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Search Results: 1 - 10 of 41816 matches for " Renato Oliveira Albuquerque;Escobar "
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Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patients
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Ferraz, Paulo Ernando;Lima, Ricardo Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.1590/S0102-76382011000200007
Abstract: background: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. diabetes is a feared risk factor for mediastinitis and viewed with caution by cardiovascular surgeons. objective: to identify risk factors for mediastinitis in diabetics undergoing cabg surgery with use of unilateral ita in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: retrospective study of 157 diabetics operated between may 2007 and april 2010. nine preoperative variables, five intraoperative variables and seven postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated. univariate and multivariate logistic regression analyses were applied. results: the incidence of mediastinitis was 7% (n=11), with a lethality rate of 36.1% (n=4). variables associated with increased risk of mediastinitis were: use of pedicled ita (or 8.25, 95% ci 2.03 to 66.10, p=0.016), postoperative renal complications (or 5.10, 95% ci 1.03 to 25.62, p=0.049) and re-operation (or 7.45, 95% ci 1.24 to 42.17, p=0.023). in multivariate analysis using backward logistic regression, only one variable remained as independent risk factor: use of pedicled ita (or 7.64, 95% ci 1.95 to 61.6, p=0.048), in comparison to skeletonized ita. conclusions: we suggest that diabetics should be considered for strategies to minimize risk of infection. in diabetics that undergo unilateral ita, the problem seems to be related to how ita is harvested. diabetics should always be considered for use of skeletonized ita.
Validation of MagedanzSCORE as a predictor of mediastinitis after coronary artery bypass graft surgery
, Michel Pompeu Barros de Oliveira;Figueira, Evelyn Soares;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110013
Abstract: objective: the aim of this study is to evaluate the applicability of a new score for predicting mediastinitis - magedanzscore - in patients undergoing coronary artery bypass graft (cabg) surgery in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: retrospective study involving 500 patients operated between may/2007 and april/2010. the registers contained all the information used to calculate the magedanzscore. the outcome of interest was mediastinitis. we calculated sensitivity, specificity, positive predictive value, negative predictive value, concordance and accuracy. the accuracy of the model was evaluated by roc (receiver operating characteristic) curve. results: the incidence of mediastinitis was 5.6%, with a lethality rate of 32.1%. in univariate analysis, the five variables of the magedanzscore were predictors of postoperative mediastinitis: chronic obstructive pulmonary disease (or 6.42; 95.0% ci 2.76-14.96; p<0.001), obesity (or 3.06; 95.0% ci 1.32-7.09; p=0.009), surgical reintervention (or 82.40; 95.0% ci 30.40-223.30; p<0.001), multiple transfusion (or 3.33; 95.0% ci 1.52-7.29; p=0.003) and stable angina class iv or unstable (or 2.59; 95.0% ci 1.19-7.64; p=0.016) according to canadian cardiovascular society. the score had a sensitivity of 96.4%, specificity of 90.0%, positive predictive value of 36.5%, negative predictive value of 99.8% and 90.4% concordance. the accuracy measured by the area under the roc curve was 96.2% (95.0% ci 94.5%-97.9%). conclusions: the magedanzscore proved to be a simple and objective index, revealing a satisfactory predictor of development of postoperative mediastinitis in patients undergoing cabg surgery at our institution
Predictors of transfusion of packed red blood cells in coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110044
Abstract: objectives: finding predictors of blood transfusion may facilitate the most efficient approach for the use of blood bank services in coronary artery bypass grafting procedures. the aim of this retrospective study is to identify preoperative and intraoperative patient characteristics predicting the need for blood transfusion during or after cabg in our local cardiac surgical service. methods: 435 patients undergoing isolated first-time cabg were reviewed for their preoperative and intraoperative variables and analyzed postoperative data. patients were 255 males and 180 females, with mean age 62.01 ± 10.13 years. regression logistic analysis was used for identifying the strongest perioperative predictors of blood transfusion. results: blood transfusion was used in 263 patients (60.5%). the mean number of transfused blood products units per patient was 2.27 ± 3.07 (0-23) units. the total number of transfused units of blood products was 983. univariate analysis identified age >65 years, weight <70 kg, body mass index <25 kg/m2, hemoglobin <13mg/dl, hematocrit < 40% and ejection fraction <50%, use of cardiopulmonary bypass (cpb), not using an internal thoracic artery as a bypass, and multiple bypasses as significant predictors. the strongest predictors using multivariate analysis were hematocrit < 40% (or 2.58; ci 1.62-4.15; p<0.001), cpb use (or 2.00; ci 1.27-3.17; p=0.003) and multiple bypasses (or 2.31; ci 1.31-4.08; p=0.036). conclusions: the identification of these risk factors leads to better identification of patients with a grater probability of using blood, allocation blood bank resources and cost-effectiveness use of blood products.
