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Programa de Residência Médica em Cardiologia de Adultos do InCor em 2022: 40 Anos Formando Cardiologistas para as Demandas do Brasil
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Lottenberg, Marcos Pita

; Bichuette, Luciana Dornfeld

; Bortolotto, Luiz Aparecido

; Gowdak, Luís Henrique Wolff

; Darrieux, Francisco Carlos da Costa

; Binotto, Maria Angélica

; Kalil Filho, Roberto

; Caramelli, Bruno

Arquivos Brasileiros de Cardiologia

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nov 2022, Volume 119 N. 5 Pages 43 - 51

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

Resumo Fundamento Diante de dados demográficos referentes às áreas de atuação dos cardiologistas no Brasil, a coordenação do Programa de Residência Médica em Cardiologia do Instituto do Coração (PRM INCOR) entendeu a necessidade de uma atualização de seu conteúdo programático, a fim de adaptar o processo de formação à realidade profissional do cardiologista. Objetivo O presente artigo tem como objetivo descrever à comunidade científica as atualizações recentemente implementadas no PRM INCOR. Métodos No artigo, descrevemos as atualizações recentes do PRM INCOR, comparando a grade teórica pregressa e a atual. Expomos também o racional por trás de tais mudanças com dados de literatura relacionados à atuação do médico cardiologista no mercado de trabalho. Resultado Houve uma redução da carga horária destinada a estágios de terapia intensiva, e um incremento nas atividades ambulatoriais relacionadas a medidas de prevenção primária e secundária. Além disso, o programa passou por uma reformulação de seu conteúdo didático, organizado agora por núcleos de competência. Conclusão A atualização da grade curricular decorre da necessidade de adequar o PRM INCOR à realidade atual do mercado de trabalho brasileiro. O grupo envolvido na atualização está ciente que se trata de um processo dinâmico e que pode exigir modificações no decorrer do tempo.

Abstract Background Considering demographic data related to the cardiologist’s fields of work in Brazil, the administrative board of the InCor medical residency program decided for an update of its curriculum content, to adapt the educational process to the cardiologist’s work reality. Objective This article aimed to describe the recent updates applied to the InCor medical residency program. Methods In the article, we described the recent updates on the InCor residency program, and compared the current curriculum track with the previous one. We also presented the rationale for these changes, based on the literature on the participation of cardiologists in the labor market. Results There was a reduction in the working hours of residents in training in the intensive care unit, and an increase in the outpatient activities of primary and secondary prevention. Also, the didactic content was reformulated and became organized by the corresponding division. Conclusion The update of the curriculum track of the InCor medical residency program was required in order to adapt it to the Brazilian labor market. The commission in charge of this update is aware that this is a dynamic process that may need changes over time.

https://doi.org/10.36660/abc.20220457

Lifestyle, inadequate environments in childhood and their effects on adult cardiovascular health
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Back, Isabela de Carlos

; Barros, Nelson Filice de

; Caramelli, Bruno

Jornal de Pediatria

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2022, Volume 98 Suppl. 1 Pages 19 - 26

Abstract: En | Text: En | PDF: En

Abstract Objectives: To discuss the associations between habits and environment in childhood and cardiovascular effects on adults. Source of data: Search in PubMed, Scielo and Science databases, cohort or case-control studies, and systematic or scope-based reviewson the causal relationship among exposures in the pediatric age group and cardiovascular effects in adults. Synthesis of data: The authors identified 41 eligible articles, which demonstrated an impact on cardiovascular health (characterized as surrogate events - structural or functional vascular alterations or left ventricular dysfunction - or clinical events - myocardial infarction, stroke or cardiovascular death) with environmental aspects (intrauterine or economically poor environment, violence, reduced life expectancy and serious infections) and habits (nutrition, physical activity and tobacco exposure). In addition to the direct and independent associations between exposures and outcomes, several traditional cardiovascular risk factors (CVRF) or family histories are also intermediate pathophysiological pathways in the described phenomena. Conclusions: There are direct relationships between lifestyle and inadequate environments in childhood and cardiovascular effects, although the observed associations showed divergences in terms of results and interpretation. In spite of these, it is recommended to encourage healthy lifestyles and protection against childhood adverse exposures, as habit formation occurs at this age, and its relationship with CVRF since childhood has already been well established. On the other hand, the format and intensity of the stimulus must respect the social, cultural and psychological aspects of each population, aiming to obtain the best and most lasting result without generating harmful consequences for the individuals.

