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Biomedical subjects

R Rodrigues

Publications and source records attributed to R Rodrigues.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Acute pancreatitis and pregnancy].

Acute pancreatitis during pregnancy is a rare and serious condition with a difficult diagnosis. The authors report a case of acute pancreatitis in a 37 year old woman in the 32nd week of pregnancy. Gallstones were the etiology found. One week after support care as medical management, a recurrent episode of pancreatitis occurred. The choice treatment was endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy. This procedure improved symptoms. Delivery, puerperium and breastfeeding occurred without any problem. Surgery (cholecystectomy) was performed 15 days after delivery, during a new acute episode. The Authors discuss the etiopathogenic, diagnostic and therapeutic management, feto-maternal morbidity and mortality for acute pancreatitis in pregnancy.

Acute Disease↗
PubMed1996

[Surgical myocardial revascularization in young patients].

PURPOSE: To determine early and late results of surgical myocardial revascularization (SMR) in young patients. METHODS: We studied retrospectively 73 patients aging less than 40 years and submitted to SMR between 1975 and 1989. The method used was patient card review and thelephone contact with the patient or his physician. RESULTS: Follow-up was obtained in all cases in a period of 2 to 185 (59.9 +/- 41.0) months. Of the coronary risk factors smoking was the most frequent. One vessel coronary artery disease was observed in 16 (21.9%) patients, 2 and 3 vessel coronary artery disease in 26 (35.6%) and 32 (43.8%) patients respectively. SMR was considered complete in 68 (93.2%) patients. An associated procedure was performed on 10 cases: Left ventricular aneurysm repair in 9 (12.3%) and mitral valve replacement in one (1.4%). Perioperative myocardial infarction occurred in 7 (9.5%) patients and one of them died (operative mortality: 1.4%). During follow-up, 6 (8.3%) patients died with an actuarial survival rate of 89.1% at 15 years. An event free survival rate of 68.3% was observed at 10 years. From 66 survivors, 53 (80.3%) were asymptomatic at late follow-up and 48 (72.7%) patients returned to work. CONCLUSION: Surgical myocardial revascularization in young patients associated with medical treatment, has good early and late results with a high percentage of patients asymptomatic and reemployed at a late follow-up.

Adult↗
PubMed1995

Evaluation of the efficacy and safety of oral nicardipine in treatment of urgent hypertension: a multicenter, randomized, double-blind, parallel, placebo-controlled clinical trial.

This study was a prospective, randomized, double-blind, placebo-controlled clinical trial designed to evaluate the safety and efficacy of oral nicardipine for the treatment of urgent hypertension in the emergency department. Of 57 patients with urgent hypertension 53 patients were enrolled: 36 men and 17 women, 43 black and 10 white, age range 48 +/- 11 years, and diastolic blood pressure 128 +/- 7 mm Hg. Patients were randomly assigned to receive 30 mg nicardipine or placebo in blind fashion followed by 30 mg open-label nicardipine in nonresponders. Responders to one or two doses of nicardipine received 30 or 40 mg nicardipine three times a day for 1 week after discharge from the emergency department. Adequate blood pressure reduction, defined as a reduction of diastolic blood pressure to less than 100 mm Hg or by at least 20 mm Hg, was achieved in 65% and 22% of patients who received 30 mg nicardipine or placebo (p = 0.002). Adequate blood pressure reduction after administration of open-label nicardipine occurred in 76% of the nonresponders to placebo. Blood pressure reductions were maintained at 1 week after discharge. The drug was well tolerated, and no significant adverse events occurred. We conclude that oral nicardipine is a safe and effective drug for the initial treatment of urgent hypertension.

Administration, Oral↗
PubMed1995

[Adequacy of of pacemakers responsive to the volume-minute ventilation rate in heart transplantation patients].

PURPOSE: To evaluate in the late post-operative period (PO) the chronotropic response to exercise of patients submitted to orthotopic cardiac transplantation (CT) and the implant of a cardiac pacemaker (PM). METHODS: A rate response ventricular PM (VVI+R) which uses minute ventilation (MV) as a sensor was implanted in five patients in the early PO of CT due to chronotropic incompetence. The patients were 31 to 64 years old and the indication to implant of PM was low ventricular escape rhythm following atrial taquicardia/bradycardia (one case) or sinus bradycardia (4 cases). The study was performed by means of paired exercise tests using Naughton protocol in order to compare the heart rate in VVI (prefixed heart rate) and VVIR+MV (rate response) mode. The duration of the exercise was compared between the two modes of stimulation. RESULTS: In VVI mode the heart rate was significantly lower than in VVIR+MV mode for comparable periods of exercise (101 +/- 12 ppm vs 132 +/- 4 ppm; p < 0.05); in VVIR+MV mode the patients had a prolonged time of exercise as compared to VVI mode (15 +/- 7 min vs 12 +/- 7 min; NS). CONCLUSION: The MV rate response PM provided patients with satisfactory heart during exercise and may be an adequate option to patients submitted to CT who present chronotropic incompetence.

Adult↗
PubMed1993

Expression and function of CD5 and CD28 in patients with rheumatoid arthritis.

