PubMed Health⌕ Search

Biomedical subjects

J L Sarmento

Publications and source records attributed to J L Sarmento.

7 recordsLinked to original sources
PubMed1994

[The cardiac toxicity of cancer chemotherapy].

The presence of secondary effects following the administration of chemotherapeutic drugs is an important limitation to cancer therapy. Of these, cardiotoxicity is of crucial importance due to its negative influence on survival. The anthracyclines and cyclophosphamide are the most important cardiotoxic antineoplastic agents currently used. If we agree on a ceiling dosage of chemotherapy we will deprive some patients with a highly functional cardiac reserve of a potential benefit in the control of their cancer. Other patients who are more susceptible to the cardiotoxic effects of anticancer agents will suffer from severe cardiac disfunction following small cumulative doses of anthracyclines. The authors discuss the main cardiotoxic effects of several antineoplastic drugs with special attention given to the anthracycline group. Several diagnostic methods potentially useful in cardiac monitoring are described. Radionuclide angiocardiography is considered the gold-standard in monitoring anthracycline cardiotoxicity. Other invasive methods like endomyocardial biopsy and right heart catheterization can be clinically useful when nuclear angiocardiography is inconclusive. The authors propose an approach to the prevention of anthracycline cardiotoxicity. Other chemotherapeutic agents like cyclophosphamide are associated with the presence of myopericarditis which is sometimes fatal. The cardiotoxic effects of anticancer treatment with 5-fluorouracil, mitoxantrone, carmustine, amsacrine and interferon are less frequent and usually more benign. Finally we discuss bone marrow transplantation and its related cardiotoxicity.

Antineoplastic Agents↗
PubMed1992

[Pulmonary embolism--mortality risk].

We conducted a retrospective analysis on 311 patients with clinical diagnosis of pulmonary embolism (PE) in a period of 3 years. 163 patients were excluded based on clinical-laboratorial criteria. The remaining 146 patients had a median age of 69 years (range: 30-91 years). 54% of the patients were male. We found dyspnea (94%), abnormal cardiopulmonary observation (89%), risk factors for venous thromboembolism (74%), tachycardia (53%), cyanosis (49%), and neck vein distension (45%) to be the most frequent findings. 64% of the patients had heart failure, 32% had myocardial ischemia, 13% had cancer, and 11% had myocardial infarction. Lactic dehydrogenase (LDH) was higher than two-fold in 54% of the patients. There was severe hypoxemia in 55% of the cases and hypocapnia in 43% of the cases. Creatinine phosphokinase (CPK) was elevated in 16% of the cases. Electrocardiography was suggestive of PE in 37% of the cases. Echocardiography showed right heart dysfunction in 30% of the cases, 92% of the patients were treated with heparin, 37 patients (25%) died, 54% of which during the first 4 days after admittance. Trying to define an index of mortality in PE we evaluated all patients by discriminant analysis coming up with 14 items with good discriminative power. By approximation of their odds-ratios we determined how many points would correspond to each item in the total sum.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Coxsackie B4 infection, myopericarditis and diabetes mellitus].

The authors described a case of acute miopericarditis with evolution towards dilated cardiomiopathy, secondary to Coxsackie B4 infection, in a patient developing a concomitant insulin dependent diabetes (DIDM), admitted to be also an expression of this infection. The pathogenesis and the immunological basis of this aggression is discussed and some therapeutic considerations made.

Coxsackievirus Infections↗
PubMedDate not supplied

[Neoplastic hypercoagulability. Apropos of 2 cases with Trousseau syndrome].

The authors describe two cases with venous thromboembolism and neoplasia (ovary and stomach), which also showed evidence of arterial thromboembolic phenomena--cerebrovascular disease in the 1st case and acute myocardial infarction in the 2nd case--favouring the existence of nonbacterial thrombotic endocarditis. This presentation of neoplastic hypercoagulability is frequently underrated in clinical practice. Pathogenesis, clinical manifestations, etiology, and therapeutics of these syndromes are discussed in relation to the presented cases.

Aged↗
PubMedDate not supplied

[Cardiac manifestations of connective tissue diseases].

We have studied the cardiac manifestations of connective tissue diseases. In 213 files of patients with connective tissue disease of the Department of Medicina I, Hospital Santa Maria, during 21 years. Cardiac manifestations were observed in 63 (90%) SLE. Pericarditis was the most frequent manifestation and occurred in 33 patients (43%). The cardiac manifestations were observed in 40 (41%) RA. Pericarditis appeared in 11 patients, valvulopathy in 12 patients and coronaropathy in 11 patients. In 10 of PD diagnosed patients, ECG abnormalities were the only findings. Arrhythmias, conduction disturbances, cardiac failure and coronaropathy were the cardiac manifestations of PSS in 11 patients. Polyarteritis Nodosa patients had myocardial ischemia and another had a malignant hypertension diagnosis. We found pericardial effusion in one patient and angina in another one with MCTD diagnosis. We did'nt find any cardiac manifestation in AS. Cardiac manifestations are frequent in connective tissue diseases. The ECG, ECO and pathology show abnormal findings. Although there is not clinical cardiological expression of the disease we suggest the use of ECG. ECO Holter electrocardiography and isotopic myocardial perfusion scan technics in the clinical evaluation of such patients.

Adolescent↗