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A Carvalho

Publications and source records attributed to A Carvalho.

At least 19 recordsLinked to original sources
PubMed1996

[Adult type respiratory distress syndrome (ARDS) induced by hydrocarbons].

The authors present a case of a child aged 32 months, victim of accidental ingestion of an unidentified hydrocarbon product. Sixteen hours following hospitalization, the patient began polypnea with progressive hypoxemia, with the radiograph showing ARDS pattern. Mechanical ventilation was initiated on the 2nd day of admission. During hospitalization the patient developed pneumomediastinum and bilateral pneumothorax which justified active drainage. Inspite of the initial poor prognosis, the patient improved, with no symptoms after discharge. The authors discuss certain theoretical considerations regarding hydrocarbon intoxication.

Age Factors↗
PubMed1996

Sarcoidosis-tuberculosis association: a case report.

The association of sarcoidosis and tuberculosis is rare and, its differentiation is sometimes very difficult. We report the case of a young man who presented with type III sarcoidosis complicated by pulmonary tuberculosis within 17 months of the diagnosis, leading to a fatal outcome. A change in antimycobacterial antigen complex A60 immunoglobulin G (IgG) titres, as seen in our case, may be helpful in differentiating between the two diseases.

Adult↗
PubMed1995

Early intervention with Portuguese mothers: a 2-year follow-up.

Results of a 2-year follow-up after an early intervention with low-middle-class primiparous Portuguese mothers are presented. On the 3rd day of their infants' lives, 40 mothers underwent a structured intervention using selected items of the Brazelton Neonatal Behavioral Assessment Scale. An additional 20 mothers randomized to the control group had a talk with a pediatrician about general problems of infant health care. On Day 28, the "sensory orientation" and "cuddliness" competencies of the infants in the experimental group were significantly enhanced when compared with the same competencies among the infants in the control group. In addition, dyads in the experimental group had established a more favorable pattern of interaction, particularly after short stressful situations (these situations included short separations from the mother in which a stranger was present, short separations in which no one was present, and a stillface situation). Short-term effects (the first month of life) were particularly noticeable, especially in terms of the babies' neurobehavioral development and mother-infant interaction. Long-term effects (3, 6, 9, 12, 15, 18, and 24 months), though less clear, were evident in the form of better interactive patterns among the dyads in the experimental group. This was particularly evident after the stressful situations to which they were submitted. These results are discussed in terms of both their scope and their clinical impact.

Facial Expression↗
PubMed1994

Epidemiology of hepatitis C in central Portugal. Prevalence of anti-HCV in the population of the Coimbra District.

Anti-hepatitis C virus antibody (anti-HCV) screening was performed in a sample of the adult population of the Coimbra District. 657 persons were included (267 male and 390 female, mean age of 42.7 + 13.1 years), aleatorily chosen from four characteristic regions. Anti-HCV was detected using an ELISA-2 test and all positive sera were also tested with RIBA-2. General prevalence of anti-HCV was 0.46%. All positive patients live in urban areas and presented risk factors for HCV infection. Anti-HCV was found in 33.3% of intravenous drug abusers, in 1.8% of transfused individuals, in 1.33% of alcoholics (higher than 80 g/d alcohol ingestion), in 1% of cases with history of surgical operations, and in 0.65% of persons who lived in risk regions for hepatitis B. We conclude that anti-HCV prevalence is low in our region. We think it is important to perform other studies on larger samples of general population and to study risk groups.

Adult↗
PubMed1993

No evidence of genetic heterogeneity in Brazilian facioscapulohumeral muscular dystrophy families (FSHD) with 4q markers.

The gene responsible for facioscapulohumeral muscular dystrophy (FSHD), an autosomal dominant neuromuscular condition, has been mapped to chromosome 4. Until recently, the two closest available markers were D4S139 and D4S163 but a new marker (p13E-11) which recognizes de novo rearrangements in isolated cases of FSHD characterized by shorter EcoRI fragments has been now identified. Linkage analysis in FSHD families with p13E-11 shows that usually a smaller fragment segregates with the disease gene among the affected individuals from each genealogy. In the present paper, we report the results from linkage analysis with the marker loci D4S163 and D4S139 in 6 FSHD families and with p13E-11 in these and in 6 other additional Brazilian families (total of 12). The results from such analysis do not suggest genetic heterogeneity for FSHD in our population. In 11 out of the 12 families studied with p13E-11, a shorter specific EcoRI band was found to segregate in all affected patients from each genealogy. In one family, the normal individuals had a smaller EcoRI fragment than the affected ones. The size of the EcoRI fragments detected with p13E-11 varied from 13.5 to 29 kb but was constant within each genealogy. Our results suggest that the use of the marker p13E-11 for preclinical and prenatal diagnosis should be done only in families in which it is possible to identify the fragments segregating among the affected individuals.

Adolescent↗
PubMed1993

[Hepatitis C epidemiology in the central area of Portugal. Prevalence of anti-HCV in the population of the district of Coimbra].

