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1.
Therapeutic Adherence According to the Morisky Scale in Patients with Hypertension
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Lanza, Vinícius Encenha
; Silva, Gabriel Oliveira
; Quiroga, Celi Cristina Calamita
; Cavalcante, Margaret Assad
; Barroso, Weimar Kunz Sebba
; Brandão, Andréa Araujo
; Barbosa, Eduardo Costa Duarte
; Malachias, Marcus Vinicius Bolivar
; Gomes, Marco Mota
; Amodeo, Celso
; Povoa, Rui Manoel dos Santos
; Précoma, Dalton Bertolim
; Sousa, Antônio Carlos Sobral
; Dantas, João Miguel Malta
; Cesarino, Evandro José
; Barros e Silva, Pedro G. M. de
; Veiga Jardim, Paulo Cesar B.
; Lopes, Renato D.
.
International Journal of Cardiovascular Sciences
- Journal Metrics
Abstract Background In view of the high prevalence of hypertension and the importance of adequate drug therapy in the prevention of complications, it is necessary to know the adherence to drug treatment in this population. Objective To verify adherence to antihypertensive drug treatment in Brazilian patients with hypertension using the Morisky-Green Test (MGT), relating it with demographic data. Methods Prospective, observational, multicenter, national registry study, with 2,578 hypertensive patients participating in study I, the Brazilian Cardiovascular Registry of Arterial Hypertension (I-RBH), recruited in the five regions of Brazil. The analyses carried out on the data were descriptive statistics, qui-square tests, ANOVA, and logistic regression, adopting 5% as the significance level for the tests. Results The research shows that 56.13% of patients in the sample were female; 56.71% were elderly (≥ 65 years); 55.86% were White; 52.37% were from the Southeast Region; and 59.74% were non-adherent. Logistic regression showed an independent relationship between patients’ age, ethnicity, and region with medication adherence. Conclusion Adherence to treatment is the key to reducing high rates of cardiovascular complications. The study brings a successful outcome in the relationship between the factors ethnicity, age, and region of patients with hypertension and medication adherence. To this end, it is necessary to understand these factors, considering systematic evaluation in the care of patients with hypertension and other chronic non-communicable diseases. This study is a significant contribution to multidisciplinary teams, as it highlights which risk factors interfere with medication adherence, incorporating better strategies in health education. complications population MoriskyGreen Morisky Green MGT, MGT , (MGT) Prospective observational multicenter 2578 2 578 2,57 I IRBH, IRBH RBH (I-RBH) Brazil statistics quisquare qui square tests ANOVA 5 5613 56 13 56.13 female 5671 71 56.71 ≥ ( 6 years years) 5586 55 86 55.86 White 5237 52 37 52.37 Region 5974 59 74 59.74 nonadherent. nonadherent non adherent. adherent non-adherent age ethnicity end noncommunicable communicable diseases teams education (MGT 257 57 2,5 (I-RBH 561 1 56.1 567 7 56.7 558 8 55.8 523 3 52.3 597 59.7 25 2, 56. 55. 52. 59.
2.
Multidisciplinary Scientific Cruises for Environmental Characterization in the Santos Basin – Methods and Sampling Design
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Moreira, Daniel L.
; Dalto, Adriana G.
; Figueiredo JR, Alberto G.
; Valerio, Aline M.
; Detoni, Amalia M. S.
; Bonecker, Ana C. T.
; Signori, Camila N.
; Namiki, Cláudia
; Sasaki, Dalton K.
; Pupo, Daniel V.
; Silva, Danilo A.
; Kutner, Deborah S.
; Duque-Castaño, Diana C.
; Marcon, Eduardo H.
; Gallotta, Fabiana D. C.
; Paula, Fabiana S.
; Gallucci, Fabiane
; Roque, Gabriela C. F.
; Campos, Giulia S.
; Fonseca, Gustavo
; Mattos, Gustavo
; Lavrado, Helena P.
; Silveira, Ilson C. A. da
; Costa, Jessica O.
; Santos Filho, João R. dos
; Carneiro, Juliane C.
; Moreira, Julio C.F.
; Rozo, Laura
; Araujo, Leandro F.M.
; Lazzari, Letícia
; Silva, Letícia O. da
; Michelazzo, Luan S.
; Fernandes, Luciano F.
; Dottori, Marcelo
; Araújo Jr., Marcus A. G. de
; Chuqui, Mateus G.
; Ceccopieri, Milena
; Borges-Silva, Milton
; Kampel, Milton
; Bergo, Natascha M.
; Silva, Paulo V. M.
; Tura, Pedro M.
; Moura, Rafael B. de
; Romano, Renato G.
; Martins, Renato P.
; Carreira, Renato S.
; Toledo, Rodrigo G.A.
; Bonecker, Sérgio L.C.
; Disaró, Sibelle T.
; Rodrigues, Silvana V.
; Corbisier, Thais N.
; Vicente, Thaisa M.
; Paiva, Vitor G. de
; Pellizari, Vivian H.
; Belo, Wellington C.
; Brandini, Frederico P.
; Sousa, Silvia H.M
.
