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Santos M, Paula SB, Santos H, Almeida I, Almeida S, Tavares J, Santos L, Almeida ML. Supraventricular arrhythmias in MINOCA patients. Europace 2022. [DOI: 10.1093/europace/euac053.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
De novo atrial fibrillation (AF) is a frequent complication of acute coronary syndromes (ACS). However, 5-15% of patients (pts) admitted with suspected acute myocardial infarction have no significant lesions on coronary angiography (>50%) (MINOCA). Contrary to initial beliefs, MINOCA is not a benign disease, given that mortality and incidence of adverse events is similar to ACS.
Objective
To evaluate predictors and prognosis of AF in the setting of MINOCA.
Methods
Based on a multicenter retrospective study, data collected from admissions between 2013 and 2020. Pts without data on cardiovascular history or uncompleted clinical data were excluded. We included 7590 pts with non-ST elevation myocardial infarction (NSTEMI). Between those, 1561 (19.2%) were MINOCA. We divided MINOCA pts in 2 groups (G): GA – MINOCA with de novo AF; GB – MINOCA without de novo AF during in-hospital stay.
Results
MINOCA pts’ mean age was 65±13, 62% were male and 2.1% had de novo AF. GA pts were older (76±10 vs 65±13, p<0.001), had higher rates of Killip-Kimball class (KKC) >I (27.8% vs 9.7%, p=0.027) and kidney function impairment (50% vs 10.2%, p<0.001), lower haemoglobin at admission (13±1.5 vs 13.7±1.8, p=0.038), higher rates of diuretics (56.3% vs 17.6%, p<0.001) and amiodarone usage during hospitalization (31.3% vs 3.6%, p<0.001) and higher rates of left ventricle ejection fraction (LVEF)<50% (47.1% vs 19.1%, p=0.009). The Gs were similar regarding gender, times from symptoms to admission, cardiovascular risk factors and past history of heart failure, stroke or ACS, and heart rate and systolic arterial tension at admission. In the global population, older age (p=0.001, OR 1.87, CI 1.23-2.72), KKC>I (p=0.004, OR 1.76, CI 1.19-2.61) and LVEF<50% (p<0.001, OR 2.25, CI 1.5-3.38) were predictors of AF during hospitalization. In MINOCA pts, only older age (p=0.014, OR 4.2, CI 1.34-13.2) and LVEF<50% (p<0.001, OR 7.44, CI 2.17-25.47) were predictors of de novo AF. Regarding 1 year-prognosis, the occurrence of AF in MINOCA pts was associated with worse outcomes, namely 1year-mortality (log rank=0.002) and 1-year all cause readmission (log rank 0.028)
Conclusion
As expected, AF in the setting of MINOCA is associated with poorer prognosis. Pts with older age and LV dysfunction are at higher risk of de novo AF in this population.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - SB Paula
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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Fitzpatrick C, Almeida ML, Harvey E, Garon-Carrier G, Berrigan F, Asbridge M. An examination of bedtime media and excessive screen time by Canadian preschoolers during the COVID-19 pandemic. BMC Pediatr 2022; 22:212. [PMID: 35436899 PMCID: PMC9418412 DOI: 10.1186/s12887-022-03280-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background Risky media use in terms of accumulating too much time in front of screens and usage before bedtime in early childhood is linked to developmental delays, reduced sleep quality, and unhealthy media use in later childhood and adulthood. For this reason, we examine patterns of media use in pre-school children and the extent to which child and family characteristics contribute to media use during the COVID-19 pandemic. Methods A cross-sectional study of digital media use by Canadian preschool-aged children (mean age = 3.45, N = 316) was conducted at the start of the COVID-19 pandemic between April and August of 2020. Parents completed a questionnaire and 24-h recall diary in the context of an ongoing study of child digital media use. From these responses we estimated hours of average daily screen time, screen time in the past 24 h, average daily mobile device use, and media use before bedtime. Parents also answered questions about their child (i.e., age, sex, temperament), family characteristics (parental mediation style, parental screen time, education, income), and contextual features of the pandemic (ex., remote work, shared childcare). Daycare closures were directly assessed using a government website. Results Our results indicate that 64% of preschoolers used more than 2 h of digital media hours/day on average during the pandemic. A majority (56%) of children were also exposed to media within the hour before bedtime. Logistic and multinomial regressions revealed that child age and temperament, restrictive parental mediation, as well as parent digital media use, education, satisfaction with the division of childcare, remote work, and number of siblings and family income were all correlates of risky digital media use by preschoolers. Conclusions Our results suggest widespread risky media use by preschoolers during the pandemic. Parenting practices that include using more restrictive mediation strategies may foster benefits in regulating young children’s screen time.
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Affiliation(s)
- C Fitzpatrick
- Département de l'enseignement au préscolaire et au primaire, Université de Sherbrooke, Sherbrooke, Canada. .,Department of Childhood Education, University of Johannesburg, Gauteng, South Africa.
| | - M L Almeida
- Federal University of Rio Grande Do Sul, Porto Alegre, Brasil
| | - E Harvey
- Département des sciences de l'éducation, Université Sainte-Anne, Church Point, Canada
| | - G Garon-Carrier
- Département de psychoéducation, Université de Sherbrooke, Sherbrooke, Canada
| | - F Berrigan
- Faculté des sciences de l'activité physique, Université de Sherbrooke, Sherbrooke, Canada
| | - M Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.,Department of Emergency Medicine, Dalhousie University, Halifax, Canada
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Gil I, Santos-Costa P, Bobrowicz-Campos E, Barata A, Parola V, Coelho A, Santos E, Almeida ML, Apóstolo J. Pilot study on the effectiveness of Reminiscence Therapy on cognition, depressive symptoms, and quality of life in nursing home residents. Transl Med UniSa 2021; 23:82-91. [PMID: 34447721 PMCID: PMC8370515 DOI: 10.37825/2239-9747.1018] [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] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Aim This study aimed to assess the effectiveness of the group Reminiscence Therapy (RT) on cognition, depressive symptoms, and quality of life (QOL) in older adults recruited in nursing homes. Methods A pilot study with a one-group pretest-posttest design was conducted between September 2017 and March 2018 in five nursing homes from central Portugal. A comprehensive RT program (Core program followed by a Follow-up program) was provided to clinically stable volunteers aged 65 years or more, who did not have severe cognitive impairment. Results From the 50 older adults (32 women and 18 men, with mean age of 83.32±7.76, and mean education level of 5.48±4.05) considered eligible to participate in the study, 35 (mean age: 84.17±7.46, mean education level of 6.14±4.49) completed the Core Program and 28 completed the Follow-up Program (mean age: 84.25±7.66, mean education level of 6.18±4.57). Based on the Wilcoxon Test, it was observed that the participants' cognitive performance did not change during the two RT programs. No significant changes were confirmed in relation to depressive symptomatology and QOL. Conclusion Although no statistically significant improvements of the older adults' cognitive function, depressive symptomatology, and quality of life were found, the stabilization of such outcomes are relevant from a clinical viewpoint. Further studies are necessary to confirm these findings.
