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Biomedical subjects

A Fernandes

Publications and source records attributed to A Fernandes.

At least 37 records · Page 2Linked to original sources
PubMed1987

Intrathecal administration of morphine for the relief of pains in labour and estimation of maternal and fetal plasma concentration of morphine.

Thirteen healthy women in active labour received an intrathecal injection of morphine 1.0 mg. Eighty-five percent (11 patients) experienced acceptable or good pain relief. Analgesia set in 15-45 min after injection and reached a maximum after 15-120 min and lasted until delivery. Eighty-five percent (11 patients) of the patients developed mild side-effects i.e., pruritus, nausea and emesis. The intrathecal injection of morphine did not adversely affect the condition of the infant. Venous blood samples from the patients and umbilical cords for estimation of plasma morphine showed extremely low concentrations. No patients experienced any discomfort during the injection of morphine. These results indicate that morphine 1.0 mg administered intrathecally decreases labour pains to an acceptable level.

Anesthesia, Obstetrical↗
PubMed1987

Abnormal development of the axial length of aphakic monkey eyes.

Neonatal cataract surgery is becoming more common because irreversible amblyopia occurs if an eye receives inadequate inputs during an early sensitive period of visual development. To model conditions for treating congenital monocular cataracts in humans, we have reared rhesus monkeys which underwent unilateral lensectomy as neonates. Post-surgical A-scan ultrasonography at 8-26 months revealed that the axial length of the aphakic eye in these monkeys was shorter when compared to that of the unoperated eye. This finding has important implications for the long-term clinical management of lensectomized infants in order to achieve good vision in the aphakic eye.

Animals↗
PubMed1986

Indirect monitoring and analysis of truncal stress over extended time periods.

Low back pain is a common ailment encountered in clinical practice, yet there has hitherto been no completely satisfactory method for the measurement of truncal stress, which is a major factor in low back pain. Truncal stress has been difficult to record during the course of a working day because subjects were constrained by trailing cables attached to the monitoring equipment. We have used a pressure sensitive transmitter (radio pill) to record intra-abdominal pressure, which has been shown previously to be an indirect measure of truncal stress. The system makes possible multichannel recordings on magnetic tape throughout the working day by using a portable, battery powered recorder strapped to the subject's waist. A novel ferrite rod contributes materially to minimizing artefacts due to signal loss. The recorded data are replayed, at 60 times real time, into a microcomputer programmed to analyse this data.

Abdomen↗
PubMed1986

Extended-wear contact lens correction of aphakia in infant primates. Corneal studies.

Extended-wear contact lenses (EWCL) are being used increasingly for the correction of aphakia in infants, but there is a lack of data documenting their effects on the corneas of young children. Therefore, corneal studies were performed on infant monkeys wearing EWCL for the correction of surgical aphakia. Nine newborn monkeys underwent unilateral lensectomy and anterior vitrectomy. Seven eyes were fitted with aphakic EWCL postoperatively and two wore no lenses. After at least six months, corneas were studied with slit-lamp and specular microscopy, and with light microscopy (LM) and electron microscopy (EM). Small central corneal opacities developed in two aphakic eyes corrected with EWCL after episodes of keratoconjunctivitis. One of these corneas was found to have a mildly increased coefficient of variation (CV) of endothelial cell size (polymegathism). Although EWCL are well tolerated by the corneas of aphakic infant primates, their association with endothelial polymegathism, which may indicate physiologic compromise, mandates careful long-term follow-up.

Animals↗
PubMed1986

Liver trauma.

A series of 97 patients has been studied who were treated for liver injury at Westmead Hospital between January 1979 and January 1985. Patients were noted to be younger than those reported in previous series from Sydney, and to have suffered more frequent, significant, head injuries. Paramedical roadside intervention probably allowed more patients to reach hospital alive than was the case before the advent of the Intensive Care Ambulance system. Improved organ imaging has allowed more confident non-operative management of 13% of patients. Hepatic resection has been used infrequently (10%). Packing has been used in six patients as part of the definitive treatment of severe injuries and coagulopathy, and to allow the transfer of a further seven patients from peripheral hospitals. Ten of these 13 patients survived. Head injury continues to be a major cause of death in these patients. Death from the liver injury itself is usually associated with high grade damage to the liver and the associated hepatic veins and vena cava. It is speculated that improvement in the management of these lethal injuries will come about only from the early identification of patients likely to have suffered such trauma, and the pre-operative control of bleeding. Balloon catheter placement under radiological control, to tamponade the inferior vena cava and abdominal aorta, is suggested as one means by which this goal might be achieved.

Adolescent↗
PubMed1978

ABO and Rh phenotyping of foetal blood obtained by foetoscopy.

Blood samples taken from the foetus by foetoscopy early in the 2nd trimester of pregnancy can be used for reliable blood grouping. However, the sampling technique is not perfect. In 5 out of 15 pregnant women, no foetal blood was obtained, although between 1 and 10 samples were taken on each occasion. One-third of 56 samples from the 10 women contained foetal blood. Contamination of samples with amniotic fluid varied, but did not interfere with the blood grouping. ABO and Rh typing of the foetus was possible even if the samples were contaminated with large amounts of maternal blood. In nine cases, blood grouping of the foetus was performed on red cells from foetoscopy samples. Control blood samples from the foetus following abortion were obtained in seven of these cases, and the foetoscopic results were confirmed.

ABO Blood-Group System↗
PubMed1977

The blocking effect of epidural analgesia on the adrenocortical and hyperglycemic responses to surgery.

