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1.
[SciELO Preprints] - Cardiovascular Statistics – Brazil 2023
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Oliveira, Gláucia Maria Moraes de
Brant, Luisa Campos Caldeira
Polanczyk, Carisi Anne
Malta, Deborah Carvalho
Biolo, Andreia
Nascimento, Bruno Ramos
Souza, Maria de Fatima Marinho de
Lorenzo, Andrea Rocha De
Fagundes Júnior, Antonio Aurélio de Paiva
Schaan, Beatriz D.
Silva, Christina Grüne de Souza e
Castilho, Fábio Morato de
Cesena, Fernando Henpin Yue
Soares, Gabriel Porto
Xavier Junior, Gesner Francisco
Barreto-Filho, Jose Augusto Soares
Passaglia, Luiz Guilherme
Pinto-Filho, Marcelo Martins
Machline-Carrion, M. Julia
Bittencourt, Marcio Sommer
Pontes Neto, Octavio M.
Villela, Paolo Blanco
Teixeira, Renato Azeredo
Stein, Ricardo
Sampaio, Roney Orismar
Gaziano, Thomaz A.
Perel, Pablo
Roth, Gregory A.
Ribeiro, Antonio Luiz Pinho
The publication Cardiovascular Statistics – Brazil aims to provide an annual compilation of data and research on the epidemiology of CVDs in Brazil. The report integrates official statistics from the Brazilian Ministry of Health and other governmental entities alongside data from the GBD project, coordinated by the IHME at the University of Washington. Additionally, it incorporates data derived from various sources and scientific studies, including cohorts and registries, that relate to CVDs and their associated risk factors. This publication is intended for a wide range of individuals, including researchers, clinicians, patients, healthcare policymakers, media professionals, the general public, and other interested parties seeking extensive national data about heart disease and stroke. Volunteer researchers from various Brazilian universities and research institutions carry out the project. The group is led by a five-member steering committee (ALPR, CAP, DCM, GMMO, and LCCB). The Brazilian Society of Cardiology fully supports this initiative, and the project receives collaborative support from the GBD Brazil Network and an International Committee (GAR, PP, and TAG) from both the IHME/University of Washington (GAR) and the World Heart Federation (PP and TAG).
A publicação Estatística Cardiovascular – Brasil tem por objetivo fornecer uma compilação anual dos dados e das pesquisas sobre a epidemiologia das DCV no Brasil. Este documento integra as estatísticas oficiais do Ministério da Saúde do Brasil e outras entidades governamentais ao lado de dados do projeto GBD, coordenado pelo IHME da Universidade de Washington. Além disso, incorpora dados derivados de várias fontes e estudos científicos, inclusive coortes e registros, relacionados às DCV e fatores de risco associados. Esta publicação destina-se a um público variado, incluindo pesquisadores, clínicos, pacientes, formuladores de políticas de saúde, profissionais da mídia, o público em geral e todos aqueles que buscam dados nacionais abrangentes sobre DCV e acidente vascular cerebral. Pesquisadores voluntários de várias universidades e instituições de pesquisa brasileiros realizaram este projeto. O grupo é liderado por um comitê diretivo com cinco membros (ALPR, CAP, DCM, GMMO e LCCB). A Sociedade Brasileira de Cardiologia apoia integralmente esta iniciativa e o projeto recebe colaboração da Rede GBD Brasil1 e do GBD International Committee (GAR, PP e TAG) do IHME/Universidade de Washington (GAR) e da World Heart Federation (PP e TAG).
2.
