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Article ; Online: Burnout nos Médicos de Família de um Agrupamento de Centros de Saúde Face à Pandemia COVID-19

Ana Catarina Camões / Maria Inês Melo Ferreira / Ana Teresa Fróis / José Caetano Silva / Cassilda Costa / Raquel S. Correia / Fátima Ferreira

Gazeta Médica, Vol 1, Iss

2022 Volume 1

Abstract: INTRODUÇÃO: Durante a pandemia COVID-19, os quadros de burnout parecem ter-se agravado nos médicos. Como tal, pretendeu-se determinar a prevalência de burnout, reflexo da pandemia COVID-19, nos médicos de família de um Agrupamento de Centros de Saúde. ... ...

Abstract	INTRODUÇÃO: Durante a pandemia COVID-19, os quadros de burnout parecem ter-se agravado nos médicos. Como tal, pretendeu-se determinar a prevalência de burnout, reflexo da pandemia COVID-19, nos médicos de família de um Agrupamento de Centros de Saúde. MATERIAL E MÉTODOS: Estudo analítico descritivo transversal, com questionário anónimo de autorresposta, durante abril e maio de 2021. Aplicação do Maslach Burnout Inventory-Health Services Survey. RESULTADOS: Obtiveram-se 60 respostas válidas. Amostra predominantemente feminina (82%), entre os 36 e 45 anos (53%). Trabalhavam numa Unidade de Saúde Familiar 78%, e 22% numa Unidade de Cuidados de Saúde Personalizados. Afirmaram ter pensado mudar de profissão, instituição ou serviço no último mês, 52%. Apresentaram elevada exaustão emocional 70%, 40% elevada despersonalização e 45% baixa realização pessoal. Apresentaram burnout 32%. A exaustão emocional foi maior para carga horária semanal >40 horas (p=0,011). Baixa realização pessoal (p=0,004) e burnout (p=0,034) revelaram-se mais prevalentes nas faixas etárias mais baixas. Não se observaram relações estatisticamente significativas entre burnout e sexo ou local de trabalho. DISCUSSÃO: A prevalência estimada de burnout nos médicos de família é duas vezes superior à de 2016 na zona norte e oito vezes superior à nacional de 2012. Dada a relação temporal, é provável existir uma relação deste aumento de prevalência com a pandemia COVID-19. A maior prevalência de burnout nos mais jovens poderá evidenciar estratégias de coping com o stress ocupacional menos efetivas. CONCLUSÃO: A prevenção do burnout nos médicos de família deve ser uma prioridade, dada a sua elevada prevalência e impacto na saúde mental, bem como forma de prevenção quinquenária em saúde.
Keywords	COVID-19 ; Esgotamento Profissional ; Esgotamento Psicológico ; Médicos de Família ; Pandemia ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	José de Mello Saúde
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Burnout nos Médicos de Família de um Agrupamento de Centros de Saúde Face à Pandemia COVID-19

Ana Catarina Camões / Maria Inês Melo Ferreira / Ana Teresa Fróis / José Caetano Silva / Cassilda Costa / Raquel S. Correia / Fátima Ferreira

Gazeta Médica, Vol 1, Iss

2022 Volume 1

Abstract	INTRODUÇÃO: Durante a pandemia COVID-19, os quadros de burnout parecem ter-se agravado nos médicos. Como tal, pretendeu-se determinar a prevalência de burnout, reflexo da pandemia COVID-19, nos médicos de família de um Agrupamento de Centros de Saúde. MATERIAL E MÉTODOS: Estudo analítico descritivo transversal, com questionário anónimo de autorresposta, durante abril e maio de 2021. Aplicação do Maslach Burnout Inventory-Health Services Survey. RESULTADOS: Obtiveram-se 60 respostas válidas. Amostra predominantemente feminina (82%), entre os 36 e 45 anos (53%). Trabalhavam numa Unidade de Saúde Familiar 78%, e 22% numa Unidade de Cuidados de Saúde Personalizados. Afirmaram ter pensado mudar de profissão, instituição ou serviço no último mês, 52%. Apresentaram elevada exaustão emocional 70%, 40% elevada despersonalização e 45% baixa realização pessoal. Apresentaram burnout 32%. A exaustão emocional foi maior para carga horária semanal >40 horas (p=0,011). Baixa realização pessoal (p=0,004) e burnout (p=0,034) revelaram-se mais prevalentes nas faixas etárias mais baixas. Não se observaram relações estatisticamente significativas entre burnout e sexo ou local de trabalho. DISCUSSÃO: A prevalência estimada de burnout nos médicos de família é duas vezes superior à de 2016 na zona norte e oito vezes superior à nacional de 2012. Dada a relação temporal, é provável existir uma relação deste aumento de prevalência com a pandemia COVID-19. A maior prevalência de burnout nos mais jovens poderá evidenciar estratégias de coping com o stress ocupacional menos efetivas. CONCLUSÃO: A prevenção do burnout nos médicos de família deve ser uma prioridade, dada a sua elevada prevalência e impacto na saúde mental, bem como forma de prevenção quinquenária em saúde.
Keywords	COVID-19 ; Esgotamento Profissional ; Esgotamento Psicológico ; Médicos de Família ; Pandemia ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	José de Mello Saúde
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Burnout nos Médicos de Família de um Agrupamento de Centros de Saúde Face à Pandemia COVID-19

