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Ravetti CG, Vassallo PF, Ataíde TBLS, Bragança RD, dos Santos ACS, Lima Bastos FD, Rocha GC, Muniz MR, Borges IN, Marinho CC, Nobre V. Impact of bedside ultrasound to reduce the incidence of acute renal injury in high-risk surgical patients: a randomized clinical trial. J Ultrasound 2022:10.1007/s40477-022-00730-y. [DOI: 10.1007/s40477-022-00730-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/05/2022] [Indexed: 12/04/2022] Open
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Sousa DC, Leite AS, Faria BCD, Sacramento LGG, Marinho CC, Caramelli P. Cognitive impairment one year after hospitalization due to COVID‐19 infection in Brazil: preliminary results. Alzheimers Dement 2022. [DOI: 10.1002/alz.065890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bretas DC, Leite AS, Mancuzo EV, Prata TA, Andrade BH, Oliveira JDGF, Batista AP, Machado-Coelho GLL, Augusto VM, Marinho CC. Lung function six months after severe COVID-19: Does time, in fact, heal all wounds? Braz J Infect Dis 2022; 26:102352. [PMID: 35500646 PMCID: PMC9042802 DOI: 10.1016/j.bjid.2022.102352] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/15/2022] Open
Abstract
Background COVID-19 has been associated with persistent symptoms and functional changes, especially in those surviving severe disease. Methods We conducted a prospective multicenter study in patients with severe COVID-19 to determine respiratory sequelae. Patients were stratified into two groups: ward admission (WA) and intensive care unit (ICU) admission. In each follow-up visit, the patients where inquired about cough and dyspnea, and performed spirometry, lung volumes, carbon monoxide diffusion capacity (DLCO), 6-minute walk test (6MWT), and respiratory muscle strength (MIP and MEP). Results of pulmonary function tests at 45 days and 6 months after hospital admission were compared using paired analysis. Results 211 patients were included, 112 in WA and 99 in ICU. Dyspnea persisted in 64.7% in the WA and 66.7% in the ICU group after 6 months. Lung function measures showed significant improvement between 45 days and 6 months, both in WA and ICU groups in VC, FVC, FEV1, total lung capacity, and 6MW distance measures. The improvement in the proportions of the altered functional parameters was significant in the ICU group for VC (44.2% 45 d; 20.8% 6 m; p = 0,014), FVC (47.6% 45 d; 28% 6 m; p = 0,003), FEV1 (45.1% 45 d; 28% 6 m; p = 0,044), DLCO (33.8% 45 d; 7.7% 6 m; p < 0,0001). Conclusion Six months follow-up of patients with the severe forms of COVID-19 showed significant improvement in the lung function measures compared to 45 days post hospital discharge. The difference was more evident in those requiring ICU admission.
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Mancuzo EV, Marinho CC, Machado-Coelho GLL, Batista AP, Oliveira JF, Andrade BH, Brandão ÁLT, Leite ASM, Ferreira PC, Roveda JRC, Leite AS, Augusto VM. Lung function of patients hospitalized with COVID-19 at 45 days after hospital discharge: first report of a prospective multicenter study in Brazil. J Bras Pneumol 2021; 47:e20210162. [PMID: 34932718 PMCID: PMC8836626 DOI: 10.36416/1806-3756/e20210162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/18/2021] [Indexed: 01/08/2023] Open
Abstract
Objective: Because SARS-CoV-2 infection can severely affect the lungs and persistent functional changes can occur after severe disease, we aimed to determine lung function parameters of COVID-19 patients at 45 days after hospital discharge and compare changes according to the severity of the disease. Methods: This was a prospective descriptive analytical multicenter study. The participants were allocated into three groups: ward admission (WA) group; ICU admission not on mechanical ventilation (ICU/MV−) group; and ICU admission on MV (ICU/MV+) group. Lung volumes, DLco, MIP, MEP, and six-minute walk distance (6MWD) were measured 45 days after discharge. Results: The sample comprised 242 patients (mean age = 59.4 ± 14.8 years; 52.1% of males), and 232 (96%) had altered lung function. In the total cohort, restrictive disorder was observed in 96%, as well as reductions in DLco (in 21.2% of the patients), FEV1/FVC (in 39.7%), and PEmax (in 95.8%), with no differences between the groups. Comparing the groups, the ICU/MV+ group had reduced DLco in 50% of the patients (p < 0.001) and a lower mean 6MWD % of the predicted value (p = 0.013). Oxygen desaturation in the six-minute walk test was observed in 32.3% of the cohort and was less frequent in the IE group. Conclusions: This is the first South American study involving severe COVID-19 survivors whose lung function was assessed 45 days after hospital discharge. Changes were frequent, especially in those on MV, which highlights the importance of lung function evaluation after severe COVID-19.
