RICARDO SIMOES NEVES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
12 resultados
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Agora exibindo 1 - 10 de 12
- Peripheral oxygen saturation, heart rate, and blood pressure during dental treatment of children with cyanotic congenital heart disease(2014) DUTRA, Rosane Menezes Faria; NEVES, Itamara Lucia Itagiba; NEVES, Ricardo Simoes; ATIK, Edmar; SANTOS, Ubiratan de PaulaOBJECTIVES: In this observational study, we evaluated the peripheral oxygen saturation (SpO2), heart rate, and blood pressure of children with cyanotic congenital heart disease who were undergoing dental extraction. METHODS: Forty-four patients between the ages of 6 and 12 years who underwent upper primary tooth extraction were included in the study. Of these, 20 patients were in the cyanotic congenital heart disease group and 24 were in the control group. RESULTS: Peripheral oxygen saturation, heart rate, and systolic blood pressure in the cyanotic congenital heart disease group varied quite significantly during the treatment protocol (p < 0.05), with values of 80.5% (+/- 7.6) to 82.8% (+/- 7.8), 95.3 beats per minute (bpm) (+/- 11.3) to 101.3 bpm (+/- 9.8), and 93.6 mm Hg (+/- 13,3) to 103.8 mm Hg (+/- 12.7), respectively. The variations in the control group during the procedure were also significant. CONCLUSIONS: The changes observed during the study protocol, although statistically significant, were mild and lacked clinical relevance. The results indicate that dental treatment of children with cyanotic heart disease using a standardized protocol in decentralized offices without the support of a surgical center is safe.
- Effect of Penicillin G Every Three Weeks on Oral Microflora by Penicillin Resistant Viridans Streptococci(2012) AGUIAR, Andre Andrade de; SAMPAIO, Roney Orismar; SAMPAIO, Jorge Luiz de Mello; SPINA, Guilherme Sobreira; NEVES, Ricardo Simoes; MOREIRA, Luiz Felipe Pinho; GRINBERG, MaxBackground: Benzathine penicillin G every 3 weeks is the standard protocol for secondary prophylaxis for recurrent rheumatic fever. Objective: Assess the effect of Benzathine penicillin G on Streptococcus sanguinis and in patients with cardiac valvular disease due to rheumatic fever receiving secondary prophylaxis. Methods: Oral streptococci were evaluated before (baseline) and 7 days (day 7) after Benzathine penicillin G in 100 patients receiving routine secondary rheumatic fever prophylaxis. Saliva samples were evaluated for colony count and presence of S. sanguinis and S. oralis. Chewing-stimulated saliva samples were serially diluted and plated onto both nonselective and selective 5% sheep blood agar containing penicillin G. The species were identified using conventional biochemical tests. Minimal inhibitory concentrations were determined with the Etest. Results: No statistical differences were found in the presence of S. sanguinis comparing baseline and day 7 (p = 0.62). However, the existing number of positive cultures of S. oralis on day 7 after Benzathine penicillin G presented a significant increase compared to baseline (p = 0.04). No statistical difference was found between baseline and day 7 concerning the number of S. sanguinis or S. oralis CFU/mL and median minimal inhibitory concentrations. Conclusion: This study showed that Benzathine penicillin G every 3 weeks did not change the colonization by S. sanguinis, but increased colonization of S. oralis on day 7 of administration. Therefore, susceptibility of Streptococcus sanguinis and Streptococcus oralis to penicillin G was not modified during the penicillin G routine secondary rheumatic fever prophylaxis. (Arq Bras Cardiol 2012;98(5):452-458)
