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Search Results: 1 - 10 of 7282 matches for " Louis;Ver?osa "
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Estudo das altera??es eletrocardiográficas com o uso de antidepressivos tricíclicos em pacientes com dor cr?nica
Cunha Jr., Ricardo Joaquim da;Barrucand, Louis;Verosa, Nubia;
Revista Brasileira de Anestesiologia , 2009, DOI: 10.1590/S0034-70942009000100007
Abstract: background and objectives: tricyclic antidepressants (tcas) are widely used as analgesics in chronic lumbar pain and neuropathic pain. the objective of this study was to evaluate the electrocardiographic changes in patients with chronic pain treated with amitriptyline or imipramine. methods: forty patients, ages 26 to 81 years (57.27 ± 13.65 years) of both genders (female 19, male 21), with neuropathic syndromes (lumbosciatalgia, postlaminectomy syndromes, and post-herpetic neuritis, among others) participated in this study; 60% had cardiovascular diseases; 30% had changes in the ecg (rbbb, lbbb, first-degree avb, lahb, or pvcs). three ecgs were done in each patient: one ecg was done before beginning treatment, and 30 and 60 days after beginning treatment evaluating pr, qrs, qt, qtc, dqt, dqtc, and hr. thirty-two patients were on amitriptyline and eight on imipramine. the mean dose at the end of the study was 54.29 mg of amitriptyline and 46.87 mg of imipramine. results: analysis of electrocardiographic parameters after the use of tcas showed that amitriptyline caused a transitory increase in heart rate in females (p = 0.049), and the duration of the qrs in patients 60 years or older and patients with cardiopathies (p = 0.01). in patients who received 75 mg of amitriptyline, the qtc interval was greater when compared to that of patients who received 25 mg of the drug (p = 0.0044). the increase in those parameters demonstrated the effects of amitriptyline on cardiac conduction; however, clinical compromise was not seen, since they remained within normal limits (qrs < 110 msec and qtc < 470 msec). conclusions: the chronic use of tacs proved to be safe and effective, and it did not show changes in cardiac conduction with clinical repercussion.
Análise clínica e terapêutica dos pacientes oncológicos atendidos no programa de dor e cuidados paliativos do Hospital Universitário Clementino Fraga Filho no ano de 2003
Salamonde, Giselane Lacerda Figueredo;Verosa, Nubia;Barrucand, Louis;Costa, Ant?nio Filpi Coimbra da;
Revista Brasileira de Anestesiologia , 2006, DOI: 10.1590/S0034-70942006000600005
Abstract: background and methods: the main goal of palliative care is the control of pain and other symptoms in patients with chronic diseases without possibility of cure, especially advanced cancer. about 75% of patients with advanced cancer experience severe pain, which interferes with quality of life and, according to the who, it is considered a worldwide medical emergency. this study evaluated the profile of oncology patients enrolled in the chronic pain treatment and palliative care program of the hucff/fm/ufrj, focusing on the role of the anesthesiologist, medications used, humanization of the treatment, and improvement in patient's quality of life. methods: the 2003-oncology patients' charts were analyzed retrospectively. several parameters were compared: age, race, gender, preexisting conditions organ the cancer originated from, type of pain and other symptoms, medications, hospital routine, and end of treatment. results: the types of pain included nociceptive, neuropathic, and incidental, which were evaluated using the unidimensional faces pain rating scale. in the first week, patients were treated with home-based patient controlled analgesia (pca) with oral methadone. after this period, the patient returned to the clinic to calculate the regular dose of methadone. other opioids used included codeine, tramadol, morphine, and oxycodone. besides pain, patients experienced: constipation, vomiting, delirium, sleep disturbances, and dyspnea. neuroleptics, corticosteroids, and laxatives were also used as adjuvant therapy. conclusions: patient controlled analgesia with methadone is safe and effective, since there were no significant side effects. the clinical and pharmacological knowledge of the anesthesiologist in the multidisciplinary team provided for better patient care, relief of symptoms, and humanization of the final stages of life.
