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Biomedical subjects

M H Lopes

Publications and source records attributed to M H Lopes.

At least 19 recordsLinked to original sources
PubMed1998

Follow-up of 18 patients with human immunodeficiency virus infection and chronic Chagas' disease, with reactivation of Chagas' disease causing cardiac disease in three patients.

A series of 18 patients with chronic Chagas' disease and human immunodeficiency virus infection were followed up for 2 to 66 months (median, 15.5 months). Artificial xenodiagnosis was positive for 81.3% and natural xenodiagnosis was positive for 81.8% of patients for whom they were performed; 81.8% of 11 patients had medium- or high-level parasitemia. Reactivation of Chagas' disease--direct microscopic examination of blood revealing parasites and, clinically, patients presenting with cardiac disease--occurred in three patients (16.7%). Specific antitrypanosomal treatment with benznidazole was effective in reducing the level of parasitemia and improving the clinical condition in three of the four patients treated.

Adult↗
PubMed1998

Reactivation of Chagas' disease in a human immunodeficiency virus-infected patient leading to severe heart disease with a late positive direct microscopic examination of the blood.

We report a human immunodeficiency virus (HIV)-infected man with chronic Chagas' disease who developed a congestive heart failure that could not be clinically controlled. Endomyocardial biopsy revealed severe myocarditis and the xenodiagnosis result was positive, but Trypanosoma cruzi by direct microscopic examination of the blood was found only four months after the symptoms had started. Treatment with benznidazole was effective in reducing parasitemia, stabilizing the clinical status, and controlling tissue damage related to the parasite. Although the finding of T. cruzi trypomastigotes by direct microscopic examination of the blood has been considered the mark of Chagas' reactivation in immunocompromised patients with chronic disease, in this case it was a late finding.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Opinion of alumni about the teaching of nursing diagnosis according to North American Nursing Diagnosis Association].

In accordance to North American Nursing Diagnosis Association (NANDA), nursing diagnosis is a clinical judgement of the individual, family or community answers to the vital process or to the actual or potential health problems. These gives the basis for the intervention selection by which the nurse is responsible. Believing in the importance of nursing diagnosis, its teaching was introduced 4 years ago in the subjects of Woman s Health Assistance and Perinatal Nursing, in the 6o. period of the undergraduate course in nursing at UNICAMP. Aiming at evaluating these experience, we proposed to get the students opinion and obtain subsides to perfect teaching. Teoric teaching of 4 hours was given and it was indicated the basic bibliography. The supervised practical application was developed during 21 hours in a neonatal unit and 45 hours in health centers. At the end of the subjects, 16 students answered a form with closed and open questions. All the students considered valid the study of the nursing diagnoses. Most of the students considered more proper to introduce the teaching in the 3o. semester, when the nursing basic procedures is begun. As to the difficult of learning in the use of diagnoses, 68.7% of the students reported a difficult level higher to 25% and lower to 75%. The students group considers that the study of nursing diagnoses brought modifications in its concept of nursing assistance.

Attitude of Health Personnel↗
PubMed1997

[Educational program in universal precaution measures: a methodological approach].

An updating program on measures of universal precautions (M.U.P.) was developed at the Center of Whole Care of Woman's Health (Centro de Atenção Integral à Saúde da Mulher-CAISM). These measures and the procedures in the case of work accident were published in a booklet. First, servants should be aware of the matter of stress and its influence on the quality of life. Then, updating was carried through encouraging the reflection on the consequences of the non-adoption of M.U.P. The answers to 286 pre-tests and 242 post-tests were analyzed and the results showed a significantly higher index of correct answers (p < 0.01), mainly regarding the appropriate use of glove.

Education, Nursing↗
PubMed1997

[The most frequent nursing diagnoses in an oncology admission unit].

The aim of this paper was to survey the most frequent nursing diagnoses by means of the nursing history and medical procedure in order to help the care provided at the Oncology Nursing Service of Women Health Whole Care (Centro de Atenção Integral à Saúde da Mulher-CAISM). The five most common diagnoses were: risk for infection, risk for altered body temperature, risk for aspiration and colonic constipation of the exchanging pattern, and risk for activity intolerance of the moving pattern. Data collection was based on these patterns. Data predominantly involving social, cultural, psychological and spiritual aspects were hardly interpreted, because they were poorly registered or omitted.

