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1.
São Paulo med. j ; 142(1): e2022355, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1450509

ABSTRACT

ABSTRACT BACKGROUND: There is a lack of studies evaluating the oral health of traditional indigenous communities in Brazil. OBJECTIVES: Thus, the objective of this study was to describe the oral health characteristics of the indigenous Fulni-ô ethnic group in Northeast Brazil. DESIGN AND SETTING: A cross-sectional observational investigation was conducted within the Project on Atherosclerosis among Indigenous Populations. METHODS: This study included participants of both sexes from the Fulni-ô ethnic group. The participants included in this investigation underwent a comprehensive oral health evaluation by a registered and experienced dentist to assess oral health and identify potentially malignant oral lesions. Participants with suspicious lesions were referred for biopsy. Shapiro-Wilk, Mann-Whitney, and Student's t-tests were used, and measures of central tendency and dispersion were described. Statistical significance was 5%. RESULTS: A total of 104 individuals were included in this study. The prevalence of the use of tobacco derivatives was 94.0%, with similarities between sexes. The prevalence of oral changes in this study population was 84.4%. Fifty-one individuals who underwent oral reassessment were referred for oral lesion biopsy. CONCLUSIONS: This study demonstrated a high prevalence of oral alterations in the Fulni-ô population. Histopathological analyses indicated the presence of mild oral epithelial dysplasia in five cases.

2.
Almeida, André Luiz Cerqueira; Melo, Marcelo Dantas Tavares de; Bihan, David Costa de Souza Le; Vieira, Marcelo Luiz Campos; Pena, José Luiz Barros; Del Castillo, José Maria; Abensur, Henry; Hortegal, Renato de Aguiar; Otto, Maria Estefania Bosco; Piveta, Rafael Bonafim; Dantas, Maria Rosa; Assef, Jorge Eduardo; Beck, Adenalva Lima de Souza; Santo, Thais Harada Campos Espirito; Silva, Tonnison de Oliveira; Salemi, Vera Maria Cury; Rocon, Camila; Lima, Márcio Silva Miguel; Barberato, Silvio Henrique; Rodrigues, Ana Clara; Rabschkowisky, Arnaldo; Frota, Daniela do Carmo Rassi; Gripp, Eliza de Almeida; Barretto, Rodrigo Bellio de Mattos; Silva, Sandra Marques e; Cauduro, Sanderson Antonio; Pinheiro, Aurélio Carvalho; Araujo, Salustiano Pereira de; Tressino, Cintia Galhardo; Silva, Carlos Eduardo Suaide; Monaco, Claudia Gianini; Paiva, Marcelo Goulart; Fisher, Cláudio Henrique; Alves, Marco Stephan Lofrano; Grau, Cláudia R. Pinheiro de Castro; Santos, Maria Veronica Camara dos; Guimarães, Isabel Cristina Britto; Morhy, Samira Saady; Leal, Gabriela Nunes; Soares, Andressa Mussi; Cruz, Cecilia Beatriz Bittencourt Viana; Guimarães Filho, Fabio Villaça; Assunção, Bruna Morhy Borges Leal; Fernandes, Rafael Modesto; Saraiva, Roberto Magalhães; Tsutsui, Jeane Mike; Soares, Fábio Luis de Jesus; Falcão, Sandra Nívea dos Reis Saraiva; Hotta, Viviane Tiemi; Armstrong, Anderson da Costa; Hygidio, Daniel de Andrade; Miglioranza, Marcelo Haertel; Camarozano, Ana Cristina; Lopes, Marly Maria Uellendahl; Cerci, Rodrigo Julio; Siqueira, Maria Eduarda Menezes de; Torreão, Jorge Andion; Rochitte, Carlos Eduardo; Felix, Alex.
Arq. bras. cardiol ; 120(12): e20230646, dez. 2023. tab, graf
Article in Portuguese | LILACS-Express | LILACS, SESSP-IDPCPROD, SES-SP | ID: biblio-1527794
3.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 69(2): 240-245, Feb. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1422625

ABSTRACT

SUMMARY OBJECTIVE: The aim of this study was to investigate whether the degree of urbanization influences the prevalence of chronic kidney disease in Brazilian indigenous people. METHODS: This is a cross-sectional study conducted between 2016 and 2017 in northeastern Brazil and includes individuals aged between 30 and 70 years from two specific indigenous groups who volunteered to participate in the study: the Fulni-ô people (lowest degree of urbanization) and the Truká group (greater degree of urbanization). Cultural and geographical parameters were used to characterize and measure the magnitude of urbanization. We excluded individuals with known cardiovascular disease or renal failure who required hemodialysis. Chronic kidney disease was defined as a single measurement of an estimated glomerular filtration rate <60 mL/min/1.73 m2 using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. RESULTS: A total of 184 indigenous people from the Fulni-ô group and 96 from the Truká group with a median age of 46 years (interquartile range: 15.2) were included. We found a chronic kidney disease rate of 4.3% in the total indigenous population, generally affecting an older population: 41.7% over 60 years old (p<0.001). The Truká people had a chronic kidney disease prevalence of 6.2%, with no differences in kidney dysfunction across age groups. The Fulni-ô participants had a chronic kidney disease prevalence of 3.3%, with a higher proportion of kidney dysfunction in older participants (of the six Fulni-ô indigenous people with chronic kidney disease, five were older). CONCLUSION: Our results suggest that a higher degree of urbanization seems to negatively influence the prevalence of chronic kidney disease in Brazilian indigenous people.

