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Search Results: 1 - 10 of 1596 matches for " Adib Domingos;Piegas "
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Fibrila??o atrial no pós-operatório de cirurgia de revasculariza??o do miocárdio: características do perfil clínico associadas a óbitos hospitalares
Oliveira, Dinaldo Cavalcanti de;Ferro, Carlos Romério;Oliveira, Jo?o Bosco de;Prates, Guilherme Jose;Torres, Audrey;Egito, Enilton Sergio Tabosa do;Arraes, Magali Santos;Souza, Luis Carlos Bento de;Jatene, Adib Domingos;Piegas, Leopoldo Soares;
Arquivos Brasileiros de Cardiologia , 2007, DOI: 10.1590/S0066-782X2007001300004
Abstract: objective: to identify factors associated with a higher likelihood of in-hospital death in patients submitted to coronary artery bypass graft surgery (cabg) who developed atrial fibrillation (af) postoperatively. methods: the authors analyzed data from 397 consecutive patients submitted to cabg that developed af postoperatively between 2000 and 2003. the patients were divided into 2 groups: group 1 (g1) comprised patients who survived (n=369); and group 2 (g2) comprised patients who died during hospital stay (n=28). statistical analysis was performed using student's t test and chi-square test, and p values < 0.05 were considered significant. results: a comparative analysis between g1 and g2 showed that there was no difference between the groups as regards age (67.3 ± 8.4 versus 69.3 ± 9.6; p = 0.4), male gender (75.9% versus 64.3%; p = 0.1), systemic arterial hypertension (75.3% versus 85.7%; p = 0.2) and congestive heart failure (17% versus 17%; p = 1). group 2 presented higher rates for previous acute myocardial infarction (14.6% versus 28.6%; p = 0.05), left ventricular ejection fraction < 40% (12.2% versus 32.1%; p = 0.003), previous cerebrovascular accident (0.8% versus 17.9%; p = 0.03), previous percutaneous coronary intervention (19.5% versus 39.3%; p = 0.01) and previous cabg (19.3% versus 35.7%; p = 0.03). conclusion: clinical history of acute myocardial infarction, cabg, percutaneous coronary intervention, cerebrovascular accident and severe ventricular dysfunction were significantly more frequent in the group that died during hospital stay, which suggests a possible association of these factors with a higher likelihood of death following cabg.
Fatores de risco para acidente vascular encefálico após cirurgia de revasculariza??o do miocárdio
Oliveira, Dinaldo Cavalcanti de;Ferro, Carlos Romerio;Oliveira, Jo?o Bosco de;Malta, Marcelo Menezes;Barros Neto, Plínio;Cano, Silvia J. F.;Martins, Stevan Krieker;Souza, Luis Carlos B.;Jatene, Adib Domingos;Piegas, Leopoldo Soares;
Arquivos Brasileiros de Cardiologia , 2008, DOI: 10.1590/S0066-782X2008001600005
Abstract: background: stroke is a feared complication after coronary artery bypass grafting surgery (cabg), with an incidence between 1.3 and 4.3%. objective: to identify predictive factors for stroke after cabg in the modern era of cardiac surgery. methods: this is a case-control study of 65 pairs of patients, paired by sex, age (+ 3 years) and date of cabg (+ 3 months). the cases were patients submitted to elective cabg with extracorporeal circulation (ecc) that presented stroke (defined as clinical neurological deficit up to 24 hours post-operatively and confirmed by imaging assessment) and the controls were those individuals submitted to elective cabg with ecc, but without stroke. results: the univariate analysis demonstrated that the number of revascularized vessels was associated with the occurrence of stroke after the cabg (3 ± 0.8 vs. 2.76 ± 0.8, p = 0.01). the multivariate analysis by conditional logistic regression showed that systemic arterial hypertension (sah) [or: 6.1 (1.5 - 24), p = 0.009] and diabete mellitus (dm) [or: 3.1 (1.09 - 11), p= 0.03] were the determinants of the highest chance of stroke after cabg, whereas acute myocardial infarction (ami) > 1 month, was the determinant of the lowest chance of stroke [or: 0.1 (0.03 - 0.36), p = 0.003]. conclusion: hypertension and diabete mellitus were identified as independent predictors of stroke within the first 24 postoperative hours after cabg. in patients with such risk factors, it is possible that the knowledge of the causal mechanisms of brain injury represents a strategy capable of decreasing the incidence of stroke after cabg.