Abstract The Santos Basin (SB) is the main petroliferous basin in the Brazilian continental margin and one of the most studied marine areas in Brazil. However, historical data suggest that new efforts should be carried out to acquire quantitative biological data, especially in the deep sea, to establish the baseline of essential ocean variables in different ecosystems for future monitoring programs. The Brazilian energy company Petrobras planned and executed 24 oceanographic cruises over a period of 2 years to assess the benthic (SANSED cruise) and pelagic (SANAGU cruise) systems of the SB (356 days at sea in 2019 and 2021/2022). These efforts were part of the Santos Project, which comprised a comprehensive environmental study aimed at investigating benthic and pelagic variables to characterize ecology, biogeochemistry, thermohaline properties of water masses, and ocean circulation patterns, geomorphology, and sedimentology, as well as organic and inorganic chemistry. Here we present the detailed sampling designs and the field methods employed on board, during the SB scientific cruises. All sampling protocols were based on standardized approaches. For the benthos analyses, triplicate sediment samples were performed using a GOMEX-type box corer (0.25 m²) or a large modified Van Veen grab (0.75 m²) at 100 stations ranging from 25 to 2400 m depth. At each station, 25 geochemical and physico-chemical parameters were analyzed in addition to micro-, meio-, and macrofauna and living foraminifera samples. For the pelagic system, 60 stations were selected to investigate the plankton community, ranging in size from pico- to macroplankton, through vertical, horizontal, and oblique net hauls (20, 200, and 500 μm mesh size), as well as 25 biogeochemical parameters collected with an aid of a CTD-rosette sampler. Part of this scientific information also serves the Regional Environmental Characterization Project (PCR-BS) in support of Petrobras’ Santos Basin drilling licensing process led by the Brazilian Environmental Agency – IBAMA. This project contributes to the sustainable development of the SB, in line with the guidelines of the United Nations Decade of Ocean Science for Sustainable Development. (SB Brazil However programs SANSED cruise SANAGU 356 (35 201 2021/2022. 20212022 2021/2022 . 2021 2022 2021/2022) ecology biogeochemistry masses patterns geomorphology sedimentology chemistry board approaches analyses GOMEXtype GOMEX type 0.25 025 0 (0.2 m² 0.75 075 75 (0.7 10 240 depth station physicochemical physico chemical micro, micro , micro- meio, meio meio- system 6 community pico macroplankton vertical horizontal 20, 20 (20 200 50 size, size) CTDrosette CTD rosette sampler PCRBS PCR BS (PCR-BS IBAMA Development 35 (3 2021202 2021/202 202 0.2 02 (0. 0.7 07 7 1 (2 5 3 ( 202120 2021/20 0. (0 20212 2021/2 2021/
3.
Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023 202 20 2
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Marin-Neto, José Antonio
; Rassi Jr, Anis
; Oliveira, Gláucia Maria Moraes
; Correia, Luís Claudio Lemos
; Ramos Júnior, Alberto Novaes
; Luquetti, Alejandro Ostermayer
; Hasslocher-Moreno, Alejandro Marcel
; Sousa, Andréa Silvestre de
; Paola, Angelo Amato Vincenzo de
; Sousa, Antônio Carlos Sobral
; Ribeiro, Antonio Luiz Pinho
; Correia Filho, Dalmo
; Souza, Dilma do Socorro Moraes de
; Cunha-Neto, Edecio
; Ramires, Felix Jose Alvarez
; Bacal, Fernando
; Nunes, Maria do Carmo Pereira
; Martinelli Filho, Martino
; Scanavacca, Maurício Ibrahim
; Saraiva, Roberto Magalhães
; Oliveira Júnior, Wilson Alves de
; Lorga-Filho, Adalberto Menezes
; Guimarães, Adriana de Jesus Benevides de Almeida
; Braga, Adriana Lopes Latado
; Oliveira, Adriana Sarmento de
; Sarabanda, Alvaro Valentim Lima
; Pinto, Ana Yecê das Neves
; Carmo, Andre Assis Lopes do
; Schmidt, Andre
; Costa, Andréa Rodrigues da
; Ianni, Barbara Maria
; Markman Filho, Brivaldo
; Rochitte, Carlos Eduardo
; Macêdo, Carolina Thé
; Mady, Charles
; Chevillard, Christophe
; Virgens, Cláudio Marcelo Bittencourt das
; Castro, Cleudson Nery de
; Britto, Constança Felicia De Paoli de Carvalho
; Pisani, Cristiano
; Rassi, Daniela do Carmo
; Sobral Filho, Dário Celestino
; Almeida, Dirceu Rodrigues de
; Bocchi, Edimar Alcides
; Mesquita, Evandro Tinoco
; Mendes, Fernanda de Souza Nogueira Sardinha
; Gondim, Francisca Tatiana Pereira
; Silva, Gilberto Marcelo Sperandio da
; Peixoto, Giselle de Lima
; Lima, Gustavo Glotz de
; Veloso, Henrique Horta
; Moreira, Henrique Turin
; Lopes, Hugo Bellotti
; Pinto, Ibraim Masciarelli Francisco
; Ferreira, João Marcos Bemfica Barbosa
; Nunes, João Paulo Silva
; Barreto-Filho, José Augusto Soares
; Saraiva, José Francisco Kerr
; Lannes-Vieira, Joseli
; Oliveira, Joselina Luzia Menezes
; Armaganijan, Luciana Vidal
; Martins, Luiz Cláudio
; Sangenis, Luiz Henrique Conde
; Barbosa, Marco Paulo Tomaz
; Almeida-Santos, Marcos Antonio
; Simões, Marcos Vinicius
; Yasuda, Maria Aparecida Shikanai
; Moreira, Maria da Consolação Vieira
; Higuchi, Maria de Lourdes
; Monteiro, Maria Rita de Cassia Costa
; Mediano, Mauro Felippe Felix
; Lima, Mayara Maia
; Oliveira, Maykon Tavares de
; Romano, Minna Moreira Dias
; Araujo, Nadjar Nitz Silva Lociks de
; Medeiros, Paulo de Tarso Jorge
; Alves, Renato Vieira
; Teixeira, Ricardo Alkmim
; Pedrosa, Roberto Coury
; Aras Junior, Roque
; Torres, Rosalia Morais
; Povoa, Rui Manoel dos Santos
; Rassi, Sergio Gabriel
; Alves, Silvia Marinho Martins
; Tavares, Suelene Brito do Nascimento
; Palmeira, Swamy Lima
; Silva Júnior, Telêmaco Luiz da
; Rodrigues, Thiago da Rocha
; Madrini Junior, Vagner
; Brant, Veruska Maia da Costa
; Dutra, Walderez Ornelas
; Dias, João Carlos Pinto
.
4.
IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva IMPACTOMR IMPACTO MR IMPACTO-MR
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Tomazini, Bruno M
; Nassar Jr, Antonio Paulo
; Lisboa, Thiago Costa
; Azevedo, Luciano César Pontes de
; Veiga, Viviane Cordeiro
; Catarino, Daniela Ghidetti Mangas
; Fogazzi, Debora Vacaro
; Arns, Beatriz
; Piastrelli, Filipe Teixeira
; Dietrich, Camila
; Negrelli, Karina Leal
; Jesuíno, Isabella de Andrade
; Reis, Luiz Fernando Lima
; Mattos, Renata Rodrigues de
; Pinheiro, Carla Cristina Gomes
; Luz, Mariane Nascimento
; Spadoni, Clayse Carla da Silva
; Moro, Elisângela Emilene
; Bueno, Flávia Regina
; Sampaio, Camila Santana Justo Cintra
; Silva, Débora Patrício
; Baldassare, Franca Pellison
; Silva, Ana Cecilia Alcantara
; Veiga, Thabata
; Barbante, Leticia
; Lambauer, Marianne
; Campos, Viviane Bezerra
; Santos, Elton
; Santos, Renato Hideo Nakawaga
; Laranjeiras, Ligia Nasi
; Valeis, Nanci
; Santucci, Eliana
; Miranda, Tamiris Abait
; Patrocínio, Ana Cristina Lagoeiro do
; Carvalho, Andréa de
; Sousa, Eduvirgens Maria Couto de
; Sousa, Ancelmo Honorato Ferraz de
; Malheiro, Daniel Tavares
; Bezerra, Isabella Lott
; Rodrigues, Mirian Batista
; Malicia, Julliana Chicuta
; Silva, Sabrina Souza da
; Gimenes, Bruna dos Passos
; Sesin, Guilhermo Prates
; Zavascki, Alexandre Prehn
; Sganzerla, Daniel
; Medeiros, Gregory Saraiva
; Santos, Rosa da Rosa Minho dos
; Silva, Fernanda Kelly Romeiro
; Cheno, Maysa Yukari
; Abrahão, Carolinne Ferreira
; Oliveira Junior, Haliton Alves de
; Rocha, Leonardo Lima
; Nunes Neto, Pedro Aniceto
; Pereira, Valéria Chagas
; Paciência, Luis Eduardo Miranda
; Bueno, Elaine Silva
; Caser, Eliana Bernadete
; Ribeiro, Larissa Zuqui
; Fernandes, Caio Cesar Ferreira
; Garcia, Juliana Mazzei
; Silva, Vanildes de Fátima Fernandes
; Santos, Alisson Junior dos
; Machado, Flávia Ribeiro
; Souza, Maria Aparecida de
; Ferronato, Bianca Ramos
; Urbano, Hugo Corrêa de Andrade
; Moreira, Danielle Conceição Aparecida
; Souza-Dantas, Vicente Cés de
; Duarte, Diego Meireles
; Coelho, Juliana
; Figueiredo, Rodrigo Cruvinel
; Foreque, Fernanda
; Romano, Thiago Gomes
; Cubos, Daniel
; Spirale, Vladimir Miguel
; Nogueira, Roberta Schiavon
; Maia, Israel Silva
; Zandonai, Cassio Luis
; Lovato, Wilson José
; Cerantola, Rodrigo Barbosa
; Toledo, Tatiana Gozzi Pancev
; Tomba, Pablo Oscar
; Almeida, Joyce Ramos de
; Sanches, Luciana Coelho
; Pierini, Leticia
; Cunha, Mariana
; Sousa, Michelle Tereza
; Azevedo, Bruna
; Dal-Pizzol, Felipe
; Damasio, Danusa de Castro
; Bainy, Marina Peres
; Beduhn, Dagoberta Alves Vieira
; Jatobá, Joana D’Arc Vila Nova
; Moura, Maria Tereza Farias de
; Rego, Leila Rezegue de Moraes
; Silva, Adria Vanessa da
; Oliveira, Luana Pontes
; Sodré Filho, Eliene Sá
; Santos, Silvana Soares dos
; Neves, Itallo de Lima
; Leão, Vanessa Cristina de Aquino
; Paes, João Lucidio Lobato
; Silva, Marielle Cristina Mendes
; Oliveira, Cláudio Dornas de
; Santiago, Raquel Caldeira Brant
; Paranhos, Jorge Luiz da Rocha
; Wiermann, Iany Grinezia da Silva
; Pedroso, Durval Ferreira Fonseca
; Sawada, Priscilla Yoshiko
; Prestes, Rejane Martins
; Nascimento, Glícia Cardoso
; Grion, Cintia Magalhães Carvalho
; Carrilho, Claudia Maria Dantas de Maio
; Dantas, Roberta Lacerda Almeida de Miranda
; Silva, Eliane Pereira
; Silva, Antônio Carlos da
; Oliveira, Sheila Mara Bezerra de
; Golin, Nicole Alberti
; Tregnago, Rogerio
; Lima, Valéria Paes
; Silva, Kamilla Grasielle Nunes da
; Boschi, Emerson
; Buffon, Viviane
; Machado, André Sant’Ana
; Capeletti, Leticia
; Foernges, Rafael Botelho
; Carvalho, Andréia Schubert de
; Oliveira Junior, Lúcio Couto de
; Oliveira, Daniela Cunha de
; Silva, Everton Macêdo
; Ribeiro, Julival
; Pereira, Francielle Constantino
; Salgado, Fernanda Borges
; Deutschendorf, Caroline
; Silva, Cristofer Farias da
; Gobatto, Andre Luiz Nunes
; Oliveira, Carolaine Bomfim de
; Dracoulakis, Marianna Deway Andrade
; Alvaia, Natália Oliveira Santos
; Souza, Roberta Machado de
; Araújo, Larissa Liz Cardoso de
; Melo, Rodrigo Morel Vieira de
; Passos, Luiz Carlos Santana
; Vidal, Claudia Fernanda de Lacerda
; Rodrigues, Fernanda Lopes de Albuquerque
; Kurtz, Pedro
; Shinotsuka, Cássia Righy
; Tavares, Maria Brandão
; Santana, Igor das Virgens
; Gavinho, Luciana Macedo da Silva
; Nascimento, Alaís Brito
; Pereira, Adriano J
; Cavalcanti, Alexandre Biasi
.
RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos. Objetivo IMPACTOMR, IMPACTOMR IMPACTO MR, MR saúde Métodos Resultados System demográficos comorbidades funcional secundários laboratoriais outros 201 2020 33983 33 983 33.98 5 principal Conclusão multicêntricos 20 202 3398 3 98 33.9 2 339 9 33.
ABSTRACT 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. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials. Objective IMPACTOMR, IMPACTOMR IMPACTO MR, MR careassociated associated multidrugresistant multidrug resistant bacteria Methods selection collection objectives Results System status scores diagnoses laboratory stay others 201 2020 33983 33 983 33,98 5 Conclusion trials 20 202 3398 3 98 33,9 2 339 9 33,
5.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
6.
