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Open Journal of Anesthesiology 2015年第10期5卷 217-218页

作者： Carlos Galhardo Jr. Carlos Darcy Alves Bersot departament of anesthesia at unimed-rio hospital Rio de Janeiro Brazil departament of anesthesia at Lagoa Federal hospital-SUS Rio de Janeiro Brazil

Transcatheter aortic valve replacement (TAVR) is a new therapeutic option to treat patients with symptomatic severe aortic stenosis, and a prohibitive mortality risk for conventional surgical AVR2. A thorough understanding of the procedural steps involved in TAVR is imperative for all components of the heart time. Balloon aortic valvuloplasty under rapid ventricular pacing is one of the main procedural steps, and is usually performed before valve insertion to enable passage of the prosthesis through the stenotic native aortic valve. Hemodynamic collapse necessitating prompt intervention may occur at different stages during the procedure.

关键词： Cardiovascular anesthesia Surgery Hemodynamics Control

Fibrosis assessment using Fibro Meter combined to first generation tests in hepatitis C

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World Journal of Hepatology 2017年第6期9卷 310-317页

作者： Maria Chiara Chindamo Jerome Boursier Ronir Raggio Luiz Isabelle Fouchard-Hubert Vera Lúcia Nunes Pannain Joao Marcello de Araújo Neto Henrique Sérgio Moraes Coelho Renata de Mello Perez Paul Calès Cristiane Alves Villela-Nogueira departament of Internal Medicine Federal University of Rio de Janeiro Department of Hepatology University Hospital HIFIH Laboratory UPRES 3859SFR 4208Bretagne Loire University Institute of Public Health Studies Federal University of Rio de Janeiro departament of Pathology Federal University of Rio de Janeiro Gastroenterology Department University of the State of Rio de Janeiro D’Or Institute for Research and Education

AIMTo evaluate the performance of FibroMeterVirus3G combined to the first generation tests aspartate aminotransferase-to-platelet ratio index (APRI) or Forns index to assess significant fibrosis in chronic hepatitis C (CHC). METHODSFirst generation tests APRI or Forns were initially applied in a derivation population from rio de Janeiro in Brazil considering cut-offs previously reported in the literature to evaluate significant fibrosis. FibroMeterVirus3G was sequentially applied to unclassified cases from APRI or Forns. Accuracy of non-invasive combination of tests, APRI plus FibroMeterVirus3G and Forns plus FibroMeterVirus3G was evaluated in the Brazilian derivation population. APRI plus FibroMeterVirus3G combination was validated in a population of CHC patients from Angers in France. All patients were submitted to liver biopsy staged according to METAVIR score by experienced hepatopathologists. Significant fibrosis was considered as METAVIR F ≥ 2. The fibrosis stage classification was used as the reference for accuracy evaluation of non-invasive combination of tests. Blood samples for the calculation of serum tests were collected on the same day of biopsy procedure or within a maximum 3 mo interval and stored at -70 °C. RESULTSSeven hundred and sixty CHC patients were included (222 in the derivation population and 538 in the validation group). In the derivation population, the FibroMeterVirus3G AUROC was similar to APRI AUROC (0.855 vs 0.815, P = 0.06) but higher than Forns AUROC (0.769, P Virus3G cut-off to discriminate significant fibrosis was 0.61 (80% diagnostic accuracy; 75% in the validation population, P = 0.134). The sequential combination of APRI or Forns with FibroMeterVirus3G in derivation population presented similar performance compared to FibroMeterVirus3G used alone (79% vs 78% vs 80%, respectively, P = 0.791). Unclassified cases of significant fibrosis af

关键词： Chronic hepatitis C Fibrosis Liver biopsy Non-invasive methods FibroMeterVirus3G Combination algorithms

Prevalence,phenotype and medication for the pediatric inflammatory bowel disease population of a state in Southeastern Brazil

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World Journal of Clinical Pediatrics 2022年第4期11卷 341-350页

作者： Adalberta Lima Martins Renata de SáBrito Fróes Maria da Penha Zago-Gomes Pharmaceutical Assistance Health Department of Espírito SantoVitoria 29052-210Espírito SantoBrazil Department of Gastroenterology GastromedRio de Janeiro 22640-100Rio de JaneiroBrazil departament of Medical Clinical Hospital Universitário Cassiano Antonio MoraesVitoria 29042-755Espírito SantoBrazil

BACKGROUND Inflammatory bowel disease(IBD)can lead to social and economic impacts *** Brazil,where its adult prevalence is increasing,the epidemiology of the pediatric population is not well known,although there is a documented increase in pediatric IBD incidence *** has continental dimensions,and Espírito Santo is a state of southeastern Brazil,the region with the highest demographic densities and is the economically most important in the *** To assess the prevalence,incidence,phenotype and medications in a Southeastern Brazilian pediatric *** Data were retrieved from the Public Medication-Dispensing System of the Department of Health in Espírito Santo state from documentation required to have access to highly expensive medication from August 1,2012 to July 31,*** were 1048 registered patients with IBD of all ages,and of these patients,the cases≤17 years were *** data were obtained through the analysis of administrative requests for these medications and included medical reports,endoscopy exams,histopathology and imaging tests,which followed the Clinical Protocols and Therapeutic Guidelines of the Brazilian *** confirmed cases of IBD were included in the *** There were 55 pediatric patients/1048 registered patients(5.34%),with Crohn's disease(CD)representing 30/55(55%),ulcerative colitis(UC)24/55(43.6%)and 1 unclassified IBD,a significant difference from adult patients(P=0.004).The prevalence of IBD in pediatric patients was 5.02 cases/100.000 inhabitants;the incidence in 2014 was 1.36 cases/100.000 *** mean age at diagnosis was 12.2 years(±4.2).There were 7 children diagnosed up to 6 years old,7 between 7 to 10 years old and 41 between 11 and≤17 years *** was no difference in the distribution of UC and CD between these age categories(P=0.743).There was no difference in gender distribution in relation to *** and adolescents with UC had a predominance of

关键词： Inflammatory bowel disease Pediatric Prevalence Phenotype Brazil

Stages of care for patients with chronic hepatitis C at a hospital in southern Brazil

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World Journal of Hepatology 2023年第8期15卷 973-984页

作者： Manoela Badinelli Vaucher Camila Ubirajara Silva Ivana Rosângela Santos Varella Arthur Yu-Shin Kim Dimas Alexandre Kliemann Department of Hepatology Universidade Federal de Ciências da Saúde de Porto AlegrePorto Alegre 90050-170Rio Grande do SulBrazil Department of Medicine Universidade do Vale do TaquariLajeado 95914-014RSBrazil Department of Application and Monitoring of Injectable Drugs Hospital Sanatório PartenonPorto Alegre 90650-000RSBrazil Department of Epidemiology Hospital Nossa Senhora da ConceiçãoPorto Alegre 91350-200Rio Grande do SulBrazil Department of Infectious Diseases Massachusetts General HospitalBostonMA 02114United States Department of Medicine Harvard Medical SchoolBostonMA 02114United States departament of Infectious Diseases Hospital Nossa Senhora da ConceiçãoPorto Alegre 91350-200Rio Grande do SulBrazil

BACKGROUND Hepatitis C virus(HCV)is defined as a public health problem by the World Health Organization(WHO)and since then has defined targets through the HCV *** HCV cascade of care highlights the progress towards these goals and essential interventions that need to be delivered along this continuum *** To document the treatment cascade for patients with HCV infection at the hospital Nossa Senhora da Conceição(HNSC),defining the percentage of antibody-positive patients who collected molecular biology tests(polymerase chain reaction),attended outpatient clinic assistance,underwent treatment,and achieved a virologic cure termed sustained virologic response(SVR).METHODS With the retrospective cohort design,patients diagnosed with HCV infection in the period between January 1,2015 and December 31,2020 were *** from HCV notification forms,electronic medical records,Computerized Laboratory Environment Manager System,and Medicine Administration System(evaluation of special medications)were collected in 2022 and all information up to that period was *** data were analyzed with IBM SPSS version 25,and Poisson regression with robust simple variance was performed for analysis of variables in relation to each step of the *** with Prior data for HNSC patien

关键词： Cascade of care Elimination Hepatitis C virus Sustained virologic response

Feasibility of performing the 3-minute step test with remote supervision in children and adolescents with cystic fibrosis: A comparative study

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Pediatric Investigation 2024年第2期8卷 83-90页