Ana Catarina Camões / Maria Inês Melo Ferreira / Ana Teresa Fróis / José Caetano Silva / Cassilda Costa / Raquel S. Correia / Fátima Ferreira

Gazeta Médica, Vol 1, Iss

2022 Volume 1

Abstract	INTRODUÇÃO: Durante a pandemia COVID-19, os quadros de burnout parecem ter-se agravado nos médicos. Como tal, pretendeu-se determinar a prevalência de burnout, reflexo da pandemia COVID-19, nos médicos de família de um Agrupamento de Centros de Saúde. MATERIAL E MÉTODOS: Estudo analítico descritivo transversal, com questionário anónimo de autorresposta, durante abril e maio de 2021. Aplicação do Maslach Burnout Inventory-Health Services Survey. RESULTADOS: Obtiveram-se 60 respostas válidas. Amostra predominantemente feminina (82%), entre os 36 e 45 anos (53%). Trabalhavam numa Unidade de Saúde Familiar 78%, e 22% numa Unidade de Cuidados de Saúde Personalizados. Afirmaram ter pensado mudar de profissão, instituição ou serviço no último mês, 52%. Apresentaram elevada exaustão emocional 70%, 40% elevada despersonalização e 45% baixa realização pessoal. Apresentaram burnout 32%. A exaustão emocional foi maior para carga horária semanal >40 horas (p=0,011). Baixa realização pessoal (p=0,004) e burnout (p=0,034) revelaram-se mais prevalentes nas faixas etárias mais baixas. Não se observaram relações estatisticamente significativas entre burnout e sexo ou local de trabalho. DISCUSSÃO: A prevalência estimada de burnout nos médicos de família é duas vezes superior à de 2016 na zona norte e oito vezes superior à nacional de 2012. Dada a relação temporal, é provável existir uma relação deste aumento de prevalência com a pandemia COVID-19. A maior prevalência de burnout nos mais jovens poderá evidenciar estratégias de coping com o stress ocupacional menos efetivas. CONCLUSÃO: A prevenção do burnout nos médicos de família deve ser uma prioridade, dada a sua elevada prevalência e impacto na saúde mental, bem como forma de prevenção quinquenária em saúde.
Keywords	COVID-19 ; Esgotamento Profissional ; Esgotamento Psicológico ; Médicos de Família ; Pandemia ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	José de Mello Saúde
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Structure prediction and functional analysis of a non-permutated lectin from Dioclea grandiflora

de Sousa, Bruno Lopes / Benildo Sousa Cavada / Celso Shiniti Nagano / João Batista Cajazeiras / José Caetano Silva-Filho / Kyria Santiago do Nascimento / Rafael da Conceição Simões / Rodrigo Maranguape da Silva Cunha

Biochimie. 2016 Dec., v. 131

2016

Abstract: Legume lectins have been widely studied and applied for many purposes in the last few decades, but many of their physiological aspects remain elusive. The Diocleinae legume subtribe, which includes intensively explored lectins, such as ConA, presents an ... ...