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Ravetti CG, Vassallo PF, de Barros GM, Rocha GC, Chamon S, Borges IN, Marinho CC, Cabral MADS, Duani H, de Andrade MVM, Nobre V. Lung Ultrasound Can Predict the Clinical Course and Severity of COVID-19 Disease. Ultrasound Med Biol 2021; 47:2090-2096. [PMID: 34088531 PMCID: PMC8092622 DOI: 10.1016/j.ultrasmedbio.2021.04.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/02/2021] [Accepted: 04/26/2021] [Indexed: 05/05/2023]
Abstract
Coronavirus disease 2019 (COVID-19) compromises the lung in large numbers of people. The development of minimally invasive methods to determine the severity of pulmonary extension is desired. This study aimed to describe the characteristics of sequential lung ultrasound and to test the prognostic usefulness of this exam in a group of patients admitted to the hospital with COVID-19. We prospectively evaluated patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection admitted to our hospital between April and August 2020. Bedside lung ultrasound exams were performed at three time points: at inclusion in the study, after 48 h and on the seventh day of follow-up. Lung ultrasound scores were quantified according to the aeration loss in each of eight zones scanned. Sixty-six participants were included: 42 (63.6%) in the intensive care unit and 24 (36.3%) in the ward. Lung ultrasound scores were higher in participants admitted to the intensive care unit than in those admitted to the ward at the time of inclusion (16 [13-17] vs. 10 [4-14], p < 0.001), after 48 h (15.5 [13-17] vs. 12.5 [8.2-14.7], p = 0.001) and on the seventh day (16 [14-17] vs. 7 [4.5-13.7], p < 0.001) respectively. Lung ultrasound score measured at the time of inclusion in the study was independently associated with the need for admission to the intensive care unit (odds ratio = 1.480; 95% confidence interval, 1.093-2.004; p = 0.011) adjusted by the Sequential Organ Failure Assessment score.
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Affiliation(s)
- Cecilia Gómez Ravetti
- Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | | | - Guilherme Monteiro de Barros
- Empresa Brasileira de Serviços Hospitalares, Belo Horizonte, Brazil; Postgraduate Program in Health Sciences, Infectious Diseases and Tropical Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Guilherme Carvalho Rocha
- Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Samuel Chamon
- Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Isabela Nascimento Borges
- Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carolina Coimbra Marinho
- Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Máderson Alvares de Souza Cabral
- Postgraduate Program in Health Sciences, Infectious Diseases and Tropical Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Helena Duani
- Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Vandack Nobre
- Postgraduate Program in Health Sciences, Infectious Diseases and Tropical Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Batista AP, Barbosa KF, de Azevedo RJ, Vianna VN, de Queiroz EM, Marinho CC, Machado-Coelho GLL. Hypertension is associated with a variant in the RARRES2 gene in populations of Ouro Preto, Minas Gerais, Brazil: a cross-sectional study. Int J Mol Epidemiol Genet 2021; 12:40-51. [PMID: 34336137 PMCID: PMC8310885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/31/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Arterial hypertension (AH) is implicated in vascular health and contributes significantly to cardiovascular morbidity and mortality. In addition to the contribution of usual risk factors for AH, elucidating the influence of genetic factors is a promising area of investigation. Therefore, we evaluated the association between AH and cardiovascular risk factors (CVRFs) and genetic polymorphisms in communities in Southeast Brazil. METHODS A total of 515 adults aged 18-91 years, who were cross-sectionally assessed between 2015-2016, were included. Demographic, clinical, behavioral, anthropometric characteristics, and laboratory parameters and 12 single nucleotide polymorphisms in seven candidate genes involved in cardiovascular risk (RARRES2, AGT, NOS3, GNB3, APOE, APOB, APOC3, LDLR, and