Biomedical subjects

Lídia Raquel de Carvalho

Publications and source records attributed to Lídia Raquel de Carvalho.

10 recordsLinked to original sources

PubMed2006

Early hemodynamic and renal effects of hemorrhagic shock resuscitation with lactated Ringer's solution, hydroxyethyl starch, and hypertonic saline with or without 6% dextran-70.

BACKGROUND: Considering the renal effects of fluid resuscitation in hemorrhaged patients, the choice of fluid has been a source of controversy. In a model of hemorrhagic shock, we studied the early hemodynamic and renal effects of fluid resuscitation with lactated Ringer's (LR), 6% hydroxyethyl starch (HES), and 7.5% hypertonic saline (HS) with or without 6% dextran-70 (HSD). MATERIALS AND METHODS: Forty-eight dogs were anesthetized and submitted to splenectomy. An estimated 40% blood volume was removed to maintain mean arterial pressure (MAP) at 40 mm Hg for 30 min. The dogs were divided into four groups: LR, in a 3:1 ratio to removed blood volume; HS, 6 mL kg(-1); HSD, 6 mL kg(-1); and HES in a 1:1 ratio to removed blood volume. Hemodynamics and renal function were studied during shock and 5, 60, and 120 min after fluid replacement. RESULTS: Shock treatment increased MAP similarly in all groups. At 5 min, cardiac filling pressures and cardiac performance indexes were higher for LR and HES but, after 120 min, there were no differences among groups. Renal blood flow and glomerular filtration rate (GFR) were higher in LR at 60 min but GFR returned to baseline values in all groups at 120 min. Diuresis was higher for LR at 5 min and for LR and HES at 60 min. There were no differences among groups in renal variables 120 min after treatment. CONCLUSIONS: Despite the immediate differences in hemodynamic responses, the low-volume resuscitation fluids, HS and HSD, are equally effective to LR and HES in restoring renal performance 120 min after hemorrhagic shock treatment.

Anesthesia↗

PubMed2006

Perioperative cardiac arrest and its mortality in children. A 9-year survey in a Brazilian tertiary teaching hospital.

BACKGROUND: The incidence of perioperative cardiac arrest and mortality in children is higher than in adults. This survey evaluated the incidence, causes, and outcome of perioperative cardiac arrests in a pediatric surgical population in a tertiary teaching hospital between 1996 and 2004. METHODS: The incidence of cardiac arrest during anesthesia was identified from an anesthesia database. During the study period, 15,253 anesthetics were performed in children. Data collected included patient demographics, surgical procedures (elective, urgent, or emergency), ASA physical status classification, anesthesia provider information, type of surgery, surgical areas, and outcome. All cardiac arrests were reviewed and grouped by the cause of arrest and death into one of four groups: totally anesthesia-related, partially anesthesia-related, totally surgery-related, or totally child disease or condition-related. RESULTS: There were 35 cardiac arrests (22.9 : 10,000) and 15 deaths (9.8 : 10,000). Major risk factors for cardiac arrest were neonates and children under 1 year of age (P < 0.05) with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05), and general anesthesia (P < 0.05). Child disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were seven cardiac arrests because of anesthesia (4.58 : 10,000)--four totally (2.62 : 10,000) and three partially related to anesthesia (1.96 : 10,000). There were no anesthesia attributable deaths reported. The main causes of anesthesia attributable cardiac arrest were respiratory events (71.5%) and medication-related events (28.5%). CONCLUSIONS: Perioperative cardiac arrests were relatively higher in neonates and infants than in older children with severe underlying disease and during emergency surgery. The fact that all anesthesia attributable cardiac arrests were related to airway management and medication administration is important in prevention strategies.

Adolescent↗

PubMed2006

Residual signal auto-correlation to evaluate speech in Parkinson's disease patients.

OBJECTIVE: To evaluate the maximum residual signal auto-correlation also known as pitch amplitude (PA) values in patients with Parkinson's disease (PD) patients. METHOD: The signals of 21 Parkinson's patients were compared with 15 healthy individuals, divided according age and gender. RESULTS: Statistical difference was seen between groups for PA, 0.39 for controls and 0.25 for PD. Normal value threshold was set as 0.3; (p<0.001). In the Parkinson's group 80.77%, and in the control group only 12.28%, had a PA<0.3 demonstrating an association between these variables. The dispersion diagram for age and PA for PD individuals showed p=0.01 and r=0.54. There was no significant difference in relation to gender and PA between groups. CONCLUSION: The significant differences in pitchs amplitude between PD patients and healthy individuals demonstrate the methods specificity. The results showed the need of prospective controlled studies to improve the use and indications of residual signal auto-correlation to evaluate speech in PD patients.

