Intervenção coronária percutânea no enfarte agudo do miocárdio: influência no prognóstico dos doentes

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular. Área de especialização: Intervenção Cardiovascular.

Relações morfológicas entre a aorta torácica avaliada por ecocardiografia e a aorta abdominal estudada por ultrassonografia

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Área de especialização em Ultrassonografia Cardiovascular.

Perfil ecocardiográfico do doente com estenose aórtica degenerativa

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Área de especialização: Ultrassonografia Cardiovascular.

Efeito agudo do exercício físico na rigidez arterial

Este estudo pretendeu reproduzir uma tarefa da vida diária (marcha com transporte de peso nos membros superiores) realizada de forma rotineira e até aconselhada no contexto da prevenção e reabilitação de patologia cardiovascular, desta forma, teve como objectivo avaliar o efeito agudo de uma sessão de exercício aeróbio associado a exercício isométrico na rigidez arterial em indivíduos jovens. Foram recrutados 14 indivíduos do sexo masculino com média de idade de 30,3±3,6 anos. Foram realizadas duas sessões de exercício com uma semana de intervalo. Em ambas as sessões de exercício, os sujeitos caminharam num tapete rolante a uma velocidade de 5,0 km/h por um período de dez minutos, sendo que, numa das sessões, determinada aleatoriamente, carregaram o equivalente a 10% do seu peso corporal distribuído igualmente pelos dois membros superiores em dois garrafões de água. Avaliou-se em repouso e imediatamente após o exercício, a pressão arterial periférica, a frequência cardíaca e a rigidez arterial. A análise da rigidez arterial foi efectuada na artéria radial do membro superior direito com um sistema transdutor automático de pressão. Os parâmetros reportados neste estudo são a frequência cardíaca, a pressão arterial sistólica e diastólica, a pressão arterial média, a pressão central (aórtica) sistólica, a pressão de pulso central, a pressão de aumentação e o índice de aumentação a 75 bmp (Aix@75). Em repouso, não se verificaram diferenças significativas entre as duas sessões de exercício nos parâmetros avaliados. O principal resultado do presente estudo indica que a rigidez arterial aumenta de forma aguda com a realização de caminhada (exercício aeróbio) apenas quando esta é acompanhada do transporte nos membros superiores de uma carga externa (exercício isométrico) [Aix@75: -5.5(8.4) para -1.36(8.17)%, p<0.05]. Relativamente ao protocolo exclusivamente aeróbio não se verificaram diferenças significativas na rigidez arterial [Aix@75: -4.2(9.1) para -4.69(7.93)%, p>0.05]. Em conclusão, os resultados do presente estudo indicam que a rigidez arterial, em indivíduos jovens e aparentemente saudáveis, aumenta de forma significativa apenas quando o exercício aeróbio é acompanhado de exercício isométrico de membros superiores com transporte de carga adicional.

Exposição profissional a nanopartículas na indústria farmacêutica: estudo exploratório

Mestrado em Segurança e Higiene no Trabalho

Contribuição para a caracterização da emissão de nanopartículas em processos de soldadura e avaliação de riscos decorrentes do processo

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Química e Biológica Ramo de processos químicos

Avaliação ecocardiográfica da função do ventrículo direito após cirurgia cardíaca com circulação extracorporal

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Ramo de especialização: Ultrassonografia Cardiovascular

Avaliação ecocardiográfica da insuficiência mitral concomitante, na substituição valvular aórtica isolada: é possível prevê-la?

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Ramo de especialização: Ultrassonografia Cardiovascular

Avaliação ecocardiográfica da influência do jejum na resposta a um aumento reversível da pré-carga

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Ramo de especialização: Ultrassonografia Cardiovascular

Mechanical properties of stent-graft materials

An aneurysm is a localized blood-filled dilatation of an artery whose consequences can be deadly. One of its current treatments is endovascular aneurysm repair, a minimally invasive procedure in which an endoprosthesis, called a stent-graft, is placed transluminally to prevent wall rupture. Early stent-grafts were custom designed for the patient through the assembling of off-the-shelf components by the operating surgeon. However, nowadays, stent-grafts have become a commercial product. The existing endoprostheses differ in several aspects, such as shape design and materials, but they have in common a metallic scaffold with a polymeric covering membrane. This article aims to gather relevant information for those who wish to understand the principles of stent-grafts and even to develop new devices. Hence, a stent-graft classification based on different characteristics is presented and the desired features for an ideal device are pointed out. Additionally, the materials currently in use to fabricate this type of endoprosthesis are reviewed and new materials are suggested.

