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Search Results: 1 - 10 of 8552 matches for " Gesmar Volga Haddad;Pinto "
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Study of the cardiac alterations in HIV-infected children consequent to the antiretroviral therapy: prospective study of 47 cases
Herdy Gesmar Volga Haddad,Pinto Carlos Alberto M.,Lopes Vania Gloria S.,Ribeiro Raquel P.
Arquivos Brasileiros de Cardiologia , 2003,
Abstract: OBJECTIVE: Detect of cardiac alterations in children with AIDS and compare their evolution with the administration of only one anti-retroviral and the recent cases who received drugs in combination. METHODS: We prospectively studied 47 children in 3 groups: group 1, 20 cases treated only with zidovudine; group 2, 10 patients treated initially with zidovudine and later with a combination of drugs and in group 3, 17 patients, who receiced two or three since the beginning. In all patients it was done chest X-ray, EKG and echocardiography every 6 months and after death complete pathological study. RESULTS: Among the 45 patients cases 26 (57%) were index cases. Malnutrition, diarrhea tachycardia, signs of congestive heart failure, pericardial effusion, abnormal ventricular repolarization and arrhythmias were more frequent in group 1. Echocardiographic abnormalities were present in 10 (50%) children of group 1. They were less frequent in the others two groups. In regard to the outcome in group 1, two patients had worsening of sings of cardiomyopaty and 4 died. Cardiac dysfunction in all cases of group 2 and 3 improved with the medication. CONCLUSION:- The children who received combination and their cardiac alterations had more favorable outcome than those who received only one drug.
Rheumatic carditis treated with high doses of pulsetherapy methylprednisolone. Results in 70 children over 12 years
Herdy Gesmar Volga Haddad,Pinto Carlos Alberto,Olivaes Maria Cecilia,Carvalho Elisabeth Amabile
Arquivos Brasileiros de Cardiologia , 1999,
Abstract: PURPOSE: To report the result of patients treated with IV methylprednisolone divided into three groups and compare their follow-up during the last 12 years. METHODS: Seventy children with active rheumatic carditis (76 episodes) in heart failure Class III and IV (NYHA) were studied. The diagnosis was based on modified Jones' criteria. After ruling out infections and strongyloidiasis, treatment with IV methylprednisolone bolus was started three times a week until the laboratory tests became negative. Patients were divided into 3 groups, according to the time of hospital admittance: Groups 1, 2 and 3, comprising of 40, 18 and 12 children, respectively. RESULTS: Eighteen children in Group 1 (45%) were in their 1st attack: 2 series of pulsetherapy were used in 10 (25%), 3 in 9 (23%) and 4 in 21 (52%). In Group 2, 14 cases (77%) were in their 1st attack: 2 series were used in 7 (39%), 4 in 9 (50%) and 5 in 2 (11%). The echocardiogram showed a flail mitral valve in 12 (66%) of these patients (1 death occurred after mitral valvoplasty). In Group 3, 6 patients needed 5 or more series of pulsetherapy and a flail mitral valve was present in 5 (41%). One child underwent mitral valve replacement while still in the active phase, after 8 series of pulsetherapy, and another died. The number of patients who needed 5 or more series was significantly higher in Group 3. CONCLUSION: There were variations in the presentation and evolution of the cases during these 12 year. The established pulsetherapy protocol continues to be useful to treat severe cases.