Estudo comparativo entre uma e duas doses efetivas (DE95) de rocur?nio para a intuba??o traqueal
Miranda, Luciano Carlos Gomes de;Barrucand, Louis;Costa, José;Verosa, Núbia;
Revista Brasileira de Anestesiologia , 2008, DOI: 10.1590/S0034-70942008000300002
Abstract: background and objectives: neuromuscular blockers (nmb) are used to induce relaxation of skeletal muscles and facilitate tracheal intubation (ti). according to the literature, two effective doses (ed95) of nmb are ideal for ti. rocuronium is a steroid-type, synthetic, non-depolarizing neuromuscular blocker of medium duration. the objective of this study was to evaluate and compare the conditions of tracheal intubation with one and two effective doses (ed95) of rocuronium, following the criteria of the copenhagen consensus conference. methods: sixty patients of both genders, ages 20 to 60 years, physical status asa i and ii, mallampati 1 and 2, body mass index (bmi) < 35, who underwent general anesthesia, randomly divided in two groups of 30 patients, were evaluated. group 1 (g1) received 0.3 mg.kg-1 of rocuronium (1 ed95), and group 2 (g2) received 0.6 mg.kg-1 (2 de95). parameters used to evaluate ti were based on the criteria of the copenhagen consensus conference (good clinical research practice): laryngoscopy, vocal cords (position and movements), reaction to the insertion of the tube and/or filling of the cuff (movements of limbs and cough). results: all intubations were considered excellent or good (acceptable); therefore, there were no cases of failure or any intubation considered bad (unacceptable). the results of the statistical analysis were not significant. consequently, we did not observe any clinically significant differences in the parameters evaluated. conclusions: both doses of rocuronium, 0.3 mg.kg-1 and 0.6 mg.kg-1 ed95, provided clinically satisfactory parameters of ti in elective procedures.
Uso da metadona no tratamento da dor neuropática n?o-oncológica: relato de casos
Juver, Jeane Pereira da Silva;Figueiredo, Nubia Verosa;Barrucand, Louis;Tostes, Mauricio de Assis;
Revista Brasileira de Anestesiologia , 2005, DOI: 10.1590/S0034-70942005000400010
Abstract: background and objectives: this report includes seven patients with chronic non-oncologic neuropathic pain who have not responded to classic approaches with tricyclic antidepressant and anticonvulsant drugs. oral methadone, a synthetic opioid similar to morphine, is referred as alternative to treat neuropathic pain due to its non-competitive antagonist action on nmda receptors. this study aimed at evaluating methadone to treat chronic non-oncologic neuropathic pain patients who have not responded to classic approaches. case reports: seven cases in which methadone dose was titrated in subsequent visits are presented. pain severity according to facial scale, side effects and improved functional capacity were evaluated 1, 7, 14, 30 and 180 days after treatment beginning. there has been decrease in pain severity and in the incidence of side effects, such as constipation, sedation, nausea, headache and insomnia. there has been no euphoria, sweating, myoclonia, urinary retention, decreased libido and respiratory depression. conclusions: patients responded satisfactorily to low dose medication, side effects were controlled with simple measures and there has been significant functional capacity improvement. in the conditions of this study, methadone was an effective, safe and low-cost option to treat non-oncologic neuropathic pain.