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Affiliation(s)
- I Gil
- Department of Elderly Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal.,The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal
| | - P Santos-Costa
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal.,Department of Fundamental Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal
| | - E Bobrowicz-Campos
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal.,Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra 3000-115, Portugal
| | - A Barata
- Department of Elderly Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal.,The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal
| | - V Parola
- Department of Elderly Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal.,The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal
| | - A Coelho
- Department of Elderly Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal.,The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal
| | - E Santos
- The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal.,Rheumatology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra 3000-075, Portugal
| | - M L Almeida
- Department of Elderly Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal.,The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal
| | - J Apóstolo
- Department of Elderly Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal.,The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra 3046-851, Portugal
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Santos M, Santos H, Almeida I, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Atrial Fibrillation in Acute Coronary Syndrome - early onset impact on MACE. Europace 2021. [DOI: 10.1093/europace/euab116.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
on behalf of the Investigators of " Portuguese Registry of ACS "
Introduction
Atrial Fibrillation (AF) complicates approximately 10% of acute coronary syndromes (ACS) and it is, therefore, important to access its impact on ACS patients’ (pts) prognosis.
Objective
To evaluate early onset (≤48h) de novo atrial fibrillation (AF) as predictor of major adverse cardiovascular events (MACE) and in-hospital complications.
Methods
Based on a multicenter retrospective study, data collected from admissions between 1/10/2010 and 8/01/2019. Pts were divided in two groups: A – early onset de novo AF (EOAF), and B – late onset de novo AF (LOAF). Patients without data on previous cardiovascular history or uncompleted clinical data were excluded. Univariate logistic regression was performed to assess if LOAF in ACS was a predictor of MACE or complications.
Results
29851 pts had ACS. EOAF occurred in 584 pts (2.0%) and LOAF in 360 pts (1.2%). EOAF were younger (73 ± 13 vs 77 ± 10, p < 0.001) and smokers (21.3% vs 12.1%, p < 0.001). LOAF had higher rates of diabetes mellitus (40.1% vs 30.2%, p < 0.001), angina (30.8% vs 21.4%, p < 0.001), previous ACS (22.5% vs 15.4%, p = 0.006), previous revascularization (percutaneous coronary intervention 14% vs 9.5%, p = 0.032; coronary artery bypass surgery 8.4% vs 3.9%, p = 0.004). ST-segment elevation myocardial infarction (MI) rates were higher in EOAF (56.8% vs 46.9%, p = 0.003) and were admitted directly to the cath lab more often (21.7% vs 13.4%, p = 0.001). Non-ST elevation MI rates were higher in LOAF (44.2% vs 37.7%, p = 0.048). LOAF times from first symptoms to admission were longer (420min vs 183%, p < 0.001), mean brain natriuretic peptide levels were higher (579 vs 447, p = 0.009) and diuretics usage was more frequent (72.8% vs 54.3%, p < 0.001). EOAF had higher rates of heart failure (32.1% vs 17.2%, p < 0.001), atrioventricular block (10.5% vs 7.8%, p = 0.006) and sustained ventricular tachycardia (8.1% vs 3.1%, p = 0.001). LOAF had higher in-hospital mortality (14.2% vs 9.6%, p = 0.031) and longer hospital stay (12 days vs 7 days, p < 0.001). Logistic regression confirmed that EOAF was predictive of in-hospital heart failure (p < 0.001, OR 2.15) and atrioventricular block (p = 0.008, OR 7.46). Regarding 1 year-follow-up, EOAF had poorer prognosis comparing to LOAF (59.3% vs 73.0%, p = 0.018, OR 1.62, CI 1.09-2.42)
Conclusion
EOAF is predictive of MACE, namely heart failure and atrioventricular block, and is associated to poorer prognosis comparing to LOAF.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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5
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Santos M, Santos H, Almeida I, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Cardiac arrest in Acute Coronary Syndrome: predictors and prognosis. Europace 2021. [DOI: 10.1093/europace/euab116.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
on behalf of the Investigators of " Portuguese Registry of ACS "
Introduction
Cardiac arrest (CA) is a potential complication of acute coronary syndromes (ACS) and it is, therefore, important to access its impact on prognosis and identify patients with higher risk of CA in the setting of ACS.
Objective
To evaluate predictors and prognosis of CA in the setting of ACS.
Methods
Based on a multicenter retrospective study, data collected between 1/10/2010 and 4/09/2019. Patients (pts) without data on previous cardiovascular history or uncompleted clinical data were excluded. Pts were divided in 2 groups (G): GA – pts without CA; GB - pts with CA during hospitalization. Logistic regression and survival analysis was performed.
Results
Between 25718 pts with ACS, CA occurred in 651 (2.5%). GB was younger (65 ± 15 vs 67 ± 14, p < 0.001), had higher rates of smoking (35.8% vs 26.4%, p < 0.001), and lower rates of hypertension (62.3% vs 70.9%, p < 0.001), diabetes (25.7% vs 31.7%, p < 0.001), dyslipidaemia (53.8% vs 61.7%, p < 0.001), previous ACS (17.2% vs 20.6%, p = 0.037) and coronary artery bypass grafting (CABG) (1.9% vs 5.1%, p < 0.001). Both groups were similar regarding previous heart failure (p = 0.450) and chronic kidney disease (p = 0.560). GB had shorter times from first symptoms to admission (158min vs 243min, p < 0.001). GA had higher rate of non-ST-elevation myocardial infarction (MI) (78.6% vs 41.4%, p < 0.001), whether GB had higher rates of ST-elevation myocardial infarction (STEMI) (46.7% vs 18.1%, p < 0.001), namely anterior (54.9% vs 46.9%, p < 0.001). GB had lower blood pressure (BP) (122 ± 33 vs 139 ± 28, p < 0.001), higher heart rate (HR) (83 ± 23 vs 77 ± 19, p < 0.001), presented more frequently in Killip-Kimball class (KKC) ≥2 (37.6% vs 14.6%, p < 0.001), in atrial fibrillation (AF) (13.9% vs 7.0%, p < 0.001) and with right bundle block (10.6% vs 5.3%, p < 0.001). GB had higher rates of common trunk culprit lesion (CL) (3.9% vs 1.6%, p < 0.001), anterior descending coronary CL (49% vs 37%, p < 0.001), 1 vessel lesion (53.4% vs 38.5%, p < 0.001), lower CABG rates (4.3% vs 6.3%, p = 0.042), more left ventricle dysfunction (57.7% vs 38.7%, p < 0.001) and needed more frequently mechanical ventilation (35.3% vs 1.1%, p < 0.001), non-invasive ventilation (6.8% vs 1.6%, p < 0.001) and provisory pacemaker (9.4% vs 1.3%, p < 0.001). Logistic regression confirmed that older age (p < 0.001, OR 1.89, CI 1.35-2.64), higher HR (p < 0.029, OR 1.33, CI 1.03-1.71), lower BP (P < 0.001, OR 2.67, CI 1.94-3.68), KKC ≥2 (p < 0.001, OR 2.35, CI 1.84-3.00), AF at admission (p < 0.001, OR 1.84, CI 1.34-2.51), STEMI (p < 0.001, OR 4.08, CI 3.66-6.77), lower left ventricle function (p = 0.009, OR 1.38, CI 1.08-1.75) were predictors of CA. Event-free survival was higher in GA than GB (92.8% vs 83.3%, OR 1.68, p = 0.008, CI 1.41-2.47).
