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[SciELO Preprints] - Cardiovascular Statistics – Brazil 2023
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Oliveira, Gláucia Maria Moraes de Brant, Luisa Campos Caldeira Polanczyk, Carisi Anne Malta, Deborah Carvalho Biolo, Andreia Nascimento, Bruno Ramos Souza, Maria de Fatima Marinho de Lorenzo, Andrea Rocha De Fagundes Júnior, Antonio Aurélio de Paiva Schaan, Beatriz D. Silva, Christina Grüne de Souza e Castilho, Fábio Morato de Cesena, Fernando Henpin Yue Soares, Gabriel Porto Xavier Junior, Gesner Francisco Barreto-Filho, Jose Augusto Soares Passaglia, Luiz Guilherme Pinto-Filho, Marcelo Martins Machline-Carrion, M. Julia Bittencourt, Marcio Sommer Pontes Neto, Octavio M. Villela, Paolo Blanco Teixeira, Renato Azeredo Stein, Ricardo Sampaio, Roney Orismar Gaziano, Thomaz A. Perel, Pablo Roth, Gregory A. Ribeiro, Antonio Luiz Pinho

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Publication date: 2023-12-14

Abstract: En Pt

The publication Cardiovascular Statistics – Brazil aims to provide an annual compilation of data and research on the epidemiology of CVDs in Brazil.  The report integrates official statistics from the Brazilian Ministry of Health and other governmental entities alongside data from the GBD project, coordinated by the IHME at the University of Washington. Additionally, it incorporates data derived from various sources and scientific studies, including cohorts and registries, that relate to CVDs and their associated risk factors. This publication is intended for a wide range of individuals, including researchers, clinicians, patients, healthcare policymakers, media professionals, the general public, and other interested parties seeking extensive national data about heart disease and stroke.  Volunteer researchers from various Brazilian universities and research institutions carry out the project. The group is led by a five-member steering committee (ALPR, CAP, DCM, GMMO, and LCCB). The Brazilian Society of Cardiology fully supports this initiative, and the project receives collaborative support from the GBD Brazil Network and an International Committee (GAR, PP, and TAG) from both the IHME/University of Washington (GAR) and the World Heart Federation (PP and TAG). 

A publicação Estatística Cardiovascular – Brasil tem por objetivo fornecer uma compilação anual dos dados e das pesquisas sobre a epidemiologia das DCV no Brasil.  Este documento integra as estatísticas oficiais do Ministério da Saúde do Brasil e outras entidades governamentais ao lado de dados do projeto GBD, coordenado pelo IHME da Universidade de Washington. Além disso, incorpora dados derivados de várias fontes e estudos científicos, inclusive coortes e registros, relacionados às DCV e fatores de risco associados. Esta publicação destina-se a um público variado, incluindo pesquisadores, clínicos, pacientes, formuladores de políticas de saúde, profissionais da mídia, o público em geral e todos aqueles que buscam dados nacionais abrangentes sobre DCV e acidente vascular cerebral. Pesquisadores voluntários de várias universidades e instituições de pesquisa brasileiros realizaram este projeto. O grupo é liderado por um comitê diretivo com cinco membros (ALPR, CAP, DCM, GMMO e LCCB). A Sociedade Brasileira de Cardiologia apoia integralmente esta iniciativa e o projeto recebe colaboração da Rede GBD Brasil1 e do GBD International Committee (GAR, PP e TAG) do IHME/Universidade de Washington (GAR) e da World Heart Federation (PP e TAG). 

https://doi.org/10.1590/SciELOPreprints.7707

Fruit production and quality of ‘Paluma’ guava with nematode-tolerant rootstock irrigated in the semi-arid region
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Simões, Welson L.

; Andrade, Victor P. M. de

; Silva, Jucicléia S. da

; Santos, Carlos A. F.

; Sousa, José S. C. de

; Calgaro, Marcelo

; Barbosa, Kaio V. F.

