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J Sá

Publications and source records attributed to J Sá.

9 recordsLinked to original sources
PubMed1995

[Thrombolytic therapy in acute myocardial infarct: the reasons for ineligibility].

STUDY OBJECTIVE: to establish the reasons of ineligibility for thrombolytic therapy (TL) in a group of patients with acute myocardial infarction (AMI). DESIGN: retrospective analysis of protocols and clinical records. SETTING: the medical intensive care unit (ICU) of a tertiary care hospital. PATIENTS AND METHODS: we studied the records from patients with AMI admitted to the ICU during a five-year period (1987-91) and excluded from TL, to determine the cause(s) of ineligibility. RESULTS: we found 1669 patients with AMI, 89 of which were excluded from the study. Of the remaining 1580 patients, 1274 (80.6%) did not receive TL. Mean age was 64.4 years; 66.4% were men. Mortality was 24.6%. Mean duration of chest pain was 19.4 hours. Chief reasons for exclusion from TL were advanced age (43.1% of patients) and delayed presentation (55.7%); one of these was present in 79.2%. CONCLUSIONS: this study confirmed the high mortality of patients with AMI who do not receive TL. Advanced age and delayed presentation were the main causes of ineligibility. As age is being abandoned as an exclusion criterion, efforts for expansion of TL should center on the earlier arrival of patients to centers where it is available.

Adult↗
PubMed1994

[Vasculitis associated with ANCA].

The authors present a case report of a 62-year old woman, with hypertension for many years. She suffered from weakness, anorexia and weight loss in the last 6 months. On admission, anemia, elevated ESR, haematuria, proteinuria and renal failure were present. Renal biopsy was compatible with chronic glomerulonephritis. The clinical picture and positivity for P-ANCA suggested systemic vasculitis. Later evidence of maxillary sinusitis and nasal mucosae ulcers as well as pneumonitis, although biopsy did not reveal granulomas, suggested the diagnosis of Wegener Vasculitis. Medicated with Cyclophosphamide and Prednisolone, for a year, with improvement. The authors make a brief discussion of the clinical criteria for classification of ANCA-associated systemic vasculitis.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1993

[Cor pulmonale caused by neoplasm cell embolism].

The authors describe a case of Cor Pulmonale due to Tumor Cell Embolization in a 42-year-old woman with no history of antecedent malignant disease. The primary tumor was a Choriocarcinoma which could not be found in postmortem examination. The pathophysiology, clinical manifestations and diagnostic evaluation of this entity are briefly discussed.

Adult↗
PubMed1992

[Surgical and trauma patients in a medical intensive care unit].

OBJECTIVE: to characterize and to assess in terms of severity the surgical and trauma patients admitted to a medical intensive care unit (ICU). DESIGN: retrospective study base on clinical records and the ICU computerized database. SETTING: the medical ICU of a tertiary hospital. RESULTS: of the 2468 patients admitted to the ICU in 1989, 289 (11.7%) were surgical or trauma ones. The more frequent reasons for admission were: the need for mechanical ventilation, metabolic problems, and depression of consciousness. Of these 289 patients, 48.1% required mechanical ventilation, 14.9 hemodialysis; 4.8% had a pulmonary artery catheter inserted. Mean APACHE II, TISS and MOF scores were high (20.09 +/- 9.29, 24.17 +/- 11.45 and 5.4 +/- 3.59); they were determined in 79.2, 88.2 and 43.9% of patients respectively. Both APACHE and TISS scores were correlated with mortality. When compared with medical patients, surgical/trauma ones although younger (52.9 +/- 20.7 years versus 55.9 +/- 20.2, p = 0.00152), had a longer mean stay in the ICU (7.63 +/- 12.7 days v. 3.64 +/- 7.61, p = 0.0001), and a higher mortality (also in the ICU) (28.7 v. 16.7, p = 0.0005. COMMENTS: these are seriously ill patients, who are frequently referred to the ICU in late stages of clinical evolution. We propose they should be closely followed, from the earliest possible stage, by medical-surgical teams, in order to benefit from a multidisciplinary approach.

Adult↗
PubMed1992

[Poisoning at a polyvalent intensive care unit].

A retrospective analysis was made concerning 1340 admissions to a multidisciplinary Intensive Care Unit over four years (1986-1989), because of acute poisoning. In 666 patients occurred 735 drug overdoses and in 674 patients, 691 non-drug intoxications. The drugs with main action in central nervous system were the most frequent in drug overdoses and the organophosphates insecticides in the non-drug intoxications. During the considered period there was an absolute and relative fall in the number of admissions for acute poisoning (480 vs 244, 15.1% vs 9.9%). The patients admitted were 698 men (289 in drug-overdoses and 409 in non-drug group) with a statistically significant difference between the type of intoxication and sex (p less than 0.001). Age mean was 40.2 +/- 19.6 years, almost the same in the two groups of intoxications. The peak incidence occurred from March to October. From the hospital area of Lisbon came 814 patients and outside of Lisbon 495 patients. The mean duration of stay in the ICU was 3.90 +2- 6.15 days, being 2.71 +/- 3.80 in the drug overdoses and 5.08 +/- 7.62 in non-drug intoxications (p less than 0.001). From the therapeutic measures we emphasize mechanical ventilation (29.5%), total parenteral nutrition (18.5%), dialysis (2.9%), Swan-Ganz catheter (2.8%) and pacemaker (1.2%). The mortality rate was 13.7%, higher in non-drug intoxications (23.0%) than in drug overdoses (4.4%) (p less than 0.0001).

Adolescent↗
PubMedDate not supplied

[Importance of magnetic resonance in Parkinson disease. An analytic study of the pars compacta].

The authors have studied by high field MR (Signa 1.5 T, GE) 11 patients with known Parkinson's disease and 19 normal controls. In all cases the widths of the pars compacta were measured by optical densitometry in T2-weighted images (gradient-echo TR 2600, TE 80). In Parkinson's patients the compactae of the nigra were found to be significantly thinned (p less than 0.01) which may be of importance for the discussion of the physicopathology and clinic of the extrapyramidal disease.

Female↗