Papers by Luiz Cláudio Martins
Frontiers in Cardiovascular Medicine
BackgroundChronic Chagas cardiomyopathy (CCC) constitutes the most life-threatening consequence o... more BackgroundChronic Chagas cardiomyopathy (CCC) constitutes the most life-threatening consequence of the Trypanosoma cruzi infection. Our goal was to test in CCC the associations of the myocardial tissue phenotype with cardiac dysfunction, and heart failure (HF) severity, using cardiac magnetic resonance (CMR).MethodsWe performed a prospective observational cohort of patients with consecutive CCC with a CMR protocol, including ventricular function, myocardial T1, and late gadolinium enhancement (LGE). Extracellular volume (ECV), and intracellular water lifetime, τic, a measure of cardiomyocyte diameter, were compared to CCC disease progression, including Rassi score and New York Heart Association (NYHA) class. An exploratory prognostic analysis was performed to investigate the association of both ECV and τic with CV death.ResultsA total of 37 patients with intermediate-to-high-risk CCC were enrolled (Chagas Rassi score ≥7, mean left ventricle (LV) ejection fraction (EF) 32 ± 16%). Myo...
BMC Pulmonary Medicine, 2022
Background Elderly people are more likely to suffer severe chronic obstructive pulmonary disease ... more Background Elderly people are more likely to suffer severe chronic obstructive pulmonary disease (COPD) and require long-term home oxygen therapy (LTOT) as part of their treatment. LTOT has advantages such as improvement in symptoms, but there are also disadvantages such as physical barriers, psychosocial barriers and emotional challenges. The aim of this study is to understand the experiences of elderly people with COPD using LTOT with respect to their feelings attributed to therapy. Methods Qualitative study. Seven semidirected interviews were conducted with patients with a confirmed COPD diagnosis who used LTOT and were treated at an outpatient service. The content analysis technique was applied with the support of WebQDA software 2.0. Results Three categories emerged that were associated with the use of LTOT: (1) poor self-image; (2) feelings of sadness and (3) the impact of LTOT on others such as family and friends. Conclusions LTOT in elderly people with COPD was associated wi...
A obesidade provoca alteracoes importantes na funcao pulmonar, e alguns exames, como espirometria... more A obesidade provoca alteracoes importantes na funcao pulmonar, e alguns exames, como espirometria e capnografia volumetrica (VCap), podem ajudar a diagnosticar essas complicacoes. Objetivo foi descrever a influencia da perda de peso na melhora da funcao pulmonar. Foi avaliado um individuo com obesidade morbida grau III, que participou da abordagem de perda de peso multidisciplinar do HC da Unicamp e foi submetido a avaliacoes iniciais e finais de medidas antropometricas e da funcao pulmonar. Foi realizada espirometria, capnografia volumetrica e risco de desenvolvimento da Apneia do Sono pelo questionario de Berlim. Apos a perda de peso de 90kg, IMC de 28kg / m², observou-se melhora nos valores espirometricos no primeiro e segundo momentos nas variaveis de capacidade vital forcada (CVF), volume expiratorio final no primeiro segundo (FEV1), fluxo expiratorio final. Ja na capnografia volumetrica houve aumento do volume minuto alveolar [MValv (L)], volume minuto do espaco morto das ...
Brazilian Journal of Transplantation, 2017
Objetivo: O estudo teve como objetivo buscar associação entre derrame pleural e ascite, com o ach... more Objetivo: O estudo teve como objetivo buscar associação entre derrame pleural e ascite, com o achado de linhas B difusas na ultrassonografia pulmonar em pacientes cirróticos, em fila de transplante hepático. Método: O presente projeto caracteriza-se como um estudo longitudinal observacional, no qual foram avaliados 56 pacientes na fila de transplante hepático, do ambulatório de transplante do Gastrocentro - UNICAMP. Nesses pacientes, foram coletados dados gerais e relacionados à doença hepática, realizada ultrassonografia pulmonar para identificação de linhas B difusas e derrame pleural, e ultrassonografia abdominal para avaliar a presença de ascite. Resultados: Dentre os 56 pacientes avaliados, foram encontrados sete pacientes com derrame pleural à ultrassonografia, representando 12,5% da amostra estudada, enquanto que os sem derrame pleural somaram 49 pacientes, 87,5% do total. Além disso, foram encontradas linhas B difusas em 27 pacientes, correspondendo a 48,21% da amostra de ...
