Navegando por Palavras-chave "evolução clínica"
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- ItemAcesso aberto (Open Access)Avaliação ecocardiográfica evolutiva do infarto do miocárdio em ratos jovens e adultos(Sociedade Brasileira de Cardiologia - SBC, 2008-11-01) Pabis, Francisco Cesar; Miyague, Nelson Itiro; Francisco, Julio César; Woitowicz, Vinícius; Carvalho, Katherine Athayde Teixeira de; Faria-Neto, José Rocha; Moisés, Valdir Ambrósio [UNIFESP]; Guarita-Souza, Luiz César; Pontifícia Universidade Católica do Paraná; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: The regeneration of cardiomyocytes after a myocardial infarction (MI) is more evident in young animals; however, it is not known whether it is associated with functional improvement. OBJECTIVE: To perform the functional analysis by echocardiography (echo) of young adult rats submitted to MI. METHODS: Seventy-two animals were included in the study: 35 young rats (group Y) that were 28 days old and 37 adult rats (group A) that were 153 days old. The rats were subdivided in two subgroups: infarcted (YI and AI) and control (YC and AC). The animals were assessed by echocardiogram on the 7thand 30th postoperative days for the analysis of the ejection fraction (EF) and the final systolic (FSV) and diastolic volume (FDV) of the left ventricle. Only animals with EF < 40% were included in the study. RESULTS: The comparison of the FDV and FSV between infarcted and control animals showed that there was a significant increase in infarcted adult animals at the two analyzed phases. Among young animals only the FSV was significantly higher on the 7th day. The intragroup evolution analysis showed an increase in FDV and FSV in the two young subgroups, which was proportional to growth and only increase in FDV in the infarcted adult group. There was an improvement in EF in young rats, whereas EF remained decreased in adult rats when compared to controls. CONCLUSION: The infarcted young rats presented improvement in the systolic function and ventricular volumes 30 days after the infarction, whereas the adult rats presented increased FDV with no improvement in systolic function.
- ItemAcesso aberto (Open Access)A first-year dornase alfa treatment impact on clinical parameters of patients with cystic fibrosis: the Brazilian cystic fibrosis multicenter study(Sociedade de Pediatria de São Paulo, 2013-12-01) Rozov, Tatiana; Silva, Fernando Antônio A. E; Santana, Maria Angélica; Adde, Fabíola Villac; Mendes, Rita Heloisa; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio Grande do Sul Faculdade de Medicina; Secretaria da Saúde da Bahia Hospital Especializado Octávio Mangabeira; Universidade de São Paulo (USP); Hospital de Base do Distrito FederalOBJECTIVE:To describe the clinical impact of the first year treatment with dornase alfa, according to age groups, in a cohort of Brazilian Cystic Fibrosis (CF) patients.METHODS:The data on 152 eligible patients, from 16 CF reference centers, that answered the medical questionnaires and performed laboratory tests at baseline (T0), and at six (T2) and 12 (T4) months after dornase alfa initiation, were analyzed. Three age groups were assessed: six to 11, 12 to 13, and >14 years. Pulmonary tests, airway microbiology, emergency room visits, hospitalizations, emergency and routine treatments were evaluated. Student's t-test, chi-square test and analysis of variance were used when appropriated.RESULTS:Routine treatments were based on respiratory physical therapy, regular exercises, pancreatic enzymes, vitamins, bronchodilators, corticosteroids, and antibiotics. In the six months prior the study (T0 phase), hospitalizations for pulmonary exacerbations occurred in 38.0, 10.0 and 61.4% in the three age groups, respectively. After one year of intervention, there was a significant reduction in the number of emergency room visits in the six to 11 years group. There were no significant changes in forced expiratory volume in one second (VEF1), in forced vital capacity (FVC), in oxygen saturation (SpO2), and in Tiffenau index for all age groups. A significant improvement in Shwachman-Kulczychi score was observed in the older group. In the last six months of therapy, chronic or intermittent colonization by P. aeruginosa was detected in 75.0, 71.4 and 62.5% of the studied groups, respectively, while S. aureus colonization was identified in 68.6, 66.6 and 41.9% of the cases.CONCLUSIONS:The treatment with dornase alfa promoted the maintenance of pulmonary function parameters and was associated with a significant reduction of emergency room visits due to pulmonary exacerbations in the six to 11 years age group, with better clinical scores in the >14 age group, one year after the intervention.