Sepse no pós-operatório de cirurgia cardíaca: descri??o do problema
Oliveira, Dinaldo Cavalcanti de;Oliveira Filho, Jo?o Bosco de;Silva, Rogério Ferreira;Moura, Simone Soares;Silva, Diego Janstk;Egito, Enilton Sergio Tabosa do;Martins, Stevan Krieger;Souza, Luis Carlos Bento;Jatene, Adib Domingos;Piegas, Leopoldo Soares;
Arquivos Brasileiros de Cardiologia , 2010, DOI: 10.1590/S0066-782X2010000300012
Abstract: background: in spite of the advances in sepsis diagnosis and treatment in the last years, the morbidity and mortality are still high. objective: to assess the prevalence, in-hospital evolution and prognosis of patients that presented sepsis in the postoperative period of cardiac surgery. methods: this is a prospective study that included patients (n = 7,332) submitted to cardiac surgery (valvular or coronary) between january 1995 and december 2007. the classic criteria of sepsis diagnosis were used to identify the patients that developed such condition and the preoperative comorbidities, in-hospital evolution and prognosis were evaluated. results: sepsis occurred in 29 patients (prevalence = 0.39%). there was a predominance of the male when compared to the female sex (79% vs. 21%). mean age was 69 ± 6.5 years. the main preoperative comorbidities were: systemic arterial hypertension (79%), dyslipidemia (48%) and family history of coronary artery disease (38%). the mean apache score was 18 ± 7, whereas the sofa score was 14.2 ± 3.8. the primary infectious focus was pulmonary in 19 patients (55%). there were 19 positive cultures and the mean iv hydration during the first 24 hours was 1,016 ± 803 ml. the main complications were acute renal failure (65%), low cardiac output syndrome (55%) and malignant ventricular arrhythmia (55%). mortality was 79% (23 patients). conclusion: the occurrence of sepsis after cardiac surgery was a rare event; however, its occurrence showed catastrophic clinical outcomes. the high morbidity and mortality showed the need to improve treatment, aiming at patients' better clinical evolution.
Prevalência e fatores de risco na associa??o entre doen?a arterial coronariana e aneurisma de aorta
Ferro, Carlos Romério Costa;Oliveira, Dinaldo Cavalcanti de;Guerra, Fábio de Freitas Guimar?es;Lucena, Alexandre Jorge de;Nunes, Fabiana Piech;Ortiz, Sergio Tranchesi;Egito, Enilton Sergio Tabosa;Sousa, Luis Carlos Bento de;Jatene, Adib Domingos;Piegas, Leopoldo Soares;
Arquivos Brasileiros de Cardiologia , 2007, DOI: 10.1590/S0066-782X2007000100007
Abstract: objective: to evaluate cad prevalence in patients with aortic aneurysm, as well as differences related to aneurysm topographies. to describe the primary risk factors for cad related to this association and their occasional differences according to aa topographies. methods: this was an open, prospective, nonrandomized study that evaluated 95 patients (66 men and 33 women, mean age 63 ± 11.8). all patients, asymptomatic for cad, had undergone aortic ct and coronary angiography. according to the aa topography, they were classified into three groups: 1) patients with thoracic aortic aneurysm (taa); 2) thoracoabdominal aortic aneurysm (taaa); and 3) abdominal aortic aneurysm (aaa). a database was created to store information from clinical data and complementary examinations. statistical analysis was performed using the student?s t test or analysis of variance (anova) for continuous variables and chi-square test for categorical variables. p values < 0.05 were considered statistically significant. results: cad prevalence was 63.1%, and aaa was more prevalent than taa and taaa (76% vs. 70% vs. 30%, p = 0.001). the comparative analysis of cad risk factors based on the aortic aneurysm topography revealed that smoking and dyslipidemia were more prevalent among aaa patients (74.5% vs. 42.3% vs. 60%, p = 0.01 and (54.2% vs. 19.9% vs. 60%, p = 0.007, respectively). as for coronary lesion severity in the population of aa patients, 12 (20%) had at least one lesion > 70% and 19 (31.6%), > 50%. fifteen patients (25%) had single-vessel disease, 11 (18%) had two-vessel disease, and 34 (57%) had three-vessel disease. conclusion: asymptomatic cad is highly prevalent in aa patients, particularly among those with aaa. study results suggest the need for diagnostic stratification for cad in patients with aa, especially those with aaa.
