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Liver steatosis as a predictor of incident diabetes in adults: a prospective evaluation in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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Faria, Luciana Costa

; Diniz, Maria de Fátima Haueisen Sander

; Giatti, Luana

; Schmidt, Maria Inês

; Goulart, Alessandra Carvalho

; Duncan, Bruce Bartholow

; Barreto, Sandhi Maria

Cadernos de Saúde Pública

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2023, Volume 39 N. 3 elocation e00090522

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

Evidências epidemiológicas crescentes sugerem uma relação bidirecional entre a doença hepática gordurosa não alcoólica (DHGNA) e o diabetes tipo 2 e que a DHGNA pode preceder e/ou promover o desenvolvimento de diabetes. O objetivo deste estudo foi investigar se a esteatose hepática está associada à incidência de diabetes no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). O ELSA-Brasil é um estudo de coorte ocupacional com servidores públicos ativos ou aposentados, com idades entre 35 e 74 anos, de seis capitais do Brasil. Foram excluídos os participantes com diabetes no início do estudo, aqueles que relataram consumo excessivo de álcool ou com falta de informações sobre covariáveis relevantes e indivíduos com hepatite ou cirrose autorreferida. No total, 8.166 indivíduos participaram e o tempo médio de seguimento foi de 3,8 anos. O modelo de regressão proporcional de Cox foi utilizado para estimar a razão de risco (HR) ajustada para as associações. A ultrassonografia abdominal foi utilizada para detectar esteatose hepática. No período de seguimento, a incidência cumulativa de diabetes foi de 5,25% em todo o grupo de participantes e de 7,83% e 3,88% nos grupos com e sem esteatose hepática, respectivamente (p < 0,001). Em comparação com aqueles sem esteatose, os indivíduos com esteatose hepática apresentaram um risco elevado de desenvolver diabetes (HR = 1,31; IC95%: 1,09-1,56) após o ajuste para potenciais fatores de confusão, incluindo o índice de massa corporal (IMC). A esteatose hepática foi um preditor independente de diabetes incidente no ELSA-Brasil. Os médicos devem incentivar mudanças no estilo de vida e a triagem para diabetes para pacientes com fígado gorduroso.

La creciente evidencia epidemiológica sugiere una relación bidireccional entre la enfermedad del hígado graso no alcohólica (EHGNA) y la diabetes tipo 2 y que la EHGNA puede preceder y/o desarrollar la diabetes. El objetivo de este estudio fue investigar si la esteatosis hepática está asociada con la incidencia de diabetes en el Estudio Longitudinal de Salud del Adulto (ELSA-Brasil). ELSA-Brasil es un estudio de cohorte ocupacional, realizado con funcionarios públicos activos o jubilados, con edades entre 35 y 74 años, de seis capitales en Brasil. Se excluyeron a los participantes con diabetes al inicio del estudio, aquellos que informaron consumir excesivamente alcohol o que carecían de información sobre las covariables relevantes, y los individuos con hepatitis o cirrosis autorreportada. En total participaron 8.166 sujetos, y el tiempo medio de seguimiento fue de 3,8 años. Se utilizó el modelo de regresión proporcional de Cox para estimar la razón de riesgo ajustada (HR) en las asociaciones. Se realizó ecografía abdominal para detectar esteatosis hepática. En el periodo de seguimiento, el grupo de participantes tuvo incidencia acumulada de diabetes del 5,25%, y en los grupos con y sin esteatosis hepática fueron del 7,83% y el 3,88%, respectivamente (p < 0,001). Los individuos con enfermedad de hígado graso tuvieron mayor riesgo de desarrollar diabetes (HR = 1,31; IC95%: 1,09-1,56) después de ajustar los posibles factores de confusión, incluido el índice de masa corporal (IMC), en comparación con aquellos sin esteatosis. La esteatosis hepática fue un predictor independiente de diabetes incidente en ELSA-Brasil. Los médicos deben alentar cambios en el estilo de vida y la detección de diabetes a los pacientes con hígado graso.

