Prevalência do Diagnóstico de DPOC em Pacientes internados com Cardiopatia Isquêmica em um Hospital Universitário no interior do Estado do Rio Grande do Sul

Background and objectives: the Chronic Obstructive Pulmonary Disease (COPD) appears as a public health problem and has received increasing attention in recent years. We sought to evaluate the proportion of patients who were hospitalized for ischemic heart disease (IHD), had a history of exposure to risk factors and / or had been diagnosed with COPD. Methods: Cross-sectional, observational study prospectively. We selected all patients over 40 years admitted from September 2014 to June 2015, with the diagnosis of IC. Data were analyzed using SPSS 22.0 program. Results: The study included 69 patients who were hospitalized with a diagnosis of IC in the years 2014 and 2015. The average age of patients was 65 years and of these, 35 (50.7%) were male. The mean duration of hospitalization of these patients was 3 days. Patients who were diagnosed with COPD and were treated were six (8.69%), and those who had undergone previous spirometry totaled 5 (7.24%). As for respiratory symptoms in patients with IC, 25 patients (64.1%) had cough, sputum or dyspnea. There was a 8.7% of patients reported have been previously diagnosed with COPD. Conclusions: Despite the high prevalence of respiratory symptoms and exposure to risk factors, patients with COPD have more events and increased mortality from ischemic heart disease, our study suggests that there is a high percentage of underdiagnosis of COPD patients hospitalized for ischemic heart disease in our midst. KEYWORDS: Pulmonary Disease, Chronic Obstructive. Myocardial Ischemia. Risk Factors.Antecedentes y objetivos: La Enfermedad Pulmonar Obstructiva Crónica (EPOC) constituye un problema de salud pública y ha recibido creciente atención en los últimos años. Se buscó evaluar cuál era la proporción de pacientes hospitalizados por cardiopatía isquémica (CI) que contaba con historia de exposición a factores de riesgo y/o habían sido diagnosticados con EPOC. Métodos: Estudio transversal, observacional, del tipo prospectivo. Se seleccionaron todos los pacientes mayores de 18 años, lúcidos, que aceptaran participar del estudio, ingresados desde septiembre 2014 a junio 2015 con diagnóstico de CI. Datos analizados mediante programa SPSS 22.0. Resultados: Fueron incluidos 69 pacientes hospitalizados con diagnóstico de CI en 2014 y 2015. La media etaria fue de 65 años; de estos, 35 (50,7%) eran de sexo masculino. El promedio de duración de la internación de los pacientes fue de 3 días. Los pacientes con diagnóstico de EPOC que estaban en tratamiento fueron 6 (8,69%), y los que habían realizado espirometría anterior totalizaron 5 (7,24%). En cuanto a los síntomas respiratorios en pacientes con CI, 25 pacientes (64,1%) tenían tos, expectoración o disnea. Hubo reporte de que el 8,7% de los pacientes ya había sido diagnosticado previamente con EPOC. Conclusiones: A pesar de que la alta prevalencia de síntomas respiratorios y exposición a factores de riesgo hace que los pacientes con EPOC sufran mayor número de eventos y mayor mortalidad por cardiopatía isquémica, nuestro estudio sugiere que existe un alto porcentaje de subdiagnóstico de EPOC en pacientes internados por cardiopatía isquémica en nuestro medio. Palabras clave: Enfermedad pulmonar obstructiva crónica. La cardiopatía isquémica. Factores de riesgo.Justificativa e objetivos: A Doença Pulmonar Obstrutiva Crônica (DPOC) é um problema de saúde pública e tem recebido crescente atenção nos últimos anos. Buscouse avaliar qual a proporção dos pacientes que internaram por cardiopatia isquêmica (CI) tinham história de exposição a fatores de risco e/ou haviam sido diagnosticados como portadores de DPOC. Métodos: estudo transversal, observacional, do tipo prospectivo. Foram selecionados todos os pacientes, acima de 18 anos, lúcidos e que concordaram em participar do estudo, internados no período de setembro de 2014 a junho de 2015, com o diagnóstico de CI. Os dados analisados foram analisados no programa SPSS 22.0. Resultados: foram incluídos 69 pacientes que internaram com diagnóstico de CI nos anos de 2014 e 2015. A média de idade dos pacientes foi de 65 anos e destes, 35 (50,7%) eram do sexo masculino. A média da duração de internação desses pacientes foi de 3 dias. Os pacientes que apresentavam diagnóstico de DPOC e estavam em tratamento eram 6 (8,69%), e os que haviam realizado espirometria prévia totalizavam 5 (7,24%). Quanto às manifestações respiratórias nos pacientes com CI, 25 pacientes (64,1%) apresentavam tosse, expectoração ou dispneia. Houve um relato de 8,7% dos pacientes já terem sido diagnosticados previamente como portadores de DPOC. Conclusões: Apesar da alta prevalência de sintomas respiratórios e exposição a fatores de risco, pacientes com DPOC tem maior número de eventos e maior mortalidade por cardiopatia isquêmica, nosso estudo sugere que existe uma alta porcentagem de subdiagnóstico de DPOC em pacientes internados por cardiopatia isquêmica em nosso meio.portadores de DPOC. Conclusões: Apesar da alta prevalência de sintomas respiratórios e exposição a fatores de risco, pacientes com DPOC tem maior número de eventos e maior mortalidade por cardiopatia isquêmica, nosso estudo sugere que existe uma alta porcentagem de subdiagnóstico de DPOC em pacientes internados por cardiopatia isquêmica em nosso meio. DESCRITORES: Doença Pulmonar Obstrutiva Crônica. Cardiopatia Isquêmica. Fatores de risco