Pulmonology, 2020
Introduction: The adipose tissue secretes adipokines and influences the release of inflammatory m... more Introduction: The adipose tissue secretes adipokines and influences the release of inflammatory mediators contributing to a state of low-grade systemic inflammation that may change lung function. Objective: To correlate levels of adipokines and inflammatory mediators with lung function in individuals with obesity and bronchial asthma symptoms. Materials and methods: A cross-sectional study, including women with obesity (grade II and III) with symptoms and clinical diagnosis of asthma. Anthropometric measurements (weight, height, BMI), pulmonary function test (spirometry), asthma control test questionnaire, collection of systemic inflammatory markers (blood collection) and pulmonary markers (sputum collection) were collected and were analyzed: IL-6, IL-8, TNF-␣, adiponectin, resistin, leptin and C-reactive protein (CRP). The patients were stratified into two groups according to asthma control. Results: 80 women were analyzed and 40% had an ACT score greater than or equal to 18 and were classified as ''controlled asthma''. More than half of the patients of ACT < 18 score obtaining measures of FEV1, PEF and FEF25-75% below and 80% of predicted. There was a significant and negative correlation between IL-6 in the sputum with FVC and FEF25-75% in the group ACT < 18 and with FVC and FEV1 in the group ACT ≥ 18.
Resumos do..., 2019
As alterações pulmonares, devido ao estado inflamatório sistêmico, possuem grande impacto no prog... more As alterações pulmonares, devido ao estado inflamatório sistêmico, possuem grande impacto no prognóstico e sobrevida dos pacientes com doença hepática avançada. Esta pesquisa teve como escopo correlacionar as alterações pulmonares visualizadas na ultrassonografia (US) com as alterações visualizadas na tomografia computadorizada de alta resolução (TC)-considerada padrão-ouro para avaliação pulmonar-, a gravidade da doença hepática, alterações da espirometria, tempo de ventilação mecânica e tempo de internação na Unidade de Terapia Intensiva (UTI). Dentre os pacientes estudados, não houve diferença significativa entre US e TC para avaliação de óbito e desfechos póstransplante, o que fortalece o ganho de importância da avaliação pré-operatória com a US, um exame de menor custo, menos invasivo e de maior facilidade de realização, além de ser mais sensível para detectar congestão pulmonar, um possível fator que reduz as chances de realização de transplante hepático, por aumentar o risco cirúrgico.
Saúde (Santa Maria), 2019
Este estudo teve o objetivo de avaliar os artigos de treinamento muscular inspiratório em idosos ... more Este estudo teve o objetivo de avaliar os artigos de treinamento muscular inspiratório em idosos com desmame da ventilação mecânica, nos últimos cinco anos. O levantamento bibliográfico foi realizado através de publicações indexadas na base de dados da Biblioteca Virtual de Saúde (BVS): Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana em Ciências de Saúde (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), US national Library of Medicine National Institutesof Health (PUBMED), Controlled Trials database (COCHRANE) e Physiotherapy evidence database (PEDro). Para organização do estudo, foram seguidos os critérios da revisão sistemática. Após avaliação, foram selecionados cinco artigos que se enquadravam nos critérios do estudo. Os artigos incluídos na revisão apresentaram rigor metodológico em todos os protocolos de treino muscular inspiratório utilizado, sendo que nem todos eram específicos para idosos, porém a idade média encontrada...