Abstract	Legume lectins have been widely studied and applied for many purposes in the last few decades, but many of their physiological aspects remain elusive. The Diocleinae legume subtribe, which includes intensively explored lectins, such as ConA, presents an unusual and extensive post-translational process which results in minor alterations in protein structure, in turn making its function elusive. Despite previous reports about Diocleinae precursor activity, no structural or functional analyses have ever been carried out to understand the impacts of post-translational processing relative to lectin structure and binding specificity. Here we analyzed the functionality of a non glycosylated, recombinantly expressed lectin precursor from Dioclea grandiflora through inhibition assays, corroborating the experimental data with structural information generated by molecular modeling, docking calculations and molecular dynamics simulations. We demonstrate that Diocleinae precursors are active and share the same carbohydrate specificity as mature lectins. At the same time, however, subtle structural alterations were detected and mostly result in an “incomplete” functionality of the precursor, as consequence of an immature binding site and an unstructured tetramer interface, affecting carbohydrate binding and oligomer formation, respectively.
Keywords	binding sites ; carbohydrate binding ; carbohydrates ; concanavalin A ; Dioclea ; glycosylation ; legumes ; molecular dynamics ; molecular models ; prediction ; protein structure ; simulation models
Language	English
Dates of publication	2016-12
Size	p. 54-67.
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	120345-9
ISSN	0300-9084
ISSN	0300-9084
DOI	10.1016/j.biochi.2016.09.010
Database	NAL-Catalogue (AGRICOLA)

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Article: High-resolution structure of a new Tn antigen-binding lectin from Vatairea macrocarpa and a comparative analysis of Tn-binding legume lectins

Sousa, Bruno Lopes / Andrzej Łyskowski / Benildo Sousa Cavada / Bruno Anderson Matias Rocha / Celso Shiniti Nagano / Gustavo Arruda Bezerra / José Caetano Silva Filho / Karl Gruber / Plínio Delatorre / Prashant Kumar / Ronniery Ilário Pereira

international journal of biochemistry & cell biology. 2015 Feb., v. 59

2015

Abstract: Plant lectins have been studied as histological markers and promising antineoplastic molecules for a long time, and structural characterization of different lectins bound to specific cancer epitopes has been carried out successfully. The crystal ... ...

Abstract	Plant lectins have been studied as histological markers and promising antineoplastic molecules for a long time, and structural characterization of different lectins bound to specific cancer epitopes has been carried out successfully. The crystal structures of Vatairea macrocarpa (VML) seed lectin in complex with GalNAc-α-O-Ser (Tn antigen) and GalNAc have been determined at the resolution of 1.4Å and 1.7Å, respectively. Molecular docking analysis of this new structure and other Tn-binding legume lectins to O-mucin fragments differently decorated with this antigen provides a comparative binding profile among these proteins, stressing that subtle alterations that may not influence monosaccharide binding can, nonetheless, directly impact the ability of these lectins to recognize naturally occurring antigens. In addition to the specific biological effects of VML, the structural and binding similarities between it and other lectins commonly used as histological markers (e.g., VVLB4 and SBA) strongly suggest VML as a candidate tool for cancer research.
Keywords	bioactive properties ; crystal structure ; epitopes ; histology ; lectins ; legumes ; molecular models ; neoplasms ; Vatairea
Language	English
Dates of publication	2015-02
Size	p. 103-110.
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	1228429-4
ISSN	1878-5875 ; 1357-2725
ISSN (online)	1878-5875
ISSN	1357-2725
DOI	10.1016/j.biocel.2014.12.002
Database	NAL-Catalogue (AGRICOLA)

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Article: Structural characterization of a lectin from Canavalia virosa seeds with inflammatory and cytotoxic activities

Osterne, Vinicius Jose Silva / Adolph Annderson GonÃ§alves Costa Barreto / Alysson Chaves Almeida / Ana Maria Sampaio Assreuy / Ana Paula Machado Nascimento / Benildo Sousa Cavada / Bruno Anderson Matias Rocha / Celso Shiniti Nagano / Ingrid Alessandra Victoria Wolin / Jose Caetano Silva-Filho / Kyria Santiago Nascimento / Mayara Queiroz Santiago / Plinio Delatorre / Renata Morais Ferreira Amorim / Rodrigo Bainy Leal / Vanir Reis Pinto-Junior

International journal of biological macromolecules. 2017 Jan., v. 94

2017

Abstract: A lectin from Canavalia virosa, Diocleinae subtribe, was purified by affinity chromatography with Sephadex G-50 matrix and named ConV. The primary structure of ConV was obtained by mass spectrometry and crystals were obtained by the vapor diffusion ... ...