Anti-hepatitis C virus antibody (anti-HCV) screening was performed in a sample of the adult population of the Coimbra District. 657 persons were included (267 male and 390 female, mean age of 42.7 +/- 13.1 years), aleatorily chosen from four characteristic councils. Anti-HCV was detected using an ELISA-2 test and all positive sera were also tested with RIBA-2. General prevalence of anti-HCV was 0.46%. All positive patients live in urban areas and presented risk factors for HCV infection. Anti-HCV was found in 33.3% of intravenous drug abusers, in 1.8% of transfused individuals, in 1.33% of alcoholics (higher than 80 g/d alcohol ingestion), in 1% of cases with history of surgical operations, and in 0.65% of persons who lived in risk regions for hepatitis B. We conclude that anti-HCV prevalence is low in our region. We think it is important to perform other studies in larger samples of general population and to study risk groups.

Adult↗
PubMed1993

[Cefoxitin: its role in the therapy of anaerobic infections].

Cefoxitin is a second generation cephalosporin commonly used to treat anaerobic and mixed infections. The authors reviewed the recently published data about the efficacy of cefoxitin; its utility in different clinical entities, patterns of resistance and resistance mechanisms, indications and reliability of in vitro susceptibility testing. These data indicate the need for determining susceptibility patterns of anaerobics at each hospital and point out to the essential close communication between the microbiologist and clinician to the rational treatment of anaerobic infections.

Bacteria, Anaerobic↗
PubMed1993

["Severe" congestive heart failure at a medical center].

UNLABELLED: Heart failure (HF) is a dynamic clinical syndrome depending on multiple hemodynamic and neurohormonal factors. This syndrome concerns not only left ventricular systolic dysfunction but also left ventricular diastolic dysfunction and right ventricular dysfunction. Clinical features and therapeutic approaches are different for each of them. NYHA class IV is just one of the various prognostic factors of heart failure; consequently, severe heart failure is not synonymous of NYHA class IV. OBJECTIVE: To study hospitalised patients with heart failure in NYHA class IV, in order to characterise the predominant dysfunction, and analyze evolution and mortality. DESIGN: A retrospective analysis of a prospective study. SETTING: Hundred and eight hospitalised patients (1985-89). Patients with chronic obstructive pulmonary disease and acute myocardial infarction were excluded. PATIENTS: Sixty nine patients: 29 female and 40 male, aged 18 to 81 years old (m = 59 +/- 15.5). METHODS: Patients were clinically examined and had chest radiographs, electrocardiogram and M + 2D mode echocardiogram. Three groups were identified: Group I-patients with predominant left ventricular systolic dysfunction; Group II-patients with predominant left ventricular diastolic dysfunction; Group III-patients with predominant right ventricular dysfunction. RESULTS: 41% of the patients had coronary artery disease; 44%, valvular heart disease; 11.8% dilated cardiomyopathy; 8.7% hypertrophic cardiomyopathy; 8.7% hypertensive cardiomyopathy. Fifty five percent of the patients were in group I and the major aetiology were coronary artery disease and valvular heart disease; 25% of the patients were in group II and the major aetiology were coronary artery disease and hypertrophic cardiomyopathy; 20% of the patients were in group III, all had valvular heart disease. The global mortality during the hospitalisation period was 15.9%, mostly group III (29%) and II (17%). CONCLUSIONS: Heart failure patients in NYHA class IV formed an heterogeneous group, requiring individualised therapeutic approaches. Left ventricular systolic dysfunction was the major pathophysiological mechanism, however, diastolic dysfunction and right ventricular dysfunction were frequent. Coronary artery disease presented as a frequent aetiology of heart failure, resulting in diastolic and/or systolic dysfunction. Valvular heart disease can be present as left ventricular systolic or diastolic dysfunction or as a right ventricular dysfunction, depending on the valvulopathy and the time of evolution. Echocardiography, in association with clinical features, has been very useful for each patient approach, allowing HF aetiology and pathophysiological mechanisms characterisation. The low mortality observed in this study was related certainly to the correction of precipitating factors, together with early etiologic diagnosis and pathophysiological characterisation, and adequate individualised treatment.

Adolescent↗
PubMed1993

Purification of superoxide dismutase from placental haemolisate blood: a simple and efficient method.

Superoxide dismutase functions as a scavenger of superoxide radical protecting living organisms. This enzyme has potential use as anti-inflammatory or anti-reperfusion injury drug. Here we present a simple and efficient SOD purification method from human placental blood. Superoxide dismutase from clarified haemolysed placental blood after chloroform and ethanol treatment was purified by DEAE-Sepharose, Phenyl-Sepharose chromatographies and cross flow ultrafiltration. The purified product is 98% pure by SDS-PAGE with 71% yield and specific activity of 2.8 x 10(5) U/mg protein.

