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[SciELO Preprints] - Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
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Fernandes, Fabio
Simões, Marcus V.
Correia, Edileide de Barros
Marcondes-Braga, Fabiana G.
Coelho-Filho, Otavio Rizzi
Mesquita, Cláudio Tinoco
Mathias-Junior, Wilson
Rochitte, Carlos Eduardo
Ramires, Felix José Alvarez
Alves, Silvia Marinho Martins
Montera, Marcelo Westerlund
Lopes, Renato Delascio
Oliveira-Junior, Mucio Tavares
Scolari, Fernando L.
Avila, Walkiria Samuel
Canesin, Manoel Fernandes
Bacal, Fernando
Bocchi, Edimar Alcides
Moura, Lídia Ana Zytynski
Saad, Eduardo Benchimol
Scanavacca, Mauricio I.
Valdigem, Bruno Pereira
Cano , Manuel Nicolas
Abizaid , Alexandre
Ribeiro, Henrique Barbosa
Lemos-Neto, Pedro Alves
Ribeiro, Gustavo Calado de Aguiar
Jatene, Fabio Biscegli
Dias, Ricardo Ribeiro
Beck-da-Silva, Luis
Rohde, Luis Eduardo P.
Bittencourt, Marcelo Imbroinise
Pereira, Alexandre
Krieger, José Eduardo
Villacorta, Humberto
Martins, Wolney de Andrade
Figueiredo-Neto, José Albuquerque de
Cardoso , Juliano Novaes
Pastore, Carlos Alberto
Jatene, Ieda Biscegli
Tanaka, Ana Cristina Sayuri
Hotta, Viviane Tiemi
Romano, Minna Moreira Dias
Albuquerque, Denilson Campos de
Mourilhe-Rocha, Ricardo
Hajjar, Ludhmila Abrahão
Brito, Fabio Sandoli de
Caramelli , Bruno
Calderaro, Daniela
Farsky, Pedro Silvio
Colafranceschi , Alexandre Siciliano
Pinto, Ibraim Masciarelli
Vieira , Marcelo Luiz Campos
Danzmann, Luiz Claudio
Barberato , Silvio Henrique
Mady, Charles
Martinelli-Filho, Martino
Torbey , Ana Flavia Malheiros
Schwartzmann, Pedro Vellosa
Macedo, Ariane Vieira Scarlatelli
Ferreira , Silvia Moreira Ayub
Schmidt, Andre
Melo , Marcelo Dantas Tavares de
Lima-Filho, Moysés Oliveira
Sposito, Andrei C.
Brito, Flavio de Souza
Biolo, Andreia
Madrini-Junior, Vagner
Rizk, Stéphanie Itala
Mesquita, Evandro Tinoco
A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE. Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).
La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).
Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.
2.
Effect of different design and surface treatment on the load-to-failure of ceramic repaired with composite
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Tavares, Mauricio JM
; Amaral, Flavia LB
; Basting, Roberta T
; Turssi, Cecilia P
; França, Fabiana MG
.
RESUMO Embora fraturas e lascamento de restauragoes vitrocerámicas sejam comuns, alguns casos podem ser reparados com compósito direto. Objetivo investigar o efeito da interagao de diferentes formas e tratamentos de superficie na carga de ruptura de uma vitrocerámica reforgada com dissilicato de litio reparada com compósito nanoparticulado. Materials e Método A superficie superior de espécimes de vitroceramica (IPS e.max Press, Ivoclar Vivadent) foi preparada com tres formas (plana, plato único, ou duplo) e recebeu (n=11): ‘nenhum tratamento’, ‘condicionamento com ácido hidrofluoridrico 5%’, ou ‘jateamento com AfOf. Ambos espécimes condicionados e jateados receberam silano e adesivo universal. Todos os espécimes foram reparados incrementalmente com compósito (Filtek Z350, 3M ESPE) até6 mm acima do plato cerámico mais alto, armazenados em saliva artificial á 37 °C por 21 dias, e submetidos á 1.000 termociclos (5 e 55 °C). A interface compósito-cerámica de cada amostra foi testada á tragao até sua falha em máquina universal e o modo de falha foi determinado com estereomicroscópio. A morfologia da superficie de uma amostra representativa de forma/tratamento de superficie foi observada através de microscopia eletronica de varredura (MEV). Resultados Independentemente da forma ceramica, a ausencia de tratamento superficial resultou em valores de carga de ruptura significativamente menores. Nao foi observada differenga significativa entre os espécimes planos condicionados ou jateados; no entanto, o condicionamento resultou em valores significativamente maiores que o jateamento para espécimes com plato único e duplo. A maioria (60%) dos espécimes condicionados e com plato único ou duplo apresentou falhas mistas. Imagens SEM demonstraram rugosidade superficial mais regular dos espécimes condicionados que os jateados. Conclusoes O tratamento superficial de uma restauragao defeituosa de vitrocerámica reforgada por dissilicato de litio tem maior influencia na retengao do reparo de compósito do que sua forma macroscópica; ainda, o condicionamento com ácido hidrofluoridrico parece proporcionar maior resistencia de uniao ao reparo com compósito.
ABSTRACT Glass ceramics are widely used to manufacture esthetic veneers, inlays, onlays, and crowns. Although the clinical survival rates ofglass-ceramic restorations arefavorable,fractures or chips are common. Certain cases can be repaired with direct composite. Aim The aim of this study was to investigate the interaction effect of different designs and surface treatments on the load-to-failure of lithium disilicate glass-ceramic repaired with nanofilled composite. Materials and Method Lithium-disilicate glass-ceramic slabs (IPS e.max Press, Ivoclar Vivadent) with three different designs of the top surface (flat, single plateau, or doubleplateau) (n=U) received ‘no treatment’, ‘5% HF etching’, or “AI2O3 sandblasting”. HF-etched and sandblasted slabs also received silane and universal one-step adhesive application. All slabs were incrementally repaired with nanofilled composite (Filtek Z350, 3M ESPE) up to6 mm above the highest ceramic top plateau. Specimens were stored in artificial saliva at 37 °C for 21 days and then subjected to 1,000 thermocycles between 5 and 55 °C. The interface composite-ceramic of each specimen was tensile tested until failure in a universal testing machine and the mode of failure was determined under a stereomicroscope. The ceramic surface morphology of one representative tested specimen from each subgroup (design/surface treatment) was observed through scanning electron microscopy (SEM). Results Regardless of ceramic design, the absence of surface treatment resulted in significantly lower load-to-failure values. No significant differences in load-to-failure values were observed between HF-etched and sandblasted specimens for the flat design; however, HF etching resulted in significantly higher load-to-failure values than sandblasting for both single plateau and double plateau designs. The majority (60%) of HF-etched specimens with single plateau or double plateau presented mixed failures. SEM photomicrographs showed that HF-etched specimens had smoother surfaces than sandblasted specimens. Conclusion The surface treatment of a defective lithium disilicate glass-ceramic restoration has more influence than its macroscopic design on the retention of the composite repair. HF etching seems to provide higher bond strength to the composite repair.
3.
Metoprolol for prevention of bucking at orotracheal extubation: a double-blind, placebo-controlled randomised trial extubation doubleblind, doubleblind double blind, blind double-blind placebocontrolled placebo controlled
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Queiroz, Murilo Neves de
; Mendonca, Fabrício Tavares
; Matos, Maurício Vargas de
; Lino, Rafael Santos
; Carvalho, Luiz Sérgio Fernandes de
.