The adrenocortical and hyperglycemic responses to hysterectomy were studied in five groups of patients receiving: general anesthesia (group I), general anesthesia + epidural analgesia extending from Th10-S5 (group II), general anesthesia + epidural analgesia extending from Th8-S4--5 (group III), general anesthesia + epidural analgesia extending from Th4--6-S5 (group IV) and epidural analgesia extending from Th4-S5 without general anesthesia (group V). The results showed that the cortisol response was abolished in group V, inhibited in group IV and normal in groups II and III. The hyperglycemic response to surgery was inhibited in groups II, III and IV, and abolished in group V. Epidural analgesia from Th4 to S5, preventing the adrenocortical and hyperglycemic responses to hysterectomy, and possibly also inhibiting other components of the endocrine-metabolic response to surgery, may have important applications in further studies of the physiologic significance of the endocrine-metabolic response to surgery.

Adrenal Cortex↗
PubMedDate not supplied

[Unsustained ventricular tachycardia and accelerated idioventricular rhythm--clinical and electrocardiographic features].

OBJECTIVE: To compare clinical and electrocardiographic characteristics of Nonsustained Ventricular Tachycardia (NSVT) and Idioventricular Accelerated Rhythm (IVAR). MATERIAL AND METHODS: We studied 155 patients, 113 men and 42 women, with mean age 54 +/- 14 retrospectively, of these, 108 had NSVT and 47 IVAR. The arrhythmias were defined as follows: NSVT-more than 3 ventricular consecutive beats with an heart rate superior to 110 b/m and lasting less than 30 s.; IVAR-3 or more ventricular consecutive beats with an heart rate equal or superior to 50 and lower than 110 b/m, lasting less than 30 s. We evaluated clinical data (symptoms, functional class and anti-arrhythmic therapy), electrocardiographic data (rhythm, changes in conduction and repolarization) and ventricular function (with ECO, Radionuclide Angiography or Ventriculography). In the Holter recording (ECG-H), we analysed the presence of associated ventricular arrhythmias, their electrocardiographic characteristics (number of episodes, number of beats per episode, previous arrhythmia rate, morfology, regularity) and the relations of the arrhythmia with symptoms. RESULTS: Analysis of underlying pathology showed in both groups, the importance of coronary artery disease (44.5% vs 40%) followed by valvular heart disease (24% vs 27.6%) and cardiomyopathy (22.2% vs 17%) respectively to NSVT and IVAR. Only in the NSVT group there were patients without cardiac pathology (3.6%). Comparing with one control group of our department, this distribution was substantially different (p less than 0.0001). All IVAR episodes were assympthomatic compared with 90% of NSVT. Ventricular premature beats were found in all NSVT patients and in 90% of IVAR patients, and were frequent (greater than 10/h) in 79% and 60%, couplets in 84% and 53% respectively (ns). The previous rate of the arrhythmia was 85.3 +/- 20 b/m in NSVT against 68.7 +/- 14 in IVAR (p less than 0.0001). We found left ventricular disfunction in 60% of NSVT patients and in 63.7% in IVAR patients, being serious in 35% and 39% respectively. The follow-up was of 18.5 months (1-72) and posterior evolution showed 14.8% and 17% of deaths with no relation to the arrhythmia, although in NSVT the number of complexes and episodes were related with the ventricular disfunction (p = 0.02 and p = 0.05). CONCLUSION: Both arrhythmias appeared in patients with similar clinical and arrhythmic setting and identified a population with structural cardiopathy, bad function and poor outcome.

Adult↗
PubMedDate not supplied

[Alcoholism in an industrial population: diagnosis, prevalence and conditioning factors].

The pattern of alcohol consumption has been studied among 92 males, workers in a factory of the Lisbon area. In this population there were three groups of ethanol consumers: I--non consumers, 6%; II--medium, up to 80g/day, 68%; III--heavy consumers, more than 80g/day, 26%. Another group (IV) was considered, for reference, with 23 patients with heavy alcoholism in the outpatients of an alcoholic addicts clinic. Besides the clinical questionnaire and medical examination, the following methods have been used and analysed: brief MAST; Le Gô, Mean Corpuscular Volume (MCV), serum glutamic oxalacetic Trasaminase (SGOT), and gama-glutamyl transpepticlase (gamma GT). The mean ethanol consumption in group IV was significantly higher than in group III (p less than 0.005), and in group III higher than in group II (p less than 0.001). Group IV demarked itself form group III due to a higher prevalence of symptoms of physical dependence (p less than 0.001), and of consumption of tranquilizers (p less than 0.01). In group III the sensitivity of brief MAST has been only 8.5% and of Le Gô 13%. An increased MCV was found in 20% of individuals in group I, 4.9% in group II, 20% in group IV. The SGOT was normal in groups I and II, and increased in 8.7% of group III and 30.4% of group IV (p less than 0.05). The gamma GT was normal in group I and abnormal in 4.7% of group IV (p less than 0.01). In conclusion, approximately 25% of the workers have an excessive ethanol consumption.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Semiologic considerations and clinical significance of magnetic resonance in 11 intracranial aneurysms].

The author's experience with high-field Magnetic Resonance (Signa, 1.5 T, G.E.) in 11 cases of intracranial aneurysms (6 presenting as space lesion and 5 with symptoms of rupture) is reported. Spin-echo, gradient-echo and GRASS (fast-scan or flip-angle) sequences have been used and results compared with those of CT-scan and angiography. Magnetic Resonance findings, relating to blood flow and oxidation of haemoglobin (within the lumen, in the wall and at the periphery of the aneurysm) were interpreted from the point of diagnosis and surgical planning. The authors concluded that Magnetic Resonance should be considered as a routine investigation for intracranial aneurysms particularly when it is suspected that they might be voluminous and/or thrombosed.

Adolescent↗