SARS-CoV-2 and rhinovirus infections: are there differences in clinical presentation, laboratory abnormalities, and outcomes in the pediatric population?
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Pereira, Maria Fernanda Bádue
; Suguita, Priscila
; Litvinov, Nadia
; Farhat, Sylvia Costa Lima
; Paula, Camila Sanson Yoshino de
; Lázari, Carolina dos Santos
; Bedê, Pedro Vale
; Framil, Juliana Valeria de Souza
; Bueno, Catarina
; Branas, Priscila Cristina Abduch Adas
; Guimarães, Irina Monteiro da Costa
; Leite, Marcia Marques
; Navega, Ana Carolina Barsaglini
; Nanbu, Danilo Yamamoto
; Schvartsman, Claudio
; Pinho, João Renato Rebello
; Silva, Clovis Artur Almeida
; Marques, Heloisa Helena de Sousa
; Eisencraft, Adriana Pasmanik
; Rossi Jr, Alfio
; Delgado, Artur Figueiredo
; Leal, Gabriela Nunes
; Gibelli, Maria Augusta Cicaroni
; Palmeira, Patricia
; Sakita, Neusa Keico
; Santos, Emilly Henrique dos
; Rocha, Mussya Cisotto
; Kanunfre, Kelly Aparecida
; Okay, Thelma Suely
; Carneiro-Sampaio, Magda
; Carvalho, Werther Brunow de
.
Revista do Instituto de Medicina Tropical de São Paulo
- Journal Metrics
ABSTRACT This study aims to assess COVID-19 and other respiratory viruses in pediatric patients. Between April 17 and September 30, 2020, we collected 1,566 respiratory samples from 1,044 symptomatic patients who were younger than 18 years old to assess SARS-CoV-2 infection. Of these, 919 were analyzed for other respiratory pathogens (ORP). Patients with laboratory-confirmed COVID-19 or ORP were included. We evaluated 76 pediatric COVID-19 infections and 157 other respiratory virus infections. Rhinovirus occurred in 132/157 (84%). COVID-19 patients who were significantly older, had more fevers, headaches and pneumonia than those with ORP. The median white blood cell count was lower in patients with SARS-CoV-2 than in those with ORP (6,470 versus 8,170; p=0.02). COVID-19 patients had significantly worse symptoms than those with ORP.
7.
Qualidade de vida e desfechos em longo prazo após hospitalização por COVID-19: Protocolo para um estudo de coorte prospectivo (Coalizão VII)
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Rosa, Regis Goulart
; Robinson, Caroline Cabral
; Veiga, Viviane Cordeiro
; Cavalcanti, Alexandre Biasi
; Azevedo, Luciano César Pontes de
; Machado, Flávia Ribeiro
; Berwanger, Otavio
; Avezum, Álvaro
; Lopes, Renato Delascio
; Lisboa, Thiago Costa
; Teixeira, Cassiano
; Zampieri, Fernando Godinho
; Tomazini, Bruno Martins
; Kawano-Dourado, Letícia
; Schneider, Daniel
; Souza, Denise de
; Santos, Rosa da Rosa Minho dos
; Silva, Sabrina Souza da
; Trott, Geraldine
; Gimenes, Bruna dos Passos
; Souza, Ana Paula de
; Barroso, Bruna Machado
; Costa, Lauren Sezerá
; Brognoli, Liége Gregoletto
; Pelliccioli, Melissa Pezzetti
; Studier, Nicole dos Santos
; Schardosim, Raíne Fogliati de Carli
; Haubert, Tainá Aparecida
; Pallaoro, Victoria Emanuele Lobo
; Oliveira, Debora Mariani de
; Velho, Pedro Isaacsson
; Medeiros, Gregory Saraiva
; Gazzana, Marcelo Basso
; Zavascki, Alexandre Prehn
; Pitrez, Paulo Márcio
; Oliveira, Roselaine Pinheiro de
; Polanczyk, Carisi Anne
; Nasi, Luiz Antônio
; Hammes, Luciano Serpa
; Falavigna, Maicon
.
RESUMO Introdução: Os efeitos provocados pela COVID-19 em longo prazo são desconhecidos. O presente estudo tem como objetivo avaliar os fatores associados com a qualidade de vida relacionada à saúde e os desfechos em longo prazo em sobreviventes à hospitalização por COVID-19 no Brasil. Métodos: Este será um estudo multicêntrico de coorte prospectivo, aninhado em cinco ensaios clínicos randomizados desenhados para avaliar os efeitos dos tratamentos específicos para COVID-19 em mais de 50 centros no Brasil. Pacientes adultos sobreviventes à hospitalização por infecção por SARS-CoV-2 comprovada ou suspeita serão seguidos por um período de 1 ano, por meio de entrevistas telefônicas estruturadas. O desfecho primário é o escore de utilidade para qualidade de vida relacionada à saúde após 1 ano, avaliado segundo o questionário EuroQol-5D3L. Os desfechos secundários incluirão mortalidade por todas as causas, eventos cardiovasculares graves, reospitalizações, retorno ao trabalho ou estudo, condição funcional física avaliada pelo instrumento Lawton-Brody Instrumental Activities of Daily Living, dispneia avaliada segundo a escala de dispneia modificada do Medical Research Council, necessidade de suporte ventilatório em longo prazo, sintomas de ansiedade e depressão avaliados segundo a Hospital Anxiety and Depression Scale, sintomas de transtorno de estresse pós-traumático avaliados pela ferramenta Impact of Event Scale-Revised e autoavaliação da condição de saúde, conforme a Escala Visual Analógica do EuroQol-5D3L. Serão utilizadas equações de estimativas generalizada para testar a associação entre cinco conjuntos de variáveis (1 - características demográficas, 2 - condição de saúde pré-morbidade, 3 - características da doença aguda, 4 - terapias específicas para COVID-19 recebidas e 5 - variáveis pós-alta atualizadas) e desfechos. Ética e disseminação: O protocolo do estudo foi aprovado pelos Comitês de Ética em Pesquisa de todas as instituições participantes. Os resultados serão disseminados por meio de conferências e periódicos revisados por pares.