; Nascimento, Bruno R. do

Revista Brasileira de Engenharia Agrícola e Ambiental

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may 2023, Volume 27 N. 5 Pages 400 - 406

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Using nematode-resistant and/or -tolerant rootstock is a strategy that has maintained guava cultivation feasible in the irrigated perimeters of the Brazilian semi-arid region. The objective was to evaluate the production, gas exchange, and fruit quality of ‘Paluma’ guava with and without nematode-tolerant rootstock under different irrigation depths and production periods. The experimental design was randomized blocks, in the mixed 2 × 4 × 2 factorial scheme, corresponding to two forms of cultivation of ‘Paluma’ guava (without and with nematode-tolerant rootstock), four irrigation depths (60, 80, 100, and 120% of crop evapotranspiration - ETc), and two production periods, with four replicates. Guava plants were evaluated for physiological, production and post-harvest quality parameters. Gas exchange in ‘Paluma’ guava leaves was higher in the second production cycle, under irrigation depths above 100% ETc, not differing with the use of the rootstock. The use of the rootstock ‘BRS Guaraçá’ promotes a greater number of fruits and production with the increase of the irrigation depth, mainly in the second half of the year, with the increase of soluble solids and titratable acidity in the fruits.

RESUMO A utilização de porta enxerto resistente e ou tolerante a nematoides é uma estratégia que tem tornado viável a manutenção dos cultivos de goiabeira nos perímetros irrigados do semiárido brasileiro. Assim, o objetivo foi avaliar a produção, trocas gasosas e qualidade dos frutos da goiabeira ‘Paluma’ com e sem o porta enxerto tolerante a nematoide sob diferentes lâminas de irrigação e épocas de produção no Semiárido Brasileiro. O delineamento experimental foi em blocos ao acaso, no esquema fatorial misto 2 × 4 × 2, sendo duas formas de cultivo da goiabeira ‘Paluma’ (sem e com o porta enxerto tolerante a nematoide), quatro lâminas de irrigação (60, 80, 100 e 120% da evapotranspiração da cultura - ETc) e duas épocas de produção, com quatro repetições. Foram realizadas avaliações fisiológicas das plantas, produção e qualidade pós-colheita. As trocas gasosas nas folhas da goiabeira ‘Paluma’ foram maiores no segundo ciclo de produção, quando irrigada com lâminas de irrigação acima de 100% da ETc, não diferindo com o uso do porta enxerto. O uso do porta-enxerto ‘BRS Guaraçá’ proporciona um maior número de frutos e produção com o aumento da lâmina de irrigação, principalmente no segundo semestre do ano, bem como o aumento do teor de sólidos solúveis e acidez nos frutos.

https://doi.org/10.1590/1807-1929/agriambi.v27n5p400-406

Calculation of the Minimal Important Clinical Difference of the Lysholm and IKDC Scores After Anterior Cruciate Ligament Reconstruction
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Nascimento, Bruno Fajardo do

; Lima, Mariana Bandeira da Rocha

; Dias Júnior, Jair Moreira

; Antunes Filho, Jurandir

; Campos, Túlio Vinícius de Oliveira

; Mendes Júnior, Adriano Fernando

Revista Brasileira de Ortopedia

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feb 2023, Volume 58 N. 1 Pages 79 - 84

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Objective To calculate the minimal important clinical difference (MICD) value for the Lysholm and International Knee Documentation Committee (IKDC) scores in a sample of patients submitted to anterior cruciate ligament reconstruction. Methods Primary, observational, retrospective, analytical study of participants submitted to anterior cruciate ligament reconstruction from March 2019 to December 2020 by the same surgeon, with a minimum follow-up of 6 months, analysis of knee function in the pre- and postoperative period by the Lysholm and IKDC scores, and answer to an anchor question at 6 months postoperatively for the calculation of the MICD of each score. Results A total of 59 patients participated in the study, with a mean age of 27.1 ± 5.7 years old. In the comparison between pre- and postoperative scores of all groups, there was an increase in values with statistical significance after intervention. The MICD was 5.5 for the Lysholm score, and the MICD value for the IKDC score could not be determined. Conclusion For the Lysholm score, the calculation of the MICD value by the anchor question method in the sample evaluated was 5.5. It was not possible to determine the value of the MICD for the IKDC score.

