Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 6 de 6
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Bernardete, Weber; Bersch, Ferreira  C; Torreglosa, Camila R; Marcadenti, Aline; Lara, Enilda S; Silva, Jaqueline T da; Costa, Rosana P; Santos, Renato H N; Berwanger, Otavio; Bosquetti, Rosa; Pagano, Raira; Mota, Luis G S; Oliveira, Juliana D de; Soares, Rafael M; Galante, Andrea P; Silva, Suzana A da; Zampieri, Fernando G; Kovacs, Cristiane; Amparo, Fernanda C; Moreira, Priscila; Silva, Renata A da; Santos, Karina G dos; Monteiro, Aline S5,; Paiva, Catharina C J; Magnoni, Carlos D; Moreira, Annie S; Peçanha, Daniela O; Missias, Karina C S; Paula, Lais S de; Marotto, Deborah; Souza, Paula; Martins, Patricia R T; Santos, Elisa M dos; Santos, Michelle R; Silva, Luisa P; Torres, Rosileide S; Barbosa, Socorro N A A; Pinho, Priscila M de; Araujo, Suzi H A de; Veríssimo, Adriana O L; Guterres, Aldair S; Cardoso, Andrea F R; Palmeira, Moacyr M; Ataíde, Bruno R B de; Costa, Lilian P S; Marinho, Helyde A; Araújo, Celme B P de; Carvalho, Helen M S; Maquiné, Rebecca O; Caiado, Alessandra C; Matos, Cristina H de; Barretta, Claiza; Specht, Clarice M; Onofrei, Mihaela; Bertacco, Renata T A; Borges, Lucia R; Bertoldi, Eduardo G; Longo, Aline; Ribas, Bruna L P; Dobke, Fernanda; Pretto, Alessandra D B; Bachettini, Nathalia P; Gastaud, Alexandre; Necchi, Rodrigo; Souza, Gabriela C; Zuchinali, Priccila; Fracasso, Bianca M; Bobadra, Sara; Sangali, Tamirys D; Salamoni, Joyce; Garlini, Luíza M; Shirmann, Gabriela S; Los Santos, Mônica L P de; Bortonili, Vera M S; Santos, Cristiano P dos; Bragança, Guilherme C M; Ambrózio, Cíntia L; Lima, Susi B E; Schiavini, Jéssica; Napparo, Alechandra S; Boemo, Jorge L; Nagano, Francisca E Z; Modanese, Paulo V G; Cunha, Natalia M; Frehner, Caroline; Silva, Lannay F da; Formentini, Franciane S; Ramos, Maria E M; Ramos, Salvador S; Lucas, Marilia C S; Machado, Bruna G; Ruschel, Karen B; Beiersdorf, Jâneffer R; Nunes, Cristine E; Rech, Rafael L; Damiani, Mônica; Berbigier, Marina; Poloni, Soraia; Vian, Izabele; Russo, Diana S; Rodrigues, Juliane; Moraes, Maria A P de; Costa, Laura M da; Boklis, Mirena; El Kik, Raquel M; Adorne, Elaine F; Teixeira, Joise M; Trescastro, Eduardo P; Chiesa, Fernanda L; Telles, Cristina T; Pellegrini, Livia A; Reis, Lucas F; Cardoso, Roberta G M; Closs, Vera E; Feres, Noel H; Silva, Nilma F da; Silva, Neyla E; Dutra, Eliane S; Ito, Marina K; Lima, Mariana E P; Carvalho, Ana P P F; Taboada, Maria I S; Machado, Malaine M A; David, Marta M; Júnior, Délcio G S; Dourado, Camila; Fagundes, Vanessa C F O; Uehara, Rose M; Sasso, Sandramara; Vieira, Jaqueline S O; Oliveira, Bianca A S de; Pereira, Juliana L; Rodrigues, Isa G; Pinho, Claudia P S; Sousa, Antonio C S; Almeida, Andreza S; Jesus, Monique T de; Silva, Glauber B da; Alves, Lucicna V S; Nascimento, Viviane O G; Vieira, Sabrina A; Coura, Amanda G L; Dantas, Clenise F; Leda, Neuma M F S; Medeiros, Auriene L; Andrade, Ana C L; Pinheiro, Josilene M F; Lima, Luana R M de; Sabino, L S; Souza, C V S de; Vasconcelos, S M L; Costa, F A; Ferreira, R C; Cardoso, I B; Navarro, L N P; Ferreira, R B; Júnior, A E S; Silva, M B G; Almeida, K M M; Penafort, A M; Queirós, A P O de; Farias, G M N; Carlos, D M O; Cordeiro, C G N C; Vasconcelos, V B; Araújo, E M V M C de; Sahade, V; Ribeiro, C S A; Araujo, G A; Gonçalves, L B; Teixeira, C S; Silva, L M A J; Costa, L B de; Souza, T S; Jesus, S O de; Luna, A B; Rocha, B R S da; Santos, M A; Neto, J A F; Dias, L P P; Cantanhede, R C A; Morais, J M; Duarte, R C L; Barbosa, E C B; Barbosa, J M A; Sousa, R M L de; Santos, A F dos; Teixeira, A F; Moriguchi, E H; Bruscato, N M; Kesties, J; Vivian, L; Carli, W de; Shumacher, M; Izar, M C O; Asoo, M T; Kato, J T; Martins, C M; Machado, V A; Bittencourt, C R O; Freitas, T T de; Sant'Anna, V A R; Lopes, J D; Fischer, S C P M; Pinto, S L; Silva, K C; Gratão, L H A; Holzbach, L C; Backes, L M; Rodrigues, M P; Deucher, K L A L; Cantarelli, M; Bertoni, V M; Rampazzo, D; Bressan, J; Hermsdorff, H H M; Caldas, A P S; Felício, M B; Honório, C R; Silva, A da; Souza, S R; Rodrigues, P A; Meneses, T M X de; Kumbier, M C C; Barreto, A L; Cavalcanti, A B.
Am. heart j. ; 215: 187-197, Set. 2019. gráfico, tabela
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1023356