The SISBIOTA-Diptera Brazilian Network: A long-term survey of Diptera from unexplored Brazilian Western Arc of Amazon, Cerrado, and Pantanal
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Lamas, Carlos José Einicker
; Fachin, Diego Aguilar
; Falaschi, Rafaela Lopes
; Alcantara, Daniel Máximo Correa de
; Ale-Rocha, Rosaly
; Amorim, Dalton de Souza
; Araújo, Maíra Xavier
; Ascendino, Sharlene
; Baldassio, Letícia
; Bellodi, Carolina Ferraz
; Bravo, Freddy
; Calhau, Julia
; Capellari, Renato Soares
; Carmo-Neto, Antonio Marcelino do
; Cegolin, Bianca Melo
; Couri, Márcia Souto
; Carvalho, Claudio José Barros de
; Dios, Rodrigo de Vilhena Perez
; Falcon, Aida Vanessa Gomez
; Fusari, Livia Maria
; Garcia, Carolina de Almeida
; Gil-Azevedo, Leonardo Henrique
; Gomes, Marina Morim
; Graciolli, Gustavo
; Gudin, Filipe Macedo
; Henriques, Augusto Loureiro
; Krolow, Tiago Kütter
; Mendes, Luanna Layla
; Limeira-de-Oliveira, Francisco
; Maia, Valéria Cid
; Marinoni, Luciane
; Mello, Ramon Luciano
; Mello-Patiu, Cátia Antunes de
; Morales, Mírian Nunes
; Oliveira, Sarah Siqueira
; Patiu, Claudemir
; Proença, Barbara
; Pujol-Luz, Cristiane Vieira de Assis
; Pujol-Luz, José Roberto
; Rafael, José Albertino
; Riccardi, Paula Raile
; Rodrigues, João Paulo Vinicios
; Roque, Fabio de Oliveira
; Sallum, Maria Anice Mureb
; Santis, Marcelo Domingos de
; Santos, Charles Morphy Dias dos
; Santos, Josenilson Rodrigues dos
; Savaris, Marcoandre
; Shimabukuro, Paloma Helena Fernandes
; Silva, Vera Cristina
; Schelesky-Prado, Daniel de Castro
; Silva-Neto, Alberto Moreira da
; Camargo, Alexssandro
; Sousa, Viviane Rodrigues de
; Urso-Guimarães, Maria Virginia
; Wiedenbrug, Sofia
; Yamaguchi, Carolina
; Nihei, Silvio Shigueo
.
ABSTRACT The SISBIOTA-BRASIL was a three-year multimillion-dollar research program of the Brazilian government to document plants and animals in endangered/understudied areas and biomes in Brazil. Distributional patterns and the historical events that generated them are extensively unknown regarding Brazilian fauna and flora. This deficiency hinders the development of conservation policies and the understanding of evolutionary processes. Conservation decisions depend on precise knowledge of the taxonomy and geographic distribution of species. Given such a premise, we proposed to research the diversity of Diptera of the Brazilian western arc of Amazon, Cerrado, and Pantanal in the states of Mato Grosso, Mato Grosso do Sul, and Rondônia. Three important biomes of the South American continent characterize these Brazilian states: Amazon forest, Cerrado (Brazilian Savannah), and Pantanal. Besides their ecological relevance, these biomes historically lack intensive entomological surveys. Therefore, they are much underrepresented in the Brazilian natural history collections and in the scientific literature, which is further aggravated by the fact that these areas are being exponentially and rapidly converted to commercial lands. Our project involved over 90 collaborators from 24 different Brazilian institutions and one from Colombia among researchers, postdocs, graduate and undergraduate students, and technicians. We processed and analyzed nearly 300,000 specimens from ~60 families of Diptera collected with a large variety of methods in the sampled areas. Here, we provide a detailed overview of the genera and species diversity of 41 families treated. Our results point to a total of 2,130 species and 514 genera compiled and identified for the three states altogether, with an increase of 41% and 29% in the numbers of species and genera known for the three states combined, respectively. Overall, the 10 most species-rich families were Tachinidae, Cecidomyiidae, Tabanidae, Psychodidae, Sarcophagidae, Stratiomyidae, Bombyliidae, Syrphidae, Tephritidae, and Asilidae. The 10 most diverse in the number of genera were Tachinidae, Stratiomyidae, Asilidae, Mycetophilidae, Syrphidae, Tabanidae, Muscidae, Dolichopodidae, Sarcophagidae, and Chloropidae. So far, 111 scientific papers were published regarding taxonomic, phylogenetic, and biogeographical aspects of the studied families, with the description of 101 new species and three new genera. We expect that additional publications will result from this investigation because several specimens are now curated and being researched by specialists.
3.
[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;
4.
Prediction of malaria using deep learning models: A case study on city clusters in the state of Amazonas, Brazil, from 2003 to 2018
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Barboza, Matheus Félix Xavier
; Monteiro, Kayo Henrique de Carvalho
; Rodrigues, Iago Richard
; Santos, Guto Leoni
; Monteiro, Wuelton Marcelo
; Figueira, Elder Augusto Guimaraes
; Sampaio, Vanderson de Souza
; Lynn, Theo
; Endo, Patricia Takako
.