To assess the role of CD5 and CD28 in the pathogenesis of the decreased cellular immune function in patients with rheumatoid arthritis (RA) we analysed the expression and function of these T-cell surface molecules. The expression of CD5 as well as of CD28 in synovial and peripheral blood T cells was similar to that of control T cells. Monoclonal antibodies (mAb) directed at CD28 and CD5 were able to provide an accessory signal to anti-CD3 activated T cells both from the synovial fluid and from the peripheral blood. However, the proliferation induced by anti-CD3 mAb in conjunction with anti-CD5 or anti-CD28 mAb was always higher in peripheral blood (PB) T cells compared to the paired synovial fluid T cells. After simultaneous ligation of CD5 and CD28, proliferation was induced in the PB T cells. However, when compared to control PB T cells, this proliferation was significantly lower in the RA patients. Purified normal memory (CD45RO+) T cells proliferated less strongly than naive (CD45RA+) T cells, but no difference was observed between rheumatoid and normal memory T-cell proliferative responses. However, enriched PB CD45RA+ T cells from rheumatoid patients proliferated less vigorously to CD5 and CD28 ligation when compared to normal enriched CD45RA+ T cells. Synovial fluid (SF) T cells, which are mainly of the memory cell type, did not proliferate after simultaneous ligation of CD5 and CD28. This refractory state of synovial T cells could not be explained by a difference in the surface expression of CD5 or CD28. Our data suggest that the cellular immune dysfunction in the PB from rheumatoid patients may be due to a decreased responsiveness of the naive T-cell subset to accessory signals provided by CD5 and CD28. In addition, SF T cells appear hyporesponsive to stimulating signals provided through CD5 and CD28.

Antibodies, Monoclonal↗
PubMed1993

[Serologic diagnosis of several infectious diseases].

Serological tests are, in some situations, the only method of diagnosis of some infectious diseases. The authors make a review of the literature about the most important tests used in the most common infectious diseases and also their interpretation. It is important to point out that serology should not be considered alone but compared to clinical manifestations presented by the patient. It is also necessary, in some cases, to obtain two samples of serum, to confirm if there is an increase in the antibodies' titles. The results sent from the laboratory should be interpreted based on references given by it.

Boutonneuse Fever↗
PubMed1993

Surgical repair of ventricular aneurysms. Early results with Cooley's technique.

Using bovine pericardium instead of Dacron for grafting, we performed ventricular endoaneurysmorrhaphy (Cooley's technique) in 13 patients with postmyocardial infarction left ventricular aneurysm. Twelve patients were men and 1 was a woman; their ages ranged from 38 to 67 years (mean, 51.2 +/- 11.4 years). Eight patients had large anterolateral aneurysms, 4 had apical aneurysms, and 1 had a false inferior aneurysm. Postoperatively, the mean cardiac index increased from 2.07 +/- 0.50 to 3.09 +/- 0.99 L/min/m2 (p < 0.05), with a mean percentage increase of 50.17% +/- 37.03%. No patient required postoperative mechanical circulatory assistance, and pharmacologic support could be withdrawn soon after surgery. All patients had uncomplicated recoveries and were asymptomatic upon discharge, at a mean time of 9.0 +/- 2.3 days after surgery. We conclude that ventricular endoaneurysmorrhaphy provides excellent initial results, and we believe, through subjective analysis of ventriculograms, that the use of bovine pericardium for grafting produces better functional results than does the use of Dacron.

Adult↗
PubMed1992

[Coronary transluminal angioplasty after the use of thrombolytic therapy in acute myocardial infarction].

PURPOSE: To present the Cardiology Institute of Rio Grande do Sul experience with percutaneous coronary angioplasty (PTCA), after thrombolytic therapy in acute myocardial infarction (AMI). METHODS: Fifty-three patients with transmural AMI in whom early successful intravenous streptokinase recanalization was followed by PTCA. The mean age was 50 years, male patients were more frequent, the predominant area of infarct was anterior wall and more frequently the "culprit" coronary was the left anterior descendent. The main indication of PTCA was uniarterial lesion with less than 20 mm of length. RESULTS: The success comes out in 44 patients (81.5%). Ten patients (18.5%) were considered unsuccessful and were referred to emergency bypass graft surgery. The in-hospital AMI rate after PTCA was 5.5%. In the follow-up the reestenoses rate was 11% and reocclusion was 3.7%. New PTCA was necessary in 3 patients (5.5%) and in one, by-pass graft (1.8%). CONCLUSIONS: PTCA is an important and secure modality of complementary therapy after thrombolytic therapy with low morbidity and mortality.

Adult↗
PubMed1991

[Modified Cooley technique for surgical repair of left ventricular aneurysms].

