maximal oxygen uptake and the anaerobic threshold were determined. Compared with findings in the VVI mode, rate response VVIR pacing increased maximal exercise heart rate from 74 +/- 10 to 118 +/- 21 bpm (p less than 0.001). This increase in heart rate was associated with an increase of maximal oxygen uptake from 14.3 +/- 5 to 18.3 +/- 6 ml/kg per min (p less than 0.04) and a delay of the anaerobic threshold to a higher oxygen consumption of 14.6 +/- 5 vs 10.6 +/- 5 ml/kg per min (p less than 0.04). The individual increase in oxygen uptake was a direct function of the change in exercise heart rate independent of the implanted pacing device. The improved aerobic capacity resulted in a 17% increase in exercise tolerance and a 19% increase of exercise time. Cardiopulmonary exercise testing appears to be a useful noninvasive technique to quantify the cardiopulmonary benefit of rate response pacing.
Femoral duplication: a case report.
Femoral duplication is a rare anomaly that has been described as an isolated entity and in association with other congenital defects. Since the description by Erlich in 1885, 24 additional cases have been reported. The present report concerns a 34-week black female infant with apparent bilateral femoral duplication associated with a meningocele and abdominal, genitourinary, vertebral, and lower-limb anomalies. The cause is unknown. Femoral duplication is a developmental field defect, hence causally heterogeneous.
Atmospheric baseline levels of PCDD and PCDF in the region of Oporto.
An external monitoring plan (EMP) is being implemented in the region of Oporto, Portugal, to follow the potential effects of a future incinerator of municipal solid waste. Polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/PCDF) were measured during 1998 and the first semester of 1999, prior to the working up of the incineration unit. The baseline levels obtained through this intensive monitoring work are presented and discussed in the present paper.
Atmospheric impact assessment and monitoring of dioxin emissions of municipal solid waste incinerators in Portugal.
In Portugal two municipal solid waste (MSW) incinerators are under construction in the metropolitan areas of Lisbon and Porto. During the development of the Environmental Impact Assessment (EIA) studies of these units the authors found several limitations and uncertainties associated to the assessment of the environmental impact. Uncertainties were particularly felt on the assessment of the environmental impacts associated with the atmospheric emissions of PCDD and PCDF. At present an External Monitoring Plan is under design.