https://doi.org/10.1016/j.jped.2021.09.005

Atualização da Diretriz de Avaliação Cardiovascular Perioperatória da Sociedade Brasileira de Cardiologia: Foco em Manejo dos Pacientes com Intervenção Coronária Percutânea – 2022
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Calderaro, Daniela

; Bichuette, Luciana Dornfeld

; Maciel, Pamela Camara

; Cardozo, Francisco Akira Malta

; Ribeiro, Henrique Barbosa

; Gualandro, Danielle Menosi

; Baracioli, Luciano Moreira

; Soeiro, Alexandre de Matos

; Serrano Jr., Carlos Vicente

; Costa, Ricardo Alves da

; Caramelli, Bruno

Arquivos Brasileiros de Cardiologia

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2022, Volume 118 N. 2 Pages 536 - 547

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

https://doi.org/10.36660/abc.20220039

Hemodynamic depression after carotid surgery: Incidence, risk factors and outcomes
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Bogniotti, Lauro A.C.

; Teivelis, Marcelo P.

; Cardozo, Francisco A.M.

; Caramelli, Bruno

; Wolosker, Nelson

; Puech-Leão, Pedro

; Luccia, Nelson De

; Calderaro, Daniela

Clinics

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2022, Volume 77 elocation 100090

Abstract: En | Text: En | PDF: En

Abstract Introduction: Hemodynamic Depression (HD) characterized by hypotension and bradycardia is a complication of carotid surgery due to direct autonomic stimulation in the carotid sinus. The authors believe the incidence of HD is high and possibly related to major cardiac complications. Methods: Analysis of patient records during admissions for carotid surgery between January 2014 and December 2018 in two hospitals. HD was defined as bradycardia or hypotension in the first 24 postoperative hours. Bradycardia was defined as heart rate < 50bpm; hypotension as systolic blood pressure < 90 mmHg, continuous use of vasopressors, or a drop in SBP > 20% compared to preoperative values. Myocardial infarction, stroke, and cardiovascular death were defined as adverse events. Results: Overall, 237 carotid surgeries (178 endarterectomies, 59 angioplasties) were studied, and the global incidence of HD was 54.4% (hypotension in 50.2%, bradycardia in 11.0%, and hypotension and bradycardia in 6.8%). The independent predictors of HD were asymptomatic carotid stenosis (OR = 1.824; 95% CI 1.014 −3.280; p = 0.045), endovascular surgery (OR = 3.319; 95% CI 1.675−6.576; p = 0.001) and intraoperative hypotension or bradycardia (OR = 2.144; 95% CI 1.222−3.762; p = 0.008). Hypotension requiring continuous vasopressor infusion was the only factor independently associated with adverse cardiovascular events (OR = 5.504; 95% CI 1.729-17.529; p = 0.004). Discussion/conclusion: Incidence of Hemodynamic Depression after carotid surgery is high and independently associated with surgical technique, symptomatic repercussion of the carotid stenosis, and intraoperative hypotension or bradycardia. Hypotension requiring the continuous infusion of vasopressors was independently associated with the occurrence of MACE.

https://doi.org/10.1016/j.clinsp.2022.100090

Medical students with performance difficulties need wide support: Initial results of an academic tutoring program
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Bellodi, Patrícia Lacerda

; Dolhnikoff, Marisa

; Jacomo, Alfredo Luiz

; Jorge, Alexander Augusto de Lima

; Ferraro, Alexandre Archanjo

; Germani, Ana Claudia Camargo Gonçalves

; Tannuri, Ana Cristina Aoun

; Tess, Beatriz Helena Carvalho

; Caramelli, Bruno

; Malheiros, Denise Maria Avancini Costa

; Tibério, Iolanda de Fátima Lopes Calvo

; Otoch, José Pinhata

; Silva, Luiz Fernando Ferraz da

; Castro, Luiz Henrique Martins

; Zerbini, Maria Cláudia Nogueira

; Dolhnikoff, Marisa

; Martins, Milton de Arruda

; Souza, Rogério de

; Francisco, Rossana Pulcineli Vieira

Clinics

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2021, Volume 76 elocation e2495

