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Search Results: 1 - 10 of 174950 matches for " Dinaldo Cavalcanti de;Ferro "
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Fibrila??o atrial no pós-operatório de cirurgia cardíaca
Ferro, Carlos Romério Costa;Oliveira, Dinaldo Cavalcanti de;Nunes, Fabiana Piech;Piegas, Leopoldo Soares;
Arquivos Brasileiros de Cardiologia , 2009, DOI: 10.1590/S0066-782X2009000700011
Abstract: atrial fibrillation (af) is an arrhythmia frequently seen in the postoperative period of cardiac surgery. in this context, it is associated with the presence of comorbidities, longer length of hospital stay, and higher costs related to surgery. the mechanisms involved in the genesis of af in the postoperative period of cardiac surgery (afpo) are different from those causing paroxysmal af. knowledge of these mechanisms permits the use of efficient measures to reduce the incidence of this arrhythmia. according to recommendations of the literature, treatment is efficient and safe, because the rates of reversion to sinus rhythm are high and complications are reduced, and it is not associated with a high frequency of side effects.
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.
Evolu??o clínica muito tardia de pacientes com infarto agudo do miocárdio submetidos a angioplastia primária
Oliveira, Dinaldo Cavalcanti de;Oliveira, Jo?o Bosco;Ferro, Carlos Romerio;Rosa, Carla Gon?alves;Borba, Luciano Araujo;Knopp, Francine;Oliveira, Gustavo Porto;Silva, Cleiton Ramos;Piegas, Leopoldo Soares;
Arquivos Brasileiros de Cardiologia , 2008, DOI: 10.1590/S0066-782X2008000400002
Abstract: background: information on the clinical progression, in the long term, of patients submitted to mechanical reperfusion is scarce. objective: the objective of this study is to describe the long-term clinical progression of patients submitted to primary stenting. methods: between january 1998 and december 2003 we studied a non-concurring cohort with a fixed population of 202 patients (mean age = 61.2 ± 7.7 years; 74.7% males and 25.3% females) submitted to primary stenting. all the patients were followed up clinically and we assessed the occurrence of deaths, acute myocardial infarction (ami), cerebral vascular accident (cva) and surgical or percutaneous myocardial revascularization (mr). kaplan-meier survival curves were built for the following events: death, deaths/ami, deaths/ami/cva and major cardiovascular events (mce). results: in 91.5% of the patients the procedure was successful. during hospital stay, mortality was 3.4%; reinfarction was 0.9%; cva was 1.8%; and urgent mr was 1.4%. clinical follow-up varied from 29 to 100 months (mean = 58.7 ± 19.7 months). death-free survival was estimated at 93.6%; death/ami-free survival at 89.6%; death-ami/cva-free survival at 87.1%; and mce-free survival at 71.3% conclusion: primary stenting presented excellent results during hospital stay. very late clinical follow-up demonstrated that these good initial results have held up.
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.
Resistência à aspirina: realidade ou fic??o?
Oliveira, Dinaldo Cavalcanti de;Silva, Rogerio Ferreira;Silva, Diego Jantsk;Lima, Valter Correia de;
Arquivos Brasileiros de Cardiologia , 2010, DOI: 10.1590/S0066-782X2010001300024
Abstract: a meta-analysis of clinical studies of patients with cardiovascular disease demonstrated that the use of aspirin was associated with a 22% decrease in death rates and relevant ischemic vascular events. however, clinical studies demonstrated that patients that regularly took aspirin presented recurrence of cardiovascular events. such observation led to the question whether, in some patients, the aspirin was not effective in blocking platelet aggregation and these patients were called unresponsive to aspirin or aspirin-resistant. the clinical aspirin resistance is characterized as the occurrence of cardiovascular events in patients during treatment with aspirin, whereas the laboratory resistance is defined as the persistence of platelet aggregation, documented by laboratory test, in patients regularly taking aspirin. patients that are aspirin-resistant presented, according to laboratory tests, on average 3.8 times more cardiovascular events when compared to non-resistant ones.
Forma isolada do miocárdio n?o-compactado
Oliveira, Dinaldo Cavalcanti de;Malta, Marcelo Menezes;Pinheiro, Jairo Alves;Piegas, Leopoldo Soares;
Arquivos Brasileiros de Cardiologia , 2007, DOI: 10.1590/S0066-782X2007000200021
Abstract: noncompacted myocardium (ncm) is a rare congenital heart disease, first reported 15 years ago and with only a few published cases. in this paper, we report the main clinical findings and the complementary exams that suports ncm diagnostic. discretion of anamnesis and physical examination, together with characteristic image complementary exams findings of symptomatic ncm. (case report). the clinical assessment and the electrocardiogram at the admission found bigeminism ventricular. a tridimensional doppler echocardiogram was performed and showed numerous and prominent myocardium trabeculations and deep intertrabecular recess filled with blood that communicate with the ventricular cavity, more present in the septal-apical area. magnetic resonance imaging supported the echocardiographic findings and ruled out the presence of others cardiac malformations. the clinical and imaging complementary exams filled out the touchstones that support isolated ncm diagnose. is important to know that suggestive ncm findings permits an earlier diagnostic and treatment.
