Hypertension and Abdominal Aortic Aneurysms: Risk Factors, Diagnosis, and Endovascular Treatment

Introduction: Hypertension is a chronic condition characterized by persistently elevated blood pressure, which significantly contributes to cardiovascular morbidity and mortality. When not properly controlled, it can lead to severe complications, including abdominal aortic aneurysms, a pathological dilation of the arterial wall that may result in rupture and sudden death. The interaction between hypertension and abdominal aortic aneurysms has been extensively studied, highlighting that hypertension is a crucial risk factor for the development and growth of these aneurysms. The therapeutic approach for these patients involves monitoring and treatment strategies, with endovascular treatment emerging as an effective minimally invasive option. Objective: The systematic literature review aimed to assess the risk factors associated with hypertension and abdominal aortic aneurysms, as well as to examine the diagnostic methods and the effectiveness of endovascular treatment for this condition. Methodology: The methodology was based on the PRISMA checklist and included an extensive search in the databases PubMed, Scielo, and Web of Science. The descriptors used were "hypertension," "abdominal aortic aneurysm," "endovascular treatment," "aneurysm diagnosis," and "cardiovascular risk factors" to find relevant articles. Studies published in the last 10 years that addressed clinical, diagnostic, and therapeutic aspects related to the topic were included. The inclusion criteria were: clinical studies, systematic reviews, and randomized controlled trials; publications in peer-reviewed journals; and studies involving adult patients with a diagnosis of hypertension and abdominal aortic aneurysm. The exclusion criteria were: studies that did not specifically address abdominal aortic aneurysms; articles outside the scope of endovascular treatment; and publications older than a decade. Results: The results showed that hypertension is a predominant risk factor for the development and growth of abdominal aortic aneurysms. Early diagnosis through imaging techniques, such as ultrasound and computed tomography, was crucial for managing the condition. Endovascular treatment was highlighted as an effective approach, offering advantages over open surgery, such as shorter recovery time and fewer complications. Studies indicated that regular monitoring and early intervention are essential for reducing mortality associated with abdominal aortic aneurysms. Conclusion: In conclusion, hypertension plays a significant role in the development and progression of abdominal aortic aneurysms. Early diagnosis and the choice of endovascular treatment have been shown to improve clinical outcomes and reduce mortality. Endovascular treatment represents a viable and less invasive alternative compared to traditional surgery, proving to be an important approach in managing patients with abdominal aortic aneurysms associated with hypertension.Introduction: Hypertension is a chronic condition characterized by persistently elevated blood pressure, which significantly contributes to cardiovascular morbidity and mortality. When not properly controlled, it can lead to severe complications, including abdominal aortic aneurysms, a pathological dilation of the arterial wall that may result in rupture and sudden death. The interaction between hypertension and abdominal aortic aneurysms has been extensively studied, highlighting that hypertension is a crucial risk factor for the development and growth of these aneurysms. The therapeutic approach for these patients involves monitoring and treatment strategies, with endovascular treatment emerging as an effective minimally invasive option. Objective: The systematic literature review aimed to assess the risk factors associated with hypertension and abdominal aortic aneurysms, as well as to examine the diagnostic methods and the effectiveness of endovascular treatment for this condition. Methodology: The methodology was based on the PRISMA checklist and included an extensive search in the databases PubMed, Scielo, and Web of Science. The descriptors used were "hypertension," "abdominal aortic aneurysm," "endovascular treatment," "aneurysm diagnosis," and "cardiovascular risk factors" to find relevant articles. Studies published in the last 10 years that addressed clinical, diagnostic, and therapeutic aspects related to the topic were included. The inclusion criteria were: clinical studies, systematic reviews, and randomized controlled trials; publications in peer-reviewed journals; and studies involving adult patients with a diagnosis of hypertension and abdominal aortic aneurysm. The exclusion criteria were: studies that did not specifically address abdominal aortic aneurysms; articles outside the scope of endovascular treatment; and publications older than a decade. Results: The results showed that hypertension is a predominant risk factor for the development and growth of abdominal aortic aneurysms. Early diagnosis through imaging techniques, such as ultrasound and computed tomography, was crucial for managing the condition. Endovascular treatment was highlighted as an effective approach, offering advantages over open surgery, such as shorter recovery time and fewer complications. Studies indicated that regular monitoring and early intervention are essential for reducing mortality associated with abdominal aortic aneurysms. Conclusion: In conclusion, hypertension plays a significant role in the development and progression of abdominal aortic aneurysms. Early diagnosis and the choice of endovascular treatment have been shown to improve clinical outcomes and reduce mortality. Endovascular treatment represents a viable and less invasive alternative compared to traditional surgery, proving to be an important approach in managing patients with abdominal aortic aneurysms associated with hypertension

