Subject(s)
Aorta, Thoracic/abnormalities , Aorta, Thoracic/surgery , Heart Septal Defects/surgery , Pulmonary Atresia/surgery , Angiography/methods , Aorta, Thoracic/pathology , Echocardiography , Heart Septal Defects/pathology , Humans , Infant, Newborn , Male , Pulmonary Atresia/pathology , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the height and weight development of children with congenital heart disease undergoing surgery with the goal of determining when they reach the threshold of normal development and whether there are differences between patients with developmental pattern below the level of normality preoperatively (z-score<-2 for the analyzed parameter) in comparison to the total group of cardiac patients. METHODS: We prospectively followed up 27 children undergoing operation into five time periods: preoperatively and at four subsequent outpatient appointments: 1st month, 3rd month, 6th month and 12th month after hospital discharge. The anthropometric parameters used were median z-score (MZ), weight (WAZ), height (HAZ), subscapular skinfold (SSFAZ), upper arm circumference (UAC) and triceps skinfold (TSFAZ). The evolution assessment of the parameters was performed by analysis of variance and comparison with the general normal population from unpaired t test, both in the total group of cardiac patients, and in subgroups with preoperative parameters below the normal level (Zm<-2). RESULTS: In the total group there was no significant evolution of MZ of all parameters. WAZ was statistically lower than the normal population until the 1st month of follow-up (P=0.028); HAZ only preoperatively (P=0.044), SSFAZ in the first month (P=0.015) and at 12th month (P=0.038), UAC and TSFAZ were always statistically equal to the general population. In patients whose development was below the level of normality, there were important variation of WAZ (P=0.002), HAZ (P=0.001) and UAC (P=0.031) after the operation, and the WAZ was lower than the normal population until the 3rd month (P=0.015); HAZ and UAC, until the first month (P=0.024 and P=0.039 respectively), SSFAZ, up to the 12th month (P=0.005), the TSFAZ only preoperatively (P=0.011). CONCLUSION: The operation promoted the return to normalcy for those with heart disease in general within up to three months, but for the group of patients below normal developmental pattern of the return occurred within 12 months.
Subject(s)
Body Weight/physiology , Child Development/physiology , Heart Defects, Congenital/surgery , Weight Gain/physiology , Age Factors , Analysis of Variance , Anthropometry , Child , Child, Preschool , Female , Follow-Up Studies , Heart Defects, Congenital/rehabilitation , Humans , Infant , Male , Postoperative Period , Preoperative Period , Prospective Studies , Reference Values , Time Factors , Treatment OutcomeABSTRACT
Objetivo: Avaliar a evolução pôndero-estatural de crianças com cardiopatias congênitas submetidas a tratamento cirúrgico com intuito de determinar quando atingem o limiar de desenvolvimento normal e se há diferenças entre pacientes com padrão de desenvolvimento abaixo do patamar da normalidade no pré-operatório (z-score<-2 para o parâmetro analisado) em relação ao grupo total de cardiopatas. Métodos: Acompanhamento prospectivamente de 27 crianças submetidas à operação em cinco períodos: pré-operatório e em quatro subsequentes retornos ambulatoriais: 1º mês, 3º mês, 6º mês e 12º mês após a alta hospitalar. Os parâmetros antropométricos usados foram a média do z-score (Zm) do peso (ZmP/I), da altura (ZmA/I), prega cutânea subescapular (ZmPCS/I), perímetro braquial (ZmPB/I) e prega cutânea tricipital (ZmPCT/I). A avaliação da evolução dos parâmetros foi feita pela análise de variância e a comparação com a população geral normal pelo teste t não pareado, tanto no grupo total dos cardiopatas, quanto nos subgrupos com parâmetros pré-operatórios abaixo do patamar da normalidade (Zm<-2). Resultados: No grupo total não houve evolução significativa dos Zm de todos os parâmetros. O ZmP/I foi estatisticamente menor que da população normal até o 1º mês de seguimento (P=0,028); o ZmA/I, somente no pré operatório (P=0,044); o ZmPCS/I, no o 1º mês (P=0,015) e no 12º mês (P=0,038); o ZmPB/I e o ZmPCT/I sempre foram estatisticamente iguais ao da população geral. Nos pacientes com desenvolvimento abaixo do limiar da normalidade houve variação importante do ZmP/I (P=0,002), do ZmA/I (P=0,001) e ...