Hipotens?o controlada induzida por halotano em coelhos
Figueiredo, Nubia Verosa;Schanaider, Alberto;Barrucand, Louis;Costa, Allan Antonio da;
Revista do Colégio Brasileiro de Cirurgi?es , 2003, DOI: 10.1590/S0100-69912003000500004
Abstract: background: the authors describe haemodynamic changes secondary to controlled and induced hypotension during anesthesia with different halothane concentrations. methods: twenty-nine new zealand white rabbits (oryctolagus cuniculus) were divided into four groups. a control group, composed by five animals, was compared to groups i, ii, and iii, with eight rabbits each one (n=8), that underwent anesthesia with halothane in concentrations of 1,0%, 1,5% and 2,0% respectively. cardiac and respiratory rates, body temperature, average arterial blood pressure, ph values, arterial oxygen tension (pao2), arterial carbon dioxide tension (paco2), bicarbonate concentrations (-hco3), base excess (be), and haemoglobin oxygen saturation (sat o2) were studied. all parameters were registered before, during and after halothane anesthesia induced hypotension. corneal and pupilary reflexes and cardiogram were followed continuously. results: halothane resulted in hypotension and reduced heart rate. rabbits have an alcaline blood ph. the metabolic acidosis trend observed was of transient character. halothane did not modify sato2.. conclusion: halothane is a safe and efficient anaesthetic to promote induced or controlled hypotension in rabbits.
Uso da lidocaína tópica a 4% para terapia ocupacional em pacientes com síndrome dolorosa complexa regional: relato de casos
Machado, Anna Paula Moreira Alves;Costa, José;Cortes, Maria José;Izidoro, Cecília Maria;Barrucand, Louis;Verosa, Nubia;
Revista Dor , 2012, DOI: 10.1590/S1806-00132012000300017
Abstract: background and objectives: complex regional pain syndrome (crps) is a central nervous system disorder with sympathetic dysfunction. its pathophysiology is not clear. there is peripheral inflammation and hypoxia. pain distresses patients. these case reports aimed at evaluating topic 4% lidocaine during occupational therapy of outpatients with crps. case reports: participated in this study five patients aged above 18 years, with upper limb crps types i and ii, who were evaluated in six visits with an interval of seven days. in the first, they were medicated with gabapentin and in the other five the dose was increased. as from the second visit, topic 4% lidocaine was applied approximately 30 minutes before rehabilitation exercises. four patients had crps type i. in decreasing order, referred symptoms were: sting, burning, allodynia, shock and paresthesia. all patients had edema and motor dysfunction. topic 4% lidocaine allowed patients to perform the exercises proposed by the occupational therapist, in outpatient regimen, with significant pain intensity improvement. conclusion: topic 4% lidocaine allowed rehabilitation with significant pain intensity improvement.
Controle da dor pós-operatória da artroplastia total do joelho: é necessário associar o bloqueio do nervo isquiático ao bloqueio do nervo femoral?
Zugliani, Affonso H.;Verosa, Nubia;Amaral, José Luiz Gomes do;Barrucand, Louis;Salgado, Cátia;Karam, Márcia Borges Hage;
Revista Brasileira de Anestesiologia , 2007, DOI: 10.1590/S0034-70942007000500006
Abstract: background and objectives: total knee arthroplasty (tka) causes severe tissue trauma, leading to severe postoperative pain. good postoperative analgesia is fundamental and one should consider that early mobilization of the joint is an important aspect to obtain good results. there is a controversy in the literature on the efficacy of isolated femoral nerve block. the objective of this study was to evaluate postoperative analgesia with the association of sciatic and femoral nerve block. methods: seventeen patients undergoing tka under spinal anesthesia were divided in two groups: a and b. in group a (n = 9), femoral nerve block was performed, while in group b (n = 8), femoral and sciatic nerve block were done. the blockades were done in the immediate postoperative period with 20 ml of 0.5% of ropivacaine. pain was evaluated in the first 24 hours using the visual analog scale and the verbal scale. the length of time between the nerve block and the first complaint of pain (m1) was also evaluated. results: the median of the duration of analgesia (m1) in group a was 110 min, while in group b it was 1285 min (p = 0.0001). there were no complications related to the technique used. conclusions: sciatic nerve block, when associated with femoral nerve block, under the conditions of the present study, improved significantly the quality of postoperative analgesia in tka.
