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Resumo Fundamento: A cardiomiopatia associada à lipodistrofia parcial (LP) ainda não foi bem descrita. Objetivo: Caracterizar a morfologia e a função cardíaca na LP. Métodos: Pacientes com LP e controles foram avaliados prospectivamente por ecocardiografia transtorácica e ecocardiografia por speckle-tracking (Strain Longitudinal Global, SLG). A relação entre as variáveis ecocardiográficas e o diagnóstico de LP foi testada com modelos de regressão, considerando o efeito da pressão arterial sistólica (PAS). Adotou-se um nível de significância de 5%. Resultados: Vinte e nove pacientes com LP foram comparados com 17 controles. Eles não se diferiram quanto à idade (p=0,94), sexo ou índice de massa corporal (p= 0,05). Os pacientes com LP apresentaram PAS estatisticamente mais alta (p=0,02) em comparação aos controles. Ainda, os pacientes com LP apresentaram maior dimensão do átrio (37,3 ± 4,4 vs. 32,1 ± 4,3 mm, p= 0,001) e maior volume atrial (30,2 ± 7,2 vs. 24,9 ± 9,0 mL/m2, p=0,02), massa do Ventrículo Esquerdo (VE) (79,3 ± 17,4 vs. 67,1 ± 19,4; p=0,02), e parâmetros sistólicos reduzidos do VE (E’ lateral, p= 0,001) (E’ septal, p= 0,001), (razão E/E’, p= 0,02). A fração de ejeção do VE (64,7 ± 4,6 vs. 62,2 ± 4,4 %, p = 0,08) e o SLG não foram estatisticamente diferentes entre os grupos (-17,1±2,7 vs-18.0 ± 2,0%, p= 0,25). Observou-se uma reação positiva do átrio esquerdo (β 5,6; p<0,001), espessura da parede posterior (β 1,3; p=0,011), E’ lateral (β -3,5; p=0,002) e E’ septal (β -3,2; p<0,001) com o diagnóstico de LP, mesmo após o ajuste para a PAS. Conclusão: Os pacientes com LP apresentam hipertrofia do VE, aumento do átrio esquerdo, e disfunção diastólica do VE apesar de fração de ejeção do VE e SLG preservados. Os parâmetros ecocardiográficos estão relacionados com o diagnóstico de LP, independentemente da PAS. Fundamento (LP descrita Objetivo Métodos speckletracking speckle tracking Strain Global SLG. . SLG) regressão (PAS) Adotouse Adotou 5 5% Resultados 1 p=0,94, p094 p=0,94 , 0 94 (p=0,94) (p 0,05. 005 0,05 05 0,05) p=0,02 p002 02 (p=0,02 Ainda 37,3 373 37 3 (37, 44 4 4, vs 321 32 32, 43 mm 0,001 0001 001 30,2 302 30 2 (30, 72 7 7, 249 24 9 24, 90 9, mLm2 mLm mL m2 m mL/m2 p=0,02, p=0,02) (VE 79,3 793 79 (79, 174 17, 671 67 67, 19,4 194 19 E (E 0,001, razão E/E, EE E/E E/E’ 0,02. 002 0,02 0,02) 64,7 647 64 (64, 46 6 622 62 62, % 0,08 008 08 17,1±2,7 17127 (-17,1±2, vs18.0 vs180 18.0 18 vs-18. 20 2,0% 0,25. 025 0,25 25 0,25) Observouse Observou β 5,6 56 p<0,001, p0001 p<0,001 1,3 13 p=0,011, p0011 p=0,011 011 p=0,011) 3,5 35 -3,5 p=0,002 p0002 3,2 -3,2 Conclusão preservados (PAS p09 p=0,9 (p=0,94 00 0,0 p=0,0 p00 (p=0,0 37, (37 0,00 000 30, (30 mL/m 79, (79 19, 64, (64 17,1±2, 1712 (-17,1±2 vs18 vs18. 180 18. vs-18 2,0 0,2 5, p000 p<0,00 1, p001 p=0,01 01 3, -3, p=0,00 p0 p=0, (p=0,9 0, (p=0, (3 (7 (6 17,1±2 171 (-17,1± vs1 vs-1 2, p<0,0 -3 p=0 (p=0 ( 17,1± (-17,1 vs- p<0, - 17,1 (-17, p<0 (-17 p< (-1 (-