Blotting, Western↗
PubMed1990

Neutralization of low molecular weight heparin by polybrene prevents thromboxane release and severe pulmonary hypertension in awake sheep.

Protamine reversal of heparin anticoagulation in patients is occasionally associated with life-threatening acute pulmonary hypertension. In a sheep model, we evaluated the effect on this adverse cardiopulmonary reaction of modifying the type of heparin (low molecular weight heparin compared with unfractionated heparin) and the type of heparin antagonist (polybrene compared with protamine). Protamine reversal of low molecular weight heparin (LMWH) and polybrene reversal of unfractionated heparin induced more than a 10-fold increase of plasma thromboxane B2 levels, a threefold increase of pulmonary vascular resistance and pulmonary artery pressure, and a 25% decrease of PaO2. A similar adverse reaction followed protamine reversal of conventional unfractionated heparin. However, with polybrene (1 mg/kg) reversal of LMWH (1 mg/kg), we measured neither pulmonary hypertension (pulmonary artery pressure was 22.6 +/- 3.6 mm Hg at 1 minute after polybrene reversal of LMWH compared with 47.9 +/- 4.2 mm Hg after protamine reversal of unfractionated heparin, p less than 0.005 groups differ), hypoxemia (PaO2 was unchanged 2 minutes after polybrene compared with a decrease of 26 mm Hg 2 minutes after protamine, p less than 0.05), nor acute release of thromboxane into arterial plasma (thromboxane B2 was 0.2 +/- 0.1 at 1 minute after polybrene compared with 3.7 +/- 1.7 ng/ml at 1 minute after protamine, p less than 0.005). The hemodynamic effects and mediator release were also benign after neutralization of larger doses of LMWH (3 mg/kg) by polybrene (3 mg/kg). The increases of activated clotting time and activated partial thromboplastin time due to both types of heparin were completely reversed with polybrene. Anti-Xa activity increased to more than 3 IU/ml 4 minutes after LMWH anticoagulation (p less than 0.01) but was only partially neutralized by polybrene. Various polyanion-polycation complexes that are formed when heparin anticoagulation is reversed induce thromboxane release and acute pulmonary vasoconstriction in awake sheep. Reversal of LMWH anticoagulation with polybrene does not elicit this adverse reaction.

Animals↗
PubMed1989

Effect of platelet depletion on lung vasoconstriction in heparin-protamine reactions.

In six awake sheep the control heparin-protamine reaction was associated with a 150-fold rise in arterial plasma thromboxane B2 (TxB2) levels, a 4.5-fold increase in pulmonary vascular resistance, a 20% decrease in cardiac output, a 30% decrease in arterial PO2, and a 30% reduction in arterial white blood cell concentrations. Depletion of 99% of circulating platelets by antibodies did not prevent either acute and severe pulmonary hypertension or increased plasma TxB2 levels induced by heparin-protamine administration. We produced sheep platelet aggregation in vitro with bovine thrombin and measured marked TxB2 release (36.3 +/- 16.3 ng/10(9) platelets). In contrast, neither heparin, protamine, nor heparin-protamine complexes over a 10,000-fold range of concentrations induced platelet aggregation and release of thromboxane in vitro. Therefore sheep platelets are not the source of thromboxane production associated with acute pulmonary hypertension during the heparin-protamine reaction, and other cells must produce the thromboxane.

Animals↗
PubMed1987

Pulmonary vascular obstruction in severe ARDS: angiographic alterations after i.v. fibrinolytic therapy.

IV streptokinase was infused to test the potential reversibility of adult respiratory distress syndrome (ARDS) associated pulmonary vascular thrombosis in five patients suffering from severe ARDS with elevated mean pulmonary artery pressure, increased pulmonary vascular resistance, and angiographically documented pulmonary vascular thrombosis. At 48 hr there was clearance of obstructions in arteries larger than 1 mm in diameter in all patients, increased filling of the microvasculature and small arteries less than 1 mm in diameter in four patients, a fall in pulmonary vascular resistance in all patients, a rise in cardiac output in four patients, improved oxygenation (PAO2/FlO2) in three patients, and variable changes in shunt fraction and ventilator pressures. Expressed as a mean fraction of the preinfusion controls, the postinfusion physiologic values were pulmonary artery pressure = 0.89 mm Hg, pulmonary vascular resistance = 0.68 mm Hg X min/L, cardiac output = 1.36 L/min, central venous pressure = 0.77 cm H2O, pulmonary capillary wedge pressure = 0.92 mm Hg, PAO2/FlO2 = 1.08, and shunt fraction = 0.95. Follow-up angiography showed no evidence of reocclusion. Postmortem studies of the three nonsurvivors confirmed recanalization of thrombosed pulmonary arteries. One documented bleeding episode occurred. We conclude that fibrinolytic infusion can lyse thrombi and possibly improve hemodynamics and oxygenation in ARDS-associated pulmonary vascular thrombosis.

Angiography↗