Biomedical subjects

J Monteiro

Publications and source records attributed to J Monteiro.

57 records · Page 4Linked to original sources

PubMedDate not supplied

[Coronary thrombosis in patients who have died of acute myocardial infarct. A clinico-anatomical study of 167 successive cases].

AIM: To determine the incidence of recent coronary thrombus in a population died of acute myocardial infarction (AMI) and to evaluate the relation between its presence and some clinical parameters (age, gender, time interval between the onset of symptoms and death and cause of death). POPULATION AND METHODS: 167 hearts of consecutive patients died of AMI and without thrombolytic therapy. Hearts were fixed in formaldehyde 10% for two weeks and then the epicardial coronary arteries were divided in 5 mm segments, which were examined by visual inspection to identify recent thrombi. Cuts for microscopical observation were obtained in cause of doubt. In each patients a clinical protocol with 64 parameters is performed. In statistical treatment Pearson's dispersion test and Student's t test were used. RESULTS: We found coronary thrombus in the infarction related artery in 74%. The thrombus distribution in the epicardiac coronary arteries was the following: 47% in the anterior descendent artery, 27% in the right coronary artery, 21% in the left circumflex and 5% in the left main. The comparison between the groups with and without coronary thrombus showed no differences in age and gender, but the time interval between AMI and death was shorter in the group with thrombus. Concerning the different causes of death (cardiac failure, cardiac rupture and others) the coronary thrombus prevailed in the group with left ventricule free wall rupture. There was no influence of the time interval between AMI and death on the larger prevalence of coronary thrombus found in cardiac rupture. CONCLUSIONS: The frequency of recent coronary thrombus in the infarction related artery was of 74% in this group of patients died of AMI without thrombolytic therapy. The presence of coronary thrombus was not related with patients age or gender. The frequency of coronary thrombus was inversely proportional to the time interval between AMI and death, and larger in the group with left ventricule free wall rupture.

Age Factors↗

PubMedDate not supplied

[Acute cerebrovascular disorder and arterial hypertension. Prospective study with 248 patients].

OBJECTIVE: To evaluate the hypertension associated to different types and sub-types of cerebrovascular disease (stroke), with particular reference to the frequency of hypertension, the values of blood pressure, the risk factors and the involvement of other target organs. DEFINITION: Prospective study in 248 patients with acute stroke admitted to a Clinical Medicine Unit in three independent time periods. SETTING: Internal Medicine Clinic of University Hospital in Lisbon. METHODS: Medical, neurological and cardiologic examination were performed and all patients were also submitted to different complementary tests, including a computer tomography scan of the brain, and an echocardiogram. The values of blood pressure were measured in the admission at the urgent service and 24 h after in the the ward. We identified three sub-types of stroke: intracerebral hemorrhage (IH), ischaemic stroke (IS) and lacunes (L). For each sub-type and for those with hypertension or not, we evaluated: age, sex, duration of stay in hospital and mortality. We also compared for each sub-type the values of blood pressure, the risk factor and the repercussion on other target organs. PATIENTS: Two hundred and forty eight patients (52% were men) with mean age 68.0 +/- 10.2 years, and ages among 40 and 92 years. Thirty-seven patients (15%) died. MAIN RESULTS: In the entire population (n = 248) hypertension were more prevalent in IH 83% and L 82% than in IS 59% (p < 0.0005). Hypertension was present in 172 patients (69%) and 81 (47%) were IS, 58 (34%) L and 33 (19%) IH. Sixty six percent of the 172 patients with hypertension had at least another risk factor and the most aged ones (> 65 years old) were more frequent in IS 75% than in HI 45% or L 58% (p < 0.001). For all subtypes blood pressure measurements were higher in admission than in ward and they were also higher in IH than in IS (p < 0.05). Hypertensive cardiopathy was more prevalent in IH 76% and L 61% than in IS 49% (p < 0.05). Renal failure was more frequent in IS 37% than in IH 28% and L 17% (p < 0.05). CONCLUSIONS: Hypertension is very frequent, and like advanced age is a major risk factor of stroke. Hypertension is frequently associated with one or more risk factors. Hypertensive cardiopathy is more related with IH and L and the renal involvement with IS.

Acute Disease↗

PubMedDate not supplied

[Delayed primary anastomosis in esophageal atresia without fistula. 10 years' experience].

From 1984 until 1994 there were 7 cases of newborn with esophageal atresia without fistulae, five of which were treated through primary anastomosis and two of these presented exceptional long gaps. This article is an analysis of these 7 newborns, their post-operative complications and the therapeutics used. Two deaths occurred due to associated serious cardiac pathologies, which made delayed primary anastomosis impossible, and one sudden death four months after the esophageal anastomosis. Three of these cases present a good stature-weight progression and one remains slightly under the 5 percentile. Considering our results, the delayed primary anastomosis in the esophageal atresias with long gap, in spite of the post-operative complications, shall continue to be the author's choice.

Anastomosis, Surgical↗