Abstract: En | Text: En | PDF: En

BACKGROUND: Even students with previous academic success may face challenges that affect their academic performance. Many medical schools offer programs to students at the risk of academic failure, to ensure that they succeed in the course. OBJECTIVE AND METHODS: In this report we describe a pioneering academic tutoring program developed at a Brazilian medical school and discuss the initial results of the program based on the feedback from tutors and data regarding the progression of students in the medical course. RESULTS: In 2018, 33 students enrolled into the program. Students' performance difficulties were mainly associated with mental health problems and socioeconomic vulnerability. Of the 33 students, 27 (81.8%) were assisted by the Mental Health Support Service and 16 (48.5%) were assisted by the Social Assistance Service. In addition to the planning academic activity class load, tutors were able to assist students in solving socioeconomic issues, carrying out personal support interventions with the promotion of self-esteem, and presenting suggestions for behavioral changes in their routine. For most students (72%), the action plan proposed by the tutors was successful. Eight of the 14 (57%) students in the fourth year progressed to the final two years of in-hospital practical training (internship). CONCLUSIONS: The Academic Tutoring Program showed positive results for most of the students. Close monitoring and tutor intervention allowed students with poor academic performance to overcome the low performance cycle. These important tasks demand time and energy from tutors, and institutional recognition of these professionals is essential for the successful maintenance of the program.

https://doi.org/10.6061/clinics/2021/e2495 377 downloads

Cardiology referral during the COVID-19 pandemic
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Santorio, Nathalia Conci

; Cardozo, Francisco Akira Malta

; Miada, Rodrigo Freddi

; Pitta, Fabio Grunspun

; Tavares, Caio de Assis Moura

; Habrum, Fabio Cetinic

; Pinesi, Henrique Trombini

; Magalhães, Iuri Resedá

; Menezes, Maria Clara Saad

; Caramelli, Bruno

; Calderaro, Daniela

Clinics

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2021, Volume 76 elocation e3538

Abstract: En | Text: En | PDF: En

OBJECTIVES: This study presents the cardiology referral model adopted at the University of São Paulo-Hospital das Clínicas complex during the initial period of the coronavirus disease (COVID-19) pandemic, main reasons for requesting a cardiologic evaluation, and clinical profile of and prognostic predictors in patients with COVID-19. METHODS: In this observational study, data of all cardiology referral requests between March 30, 2020 and July 6, 2020 were collected prospectively. A descriptive analysis of the reasons for cardiologic evaluation requests and the most common cardiologic diagnoses was performed. A multivariable model was used to identify independent predictors of in-hospital mortality among patients with COVID-19. RESULTS: Cardiologic evaluation was requested for 206 patients admitted to the ICHC-COVID. A diagnosis of COVID-19 was confirmed for 180 patients. Cardiologic complications occurred in 77.7% of the patients. Among these, decompensated heart failure was the most common complication (38.8%), followed by myocardial injury (35%), and arrhythmias, especially high ventricular response atrial fibrillation (17.7%). Advanced age, greater need of ventilatory support on admission, and pre-existing heart failure were independently associated with in-hospital mortality. CONCLUSIONS: A hybrid model combining in-person referral with remote discussion and teaching is a viable alternative to overcome COVID-19 limitations. Cardiologic evaluation remains important during the pandemic, as patients with COVID-19 frequently develop cardiovascular complications or decompensation of the underlying heart disease.

https://doi.org/10.6061/clinics/2021/e3538

Children First Study II: an educational programme on cardiovascular prevention in public schools can reduce parents' cardiovascular risk
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Pinto, Cristiano J. M.

; Fornari, Luciana S.

; Oyama, Silvia M. R.

; Rodrigues, Maria M. D.

; Davanço, Taciana

; Caramelli, Bruno

Revista da Associação Médica Brasileira

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sep 2020, Volume 66 N. 9 Pages 1217 - 1224

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

RESUMO OBJETIVO: Analisar se a implementação de um programa educacional multidisciplinar para prevenção cardiovascular em escolas públicas durante um ano pode contribuir para reduzir o escore de risco cardiovascular de Framingham dos pais das crianças. MÉTODOS: Estudo prospectivo, de base comunitária, caso-controle em duas escolas públicas de São Paulo, Brasil. Os alunos foram randomizados para receber recomendações de estilo de vida saudável por duas abordagens diferentes. O grupo controle recebeu folhetos educacionais de saúde cardiovascular encaminhados para seus pais. O grupo intervenção recebeu os mesmos folhetos e as crianças foram expostas a um programa educacional semanal, durante um ano, com uma equipe multidisciplinar em prevenção cardiovascular. Dados clínicos e laboratoriais foram coletados no início e no final do estudo. RESULTADOS: Foram sujeitos do estudo 418 pais das crianças das escolas. No início da pesquisa, o total de pais com escore de Framingham intermediário ou alto (risco superior a 10% de doença cardiovascular nos próximos dez anos) foi de 6,9% no grupo controle e de 13,3% no grupo intervenção. Após um ano, dentre os pais com escore de risco de Framingham intermediário ou alto, foi observada redução de 22,2% no grupo intervenção e aumento de 33,3% no grupo controle (p=0,031). Os fatores de risco cardiovascular que melhoraram no grupo de intervenção foram pressão arterial, LDL-colesterol (lipoproteína de baixa densidade) e glicemia. CONCLUSÃO: Um programa educacional de prevenção cardiovascular para crianças em idade escolar, em escolas públicas, pode reduzir o risco cardiovascular de seus pais.