Study of the cardiac alterations in HIV-infected children consequent to the antiretroviral therapy: prospective study of 47 cases
Herdy, Gesmar Volga Haddad;Pinto, Carlos Alberto M.;Lopes, Vania Gloria S.;Ribeiro, Raquel P.;Gomes, Ivete Martins;Tchou, Hsu Y.;Melo, Renata;Kurdian, Bedros;Tavares Jr., Plínio de Assis;
Arquivos Brasileiros de Cardiologia , 2003, DOI: 10.1590/S0066-782X2003000300007
Abstract: objective: detect of cardiac alterations in children with aids and compare their evolution with the administration of only one anti-retroviral and the recent cases who received drugs in combination. methods: we prospectively studied 47 children in 3 groups: group 1, 20 cases treated only with zidovudine; group 2, 10 patients treated initially with zidovudine and later with a combination of drugs and in group 3, 17 patients, who receiced two or three since the beginning. in all patients it was done chest x-ray, ekg and echocardiography every 6 months and after death complete pathological study. results: among the 45 patients cases 26 (57%) were index cases. malnutrition, diarrhea tachycardia, signs of congestive heart failure, pericardial effusion, abnormal ventricular repolarization and arrhythmias were more frequent in group 1. echocardiographic abnormalities were present in 10 (50%) children of group 1. they were less frequent in the others two groups. in regard to the outcome in group 1, two patients had worsening of sings of cardiomyopaty and 4 died. cardiac dysfunction in all cases of group 2 and 3 improved with the medication. conclusion:- the children who received combination and their cardiac alterations had more favorable outcome than those who received only one drug.
Rheumatic carditis treated with high doses of pulsetherapy methylprednisolone. Results in 70 children over 12 years
Herdy, Gesmar Volga Haddad;Pinto, Carlos Alberto;Olivaes, Maria Cecilia;Carvalho, Elisabeth Amabile;Tchou, Hsu;Cosendey, Raquel;Ribeiro, Raquel;Azeredo, Fabiano;Souza, Debora de;Herdy, Artur H.;Lopes, Vania Glória S.;
Arquivos Brasileiros de Cardiologia , 1999, DOI: 10.1590/S0066-782X1999000500007
Abstract: purpose: to report the result of patients treated with iv methylprednisolone divided into three groups and compare their follow-up during the last 12 years. methods: seventy children with active rheumatic carditis (76 episodes) in heart failure class iii and iv (nyha) were studied. the diagnosis was based on modified jones' criteria. after ruling out infections and strongyloidiasis, treatment with iv methylprednisolone bolus was started three times a week until the laboratory tests became negative. patients were divided into 3 groups, according to the time of hospital admittance: groups 1, 2 and 3, comprising of 40, 18 and 12 children, respectively. results: eighteen children in group 1 (45%) were in their 1st attack: 2 series of pulsetherapy were used in 10 (25%), 3 in 9 (23%) and 4 in 21 (52%). in group 2, 14 cases (77%) were in their 1st attack: 2 series were used in 7 (39%), 4 in 9 (50%) and 5 in 2 (11%). the echocardiogram showed a flail mitral valve in 12 (66%) of these patients (1 death occurred after mitral valvoplasty). in group 3, 6 patients needed 5 or more series of pulsetherapy and a flail mitral valve was present in 5 (41%). one child underwent mitral valve replacement while still in the active phase, after 8 series of pulsetherapy, and another died. the number of patients who needed 5 or more series was significantly higher in group 3. conclusion: there were variations in the presentation and evolution of the cases during these 12 year. the established pulsetherapy protocol continues to be useful to treat severe cases.
Cardiac abnormalities in the acquired immunodeficiency syndrome. A prospective study with a clinical-pathological correlation in twenty-one adult patients
Herdy Gesmar Volga Haddad,Herdy Artur Haddad,Almeida Pedro Savio,Carvalho Roberto de
Arquivos Brasileiros de Cardiologia , 1999,
Abstract: OBJECTIVE - To evaluate the cardiac abnormalities and their evolution during the course of the acquired immunodeficiency syndrome, as well as to correlate clinical and pathological data. METHODS - Twenty-one patients, admitted to the hospital with the diagnosis of acquired immunodeficiency syndrome, were prospectively studied and followed until their death. Age ranged from 19 to 42 years (17 males). ECG and echocardiogram were also obtained every six months. After death, macro- and microscopic examinations were also performed. RESULTS - The most frequent causes of referral to the hospital were: diarrhea or repeated pneumonias, tuberculosis, toxoplasmosis or Kaposi sarcoma. The most frequent findings were acute or chronic pericarditis (42%) and dilated cardiomyopathy (19%). Four patients died of cardiac problems: infective endocarditis, pericarditis with pericardial effusion, bacterial myocarditis and infection by Toxoplasma gondii. CONCLUSION - Severe cardiac abnormalities were the cause of death in some patients. In the majority of the patients, a good correlation existed between clinical and anatomical-pathological data. Cardiac evaluation was important to detect early manifestations and treat them accordingly, even in asymptomatic patients.