4.
Arq. bras. cardiol ; 120(3): e20220183, 2023. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1429773

ABSTRACT

Resumo Fundamento A avaliação do Escore de Cálcio Coronariano (ECC) pode ser realizada por tomografia computadorizada sem contraste para prever eventos cardiovasculares, mas tem menor valor na estratificação de risco em pacientes sintomáticos. Objetivo Identificar e validar preditores de obstrução coronariana significativa (OCS) em pacientes sintomáticos sem calcificação da artéria coronária. Métodos Um total de 4258 participantes foram rastreados dos estudos CORE64 e CORE 320, nos quais foram avaliados pacientes encaminhados para angiografia invasiva, e do Quanta Registry que incluiu pacientes encaminhados para angiotomografia. Modelos de regressão logística avaliaram associações entre fatores de risco cardiovascular, ECC e OCS. Um nível de significância de 5% foi usado nas análises. Resultados Dos 509 participantes do estudo CORE, 117 (23%) apresentaram um ECC igual a zero; 13 (11%) pacientes sem cálcio coronariano apresentaram OCS. A ausência de cálcio coronariano correlacionou-se com idade mais jovem, sexo feminino, índice de massa corporal mais baixo, ausência de diabetes, e ausência de dislipidemia. O fato de ser fumante atual aumentou em 3,5 vezes a probabilidade de OCS e outros fatores de risco cardiovasculares não apresentaram associação significativa. Considerando os achados clínicos, um algoritmo para estratificar os pacientes com ECC igual a zero foi proposto, e tiveram desempenho limitado na coorte de validação (AUC 58; IC95% 43, 72). Conclusão Um perfil de risco cardiovascular mais baixo está associado a um ECC igual a zero em pacientes de alto risco. Tabagismo é o preditor mais forte de OCS em pacientes com ausência de cálcio coronariano.


Abstract Background Coronary artery calcium (CAC) scanning can be performed using non-contrast computed tomography to predict cardiovascular events, but has less value for risk stratification in symptomatic patients. Objective To identify and validate predictors of significant coronary obstruction (SCO) in symptomatic patients without coronary artery calcification. Methods A total of 4,258 participants were screened from the CORE64 and CORE320 studies that enrolled patients referred for invasive angiography, and from the Quanta Registry that included patients referred for coronary computed tomography angiography (CTA). Logistic regression models evaluated associations between cardiovascular risk factors, CAC, and SCO. An algorithm to assess the risk of SCO was proposed for patients without CAC. Significance level of 5% was used in the analyses. Results Of the 509 participants of the CORE study, 117 (23%) had zero coronary calcium score; 13 (11%) patients without CAC had SCO. Zero calcium score was related to younger age, female gender, lower body mass index, no diabetes, and no dyslipidemia. Being a current smoker increased ~3.5 fold the probability of SCO and other CV risk factors were not significantly associated. Considering the clinical findings, an algorithm to further stratify zero calcium score patients was proposed and had a limited performance in the validation cohort (AUC 58; 95%CI 43, 72). Conclusion A lower cardiovascular risk profile is associated with zero calcium score in a setting of high-risk patients. Smoking is the strongest predictor of SCO in patients without CAC.

5.
Rev. bras. educ. méd ; 47(3): e101, 2023. graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1449633

ABSTRACT

Resumo: Introdução: As comunidades tradicionais são grupos de indivíduos socialmente organizados que partilham comportamentos econômicos, socioambientais e culturais comuns. Entre elas, destacam-se as comunidades indígenas no Brasil, que vêm sofrendo o impacto da urbanização, do crescimento de doenças crônicas e epidemias e do aumento da insegurança alimentar. Relato de experiência: Este estudo teve como objetivo descrever as experiências da equipe de saúde, quanto ao uso de uma ferramenta de gestão de dados na assistência, em uma comunidade indígena no Nordeste brasileiro. Trata-se de um relato de experiência do uso de uma ferramenta digital nas ações assistenciais em uma comunidade tradicional. A equipe de saúde foi dividida em dois grupos: agentes comunitários de saúde e estudantes de Medicina. Discussão: A descrição das experiências e a análise das narrativas resultaram na identificação de 258 citações, que foram classificadas em 12 categorias, relacionadas ao objeto de estudo. Dentre estas, as questões ligadas aos benefícios da ferramenta foram as mais mencionadas (43,41%), em que os subgrupos abordaram diferentes reflexões. A segunda categoria mais citada se referia às limitações da ferramenta (15,11%), sendo a necessidade do sinal de internet o ponto crítico. Ou seja, esta pesquisa mostra vantagens da ferramenta na atenção à saúde, mas também explicita fragilidades inerentes ao seu uso, de modo a trazer questões importantes dessa vivência e estimular práticas semelhantes. Conclusão: Esse relato de experiência, como método científico, traz importantes questões vivenciadas, relacionadas à aplicabilidade prática de uma ferramenta digital em uma comunidade indígena. Apesar de ser inegável que há pontos de fragilidade evidentes, eles não comprometeram o resultado afirmativo da vivência, melhorando a assistência.