Doen?a arterial coronariana subclínica em pacientes com Diabetes Mellitus tipo 1 em hemodiálise
Oliveira, Dinaldo Cavalcanti de;Brito Junior, Fabio Sandoli de;Fernandes, Rosley Weber Alvarenga;Sa, Jo?o Roberto de;Lima, Valter Correia de;
Arquivos Brasileiros de Cardiologia , 2009, DOI: 10.1590/S0066-782X2009000700004
Abstract: background: in patients with type 1 diabetes mellitus, atherosclerosis occurs earlier in life and coronary artery disease (cad) constitutes the major cause of death. objective: evaluate the prevalence and anatomic characteristics of coronary artery disease (cad) in type 1 diabetic patients with chronic renal failure undergoing hemodialysis. methods: this is a descriptive study of 20 patients with type 1 diabetes mellitus undergoing hemodialysis without known cad. cad was assessed by quantitative coronary angiography (qca) and intravascular ultrasound (ivus). qca was performed in all lesions >30%, visually. all proximal 18-mm segments of the coronary arteries were analyzed by ivus. all other coronary segments with stenosis >30% were also analyzed. results: angiography detected 29 lesions >30% in 15 patients (75%). eleven (55%) of the lesions were >50% and 10 (50%) >70%. thirteen patients had all 3 major arteries interrogated by ivus. atherosclerosis was present in all patients and in all 51 proximal 18-mm segments analyzed. the mean vessel diameter of these segments was significantly larger at the ivus than at the qca, for all vessels. ivus images of 25 (86.2%) of the 29 lesions >30% were obtained. fibrotic plaques were common (48%) and 60% had intermediate vessel remodeling. conclusion: cad was present in all vessels of all type 1 diabetic patients undergoing hemodialysis. these findings are in agreement with other autopsy, angiography and ivus studies. additionally, they indicate the need for additional epidemiological and imaging studies to better understand and treat such a complex and serious clinical condition affecting young people.
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.
Can Carbohydrate Mouth Rinse Improve Performance during Exercise? A Systematic Review
Thays de Ataide e Silva,Maria Eduarda Di Cavalcanti Alves de Souza,Jamile Ferro de Amorim,Christos G. Stathis,Carol Góis Leandro,Adriano Eduardo Lima-Silva
Nutrients , 2014, DOI: 10.3390/nu6010001
Abstract: The purpose of this review was to identify studies that have investigated the effect of carbohydrate (CHO) mouth rinse on exercise performance, and to quantify the overall mean difference of this type of manipulation across the studies. The main mechanisms involving the potential benefit of CHO mouth rinse on performance was also explored. A systematic review was conducted in the following electronic databases: PubMed, SciELO, Science Direct, MEDLINE, and the Cochrane Library (Cochrane Central Register of Controlled Trials), without limit of searches. Eleven studies were classified as appropriate and their results were summarized and compared. In nine of them, CHO mouth rinse increased the performance (range from 1.50% to 11.59%) during moderate- to high-intensity exercise (~75% Wmax or 65% VO 2max, ~1 h duration). A statistical analysis to quantify the individual and overall mean differences was performed in seven of the 11 eligible studies that reported power output (watts, W) as the main performance outcome. The overall mean difference was calculated using a random-effect model that accounts for true variation in effects occurring in each study, as well as random error within a single study. The overall effect of CHO mouth rinse on performance was significant (mean difference = 5.05 W, 95% CI 0.90 to 9.2 W, z = 2.39, p = 0.02) but there was a large heterogeneity between the studies ( I 2 = 52%). An activation of the oral receptors and consequently brain areas involved with reward (insula/operculum frontal, orbitofrontal cortex, and striatum) is suggested as a possible physiological mechanism responsible for the improved performance with CHO mouth rinse. However, this positive effect seems to be accentuated when muscle and liver glycogen stores are reduced, possibly due to a greater sensitivity of the oral receptors, and require further investigation. Differences in duration of fasting before the trial, duration of mouth rinse, type of activity, exercise protocols, and sample size may account for the large variability between the studies.
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