Uma análise bibliométrica sobre uma nova abordagem: a ecofarmacovigilância

The entry of pharmaceutical into the environment can have numerous ecological consequences. For this reason, a new science proposes to mitigate and manage the possible effects of these substances on the environmental scenario, Ecopharmacovigilance. Considering all the approach around this area, the present article aims to carry out a bibliometric analysis of the literature contemplating this theme. A bibliometric survey was carried out, using only the descriptor “Ecopharmacovigilance”, to verify which research trends in this subject. Four databases were selected, and searches were performed in three languages: Portuguese, English and Spanish. The time window assigned in the present study was 2007-2020. Inclusion and exclusion criteria were designated. After refinement, the content of the articles was analyzed and briefly described. The affiliation of the researchers, typology of articles, year the articles were published, thematic areas, impact factor and number of citations were also verified. Data analysis was performed using Excel software for quantitative analysis and Nvivo for qualitative analysis. 27 articles were identified based on the established criteria. There was an increase in publications between 2015-2019. Most of the articles evaluated were literature review, described in English with predominantly Asian affiliations. The keywords most used in the studies were “Ecopharmacovigilance”, “Environment”, “Pharmaceutical”, “Residues” indicating a link between this new science and the impacts around drugs on the environment. Based on the results obtained, we encourage researchers to dedicate themselves to carrying out studies in this area.La entrada de drogas en el medio ambiente puede tener numerosas consecuencias ecológicas. Por ello, una nueva ciencia propone mitigar y gestionar los posibles efectos de estas sustancias en el escenario ambiental, la Ecofarmacovigilancia. Considerando todo el abordaje en torno a esta área, el presente artículo tiene como objetivo realizar un análisis bibliométrico de la literatura que contempla este tema. Se realizó un levantamiento bibliométrico, utilizando únicamente el descriptor “Ecofarmacovigilancia”, para verificar cuáles son las tendencias de investigación en este tema. Se seleccionaron cuatro bases de datos y se realizaron búsquedas en tres idiomas: portugués, inglés y español. La ventana de tiempo asignada en el presente estudio fue 2007-2020. Se designaron criterios de inclusión y exclusión. Después del refinamiento, se analizó y describió brevemente el contenido de los artículos. También se verificó la afiliación de los investigadores, tipología de artículos, año de publicación de los artículos, áreas temáticas, factor de impacto y número de citaciones. El análisis de datos se realizó utilizando el software Excel para el análisis cuantitativo y Nvivo para el análisis cualitativo. Se identificaron 27 artículos en base a los criterios establecidos. Hubo un aumento en las publicaciones entre 2015-2019. La mayoría de los artículos evaluados fueron revisión de literatura, descritos en inglés con afiliaciones predominantemente asiáticas. Las palabras clave más utilizadas en los estudios fueron “Ecofarmacovigilancia”, “Medio ambiente”, “Farmacéutica”, “Residuos” que indican un vínculo entre esta nueva ciencia y los impactos en torno a las drogas en el medio ambiente. En base a los resultados obtenidos, animamos a los investigadores a dedicarse a realizar estudios en esta área.A entrada de fármacos no ambiente pode ter inúmeras consequências ecológicas. Por esse motivo, uma nova ciência se propõe a mitigar e gerir os possíveis efeitos dessas substâncias no cenário ambiental, a Ecofarmacovigilância. Considerando toda a abordagem em torno dessa área, o presente artigo tem como objetivo realizar uma análise bibliométrica da literatura contemplando essa temática. Foi realizado um levantamento bibliométrico, utilizando somente o descritor “Ecofarmacovigilância”, para verificar quais tendências de pesquisa nesse assunto. Foram selecionados quatro bancos de dados, e as buscas foram realizadas em três idiomas: português, inglês e espanhol. A janela temporal atribuída no presente estudo foi de 2007-2020. Foram designados critérios de inclusão e exclusão. Após o refinamento, os conteúdos dos artigos foram analisados e descritos de forma resumida. Também foi verificado a filiação dos pesquisadores, tipologia dos artigos, ano que os artigos foram publicados, áreas temáticas, fator de impacto e quantidade de citações. A análise de dados foi realizada utilizando o software Excel para análise quantitativa e o Nvivo para análise qualitativa. Foram identificados 27 artigos com base nos critérios estabelecidos. Verificou-se um aumento das publicações entre 2015-2019. A maioria dos artigos avaliados eram de revisão bibliográficas, descritos em inglês com as filiações predominantemente da Ásia. As palavras-chaves mais utilizadas nos estudos foram “Ecopharmacovigilance”, “Environment”, “Pharmaceutical”,“Residues”indicando uma ligação entre essa nova ciência e os impactos em torno de medicamentos no ambiente. Com base nos resultados obtidos encorajamos que pesquisadores se dediquem na realização de estudos nessa área