Abstract Introduction: The long-term effects caused by COVID-19 are unknown. The present study aims to assess factors associated with health-related quality of life and long-term outcomes among survivors of hospitalization for COVID-19 in Brazil. Methods: This is a multicenter prospective cohort study nested in five randomized clinical trials designed to assess the effects of specific COVID-19 treatments in over 50 centers in Brazil. Adult survivors of hospitalization due to proven or suspected SARS-CoV-2 infection will be followed-up for a period of 1 year by means of structured telephone interviews. The primary outcome is the 1-year utility score of health-related quality of life assessed by the EuroQol-5D3L. Secondary outcomes include all-cause mortality, major cardiovascular events, rehospitalizations, return to work or study, physical functional status assessed by the Lawton-Brody Instrumental Activities of Daily Living, dyspnea assessed by the modified Medical Research Council dyspnea scale, need for long-term ventilatory support, symptoms of anxiety and depression assessed by the Hospital Anxiety and Depression Scale, symptoms of posttraumatic stress disorder assessed by the Impact of Event Scale-Revised, and self-rated health assessed by the EuroQol-5D3L Visual Analog Scale. Generalized estimated equations will be performed to test the association between five sets of variables (1- demographic characteristics, 2- premorbid state of health, 3- characteristics of acute illness, 4- specific COVID-19 treatments received, and 5- time-updated postdischarge variables) and outcomes. Ethics and dissemination: The study protocol was approved by the Research Ethics Committee of all participant institutions. The results will be disseminated through conferences and peer-reviewed journals.
https://doi.org/10.5935/0103-507x.20210003
2053 downloads
8.
Plasmodium vivax metacaspase 1 (PvMCA1) catalytic domain is conserved in field isolates from Brazilian Amazon
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de Souza, Hugo Amorim dos Santos
; Escafa, Victor Fernandes
; Blanco, Carolina Moreira
; Baptista, Bárbara de Oliveira
; de Barros, Jenifer Peixoto
; Riccio, Evelyn Ketty Pratt
; Rodrigues, Aline Beatriz Mello
; Melo, Gisely Cardoso de
; Lacerda, Marcus Vinícius Guimarães de
; de Souza, Rodrigo Medeiros
; Lima-Junior, Josué da Costa
; Guimarães, Ana Carolina Ramos
; da Mota, Fabio Faria
; da Silva, João Hermínio Martins
; Daniel-Ribeiro, Cláudio Tadeu
; Pratt-Riccio, Lilian Rose
; Totino, Paulo Renato Rivas
.
In the present study, we investigated the genetic diversity of Plasmodium vivax metacaspase 1 (PvMCA1) catalytic domain in two municipalities of the main malaria hotspot in Brazil, i.e., the Juruá Valley, and observed complete sequence identity among all P. vivax field isolates and the Sal-1 reference strain. Analysis of PvMCA1 catalytic domain in different P. vivax genomic sequences publicly available also revealed a high degree of conservation worldwide, with very few amino acid substitutions that were not related to putative histidine and cysteine catalytic residues, whose involvement with the active site of protease was herein predicted by molecular modeling. The genetic conservation presented by PvMCA1 may contribute to its eligibility as a druggable target candidate in vivax malaria.
https://doi.org/10.1590/0074-02760200584
202 downloads
9.
Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in São Paulo, Brazil - study protocol
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Ferreira, Juliana C.
; Ho, Yeh-Li
; Besen, Bruno A.M.P.
; Malbuisson, Luiz M.S.
; Taniguchi, Leandro U.
; Mendes, Pedro V.
; Costa, Eduardo L.V.
; Park, Marcelo
; Daltro-Oliveira, Renato
; Roepke, Roberta M.L.
; Silva Jr, João M.
; Carmona, Maria José C.
; Carvalho, Carlos Roberto Ribeiro
; Hirota, Adriana
; Kanasiro, Alberto Kendy
; Crescenzi, Alessandra
; Fernandes, Amanda Coelho
; Miethke-Morais, Anna
; Bellintani, Arthur Petrillo
; Canasiro, Artur Ribeiro
; Carneiro, Bárbara Vieira
; Zanbon, Beatriz Keiko
; Batista, Bernardo Pinheiro De Senna Nogueira
; Nicolao, Bianca Ruiz
; Besen, Bruno Adler Maccagnan Pinheiro
; Biselli, Bruno
; Macedo, Bruno Rocha De
; Toledo, Caio Machado Gomes De
; Pompilio, Carlos Eduardo
; Carvalho, Carlos Roberto Ribeiro De
; Mol, Caroline Gomes
; Stipanich, Cassio
; Bueno, Caue Gasparotto
; Garzillo, Cibele
; Tanaka, Clarice
; Forte, Daniel Neves
; Joelsons, Daniel
; Robira, Daniele
; Costa, Eduardo Leite Vieira
; Silva Júnior, Elson Mendes Da
; Regalio, Fabiane Aliotti
; Segura, Gabriela Cardoso
; Marcelino, Gustavo Brasil
; Louro, Giulia Sefrin
; Ho, Yeh-Li
; Ferreira, Isabela Argollo
; Gois, Jeison de Oliveira
; Silva Junior, Joao Manoel Da
; Reusing Junior, Jose Otto
; Ribeiro, Julia Fray
; Ferreira, Juliana Carvalho
; Galleti, Karine Vusberg
; Silva, Katia Regina
; Isensee, Larissa Padrao
; Oliveira, Larissa dos Santos
; Taniguchi, Leandro Utino
; Letaif, Leila Suemi
; Lima, Lígia Trombetta
; Park, Lucas Yongsoo
; Chaves Netto, Lucas
; Nobrega, Luciana Cassimiro
; Haddad, Luciana
; Hajjar, Ludhmila
; Malbouisson, Luiz Marcelo
; Pandolfi, Manuela Cristina Adsuara
; Park, Marcelo
; Carmona, Maria José Carvalho
; Andrade, Maria Castilho Prandini H De
; Santos, Mariana Moreira
; Bateloche, Matheus Pereira
; Suiama, Mayra Akimi
; Oliveira, Mayron Faria de
; Sousa, Mayson Laercio
; Louvaes, Michelle
; Huemer, Natassja
; Mendes, Pedro
; Lins, Paulo Ricardo Gessolo
; Santos, Pedro Gaspar Dos
; Moreira, Pedro Ferreira Paiva
; Guazzelli, Renata Mello
; Reis, Renato Batista Dos
; Oliveira, Renato Daltro De
; Roepke, Roberta Muriel Longo
; Pedro, Rodolpho Augusto De Moura
; Kondo, Rodrigo
; Rached, Samia Zahi
; Fonseca, Sergio Roberto Silveira Da
; Borges, Thais Sousa
; Ferreira, Thalissa
; Cobello Junior, Vilson
; Sales, Vivian Vieira Tenório
; Ferreira, Willaby Serafim Cassa
.
OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital’s electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.
https://doi.org/10.6061/clinics/2020/e2294
1957 downloads
10.
The Brazilian Society for Cardiovascular Surgery (SBCCV) and Brazilian Society for Extracorporeal Circulation (SBCEC) Standards and Guidelines for Perfusion Practice
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Caneo, Luiz Fernando
; Matte, Gregory
; Groom, Robert
; Neirotti, Rodolfo A.
; Pêgo-Fernandes, Paulo Manuel
; Mejia, Juan Alberto C.
; Figueira, Fernando Augusto Marinho dos Santos
; Carvalho Filho, Élio Barreto de
; Costa, Fábio Murilo da
; Chalegre, Sintya Tertuliano
; Kalil, Renato Abdala Karam
; Almeida, Rui M. S.
.
Brazilian Journal of Cardiovascular Surgery
- Journal Metrics
https://doi.org/10.21470/1678-9741-2018-0347
1484 downloads
11.
Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017
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Faludi, André Arpad
; Izar, Maria Cristina de Oliveira
; Saraiva, José Francisco Kerr
; Chacra, Ana Paula Marte
; Bianco, Henrique Tria
; Afiune Neto, Abrahão
; Bertolami, Adriana
; Pereira, Alexandre C.
; Lottenberg, Ana Maria
; Sposito, Andrei C.
; Chagas, Antonio Carlos Palandri
; Casella Filho, Antonio
; Simão, Antônio Felipe
; Alencar Filho, Aristóteles Comte de
; Caramelli, Bruno
; Magalhães, Carlos Costa
; Negrão, Carlos Eduardo
; Ferreira, Carlos Eduardo dos Santos
; Scherr, Carlos
; Feio, Claudine Maria Alves
; Kovacs, Cristiane
; Araújo, Daniel Branco de
; Magnoni, Daniel
; Calderaro, Daniela
; Gualandro, Danielle Menosi
; Mello Junior, Edgard Pessoa de
; Alexandre, Elizabeth Regina Giunco
; Sato, Emília Inoue
; Moriguchi, Emilio Hideyuki
; Rached, Fabiana Hanna
; Santos, Fábio César dos
; Cesena, Fernando Henpin Yue
; Fonseca, Francisco Antonio Helfenstein
; Fonseca, Henrique Andrade Rodrigues da
; Xavier, Hermes Toros
; Mota, Isabela Cardoso Pimentel
; Giuliano, Isabela de Carlos Back
; Issa, Jaqueline Scholz
; Diament, Jayme
; Pesquero, João Bosco
; Santos, José Ernesto dos
; Faria Neto, José Rocha
; Melo Filho, José Xavier de
; Kato, Juliana Tieko
; Torres, Kerginaldo Paulo
; Bertolami, Marcelo Chiara
; Assad, Marcelo Heitor Vieira
; Miname, Márcio Hiroshi
; Scartezini, Marileia
; Forti, Neusa Assumpta
; Coelho, Otávio Rizzi
; Maranhão, Raul Cavalcante
; Santos Filho, Raul Dias dos
; Alves, Renato Jorge
; Cassani, Roberta Lara
; Betti, Roberto Tadeu Barcellos
; Carvalho, Tales de
; Martinez, Tânia Leme da Rocha
; Giraldez, Viviane Zorzanelli Rocha
; Salgado Filho, Wilson
.
https://doi.org/10.5935/abc.20170121
199102 downloads
12.
I RBH - First Brazilian Hypertension Registry
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Jardim, Paulo César Brandão Veiga
; Souza, Weimar Kunz Sebba Barroso de
; Lopes, Renato Delascio
; Brandão, Andréa Araújo
; Malachias, Marcus V. Bolívar
; Gomes, Marco Mota
; Moreno Júnior, Heitor
; Barbosa, Eduardo Costa Duarte
; Póvoa, Rui Manoel dos Santos
.
Resumo Fundamento: Ainda não foi realizado um registro brasileiro para avaliar, na prática clínica diária, o atendimento a pacientes hipertensos tanto em serviços públicos quanto privados distribuídos pelas diversas regiões do país. Este conhecimento é importante como forma de verificar a efetividade deste atendimento. Objetivo: Documentar a prática clínica vigente para o tratamento da hipertensão arterial, através do conhecimento do perfil dos exames realizados, do tipo de tratamento recebido, do nível de controle da pressão arterial (PA) e da adesão ao tratamento. Métodos: Estudo nacional, observacional, prospectivo e multicêntrico que incluirá pacientes > 18 anos, hipertensos há ≥ 4 semanas, em acompanhamento em serviços públicos e privados e com assinatura do consentimento. Serão excluídos pacientes em diálise, internados nos últimos 30 dias, com insuficiência cardíaca classe III ou IV, gravidez ou amamentação, hepatopatia grave, acidente vascular cerebral ou infarto agudo nos 30 dias anteriores e doenças com prognóstico de sobrevida < 1 ano. As avaliações serão realizadas ao início e final do estudo, após acompanhamento por 1 ano. Parâmetros a serem avaliados incluirão dados antropométricos, hábitos de vida, PA, perfil lipídico, síndrome metabólica e adesão ao tratamento. Os desfechos primários serão internação por crise hipertensiva, evento cardiocirculatório e óbito cardiovascular, e os desfechos secundários serão internação por insuficiência cardíaca e necessidade de diálise. Uma análise de subgrupo avaliará a pressão central de forma não invasiva em 15% da amostra no início e final do estudo. A amostra estimada é de 3.000 indivíduos para prevalência de 5%, erro amostral de 2% e intervalo de confiança de 95%. Resultados: Os resultados serão apresentados após a avaliação final que ocorrerá quando encerrado 1 ano de seguimento. Conclusão: A análise deste registro trará melhor conhecimento sobre o tratamento da hipertensão no Brasil e possibilitará a otimização do mesmo, como forma de interferir no prognóstico da doença cardiovascular em nosso meio.