Revista dos Trabalhos de Iniciação Científica da UNICAMP, 2018
Estudo retrospectivo com pacientes cirróticos com indicação de transplante hepático que teve por ... more Estudo retrospectivo com pacientes cirróticos com indicação de transplante hepático que teve por finalidade comparar os achados da tomografia computadorizada (TC) de alta resolução de tórax (padrão áureo), com a ultrassonografia (US) de tórax, bem como com aspectos funcionais pelo exame de espirometria. Após a avaliação dos prontuários dos pacientes listados para transplante, e que apresentavam ambos os exames de imagem, a ultrassonografia detectou mais o derrame pleural quando comparado à tomografia, enquanto que, houve semelhança nos achados de síndromes pulmonares e presença de linhas B entre os métodos. Aspectos funcionais pulmonares (espirometria) foram normais para os pacientes que apresentavam os exames de imagem.
Revista da Sociedade Brasileira de Medicina Tropical, 2018
Introduction: Chagas disease (CD) prevention and control rely on studies of its distribution, cha... more Introduction: Chagas disease (CD) prevention and control rely on studies of its distribution, characteristics of individuals affected and mode of transmission. CD data in Brazil are scarce; a retrospective analysis of the clinical characteristics of 80 patients treated at the Clinical Hospital of UNICAMP, Campinas, Brazil, was performed. Methods: Patient data records were analyzed. Results: Thirty percent of the patients probably got infected through vector-borne transmission, 65% came from endemic areas, a predominance of cardiac and cardiodigestive forms was found among males, and the cardiac form prevailed (51%). Conclusions: The results update the view on the epidemiology of CD in Campinas, Brazil.
Sao Paulo medical journal = Revista paulista de medicina, Jan 15, 2018
Excess trunk body fat in obese individuals influences respiratory physiological function. The aim... more Excess trunk body fat in obese individuals influences respiratory physiological function. The aims of this study were to compare volumetric capnography findings (VCap) between severely obese patients and normal-weight subjects and to assess whether there is any association between neck circumference (NC), waist-hip ratio (WHR) and VCap among grade III obese individuals. Analytical observational case-matched cross-sectional study, University of Campinas. This cross-sectional study compared VCap variables between 60 stage III obese patients and 60 normal-weight individuals. In comparison with the normal-weight group, obese patients presented higher alveolar minute volume (8.92 ± 4.94 versus 6.09 ± 2.2; P = < 0.0001), CO2 production (278 ± 91.0 versus 209 ± 60.23; P < 0.0001), expiratory tidal volume (807 ± 365 versus 624 ± 202; P = 0.005), CO2 production per breath (21.1 ± 9.7 versus 16.7 ± 6.16; P = 0.010) and peak expiratory flow (30.9 ± 11.9 versus 25.5 ± 9.13; P = 0.004). Th...
Sao Paulo medical journal = Revista paulista de medicina
The combined effect of obesity and asthma may lead to significant impairment of quality of life (... more The combined effect of obesity and asthma may lead to significant impairment of quality of life (QOL). The aim here was to evaluate the prevalence of asthma among obese individuals, characterize the severity of impairment of quality of life and measure its relationship with pulmonary function. Observational cross-sectional study in public university hospital. Morbidly obese individuals (body mass index > 40 kg/m2) seen in a bariatric surgery outpatient clinic and diagnosed with asthma, were included. Anthropometric data were collected, the Standardized Asthma Quality of Life Questionnaire (AQLQ(S)) was applied and spirometry was performed. The subjects were divided into two groups based on the median of the score in the questionnaire (worse < 4 and better > 4) and were compared regarding anthropometric data and pulmonary function. Among the 4791 individuals evaluated, 219 were asthmatic; the prevalence of asthma was 4.57%. Of these, 91 individuals were called to start multi...
