[Comparison of coronary angiography findings in diabetic and non-diabetic women with non-ST-segment-elevation acute coronary syndrome]. / Comparação da coronariografia de mulheres diabéticas e não-diabéticas com síndrome coronariana aguda sem supradesnivelamento de ST.

OBJECTIVE: Compare hemodynamic and angiographic patterns, as well as atherosclerotic lesion morphology, in diabetic and non-diabetic females with unstable angina or non-ST-segment-elevation myocardial infarction (UA/NSTEMI). METHODS: Two interventional cardiologists determined the presence of severe atherosclerotic lesion, defined as those > or = 70%; plaque morphology, according to the American Heart Association classification; collateral circulation; plus ventricular and aortic pressures. Ejection fraction was calculated by angiography or echocardiography. RESULTS: During eight and a half years, 645 coronary angiographies were performed in women with UA/NSTEMI. In the present study, 593 female patients were assessed (215 diabetic--36%). This group differed from the non-diabetic in the following aspects: older age (61 +/- 10.6 x 58.1 +/- 11.4), higher prevalence of postmenopausal women and lower prevalence of the smoking habit. Severe three-vessel disease was significantly more frequent in diabetic patients (28% x 10%), as well as totally occluded vessels: 51 (23%) x 54 (14.3%), p < 0.005. Additionally, ejection fraction < 50% was more common in diabetic patients. CONCLUSION: These findings confirm the diffuse pattern of atherosclerotic disease in diabetic patients, as well a greater deterioration of ventricular function, which may be associated to the poorer prognosis seen in this population both in the short- and long-term.

Trachoma in Indigenous Settlements in Brazil, 2000-2008.

PURPOSE: Trachoma, caused by the bacterium Chlamydia trachomatis, is a chronic, recurrent inflammatory disease that affects the cornea and conjunctiva. Trachoma is the leading infectious cause of avoidable blindness worldwide. Its prevalence is higher among individuals of low socioeconomic status, and trachoma is common in indigenous communities. The present study presents aspects of the epidemiological profile of trachoma in indigenous communities in Brazil. METHODS: We analyzed data from two databases collected during trachoma screening activities among the population of indigenous settlements in Brazil between 2000 and 2008. Trachoma cases were detected by ocular examination in accordance with the World Health Organization simplified trachoma grading system. RESULTS: According to the surveillance database, a total of 9582 individuals in six different states were examined. Among children aged 1-9 years, the prevalence of follicular trachomatous inflammation (TF) was 35.2%. In individuals aged ≥15 years, the prevalence of trachomatous trichiasis (TT) was 1.2% in individuals and the sex-specific prevalence was 0.8% in males and 1.6% in females (p = 0.02). In a survey of two states, 2301 indigenous schoolchildren were examined. In the age bracket 5-9 years, the prevalence of TF was 4.9 (95% confidence interval 3.8-6.0%). CONCLUSION: In Brazil, trachoma appears to be a serious public health problem in indigenous settlements, which should therefore be given priority in programs aimed at the elimination of trachoma in the country.

Comparação da coronariografia de mulheres diabéticas e não-diabéticas com síndrome coronariana aguda sem supradesnivelamento de ST / Comparison of coronary angiography findings in diabetic and non-diabetic women with non-ST-segment-elevation acute coronary syndrome

OBJETIVO: Comparar o padrão hemodinâmico, angiográfico e a morfologia da lesão aterosclerótica em diabéticas e não-diabéticas com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST (AI/IAMSS). MÉTODOS: Dois hemodinamicistas determinaram a presença de lesão aterosclerótica grave, definida como > 70 por cento, a morfologia da placa, de acordo com a classificação da American Heart Association, a presença de circulação colateral e as pressões ventriculares e aórticas. A fração de ejeção foi calculada pela angiografia ou pelo ecocardiograma. RESULTADOS: Em oito anos e meio, foram realizados 645 coronariografias em mulheres com AI/IAMSS. Foram analisadas 593 pacientes (215 diabéticas - 36 por cento). Este grupo diferiu das não-diabéticas nos seguintes aspectos: idade mais alta (61 ± 10,6 x 58,1 ± 11,4), prevalência maior de mulheres pós-menopausa e menor prevalência de tabagismo. Lesão grave em três vasos foi significativamente mais freqüente nas pacientes diabéticas (28 por cento x 10 por cento), assim como vasos totalmente ocluídos: 51 (23 por cento) x 54 (14.3 por cento), p < 0.005.Fração de ejeção < 50 por cento foi mais comum nas diabéticas. CONCLUSÃO: Estes achados confirmam o acometimento difuso da doença aterosclerótica em pacientes diabéticas, assim como maior deterioração da função ventricular, que pode estar relacionada ao pior prognóstico dessa população em curto e em longo prazo.