Immediate and long-term follow-up of percutaneous balloon mitral valvuloplasty in pregnant patients with rheumatic mitral stenosis.

Percutaneous mitral balloon valvuloplasty (PMV) can be performed during pregnancy without significant maternal risk or fetal morbidity or mortality. However, little is known about long-term follow-up results after PMV in populations of pregnant women. Thus, the present study was undertaken to determine the immediate and long-term outcomes after PMV in a large cohort of pregnant patients with severe mitral stenosis. The patient population consisted of 71 consecutive pregnant women with severe rheumatic mitral stenosis admitted to the hospital with severe congestive heart failure (New York Heart Association class III and IV) for PMV. All patients underwent clinical and obstetric evaluations, electrocardiography, and 2-dimensional and Doppler echocardiography. PMV was successful in all patients, resulting in a significant increase in mitral valve area from 0.9 +/- 0.2 to 2.0 +/- 0.3 cm2 (p <0.001). At the end of pregnancy, 98% of the patients were in New York Heart Association functional class I or II. At a mean follow-up of 44 +/- 31 months, the total event-free survival rate was 54%. The mean gestational age at delivery time was 38 +/- 1 weeks. Preterm deliveries occurred in 9 patients (13%), including 2 twin pregnancies. The remaining 66 of 75 newborns (88%) had normal weight (mean 2.8 +/- 0.6 kg) at delivery. At long-term follow-up of 44 +/- 31 months after birth, the 66 children exhibited normal growth and development and did not show any clinical abnormalities. In conclusion, PMV is safe and effective, has a low morbidity and mortality rate for the mother and the fetus, and has favorable long-term results in pregnant women with rheumatic mitral stenosis in New York Heart Association functional class III or IV.

Immediate and long-term follow-up of percutaneous balloon mitral valvuloplasty in pregnant patients with rheumatic mitral stenosis

Percutaneous mitral balloon valvuloplasty (PMV) can be performed during pregnancy without significant maternal risk or fetal morbidity or mortality. However, little is known about long-term follow-up results after PMV in populations of pregnant women. Thus, the present study was undertaken to determine the immediate and long-term outcomes after PMV in a large cohort of pregnant patients with severe mitral stenosis. The patient population consisted of 71 consecutive pregnant women with severe rheumatic mitral stenosis admitted to the hospital with severe congestive heart failure (New York Heart Association class III and IV) for PMV. All patients underwent clinical and obstetric evaluations, electrocardiography, and 2-dimensional and Doppler echocardiography. PMV was successful in all patients, resulting in a significant increase in mitral valve area from 0.9 0.2 to 2.0 0.3 cm2 (p <0.001). At the end of pregnancy, 98% of the patients were in New York Heart Association functional class I or II. At a mean follow-up of 44 31 months, the total event-free survival rate was 54%. The mean gestational age at delivery time was 38 1 weeks. Preterm deliveries occurred in 9 patients (13%), including 2 twin pregnancies. The remaining 66 of 75 newborns (88%) had normal weight (mean 2.8 0.6 kg) at delivery. At long-term follow-up of 44 31 months after birth, the 66 children exhibited normal growth and development and did not show any clinical abnormalities. In conclusion, PMV is safe and effective, has a low morbidity and mortality rate for the mother and the fetus, and has favorable long-term results in pregnant women with rheumatic mitral stenosis in New York Heart Association functional class III or IV.

Polimorfismos dos genes da lipoproteína lipase e da apolipoproteína E: influência sobre o perfil lipídico no terceiro trimestre da gravidez / Lipoprotein lipase and apoliprotein E genetic polymorphisms: influence on lipid profile in the third trimester of pregnancy

O advento da genômica trouxe ferramentas capazes de identificar marcadores moleculares de suscetibilidade para dislipidemia. Nós estudamos a gravidez como fator ambiental de estresse metabólico, juntamente com o efeito de alguns polimorfismos genéticos sobre a trigliceridemia. A amostra consistiu de grávidas caucasianas aparentemente saudáveis, que foram avaliadas no terceiro trimestre.Todas as mulheres foram testadas para os polimorfismos PvuII e HindIII do gene da lipoproteína lipase e HhaI da apolipoproteína E. Os polimorfismos HindIII e HhaI influenciaram o risco para dislipidemia / The advent of genomics has brought out tools, which are capable to identify molecular markers of susceptibility to dyslipidemia. We studied pregnancy as environmental factor of metabolic stress, together with the effect of some genetic polymorphisms on triglyceridemia. The sample consisted of apparently healthy caucasian pregnant women, who were analyzed in their third trimester of pregnancy. Every woman was tested for Pvull and Hindlll polymorphisms of the lipoprotein lipase gene and Hhal of the apolipoprotein E. The polymorphisms Hindlll and Hhal have contributed to the risk of dyslipidemia...