Abstract Background: Respiratory responses to extubation can cause serious postoperative complications. Beta-blockers, such as metoprolol, can interfere with the cough pathway. However, whether metoprolol can effectively control respiratory reflexes during extubation remains unclear. The objective of this study is to evaluate the efficacy of intravenous metoprolol in attenuating respiratory responses to tracheal extubation. Methods: Randomized, double-blinded, placebo-controlled trial. Setting: Tertiary referral center located in Brasília, Brazil. Recruitment: June 2021 to December 2021. Sample: 222 patients of both sexes with an American Society of Anesthesiologists (ASA) physical status I-III aged 18–80 years. Patients were randomly assigned to receive intravenous metoprolol 5 mg IV or placebo at the end of surgery. The primary outcome was the proportion of patients who developed bucking secondary to endotracheal tube stimulation of the tracheal mucosa during extubation. Secondary outcomes included coughing, bronchospasm, laryngospasm, Mean Blood Pressure (MAP), and Heart Rate (HR) levels. Results: Two hundred and seven participants were included in the final analysis: 102 in the metoprolol group and 105 in the placebo group. Patients who received metoprolol had a significantly lower risk of bucking (43.1% vs. 64.8%, Relative Risk [RR = 0.66], 95% Confidence Interval [95% CI 0.51–0.87], p = 0.003). In the metoprolol group, 6 (5.9%) patients had moderate/severe coughing compared with 33 (31.4%) in the placebo group (RR = 0.19; 95% CI 0.08–0.43, p < 0.001). Conclusion: Metoprolol reduced the risk of bucking at extubation in patients undergoing general anesthesia compared to placebo. Background complications Betablockers, Betablockers Beta blockers, blockers Beta-blockers pathway However unclear Methods Randomized doubleblinded, doubleblinded double blinded, blinded double-blinded placebocontrolled controlled trial Setting Brasília Brazil Recruitment 202 Sample 22 ASA (ASA IIII I III 1880 18 80 18–8 years surgery bronchospasm laryngospasm MAP, MAP , (MAP) HR (HR levels Results analysis 10 43.1% 431 43 1 (43.1 vs 648 64 8 64.8% RR 0.66, 066 0.66 0 66 0.66] 95 [95 0.51–0.87, 051087 0.51–0.87 51 87 0.51–0.87] 0.003. 0003 0.003 . 003 0.003) 5.9% 59 9 (5.9% moderatesevere moderate severe 3 31.4% 314 31 4 (31.4% 0.19 019 19 008043 08 0.08–0.43 0.001. 0001 0.001 001 0.001) Conclusion 20 2 188 18– (MAP 43.1 (43. 64.8 06 0.6 [9 05108 0.51–0.8 000 0.00 00 5.9 (5.9 31.4 (31.4 0.1 01 00804 0.08–0.4 43. (43 64. 0. [ 0510 0.51–0. 0.0 5. (5. 31. (31. 0080 0.08–0. (4 051 0.51–0 (5 (31 008 0.08–0 ( 05 0.51– (3 0.08– 0.51 0.08 0.5
4.
Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024 202 20 2
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Fernandes, Fabio
; Simões, Marcus V.
; Correia, Edileide de Barros
; Marcondes-Braga, Fabiana Goulart
; Coelho-Filho, Otavio Rizzi
; Mesquita, Cláudio Tinoco
; Mathias Junior, Wilson
; Antunes, Murillo de Oliveira
; Arteaga-Fernández, Edmundo
; Rochitte, Carlos Eduardo
; Ramires, Felix José Alvarez
; Alves, Silvia Marinho Martins
; Montera, Marcelo Westerlund
; Lopes, Renato Delascio
; Oliveira Junior, Mucio Tavares de
; Scolari, Fernando Luis
; Avila, Walkiria Samuel
; Canesin, Manoel Fernandes
; Bocchi, Edimar Alcides
; Bacal, Fernando
; Moura, Lidia Zytynski
; Saad, Eduardo Benchimol
; Scanavacca, Mauricio Ibrahim
; Valdigem, Bruno Pereira
; Cano, Manuel Nicolas
; Abizaid, Alexandre Antonio Cunha
; Ribeiro, Henrique Barbosa
; Lemos Neto, Pedro Alves
; Ribeiro, Gustavo Calado de Aguiar
; Jatene, Fabio Biscegli
; Dias, Ricardo Ribeiro
; Beck-da-Silva, Luis
; Rohde, Luis Eduardo Paim
; Bittencourt, Marcelo Imbroinise
; Pereira, Alexandre da Costa
; Krieger, José Eduardo
; Villacorta Junior, Humberto
; Martins, Wolney de Andrade
; Figueiredo Neto, José Albuquerque de
; Cardoso, Juliano Novaes
; Pastore, Carlos Alberto
; Jatene, Ieda Biscegli
; Tanaka, Ana Cristina Sayuri
; Hotta, Viviane Tiemi
; Romano, Minna Moreira Dias
; Albuquerque, Denilson Campos de
; Mourilhe-Rocha, Ricardo
; Hajjar, Ludhmila Abrahão
; Brito Junior, Fabio Sandoli de
; Caramelli, Bruno
; Calderaro, Daniela
; Farsky, Pedro Silvio
; Colafranceschi, Alexandre Siciliano
; Pinto, Ibraim Masciarelli Francisco
; Vieira, Marcelo Luiz Campos
; Danzmann, Luiz Claudio
; Barberato, Silvio Henrique
; Mady, Charles
; Martinelli Filho, Martino
; Torbey, Ana Flavia Malheiros
; Schwartzmann, Pedro Vellosa
; Macedo, Ariane Vieira Scarlatelli
; Ferreira, Silvia Moreira Ayub
; Schmidt, Andre
; Melo, Marcelo Dantas Tavares de
; Lima Filho, Moysés Oliveira
; Sposito, Andrei C.
; Brito, Flávio de Souza
; Biolo, Andreia
; Madrini Junior, Vagner
; Rizk, Stephanie Itala
; Mesquita, Evandro Tinoco
.
Arquivos Brasileiros de Cardiologia
- Métricas do periódico
5.
Tendência Temporal no Implante Percutâneo de Bioprótese Aórtica: Análise de 10 Anos do Registro TAVIDOR Aórtica 1
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Esteves, Vinicius
; Andrade, Pedro Beraldo de
; Zukowski, Cleverson Neves
; Araujo, Edmur
; Bezerra, Cristiano Guedes
; Oliveira, Adriano Dourado
; Melo, Eduardo Pessoa de
; Gama, Gustavo
; Cantarelli, Rodrigo
; Mattos, Luiz Alberto Piva e
; Tedeschi, Angelo
; Loures, Vitor Alves
; Vahle, Vitor
; Silva, Guilherme Barreto Gameiro
; Rati, Miguel Antonio Neves
; Lopes, Augusto Celso
; Fé Filho, Nilson de Moura
; Alves, Gustavo
; Tavares Filho, Sérgio Costa
; Kreimer, Sergio
; Tebet, Marden
; Maia, Felipe
; Oliveira, Maurício Sales de
; Fonseca, Alberto
; Camiletti, Angelina
; Albuquerque, Denilson Campos de
; Souza, Olga Ferreira de
.
