423 resultados para coronariopatia obstrutiva
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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Pós-graduação em Medicina Veterinária - FMVZ
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Pós-graduação em Bases Gerais da Cirurgia - FMB
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The indications for adenotonsillectomy in pediatric patients have changed considerably during the 90th decade. Local or systemic complications of the adenoid or tonsil hypertrophy itself have now been substituted by signs of obstructive ventilatory disturbances, including obstructive sleep apnea as the major indications for surgery. Objective: This study analyses the clinical profile of children submitted to adenotonsilectomy in their pre and postoperative state, at Botucatu Medical School-State University São Paulo, UNESP. Methods: 332 children of both genders, aged 1 to 12 years, who underwent adenotonsillectomy between 1999 and 2004, were studied, focused on epidemiological profile, pre and postoperative (1 month) symptoms, obtained from medical records. Height and weight were compared to brazilian normal age related values. Results: We found a predominance of the male gender, except in he group aged from 10 to 12 years. Considering wheight and height, we found important failure to thrive, mostly for height deficit. Among clinical aspects, we found a significant reduction in obstructive symptoms like snoring or apneia (p<0001) in the postoperative period. Conclusion: Our results were similar to the literature findings of patients clinical profile. The major indication for adenotonsillectomy in our service was clinical diagnosis of obstructive sleep apnea.
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Obstructive Sleep Apnea Syndrome (OSAS) is characterized by snoring and / or repetitive pauses in breathing during sleep associated with hypoxemia and hypercapnia. Affects approximately 1-3% of children, especially preschoolers. There is an association of OSAS with negative impact on neurocognitive development. However, there are few studies using protocols to assess cognition and behavioral disorders in children with OSAS. The objective of this study was to analyze the major studies related to the topic within the last two decades. The main studies published between 1995 to 2011 were identified through MEDLINE and LILACS databases. We selected the most relevant for OSAS in children, neurocognitive effects and association between obstructive disorders / OSAS in the target population (children). It was concluded that the studies analyzed showed that there is strong evidence regarding the overlapping of OSAS in children with neurocognitive disorders and that treatment of OSAS has positive impact on neurocognitive development.
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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Endovascular aortic aneurysm repair (EVAR) involving renal and visceral arteries remains a great challenge. Several techniques have been developed over the time to treat juxtarenal, pararenal and thoracoabdominal aneurysms, highlighting the fenestrated and branched endografts, parallel prostheses as Chimney, Periscope and Sandwich Techniques and the use of flow modulation by multilayer stent. We report a case of saccular juxtarenal aortic aneurysm with high surgical risk for complex airway access due to a history of radical laryngectomy for laryngeal neoplasm. Due to chronic aorto-iliac obstructive disease, ostial stenosis of renal artery and limited diameter of the suprarenal aorta, we discarded options involving fenestrated/branched endografts and involving parallel prostheses techniques. We present this case as a therapeutic challenge and a successful treatment option in the short-term evaluation.
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Hyperkalemia is a common electrolyte imbalance in cats with obstructive feline lower urinary tract disease (FLUTD). The effects of serum potassium elevation in heart rhythm are serious and potentially lethal. The clinical manifestations reflect changes in the excitability of the cell membrane. Increased potassium levels lead to a reduction of the resting membrane potential of heart muscle cells, making them less excitable and resulting in cardiac arrhythmias. The sinoventricular rhythm with atrial arrest is among the types of arrhythmias caused by hyperkalemia. The purpose of this report was to highlight the importance of electrocardiographic monitoring for the early detection of potentially lethal arrhythmias in cats with obstructive FLUTD. We hereby describe the occurrence of three cases treated at the Small Animal Clinic of FMVZ/Unesp, Botucatu Campus.
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Pós-graduação em Bases Gerais da Cirurgia - FMB
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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FUNDAMENTO: A redução da frequência cardíaca (FC) na angiografia por tomografia das artérias coronarianas (ATCCor) é fundamental para a qualidade de imagem. A eficácia dos bloqueadores de cálcio como alternativas para pacientes com contraindicações aos betabloqueadores não foi definida. OBJETIVOS: Comparar a eficácia na redução da FC e variabilidade RR do metoprolol e diltiazem na ATCCor. MÉTODOS: Estudo prospectivo, randomizado, aberto, incluiu pacientes com indicação clínica de ATCCor, em ritmo sinusal, com FC>70bpm e sem uso de agentes que interferissem com a FC. Cinquenta pacientes foram randomizados para grupos: metoprolol IV 5-15 mg ou até FC≤60 bpm(M), e diltiazem IV 0,25-0,60mg/kg ou até FC≤60 bpm (D). Pressão arterial (PA) e FC foram aferidas na condição basal, 1min, 3min e 5min após agentes, na aquisição e após ATCCor. RESULTADOS: A redução da FC em valores absolutos foi maior no grupo M que no grupo D (1, 3, 5min, aquisição e pós-exame). A redução percentual da FC foi significativamente maior no grupo M apenas no 1 min e 3 min após início dos agentes. Não houve diferença no 5 min, durante a aquisição e após exame. A variabilidade RR percentual do grupo D foi estatisticamente menor do que a do grupo M durante a aquisição (variabilidade RR/ FC média da aquisição). Um único caso de BAV, 2:1 Mobitz I, revertido espontaneamente ocorreu (grupo D). CONCLUSÃO: Concluímos que o diltiazem é uma alternativa eficaz e segura aos betabloqueadores na redução da FC na realização de angiografia por tomografia computadorizada das artérias coronarianas. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0)