Resumo Objetivo Calcular o valor da mínima diferença clinicamente importante (MDCI) para os escores de Lysholm e International Knee Documentation Commitee (IKDC) na amostra de pacientes submetidos a reconstrução de ligamento cruzado anterior. Métodos Estudo primário, observacional, retrospectivo, analítico, de participantes submetidos a reconstrução do ligamento cruzado anterior no período de março de 2019 a dezembro de 2020, pelo mesmo cirurgião, com seguimento mínimo de 6 meses, análise da função do joelho no período pré e pós-operatório pelos escores de Lysholm e IKDC, e resposta a uma pergunta âncora aos 6 meses de seguimento pós-operatório, para o MDCI de cada escore. Resultados Participaram do estudo 59 pacientes, com média de idade de 27,1 ± 5,7 anos. Na comparação dos escores pré- e pós-operatórios de todos os grupos, observa-se aumento dos valores com significância estatística após a intervenção. A MDCI foi de 5,5 para o escore de Lysholm, não tendo sido possível determinar o valor para o IKDC. Conclusão O cálculo do valor da MDCI pelo método da pergunta âncora, na amostra avaliada, foi de 5,5 para o escore de Lysholm. Não foi possível determinar o valor da MDCI para o IKDC.

https://doi.org/10.1055/s-0042-1756330

VEGETATIVE RESCUE AND PROPAGATION OF NATIVE Ilex paraguariensis POPULATIONS IN SANTA CATARINA STATE, BRAZIL
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Nascimento, Bruno

; Sá, Alexandra Cristina Schatz

; Corrêa, Bruno Jan Schramm

; Schilisting, Thalia

; Pereira, Mariane de Oliveira

; Navroski, Marcio Carlos

; Mantovani, Adelar

Revista Árvore

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2023, Volume 47 elocation e4710

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT When producing Ilex paraguariensis seedlings through vegetative propagation, selecting the correct populations and genotypes, and obtaining juvenile material, may be fundamental for its success. Therefore, this search aimed to test its vegetative propagation through cutting and rescue using detached branches of different populations in Santa Catarina state, Brazil. Thus, two experiments were installed in September 2019 in order to test: I) the cuttings of four populations belonging to the municipalities of Catanduvas (CT), Painel (PL), Três Barras (TB), and Urupema (UR), using ten randomly chosen genotypes from each, and; II) the epicormic sprouting of detached branches from these same populations. Both experiments were carried out in Lages, Santa Catarina. In February 2020, the cutting was evaluated according to the percentages of survival, callus, rooting, new sprouts, and original leaves permanence. The branches were evaluated every 30 days after storing, observing the percentages of sprouting branches, number of sprouts, and length of sprouts in centimeters. As for cutting, there was a low survival percentage in all populations (<15%), but some genotypes presented greater vigor, such as TB1 (46%), TB7, and TB3 (both 28%). Most live cuttings presented calluses (>70%), characteristic of material of high maturity. Rooting was low for populations (<1.5%) and genotypes (<10%). Branches presented sprouts up to 60 days, with TB presenting the highest total number of sprouts (approximately 300) and the greatest average length (2.8 cm). In general, survival and rooting of cuttings were affected by both populations and genotypes, highlighting TB. A similar response was observed for the branches’ sprouting. New studies with more populations, further analyses of the branches’ characteristics, and better storage conditions are recommended.

RESUMO Quando produzidas mudas de Ilex paraguariensis através da propagação vegetativa, a seleção correta das populações, genótipos, e ser capaz de obter material juvenil, são fundamentais para seu sucesso. Assim, o objetivo desta pesquisa foi testar sua propagação vegetativa por estaquia e resgate utilizando galhos destacados de diferentes populações do estado de Santa Catarina, Brasil. Desta forma, dois experimentos foram instalados em setembro de 2019 para testar: I) a estaquia de quatro populações, pertencentes aos municípios de Catanduvas (CT), Painel (PL), Três Barras (TB) e Urupema (UR), utilizando dez genótipos escolhidos aleatoriamente de cada, e; II) a brotação epicórmica de galhos destacados destas mesmas populações. Ambos os experimentos foram conduzidos em Lages, Santa Catarina. Em fevereiro de 2020, a estaquia foi avaliada de acordo com as porcentagens de: sobrevivência, calos, enraizamento, novas brotações e permanência das folhas originais. Os galhos foram avaliados a cada 30 dias após seu acondicionamento observando as porcentagens de galhos com brotações, número de brotações e comprimento em centímetros. Para a estaquia, houve baixa sobrevivência em todas as populações (<15%), mas com maior vigor em alguns genótipos, tais como TB1 (46%), TB7 e TB3 (ambos 28%). A maior parte das estacas vivas apresentou calo, característico de material de elevada maturidade. O enraizamento foi baixo nos níveis de população (<1,5%) e genótipo (<10%). Os galhos apresentaram brotações até 60 dias, com TB apresentando o maior número total de brotações (aproximadamente 300) e de maior comprimento médio (2,8 cm). Em termos gerais, a sobrevivência e o enraizamento de estacas foram afetados por ambos população e genótipo, destacando-se TB. Uma resposta similar foi observada para a brotação de galhos. Novos estudos contendo mais populações, análises mais aprofundadas das características dos galhos e melhores condições de acondicionamento são recomendadas..

