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Biomedical subjects

P Rocha

Publications and source records attributed to P Rocha.

At least 73 records · Page 4Linked to original sources
PubMed1977

Comparative haemodynamic effects of dobutamine and isoproterenol in man.

Dobutamine was infused at a rate of 8 mcg/kg/min in 17 patients with or without congestive heart failure. Cardiac output increased from an average 2.92 to 4.45 1/min/m2(p less than 0.001) with no change in mean aortic pressure (93.4 to 97.8 mmHg) and only a slight increase in heart rate (78 to 87 beats/min). Left ventricular end-diastolic pressure decreased from an average 19 to 13.7 mmHg (p less than 0.01). Peak left ventricular dp/dt was doubled (1147 to 2370 mmHg/sec, p less than 0.001) and Vmax increased from 1.08 to 2.18 circ/sec (p less than 0.001). In 10 patients given equi-inotropic doses (100 per cent increase in peak dp/dt) Isoproterenol produced a greater increase in cardiac output (71 percent) than Dobutamine /51 percent). Isoproterenol caused mean aortic pressure to fall significantly (8 percent) while no change was noted with Dobutamine. Accordingly, peripheral vascular resistances were reduced to a greater extent with Isoproterenol than with Dobutamine (p less than 0.05). Mean pulmonary arterial pressure decreased significantly (25 +/- 5.9 to 22 +/- 5.7 mmHg, p less than 0.05) with Isoproterenol infusion and remained unchanged with Dobutamine infusion. Dobutamine increased both stroke work (57 percent) and minute work (83 percent). With Isoproterenol however, only minute work was significantly increased (90 percent). Dobutamine therefore is a potent inotropic drug, with mild chronotropic and peripheral vascular effect and may be valuable in the management of severe heart failure not associated with hypotension.

Adult↗
PubMed1977

Left ventricular compliance in acute myocardial infarction in man.

Left ventricular end-diastolic pressure (P) and volume (V) were measured in 12 patients with acute myocardial infarction. It was assumed that the diastolic P-V relationship was exponential and corresponded to the formula P=be KV. In 7 patients submitted to volume loading, several data points of this relationship were obtained and at zero volume, the mean intercept with the ordinates was 0.037+/-0.015 kPa (SEM) (0.28+/-0.12 mmHg). In the other 5 patients, the P-V curve was plotted through this intercept and the pressure and volume co-ordinates obtained by control. The K coefficient (passive elastic modulus) was greater, and the normalised left ventricular compliance index (dV/VdP) was smaller in the infarct group than in the control group. This suggests decreased left ventricular compliance during the acute phase of myocardial infarction. By comparing left ventricular function curves plotted using either end-diastolic pressure or end-diastolic volume as the stretch index it is possible to evaluate the relative participation of decreased compliance and depressed contractility in global left ventricular function.

Acute Disease↗
PubMed1974

[Effects of selective beta adrenergic block on myocardial contractility. Relative role of negative inotropic and chronotropic effects].

Left ventricular function was studied in 15 patients both before and after intravenous administration of Practolol (an agent blocking selectively the heart beta-adrenergic receptors (beta 1)), while the heart rate was constant by right atrial pacing. The negative inotropic effect linked to the negative chronotropic effect of the beta-adrenergic blockage, represented approximately one quarter of the overall depression of the contractility. Right atrial pacing determined a decrease of the left ventricular end-diastolic pressure and an increase of the pacing rate by 20% above the spontaneous heart rate, after administration of 30 mg of Practolol, brought the contractility back to its control level.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Brain "embolism" detected by magnetic resonance imaging during percutaneous mitral balloon commissurotomy.

PURPOSE: The common finding of thrombi between the bifoil balloons when they were extracted after mitral dilation prompted us to look for evidence of minor brain embolisms using the sensitive technique of BMRI (brain magnetic resonance T2-weighted imaging). METHODS: BMRI was performed within 48 hr before and after a percutaneous mitral balloon commissurotomy (PMBC) in each of the 63 patients in this study. RESULTS: There was evidence (hyperintensity foci: HI) of a previous asymptomatic brain embolism in 38 of 63 patients before PMBC and a new HI appeared in 18 of 63 patients after the procedure. New HI signals were found exclusively in the white matter in 8 of 18 patients and in only 3 of 18 were HI signs larger than 1 cm. One patient, with an HI signal > 1 cm in the thalamus and another < 1 cm in the brain stem, presented diplopia accompanied by other minor clinical signs. The differences in HI rate among four subgroups (1, older vs younger than 43 years; 2, sinus rhythm vs atrial fibrillation; 3, echo score < 8 vs > 8; 4, patients from western countries vs the others) were not statistically significant, probably because the number of patients in each subgroup was low. Patients in atrial fibrillation had slightly more (not significant) HI before PMBC (15/20, 75%) than patients in sinus rhythm (23/43, 53%), but after PMBC their HI frequencies were similar (atrial fibrillation: 5/20, 25%; sinus rhythm: 13/43, 30%). CONCLUSION: Brain microembolism is frequent during PMBC, but is often anatomically limited and free from clinical signs in most cases. Brain embolism seems to be related mainly to the procedure itself and not the features of the patient.

Adult↗
PubMedDate not supplied

[Liaison psychiatry: a new perspective on mental health in Latin America].

The situation of Mental Health in Latin America is analyzed. Urgently creating a system able at handling the psychiatric disease increase in the years to come is a conclusion this paper strongly aims at. The beginning of Psychiatry is reviewed, and the importance of Psychiatry at the General Hospital is outlined as well as its rapprochement toward the community, which led to a better control and prevention in the field of Mental Health. A definition of Psychiatry is proposed, as a branch of Medicine which stands in between mental hospitals and communities. Active teamwork, coupled with the physician's work and the tasks other members of the health personnel are engaged in, has led to a more integrated approach onto the ill thus benefiting not only patients but also the whole community.

Delivery of Health Care↗