Perfil oftalmológico dos alunos do programa alfabetiza??o solidária em quatro municípios do Ceará
Verosa, Islane Castro;Maia, élida Ferreira;
Arquivos Brasileiros de Oftalmologia , 2003, DOI: 10.1590/S0004-27492003000200015
Abstract: purpose: to evaluate the ophthalmologic profile of "alfabetiza??o solidária" - a program that teaches illiterate adults how to read and write; to identify the main causes of low visual acuity; to show our experience and the main results of promoting visual health in the community. methods: ophthalmologic equipment (two automatic refractors, two green refractors, two supports, two chairs, four ophthalmoscopes, one portable slit lamp, two applanation tonometers, one indirect ophthalmoscope. participants: teachers trained to assess visual acuity, ophthalmologists and residents in ophthalmology, auxiliary personnel and secretaries. results: we observed that almost half of the students (46%) showed visual acuity equal to or below 0.8 in both eyes; 81.4% of the population needed optic correction and 37% needed corrective lenses for presbyopia. the majority of the population was between 41 and 50 years old, 56% of the students were female. thirty-eight percent of the students showed some ophthalmologic pathology. we found that pterygium and cataracts were the most frequent. conclusion: the program should include as prerequisite an ophthalmologic examination of each student prior to enrollment for best results.
Perfil oftalmológico dos alunos do programa alfabetiza o solidária em quatro municípios do Ceará
Verosa Islane Castro,Maia élida Ferreira
Arquivos Brasileiros de Oftalmologia , 2003,
Abstract: OBJETIVO: Avaliar o perfil oftalmológico de estudantes da Alfabetiza o Solidária no Estado do Ceará, identificar as principais causas de baixa acuidade visual, descrever a experiência e os principais resultados obtidos. MéTODOS: Foram utilizados para o exame oftalmológico de mil e sete (1007) alunos do Programa Alfabetiza o Solidária dois refratores automatizados, dois refratores tipo Greens, duas colunas pantográficas, duas cadeiras, quatro oftalmoscópios, uma lampada de fenda portátil, dois ton metros de aplana o, um oftalmoscópio indireto. Participantes: alfabetizadores treinados para medida da acuidade visual, oftalmologistas, residentes de oftalmologia, auxiliares e secretárias. RESULTADOS: Observamos que cerca da metade dos alunos (46%) tinha baixa de acuidade visual (acuidade visual menor que 0,8 em ambos os olhos), 66,33% da popula o estudada necessitou corre o óptica, destes, 37,00% eram présbitas. Predominou a popula o na faixa de 41 a 50 anos. A maioria da popula o examinada era do sexo feminino (56%). Trinta e nove por cento da po- pula o estudada apresentou alguma doen a oftalmológica. Encontramos o pterígio e a catarata como doen as mais freqüentes. CONCLUS O: O programa deve ter no início do seu funcionamento prévio exame oftalmológico dos alunos de cada comunidade, para melhor aproveitamento do conteúdo ensinado, diminuindo desta forma a grande evas o escolar.
Depress?o em pacientes com dor no cancer avan?ado
Juver, Jeane Pereira da Silva;Verosa, Núbia;
Revista Brasileira de Anestesiologia , 2008, DOI: 10.1590/S0034-70942008000300012
Abstract: background and objectives: the importance of emotional symptoms in the context of the health-disease binomium, and efforts to spread information on palliative medicine motivated this article. the objective of this literature review was to propose a reflection on the diagnosis of depression in patients with advanced cancer with pain, based on existing concepts and definitions. contents: pain and depression are prevalent symptoms in cancer patients. considering the different points of intersection between physical and mental diseases, sometimes the diagnosis of depression in patients with cancer and pain is difficult. this datum is very important because depression decreases considerably the quality of life of patients, and should be diagnosed and treated properly. conclusions: after reviewing the literature, a few questions remained unanswered. this fact awakens the interest to undertake studies that propose precise diagnostic solutions and efficient treatment of this symptom in patients with advanced cancer.
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