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Appraisal of Five Clinical Guidelines for the Management of Hypertension in Andean Countries and Europe

World Journal of Cardiovascular Diseases 2014年第5期4卷 211-216页

作者： juan moreira Edison Jaramillo Mariella Anselmi Roberto Sempertegui Patricia Ortiz Maria Belen Mena Gianni Tognoni Centro de Epidemiología Comunitaria y Medicina Tropical Esmeraldas Ecuador Department of Community Health Facultad de Ciencias Médicas Universidad Central del Ecuador Quito Ecuador Facultad de Medicina Pontificia Universidad Católica del Ecuador Quito Ecuador Fundación Salud Ambiente y Desarrollo Quito Ecuador

There is global concern on the methodological limitations, transferability and effectiveness of clinical practice guidelines (CPGs) for chronic non-communicable diseases, particularly for hypertension. Bolivia, Ecuador and Peru have regularly produced CPGs;however no formal assessment has been done on their contents, transferability and effectiveness. The past decade saw significant migration from Andean countries to Europe. Knowing how European CPGs compare with those produced in Andean countries is necessary to recommend future changes targeted to the migrant population. A systematic search of CPGs was done on indexed databases and non-indexed publications. Recognized and approved CPGs were identified by technical officers in the Ministries of Health of the respective countries. The guidelines of the European Society of hypertension and four selected CPGs from the Andean countries were assessed by two independent evaluators using the “Agree II instrument for assessing clinical practice guidelines, AGREE II Consortium, May 2009”. Comparison of the CPGs is based on the six domain scores provided by the Agree II instrument. The overall score of CPGs ranged from 1.85 to 2.94 of 6 maximum possible. The European CPG scored highest in 3 of 6 domains compared, most notably in rigor of development. Average domain scores for clarity of presentation (0.84) and scope and purpose (0.64) were highest scores for applicability (0.30). Stakeholder involvement (0.28) and rigor of development (0.17) were the lowest. The CPGs assessed appear to fail meeting the standards of quality and pertinence. They show a progressive worsening from domains declaring good intentions of being clear, to those which measure their hard aspects and implications.

关键词： Hypertension Clinical Practice Guidelines Andean Countries Chronic Non-Communicable Diseases

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Prevalence of Cardiovascular Risk Factors in Three Andean Countries: Systematic Review with Meta-Analysis 2000-2017

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World Journal of Cardiovascular Diseases 2019年第10期9卷 718-736页

作者： juan moreira Patricia Ortiz Roberto Sempertegui Mariella Anselmi Karen Pesse Edison Jaramillo Oscar Betancourt Gianni Tognoni Centro de Epidemiología Comunitaria y Medicina Tropical Esmeraldas Ecuador Fundación Salud Ambiente y Desarrollo Quito Ecuador Departamento de Pediatria Obstetrícia i Ginecologia i Medicina Preventiva Doctorante en Metodología de la Investigación Biomédicay Salud Pública Universidad Autónoma de Barcelona Barcelona España Pontificia Universidad Católica del Ecuador Facultad de Medicina Quito Ecuador Fondazione Mario Negri Sud Sta Maria Imbaro Italy

Background and Objective: A systematic review of the epidemiology of cardiovascular risk factors such as hypertension, diabetes, hypercholesterolemia, obesity and smoking in three Latin American countries was carried out. Reliability and local representativeness of this information is fundamental for tailoring non-communicable disease control strategies to the context. Materials and Methods: Electronic databases and gray literature were searched for descriptive and cross-sectional population studies reporting prevalence of the above-mentioned risk factors in populations aged over 18 years in Peru, Ecuador and Bolivia, published between January 2000 and December 2017. Results: 29 articles, which together included a population of 38,271 individuals, were incorporated in the synthesis. A pooled prevalence was obtained for?each risk factor: smoking in men 37.60% [31.56 - 43.63] was the most frequent risk factor, followed by hypercholesterolemia 26.45% [18.89 - 34.02] and obesity in women 25.53% [19.78 - 31.29]. The Global prevalence of hypertension was 19.54% [15.34 - 23.74], similar for men and women (23.11;23.26 respectively). Conclusions: Estimated pooled prevalence for the main cardiovascular risk factors is high and similar to the ones reported by international estimates, especially for hypertension and obesity. Estimated prevalence of diabetes was lowerthan the previously reported whereas for smoking it was higher. Although prevalence can be a useful indicator for monitoring the epidemiological situation of NCCD in a country, other indicators, especially?those allowing visualizing the results of interventions at local level are needed.