RESUMO

Background Complex percutaneous coronary intervention (PCI) is associated with higher ischemic risk, which can be mitigated by long-term dual antiplatelet therapy (DAPT). However, concomitant high bleeding risk (HBR) may be present, making it unclear whether short- or long-term DAPT should be prioritized. Objectives This study investigated the effects of ischemic (by PCI complexity) and bleeding (by PRECISE-DAPT [PRE dicting bleeding Complications in patients undergoing stent Implantation and Sub sequent Dual Anti Platelet Therapy] score) risks on clinical outcomes and on the impact of DAPT duration after coronary stenting. Methods Complex PCI was defined as ≥3 stents implanted and/or ≥3 lesions treated, bifurcation stenting and/or stent length >60 mm, and/or chronic total occlusion revascularization. Ischemic and bleeding outcomes in high (≥25) or non-high (<25) PRECISE-DAPT strata were evaluated based on randomly allocated duration of DAPT. Results Among 14,963 patients from 8 randomized trials, 3,118 underwent complex PCI and experienced a higher rate of ischemic, but not bleeding, events. Long-term DAPT in non-HBR patients reduced ischemic events in both complex (absolute risk difference: −3.86%; 95% confidence interval: −7.71 to +0.06) and noncomplex PCI strata (absolute risk difference: −1.14%; 95% confidence interval: −2.26 to −0.02), but not among HBR patients, regardless of complex PCI features. The bleeding risk according to the Thrombolysis In Myocardial Infarction scale was increased by long-term DAPT only in HBR patients, regardless of PCI complexity. Conclusions Patients who underwent complex PCI had a higher risk of ischemic events, but benefitted from long-term DAPT only if HBR features were not present. These data suggested that when concordant, bleeding, more than ischemic risk, should inform decision-making on the duration of DAPT. (AU)


Assuntos
Humanos , Doenças Cardiovasculares/prevenção & controle , Avaliação Nutricional , Alimentos, Dieta e Nutrição
2.
Am Heart J ; 215: 187-197, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31349110

RESUMO

BACKGROUND: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. METHODS: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. RESULTS: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ±â€¯8.4 vs 24.7 ±â€¯8.6, P < .01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P = .15). Secondary end points did not differ between groups after follow-up. CONCLUSIONS: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death.

3.
Hypertension ; 73(3): 571-577, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30661477

RESUMO

Bariatric surgery is an effective strategy for blood pressure (BP) reduction, but most of the evidence relies on office BP measurements. In this study, we evaluated the impact of bariatric surgery on 24-hour BP profile, BP variability, and resistant hypertension prevalence. This is a randomized trial including obese patients with grade 1 and 2 using at least 2 antihypertensive drugs at maximal doses or >2 at moderate doses. Patients were allocated to either Roux-en-Y Gastric Bypass (RYGB) combined with medical therapy or medical therapy alone for 12 months. The primary outcome was the 24-hour BP profile and variability (average real variability of daytime and night time BP). We evaluated the nondipping status and prevalence of resistant hypertension as secondary end points. We included 100 patients (76% female, body mass index, 36.9±2.7 kg/m2). The 24-hour BP profile (including nondipping status) was similar after 12 months, but the RYGB group required less antihypertensive classes as compared to the medical therapy alone (0 [0-1] versus 3 [2.5-4] classes; P<0.01). The average real variability of systolic nighttime BP was lower after RYGB as compared to medical therapy (between-group difference, -1.63; 95% CI, -2.91 to -0.36; P=0.01). Prevalence of resistant hypertension was similar at baseline (RYGB, 10% versus MT, 16%; P=0.38), but it was significantly lower in the RYGB at 12 months (0% versus 14.9%; P<0.001). In conclusion, RYGB significantly reduced antihypertensive medications while promoting similar 24-hour BP profile and nondipping status. Interestingly, bariatric surgery improved BP variability and may decrease the burden of resistant hypertension associated with obesity. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT01784848.


