Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM

Vitória, Brazil

Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM

Vitória, Brazil
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De Araujo M.T.M.,Federal University of Espirito Santo | Bissoli N.S.,Federal University of Espirito Santo | Gouvea S.A.,Federal University of Espirito Santo | Pacheco M.C.T.,Federal University of Espirito Santo | And 3 more authors.
Sleep and Breathing | Year: 2013

Objective: The aim of this study was to investigate the efficacy of continuous positive airway pressure (CPAP) therapy following uvulopalatopharyngoplasty (UPPP) to prevent blood pressure (BP) elevation during sleep. Methods: Sixteen normotensive patients with OSA were subjected to UPPP with or without septoplasty. These patients were instrumented for 24 h of ambulatory BP recording, polysomnography, nocturnal urinary catecholamine and pain evaluation using a visual analogue scale in the day prior to surgery (D-1), following the surgery (D+1) and 30 days later (D+30). For the D+1, the patients were divided into two groups: the without CPAP therapy group and the with CPAP therapy group. Results: The apnoea-hypopnoea index (AHI) significantly increased in the patients without CPAP therapy compared with the D-1 (74 ± 23 vs. 35 ± 6 times/h, p < 0.05), and in the CPAP group, there was a significant reduction in the average AHI value to 14 ± 6 times/h, p < 0.01. During D+1, we observed an increase in the nocturnal systolic BP (10 %), diastolic BP (12 %) and heart rate (14 %) in the group without CPAP. These metrics were re-established in the CPAP group to values that were similar to those that were observed on the D-1. The absence of nocturnal dipping in the group without CPAP was followed by a significant increase in nocturnal norepinephrine (42 ± 12 μg/l/12 h) and epinephrine (8 ± 2 μg/l/12 h) levels compared with the D-1 (norepinephrine 17 ± 3; epinephrine 2 ± 0.3 μg/l/12 h, p < 0.001). In the patients who used the CPAP treatment, the nocturnal catecholamine levels were similar to D-1. The effectiveness of intravenous analgesic therapy was verified by a significant decrease in the pain scores in patients both with and without CPAP therapy. Conclusion: These data confirm an increase in the AHI on the night following UPPP with or without septoplasty. This increase promotes an absence of nocturnal dipping and a significant increase in urinary catecholamine levels. CPAP therapy was effective to prevent the transitory increase in BP. © 2013 Springer-Verlag Berlin Heidelberg.


Silva I.V.,Federal University of Espirito Santo | Rezende L.C.D.,Federal University of Espirito Santo | Lanes S.P.,Federal University of Espirito Santo | Lanes S.P.,Criobanco Inc. | And 9 more authors.
Maturitas | Year: 2010

Objective: To evaluate the association of -397T>C and -351A>G single nucleotide polymorphisms (SNPs) - also called PvuII and XbaI, respectively - located on estrogen receptor alpha (ERS1) gene with age at menarche, menopause onset, fertility and miscarriage in a population of post-menopausal women. Study design: Cross-sectional study with 273 healthy, high miscegenated, post-menopausal women (mean age of 63.1 ± 9.7 years old). Subjects were genotyped for PvuII and XbaI SNPs by PCR-RFLP and confirmed by automatic sequencing. Reproduction informations (age at menarche, age at menopause, number of pregnancies, fertility rate and miscarriages) were obtained by retrospective study using a questionnaire. Result(s): Age at menarche, menopause onset, number of pregnancies, total fertility rate, and parity did not seem to be influenced by any of the studied genotypes (chi-square, p > 0.05). However, women carrying the xx genotype showed a 44% higher chance of miscarriage, whereas this value did not trespass 16% for any other genotype analyzed. It has been also observed a higher occurrence of miscarriage in association with combined xxpp genotype of ERS1 gene (chi-square, p < 0.01). Conclusion(s): The present data indicate that the studied SNPs on ERS1 gene do not influence the menstrual cycle timing and parity but there is a strong relationship between the xx ERS1 SNP genotype and the incidence of miscarriage in the post-menopausal population analyzed. © 2010 Elsevier Ireland Ltd. All rights reserved.


