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Biomedical subjects

E C Soares

Publications and source records attributed to E C Soares.

17 recordsLinked to original sources
PubMed2004

Liver transplant recipients mortality on the waiting list: long-term comparison to Child-Pugh classification and MELD.

We sought to evaluate our experience concerning the high waiting list mortality rate for orthotopic liver transplantation (OLT) using the MELD (Model for End-Stage Liver Disease), which has been shown to predict short-term survival better than Child-Turcotte-Pugh (CTP) classification. The predominant end-stage disease was cirrhosis due to hepatitis C virus (67%), patient mean age was 36.8 years, and 72.1% were men. When the patients were included on a waiting list, the MELD score was stratified into W: 0 to 10; X: 11 to 20, and Y: 21 to 40 and the CPT as A: 5 to 6, B: 7 to 9, and C: 10 to 15. It was also observed that 77.8% of patients were on the waiting list, 16.4% underwent OLT and 5.8% had been removed. The estimated survival rate after 1 year was W = 85.4%; X = 83.3%, Y = 46.8%; A = 81.3%, B = 84.2%, C = 45.9%. Child median score was 8 +/- 1.5 (5 to 15) and the MELD was 14.7 +/- 5.1 (8 to 43). The mortality rate was 20.2%. Severe patients classified as Y or C showed greater mortality than the other groups (P <.001), but no significant difference between Y and C strata. The mortality rate was the same as in previous years.

Adolescent↗
PubMed2001

Long-term prognosis of cirrhosis after spontaneous bacterial peritonitis treated with ceftriaxone.

Spontaneous bacterial peritonitis (SBP) is a frequent infection in cirrhotic patients with ascites, with a poor prognosis. The aims of this study were to determine the long-term survival of cirrhotic patients with SBP treated with ceftriaxone and to identify predictive factors related to survival. We studied 47 first episodes of SBP treated with ceftriaxone with a mean follow-up of 272 days. Nineteen variables were recorded to evaluate their relation to survival. The most frequent organism that caused SBP was Escherichia coli (40%). Spontaneous bacterial peritonitis resolution was achieved in 67% of patients. After resolution, SBP recurrence was observed in 44% of patients. The cumulative probability of survival was 68.1% at 1 month and 30.8% at 6 months. After uni-and multivariate analyses of all cases, SBP resolution ( p = 0.0001) and international normalized ratio (INR) ( p = 0.0057) were found to be related to survival. Another analysis performed after SBP resolution and SBP recurrence showed that ascitic fluid-positive culture ( p = 0.0344) and INR ( p = 0.0218) had statistical significance as variables predictive of long-term survival. We conclude that the survival of cirrhotic patients is very short after the first episode of SBP, a fact probably related to advanced liver disease, as liver dysfunction (INR) is the most important factor related to long-term patient survival.

Adult↗
PubMed2001

Lipoma of the right atrium.

The patient is a 54-year-old asymptomatic male with a tumor in the right atrium that was diagnosed on transesophageal echocardiography and confirmed as a lipoma of the right atrium on computerized tomography. The patient underwent surgical repair with extracorporeal circulation. The tumor was resected, and its base of implantation in the atrium was repaired with a flap of bovine pericardium. The diagnosis of lipoma was confirmed on histopathological examination. Locating of the tumor with the aid of transesophageal echocardiography was very useful in the strategy of cannulation of the venae cava for installation of the circuit of extracorporeal circulation. The patient had a good postoperative evolution.

Heart Atria↗
PubMed2000

The prevalence of TT virus infection in renal transplant recipients in Brazil.

BACKGROUND: Recently, TT virus (TTV) was discovered as a potential causative agent for non-A-E hepatitis. Little is known about the prevalence of TTV infection in renal transplant recipients. METHODS: One hundred and seventeen Brazilian renal transplant recipients and 100 normal subjects were examined to determine the prevalence of TTV infection. The TTV DNA in serum and its genotype were examined using polymerase chain reaction and restriction enzyme length polymorphism, respectively. RESULTS: TTV DNA was detected in 63/117 (53.8%) renal transplant recipients in contrast to its detection in 10/100 (10%) normal subjects (P<0.001). There was no statistical difference in the distribution of TTV genotypes between these groups. There was no significant difference in clinical backgrounds between TTV positive and negative patients. CONCLUSIONS: These results indicate a risk for TTV infection in renal transplant recipients in Brazil. They also indicate that TTV itself might not have a strong correlation with the pathogenicity of liver diseases.