Brazilian journal of cardiovascular surgery
Introduction: During cardiac arrest, end-tidal CO2 (PetCO2), VCO2 and coronary perfusion pressure... more Introduction: During cardiac arrest, end-tidal CO2 (PetCO2), VCO2 and coronary perfusion pressure fall abruptly and tend to return to normal levels after an effective return of spontaneous circulation. Therefore, the monitoring of PetCO2 and VCO2 by capnography is a useful tool during clinical management of cardiac arrest patients. Objective: To assess if PetCO2, VCO2 and coronary perfusion pressure are useful for the prediction of return of spontaneous circulation in an animal model of cardiac arrest/cardiopulmonary resuscitation treated with vasopressor agents. Methods: 42 swine were mechanically ventilated (FiO2=0.21). Ventricular fibrillation was induced and, after 10 min, unassisted cardiac arrest was initiated, followed by compressions. After 2 min of basic cardiopulmonary resuscitation, each group received: Adrenaline, Saline-Placebo, Terlipressin or Terlipressin + Adrenaline. Two minutes later (4 th min of cardiopulmonary resuscitation), the animals were defibrillated and the ones that survived were observed for an additional 30 min period. The variables of interest were recorded at the baseline period, 10 min of ventricular fibrillation, 2 nd min of cardiopulmonary resuscitation, 4 th min of cardiopulmonary resuscitation, and 30 min after return of spontaneous circulation. Results: PetCO2 and VCO2 values, both recorded at 2 min and 4 min of cardiopulmonary resuscitation, have no correlation with the return of spontaneous circulation rates in any group. On the other hand, higher values of coronary perfusion pressure at the 4th min of cardiopulmonary resuscitation have been associated with increased return of spontaneous circulation rates in the adrenaline and adrenaline + terlipressin groups. Conclusion: Although higher values of coronary perfusion pressure at the 4th min of cardiopulmonary resuscitation have been associated with increased return of spontaneous circulation rates in the animals that received adrenaline or adrenaline + terlipressin, PetCO2 and VCO2 have not been shown to be useful for predicting return of spontaneous circulation rates in this porcine model.
Revista Brasileira de Terapia Intensiva, 2016
Objective: To evaluate the presence of hyponatremia and natriuresis and their association with at... more Objective: To evaluate the presence of hyponatremia and natriuresis and their association with atrial natriuretic factor in neurosurgery patients. Methods: The study included 30 patients who had been submitted to intracranial tumor resection and cerebral aneurism clipping. Both plasma and urinary sodium and plasma atrial natriuretic factor were measured during the preoperative and postoperative time periods. Results: Hyponatremia was present in 63.33% of the patients, particularly on the first postoperative day. Natriuresis was present in 93.33% of the patients, particularly on the second postoperative Conflicts of interest: None.
Revista Brasileira de Cirurgia Cardiovascular, 2015
How to cite Complete issue More information about this article Journal's homepage in redalyc.org ... more How to cite Complete issue More information about this article Journal's homepage in redalyc.org Scientific Information System Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Non-profit academic project, developed under the open access initiative 668
Acta Cirurgica Brasileira, 2015
Design of the study, technical procedures, manuscript writing, supervised all phases of the study.
Revista da Sociedade Brasileira de Medicina Tropical, 2000
Fluids in which Mycobacterium tuberculosis are seldom found, such as pleural and cerebrospinal li... more Fluids in which Mycobacterium tuberculosis are seldom found, such as pleural and cerebrospinal liquids, are good candidates to be studied using PCR techniques. We detail our experience with a PCR assay applied to pleural and cerebrospinal fluids using the primer MPB64. Seventy three specimens were analyzed: 30 pleural fluids (PF), 26 pleural biopsies (PB) and 17 cerebrospinal fluids (CSF). The gold standard for the diagnosis of tuberculous meningitis was the positive culture for M. tuberculosis in CSF. Tuberculous pleural effusion was diagnosed when cultures of PF and/or PB were positive for M. tuberculosis, or the PB histology showed granulomas. Our results, compared to the gold standards employed, showed a sensitivity of 70%, specificity of 88%, positive predictive value of 82% and negative predictive value of 80%. The high specificity of the MPB64 fragment while still retaining a good sensitivity makes it very well suited for pleural and cerebrospinal tuberculosis diagnosis.