SUMMARY OBJECTIVE: The aim of this study was to analyze whether the implementation of a multidisciplinary educational programme for cardiovascular prevention in public schools can contribute to reducing the Fram INGHAM CARDIOVASCULAR RISK SCORE OF THE CHILDREN'S PARENTS AFTER ONE YEAR. METHODS: This was a prospective, community-based, case-control study carried out in public schools in Sao Paulo, Brasil. Students were randomized to receive healthy lifestyle recommendations by two different approaches. The control group received written cardiovascular health educational brochures for their parents. The intervention group received the same brochures for the parents, and the children were exposed to a weekly educational programme on cardiovascular prevention with a multidisciplinary health team for one year. Clinical and laboratorial data were collected at the onset and end of the study. RESULTS: We studied 265 children and their 418 parents. At the baseline, the rate of parents with intermediate or high Framingham scores (risk of cardiovascular disease over the next 10 years greater than 10%) was 6.9% in the control group and 13.3% in the intervention group. After one year, the rate of parents with intermediate or high Framingham risk score was reduced by 22.2% in the intervention group and increased by 33.3% in the control group (p=0.031). The cardiovascular risk factors that improved in the intervention group were blood pressure, LDL-cholesterol (low-density lipoprotein cholesterol), and glucose levels. CONCLUSION: An educational programme on cardiovascular prevention for school-age children in public schools can reduce the cardiovascular risk of their parents.

https://doi.org/10.1590/1806-9282.66.9.1217 530 downloads

A Síndrome de Takotsubo Existe como uma Doença Específica?
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Caramelli, Bruno

Arquivos Brasileiros de Cardiologia

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aug 2020, Volume 115 N. 2 Pages 217 - 218

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

https://doi.org/10.36660/abc.20200470 584 downloads

Communication gap between health professionals and patients on anticoagulant therapy in the WhatsApp era
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Yu, Pai Ching

; Caramelli, Bruno

Arquivos de Neuro-Psiquiatria

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dec 2018, Volume 76 N. 12 Pages 805 - 806

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0004-282x20180139 1070 downloads

10.

From Journals to Bedside: We Must Improve the Compliance with Practice Guidelines
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Kumagai, Barbara

; Caramelli, Bruno

Arquivos Brasileiros de Cardiologia

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oct 2018, Volume 111 N. 4 Pages 605 - 606

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

https://doi.org/10.5935/abc.20180186 414 downloads

11.

Anticoagulants and antiplatelet drugs during cataract surgery
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Kara-Junior, Newton

; Koch, Camila Ribeiro

; Santhiago, Marcony Rodrigues de

; Fornari, Luciana

; Caramelli, Bruno

Arquivos Brasileiros de Oftalmologia

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aug 2018, Volume 81 N. 4 Pages 348 - 353

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

RESUMO Os pacientes submetidos à cirurgia de catarata são geralmente idosos e muitos deles usam drogas com efeitos sistêmicos. No entanto, o cirurgião deve estar ciente dos riscos em manter ou descontinuar medicamentos sistêmicos no pré-operatório da cirurgia de catarata, como os anticoagulantes e os antiplaquetários. Este artigo tem como objetivo revisar a classe de drogas antiplaquetárias e anticoagulantes e orientar o cirurgião de catarata. A classe de fármacos anticoagulantes e antiplaquetária reduz a incidência de eventos potencialmente tromboembólicos. A anestesia tópica ou intracameral nesses pacientes deve ser preferida em relação à anestesia com agulhas. Aspirina pode ser mantida com segurança nos pacientes submetidos à cirurgia de catarata. A varfarina foi amplamente estudada e os riscos na cirurgia de catarata são baixos, no entanto, o INR deve ser controlado. Mais estudos são necessários com anticoagulantes orais diretos. Anestesia na cirurgia de catarata tem baixo risco de complicações, mesmo em uso de anticoagulantes ou antiplaquetários sistêmicos. A descontinuação desta classe de medicamentos no pré-operatório da cirurgia de catarata pode aumentar os riscos sistêmicos tromboembólicos.

ABSTRACT Patients undergoing cataract surgery are generally elderly, and many take drugs with systemic effects. The surgeon must be aware of the risks of continuing or discontinuing such medications perioperatively. Antiplatelet drugs and anticoagulants, prescribed to reduce the incidence of thromboembolic events, are often used in this population. This paper aims to review the perioperative use of antiplatelet and anticoagulant drugs in the setting of cataract surgery. Topical or intracameral anesthesia is preferred over anesthesia injected with needles. Aspirin can be safely continued in patients undergoing cataract surgery. Warfarin has been extensively studied, and the risk of hemorrhage associated with cataract surgery is low if the international normalized ratio is in the therapeutic range. Only a few studies of direct oral anticoagulants are available, and therefore no definite recommendations regarding those agents can be made at this time. Anesthesia in cataract surgery carries a low risk, even for patients taking anticoagulant or antiplatelet drugs. The discontinuation of this class of drugs before cataract surgery may increase the risk of thromboembolism.

https://doi.org/10.5935/0004-2749.20180069 12764 downloads

12.

Both glucocentric and cardiocentric approaches are necessary for a resilient disease such as diabetes
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Caramelli, Bruno

; Gualandro, Danielle Menosi

Revista da Associação Médica Brasileira

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mar 2018, Volume 64 N. 3 Pages 212 - 213

Abstract: En | Text: En | PDF: En

Summary Diabetes mellitus (DM) is a complex disease that compromises almost all systems in the human organism. Independently of the intrinsic mechanisms, the source of all consequences of DM is hyperglycemia, a condition associated to intense metabolic changes that will lead to increased morbidity and mortality in the long term. Several different therapeutic hypoglycemic oral agents were developed and significantly facilitated the treatment of hyperglycemia acting at different sites, since patients could take more than one agent. This glucocentric approach was somehow criticized as those hypoglycemic drugs have shown weaker than expected benefits in terms of cardiovascular outcomes and there was a sub use of statins and antihypertensive agents in this population. On the other hand, the catastrophic cardiovascular consequences of hypoglycemia in older adults submitted to tight glycemic control and the results of recent clinical trials that showed impressive reduction in cardiovascular outcomes with less potent antidiabetic agents seem to pave the way to a cardiocentric approach including a lax treatment of DM. Interestingly, the results obtained in recent studies with SGLT2 inhibitors are being mostly attributed to mechanisms other than its hypoglycemic effect in spite of including patients at high cardiovascular risk already taking hypoglycemic agents. Considering the worldwide growing number of patients with diabetes, caregivers must follow a dialectical thinking and choose a synthesis approach where glycemic control is the first and foremost target to be achieved, followed by control of cardiovascular risk factors.

https://doi.org/10.1590/1806-9282.64.03.212 923 downloads

13.

3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology
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Gualandro, Danielle Menosi

; Yu, Pai Ching

; Caramelli, Bruno

; Marques, André Coelho

; Calderaro, Daniela

; Fornari, Luciana Savoy

; Pinho, Claudio

; Feitosa, Alina Coutinho Rodrigues

; Polanczyk, Carisi Anne

; Rochitte, Carlos Eduardo

; Jardim, Carlos

; Vieira, Carolina L. Z.

; Nakamura, Debora Y. M.

; Iezzi, Denise

; Schreen, Dirk

; Adam, Eduardo Leal

; D’Amico, Elbio Antonio

; Lima, Emerson Q. de

; Burdmann, Emmanuel de Almeida

; Mateo, Enrique Indalecio Pachón

; Marcondes-Braga, Fabiana Goulart

; Machado, Fabio S.

; Paula, Flavio J. de

; Carmo, Gabriel Assis Lopes do

; Feitosa-Filho, Gilson Soares

; Prado, Gustavo Faibischew

; Lopes, Heno Ferreira

; Fernandes, João R. C.

; Lima, José J. G. de

; Sacilotto, Luciana

; Drager, Luciano Ferreira

; Vacanti, Luciano Janussi

; Rohde, Luis Eduardo Paim

; Prada, Luis F. L.

