Search PubMed⌕ Search

Biomedical subjects

M Lima

Publications and source records attributed to M Lima.

126 records · Page 7Linked to original sources
PubMedDate not supplied

[Thoracoscopic management of suspected thoraco-pulmonary malignant diseases in pediatric age].

Recent improvements and miniaturization of instruments have encouraged a wider use of thoracoscopy and laparoscopy as a modality for diagnostic and operative procedures in pediatric age. The utility of thoracoscopy in pediatric patients with suspected thoracopulmonary oncological diseases is shown by diagnostic accuracy and, if necessary, the possibility to perform at the meantime a mininvasive surgery. We report the experience of our Institution in 16 patients with suspected thoraco-pulmonary oncological diseases and treated for this reason with thoracoscopy. Thoracoscopic is indicated in cases of suspected oncological diseases in children both for diagnosis and treatment.

Adolescent↗
PubMedDate not supplied

Reactive phenotypes after acute and chronic NK-cell activation.

Several phenotypic changes have been shown to occur after NK-cell stimulation, involving molecules that have been proved to regulate NK-cell migration into tissues and NK-cell activation and proliferation as well as target cell recognition and killing. Here, we review the reactive phenotypes observed in vivo after acute and chronic NK-cell activation.

CD56 Antigen↗
PubMedDate not supplied

A pain educational program for pediatric nurses: topics and key points.

The undertreatment of pain in children may lead to severe consequences. Basic knowledge about pain in this category of patients may improve pain assessment and its management. In line with the Project established by the Italian Ministry of Health, authors planned an educational program devoted to the pediatric nurses. The concept of brain and of cognitive development, the methodological bases of the pain measurement and the cognition of long-term consequences on pain have been the key points of the program. The course was efficacious and highly appreciated by nurses. The improvement of practice standards will be the true indicator of its efficacy.

Adult↗
PubMedDate not supplied

[Structural changes in pulmonary vessels and coronary arteries in hypoplastic left heart syndrome].

In order to correlate gross morphological features with pulmonary and coronary vasculature changes in hypoplastic left heart syndrome (HLHS) 15 heart-lung necropsy specimens from neonates were analysed. Histology of left atrium wall, lung vessels with pulmonary arteriolar disease morphometric grading, study of intra and extra pulmonary wall veins and coronary arteries were recorded. Classic HLHS was observed in 11, and DORV with mitral atresia in 4, the foramen ovale (FO) being the only left atrium outflow tract in all. All specimens had increased % of thickness and muscular extension of arterioles and increased wall thickness of pulmonary veins, but severer arteriolar and venous changes with left atrium fibrosis were noticed in 8 specimens with either closed FO (3 cases) or mean FO diameter (d) of 5 mm when compared with specimens with mean FOd of 9 mm. Coronary arteries histology disclosed in 4 of 8 specimens with opened but hypoplastic mitral valve, intima proliferative changes with lumen narrowing, not observed in 7 specimens with mitral valve atresia. We concluded that in HLHS closed or restrictive FO and permeable mitral valve may predispose neonates to respiratory complications, right ventricle abnormal function and arrhythmias, specially after cardiac surgery.

Aorta↗
PubMedDate not supplied

[Endocarditis caused by Candida parapsilosis after total correction of tetralogy of Fallot. Medico-surgical treatment].

Three children with Candida Parapsilosis endocarditis after total surgical correction for Tetralogy of Fallot, are reported. Blood cultures became negative in one child with amphotericin-B and in the other two with Ketoconazole, before reoperation for septal patch replacement. Oral therapy with Ketoconazole continued for a total of 24 months, and during a mean follow-up of 36 months no side effects or reinfection occurred. Medical and surgical conjoined therapy, with surgical timing decided on clinical and laboratorial grounds, were important for good results and cure.

Candidiasis↗
PubMedDate not supplied

[Interatrial communication associated with dilated cardiomyopathy].