https://doi.org/10.1590/1806-908820230000010

Diretrizes, Posicionamentos e Normatizações: Documentos de Auxílio à Prática Médica
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Sousa, Antônio Carlos Sobral

; Corrêa Filho, Harry

; Nascimento, Bruno

; Issa, Aurora Castro

; Vieira, Marcelo Luiz Campos

; Markman Filho, Brivaldo

Arquivos Brasileiros de Cardiologia

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sep 2022, Volume 119 N. 3 Pages 496 - 498

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20220001

Carga de Doenças Cardiovasculares Atribuível aos Fatores de Risco nos Países de Língua Portuguesa: Dados do Estudo “Global Burden of Disease 2019”
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Nascimento, Bruno Ramos

; Brant, Luisa Campos Caldeira

; Naback, André Dias Nassar

; Veloso, Guilherme Augusto

; Polanczyk, Carisi Anne

; Ribeiro, Antonio Luiz Pinho

; Malta, Deborah Carvalho

; Ferreira, Albano Vicente Lopes

; Oliveira, Gláucia Maria Moraes de

Arquivos Brasileiros de Cardiologia

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jun 2022, Volume 118 N. 6 Pages 1028 - 1048

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: O impacto dos fatores de risco (FR) sobre a morbimortalidade por doença cardiovascular (DCV) na maioria dos países de língua portuguesa (PLP) é pouco conhecido. Objetivo: Analisar a morbimortalidade por DCV atribuível aos FR e sua variação nos PLP de 1990 a 2019, a partir de estimativas do estudo Global Burden of Disease (GBD) 2019. Métodos: Avaliamos as mudanças nos FR ocorridas no período, as taxas de mortalidade e os anos de vida perdidos por incapacidade (DALYs), padronizados por idade, entre 1990 e 2019. Realizou-se a correlação entre a variação percentual das taxas de mortalidade e o índice sociodemográfico (SDI) de cada PLP pelo método de Spearman. O valor p<0,05 foi considerado estatisticamente significativo. Resultados: A pressão arterial sistólica (PAS) elevada foi o principal fator de risco para mortalidade e DALY por DCV para todos os PLP. A mortalidade por DCV mostrou uma tendência de redução em 2019, maior em Portugal (-66,6%, IC95% -71,0 - -61,2) e no Brasil (-49,8%, IC95% -52,5 - -47,1). Observou-se tendência à correlação inversa entre SDI e a variação percentual da mortalidade, que foi significativa para os riscos dietéticos (r=-0,70, p=0,036), colesterol LDL elevado (r=-0,77, p=0,015) e PAS elevada (r=-0,74, p=0,023). Conclusões: Além da PAS, os FR dietéticos e metabólicos justificaram uma maior variação da carga de DCV, correlacionada com o SDI nos PLP, sugerindo a necessidade de adoção de políticas de saúde adaptadas à realidade de cada país, visando a redução de seu impacto sobre a população.