Increasing epidemiological evidence suggests a bidirectional relationship between non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes, and that NAFLD may precede and/or promote the development of diabetes. This study aimed to investigate whether liver steatosis is associated with the incidence of diabetes in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The ELSA-Brasil is an occupational cohort study of active or retired civil servants, aged 35-74 years, in six capital cities in Brazil. We excluded participants with diabetes at baseline, those who reported excessive alcohol consumption or with missing information on relevant covariates, and those with self-referred hepatitis or cirrhosis. In total, 8,166 individuals participated, and the mean duration of follow-up was 3.8 years. The Cox proportional regression model was used to estimate the adjusted hazard ratio (HR) for the associations. Abdominal ultrasonography was used to detect liver steatosis. In the follow-up period, the cumulative incidence of diabetes was 5.25% in the whole sample, 7.83% and 3.88% in the groups with and without hepatic steatosis, respectively (p < 0.001). Compared to those without steatosis, individuals with hepatic steatosis had an increased risk of developing diabetes (HR = 1.31; 95%CI: 1.09-1.56) after adjustment for potential confounders, including body mass index (BMI). Hepatic steatosis was an independent predictor of incident diabetes in the ELSA-Brasil cohort study. Physicians should encourage changes in lifestyle and screen for diabetes in patients with fatty liver.

https://doi.org/10.1590/0102-311xen090522

Dietary pattern in women with polycystic ovary syndrome with and without associated non-alcoholic fatty liver disease: A cross-sectional study
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Guimarães, Thais Cristine Moura

; Taranto, Daniela Oliveira de Lima

; Couto, Claudia Alves

; Nardelli, Mateus Jorge

; Cândido, Ana Lucia

; Hott, Cristina de Almeida

; Anastácio, Lucilene Rezende

; Reis, Fernando M.

; Rocha, Ana Luiza Lunardi

; Faria, Luciana Costa

Clinics

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2023, Volume 78 elocation 100288

Abstract: En | Text: En | PDF: En

Abstract Introduction Women with Polycystic Ovary Syndrome (PCOS) have a higher prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) than the general population. PCOS and NAFLD have common metabolic risk factors, however, the role of diet in NAFLD development is still uncertain in PCOS women. Objective To evaluate and compare the dietary patterns and nutritional intake in patients with PCOS with and without NAFLD. Method Cross-sectional study that included patients with PCOS diagnosed according to Rotterdam criteria. All participants were submitted to abdominal ultrasound to investigate liver steatosis. Dietary profile was assessed by 24-hour food recall (24hR), and Food Frequency Questionnaire (FFQ). Diet quality was assessed by the Healthy Eating Index (HEI) adapted for the Brazilian population. Physical activity practice was also assessed. Results 87 participants were included (average age 35.2 ± 5.7 years), among whom, 67 (77%) had NAFLD. The group with PCOS and NAFLD presented higher body mass index (BMI) (34.9 ± 4.5 vs. 30.4 ± 4.9 kg/m2; p = 0.001), Waist Circumference (WC) (103 [97‒113] vs. 95 [87.5‒100] cm; p < 0.001) and were considered physically active less frequently than those without NAFLD (34.3% vs. 60%; p = 0.04). Food intake and dietary patterns assessed by 24hR, FFQ and HEI presented no difference between the groups. Conclusions PCOS women with coexistent NAFLD had higher BMI, WC and were less physically active than those without NAFLD. Dietary evaluation showed that PCOS women with NAFLD had no significant difference in macro and micronutrients or food group intake and diet quality in comparison to those without NAFLD.

https://doi.org/10.1016/j.clinsp.2023.100288

Occult hepatitis B virus infection in patients with chronic liver disease of different etiology in a Brazilian referral center: comparison of two different hepatitis B virus deoxyribonucleic acid amplification protocols: a cross-sectional study
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Faria, Alessandra Coutinho de

; Correa, Bernardo Henrique Mendes

; Faria, Luciana Costa

; Vidigal, Paula Vieira Teixeira

; Xavier, Marcelo Antônio Pascoal

; Ferrari, Teresa Cristina Abreu

Sao Paulo Medical Journal

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2023, Volume 141 N. 3 elocation e2022147

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Occult hepatitis B virus infection (OBI) is defined as the presence of hepatitis B virus (HBV) deoxyribonucleic acid (DNA) in the liver of individuals with undetectable hepatitis B virus surface antigen (HBsAg) in the serum. The actual prevalence of OBI and its clinical relevance are not yet fully understood. OBJECTIVE: To evaluate the prevalence of HBV DNA in liver biopsies of HBsAg-negative patients with chronic liver disease of different etiologies in a referral center in Brazil and compare two different HBV DNA amplification protocols to detect HBV. DESIGN AND SETTING: This cross-sectional observational study was conducted at the Liver Outpatient Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil, between January 2016 and December 2019. METHODS: HBV DNA was investigated in 104 liver biopsy samples from individuals with chronic liver disease of different etiologies, in whom HBsAg was undetectable in serum by nested-polymerase chain reaction (nested-PCR), using two different protocols. RESULTS: OBI, diagnosed by detecting HBV DNA using both protocols, was detected in 6.7% of the 104 individuals investigated. Both protocols showed a good reliability. CONCLUSION: In addition to the differences in the prevalence of HBV infection in different regions, variations in the polymerase chain reaction technique used for HBV DNA amplification may be responsible for the large variations in the prevalence of OBI identified in different studies. There is a need for better standardization of the diagnostic methods used to diagnose this entity.

https://doi.org/10.1590/1516-3180.2022.0147.r1.12072022

Liver steatosis as a predictor of incident diabetes in adults: a prospective evaluation in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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Faria, Luciana Costa

; Diniz, Maria de Fátima Haueisen Sander

; Giatti, Luana

; Schmidt, Maria Inês

; Goulart, Alessandra Carvalho

; Duncan, Bruce Bartholow

; Barreto, Sandhi Maria

Cadernos de Saúde Pública

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2023, Volume 39 N. 3 elocation e00090522

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

https://doi.org/10.1590/0102-311xen090522

Shotgun metagenomic sequencing of the first case of monkeypox virus in Brazil, 2022
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Claro, Ingra Morales

; Romano, Camila Malta

; Candido, Darlan da Silva

; Lima, Evelyn Lepka de

; Lindoso, José Angelo Lauletta

; Ramundo, Mariana Severo

; Moreira, Filipe Romero Rebello

; Barra, Luiz Alberto Costa

; Borges, Luciana Marques Sansão

; Medeiros, Lucas Alberto

; Tomishige, Marcia Y. S.

; Moutinho, Tomas

; Silva, Anderson José Dias da

; Rodrigues, Camila Cristina Martini

; Azevedo, Luiz Cesar Fernandes de

; Villas-Boas, Lucy Santos

; Silva, Camila Alves Maia da

; Coletti, Thaís Moura

; Manuli, Erika R.

; O’Toole, Aine

; Quick, Joshua

; Loman, Nicholas

; Rambaut, Andrew

; Faria, Nuno R.

; Figueiredo-Mello, Claudia

; Sabino, Ester Cerdeira

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e48

Abstract: En | Text: En | PDF: En

ABSTRACT Monkeypox virus (MPXV), a zoonotic virus endemic to the African continent, has been reported in 33 non-endemic countries since May 2022. We report an almost complete genome of the first confirmed case of MPXV in Brazil. Shotgun metagenomic sequencing was completed in 18 hours, from DNA extraction to consensus sequence generation.

https://doi.org/10.1590/s1678-9946202264048

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Faria, Alessandra Coutinho de

; Correa, Bernardo Henrique Mendes

; Faria, Luciana Costa

; Vidigal, Paula Vieira Teixeira

; Xavier, Marcelo Antônio Pascoal

; Ferrari, Teresa Cristina Abreu

Sao Paulo Medical Journal

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2022, N. ahead

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1516-3180.2022.0147.r1.12072022

Cross-cultural adaptation of the Activities of Daily Living Questionnaire-Brazil in Parkinson’s disease
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ALVES, Walter Luis Teixeira

; FARIA-FORTINI, Iza de

; GALVÃO, Ana Carolina Daher Ribas

; CARDOSO, Francisco Eduardo Costa

; SCALZO, Paula Luciana

Arquivos de Neuro-Psiquiatria

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dec 2021, Volume 79 N. 12 Pages 1101 - 1108

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

RESUMO Antecedentes: Medidas adaptadas transculturalmente para avaliar o desempenho nas atividades de vida diária (AVD) em indivíduos com doença de Parkinson (DP) são limitadas no Brasil. Objetivo: Adaptar transculturalmente o Questionário AVD e analisar sua reprodutibilidade em indivíduos com DP. Métodos: O Questionário AVD foi traduzido e adaptado transculturalmente para o português do Brasil. A reprodutibilidade foi analisada usando a confiabilidade teste-reteste e os valores de concordância. A confiabilidade dos itens individuais e as pontuações totais foram calculadas. Os limites de concordância foram verificados usando o gráfico Bland-Altman. O erro padrão da medida (EPM) e a diferença mínima detectável (DMD) foram calculadas. Pacientes classificados nos estágios 1–4 da escala de Hoehn e Yahr foram elegíveis. Resultados: Não foi identificada divergência entre a versão original e a versão adaptada, que demonstrou equivalência semântica e conceitual adequada. O gráfico Bland-Altman não mostrou mudanças sistemáticas nas pontuações médias do teste-reteste. O coeficiente de correlação intraclasse (CCI) foi de 0,98 (intervalo de confiança de 95% [IC95%] 0,93–0,99) e todos os itens individuais apresentaram bons níveis de confiabilidade (>0,60). Os valores do EPM (EPM%) e DMD (DMD%) foram 3,0 (6,75%) e 8,2 (18,7%), respectivamente. Esses valores estão em conformidade com os valores recomendados. Conclusões: O Questionário AVD-Brasil é um instrumento confiável para uso clínico e de pesquisa para avaliar a autopercepção do desempenho nas AVD em indivíduos com DP.

ABSTRACT Background: Culturally adapted measures to assess the performance of activities of daily living (ADL) in individuals with Parkinson’s disease (PD) are limited in Brazil. Objective: To adapt the ADL Questionnaire to the Brazilian culture and to analyze its reproducibility in individuals with PD. Methods: The ADL Questionnaire was translated and cross-culturally adapted to Brazilian Portuguese language. Reproducibility was analyzed using test-retest reliability and agreement values. The test-retest reliability of the individual items and total scores were calculated. The limits of agreement were verified using the Bland-Altman plot. The standard error of measurement (SEM) and the minimum detectable change (MDC) were calculated. Patients who were classified on a score of 1–4 on the modified Hoehn and Yahr scale were eligible. Results: No divergence was identified between the original and the adapted version, which demonstrated adequate semantic and conceptual equivalence. The Bland-Altman plot showed no systematic changes in the mean test-retest scores. The intraclass correlation coefficient (ICC) was 0.98 (95% confidence interval [95%CI] 0.93–0.99), and all individual items showed good levels of reliability (>0.60). The SEM (SEM%) and MDC (MDC%) values were 3.0 (6.75%) and 8.2 (18.7%), respectively. These values are within the recommended values. Conclusions: The ADL-Brazil Questionnaire is a reliable instrument to be used for clinical and research purposes to assess self-perceptions of ADL performance in individuals with PD.

https://doi.org/10.1590/0004-282x-anp-2020-0396 2 downloads

Atualização da Diretriz Brasileira de Hipercolesterolemia Familiar – 2021
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Izar, Maria Cristina de Oliveira

; Giraldez, Viviane Zorzanelli Rocha

; Bertolami, Adriana

; Santos Filho, Raul Dias dos

; Lottenberg, Ana Maria

; Assad, Marcelo Heitor Vieira

; Saraiva, José Francisco Kerr

; Chacra, Ana Paula M.

; Martinez, Tania L. R.

; Bahia, Luciana Ribeiro

; Fonseca, Francisco Antonio Helfenstein

; Faludi, Andre Arpad

; Sposito, Andrei C.

; Chagas, Antônio Carlos Palandri

; Jannes, Cinthia Elim

; Amaral, Cristiane Kovacs

; Araújo, Daniel Branco de

; Cintra, Dennys Esper

; Coutinho, Elaine dos Reis

; Cesena, Fernando

; Xavier, Hermes Toros

; Mota, Isabela Cardoso Pimentel

; Giuliano, Isabela de Carlos Back

; Faria Neto, José Rocha

; Kato, Juliana Tieko

; Bertolami, Marcelo Chiara

; Miname, Marcio Hiroshi

; Castelo, Maria Helane Costa Gurgel

; Lavrador, Maria Sílvia Ferrari

; Machado, Roberta Marcondes

; Souza, Patrícia Guedes de

; Alves, Renato Jorge

; Machado, Valeria Arruda

; Salgado Filho, Wilson

Arquivos Brasileiros de Cardiologia

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oct 2021, Volume 117 N. 4 Pages 782 - 844

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

https://doi.org/10.36660/abc.20210788 231 downloads

Peculiaridade dos Pacientes com Arritmias Hereditárias na Pandemia pela COVID-19
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Sacilotto, Luciana

; Olivetti, Natalia Quintella Sangiorgi

; Pisani, Cristiano Faria

; Wu, Tan Chen

; Hajjar, Ludhmila Abrahão

; Melo, Sissy Lara de

; Bueno, Sávia Christina Pereira

; Rivarola, Esteban Wisnivesky Rocca

; Chokr, Muhieddine Omar

; Hardy, Carina Abigail

; Hachul, Denise Tessariol

; Darrieux, Francisco Carlos da Costa

; Scanavacca, Mauricio Ibrahim

Arquivos Brasileiros de Cardiologia

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aug 2021, Volume 117 N. 2 Pages 394 - 403

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

Resumo Desde dezembro de 2019, observamos o rápido avanço da síndrome respiratória aguda grave causada pelo coronavírus 2019 (SARS-CoV-2). O impacto da evolução clínica de uma infecção respiratória é pouco conhecido em pacientes portadores de arritmias hereditárias, devido à baixa prevalência dessas doenças. Os pacientes que apresentam quadros infecciosos podem exacerbar arritmias primárias ocultas ou bem controladas, por diversos fatores, tais como febre, distúrbios eletrolíticos, interações medicamentosas, estresse adrenérgico e, eventualmente, o próprio dano miocárdico do paciente séptico. O objetivo desta revisão é destacar os principais desafios que podemos encontrar durante a pandemia pela Covid 19, especificamente nos pacientes com arritmias hereditárias, com destaque para a síndrome do QT longo congênito (SQTL), a síndrome de Brugada (SBr), a taquicardia ventricular polimórfica catecolaminérgica (TVPC) e a cardiomiopatia arritmogênica do ventrículo direito.

Abstract Since December 2019 we have observed the rapid advance of the severe acute respiratory syndrome caused by the new coronavirus (SARS-CoV-2). The impact of the clinical course of a respiratory infection is little known in patients with hereditary arrhythmias, due to the low prevalence of these diseases. Patients who present with infectious conditions may exacerbate hidden or well-controlled primary arrhythmias, due to several factors, such as fever, electrolyte disturbances, drug interactions, adrenergic stress and, eventually, the septic patient’s own myocardial damage. The aim of this review is to highlight the main challenges we may encounter during the Covid 19 pandemic, specifically in patients with hereditary arrhythmias, with emphasis on the congenital long QT syndrome (LQTS), Brugada syndrome (SBr), ventricular tachycardia polymorphic catecholaminergic (CPVT) and arrhythmogenic right ventricular cardiomyopathy.

https://doi.org/10.36660/abc.20200391 337 downloads

10.

Ablação por Cateter de Taquicardia Atrial Focal com Ativação Precoce Próxima ao Feixe de His, a Partir da Cúspide Aórtica não Coronária
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Chokr, Muhieddine

; Moura, Lucas G. de

; Sousa, Italo Bruno dos Santos

; Pisani, Cristiano Faria

; Hardy, Carina Abigail

; Melo, Sissy Lara de

; Ponte Filho, Arnobio Dias da

; Costa, Ieda Prata

; Tavora, Ronaldo Vasconcelos

; Sacilotto, Luciana

; Wu, Tan Chen

; Darrieux, Francisco Carlos da Costa

; Hachul, Denise Tessariol

; Aiello, Vera Demarchi

; Scanavacca, Mauricio

Arquivos Brasileiros de Cardiologia

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jan 2021, Volume 116 N. 1 Pages 119 - 126

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

Resumo Fundamento A ablação da taquicardia atrial (TA) com local de ativação mais precoce próxima ao feixe de His é um desafio, devido ao risco de bloqueio de AV completo por sua proximidade ao sistema de His-Purkinje (SHP). Uma alternativa para minimizar esse risco é posicionar o cateter na cúspide não coronária (CNC), que é anatomicamente contígua à região para-Hissiana. Objetivos O objetivo deste estudo foi fazer uma revisão de literatura e avaliar as características eletrofisiológicas, a segurança e o índice de sucesso de aplicação de radiofrequência (RF) por cateter na CNC para o tratamento de TA para-Hissiana em uma série de casos. Métodos Avaliamos retrospectivamente dez pacientes (Idade: 36±10 anos) que foram encaminhados para ablação de taquicardia paroxística supraventricular (TPSV) e haviam sido diagnosticados com TA focal para-Hissiana confirmada por manobras eletrofisiológicas clássicas. Para a análise estatística, um P valor d <0.05 foi considerado estatisticamente significativo. Resultados A ativação atrial mais precoce na posição His foi de 28±12ms da onda P, e a CNC foi 3±2ms antes da posição His, sem evidência de potencial His em todos os pacientes. Foi aplicada RF à CNC (cateter de ponta de 4-mm; 30W, 55°C) e a taquicardia foi interrompida em 5±3s sem aumento no intervalo PR ou evidência de um ritmo juncional. Os testes eletrofisiológicos não induziram novamente a taquicardia em 9/10 pacientes. Não houve complicações em nenhum procedimento. Durante o período de acompanhamento de 30 ± 12 meses, nenhum paciente apresentou recorrência de taquicardia. Conclusão O tratamento percutâneo de TA para-Hissiana por meio de CNC é uma estratégia segura e eficiente, tornando-se uma opção interessante para o tratamento de arritmia complexa. (Arq Bras Cardiol. 2021; 116(1):119-126)

Abstract Background Atrial tachycardia (AT) ablation with earliest activation site close to the His-Bundle is a challenge due to the risk of complete AV block by its proximity to His-Purkinje system (HPS). An alternative to minimize this risk is to position the catheter on the non-coronary cusp (NCC), which is anatomically contiguous to the para-Hisian region. Objectives The aim of this study was to perform a literature review and evaluate the electrophysiological characteristics, safety, and success rate of catheter-based radiofrequency (RF) delivery in the NCC for the treatment of para-Hisian AT in a case series. Methods This study performed a retrospective evaluation of ten patients (Age: 36±10 y-o) who had been referred for SVT ablation and presented a diagnosis of para-Hisian focal AT confirmed by classical electrophysiological maneuvers. For statistical analysis, a p-value of <0.05 was considered statistically significant. Results The earliest atrial activation at the His position was 28±12ms from the P wave and at the NCC was 3±2ms earlier than His position, without evidence of His potential in all patients. RF was applied on the NCC (4-mm-tip catheter; 30W, 55ºC), and the tachycardia was interrupted in 5±3s with no increase in the PR interval or evidence of junctional rhythm. Electrophysiological tests did not reinduce tachycardia in 9/10 of patients. There were no complications in all procedures. During the 30 ± 12 months follow-up, no patient presented tachycardia recurrence. Conclusion The percutaneous treatment of para-Hisian AT through the NCC is an effective and safe strategy, which represents an interesting option for the treatment of this complex arrhythmia. (Arq Bras Cardiol. 2021; 116(1):119-126)

https://doi.org/10.36660/abc.20180449 488 downloads

11.

Controle do Intervalo QT para Prevenção de Torsades de Pointes Durante uso de Hidroxicloroquina e/ou Azitromicina em Pacientes com COVID 19
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Wu, Tan Chen

; Sacilotto, Luciana

; Darrieux, Francisco Carlos da Costa

; Pisani, Cristiano Faria

; Melo, Sissy Lara de

; Hachul, Denise Tessariol

; Scanavacca, Mauricio

Arquivos Brasileiros de Cardiologia

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jun 2020, Volume 114 N. 6 Pages 1061 - 1066

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

https://doi.org/10.36660/abc.20200389 4835 downloads

12.

Clinical and laboratory parameters as predictors of long-term outcome according to the etiology of underlying chronic liver disease in patients who underwent liver transplantation for hepatocellular carcinoma treatment
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Diniz, Paulo Henrique Costa

; Silva, Serena Dafne do Carmo

; Faria, Luciana Costa

; Vidigal, Paula Vieira Teixeira

; Ferrari, Teresa Cristina de Abreu

Clinics

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2020, Volume 75 elocation e1529

Abstract: En | Text: En | PDF: En

OBJECTIVES: This study aimed to analyze clinical and laboratory parameters and their association with long-term outcomes in patients who underwent liver transplantation for hepatocellular carcinoma treatment, according to the etiology of the underlying chronic liver disease, in order to identify predictors of response to this therapeutic modality. METHODS: Demographic, clinical, and laboratory data from a cohort of 134 patients who underwent orthotopic liver transplantation for hepatocellular carcinoma treatment at a referral center in Brazil were retrospectively selected and compared according to the etiologic group of the underlying chronic liver disease. Events, defined as tumor recurrence or death from any cause, and event-free survival were also analyzed, and multivariate analysis was performed. RESULTS: The etiologies comprised hepatitis C and B virus infection, alcohol abuse, and cryptogenic disorder. Although liver transplantation was performed outside the Milan criteria in 33.3% of the subjects, according to pathologic examination of the explanted liver, the Model for End-Stage Liver Disease score was low (<22) in most patients (70.6%) and recurrence was identified in only 10 (7.9%) patients. Events occurred in 37 patients (28.5%), and the median event-free survival was 75 months (range, 24-116 months). No difference among etiologic groups was found in the parameters analyzed, which were not independently associated with outcome. CONCLUSION: Clinical and laboratory characteristics according to etiologic groups were not different, which might have led to comparable long-term outcomes among these patient groups and failure to identify predictors that could aid in better selection of subjects for liver transplantation in the management of this cancer.

https://doi.org/10.6061/clinics/2020/e1529 258 downloads

13.

UPDATE OF THE BRAZILIAN SOCIETY OF HEPATOLOGY RECOMMENDATIONS FOR DIAGNOSIS AND MANAGEMENT OF AUTOIMMUNE DISEASES OF THE LIVER
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COUTO, Cláudia Alves

; TERRABUIO, Debora Raquel Benedita

; CANÇADO, Eduardo Luiz Rachid

; PORTA, Gilda

; LEVY, Cynthia

; SILVA, Antônio Eduardo Benedito

; BITTENCOURT, Paulo Lisboa

; CARVALHO FILHO, Roberto José de

; CHAVES, Dalton Marques

; MIURA, Irene Kazue

; CODES, Liana

; FARIA, Luciana Costa

; EVANGELISTA, Andreia Silva

; FARIAS, Alberto Queiroz

; GONÇALVES, Luciana Lofêgo

; HARRIZ, Michelle

; LOPES, Edmundo Pessoa de Almeida

; LUZ, Gustavo Oliveira

; OLIVEIRA, Patrícia Marinho Costa

; OLIVEIRA, Elze Maria Gomes

; SCHIAVON, Janaina Luz Narciso

; SEVÁ-PEREIRA, Tiago

Arquivos de Gastroenterologia

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jun 2019, Volume 56 N. 2 Pages 232 - 241

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

RESUMO Desde a publicação em 2015 das recomendações da Sociedade Brasileira de Hepatologia sobre a prevenção e tratamento de doenças hepáticas autoimunes, novos dados baseados em evidências científicas foram publicados na literatura, mudando o diagnóstico e tratamento da hepatite autoimune (HAI), colangite biliar primária (CBP), colangite esclerosante primária (CEP), síndromes de sobreposição de HAI, CBP e CEP e o manejo de complicações específicas além de outros tópicos relativos à HAI e doenças hepáticas colestáticas. Este manuscrito atualiza as recomendações anteriores de acordo com as melhores evidências disponíveis na literatura até o momento. O mesmo painel de experts que participou da primeira diretriz revisou todas as recomendações de acordo com os dados publicados na literatura e elaborou um manuscrito submetido subsequentemente à apreciação e revisão de todos os membros da Sociedade Brasileira de Hepatologia via homepage da sociedade. As recomendações finais atualizadas foram condensadas no presente documento.

ABSTRACT New data concerning the management of autoimmune liver diseases have emerged since the last single-topic meeting sponsored by the Brazilian Society of Hepatology to draw recommendations about the diagnosis and treatment of autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), overlap syndromes of AIH, PBC and PSC and specific complications and topics concerning AIH and cholestatic liver diseases. This manuscript updates those previous recommendations according to the best evidence available in the literature up to now. The same panel of experts that took part in the first consensus document reviewed all recommendations, which were subsequently scrutinized by all members of the Brazilian Society of Hepatology using a web-based approach. The new recommendations are presented herein.

https://doi.org/10.1590/s0004-2803.201900000-43 3841 downloads

14.

Seroprevalence of Toxoplasma gondii and Toxocara canis in a human rural population of Southern Rio Grande do Sul
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Araújo, Adelita Campos

; Villela, Marcos Marreiro

; Sena-Lopes, Ângela

; Farias, Nara Amélia da Rosa

; Faria, Laura Maria Jorge de

; Avila, Luciana Farias da Costa

; Berne, Maria Elisabeth Aires

; Borsuk, Sibele

Revista do Instituto de Medicina Tropical de São Paulo

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2018, Volume 60 elocation e28

Abstract: En | Text: En | PDF: En

ABSTRACT Due to the growing population of pets, especially homeless dogs and cats, zoonoses still represent a significant public health problem. Toxoplasma gondii and Toxocara spp. are epidemiologically important zoonotic agents as they are etiological factors of human toxoplasmosis and toxocariasis, respectively. These parasites remain neglected even though they are substantially prevalent in rural areas. The aim of this study was to investigate T. gondii and T. canis seroprevalence and risk factors of seropositivity in a rural population in Pelotas municipality, Brazil. The study participants (n=344) were patients of a Basic Healthcare Unit (BHU) located in Cerrito Alegre. Blood samples were collected and tested for T. gondii antibodies by indirect immunofluorescence and T. canis antibodies by an indirect ELISA that targets an excreted-secreted antigen (TES). T. gondii seropositivity was 53.2%, with higher titers (1:256 - 1:1,024) in individuals who habitually eat pork, beef, or chicken, while T. canis seropositivity was 71.8% and concomitant T. gondii and T. canis seropositivity was 38.3%. Among the seropositivity risk factors assessed, only habitual undercooked meat consumption was significant (p = 0.046; OR = 3.7) for T. gondii and none of them were associated with T. canis seropositivity. Both parasites have a high prevalence in rural areas, which reinforces the need to invest in rural community education and health.

https://doi.org/10.1590/s1678-9946201860028 2156 downloads

15.

Vigilância em Saúde do Trabalhador na Atenção Básica: aprendizagens com as equipes de Saúde da Família de João Pessoa, Paraíba, Brasil
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Amorim, Luciana de Assis

; Silva, Thais Lacerda e

; Faria, Horácio Pereira de

; Machado, Jorge Mesquita Huet

; Dias, Elizabeth Costa

Ciência & Saúde Coletiva

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oct 2017, Volume 22 N. 10 Pages 3403 - 3413

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

Resumo O estudo analisa ações de Vigilância em Saúde do Trabalhador desenvolvidas por equipes de Saúde da Família, a partir da percepção de médicos e enfermeiros no município de João Pessoa. Utilizou-se questionário com 30 questões organizadas em quatro blocos: identificação do profissional; práticas de atenção à saúde dos trabalhadores com ênfase no perfil produtivo e epidemiológico e apoio matricial e institucional às equipes. Participaram 179 profissionais; 82% mulheres; 46% com 50 anos ou mais e 60% com atuação há mais de 10 anos na atividade. Os resultados evidenciam que ações de Vigilância em Saúde do Trabalhador não estão incorporadas no cotidiano de trabalho das equipes: 53% realizam mapeamento das atividades produtivas e 30% correlacionam-nas com situações de riscos para a saúde. Referem ações para eliminar/mitigar a exposição a situações de riscos e vulnerabilidade, 24%. O apoio às equipes de Saúde da Família pelo Centro de Referência em Saúde do Trabalhador foi referido por 45% dos participantes, menor que pela Vigilância em Saúde do Trabalhador (32%). A participação em processos de qualificação em saúde do trabalhador foi mencionada por 24% dos profissionais. Os resultados sugerem necessidade de ampliar e fortalecer os processos de educação permanente e apoio técnico às equipes.

Abstract This study analyzed the Worker’s Surveillance activities of Family Health teams, based on the perceptions of physicians and nurses in the city of João Pessoa. We used a 30-question questionnaire split into four blocks: data on the professional, occupational healthcare practices focusing on the production and epidemiological profile, and matrix and institutional support to the teams. A total of 179 professionals participated, 82% of them were female, and 46% aged 50 or more; 60% had worked in the area for more than 10 years. Results show that Worker’s Surveillance activities are not part of team day-to-day activities: 53% mapped productive activities and 30% related them to health hazards. Twenty-four percent mentioned activities to eliminate/mitigate exposure to risk and vulnerabilities. The support of Family Health teams by the Reference Center for Occupational Health was mentioned by 45% of the participants, less than the number reported for Worker’s Surveillance. Involvement in occupational health training was mentioned by 24% of the professionals. Results suggest the need to expand and strengthen continued education and team support.

https://doi.org/10.1590/1413-812320172210.17532017 224 downloads

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