Adolescent↗
PubMed2000

Short-term follow-up of patients after aneurysmectomy of the left ventricle.

OBJECTIVE: Left ventricular aneurysm is a complication of myocardial infarction that can best be treated by reconstructive surgeries that can restore ventricular geometry. We analyzed immediate results in a group of consecutive patients who underwent surgical correction of left ventricular aneurysms. METHODS: From January '90 to August '99, 94 patients - mean age 58.4 (ranging from 36 to 73 years), 65 (69. 1%) males and 9 ( 30.8%) females - were operated upon. Pre-operative ejection fraction ranged from 0.22 to 0.58 (mean = 0.52), and the aneurysm was located in the antero-lateral area in 90.4% of the cases. Functional class III and IV (NYHA) was present in 82 (87.2%) patients, and 12 (12.7%) were in functional class I and II. Congestive heart failure was the most frequent cause (77.6%), occurring in isolation in 24.4% or associated with coronary artery diseases in 53.2%. RESULTS: Short-term follow-up showed a 7.4% mortality, and low cardiac output was the main cause of death. Coming off pump was uneventful in 73 patients (77.6%), with a 3.2% mortality and with the use of inotropics in 20 (21.3%). One patient (1%) did not come off the pump. CONCLUSION: Surgical correction was adequate in the immediate follow-up of operated patients, and mortality was higher in patients with higher functional class.

Adult↗
PubMed2000

HIV testing among tuberculosis patients in the era of antiretroviral therapy: a population-based study in Brazil.

SETTING: Rio de Janeiro, Brazil, a city with 29862 cases of tuberculosis (TB) reported between January 1995 and June 1998. OBJECTIVES: To evaluate the counseling and testing practices for human immunodeficiency virus (HIV) infection among TB patients, and to identify the patient characteristics associated with HIV screening as antiretroviral therapy was introduced. DESIGN: Cross-sectional study of patients with TB who were reported to the health department and who initiated anti-TB treatment. The main outcome measure was screened versus not screened for HIV. RESULTS: The proportion of TB patients who received HIV screening increased from January 1995 through June 1998 (P < 0.001). Among young adults aged 20-49 years with TB, the independent predictors of HIV screening were a diagnosis of both pulmonary and extrapulmonary TB (odds ratio [OR] = 2.4, 95% confidence interval [CI] 2.1-2.8); TB meningitis (OR = 13.5, 95%CI 6.5-31.5); disseminated TB (OR = 8.2, 95%CI 5.3-12.9); lymphatic TB (OR = 5.6, 95%CI 4.7-6.6); and male sex (OR = 1.4, 95%CI 1.3-1.6). Patients with newly diagnosed TB who were women, lived in a low income neighborhood (OR = 0.7, 95%CI, 0.6-0.7), and sought TB treatment in their own residential neighborhood (OR = 0.3, 95%CI 0.3-0.4) were less likely to receive HIV counseling and testing. CONCLUSION: Health care providers in Rio de Janeiro selectively offered HIV counseling and testing to persons they perceived to be at risk for HIV and those with advanced stages of TB. HIV counseling and testing should be expanded and offered to all TB patients.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Gelatin particle indirect agglutination test for serodiagnosis of schistosomiasis: comparative study with enzyme-linked immunosorbent assay.

A new serological test, the gelatin particle agglutination test (GPAT), was used for the serodiagnosis of schistosomiasis mansoni. This technique showed the sensitivity (90.6%) and specificity (97.8%) close to those of enzyme-linked immunosorbent assay. The GPAT can be easily and rapidly performed without specialized equipment, by using lyophilized antigen-coated gelatin particles. The test also seems to be useful for mass screening of Schistosoma infection in field conditions.

