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Biomedical subjects

J A Sousa

Publications and source records attributed to J A Sousa.

8 recordsLinked to original sources
PubMed2000

Retrograde endopyelotomy using an original home-made diathermy probe.

PURPOSE: To describe an easily home-made diathermy probe for the performance of retrograde endopyelotomies using a small-caliber rigid ureteroscope. METHODS: The diathermy probe is easily built by putting a rigid guidewire through a 5F ureteral catheter, the distal tip being naked and slightly bent. The other end is linked to the electric generator. Among a total of 24 retrograde endopyelotomies performed to treat ureteropelvic junction obstruction in the last 7 years, five were done using this device. RESULTS: Surgery with the probe took an average of 30 minutes. There were no complications, and, as of today, all cases are successes. CONCLUSION: This device allows the performance of retrograde endopyelotomy using a small-caliber ureteroscope. Long-term results will presumably match the good results obtained using the larger-caliber ureteroscopes with the classic cold knife.

Adolescent↗
PubMed1994

Interhospital transfer of cardiac patients: does air transport make a difference?

INTRODUCTION: The purpose of this study was to compare the outcome of interhospital transported cardiac patients for whom bias in selecting transport mode was removed due to helicopter unavailability. METHODS: Patients with the diagnosis of unstable angina or myocardial infarction who underwent transport by ground only because helicopter transport was not available, were compared to patients transported by helicopter. Patients were matched by gender and referring hospital. Ninety-six patients were studied and both groups were comparable in age, diagnosis, Killip classification, treatment with thrombolytics and post-transport procedures. RESULTS: There were no statistically significant differences between the groups for mean ICU days (5.3 air vs. 3.5 ground) and mean hospital days (9.9 vs. 8.2, respectively). No differences were detected in the proportions of deaths within 72 hours of arriving at the receiving institution (1/48 air vs. 0/48 ground), but air transportation was associated with more total deaths (9/48 vs. 1/48, respectively). CONCLUSION: It appears that the interhospital transport of cardiac patients by air offers no outcome advantage over ground transport.

Air Ambulances↗
PubMed1994

Improved flight following through continuous quality improvement.

INTRODUCTION: Flight following is a key component of an air medical transport service's safety program. National standards require conscientious adherence to flight following. EastCare monitored its compliance with internal flight-following requirements for three years. SETTING: EastCare is a single-helicopter, hospital-based air medical transport service located in a rural region of the southeastern United States. It has a full-time staff of flight nurses, pilots and communications specialists. METHODS: A continuous quality improvement (CQI) process was initiated to delineate specific areas requiring improvement. These areas were discussed at the air medical service's monthly CQI meetings. RESULTS: In 1989, the communications specialists achieved flight following intervals of < or = 15 minutes in 98% of attempts. In 1990 and 1991, the frequency of flight-following intervals of < or = 15 minutes were 98.8% and 99.6%, respectively. The CQI process pointed out educational requirements, technological problems and other areas for improvement. CONCLUSION: The use of a structured CQI process for this service directly contributed to consistently strong compliance in the frequency of flight following.

Air Ambulances↗
PubMed1993

Prevalence of Candida albicans in vaginal fluid of asymptomatic Portuguese women.

Candida albicans is by far the most frequent agent of genital candidosis. We studied the prevalence of C albicans in normal asymptomatic women attending primary health care centers throughout Portugal. The overall prevalence of C albicans in the vaginal fluid of 1,004 women studied was 10.4%. Interestingly, the prevalence rates were lower (6.8%) in women taking combination oral contraceptives and higher (13.0%) in those using intrauterine devices.

Adolescent↗
PubMed1990

Comparative study of the mutagenic and genotoxic activity associated with inhalable particulate matter in Rio de Janeiro air.

We have determined the genotoxic and mutagenic activities associated with inhalable particulate matter (IPM) collected in Rio de Janeiro, Brazil, Camden, NJ, and Caldecott Tunnel, CA, and used these results to compare three different bioassays. Samples collected every 12 hr (Rio) or every 24 hr (Camden) were extracted sequentially with cyclohexane (CX), dichloromethane (DCM), and acetone (ACE), for a rough fractionation by polarity, and composites of the extracts were tested for mutagenicity using the Salmonella frame shift (TA98) and base substitution (TA100) tester strains, as well as for genotoxicity using the Rossman Microscreen bioassay based on the induction of lambda-prophage in a lysogenic Escherichia coli strain. All samples were tested without and with S9 metabolic activation. Maximum mutagenic and genotoxic activities were in the nonpolar (CX) and polar (ACE) fractions, respectively, indicating that these two assays detect different classes of compounds with different efficiencies. Oxidative aging of the Rio aerosol is indicated by a shift in activities in both tests from the less polar fractions in the day to the polar (ACE) fraction at night. The Rio TA98 mutagenic (18 rev/m3) and genotoxic (1.4 x 10(5) PFU/m3) activities were higher than those for Camden, an Eastern U.S. city, by factors of 1.4 and 2.8, respectively.

Air Pollutants↗
PubMedDate not supplied

Extortion in the emergency department.

We present the case of a 33-yr-old female patient who, along with members of her family, attempted to extort approximately $6000.00 from our institution and her insurance company. This attempted extortion was done under the guise of a missed retained foreign body. The patient initially presented to our emergency department with a laceration to her right forearm; X-ray studies obtained after the wound had been sutured revealed no foreign body. Several days later, the patient and family members approached our administrative staff demanding recompense for metal fragments discovered in the patient's wound at another facility. Comparison of radiographs revealed that the metallic fragments were placed in the wound after she was treated and released from our emergency department, and monetary compensation was denied.

Adult↗