Erysipelothrix endocarditis with previous cutaneous lesion: report of a case and review of the literature

This report describes the first documented case of Erysipelothrix rhusiopathiae endocarditis in Latin America. The patient was a 51-years-old male, moderate alcoholic, with a previous history of aortic failure. He was used to fishing and cooking as a hobby and had his left hand wounded by a fish-bone. The disease began with erysipeloid form and developed to septicemia and endocarditis. He was treated with antibiotics and surgery for aortic valve replacement. There are only 46 cases of E. rhusiopathiae endocarditis reported to date. The authors wonder if several other cases might go unreported for lack of microbiological laboratorial diagnosis.

Acute disseminated histoplasmosis and endocarditis

Acute disseminated histoplasmosis is a frequent condition in HIV carriers. Thirty-five cases of endocarditis caused by Histoplasma capsulatum have been reported in international literature, and all these descriptions correspond to a context of subacute disseminated histoplasmosis. This paper presents the case of a HIV-positive patient with fever, dyspnea, weight loss, vomiting and polyadenopathies to whom histoplasmosis was diagnosed following blood-cultures and isolation of the agent responsible for cutaneous lesions, and in whom aortic-valve vegetations were found during an echocardiogram. The patient was treated with amphotericin B and had a good outcome; subsequent echocardiograms showed no vegetations. Literature on the subject is reviewed, with special emphasis on diagnosis and treatment of previously described cases.

Molecular epidemiology of a nosocomial outbreak due to Enterobacter cloacae and Enterobacter agglomerans in Campinas, São Paulo, Brazil

A total of 73 isolates (57 Enterobacter cloacae and 16 Enterobacter agglomerans), recovered during an outbreak of bacteremia in the Campinas area, São Paulo, Brazil, were studied. Of these isolates, 61 were from parenteral nutrition solutions, 9 from blood cultures, 2 from a sealed bottle of parenteral nutrition solution, and one was of unknown origin. Of the 57 E. cloacae isolates, 54 were biotype 26, two were biotype 66 and one was non-typable. Of 39 E. cloacae isolates submitted to ribotyping, 87.2% showed the same banding pattern after cleavage with EcoRI and BamHI. No important differences were observed in the antimicrobial susceptibility patterns among E. cloacae isolates exhibiting the same biotype, serotype and ribotype. All E. agglomerans isolates, irrespective of their origin, showed same patterns when cleaved with EcoRI and BamHI. The results of this investigation suggest an intrinsic contamination of parenteral nutrition solutions and incriminate these products as a vehicle of infection in this outbreak.

Infective endocarditis (IE) first diagnosed at autopsy: analysis of 31 cases in Ribeirão Preto, Brazil

Thirty one infective endocarditis (IE) fatal cases whose diagnosis was first obtained at autopsy were studied. The clinical data of these patients (Group 1) showed significant differences compared to other 141 IE cases (Group 2). The average age of 53 years in Group 1 patients was 18 years higher than that of Group 2. The Group 1 patients had a low frequency of IE predisposing heart disease. Both patient groups presented fever (about 87%), but a significant low frequency of cardiac murmur (25.8%) was observed in Group 1 patients and echocardiography tests were performed in only 16.1%, suggesting that IE diagnosis was not suspected. Likewise, although most Group 1 patients appeared with severe acute illness, they did not present the classic IE clinical presentation. Blood cultures were performed in only 64.5% of the Group 1 patients. However, bacteria were isolated in 70% of these blood cultures and Staphylococcus aureus was isolated in 71.4%. The bacteria attacked mitral and aortic valves. Complications such as embolizations and cardiac failure occurred in almost half of the cases and they also presented with infections of the lungs, urinary tract, and central nervous system. Medical procedures were performed in practically all fatal cases whose diagnosis was first obtained at autopsy. Sepsis occurred in about half of the patients and it was followed by shock in more than 25%. This form of IE must be suspected in mature and in old febrile hospitalized patients having infection predisposing diseases, embolization, and suffering medical procedures.