Abstract Background: Cardiomyopathy associated with partial lipodystrophy (PL) has not been well described yet. Objective: To characterize cardiac morphology and function in PL. Methods: Patients with familial PL and controls were prospectively assessed by transthoracic echocardiography and with speckle-tracking echocardiography (global longitudinal strain, GLS). The relationship between echocardiographic variables and PL diagnosis was tested with regression models, considering the effect of systolic blood pressure (SBP). Significance level of 5% was adopted. Results: Twenty-nine patients with PL were compared to 17 controls. They did not differ in age (p=0.94), gender or body mass index (p= 0.05). Patients with PL had statistically higher SBP (p=0.02) than controls. Also, PL patients had higher left atrial dimension (37.3 ± 4.4 vs. 32.1 ± 4.3 mm, p= 0.001) and left atrial (30.2 ± 7.2 vs. 24.9 ± 9.0 mL/m2,p=0.02), left ventricular (LV) mass (79.3 ± 17.4 vs. 67.1 ± 19.4, p=0.02), and reduced diastolic LV parameters (E’ lateral, p= 0.001) (E’ septal, p= 0.001), (E/E’ ratio, p= 0.02). LV ejection fraction (64.7 ± 4.6 vs. 62.2 ± 4.4 %, p= 0.08) and GLS were not statistically different between groups (-17.1 ± 2.7 vs. -18.0 ± 2.0 %, p= 0.25). There was a positive relationship of left atrium (β 5.6, p<0.001), posterior wall thickness, (β 1.3, p=0.011), E’ lateral (β -3.5, p=0.002) and E’ septal (β -3.2, p<0.001) with PL diagnosis, even after adjusted for SBP. Conclusion: LP patients have LV hypertrophy, left atrial enlargement, and LV diastolic dysfunction although preserved LVEF and GLS. Echocardiographic parameters are related to PL diagnosis independent of SBP. Background (PL yet Objective Methods speckletracking speckle tracking global strain . GLS) models (SBP) 5 adopted Results Twentynine Twenty nine 1 p=0.94, p094 p p=0.94 , 0 94 (p=0.94) (p 0.05. 005 0.05 05 0.05) p=0.02 p002 02 (p=0.02 Also 37.3 373 37 3 (37. 44 4 4. vs 321 32 32. 43 mm 0.001 0001 001 30.2 302 30 2 (30. 72 7 7. 249 24 9 24. 90 9. mL/m2,p=0.02, mLm2p002 mLmp mL/m2,p=0.02 mL m2 m mL/m2,p=0.02) (LV 79.3 793 79 (79. 174 17. 671 67 67. 194 19 19.4 p=0.02, p=0.02) E (E 0.001, E/E EE (E/E ratio 0.02. 002 0.02 0.02) 64.7 647 64 (64. 46 6 622 62 62. % 0.08 008 08 17.1 171 (-17. 27 2. 18.0 180 18 -18. 20 0.25. 025 0.25 25 0.25) β 56 5.6 p<0.001, p0001 p<0.001 thickness 13 1.3 p=0.011, p0011 p=0.011 011 p=0.011) 3.5, 35 -3.5 p=0.002 p0002 3.2, -3.2 Conclusion hypertrophy enlargement (SBP p09 p=0.9 (p=0.94 00 0.0 p=0.0 p00 (p=0.0 37. (37 0.00 000 30. (30 mLm mLm2p00 mL/m2,p=0.0 79. (79 19. 64. (64 (-17 18. -18 0.2 5. p000 p<0.00 1. p001 p=0.01 01 3.5 -3. p=0.00 3.2 p0 p=0. (p=0.9 0. (p=0. (3 mLm2p0 mL/m2,p=0. (7 (6 (-1 -1 p<0.0 3. -3 p=0 (p=0 ( mLm2p mL/m2,p=0 (- - p<0. mL/m2,p= p<0 mL/m2,p p<

https://doi.org/10.36660/abc.20230442

Ectopic fat in muscle and poor glycemic control are negatively associated with trabecular bone score in type 2 diabetes
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Araújo, Iana Mizumukai de

; Salmon, Carlos Ernesto Garrido

; Paula, Francisco José Albuquerque de

Clinics

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2024, Volume 79 elocation 100430

