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1.
Glob Heart ; 17(1): 49, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36051327

RESUMO

Objectives: Describe the use and findings of cardiopulmonary imaging-chest X-ray (cX-ray), echocardiography (cEcho), chest CT (cCT), lung ultrasound (LUS), and/or cardiac magnetic resonance imaging (cMRI)-in COVID-19 hospitalizations in Latin America (LATAM). Background: There is a lack of information on the images used and their findings during the SARS-CoV-2 pandemic in LATAM. Methods: Multicenter, prospective, observational study of COVID-19 inpatients, conducted from March to December 2020, from 12 high-complexity centers, in nine LATAM countries. Adults (>18 years) with at least one imaging modality performed, followed from admission until discharge and/or in-hospital death, were included. Results: We studied 1,435 hospitalized patients (64% males) with a median age of 58 years classified into three regions: Mexico (Mx), 262; Central America and Caribbean (CAC), 428; and South America (SAm), 745. More frequent comorbidities were overweight/obesity, hypertension, and diabetes. During hospitalization, 58% were admitted to the ICU. The in-hospital mortality was 28%, and it was highest in Mx (37%).The most frequent images performed were cCT (61%), mostly in Mx and SAm, and cX-ray (46%), significant in CAC. The cEcho was carried out in 18%, similarly among regions, and LUS was carried out in 7%, with a higher frequently in Mx. Abnormal findings on the cX-ray were peripheral or basal infiltrates, and in cCT abnormal findings were the ground glass infiltrates, more commonly in Mx. In LUS, interstitial syndrome was the most abnormal finding, predominantly in Mx and CAC.Renal failure was the most prevalent complication (20%), predominant in Mx and SAm. Heart failure developed in 13%, predominant in Mx and CAC. Lung thromboembolism was higher in Mx while myocardial infarction was in CAC.Logistic regression showed associations of abnormal imaging findings and their severity, with comorbidities, complications, and evolution. Conclusions: The use and findings of cardiopulmonary imaging in LATAM varied between regions and had a great impact on diagnosis and prognosis.


Assuntos
COVID-19 , Adulto , COVID-19/diagnóstico por imagem , COVID-19/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , SARS-CoV-2 , Tomografia Computadorizada por Raios X/métodos
2.
Int J Cardiol Heart Vasc ; 40: 101015, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35372663

RESUMO

Background: Services during the pandemic were severely restricted, public reluctance to seek medical assistance rose, with a reduction of diagnostic and therapeutic modalities use in coronary artery disease (CAD). However, information about perceived barriers of care among cardiologists is limited. We aim to explore these barriers diagnostic and treatment modalities of CAD in Latin America during the pandemic. Methods: An anonymous Google form 12 closed-questions survey was conducted between November 2020 to January 2021. Latin American cardiologists members of the Imaging Society (SISIAC) of the Inter-American Society of Cardiology (SIAC) were reached by email and social media. Results: Differences were found in relation to patients' perceived reluctance to undergo testing, particularly in South America and inpatient care (p < 0.05). Respondents' perceived barriers in the use of CV tests were higher in South America (p < 0.05) and related to public practice (p < 0.01). Barriers to the treatment of myocardial infarction were present in all regions (p < 0.05), and follow-up was influenced by COVID-19 in both public and private practices (p = 0.01). Conclusions:  Regardless of treatment and diagnostic approach (invasive or non-invasive) followed, according to physicians' perception, the pandemic significantly impacted the clinical management of CAD in the Latin American population, similar to the global situation.