Resumo Fundamento O implante percutâneo de bioprótese valvar aórtica (TAVI) consolidou-se como opção terapêutica da estenose aórtica de grau importante. Dados sobre as características evolutivas dos procedimentos e dos resultados obtidos com a técnica ao longo da última década, em escala nacional, são desconhecidos. Objetivos Analisar a tendência temporal referente ao perfil demográfico, características dos procedimentos e desfechos hospitalares de pacientes submetidos a TAVI na Rede D’Or São Luiz. Métodos Registro observacional envolvendo 29 instituições nacionais. Comparou-se características dos procedimentos realizados de 2012 a 2017 (Grupo 1) e de 2018 a 2023 (Grupo 2). Foram considerados significantes os resultados com valor de p < 0,05. Resultados Foram analisados 661 casos, 95 pertencentes ao Grupo 1 e 566 ao Grupo 2. A média de idade foi 81,1 anos. Observou-se no Grupo 1 maior prevalência de pacientes em classe funcional III ou IV e escore de risco > 8%. Foi mais frequente o emprego de anestesia geral, monitorização ecocardiográfica transesofágica e via de acesso por dissecção. Maior taxa de sucesso do procedimento (95,4% versus 89,5%; p = 0,018) foi aferida em implantes efetivados a partir de 2018, assim como menor mortalidade (3,9% versus 11,6%; p = 0,004) e necessidade de marcapasso definitivo (8,5% versus 17,9%; p = 0,008). Conclusões A análise temporal de 10 anos do Registro TAVIDOR demonstra uma queda na complexidade clínica dos pacientes. Além disso, o avanço para técnicas de implante minimalistas, somadas à evolução tecnológica dos dispositivos, podem ter contribuído para desfechos favoráveis dentre aqueles cujo implante ocorreu no último quinquênio. (TAVI consolidouse consolidou se importante década nacional desconhecidos demográfico DOr D Or Luiz 2 nacionais Comparouse Comparou 201 202 . 2) 005 0 05 0,05 66 casos 9 56 811 81 81, Observouse Observou 8 8% geral dissecção 95,4% 954 4 (95,4 89,5% 895 89 5 0,018 0018 018 3,9% 39 3 (3,9 11,6% 116 11 6 0,004 0004 004 8,5% 85 (8,5 17,9% 179 17 0,008. 0008 0,008 008 0,008) disso minimalistas dispositivos quinquênio 20 00 0,0 95,4 (95, 89,5 0,01 001 01 3,9 (3, 11,6 0,00 000 8,5 (8, 17,9 0, 95, (95 89, 3, (3 11, 8, (8 17, (9 (
Abstract Background Transcatheter aortic valve implantation (TAVI) has established itself as the preferential strategy to approach severe aortic stenosis. Information on procedural improvements and nationwide results obtained with the technique throughout the past decade are unknown. Objectives To assess the temporal variation of the demographic profile, procedural characteristics, and in-hospital outcomes of patients undergoing TAVI procedures at the Rede D’Or São Luiz. Methods Observational registry comprising 29 national institutions, comparing the characteristics of the TAVI procedures performed from 2012 to 2017 (Group 1) to those performed from 2018 to 2023 (Group 2). The statistical significance level adopted was p < 0.05. Results This study assessed 661 patients, 95 in Group 1 and 566 in Group 2, with a mean age of 81.1 years. Group 1 patients had a higher prevalence of New York Heart Association functional class III or IV and STS risk score > 8%. In addition, they more often underwent general anesthesia, transesophageal echocardiographic monitoring, and access through femoral dissection. Group 2 patients had a higher success rate of the TAVI procedure (95.4% versus 89.5%; p = 0.018), lower mortality (3.9% versus 11.6%; p = 0.004), and less often needed permanent pacemaker implantation (8.5% versus 17.9%; p = 0.008). Conclusions The 10-year temporal trends analysis of the TAVIDOR Registry shows a reduction in patients’ clinical complexity over time. Furthermore, the advance to minimalistic implantation techniques, added to the technological evolution of the devices, may have contributed to the favorable outcomes observed among those whose implantation occurred in the last 5 years studied. (TAVI stenosis unknown profile inhospital hospital DOr D Or Luiz institutions 201 202 2. . 2) 005 0 05 0.05 66 9 56 811 81 81. 8 8% addition anesthesia monitoring dissection 95.4% 954 4 (95.4 89.5% 895 89 0.018, 0018 0.018 , 018 0.018) 3.9% 39 3 (3.9 11.6% 116 11 6 0.004, 0004 0.004 004 0.004) 8.5% 85 (8.5 17.9% 179 17 0.008. 0008 0.008 008 0.008) 10year year 10 time Furthermore techniques devices studied 20 00 0.0 95.4 (95. 89.5 001 0.01 01 3.9 (3. 11.6 000 0.00 8.5 (8. 17.9 0. 95. (95 89. 3. (3 11. 8. (8 17. (9 (
6.
Catálogo Taxonômico da Fauna do Brasil: Setting the baseline knowledge on the animal diversity in Brazil Brasil
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Boeger, Walter A.
; Valim, Michel P.
; Zaher, Hussam
; Rafael, José A.
; Forzza, Rafaela C.
; Percequillo, Alexandre R.
; Serejo, Cristiana S.
; Garraffoni, André R.S.
; Santos, Adalberto J.
; Slipinski, Adam
; Linzmeier, Adelita M.
; Calor, Adolfo R.
; Garda, Adrian A.
; Kury, Adriano B.
; Fernandes, Agatha C.S.
; Agudo-Padrón, Aisur I.
; Akama, Alberto
; Silva Neto, Alberto M. da
; Burbano, Alejandro L.
; Menezes, Aleksandra
; Pereira-Colavite, Alessandre
; Anichtchenko, Alexander
; Lees, Alexander C.
; Bezerra, Alexandra M.R.
; Domahovski, Alexandre C.
; Pimenta, Alexandre D.
; Aleixo, Alexandre L.P.
; Marceniuk, Alexandre P.
; Paula, Alexandre S. de
; Somavilla, Alexandre
; Specht, Alexandre
; Camargo, Alexssandro
; Newton, Alfred F.
; Silva, Aline A.S. da
; Santos, Aline B. dos
; Tassi, Aline D.
; Aragão, Allan C.
; Santos, Allan P.M.
; Migotto, Alvaro E.
; Mendes, Amanda C.
; Cunha, Amanda
; Chagas Júnior, Amazonas
; Sousa, Ana A.T. de
; Pavan, Ana C.
; Almeida, Ana C.S.
; Peronti, Ana L.B.G.
; Henriques-Oliveira, Ana L.
; Prudente, Ana L.
; Tourinho, Ana L.
; Pes, Ana M.O.
; Carmignotto, Ana P.
; Wengrat, Ana P.G. da Silva
; Dornellas, Ana P.S.
; Molin, Anamaria Dal
; Puker, Anderson
; Morandini, André C.
; Ferreira, André da S.
; Martins, André L.
; Esteves, André M.
; Fernandes, André S.
; Roza, André S.
; Köhler, Andreas
; Paladini, Andressa
; Andrade, Andrey J. de
; Pinto, Ângelo P.
; Salles, Anna C. de A.
; Gondim, Anne I.
; Amaral, Antonia C.Z.
; Rondón, Antonio A.A.
; Brescovit, Antonio
; Lofego, Antônio C.
; Marques, Antonio C.
; Macedo, Antonio
; Andriolo, Artur
; Henriques, Augusto L.
; Ferreira Júnior, Augusto L.
; Lima, Aurino F. de
; Barros, Ávyla R. de A.
; Brito, Ayrton do R.
; Romera, Bárbara L.V.
; Vasconcelos, Beatriz M.C. de
; Frable, Benjamin W.
; Santos, Bernardo F.
; Ferraz, Bernardo R.
; Rosa, Brunno B.
; Sampaio, Brunno H.L.
; Bellini, Bruno C.
; Clarkson, Bruno
; Oliveira, Bruno G. de
; Corrêa, Caio C.D.
; Martins, Caleb C.
; Castro-Guedes, Camila F. de
; Souto, Camilla
; Bicho, Carla de L.
; Cunha, Carlo M.
; Barboza, Carlos A. de M.
; Lucena, Carlos A.S. de
; Barreto, Carlos
; Santana, Carlos D.C.M. de
; Agne, Carlos E.Q.
; Mielke, Carlos G.C.
; Caetano, Carlos H.S.
; Flechtmann, Carlos H.W.
; Lamas, Carlos J.E.
; Rocha, Carlos
; Mascarenhas, Carolina S.
; Margaría, Cecilia B.
; Waichert, Cecilia
; Digiani, Celina
; Haddad, Célio F.B.
; Azevedo, Celso O.
; Benetti, Cesar J.
; Santos, Charles M.D. dos
; Bartlett, Charles R.
; Bonvicino, Cibele
; Ribeiro-Costa, Cibele S.
; Santos, Cinthya S.G.
; Justino, Cíntia E.L.
; Canedo, Clarissa
; Bonecker, Claudia C.
; Santos, Cláudia P.
; Carvalho, Claudio J.B. de
; Gonçalves, Clayton C.
; Galvão, Cleber
; Costa, Cleide
; Oliveira, Cléo D.C. de
; Schwertner, Cristiano F.
; Andrade, Cristiano L.
; Pereira, Cristiano M.
; Sampaio, Cristiano
; Dias, Cristina de O.
; Lucena, Daercio A. de A.
; Manfio, Daiara
; Amorim, Dalton de S.
; Queiroz, Dalva L. de
; Queiroz, Dalva L. de
; Colpani, Daniara
; Abbate, Daniel
; Aquino, Daniel A.
; Burckhardt, Daniel
; Cavallari, Daniel C.
; Prado, Daniel de C. Schelesky
; Praciano, Daniel L.
; Basílio, Daniel S.
; Bená, Daniela de C.
; Toledo, Daniela G.P. de
; Takiya, Daniela M.
; Fernandes, Daniell R.R.
; Ament, Danilo C.
; Cordeiro, Danilo P.
; Silva, Darliane E.
; Pollock, Darren A.
; Muniz, David B.
; Gibson, David I.
; Nogueira, David S.
; Marques, Dayse W.A.
; Lucatelli, Débora
; Garcia, Deivys M.A.
; Baêta, Délio
; Ferreira, Denise N.M.
; Rueda-Ramírez, Diana
; Fachin, Diego A.
; Souza, Diego de S.
; Rodrigues, Diego F.