Abstract: En | Text: En | PDF: En

Abstract Introduction: Type 2 Diabetes (T2D) is associated with fractures, despite preserved Bone Mineral Density (BMD). This study aimed to evaluate the relationship between BMD and trabecular bone score (TBS) with the reallocation of fat within muscle in individuals with eutrophy, obesity, and T2D. Methods: The subjects were divided into three groups: eutrophic controls paired by age and sex with the T2D group (n = 23), controls diagnosed with obesity paired by age, sex, and body mass index with the T2D group (n = 27), and the T2D group (n = 29). BMD and body fat percentage were determined using dual-energy X-Ray absorptiometry. TBS was determined using TBS iNsight software. Intra and extramyocellular lipids in the soleus were measured using proton magnetic resonance spectroscopy. Results: TBS was lower in the T2D group than in the other two groups. Glycated hemoglobin (A1c) was negatively associated with TBS. Body fat percentage was negatively associated with TBS and Total Hip (TH) BMD. TH BMD was positively associated with intramuscular lipids. A trend of negative association was observed between intramuscular lipids and TBS. Conclusion: This study showed for the first time that the reallocation of lipids within muscle has a negative association with TBS. Moreover, these results are consistent with previous studies showing a negative association between a parameter related to insulin resistance (intramuscular lipids) and TBS. Introduction TD T D (T2D fractures . (BMD) (TBS eutrophy Methods groups n 23, 23 , 23) 27, 27 27) 29. 29 29) dualenergy dual energy XRay X Ray absorptiometry software spectroscopy Results A1c Ac c (A1c (TH Conclusion Moreover (BMD

https://doi.org/10.1016/j.clinsp.2024.100430

Bone, fat, and muscle interactions in health and disease
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Gomes, Mayra Macena

; Silva, Maisa Monseff Rodrigues da

; Araújo, Iana Mizumukai de

; Paula, Francisco José Albuquerque de

Archives of Endocrinology and Metabolism

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oct 2022, Volume 66 N. 5 Pages 611 - 620

Abstract: En | Text: En | PDF: En

Abstract Energy metabolism is a point of integration among the various organs and tissues of the human body, not only in terms of consumption of energy substrates but also because it concentrates a wide interconnected network controlled by endocrine factors. Thus, not only do tissues consume substrates, but they also participate in modulating energy metabolism. Soft mesenchymal tissues, in particular, play a key role in this process. The recognition that high energy consumption is involved in bone remodeling has been accompanied by evidence showing that osteoblasts and osteocytes produce factors that influence, for example, insulin sensitivity and appetite. Additionally, there are significant interactions between muscle, adipose, and bone tissues to control mutual tissue trophism. Not by chance, trophic and functional changes in these tissues go hand in hand from the beginning of an individual’s development until aging. Likewise, metabolic and nutritional diseases deeply affect the musculoskeletal system and adipose tissue. The present narrative review highlights the importance of the interaction of the mesenchymal tissues for bone development and maintenance and the impact on bone from diseases marked by functional and trophic disorders of adipose and muscle tissues. Arch Endocrinol Metab. 2022;66(5):611-20

https://doi.org/10.20945/2359-3997000000550

Definition and management of very high fracture risk in women with postmenopausal osteoporosis: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Association of Bone Assessment and Metabolism (ABRASSO)
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Silva, Barbara C.

; Madeira, Miguel

; d’Alva, Catarina Brasil

; Maeda, Sergio Setsuo

; Holanda, Narriane Chaves Pereira de

; Ohe, Monique Nakayama

; Szejnfeld, Vera

; Zerbini, Cristiano A. F.

; Paula, Francisco José Albuquerque de

; Bandeira, Francisco

Archives of Endocrinology and Metabolism

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oct 2022, Volume 66 N. 5 Pages 591 - 603