Abstract: Introduction: Traditional communities are groups of socially organized individuals with common economic, socio-environmental, and cultural behaviors. Brazil's indigenous communities are a prime example of these groups, suffering the impact of urbanization, the growth of chronic diseases, epidemics, and increased food insecurity. Experience report: To describe the health team's experiences in the use of a data management tool for care in an indigenous community in northeastern Brazil. Methodology: This is an experience report on the use of a digital tool to assist actions in a traditional community. The health team was divided into community health agents and medical students. Discussion: The description of the experiences and analysis of the narratives resulted in identifying 258 citations, classified into 12 categories related to the study scope. Of these, issues related to benefits of the tool were the most commonly mentioned (43.41%), where the subgroups addressed different reflections. The second most cited category referred to the tool's limitations (15.11%), with the need for an internet connection being the critical point. This research, therefore, shows the tool's advantages in health care but also explains weaknesses inherent to its use, raising important issues of this experience and stimulating similar practices. Conclusion: This experience report, as a scientific method, addresses essential experienced issues related to the practical applicability of a digital tool in an indigenous community. Although it is undeniable that there are obvious points of weakness, these did not compromise the positive result of the experience, and care was improved.

6.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 68(11): 1530-1536, Nov. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1406588

ABSTRACT

SUMMARY OBJECTIVE: The aim of this work was to present hypotheses supporting capoeira as an activity aimed at health rehabilitation and maintenance of quality of life. METHODS: Capoeira players (n=245), residing in Brazil and abroad, were evaluated for quality of life (physical, social, psychological, and environmental domains from WHOQOL-bref). The capoeira players' quality of life scores were compared to normative values and reference values in martial arts. Besides, studies involving capoeira (Medline/Embase/Cinahl/SportDiscus) were also reviewed for health-related hypotheses, describing population, intervention, comparator, and outcome. RESULTS: There are hypotheses on capoeira improving health through (1) body composition, addressed by two studies investigating waist circumference, bone, and muscle mass; (2) functional capacity, investigated by three studies considering performance variables; (3) metabolism, in two studies demonstrating triglycerides and blood glucose reduction, and an enhancement of anaerobic glycolysis; and (4) cardiovascular parameters, addressed by two studies highlighting an increase in maximal oxygen consumption, heart rate, and rate of pressure product reduction, as well as an increase in parasympathetic activity at rest. The sample of this study had higher quality of life scores when compared to normative values for Brazilians, similar quality of life when it comes to social relationships, higher quality of life in the psychological and environmental domains, and lower quality of life in the physical domain when compared to practitioners of other combat sports/martial arts. CONCLUSION: An analysis of the impacts of capoeira resulted in hypotheses on the rehabilitation of players' biological health. Although the individuals were evaluated within the pandemic period, their quality of life domains were similar or superior to normative or reference values found by studies from before the pandemic.

8.
Article in Portuguese | LILACS | ID: biblio-1379938

ABSTRACT

As ações para construção de um modelo de prestação de serviços de saúde para a população indígena só foram intensificadas em 2002, quando foi criada a Política Nacional de Saúde dos Povos Indígenas. Dessa forma, ocorreu a utilização de profissionais oriundos do Projeto Mais Médicos nos Distritos Sanitários Especiais Indígenas. Assim, este trabalho descreve a experiência de profissionais do Projeto Mais Médicos para o Brasil em comunidades indígenas do norte da Bahia, no polo de Paulo Afonso. Essas comunidades se caracterizam por baixas condições socioeconômicas de maneira geral e os povos indígenas do sertão do nordeste brasileiro são amplamente afetados pelo processo de urbanização. Durante o programa, foi possível perceber que as comunidades indígenas já trazem consigo os efeitos psicológicos das lutas territoriais, dos históricos de repressão violenta e da persistente cultura preconceituosa por parte do não indígena. Além disso, são evidentes o empenho e a dedicação do médico bolsista do Projeto Mais Médicos, bem como seu interesse em gerar cuidados para as comunidades tradicionais indígenas de seu polo de atuação, no entanto, vale ressaltar que mesmo após tantos anos da implementação do Projeto Mais Médicos, existe uma grande dificuldade no preenchimento de vagas destinadas ao atendimento nas comunidades indígenas e os últimos editais não conseguiram um médico para preenchimento da vaga em aberto para o polo de Paulo Afonso.