PPARG) were evaluated, with AH as the outcome. Sex, age, and laboratory parameters were considered the main confounding factors. RESULTS There was a significant association between age >60 years (odds ratio [OR] =6.74), alcohol dependence (OR=3.84), smoking (OR=1.74), overweight (OR=1.74), high plasma triglyceride (TG) levels (OR=1.98) and low high-density lipoprotein (HDL-c) (OR=6.22), diabetes (OR=3.68), and insulin resistance (OR=2.40) and AH. A significant association was observed between rs4721 in RARRES2 and AH. The T allele in homozygosis was a potent chance modifier for AH. The highest chance gradients for AH were characterized by the presence of the TT genotype and DMT2 (OR=9.70), high TG (OR=6.26), low HDL-c (OR=8.20), and age more than 60 years (OR=9.96). CONCLUSION The interaction of the T allele of the rs4721 polymorphism in RARRES2 with CVRFs may predispose carriers to a higher cardiovascular risk.
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Affiliation(s)
- Aline Priscila Batista
- Nucleus for Research in Biological Sciences, Federal University of Ouro PretoOuro Preto, Brazil
- Laboratory of Epidemiology, School of Medicine, Federal University of Ouro PretoOuro Preto, Brazil
| | - Keila Furbino Barbosa
- Laboratory of Epidemiology, School of Medicine, Federal University of Ouro PretoOuro Preto, Brazil
| | - Rafael Júnior de Azevedo
- Laboratory of Epidemiology, School of Medicine, Federal University of Ouro PretoOuro Preto, Brazil
| | - Valeska Natiely Vianna
- Laboratory of Epidemiology, School of Medicine, Federal University of Ouro PretoOuro Preto, Brazil
| | - Erica Maria de Queiroz
- Nucleus for Research in Biological Sciences, Federal University of Ouro PretoOuro Preto, Brazil
- Laboratory of Epidemiology, School of Medicine, Federal University of Ouro PretoOuro Preto, Brazil
| | - Carolina Coimbra Marinho
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Minas GeraisBelo Horizonte, Brazil
| | - George Luiz Lins Machado-Coelho
- Nucleus for Research in Biological Sciences, Federal University of Ouro PretoOuro Preto, Brazil
- Laboratory of Epidemiology, School of Medicine, Federal University of Ouro PretoOuro Preto, Brazil
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Cabral MADS, Fonseca TN, Pereira LDO, Nobre Jr. VA, Marinho CC, Silva LCS, Duani H. PERFIL EPIDEMIOLÓGICO DOS PACIENTES ADULTOS NOTIFICADOS COM SUSPEITA OU CONFIRMAÇÃO DE COVID‐19 NO HOSPITAL DAS CLÍNICAS DA UFMG. Braz J Infect Dis 2021. [PMCID: PMC7936802 DOI: 10.1016/j.bjid.2020.101086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Gomez Ravetti C, Ataide TBLS, Barreto LM, Bastos FDL, Gomes AGDR, Detoffol RB, Marinho CC, Nobre V. Lung ultrasound is useful in oncohematologic patients with respiratory dysfunction admitted to an Intensive Care Unit (ICU): a pilot study. Med Ultrason 2020; 22:2332. [PMID: 32399525 DOI: 10.11152/mu-2332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIMS This pilot study aimed to evaluate the usefulness of a sequential lung ultrasound score (LUS) in immunosuppressed patients with oncohematologic diseases and acute respiratory dysfunction hospitalized in an intensive care unit (ICU). MATERIALS AND METHODS LUS was calculated at ICU admission, after 24 h, 48 h and at discharge. A score ranging from 0 to 26 was attributed according to the number of B lines, presence of lung consolidation and pleural effusion. RESULTS Twenty-six patients were included. The median age was 50 years [interquartile range (IQR) 21] and 14 (54%) were male. LUS on the day of ICU admission was significantly higher in non-survivors compared to survivors (13 [5] vs 9 [9], respectively; p=0.047). The median delta LUS (LUS_D2 - LUS_D1) did not show difference between survivors and non-survivors (2 [0-7.5] vs 1 [-1.5 - 5], p=0.33). Among patients initially submitted to noninvasive mechanical ventilation (NIMV), no difference in LUS at inclusion or after 24 h was found between those who succeeded or failed on this support. CONCLUSION The use of LUS to quantify lung aeration loss in oncohematologic patients hospitalized in an ICU due to acute respiratory dysfunction might be a helpful tool to predict the severity of the illness.