Rodrigues J.B.S.R.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | Saleme N.A.S.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | Junior C.J.,Hospital Santa Casa Of Misericordia Of Vitoria Hscmv | Junior J.L.B.,Hospital Santa Casa Of Misericordia Of Vitoria Hscmv | And 4 more authors.
Coluna/ Columna | Year: 2015

Schwannomas are benign tumors, usually solitary, encapsulated, slow-growing, which have their origin in differentiated neoplastic Schwann cells with extramedullary intradural usual development related to nerve roots. The melanotic schwannoma is a variant of these tumors whose location in almost one third of cases is on the posterior spinal nerve root, with a nonspecific clinical presentation. Magnetic resonance imaging is the most widely used test for the diagnosis, revealing hyperintense T1-weighted sequences and hypointense T2-weighted sequences. Diagnostic confirmation is obtained by histological and immunohistochemical studies, in which there is intense cytoplasmatic pigmentation. There are two distinct types of melanotic schwannomas: sporadic and psammomatous, the latter related to the called Carney complex, a form of multiple endocrine neoplasm with familiar character. In literature we found few cases of these neoplasms, the largest series consisting of five cases. The objective of this study is to report a rare case of melanotic schwannoma of the lumbar spine of the sporadic type of extramedullary location. We also present a brief review of the literature containing the main characteristics of the tumor, including its different forms, differential diagnoses, data from histological and immunohistochemical studies as well as the currently recommended approach in order to contribute to a better understanding of this neoplasm.


Paganotti M.A.,University Of Vila Velha Uvv | Valim V.,Federal University of Espirito Santo | Serrano E.V.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria Emescam | Serrano E.V.,Federal University of Espirito Santo | And 3 more authors.
Revista Brasileira de Reumatologia | Year: 2015

Objective: To carry out the cross-cultural adaptation of EULAR Sjögren's Syndrome PatientReported Index (ESSPRI) for Portuguese language and evaluate its psychometric properties.Method: Cross-sectional study of patients with primary Sjögren's syndrome (SS). The psy-chometric properties (intraobserver reproducibility and construct validity) were studied. Inconstruct validity, ESSPRI was compared with the Patient's Global Assessment (PGA), Profileof Fatigue and Discomfort (Profad), Sicca Symptoms Inventory (SSI) and Functional Assess-ment of Chronic Illness Therapy (Facit-F). Statistical tests used were: Cronbach's alpha,intraclass correlation coefficient (ICC), Bland-Altman method and Spearman coefficient.A value of p = 0.05 was considered significant.Results: There was no difference between versions in both languages; thus, a Brazilian con-sensual version was obtained. All subjects were women aged 49.4 ± 11.6 years, with onsetof symptoms of 7.2 ± 5.4 years, and time of diagnosis of 3.0 ± 3.3 years. The mean ESSPRIwas 6.87 ± 1.97. The intraobserver reproducibility was high and significant (0.911) and, withBland-Altman method, there was no systematic bias in the agreement of measures amongevaluations. A moderate correlation of ESSPRI with all tested instruments was observed. © 2015 Elsevier Editora Ltda.


