984 resultados para laryngeal stenosis


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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Objetivo: Estimar as probabilidades acumuladas de sobrevida dos pacientes diagnosticados com carcinoma espinocelular nos 10 primeiros anos do Centro de Oncologia Bucal da UNESP, Campus de Araçatuba, de 1991 a 2000, observadas até 2005, estabelecendo os possíveis fatores prognósticos significativos para o óbito. Méttodo: A análise de sobrevida foi realizada em uma coorte de 280 pacientes com carcinoma espinocelular, no Centro de Oncologia Bucal da Faculdade de Odontologia de Araçatuba, UNESP, entre 1991 e 2000. Para avaliar a associação entre as variáveis independentes e o óbito, realizou-se o teste Log Rank. A probabilidade do teste com p-valor menor que 0,25 ficou estabelecida para a inclusão das covariáveis no processo de ajustamento do modelo. A sobrevida foi estimada pelo método de produto limite de Kaplan-Meier. Os fatores prognósticos foram estimados pelo modelo de riscos proporcionais de Cox, calculando-se razão da função de risco (HR). A análise de resíduo foi realizada para verificar o ajuste do modelo. Resultados: As taxas de probabilidades acumuladas de sobrevida de 280 pacientes, para os casos em estádio IV, foram, 56,74%, 32,13%, 23,71% e 20,57%, respectivamente, até 1, 2, 3 e 5 anos após o diagnóstico. Pacientes no estádio I apresentaram sobrevida em 5 anos de 81,73%. O estadiamento clínico da doença no diagnóstico foi o único fator prognóstico definido no processo de ajuste de modelo. A estimativa da razão da função de riscos de morrer em pacientes diagnosticados no estádio III (HR=3,3), é praticamente três vezes o risco daqueles em estádio I; da mesma forma, o risco de morrer dos diagnosticados em estádio IV (HR=6,17) é cerca de seis vezes ao daqueles em estádio I. Conclusões: A covariável que permaneceu no modelo final foi estadiamento clínico no momento do diagnóstico, sendo, pois, o único fator prognóstico.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Tetralogy of Fallot is a complex cardiac malformation characterized by four anatomical defects: pulmonary valve stenosis, right ventricular hypertrophy, interventricular septal defect and aortic dextroposition. Imaging techniques are useful in the diagnosis of this disease, such as radiography for screening and Doppler echocardiography for a definitive diagnosis. Our objective is to report the radiographic and Doppler echocardiographic aspects of a tetralogy of Fallot case in a 10 month-old Border Collie dog.

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Background/aims: Cardiovascular diseases are major causes of mortality in chronic renal failure patients before and after renal transplantation. Among them, coronary disease presents a particular risk; however, risk predictors have been used to diagnose coronary heart disease. This study evaluated the frequency and importance of clinical predictors of coronary artery disease in chronic renal failure patients undergoing dialysis who were renal transplant candidates, and assessed a previously developed scoring system. Methods: Coronary angiographies conducted between March 2008 and April 2013 from 99 candidates for renal transplantation from two transplant centers in Sao Paulo state were analyzed for associations between significant coronary artery diseases (>= 70% stenosis in one or more epicardial coronary arteries or >= 50% in the left main coronary artery) and clinical parameters. Results: Univariate logistic regression analysis identified diabetes, angina, and/or previous infarction, clinical peripheral arterial disease and dyslipidemia as predictors of coronary artery disease. Multiple logistic regression analysis identified only diabetes and angina and/or previous infarction as independent predictors. Conclusion: The results corroborate previous studies demonstrating the importance of these factors when selecting patients for coronary angiography in clinical pretransplant evaluation.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Purpose: To determine, in dogs anesthetized with nitrous oxide (N2O), whether the endotracheal tube (ETT) cuffed with a Lanz® pressure regulating valve decreases the tracheal consequences of tracheal intubation. Methods: Sixteen mixed-breed dogs were allocated to two groups according to the ETT used: Control group (n = 8) - Rüsch ETT, and Lanz group (n = 8) - ETT with Lanz® pressure regulating valve. The ETT cuffs in both groups were inflated with air to an intracuff pressure of 30 cm H2O. Anesthesia was induced and maintained with pentobarbitone and N2O (1.5 L·min-1) and O2 (1 L·min-1). ETT cuff pressures were measured before (control) and 60, 120, and 180 min during N2O administration. The dogs were sacrificed, and biopsy specimens from four predetermined areas of the tracheal mucosa in contact with the ETT were collected for light and scanning electron microscopy (SM) examination. Results: Cuff pressures in the Control group were higher than in the Lanz group at all time points studied (P < 0.001), with an increase over time only in the Control group (P < 0.001). Median neutrophilic inflammatory infiltration values of the epithelial surface, and in the subepithelial layer in contact with the cuff, were higher in the Control group as compared to the Lanz group (3.0 vs 1.0 and 3.0 vs 1.5 respectively) (P < 0.05). On SM examination, median histological grades were higher in the Control group compared to Lanz group (2.9 vs 1.9 respectively), (P < 0.05). Conclusions: The Lanz® ETT decreases tracheal mucosal injury in dogs.

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The purpose of this investigation was to determine whether changes in myosin heavy chain (MHC) expression and atrophy in rat skeletal muscle are observed during transition from cardiac hypertrophy to chronic heart failure (CHF) induced by aortic stenosis (AS). AS and control animals were studied 12 and 18 weeks after surgery and when overt CHF had developed in AS animals, 28 weeks after the surgery. The following parameters were studied in the soleus muscle: muscle atrophy index (soleus weight/body weight), muscle fibre diameter and frequency and MHC expression. AS animals presented decreases in both MHC1 and type I fibres and increases in both MHC2a and type IIa fibres during late cardiac hypertrophy and CHF. Type IIa fibre atrophy occurred during CHF. In conclusion, our data demonstrate that skeletal muscle phenotype changes occur in both late cardiac hypertrophy and heart failure; this suggests that attention should be given to the fact that skeletal muscle phenotype changes occur prior to overt heart failure symptoms.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)