Abstract Background: A registry assessing the care of hypertensive patients in daily clinical practice in public and private centers in various Brazilian regions has not been conducted to date. Such analysis is important to elucidate the effectiveness of this care. Objective: To document the current clinical practice for the treatment of hypertension with identification of the profile of requested tests, type of administered treatment, level of blood pressure (BP) control, and adherence to treatment. Methods: National, observational, prospective, and multicenter study that will include patients older than 18 years with hypertension for at least 4 weeks, following up in public and private centers and after signing a consent form. The study will exclude patients undergoing dialysis, hospitalized in the previous 30 days, with class III or IV heart failure, pregnant or nursing, with severe liver disease, stroke or acute myocardial infarction in the past 30 days, or with diseases with a survival prognosis < 1 year. Evaluations will be performed at baseline and after 1 year of follow-up. The parameters that will be evaluated include anthropometric data, lifestyle habits, BP levels, lipid profile, metabolic syndrome, and adherence to treatment. The primary outcomes will be hospitalization due to hypertensive crisis, cardiocirculatory events, and cardiovascular death, while secondary outcomes will be hospitalization for heart failure and requirement of dialysis. A subgroup analysis of 15% of the sample will include noninvasive central pressure evaluation at baseline and study end. The estimated sample size is 3,000 individuals for a prevalence of 5%, sample error of 2%, and 95% confidence interval. Results: The results will be presented after the final evaluation, which will occur at the end of a 1-year follow-up. Conclusion: The analysis of this registry will improve the knowledge and optimize the treatment of hypertension in Brazil, as a way of modifying the prognosis of cardiovascular disease in the country.
https://doi.org/10.5935/abc.20160120
3704 downloads
13.
Determinants of prolonged length of hospital stay after cardiac surgery: impact of rheumatic heart disease
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Pato, Mariângela F
; Gelape, Cláudio L
; Cassiano, Tammy JM
; Carvalho, Adriano
; Cintra, Priscila R
; Passaglia, Luiz G
; Costa, Henrique S
; Tan, Timothy C
; Santos Junior, Paulo Cerqueira dos
; Bráulio, Renato
; Nunes, Maria CP
.
OBJETIVO: A doença cardíaca reumática continua a ser um problema grave de saúde nos países em desenvolvimento. Vários fatores contribuem para a morbidade relacionada com a cirurgia valvar cardíaca, mas o papel da etiologia reumática das valvopatias não está bem definido. Este estudo foi desenhado para determinar participação adicional de valvopatias reumáticas na previsão de morbidade após cirurgia cardíaca na era atual de tratamento da doença. MÉTODOS: Este estudo incluiu prospectivamente 164 pacientes submetidos a cirurgia cardíaca, entre junho de 2010 a junho de 2011. O resultado medido foi a duração da estadia prolongada, definido como tempo de permanência maior ou igual ao percentil 75 para a duração da estada para cada operação, incluindo a dia da alta. RESULTADOS: A cardiopatia reumática esteve presente em 32 pacientes (20%) e em todos os pacientes submetidos à substituição da válvula. Pacientes com doenças cardíacas reumáticas eram mais jovens e com menos comorbidades comparados com pacientes não-reumáticos; a maioria deles (63%) tinha tido cirurgia prévia. Quarenta e um pacientes foram classificados como tendo um tempo de permanência hospitalar prolongado; 11 (34%) pacientes com doenças reumáticas e 30 (23%) com doenças não-reumáticas. A doença reumática não se apresentou associada com período de internação prolongado, na análise univariada; No entanto, após o ajuste para outros fatores, incluindo endocardite infecciosa, duração da cirurgia, tempo de ventilação mecânica, EuroSCORE, e pneumonia no pós-operatório, a doença reumática revelou-se um preditor de hospitalização prolongada. CONCLUSÕES: Este estudo demonstra que a doença cardíaca reumática é um importante fator associado com internação prolongada, após o ajuste para fatores de risco bem conhecidos de morbidade após cirurgia cardíaca. A febre reumática ainda é prevalente entre os pacientes que se submeteram à cirurgia cardíaca na época atual, contribuindo para aumentar a morbidade pós-operatória.
BACKGROUND: Rheumatic heart disease remains a major health problem in developing countries. Several factors contribute to valve-related morbidity after cardiac surgery, but the role of rheumatic etiology of valve disease is not well defined. This study was designed to determine the additional value of rheumatic valve disease in predicting morbidity after cardiac surgery in the current era of heart valve disease treatment. METHOD: This study prospectively included 164 patients for cardiac surgery from June 2010 to June 2011. The outcome was prolonged length of stay, defined as a length of stay greater than or equal to the 75th percentile for length of stay for each operation, including the day of discharge. RESULTS: Rheumatic heart disease was present in 32 patients (20%) and all rheumatic patients underwent valve replacement. Rheumatic heart disease patients were younger with less comorbidities compared to non-rheumatic patients, with most (63%) having had previous surgery. Forty-one patients were classified as having a prolonged hospital length of stay; 11 (34%) patients with rheumatic and 30 (23%) non-rheumatic fever. Rheumatic heart disease was not associated with prolonged hospital stay in the univariate analysis; however, after adjustment for other factors including infectious endocarditis, surgery duration, mechanical ventilation time, EuroSCORE, and postoperative pneumonia, it was found to be a predictor of prolonged hospitalization. CONCLUSION: This study demonstrates that rheumatic heart disease was an important factor associated with prolonged hospital, after adjustment for well-known risk factors of morbidity after cardiac surgery. Rheumatic fever is still prevalent among the patients who underwent to cardiac surgery in the current age, contributing to increase the postoperative morbidity.
https://doi.org/10.5935/MedicalExpress.2015.03.04
2783 downloads
14.
Influence of ecological filters on phytoplankton communities in semi-arid solar saltern environments
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Costa, Raiane Santos
; Molozzi, Joseline
; Hepp, Luiz Ubiratan
; Costa, Diógenes Félix da Silva
; Nunes da Silva, Paulo Roberto
; Rocha, Renato de Medeiros
; Barbosa, José Etham de Lucena
.