Adolescent↗
PubMed1995

Simultaneous occurrence of acute myocarditis and reactivated Chagas' disease in a patient with AIDS.

Myocarditis is not an uncommon finding in autopsy series of patients with AIDS, although clinically important myocarditis is rarely noted. We describe a 50-year-old woman with AIDS and chronic chagasic megaesophagus, without previous cardiac abnormalities, who experienced reactivation of Chagas' disease, characterized by the finding of Trypanosoma cruzi via direct microscopic examination of the buffy coat, xenodiagnosis, and blood culture; she developed fatal acute myocarditis. Reactivation of Chagas' disease in patients with AIDS has been reported, but in the great majority of cases it has been associated with central nervous system involvement. In areas where Chagas' disease is endemic, reactivation may occur in patients with AIDS.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Paracoccidioidomycosis in a renal transplant recipient.

Paracoccidioidomycosis is a fungal infection rarely described in immunodeficient patients. We report a severe case of pulmonary paracoccidioidomycosis in a renal transplant recipient and demonstrate deficiencies of in vitro lymphocytic transformation assays, skin hypersensitivity tests, as well as low levels of antibodies to Paracoccidioides brasiliensis.

Adult↗
PubMedDate not supplied

[Support for decision making in nursing in cases of altered urinary elimination: Alturin.Exp System].

Lopes, Palombo and Sabbatini have developed a system for computer-aided decision in nursing named ALTURIN.EXP, based on SABBATINI'S EXPERTMD system and the North American Nursing Diagnosis Association (NANDA) nursing diagnosis classification, which is related to nursing diagnosis for altered urinary elimination. The ALTURIN.EXP defines the specific altered urinary elimination diagnosis and indicates the most common nursing interventions. Our purpose was testing the program clinically. Twenty-nine cases of altered urinary elimination in women with gynecological and oncogynecological problems have been described. Three nurses provided the principal and secondary diagnoses when regarded. These diagnoses were compared to those of the program. As previously elaborated, the program, in some cases, provided the secondary diagnosis. The clinical cases use has led to a review on the program structure in order to decrease error possibility.

Decision Making, Computer-Assisted↗
PubMedDate not supplied

Measles vaccination: influence of age on its efficacy.

The authors compare the serologic efficacy and the clinical protection afforded by three different measles vaccination schemes in adequately nourished children in São Paulo city, Brazil. Two hundred forty two children were divided into three groups. Group A, comprising 117 children who had received the vaccine before 12 months of age and a second dose at 12 months of age or more. Group B, comprising 46 children who had received only one dose, before 12 months of age. Group C, comprising 79 children who had received only one dose, at 12 months of age or more. The geometric mean titer of antibodies in Group A was 790.1; in Group B, 251.1; and in Group C, 550.3. There was no statistically significant difference between Groups A and C. The exposure to the measles virus was probably similar in all groups, and the children in Group A and C had similar chances of acquiring the disease after vaccination whereas in Group B the chances were higher when compared to the other two groups. The results obtained in this study favor the use, in developing countries, of a vaccination program against measles that includes an early first dose at eight months of age and revaccination after 12 months of age.

Age Factors↗
PubMedDate not supplied

[Acute Chagas' disease: transmission routes, clinical aspects and response to specific therapy in diagnosed cases in an urban center].

The authors report clinical features and therapeutic response of 24 outpatients with acute Chagas' disease, and 3 in the initial chronic phase, referred to the Clinic for Infectious and Parasitic Diseases of the FMUSP "Clínicas" Hospital between 1974 and 1987. The following transmission routes were involved: triatominae in 7 cases, blood transfusion in 9, kidney transplantation and/or blood transfusion in 4, accidental in 1, oral route in 3, probably breast feeding in 1, congenital or breast feeding in 1, and congenital or blood transfusion in 1. Six patients infected by triatominac acquired the disease between 1974 and 1980 and one in 1987. The blood transfusion infected patients acquired the disease in Greater São Paulo, seven of whom after 1983. The acute phase Chagas' disease was oligosymptomatic in 4 patients: three of such patients being immunocompromised by drugs or other diseases. Another two adult immunocompromised patients developed myocarditis and congestive heart failure. Clinical features were severe in 5 from 6 children under two years, irrespective of the transmission route. Evaluation of the acute phase patients treated with benznidazol (4-10 mg/kg/day) showed: therapeutic failure in 4/16 (25.0%); possible cure in 9/16 (53.2%) and inconclusive results in 3/16 (18.8%). The antibody and complement-mediated lysis reaction was in keeping with the xenodiagnosis in 18/22 cases, having shown negative results after treatment earlier than classical serological reactions. One aplastic anaemia patient receiving corticosteroid presented lymphoproliferative disease 6 years after being treated with benznidazol for acute Chagas' disease.

