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1.
Artigo em Francês | MEDLINE | ID: mdl-1885893

RESUMO

The authors report a case of replacement of a mitral valve and of tricuspid annuloplasty using extracorporeal circulation in a pregnancy of 23 weeks amenorrhoea with a satisfactory result for the mother and the birth of a healthy baby after 35 weeks of amenorrhoea. A review of the literature made it possible to analyse the problems occurring in pregnancies in woman who have been fitted with a cardiac valve prosthesis and who have to have cardiac surgery in pregnancy.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Circulação Extracorpórea/métodos , Insuficiência da Valva Mitral/cirurgia , Complicações Cardiovasculares na Gravidez/cirurgia , Insuficiência da Valva Tricúspide/cirurgia , Adulto , Cateterismo Cardíaco , Eletrocardiografia , Feminino , Monitorização Fetal , Idade Gestacional , Humanos , Insuficiência da Valva Mitral/diagnóstico , Insuficiência da Valva Mitral/diagnóstico por imagem , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico , Complicações Cardiovasculares na Gravidez/diagnóstico por imagem , Radiografia , Insuficiência da Valva Tricúspide/diagnóstico , Insuficiência da Valva Tricúspide/diagnóstico por imagem
2.
Med Sante Trop ; 23(3): 344-6, 2013.
Artigo em Francês | MEDLINE | ID: mdl-24026002

RESUMO

Amebic liver abscess is the main complication of amebic dysentery. Recurrences after treatment and apparent healing are very uncommon. The purpose of this report is to describe the case of a patient with a very late relapse of an amebic liver abscess, 10 years after the first episode. This recurrence seems due to an incomplete initial treatment. This case illustrates the reason for and importance of complying with the current therapeutic strategy: nitroimidazole followed by a luminal agent to eradicate intestinal amebic colonization.


Assuntos
Abscesso Hepático Amebiano/diagnóstico , Idoso , Antiprotozoários/uso terapêutico , Humanos , Abscesso Hepático Amebiano/tratamento farmacológico , Masculino , Metronidazol/uso terapêutico , Oxiquinolina/análogos & derivados , Oxiquinolina/uso terapêutico , Recidiva , Fatores de Tempo
3.
Anesth Analg ; 69(2): 174-9, 1989 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-2764287

RESUMO

This randomized study was designed to determine the cardiovascular effects of normovolemic hemodilution and lumbar epidural anesthesia in patients scheduled for vascular surgery. The patients were randomly assigned to three different groups: group 1 (N = 10) included patients undergoing lumbar epidural anesthesia without hemodilution; group 2 (N = 10) consisted of patients with normovolemic hemodilution without epidural anesthesia; and in group 3 (N = 10) normovolemic hemodilution was produced during lumbar epidural anesthesia. The three groups included several patients with a history of either myocardial infarction or stable mild angina or treated and controlled hypertension. In group 1, the level of epidural anesthesia reached T-9 +/- 1. After lumbar epidural anesthesia and 7 mL/kg colloid infusion, pulmonary capillary wedge pressure increased slightly but significantly above baseline, without significant changes either in mean arterial pressure or in cardiac index. In group 2, the same colloid infusion as in group 1 when infused before normovolemic hemodilution increased pulmonary capillary wedge pressure and cardiac index without significant effects on arterial blood pressure. Normovolemic hemodilution using a colloid solution decreased hemoglobin concentration (18%) and increased cardiac index significantly (9%). No significant change in systemic oxygen transport or in total body oxygen consumption was observed. In group 3, with anesthesia to T-9 +/- 1, hemodynamic changes were as observed in group 1. After normovolemic hemodilution, hemoglobin concentration decreased significantly (15%), whereas cardiac index increased significantly (15%) without significant changes either in mean arterial pressure or in heart rate. Systemic oxygen transport and total body oxygen consumption did not change significantly. No patient experienced chest pain or electrocardiographic evidence of myocardial ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Anestesia Epidural , Hemodiluição , Pressão Sanguínea , Débito Cardíaco , Gelatina/administração & dosagem , Frequência Cardíaca , Hemodiluição/métodos , Hemoglobinas/análise , Humanos , Vértebras Lombares , Pessoa de Meia-Idade , Oxigênio/sangue , Consumo de Oxigênio , Substitutos do Plasma/administração & dosagem , Pressão Propulsora Pulmonar , Distribuição Aleatória , Procedimentos Cirúrgicos Vasculares
4.
Acta Anaesthesiol Scand ; 38(6): 562-8, 1994 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-7976146

RESUMO

Twenty patients, scheduled for surgical resection of thoracoabdominal aortic aneurysm were divided into two groups according to the type of differential lung ventilation used during graft replacement of the descending thoracic aorta. In the high-frequency jet ventilation (HFJV) group of ten patients, HFJV was applied to the left lung once collapsed and retracted by the surgeon, the patient lying in the right lateral decubitus and being intubated by a Carlens' tube. In the continuous positive airway pressure (CPAP) group of ten patients, CPAP was applied to the left lung at the same mean airway pressure as HFJV (1 kPa). Before anaesthetic induction, an arterial and a Swan-Ganz catheter were inserted for cardiovascular monitoring. The same anaesthetic technique using fentanyl 6 micrograms.kg-1, flunitrazepam 0.02 mg.kg-1 and pancuronium 0.1 mg.kg-1 was used for each patient. Haemodynamic and respiratory measurements were made; 15 min after positioning the patients in the right lateral decubitus using two-lung ventilation; 15 min after collapse and retraction of the left lung using one-lung ventilation and 15 min after using differential lung ventilation with CPAP or HFJV. Left lung collapse with conventional one-lung ventilation induced a dramatic decrease in arterial oxygenation: PaO2/FIO2 ratio decreased from 43 +/- 6 kPa to 20 +/- 8 kPa, alveolo-arterial oxygen difference increased from 24 +/- 7 kPa to 72 +/- 11 kPa and pulmonary shunt increased from 17 +/- 2% to 37 +/- 3%. Whereas differential lung ventilation with CPAP did not improve any of the respiratory parameters measured, differential lung ventilation with HFJV, significantly increased PaO2/FIO2 ratio to 41 +/- 14 kPa.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Ventilação em Jatos de Alta Frequência , Pulmão/fisiologia , Respiração com Pressão Positiva , Respiração/fisiologia , Adulto , Idoso , Anestesia Intravenosa , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Consumo de Oxigênio/fisiologia , Atelectasia Pulmonar/fisiopatologia , Capacidade de Difusão Pulmonar/fisiologia , Respiração Artificial , Volume de Ventilação Pulmonar/fisiologia , Relação Ventilação-Perfusão/fisiologia
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