Systemic Lupus Erythematosus (SLE): Most Common Clinical Manifestations and Renal Complications

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that manifests through a broad spectrum of symptoms, reflecting its complex and systemic nature. Among the most common clinical manifestations of SLE are the articular, cutaneous, and hematological symptoms. Patients often present with arthritis, which can cause joint pain and swelling, cutaneous rashes such as the butterfly-shaped erythema, and hematological alterations, including anemia and leukopenia. These symptoms vary in intensity and can significantly impact quality of life, making the diagnosis and management of the disease challenging.In addition to general clinical manifestations, renal complications play a crucial role in the clinical picture of SLE. Lupus nephritis is a particularly severe renal complication that occurs when the immune system attacks the kidneys, resulting in inflammation and damage. This condition can manifest through symptoms such as proteinuria (presence of proteins in the urine) and hematuria (blood in the urine), signs indicating significant renal involvement. Lupus nephritis not only affects renal function but can also lead to severe complications such as nephrotic syndrome and chronic kidney failure, making early detection and effective treatment essential to prevent disease progression. The interaction between these manifestations and complications makes SLE management complex, requiring careful evaluation and multidisciplinary care to optimize patient outcomes. The diagnosis of lupus nephritis is a critical aspect of managing Systemic Lupus Erythematosus (SLE). Detecting this renal complication involves a series of laboratory and imaging tests. Urinalysis reveals changes such as proteinuria and hematuria, while renal function tests measure the kidneys' ability to filter substances from the blood. Additionally, renal biopsy may be essential for assessing the degree of inflammation and damage in the renal tissues, providing detailed information for more precise treatment. The treatment and management of renal complications in SLE require a careful and integrated approach. Therapeutic strategies often include the use of immunosuppressive medications to reduce immune system activity and corticosteroids to control inflammation. Antiproteinuric agents are also used to minimize protein loss in the urine and protect renal function. The effectiveness of treatment is monitored through regular follow-ups of laboratory and clinical parameters, adjusting therapy as needed to optimize results. The impact of renal complications on the prognosis of SLE is significant. The presence of lupus nephritis can exacerbate the clinical picture and lead to severe consequences, such as chronic kidney failure, which requires advanced treatments like dialysis. Early detection and appropriate management of these complications are crucial for improving overall prognosis and quality of life. Ongoing monitoring and timely intervention are essential to prevent disease progression and reduce associated morbidity.Introdução: O Lúpus Eritematoso Sistêmico (LES) é uma doença autoimune crônica que afeta múltiplos sistemas orgânicos, apresentando um amplo espectro de manifestações clínicas. Essa patologia é caracterizada pela produção anômala de anticorpos que atacam tecidos e órgãos, levando a inflamações e danos generalizados. As manifestações clínicas do LES são variadas, incluindo sintomas articulares, dermatológicos, hematológicos e neurológicos. Entre as complicações mais graves estão as renais, que podem se manifestar como nefrite lúpica, resultando em comprometimento renal significativo e potencialmente fatal. Objetivo: A revisão sistemática de literatura teve como propósito analisar as manifestações clínicas mais comuns do LES, com foco específico nas complicações renais associadas à doença. Metodologia: Para a realização da revisão, utilizou-se o checklist PRISMA para garantir a transparência e a qualidade da pesquisa. Foram consultadas as bases de dados PubMed, Scielo e Web of Science, empregando cinco descritores principais: "Lúpus Eritematoso Sistêmico", "manifestações clínicas", "nefrite lúpica", "complicações renais", e "diagnóstico". Os critérios de inclusão abrangeram artigos revisados por pares publicados nos últimos 10 anos, que abordassem manifestações clínicas e complicações renais do LES, e que estivessem disponíveis em inglês, português ou espanhol. Foram excluídos artigos que não apresentavam dados específicos sobre complicações renais, estudos não originais, e artigos cujo foco principal não fosse a doença em questão. Resultados: A revisão revelou que as manifestações clínicas mais frequentes do LES incluem artrite, erupções cutâneas, e distúrbios hematológicos como leucopenia e anemia. As complicações renais, notadamente a nefrite lúpica, foram identificadas como uma das manifestações mais graves e prevalentes, com sintomas como proteinúria, hematuria, e insuficiência renal. A nefrite lúpica pode evoluir para formas graves, incluindo a síndrome nefrótica e a insuficiência renal crônica, exigindo intervenção médica intensiva para manejo adequado. Conclusão: A análise das literaturas destacou que o LES apresenta uma ampla gama de manifestações clínicas, com complicações renais sendo particularmente críticas. A identificação precoce e o tratamento eficaz da nefrite lúpica são essenciais para melhorar o prognóstico e reduzir a morbidade associada a esta condição. As estratégias de manejo devem focar na monitorização rigorosa das funções renais e na intervenção precoce para prevenir danos renais irreversíveis