Actions for building a health service delivery model geared towards the indigenous population became more prominent only in 2002, upon creation of the National Health Policy for Indigenous Peoples. As a result, professionals from the Mais Médicos Project were included in the Special Indigenous Health Districts. Hence, this study describes the experience of professionals from the More Doctor for Brazil project within indigenous communities in northern Bahia, at the Paulo Afonso center. Overall, these communities face low socioeconomic conditions and the indigenous peoples of the Sertão are largely affected by urbanization processes. During the program, the professionals noted that indigenous communities bear the psychological effects of land struggles, the history of violent repression and the persistent prejudiced culture espoused by non-indigenous. Moreover, the commitment and dedication of Mais Médicos physicians, as well as their interest in providing care for the traditional indigenous communities in their area of activity, is evident. Importantly, however, even many years after the implementation of the Mais Médicos Project, vacancies geared towards indigenous health are difficult to fill out and the last public notices were unable to find a doctor to fill the open vacancy for the Paulo Afonso center.


Las acciones para construir un modelo de prestación de servicios de salud a la población indígena recién se intensificaron en el año 2002 cuando se creó la Política Nacional de Salud para los Pueblos Indígenas. De esta forma, se incluyó a profesionales en el Proyecto Más Médicos en los Distritos Sanitarios Especiales de Salud Indígena. Así, este trabajo describe la experiencia de profesionales del Proyecto Más Médicos para Brasil en comunidades indígenas del Norte de Bahía, en el polo Paulo Afonso. Estas comunidades se caracterizan por tener condiciones socioeconómicas bajas en general, y los pueblos indígenas del sertão del Nordeste Brasileño son en gran medida afectados por el proceso de urbanización. Durante el programa se pudo percibir que las comunidades indígenas traen consigo los efectos psicológicos de las luchas territoriales, la historia de represión violenta y la cultura prejuiciosa persistente por parte de los no indígenas. Además, es notorio el compromiso y dedicación del médico becario del Proyecto Más Médicos, así como su interés por brindar atención a las comunidades indígenas tradicionales de su zona de actuación; sin embargo, vale mencionar que aún después de tantos años de implementación del Proyecto Más Médicos, existe una gran dificultad para cubrir las vacantes destinadas a la atención de las comunidades indígenas y los últimos avisos públicos no encontraron a médicos para llenar la vacante abierta para el polo Paulo Afonso.


Subject(s)
Social Class , Health Consortia , Health of Indigenous Peoples , Indigenous Peoples , Health Policy , Health Services
9.
Arq. bras. cardiol ; 119(1): 37-45, abr. 2022. graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1383709

ABSTRACT

Resumo Fundamento: A pandemia da COVID-19 tem causado um impacto sobre a mortalidade por várias doenças em todo o mundo, especialmente por doenças cardiovasculares (DCVs). O Brasil é um país de dimensões continentais com diferenças significativas na estrutura de saúde entre seus estados. Objetivo: Analisar a mortalidade hospitalar por DCV no sistema público de saúde durante o primeiro ano da pandemia por COVID-19 (2020) no Brasil. Métodos: Este é um estudo ecológico analisando o número absoluto de mortes hospitalares e a taxa de mortalidade hospitalar no Brasil, suas macrorregiões, e unidades federativas. Os dados foram obtidos do Sistema de Informações Hospitalares (SIH) do Ministério da Saúde. O P-escore foi usado para analisar o excesso de mortalidade. O escore compara os eventos observados com os eventos esperados para um dado local e período. O escore-P foi corrigido por um modelo de regressão joinpoint, com um intervalo de confiança de 95% e nível de significância de 5%. Resultados: Houve 93.104 óbitos hospitalares por DCV no Brasil em 2020, o que representa 1495 menos óbitos (escore-P: -1,58) que o esperado. A região centro-oeste apresentou um escore-P positivo, com um aumento de 15,1% no número de mortes. Dez estados apresentaram um maior número de óbitos em 2020. Ainda, observou-se um excesso de 13,3% de mortalidade hospitalar no país como um todo, e um excesso de mortalidade hospitalar em todas as macrorregiões. Conclusões: Houve uma diminuição no número absoluto de óbitos hospitalares, bem como um aumento na taxa de mortalidade por DCV no Brasil em 2020, após o início da pandemia por COVID-19.


Abstract Background: The COVID-19 pandemic has had an impact on mortality from several diseases worldwide, especially cardiovascular diseases (CVD). Brazil is a continent-sized country with significant differences in the health care structure between its federative units. Objective: Analyze in-hospital mortality from CVDs in the Brazilian public health system during the first year of the COVID-19 pandemic (2020). Methods: This is an ecological study analyzing the absolute number of in-hospital deaths and the rate of in-hospital mortality in Brazil, its macro-regions, and federative units. Data were obtained from the Hospital Information System of the Brazilian Ministry of Health. To analyze excess mortality, the P-score was used. It compares the events observed with those expected for a given place and period. The P-score was corrected by the joinpoint regression model, with a 95% confidence interval and 5% significance level. Results: There were 93,104 in-hospital deaths due to CVD in Brazil in 2020, representing 1,495 fewer deaths (P score: −1.58) than expected. The central-west region had a positive P-score, with a 15.1% increase in the number of deaths. Ten federative units showed a greater number of deaths in 2020. There was also a 13.3% excess in-hospital mortality at the country level, and an excess in-hospital mortality in all macro-regions. Conclusions: There was a decrease in the absolute number of in-hospital deaths, as well as an increase in in-hospital mortality from CVD in Brazil, in 2020, after the COVID-19 pandemic onset.