Objective: To evaluate the height and weight development of children with congenital heart disease undergoing surgery with the goal of determining when they reach the threshold of normal development and whether there are differences between patients with developmental pattern below the level of normality preoperatively (z-score<-2 for the analyzed parameter) in comparison to the total group of cardiac patients. Methods: We prospectively followed up 27 children undergoing operation into five time periods: preoperatively and at four subsequent outpatient appointments: 1st month, 3rd month, 6th month and 12th month after hospital discharge. The anthropometric parameters used were median z-score (MZ), weight (WAZ), height (HAZ), subscapular skinfold (SSFAZ), upper arm circumference (UAC) and triceps skinfold (TSFAZ). The evolution assessment of the parameters was performed by analysis of variance and comparison with the general normal population from unpaired t test, both in the total group of cardiac patients, and in subgroups with preoperative parameters below the normal level (Zm<-2). Results: In the total group there was no significant evolution of MZ of all parameters. WAZ was statistically lower than the normal population until the 1st month of follow-up (P=0.028); HAZ only preoperatively (P=0.044), SSFAZ in the first month (P=0.015) and at 12th month (P=0.038), UAC and TSFAZ were always statistically equal to the general population. In patients whose development was below the level of normality, there were important variation of WAZ (P=0.002), HAZ (P=0.001) and UAC (P=0.031) after the operation, and the WAZ was lower than the normal population until the 3rd month (P=0.015); HAZ and UAC, until the first month (P=0.024 and P=0.039 respectively), SSFAZ, up to the 12th month (P=0.005), the TSFAZ only preoperatively (P=0.011). Conclusion: The operation promoted the return to normalcy for those with heart disease in general ...
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Body Weight/physiology , Child Development/physiology , Heart Defects, Congenital/surgery , Weight Gain/physiology , Age Factors , Analysis of Variance , Anthropometry , Follow-Up Studies , Heart Defects, Congenital/rehabilitation , Postoperative Period , Preoperative Period , Prospective Studies , Reference Values , Time Factors , Treatment OutcomeABSTRACT
Bacterial endocarditis is a severe infectious disease. of which treatment is traditionally carried out in hospitalized patients through intravenous medication. The possibility of at-home or ambulatory treatment. for stringently selected cases. is attractive from the social as well as from the economic point of view. We report 6 patients with a diagnosis of bacterial endocarditis caused by Streptococcus. treated partially or completely on an outpatient basis. All of them evolved without complications and presented complete resolution of the infection.
Subject(s)
Ambulatory Care/standards , Endocarditis, Bacterial/drug therapy , Streptococcal Infections/drug therapy , Adult , Aged , Ambulatory Care/methods , Endocarditis, Bacterial/microbiology , Female , Humans , Male , Middle AgedABSTRACT
A endocardite bacteriana é uma grave doença infecciosa cujo tratamento é tradicionalmente feito com o paciente internado. recebendo medicação intravenosa. A possibilidade de tratamento domiciliar ou ambulatorial. em casos estritamente selecionados. é atraente tanto do ponto de vista social quanto do econômico. Apresentamos o relato de 6 pacientes com diagnóstico de endocardite bacteriana por Streptococcus. tratados parcial ou integralmente em regime ambulatorial. Todos evoluíram sem complicações e com resolução completa do quadro infeccioso.
Bacterial endocarditis is a severe infectious disease. of which treatment is traditionally carried out in hospitalized patients through intravenous medication. The possibility of at-home or ambulatory treatment. for stringently selected cases. is attractive from the social as well as from the economic point of view. We report 6 patients with a diagnosis of bacterial endocarditis caused by Streptococcus. treated partially or completely on an outpatient basis. All of them evolved without complications and presented complete resolution of the infection.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Ambulatory Care/standards , Endocarditis, Bacterial/drug therapy , Streptococcal Infections/drug therapy , Ambulatory Care/methods , Endocarditis, Bacterial/microbiologySubject(s)
Heart Septal Defects, Atrial/surgery , Heart Septal Defects, Ventricular/surgery , Aortic Valve Insufficiency/surgery , Child, Preschool , Electrocardiography , Female , Heart Atria/abnormalities , Heart Septal Defects, Atrial/diagnosis , Heart Septal Defects, Ventricular/diagnosis , HumansSubject(s)
Humans , Female , Child , Heart Failure , Thoracotomy , Echocardiography , Extracorporeal CirculationSubject(s)
Heart Atria/abnormalities , Heart Septal Defects, Atrial/diagnosis , Pulmonary Veins/abnormalities , Child, Preschool , Diagnosis, Differential , Female , Heart Atria/pathology , Heart Murmurs/congenital , Heart Murmurs/diagnosis , Humans , Pulmonary Veins/diagnostic imaging , Pulmonary Veins/surgery , RadiographyABSTRACT
We report the case of an asymptomatic six-year-old child with left atrial isomerism and sinus venosus atrial septal defect. The physical examination revealed several periods of bradycardia. During a 24-hour electrocardiographic monitoring the patient presented a significant sinus node dysfunction with sinus pauses of up to 2.4 seconds. A permanent pacemaker was implanted, with a satisfactory outcome.