Towards Malaria Elimination: A Nationwide Case-Control Study to Assess Risk Factors for Severe Malaria-Related Deaths in Brazil.

OBJECTIVE: The objective of this study is to describe malaria-related deaths and assess their risk factors. METHODS: This is a case-control study using data from Brazil's Ministry of Health (2011-2020) on malaria-related deaths (ICD-10: B50-B54). A probabilistic record linkage was performed to match epidemiological data (Sivep-Malaria and Sinan) with death records from the Mortality Information System (SIM). Cases were defined as individuals who died of malaria, and controls were malaria cases that did not result in death. Logistic regression models were used to identify the factors associated with malaria mortality. RESULTS: A total of 632 malaria-related deaths were recorded, with 454 (71.8%) occurring in the Amazon region and 178 (28.1%) outside it. Risk factors in the Amazon included age ( 60 years; p ≤ 0.01), delayed treatment (> 48 h; p < 0.001), illiteracy (p = 0.01), and living in indigenous population villages (p < 0.001), while active case detection was protective (p = 0.01). In the Extra-Amazon, risk factors included delayed treatment (p = 0.049), P. falciparum or mixed infections (p < 0.049), foreign-acquired infections (p = 0.01), and higher education level (p = 0.03)-which is a proxy for increased income and travel frequency, which may increase the likelihood of exposure in endemic areas and delayed diagnosis upon return. CONCLUSION: This nationwide record-linkage study shows that malaria deaths remain concentrated in socially vulnerable groups: infants, older adults, and especially indigenous populations living in the Amazon. Delayed treatment is also a determinant for deaths, in both endemic and non-endemic regions, while active case detection markedly reduces the odds of death. To reach Brazil's zero-malaria-death target by 2030, it is needed to improve timely diagnosis and treatment, to enhance epidemiological information systems along with active surveillance amplification in remote communities. Finally, integrating national health-information systems allows real-time monitoring, and with coordinated action, eliminating malaria deaths remains achievable

PROCESSO SUCESSÓRIO E MUDANÇAS ORGANIZACIONAIS: UM ESTUDO DE CASO EM UMA PANIFICADORA.

A sucessão é um processo muito importante para as empresas familiares, uma vez que grande parte da mortalidade deste tipo de empresa ocorre no momento de um processo sucessório. Este trabalho tem por objetivo analisar como ocorre o processo sucessório em uma empresa familiar no ramo de panificação. Os procedimentos metodológicos partem de um estudo de caso de um processo sucessório que começou em 2010. Tratando-se de uma análise qualitativa, descreveu-se a empresa, utilizou-se como instrumento de coleta de dados a entrevista. As categorias pesquisadas para a coleta de dados foram: empresa familiar e processo de sucessão. Os resultados mostram que não houve preparação antes da sucessão, esse processo deu-se de forma natural, pois o atual gestor foi criado dentro da empresa e dentre os vários irmãos foi o que mais se destacou por sempre acompanhar o sucedido nos negócio

VARIÁVEIS SOCIODEMOGRÁFICAS E ANTROPOMÉTRICAS SÃO EFICAZES PARA RASTREAR SARCOPENIAS PROVÁVEL E CONFIRMADA EM IDOSOS COMUNITÁRIOS?