Risk factors for mediastinitis after coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.1590/S0102-76382011000100008
Abstract: objective: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. the aim of this study is to identify risk factors for mediastinitis in patients undergoing coronary artery bypass grafting (cabg), without the use of bilateral internal thoracic artery (ita), at the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: a retrospective study of 500 consecutive patients operated on between may 2007 and april 2010. ten preoperative variables, seven intraoperative variables and seven postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated. univariate and multivariate logistic regression analyses were performed. results: the incidence of mediastinitis was 5.6% (n=28), with a lethality rate of 32.1% (n=9). in multivariate analysis using logistic regression, five variables remained as independent risk factors: obesity (or 2.60, 95% ci 1.11 to 6.68), diabetes (or 2.71, 95% ci 1.18 to 6.65), smoking (or 2.10, 95% ci 1.12 to 4.67), use of pedicled internal thoracic artery (or 5.17, 95% ci 1.45 to 18.42) and on-pump cabg (or 2.26, 95% ci 1.14 to 5.85). conclusion: this study identified the following independent risk factors for mediastinitis after cabg: obesity, diabetes, smoking, use of pedicled ita and on-pump cabg.
EuroSCORE e mortalidade em cirurgia de revasculariza??o miocárdica no Pronto Socorro Cardiológico de Pernambuco
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Silva, Frederico Pires Vasconcelos;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000400010
Abstract: objective: the aim of this study is to evaluate the applicability of euroscore in patients undergoing coronary artery bypass graft (cabg) surgery at the division of cardiovascular surgery of pernambuco cardiologic emergency medical services - procape. methods: a retrospective study involving 500 patients operated between may 2007 and april 2010. the registers contained all the information used to calculate the euroscore. the outcome of interest was death. univariate analysis and multivariate analysis by backward logistic regression were applied to assess the association between each variable in the euroscore and deaths. the following parameters were calculated: sensitivity, specificity, positive predictive value, and negative predictive value. the power of concordance between the predicted mortality by the euroscore and the observed mortality was measured using the kappa coefficient. the accuracy of the model was evaluated by the roc (receiver operating characteristic) curve. results: the incidence of death was 13%. in multivariate analysis, nine variables remained independent predictors of death: chronic obstructive pulmonary disease, creatinine >2,3mg/dl, active endocarditis, preoperative critical state, unstable angina, ejection fraction 30% to 50%, acute myocardial infarction < 90 days, emergency surgery and additional surgery. the score had a sensitivity of 88.4%, specificity of 79.3%, positive predictive value of 40.7%, negative predictive value of 97.7% and 80.6% concordance. the accuracy measured by the area under the roc curve was 0.892 (95% ci 0.862-0.922). conclusions: the euroscore proved to be a simple and objective index, revealing a satisfactory discriminator of postoperative evolution in patients undergoing cabg surgery at our institution.