Mycobacterium tuberculosis causing tuberculous lymphadenitis in Maputo, Mozambique

BACKGROUND: The zoonosis bovine tuberculosis (TB) is known to be responsible for a considerable proportion of extrapulmonary TB. In Mozambique, bovine TB is a recognised problem in cattle, but little has been done to evaluate how Mycobacterium bovis has contributed to human TB. We here explore the public health risk for bovine TB in Maputo, by characterizing the isolates from tuberculous lymphadenitis (TBLN) cases, a common manifestation of bovine TB in humans, in the Pathology Service of Maputo Central Hospital, in Mozambique, during one year. RESULTS: Among 110 patients suspected of having TBLN, 49 had a positive culture result. Of those, 48 (98 %) were positive for Mycobacterium tuberculosis complex and one for nontuberculous mycobacteria. Of the 45 isolates analysed by spoligotyping and Mycobacterial Interspersed Repetitive Unit - Variable Number Tandem Repeat (MIRU-VNTR), all were M. tuberculosis. No M. bovis was found. Cervical TBLN, corresponding to 39 (86.7 %) cases, was the main cause of TBLN and 66.7 % of those where from HIV positive patients. We found that TBLN in Maputo was caused by a variety of M. tuberculosis strains. The most prevalent lineage was the EAI (n?=?19; 43.2 %). Particular common spoligotypes were SIT 48 (EAI1_SOM sublineage), SIT 42 (LAM 9), SIT 1 (Beijing) and SIT53 (T1), similar to findings among pulmonary cases. CONCLUSIONS: M. tuberculosis was the main etiological agent of TBLN in Maputo. M. tuberculosis genotypes were similar to the ones causing pulmonary TB, suggesting that in Maputo, cases of TBLN arise from the same source as pulmonary TB, rather than from an external zoonotic source. Further research is needed on other forms of extrapulmonary TB and in rural areas where there is high prevalence of bovine TB in cattle, to evaluate the risk of transmission of M. bovis from cattle to humans.Swedish International Development Cooperation Agency / Department for Research Cooperation (Sida/SAREC) through Eduardo Mondlane University and Karolinska Institutet Research and Training (KIRT) collaboratio

Lineage Analysis of Circulating Trypanosoma cruzi Parasites and Their Association with Clinical Forms of Chagas Disease in Bolivia

Around 30–50% of Trypanosoma cruzi infections in Latin America cause chronic Chagas disease 10–30 years after the primary infection due to lack of effective treatment. The major clinical complications associated with chronic Chagas disease are cardiac myositis (leading to cardiac failure), and autonomous neuroplexus degeneration of the digestive tract that can cause megacolon or megaesophagus. Therefore, there are three major clinical forms of Chagas disease; cardiac, digestive and indeterminate (asymptomatic). The parasites, which can infect humans as well as other mammals, are transmitted by species of triatomines commonly found in the Americas. The parasite is divided in at least six discrete typing units: TcI, TcIIa–e. In humans, the TcI is mainly observed in Central America and northern parts of South America while the TcIIb/d/e is confined mainly to the southern cone of Latin America. We determined which DTU were prevalent in chronic patients in Bolivia, where the three clinical forms and several DTUs of the parasites are present, in order to determine whether there was a link between a particular parasite DTU and a particular clinical outcome. We found a vast majority of TcIId but its kDNA polymorphism showed no association with any of the clinical manifestations of chronic Chagas