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Affiliation(s)
- Cecilia Gomez Ravetti
- 1-Postgraduate Program in Health Sciences: Infectology and Tropical Medicine, Department of Internal Medicine, School of Medicine, UFMG, Belo Horizonte, Minas Gerais, Brazil 2- ICU of Hospital das Clínicas of Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brazil. 3- NIIMI (Núcleo de Interdisciplinar de Investigação em Medicina Intensiva).
| | | | - Lidia Miranda Barreto
- 1-Postgraduate Program in Health Sciences: Infectology and Tropical Medicine, Department of Internal Medicine, School of Medicine, UFMG, Belo Horizonte, Minas Gerais, Brazil 2- ICU of Hospital das Clínicas of Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brazil. 3- NIIMI (Núcleo de Interdisciplinar de Investigação em Medicina Intensiva).
| | - Fabricio De Lima Bastos
- 1-Postgraduate Program in Health Sciences: Infectology and Tropical Medicine, Department of Internal Medicine, School of Medicine, UFMG, Belo Horizonte, Minas Gerais, Brazil 3- NIIMI (Núcleo de Interdisciplinar de Investigação em Medicina Intensiva).
| | - Angelica Gomide Dos Reis Gomes
- 1-Postgraduate Program in Health Sciences: Infectology and Tropical Medicine, Department of Internal Medicine, School of Medicine, UFMG, Belo Horizonte, Minas Gerais, Brazil 3- NIIMI (Núcleo de Interdisciplinar de Investigação em Medicina Intensiva).
| | - Renan Braganca Detoffol
- 1-Postgraduate Program in Health Sciences: Infectology and Tropical Medicine, Department of Internal Medicine, School of Medicine, UFMG, Belo Horizonte, Minas Gerais, Brazil 2- ICU of Hospital das Clínicas of Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brazil..
| | - Carolina Coimbra Marinho
- 2- ICU of Hospital das Clínicas of Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brazil. 3- NIIMI (Núcleo de Interdisciplinar de Investigação em Medicina Intensiva) 4-Department of Internal Medicine, School of Medicine, UFMG, Belo Horizonte, Minas Gerais, Brazil.
| | - Vandack Nobre
- 1-Postgraduate Program in Health Sciences: Infectology and Tropical Medicine, Department of Internal Medicine, School of Medicine, UFMG, Belo Horizonte, Minas Gerais, Brazil 2- ICU of Hospital das Clínicas of Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brazil. 3- NIIMI (Núcleo de Interdisciplinar de Investigação em Medicina Intensiva).