Mortalidade perioperatória em diabéticos submetidos à cirurgia de revasculariza??o miocárdica
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Lima, Ricardo de Carvalho;
Revista do Colégio Brasileiro de Cirurgi?es , 2012, DOI: 10.1590/S0100-69912012000100006
Abstract: objective: to investigate the risk factors for in-hospital death in diabetic patients undergoing isolated coronary artery bypass grafting (cabg). methods: we conducted a retrospective study with 305 consecutive diabetic patients undergoing cabg in the division of cardiovascular surgery of our institution from april 2004 to april 2010. univariate analysis for categorical variables was performed with the chi-square or fisher's exact test, as appropriate. potential risk factors with p <0.05 in the univariate analysis were included in the multivariate analysis, which was performed by backward logistic regression. values of p <0.05 were considered statistically significant. results: the study population had a mean age of 61.44 years (± 9.81) and 65.6% (n=200) were male. the in-hospital mortality rate was 11.8% (n=36). the following independent risk factors for death were identified: on-pump cabg (or 6.15, 95% ci 1.57 to 24.03, p=0.009) and low cardiac output in the postoperative period (or 34.17, 95% ci 10.46 to 111.62, p <0.001). the use of internal thoracic artery (ita) was an independent protective factor for death (or 0.27, 95% ci 0.08 to 0.093, p=0.038). conclusion: this study identified the following independent risk factors for death after cabg: on-pump cabg and low cardiac output syndrome. the use of ita was an independent protective factor.
Sweet pepper seed responses to inoculation with microorganisms and coating with micronutrients, aminoacids and plant growth regulators
Diniz, Kênia Almeida;Silva, Paulo de Albuquerque;Oliveira, Jo?o Almir;Evangelista, José Renato Emiliorelli;
Scientia Agricola , 2009, DOI: 10.1590/S0103-90162009000300002
Abstract: small sized seeds, such as the horticultural species, have limited quantities of reserves that can be balanced by coating then with essential nutrients for their initial development. in addition, inoculation of the seeds with microorganisms may protect the plants against phytopathogens, thus enhancing their growth. the present work had the objective of evaluate the physiological quality and seedling development of sweet pepper seeds and seedlings coated with several kind of films. seeds were first coated with polymers and then with antagonistic microorganisms (trichoderma viride, trichoderma polysporhum, trichoderma stromaticum, beauveria bassiana, metarhizium anisopliae), mycorrhizas, aminoacids, micronutrients and plant growth regulators. evaluation was performed for percentage of germination and for seedling emergence, speed of emergence index, number of plants, dry mass of the aerial and root parts and height of the seedlings. inoculation with trichoderma viride increased the percentage and rate of the seedlings emergence inoculation with trichoderma viride, metarhizium anisopliae and mycorrhizas promote better seedling development; seed microbiolization with microorganisms trichoderma viride, t. polysporhum, t. stromaticum, beauveria bassiana, metarhizium anisopliae. mycorrhizas mixture negatively affected seeds and seedling quality. seed covering with plant growht regulator, at a 5 ml kg-1 dose increased the roots dry matter.
Tratamento cirúrgico da coarcta??o da aorta: experiência de três décadas
Oliveira, Alline de Souza Alves;Carneiro, Breno Barbosa de Siqueira;Lima, Ricardo de Carvalho;Cavalcanti, Catarina;Villachan, Roberta;Arraes, Nadja;Lins, Ricardo de Albuquerque;Escobar, Mozart;
Revista Brasileira de Cirurgia Cardiovascular , 2007, DOI: 10.1590/S0102-76382007000300008
Abstract: objective:to make a 30-year review of the immediate results of coarctation of the aorta (coao) operation, between 1974 and 2004. all the patients underwent coao whether in isolation or associated with other congenital defects. methods: the following data was investigated: age at the time of surgery, gender, associated lesions, type of surgical technique, and immediate surgical outcome, particularly focusing the presence of systemic arterial hypertension. results: one hundred and four patients underwent coao. of the 104 enrolled patients, 75 (72%) were pediatric patients and 29 (28%) adults patients. in the pediatric group, 23 (22%) were considered neonates, 17 (16%) infants, and 35 (34%) children. the associated defects were present in 66 (63.5%) patients, 54 (51.9%) in the pediatric group and 12 (11.3%) in the adult group. seven (6.7%) deaths were observed in the immediate postoperative period. among the various surgical techniques employed, aortoplasty was used in 80 patients (76.9%); end-to-end anastomosis in 15 (14.4%); teles technique in seven (6.7%), waldhausen technique in one (1%), and it was not possible to identify the technique in one patient (1%). conclusions: despite the limitations of the present study, it may be noted that the results were good with the corrective surgery being performed safely and with a low mortality rate. medium- and long-term follow-up was impaired by the well-known structural deficiencies in brazil.