Lower Hemi-Continuity, Open Sections, and Convexity: Counter Examples in Infinite Dimensional Spaces  [PDF]
Adib Bagh
Theoretical Economics Letters (TEL) , 2012, DOI: 10.4236/tel.2012.22022
Abstract: A lower hemi-continuous correspondence with open and convex values in Rn must have open lower sections. This well- known fact has been used to establish the existence of continuous selections, maximal elements, and fixed points of correspondences in various economic applications. Since there is an increasing number of economic models that use correspondences in an infinite-dimensional setting, it is important to know whether or not the above fact remains valid in such applications. The aim of this paper is to show that the above fact no longer holds when Rn is replaced with an infinite-dimensional space. This is accomplished by using the standard orthonormal base in a Hilbert space H to construct two correspondences with values in H equipped with the weak topology. The first correspondence is lower hemi-continuous with open and convex values but does not have open lower sections. The second is a lower hemi-continuous correspondence that fails to have an open graph despite having open and convex upper and lower sections. These counter-examples demonstrate that in an infinite-dimensional setting, it is no longer possible to rely on the geometric properties of a lower hemi-continuous map (the convexity of its sections) to establish the topological properties (open lower sections, open graph) needed in many economic applications.
Paraplegia following intraaortic balloon circulatory assistance
Benício, Anderson;Moreira, Luiz Felipe P.;Auler Jr, Otávio Costa;Stolf, Noedir Ant?nio Groppo;Jatene, Adib Domingos;
Arquivos Brasileiros de Cardiologia , 1999, DOI: 10.1590/S0066-782X1999000400009
Abstract: intraaortic balloon counterpulsation is frequently used in patients experiencing severe ventricular dysfunction following maximal drug therapy. however, even with the improvement of percutaneous insertion techniques, the procedure has always been followed by vascular, infectious, and neurological complications. this article describes a case of paraplegia due to intraaortic balloon counterpulsation in the postoperative period of cardiac surgery.
Risk factors for acute myocardial infarction during the postoperative period of myocardial revascularization
Costa Jr., José Ribamar;Oliveira, Dinaldo C.;DerBedrossian, Alexei;Egito, Enilton T.;Romano, Edson R.;Barbosa, Marcos O.;Liguori, Ieda M.;Fahran, Jorge;Souza, Luis C. B.;Jatene, Adib D.;Piegas, Leopoldo S.;
Arquivos Brasileiros de Cardiologia , 2003, DOI: 10.1590/S0066-782X2003000300008
Abstract: objective: to identify risk factors for acute myocardial infarction during the postoperative period after myocardial revascularization. methods: this was a case-control study paired for sex, age, number, type of graft used, coronary endarterectomy, type of myocardial protection, and use of extracorporeal circulation. we assessed 178 patients (89 patients in each group) undergoing myocardial revascularization, and the following variables were considered: dyslipidemia, systemic hypertension, smoking, diabetes mellitus, previous myocardial revascularization surgery, previous coronary angioplasty, and acute myocardial infarction. results: baseline clinical characteristics did not differ in the groups, except for previous myocardial revascularization surgery, prevalent in the case group (34 patients vs. 12 patients; p = 0.0002). this was the only independent predictor of risk for acute myocardial infarction in the postoperative period, based on a multivariate logistic regression analysis (p=0.0001). mortality and the time of hospital stay of the case group were significantly higher (19.1% vs. 1.1%; p<0.001 and 15.7 days vs. 10.6 days; p<0.05 respectively) than those of the control. conclusion: only previous myocardial revascularization was an independent predictor of acute myocardial infarction in the postoperative period, based on multivariate logistic regression analysis.