Plastia mitral cirúrgica em crian?as com febre reumática
Silva, Andréa Rocha e;Herdy, Gesmar Volga Haddad;Vieira, Alan Araujo;Sim?es, Luiz Carlos;
Arquivos Brasileiros de Cardiologia , 2009, DOI: 10.1590/S0066-782X2009000600004
Abstract: background: mitral repair is well accepted in children with rheumatic fever. objective: to analyze the outcomes of surgical mitral repair in children with rheumatic lesions after four years of follow-up. methods: retrospective study of 40 patients younger than 18 years, who underwent surgery in the national institute of cardiology (rio de janeiro) between january 1998 and january 2003. the echocardiographic degree of mitral regurgitation; surgical technique used; pre and postoperative functional class; patient outcome; need for valve replacement; and deaths were analyzed. results: twenty one patients (52.5%) were females. severe mitral regurgitation was observed in 32 patients (80%) and moderate in eight (20%). three immediate deaths occurred (7.5%). three months after surgery, echocardiography showed no valve regurgitation or mild regurgitation in 35 of 37 cases (94.6%) patients, and severe regurgitation in two (5.2%). thirty three cases (82.5%) were in functional class iii or iv in the preoperative period, and three months after surgery all the 37 cases (100%) were in functional class i or ii. the differences between the degree of mitral regurgitation and functional class in pre and postoperative periods were statistically significant (p<0.01). seven (19%) patients underwent heart valve replacement before four years of follow-up. conclusion: mitral valve repair showed favorable results in most of the cases as regards the degree of mitral regurgitation and the pre and postoperative functional class. only 19% of the patients required surgical valve replacement before four years of follow-up.
Avalia??o clínica e funcional tardia de arritmias em crian?as operadas de Tetralogia de Fallot
Pfeiffer, Maria Eulália Thebit;Andrea, Eduardo Machado;Serra, Salvador Manoel;Assump??o, Claudio Roberto;Herdy, Gesmar Volga Haddad;
Arquivos Brasileiros de Cardiologia , 2010, DOI: 10.1590/S0066-782X2010005000092
Abstract: background: cardiac arrhythmias are the major cause of late sudden death in patients undergoing repair of tetralogy of fallot (tf). objective: to evaluate the occurrence of cardiac arrhythmias in children and adolescents undergoing repair of tf, and to associate them with clinical aspects and laboratory tests. methods: cross-sectional study of 37 patients undergoing repair of tf at instituto estadual de cardiologia aloysio de castro (rio de janeiro). after review of the medical records and clinical assessment, the patients underwent electrocardiography (ecg), echocardiography (echo), 24-h holter monitoring and exercise test (et), whose results were subjected to statistical analysis. results: a total of 37 patients of whom 54% were males with a mean age of 9.7 ± 3.5 years and mean follow-up period of 4.7 ± 1.9 years were studied. the abnormalities most frequently found were: on ecg: right bundle branch block (89%); echo: severe pulmonary regurgitation (43%), mild pulmonary stenosis (73%), moderate right ventricular hypertrophy (rvh, 57%); on et: low exercise capacity (90%), impaired chronotropic response (40%), arrhythmias (20%); on holter monitoring: arrhythmias (59%, of which 44% were ventricular, 38% supraventricular, and 24% both ventricular and supraventricular, with predominance of infrequent and benign ventricular premature beats). five patients (15%) presented with multiform ventricular premature beats. there was an association of ventricular arrhythmia with moderate and severe rvh (p=0.026), as well as with right ventricle-to-pulmonary artery gradient (rv/pa) > 45 mmhg (p=0.004). the logistic regression analysis showed that increased rv/pa gradient was an independent predictor of ventricular arrhythmia (p=0.017). conclusion: cardiac arrhythmia was a common finding in a large proportion of children and adolescents after surgical repair of tf; however, it was infrequent and benign in most of the cases. the rv/pa gradient was considered a strong predictor of ve
Complica??es cardiovasculares em crian?a com insuficiência renal cr?nica
Herdy, Gesmar Volga Haddad;Lopes, Vania Gloria Silami;Olivaes, Maria Cecília;Mota, Isabele Coelho;Vasconcelos, Marcio Moacyr;
Arquivos Brasileiros de Cardiologia , 2007, DOI: 10.1590/S0066-782X2007000200020
Abstract: we describe a case 11 year-old boy, in which a chronic renal disease and secondary hyperparathyroidism was treated by dyalisis, calcitriol, and calcium supplementation. he developed dyslipidemia, calcified lesions with thrombus formation in several organs and vessels. necropsy findings showed ischemic cerebral necrosis, calcification in arteries including coronaries, and myocardial infarction.