10.
Rev. Soc. Bras. Med. Trop ; 55: e0119, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1406995

ABSTRACT

ABSTRACT Background: Although most coronavirus disease 2019 (COVID-19) infections are mild, some patients have severe clinical conditions requiring hospitalization. Data on the severity of COVID-19 in Brazil are scarce and are limited to public databases. This study aimed to investigate the clinical and laboratory factors associated with the severity of COVID-19 in a cohort of hospitalized adults from two hospitals in Northeast Brazil. Methods: Patients over 18 years of age who were hospitalized between August 2020 and July 2021 with a confirmed diagnosis of COVID-19 were included. The patients were classified into two groups: moderate and severe. Clinical, laboratory and imaging parameters were collected and compared between the groups. A multivariate logistic regression model was used to determine the predictors of COVID-19 severity. Results: This study included 495 patients (253 moderate and 242 severe). A total of 372 patients (75.2%) were between 18 and 65 years of age, and the majority were male (60.6%; n = 300). Patients with severe disease had higher levels of leukocytes, neutrophils, platelets, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, blood glucose, C-reactive protein, ferritin, D-dimer, aspartate aminotransferase, creatinine, and urea (p < 0.05). In multivariate logistic regression, the following variables were significant predictors of COVID-19 severity: leukocytes (odds ratio [OR] 3.27; 95% confidence interval [CI] 2.12-5.06), international normalized ratio (INR) (OR 0.22, 95% CI 0.14-0.33), and urea (OR 4.03; 95% CI 2.21-7.35). Conclusions: The present study identified the clinical and laboratory factors associated with the severity of COVID-19 in hospitalized Brazilian individuals.

13.
Rev. Assoc. Med. Bras. (1992) ; 67(9): 1221-1225, Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1351477

ABSTRACT

SUMMARY OBJECTIVE: The aim of this study was to analyze and compare the indicators of urban mobility and the number of new cases of COVID-19 recorded daily between 2020 and 2021. METHODS: An observational study was carried out involving new cases of COVID-19 registered daily in the state of Pernambuco, Brazil between March 12, 2020 and March 28, 2021 and six indicators of urban mobility. For analysis, the study was divided into two periods: the first was composed of 295 days and represents the year 2020 and the second was composed of 86 days and represents the year 2021. Spearman's non-parametric correlation was used. RESULTS: In 2021, the greatest reductions in relation to the baseline were observed in parks (-29.0) and in retail and recreation areas (-28.7). However, these reductions were smaller than those observed in the previous year, indicating a greater circulation of people in 2021 when compared with mobility in 2020. In contrast, in residential areas, there was a reduction in the percentage change in relation to the previous year (11.2 in 2019 and 7.6 in 2021). In grocery and pharmacy, there was an increase 1.8 times greater than that observed in 2020 (9.1 in 2020 and 17.0 in 2021). It is also noteworthy that the daily average of new cases almost doubled in value (753.4 in 2020 and 1409.1 in 2021). CONCLUSION: More vigorous measures must be taken to adequately control the pandemic.


Subject(s)
Humans , COVID-19 , Brazil , Pandemics , SARS-CoV-2
14.
Arq. bras. cardiol ; 117(2): 416-422, ago. 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1339143

ABSTRACT

Resumo Hipertensão arterial sistêmica (HAS) e diabetes mellitus (DM) são dois dos principais fatores de risco para a mortalidade por COVID-19. Descrever a prevalência e o perfil clínico-epidemiológico de óbito por COVID-19 ocorridos em Pernambuco, Brasil, entre 12 de março e 14 de maio de 2020 entre pacientes que possuíam hipertensão arterial sistêmica e/ou diabetes mellitus como doenças prévias. Estudo observacional transversal. Foram analisadas as seguintes variáveis: município de procedência, sexo, faixa etária, tempo entre o início dos sinais/sintomas e o óbito, sinais/sintomas, tipo de comorbidades e hábitos de vida. Variáveis categóricas foram descritas por meio de frequências e variáveis contínuas por meio de medidas de tendência central e de dispersão. Os testes de Mann-Whitney e Kruskal-Wallis foram utilizados. Dos 1.276 registros incluídos no estudo, 410 apresentavam HAS e/ou DM. A prevalência de HAS foi 26,5% (n=338) e de DM foi 19,7% (n=252). Dos registros, 158 (12,4%) eram de pacientes que possuíam somente HAS, 72 (5,6%) somente DM e 180 (14,1%) apresentavam HAS e DM. Dos indivíduos com HAS, 53,3% apresentavam DM e 71,4% dos diabéticos apresentam HAS. A mediana (em dias) do tempo entre o início dos sinais/sintomas e o desfecho óbito foi 8,0 (IIQ 9,0), sem diferença significativa entre os grupos de comorbidades (p=0,633), sexo (p=0,364) e faixa etária (p=0,111). Observou-se maior prevalência de DM e HAS na população masculina (DM — 61,3% eram homens e 38,9% mulheres; HAS — 53,2% eram homens e 46,8% mulheres). Os sinais/sintomas mais frequentes foram dispneia (74,1%; n=304), tosse (72,2%; n=296), febre (68,5%; n=281) e saturação de O2<95% (66,1%; n=271). Dos hipertensos, 73,3% (n=100) apresentavam outras comorbidades/fatores de risco associados, e 54,2% (n=39) dos diabéticos apresentavam outras comorbidades/fatores de risco associados. Destacaramse as cardiopatias (19,5%; n=80), obesidade (8,3%; n=34), doença respiratória prévia (7,3%; n=30) e nefropatia (7,8%; n=32). A prevalência de tabagismo foi 8,8% (n=36) e de etilismo alcançou 3,4% (n=14). O estudo mostrou que a prevalência de HAS foi superior à prevalência de DM nos indivíduos que foram a óbito por COVID-19. Em idosos, a prevalência foi superior à observada em indivíduos não idosos.