; Pádua, Diego G. de
; Barbosa, Diego N.
; Dolibaina, Diego R.
; Amaral, Diogo C.
; Chandler, Donald S.
; Maccagnan, Douglas H.B.
; Caron, Edilson
; Carvalho, Edrielly
; Adriano, Edson A.
; Abreu Júnior, Edson F. de
; Pereira, Edson H.L.
; Viegas, Eduarda F.G.
; Carneiro, Eduardo
; Colley, Eduardo
; Eizirik, Eduardo
; Santos, Eduardo F. dos
; Shimbori, Eduardo M.
; Suárez-Morales, Eduardo
; Arruda, Eliane P. de
; Chiquito, Elisandra A.
; Lima, Élison F.B.
; Castro, Elizeu B. de
; Orlandin, Elton
; Nascimento, Elynton A. do
; Razzolini, Emanuel
; Gama, Emanuel R.R.
; Araujo, Enilma M. de
; Nishiyama, Eric Y.
; Spiessberger, Erich L.
; Santos, Érika C.L. dos
; Contreras, Eugenia F.
; Galati, Eunice A.B.
; Oliveira Junior, Evaldo C. de
; Gallardo, Fabiana
; Hernandes, Fabio A.
; Lansac-Tôha, Fábio A.
; Pitombo, Fabio B.
; Dario, Fabio Di
; Santos, Fábio L. dos
; Mauro, Fabio
; Nascimento, Fabio O. do
; Olmos, Fabio
; Amaral, Fabio R.
; Schunck, Fabio
; Godoi, Fábio S. P. de
; Machado, Fabrizio M.
; Barbo, Fausto E.
; Agrain, Federico A.
; Ribeiro, Felipe B.
; Moreira, Felipe F.F.
; Barbosa, Felipe F.
; Silva, Fenanda S.
; Cavalcanti, Fernanda F.
; Straube, Fernando C.
; Carbayo, Fernando
; Carvalho Filho, Fernando
; Zanella, Fernando C.V.
; Jacinavicius, Fernando de C.
; Farache, Fernando H.A.
; Leivas, Fernando
; Dias, Fernando M.S.
; Mantellato, Fernando
; Vaz-de-Mello, Fernando Z.
; Gudin, Filipe M.
; Albuquerque, Flávio
; Molina, Flavio B.
; Passos, Flávio D.
; Shockley, Floyd W.
; Pinheiro, Francielly F.
; Mello, Francisco de A.G. de
; Nascimento, Francisco E. de L.
; Franco, Francisco L.
; Oliveira, Francisco L. de
; Melo, Francisco T. de V.
; Quijano, Freddy R.B.
; Salles, Frederico F.
; Biffi, Gabriel
; Queiroz, Gabriel C.
; Bizarro, Gabriel L.
; Hrycyna, Gabriela
; Leviski, Gabriela
; Powell, Gareth S.
; Santos, Geane B. dos
; Morse, Geoffrey E.
; Brown, George
; Mattox, George M.T.
; Zimbrão, Geraldo
; Carvalho, Gervásio S.
; Miranda, Gil F.G.
; Moraes, Gilberto J. de
; Lourido, Gilcélia M.
; Neves, Gilmar P.
; Moreira, Gilson R.P.
; Montingelli, Giovanna G.
; Maurício, Giovanni N.
; Marconato, Gláucia
; Lopez, Guilherme E.L.
; Silva, Guilherme L. da
; Muricy, Guilherme
; Brito, Guilherme R.R.
; Garbino, Guilherme S.T.
; Flores, Gustavo E.
; Graciolli, Gustavo
; Libardi, Gustavo S.
; Proctor, Heather C.
; Gil-Santana, Helcio R.
; Varella, Henrique R.
; Escalona, Hermes E.
; Schmitz, Hermes J.
; Rodrigues, Higor D.D.
; Galvão Filho, Hilton de C.
; Quintino, Hingrid Y.S.
; Pinto, Hudson A.
; Rainho, Hugo L.
; Miyahira, Igor C.
; Gonçalves, Igor de S.
; Martins, Inês X.
; Cardoso, Irene A.
; Oliveira, Ismael B. de
; Franz, Ismael
; Fernandes, Itanna O.
; Golfetti, Ivan F.
; S. Campos-Filho, Ivanklin
; Oliveira, Ivo de S.
; Delabie, Jacques H.C.
; Oliveira, Jader de
; Prando, Jadila S.
; Patton, James L.
; Bitencourt, Jamille de A.
; Silva, Janaina M.
; Santos, Jandir C.
; Arruda, Janine O.
; Valderrama, Jefferson S.
; Dalapicolla, Jeronymo
; Oliveira, Jéssica P.
; Hájek, Jiri
; Morselli, João P.
; Narita, João P.
; Martin, João P.I.
; Grazia, Jocélia
; McHugh, Joe
; Cherem, Jorge J.
; Farias Júnior, José A.S.
; Fernandes, Jose A.M.
; Pacheco, José F.
; Birindelli, José L.O.
; Rezende, José M.
; Avendaño, Jose M.
; Duarte, José M. Barbanti
; Ribeiro, José R. Inácio
; Mermudes, José R.M.
; Pujol-Luz, José R.
; Santos, Josenilson R. dos
; Câmara, Josenir T.
; Teixeira, Joyce A.
; Prado, Joyce R. do
; Botero, Juan P.
; Almeida, Julia C.
; Kohler, Julia
; Gonçalves, Julia P.
; Beneti, Julia S.
; Donahue, Julian P.
; Alvim, Juliana
; Almeida, Juliana C.
; Segadilha, Juliana L.
; Wingert, Juliana M.
; Barbosa, Julianna F.
; Ferrer, Juliano
; Santos, Juliano F. dos
; Kuabara, Kamila M.D.
; Nascimento, Karine B.
; Schoeninger, Karine
; Campião, Karla M.
; Soares, Karla
; Zilch, Kássia
; Barão, Kim R.
; Teixeira, Larissa
; Sousa, Laura D. do N.M. de
; Dumas, Leandro L.
; Vieira, Leandro M.
; Azevedo, Leonardo H.G.
; Carvalho, Leonardo S.
; Souza, Leonardo S. de
; Rocha, Leonardo S.G.
; Bernardi, Leopoldo F.O.
; Vieira, Letícia M.
; Johann, Liana
; Salvatierra, Lidianne
; Oliveira, Livia de M.
; Loureiro, Lourdes M.A. El-moor
; Barreto, Luana B.
; Barros, Luana M.
; Lecci, Lucas
; Camargos, Lucas M. de
; Lima, Lucas R.C.
; Almeida, Lucia M.
; Martins, Luciana R.
; Marinoni, Luciane
; Moura, Luciano de A.
; Lima, Luciano
; Naka, Luciano N.
; Miranda, Lucília S.
; Salik, Lucy M.
; Bezerra, Luis E.A.
; Silveira, Luis F.
; Campos, Luiz A.
; Castro, Luiz A.S. de
; Pinho, Luiz C.
; Silveira, Luiz F.L.
; Iniesta, Luiz F.M.
; Tencatt, Luiz F.C.
; Simone, Luiz R.L.
; Malabarba, Luiz R.
; Cruz, Luiza S. da
; Sekerka, Lukas
; Barros, Lurdiana D.
; Santos, Luziany Q.
; Skoracki, Maciej
; Correia, Maira A.
; Uchoa, Manoel A.
; Andrade, Manuella F.G.
; Hermes, Marcel G.
; Miranda, Marcel S.
; Araújo, Marcel S. de
; Monné, Marcela L.
; Labruna, Marcelo B.
; Santis, Marcelo D. de
; Duarte, Marcelo
; Knoff, Marcelo
; Nogueira, Marcelo
; Britto, Marcelo R. de
; Melo, Marcelo R.S. de
; Carvalho, Marcelo R. de
; Tavares, Marcelo T.
; Kitahara, Marcelo V.
; Justo, Marcia C.N.
; Botelho, Marcia J.C.
; Couri, Márcia S.
; Borges-Martins, Márcio
; Felix, Márcio
; Oliveira, Marcio L. de
; Bologna, Marco A.
; Gottschalk, Marco S.
; Tavares, Marcos D.S.
; Lhano, Marcos G.
; Bevilaqua, Marcus
; Santos, Marcus T.T.
; Domingues, Marcus V.
; Sallum, Maria A.M.
; Digiani, María C.
; Santarém, Maria C.A.
; Nascimento, Maria C. do
; Becerril, María de los A.M.
; Santos, Maria E.A. dos
; Passos, Maria I. da S. dos
; Felippe-Bauer, Maria L.
; Cherman, Mariana A.
; Terossi, Mariana
; Bartz, Marie L.C.
; Barbosa, Marina F. de C.
; Loeb, Marina V.
; Cohn-Haft, Mario
; Cupello, Mario
; Martins, Marlúcia B.
; Christofersen, Martin L.
; Bento, Matheus
; Rocha, Matheus dos S.
; Martins, Maurício L.
; Segura, Melissa O.
; Cardenas, Melissa Q.
; Duarte, Mércia E.
; Ivie, Michael A.
; Mincarone, Michael M.
; Borges, Michela
; Monné, Miguel A.
; Casagrande, Mirna M.
; Fernandez, Monica A.
; Piovesan, Mônica
; Menezes, Naércio A.
; Benaim, Natalia P.
; Reategui, Natália S.
; Pedro, Natan C.
; Pecly, Nathalia H.
; Ferreira Júnior, Nelson
; Silva Júnior, Nelson J. da
; Perioto, Nelson W.
; Hamada, Neusa
; Degallier, Nicolas
; Chao, Ning L.
; Ferla, Noeli J.
; Mielke, Olaf H.H.
; Evangelista, Olivia
; Shibatta, Oscar A.
; Oliveira, Otto M.P.
; Albornoz, Pablo C.L.
; Dellapé, Pablo M.
; Gonçalves, Pablo R.
; Shimabukuro, Paloma H.F.
; Grossi, Paschoal
; Rodrigues, Patrícia E. da S.
; Lima, Patricia O.V.
; Velazco, Paul
; Santos, Paula B. dos
; Araújo, Paula B.
; Silva, Paula K.R.
; Riccardi, Paula R.
; Garcia, Paulo C. de A.
; Passos, Paulo G.H.
; Corgosinho, Paulo H.C.
; Lucinda, Paulo
; Costa, Paulo M.S.
; Alves, Paulo P.
; Roth, Paulo R. de O.
; Coelho, Paulo R.S.
; Duarte, Paulo R.M.
; Carvalho, Pedro F. de
; Gnaspini, Pedro
; Souza-Dias, Pedro G.B.
; Linardi, Pedro M.
; Bartholomay, Pedro R.
; Demite, Peterson R.
; Bulirsch, Petr
; Boll, Piter K.
; Pereira, Rachel M.M.
; Silva, Rafael A.P.F.
; Moura, Rafael B. de
; Boldrini, Rafael
; Silva, Rafaela A. da
; Falaschi, Rafaela L.
; Cordeiro, Ralf T.S.
; Mello, Ramon J.C.L.
; Singer, Randal A.
; Querino, Ranyse B.
; Heleodoro, Raphael A.
; Castilho, Raphael de C.
; Constantino, Reginaldo
; Guedes, Reinaldo C.
; Carrenho, Renan
; Gomes, Renata S.
; Gregorin, Renato
; Machado, Renato J.P.
; Bérnils, Renato S.
; Capellari, Renato S.
; Silva, Ricardo B.
; Kawada, Ricardo
; Dias, Ricardo M.
; Siewert, Ricardo
; Brugnera, Ricaro
; Leschen, Richard A.B.
; Constantin, Robert
; Robbins, Robert
; Pinto, Roberta R.
; Reis, Roberto E. dos
; Ramos, Robson T. da C.
; Cavichioli, Rodney R.
; Barros, Rodolfo C. de
; Caires, Rodrigo A.
; Salvador, Rodrigo B.
; Marques, Rodrigo C.
; Araújo, Rodrigo C.
; Araujo, Rodrigo de O.
; Dios, Rodrigo de V.P.
; Johnsson, Rodrigo
; Feitosa, Rodrigo M.
; Hutchings, Roger W.
; Lara, Rogéria I.R.
; Rossi, Rogério V.
; Gerstmeier, Roland
; Ochoa, Ronald
; Hutchings, Rosa S.G.
; Ale-Rocha, Rosaly
; Rocha, Rosana M. da
; Tidon, Rosana
; Brito, Rosangela
; Pellens, Roseli
; Santos, Sabrina R. dos
; Santos, Sandra D. dos
; Paiva, Sandra V.
; Santos, Sandro
; Oliveira, Sarah S. de
; Costa, Sávio C.
; Gardner, Scott L.
; Leal, Sebastián A. Muñoz
; Aloquio, Sergio
; Bonecker, Sergio L.C.
; Bueno, Sergio L. de S.
; Almeida, Sérgio M. de
; Stampar, Sérgio N.
; Andena, Sérgio R.
; Posso, Sergio R.
; Lima, Sheila P.
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; Cohen, Simone C.
; Brandão, Simone N.
; Rosa, Simone P.
; Ribeiro, Síria L.B.
; Letana, Sócrates D.
; Santos, Sonia B. dos
; Andrade, Sonia C.S.
; Dávila, Stephane
; Vaz, Stéphanie
; Peck, Stewart B.
; Christo, Susete W.
; Cunha, Suzan B.Z.
; Gomes, Suzete R.
; Duarte, Tácio
; Madeira-Ott, Taís
; Marques, Taísa
; Roell, Talita
; Lima, Tarcilla C. de
; Sepulveda, Tatiana A.
; Maria, Tatiana F.
; Ruschel, Tatiana P.
; Rodrigues, Thaiana
; Marinho, Thais A.
; Almeida, Thaís M. de
; Miranda, Thaís P.
; Freitas, Thales R.O.
; Pereira, Thalles P.L.
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; Pacheco, Thaynara L.
; Martins, Thiago F.
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; Carvalho, Thiago R. de
; Polizei, Thiago T.S.
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; Henry, Thomas
; Pikart, Tiago G.
; Porto, Tiago J.
; Krolow, Tiago K.
; Carvalho, Tiago P.
; Lotufo, Tito M. da C.
; Caramaschi, Ulisses
; Pinheiro, Ulisses dos S.
; Pardiñas, Ulyses F.J.
; Maia, Valéria C.
; Tavares, Valeria
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; Espíndola, Vinicius C.
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; Piacentini, Vítor de Q.
; Sandoval-Gómez, Vivian E.
; Trevine, Vivian
; Sousa, Viviane R.
; Sant’Anna, Vivianne B. de
; Mathis, Wayne N.
; Souza, Wesley de O.
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; Tomaszewska, Wioletta
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; Ovando, Ximena M.C.
; Leite, Yuri L.R.
.
ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others. publications problem uptodate up date classifications context exception (CTFB http//fauna.jbrj.gov.br/, httpfaunajbrjgovbr http //fauna.jbrj.gov.br/ , jbrj gov br (http://fauna.jbrj.gov.br/) 2015 Brazil 80 specialists 1 2024 133691 133 691 133,69 125138 125 138 125,13 82.3%, 823 82 3 (82.3% 102000 102 000 102,00 7.69%, 769 7 69 (7.69% 11000 11 11,00 . 3,567 3567 567 (3,56 2,292 2292 2 292 (2,29 1,833 1833 833 (1,83 1,447 1447 447 (1,44 1000 1,00 831 (83 628 (62 606 (60 520 (52 50 users science health biology law anthropology education others http//fauna.jbrj.gov.br/ faunajbrjgovbr //fauna.jbrj.gov.br (http://fauna.jbrj.gov.br/ 201 8 202 13369 13 133,6 12513 12 125,1 82.3% (82.3 10200 10 00 102,0 7.69% 76 6 (7.69 1100 11,0 3,56 356 56 (3,5 2,29 229 29 (2,2 1,83 183 83 (1,8 1,44 144 44 (1,4 100 1,0 (8 62 (6 60 52 (5 5 http//fauna.jbrj.gov.br (http://fauna.jbrj.gov.br 20 1336 133, 1251 125, 82.3 (82. 1020 0 102, 7.69 (7.6 110 11, 3,5 35 (3, 2,2 22 (2, 1,8 18 (1, 1,4 14 4 ( 82. (82 7.6 (7. 3, (3 2, (2 (1 7. (7
7.