A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EURO bservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry

Aims: Given the advances in atrial fibrillation (AF) management and the availability of new European Society of Cardiology (ESC) guidelines, there is a need for the systematic collection of contemporary data regarding the management and treatment of AF in ESC member countries. Methods and results: We conducted a registry of consecutive in- and outpatients with AF presenting to cardiologists in nine participating ESC countries. All patients with an ECG-documented diagnosis of AF confirmed in the year prior to enrolment were eligible. We enroled a total of 3119 patients from February 2012 to March 2013, with full data on clinical subtype available for 3049 patients (40.4% female; mean age 68.8 years). Common comorbidities were hypertension, coronary disease, and heart failure. Lone AF was present in only 3.9% (122 patients). Asymptomatic AF was common, particularly among those with permanent AF. Amiodarone was the most common antiarrhythmic agent used (~20%), while beta-blockers and digoxin were the most used rate control drugs. Oral anticoagulants (OACs) were used in 80% overall, most often vitamin K antagonists (71.6%), with novel OACs being used in 8.4%. Other antithrombotics (mostly antiplatelet therapy, especially aspirin) were still used in one-third of the patients, and no antithrombotic treatment in only 4.8%. Oral anticoagulants were used in 56.4% of CHA 2DS2-VASc = 0, with 26.3% having no antithrombotic therapy. A high HAS-BLED score was not used to exclude OAC use, but there was a trend towards more aspirin use in the presence of a high HAS-BLED score. Conclusion: The EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot Registry has provided systematic collection of contemporary data regarding the management and treatment of AF by cardiologists in ESC member countries. Oral anticoagulant use has increased, but novel OAC use was still low. Compliance with the treatment guidelines for patients with the lowest and higher stroke risk scores remains suboptimal. © The Author 2013

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Elliptic flow of electrons from heavy-flavour hadron decays at mid-rapidity in Pb-Pb collisions at root s(NN)=2.76 TeV

The elliptic flow of electrons from heavy-flavour hadron decays at mid-rapidity (|y| <0.7) is measured in Pb-Pb collisions at TeV with ALICE at the LHC. The particle azimuthal distribution with respect to the reaction plane can be parametrized with a Fourier expansion, where the second coefficient (v (2)) represents the elliptic flow. The v (2) coefficient of inclusive electrons is measured in three centrality classes (0-10%, 10-20% and 20-40%) with the event plane and the scalar product methods in the transverse momentum (p (T)) intervals 0.5-13 GeV/c and 0.5-8 GeV/c, respectively. After subtracting the background, mainly from photon conversions and Dalitz decays of neutral mesons, a positive v (2) of electrons from heavy-flavour hadron decays is observed in all centrality classes, with a maximum significance of 5.9 sigma in the interval 2 <p (T) <2.5 GeV/c in semi-central collisions (20-40%). The value of v (2) decreases towards more central collisions at low and intermediate p (T) (0.5 <p (T) <3 GeV/c). The v (2) of electrons from heavy-flavour hadron decays at mid-rapidity is found to be similar to the one of muons from heavy-flavour hadron decays at forward rapidity (2.5 <y <4). The results are described within uncertainties by model calculations including substantial elastic interactions of heavy quarks with an expanding strongly-interacting medium.Peer reviewe

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Forward-central two-particle correlations in p-Pb collisions at root s(NN)=5.02 TeV

Two-particle angular correlations between trigger particles in the forward pseudorapidity range (2.5 2GeV/c. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B. V.Peer reviewe

Event-shape engineering for inclusive spectra and elliptic flow in Pb-Pb collisions at root(NN)-N-S=2.76 TeV

Peer reviewe

Centrality dependence of charged jet production in p–Pb collisions at √sNN = 5.02 TeV

Peer reviewe