- ItemAcesso aberto (Open Access)Osteomielite hematogênica aguda em Pediatria: análise de casos atendidos em hospital universitário(Sociedade de Pediatria de São Paulo, 2012-09-01) Puccini, Pedro Fiorini; Ferrarini, Maria Aparecida G.; Iazzetti, Antônio Vladir [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To describe occurrence, evolution, and outcome of acute hematogenous osteomyelitis in children and adolescents. METHODS: A descriptive study of 21 cases with patients aged zero to 14 years-old, diagnosed with acute hematogenous osteomyelitis assisted at the Pediatric Infectious Disease Follow-Up Clinic of Escola Paulista de Medicina, between 2005 and 2009. The medical records were reviewed. Descriptive analysis and Spearman's rank correlation were performed, with a 95% confidence interval. RESULTS: The incidence in males was higher than in females, and children over five years of age were the most affected ones. Fever and pain were the main symptoms, and the long bones were the most often affected. The most commonly recovered pathogen was Staphylococcus aureus. The time interval between the onset of symptoms and the diagnosis was 9.7 days, the length of hospital stay was 24.7 days, and the duration of treatment was 71.7 days. Complete resolution occurred in 71.4% of the cases and complications appeared in 28.6% of them, being chronic osteomyelitis the main one. CONCLUSIONS: Data regarding gender, age, etiology, and evolution were in accordance with literature reports. The duration of the treatment was ten weeks, which is longer than usual reports. There were no significant correlations between duration of symptoms before the diagnosis, duration of hospital stay, and duration of treatment, considering the small sample size.
- ItemAcesso aberto (Open Access)Perfil das crianças submetidas à correção de cardiopatia congênita e análise das complicações respiratórias(Sociedade de Pediatria de São Paulo, 2012-01-01) Oliveira, Priscila Mara N. [UNIFESP]; Held, Priscila Antonichelli de; Grande, Rosângela Aparecida A.; Ribeiro, Maria Ângela Gonçalves de Oliveira; Bobbio, Tatiana Godoy; Schivinski, Camila Isabel S.; Universidade Federal de São Paulo (UNIFESP); Pontifícia Universidade Católica de Campinas Hospital Celso Pierro; Universidade Estadual de Campinas (UNICAMP); Universidade do Estado de Santa Catarina; UdescOBJECTIVE: To describe the profile of children that undergo surgical correction of congenital heart disease (CHD) in a university hospital and to compare patients with and without postoperative respiratory complications. METHOD: This observational analytical study reviewed the records of children that underwent corrective surgery for CHD a Brazilian University Hospital during 11 months. The following demographic variables were collected: age, sex, body mass index, comorbidities, and CHD types. Demographic variables and data about the intra- and postoperative care were compared for patients with and without postoperative respiratory complications. The Mann-Whitney and the Fisher exact tests were used, and the level of significance was set at p<0.05. RESULTS: The sample consisted of 55 children (49% boys) whose median age was 37.5 months. Three or more CHD were found in 29.1%, and 53% of all cases had comorbidities. The analysis of postoperative respiratory complications revealed that 31% of the patients had atelectasis and pleural effusion and 5.5% had laryngitis, pneumomediastinum or lung injury. Non-respiratory complications were identified in 24% of the patients. Survival was 89%. Children with postoperative respiratory complications received mechanical ventilation for a longer time and had a prolonged hospital stay (p<0.001). CONCLUSION: The association between respiratory complications, longer mechanical ventilation and longer hospital stay reinforced the need to avoid such complications to reduce costs of a prolonged hospital stay.