Diretriz de Tomografia Computadorizada e Ressonância Magnética Cardiovascular da Sociedade Brasileira de Cardiologia e do Colégio Brasileiro de Radiologia – 2024 202 20 2
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Magalhães, Tiago Augusto
; Carneiro, Adriano Camargo de Castro
; Moreira, Valéria de Melo
; Trad, Henrique Simão
; Lopes, Marly Maria Uellendahl
; Cerci, Rodrigo Julio
; Nacif, Marcelo Souto
; Schvartzman, Paulo R.
; Chagas, Antônio Carlos Palandrini
; Costa, Isabela Bispo Santos da Silva
; Schmidt, André
; Shiozaki, Afonso Akio
; Montenegro, Sérgio Tavares
; Piegas, Leopoldo Soares
; Zapparoli, Marcelo
; Nicolau, José Carlos
; Fernandes, Fabio
; Hadlich, Marcelo Souza
; Ghorayeb, Nabil
; Mesquita, Evandro Tinoco
; Gonçalves, Luiz Flávio Galvão
; Ramires, Felix José Alvarez
; Fernandes, Juliano de Lara
; Schwartzmann, Pedro Vellosa
; Rassi, Salvador
; Torreão, Jorge Andion
; Mateos, José Carlos Pachón
; Beck-da-Silva, Luiz
; Silva, Marly Conceição
; Liberato, Gabriela
; Oliveira, Gláucia Maria Moraes de
; Feitosa Filho, Gilson Soares
; Carvalho, Hilka dos Santos Moraes de
; Markman Filho, Brivaldo
; Rocha, Ricardo Paulo de Sousa
; Azevedo Filho, Clerio Francisco de
; Taratsoutchi, Flávio
; Coelho-Filho, Otavio Rizzi
; Kalil Filho, Roberto
; Hajjar, Ludhmila Abrahão
; Ishikawa, Walther Yoshiharu
; Melo, Cíntia Acosta
; Jatene, Ieda Biscegli
; Albuquerque, Andrei Skromov de
; Rimkus, Carolina de Medeiros
; Silva, Paulo Savoia Dias da
; Vieira, Thiago Dieb Ristum
; Jatene, Fabio Biscegli
; Azevedo, Guilherme Sant Anna Antunes de
; Santos, Raul D.
; Monte, Guilherme Urpia
; Ramires, José Antonio Franchini
; Bittencourt, Marcio Sommer
; Avezum, Alvaro
; Silva, Leonardo Sara da
; Abizaid, Alexandre
; Gottlieb, Ilan
; Precoma, Dalton Bertolim
; Szarf, Gilberto
; Sousa, Antônio Carlos Sobral
; Pinto, Ibraim Masciarelli Francisco
; Medeiros, Fábio de Morais
; Caramelli, Bruno
; Parga Filho, José Rodrigues
; Santos, Tiago Senra Garcia dos
; Prazeres, Carlos Eduardo Elias dos
; Lopes, Marcelo Antonio Cartaxo Queiroga
; Avila, Luiz Francisco Rodrigues de
; Scanavacca, Mauricio Ibrahim
; Gowdak, Luis Henrique Wolff
; Barberato, Silvio Henrique
; Nomura, Cesar Higa
; Rochitte, Carlos Eduardo
.
8.
Diretriz de Avaliação Cardiovascular Perioperatória da Sociedade Brasileira de Cardiologia – 2024 202 20 2
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Gualandro, Danielle Menosi
; Fornari, Luciana Savoy
; Caramelli, Bruno
; Abizaid, Alexandre Antonio Cunha
; Gomes, Brenno Rizerio
; Tavares, Caio de Assis Moura
; Fernandes, Caio Julio Cesar dos Santos
; Polanczyk, Carisi Anne
; Jardim, Carlos
; Vieira, Carolina Leticia Zilli
; Pinho, Claudio
; Calderaro, Daniela
; Schreen, Dirk
; Marcondes-Braga, Fabiana Goulart
; Souza, Fábio de
; Cardozo, Francisco Akira Malta
; Tarasoutchi, Flavio
; Carmo, Gabriel Assis Lopes
; Kanhouche, Gabriel
; Lima, José Jayme Galvão de
; Bichuette, Luciana Dornfeld
; Sacilotto, Luciana
; Drager, Luciano Ferreira
; Vacanti, Luciano Janussi
; Gowdak, Luis Henrique Wolff
; Vieira, Marcelo Luiz Campos
; Martins, Marcelo Luiz Floriano Melo
; Lima, Márcio Silva Miguel
; Lottenberg, Marcos Pita
; Aliberti, Márlon Juliano Romero
; Marchi, Mauricio Felippi de Sá
; Paixão, Milena Ribeiro
; Oliveira Junior, Mucio Tavares de
; Yu, Pai Ching
; Cury, Patricia Ramos
; Farsky, Pedro Silvio
; Pessoa, Ranna Santos
; Siciliano, Rinaldo Focaccia
; Accorsi, Tarso Augusto Duenhas
; Correia, Vinícius Machado
; Mathias Junior, Wilson
.
9.
Long-term oncological and surgical outcomes after Video Endoscopic Inguinal Lymphadenectomy (VEIL) in patients with penile cancer Longterm Long term VEIL (VEIL
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Tobias-Machado, Marcos
; Ornellas, Antonio A.
; Hidaka, Alexandre K.
; Medina, Luis G.
; Mattos, Pablo A. L.
; Besio, Ruben S.
; Abreu, Diego
; Castro, Pedro R.
; Nishimoto, Ricardo H.
; Astigueta, Juan
; Dourado, Aurus
; Machado, Roberto D.
; Magnabosco, Wesley J.
; Corona-Montes, Victor
; Villoldo, Gustavo M.
; Zampolli, Hamilton C.
; Taha, Anis
; Auad, Pericles R.
; Faria, Eliney F.
; Arantes, Paulo B. O.
; Tavares, Alessandro
; Nascimento, Francisco S. M. S.
; Brazão Jr., Eder S.
; Rocha, Maurício M.
; Costa, Walter H.
; Panico, Vinicius
; Reis, Leonardo O.
; Almeida-Carrera, Roberto J.
; Silva, Rafael C.
; Zequi, Stênio C.
; Calixto, José R. R.
; Sotelo, Rene
.
ABSTRACT Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer. Objective VEIL. . (VEIL) Methods 2 CoalitionLatin Coalition Latin PeCLA PeC LA (PeC-LA technique intermediate/highrisk intermediatehighrisk intermediate/high risk intermediate high nonfixed non fixed diameter range Results 200 2020 5 4568 45 68 (45-68 old 9 60120. 60120 60 120 (60-120) 1 616. 616 6 16 (6-16) 157 15 7 15.7% 19 1.9 86 8 8. 48 4.8 respectively 267 26 26.7 nonpalpable 28 2.8 10y y 742 74 74.2 848 84 84.8% pN0 pN pN1 100 100% 824 82 82.4% 727 72 72.7 91 9.1% Conclusion morbidity noninvasive invasive biopsy nonbulky bulky (VEIL highrisk intermediatehigh 20 202 456 (45-6 6012 12 (60-120 61 (6-16 15.7 1. 4. 26. 2. 74. 84.8 82.4 72. 9.1 (45- 601 (60-12 (6-1 15. 84. 82. 9. (45 (60-1 (6- (4 (60- (6 ( (60
10.
Laparoscopic pyeloplasty proficiency during a residency program after adoption of a standardized simulation training program is maintained during the COVID pandemic despite reduced surgery volume
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Gorgen, Antonio Rebello Horta
; Abreu, Fernando Jahn da Silva
; Paludo, Artur de Oliveira
; Menegolla, Mauricio Picolo
; Oliveira, Renan Timóteo de
; Tavares, Patric Machado
; Rosito, Tiago Elias
.