Abstract: En | Text: En | PDF: En

ABSTRACT Several drugs are available for the treatment of osteoporosis in postmenopausal women. Over the last decades, most patients requiring pharmacological intervention were offered antiresorptive drugs as first-line therapy, while anabolic agents were considered a last resource for those with therapeutic failure. However, recent randomized trials in patients with severe osteoporosis have shown that anabolic agents reduce fractures to a greater extent than antiresorptive medications. Additionally, evidence indicates that increases in bone mineral density (BMD) are maximized when patients are treated with anabolic agents first, followed by antiresorptive therapy. This evidence is key, considering that greater increases in BMD during osteoporosis treatment are associated with a more pronounced reduction in fracture risk. Thus, international guidelines have recently proposed an individualized approach to osteoporosis treatment based on fracture risk stratification, in which the stratification risk has been refined to include a category of patients at very high risk of fracture who should be managed with anabolic agents as first-line therapy. In this document, the Brazilian Society of Endocrinology and Metabolism and the Brazilian Association of Bone Assessment and Metabolism propose the definition of very high risk of osteoporotic fracture in postmenopausal women, for whom anabolic agents should be considered as first-line therapy. This document also reviews the factors associated with increased fracture risk, trials comparing anabolic versus antiresorptive agents, efficacy of anabolic agents in patients who are treatment naïve versus those previously treated with antiresorptive agents, and safety of anabolic agents.

https://doi.org/10.20945/2359-3997000000522

CLINICAL AND EPIDEMIOLOGICAL EVALUATION OF COMPLICATIONS ASSOCIATED WITH GALLSTONES IN A TERTIARY HOSPITAL
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AGUIAR, Ridson Guilherme Parente de

; SOUZA JÚNIOR, Francisco Emanoel Albuquerque de

; ROCHA JÚNIOR, José Leonardo Gomes

; PESSOA, Francisco Sérgio Rangel de Paula

; SILVA, Leidiane Pinho da

; CARMO, Gardênia Costa do

Arquivos de Gastroenterologia

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sep 2022, Volume 59 N. 3 Pages 352 - 357

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

RESUMO Contexto: A litíase biliar pode ser definida como a presença de cálculo ou barro biliar na vesícula e/ou nos ductos biliares. A doença pode ser assintomática ou sintomática, podendo levar a complicações e, consequentemente, a um pior prognóstico, como colecistite aguda, coledocolitíase, colangite e pancreatite aguda. O risco de complicações aumenta após o primeiro episódio de cólica biliar. Objetivo: Avaliação clínica-epidemiológica dos pacientes internados em enfermaria de gastroenterologia de um hospital terciário, com complicações relacionadas à litíase biliar. Métodos: Foram avaliados 158 pacientes internados no período de 1º de janeiro de 2013 a 24 de fevereiro de 2021, por meio de análise de relatório de alta e prontuário. Resultados: Houve uma predominância do sexo feminino (76,6%), e a média de idade dos pacientes foi de 51,6 anos. Homens eram significativamente mais velhos que as mulheres (P=0,005). A maioria (57,6%) apresentava alguma comorbidade, sendo as mais frequentes: hipertensão arterial sistêmica, diabetes mellitus e obesidade. A média de tempo de internação foi de 24 dias, sendo significativamente maior para os homens (P=0,046), mas sem relação direta com a idade (P=0,414). A complicação mais frequente foi a coledocolitíase, e 55,7% dos pacientes sem colecistectomia prévia apresentaram relato de cólica biliar antes da internação, em média, 1,5 anos antes. Histórico de colecistectomia prévia estava presente em 17,1% dos avaliados. Ultrassonografia abdominal, seguida de colangiorressonância magnética foram os exames complementares mais frequentemente realizados para definição diagnóstica. Em relação às medidas terapêuticas, a colangiopancreatografia endoscópica retrógrada (CPRE) foi necessária em 47,3% dos pacientes sem colecistectomia prévia e 81,4% dos pacientes com colecistectomia prévia. Dos pacientes ainda não colecistectomizados, 84% deles puderam ser submetidos ao procedimento antes da alta. Conclusão: Houve predomínio do sexo feminino. Os homens foram significativamente mais velhos do que as mulheres e tiveram uma permanência hospitalar consideravelmente mais longa. A complicação mais frequente foi a coledocolitíase, e cerca de metade dos pacientes relatou cólica biliar prévia. A CPRE foi necessária para a maioria dos pacientes.