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Marinho CC, Nicolato AJPG, Reis VW, Dos Santos RC, Silva JC, Faria HP, Machado-Coelho GLL. Ultrasound evaluation of schistosomiasis-related morbidity among the Xakriabá people in the state of Minas Gerais, Brazil. Radiol Bras 2020; 53:7-13. [PMID: 32313330 PMCID: PMC7159047 DOI: 10.1590/0100-3984.2019.0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective To use ultrasound to investigate the morbidity related to schistosomiasis in the Xakriabá indigenous population. Materials and Methods This was a field-based census study conducted in the territory of the Xakriabá people. A total of 166 individuals were invited, and 148 (≤ 77 years of age) agreed to participate. Most participants underwent abdominal ultrasound, physical examination, and stool examination. Mann-Whitney U and chi-square tests were used for comparisons. We determined risk by calculating odds ratio (OR) and performed logistic regression analysis. Results Schistosoma mansoni eggs were found in 31 (26.7%) of the 116 stool samples examined, 22 (70.9%) of the 31 being from individuals 4-16 years of age. The median count was 144 eggs/g of feces (interquartile range, 264). Of the 105 participants examined with ultrasound, 68 (64.8%) had hepatomegaly (left lobe), 6 (5.7%) had splenomegaly, and 4 (3.8%) had portal hypertension. Egg-positive stool samples were more common in those with an enlarged left lobe (OR = 3.4; 95% confidence interval (CI): 1.1-11.2; p = 0.043). Periportal fibrosis was found in 30 participants (28.6%), of whom 9 (30%) had pattern C, 10 (33.3%) had pattern D, and 11 (36.7%) had pattern Dc. Age was the only independent risk factor for fibrosis (p = 0.007). Fibrosis was up to nine-fold more common in alcohol drinkers than in nondrinkers (OR = 9.28; 95% CI: 2.60-33.06; p < 0.001). Among the 138 participants in whom the clinical form was classified, the chronic hepatic form was identified in 54 (39.1%), of whom 32 (59.2%) were under 30 years of age and one (1.8%) was hepatosplenic. Conclusion Schistosomiasis in the Xakriabá population is characterized by a high frequency of egg-positive stool samples, predominantly in children/adolescents, and by chronic hepatic form in the young, especially among alcohol drinkers.
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Affiliation(s)
| | | | | | | | - Jaime Costa Silva
- Ministério da Saúde, Fundação Nacional de Saúde (Funasa), Brasília, DF, Brazil
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Barbosa KF, Batista AP, Nacife MBPSL, Vianna VN, Oliveira WWD, Machado EL, Marinho CC, Machado-Coelho GLL. Factors associated with non-use of condoms and prevalence of HIV, viral hepatitis B and C and syphilis: a cross-sectional study in rural communities in Ouro Preto, Minas Gerais, Brazil, 2014-2016. Epidemiol Serv Saude 2019; 28:e2018408. [PMID: 31460658 DOI: 10.5123/s1679-49742019000200023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/05/2019] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to investigate socio-demographic factors associated with non-use of condoms, and to describe the prevalence of sexually transmitted infections (STI) in rural communities of Ouro Preto, Minas Gerais, Brazil, 2014 to 2016. METHODS data were gathered from individual interviews and rapid tests were performed; associations were tested using Poisson regression, with a 95% confidence interval (95%CI). RESULTS we detected 3.8 cases/10,000 inhabitants for hepatitis B and syphilis, and 1.3 cases/10,000 inhabitants for hepatitis C; no HIV cases were detected; in the multivariate analysis we found higher prevalence rates of condom non-use among the group of individuals who were married, had common law partners or were widowed (PR=1.20 - 95%CI 1.06;1.36). CONCLUSION individuals in a stable relationship formed the group with the highest prevalence rate of condom non-use; new syphilis and viral hepatitis cases were detected using rapid tests during the survey.