Abstract	A lectin from Canavalia virosa, Diocleinae subtribe, was purified by affinity chromatography with Sephadex G-50 matrix and named ConV. The primary structure of ConV was obtained by mass spectrometry and crystals were obtained by the vapor diffusion method at 293K and belonged to orthorhombic space group P21221 with two molecules in its asymmetric unit. The structure obtained presented Rfactor and Rfree of 18.91% and 24.92% respectively, with no residues in nonallowed regions of Ramachandran plot. The crystal structure was solved at 2.53Ã and was demonstrated to be very similar to other lectins from the same subtribe. In inflammatory tests, ConV elicited paw edema, but incubation of lectin with glucose beforehand was able to reduce the edematogenic effect, indicating the involvement of the carbohydrate recognition domain in this process. The lectin also showed toxicity to rat C6 glioma cells, disrupting the mitochondrial membrane potential (ÎYm) and decreasing cell viability, indicating an anticancer potential for ConV. In silico studies confirmed that ConV interacts strongly with carbohydrates that comprise the N-glycans of glycoproteins. This finding corroborates the hypothesis which holds that the lectin domain interacts with glycans in molecular targets and that this contributes to the effects observed in biological activities.
Keywords	affinity chromatography ; Canavalia cathartica ; cell viability ; crystal structure ; crystals ; cytotoxicity ; edema ; glucose ; glycoproteins ; lectins ; mass spectrometry ; membrane potential ; mitochondrial membrane ; polysaccharides ; seeds ; vapors
Language	English
Dates of publication	2017-01
Size	p. 271-282.
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	282732-3
ISSN	1879-0003 ; 0141-8130
ISSN (online)	1879-0003
ISSN	0141-8130
DOI	10.1016/j.ijbiomac.2016.10.020
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Molecular Modeling of Lectin-Like Protein from Acacia farnesiana Reveals a Possible Anti-Inflammatory Mechanism in Carrageenan-Induced Inflammation

Vanessa Erika Ferreira Abrantes / Bruno Anderson Matias da Rocha / Raphael Batista da Nóbrega / José Caetano Silva-Filho / Claudener Souza Teixeira / Benildo Sousa Cavada / Carlos Alberto de Almeida Gadelha / Sergio Henrique Ferreira / Jozi Godoy Figueiredo / Tatiane Santi-Gadelha / Plinio Delatorre

BioMed Research International, Vol

2013 Volume 2013

Abstract: Acacia farnesiana lectin-like protein (AFAL) is a chitin-binding protein and has been classified as phytohaemagglutinin from Phaseolus vulgaris (PHA). Legume lectins are examples for structural studies, and this family of proteins shows a remarkable ... ...

Abstract	Acacia farnesiana lectin-like protein (AFAL) is a chitin-binding protein and has been classified as phytohaemagglutinin from Phaseolus vulgaris (PHA). Legume lectins are examples for structural studies, and this family of proteins shows a remarkable conservation in primary, secondary, and tertiary structures. Lectins have ability to reduce the effects of inflammation caused by phlogistic agents, such as carrageenan (CGN). This paper explains the anti-inflammatory activity of AFAL through structural comparison with anti-inflammatory legume lectins. The AFAL model was obtained by molecular modeling and molecular docking with glycan and carrageenan were performed to explain the AFAL structural behavior and biological activity. Pisum sativum lectin was the best template for molecular modeling. The AFAL structure model is folded as a β sandwich. The model differs from template in loop regions, number of β strands and carbohydrate-binding site. Carrageenan and glycan bind to different sites on AFAL. The ability of AFAL binding to carrageenan can be explained by absence of the sixth β-strand (posterior β sheets) and two β strands in frontal region. AFAL can inhibit pathway inflammatory process by carrageenan injection by connecting to it and preventing its entry into the cell and triggers the reaction.
Keywords	Medicine ; R
Language	English
Publishing date	2013-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Lectins from Parkia biglobosa and Parkia platycephala: A comparative study of structure and biological effects

Bari, Alfa Umaro / Ana Maria Sampaio Assreuy / Benildo Sousa Cavada / Bruno Anderson Matias Rocha / Claudener Souza Teixeira / Cornevile Correia Neto / Henri Debray / Jose Caetano Silva-Filho / Kyria Santiago Nascimento / LÃvia Paulo Pereira / Mayara Queiroz Santiago / Plinio Delatorre / Vanir Reis Pinto-Junior / Vinicius Jose Silva Osterne

International journal of biological macromolecules. 2016 Nov., v. 92

2016

Abstract: The relation structure-activity of the Mimosoideae lectins of Parkia platycephala (PPL) and Parkia biglobosa (PBL) was analyzed in this study. PBL was solved by X-ray crystallography at a resolution of 2.1Ã¿, and the crystal structure belonged to the ... ...