Manejo do trauma esplênico / The management of splenic trauma

De setembro de 1979 a fevereiro de 1991, 58 pacientes requerendo esplenectomia, esplenorrafia, hemiesplenectomia ou autotransplante foram tratados em duas instituiçöes gerais. Foi realizado um estudo descritivo transversal com o objetivo de revisar a esperiência dos autores a luz da literatura. Foram coletados dados referentes a faixa etária, sexo, mecanismo do trauma, grau do trauma, cirurgia realizada, traumas associados, complicaçöes pós-operatórias, tempo de internaçäo e mortalidade. A média de idade foi de 30,5 anos e 81% eram do sexo masculino. O mecanismo do trauma foi fechado em 91,4% dos pacientes, sobressaindo-se o acidente por moto ou veículo (AMV). A esplenectomia foi o tratamento principal em 91,4% dos pacientes. Houve trauma esplênico isolado em 60,3%. As complicaçöes mais frequentes foram de origem pulmonar em 13,7%. O tempo de internaçäo diferiu significativamente entre o trauma esplênico isolado e associado (p < 0,01). A mortalidade foi de 1,7%. Concluiu-se que a lesäo esplênica ocorreu principalmente através de trauma fechado. O procedimento cirúrgico depende diretamente do tipo de trauma. O tempo de permanência hospitalar, bem como a mortalidade, estäo associados a lesöes de outros orgäos

Trauma hepatico / Liver trauma

Estudo descritivo transversal de setembro de 1979 a fevereiro de 1991, abrangendo 49 pacientes que foram submetidos a laparrotomia por trauma hepatico em duas instituicoes gerais. Foi analisado as seguintes variaveis:faixa etaria, sexo, mecanismo de trauma, distribuicao anatomica, cirurgia realizada, traumas associados, complicacoes pos-operatorias, tempo de internacao e mortalidade. A idade media foi de 29 anos e 58,7//eram do sexo masculino. Concluiram que tecnicas simples de reparo foram suficientes em 96,3//dos traumas penetrantes e em 77,3//dos traumas fechados; e a mortalidade tardia apos trauma hepatico esta diretamente relacionada com o estado original de choque, gravidade do trauma e falencia de um ou multiplos orgaos

Analise retrospectiva do tratamento de pacientes com obstrucao intestinal aguda / Retrospective study of patients treatment with acute intestinal obstruction

Este artigo consiste no estudo retrospectivo de 62 pacientes submetidos a 66 cirurgias para alivio de obstrucao intestinal (OI) no Servico de Cirurgia Geral do Hospital Regional de Sao Jose, Santa Catarina, no periodo de marco de 1988 a julho de 1990. Procura demonstrar a incidencia de OI quanto a faixa etaria, sexo, sinais e sintomas predominantes, compatibilidade radiologica, cirurgia previa, diagnostico de obstrucao, cirurgia realizada, complicacoes pos-operatorias e mortalidade. A OI incidiu preferencialmente na faixa etaria de41 a 50 anos e no sexo feminino. A analise dos sinais e sintomas classicos revelou dor em 59 casos (95,16 por cento), nauseas e/ou vomitos em 41 casos (66,12 por cento) e distencao abdominal em 39 casos (62,90 por cento). Apresentavam sinais radiologicos de OI 59 casos (95,16 por cento). Quanto ao diagnostico de obstrucao, bridas foram a causa em 37 casos (56,06 por cento) e as hernias crurais estranguladas em 09 casos (13,63 por cento). A mortalidade operatoria atingiu 7,5 por cento dos casos. Os autores ressaltam a importancia do diagnostico precoce e concluem que a mortalidade esta relacionada a afeccao de base.