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Affiliation(s)
- Keila Furbino Barbosa
- Universidade Federal de Ouro Preto, Departamento de Medicina da Família, Saúde Mental e Saúde Coletiva, Ouro Preto, MG, Brasil
| | - Aline Priscila Batista
- Universidade Federal de Ouro Preto, Departamento de Medicina da Família, Saúde Mental e Saúde Coletiva, Ouro Preto, MG, Brasil
| | | | - Valeska Natiely Vianna
- Universidade Federal de Ouro Preto, Departamento de Medicina da Família, Saúde Mental e Saúde Coletiva, Ouro Preto, MG, Brasil
| | - Wandeir Wagner de Oliveira
- Universidade Federal de Ouro Preto, Departamento de Medicina da Família, Saúde Mental e Saúde Coletiva, Ouro Preto, MG, Brasil
| | - Elaine Leandro Machado
- Universidade Federal de Ouro Preto, Departamento de Medicina da Família, Saúde Mental e Saúde Coletiva, Ouro Preto, MG, Brasil
| | - Carolina Coimbra Marinho
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte, MG, Brasil
| | - George Luiz Lins Machado-Coelho
- Universidade Federal de Ouro Preto, Departamento de Medicina da Família, Saúde Mental e Saúde Coletiva, Ouro Preto, MG, Brasil
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Marinho CC, Grobério AC, Silva CTFD, Lima TLFD, Santos RCD, Araújo LGD, Reis VWD, Machado-Coelho GLL. Morbidity of schistosomiasis mansoni in a low endemic setting in Ouro Preto, Minas Gerais, Brazil. Rev Soc Bras Med Trop 2017; 50:805-811. [DOI: 10.1590/0037-8682-0009-2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 12/14/2017] [Indexed: 11/22/2022] Open
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Botoni FA, Ribeiro ALP, Marinho CC, Lima MMO, Nunes MDCP, Rocha MOC. Treatment of Chagas cardiomyopathy. Biomed Res Int 2013; 2013:849504. [PMID: 24350293 PMCID: PMC3857751 DOI: 10.1155/2013/849504] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 09/17/2013] [Accepted: 09/17/2013] [Indexed: 12/13/2022]
Abstract
Chagas' disease (ChD), caused by the protozoa Trypanosoma cruzi (T. cruzi), was discovered and described by the Brazilian physician Carlos Chagas in 1909. After a century of original description, trypanosomiasis still brings much misery to humanity and is classified as a neglected tropical disease prevalent in underdeveloped countries, particularly in South America. It is an increasing worldwide problem due to the number of cases in endemic areas and the migration of infected subjects to more developed regions, mainly North America and Europe. Despite its importance, chronic chagas cardiomyopathy (CCC) pathophysiology is yet poorly understood, and independently of its social, clinical, and epidemiological importance, the therapeutic approach of CCC is still transposed from the knowledge acquired from other cardiomyopathies. Therefore, the objective of this review is to describe the treatment of Chagas cardiomyopathy with emphasis on its peculiarities.
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Affiliation(s)
- Fernando A. Botoni
- Postgraduate Course of Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, 30130 100 Belo Horizonte, MG, Brazil
- Hospital das Clínicas, Universidade Federal de Minas Gerais, 30130 100 Belo Horizonte, MG, Brazil
- Fundação Hospitalar do Estado de Minas Gerais, 30150 260 Belo Horizonte, MG, Brazil
| | - Antonio Luiz P. Ribeiro
- Postgraduate Course of Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, 30130 100 Belo Horizonte, MG, Brazil
- Hospital das Clínicas, Universidade Federal de Minas Gerais, 30130 100 Belo Horizonte, MG, Brazil
| | | | - Marcia Maria Oliveira Lima
- Departamento de Fisioterapia, Universidade Federal do Vale do Mucuri e Jequitinhonha, 39100 000 Diamantina, MG, Brazil
| | - Maria do Carmo Pereira Nunes
- Postgraduate Course of Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, 30130 100 Belo Horizonte, MG, Brazil
- Hospital das Clínicas, Universidade Federal de Minas Gerais, 30130 100 Belo Horizonte, MG, Brazil
| | - Manoel Otávio C. Rocha
- Postgraduate Course of Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, 30130 100 Belo Horizonte, MG, Brazil
- Hospital das Clínicas, Universidade Federal de Minas Gerais, 30130 100 Belo Horizonte, MG, Brazil
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Carvalho GLXD, Moreira LE, Pena JL, Marinho CC, Bahia MT, Machado-Coelho GLL. A comparative study of the TF-Test®, Kato-Katz, Hoffman-Pons-Janer, Willis and Baermann-Moraes coprologic methods for the detection of human parasitosis. Mem Inst Oswaldo Cruz 2012; 107:80-4. [DOI: 10.1590/s0074-02762012000100011] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 12/14/2011] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | - Maria Terezinha Bahia
- Universidade Federal de Ouro Preto, Brasil; Universidade Federal de Ouro Preto, Brasil