Endovascular Treatment of Giant Splenic Artery Aneurysm
Adenauer Marinho de Oliveira Góes Junior,Amanda Silva de Oliveira Góes,Paloma Cals de Albuquerque,Renato Menezes Palácios,Simone de Campos Vieira Abib
Case Reports in Surgery , 2012, DOI: 10.1155/2012/964093
Abstract: Introduction. Visceral artery aneurysms are uncommon. Among them, splenic artery is the most common (46–60%). Most splenic artery aneurysms are asymptomatic and diagnosed incidentally, but its rupture, potentially fatal, occurs in up to 8% of cases. Presentation of Case. A female patient, 64 years old, diagnosed with a giant aneurysm of the splenic artery (approximately 6.5?cm in diameter) was successfully submitted to endovascular treatment by stent graft implantation. Discussion. Symptomatic aneurysms and those larger than 2?cm represent some of the main indications for intervention. The treatment may be by laparotomy, laparoscopy, or endovascular techniques. Among the various endovascular methods discussed in this paper, there is stent graft implantation, a method still few reported in the literature. Conclusion. Although some authors still consider the endovascular approach as an exception to the treatment of SAA, in major specialized centers these techniques have been consolidated as the preferred choice, reserving the surgical approach in cases where this cannot be used. For being a less aggressive approach, it offers an opportunity of treatment to patients considered “high risk” for surgical treatment by laparotomy/laparoscopy. 1. Introduction Visceral artery aneurysms (VAAs) are uncommon. Among them, splenic artery is the most common (46–60%), followed by hepatic artery (20%) and superior mesenteric artery (5-6%) [1–6]. Seventy-five percent of VAAs are asymptomatic. The most common symptom is pain in the upper left quadrant of the abdomen or in the epigastrium, radiating to left shoulder, nausea, and vomiting. [1, 2, 7, 8]. The rupture occurs in 3% to 8% of cases, is manifested by hypovolemic shock, and is potentially fatal [1, 2, 4, 7, 8]. The splenic artery aneurysms can be approached by laparotomy, laparoscopy, or endovascular techniques. The endovascular option, less invasive, has less morbidity and faster postoperative recovery [1–4, 8]. Among the various endovascular techniques, covered stent implantation has been little reported in the literature. The authors present a case of splenic artery aneurysm treated by this method. 2. Presentation of Case A female patient, 64 years old, controlled hypertension, and 2 previous pregnancies, presented as main complaint episodes of mild pain in the epigastrium and left hypochondrium, evolving for about 12 months. Physical examination of the abdomen was nonspecific, with ill-defined pain on palpation of the mesogastrium and left hypochondrium. In the hospital of origin she was submitted to
Decomposi??o térmica de espumas de poliuretano para fabrica??o de vitroceramica celular de Li2O-ZrO2-SiO2-Al2O3 (LZSA)
Silveira, Cristian Berto da;Escobar, Jairo A.;Quintero, Miguel W.;Sousa, Eliandra de;Moraes, Elisangela Guzzi de;Oliveira, Ant?nio Pedro Novaes de;Rambo, Carlos Renato;Hotza, Dachamir;
Química Nova , 2007, DOI: 10.1590/S0100-40422007000500010
Abstract: characterization of the thermal decomposition of polyurethane (pur) foams was performed by fourier-transformed infrared (ft-ir) spectroscopy and thermogravimetric analysis (tga). three main weight loss paths were observed by tga, the residue being lower than 3 wt.% for 3 different pur foams analyzed. ft-ir spectra indicated co2, co, nh3 and isocyanides as main decomposition products. pur foams of different cell sizes were immersed in a slurry of the parent glass ceramic of composition li2o-zro2-sio2-al 2o3 (lzsa) and submitted to heat treatment. the lzsa cellular glass ceramics obtained after sintering and crystallization resembled the original morphology of the pur foams.
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