Subject(s)
Humans , Diabetes Mellitus/epidemiology , COVID-19 , Hypertension/epidemiology , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Retrospective Studies , SARS-CoV-2
16.
ABC., imagem cardiovasc ; 34(4): eabc256, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1359750

ABSTRACT

Fundamento: A ecocardiografia transtorácica (ETT) pode desempenhar um papel crucial na avaliação das manifestações cardíacas da COVID-19. Objetivo: Nosso objetivo foi relatar a prevalência das principais anormalidades ecocardiográficas em pacientes hospitalizados com COVID-19. Métodos: Realizou-se estudo observacional multicêntrico prospectivo com pacientes com COVID-19 submetidos a ETT durante a internação. Pacientes com insuficiência cardíaca prévia, doença arterial coronariana ou fibrilação atrial foram classificados como portadores de doença cardiovascular (DCV) prévia. Foram coletados dados clínicos e ecocardiográficos da estrutura e da função cardíaca. Resultados: Avaliamos 310 pacientes com COVID-19, com 62±16 anos de idade, 61% homens, 53% com hipertensão arterial, 33% com diabetes e 23% com DCV prévia. No total, 65% dos pacientes necessitaram de suporte em unidade de terapia intensiva. As alterações ecocardiográficas mais prevalentes foram hipertrofia do ventrículo esquerdo (VE) (29%), hipertensão pulmonar (25%), disfunção sistólida do VE (16,5%), disfunção sistólica do ventrículo direito (VD) (15,9%), disfunção diastólica do VE grau II/III (11%) e alteração da contratilidade regional do VE (11%). Derrame pericárdico foi incomum (7%). Hipertrofia do VE (25 vs. 45%, p=0,001), disfunção sistólica do VE (11 vs. 36%, p<0,001), alterações da contratilidade regional (6 vs. 29%, p<0,001), disfunção diastólica do VE grau II/III (9 vs. 19%, p=0,03) e hipertensão pulmonar (22 vs. 36%, p=0,019) foram menos comuns nos pacientes sem do que com DCV prévia. A disfunção sistólica do VD mostrou-se semelhante em pacientes sem e com DCV prévia (13 vs. 25%, p=0,07). Conclusões: Entre os pacientes hospitalizados com COVID-19, os achados ecocardiográficos anormais foram comuns, porém menos encontrados naqueles sem DCV. A disfunção sistólica do VD pareceu afetar de forma semelhante pacientes com e sem DCV prévia. (AU)


Background: Transthoracic echocardiography (TTE) may play a crucial role in the evaluation of cardiac manifestations of coronavirus disease 2019 (COVID-19). Objective: We aimed to report the prevalence of the main echocardiographic abnormalities of hospitalized COVID-19 patients. Methods: We performed a prospective multicenter observational study in patients with COVID-19 who underwent TTE during hospitalization. Patients with pre-existing heart failure, coronary artery disease, or atrial fibrillation were categorized as having previous cardiovascular disease (CVD). Clinical and echocardiographic data about cardiac structure and function were collected. Results: We evaluated 310 patients with COVID-19 (mean age, 62±16 years; 61% men; 53% with arterial hypertension; 33% with diabetes; and 23% with previous CVD). Overall, 65% of the patients required intensive care unit support. The most prevalent echocardiographic abnormalities were LV hypertrophy (29%), pulmonary hypertension (25%), left ventricular (LV) systolic dysfunction (16.5%), right ventricular (RV) systolic dysfunction (15.9%), grade II/III LV diastolic dysfunction (11%), and LV regional wall motion abnormality (11%). Pericardial effusion was uncommon (7% of cases). LV hypertrophy (25% vs. 45%, p=0.001), LV systolic dysfunction (11% vs. 36%, p<0.001), regional wall motion abnormalities (6% vs. 29%, p<0.001), grade II/III LV diastolic dysfunction (9% vs. 19%, p=0.03), and pulmonary hypertension (22% vs. 36%, p=0.019) were less common in patients without previous CVD. RV systolic dysfunction occurred at similar frequencies in patients with versus without previous CVD (13% vs. 25%, p=0.07). Conclusions: Among patients hospitalized with COVID-19, abnormal echocardiographic findings were common, but less so among those without previous CVD. RV systolic dysfunction appeared to affect similar proportions of patients with versus without previous CVD. (AU)