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Caliman A, Carneiro LS, Santangelo JM, Guariento RD, Pires APF, Suhett AL, Quesado LB, Scofield V, Fonte ES, Lopes PM, Sanches LF, Azevedo FD, Marinho CC, Bozelli RL, Esteves FA, Farjalla VF. Temporal coherence among tropical coastal lagoons: a search for patterns and mechanisms. BRAZ J BIOL 2011; 70:803-14. [PMID: 21085785 DOI: 10.1590/s1519-69842010000400011] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 06/05/2010] [Indexed: 11/22/2022] Open
Abstract
Temporal coherence (i.e., the degree of synchronicity of a given variable among ecological units within a predefined space) has been shown for several limnological features among temperate lakes, allowing predictions about the structure and function of ecosystems. However, there is little evidence of temporal coherence among tropical aquatic systems, where the climatic variability among seasons is less pronounced. Here, we used data from long-term monitoring of physical, chemical and biological variables to test the degree of temporal coherence among 18 tropical coastal lagoons. The water temperature and chlorophyll-a concentration had the highest and lowest temporal coherence among the lagoons, respectively, whereas the salinity and water colour had intermediate temporal coherence. The regional climactic factors were the main factors responsible for the coherence patterns in the water temperature and water colour, whereas the landscape position and morphometric characteristics explained much of the variation of the salinity and water colour among the lagoons. These results indicate that both local (lagoon morphometry) and regional (precipitation, air temperature) factors regulate the physical and chemical conditions of coastal lagoons by adjusting the terrestrial and marine subsidies at a landscape-scale. On the other hand, the chlorophyll-a concentration appears to be primarily regulated by specific local conditions resulting in a weak temporal coherence among the ecosystems. We concluded that temporal coherence in tropical ecosystems is possible, at least for some environmental features, and should be evaluated for other tropical ecosystems. Our results also reinforce that aquatic ecosystems should be studied more broadly to accomplish a full understanding of their structure and function.
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Affiliation(s)
- A Caliman
- Departamento de Ecologia, Instituto de Biologia, Prédio do CCS, Universidade Federal do Rio de Janeiro – UFRJ, Ilha do Fundão, CP 68020, CEP 21941-590, Rio de Janeiro, RJ, Brazil
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Marinho CC, Bretas T, Voieta I, Queiroz LCD, Ruiz-Guevara R, Teixeira AL, Antunes CM, Prata A, Lambertucci JR. Serum hyaluronan and collagen IV as non-invasive markers of liver fibrosis in patients from an endemic area for schistosomiasis mansoni: a field-based study in Brazil. Mem Inst Oswaldo Cruz 2010; 105:471-8. [DOI: 10.1590/s0074-02762010000400020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 09/04/2009] [Indexed: 12/27/2022] Open
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Azeredo LM, Queiroz LCD, Marinho CC, Espírito Santo MCCD, Chammas MC, Ruiz-Guevara R, Prata A, Antunes CMF, Lambertucci JR, Cerri GG. Aspectos ultrassonográficos e hemodinâmicos da esquistossomose mansônica: avaliação pela ultrassonografia Doppler em áreas endêmicas. Radiol Bras 2010. [DOI: 10.1590/s0100-39842010000200004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Este estudo de campo objetivou identificar as alterações ultrassonográficas e hemodinâmicas indicativas da morbidade da esquistossomose mansônica em áreas endêmicas. MATERIAIS E MÉTODOS: Foram examinados pela ultrassonografia Doppler 554 pacientes esquistossomóticos em três áreas com níveis distintos de endemicidade: baixa endemicidade (n = 109); média endemicidade (n = 255) e alta endemicidade (n = 190). Para o estudo ultrassonográfico foi utilizado o protocolo da Organização Mundial da Saúde (Niamey Working Group, 2000). Pelo Doppler foram avaliados: vasos portais, artérias hepática e esplênica, veias hepáticas e vasos colaterais. RESULTADOS: Houve correlação significativa entre a frequência das alterações ultrassonográficas e o nível de endemicidade das áreas, exceto a hipertrofia do lobo esquerdo. As veias hepáticas apresentaram padrão de fluxo alterado em 23,7% dos casos, alteração esta relacionada à presença e à intensidade de espessamento periportal. A artéria hepática não apresentou alterações nos parâmetros avaliados. Os vasos colaterais foram identificados apenas na área de alta endemicidade. A artéria esplênica apresentou alterações (aumento do calibre, da velocidade e do índice de resistência) mais frequentes na área de alta endemicidade, com diferença significativa entre os grupos. CONCLUSÃO: A ultrassonografia Doppler mostrou-se ferramenta auxiliar importante no estudo da morbidade relacionada à esquistossomose mansônica, contribuindo para definição mais precisa do perfil da doença nas áreas endêmicas.