Abla??o da fibrila??o atrial por cateter com radiofreqüência guiada por mapeamento espectral endocárdico dos "ninhos de FA" em ritmo sinusal
Mateos, José Carlos Pachón;Mateos, Enrique I. Pachón;Lobo, Tasso J.;Pachón, Maria Zélia C.;Mateos, Juán Carlos Pachón;Pachón, Denilda Queiroz V.;Vargas, Remy Nelson A.;Piegas, Leopoldo S.;Jatene, Adib D.;
Arquivos Brasileiros de Cardiologia , 2007, DOI: 10.1590/S0066-782X2007001500001
Abstract: background: two types of myocardia can be observed through the endocardial spectral mapping (sm) in sinus rhythm: the compact type with a smooth spectrum and the fibrillar type with a segmented spectrum (atrial fibrillation nests). during the atrial fibrillation (af), the compact type has an organized activation and low frequency (passive), whereas the fibrillar type has a rather disorganized activation and high frequency (active/resonant), with both being activated by high-frequency sustained tachycardia - the background tachycardia (bt). objective: to describe the treatment of af by the ablation of the af nests and bt. methods: 1) catheter ablation of the af nests with rf [4/8mm-60o/30-40j/30s] guided by sm in sinus rhythm, outside the pulmonary vein; 2) atrial stimulation -300ppm; 3) additional ablation of the af nests if af is induced; 4) focal ablation if bt and/or flutter is induced; 5)clinical follow-up+ ecg+ holter. results: a total of 50±18 af nests/patient were treated. after 11.3±8m, 81 patients (88%) did not present af (28.3% with antiarrhythmic drugs). after the ablation of the af nests, af was not reinduced in 61 patients (71%) and bt was induced and treated in 24 patients (26%). there were two episodes of pericardial bleeding (1 treated clinically and 1 surgically), caused by sheaths that are no longer used conclusion: the sm in sinus rhythm can be used in the ablation of af nests. during the af, the af nests present a reactive-resonant pattern and the compact myocardium is passive, stimulated by the high frequency of the bt. after the ablation of the af nests and the bt, it was not possible to reinduce the sustained af. the ablation of af nests outside the pulmonary veins showed to be safe and highly effective in the cure and/or clinical control of the af.
Anastomose mamária-coronária: análise de 2923 casos
Dinkhuysen, Jarbas J;Souza, Luis Carlos Bento de;Fichino, Maria Zenaide Soares;Chaccur, Paulo;Arnoni, Antoninho Sanfins;Piegas, Leopoldo S;Magalh?es, Hélio M. de;Paulista, Paulo P;Sousa, J. Eduardo M. R;Jatene, Adib D;
Revista Brasileira de Cirurgia Cardiovascular , 1987, DOI: 10.1590/S0102-76381987000100002
Abstract: at the instituto dante pazzanese de cardiollogia, the use of mammary-coronary anastomosis was iniciated in 1972, isolated or with saphenous vein by-pass or other procedure. initially only left internal mammary artery lad anastomosis was employed in a few (57) cases. in 1973/1974, the aplication of this technique was intensified-386 cases. the method was practically descontinued between 1975 to 1982 - only 43 cases were performed. since then, its use increased steadily and the right internal mammary artery has been used as well. in 1984, studying 177 patients, we observed that this technique does not influence the incidence of external dehiscence on the reoperation for bleeding; but in 25% occurred an elevation of hemolateral diaphragm, in 17% atelectasis, and in 27.6% pleural effusion. in 654 patients with mammary-coronary anastomoses and saphenous vein grafts followed up to nine years; patency was 91.5% for mammaries and 70.6% for saphenous veins. in another group of 102 patients with isolated mammarycoronary anastomosis patency was 94.4% in a period between 5 and 10 years. the mortality rate of all 2923 cases was 3.45%.
Revasculariza??o cirúrgica após reperfus?o no infarto agudo do miocárdio
Mattos, Luiz Alberto;Piegas, Leopoldo S;Pinto, Ibraim Francisco;Tanajura, Luiz Fernando Leite;Moraes, Amanda Guerra de;Pimentel, Wilson;Buchler, Jorge;Dinjuysen, Jarbas J;Souza, Luiz Carlos Bento de;Paulista, Paulo P;Jatene, Adib D;Sousa, J. Eduardo M. R;
Revista Brasileira de Cirurgia Cardiovascular , 1987, DOI: 10.1590/S0102-76381987000200003
Abstract: the coronary artery bypass surgery is frequently used to treat the residual lesion after myocardial infarction reperfusion. patients may undergo surgery during the acute or late phase. this study analyses the results of 45/159 (28%) patients who underwent a coronary bypass surgery after successful myocardial reperfusion with streptokinase or percutaneous transluminal coronary angioplasty (ptca). patients were divided into two groups accordingly to the reperfusion technique: i) 27 (60%) reperfused with the use of streptokinase, intracoronary in 22 (81%) and intravenous in 5 (18%); ii) 18 (40%) reperfused with the aid of ptca, alone in 10 (55%) and following previous streptokinase in 8 (45%). patientes were analysed at the moment of surgery, clinical evolution, late cinecoronariography and death, and were followed from 2 to 55 months. authors analise the results and the capacity of bypass surgery complement successfull myocardial reperfusion during acute myocardial infarction.
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