Abstract Background: The impact of risk factors (RF) on morbidity and mortality from cardiovascular disease (CVD) for most Portuguese-speaking countries (PSC) is little known. Objectives: We aimed to analyze the morbidity and mortality from CVD attributable to RF and its variation, from 1990 to 2019, in PSC, based on estimates from the Global Burden of Disease (GBD) 2019 study. Methods: We evaluated changes in cardiovascular RF, mortality rates and age-standardized disability-adjusted life years (DALYs) between 1990 and 2019. The correlation between percentage changes in mortality rates and the sociodemographic index (SDI) of each PSC was evaluated by the Spearman method. A p-value <0.05 was considered statistically significant. Results: Elevated systolic blood pressure (SBP) was the main RF for mortality and DALYs for CVD for all PSC. Mortality from CVD showed a downward trend in 2019, more accentuated in Portugal (-66.6%, 95%CI -71.0 - -61.2) and in Brazil (-49.8%, 95%CI -52.5 - -47.1). There was a trend towards an inverse correlation between SDI and the percent change in mortality, which was significant for dietary risks (r=-0.70, p=0.036), high LDL cholesterol (r=-0.77, p=0.015) and high SBP (r=-0.74, p=0.023). Conclusions: In addition to SBP, dietary and metabolic RF justified a greater variation in the burden of CVD correlated with SDI in the PSC, suggesting the need to adopt health policies adapted to the reality of each country, aiming to reduce their impact on population.

https://doi.org/10.36660/abc.20210680

Text Messages to Promote Secondary Prevention after Acute Coronary Syndrome (IMPACS trial)
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Passaglia, Luiz Guilherme

; Brant, Luisa Campos Caldeira

; Silva, José Luiz Padilha da

; Nascimento, Bruno Ramos

; Ribeiro, Antônio Luiz Pinho

International Journal of Cardiovascular Sciences

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mar 2022, Volume 35 N. 2 Pages 202 - 213

Abstract: En | Text: En | PDF: En

Abstract Background Short message service (SMS) to promote healthcare improves the control of cardiovascular risk factors, but there is a lack of evidence in low and middle-income countries, particularly after acute coronary syndromes (ACS). Objective This study aims to evaluate whether the use of SMS increases risk factor control after hospital discharge for ACS. Methods IMPACS is a 2-arm randomized trial with 180 patients hospitalized due to ACS at a tertiary hospital in Brazil. Eligible patients were randomized (1:1) to an SMS intervention (G1) or standard care (G2) upon hospital discharge. The primary endpoint was set to achieve 4 or 5 points in a risk factor control score, consisting of a cluster of 5 modifiable risk factors: LDL-C <70mg/dL, blood pressure (BP) <140/90mmHg, regular exercise (≥5 days/week, 30 minutes/session), nonsmoker status, and body mass index (BMI) <25 kg/m2] at 6 months. Secondary outcomes were components of the primary outcome plus rehospitalization, cardiovascular death, and death from any cause. Results are designated as significant if p<0.05. Results From randomized patients, 147 were included in the final analysis. Mean age was 58 (51–64) years, 74% males. The primary outcome was achieved by 12 (16.2%) patients in G1 and 15 (20.8%) in G2 (OR=0.73, 95%CI 0.32–1.70, p=0.47). Secondary outcomes were also similar: LDL-C<70 mg/dl (p=0.33), BP<140/90 mmHg (p=0.32), non-smoker (p=0.74), regular exercise (p=0.97), BMI (p=0.71), and rehospitalization (p=0.06). Death from any cause occurred in three participants (2%), including one cardiovascular death in each group. Conclusion SMS intervention did not significantly improve cardiovascular risk factor control when compared to standard care in patients discharged after ACS in Brazil.

https://doi.org/10.36660/ijcs.20200378

Estatística Cardiovascular – Brasil 2021
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Oliveira, Gláucia Maria Moraes de

; Brant, Luisa Campos Caldeira

; Polanczyk, Carisi Anne

; Malta, Deborah Carvalho

; Biolo, Andreia

; Nascimento, Bruno Ramos

; Souza, Maria de Fatima Marinho de

; Lorenzo, Andrea Rocha De

; Fagundes Júnior, Antonio Aurélio de Paiva

; Schaan, Beatriz D.

; Castilho, Fábio Morato de

; Cesena, Fernando Henpin Yue

; Soares, Gabriel Porto

; Xavier Junior, Gesner Francisco

; Barreto Filho, Jose Augusto Soares

; Passaglia, Luiz Guilherme

; Pinto Filho, Marcelo Martins

; Machline-Carrion, M. Julia

; Bittencourt, Marcio Sommer

; Pontes Neto, Octavio M.