关键词： Cardiovascular Hypertension Risk Factors

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Presence of c.3956del C mutation in familial adenomatous polyposis patients from Brazil

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World Journal of Gastroenterology 2015年第31期21卷 9413-9419页

作者： Caroline Aquino moreira-Nunes Diego di Felipe ávila Alcantara Sérgio Figueiredo Lima-Júnior Sandro Roberto de Araújo Cavalléro juan Antonio Rey Giovanny Reboucas Pinto Paulo Pimentel de Assumpcao Rommel Rodriguez Burbano Biological Science Institute Federal University of Pará Nucleus of Research in Oncology Federal University of Pará Molecular Neuro-oncogenetics Laboratory Research Unit-Unidad de InvestigaciónHospital Universitario La Paz Genetics and Molecular Biology Laboratory Federal University of Piaui

AIM: To characterize APC gene mutations and correlate them with patient phenotypes in individuals diagnosed with familial adenomatous polyposis(FAP) in northern Brazil. METHODS: A total of 15 individuals diagnosed with FAP from 5 different families from the north of Brazil were analyzed in this study. In addition to patients with histopathological diagnosis of FAP,family members who had not developed the disease were also tested in order to identify mutations and for possible genetic counseling. All analyzed patients or their guardians signed a consent form approved by the Research Ethics Committee of the Jo?o de Barros Barreto University Hospital(Belem,Brazil). DNA extracted from the peripheral blood of a member of each of the affected families was subjected to direct sequencing. The proband of each family was sequenced to identify germline mutations using the Ion Torrent platform. To validate the detected mutations,Sanger sequencing was also performed. The samples from all patients were also tested for the identification of mutations by real-time quantitative polymerase chain reaction using the amplification refractory mutation system. RESULTS: Through interviews with relatives and a search of medical records,it was possible to construct genograms for three of the five families included in the study. All 15 patients from the five families with FAP exhibited mutations in the APC gene,and all mutations were detected in exon 15 of the APC gene. In addition to the patients with a histological diagnosis of FAP,family members without disease symptoms showed the mutation in the APC gene. In the present study,we detected two of the three most frequent germline mutations in the literature: the mutation at codon 1309 and the mutation at codon 1061. The presence of c.3956 del C mutation was found in all families from this study,and suggests that this mutation was introduced in the population of the State of Pará through ancestor immigration(i.e.,a de novo mutation that arose

关键词： Familial adenomatous polyposis APC Torrent sequencing Colorectal cancer

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Isolated Autoimmune Orchitis Due to IgG4 Hypersecretion Presenting as Tumor-Like Mass: Case Report and Review of Literature

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Open Journal of Urology 2022年第1期12卷 51-56页

作者： Francisco Marcos da Silva Barroso Flavio Antunes de Sousa Paloma Menezes de Souza Gustavo Lopes de Castro Katia Ramos moreira Leite Monique Freire Santana Roger Arthur da Cunha Alves Gabriela Ayumi Owada Borges juan Eduardo Rios Rodriguez Urology Service Getúlio Vargas University Hospital (HUGV) Manaus Amazonas Brazil General Surgery Service Santa Casa de Ribeir&#227 o Preto Ribeir&#227 o Preto Brazil Sã o Paulo University (USP) Ribeir&#227 o Preto Brazil Faculty of Medicine Federal University of Amazonas (UFAM) Manaus Amazonas Brazil Pathology Department Sírio-Libanes Hospital S&#227 o Paulo Brazil Faculty of Medicine S&#227 o Paulo University (USP) S&#227 o Paulo Brazil Patholgy Service Getúlio Vargas University Hospital (HUGV) Manaus Amazonas Brazil Dr. Heitor Vieira Dourado Tropical Medicine Foundation Manaus Amazonas Brazil Teaching and Research Department Oncology Center Control Foundation (FCECON) Manaus Amazonas Brazil Urology Service Hospital Pronto-Socorro 28 de Agosto Manaus Amazonas Brazil General Surgery Service Getúlio Vargas University Hospital (HUGV) Manaus Amazonas Brazil

Background: IgG4-related disease is a rare autoimmune condition that presents with lymphoplasmacytic infiltrate and fibrosis in the organ affected. Isolated testicle involvement is uncommon and there are only a few cases reported in the literature. Case Presentation: We report a case of isolated chronic orchitis due to IgG4 hypersecretion in a 61-year-old patient that evolved with asymptomatic tumor-like mass growth and was treated with left orchiectomy. Histopathological study revealed orchitis related to IgG4 hypersecretion disease. Conclusion: IgG4-related disease can be manifested as a multi or single-organ disorder. Most diagnoses are made after surgery with histopathological analysis. Most of the cases in literature stand out the difficulty in diagnosis and necessity of high suspicion due to this condition’s similarity with neoplasm presentation.

关键词： Orchitis IgG4-Related Disease Autoimmune Testicle Inflammatory

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