Browsing by Author "Antunes, A"
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- História natural da dilatação pielocalicial pré-natalPublication . Franco, S; Carvalho, G; Antunes, A; Brito, M; Morais, C; Barros, JSINTRODUCTION: It is estimated that genitourinary anomalies comprise 20% of all antenatally detected fetal anomalies, and pyelocaliectasia is the most common one. Detection of antenatal dilatation of the urinary tract does not always indicate postnatal urinary tract obstruction or even a significant genitourinary anomaly. Most cases will improve spontaneously, representing a temporary physiologic impedence and do not require surgery. MATERIALS AND METHODS: In a two-year period we studied 197 newborns, with prenatal pyelocaliectasia, without concomitant anomaly, delivered at Maternidade Dr. Daniel de Matos. In the postnatal follow-up period, the infants were followed at Pediatrics Department, at our Center. RESULTS: A male predilection was found. Ultrasonic follow-up of the 197 infants showed that pyelocaliectasia resolved in 97%, while 3% still presented it in the postnatal ultrasound. Complementary renal evaluation, with voiding cystourethrography and radionuclide imaging, was realised in 29 (15%) infants to further characterize the abnormality detected in postnatal ultrasound. Surgery was performed in four (2%) children. CONCLUSION: Prenatally diagnosed pyelocaliectasia may be safely observed, and surgical correction should be performed only if renal compromise occurs.
- Pacing biventricular: experiência inicialPublication . Pires, R; Monteiro, P; Cristovão, J; Antunes, A; Ventura, M; Costa, M; Ermida, P; Providência, LAINTRODUCTION: Biventricular pacing has been studied for the treatment of chronic heart failure (CHF). This technique seems to be able to improve symptoms and exercise tolerance, in patients with advanced CHF and prolonged QRS duration. OBJECTIVE: To present our experience with biventricular pacing in the management of severe CHF. METHODS: Between June 2000 and March 2001, 8 patients with dilated cardiomyopathy and left bundle branch block (LBBB) were selected for transvenous biventricular pacing system implantation. Mean age: 54.12 +/- 16.8 years; 5 males. The etiology was: idiopathic in 6 cases; operated congenital heart disease in 1, and ischemic in the other. Despite tailored treatment of CHF (with all patients taking diuretics and angiotensin-converting enzyme inhibitors), 7 patients remained in NYHA class III and 1 in IV. The quality of life score (assessed by the "Minnesota living with heart failure questionnaire") was 62.25 +/- 11.29. Seven patients had sinus rhythm and only one chronic atrial fibrillation; mean PQ duration--220 +/- 76.37 ms; mean QRS duration--168.75 +/- 20.31 ms. RESULTS: Implant failure, due to coronary sinus dissection and to excessive fluoroscopy time, with no coronary sinus catheterization, occurred in 2 cases (success rate: 75%). Implant data: mean implant procedure duration: 122.5 +/- 47.82 min; mean fluoroscopy time: 35.66 +/- 22.06 min; QRS duration, after implant: 133.33 +/- 15.05 ms. Left ventricular lead final position: anterolateral in 2 patients and lateral in 4. Pacing thresholds: biventricular--1.36 +/- 0.6 V; right ventricle--0.28 +/- 0.04 V; right atrium--0.32 +/- 0.08 V. Pacing impedance (left ventricle): 1013.33 +/- 147.87 omega. Follow-up (1st and 3rd month): one patient died, suddenly, 15 days after the procedure. In the others, an improvement in the quality of life index and functional class was found. These results were independent of echocardiography data. There were no significant differences in the pacing threshold and impedance during the follow-up. CONCLUSIONS: Patients with advanced CHF and widened QRS benefited from biventricular stimulation, in which improvement on the clinical status was evident.
- Saúde oral na grávidaPublication . Antunes, A; Rosete, V; Fagulha, JDescriptive study with an analytic component, on pregnant women that went for consultation to Maternidade Daniel de Matos (Coimbra, Portugal) during the second week of July 1997. 80 women were randomly selected and asked to answer a questionnaire, concerning level of knowledge towards oral health as well as dietary and oral hygiene habits before and during pregnancy. It was also quantified the dental plaque indicator by using a plaque staining method. The knowledge about oral health is globally speaking, insufficient; dietary habits are mainly cariogenic although pregnant women tend to lower their sugar intake. During pregnancy women rarely go to see the dentist, especially the less educated ones. The dental plaque levels are globally high, indicating oral hygiene habits of low quality.
- Valor prognóstico da expressão por imuno-histoquímica do c-erb-2: em doentes sob terapêutica adjuvante com Tamoxifeno por carcinoma primário da mamaPublication . Antunes, A; Silva, T; Godinho, I; Amaral, A; Oliveira, CFINTRODUCTION: The c-erb2 proto-oncogene is a member of the epidermal growth factor receptor family and has been associated with a more aggressive breast tumour biology and resistance to some types of treatments. AIMS: To evaluate the prognostic value of c-erb-2 receptor, from primary breast cancer on tamoxifen therapy. METHODS: We examined 66 paraffin-embedded sections from primary breast cancers. Patients were treated with surgery plus adjuvant treatment with tamoxifen; 58% had also received chemotherapy and/or radiotherapy. Membrane staining for c-erb-2 was evaluated by immunohistochemistry and overall survival and relapse-free survival were compared between positives and negatives for c-erb-2. RESULTS: 43,9% of tumours over expressed c-erb-2 receptor, but this was not associated with a worse prognosis on overall survival either on relapse free-survival, with a p value of 0,15 and 0,2 respectively. CONCLUSIONS: There is not any advantage to determine c-erb-2 as a prognostic factor on overall survival either on relapse free-survival. Attending the homogenous characteristics between both groups with any statistical differences according age.