Asfixia perinatal e problemas cardíacos
Herdy Gesmar Volga H.,Lopes Vania Glória S.,Arag?o Maria Luiza S.,Pinto Carlos Alberto M.
Arquivos Brasileiros de Cardiologia , 1998,
Abstract: OBJETIVO: Avaliar a gravidade das complica es cardíacas na asfixia neonatal, sua evolu o e correlacioná-las com o grau e dura o do processo hipóxico. MéTODOS: Foram estudados 90 bebês nos últimos 7 anos com grau de Apgar <6 no 5°min de vida. Pelo protocolo, após o exame físico e os cuidados intensivos, eram submetidos a dosagem do pH arterial, CPK-MB, DHL, glicemia, além da realiza o de radiografia de tórax, eletrocardiograma (ECG), ecocardiograma, seriados e repetidos a cada semana. Aqueles que faleceram eram levados à necropsia. RESULTADOS: Dos 90, 73 (81%) eram prematuros, 30 (41%) eram apropriados para a idade gestacional (AIG) e 43 (59%) eram pequenos(PIG). Em 21 (23%) casos havia pH arterial <7,2. Os quadros clínicos mais observados foram: pneumonia em 28 (31%), anemia 24 (26%) e icterícia moderada 12 (5%), entre outros. Ao exame físico observaram-se: sopro sistólico em 46 (50%), ictus propulsivo 18 (20%) e ICC em 8 (9%). No ECG, os sinais mais freqüentes foram altera es de repolariza o (ST e T) em 44 (49%). No ecocardiograma, observou-se persistência do canal arterial (PCA) em 20 (22%), regurgita o tricúspide em 6 (7%), hipertens o pulmonar em 6 (8%), hipocontratilidade de VE e dilata o de VD em 4 (5%). Dos 23 óbitos, 14 foram estudados e as altera es mais freqüentes foram necrose de fibras em 8 (68%) casos e em 4 (29%) congest o, vacuoliza o e perda de estria o. CONCLUS O: A maioria teve evolu o favorável mesmo naqueles que tiveram acidemia importante. Muitas altera es de ECG e ecocardiograma se normalizaram. Daqueles que evoluíram para o óbito, as les es mais graves ocorreram nos que sofreram, por mais tempo, processo anóxico.
Feocromocitoma em crian?a
Herdy, Gesmar Volga Haddad;Olivaes, Maria Cecília;Lopes, Vania Glória Silami;Pontes, Carlos Adriano Gazanego;Ormond Filho, Jo?o Batista;Fonseca, Eliene C.;
Arquivos Brasileiros de Cardiologia , 2005, DOI: 10.1590/S0066-782X2005000300014
Abstract: pheochromocytoma is a neoplasia of chromaffin cells that is very rare in children. its signs and symptoms result from the release of catecholamines. we report the case of a child with pheochromocytoma of difficult clinical management, confirmed on the anatomicopathological study, and cured after surgical resection.
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