; Villela, Paolo Blanco

; Teixeira, Renato Azeredo

; Sampaio, Roney Orismar

; Gaziano, Thomaz A.

; Perel, Pablo

; Roth, Gregory A.

; Ribeiro, Antonio Luiz Pinho

Arquivos Brasileiros de Cardiologia

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jan 2022, Volume 118 N. 1 Pages 115 - 373

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20211012

Burden of Cardiovascular diseases attributable to risk factors in Brazil: data from the "Global Burden of Disease 2019" study
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Brant, Luisa Campos Caldeira

; Nascimento, Bruno Ramos

; Veloso, Guilherme Augusto

; Gomes, Crizian Saar

; Polanczyk, Carisi

; Oliveira, Gláucia Maria Moraes de

; Flor, Luisa Sorio

; Gakidou, Emmanuela

; Ribeiro, Antonio Luiz Pinho

; Malta, Deborah Carvalho

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Suppl. 1 elocation e0263-2021

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: To better understand trends in the main cause of death in Brazil, we sought to analyze the burden of cardiovascular risk factors (RF) and cardiovascular diseases (CVD) attributable to specific RFs in Brazil from 1990 to 2019, using the estimates from the GBD 2019 study. METHODS: To estimate RF exposure, the Summary Exposure Value (SEV) was used, whereas for disease burden attributed to RF, mortality and disability-adjusted life-years (DALY) due to CVD were used. For comparisons over time and between states, we compared age-standardized rates. The sociodemographic index (SDI) was used as a marker of socioeconomic conditions. RESULTS: In 2019, 83% of CVD mortality in Brazil was attributable to RF. For SEV, there was a reduction in smoking and environmental RF, but an increase in metabolic RF. High systolic blood pressure and dietary risks continue to be the main RF for CVD mortality and DALY. While there was a decline in age-standardized mortality rates attributable to the evaluated RF, there was also a stability or increase in crude mortality rates, with the exception of smoking. It is important to highlight the increase in the risk of death attributable to a high body mass index. Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs. CONCLUSIONS: Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies.

https://doi.org/10.1590/0037-8682-0263-2021

10.

Impact of the COVID-19 pandemic on hospital admissions for cardiovascular diseases in a large Brazilian urban center
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Ribeiro, Edmar Geraldo

; Pinheiro, Pedro Cisalpino

; Nascimento, Bruno Ramos

; Cacique, João Pedro Pereira

; Teixeira, Renato Azeredo

; Nascimento, Jamil de Souza

; Franco, Tulio Batista

; Brant, Luisa Campos Caldeira

; Malta, Deborah Carvalho

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Suppl. 1 elocation e0264-2021

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: The COVID-19 pandemic has had a great impact on the behavior of individuals and the organization of health systems. This study analyzed the COVID-19 pandemic’s effect on public hospitalizations for cardiovascular diseases (CVD) in a large city in Brazil, Belo Horizonte, MG, with approximately 2.5 million inhabitants. METHODS: In a time-series analysis, this study used administrative data from the national “Hospital Information System” from 2010 to February 2020 to estimate the expected number of hospitalizations for CVD by month during the COVID-19 pandemic in Belo Horizonte in 2020 using the Auto-Regressive Integrated Moving Average model. For CVD, this study compared the expected number of hospital admissions, intensive care use, deaths during hospitalization, and mean length of stay with the observed number during the period. RESULTS: There were 6,517 hospitalizations for CVD from March to December 2020, a decrease of 16.3% (95% CI: 4.7-25.3) compared to the projected. The number of intensive care hospitalizations for CVD fell 24.1% (95% CI 13-32.7). The number of deaths also decreased (17.4% [80% CI: 0 - 0.30]), along with the reduction in hospitalizations, as did the length of stay for CVD hospitalizations. These reductions, however, were not significant. CONCLUSIONS: Hospitalizations for CVD were 16.3% lower than expected in a large Brazilian city, possibly due to the fear of getting infected or going to hospitals. Public campaigns informing how to proceed in case of CVD show that prompt urgent attention is essential to mitigate the indirect effects of the pandemic on CVD.

https://doi.org/10.1590/0037-8682-0264-2021

11.