Revista da Sociedade Brasileira de Medicina Tropical
- Journal Metrics
ABSTRACT Background: Malaria is curable. Nonetheless, over 229 million cases of malaria were recorded in 2019, along with 409,000 deaths. Although over 42 million Brazilians are at risk of contracting malaria, 99% percent of all malaria cases in Brazil are located in or around the Amazon rainforest. Despite declining cases and deaths, malaria remains a major public health issue in Brazil. Accurate spatiotemporal prediction of malaria propagation may enable improved resource allocation to support efforts to eradicate the disease. Methods: In response to calls for novel research on malaria elimination strategies that suit local conditions, in this study, we propose machine learning (ML) and deep learning (DL) models to predict the probability of malaria cases in the state of Amazonas. Using a dataset of approximately 6 million records (January 2003 to December 2018), we applied k-means clustering to group cities based on their similarity of malaria incidence. We evaluated random forest, long-short term memory (LSTM) and dated recurrent unit (GRU) models and compared their performance. Results: The LSTM architecture achieved better performance in clusters with less variability in the number of cases, whereas the GRU presents better results in clusters with high variability. Although Diebold-Mariano testing suggested that both the LSTM and GRU performed comparably, GRU can be trained significantly faster, which could prove advantageous in practice. Conclusions: All models showed satisfactory accuracy and strong performance in predicting new cases of malaria, and each could serve as a supplemental tool to support regional policies and strategies.
5.
Chagas disease mortality during the coronavirus disease 2019 pandemic: A Brazilian referral center experience
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Hasslocher-Moreno, Alejandro Marcel
; Saraiva, Roberto Magalhães
; Silva, Gilberto Marcelo Sperandio da
; Xavier, Sergio Salles
; Sousa, Andréa Silvestre de
; Costa, Andrea Rodrigues da
; Mendes, Fernanda de Souza Nogueira Sardinha
; Mediano, Mauro Felippe Felix
.
Revista da Sociedade Brasileira de Medicina Tropical
- Journal Metrics
ABSTRACT Background We investigated the mortality rates of patients with Chagas disease (CD) during the coronavirus disease 2019 (COVID-19) pandemic and assessed the association between this mortality and CD clinical presentation and comorbidities. Methods: This was an observational retrospective study with clinical data retrieved from medical records. Results: Comorbidities were more prevalent among patients who died from COVID-19 than those who died from other causes. The proportion of patients according to CD clinical presentation was similar between the two groups. Conclusions: The prevalence of comorbidities seems to be related to a poorer prognosis in CD and COVID-19.
6.
Posicionamento sobre Diagnóstico e Tratamento da Amiloidose Cardíaca – 2021
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Simões, Marcus V.
; Fernandes, Fabio
; Marcondes-Braga, Fabiana G.
; Scheinberg, Philip
; Correia, Edileide de Barros
; Rohde, Luis Eduardo P.
; Bacal, Fernando
; Alves, Silvia Marinho Martins
; Mangini, Sandrigo
; Biolo, Andréia
; Beck-da-Silva, Luis
; Szor, Roberta Shcolnik
; Marques Junior, Wilson
; Oliveira, Acary Souza Bulle
; Cruz, Márcia Waddington
; Bueno, Bruno Vaz Kerges
; Hajjar, Ludhmila Abrahão
; Issa, Aurora Felice Castro
; Ramires, Felix José Alvarez
; Coelho Filho, Otavio Rizzi
; Schmidt, André
; Pinto, Ibraim Masciarelli Francisco
; Rochitte, Carlos Eduardo
; Valicelli, Flávio Henrique
; Vieira, Marcelo Luiz Campos
; Mesquita, Cláudio Tinoco
; Ramos, Celso Dario
; Soares-Junior, José
; Romano, Minna Moreira Dias
; Mathias Junior, Wilson
; Garcia Junior, Marcelo Iório
; Montera, Marcelo Westerlund
; Melo, Marcelo Dantas Tavares de
; Silva, Sandra Marques e
; Garibaldi, Pedro Manoel Marques
; Alencar Neto, Aristóteles Comte de
; Lopes, Renato Delascio
; Ávila, Diane Xavier de
; Viana, Denizar
; Saraiva, José Francisco Kerr
; Canesin, Manoel Fernandes
; Oliveira, Glaucia Maria Moraes de
; Mesquita, Evandro Tinoco
.
https://doi.org/10.36660/abc.20210718
330 downloads
7.
Caracterização Histológica das Lesões da Valva Mitral de Pacientes com Cardiopatia Reumática
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Gomes, Nayana F. A.
; Pascoal-Xavier, Marcelo A.
; Passos, Livia S. A.
; Paula, Thiago Mendonça Nunes
; Aguiar, João Marcelo de Souza
; Guarçoni, Felipe Vieira
; Nassif, Maria Cecília Landim
; Gelape, Claudio Leo
; Braulio, Renato
; Costa, Paulo Henrique N.
; Passaglia, Luiz Guilherme
; Martins, Raquel Braga
; Dutra, Walderez O.
; Nunes, Maria Carmo P.
.