Abstract	The relation structure-activity of the Mimosoideae lectins of Parkia platycephala (PPL) and Parkia biglobosa (PBL) was analyzed in this study. PBL was solved by X-ray crystallography at a resolution of 2.1Ã¿, and the crystal structure belonged to the C2221 space group. Structural organization and binding sites were also characterized. Specifically, PBL monomer consists of three Î²-prism domains tandemly arranged with each one presenting a different carbohydrate recognition domain (CRD). PPL showed antinociceptive activity in the mouse model of acetic acid-induced writhes with maximal inhibitory effect by 74% at 1mg/mL. PPL also demonstrated anti-inflammatory effect causing inhibition of leukocyte migration induced by both direct and indirect chemoattractants. These PPL activities were compared to that of PBL described previously. Molecular docking of both PBL and PPL demonstrated some differences in carbohydrate-lectin interaction energy. Comparing structure and biological effects of the two lectins provided new data about their structure and the relation with its biological activities.
Keywords	analgesic effect ; animal models ; anti-inflammatory activity ; binding sites ; cell movement ; chemoattractants ; crystal structure ; energy ; lectins ; leukocytes ; molecular models ; Parkia biglobosa ; Parkia platycephala ; X-ray diffraction
Language	English
Dates of publication	2016-11
Size	p. 194-201.
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	282732-3
ISSN	1879-0003 ; 0141-8130
ISSN (online)	1879-0003
ISSN	0141-8130
DOI	10.1016/j.ijbiomac.2016.07.032
Database	NAL-Catalogue (AGRICOLA)

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Article: Structural analysis of Centrolobium tomentosum seed lectin with inflammatory activity

Almeida, Alysson Chaves / Vinicius Jose da Silva Osterne / Mayara Queiroz Santiago / Vanir Reis Pinto-Junior / Jose Caetano Silva-Filho / Claudia Figueiredo Lossio / Francisco Lucas Faustino Nascimento / Ricardo Patricio Honorato Almeida / Claudener Souza Teixeira / Rodrigo Bainy Leal / Plinio Delatorre / Bruno Anderson Matias Rocha / Ana Maria Sampaio Assreuy / Kyria Santiago Nascimento / Benildo Sousa Cavada

Archives of biochemistry and biophysics. 2016 Apr. 15, v. 596

2016

Abstract: A glycosylated lectin (CTL) with specificity for mannose and glucose has been detected and purified from seeds of Centrolobium tomentosum, a legume plant from Dalbergieae tribe. It was isolated by mannose-sepharose affinity chromatography. The primary ... ...

Abstract	A glycosylated lectin (CTL) with specificity for mannose and glucose has been detected and purified from seeds of Centrolobium tomentosum, a legume plant from Dalbergieae tribe. It was isolated by mannose-sepharose affinity chromatography. The primary structure was determined by tandem mass spectrometry and consists of 245 amino acids, similar to other Dalbergieae lectins. CTL structures were solved from two crystal forms, a monoclinic and a tetragonal, diffracted at 2.25 and 1.9Â Ã, respectively. The carbohydrate recognition domain (CRD), metal-binding site and glycosylation site were characterized, and the structural basis for mannose/glucose-binding was elucidated. The lectin adopts the canonical dimeric organization of legume lectins. CTL showed acute inflammatory effect in paw edema model. The protein was subjected to ligand screening (dimannosides and trimannoside) by molecular docking, and interactions were compared with similar lectins possessing the same ligand specificity. This is the first crystal structure of mannose/glucose native seed lectin with proinflammatory activity isolated from the Centrolobium genus.
Keywords	Centrolobium ; affinity chromatography ; amino acids ; crystal structure ; edema ; glucose ; glycosylation ; lectins ; legumes ; mannose ; molecular models ; screening ; seeds ; tandem mass spectrometry
Language	English
Dates of publication	2016-0415
Size	p. 73-83.
Publishing place	Elsevier Inc.
Document type	Article
ZDB-ID	523-x
ISSN	1096-0384 ; 0003-9861
ISSN (online)	1096-0384
ISSN	0003-9861
DOI	10.1016/j.abb.2016.03.001
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Manuseio do canal arterial patente no prematuro com síndrome de angústia respiratória

