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Silent myocardial ischemia: 3 years' experience with Holter.
de Pádua, F; Serviço de Medicina IV, Hospital de Santa Maria, Instituto Nacional de Cardiologia Preventiva, Lisboa.; Fiuza, M; Correia, JThe authors describe their experience concerning silent myocardial ischemia diagnosed by Holter monitoring technique, and present an update review about this issue. The new concepts of stunned and hibernated myocardium are analyzed, as well as the concepts of ischemic cascade, total ischemic burden and variable residual coronary reserve. Diagnostic methods and therapeutic decisions are also reviewed. ; The aut...
Hereditary protein C deficiency and portal vein thrombosis.
dos Santos, J N; Serviço de Medicina 4, Hospital de Santa Maria, Faculdade de Medicina de Lisboa.; Mello e Silva, A; Alexandrino, P; Saldanha, TInherited defects of the natural coagulation inhibitors predispose patients to thrombosis. These disorders have similar clinical presentations with a strong family of thrombosis, episodes of recurrent venous thromboembolism, beginning in early adulthood. We report a case of upper gastrointestinal bleeding in a patient with portal hypertension due to portal-vein thrombosis secondary to hereditary protein C defic...
Rational distribution of resources in intensive medicine. Analysis of admission...
Carneiro, A V; Cadeira de Medicina III-A, Faculdade de Medicina de Lisboa, Hospital Universitário de Santa Maria.; Lopes, M G; De Pádua, FCost-containment in health care has become a major issue in today's practice of medicine. With its needs in advanced technologies and skilled personnel, intensive care is among the most expensive of all hospital activities. This fact makes the analysis of indications for intensive care unit admission, as well as early discharge, of paramount importance: patients who are not likely to benefit from intensive care...
Risk stratification and prognosis in critical surgical patients using the Acute...
Carneiro, A V; UCIM do Serviço de Medicina 4 e Serviço de Patologia Cirúrgica, Hospital Universitário de Santa Maria, Lisboa.; Leitão, M P; Lopes, M GOutcome prediction in critical surgical patients admitted to intensive care units (ICU) has been established using several scoring systems. To evaluate the predictive performance of the Acute Physiology, Age and Chronic Health Evaluation (APACHE III) scoring system in these patients, we studied a population admitted to a surgical ICU in our University Hospital.We collected prospective data on 220 consecutive pa...
Coronary artery disease, myocardial perfusion and ventricular function in Q-wav...
Macieira-Coelho, E; Hospital Universitário de Sta. Maria, Serviço de Medicina III/IV., Lisboa.; Garcia-Alves, M; da Costa, B; Cantinho, G; Pedro, PControversy remains in considering non-Q wave myocardial infarction (NQMI) a distinct pathophysiological entity of Q wave myocardial infarction (QMI). In order to analyze the severity of coronary artery disease, extension of myocardial scar or myocardial ischemia and ventricular function, 78 consecutive patients with QMI and 32 with NQMI, mean age 55.4 +/- 8.5, not submitted to thrombolytic therapy, were studie...
Significance exercise-induced ST elevation in patients with myocardial infarcti...
Carvalho, M; Serviço de Medicina IV-H.S.M., Instituto de Medicina Nuclear-F.M.L INIC-LA3, Lisboa.; Cantinho, G; de Lacerda, A P; Dionísio, IIn 52 patients with previous myocardial infraction, 49 men and 3 women (mean age 56 +/- 7.1 years) the significance of ST-segment elevation during the stress-test, was evaluated. Of the 52 patients 15 (29%) showed St-segment elevation and 37(71%), showed no alteration of the ST-segment. Extension of coronary disease, degree of obstruction, wall motion abnormalities and the presence of residual ischemia were eva...
Prognostic systems in intensive care: general principles, development, and clin...
Carneiro, A V; Cadeira de Medicina III-A e Serviço de Medicina IV, Hospital de Santa Maria, Lisboa.; Ivo, M; Girão, J; De Pádua, F; Lopes, M GIn this review article, we present the need for prognostic scoring in clinical medicine, specially in Intensive Care Medicine (ICM). The general principles of prognostication in ICM are discussed, and three general scoring systems are presented: ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION (APACHE) in its 3 versions, SIMPLIFIED ACUTE PHYSIOLOGY SCORE (SAPS) and MORTALITY PREDICTION MODEL (MPM). The use of the...
Herpes zoster and controlateral hemiplegia in an African patient infected with ...
Carneiro, A V; Serviço de Medicina IV, Hospital Universitário de Santa Maria, Lisboa.; Ferro, J; Figueiredo, C; Costa, L; Campos, J; de Pádua, FOne of the neurologic complications of human immunodeficiency virus infection are cerebrovascular accidents. In HIV infected patients, ischemic strokes have been reported secondary to nonbacterial thrombotic endocarditis and cerebral arteritis. We describe an unusual cause of stroke in HIV-1 infection: Herpes Zoster ophtalmicus with contralateral hemiplegia. ; One of the neurologic complications of human immun...
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