Resumo Fundamentos: Os mecanismos subjacentes pelos quais a doença cardíaca reumática (DCR) levam à disfunção valvar grave não são totalmente compreendidos. Objetivo: O presente estudo avaliou as alterações histopatológicas nas valvas mitrais (VM) buscando uma associação entre o padrão de disfunção valvar predominante e os achados histopatológicos. Métodos: Em 40 pacientes submetidos à troca da VM devido a DCR e em 20 controles submetidos a transplante cardíaco, foram analisados os aspectos histológicos da VM excisada. Dados clínicos e ecocardiográficos também foram coletados. As análises histológicas foram realizadas usando coloração com hematoxilina-eosina. Determinou-se inflamação, fibrose, neoangiogênese, calcificação e metaplasia adiposa. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados: A idade média dos pacientes com DCR foi de 53±13 anos, sendo 36 (90%) do sexo feminino, enquanto a idade média dos controles foi de 50±12 anos, semelhante aos casos, sendo a maioria do sexo masculino (70%). O endocárdio valvar reumático apresentou espessura maior que os controles (1,3±0,5 mm versus 0,90±0,4 mm, p=0,003, respectivamente), e infiltrado inflamatório mais intenso no endocárdio (78% versus 36%; p=0,004), com predominância de células mononucleares. Ocorreu fibrose moderada a acentuada mais frequentemente em válvulas reumáticas do que em válvulas controle (100% vs. 29%; p<0,001). Ocorreu calcificação em 35% das valvas reumáticas, principalmente entre as valvas estenóticas, associada à área valvar mitral (p=0,003). Conclusões: Apesar do intenso grau de fibrose, o processo inflamatório permanece ativo na valva mitral reumática, mesmo em doença tardia com disfunção valvar. A calcificação predominou em valvas estenóticas e em pacientes com disfunção ventricular direita.
Abstract Background: The underlying mechanisms by which rheumatic heart disease (RHD) lead to severe valve dysfunction are not completely understood. Objective: The present study evaluated the histopathological changes in mitral valves (MV) seeking an association between the pattern of predominant valvular dysfunction and histopathological findings. Methods: In 40 patients who underwent MV replacement due to RHD, and in 20 controls that underwent heart transplant, histological aspects of the excised MV were analyzed. Clinical and echocardiographic data were also collected. Histological analyses were performed using hematoxylin-eosin staining. Inflammation, fibrosis, neoangiogenesis, calcification and adipose metaplasia were determined. A p value<0.05 was considered to be statistically significant. Results: The mean age of RHD patients was 53±13 years, 36 (90%) were female, whereas the mean age of controls was 50±12 years, similar to the cases, with the majority of males (70%). The rheumatic valve endocardium presented greater thickness than the controls (1.3±0.5 mm versus 0.90±0.4 mm, p=0.003, respectively), and a more intense inflammatory infiltrate in the endocardium (78% versus 36%; p=0.004), with predominance of mononuclear cells. Moderate to marked fibrosis occurred more frequently in rheumatic valves than in control valves (100% vs. 29%; p<0.001). Calcification occurred in 35% of rheumatic valves, especially among stenotic valves, which was associated with the mitral valve area (p=0.003). Conclusions: Despite intense degree of fibrosis, the inflammatory process remains active in the rheumatic mitral valve, even at late disease with valve dysfunction. Calcification predominated in stenotic valves and in patients with right ventricular dysfunction.
https://doi.org/10.36660/abc.20200154
542 downloads
8.
Functional capacity and rehabilitation strategies in Covid-19 patients: current knowledge and challenges
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Frota, Aline Xavier
; Vieira, Marcelo Carvalho
; Soares, Carla Cristiane Santos
; Silva, Paula Simplício da
; Silva, Gilberto Marcelo Sperandio da
; Mendes, Fernanda de Souza Nogueira Sardinha
; Mazzoli-Rocha, Flavia
; Veloso, Henrique Horta
; Costa, Ananda Dutra da
; Lamas, Cristiane da Cruz
; Valete-Rosalino, Claudia Maria
; Gonçalves, Tatiana Rehder
; Costa, Henrique Silveira
; Rodrigues Junior, Luiz Fernando
; Mediano, Mauro Felippe Felix
.
Revista da Sociedade Brasileira de Medicina Tropical
- Journal Metrics
Abstract Covid-19 is a novel infectious disease whose spectrum of presentation ranges from absence of symptoms to widespread interstitial pneumonia associated with severe acute respiratory syndrome (SARS), leading to significant mortality. Given the systemic pattern of Covid-19, there are many factors that can influence patient's functional capacity after acute infection and the identification of such factors can contribute to the development of specific rehabilitation strategies. Pulmonary impairment is the primary cause of hospitalization due to Covid-19, and can progress to SARS as well as increase length of hospitalization. Moreover, cardiac involvement is observed in approximately 30% of hospitalized patients, with an increased risk of acute myocarditis, myocardial injury, and heart failure, which may compromise functional capacity in the long-term. Thromboembolic complications have also been reported in some patients with Covid-19 and are associated with a poor prognosis. Musculoskeletal complications may result from long periods of hospitalization and immobility, and can include fatigue, muscle weakness and polyneuropathy. Studies that address the functional capacity of patients after Covid-19 infection are still scarce. However, based on knowledge from the multiple systemic complications associated with Covid-19, it is reasonable to suggest that most patients, especially those who underwent prolonged hospitalization, will need a multiprofessional rehabilitation program. Further studies are needed to evaluate the functional impact and the rehabilitation strategies for patients affected by Covid-19.