Revista Brasileira de Cirurgia Cardiovascular, 2011
Introduction: Experimental studies on pulmonary embolism (PE) are usually performed under mechani... more Introduction: Experimental studies on pulmonary embolism (PE) are usually performed under mechanical ventilation. Most patients with suspicion of PE enter the Emergency Services in spontaneous breathing and environmental air. Thus, under these conditions, measurements of hemodynamic, gasometric and capnographic variables contribute largely to a more specific comprehension of cardiopulmonary and gasometric alterations in the acute phase of the disease. Studies which evaluated animals under conditions are lacking. Objective: This study aimed to submit animals under spontaneous ventilation and without supplemental oxygen to PE. Methods: PE was induced in six pigs using autologous blood clots, and cardiorespiratory and gasometric records were performed before and after PE. The values of "near fatal" mean pulmonary arterial pressure (MPAP) were previously determined. Results: The presence of obstructive shock could be evidenced by increased MPAP (from 17.8±3.5 to 41.7±3.3 mmHg) (P<0.0001) and decreased cardiac output (from 4.9±1.0 to 2.7±1.0 L/min) (P<0.003). Consequently, metabolic acidosis occurred (Lac art) (from 2.4±0.6 to 5.7±1.8 mmol/L) (P<0.0001). It was observed hypoxemia (from 73.5±12.7 to 40.3±4.6 mmHg) (P<0.0001); however, PaCO 2 did not vary (from 44.9±4.4 to 48.2±6.0 mmHg) (NS). There were significant increases in both P(a-et)CO 2 (from 4.8±2.8 to 37.2±5.8 mmHg) and P(A-a)O 2 (from 8.2±8.9 to 37.2±10.3 mmHg) (both P<0.0001). There was also a significant increase in the total alveolar minute volume (from 4.0±0.9 to 10.6±2.9 L/min) (P<0.0001). Conclusion: In this model, the near fatal MPAP was from 2 to 2.5 times the basal MPAP; and the capnographic variables, associated with arterial and venous gasometry, showed effective in discriminating an acute obstructive profile.
Revista brasileira de anestesiologia
The objective of the present study was to evaluate the efficacy of terlipressin (TP) vs. adrenali... more The objective of the present study was to evaluate the efficacy of terlipressin (TP) vs. adrenaline (ADR) in increasing coronary perfusion pressure (CPP) and return of spontaneous circulation (ROSC) in swine CPR. Under anesthesia with ketamine/thiopental, ventricular fibrillation was induced in 44 female immature pigs, remaining unassisted for 10 minutes, followed by 2 minutes of manual CPR (100 compression/10 ventilations/min with air). Animals were, then, divided into four groups: 1) ADR (45μg.kg(-1)); 2) saline-placebo (10mL); 3) TP 20μg.kg(-1)); and TP (20μg.kg(-1)) + ADR (45μg.kg(-1)). Defibrillation was performed after 2 minutes, observing surviving animals for a 30-minute period. Electrocardiogram, systemic BP, DBP, and PetCO(2) were monitored continuously. Terlipressin did not differ from placebo regarding the effects on CPP, with low rates of ROSC in both groups (1/11 vs. 2/11; p=NS). Adrenaline increased CPP from 13±12 to 54±15mmHg (p<0.0001), similar effect to TP + ADR...
Revista Brasileira de Terapia Intensiva, 2014
Conflicts of interest: With the help of the Brazilian Thoracic Society, the AMIB Division of Scie... more Conflicts of interest: With the help of the Brazilian Thoracic Society, the AMIB Division of Scientific Issues procured financial support from industrial companies and laboratories, distributed as sponsorship quotas, to cover part of the event costs (participants' air tickets, food and lodging). None of those companies participated in the drafting of the present document, nor had access to its content until it was disclosed (after its final format was approved) as brochures distributed at the Brazilian Congress of Intensive Care Medicine in Rio de Janeiro in 2013. The companies that collaborated with the present project are:
Acta Cirurgica Brasileira, 2015
Design of the study, technical procedures, manuscript writing, supervised all phases of the study.
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Papers by Luiz Cláudio Martins