ABSTRACT Background: Gallstones are the presence of bile clay in the gallbladder or bile ducts. The disease can be asymptomatic or symptomatic and can lead to complications and consequently a worse prognosis, such as acute cholecystitis, choledocholithiasis, cholangitis, and acute pancreatitis. The risk of complications increases after the first episode of biliary colic. Objective: A clinical-epidemiological evaluation of patients admitted to a gastroenterology ward of a tertiary care hospital with gallstone-related complications. Methods: We evaluated 158 patients admitted through discharge reports and medical records analysis from January 1, 2013, to February 24, 2021. Results: The female sex was predominant (76.6%), and the mean age of patients was 51.6 years. Men were significantly older than women (P=0.005). Most (57.6%) had some comorbidity, the most frequent being systemic arterial hypertension, diabetes mellitus, and obesity. The mean hospitalization time was 24 days, significantly longer in men (P=0.046) but without a direct relationship with age (P=0.414). The most frequent complication was choledocholithiasis, and 55.7% of patients without previous cholecystectomy had a report of biliary colic before admission, on average 1.5 years previously. A history of a prior cholecystectomy was present in 17.1% of those evaluated. Abdominal ultrasonography followed by magnetic resonance cholangiography was the most frequently performed exam for diagnostic definition. Regarding therapeutic measures, endoscopic retrograde cholangiopancreatography was necessary for 47.3% of patients without previous cholecystectomy and 81.4% of patients who have already had a cholecystectomy. Among patients not yet cholecystectomized, 84% underwent the procedure before discharge. Conclusion: The female patients were predominant. Men were significantly older than women and had more extended hospital stays. The most frequent complication was choledocholithiasis, and around half of the patients reported previous biliary colic. endoscopic retrograde cholangiopancreatography has been necessary for the majority of the patients.

https://doi.org/10.1590/s0004-2803.202203000-64

Official position of the Brazilian Association of Bone Assessment and Metabolism (ABRASSO) on the evaluation of body composition by densitometry: part I (technical aspects)— general concepts, indications, acquisition, and analysis
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Maeda, Sergio Setsuo

; Peters, Barbara Santarosa Emo

; Martini, Lígia Araújo

; Antunes, Hannah Karen Moreira

; Gonzalez, Maria Cristina

; Arantes, Henrique Pierotti

; Prado, Carla M.

; Pinto, Camila Lemos

; Araújo, Iana Mizumukai de

; Paula, Francisco José Albuquerque de

; Borges, Joao Lindolfo Cunha

; Albergaria, Ben-Hur

; Ushida, Marcela

; Souza, Guilherme Cardenaz de

; Mendonça, Laura Maria Carvalho de

; Prado, Mirley do

; Pinheiro, Marcelo de Medeiros

Advances in Rheumatology

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2022, Volume 62 elocation 7

Abstract: En | Text: En | PDF: En

Abstract Objective: To review the technical aspects of body composition assessment by dual-energy X-ray absorptiometry (DXA) and other methods based on the most recent scientific evidence. Materials and methods: This Official Position is a result of efforts by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism (Associação Brasileira de Avaliação Óssea e Osteometabolismo, ABRASSO) and health care professionals with expertise in body composition assessment who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications. In this first part of the Official Position, the authors discuss the different methods and parameters used for body composition assessment, general principles of DXA, and aspects of the acquisition and analysis of DXA scans. Conclusion: Considering aspects of accuracy, precision, cost, duration, and ability to evaluate all three compartments, DXA is considered the gold-standard method for body composition assessment, particularly for the evaluation of fat mass. In order to ensure reliable, adequate, and reproducible DXA reports, great attention is required regarding quality control procedures, preparation, removal of external artifacts, imaging acquisition, and data analysis and interpretation.

https://doi.org/10.1186/s42358-022-00241-8

Repetitive stress fracture: a warning sign of genetic susceptibility to fracture? A case report of a heterozygous variant in SERPINF1
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Moreira, Mariana Lima Mascarenhas

; Araújo, Iana Mizumukai de

; Molfetta, Greice Andreotti de

; Silva Jr., Wilson Araújo

; Paula, Francisco José Albuquerque de

Archives of Endocrinology and Metabolism

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aug 2021, Volume 65 N. 4 Pages 500 - 504