https://doi.org/10.1590/0037-8682-0789-2020
4144 downloads
9.
Diagnostic performance of the Xpert MTB/RIF assay in BAL fluid samples from patients under clinical suspicion of pulmonary tuberculosis: a tertiary care experience in a high-tuberculosis-burden area
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Brito, Guilherme Machado Xavier de
; Mafort, Thiago Thomaz
; Ribeiro-Alves, Marcelo
; Reis, Larissa Vieira Tavares dos
; Leung, Janaína
; Leão, Robson Souza
; Rufino, Rogério
; Rodrigues, Luciana Silva
.
RESUMO Objetivo: Avaliar o desempenho diagnóstico do teste Xpert MTB/RIF - teste molecular rápido para tuberculose, comparando-o com o da pesquisa de BAAR e da cultura, em amostras de LBA de pacientes com suspeita clínica de tuberculose pulmonar (TBP) que apresentam baciloscopia de escarro negativa ou produzem amostras com quantidade insuficiente de escarro. Métodos: Estudo retrospectivo de 140 casos suspeitos de TBP em pacientes que apresentaram baciloscopia negativa ou produziram amostras de escarro insuficientes e foram avaliados em um hospital-escola terciário na cidade do Rio de Janeiro (RJ). Todos os pacientes foram submetidos à fibrobroncoscopia com LBA. Os espécimes de LBA foram avaliados por meio da realização de pesquisa de BAAR, cultura para micobactérias e teste Xpert MTB/RIF. Resultados: Entre os 140 pacientes, resultados de todos os três exames microbiológicos estavam disponíveis para 73 (52,1%), dos quais 22 apresentaram cultura positiva, 17, pesquisa de BAAR positiva, e 20, teste Xpert MTB/RIF positivo. A sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e precisão global da pesquisa de BAAR foram de 68,1%, 96,1%, 88,2%, 87,5% e 87,6%, respectivamente, contra 81,8%, 96,1%, 90,0%, 92,4% e 91,8%, respectivamente, do teste Xpert MTB/RIF. A concordância entre a pesquisa de BAAR e a cultura foi de 82,3% (kappa = 0,46; p < 0,0001), enquanto a concordância entre o teste Xpert MTB/RIF e a cultura foi de 91,8% (kappa = 0,8; p < 0,0001). Conclusões: Em amostras de LBA, o teste Xpert MTB/RIF tem melhor desempenho do que os métodos tradicionais, fornecendo uma alternativa confiável à análise do escarro em casos suspeitos de TBP. No entanto, a taxa de resultados discordantes merece uma reflexão cuidadosa.
ABSTRACT Objective: To assess the diagnostic performance of the Xpert MTB/RIF assay, a rapid molecular test for tuberculosis, comparing it with that of AFB staining and culture, in BAL fluid (BALF) samples from patients with clinically suspected pulmonary tuberculosis (PTB) who are sputum smear-negative or produce sputum samples of insufficient quantity. Methods: This was a retrospective study of 140 cases of suspected PTB in patients who were smear-negative or produced insufficient sputum samples and were evaluated at a tertiary teaching hospital in the city of Rio de Janeiro, Brazil. All of the patients underwent fiberoptic bronchoscopy with BAL. The BALF specimens were evaluated by AFB staining, mycobacterial culture, and the Xpert MTB/RIF assay. Results: Among the 140 patients, results for all three microbiological examinations were available for 73 (52.1%), of whom 22 tested positive on culture, 17 tested positive on AFB staining, and 20 tested positive on the Xpert MTB/RIF assay. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy for AFB staining were 68.1%, 96.1%, 88.2%, 87.5%, and 87.6%, respectively, compared with 81.8%, 96.1%, 90.0%, 92.4%, and 91.8%, respectively, for the Xpert MTB/RIF assay. The agreement between AFB staining and culture was 82.3% (kappa = 0.46; p < 0.0001), whereas that between the Xpert MTB/RIF assay and culture was 91.8% (kappa = 0.8; p < 0.0001). Conclusions: In BALF samples, the Xpert MTB/RIF assay performs better than do traditional methods, providing a reliable alternative to sputum analysis in suspected cases of PTB. However, the rate of discordant results merits careful consideration.
https://doi.org/10.36416/1806-3756/e20200581
196 downloads
10.
Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil
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Pileggi, Gecilmara Salviato
; Ferreira, Gilda Aparecida
; Gomides Reis, Ana Paula Monteiro
; Reis Neto, Edgard Torres
; Abreu, Mirhelen Mendes
; Albuquerque, Cleandro Pires
; Araújo, Nafice Costa
; Bacchiega, Ana Beatriz
; Bianchi, Dante Valdetaro
; Bica, Blanca
; Bonfa, Eloisa Duarte
; Borba, Eduardo Ferreira
; Brito, Danielle Christinne Soares Egypto
; Duarte, Ângela Luzia Branco Pinto
; Santo, Rafaela Cavalheiro Espírito
; Fernandes, Paula Reale
; Guimarães, Mariana Peixoto
; Gomes, Kirla Wagner Poti
; Kakehasi, Adriana Maria
; Klumb, Evandro Mendes
; Lanna, Cristina Costa Duarte
; Marques, Claudia Diniz Lopes
; Monticielo, Odirlei André
; Mota, Licia Maria Henrique
; Munhoz, Gabriela Araújo
; Paiva, Eduardo Santos
; Pereira, Helena Lucia Alves
; Provenza, José Roberto
; Ribeiro, Sandra Lucia Euzébio
; Rocha Junior, Laurindo Ferreira
; Sampaio, Camila Santana Justo Cintra
; Sampaio, Vanderson Souza
; Sato, Emília Inoue
; Skare, Thelma
; de Souza, Viviane Angelina
; Valim, Valeria
; Lacerda, Marcus Vinícius Guimarães
; Xavier, Ricardo Machado
; Pinheiro, Marcelo Medeiros
.
Abstract Background: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. Methods: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. Results: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). Conclusion: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).
https://doi.org/10.1186/s42358-021-00217-0
22 downloads
11.
Temporal changes in the clinical-epidemiological profile of patients with Chagas disease at a referral center in Brazil
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Hasslocher-Moreno, Alejandro Marcel
; Saraiva, Roberto Magalhaes
; Brasil, Pedro Emmanuel Alvarenga Americano do
; Sangenis, Luiz Henrique Conde
; Xavier, Sergio Salles
; Sousa, Andréa Silvestre de
; Sperandio-da-Silva, Gilberto Marcelo
; Mendes, Fernanda de Souza Nogueira Sardinha
; Costa, Andréa Rodrigues da
; Holanda, Marcelo Teixeira de
; Veloso, Henrique Horta
; Mazzoli-Rocha, Flavia
; Carneiro, Fernanda Martins
; Portela, Luciana Fernandes
; Mediano, Mauro Felippe Felix
.
Revista da Sociedade Brasileira de Medicina Tropical
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Abstract INTRODUCTION We aimed to describe the sociodemographic, epidemiological, and clinical characteristics of patients with chronic Chagas disease (CD) at an infectious disease referral center. Changes in patient profiles over time were also evaluated. METHODS This retrospective study included patients with CD from November 1986-December 2019. All patients underwent an evaluation protocol that included sociodemographic profile; epidemiological history; anamnesis; and physical, cardiologic, and digestive examinations. Trend differences for each 5-year period from 1986 to 2019 were tested using a nonparametric trend test for continuous and generalized linear models with binomial distribution for categorical variables. RESULTS A total of 2,168 patients (52.2% women) were included, with a mean age of 47.8 years old. White patients with low levels of education predominated. The reported transmission mode was vectorial in 90.2% of cases. The majority came from areas with a high prevalence (52.2%) and morbidity (67.8%) of CD. The most common clinical presentation was the indeterminate form (44.9%). The number of patients referred gradually decreased and the age at admission increased during the study period, as did the patients’ levels of education. CONCLUSIONS The clinical profile of CD is characterized by a predominance of the indeterminate form of the disease. Regarding the patients who were followed up at the referral center, there was a progressive increase in the mean age and a concomitant decrease in the number of new patients. This reflects the successful control of vector and transfusion transmission in Brazil as well as the aging population of patients with CD.
https://doi.org/10.1590/0037-8682-0040-2021
158 downloads
12.
Expression and antigenic analysis of the recombinant TRP36 protein from Ehrlichia canis São Paulo strain for serologic tests
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Medeiros, Miguel Ângelo da Silva
; Silva, Maria Helena da
; Matta, Maria Adelaide do Valle
; Ferreira, Eliane de Oliveira
; Machado, Sérgio Lisboa
; Soares, João Fábio
; Labruna, Marcelo Bahia
; Toma, Helena Keiko
; Xavier, Márcia de Souza
; Meirelles, Maria de Nazareth Silveira Leal de
; Almosny, Nádia Regina Pereira
.