3.
Mem. Inst. Oswaldo Cruz ; 111(12): 757-764, Dec. 2016. graf
Artigo em Inglês | LILACS | ID: biblio-829258

RESUMO

We evaluated the effects of a non-hepatotropic parasite infection (Taenia crassiceps) on the outcome of acetaminophen-induced acute liver failure in mice. Uninfected and T. crassiceps infected mice orally received either 300 mg/kg acetaminophen or water as vehicle (n = 5 per group). Survival analysis, hepatocyte necrosis, alanine aminotransferase (ALT) levels, CYP2E1 protein, interleukin (IL-) 5, and IL-6 were assessed for all groups. All infected mice died within 16 h after exposure to acetaminophen (Tc+APAP group), whereas only one-third of uninfected animals exposed to acetaminophen (APAP group) died. Uninfected (Control group) and infected (Tc group) mice that received the vehicle showed no liver damage. Tc+APAP mice exhibited massive liver necrosis characterised by marked balloning degeneration of hepatocytes and higher serum ALT compared to Control, Tc, and APAP animals. Liver tissue from Tc+APAP mice also displayed increased expression of CYP2E1 protein and higher mRNA and protein levels of IL-5 and IL-6 compared to the other groups. These findings suggest that non-hepatotropic parasite infections may increase mortality following acute liver failure by promoting hepatocyte necrosis via IL-5 and IL-6-dependent CYP2E1 overproduction. This study identifies new potential risk factors associated with severe acute liver failure in patients.


Assuntos
Animais , Feminino , Acetaminofen , Analgésicos não Narcóticos , Falência Hepática Aguda , Teníase/parasitologia , Acetaminofen/administração & dosagem , Alanina Transaminase/sangue , Analgésicos não Narcóticos/administração & dosagem , Biomarcadores/sangue , Citocromo P-450 CYP2E1/biossíntese , Citocromo P-450 CYP2E1/sangue , Modelos Animais de Doenças , Hepatócitos/parasitologia , Hepatócitos/patologia , Interleucina-5/sangue , Interleucina-6/sangue , Falência Hepática Aguda/induzido quimicamente , Falência Hepática Aguda/mortalidade , Falência Hepática Aguda/parasitologia , Falência Hepática Aguda/patologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Teníase/patologia
4.
Mem Inst Oswaldo Cruz ; 111(12): 757-764, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27812602

RESUMO

We evaluated the effects of a non-hepatotropic parasite infection (Taenia crassiceps) on the outcome of acetaminophen-induced acute liver failure in mice. Uninfected and T. crassiceps infected mice orally received either 300 mg/kg acetaminophen or water as vehicle (n = 5 per group). Survival analysis, hepatocyte necrosis, alanine aminotransferase (ALT) levels, CYP2E1 protein, interleukin (IL-) 5, and IL-6 were assessed for all groups. All infected mice died within 16 h after exposure to acetaminophen (Tc+APAP group), whereas only one-third of uninfected animals exposed to acetaminophen (APAP group) died. Uninfected (Control group) and infected (Tc group) mice that received the vehicle showed no liver damage. Tc+APAP mice exhibited massive liver necrosis characterised by marked balloning degeneration of hepatocytes and higher serum ALT compared to Control, Tc, and APAP animals. Liver tissue from Tc+APAP mice also displayed increased expression of CYP2E1 protein and higher mRNA and protein levels of IL-5 and IL-6 compared to the other groups. These findings suggest that non-hepatotropic parasite infections may increase mortality following acute liver failure by promoting hepatocyte necrosis via IL-5 and IL-6-dependent CYP2E1 overproduction. This study identifies new potential risk factors associated with severe acute liver failure in patients.


Assuntos
Acetaminofen , Analgésicos não Narcóticos , Falência Hepática Aguda , Teníase/parasitologia , Acetaminofen/administração & dosagem , Alanina Transaminase/sangue , Analgésicos não Narcóticos/administração & dosagem , Animais , Biomarcadores/sangue , Citocromo P-450 CYP2E1/biossíntese , Citocromo P-450 CYP2E1/sangue , Modelos Animais de Doenças , Feminino , Hepatócitos/parasitologia , Hepatócitos/patologia , Interleucina-5/sangue , Interleucina-6/sangue , Falência Hepática Aguda/induzido quimicamente , Falência Hepática Aguda/mortalidade , Falência Hepática Aguda/parasitologia , Falência Hepática Aguda/patologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Teníase/patologia
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