INTRODUÇÃO: Utilizar indicadores sociodemográficos e antropométricos pode ser uma estratégia prática, barata e eficaz para rastrear precocemente idosos com sarcopenia. OBJETIVO: Identificar pontos de corte em variáveis sociodemográficas e antropométricas para rastreio das sarcopenias provável e confirmada em idosos comunitários. MÉTODOS: Estudo transversal com 308 idosos de ambos os sexos. Consideraram-se como fatores preditores as variáveis sociodemográficas (idade, escolaridade) e antropométricas [peso, estatura, índice de massa corporal (IMC), circunferências da cintura (CC) e da panturrilha dominante (CPD)]. Os desfechos foram as sarcopenias provável [avaliada por tempo ≥15 segundos no teste de sentar e levantar da cadeira de 5 repetições (TSLC5rep)] e confirmada (avaliada pelo TSLC5rep e equação de Lee). Para análise da capacidade de rastreio das variáveis sociodemográficas e antropométricas para as sarcopenias foram utilizadas análise de curva Receiver Operating Characteristic (ROC). RESULTADOS: Para rastreio da sarcopenia provável em idosas pode ser utilizada valores &gt;91 cm na CC (AUC:0,61 IC95%:0,53;0,69), em idosos a idade superior a 69 anos parece ser mais indicada (AUC:0,62 IC95%:0,52;0,70). Para rastreio da sarcopenia confirmada, as variáveis ​​idade (&gt;76 anos e &gt;73 anos), peso (≤58 cm e ≤71 cm), IMC (≤27,66 Kg/m2 e ≤24,45 Kg/m2), CC (≤92 cm e ≤98 cm) e CPD (≤35 cm e ≤34 cm) (AUC &gt;0,70 para todas as variáveis) podem ser utilizadas em mulheres e homens, respectivamente. CONCLUSÃO: Variáveis ​​sociodemográficas e antropométricas são ferramentas simples e acessíveis para o rastreamento da sarcopenia em idosos.</jats:p

Contexto fisiopatológico da doença mineral óssea na doença renal crônica

Objetivo: Apresentar a doença mineral óssea (DMO) e a importância do seu diagnóstico para a estruturação de um melhor manejo do paciente nefrológico. Revisão bibliográfica: Estima-se que 10 milhões de pessoas tenham doença renal crônica (DRC) no Brasil. Nesse contexto, a perda da função renal associada ao aumento de fosfato sérico, à diminuição sistêmica de cálcio e de calcitriol levam a um estímulo potente para o desenvolvimento de um quadro de hiperparatireoidismo secundário (HPTS) que resulta em acometimentos sistêmicos. O diagnóstico de DMO-DRC é baseado na análise laboratoriais de cálcio, fosfato, paratormônio (PTH) e vitamina D. A intervenção na DMO-DRC em pacientes com DRC nos estágios de 3 a 5 deve incluir os pontos de melhora da deficiência de vitamina D e a regulação dos valores de fósforo, cálcio e PTH. Considerações finais: Dado o aumento do número de pacientes com DRC em âmbito nacional, e as constantes modificações das diretrizes clínicas, torna-se importante a atualização do saber médico em relação a tal condição clínica a fim de garantir uma melhor conduta aos pacientes com acometimentos renais.</jats:p

Inflammatory biomarkers of osteosarcopenia in community-dwelling older woman

Summary: Background: The concomitant loss of lean muscle mass and bone mineral density is known as osteosarcopenia. This disorder can result in increased physical impairment in addition to an increased risk of falls and fractures. Although the diagnostic of osteoporosis and sarcopenia has been described, the inflammatory mediators that identify the presence of osteosarcopenia and propose possible inflammatory mechanisms implicated in muscle and bone loss are unknown. The objective of this study was to evaluate a panel of inflammatory biomarkers and investigate its relationship with the presence of osteosarcopenia. Methods: Body composition was assessed using Dual X-ray absorptiometry and handgrip strength using a Jamar dynamometer. Blood samples were collected for evaluation the plasmatic concentrations of adiponectin, brain-derived neurotrophic factor (BDNF), interferon ɣ (IFN), interleukins 2, 4, 5, 6, 8 and 10, leptin, resistin, tumour necrosis factor (TNF) and its soluble receptors (sTNFr) 1 and 2. Results: In seventy-one older women the age was 75 (±7) years, BMI 26.1 (±4.5) kg/m2, handgrip strength 19 (±6) kgf and the muscle mass index was 6.39 (±1.05) kg/m2. The diagnosis of osteosarcopenia was found in 25% of the sample. Analysis of the distribution of biomarkers demonstrate the osteosarcopenia group presented greater concentrations among all markers measured, and significant differences was found in plasmatic concentrations of interleukin 8 (p = 0.02). Subgroup analysis showed that group with osteopenia plus sarcopenia had significantly greater IL-6 (p = 0.03) and IL-8 (p = 0.007) concentrations. Conclusions: In a panel of biomarkers, IL-6 and IL-8 were found to be related with diagnosis of osteosarcopenia in community-dwelling older women. These results may contribute to understand the inflammatory mechanisms and suggest a diagnostic strategy for these patients, also informing new strategies for prevention, monitoring, and treatment of osteosarcopenia