Revista Brasileira de Parasitologia Veterinária
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Resumo Ehrlichia canis é o principal agente etiológico da erliquiose monocítica canina (EMC), uma doença infecciosa canina globalmente dispersa. No Brasil, a EMC é considerada endêmica, e a infecção pode atingir 65% em cães em alguns estados. O diagnóstico de erliquiose é importante para fins de tratamento e epidemiológicos. A proteína TRP36 de E. canis leva a uma resposta humoral com produção de anticorpos em fase aguda, encontrada durante o curso da doença. O objetivo deste estudo foi obter a proteína TRP36 recombinante da amostra São Paulo de E. canis e avaliar seu potencial como ferramenta para o diagnóstico sorológico da CME. O isolado de E. canis São Paulo foi cultivado em células da linhagem DH82 e o DNA genômico foi obtido. O fragmento de DNA bacteriano que codifica toda a ORF de TRP36 foi clonado no vetor pBAD / Thio-TOPO e transformado em células competentes Escherichia coli DH10B, com o plasmídeo portador de trp36 para expressão de proteínas. Para avaliar a antigenicidade da proteína, 16 amostras de soro canino foram previamente analisadas (por PCR e teste sorológico comercial SNAP®4Dx®). Os resultados estavam de acordo com o teste SNAP®4Dx®. Os experimentos que utilizam essa proteína recombinante como antígeno, visando ao desenvolvimento de um teste sorológico baseado no ELISA, são o próximo passo para produzir um teste de diagnóstico confiável, acessível e útil para o diagnóstico da EMC no Brasil.
Abstract Ehrlichia canis is the main etiological agent of canine monocytic ehrlichiosis (CME), a globally canine infectious disease. In Brazil, CME is considered to be endemic, and its prevalence can reach 65% in some states. The diagnosis of ehrlichiosis is important for treatment and epidemiological purposes. The E. canis TRP36 (Tandem Repeat Protein) protein elicits the earliest acute-phase antibody response observed during the course of the disease. This study aimed to generate the recombinant TRP36 protein from E. canis São Paulo strain and to evaluate its potential as a tool for the serologic diagnosis of CME. The E. canis São Paulo isolate was cultivated in DH82 lineage cells, and its genomic DNA was obtained. The bacterial DNA fragment encoding the entire ORF of TRP36 was cloned into the pBAD/Thio-TOPO vector and transformed into Escherichia coli DH10B competent cells with the trp36-bearing plasmid for protein expression. To evaluate the protein antigenicity, 16 canine serum samples were previously tested (by PCR and the commercial SNAP®4Dx® serological test). The results were in accordance with the SNAP®4Dx® test. Experiments using this recombinant protein as an antigen, targeting the development of a serologic test based on ELISA methodology, are the next step to produce a reliable, affordable and useful diagnostic tool for CME in Brazil.
https://doi.org/10.1590/s1984-29612020051
900 downloads
13.
Updated Cardiovascular Prevention Guideline of the Brazilian Society of Cardiology - 2019
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Précoma, Dalton Bertolim
; Oliveira, Gláucia Maria Moraes de
; Simão, Antonio Felipe
; Dutra, Oscar Pereira
; Coelho, Otávio Rizzi
; Izar, Maria Cristina de Oliveira
; Póvoa, Rui Manuel dos Santos
; Giuliano, Isabela de Carlos Back
; Alencar Filho, Aristóteles Comte de
; Machado, Carlos Alberto
; Scherr, Carlos
; Fonseca, Francisco Antonio Helfenstein
; Santos Filho, Raul Dias dos
; Carvalho, Tales de
; Avezum Jr., Álvaro
; Esporcatte, Roberto
; Nascimento, Bruno Ramos
; Brasil, David de Pádua
; Soares, Gabriel Porto
; Villela, Paolo Blanco
; Ferreira, Roberto Muniz
; Martins, Wolney de Andrade
; Sposito, Andrei C.
