Evaluation of Tpeak–Tend and QT intervals in Chagas’ Disease, Chronic Phase and Normal Electrocardiogram

Introduction: Chagas’ disease lacks elements to predict which carriers will evolve into cardiac form and which will remain in undetermined form. Objective: To evaluate the relationship between electrocardiographic evolution and Tpeak–Tend and QT intervals, both corrected for heart rate, in chagasic patients with normal initial electrocardiogram. Method: Chagasic patients admitted to the institution until 2002 were retrospectively evaluated, and the electrocardiogram was normal at the first consultation. The Tpeak–Tend and QT intervals were measured in milliseconds at the V2 and V5 derivations, with the mean values corrected for heart rate (Bazett). The relationship of these values with the electrocardiographic evolution of the individuals was analyzed, considering the gender, time of evolution and whether they received benznidazole or not. Results: The corrected Tpeak–Tend interval showed no statistical significance among those who maintained or not normal electrocardiogram. The corrected QT interval, the treatment with benznidazole and the time of evolution showed significance for the maintenance of normal electrocardiogram. In the multivariate evaluation, treatment with benznidazole, the QTc interval and the time of evolution were independent variables for the maintenance of normal electrocardiogram. Conclusion: The Tpeak–Tend interval showed no predictor of electrocardiographic evolution. The increased QT interval favored changes

Influência das Drogas Antiarrítmicas nos Limiares de Desfibrilaçao em Pacientes Portadores de Cardioversor-Desfibrilador Implantável

Atualmente os cardioversores-desfibriladores implantáveis, em funçao de sua eficácia e segurança, tornaram-se a primeira opçao de tratamento na profilaxia secundária de morte súbita e, em algumas situaçoes, na profilaxia primária. No entanto, o emprego desta prótese comumente está associado ao uso de drogas antiarrítmicas em pacientes de alto risco para morte súbita. Os antiarrítmicos freqüentemente sao julgados como responsáveis por alteraçoes dos limiares de desfibrilaçao ventricular, especialmente a amiodarona. Portanto um conhecimento básico sobre a interaçao entre estas drogas e limiares de desfibrilaçao é fundamental, no momento da seleçao de um determinado agente

Influência das Drogas Antiarrítmicas nos Limiares de Desfibrilaçao em Pacientes Portadores de Cardioversor-Desfibrilador Implantável

Atualmente os cardioversores-desfibriladores implantáveis, em funçao de sua eficácia e segurança, tornaram-se a primeira opçao de tratamento na profilaxia secundária de morte súbita e, em algumas situaçoes, na profilaxia primária. No entanto, o emprego desta prótese comumente está associado ao uso de drogas antiarrítmicas em pacientes de alto risco para morte súbita. Os antiarrítmicos freqüentemente sao julgados como responsáveis por alteraçoes dos limiares de desfibrilaçao ventricular, especialmente a amiodarona. Portanto um conhecimento básico sobre a interaçao entre estas drogas e limiares de desfibrilaçao é fundamental, no momento da seleçao de um determinado agente

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Usefulness of PCR-based assays to assess drug efficacy in Chagas disease chemotherapy: value and limitations

One major goal of research on Chagas disease is the development of effective chemotherapy to eliminate the infection from individuals who have not yet developed cardiac and/or digestive disease manifestations. Cure evaluation is the more complex aspect of its treatment, often leading to diverse and controversial results. The absence of reliable methods or a diagnostic gold standard to assess etiologic treatment efficacy still constitutes a major challenge. In an effort to develop more sensitive tools, polymerase chain reaction (PCR)-based assays were introduced to detect low amounts of Trypanosoma cruzi DNA in blood samples from chagasic patients, thus improving the diagnosis and follow-up evaluation after chemotherapy. In this article, I review the main problems concerning drug efficacy and criteria used for cure estimation in treated chagasic patients, and the work conducted by different groups on developing PCR methodologies to monitor treatment outcome of congenital infections as well as recent and late chronic T. cruzi infections