Subject(s)
Humans , Male , Adolescent , Adult , Middle Aged , Echocardiography/statistics & numerical data , COVID-19/complications , COVID-19/physiopathology , COVID-19/diagnostic imaging , Heart Failure/classification , Cardiovascular Diseases/history , Epidemiologic Factors , Hypertrophy, Left Ventricular/diagnostic imaging , Ventricular Dysfunction, Right/diagnostic imaging , Diabetes Mellitus/history , Hypertension/history , Hypertension, Pulmonary/diagnostic imaging
18.
ABC., imagem cardiovasc ; 33(4): eabc101, 20200000.
Article in Portuguese | LILACS | ID: biblio-1146298

ABSTRACT

Fundamento: O acidente vascular encefálico (AVE) é prevalente no mundo. Reconhecimento precoce da doença cardiovascular subclínica pode predizer um primeiro episódio de AVE isquêmico; o speckle tracking associado à ecocardiografia (STE) permite detecção precoce da disfunção miocárdica subclínica. Objetivo: Provar a associação entre deformação miocárdica avaliada pelo STE e primeiro episódio de AVE em indivíduos saudáveis. Método: Incluímos participantes entre 40-80 anos com primeiro episódio de AVE isquêmico sem cardiopatia conhecida, pareados por sexo, idade e hipertensão com grupo controle saudável na proporção 1:2. STE avaliou strain longitudinal (SL) do ventrículo esquerdo (VE), e ecocardiografia tradicional foi realizada. Análises univariada e multivariada avaliaram as relações do AVE com fatores de risco cardiovasculares e parâmetros derivados da ecocardiografia. Resultado: 29 casos e 62 controles foram incluídos. Média etária foi 60 ± 12 anos; 54% eram homens. Tabagismo foi mais prevalente em casos do que em controles (34% vs. 9%; p=0.001). Nenhum outro fator de risco evidenciou diferença estatística. Casos tiveram menor deformação miocárdica comparados aos controles (SL -16.7 ± 3.4% vs. -19.2 ± 2.8%; p < 0.001). Não houve diferença em relação aos parâmetros ecocardiográficos tradicionais. Após ajuste para tabagismo e hiperlipidemia, SL manteve-se independentemente associado com AVE (OR=1.3; 95% CI, 1.1 ­ 1.6; p=0.005). A área abaixo à curva ROC para AVE aumentou significativamente após adicionar SL ao tabagismo (0.65 para 0.78, respectivamente; p=0.009). Conclusão: SL tem independente associação com o primeiro episódio de AVE isquêmico em adultos de média idade com corações geralmente normais. SL pode ser potencial marcador de risco nesta população


Background: Stroke is prevalent worldwide, and early recognition of subclinical cardiovascular (CV) disease could predict a first ischemic stroke (IS) episode. Speckle-tracking echocardiography (STE) allows the detection of early subclinical myocardial dysfunction. Aim: To examine the association between myocardial deformation, evaluated by STE, and first episode of IS in a sample of otherwise healthy patients. Methods: We included individuals between 40­80 years old, with a first incidence of IS, with no known CV disease, matched to healthy controls by sex, age, and hypertension at a 1:2 ratio. STE was used to assess LV global longitudinal strain (GLS), and traditional echocardiography was performed. Univariate and multivariable analyses were performed to assess the relationship among stroke, CV risk factors, and echocardiographyderived parameters. Results: A total of 29 cases and 62 controls were included. The mean age of the patients was 60 ± 12 y/o, and 54% were males. Smoking was more prevalent in cases compared to controls (34% vs. 9%; p = 0.001), and there were no significant differences in the other examined risk factors. Cases had less myocardial deformation compared to controls (GLS: -16.7% ± 3.4% vs. -19.2 ± 2.8%; p < 0.001), and there was no


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cardiovascular Diseases/diagnostic imaging , Hypoxia, Brain/diagnostic imaging , Ventricular Dysfunction, Left/diagnostic imaging , Stroke/diagnostic imaging , Risk Factors , Longitudinal Studies
19.
Acta cir. bras ; 33(11): 991-999, Nov. 2018. graf
Article in English | LILACS | ID: biblio-973476

ABSTRACT

Abstract Purpose: To determine whether the absence of transglutaminase 2 enzyme (TG2) in TG2 knockout mice (TG2-/-) protect them against early age-related functional and histological arterial changes. Methods: Pulse wave velocity (PWV) was measured using non-invasive Doppler and mean arterial pressure (MAP) was measured in awake mice using tail-cuff system. Thoracic aortas were excised for evaluation of endothelial dependent vasodilation (EDV) by wire myography, as well as histological analyses. Results: PWV and MAP were similar in TG2-/-mice to age-matched wild type (WT) control mice. Old WT mice exhibited a markedly attenuated EDV as compared to young WT animals. The TG2-/-young and old mice had enhanced EDV responses (p<0.01) as compared to WT mice. There was a significant increase in TG2 crosslinks by IHC in WT old group compared to Young, with no stain in the TG2-/-animals. Optical microscopy examination of Old WT mice aorta showed thinning and fragmentation of elastic laminae. Young WT mice, old and young TG2-/-mice presented regularly arranged and parallel elastic laminae of the tunica media. Conclusion: The genetic suppression of TG2 delays the age-induced endothelial dysfunction and histological modifications.