Subject(s)
Heart Septal Defects, Atrial/complications , Sinoatrial Node/physiopathology , Cardiac Pacing, Artificial , Child , Female , Heart Atria/abnormalities , Heart Septal Defects, Atrial/physiopathology , Humans , Sinoatrial Node/surgery , Treatment OutcomeABSTRACT
É relatado o caso de uma criança com seis anos de idade, assintomática, portadora de isomerismo atrial esquerdo e comunicação interatrial do tipo seio venoso. Ao exame físico, apresentava vários períodos de ritmo bradicárdico. Durante monitorização eletrocardiográfica de 24 horas, apresentou importante disfunção sinusal, com pausas sinusais de até 2,4 segundos. Foi implantado marcapasso definitivo com evolução satisfatória.
We report the case of an asymptomatic six-year-old child with left atrial isomerism and sinus venosus atrial septal defect. The physical examination revealed several periods of bradycardia. During a 24-hour electrocardiographic monitoring the patient presented a significant sinus node dysfunction with sinus pauses of up to 2.4 seconds. A permanent pacemaker was implanted, with a satisfactory outcome.
Subject(s)
Humans , Child , Heart Septal Defects, Atrial/complications , Sinoatrial Node/physiopathology , Cardiac Pacing, Artificial , Sinoatrial Node/surgery , Treatment OutcomeSubject(s)
Humans , Male , Child , Aneurysm/surgery , Pulmonary Valve Stenosis/pathology , Echocardiography , Pericardium , Pulmonary ArterySubject(s)
Adult , Male , Humans , Heart Diseases , Transplantation, Homologous , Cyanosis , ElectrocardiographySubject(s)
Humans , Female , Infant , Atrial Appendage/surgery , Heart Atria/surgery , Cardiac Surgical ProceduresABSTRACT
A disfunção do músculo cardíaco não é necessariamente responsável pela maioria dos sintomas que ocorrem em pacientes com Insuficiência Cardíaca Congestiva. Especula-se que a disfunção da musculatura esquelética por apoptose seja também um dos componentes da síndrome. Os objetivos do presente estudo foram de avaliar a presença ou não de apoptose muscular esquelética em miócitos do músculo vasto lateral da coxa em pacientes com insuficiência cardíaca congestiva da classe funcional II e III da NYHA, e observar se há correlação entre apoptose e os parâmetros hemodinâmicos. Catorze pacientes eom ICC, sob terapêutica otimizada, foram submetidos à biópsia do músculo vasto lateral a céu aberto com análise sob a coloração de Hematoxilina Eosina. Deste grupo, dois pacientes (14,3 por cento) apresentaram positividade para apoptose, além disso, todos os catorze tinham algum grau de degeneração muscular. Não houve correlação entre a presença de apoptose e os parâmetros hemodinâmicos. Estes resultados mostraram que os pacientes com ICC posem apresentar apoptose em musculatura esquelética, associada a maior ou menor grau de degeneração muscular, achado que justificaria alguns dos sintomas. A análise dos tecidos por outras técnicas podera constatar maior prevalência do fenômeno
Subject(s)
Male , Female , Adult , Middle Aged , Apoptosis , Heart Failure/complications , Heart Failure/pathology , Muscle, Skeletal/cytology , Muscle, Skeletal/pathologyABSTRACT
Os autores relatam um caso de anomalia de Ebstein da valva mitral em pacientes de dois anos e nove meses de idade, que apresentou descompensaçäo cardíaca durante o 1§ ano de vida, decorrente de grave insuficiência mitral. Os aspectos ecocardiográficos e angiográficos desta rara afecçäo säo apresentados e discutidos. A criança foi submetida a tratamento cirúrgico. Os achados cirúrgicos comprovaram o diagnóstico. A técnica cirúrgica utilizada foi a implantaçäo de prótese biológica em posiçäo mitral sem a retirada do tecido valvar natural. A evoluçäo pós-cirúrgica tem sido sem complicaçöes