PURPOSE: To evaluate early postoperative results of modified Cooley's technique of ventricular endoaneurysmorrhaphy. PATIENTS AND METHODS: Eight patients, seven males, with ages ranging 38.0 to 67.0 years (m = 51.2 +/- 11.4 years) and with postinfarction left ventricular aneurysms were submitted to surgical repair by a modified Cooley's technique of ventricular endoaneurysmorrhaphy. RESULTS: No postoperative complication occurred and all patients were discharged from the hospital asymptomatic on a mean time of 9.0 +/- 2.3 days after surgery. The mean cardiac index increased from 2.1 +/- 0.5 to 3.3 +/- 1.1 l/min (p less than 0.05) with a mean percentual increase of 53.0%. No patient required mechanical circulatory assistance after surgery and the pharmacological support could be interrupted soon. CONCLUSION: Ventricular endoaneurysmorrhaphy searchs to restore shape, contour and volume to the left ventricle and has shown excellent initial results.

Adult↗
PubMed1990

Influence of co-dergocrine on platelet aggregation.

In the present investigation, we studied the influence of co-dergocrine mesylate (dihydroergotoxin mesylate) on platelet aggregation induced by adrenaline, adenosine diphosphate (ADP) and collagen in vitro. Platelet-rich plasma was incubated with increasing concentrations of co-dergocrine (1.5, 3.0, 6.0, 12.0, 24.0, and 48.0 micrograms/ml). The lowest concentration of co-dergocrine tested (1.5 micrograms/ml) inhibited adrenaline-induced aggregation by 97%. Higher concentrations of the compound caused similar degrees of inhibition. ADP-induced aggregation was only decreased significantly (20%, P less than 0.001) by the highest concentration of co-dergocrine, whereas collagen-induced aggregation was not affected. Our results demonstrate that co-dergocrine selectively inhibits platelet aggregation triggered by adrenaline in vitro.

Adenosine Diphosphate↗
PubMed1989

Treatment of resistant hypertension: 3 years of follow-up with the combination of verapamil and methyldopa.

A combination of verapamil (V), methyldopa (M), and hydrochlorothiazide (H) was tried in hypertensive patients resistant to the usual stepped-care therapy. After at least 60 days with a third-step regimen, placebo was added during the last 2 weeks. Twenty patients whose diastolic blood pressure (DBP) remained greater than 100 mm Hg were assigned to the study. During the initial titration period patients received increasing doses of V (240-480 mg) and M (500-1,500 mg). H was kept at 50 mg/day. Other previously administered drugs were gradually withdrawn. Goal pressure was DBP less than or equal to 95 mm Hg. Follow-up lasted 3 years. Sixteen patients participated in the investigation until the end and all but one reached the goal DBP. Mean systolic BP dropped from 187 +/- 17 to 150 +/- 15 mm Hg (p less than 0.05) and DBP from 118 +/- 12 to 90 +/- 9 mm Hg (p less than 0.01). Adverse effects were rare and mild. Other control measurements did not show any change except improvement of the electrocardiogram of 11 patients, and of the optic fundus of 10 patients. The number of drug unities to be taken dropped from 10 +/- 4 to 7 +/- 2 (p less than 0.05). The abovementioned combination seems to be useful in the control of resistant hypertension. Efficacy was sustained and tolerability was excellent. A potential to reverse target organ damage, namely of the heart and optic fundus, is suggested.

Adult↗
PubMed1989

[Bedside cardiac catheterization. Advantages and disadvantages].

Three hundred patients submitted to bedside heart catheterization (BHC) from 1973 to 1985 were studied, in order to assess advantages and risks of the procedure. Two-hundred and sixty seven patients (89%) suffered a myocardial infarction (MI) and 146 of them were in functional class (Killip) II, 36 in FC III and 71 in FC IV. Thirty cases were submitted to BHC due to congestive heart failure. BHC was successful in 288 patients (96%) and the wedge pressure (WP) could be measured in 236 cases (78.7%). The WP was less than 18 mmHg in 47.2% of the patients in FC II, in 44.9% of the patients in FC III and in 35.3% of those in FC IV. Minor complications occurred in 33 cases (11.0%); balloon rupture in 12 (4.0%), transient arrhythmias in 11 (3.7%) and lumen obstruction in another 10 cases (3.3%). Forty five patients (15.0%) presented major complications related to the procedure: pulmonary infarction (PI) in 18 cases (6%), phlebitis in 15 cases (5%), sustained arrhythmias in 10 cases (3.3%), pulmonary artery rupture and endocarditis each in 1 case. The mean age between the group of patients with and without complications was similar the maintenance time as greater in the group of patients with complications: 3.4 +/- 0.2 vs 2.7 +/- 0.1 days (p less than 0.05). We concluded that many patients with clinical evidence of heart failure had WP smaller than 18 mmHg, emphasizing the value of the procedure in patients with complicated MI. The maintenance time was associated with the occurrence of complications, mainly PI and phlebitis.

Adult↗
PubMed1989

[Evaluation of the use of amiodarone in outpatients].

From the group of patients follow-up at the arrhytmias out-patients clinic of the Institute of Cardiology from Rio Grande do Sul, Brasil, one hundred (100) patients were selected in order to evaluate the efficacy, benefits and side effects of short term use (minimum of 3 months) of amiodarone. During the period of study, the authors had found that average doses of amiodarone (200 mg/day) were highly effective for ventricular and supraventricular in addition, they also noticed a very low incidence of side-effects independent of the cardiopathy.

Adult↗