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S dos S Carvalhal

Publications and source records attributed to S dos S Carvalhal.

At least 19 recordsLinked to original sources

[Chagas disease and primary arterial hypertension].

PURPOSE: To evaluate the pressoric behaviour in chagasic patients in different stages of myocardial damage and to correlate Chagas' disease with arterial hypertension. METHODS: The arterial blood pressure of 644 chagasic patients surveyed in the HC-UNICAMP, with arterial hypertension or not, associated with the stage of myocardial dysfunction was evaluated. This group was compared with 370 hypertensive patients without Chagas' disease. Both were divided by sex and age. The results were evaluated by covariance analysis and the significance was pointed at p < 0.05. RESULTS: The chagasic group presented a high prevalence of arterial hypertension with 16.8% in the clinical phase I, 27.8% in the phase II and 34% in the III. Both hypertensive and nonhypertensive chagasic patients had a significant drop in clinical phase I after the age of 30 years. The chagasic patients classified in phase II presented a high prevalence between 30-50 years, not associated with the pressoric behaviour and/or sex. The symptomatic myocardial dysfunction (phase III) was uncommon below 40 years old in chagasic group with hypertension or not, but presented a highest prevalence in male hypertensive chagasic patients above 50 years old. CONCLUSION: The study demonstrated a more usual association of Chagas' disease and hypertension in patients with symptomatic myocardial dysfunction, above 50 years old. This find evidenciates the somatory and progressive effect of both diseases. It is possible that the pathogenic mechanisms of Chagas' disease contributed to the increment of the arterial blood pressure.

Adult↗

[Pathogenesis of mitral valve prolapse in patients with chronic Chagas disease: study of papillary muscle myocarditis].

PURPOSE: Studying the mitral valve in chronic Chagas' heart disease, searching a possible cause effect relationship between this condition and valve prolapse. METHODS: Seventeen hearts were surveyed from individuals exhibiting chronic chagasic cardiopathy, 11 males and 6 females, aged between 31-84 (average 54) years. The hearts came from necropsies carried out until a year before. Properly preserved samples were analyzed macro and microscopically. Fragments were excised from the mitral valve papillary muscles, anterior, lateral and posterior regions of the left ventricle, interventricular septum, free wall of right ventricle and atrium walls. RESULTS: Chronic myocarditis was found ill all the samples (mild in 6 of them, moderate in 7 and severe in 4). Also, the papillary muscles exhibited myocarditis in all of the samples, and in 15 of them the degree of severity was equal to or superior than the observed in degree other regions of the heart. CONCLUSION: The chronic chagasic cardiopathy, the papillary muscle constitute a frequent site of myocarditis. This fact must be held in mind when one discusses the pathogenesis of the prolapse of the valve.

Adult↗

[Anatomo-clinical diagnosis correlation. Retrospective assessment of the clinical diagnosis in necropsies].

The post mortem findings in 200 autopsies were compared with the clinical diagnoses. Twenty diseases were analysed with respect to clinico-pathological correlation. In relation to the respective totals the diseases most frequently missed clinically were (false negative) pyelonephritis (100%), pulmonary embolus (87.50%) and bronchopneumonia (58.16%). In relation to the respective totals the clinical diagnoses less frequently confirmed (false positive) were tuberculosis (69.56%), paracoccidioidomycosis (57.14%), sepsis (53.13%) and Chagas' disease (44.44%). There was clinicopathological agreement in 97 autopsies (48.50%). In 19 cases (9.50%) if the diagnostic error had been detected during life this probably would have changes the prognosis. The findings are discussed in the light of previous studies. The importance of routine post-mortem examination and clinico-pathological correlation is stressed.

Autopsy↗