Conclusion
As expected, CA in the setting of ACS is associated with poorer prognosis. Several characteristics of the pts may help to predict the development of CA during hospitalization, allowing earlier identification and prompt treatment.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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6
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Santos M, Santos H, Almeida I, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. In-hospital outcomes of sustained ventricular tachycardia in the setting of Acute Coronary Syndrome. Europace 2021. [DOI: 10.1093/europace/euab116.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
on behalf of the Investigators of " Portuguese Registry of ACS "
Introduction
Sustained ventricular tachycardia (SVT) complicates up to 20% of acute coronary syndromes (ACS) and it is, therefore, important to access its impact on prognosis and identify patients with higher risk of SVT.
Objective
To evaluate predictors of early onset (<48h) and late onset (≥48h) SVT.
Methods
Based on a multicenter retrospective study, data collected from admissions between 1/10/2010 and 4/09/2019. Patients (pts) were divided in two groups (G): A – pts that presented early onset SVT (ESVT), and B – pts that presented late onset SVT (LSVT). Pts without data on previous cardiovascular history or uncompleted clinical data were excluded. Logistic regression was performed to assess predictors of SVT in ACS.
Results
Between 29851 pts with ACS, 364 (1.2%) presented SVT. ESVT – 251 pts (69%); LSVT – 91 pts (25%). LSVT G was older (74 ± 13 vs 68 ± 14, p = 0.003), was admitted directly to cat lab less frequently (10.1% vs 24.8%, p = 0.003), had longer times from first symptoms to admission (440min vs 261 min, p < 0.001) and had higher rates of previous stroke (14.4% vs 6.8%, p = 0.028). LSVT G had higher rates of non-ST-elevation myocardial infarction (MI) (35.2% vs 23.1%, p = 0.025) and lower rates of ST-elevation MI (53.8% vs 71.7%, p = 0.002), although both G were similar regarding MI location (anterior – p = 0.135, inferior – p = 0.097). LSVT G had higher systolic blood pression (130 ± 33 vs 122 ± 33, p = 0.050), presented more frequently in Killip-Kimball class ≥2 (52.5% vs 35.5%, p = 0.005) and with atrial fibrillation (21.2% vs 12.4%, p = 0.045), and had higher brain-natriuretic peptide (1075 vs 329, p < 0.001). LSVT G was treated more frequently with diuretics (80.0% vs 47.8%, p < 0.001), amiodarone (62.2% vs 48.8%, p = 0.029), digoxin (8.9% vs 2.4%, p = 0.013) and levosimendan (11.1% vs 2.8%, p = 0.004). ESVT G had higher rates of performed coronarography (88.4% vs 79.1%, p = 0.028) but lower rate of 3 vessels disease (58.5% vs 70.8%, p = 0.017). LSVT G had higher rates of severe (<30%) left ventricle dysfunction (32.9% vs 15.4%, p < 0.001) and need to non-invasive ventilation (23.1% vs 6.8%, p < 0.001). Regarding in-hospital complications, ESVT G had higher rates of heart failure (34.7% vs 19.1%, p = 0.006), atrioventricular block (15.7% vs 1.1%, p < 0.001), atrial fibrillation (20.4% vs 7.7%, p = 0.006) and major haemorrhage (5.2% vs 0.0%, p = 0.024). LSVT G had higher rates of in-hospital death (44.4% vs 20.9%, p < 0.001) and in-hospital stay (14 days vs 7 days, p < 0.001). The G were similar regarding re-infarction (p = 0.216), shock (p = 0.179), mechanical complications (p = 1.00), cardiac arrest (p = 0.097) and stroke (0.348) rates. Logistic regression confirmed ESVT was predictive in-hospital heart failure (p = 0.010, OR 2.67) and de novo AF (p = 0.001, OR 5.56), whether LSVT was predictive of in-hospital death (p = 0.002, OR 2.70).
Conclusion
LSVT was associated with higher rates of in-hospital complications, but ESVT was associated with higher in-hospital mortality.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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Santos M, Santos H, Almeida I, Paula S, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Acute heart failure: does etiology matter? Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Patients (pts) with acute heart failure (AHF) are a heterogeneous population. The etiology of the heart disfunction may play a role in prognosis. Risk stratification at admission may help predict in-hospital complications and needs.
Objective
To explore predictors of in-hospital mortality (IHM), post discharge early mortality [1-month mortality (1mM)] and late mortality [1-year mortality (1yM)] and early and late readmission, respectively 1-month readmission (1mRA) and 1-year readmission (1yRA), in our center population, using real-life data.
Methods
Based on a single-center retrospective study, data collected from patients (pts) admitted in the Cardiology department with AHF between 2010 and 2017. Pts without data on previous cardiovascular history or uncompleted clinical data were excluded. The pts were divided in 3 groups: ischemic etiology (IE), valvular etiology (VE) and other etiologies (OE), which included hypertensive and idiopathic cardiomyopathies). Statistical analysis used non-parametric tests and Kaplan-Meyer survival analysis.
Results
We included 300 pts admitted with AHF. Mean age was 67.4 ± 12.6 years old and 72.7% were male. 37.7% had previous history of revascularization procedures, 66.9% had hypertension, 41% were diabetic and 38% had dyslipidaemia. The heart failure was of IE in 45%, VE in 22.7% and of OE in 32.3% of the cases.
There were no significant differences between groups regarding body mass index, Killip-Kimball class, systolic blood pressure at admission, blood tests aspects at admission (namely, creatinine, sodium or urea), inotropes’ usage or need of non-invasive or invasive ventilation. However, IE group had higher percentage of males comparing to VE e OE (83.0% vs 55.9% vs 70.1%, respectively, p < 0.001), higher rates of prior revascularization procedures (68.9%, vs 19.1%, vs 7.2%, p < 0.001) and higher rates of traditional cardiovascular risk factors, namely hypertension (74.1% vs 55.9% vs 57.7%, p = 0.014), diabetes mellitus (48.1% vs 27.9% vs 27.8%, p = 0.002) and dyslipidaemia (48.9% vs 30.9% vs 40.2%, p = 0.022). OE group was younger compared to IE and VE (63.9 ± 13.5 vs 68.9 ± 11.1 vs 69.5 ± 13.0 years old, respectively, p = 0.003). VE group had less left ventricle disfunction comparing to IE and VE groups (left ventricle ejection fraction 40.8 ± 14.1 vs 32.2 ± 9.8 vs 31.6 ± 12.8%, respectively, p < 0.001).
The groups showed no significant differences regarding IHM (IE 5.2% vs VE 8.8% vs OE 2.1%, p = 0.146), 1mRA (IE 8.1&, VE 7.4%, OE 3.1%, p = 0.276) or 1yRA (IE 55.6%, VE 54.4%, OE 47.4%, p = 0.449). However, VE group had higher rates of 1mM (VE 13.2% vs IE 8.9% vs OE 3.1%, p = 0.05) and 1yM compared to IE and OE (33.8% vs 30.4% vs 17.5%, respectively, p = 0.34). These aspects are represented in Kaplan Meier survival curves.
Conclusion
In our population, the etiology of heart failure was predictor of early and late post-discharge mortality but not readmission.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Paula
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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8
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Santos M, Almeida I, Santos H, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Predictors of early and late re-hospitalization and mortality in non-ST elevation myocardial infarction. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Regarding prognosis, acute coronary syndromes (ACS) are heterogeneous. Non-ST elevation myocardial infarction (NSTEMI) is a subtype of ACS. In-hospital (IH) and post-hospitalization (PH) risk stratification is crucial.
Objective
To identify predictors of IH and PH mortality (early and late), as well as predictors of early and late re-admission (RA) in our center population suffering NSTEMI, using real-life data.
Methods
Based on a single-center retrospective study, data collected from admissions between 1/01/2018 and 11/12/2019. Patients (pts) who survived the ACS and were discharged from the hospital were included. Concerning prognosis, we assessed 1-month M and RA (1mM and 1mRA), 6-month M and RA (6mM and 6mRA), 1-year M and RA (1yM and 1yRA).
Results
268 pts with ACS, 59.7% were males and mean age was 66.4 ± 12.5 years old. NSTEMI was the diagnosis in 66.4% and ST elevation myocardial infarction (STEMI) in 31%. Mean creatinine was 1.2 ± 1ml/min, mean sodium was 138 ± 3mmol/L, mean blood urea nitrogen (BUN) was 21 ± 12mg/dL and mean haemoglobin (Hb) was 13.6 ± 1.9g/dL. 88.2% of the pts presented in Killip-Kimball class (KKC) 1, 5.7% in KKC 2, 5.7% in KKC 3 and 0.4% in KKC IV; furthermore, 4.1% of the pts presented de novo AF. Concerning coronary artery disease, 250 were submitted to coronary angiography – 18.8% had no lesions or non-significant lesions (stenosis <50%), 34.8% had one significant lesion, 23.2% had 2 significant lesions and 23.2% had 3 or more. Regarding left ventricle (LV) function, 70.5% of the pts had no LV dysfunction, 15.7% had mild LV impairment (LVI), 9.3% moderate LVI and 4.5% had severe LVI. 8.4% of the patients experienced IH complications, such as auriculoventricular block, heart failure, ventricular tachycardia, stroke, cardiorespiratory arrest and major haemorrhage, during hospitalization. 1mM rate was 1.9% and 1yM rate was 7.8%.
KKC (p = 0.001), BUN (p = 0.007), LV function (p= 0.001) and de novo AF (p = 0.46) were predictors of 1mM. Age (p = 0.004), KKC (p = 0.031), BUN (p = 0.002), sodium (p = 0.037), creatinine (p = 0.001), Hb (p = 0.003), LV function (p < 0.001), de novo AF (p < 0.001) and occurrence of IH complications (p < 0.001) were predictors of 1yM. Age (p = 0.010), male gender (p = 0.19), Hb (p = 0.031), de novo AF (p < 0.001) and occurrence of IH complications (p = 0.001) were predictors of 1mRA. Age (p = 0.004), smoking (p = 0.040), hypertension (p = 0.040), glycemia at admission (p = 0.031), Hb (p = 0.004), LV function (p = 0.019), de novo AF (p < 0.001) and occurrence of IH complications (p < 0.001) were predictors of 1yRA.
Conclusion
This study suggests that de novo AF and occurrence of IH complications are very important prognosis factors regarding early and late mortality and readmission rates.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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9
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Santos M, Santos H, Almeida I, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Acute Coronary Syndrome - reinfarction predictors and outcomes. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
on behalf of the Investigators of " Portuguese Registry of ACS "
Introduction
Reinfarction (RI) is a potential complication of acute coronary syndromes (ACS) and it is, therefore, important to access its impact on prognosis and identify patients with higher risk of RI in the setting of ACS.
Objective
To evaluate predictors and prognosis of RI in the setting of ACS.
Methods
Based on a multicenter retrospective study, data collected from admissions between 1/10/2010 and 4/09/2019. Patients (pts) without data on previous cardiovascular history or uncompleted clinical data were excluded. Pts were divided in 2 groups (G): GA – pts without RI; GB - pts with RI during hospitalization. Logistic regression and survival analysis were performed.
Results
Between 25718 pts with ACS, RI occurred in 223 (0.87%). Regarding epidemiological factors and past history, GB was older (70 ± 12 vs 67 ± 14, p < 0.001), had higher rates of hypertension (77.4% vs 70.6%, p = 0.028), previous stroke (12.1% vs 7.2%, p = 0.005), peripheric arterial disease (10.0% vs 5.5%, p = 0.004) and chronic obstructive pulmonary disease (8.6% vs 4.4%, p = 0.003). GB had higher rates of non-ST-elevation myocardial infarction (MI) (54.3% vs 45.9%, p = 0.012) and GA had higher rates of ST-elevation MI (42.4% vs 35.9%, p = 0.049). The groups were similar regarding blood pressure (p = 0.285), heart rate (p = 0.796) and Killip-Kimball class at admission, but GB had higher levels of brain natriuretic peptide (392 vs 180, p = 0.005). GB had higher rates of multivessel disease (62.8% vs 51.6%, p = 0.002), left ventricle dysfunction (50.0% vs 39.1%, p = 0.002), higher needs of mechanical ventilation (6.3% and vs 1.9%, p < 0.001) non-invasive ventilation (5.4% vs 1.7%, p < 0.001). Logistic regression confirmed that peripheric arterial disease (p = 0.011, OR 1.93, CI 1.17-3.19), multivessel disease (p = 0.003, OR 1.69, CI 1.20-2.39) and lower left ventricle function (p < 0.001, OR 2.42, CI 1.69-3.47) were predictors of RI in the setting of ACS. Event-free survival was similar between groups (p = 0.399).
Conclusion
RI in the setting of ACS was associated multivessel disease and left ventricle disfunction, however, 1-year prognosis was similar to pts who didn’t suffer RI.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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10
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Santos M, Paula S, Santos H, Almeida I, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Acute heart failure: is ACTION-ICU useful? Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Patients (pts) with acute heart failure (AHF) are a heterogeneous population. Risk stratification at admission may help predict in-hospital complications and needs. ACTION ICU score is validated to estimate the risk of complications requiring ICU care in non-ST elevation acute coronary syndromes.
Objective
To validate ACTION-ICU score in AHF as predictor of in-hospital M (IHM), post discharge early M [1-month mortality (1mM)] and 1-month readmission (1mRA), in our center population, using real-life data.
Methods
Based on a single-center retrospective study, data collected from pts admitted in the Cardiology department with AHF between 2010 and 2017. Pts without data on previous cardiovascular history or uncompleted clinical data were excluded. Statistical analysis used non-parametric tests, logistic regression analysis and ROC curve analysis.
Results
We included 300 pts admitted with AHF. Mean age was 67.4 ± 12.6 years old and 72.7% were male. 37.7% had previous history of revascularization procedures, 66.9% had hypertension, 41% were diabetic and 38% had dyslipidaemia. Mean heart rate was 95.5 ± 27.5bpm, mean systolic blood pressure (SBP) was 131.2 ± 37.0mmHg, mean urea level at admission was 68.8 ± 40.7mg/dL, mean sodium was 137.6 ± 4.7mmol/L, mean glomerular filtration rate (GFR) was 57.1 ± 23.5ml/min. 35.3% were admitted in Killip-Kimball class (KKC) 4. Mean ACTION-ICU score was 10.4 ± 2.3. Inotropes’ usage was necessary in 32.7% of the pts, 11.3% of the pts needed non-invasive ventilation (NIV), 8% needed invasive ventilation (IV). IHM rate was 5% and 1mM was 8%. 6.3% of the pts were readmitted 1 month after discharge.
Older age (p < 0.001), lower SBP (p = 0,035), presenting in KKC 4 (p < 0.001, OR 8.13) and need of inotropes (p < 0.001) were predictors of IHM in our population. Older age (OR 1.06, p = 0.002, CI 1.02-1.10), lower SBP (OR 1.01, p = 0.05, CI 1.00-1.02) and lower left ventricle ejection fraction (LVEF) (OR 1.06, p < 0.001, CI 1.03-1.09) were predictors of need of NIV. None of the studied variables were predictive of need of IV. LVEF (OR 0.924, p < 0.001, CI 0.899-0.949), lower SBP (OR 0.80, p < 0.001, CI 0.971-0.988), higher urea (OR 1.01, p < 0.001, CI 1.005-1.018) and lower sodium (OR 0.92, p = 0.002, CI 0.873-0.971) were predictors inotropes’ usage.
ACTION-ICU was able to predict IHM (OR 1.51, p = 0.02, CI 1.158-1.977), 1mM (OR 1.45, p = 0.002, CI 1.15-1.81) and inotropes’ usage (OR 1.22, p = 0.002, CI 1.08-1.39), but not 1mRA, the need of IV or NIV.
ROC curve analysis revealed ACTION-ICU performs well when predicting IHM (Area under curve (AUC) 0.729, confidence interval (CI) 0.59-0.87), inotropes’ usage (AUC 0.619, CI 0.54-0.70) and 1mM (AUC 0.705, CI 0.58-0.84).
Conclusion
In our population, ACTION-ICU score was able to predict IHM, 1mM and inotropes’s usage.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Paula
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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11
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Santos M, Paula S, Almeida I, Santos H, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Acute heart failure: predicting early in-hospital outcomes. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Patients (P) with acute heart failure (AHF) are a heterogeneous population. Risk stratification at admission may help predict in-hospital complications and needs. The Get With The Guidelines Heart Failure score (GWTG-HF) predicts in-hospital mortality (M) of P admitted with AHF. ACTION ICU score is validated to estimate the risk of complications requiring ICU care in non-ST elevation acute coronary syndromes.
Objective
To validate ACTION-ICU score in AHF and to compare ACTION-ICU to GWTG-HF as predictors of in-hospital M (IHM), early M [1-month mortality (1mM)] and 1-month readmission (1mRA), using real-life data.
Methods
Based on a single-center retrospective study, data collected from P admitted in the Cardiology department with AHF between 2010 and 2017. P without data on previous cardiovascular history or uncompleted clinical data were excluded. Statistical analysis used chi-square, non-parametric tests, logistic regression analysis and ROC curve analysis.
Results
Among the 300 P admitted with AHF included, mean age was 67.4 ± 12.6 years old and 72.7% were male. Systolic blood pressure (SBP) was 131.2 ± 37.0mmHg, glomerular filtration rate (GFR) was 57.1 ± 23.5ml/min. 35.3% were admitted in Killip-Kimball class (KKC) 4. ACTION-ICU score was 10.4 ± 2.3 and GWTG-HF was 41.7 ± 9.6. Inotropes’ usage was necessary in 32.7% of the P, 11.3% of the P needed non-invasive ventilation (NIV), 8% needed invasive ventilation (IV). IHM rate was 5% and 1mM was 8%. 6.3% of the P were readmitted 1 month after discharge.
Older age (p < 0.001), lower SBP (p = 0,035) and need of inotropes (p < 0.001) were predictors of IHM in our population. As expected, patients presenting in KKC 4 had higher IHM (OR 8.13, p < 0.001). Older age (OR 1.06, p = 0.002, CI 1.02-1.10), lower SBP (OR 1.01, p = 0.05, CI 1.00-1.02) and lower left ventricle ejection fraction (LVEF) (OR 1.06, p < 0.001, CI 1.03-1.09) were predictors of need of NIV. None of the variables were predictive of IV. LVEF (OR 0.924, p < 0.001, CI 0.899-0.949), lower SBP (OR 0.80, p < 0.001, CI 0.971-0.988), higher urea (OR 1.01, p < 0.001, CI 1.005-1.018) and lower sodium (OR 0.92, p = 0.002, CI 0.873-0.971) were predictors of inotropes’ usage.
Logistic regression showed that GWTG-HF predicted IHM (OR 1.12, p < 0.001, CI 1.05-1.19), 1mM (OR 1.10, p = 1.10, CI 1.04-1.16) and inotropes’s usage (OR 1.06, p < 0.001, CI 1.03-1.10), however it was not predictive of 1mRA, need of IV or NIV. Similarly, ACTION-ICU predicted IHM (OR 1.51, p = 0.02, CI 1.158-1.977), 1mM (OR 1.45, p = 0.002, CI 1.15-1.81) and inotropes’ usage (OR 1.22, p = 0.002, CI 1.08-1.39), but not 1mRA, the need of IV or NIV. ROC curve analysis revealed that GWTG-HF score performed better than ACTION-ICU regarding IHM (AUC 0.774, CI 0.46-0-90 vs AUC 0.731, CI 0.59-0.88) and 1mM (AUC 0.727, CI 0.60-0.85 vs AUC 0.707, CI 0.58-0.84).
Conclusion
In our population, both scores were able to predict IHM, 1mM and inotropes’s usage.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Paula
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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12
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Santos M, Santos H, Almeida I, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Stroke in acute coronary syndrome: predictors and prognosis. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
on behalf of the Investigators of " Portuguese Registry of ACS "
Introduction
Stroke is a potential complication of acute coronary syndromes (ACS) and it is, therefore, important to access its impact on prognosis and identify patients with higher risk of stroke in the setting of ACS.
Objective
To evaluate predictors and prognosis of stroke in the setting of ACS.
Methods
Based on a multicenter retrospective study, data collected from admissions between 1/10/2010 and 4/09/2019. Patients (pts) without data on previous cardiovascular history or uncompleted clinical data were excluded. Pts were divided in 2 groups (G): GA – pts without stroke; GB - pts with stroke during hospitalization. Logistic regression was performed to assess predictors of stroke in ACS. Survival analysis was evaluated through Kaplan Meier curve.
Results
Population – 25711 pts with ACS, CA occurred in 154 (0.6%). Regarding epidemiological factors and past history, GB was older (72 ± 12 vs 67 ± 14, p < 0.001), had higher rates of females (53.2% vs 27.5%, p < 0.001), diabetes (43.9% vs 31.5%, p < 0.001), previous stroke (13.3% vs 7.2%, p = 0.004), peripheric arterial disease (9.2% vs 5.5%, p = 0.044) and dementia (6.8% vs 1.7%, p < 0.001), and had lower rates of smoking (16.6% vs 26.7%, p = 0.005), dyslipidaemia (53.5% vs 61.6%, p = 0.047) and previous ACS (12.7% vs 20.6%, p = 0.017. GB had longer times from first symptoms to admission (340min vs 240min, p = 0.011). The groups were similar regarding diagnosis, namely non-ST-elevation myocardial infarction (MI) (p = 0.345) and ST-elevation MI (p = 0.541). GB had higher heart rate (HR) (84 ± 24 vs 77 ± 19, p = 0.001), presented more frequently in Killip-Kimball class (KKC) ≥2 (28.0% vs 15.1%, p < 0.001), in atrial fibrillation (AF) (16.4% vs 7.1%, p < 0.001) and with higher brain-natriuretic peptide levels (545 vs 180, p < 0.001). The groups were similar regarding culprit lesion and number of lesions. GB had more left ventricle (<50%) dysfunction (51.4% vs 39.1%, p < 0.001) and needed more frequently mechanical ventilation (10.4% vs 1.9%, p < 0.001) and provisory pacemaker (8.4% vs 1.5%, p < 0.001).
Logistic regression confirmed that older age (p = 0.018, OR 1.69, CI 1.10-2.60), female gender (p < 0.001, OR 2.09, CI 1.38-3.15), diabetes (p = 0.002, OR 1.91, CI 1.27-2.86), dementia (p = 0.047, OR 2.13, CI 1.01-4.50), AF (p = 0.024, OR 1.87, CI 1.09-3.21) and lower left ventricle function (p = 0.002, OR 2.01, CI 1.29-3.15) were predictors of stroke in the setting of ACS. Event-free survival was higher in GA than GB (79.9% vs 70.5%, OR 1.58, p < 0.001, CI 1.36-1.83).
Conclusion
As expected, stroke in the setting of ACS is associated with poorer prognosis. Several characteristics of the pts may help to predict the occurrence of stroke during hospitalizations, therefore allowing an earlier identification and prompt treatment.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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13
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Santos M, Santos H, Almeida I, Miranda H, Sa C, Chin J, Almeida S, Sousa C, Tavares J, Santos L, Almeida ML. Heart failure in Acute Coronary Syndrome: predictors and prognosis. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
on behalf of the Investigators of " Portuguese Registry of ACS "
Introduction
Heart failure (HF) is a frequent complication of acute coronary syndromes (ACS). Therefore, it is important to access its impact on prognosis and identify patients (pts) with higher risk of HF.
Objective
To evaluate predictors and prognosis of HF in the setting of ACS.
Methods
Based on a multicenter retrospective study, data collected from admissions between 1/10/2010 and 4/09/2019. Pts without data on cardiovascular history or uncompleted clinical data were excluded. Pts were divided in 2 groups (G): GA – pts without HF; GB - pts with HF during hospitalization.
Results
HF occurred in 4003 (15.6%) out of 25718 pts with ACS. GB was older (74 ± 12 vs 65 ± 13, p < 0.001), had more females (36.3% vs 26.2%, p < 0.001), had higher rates of arterial hypertension (78.4% vs 69.3%, p < 0.001), dyslipidaemia (64.4% vs 61.1%. p < 0.001), previous ACS (25.6% vs 19.7%, p < 0.001,), previous HF (16.4% vs 4.1%, p < 0.001), previous stroke (11.9% vs 6.4%, p < 0.001), chronic kidney disease (CKD) (17.1% vs 5.5%, p < 0.001), chronic obstructive pulmonary disease (COPD) (7.8% vs 3.8%, p < 0.001) and longer times from first symptoms to admission (268min vs 238min, p < 0.001). GA had higher rate of smokers (28.4% vs 16.2%, p < 0.001) and higher rate of non-ST-elevation myocardial infarction (MI) (46.5% vs 43.0%, p < 0.001). GB had higher rates of ST-elevation MI (STEMI) (49.2% vs 41.1%, p < 0.001), namely anterior STEMI (58.1% vs 44.9%, p < 0.001). GB had lower blood pressure (130 ± 32 vs 140 ± 28, p < 0.001), higher heart rate (86 ± 23 vs 76 ± 18, p < 0.001), Killip-Kimball class (KKC) ≥2 (63.2% vs 6.7%, p < 0.001), atrial fibrillation (AF) (15.4% vs 5.7%, p < 0.001), left bundle branch block (7.5% vs 3.1%, p < 0.001) and were previously treated with diuretics (39.1% vs 22.1%, p < 0.001), amiodarone (2.2% vs 1.4%, p < 0.001) and digoxin (2.8% vs 0.7%, p < 0.001). GB had higher rates of multivessel disease (66.0% vs 49.5%, p < 0.001) and planned coronary artery bypass grafting (7.3% vs 6.0%, p < 0.001), reduced left ventricle function (72.3% vs 33.4%, p < 0.001) and needed more frequently mechanical ventilation (8.2% vs 0.9%, p < 0.001), non-invasive ventilation (8.7% vs 0.5%, p < 0.001) and provisory pacemaker (4.5% vs 1.0%, p < 0.001). Logistic regression confirmed females (p < 0.001, OR 1.42, CI 1.29-1.58), diabetes (p < 0.001, OR 1.43, CI 1.30-1.58), previous ACS (p < 0.001, OR 1.27, CI 1.10-1.47), previous stroke (p < 0.001, OR 1.35, CI 1.16-1.57), CKD (p < 0.001, OR 1.76, CI 1.50-2.05), COPD (p < 0.001, OR 2.15, CI 1.82-2.54), previous usage of amiodarone (p = 0.041, OR 1.35, CI 1.01-1.81) and digoxin (p < 0.001, OR 2.30, CI 1.70-3.16), and multivessel disease (p < 0.001, OR 1.64, CI 1.67-2.32) were predictors of HF in the setting of ACS. Event-free survival was higher in GA than GB (79.5% vs 58.1%, OR 2.3, p < 0.001, CI 2.09-2.56).
Conclusion
As expected, HF in the setting of ACS is associated with poorer prognosis. Several features may help predict the HF occurrence during hospitalizations, allowing an earlier treatment.
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Affiliation(s)
- M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Tavares
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - ML Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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14
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Santos FL, Almeida ML, Albuquerque EL, Macedo-Filho A, Lyra ML, Fulco UL. Critical properties of the SIS model on the clustered homophilic network. Physica A 2020; 559:125067. [PMID: 32834437 PMCID: PMC7427564 DOI: 10.1016/j.physa.2020.125067] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/23/2020] [Indexed: 06/11/2023]
Abstract
The spreading of epidemics in complex networks has been a subject of renewed interest of several scientific branches. In this regard, we have focused our attention on the study of the susceptible-infected-susceptible (SIS) model, within a Monte Carlo numerical simulation approach, representing the spreading of epidemics in a clustered homophilic network. The competition between infection and recovery that drives the system either to an absorbing or to an active phase is analyzed. We estimate the static critical exponents β ∕ ν , 1 ∕ ν and γ ∕ ν , through finite-size scaling (FSS) analysis of the order parameter ρ and its fluctuations, showing that they differ from those associated with the contact process on a scale-free network, as well as those predicted by the heterogeneous mean-field theory.
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Affiliation(s)
- F L Santos
- Departamento de Biofísica e Farmacologia, Universidade Federal do Rio Grande do Norte, 59072-970, Natal-RN, Brazil
| | - M L Almeida
- Departamento de Biofísica e Farmacologia, Universidade Federal do Rio Grande do Norte, 59072-970, Natal-RN, Brazil
| | - E L Albuquerque
- Departamento de Biofísica e Farmacologia, Universidade Federal do Rio Grande do Norte, 59072-970, Natal-RN, Brazil
| | - A Macedo-Filho
- Universidade Estadual do Piauí, 64260-000, Piripiri-PI, Brazil
| | - M L Lyra
- Instituto de Física, Universidade Federal de Alagoas, 57072-900, Maceió-AL, Brazil
| | - U L Fulco
- Departamento de Biofísica e Farmacologia, Universidade Federal do Rio Grande do Norte, 59072-970, Natal-RN, Brazil
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15
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Rodrigues JAL, Stenvold D, Almeida ML, Sobrinho ACS, Rodrigues GS, Júnior CRB. Cardiometabolic risk factors associated with educational level in older people: comparison between Norway and Brazil. J Public Health (Oxf) 2020; 43:867-875. [PMID: 32888032 DOI: 10.1093/pubmed/fdaa144] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/19/2020] [Accepted: 08/03/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The non-communicable diseases are the major causes of death both worldwide and in high-income countries such as Norway. Understanding whether policy programs affect the health of older adults, especially considering different realities, is crucial. We aimed to analyse cardiometabolic risk factors associated with educational level in elderly people from Norway and Brazil. METHODS A total of 555 elderly people recruited from Trondheim, Norway (n = 310, age 70.7 ± 0.8 years, body mass index (BMI) 26.2 ± 3.9 kg/m2) and from Ribeirao Preto, Brazil (n = 245, age 64.1 ± 8.1 years, BMI 28.2 ± 5.5 kg/m2). All analyses were adjusted for age and sex, considering country as an independent variable. The significance level considered was P < 0.05. RESULTS Brazilian people presented a higher incidence of overweight and higher waist circumference (WC) compared to Norwegian (28.2 ± 5.5 kg/m2 and 97.0 ± 14.7 cm versus 26.4 ± 3.9 kg/m2 and 92.1 ± 11.2 cm, respectively). When classified by education level, Brazilians presented higher values for BMI, WC and triglycerides (TG) than Norwegians with the same level of education (incomplete higher education), while Norwegians presented higher values for systolic blood pressure (SBP), cholesterol total (CT), high-density lipoprotein (HDL)-cholesterol, LDL-cholesterol and handgrip strength. CONCLUSIONS Both nationalities presented important cardiometabolic risk factors. However, when considering a low level of education, the Brazilian elderly people presented more cardiometabolic risk factors than Norwegians.
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Affiliation(s)
- J A L Rodrigues
- School of Nursing of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP 14040-907, Brazil
| | - D Stenvold
- K.G. Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim 8905, 7491, Norway
| | - M L Almeida
- School of Nursing of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP 14040-907, Brazil
| | - A C S Sobrinho
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP 14040-907, Brazil
| | - G S Rodrigues
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP 14040-907, Brazil
| | - C R Bueno Júnior
- School of Nursing of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP 14040-907, Brazil.,School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP 14040-907, Brazil
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16
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Affiliation(s)
- M. L. Almeida
- Programa de Engenharia Química, COPPE, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ, Brazil
| | - R. M. Charin
- Programa de Engenharia Química, COPPE, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ, Brazil
| | - M. Nele
- Programa de Engenharia Química, COPPE, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ, Brazil
- Escola de Química, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ, Brazil
| | - F. W. Tavares
- Programa de Engenharia Química, COPPE, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ, Brazil
- Escola de Química, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ, Brazil
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17
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Alves MF, Gonçalves RF, Pavão DL, Almeida ML, Palazzi EG, Souza F, Queiroz RK, D'Angelo M. Effect of Heat Stress in the Maturation, Fertilization, and Development Rates of In Vitro-Fertilized Bovine Embryos. Biol Reprod 2012. [DOI: 10.1093/biolreprod/87.s1.220] [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] [Indexed: 11/14/2022] Open
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18
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Mascarenhas JDP, Leite JPG, Gabbay YB, Almeida ML, Linhares AC. Tetravalent rhesus-human rotavirus vaccine (RRV-TV) in Belém, Brazil: efficacy against prevailing P and G genotypes. J Trop Pediatr 2002; 48:300-2. [PMID: 12405173 DOI: 10.1093/tropej/48.5.300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To determine the efficacy of a reassortant rhesus-human tetravalent rotavirus vaccine (RRV-TV) (4 x 10(4) pfu/dose) against P and G rotavirus genotypes, 90 positive samples were tested using reverse transcription-polymerase chain reaction. The efficacy of the RRV-TV vaccine against P[8] and G1 individually or in binary combination P[8], G1 was 72 per cent (p < 0.005) 61 per cent (p < 0.013), and 70 per cent (p < 0.009), respectively, only for the first year of follow-up. In the second year, as well as after 2 years of follow-up, no efficacy was observed to these genotypes. These data indicate that further studies with rotavirus vaccines should focus on the molecular characterization of rotaviruses genotypes, in order to see whether or not cross-protection among different G and P genotypes may occur as a result of common bearing of VP4 specificities.
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Affiliation(s)
- J D P Mascarenhas
- Instituto Evandro Chagas, Fundação Nacional de Saúde, Belém, Pará, Brazil.
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19
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Catarino LM, Serrano MG, Cavazzana M, Almeida ML, Kaneshina EK, Campaner M, Jankevicius JV, Teixeira MM, Itow-Jankevicius S. Classification of trypanosomatids from fruits and seeds using morphological, biochemical and molecular markers revealed several genera among fruit isolates. FEMS Microbiol Lett 2001; 201:65-72. [PMID: 11445169 DOI: 10.1111/j.1574-6968.2001.tb10734.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Trypanosomatids are widespread in several plant families and although most isolates have been classified as Phytomonas, other trypanosomatid genera can also infect plants. In order to assess the natural occurrence of non-Phytomonas trypanosomatids in plants we characterized 21 new trypanosomatid cultures, 18 from fruits and three from seeds of 17 plant species. The trypanosomatids from fruit and seeds were compared in terms of morphological, growth, biochemical and molecular features. The high diversity among the isolates permitted the classification of the new flagellates into the genera Crithidia and Leptomonas as well as Phytomonas. The data showed that natural fruit infection with non-Phytomonas trypanosomatids is more common than usually thought, being detected in 43% of the fruit isolates.
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Affiliation(s)
- L M Catarino
- Departamento de Microbiologia, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Paraná, Brazil
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20
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Fransson B, Almeida ML, Grehn L, Ragnarsson U. Separation of spermidine derivatives by reversed-phase high-performance liquid chromatography using a UV-absorbing counter ion. J Chromatogr A 1990; 508:229-31. [PMID: 2380315 DOI: 10.1016/s0021-9673(00)91260-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- B Fransson
- Department of Biochemistry, University of Uppsala, Sweden
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21
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de Mendonça JT, Carvalho MR, da Costa RK, Franco Filho E, de Barros ML, Costa GB, Almeida ML, Souza AO. [Endomyocardial fibrosis: surgical treatment]. Arq Bras Cardiol 1989; 52:13-7. [PMID: 2684103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The authors analyse the experience acquired for surgical treatment of endomyocardiofibrosis. Among the 15 patients submitted to the operation, nine had the biventricular form, four had the disease in the right ventricle and two only in the left ventricle. The surgery consisted of endocardioectomy of the ventricles (RV--04,LV--02, bilateral--08) and replacement of the diseased atrioventricular valves (mitral--02, tricuspid--06, mitral and tricuspid--07). In one patient there was severe obstruction of the anterior descending artery and a bypass was done. Three patients had associated rheumatic mitral stenosis. There was one early operative death and three late deaths (respectively 13.34 and 37 months later). Two patients required re-operation. The first one, 33 months later, to replace the mitral valve which had been preserved in the first procedure, and the second, 12 months later, who presented ventricular septal defect secondary to rupture of the weak septum. Of all the patients who underwent surgery, 11 survived and all, except one, have had a good course. The detailed analysis of this series permitted us to conclude that: 1st--the general use of the bidimensional echocardiography in high risk patients, allows early diagnosis in a greater number of them; 2nd, the surgery must be early to avoid cardiac and extracardiac injury due to the disease; 3rd--a low profile valve must be used; 4th--to this moment there have been no signs of recurrence; 5th--surgical treatment appears to improve the course of this terrible disease.
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22
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Abstract
Incubation of neurotensin with rabbit brain cytosol fractions resulted in a rapid loss of carboxy-terminal neurotensin immunoreactivity, whereas the amino-terminal portion of neurotensin was relatively stable to degradation. Neurotensin degradation by rabbit brain cystosol fractions was activated by dithiothreitol and inhibited by thiol blocking reagents, Zn2+, and by monospecific antibodies against endo- oligopeptidases A and B, thus suggesting the possible involvement of these enzymes in neurotensin degradation by rabbit brain. An association of a proportion of endo- oligopeptidase B activity (proline endo-peptidase) with the membrane fraction of nervous tissue was suggested by the presence of proline endopeptidase activity on the membranes and by immunoprecipitation of the solubilized activity using anti-endo- oligopeptidase B antiserum.
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23
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da Cunha JJ, Almeida ML, Coimbra GC, Alves PA. [Epidemiology of periodontal disease in patients of dental clinic (author's transl)]. Rev Bras Odontol 1976; 33:156-9. [PMID: 1077182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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24
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Merzel J, Almeida ML. Maturation of goblet cells of the mouse small intestine as shown by the uptake of 35S-sodium sulfate. Anat Rec (Hoboken) 1973; 177:519-24. [PMID: 4796999 DOI: 10.1002/ar.1091770405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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