ABSTRACT Purpose: To evaluate the effect of the standardized laparoscopic simulation training program in pyeloplasty, following its implementation and during the COVID-19 pandemic. Material and Methods: A retrospective chart review was performed at Hospital de Clínicas de Porto Alegre, a tertiary referral center in south Brazil, in which 151 patients underwent laparoscopic pyeloplasty performed by residents between 2006-2021. They were divided into three groups: before and after adoption of a standardized laparoscopic simulation training program and during the COVID-19 pandemic. The main outcome was a combined negative outcome of conversion to open surgery, major postoperative complications (Clavien-Dindo III or higher) or unsuccessful procedure, defined as need for redo pyeloplasty. Results: There was a significant reduction in the combined negative outcome (21.1% vs 6.3%), surgical time (mean 200.0 min vs 177.4 min) and length of stay (median 5 days vs 3 days) after the adoption of simulation training program. These results were maintained during the COVID-19 pandemic (combined negative outcome of 6.3%, mean surgical time of 160.1 min and median length of stay of 3 days) despite a reduction in 55.4% of the surgical volume. Conclusion: A structured laparoscopic simulation program can improve outcomes of laparoscopic pyeloplasty during the learning curve. Purpose COVID19 COVID 19 COVID-1 Methods Alegre Brazil 15 20062021. 20062021 2006 2021. 2021 2006-2021 groups surgery ClavienDindo Clavien Dindo higher procedure Results 21.1% 211 21 1 (21.1 63 6.3% , 6 6.3%) 2000 200 0 200. 1774 177 4 177. 1601 160 160. 554 55 55.4 volume Conclusion curve COVID1 COVID- 2006202 202 2006-202 21.1 2 (21. 6.3 20 17 16 55. 200620 2006-20 21. (21 6. 20062 2006-2 (2 2006- (
11.
Climate-smart agriculture and soil C sequestration in Brazilian Cerrado: a systematic review Climatesmart Climate smart Cerrado
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Oliveira, Dener Márcio da Silva
; Tavares, Rose Luiza Moraes
; Loss, Arcângelo
; Madari, Beata Emoke
; Cerri, Carlos Eduardo Pellegrino
; Alves, Bruno Jose Rodrigues
; Pereira, Marcos Gervasio
; Cherubin, Maurício Roberto
.
Revista Brasileira de Ciência do Solo
- Métricas do periódico
ABSTRACT Climate-smart agriculture (CSA) practices, mainly no-tillage (NT), cover cropping (CC), soil fertilization with organic amendments (OA), and crop-livestock (CL) and crop-livestock-forestry (CLF) systems, has been widely adopted in areas from Brazilian Cerrado. The CSA may partly offset former soil C losses and contribute to climate change mitigation. However, contradictory findings brought uncertainties about the effect of CSA on soil C. Here, by a systematic review of 87 papers and using 621 data pairs, we provided a pervasive biome-scale analysis of soil C stock changes associated with the adoption of CSA across Brazilian Cerrado. All CSA practices evaluated showed average positive rates of C stock change, indicating a general tendency of soil C accretion after its adoption. In areas under NT, CC and CLF, greater rates were estimated for the deeper soil profile evaluated (0.00-1.00 m) (1.24 ± 0.85, 0.54 ± 0.54 and 1.00 ± 1.47 Mg ha–1 yr–1, respectively), while OA and CL showed more soil C accretion when the assessment was limited down to 0.10 m depth (0.82 ± 0.60 and 0.59 ± 0.66 Mg ha–1 yr–1, respectively). Unfortunately, the lack of basic information precluded any attempt to statically compare our estimations. In this sense, we must be cautious in stating that soil C sequestration occurs at those rates after the adoption of CSA practices. Despite these limitations, the results clearly show that the diversification and intensification of agricultural areas in the Cerrado by the adoption of CSA is a promising pathway to increase soil C stocks, and consequently, contribute to climate change mitigation and adaptation. Finally, our findings emphasize the importance of efforts that stimulate farmers to adopt these practices on large scale, such as Brazil’s Low-Carbon Agriculture Plan, besides providing sound empirical evidence about the role of soil C sequestration in Brazil achieving its Nationally Determined Contributions commitments. Climatesmart Climate smart (CSA notillage no tillage NT , (NT) CC, (CC) OA, (OA) croplivestock crop livestock (CL croplivestockforestry forestry CLF (CLF systems However Here 8 62 pairs biomescale biome scale 0.001.00 000100 0.00 0 00 1 (0.00-1.0 1.24 124 24 (1.2 085 85 0.85 054 54 0.5 100 1.0 147 47 1.4 ha1 ha ha– yr1 yr yr–1 respectively, respectively respectively) 010 10 0.1 0.82 082 82 (0.8 060 60 0.6 059 59 066 66 respectively. . Unfortunately estimations sense limitations stocks consequently adaptation Finally Brazils s LowCarbon Low Carbon Plan commitments (NT (CC (OA 6 001 0.001.0 00010 000 0.0 (0.00-1. 1.2 12 2 (1. 08 0.8 05 5 0. 1. 14 4 yr– 01 (0. 06 0.001. 0001 (0.00-1 (1 (0 0.001 (0.00- ( (0.00 (0.0
12.
Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023 202 20 2
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Marin-Neto, José Antonio
; Rassi Jr, Anis
; Oliveira, Gláucia Maria Moraes
; Correia, Luís Claudio Lemos
; Ramos Júnior, Alberto Novaes
; Luquetti, Alejandro Ostermayer
; Hasslocher-Moreno, Alejandro Marcel
; Sousa, Andréa Silvestre de
; Paola, Angelo Amato Vincenzo de
; Sousa, Antônio Carlos Sobral
; Ribeiro, Antonio Luiz Pinho
; Correia Filho, Dalmo
; Souza, Dilma do Socorro Moraes de
; Cunha-Neto, Edecio
; Ramires, Felix Jose Alvarez
; Bacal, Fernando
; Nunes, Maria do Carmo Pereira
; Martinelli Filho, Martino
; Scanavacca, Maurício Ibrahim
; Saraiva, Roberto Magalhães
; Oliveira Júnior, Wilson Alves de
; Lorga-Filho, Adalberto Menezes
; Guimarães, Adriana de Jesus Benevides de Almeida
; Braga, Adriana Lopes Latado
; Oliveira, Adriana Sarmento de
; Sarabanda, Alvaro Valentim Lima
; Pinto, Ana Yecê das Neves
; Carmo, Andre Assis Lopes do
; Schmidt, Andre
; Costa, Andréa Rodrigues da
; Ianni, Barbara Maria
; Markman Filho, Brivaldo
; Rochitte, Carlos Eduardo
; Macêdo, Carolina Thé
; Mady, Charles
; Chevillard, Christophe
; Virgens, Cláudio Marcelo Bittencourt das
; Castro, Cleudson Nery de
; Britto, Constança Felicia De Paoli de Carvalho
; Pisani, Cristiano
; Rassi, Daniela do Carmo
; Sobral Filho, Dário Celestino
; Almeida, Dirceu Rodrigues de
; Bocchi, Edimar Alcides
; Mesquita, Evandro Tinoco
; Mendes, Fernanda de Souza Nogueira Sardinha
; Gondim, Francisca Tatiana Pereira
; Silva, Gilberto Marcelo Sperandio da
; Peixoto, Giselle de Lima
; Lima, Gustavo Glotz de
; Veloso, Henrique Horta
; Moreira, Henrique Turin
; Lopes, Hugo Bellotti
; Pinto, Ibraim Masciarelli Francisco
; Ferreira, João Marcos Bemfica Barbosa
; Nunes, João Paulo Silva
; Barreto-Filho, José Augusto Soares
; Saraiva, José Francisco Kerr
; Lannes-Vieira, Joseli
; Oliveira, Joselina Luzia Menezes
; Armaganijan, Luciana Vidal
; Martins, Luiz Cláudio
; Sangenis, Luiz Henrique Conde
; Barbosa, Marco Paulo Tomaz
; Almeida-Santos, Marcos Antonio
; Simões, Marcos Vinicius
; Yasuda, Maria Aparecida Shikanai
; Moreira, Maria da Consolação Vieira
; Higuchi, Maria de Lourdes
; Monteiro, Maria Rita de Cassia Costa
; Mediano, Mauro Felippe Felix
; Lima, Mayara Maia
; Oliveira, Maykon Tavares de
; Romano, Minna Moreira Dias
; Araujo, Nadjar Nitz Silva Lociks de
; Medeiros, Paulo de Tarso Jorge
; Alves, Renato Vieira
; Teixeira, Ricardo Alkmim
; Pedrosa, Roberto Coury
; Aras Junior, Roque
; Torres, Rosalia Morais
; Povoa, Rui Manoel dos Santos
; Rassi, Sergio Gabriel
; Alves, Silvia Marinho Martins
; Tavares, Suelene Brito do Nascimento
; Palmeira, Swamy Lima
; Silva Júnior, Telêmaco Luiz da
; Rodrigues, Thiago da Rocha
; Madrini Junior, Vagner
; Brant, Veruska Maia da Costa
; Dutra, Walderez Ornelas
; Dias, João Carlos Pinto
.
13.