ObjetivoEste trabalho visou analisar a influência dos filtros ecológicos (variáveis abióticas) na comunidade fitoplanctônica nos ecossistemas hipersalinos.MétodosAs variáveis abióticas mensuradas no estudo foram: pH, temperatura da água, salinidade, íons amônio, nitrogênio total, nitrito, nitrato, fósforo total, fósforo reativo solúvel. A comunidade fitoplanctônica foi estudada em nível de riqueza, densidade, Diversidade de Shannon-Wiener. Os dados foram tratados através de análise de variância, regressão linear e uma análise de correspondência canônica (ACC).ResultadosNo total foram identificados 110 taxa nas 3 salinas solares, distribuídos em 9 classes taxonômicas, havendo o predomínio das classes Cyanobacteria (41,8%), Bacillariophyceae (22,7%). A espécie Pseudanabaena galeata foi à única espécie amostrada em todos os ambientes salinos. A salinidade influenciou significativamente na riqueza nas três Salinas, Augusto Severo (F(1,22) = 23,2; p < 0,001), Francisco Menescal (F(1,22) = 50,02; p < 0,001) e Santa Clara (F(1,22) = 66,33; p < 0,001). Na análise de correspondência canônica (ACC) os dois primeiros eixos explicaram 41,6% da variabilidade total dos dados, tendo apenas relação negativa com o fósforo reativo solúvel para o eixo 2.ConclusãoO estudo evidenciou a influência da dinâmica do ecossistema salino na estrutura da comunidade fitoplanctônica. Esse fato está associado aos filtros desenvolvidos pelo ambiente, onde o aumento crescente da salinidade, da temperatura, da precipitação dos sais, acaba influenciando na composição desses organismos no ecossistema.
ObjectiveThis study analyzed the influence of ecological filters (abiotic variables) on the phytoplankton community in hypersaline ecosystems.MethodsThe abiotic variables measured herein were: pH, water temperature, salinity, ammonium ion, total nitrogen, nitrite, nitrate, total phosphorus, and soluble reactive phosphorus. The phytoplankton community was studied for density, richness and Shannon-Wiener diversity index. Data were analyzed using analysis of variance, linear regression and Canonical correspondence analysis (CCA).ResultsIn total, 110 taxa were identified in 3 solar salterns, distributed into 9 taxonomic classes, with the predominance of Cyanobacteria (41.8%) and Bacillariophyceae (22.7%). The species Pseudanabaena galeata was the only species sampled in all saline environments. Salinity significantly influenced the richness in the three salterns, Augusto Severo (F(1,22) = 23.2, p <0.001), Francisco Menescal (F(1,22) = 50.02, p <0.001) and Santa Clara (F(1,22) = 66.33, p <0.001). The first two CCA axes explained 41.6% of total data variability, with a negative relationship with soluble reactive phosphorus for axis 2.ConclusionThe study showed the influence of the dynamics of salterns ecosystems on the phytoplankton community structure. This is associated with filters developed by the environment, where the increasing salinity, temperature and precipitation of salts influence the composition of these organisms in the ecosystem.
https://doi.org/10.1590/S2179-975X2714
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15.
EVALUATION OF THE MOLLUSCICIDAL POTENTIAL OF HYDROALCOHOLIC EXTRACTS OF Jatropha gossypiifolia Linnaeus, 1753 ON Biomphalaria glabrata (Say, 1818)
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Pereira Filho, Adalberto Alves
; França, Clícia Rosane Costa
; Oliveira, Dorlam's da Silva
; Mendes, Renato Juvino de Aragão
; Gonçalves, José de Ribamar Santos
; Rosa, Ivone Garros
.
Revista do Instituto de Medicina Tropical de São Paulo
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Estudou-se a ação dos extratos do caule, folhas e frutos de Jatropha gossypiifolia (Pinhão-roxo) sobre Biomphalaria glabrata analisando a sobrevivência, capacidade alimentar e de oviposição. Os extratos foram obtidos pela maceração das partes do vegetal em álcool etílico 92%, evaporados até obter-se um resíduo seco e estudados fitoquimicamente. A atividade moluscicida em B. glabrata seguiu os procedimentos recomendados pela WHO (1965). A medida de quantidade de alimento ingerido e a oviposição foi realizada durante cada experimento. O extrato das folhas de J. gossypiifolia mostrou-se um forte agente moluscicida, promovendo 100% de mortalidade de B. glabrata mesmo na menor concentração testada, 25 ppm. Com o extrato dos frutos houve variação na mortalidade, de acordo com a concentração utilizada (100, 75, 50 e 25 ppm). Os caramujos em contato com o extrato dos frutos apresentaram quando comparado ao controle uma diminuição significativa nos comportamentos alimentares e de número de embriões. O extrato do caule não apresentou atividade moluscicida e nenhuma influência sobre a capacidade alimentar e de oviposição de B. glabrata nas concentrações testadas. Em conclusão, os extratos de folhas e frutos de J. gossypiifolia investigados neste trabalho apresentam efeito moluscicida e possivelmente podem ser fontes de compostos no controle da esquistossomose.
The action of extracts from the stem, leaves, and fruit of Jatropha gossypiifolia on Biomphalaria glabrata was studied by analyzing survival, feeding capacity and oviposition ability. The extracts were obtained by macerating the plant parts in 92% ethanol, which were then evaporated until a dry residue was obtained and phytochemically studied. The molluscicidal activity on B. glabrata was investigated using the procedures recommended by WHO (1965). The amount of food ingested and oviposition were measured during each experiment. The extract of leaves from J. gossypiifolia was shown to be a strong molluscicidal agent, causing 100% mortality of B. glabrata, even in the lowest concentration tested, of 25 ppm. Regarding the fruit extract, there was variation in the mortality, depending on the concentration used (100, 75, 50 and 25 ppm). The snails that were in contact with the fruit extract had significant reduction in feeding and number of embryos in comparison to the control. The stem extract did not present molluscicidal activity nor had any influence on the feeding and oviposition abilities of B. glabrata, in the concentrations tested. In conclusion, the extracts of leaves and fruits of J. gossypiifolia investigated in this work show molluscicidal effect and may be sources of useful compounds for the schistosomiasis control.
https://doi.org/10.1590/S0036-46652014000600009
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