Vidotto M.C.,University of Sao Paulo | Sogame L.C.M.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | Gazzotti M.R.,University of Sao Paulo | Prandini M.N.,University of Sao Paulo | Jardim J.R.,University of Sao Paulo
Respiratory Care | Year: 2012

BACKGROUND: Extubation failure is defined as the re-institution of respiratory support ranging from 24 to 72 hours following scheduled extubation and occurs in 2% to 25% of extubated patients. The aim of this study was to determine clinical and surgical risk factors that may predict extubation failure in patients submitted to non-emergency intracranial surgery. METHODS: This was a prospective observational cohort study. The study was carried out on 317 subjects submitted to nonemergency intracranial surgery for tumors, aneurysms, and arteriovenous malformation. Preoperative assessment was performed and subjects were followed up for the determination of extubation failure until either discharge from hospital or death. RESULTS: Twenty-six (8.2%) of the 317 subjects experienced extubation failure following surgery. The following variables were considered for the multivariate analysis: level of consciousness at the time of extubation, duration of mechanical ventilation prior to extubation, sex and the use of intraoperative mannitol. The multivariate analysis determined that the most important variable for extubation failure was the level of consciousness at the time of extubation (P=.001), followed by female sex, which also showed to be significant (P=.006). CONCLUSIONS: Lower level of consciousness (GCS 8T-10T) and female sex were considered risk factors for extubation failure in subjects submitted to elective intracranial surgery. © 2012 Daedalus Enterprises.


Campos R.A.,Federal University of Bahia | Valle S.O.R.,Federal University of Rio de Janeiro | Franca A.T.,Federal University of Rio de Janeiro | Cordeiro E.,Recurrent Infections Outpatient Group | And 7 more authors.
Sao Paulo Medical Journal | Year: 2014

CONTEXT AND OBJECTIVE: Hereditary angioedema (HAE) with C1 inhibitor deficiency manifests as recurrent episodes of edema involving the skin, upper respiratory tract and gastrointestinal tract. It can be lethal due to asphyxia. The aim here was to evaluate the response to therapy for these attacks using icatibant, an inhibitor of the bradykinin receptor, which was recently introduced into Brazil. DESIGN AND SETTING: Prospective experimental single-cohort study on the efficacy and safety of icatibant for HAE patients. METHODS: Patients with a confirmed HAE diagnosis were enrolled according to symptoms and regardless of the time since onset of the attack. Icatibant was administered in accordance with the protocol that has been approved in Brazil. Symptom severity was assessed continuously and adverse events were monitored. RESULTS: 24 attacks in 20 HAE patients were treated (female/male 19:1; 19-55 years; median 29 years of age). The symptoms were: subcutaneous edema (22/24); abdominal pain (15/24) and upper airway obstruction (10/24). The time taken until onset of relief was: 5-10 minutes (5/24; 20.8%); 10-20 (5/24; 20.8%); 20-30 (8/24; 33.4%); 30-60 (5/24; 20.8%); and 2 hours (1/24; 4.3%). The time taken for complete resolution of symptoms ranged from 4.3 to 33.4 hours. Adverse effects were only reported at injection sites. Mild to moderate erythema and/or feelings of burning were reported by 15/24 patients, itching by 3 and no adverse effects in 6. CONCLUSION: HAE type I patients who received icatibant responded promptly; most achieved improved symptom severity within 30 minutes. Local adverse events occurred in 75% of the patients.


Brandao C.D.G.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | Neto A.N.F.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | Bernardo F.R.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | Ferreira F.B.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | And 3 more authors.
Revista Brasileira de Medicina | Year: 2012

Objective: To evaluate the frequency of obesity and its healthy habits in medical students from a private university in Vitoria (ES). Methods: Through a cross-cut study we evaluated 219 students, male and female, from 18 to 27 years old. The students answered a questionnaire about eating habits and lifestyle. Blood profile evaluation was performed. The data was analyzed using descriptive statistics analysis and the qui square test was used to compare risk factors and variables. Results: The analysis of eating frequency showed a good daily ingestion of protective foods against cardiovascular diseases and insufficient ingestion of those that increase the risk of these diseases. The frequency of obesity was 1.4%; overweigh, 16.4%; healthy weigh, 74.4%; and low weigh, 7.8%. Concerning exercises, 53.4% do exercise and 46.6% do not. Low frequency of lipid disorders was found. Conclusions: The result points to a good-quality nutrition associated with a non elevated index of overweight and obesity amongst medical students. The enrolment of colleges in orienting our future physicians and calling out attention to the role of nutrition, acquiring and maintaining good health habits is crucial. © Copyright Moreira Jr. Editora. Todos os direitos reservados.