REVERSE SURAL FLAP FOR LOWER LIMB RECONSTRUCTION
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CLIVATTI, GUSTAVO MOREIRA

; NASCIMENTO, BRUNO BAPTISTA DO

; RIBEIRO, RENAN DIEGO AMÉRICO

; MILCHESKI, DIMAS ANDRÉ

; AYRES, ARALDO MONTEIRO

; GEMPERLI, ROLF

Acta Ortopédica Brasileira

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2022, Volume 30 N. 4 elocation e248774

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: Reconstrução de lesões distais de extremidades inferiores podem ser desafiadoras devido à limitação de tecido para retalhos locais. Retalhos fasciocutâneos e musculares são opções, como o retalho fasciocutâneo sural reverso. Objetivo: Apresentar a experiência de 18 meses do Grupo de Feridas Complexas do Serviço de Cirurgia Plástica da Faculdade de Medicina da Universidade de São Paulo no uso do retalho sural reverso para reconstruções de defeitos em tornozelo, calcâneo e pé. Métodos: Estudo observacional, retrospectivo e descritivo, com dados de prontuário de todos os casos operados no serviço entre novembro de 2018 e junho de 2020. Resultados: Foram realizados nove retalhos fasciocutâneos sural reverso. Todos os pacientes eram do sexo masculino, com idade média de 38 anos. Cinco foram vítimas de acidente automobilístico, um de trauma elétrico e três apresentavam sequelas pós-traumáticas. Seis lesões localizadas em tornozelo, dois em pé e um em calcâneo. Quatro pacientes apresentaram complicações, sendo três necroses parciais e uma epiteliólise distal. Não houve perda total de retalho. O tempo médio de hospitalização foi de 30,1 dias. Conclusão: O retalho fasciocutâneo sural reverso mostrou-se uma opção viável, reprodutível e segura para reconstrução de lesões complexas em terço distal de perna e pé. Nível de Evidência IV, Série de Casos.

ABSTRACT Introduction: Reconstruction of distal wounds in lower extremities can be challenging due to the lack of tissue to perform local flaps. Fasciocutaneous and muscular flaps are some options for coverage, such as the reverse-flow fasciocutaneous sural flap. Objective: To present an 18-month experience on ankle, calcaneus, and foot reconstruction using the reverse-flow sural flap, performed by the Complex Wounds Group of the Plastic Surgery Department of the University of São Paulo Medical School. Methods: An observational, retrospective and descriptive study was performed through data survey on medical records of all patients treated between November 2018 and June 2020. Results: Nine reverse-flow fasciocutaneous sural flaps were performed. All patients were men. The mean age was 38 years old. Five patients had acute wounds for traffic collision, one electrical trauma and three chronic post-traumatic injuries. The ankle was the most common injury site (6), followed by foot (2) and calcaneus (1). Four patients had complications, three of which were partial necrosis and one distal epitheliosis. No case of total necrosis was recorded. The average hospital stay was 30.1 days. Conclusion: The reverse-flow fasciocutaneous sural flap proved to be a viable, reproducible, and reliable option for distal lower limb reconstruction. Level of Evidence IV, Case Series.

https://doi.org/10.1590/1413-785220223004e248774

12.

Response Letter: Are atypical lymphocytes a new predictive factor in the development of coronavirus disease 2019?
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Nascimento, Bruno Ramos

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0309-2022

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0037-8682-0309-2022

13.

Avaliação do Impacto da Implantação de um Sistema de Ambulância Pré-Hospitalar sobre Mortalidade por Infarto Agudo do Miocárdio em um País em Desenvolvimento
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Vieira, Rodrigo Costa Pereira