; Gowdak, Luis Henrique Wolff

; Vieira, Marcelo Luiz Campos

; Monachini, Maristela Camargo

; Macatrão-Costa, Milena Frota

; Paixão, Milena Ribeiro

; Oliveira Junior, Mucio Tavares de

; Cury, Patricia

; Villaça, Paula R.

; Farsky, Pedro Silvio

; Siciliano, Rinaldo F.

; Heinisch, Roberto Henrique

; Souza, Rogerio

; Gualandro, Sandra F.M.

; Accorsi, Tarso Augusto Duenhas

; Mathias Júnior, Wilson

Arquivos Brasileiros de Cardiologia

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sep 2017, Volume 109 N. 3 Pages 1 - 104

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

https://doi.org/10.5935/abc.20170140 100302 downloads

14.

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

Arquivos Brasileiros de Cardiologia

Journal Metrics
- Sobre o periódico
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aug 2017, Volume 109 N. 2 Pages 1 - 76

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.5935/abc.20170121 199102 downloads

15.

Exercise Improves Cardiovascular Risk Factors, Fitness, and Quality Of Life in Hiv+ Children and Adolescents: Pilot Study
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Lima, Luiz Rodrigo Augustemak de

; Back, Isabela de Carlos

; Beck, Carmem Cristina

; Caramelli, Bruno

International Journal of Cardiovascular Sciences

Journal Metrics
- Sobre o periódico
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apr 2017, Volume 30 N. 2 Pages 171 - 176

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

Resumo Crianças e adolescentes infectados pelo HIV através da transmissão mãe-filho têm alto risco de desenvolver doenças cardiovasculares precoces devido à dislipidemia, resistência à insulina e inflamação crônica de baixo grau. O objetivo do estudo piloto foi analisar o efeito de um programa de exercícios físicos lúdicos sobre os desfechos cardiovasculares, morfológicos, metabólicos, de aptidão e qualidade de vida. Um ensaio clínico não-randomizado composto por 24 sessões de exercícios aeróbicos e resistidos foi aplicado a 10 crianças e adolescentes vivendo com o HIV, oriundos de Florianópolis, SC, Brasil. As seguintes variáveis foram obtidas antes e após o programa: colesterol total, HDL-c, LDL-c, triglicerídeos, glicose, proteína-C reativa em jejum, pressão arterial, espessura íntima-média da artéria carótida comum (EIM-ACC), resistência muscular, aptidão aeróbia, antropometria e qualidade de vida medida. Após a intervenção, observou-se diminuição da pressão arterial sistólica (-6,8 mmHg, 6,6%, p = 0,019) e EIM-ACC (-60,0 µm, 12,2%; p = 0,002) após 24 sessões. Observou-se aumento na resistência muscular dos membros superiores (+3,3 rep.min-1, 63,5%, p = 0,002), flexibilidade (+5,7 cm, 26,0%; p = 0,001) e qualidade de vida (+10,4 pontos, 27,5%, p = 0,003). Em nossa amostra de crianças e adolescentes vivendo com o HIV, um programa de exercícios de curta duração foi associado com melhora no risco cardiovascular, aptidão física e qualidade de vida.

Abstract Children and adolescents infected by HIV through mother-to-child transmission are at high risk of developing premature cardiovascular diseases due to dyslipidemia, insulin resistance and low-grade chronic inflammation. The aim of the pilot study was to verify the effect of a playful exercise program on cardiovascular, morphological, metabolic, fitness, and quality of life outcomes. A non-randomized clinical trial consisting of 24 sessions of playful aerobic and resistive exercises was applied to 10 children and adolescents living with HIV from Florianopolis, Brazil. The following variables were obtained before and after the program: fasting total cholesterol, HDL-c, LDL-c, triglycerides, glucose, C-reactive protein, blood pressure, common carotid artery intima-media thickness (CCA-IMT), flexibility, muscular endurance, aerobic fitness, anthropometry, and measured quality of life. After the intervention, a decrease in systolic blood pressure (-6.8 mmHg, 6.6%; p = 0.019) and CCA-IMT (-60.0 µm, 12.2%; p = 0.002) was observed after 24 sessions. There was an increase in upper-limb muscular endurance (+3.3 rep.min-1, 63.5%; p = 0.002), flexibility (+5.7 cm, 26.0%; p = 0.001), and quality of life (+10.4 points, 27.5%; p = 0.003). In our sample of children and adolescents living with HIV, a short-term exercise program was associated with improvement in cardiovascular risk, fitness, and quality of life.

https://doi.org/10.5935/2359-4802.20170032 3981 downloads

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