作者： Fernanda Maria Vendrusculo Gisele Apolinario da Costa Maria Amelia Bagatini Brenda Maria Henrique Maia Lemes Carolina Aguiar Faria Larissa Carvalhaes de Oliveira Evanirso da Silva Aquino Marcio Vinicius Fagundes Donadio Laboratory of Pediatric Physical Activity Infant CenterPontificia Universidade Catolica do Rio Grande do Sul(PUCRS)Porto AlegreBrazil hospital Infantil Joao Paulo II-Fundacao hospitalar do Estado de Minas Gerais(FHEMIG) Belo HorizonteBrazil departament of Physiotherapy Pontificia Universidade Catolica de Minas Gerais(PUCMG)-Campus BetimBetimBrazil Department of Physiotherapy Faculty of Medicine and Health SciencesUniversitat Internacional de Catalunya(UIC)BarcelonaSpain

Importance:The 3-min step test is a simple option to monitor submaximal exercise capacity,although its use via remote video monitoring has not been investigated in children with cystic fibrosis(CF).Objective:This study aimed to assess the feasibility and reproducibility of performing the 3-min step test with remote ***:A cross-sectional study including CF patients(6-18 years)from two CF services were ***,anthropometric,clinical,and lung function data were collected and two 3-min step tests were performed:(i)in-person supervision,and(ii)remotely supervised by video *** and after the tests,heart rate(HR),oxygen saturation(SpO_(2)),and the Borg score for dyspnea and lower limb fatigue were ***:Twenty-three patients(10.7±3.7 years)with a mean FEV1 of 89.5%±23.2%were *** were no significant differences between tests,with mean differences(95%confidence intervals)in final HR of-3.3(-8.9,2.4),change in HR of-1.9(-6.1,2.1),final SpO_(2) of 0.3(-0.4,1.0),and final dyspnea of 0.1(-0.8,0.9).The intraclass correlation coefficient was 0.852(final HR),0.762(final SpO_(2)),and 0.775(final lower limb fatigue).Significant and moderate correlations were found between tests for final HR(r=0.75),change in HR(r=0.61),and final SpO_(2)(r=0.61).The Bland-Altman analysis showed a mean difference in final SpO_(2) between tests of 0.3%(limit of agreement-3.0%,3.5%).Interpretation:Physiological responses between tests were similar,indicating it was feasible to perform the 3-min step test with remote supervision in CF children.

关键词： Children Cystic fibrosis Exercise test Telehealth

Renin Angiotensin System Components and Cancer: Reports of Association

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Journal of Biosciences and Medicines 2016年第5期4卷 65-75页

作者： Maria Del Carmen Garcia Molina Wolgien Silvana Aparecida Alves Correa Pedro Alexandre Federico Breuel Afonso Celso Pinto Nazário Gil Facina Division of Mastology Department of Gynecology Federal University of Sao Paulo Paulista School of Medicine (UNIFESP-EPM) Sao Paulo Brazil Division of Mastology Departament of Gynecology Municipal Hospital and Maternity School Vila Nova Cachoeirinha Sao Paulo Brazil Division of Plastic Surgery Department of Surgery Federal University of Sao Paulo Paulista School of Medicine (UNIFESP-EPM) Sao Paulo Brazil Facvest University Center (UNIFACVEST) Post-Graduation Public Health Division Lages Santa Catarina Brazil Department of Teaching and Research Municipal Hospital and Maternity School Vila Nova Cachoeirinha Sao Paulo Brazil

Renin-Angiotensin System (RAS) is involved with hypertension and other cardiovascular diseases. However, the association of RAS components to cancer still causes suspicion. To try to clarify this, here we aimed to show this association for three important components: Angiotensin Converting Enzyme 1 (ACE1), Angiotensin Type 1 Receptor (AGTR1) and Angiotensin Type 2 Receptor (AGTR2). The first articles show that association of RAS components with cancer dates back to the 70’s. ECA1 and AGTR1 have close association with cancer and ACE1 inhibitors or AGTR1 blockers are candidates to treatment of some tumors. Moreover, the action of AGTR2 is still controversial, but most studies show that the increased expression of AGTR2 can attack the cancer cells. In breast cancer, these components have also been widely studied and many works have shown that the correlation exists. Therefore specific target using these RAS components could be a beneficial, novel therapy to various tumors.

关键词： Renin-Angiotensin System Angiotensin Converting Enzyme Angiotensin Type 1 Receptor Angiotensin Type 2 Receptor Breast Cancer Cancer