- Demographic, cardiological, microbiologic, and dental profiles of Brazilian patients who developed oral bacteria-related endocarditis(2021) MONTANO, Tania Cristina Pedroso; WANDERLEY, Marcelo Ivander Andrade; SAMPAIO, Roney Orismar; ALVES, Carolina Guimaraes Bonfim; NEVES, Itamara Lucia Itagiba; LOPES, Marcio Ajudarte; TARASOUTCHI, Flavio; STRABELLI, Tania Mara Varejao; NEVES, Ricardo Simoes; GRINBERG, Max; SANTOS-SILVA, Alan Roger; SICILIANO, Rinaldo FocacciaObjective. Infective endocarditis (IE) may cause devastating complications with high morbidity and mortality rates. The aim of the present study was to study the demographic, cardiological, microbiologic, and dental profiles of patients with oral bacteria-related IE. Study Design. We present a retrospective study of patients with oral bacteria-related IE treated at Instituto do Coracao, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Brazil, between January 2009 and December 2019. Results. Of the 100 patients included, 70% were male with a mean age of 45.4 years at diagnosis. The most affected sites were aortic and mitral valves, 60% in prosthetic heart valves, 34% in native valves, and 3% in pacemakers. The most common cause of valvular disease was rheumatic cardiopathy (51.9%), and the most frequent complications were valvular and perivalvular damage (26%). Streptococcus viridans was the most common species (96%), dental caries were present in 57% of the patients, 78% had tooth loss, 45% had apical periodontitis, and 77% were at high/moderate risk for periodontal disease. Conclusion. Oral bacteria-related IE among Brazilians was predominant in the prosthetic heart valves of young male adults previously affected by rheumatic cardiopathy. Streptococcus viridans was the main cause of IE, which was linked to patients with a poor oral health status.
- Cardiovascular risk reduction with periodontal treatment in patients on the waiting list for renal transplantation(2019) SANTOS-PAUL, Marcela A.; NEVES, Ricardo Simoes; GOWDAK, Luis Henrique W.; PAULA, Flayio J. de; DAVID-NETO, Elias; BORTOLOTTO, Luiz A.; RAMIRES, Jose Antonio F.; LIMA, Jose Jayme G. DeBackground Cardiovascular mortality is increased in chronic kidney disease, a condition with a high prevalence of periodontal disease. Whether periodontitis treatment improves prognosis is unknown. Methods The effect of periodontal treatment on the incidence of cardiovascular events and death in 206 waitlist hemodialysis subjects was compared with that in 203 historical controls who did not undergo treatment. Patients were followed up for 24 months or until death or transplantation. Results The prevalence of moderate/severe periodontitis was 74%. Coronary artery disease correlated with the severity of periodontal disease (P = .02). Survival free of cardiovascular events (94% vs 83%, log-rank 0.009), coronary events (97% vs 89%, log-rank = 0.009), and cardiovascular death (96% vs 87%, log-rank = 0.037) was higher in the evaluated group. Death by any cause did not differ between groups. Multivariate analysis showed that treatment was associated with reduction in cardiovascular events (HR 0.43; 95% CI 0.22-0.87), coronary events (HR 0.31; 95% CI 0.12-0.83), and cardiovascular deaths (HR 0.43; 95% CI 0.19-0.98). Conclusion Periodontal treatment reduced the 24-month incidence of cardiovascular events and cardiovascular death, suggesting that periodontal treatment may improve cardiovascular outcomes. We suggest that periodontal screening and eventual treatment may be considered in patients with advanced renal disease.
- Is It Safe for Patients With Cardiac Channelopathies to Undergo Routine Dental Care? Experience From a Single-Center Study(2019) OLIVEIRA, Ana Carolina Guimaraes; NEVES, Itamara Lucia Itagiba; SACILOTTO, Luciana; OLIVETTI, Natalia Quintella Sangiorgi; SANTOS-PAUL, Marcela Alves dos; MONTANO, Tania Cristina Pedroso; CARVALHO, Cintia Maria Alencar; WU, Tan Chen; GRUPI, Cesar Jose; BARBOSA, Silvio Alves; PASTORE, Carlos Alberto; SAMESIMA, Nelson; HACHUL, Denise Tessariol; SCANAVACCA, Mauricio Ibrahim; NEVES, Ricardo Simoes; DARRIEUX, Francisco Carlos CostaBackground-Brugada syndrome and long-QT syndrome may account for at least one third of unexplained sudden cardiac deaths. Dental care in patients with cardiac channelopathies is challenging because of the potential risk of life-threatening events. We hypothesized that the use of local dental anesthesia with lidocaine with and without epinephrine is safe and does not result in life-threatening arrhythmias in patients with channelopathies. Methods and Results-We performed a randomized, double-blind pilot trial comparing the use of 2% lidocaine without a vasoconstrictor and with 1:100 000 epinephrine in 2 sessions of restorative dental treatment with a washout period of 7 days (crossover trial). Twenty-eight-hour Holter monitoring was performed, and 12-lead electrocardiography, digital sphygmomanometry, and anxiety scale assessments were also conducted at 3 time points. Fifty-six dental procedures were performed in 28 patients (18 women, 10 men) with cardiac channelopathies: 16 (57.1%) had long-QT syndrome, and 12 (42.9%) had Brugada syndrome; 11 (39.3%) of patients had an implantable defibrillator. The mean age was 45.9 +/- 15.9 years. The maximum heart rate increased after the use of epinephrine during the anesthesia period from 82.1 to 85.8 beats per minute (P=0.008). In patients with long-QT syndrome, the median corrected QT was higher, from 450.1 to 465.4 ms (P 0.009) at the end of anesthesia in patients in whom epinephrine was used. The other measurements showed no statistically significant differences. No life-threatening arrhythmias occurred during dental treatment. Conclusions-The use of local dental anesthesia with lidocaine, regardless of the use of a vasoconstrictor, did not result in life-threatening arrhythmias and appears to be safe in stable patients with cardiac channelopathies.
- Bilateral paresthesia associated with cardiovascular disease and COVID-19(2022) MOREIRA, Maria Stella; NEVES, Itamara Lucia Itagiba; BERNOCHE, Claudia Yanet San Martin de; SARRA, Giovanna; SANTOS-PAUL, Marcela Alves dos; SILVA, Fernanda Campos Neves da; SCHROTER, Gabriella Torres; MONTANO, Tania Cristina Pedroso; CARVALHO, Cintia Maria Alencar de; NEVES, Ricardo Simoes
conferenceObject Arrhythmic Events in Patients With Cardiac Channelopathies Submitted to Local Dental Anesthesia. A Randomized Pilot Study(2017) OLIVEIRA, Ana Carolina Guimaraes; NEVES, Itamara; SCANAVACCA, Mauricio; SACILOTTO, Luciana; OLIVETTI, Natalia; HACHUL, Denise; BARBOSA, Silvio; GRUPI, Cesar; NEVES, Ricardo; DARRIEUX, FranciscoconferenceObject COMPARISON BETWEEN TWO DIFFERENT LOCAL HEMOSTASIS TECHNIQUES FOR DENTAL EXTRACTIONS IN PATIENTS ON DUAL ANTIPLATELET THERAPY: A WITHIN-PERSON, SINGLE-BLIND, RANDOMIZED TRIAL(2020) GUARDIEIRO, Bruno; SANTOS-PAUL, Marcela A.; SALSOSO, Rocio; DALCOQUIO, Talia; FURTADO, Remo; NEVES, Itamara L. I.; NEVES, Ricardo S.; CAVALHEIRO FILHO, Cyrillo; BARACIOLI, Luciano; NICOLAU, Jose C.- Favorable Safety Experience of Local Dental Anesthesia in ICD Recipients with Cardiac Channelopathies(2023) OLIVEIRA, Ana Carolina Guimarães; NEVES, Itamara Lucia Itagiba; SACILOTTO, Luciana; OLIVETTI, Natália Quintella Sangiorgi; BUENO, Savia Christina Pereira; PESSENTE, Gabrielle D’Arezzo; SANTOS-PAUL, Marcela Alves dos; MONTANO, Tânia Cristina Pedroso; CARVALHO, Cíntia Maria Alencar de; GRUPI, Cesar José; BARBOSA, Sílvio Alves; PASTORE, Carlos Alberto; SAMESIMA, Nelson; WU, Tan Chen; HACHUL, Denise Tessariol; SCANAVACCA, Maurício Ibrahim; NEVES, Ricardo Simões; DARRIEUX, Francisco Carlos da CostaAbstract Background Dental anesthetic management in implantable cardioverter defibrillator (ICD) recipients with cardiac channelopathies (CCh) can be challenging due to the potential risk of life-threatening arrhythmias and appropriate ICD therapies during procedural time. Objectives The present study assessed the hypothesis that the use of local dental anesthesia with 2% lidocaine with 1:100,000 epinephrine or without a vasoconstrictor can be safe in selected ICD and CCh patients, not resulting in life-threatening events (LTE). Methods Restorative dental treatment under local dental anesthesia was made in two sessions, with a wash-out period of 7 days (cross-over trial), conducting with a 28h - Holter monitoring, and 12-lead electrocardiography, digital sphygmomanometry, and anxiety scale assessments in 3 time periods. Statistical analysis carried out the paired Student’s t test and the Wilcoxon signed-rank test. In all cases, a significance level of 5% was adopted. All patients were in stable condition with no recent events before dental care. Results Twenty-four consecutive procedures were performed in 12 patients (9 women, 3 men) with CCh and ICD: 7 (58.3%) had long QT syndrome (LQTS), 4 (33.3%) Brugada syndrome (BrS), and 1 (8.3%) Catecholaminergic polymorphic ventricular tachycardia (CPVT). Holter analysis showed no increased heart rate (HR) or sustained arrhythmias. Blood pressure (BP), electrocardiographic changes and anxiety measurement showed no statistically significant differences. No LTE occurred during dental treatment, regardless of the type of anesthesia. Conclusion Lidocaine administration, with or without epinephrine, can be safely used in selected CCh-ICD patients without LTE. These preliminary findings need to be confirmed in a larger population with ICD and CCh.
- COMPARISON BETWEEN TWO DIFFERENT LOCAL HEMOSTATIC METHODS FOR DENTAL EXTRACTIONS IN PATIENTS ON DUAL ANTIPLATELET THERAPY: A WITHIN-PERSON, SINGLE-BLIND, RANDOMIZED STUDY(2023) GUARDIEIRO, Bruno; SANTOS-PAUL, Marcela alves; FURTADO, Remo Holanda de Mendonca; DALCOQUIO, Talia; SALSOSO, Rocio; NEVES, Itamara Lucia Itagiba; NEVES, Ricardo Simoes; CAVALHEIRO FILHO, Cyrillo; BARACIOLI, Luciano Moreira; NICOLAU, Jose CarloBackground Dual antiplatelet therapy (DAPT) provides additional risk reduction of ischemic events compared to aspirin monotherapy, at cost of higher bleeding risk. There are few data comparing new techniques for reducing bleeding after dental ex-tractions in these patients. Purpose This study investigated the effectiveness of the HemCon Dental Dressing (HDD) compared to oxidized cellulose gauze. Materials and methods This randomized study included 60 patients on DAPT who required at least two dental extractions (120 procedures). Each surgical site was randomized to HDD or oxidized regenerated cellulose gauze as the local hemostatic method. Intra-oral bleeding time was measured immediately after the dental extraction and represents our main endpoint for comparison of both hemostatic agents. Pro-longed bleeding, platelet reactivity measured by Multiplate Analyser (ADPtest and ASPItest) and tissue healing comparison after 7 days were also investigated. Results Intra-oral bleeding time was lower in HDD compared with control (2 [2-5] vs. 5 [2-8] minutes, P =0.001). Prolonged postoperative bleeding was observed in 7 cases (11.6%), all of them successfully managed with local sterile gauze pressure. More HDD treated sites presented better healing when compared with control sites [21 (36.8%) vs. 5 (8.8%), P =0.03]. There was poor correlation between platelet reactivity and intra-oral bleeding time.Conclusions In patients on DAPT, HDD resulted in a lower intra-oral bleeding time compared to oxidized cellulose gauze after dental extractions. Moreover, HDD also seems to improve healing conditions.