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Prata A, Ruiz-Guevara R, Antunes CMDF, Marinho CC, Queiroz LC, Voieta I, Lambertucci JR. Comparison between clinical and ultrasonographic findings in cases of periportal fibrosis in an endemic area for schistosomiasis mansoni in Brazil. Rev Soc Bras Med Trop 2010; 43:129-34. [DOI: 10.1590/s0037-86822010000200005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 03/05/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Abdominal palpation and ultrasound findings among patients from an endemic area for schistosomiasis in Brazil who had been followed up for 27 years were compared. METHODS: In 2004, 411 patients from Brejo do Espírito Santo, in the State of Bahia, were selected for the present investigation after giving their written informed consent. Based on clinical data, they were divided into three groups: 41 patients with evidence of liver fibrosis in 2004 (Group 1); 102 patients with evidence of liver fibrosis in the past (1976-1989) but not in 2004 (Group 2); and 268 patients without evidence of liver fibrosis at any time during the 27-year follow-up (Group 3). All of the patients underwent abdominal ultrasound in which the examiner did not know the result from the clinical examination. The data were stored in a database. RESULTS: The prevalence of periportal fibrosis on ultrasound was 82.9%, 56.9% and 13.4% in Groups 1, 2 and 3, respectively. In the presence of hard, nodular liver or prominent left lobe and a hard palpable spleen, ultrasound revealed periportal fibrosis in 70.9%. However, periportal fibrosis was diagnosed using ultrasound in 25.4% of the patients in the absence of clinical evidence of liver involvement. Thus, ultrasound diagnosed periportal fibrosis 3.1 times more frequently than clinical examination did. CONCLUSIONS: Although clinical examination is important in evaluating morbidity due to Manson's schistosomiasis in endemic areas, ultrasound is more accurate in diagnosing liver involvement and periportal fibrosis.
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Marinho CC, Voieta I, Azeredo LM, Nishi MP, Batista TS, Pereira ACF, Serufo JC, Queiroz LCD, Ruiz-Guevara R, Antunes CM, Prata A, Lambertucci JR. Clinical versus ultrasound examination in the evaluation of hepatosplenic schistosomiasis mansoni in endemic areas. Mem Inst Oswaldo Cruz 2006; 101 Suppl 1:317-21. [PMID: 17308789 DOI: 10.1590/s0074-02762006000900050] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Accepted: 06/26/2006] [Indexed: 11/22/2022] Open
Abstract
The best way to appraise the size of abdominal organs remains undefined. Herein we compare the size of liver and spleen in hepatosplenic schistosomiasis using clinical and ultrasound (US) examination, and the size of the organs measured by US with their visualization below the costal margin ("palpable by US"). For this study, 411 individuals from an endemic area for schistosomiasis mansoni in Brazil have been selected. We found that palpable spleens and left liver lobes are larger than non palpable ones. Also, 23% of normal spleens measured by US were palpable on clinical examination, and 22% of spleens increased in size on US were non palpable. A total of 21% of normal spleens were "palpable by US". We also found 54% of normal sized right liver lobes palpable on clinical examination, whilst 54% of the increased livers, measured by US, were non palpable. About 76% of normal right liver lobes were "palpable by US". We conclude that the association of clinical, ultrasound and magnetic resonance imaging (MRI) examinations, in the near future, should give the investigators the necessary tools to perform a more accurate clinical diagnosis of hepatosplenic schistosomiasis mansoni.
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Affiliation(s)
- Carolina Coimbra Marinho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100 Belo Horizonte, MG, Brazil
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