Browsing by Author "Andrade, H"
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- Aortic deformities: not all are aneurysmsPublication . Andrade, H; António, N; Rodrigues, D; Marinho da Silva, A; Providência, LA
- Cianose no pequeno lactente – desafio diagnósticoPublication . Amaral, ME; Silva, PV; Marinho, J; Francisco, A; Andrade, H; Martins, P; Santos, I; Rodrigues, D; Sousa, G; Pires, A; Marinho, A; Castela, E
- Encerramento Percutâneo de Fenestra uma Circulação de Fontan IntracardíacaPublication . Andrade, H; Rodrigues, D; Marinho da Silva, A; Martins, FM; Sá e Melo, AWe present a case of tricuspid atresia and the treatment that was used in a child now aged 12. The malformation was corrected at the age of five through intracardiac Fontan circulation. Later, the child developed a right-to-left shunt due to dehiscence in the intra-atrial conduit, causing significant desaturation. This was treated by transcatheter closure with a 10 mm Amplatzer device at 8 years of age. Currently the child is asymptomatic with no residual shunts, and the position of the device is normal. The percutaneous closure of Fontan fenestrations using the Amplatzer device is a therapeutic approach that provides good results. It results in normal oxygen saturation and has low morbidity. The technique is simple, available to most cardiac catheterization laboratories, safe, and offers a reasonable cost-benefit ratio. In addition, the design of the device is suitable for this type of defect.
- High blood pressure in the pediatric age groupPublication . Andrade, H; António, N; Rodrigues, D; Marinho da Silva, A; Pego, M; Providência, LAThe definition of hypertension (HT) in the pediatric age group is based on the normal distribution of blood pressure (BP) in healthy children. Normal BP is defined as being below the 90th percentile for gender, age and height, and hypertension as equal to or higher than the 95th percentile on at least three separate occasions. If the values are above the 90th percentile but below the 95th percentile, the child should be considered prehypertensive. Ambulatory BP monitoring is useful in the assessment of BP levels in the young. P values in children and adolescents have creased in the last decade, in parallel with increases in body mass index, and HT now has a prevalence of 2-5%. Obesity in childhood and adolescence is one of the main predictors of HT in adulthood, but it is also associated with other cardiovascular risk factors such as dyslipidemia, abnormal glucose metabolism, insulin resistance, inflammation and impaired vascular function. Left ventricular hypertrophy is the most prominent evidence of target organ damage caused by hypertension in children and adolescents. The goal for antihypertensive treatment is to reduce BP below the 95th percentile. Weight control, with regular physical activity and dietary changes, is the primary therapy for obesity-related hypertension. Weight loss decreases not only BP but also other cardiovascular risk factors. The indications for use of antihypertensive drugs are: symptomatic hypertension, secondary hypertension, established hypertensive target organ damage, stage 2 hypertension and failure of nonpharmacologic measures.
- Implantação de Dispositivo de Amplatzer® Após Desinserção do PrimeiroPublication . Andrade, H; Rodrigues, D; Marinho da Silva, A; Ferreira, R; Martins, FM; Sá e Melo, A
- Implantação de Dispositivo de Amplatzer® Após Desinserção do PrimeiroPublication . Andrade, H; Rodrigues, D; Marinho da Silva, A; Ferreira, R; Martins, FM; Sá e Melo, A
- Persistência do Canal Arterial: Casuística de uma Unidade de Cuidados Intensivos NeonataisPublication . Andrade, H; Loureiro, C; Tiago, J; Henriques, R; Marinho da Silva, A; Rodrigues, D; Sá e Melo, A; Alves, RROBJECTIVES: This study took place at the Neonatal Intensive Care Unit (NICU) of the Dr Daniel de Matos Maternity Hospital and evaluated the incidence of patent ductus arteriosus (PDA), the clinical evolution of the newborns affected, the treatment prescribed, and associated morbidity and mortality. METHODS: We carried out a retrospective medical chart review of newborns admitted to the NICU between January 2001 and December 2005. RESULTS: PDA was found in 69 newborns. Median gestational age (GA) was 28 weeks and birth weight (BW) 1100 grams. The diagnosis of PDA was established, on average, between the fifth and sixth day of life. Of the 53 newborns with criteria for closure, 49 had indomethacin therapy, with a success rate of 88%; surgical ligation was subsequently necessary in six of these. Thirty-eight newborns presented associated comorbidities, and eight died. CONCLUSIONS: The results obtained in this study are in agreement with the literature. In cases with GA of less than 30 weeks and/or BW below 1500g, the need for treatment for PDA closure is greater than in cases with higher GA/BW, and a more aggressive approach is required, with presymptomatic prolonged indomethacin. The results obtained in this work led us to conclude that echocardiography should be performed to screen for PDA in all newborns of less than 30 weeks or with BW below 1500g. We intend in the near future to answer a question that emerged from this study: will earlier diagnosis lead to improved outcomes?