; Halpern, Bruno
; Saraiva, José Francisco Kerr
; Carvalho, Luiz Sergio Fernandes
; Tambascia, Marcos Antônio
; Coelho-Filho, Otávio Rizzi
; Bertolami, Adriana
; Correa Filho, Harry
; Xavier, Hermes Toros
; Faria-Neto, José Rocha
; Bertolami, Marcelo Chiara
; Giraldez, Viviane Zorzanelli Rocha
; Brandão, Andrea Araújo
; Feitosa, Audes Diógenes de Magalhães
; Amodeo, Celso
; Souza, Dilma do Socorro Moraes de
; Barbosa, Eduardo Costa Duarte
; Malachias, Marcus Vinícius Bolívar
; Souza, Weimar Kunz Sebba Barroso de
; Costa, Fernando Augusto Alves da
; Rivera, Ivan Romero
; Pellanda, Lucia Campos
; Silva, Maria Alayde Mendonça da
; Achutti, Aloyzio Cechella
; Langowiski, André Ribeiro
; Lantieri, Carla Janice Baister
; Scholz, Jaqueline Ribeiro
; Ismael, Silvia Maria Cury
; Ayoub, José Carlos Aidar
; Scala, Luiz César Nazário
; Neves, Mario Fritsch
; Jardim, Paulo Cesar Brandão Veiga
; Fuchs, Sandra Cristina Pereira Costa
; Jardim, Thiago de Souza Veiga
; Moriguchi, Emilio Hideyuki
; Schneider, Jamil Cherem
; Assad, Marcelo Heitor Vieira
; Kaiser, Sergio Emanuel
; Lottenberg, Ana Maria
; Magnoni, Carlos Daniel
; Miname, Marcio Hiroshi
; Lara, Roberta Soares
; Herdy, Artur Haddad
; Araújo, Cláudio Gil Soares de
; Milani, Mauricio
; Silva, Miguel Morita Fernandes da
; Stein, Ricardo
; Lucchese, Fernando Antonio
; Nobre, Fernando
; Griz, Hermilo Borba
; Magalhães, Lucélia Batista Neves Cunha
; Borba, Mario Henrique Elesbão de
; Pontes, Mauro Ricardo Nunes
; Mourilhe-Rocha, Ricardo
.
https://doi.org/10.5935/abc.20190204
40841 downloads
14.
Research priorities for next-generation breeding of tropical forages in Brazil
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Pereira, Jorge Fernando
; Azevedo, Ana Luisa Sousa
; Pessoa-Filho, Marco
; Romanel, Elisson Antonio da Costa
; Pereira, Antonio Vander
; Vigna, Bianca Baccili Zanotto
; Souza Sobrinho, Fausto de
; Benites, Flávio Rodrigo Gandolfi
; Ledo, Francisco José da Silva
; Brito, Giovani Greigh de
; Meireles, Karem Guimarães Xavier
; Cavallari, Marcelo Mattos
; Simeão, Rosângela Maria
; Machado, Juarez Campolina
.
Abstract Pasture is the main food source for more than 200 million cattle heads in Brazil. Although Brazilian forage breeding programs have successfully released well-adapted, high-yielding cultivars over the years, the use of genomic tools in these programs is currently limited. These tools are required to tackle the main challenges for tropical forage breeding in Brazil. In this context, this notes lists the main research priorities raised at the workshop “Breeding Forages in the Genomic Era”, which are necessary to accelerate the use of genomic tools for next-generation breeding of tropical forages and allow breeders to increase genetic gains. Additionally, an online discussion forum (hosted at http://www.cnpgl.embrapa.br/genfor) has been launched to strengthen collaborations among research groups. The research priorities and more synergistic collaborations will assist researchers and decision-makers in delivering a sustainable increase in production of animal products, especially beef and milk, which are required to feed a rising world population.
https://doi.org/10.1590/1984-70332018v18n3n46
1418 downloads
15.
3ª Diretriz Brasileira de Transplante Cardíaco
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Bacal, Fernando
; Marcondes-Braga, Fabiana G.
; Rohde, Luis Eduardo Paim
; Xavier Júnior, José Leudo
; Brito, Flávio de Souza
; Moura, Lídia Ana Zytynski
; Colafranceschi, Alexandre Siciliano
; Lavagnoli, Carlos Fernando Ramos
; Gelape, Cláudio Leo
; Almeida, Dirceu Rodrigues
; Gaiotto, Fábio Antônio
; Atik, Fernando Antibas
; Figueira, Fernando Augusto M. S.
; Souza, Germano Emílio Conceição
; Rodrigues, Hélcio
; Campos, Iáscara Wozniak
; Souza Neto, João David de
; Rossi Neto, João Manoel
; Gasparetto, Juliano
; Goldraich, Lívia Adams
; Benvenuti, Luiz Alberto
; Seguro, Luis Fernando B. C.
; Ulhôa Júnior, Marcelo Botelho
; Moreira, Maria da Consolação V.
; Ávila, Mônica Samuel
; Carneiro, Rodrigo
; Mangini, Sandrigo
; Ferreira, Sílvia Moreira Ayub
; Strabelli, Tânia Mara
.
https://doi.org/10.5935/abc.20180153
28659 downloads
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