Diretriz Brasileira de Dispositivos Cardíacos Eletrônicos Implantáveis – 2023 202 20 2
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Teixeira, Ricardo Alkmim
; Fagundes, Alexsandro Alves
; Baggio Junior, José Mário
; Oliveira, Júlio César de
; Medeiros, Paulo de Tarso Jorge
; Valdigem, Bruno Pereira
; Teno, Luiz Antônio Castilho
; Silva, Rodrigo Tavares
; Melo, Celso Salgado de
; Elias Neto, Jorge
; Moraes Júnior, Antonio Vitor
; Pedrosa, Anisio Alexandre Andrade
; Porto, Fernando Mello
; Brito Júnior, Hélio Lima de
; Souza, Thiago Gonçalves Schroder e
; Mateos, José Carlos Pachón
; Moraes, Luis Gustavo Belo de
; Forno, Alexander Romeno Janner Dal
; D’Avila, Andre Luiz Buchele
; Cavaco, Diogo Alberto de Magalhães
; Kuniyoshi, Ricardo Ryoshim
; Pimentel, Mauricio
; Camanho, Luiz Eduardo Montenegro
; Saad, Eduardo Benchimol
; Zimerman, Leandro Ioschpe
; Oliveira, Eduardo Bartholomay
; Scanavacca, Mauricio Ibrahim
; Martinelli Filho, Martino
; Lima, Carlos Eduardo Batista de
; Peixoto, Giselle de Lima
; Darrieux, Francisco Carlos da Costa
; Duarte, Jussara de Oliveira Pinheiro
; Galvão Filho, Silas dos Santos
; Costa, Eduardo Rodrigues Bento
; Mateo, Enrique Indalécio Pachón
; Melo, Sissy Lara De
; Rodrigues, Thiago da Rocha
; Rocha, Eduardo Arrais
; Hachul, Denise Tessariol
; Lorga Filho, Adalberto Menezes
; Nishioka, Silvana Angelina D’Orio
; Gadelha, Eduardo Barreto
; Costa, Roberto
; Andrade, Veridiana Silva de
; Torres, Gustavo Gomes
; Oliveira Neto, Nestor Rodrigues de
; Lucchese, Fernando Antonio
; Murad, Henrique
; Wanderley Neto, José
; Brofman, Paulo Roberto Slud
; Almeida, Rui M. S.
; Leal, João Carlos Ferreira
.
14.
Galvanic vestibular stimulation and its applications: a systematic review, applications review
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Pires, Anna Paula Batista de Ávila
; Silva, Tatiana Rocha
; Torres, Maíra Soares
; Diniz, Maria Luiza
; Tavares, Maurício Campelo
; Gonçalves, Denise Utsch
.
Brazilian Journal of Otorhinolaryngology
- Métricas do periódico
Abstract Objective: Galvanic vestibular stimulation has been evaluated in the context of vestibular rehabilitation. The objective was to identify evidence in the scientific literature about the clinical applications of galvanic vestibular stimulation. Methods: In this systematic review, the articles describing the applications of galvanic vestibular stimulation were extracted from PubMed, Web of Science, MEDLINE, Scopus, LILACS and SciELO databases. The survey was limited to articles published in English, Portuguese and Spanish. All the articles about the clinical applications of galvanic vestibular stimulation were compiled. Repeated articles in the databases, literature review articles, case reports, letters and editorials were excluded. The descriptors included: galvanic vestibular stimulation, postural balance, central nervous system diseases, vestibular diseases, spinal cord diseases and cognition. Results: The search strategy resulted in the initial selection of 994 articles; the reading of titles and abstracts was accomplished in 470 articles and the complete reading in 23 articles. Clinical applications of galvanic vestibular stimulation included Ménière’s disease, vestibular neuritis, bilateral vestibular disorders, vestibular schwannoma, Parkinson’s disease, ischemic central lesions, motor myelopathies, anxiety disorders, cognition and memory. Conclusion: Galvanic vestibular stimulation has been considered a potentially useful strategy for balance rehabilitation, since it has the effect of stimulating the central connections related to the postural balance, favoring new neuronal synapses that allow the partial or total recovery of postural imbalance. Objective rehabilitation Methods PubMed Science MEDLINE Scopus databases English Spanish compiled reports excluded Results 99 47 2 Ménières Ménière s disease neuritis disorders schwannoma Parkinsons Parkinson lesions myelopathies memory Conclusion imbalance 9 4
15.
[SciELO Preprints] - Guideline of the Brazilian Society of Cardiology on Diagnosis and Treatment of Patients with Chagas Disease Cardiomyopathy
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Marin-Neto, José Antonio
Rassi Jr., Anis
Moraes Oliveira, Gláucia M.
Lemos Correia, Luís Claudio
Novaes Ramos Jr., Alberto
Hasslocher-Moreno, Alejandro Marcel
Luquetti Ostermayer, Alejandro
Sousa, Andréa Silvestre de
Amato Vincenzo de Paola, Angelo
Sobral de Sousa, Antonio Carlos
Pinho Ribeiro, Antonio Luiz
Correia Filho, Dalmo
Moraes de Souza, Dilma do Socorro
Cunha-Neto, Edecio
J. A. Ramires, Felix
Bacal, Fernando
Pereira Nunes, Maria do Carmo
Martinelli Filho, Martino
Ibrahim Scanavacca, Maurício
Magalhães Saraiva, Roberto
Alves de Oliveira Júnior, Wilson
M. Lorga-Filho, Adalberto
de Jesus Benevides de Almeida Guimarães, Adriana
Lopes Latado Braga, Adriana
Sarmento de Oliveira, Adriana
V. L. Sarabanda, Alvaro
Yecê das Neves Pinto, Ana
Assis Lopes do Carmo, André
Schmidt, André
Costa, Andréa Rodrigues da
Ianni, Barbara Maria
Markman Filho, Brivaldo
Eduardo Rochitte, Carlos
Thé Macedo, Carolina
Mady, Charles
Chevillard, Christophe
Bittencourt das Virgens, Cláudio Marcelo
Nery de Castro, Cleudson
De Paoli de Carvalho Britto, Constança Felícia
Pisani, Cristiano
do Carmo Rassi, Daniela
C. Sobral Filho, Dario
Rodrigues Almeida, Dirceu
A. Bocchi, Edimar
T. Mesquita, Evandro
de Souza Nogueira Sardinha Mendes, Fernanda
Pereira, Francisca Tatiana
Sperandio da Silva, Gilberto Marcelo
de Lima Peixoto, Giselle
Glotz de Lima, Gustavo
H. Veloso, Henrique
Turin Moreira, Henrique
Bellotti Lopes, Hugo
Masciarelli Francisco Pinto, Ibraim
Pinto Dias, João Carlos
Bemfica, João Marcos
Silva-Nunes, João Paulo
Soares Barreto-Filho, José Augusto
Kerr Saraiva, José Francisco
Lannes-Vieira, Joseli
Menezes Oliveira, Joselina Luzia
V. Armaganijan, Luciana
Martins, Luiz Cláudio
C. Sangenis, Luiz Henrique
Barbosa, Marco Paulo
Almeida-Santos, Marcos Antônio
Simões, Marcos Vinicius
Shikanai-Yasuda, Maria Aparecida
Vieira Moreira, Maria da Consolação
Higuchi, Maria de Lourdes
Costa Monteiro, Maria Rita de Cássia
Felix Mediano, Mauro Felippe
Maia Lima, Mayara
T. Oliveira, Maykon
Moreira Dias Romano , Minna
Nitz, Nadjar
de Tarso Jorge Medeiros, Paulo
Vieira Alves, Renato
Alkmim Teixeira, Ricardo
Coury Pedrosa, Roberto
Aras, Roque
Morais Torres, Rosália
dos Santos Povoa, Rui Manoel
Rassi, Sérgio Gabriel
Salles Xavier, Sérgio
Marinho Martins Alves , Silvia
B. N. Tavares, Suelene
Lima Palmeira, Swamy
da Silva Junior, Telêmaco Luiz
da Rocha Rodrigues, Thiago
Madrini Junior, Vagner
Maia da Costa , Veruska
Dutra, Walderez
This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.nbsp;
Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.
nbsp;
Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.nbsp;
The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.nbsp;
The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.nbsp; nbsp;nbsp;
Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.
Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou.
A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica.
Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas.
A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica.
A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.nbsp;nbsp;nbsp;
Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.nbsp;
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