Adolescent↗
PubMedDate not supplied

Comparison of indirect immunofluorescence test for measles antibodies with haemagglutination inhibition and plaque neutralization tests.

Indirect Immunofluorescence (IFA), Plaque Reduction Neutralization (PRN) and Haemagglutination Inhibition (HI) tests for measles antibodies were carried out in 197 sera obtained from umbilical cord and vaccinated children. The IFA was also applied to blood samples collected with filter paper. IFA results demonstrated that the test is relatively simple to perform, with good reproducibility for different antigen lots. Good correlation was obtained between IFA, PRN and HI antibody titers. Better correlation was demonstrated with IFA and PRN than with HI and PRN tests. Sensitivity of IFA in detecting antibody was less effective than PRN, however more effective than HI using rhesus monkey red blood cells. PRN antibody titers over 100 were detected by IFA but not by HI (9.7% with negative results). IFA may be of considerable practical use and able to substitute HI in seroepidemiological surveys and to evaluate vaccine efficacy. It also can be simplified by employing filter paper collected samples.

Adult↗
PubMedDate not supplied

[Inactivated vaccine against hepatitis A: review of the literature and considerations on its use].

A new, safe, highly immunogenic and probably long term effective inactivated hepatitis A virus vaccine has been licensed for clinical use. Clinical trials in developed countries have demonstrated its efficacy in preventing hepatitis A in high risk groups, such as travelers to regions where HAV infection is endemic and day care children and staff, its efficacy in postexposure conditions and in community outbreaks. The authors review the basic and changing features of the disease and its epidemiology in specific geographical regions trying to elucidate its use in the control of the disease in developing countries, especially in Brazil. Taking in consideration its efficacy, safety and immunogenicity, the inactivated hepatitis A vaccine may be of extreme value in terms of individual protection. Because this vaccine is so new, there are no formal recommendations for its use in developing countries, and appropriate public health use of hepatitis A vaccine requires up-to-date epidemiological information.

Developing Countries↗
PubMedDate not supplied

[An attempt to detect Trypanosoma cruzi in the peripheral blood of patients with Chagas' disease, in chronic phase, using quantitative buffy coat (QBC)].

Taking for granted the sensitivity of the Quantitative Buffy Coat (QBC) system, as documented in a murine experimental model, we assayed to detect Trypanosoma cruzi in the peripheral blood of 100 patients with Chagas disease in its chronic phase. By means of the method, no positivity occurred, evently as a consequence of small parasitemias, undetectable by this technique as assessed by the cases in consideration.

Acridine Orange↗
PubMedDate not supplied

[Varicella during pregnancy: report of 13 cases and review of the recent literature].

Varicella occurs infrequently during pregnancy, but its natural history is not well defined and it is not certain that it is more severe in pregnant women that in other adults. For this reason a survey of 34 adult patients with varicella, admitted to Hospital das Clínicas--FMUSP from 1976 to 1986 was carried out. There were included 13 pregnant women and 21 other immunocompetent adults (11 males and 10 females). Average age in pregnant patients was 21.4 years; 24.6 years in adult females and 25.9 in adult males. In the latter group 10 patients had complications (47.6%) and in the pregnant group only four (30.7%). In three pregnant women (23%) and in four non pregnant women (36.3%) pneumonitis occurred. Pregnant women with pneumonitis developed respiratory failure, a feature not seen among immunocompetent adults.

Adolescent↗
PubMedDate not supplied

[Typology of performance of graduate course disciplines in medicine at the Medical School of the University of São Paulo].

The results of the program for the evaluation of the curriculum of the graduation course of the Medical Faculty of the University of São Paulo are presented and discussed. Following disciplines received special attention: practice in a hospital for infections diseases, orthopedics and traumatology, medical imagery, propedeutics and preventive and social pediatrics. These disciplines were chosen in an aleatory way among those that correspond to the four models of the behaviour: increasing, decreasing, decreasing/increasing and increasing/decreasing.

Brazil↗