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3 results on '"Lucas Campos Barbosa E. Silva"'

1. Neurological and Psychiatric Disorders in Patients with Rheumatic Heart Disease: Unveiling what is Beyond Cardiac Manifestations

Author

Luiz Paulo Bastos Vasconcelos, Marcelle Cristina da Silva Bastos Vascon, Francisco Biagio Murta E. Di Flora, Flávio Augusto Paes de Oliveira, Pedro Drummond Lima, Lucas Campos Barbosa E. Silva, Breno Camargos Mucelli- Spolaor, José Luiz Padilha da Silva, William Antônio de Magalhães Esteves, Maria Carmo P. Nunes, and Antônio Lúcio Teixeira

Subjects
rheumatic heart disease, basal ganglia motor dysfunction, obsessive-compulsive symptoms, mood disorders, migraine, Diseases of the circulatory (Cardiovascular) system, RC666-701, Public aspects of medicine, RA1-1270
Abstract

Background: Rheumatic heart disease (RHD) is the most serious manifestation of rheumatic fever, which may also affect the brain. The current study assessed the prevalence of neuropsychiatric manifestations in patients with RHD, including clinical features associated with basal ganglia motor dysfunction (BGMD). Methods: We conducted neurologic and psychiatric assessments in consecutive patients with RHD referred to a tertiary center for heart valve diseases. Echocardiography was performed to assess the pattern of valvular involvement and RHD severity. Validated questionnaires for the evaluation of cognition, depression, anxiety, and obsessive-compulsive symptoms (OCS) were applied. BGMD was clinically defined by the presence of hyperkinetic movement disorders. Results: Fifty patients with age of 43.2 ± 10.8 years, 84% female, were included. Mitral valve was affected in 47 patients (94%), and 21 of them (42%) also had aortic valve involvement. Chorea (22%), chronic tics (18%), OCS (48%), major depression (34%), generalized anxiety disorder (54%), cognitive complaints (66%), migraine (52%) and seizures (18%) were frequently reported. The factors associated with BGMD were age (p = 0.018), major depression (p = 0.013), and Yale-Brown Obsessive Compulsive (Y-BOCS) score (p = 0.011). The severity of heart disease was not associated with BGMD. Conclusions: Neuropsychiatric manifestations are frequent in RHD patients, which may persist up to three decades after acute rheumatic fever. Age, major depression and severity of OCS were independently associated with BGMD. These manifestations deserve a close attention of clinicians and researchers dealing with adult patients with RHD.

Published
2022
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2. Pulmonary artery pressure response to percutaneous mitral valvuloplasty: Associated factors and clinical implications

Author

Marta Eugenia Alcici, Maria do Carmo Pereira Nunes, Timothy C. Tan, Breno Camargos Mucelli Spalaor, Tatiana Costa Diamantino, Frederico V.B. Macedo, Igor Ferreira de Sales, Juliana Rodrigues Soares, William A. M. Esteves, Guilherme Rafael Sant'Anna Athayde, Clara L. Fraga, Lucas Lodi-Junqueira, Pedro Victor Silva Valente, and Lucas Campos Barbosa E Silva

Subjects
Adult, Balloon Valvuloplasty, medicine.medical_specialty, medicine.medical_treatment, Population, Hemodynamics, Pulmonary Artery, medicine.artery, Internal medicine, Mitral valve, medicine, Humans, Mitral Valve Stenosis, Radiology, Nuclear Medicine and imaging, education, Stroke, education.field_of_study, business.industry, Mitral valve replacement, Atrial fibrillation, General Medicine, Middle Aged, medicine.disease, Pulmonary hypertension, medicine.anatomical_structure, Treatment Outcome, Echocardiography, Pulmonary artery, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

BACKGROUND Pulmonary hypertension (PH) is a marker of poor outcome in mitral stenosis (MS), which improves after percutaneous mitral valvuloplasty (PMV). However, mechanical interventions for relief of valve obstruction often but not always reduce pulmonary pressures. This study aimed to assess the parameters associated with abnormal pulmonary artery pressure (PAP) response immediately after a successful PMV, and also its impact on long-term outcome. METHODS A total of 181 patients undergoing PMV for rheumatic MS were prospectively enrolled. Invasive hemodynamic and echocardiographic measures were examined in all patients. Abnormal PAP response was defined as the mean PAP (mPAP) values unchanged at the end of the procedure. Long-term outcome was a composite endpoint of death, mitral valve replacement, repeat PMV, new onset of atrial fibrillation (AF), or stroke. RESULTS The mean age was 44.1 ± 12.6 years, and 157 patients were women (86.7%). In the overall population, mPAP decreased from 33.4 ± 13.1 mmHg pre to 27.6 ± 9.8 mmHg post (p

Published
2021

3. Uterine fibroids and pregnancy: implications and conducts

Author

Sara de Pinho Cunha Paiva, Ana Paula Caldeira Brant, Admário Silva Santos Filho, Roberta Abramo Ribeiro, Lucas Campos Barbosa e Silva, and Thiago da Costa Ramos

Subjects
Complicações na Gravidez, Hemorragia Pós-Parto, Gestação, Mioma uterino
Abstract

A prevalência de miomatose uterina na gravidez varia entre 1,6 e 10,7%. Embora a maioria das gestantes com miomas não apresente complicações durante a gestação, a miomatose pode ocasionar importantes complicações na gravidez e parto, como abortamento espontâneo, crescimento intrauterino restrito, necessidade de realização de cesareana e hemorragia pós-parto. Relata-se caso de gestante com miomatose uterina muito extensa e miomectomia prévia que evoluiu com necessidade de realização de cesariana de urgência por contrações, ameaça de ruptura uterina e realização de histerectomia pós-parto por hemorragia uterina.

Published
2020

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