Adult↗

PubMed2005

[Pediatricians and sleep-disordered breathing in the child].

OBJECTIVES: Assessment of opinions and practices of pediatricians concerning sleep-disordered breathing (SDB) in children. METHODS: Randomly 516 pediatricians were selected in the state of São Paulo, Brazil. A survey mailed to them included questions regarding: their professional profile, knowledge about SDB in childhood, opinions and practices for diagnosis and treatment of these diseases. RESULTS: 112 anonymous completed surveys were returned (21.7%). The teaching of SDB during medical school and pediatric residency raining was considered unsatisfactory respectively by 65.2% and 34.8% of the pediatricians. Forty-nine respondents (43.8%) rated their knowledge about SDB in children as regular, 39 (34.8%) as good and 17 (15.2%) as unsatisfactory. The most important sleep-related questions were: mouth breathing, breathing pauses, sleep amount, excessive daytime sleepiness and nocturnal wheezing. Clinical aspects regarded as the most significant for suspecting obstructive sleep apnea syndrome (OSAS) were: breathing pauses, adenoid hypertrophy, mouth breathing, craniofacial anomaly and snoring. The most frequent practices for evaluation of OSAS in children were: cavum radiography with referral to an otorhinolaryngologist (25%) and nocturnal pulse oximetry (14.2%). Only 11.6% of pediatricians recommended overnight polysomnography and 4.5%, nap polysomnography. The most effective practices for SDB were considered to be: adenoidectomy and adenotonsillectomy, parents counseling, weight loss and sleep hygiene. CONCLUSIONS: There is a gap between research on SDB in childhood and pediatric practice.

Adolescent↗

PubMed2004

[Immunoexpression of c-erbB-2 in intraductal proliferative lesions of the female breast].

OBJECTIVES: Genetic modifications are related to genesis and development of cancer. Neoplasias in various organs express the c-erbB-2 oncogene. In intraductal proliferations of the breast it has been assessed as a risk factor for subsequent development of carcinoma. The c-erbB-2 immunoexpression in intraductal epithelial proliferations and the relationship with histopathological characteristics of ductal carcinoma in situ (DCIS) were evaluated. METHODS: File material from 88 women, which were tissue samples formalin-fixed, paraffin-embedded blocks, was used. Of these 51 presented with DCIS and 37 with ductal hyperplasia without atypia. Ages of the women ranged from 35 to 76 years. All cases were reviewed and nuclear grade, presence of necrosis, preponderance of histological subtype and its extension were verified. Specimens were obtained for the c-erB-2 immunohistochemical study of 84 of the women in question. RESULTS: No expression of the oncogene was verified in the hyperplasias without atypias and in tissues adjacent to all tissue samples. Expression of c-erbB-2 was verified in 9 (19.1%) of the DCIS (p = 0.0001). Immunoexpression was not related to the extension of the lesions. The c-erbB-2 immunoexpression in DCIS was correlated to the histological subtype (p = 0.019), necrosis (p = 0.0066), nuclear grade (p = 0.0084) and Van Nuys Classification (p = 0.039). CONCLUSIONS: Expression of c-erbB-2 was significant in proliferative lesions with risk (DCIS) and was correlated to histopathological characteristics: high nuclear grade, presence of necrosis and comedy subtype. There was no expression in the hyperplasias without atypias and adjacent tissues.

Adult↗

PubMed2004

[Incidence of oropharyngeal dysphagia associated with stroke in a regional hospital in São Paulo State - Brazil].

Cerebrovascular disease is recognized as to be associated with the highest mortality rate in Brazil. Dysphagia, speech and language disturbances are common consequences of the high incidence of stroke. Dysphagia is known to occur in at least 50% of the patients with acute stroke. The study is designed to establish the incidence of stroke in a reference hospital. One hundred and two consecutive patients admitted between January 2001 and January 2002 underwent a neurological examination with dysphagia specific analysis, performed by speech/dysphagia professionals as soon as they have clinical conditions. The localization of the lesions are determined by computer tomography or magnetic resonance image of the brain. Sixty one patients underwent videofluorscopic evaluation of swallowing. There was detected oropharyngeal dysphagia in 78 patients (76.5%) if the examination was limited to the clinical evaluation. Nevertheless, if complemented by videofluorscopic evaluation, the incidence grows to 90%. The explanation for the high incidence observed in this study could be pointed to the fact that dysphagia was registered on different times of the convalescence period. The data reinforces the importance of repeated evaluations made by different professionals of the staff involved in acute stroke attendance.