Abstract: En | Text: En | PDF: En

SUMMARY The occurrence of fractures in young individuals is frequently overlooked by physicians, especially when associated with exercise or trauma. Nevertheless, multiple fractures should always be investigated since underlying conditions can predispose to such events. We describe here the case of a young, healthy woman who sustained multiple fractures in the lower limbs, which were initially considered to be “stress fractures”. Further investigation, including a panel of genes associated with osteogenesis imperfecta, revealed that the patient is a heterozygous carrier of a SERPINF1 variant. According to criteria recommended by the American College of Medical Genetics and Genomics and the Association for Molecular Pathology, this variant is classified as likely benign (PM2, PP3, PP4, BP1, and BP4). The patient's mother and brother were also asymptomatic carriers of the variant and had sustained previous minor fractures. The patient had normal biochemical profile and bone density. This condition has been rarely described and is not associated with low bone mineral density or altered bone turnover markers. This case highlights the importance of investigating multiple fractures in young patients who are otherwise healthy since these may be a warning sign of rare genetic conditions associated with fragility fractures.

https://doi.org/10.20945/2359-3997000000375 199 downloads

Vitamin D: more does not mean better
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Paula, Francisco José Albuquerque de

Archives of Endocrinology and Metabolism

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oct 2020, Volume 64 N. 5 Pages 493 - 494

Abstract: En | Text: En | PDF: En

https://doi.org/10.20945/2359-3997000000303 711 downloads

Association of bone mineral density with bone texture attributes extracted using routine magnetic resonance imaging
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Maciel, Jamilly Gomes

; Araújo, Iana Mizumukai de

; Trazzi, Lucio C.

; Azevedo-Marques, Paulo Mazzoncini de

; Salmon, Carlos Ernesto Garrido

; Paula, Francisco José Albuquerque de

; Nogueira-Barbosa, Marcello Henrique

Clinics

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2020, Volume 75 elocation e1766

Abstract: En | Text: En | PDF: En

OBJECTIVE: Dual-energy X-ray absorptiometry (DXA)-derived bone mineral density (BMD) often fails to predict fragility fractures. Quantitative textural analysis using magnetic resonance imaging (MRI) may potentially yield useful radiomic features to predict fractures. We aimed to investigate the correlation between BMD and texture attributes (TAs) extracted from MRI scans and the interobserver reproducibility of the analysis. METHODS: Forty-nine volunteers underwent lumbar spine 1.5-T MRI and DXA. Three-dimensional (3-D) gray-level co-occurrence matrices were measured from routine sagittal T2 fast spin-echo images using the IBEX software. Twenty-two TAs were extracted from 3-D segmented L3 vertebrae. The estimated concordance coefficient was calculated using linear regression analysis. A Pearson correlation coefficient analysis was performed to evaluate the correlation between BMD and the TAs. Interobserver reproducibility was assessed with the concordance coefficient described by Lin. RESULTS: The results revealed a fair-to-moderate significant correlation between BMD and 13 TAs (r=−0.20 to 0.39; p<0.05). Eight TAs (autocorrelation, energy, homogeneity 1, homogeneity 1.1, maximum probability, sum average, sum variance, and inverse difference normalized) negatively correlated with BMD (r=−0.20 to −0.38; p<0.05), whereas five TAs (dissimilarity, difference entropy, entropy, sum entropy, and information measure corr 1) positively correlated with BMD (r=0.29-0.39; p<0.05). The interobserver agreement was almost perfect for all significant TAs (95% confidence interval, 0.92-1.00; p<0.05). CONCLUSION: Specific TAs could be reliably extracted from routine MRI and correlated with BMD. Our results encourage future evaluation of the potential usefulness of quantitative texture measurements from MRI scans for predicting fragility fractures.

https://doi.org/10.6061/clinics/2020/e1766 251 downloads

10.

Guideline of the Brazilian Society of Cardiology on Telemedicine in Cardiology - 2019
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Lopes, Marcelo Antônio Cartaxo Queiroga

; Oliveira, Gláucia Maria Moraes de

; Ribeiro, Antonio Luiz Pinho

; Pinto, Fausto J.