Assuntos
Anti-Hipertensivos/uso terapêutico , Cirurgia Bariátrica , Monitorização Ambulatorial da Pressão Arterial/métodos , Pressão Sanguínea/fisiologia , Hipertensão/terapia , Obesidade/cirurgia , Adulto , Índice de Massa Corporal , Brasil/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Obesidade/complicações , Prevalência , Prognóstico
4.
Neurosurgery ; 83(4): 800-809, 2018 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-29538761

RESUMO

BACKGROUND: Human morbid obesity is increasing worldwide in an alarming way. The hypothalamus is known to mediate its mechanisms. Deep brain stimulation (DBS) of the ventromedial hypothalamus (VMH) may be an alternative to treat patients refractory to standard medical and surgical therapies. OBJECTIVE: To assess the safety, identify possible side effects, and to optimize stimulation parameters of continuous VMH-DBS. Additionally, this study aims to determine if continuous VMH-DBS will lead to weight loss by causing changes in body composition, basal metabolism, or food intake control. METHODS: The BLESS study is a feasibility study, single-center open-label trial. Six patients (body mass index > 40) will undergo low-frequency VMH-DBS. Data concerning timing, duration, frequency, severity, causal relationships, and associated electrical stimulation patterns regarding side effects or weight changes will be recorded. EXPECTED OUTCOMES: We expect to demonstrate the safety, identify possible side effects, and to optimize electrophysiological parameters related to VMH-DBS. No clinical or behavioral adverse changes are expected. Weight loss ≥ 3% of the basal weight after 3 mo of electrical stimulation will be considered adequate. Changes in body composition and increase in basal metabolism are expected. The amount of food intake is likely to remain unchanged. DISCUSSION: The design of this study protocol is to define the safety of the procedure, the surgical parameters important for target localization, and additionally the safety of long-term stimulation of the VMH in morbidly obese patients. Novel neurosurgical approaches to treat metabolic and autonomic diseases can be developed based on the data made available by this investigation.

5.
J. vasc. bras ; 3(4): 347-349, dez. 2004.
Artigo em Português | LILACS | ID: lil-404919

RESUMO

Objetivo: Os objetivos do presente estudo foram identificar os tipos de neoplasias e avaliar sua prevalência em 415 pacientes com trombose venosa profunda.Método: Foi investigada a presença de neoplasias, em estudo prospectivo, em 415 pacientes com trombose venosa profunda em membras inferiores, com idades entre 11 e 92 anos; média de 55,2 anos. O diagnóstico de trombose foi realizado com dúplex em todos pacientes e nos casos de dúvida foi confirmado pela flebografia. Procederam-sea história clínica e o exame físico, além de exames bioquímicas, por imagem, biópsias e cirurgias quando indicadas. Entre os principais exames laboratoriais, nos casos de suspeita clínica, realizaram-se asradiografias de tórax, endoscopia, ultra-som de abdômen, tomografia computadorizada e a ressonância magnética. Foram incluídos todos os pacientes que apresentaram trombose venosa profunda e excluídos os pacientes que já tinham diagnóstico prévio de neoplasia.Resultados: Detectou-se a presença de neoplasias em 58 (415)pacientes, representando 13,9 por cento, sendo que 27,5 por cento envolveu o trato gastrointestinal, 17,2 por cento o sistema ginecológico, 17,2 por cento o sistema nervaso central, 15,5 por cento o sistema urológico, 8,6 por cento o sistema respiratório,6,8 por cento o sistema tegumentar, 3,4 por cento o esquelético, 1,7 por cento o retroperitôneo e 1,7 por cento o reticuloendotelial.Conclusão: Conclui-se que pacientes com trombose venosa profunda apresentam uma alta prevalência de neoplasias, sendo sugerido o seu rastreamento.


Assuntos
Humanos , Masculino , Feminino , Adulto , Prevalência , Trombose Venosa/complicações , Trombose Venosa/diagnóstico , Flebografia/estatística & dados numéricos , Flebografia/métodos
6.
Rev. bras. hematol. hemoter ; 25(1): 65-66, jan.-mar. 2003.
Artigo em Português | LILACS | ID: lil-351821

RESUMO

Nasal haemorrhage or nosebleed, is the most common of haemorrhages due to the intense vasculization of the nose, the fragility of the nasal mucous membrane and its vulnerability to traumas and irritant agents. The aim of this study is to report on a reduction of episodes of nosebleed in two patients with the use of amnophtone. A 34-year-old male patient and a 44- year-old female patient presented with histories of two or more nosebleeds per week, despite treatment during the acute phase. They both sought medical assistance for other vascular complaints, which were suggestive of vascular insufficiency as, during the physical examination petechia lesions in the lower limbs were detected. They were treated with 75 mg of amnaphtone three times daily. One week after, at the follow-up, they reported an improvement of the vascular symptoms, however, more markedly was the significant improvement in relation to the nosebleeds which were frequent but had not been reported in the first consultation. In conclusion, amnaphtone demonstrated to be efficient in the prevention of recurrence of nosebleed in these patients


Assuntos
Humanos , Epistaxe , Flavonoides/administração & dosagem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA