IMPACTO-MR: a Brazilian nationwide platform study to assess infections and multidrug resistance in intensive care units.

Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria.

Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform.

Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others.

[Value of digital subtraction angiography in the imaging of a subcutaneously implanted, intra-arterial chemotherapy catheter].

Intraarterial chemotherapy is already a commonly accepted treatment method in isolated liver metastases. The high risk of transcutaneous injection of chemotherapeutic substances in the implanted catheter system requires a passage examination before the beginning of therapy. 32 digital subtraction angiograms for examination and documentation of the implanted catheter have been performed in 15 patients.

[Value of intra-arterial digital subtraction angiography].

Among 3000 digital subtraction angiographies which have been performed in our institute, 850 patients have been examined intraarterially. The advantage of i.a.

Simulation analysis of interatrial transposition of venous return (Mustard's operation).

Transposition of the great arteries is functionally corrected by Mustard's operation, an operation in which the atrial septum is removed and the resulting common atrial chamber repartitioned by a baffle to transpose venous return to the heart. To better understand the new physiology, a physically-based mathematical model of the infant circulation following Mustard's operation was developed and studied with the aid of computer simulation. The model reproduces certain clinical observations, including the tendency for mean pressure in both atria to be equal early postoperatively and for the pressure waveform to exhibit a steep y-descent in the systemic venous atrium.

[Therapeutic vascular occlusion with angiographic catheter technique (author's transl)].

Therapeutic embolization can achieve occlusion of bleeding vessels, arteriovenous fistulas and tumor feeding arteries. Many different diseases can now be treated by angiographic catheter techniques which required surgical intervention in the past. Various embolic materials were applied to produce transient or permanent vascular occlusions.

[Arteriography of the limbs of children (author's transl)].

Arteriography of upper and lower limbs will be needed when clinical and conventional radiologic examinations have not established definite diagnoses. Angiography of the upper and lower limbs is particularly important for congenital dysplasias (16 cases) or for diagnosis of tumors (15 cases). Traumatic vascular lesions needed angiography in 18 instances.

[Diagnostic and Therapeutical problems of extrahepatic portal vein stenosis].

In seven children the clinical course of extrahepatic portal vein stenosis was studied angiographically. In all children with splenomegaly it was deemed necessary to perform an X-ray barium examination of the oesophagus. Transsplenic portal venography was performed when oesophageal varices were detected to set up the best scheme for emergency treatment.