; Rey, Helena Cramer Veiga

; Zimerman, Leandro Ioschpe

; Rochitte, Carlos Eduardo

; Bacal, Fernando

; Polanczyk, Carisi Anne

; Halperin, Cidio

; Araújo, Edson Correia

; Mesquita, Evandro Tinoco

; Arruda, José Airton

; Rohde, Luis Eduardo Paim

; Grinberg, Max

; Moretti, Miguel

; Caramori, Paulo Ricardo Avancini

; Botelho, Roberto Vieira

; Brandão, Andréa Araújo

; Hajjar, Ludhmila Abrahão

; Santos, Alexandre Fonseca

; Colafranceschi, Alexandre Siciliano

; Etges, Ana Paula Beck da Silva

; Marino, Bárbara Campos Abreu

; Zanotto, Bruna Stella

; Nascimento, Bruno Ramos

; Medeiros, Cesar Rocha

; Santos, Daniel Vitor de Vasconcelos

; Cook, Daniela Matos Arrowsmith

; Antoniolli, Eduardo

; Souza Filho, Erito Marques de

; Fernandes, Fábio

; Gandour, Fabio

; Fernandez, Francisco

; Souza, Germano Emilio Conceição

; Weigert, Guilherme de Souza

; Castro, Iran

; Cade, Jamil Ribeiro

; Figueiredo Neto, José Albuquerque de

; Fernandes, Juliano de Lara

; Hadlich, Marcelo Souza

; Oliveira, Marco Antonio Praça

; Alkmim, Maria Beatriz

; Paixão, Maria Cristina da

; Prudente, Maurício Lopes

; Aguiar Netto, Miguel A. S.

; Marcolino, Milena Soriano

; Oliveira, Monica Amorim de

; Simonelli, Osvaldo

; Lemos Neto, Pedro A.

; Rosa, Priscila Raupp da

; Figueira, Renato Minelli

; Cury, Roberto Caldeira

; Almeida, Rodrigo Coelho

; Lima, Sandra Regina Franco

; Barberato, Silvio Henrique

; Constancio, Thiago Inocêncio

; Rezende, Wladimir Fernandes de

Arquivos Brasileiros de Cardiologia

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nov 2019, Volume 113 N. 5 Pages 1006 - 1056

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

https://doi.org/10.5935/abc.20190205 5274 downloads

11.

The Algorhytm: FRAX Brazil
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Albergaria, Ben Hur

; Paula, Francisco José Albuquerque

Revista Brasileira de Ginecologia e Obstetrícia

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aug 2019, Volume 41 N. 8 Pages 467 - 468

Abstract: En | Text: En | PDF: En

https://doi.org/10.1055/s-0039-1695027 284 downloads

12.

Diagnosis and treatment of hypoparathyroidism: a position statement from the Brazilian Society of Endocrinology and Metabolism
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Maeda, Sergio Setsuo

; Moreira, Carolina Aguiar

; Borba, Victória Zeghbi Cochenski

; Bandeira, Francisco

; Farias, Maria Lucia Fleiuss de

; Borges, João Lindolfo Cunha

; Paula, Francisco José Albuquerque de

; Vanderlei, Felipe Augusto Brasileiro

; Montenegro, Fábio Luiz de Menezes

; Santos, Rodrigo Oliveira

; Ferraz-de-Souza, Bruno

; Lazaretti-Castro, Marise

Archives of Endocrinology and Metabolism

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feb 2018, Volume 62 N. 1 Pages 106 - 124

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To present an update on the diagnosis and treatment of hypoparathyroidism based on the most recent scientific evidence. Materials and methods The Department of Bone and Mineral Metabolism of the Sociedade Brasileira de Endocrinologia e Metabologia (SBEM; Brazilian Society of Endocrinology and Metabolism) was invited to prepare a document following the rules set by the Guidelines Program of the Associação Médica Brasileira (AMB; Brazilian Medical Association). Relevant papers were retrieved from the databases MEDLINE/PubMed, LILACS, and SciELO, and the evidence derived from each article was classified into recommendation levels according to scientific strength and study type. Conclusion An update on the recent scientific literature addressing hypoparathyroidism is presented to serve as a basis for the diagnosis and treatment of this condition in Brazil.

https://doi.org/10.20945/2359-3997000000015 7166 downloads

13.

What Value is there in Assessing Postmenopausal Women for Vitamin D Deficiency?
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Moreira, Mariana Lima Mascarenhas

; Paula, Francisco José Albuquerque de

Revista Brasileira de Ginecologia e Obstetrícia

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nov 2017, Volume 39 N. 11 Pages 585 - 586

Abstract: En | Text: En | PDF: En

https://doi.org/10.1055/s-0037-1606858 900 downloads

14.

Redistribuição de gordura corporal e alterações no metabolismo de lipídeos e glicose em pessoas vivendo com HIV/AIDS
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Beraldo, Rebeca Antunes

; Santos, André Pereira dos

; Guimarães, Mariana Palma

; Vassimon, Helena Siqueira

; Paula, Francisco José Albuquerque de

; Machado, Dalmo Roberto Lopes

; Foss-Freitas, Maria Cristina

; Navarro, Anderson Marliere

Revista Brasileira de Epidemiologia

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sep 2017, Volume 20 N. 3 Pages 526 - 536

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

RESUMO: Introdução: A síndrome da lipodistrofia do HIV é caracterizada por alterações no metabolismo e na composição corporal, que aumentam o risco cardiovascular de pessoas vivendo com HIV/AIDS (PVHA) em uso da terapia antirretroviral de alta potência (TARV). Objetivo: Avaliar a prevalência de lipodistrofia e de alterações do metabolismo de lipídios e glicose em PVHA em uso da TARV. Métodos: Para avaliação antropométrica foram aferidos peso, estatura e circunferência abdominal (CA). Para avaliação da lipodistrofia foi realizado o exame físico (subjetivo) e o exame (objetivo) de absortometria com raios X de dupla energia (DEXA) por meio da razão de massa gorda (RMG). Foram também realizados exames de lipidograma e glicemia de jejum e utilizados os critérios sugeridos pelo The National Cholesterol Education Program III para classificação de alterações metabólicas. Resultados: A amostra final consistiu em 262 pacientes com idade média de 44,3 ± 10,2 anos. A lipodistrofia, de acordo com o exame físico, esteve presente em 47,7% (IC95% 41,7 - 53,8) dos pacientes, enquanto pela RMG (DEXA) sua prevalência foi de 40,8% (IC95% 33,1 - 48,5). A maioria (53,0%; IC95% 47,0 - 59,1) dos pacientes apresentou aumento de adiposidade abdominal segundo a CA. As alterações metabólicas mais presentes foram o HDL reduzido (67,6%; IC95% 61,9 - 73,2) e a hipertrigliceridemia (55,7%; IC95% 49,7 - 61,7). Conclusões: A alta prevalência de lipodistrofia e alterações do metabolismo de lipídios e glicose evidenciam a importância da intervenção precoce nesse grupo de pacientes para prevenir complicações cardiovasculares.

ABSTRACT: Introduction: The HIV lipodystrophy syndrome is characterized by changes in metabolism, and body composition that increase cardiovascular risk of people living with HIV/AIDS (PLWHA) using highly active antiretroviral therapy (HAART). Objective: To assess the prevalence of lipodystrophy and changes in lipid and glucose metabolism in PLWHA in use of HAART. Methods: For the anthropometric evaluation we measured weight, height and abdominal circumference (AC). For the lipodystrophy evaluation we conducted physical examination (subjective) and the (objective) examination of absorptiometry with X-ray dual energy (DEXA) by fat mass ratio (FMR). We also conducted lipid profile tests and fasting glucose and used the criteria suggested by The National Cholesterol Education Program III for metabolic disorders classification. Results: The final sample consisted of 262 patients with a mean age of 44.3 ± 10.2 years. Lipodystrophy, according to the physical examination, was present in 47.7% (95%CI 41.7 - 53.8) of patients, while the prevalence using FMR (DEXA) was 40.8% (95%CI 33.1 - 48.5). Most (53.0%; 95%CI 47.0 - 59.1) of the patients showed increased abdominal adiposity according to AC. The most prevalent metabolic alterations were reduced HDL (67.6%; 95%CI 61.9 - 73.2) and hypertriglyceridemia (55.7%; 95%CI 49.7 - 61.7). Conclusion: The high prevalence of lipodystrophy and changes in lipid and glucose metabolism show the importance of early intervention in this group of patients to prevent cardiovascular complications.

https://doi.org/10.1590/1980-5497201700030014 278 downloads

15.

Redistribuição de gordura corporal e alterações no metabolismo de lipídeos e glicose em pessoas vivendo com HIV/AIDS
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Beraldo, Rebeca Antunes

; Santos, André Pereira dos

; Guimarães, Mariana Palma

; Vassimon, Helena Siqueira

; Paula, Francisco José Albuquerque de

; Machado, Dalmo Roberto Lopes

; Foss-Freitas, Maria Cristina

; Navarro, Anderson Marliere

Revista Brasileira de Epidemiologia

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jul 2017, Volume 20 N. 3 Pages 526 - 536

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

https://doi.org/10.1590/1980-5497201700030014 5050 downloads

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