Subject(s)
Animals , Male , Aorta, Thoracic/physiology , Aging/physiology , Endothelium, Vascular/physiology , Transglutaminases/physiology , GTP-Binding Proteins/physiology , Vasodilation/physiology , Immunohistochemistry , Age Factors , Mice, Knockout , Vascular Stiffness/physiology , Pulse Wave Analysis , Arterial Pressure/physiology
20.
Arq. bras. cardiol ; 110(3): 240-245, Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-888042

ABSTRACT

Abstract Background: The cardiovascular risk burden among diverse indigenous populations is not totally known and may be influenced by lifestyle changes related to the urbanization process. Objectives: To investigate the cardiovascular (CV) mortality profile of indigenous populations during a rapid urbanization process largely influenced by governmental infrastructure interventions in Northeast Brazil. Methods: We assessed the mortality of indigenous populations (≥ 30 y/o) from 2007 to 2011 in Northeast Brazil (Bahia and Pernambuco states). Cardiovascular mortality was considered if the cause of death was in the ICD-10 CV disease group or if registered as sudden death. The indigenous populations were then divided into two groups according to the degree of urbanization based on anthropological criteria:9,10 Group 1 - less urbanized tribes (Funi-ô, Pankararu, Kiriri, and Pankararé); and Group 2 - more urbanized tribes (Tuxá, Truká, and Tumbalalá). Mortality rates of highly urbanized cities (Petrolina and Juazeiro) in the proximity of indigenous areas were also evaluated. The analysis explored trends in the percentage of CV mortality for each studied population. Statistical significance was established for p value < 0.05. Results: There were 1,333 indigenous deaths in tribes of Bahia and Pernambuco (2007-2011): 281 in Group 1 (1.8% of the 2012 group population) and 73 in Group 2 (3.7% of the 2012 group population), CV mortality of 24% and 37%, respectively (p = 0.02). In 2007-2009, there were 133 deaths in Group 1 and 44 in Group 2, CV mortality of 23% and 34%, respectively. In 2009-2010, there were 148 deaths in Group 1 and 29 in Group 2, CV mortality of 25% and 41%, respectively. Conclusions: Urbanization appears to influence increases in CV mortality of indigenous peoples living in traditional tribes. Lifestyle and environmental changes due to urbanization added to suboptimal health care may increase CV risk in this population.


Resumo Fundamento: O risco cardiovascular das diversas comunidades indígenas não está bem estabelecido e pode ser influenciado pelo processo de urbanização a que se submetem esses povos. Objetivos: Investigar o perfil da mortalidade cardiovascular (CV) das populações indígenas durante o rápido processo de urbanização altamente influenciado por intervenções governamentais de infraestrutura no Nordeste do Brasil. Métodos: Avaliamos a mortalidade de populações indígenas (≥ 30 anos) do Vale do São Francisco (Bahia e Pernambuco) no período de 2007-2011. Considerou-se mortalidade CV se a causa de morte constasse no grupo de doenças CV do CID-10 ou se tivesse sido registrada como morte súbita. As populações indígenas foram divididas em dois grupos conforme o grau de urbanização baseado em critérios antropológicos: Grupo 1 - menos urbanizadas (Funi-ô, Pankararu, Kiriri e Pankararé); e Grupo 2 - mais urbanizadas (Tuxá, Truká e Tumbalalá). Taxas de mortalidade de cidades altamente urbanizadas (Petrolina e Juazeiro) nas proximidades das áreas indígenas foram também avaliadas. A análise explorou tendências na porcentagem de mortalidade CV para cada população estudada. Adotou-se o valor de p < 0,05 como significância estatística. Resultados: Houve 1.333 mortes indígenas nas tribos da Bahia e de Pernambuco (2007-2011): 281 no Grupo 1 (1,8% da população de 2012) e 73 no Grupo 2 (3,7% da população de 2012), mortalidade CV de 24% e 37%, respectivamente (p = 0,02). Entre 2007 e 2009, houve 133 mortes no Grupo 1 e 44 no Grupo 2, mortalidade CV de 23% e 34%, respectivamente. Entre 2009 e 2010, houve 148 mortes no Grupo 1 e 29 no Grupo 2, mortalidade CV de 25% e 41%, respectivamente. Conclusões: A urbanização parece influenciar os aumentos de mortalidade CV dos povos indígenas vivendo de modo tradicional. Mudanças no estilo de vida e ambientais devidas à urbanização somadas à subótima atenção à saúde podem estar implicadas no aumento do risco CV nos povos indígenas.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Urbanization/trends , Cardiovascular Diseases/ethnology , Cardiovascular Diseases/mortality , Indians, South American/statistics & numerical data , Time Factors , Urban Population/trends , Urban Population/statistics & numerical data , Brazil/ethnology , Risk Factors , Cause of Death , Age Distribution , Life Style
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