Agglutination Tests↗
PubMedDate not supplied

Studies on prevalence of Strongyloides infection in Holambra and Maceió, Brazil, by the agar plate faecal culture method.

Prevalence of Strongyloides stercoralis infection in three areas of Brazil was surveyed by a recently developed faecal culture method (an agar plate culture). The Strongyloides infection was confirmed in 11.3% of 432 subjects examined. The diagnostic efficacy of the agar plate culture was as high as 93.9% compared to only 28.5% and 26.5% by the Harada-Mori filter paper culture and faecal concentration methods, when faecal samples were examined simultaneously by these three methods. Among the 49 positive samples, about 60% were confirmed to be positive only by the agar plate culture. These results indicate that the agar plate culture is a sensitive new tool for the correct diagnosis of chronic Strongyloides infection.

Adolescent↗
PubMedDate not supplied

[Duodenal ulcer treated by carbenoxolone sodium. Endoscopically controlled trial (author's transl)].

The authors present the results of a clinical and endoscopic controlled trial of outpatients with duodenal ulcer treated with carbenoxolone (CBX) and carbenoxolone plus antacids (CBX + AA). They observed complete healing of the duodenal ulcer in 77%-83,3% in both groups of patients. They concluded that CBX is important in the treatment of duodenal ulcer been equally effective alone or in association with antacids.

Antacids↗
PubMedDate not supplied

Effects of intravenous glucose and aminoácids of gástric secretion.

Five healthy females were submitted to parenteral nutrition with amino acids and glucose solution and the acidity and volume of gastric juice were studied. No alterations were noted in the values obtained inthe various phases studied even after the administration of betazole. We concluded that the infusion of amino acids and glucose do not alter the pattern of gastric secretion.

Adult↗
PubMedDate not supplied

[Colonoscopy technic. Evaluation of 80 examinations].

Eighty colonoscopies were done in 77 patients with the CF-MB Olympus colonoscope. A schedule of the examination is analyzed. The bowel preparation can be done at the patient's home. If the patient is well prepared psychologically, the use of antispasmodics or sedatives is not required. The position proposed for the patient is on his back with legs flexed. The symptom most frequently found during the examination was abdominal pain related to the introduction of the colonoscope and to the colon distension; 28,7% of the patients had no symptoms. In the absence of colon obstruction the colonoscope can reach the transverse colon even though fluoroscopy was not used. There were no complications in the 80 examinations performed.

Adolescent↗
PubMedDate not supplied

Ceftriaxone in the treatment of spontaneous bacterial peritonitis: ascitic fluid polymorphonuclear count response and short-term prognosis.

BACKGROUND/AIMS: In this study, ascitic fluid polymorphonuclear (PMN) response, short-term prognosis, and factors related to hospital mortality were investigated in 62 cases of spontaneous bacterial peritonitis occurring in cirrhotic patients treated with Ceftriaxone (1g every 12 hours). METHODOLOGY: The diagnostic criteria for (SBP) were ascitic fluid PMN count < 250 cells/mm3 and no evidence of secondary peritonitis. Analysis of ascitic fluid samples were obtained on admission, and on the 4th and 10th days of antibiotic therapy. RESULTS: The etiology of cirrhosis was alcohol in 63% of the cases, and 79.5% of patients belonged to Child-Pugh Class C. Ascitic fluid analysis showed positive cultures in 47% of the cases, and a marked decrease in PMN count during treatment (admission: 7762 +/- 2837; 4th day: 388 +/- 91; 10th day: 173 +/- 59 cells/mm3). Ascitic PMN was < 250 cells/mm3 within 4 days of treatment in 33% of the cases. The hospital mortality rate was 24%, and was related to gastrointestinal hemorrhage, hepatic encephalopathy, renal failure and 4th day ascitic fluid PMN count. CONCLUSION: Ceftriaxone is a safe and effective option for the treatment of SBP.

Ascitic Fluid↗