A case of atrial septal defect in association with dilated cardiomyopathy is presented. Evolutive features are mainly assessed by echocardiography. On initial presentation the findings on physical examination pointed to the diagnosis of atrial septal defect with severe congestive heart failure. In addition to the demonstration of the congenital heart disease, echocardiography showed very dilated right atrial and ventricular cavities and later appearance of right atrium intracavitary thrombi. Left cavities were initially normal but, after surgical repair of the atrial septal defect, they rapidly increased. Endomyocardial biopsy confirmed the diagnosis of cardiomyopathy, which clinically seemed to only affect the right ventricle, but actually shown to be a diffuse myocardial disease.

Cardiomegaly↗
PubMedDate not supplied

[Extralobar pulmonary sequestration in children: presentation of a case].

The pulmonary sequestration is an anatomical condition with as isle of pulmonary tissue independent from tracheobronchial tree. This tissue has an independent artery originated from aorta. Anatomically we can have two types of sequestration. The first is the condition of an isle of pulmonary tissue included without any separation in the lobe; this condition in named intra-lobar sequestration. On the other hand we have a second condition with an isle of independent pulmonary tissue surrounded with independent pleura; the last one is named extra-lobar sequestration. In the present article the authors describe a case of extralobar sequestration in a two years old girl. The symptoms presented by the girl were hyperpyrexia, tough and recurrent bronchopulmonary infections. The girl underwent surgery removal of sequestration. The authors describe their experience, the importance of symptomatology and the anatomo-pathologic characteristics of this lesions.

Age Factors↗
PubMedDate not supplied

[Conservative treatment of post-traumatic periduodenal hematoma: presentation of a clinical case and review of the literature].

The authors describe a case of post-traumatic hematoma of the duodenum in a two years old child. This is a very rare condition in paediatric age, but with the increasing incidence of traumatic pathology it can be predicted an increase of this condition. The duodenal hematoma can be treated either with surgical approach or with conservative treatment. The authors discuss the characteristics of the pathology, the etiopathogenetic mechanism, and propose the same classification adopted by some french authors. The type of lesion indicates the adequate therapy; in particular in the case report (type 1) a conservative treatment is adopted. The laboratory parametres are significative but none is diagnostic. In the present case the amylasemia is not elevated until two weeks after the trauma. Very important for diagnosis are T.C., roentgenography and echotomography, the last one can be easily used for the control of the resolution of the hematoma. The conservative treatment is based on nasogastric suction and parenteral nutrition; although the role of nonoperative treatment is emphasized, the importance of careful assessment for signs of peritonitis or enlarging tender mass cannot be overlooked.

Accidents, Traffic↗
PubMedDate not supplied

[Microsurgical spermatico-epigastric diversion in the treatment of varicocele in pre-adolescent patients].

Varicocele is not an uncommon condition in pre-adolescence. Internal spermatic vein phlebography provides insight into vascular anatomy and etiopathogenesis. Eighty-six cases treated by microsurgical spermatico-epigastric anastomosis (Belgrano technique) are reported. This technique has been shown to achieve a very high cure rate (98.8%). Several techniques of venous anastomosis are described and compared with the Belgrano technique. The results show that the latter is the ideal technique because it not only resolves reflux but also provides adequate venous drainage to the testis.

Adolescent↗
PubMedDate not supplied

[Rheumatic cardiopathy in children. A comparative study in 2 consecutive 9-year periods].

The case rate of children observed with rheumatic carditis or rheumatic heart disease during two consecutive periods of nine years are compared. The first was from October 1969 to September 1978, with previously published data, and the present study from October 1978 to September 1987. During the second period there were 38 cases, 26 of which had the first attack in Portugal, with isolated carditis in 18 (69%), associated with polyarthritis in 5 (20%) and associated with chorea in 3 (11%). Isolated mitral insufficiency was the most frequent valve lesion (80%) and 84% of the children were in NYHA class I and II when first seen. Eighteen children were followed during an average of 2.7 years and there was good compliance of secondary prevention in 78% of them with improvement of the valve lesion. The 12 cases referred from the african countries of portuguese language were more severe, and studied separately. Comparing with the first 9 years period, the case rate of rheumatic carditis, per year decreased from 12.5 to 2.3, the mortality was reduced and the clinical presentation was different, with earlier detection, milder forms and better compliance to secondary prevention.