; Marcolino, Milena Soriano

; Silva, Luis Gustavo Silva e

; Pereira, Daniella Nunes

; Nascimento, Bruno Ramos

; Jorge, Alzira de Oliveira

; Ribeiro, Antonio Luiz P

Arquivos Brasileiros de Cardiologia

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2022, N. ahead

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento O manejo efetivo de pacientes com infarto agudo do miocárdio (IAM) é tempo-dependente. Objetivos Avaliar os impactos da implantação do atendimento pré-hospitalar nas taxas de internação e de mortalidade associadas ao IAM. Métodos Estudo retrospectivo e ecológico, que avaliou dados do Sistema Único de Saúde, de todos os 853 municípios de Minas Gerais, de 2008 a 2016. A assimetria excessiva da mortalidade geral e intra-hospitalar por IAM foi suavizada usando o método empírico de Bayes. Este estudo avaliou a relação entre o do Serviço de Atendimento Médico de Urgência (SAMU) em cada município e os seguintes 3 desfechos: taxa de mortalidade geral por IAM, taxa de mortalidade intra-hospitalar por IAM e taxa de internação por IAM, utilizando o modelo hierárquico de Poisson. As taxas foram corrigidas pela estrutura etária e destendenciadas pela sazonalidade e influências temporais. Foi adotado um intervalo de confiança de 95%. Resultados As taxas de mortalidade por IAM diminuíram ao longo do estudo, em média 2% por ano, com variação sazonal. A mortalidade intra-hospitalar também apresentou tendência de queda, de 13,81% em 2008 para 11,43% em 2016. A implantação do SAMU foi associada à diminuição da mortalidade por IAM ( odds ratio [OR] = 0,967, IC 95% 0,936 a 0,998) e mortalidade intra-hospitalar por IAM (OR = 0,914, IC 95% 0,845 a 0,986), sem associação significativa com internações (OR 1,003, IC 95% 0,927 a 1,083). Conclusão A implantação do SAMU esteve associada a uma redução modesta, mas significativa, na mortalidade intra-hospitalar. Esse achado reforça o papel fundamental do cuidado pré-hospitalar no cuidado do IAM e a necessidade de investimentos nesse serviço para melhorar os desfechos clínicos em países de baixa e média renda.

Abstract Background The effective management of patients with acute myocardial infarction (AMI) is time-dependent. Objectives To assess the impacts of the implementation of prehospital care on admission rates and mortality associated with AMI. Methods Retrospective, ecological study, which assessed data from the Brazilian Universal Health System, from all 853 municipalities of Minas Gerais, from 2008 to 2016. Excessive skewness of general and in-hospital mortality rates was smoothed using the empirical Bayes method. This study assessed the relationship between Mobile Emergency Care Service (SAMU) in each municipality and the following 3 outcomes: mortality rate due to AMI, AMI in-hospital mortality, and AMI hospitalization rate, using the Poisson hierarchical model. Rates were corrected by age structure and detrended by seasonality and temporal influences. A confidence interval of 95% was adopted. Results AMI mortality rates decreased throughout the study, on average 2% per year, with seasonal variation. AMI in-hospital mortality also showed a decreasing trend, from 13.81% in 2008 to 11.43% in 2016. SAMU implementation was associated with decreased AMI mortality (odds ratio [OR] = 0.967, 95% confidence interval [CI] 0.936 to 0.998) and AMI in-hospital mortality (OR = 0.914, 95% CI 0.845 to 0.986), with no relation with hospitalizations (OR = 1.003, 95% CI 0.927 to 1.083). Conclusion SAMU implementation was associated with a modest but significant decrease in AMI in-hospital mortality. This finding reinforces the key role of prehospital care in AMI care and the need for investments on this service to improve clinical outcomes in low- and middle-income countries.

https://doi.org/10.36660/abc.20210953

14.

Sucessos e Desafios no Enfrentamento das Doenças Cardiovasculares no Brasil: Viver Mais e Melhor
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Galdino, Bruno Fernandes

; Peixoto, David Costa

; Alves, Ana Carolina

; Nascimento, Bruno Ramos

; Brant, Luisa Campos Caldeira

Arquivos Brasileiros de Cardiologia

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aug 2021, Volume 117 N. 2 Pages 341 - 342

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210589 64 downloads

15.

Regressão do Supradesnivelamento do Segmento ST como Preditor de Reperfusão no Infarto Agudo do Miocárdio: Uma Incógnita Persistente
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Macedo, Frederico V. B.

; Ferreira Filho, Domingos Sávio G.

; Nogueira, Marcelo Augusto A.

; Silva, Victor Raggazzi H. da

; Nascimento, Bruno R.

Arquivos Brasileiros de Cardiologia

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jul 2021, Volume 117 N. 1 Pages 26 - 27

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210426 97 downloads

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