Levantamento parasitológico realizado em munícipes do interior do estado de São Paulo (Brasil) entre os anos de 1957 a 1986

Parasitism caused by protozoa and helminths is a serious public health problem, affecting millions of individuals worldwide, especially in underdeveloped and developing countries. From this perspective, a parasitological survey was conducted in 37 cities in the interior of the state of São Paulo. This study focused mainly on old places such as schools and rural and urban health units in the interior of the State of São Paulo between 1957 and 1986. The objective of this study was to conduct a comprehensive survey on the data found to diagnose the occurrence of parasitic diseases in the city. Population at that time, according to their rural and urban origin, age and gender. Thus, the proposal is to make the generated data available to all interested parties in an organized and systematized manner and to discuss the reality faced by the population regarding the current public policies in Brazil relating the sanitary conditions with the occurrence of endoparasites. According to the survey conducted in the municipalities studied, 274,487 occurrences of individuals positive for endoparasites were obtained from 391,633 samples collected. The highest frequency was found in children aged 1 to 10 years with 146,090 cases, accounting for 37,302% of the infected population. The percentage of parasitized individuals decreases with increasing age.

Os quadros de parasitismos causados por protozoários e helmintos constituem sérios problemas de saúde pública, por afetarem milhões de indivíduos em todo o mundo, sobretudo, nos países subdesenvolvidos e em desenvolvimento. Sob esta perspectiva foi realizado um levantamento parasitológico em 37 cidades do interior do Estado de São Paulo. Este estudo contemplou principalmente antigos locais como as escolas e unidades de saúde rurais e urbanas do interior do Estado de São Paulo entre os anos de 1957 e 1986. O objetivo deste trabalho foi realizar um levantamento abrangente nos dados encontrados para diagnosticar a ocorrência de parasitoses na população da época, segundo sua origem rural e urbana, a faixa etária e o gênero. Dessa forma, a proposta é tornar os dados gerados disponíveis a todos os interessados de forma organizada e sistematizada e discutir a realidade enfrentada pela população frente às políticas públicas vigentes no Brasil relacionando as condições sanitárias com a ocorrência de endoparasitoses. Segundo o levantamento realizado nos municípios estudados, obteve-se 274.487 ocorrências de indivíduos positivos para endoparasitas a partir de 391.633 amostras coletadas. A maior frequência foi encontrada em crianças de 1 a 10 anos com 146.090 casos, sendo estes responsáveis por 37.302% da população infectada. A porcentagem de indivíduos parasitados diminui de acordo com o aumento da idade.

[The use of left and right internal thoracic artery grafts for revascularization of the left coronary artery]. / Uso das artérias torácicas internas esquerda e direita na revascularização da artéria coronária esquerda.

PURPOSE: To analyze the late results of patients who underwent left coronary myocardial revascularization with both internal thoracic arteries, with the right internal thoracic through the transverse sinus. METHODS: From July/83 to September/96, 233 patients underwent myocardial revascularization, with ages ranging from 35 to 76 (average of 52.8) years. One hundred and eighty five were male and 48 female. Internal thoracic arteries (466), saphenous veins (192) and epigastric arteries (11) were employed. RESULTS: The hospital mortality was 3% and the late mortality was 6.1%. The immediate postoperative bleeding was 0.8%, mediastinitis 1.7% and myocardial infarction 2.1%. The immediate and late coronariography showed the rates of patency, respectively: left internal thoracic artery 98% and 96%, right internal thoracic artery 96% and 92, and saphenous vein grafts 80% and 67.5%. CONCLUSION: The main advantage in using both internal thoracic arteries in the revascularization of the left coronary branches was the better quality of life, the low rates of cardiac events and the absence of reoperation due to occlusion of the grafts.

Eight years experience using the inferior epigastric artery for myocardial revascularization.

We present the initial experience with the use of inferior epigastric artery as a free graft for myocardial revascularization in a series of 41 patients operated on between 1987 and 1989 to show the clinical and angiographic results. Of the 41 patients, 29 were male, 12 female, with ages ranging from 33 to 72 years, and weights from 50 to 86 kg. The inferior epigastric artery grafts were predominantly employed to the anterior interventricular branch and diagonal branch. The proximal anastomosis into the aorta was done directly or with a patch of vein or pericardium. The 32 patients who survived had mean follow-up of 82 months and 22 are in functional class I, 8 in class II and 2 in class III of angina. The early patency rate was: inferior epigastric artery-anterior interventricular branch, 85.7% and inferior epigastric artery-diagonal branch. 85.7%. Sixteen patients underwent angiographic study at a mean follow-up of 81.2 months and the patency rate to the anterior interventricular branch was 77.7% and to the diagonal branch was 100%. Three patients with early occluded inferior epigastric artery were reoperated on 3, 3 and 11 months after the operation. A filiform lumen of the graft and a small ostium in the aorta was found and explained the imperfection of the direct anastomosis due to unbalance thickness of the graft and the aortic wall. Therefore it is occluded that the inferior epigastric artery is an alternative arterial graft for myocardial revascularization and that the use of a vein or pericardium patch can help the proximal anastomosis and improve potency of the graft.

Right internal thoracic artery through the transverse sinus in myocardial revascularization.

BACKGROUND: This study presents the late patency rate of the right internal thoracic artery (ITA) used in situ through the pericardium transverse sinus to the circumflex artery and its branches. METHODS: From April 1983 to December 1994, 2,642 patients were submitted to myocardial revascularization; 201 of them had bilateral ITAs. The right ITA through the transverse sinus was grafted to obtuse marginal artery in 170 patients (84.5%) and the left ITA was grafted to the anterior descending artery in 188 patients (93.5%). Angiographic studies were performed in 80 patients, 44 patients in the immediate postoperative period and 36 patients in the late follow-up (mean, 51.6 months). RESULTS: The right ITA was patent in 75 patients (93.7%) and the left ITA was patent in 77 (96.2%). At the late postoperative period, the right ITA was patent in 33 patients (91.6%) and the left ITA was patent in 34 (94.4%). CONCLUSIONS: The right ITA placed through the pericardium transverse sinus has a good long-term patency rate, similar to that observed with the left ITA and superior to that of saphenous vein grafts for myocardial revascularization.