Maia T.C.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | Brazolino M.A.N.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | de Batista P.R.,Hospital Santa Casa Of Misericordia Of Vitoria | de Batista P.R.,Vila Velha Hospital | And 5 more authors.
Acta Ortopedica Brasileira | Year: 2012

Objective: The prevalence of osteoporosis in patients with Adolescent Idiopathic Scoliosis (AIS) is believed to be higher than in the general adolescent population. An alternative to radiology for the characterization of bone mineral density may be through correlative indexes like the Osteorisk index, which is easy to access and low in cost, and which helps the doctor in the request for Bone Densitometry. Our belief that osteoporosis can affect the evolution and treatment of AIS was what motivated us to conduct this study. Our objective was to subjectively evaluate bone mineral density by the Osteorisk index in patients with AIS. Methods: Healthy patients (control group, n=30) and patients with AIS (n = 30) were evaluated, documenting age, weight and height, and establishing the Osteorisk. The unpaired Student t test was performed, with a level of significance of p <0.05. Results: The mean Osteorisk found for the patients with AIS was 6.38 ± 2.2 while in the control group, it was 8.27 ± 2.14, which represents a low risk of developing osteoporosis in both groups. Comparing these means between the groups, a lower Osteorisk was observed in the AIS group. Conclusion: Our study showed that there is low risk of developing osteoporosis in patients with AIS. Level of Evidence I, Prospective study.


Miranda M.D.A.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | De Carvalho R.S.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | Sasso R.T.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | Hegner C.C.,Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria EMESCAM | And 2 more authors.
Revista Brasileira de Medicina | Year: 2010

Objective: to investigate the frequency of AITD in patients of DM 1 at Santa Casa Hospital in Vitoria - ES. Materials and methods: through a cross-cut study we evaluated 38 prontuaries of diabetic patient type 1, male and female, were revised and data was gathered concerning the thyroid function, family history, TSH, T 4 free, antithyroid antibodies and insulin dose. Result: the frequency of thyroid dysfuntion was 18.4%, in agreement of others studies. Conclusion: because of high prevalence of thyroid autoimmune disease, is justify the screening of thyroid function in these patients. © Copyright Moreira Jr. Editora.


PubMed | Federal University of Espirito Santo, Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria Emescam and University Of Vila Velha Uvv
Type: Journal Article | Journal: Revista brasileira de reumatologia | Year: 2015

To carry out the cross-cultural adaptation of Eular Sjgrens Syndrome Patient Reported Index (ESSPRI) for Portuguese language and evaluate its psychometric properties.Cross-sectional study of patients with primary Sjgrens syndrome (SS). The psychometric properties (intraobserver reproducibility and construct validity) were studied. In construct validity, ESSPRI was compared with the Patients Global Assessment (PGA), Profile of Fatigue and Discomfort (Profad), Sicca Symptoms Inventory (SSI) and Functional Assessment of Chronic Illness Therapy (Facit-F). Statistical tests used were:Cronbachs alpha, intraclass correlation coefficient (ICC), Bland-Altman method and Spearman coefficient. A value of p 0.05 was considered significant.There was no difference between versions in both languages; thus, a Brazilian consensual version was obtained. All subjects were women aged 49.4 11.6 years, with onset of symptoms of 7.2 5.4 years, and time of diagnosis of 3.0 3.3 years. The mean ESSPRI was 6.87 1.97. The intraobserver reproducibility was high and significant (0.911) and, with Bland-Altman method, there was no systematic bias in the agreement of measures among evaluations. A moderate correlation of ESSPRI with all tested instruments was observed.The Brazilian Portuguese version of ESSPRI is a valid and reproducible version.

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