Evaluation of patients with implantable cardioverter-defibrillator in a Latin American tertiary center.

INTRODUCTION: Despite advancements in implantable cardioverter-defibrillator (ICD) technology, sudden cardiac death (SCD) remains a persistent public health concern. Chagas disease (ChD), prevalent in Brazil, is associated with increased ventricular tachycardia (VT) and ventricular fibrillation (VF) events and SCD compared to other cardiomyopathies. METHODS: This retrospective observational study included patients who received ICDs between October 2007 and December 2018. The study aims to assess whether mortality and VT/VF events decreased in patients who received ICDs during different time periods (2007-2010, 2011-2014, and 2015-2018). Additionally, it seeks to compare the prognosis of ChD patients with non-ChD patients. Time periods were chosen based on the establishment of the Arrhythmia Service in 2011. The primary outcome was overall mortality, assessed across the entire sample and the three periods. Secondary outcomes included VT/VF events and the combined outcome of death or VT/VF. RESULTS: Of the 885 patients included, 31% had ChD. Among them, 28% died, 14% had VT/VF events, and 37% experienced death and/or VT/VF. Analysis revealed that period 3 (2015-2018) was associated with better death-free survival (p = .007). ChD was the only variable associated with a higher rate of VT/VF events (p < .001) and the combined outcome (p = .009). CONCLUSION: Mortality and combined outcome rates decreased gradually for ICD patients during the periods 2011-2014 and 2015-2018 compared to the initial period (2007-2010). ChD was associated with higher VT/VF events in ICD patients, only in the first two periods.

Potential urinary biomarkers in preeclampsia: a narrative review.

INTRODUCTION: Preeclampsia (PE) is a highly relevant pregnancy-related disorder. An early and accurate diagnosis is crucial to prevent major maternal and neonatal complications and mortality. Due to the association of kidney dysfunction with the pathophysiology of the disease, urine samples have the potential to provide biomarkers for PE prediction, being minimally invasive and easy to perform. Therefore, searching for novel biomarkers may improve outcomes. This narrative review aimed to summarize the scientific literature about the traditional and potential urinary biomarkers in PE and to investigate their applicability to screen and diagnose the disorder. METHODS: A non-systematic search was performed in PubMed/MEDLINE, Scopus, and SciELO databases. RESULTS: There is significant divergence in the literature regarding traditionally used serum markers creatinine, cystatin C, and albuminuria, accuracy in PE prediction. As for the potential renal biomarkers investigated, including vascular epithelial growth factor (VEGF), placental growth factor (PlGF), and soluble fms-like tyrosine kinase (sFlt-1), urinary levels of PlGF and sFtl-1/PlGF ratio in urine seem to be the most promising as screening tests. The assessment of the global load of misfolded proteins through urinary congophilia, podocyturia, and nephrinuria has also shown potential for screening and diagnosis. Studies regarding the use of proteomics and metabolomics have shown good accuracy, sensitivity, and specificity for predicting the development and severity of PE. CONCLUSION: However, there are still many divergences in the literature, which requires future and more conclusive research to confirm the predictive role of urinary biomarkers in pregnant women with PE.

Novel Biomarkers for Posterior Urethral Valve.

The posterior urethral valve (PUV) is one of the main causes of congenital obstruction of the lower urinary tract in pediatrics. Its occurrence, although rare, can cause chronic kidney disease (CKD), with frequent progression to end stage kidney disease. Therefore, the development of new diagnostic strategies, such as biomarkers, is crucial to better assess the prognosis of patients with PUV. We aimed to review the literature on traditional and new biomarkers in PUV. For that, searches were performed in PubMed/MEDLINE, Scopus and SciELO databases. To systematize the search, terms such as "Posterior Urethral Valve", "Prognosis", "Biomarkers" and variations described in the Medical Subject Headings (MeSH) database were used. The literature showed new biomarkers of disease prognosis, with emphasis on inflammatory cytokines, proteomics and genomics techniques, as well as classic biomarkers, focusing on serum creatinine and urine osmolality. As for biomarkers recently described in the literature, the 12PUV, a set of 12 fetal urinary peptides that accurately predicted postnatal kidney function in fetuses with PUV, stands out. Similarly, oxidative stress markers, inflammatory cytokines and components of the renin-angiotensin system (RAS), when increased, were indicative of severe kidney outcomes. Genetic alterations also correlated to worse prognosis among patients with PUV, with emphasis on RAS polymorphisms and, specifically, those affecting the angiotensin-converting enzyme (ACE) and the angiotensin II receptors types 1 and 2 (AGTR1 and AGTR2) genes. Considering the severity of the PUV condition, the identification of sensitive and cost-effective biomarkers, beyond improving diagnosis, may favor the investigation of new therapeutic strategies.

Animal Hoarding: a systematic review.

OBJECTIVE: Animal hoarding is a special manifestation of Hoarding Disorder, characterized by the accumulation of animals and failure to provide them with minimal care. The main objective of this systematic review is to evaluate the characteristics of animal hoarding with a focus on the profile of affected individuals and accumulation behavior features. METHODS: A systematic search of the literature using the electronic databases MEDLINE, SCOPUS and LILACS was conducted until October 2022. We included case series (n ≥ 10) and cross-sectional studies assessing animal hoarding. RESULTS: 374 studies were initially retrieved. Most studies were classified as poor quality and significant risk of bias. 538 individuals with animal hoarding were evaluated. These individuals were predominantly middle-aged, unmarried females who lived alone in urban areas. Most residences presented unsanitary conditions. Recidivism rates varied from 13-41%. Cats and dogs were the main hoarded species, mostly acquired through unplanned breeding and found with lack of hygiene; diseases; injuries; and behavioral problems. Animal carcasses were found in up to 60% of the properties. CONCLUSION: Animal hoarding is a complex condition that requires urgent attention. More research is necessary to develop effective strategies that can save community resources, improve animal and human welfare, and prevent recidivism.

Animal hoarding: a systematic review

Objectives: Animal hoarding is a special manifestation of hoarding disorder, characterized by the accumulation of animals and failure to provide them with minimal care. The main objective of this systematic review is to evaluate the characteristics of animal hoarding, focusing on the profile of affected individuals and the features of accumulation behavior. Methods: A systematic search of the literature was conducted in the electronic databases MEDLINE, Scopus, and LILACS until October 2022. We included case series (n ≥ 10) and cross-sectional studies assessing animal hoarding. Results: A total of 374 studies were initially retrieved. Most studies were classified as having poor quality and significant risk of bias. A total of 538 individuals with animal hoarding were evaluated. These individuals were predominantly middle-aged, unmarried women who lived alone in urban areas. Most of their residences had unsanitary conditions. Recidivism rates varied from 13-41%. Cats and dogs were the main hoarded species, mostly acquired through unplanned breeding, and disease, injury, behavioral problems, and a lack of hygiene were characreristic of their condition. Animal carcasses were found in up to 60% of the properties. Conclusion: Animal hoarding is a complex condition that requires urgent attention. More research is necessary to develop effective strategies that can save community resources, improve animal and human welfare, and prevent recidivism.