Adult↗

PubMedDate not supplied

Occurrence of enteroparasites in day care centers in Botucatu (São Paulo State, Brazil) with emphasis on Cryptosporidium sp., Giardia duodenalis and Enterobius vermicularis.

The occurrence of the enteroparasites was verified in 279 children (0 to 6 years) of four municipal day cares of Botucatu/SP. Three samples of each child's feces were collected and processed by the methods of Hoffman-Pons-Janner, Faust and Ritchie and subsequent coloration of the fecal smear by the methods of Auramina-O and Ziehl-Neelsen modified for diagnosis of Cryptosporidium sp. and Graham method for diagnosis of Enterobius vermicularis. Of the analyzed children we verified a prevalence of intestinal parasitism in 53.40%, and the most frequent parasite was Giardia duodenalis (26.88%). Significant association was verified among enteroparasitosis, family income, maternal education and age; the lowest enteroparasite frequency occurred in children of families with larger income and higher education. It was observed that G. duodenalis is more prevalent in children from 0 to 4 years and E. vermicularis is more frequent in children between three and four years old. The high enteroparasite prevalence in day cares suggests complex structure in its epidemiology, where factors beyond sanitation should be considered.

Animals↗

PubMedDate not supplied

Compensatory lung growth: protein, DNA and RNA lung contents in undernourished trilobectomized rats.

PURPOSE: To demonstrate compensatory lung growth (CLG) by lung contents of proteins, DNA, and RNA in undernourished young adult rats, submitted to pulmonary trilobectomy. METHODS: We used 137 male Wistar rats, randomly distributed into 9 groups; they were submitted to three treatments (control, thoracotomy, and trilobectomy), and sacrificed at three different times (7, 30, and 90 days). In trilobectomy we removed the right median, accessory, and caudal lobes. We studied lung proteins, DNA, and RNA contents. RESULTS: In the cranial lobe and left lung, protein content was higher in trilobectomized rats however there was insufficient CLG to make up for the loss. The increase of DNA in the cranial lobe and left lung of trilobectomized rats was sufficient to compensate for this loss, resulting in a similar content to controls. RNA content in trilobectomized rats, was higher in the cranial lobe and left lung, more efficient in the cranial lobe, but less than in the other groups. CONCLUSIONS: CLG occurred in trilobectomized rats, probably with cell hyperplasia and little hypertrophy, due to the large DNA compensation and small RNA compensation. This was markedly different to well-nourished animals, who had pronounced hypertrophy.

Animals↗

PubMedDate not supplied

[Pre-menstrual cyclic mastalgia].

OBJECTIVES: To compare therapeutic effects of placebo with intake of low doses of acetyl-salysilic acid (aspirin) and a compound of retinol, pyridoxine chlorhydrate and tocopherol acetate. METHODS: The study is a prospective, controlled, triple blinded, randomized trial. From 259 patients, 81 were selected in order to follow rigid criteria of inclusion. They were divided into three groups of 27 patients, taking aspirin, vitamins or placebo respectively. The number of patients in each group was considered satisfactory for statistical analysis. Pain was scored as Grade 1 (without pain), Grade II (moderate pain) and Grade III (severe pain). The Tukey test was applied for comparison of results (statistical significance 5%). RESULTS: Clinical parameters, age, weight, BMI, parity and lactation period were similar for each group. There was a decrease of pain intensity in all groups, that was even more pronounced for the placebo group. DISCUSSION: Emphasis was given to symptomatic treatment of cyclic premenstrual mastalgia with symptoms considered to be the expression of a physiological process that can be treated with simple drugs or placebo. Usual therapeutic approaches with several drugs are criticized, including results and contraindications. CONCLUSION: This study based upon acceptable trial methodology (randomized, triple blinded, placebo controlled, prospective) did not show significant differences in the treatment of cyclic mastalgia.

Adolescent↗

PubMedDate not supplied

[Health habits and risk factors in hypertensive patients].

The purposes of this study were to assess the health habits related to risk factors in hospitalized hypertensive patients and to identify these patients' knowledge on the importance of controlling these factors. Thirty two hypertensive patients hospitalized at a University Hospital were interviewed. Although these patients mentioned that they controlled the risk factors for hypertension and that they knew about the importance of this control, a high blood pressure was observed even during hospitalization and the majority of them presented damage in target organs. There is a need to search for educative measures that will enable a change in the life style of these patients, encouraging them to control the risk factors and the evolution of the disease.

Aged↗