Milton A Meier / Waldir Jazbik / Joaquim H Coutinho / João Carlos Jazbik / José Aldrovando de Oliveira / José Caetano Silva / Rosa Célia Barbosa / Helder Paupério / Astolfo Serra Jr

Revista Brasileira de Cirurgia Cardiovascular, Vol 4, Iss 1, Pp 9-

ligadura ou indometacina?

1989 Volume 20

Abstract: A presença de canal arterial patente (PCA) com grande shunt sistêmico -pulmonar no prematuro com síndrome de angústia respiratória (SAR) está quase sempre associada a insuficiência cardíaca, displasia broncopulmonar, enterocolite necrotizante, hemorragia ...

Abstract	A presença de canal arterial patente (PCA) com grande shunt sistêmico -pulmonar no prematuro com síndrome de angústia respiratória (SAR) está quase sempre associada a insuficiência cardíaca, displasia broncopulmonar, enterocolite necrotizante, hemorragia intracraniana e morte. A ligadura do canal melhora a complacência pulmonar, reduz, significativamente, o tempo de assistência ventilatória e melhora 0 estado geral do paciente. Depois da introdução, nesta última década, da indometacina para a interrupção do PCA, no prematuro, vários estudos vêm procurando estabelecer as vantagens de uma forma de tratamento sobre a outra. O propósito do nosso estudo é comparar os resultados obtidos em 48 pacientes (pts.) (Grupo 1) submetidos a ligadura cirúrgica, nos últimos 8 anos, com 28 pts. (Grupo 2) nos quais a indometacina foi, preferentemente, utilizada. A idade gestacional média do Grupo 1 foi de 29,13 ± 2,33 semanas (24-34) e de 28,39 ± 2,30 semanas (25-32) no Grupo 2. O peso médio foi de 954,17 ± 220,68 g (540-1750 g) no Grupo 1 e de 923,21 ± 191,74 g (550-1400 g) no Grupo 2. Trinta e três (60,75%) dos pts. do Grupo 1 eram menores do que 1000 g (prematuros extremos), enquanto que 21 do Grupo 2 (75,0%) estavam nessa condição. Nove pacientes (32,1%) do Grupo 2 foram transferidos para o Grupo 1, devido ao insucesso da terapêutica com a indometacina, ou pela intolerância às doses indicadas. A ligadura foi realizada na própria unidade de terapia intensiva em 31 pts. (64,5%). A técnica empregada tem sido a de uma toracotomia póstero-lateral pequena, com preservação dos músculos do tórax e abertura pelo 3º ou 4º espaço intercostal. Por via extrapleural, o canal é alcançado e ligado com dois clips metálicos. Inicialmente, o tórax era rotineiramente drenado, apenas quando havia abertura da pleura. Mais recentemente, mesmo com a pleura aberta, somente são drenados os casos que apresentam pneumotórax prévio, ou então sangramento excessivo. A mortalidade no Grupo 1 foi de 18,75% (9 pts.) e, no Grupo 2, de 25,0% (7 pts.). Quatro pacientes do Grupo 2 transferidos para o Grupo 1 faleceram. As causas de óbito no Grupo 1 foram sépsis e hemorragia intracraniana; no Grupo 2, sépsis, enterocolite necrotizante com perfuração localizada, hemorragia intracraniana e penumotórax. Nos dois grupos, a mortalidade foi significantemente maior nos prematuros extremos. A despeito dos problemas de comparação entre os 2 grupos e das conclusões limitadas que podem ser retiradas de um estudo retrospectivo e não randomizado, acreditamos que os resultados da ligadura cirúrgica são nitidamente superiores aos obtidos com o uso da indometacina.
Keywords	persistência de canal arterial ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	Portuguese
Publishing date	1989-04-01T00:00:00Z
Publisher	Sociedade Brasileira de Cirurgia Cardiovascular
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Inter-library loan at ZB MED

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In stock of ZB MED Bonn / Germany

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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Inter-library loan at ZB MED

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Bonn / Germany

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Inter-library loan at ZB MED

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Inter-library loan at ZB MED