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Kiuchi M.G.,Federal University of Fluminense | Maia G.L.M.,Hospital Regional Darcy Vargas | De Queiroz Carreira M.A.M.,Hospital Regional Darcy Vargas | Kiuchi T.,Hospital Regional Darcy Vargas | And 5 more authors.
European Heart Journal | Year: 2013

Aims: Evaluation of the safety and efficacy of renal denervation with a standard irrigated cardiac ablation catheter (SICAC) in chronic kidney disease (CKD) patients with refractory hypertension. Methods and results: Twenty-four patients were included and treated with a SICAC. Denervation was performed by a single operator following the standard technique. Patients included with CKD were on stages 2 (n = 16), 3 (n = 4), and 4 (n = 4). Data were obtained at baseline and monthly until 180th day of follow-up. Baseline values of blood pressure (mean ± SD) were 186 ± 19 mmHg/108 ± 13 mmHg in the office, and 151 ± 18 mmHg/92 ± 11 mmHg by 24 h ambulatory blood pressure monitoring (ABPM). Office blood pressure values at 180th day after the procedure were 135 ± 13 mmHg/88 ± 7 mmHg (P < 0.0001, for both comparisons). The mean ABPM decreased to 132 ± 15 mmHg/85 ± 11 mmHg at the 180th day after the procedure (P < 0.0001 for systolic and P = 0.0015 for diastolic). Estimated glomerular filtration (mean ± SD) increased from baseline (64.4 ± 23.9 mL/min/1.73 m 2) to the 180th day (85.4 ± 34.9 mL/min/1.73 m2, P < 0.0001) of follow-up. The median urine albumin:creatinine ratio decreased from baseline (48.5, IQR: 35.8-157.2 mg/g) to the 180th day after ablation (ACR = 15.7, IQR: 10.3-34.2 mg/g, P = 0.0017). No major complications were seen. Conclusion: The procedure using SICAC seemed to be feasible, effective, and safe resulting in a better control of BP, a short-term increase in estimated glomerular filtration rate, and reduced albuminuria. Although encouraging, our data are preliminary and need to be validated in the long term. © The Author 2013. Source


Coutinho B.M.,Federal University of Fluminense | Bordalo E.,Federal University of Fluminense | Nascimento O.J.M.,Hospital Universitario Antonio Pedro
Arquivos de Neuro-Psiquiatria | Year: 2013

There are few studies reporting the association between hepatitis C virus (HCV) infection and disautonomia. We have evaluated the autonomic cardiovascular function in 12 patients with sensory small-fiber polyneuropathy infected by HCV. The mean age was 49±13 years old. The mean infection time was 9.6 years in six (50%) patients. Thermal and pinprick hypoesthesia was observed in distal legs in all patients. Autonomic symptoms were referred by eight (66.7%) patients. Among patients with abnormal autonomic cardiovascular test, five (41.7%) showed abnormal results in two or more tests. Valsalva maneuver was abnormal in seven (58.3%) patients. We can consider that there is an association of both parasympathetic and sympathetic efferent cardiovascular dysfunction in this group of patients. Source


De Carvalho A.A.V.,Federal University of Fluminense | De Carvalho A.A.V.,Hospital Universitario Antonio Pedro | Carvalho J.A.,Federal University of Fluminense | Figueiredo I.,Federal University of Fluminense | And 2 more authors.
Prenatal Diagnosis | Year: 2013

Objective: To investigate the association between the midtrimester presence of short femur and short humerus and intrauterine growth restriction. Methods: This retrospective study included ultrasound examinations of 1043 fetuses. Fetuses with normal-length bones were compared with fetuses that had femoral or humeral lengths below the 5th percentile for gestational age by Student's t-test and the chi-squared test. The association between short bones and fetal growth restriction development was evaluated by Fisher's exact test. Fetuses with estimated weight below the 10th percentile for gestational age and abnormal umbilical artery flow were considered to have growth restriction. Results: Femoral and humeral lengths were normal in 974 (93.4%) fetuses; 19 (1.8%) fetuses had short femora, 65 (6.2%) had short humeri, and 15 (1.4%) had short femora and humeri combined. Of fetuses included in the analysis, 603 (57.8%) underwent Doppler examination. Short femur [odds ratio =9.7, 95% confidence interval=1.9-50.2, P=0.03] and short humerus (odds ratio=13, 95% confidence interval=4.9-34.6, P<0.001) were associated with fetal growth restriction. Conclusion: Fetuses with midtrimester short femur, short humerus, or short femur and humerus combined require more intensive surveillance for growth restriction development. © 2012 John Wiley & Sons, Ltd. Source


Neto G.H.,Federal University of Fluminense | Neto G.H.,Hospital Universitario Antonio Pedro
Revista Brasileira de Oftalmologia | Year: 2016

The author describes a case report of a patient with unilateral enophthalmia and deep palpebral sulcus probably induced by the topical use of Bimatoprost on the side of the collateral effects described. Source


Bozi L.C.F.,Hospital Universitario Antonio Pedro | de Melo A.S.A.,Federal University of Fluminense | Marchiori E.,Federal University of Fluminense | Marchiori E.,Federal University of Rio de Janeiro
Radiologia Brasileira | Year: 2012

The present report describes the case of a 48-year-old female patient suffering from chronic renal failure on dialysis for 13 years. She presented with hemoptysis, fever, productive cough and dyspnea. Chest radiography showed predominance of ill-defined opacities in the middle and lower lung fields, bilaterally. Chest computed tomography showed groundglass opacities associated with poorly defined centrilobular nodules with ground-glass attenuation. The patient was submitted to bronchoalveolar lavage that was negative for mycobacteria and fungi. On the basis of such findings, open lung biopsy was performed, which revealed metastatic pulmonary calcification. © Colégio Brasileiro de Radiologia e Diagnóstico por Imagem. Source

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