Child↗
PubMedDate not supplied

[The echocardiogram in the first attack of rheumatic fever in childhood].

In order to evaluate the contribution of echocardiography (echo) in the first episode of rheumatic fever, 18 children (mean age: 8.5 +/- 2.9 years) observed between 1987 and 1992 have been retrospectively studied. In 11 of them the echo has been done in the first month after the initial episode. By M-Mode echo the most constant finding was a high left atrium: aorta ratio in all cases with clinical carditis. By 2D-echo, hyperechogenicity of mitral valve leaflets and subvalvular apparatus was a common finding, three patients having mitral valve prolapse, one with dilatation of the mitral ring and the other with leaflets not able to coapt. Doppler-echo displayed in 17 patients mitral valve regurgitation, and in three aortic regurgitation. In three children the diagnosis of carditis was made by echo in the absence of murmur. During follow-up mitral valve regurgitation disappeared in four children. The authors conclude that early echo is very important in all children suspected to have rheumatic fever, specially because mitral valve regurgitation can be demonstrated by color flow mapping even in the absence of cardiac murmur.

Adolescent↗
PubMedDate not supplied

[Apropos of 2 anniversaries].

The Paediatric Cardiology Service in Santa Marta Hospital accomplished 25 years of existence at the end of 1994. The Conde de S. Januário Hospital, in Macau also celebrated its 120th anniversary at the same time. The Paediatric Cardiology a paper entitled collaborated in these festivities with Service of Santa Marta Hospital Paediatric Cardiology, 25 years. Hospital de Santa Marta-Lisbon-Past, Present, Future. This paper is now published.

Anniversaries and Special Events↗
PubMedDate not supplied

[Prenatal diagnosis of congenital cardiomyopathies. Current reality in the south of the country].

In order to make an actual perspective about prenatal diagnosis of congenital heart disease in the area of influence of our department, a prospective study including 948 fetus and 185 newborn was done, 348 fetus and 20 newborn evaluated during 1993 (group I) and the remaining during 1994 (group II). In both groups indications for fetal echocardiography were mainly maternal (18%) and familiar (14%) factors, but occurrence of CHD were respectively 2% and 0% for them. Fetal factors for echocardiography account for 7%, namely arrhythmias (7%) and obstetric suspicion of CHD (6%), but occurrence of CHD was respectively 13% and 32% for group I and 36% and 48% for group II. In the newborn with serious CHD, risk factors could be identified in 30% in group I and 36% in group II, being respectively 15% and 7% referred for fetal echocardiography. It is concluded that although a rise in the number of fetus evaluated and a better obstetric accuracy have occurred, the rate of prenatal diagnosis of CHD is still very low, pointing to necessity of continuing our actual policy of teaching and spreading this area, specially in the primary health care units.

Female↗
PubMedDate not supplied

[Acute myocardial infarct in infants].

A retrospective study was made of 6 children, with nonsurgical-related acute myocardial infarction (AMI), between January 1987 and December 1994. The ratio for gender was 1 and mean age at AMI was 49 days, 4 cases being associated with congenital heart disease (Fallot's tetralogy, truncus arteriosus and DiGeorge syndrome, one case each, and anomalous origin of left coronary artery, 2 cases). Kawasaki disease and coronary embolisation from thrombosis of the renal vein occurred in the other 2 cases respectively. All developed congestive cardiac failure and cardiomegaly. In the ECG pathologic q waves with more than 35 msec occurred in all, and QT prolongation occurred in 3. Five children (83%) all with AMI in the anterior and lateral wall of the left ventricle died, death being related with cardiac mechanical failure and not with arrhythmias.

Clinical Enzyme Tests↗