Score for atrial fibrillation detection in acute stroke and transient ischemic attack patients in a Brazilian population: The acute stroke atrial fibrillation scoring system

OBJECTIVE: Atrial fibrillation is a common arrhythmia that increases the risk of stroke by four- to five-fold. We aimed to establish a profile of patients with atrial fibrillation from a population of patients admitted with acute ischemic stroke or transient ischemic attack using clinical and echocardiographic findings.METHODS: We evaluated patients consecutively admitted to a tertiary hospital with acute ischemic stroke or transient ischemic attack. Subjects were divided into an original set (admissions from May 2009 to October 2010) and a validation set (admissions from November 2010 to April 2013). The study was designed as a cohort, with clinical and echocardiographic findings compared between patients with and without atrial fibrillation. A multivariable model was built, and independent predictive factors were used to produce a predictive grading score for atrial fibrillation (Acute Stroke AF Score-ASAS).RESULTS: A total of 257 patients were evaluated from May 2009 to October 2010 and included in the original set. Atrial fibrillation was diagnosed in 17.5% of these patients. Significant predictors of atrial fibrillation in the multivariate analysis included age, National Institutes of Health Stroke Scores, and the presence of left atrial enlargement. These predictors were used in the final logistic model. For this model, the area under the receiver operating characteristic curve was 0.79. The score derived from the logistic regression analysis waThe model developed from the original data set was then applied to the validation data set, showing the preserved discriminatory ability of the model (c statistic = 0.76).CONCLUSIONS: Our risk score suggests that the individual risk for atrial fibrillation in patients with acute ischemic stroke can be assessed using simple data, including age, National Institutes of Health Stroke Scores at admission, and the presence of left atrial enlargement.Universidade Federal de São Paulo (UNIFESP) Departamento de Neurologia e NeurocirurgiaHospital Israelita Albert Einstein Setor de EcocardiografiaHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Instituto de Radiologia Setor de EcocardiografiaHospital Israelita Albert Einstein Programa Integrado de NeurologiaUNIFESP, Depto. de Neurologia e NeurocirurgiaSciEL

Score for atrial fibrillation detection in acute stroke and transient ischemic attack patients in a Brazilian population: The acute stroke atrial fibrillation scoring system

OBJECTIVE: Atrial fibrillation is a common arrhythmia that increases the risk of stroke by four- to five-fold. We aimed to establish a profile of patients with atrial fibrillation from a population of patients admitted with acute ischemic stroke or transient ischemic attack using clinical and echocardiographic findings. METHODS: We evaluated patients consecutively admitted to a tertiary hospital with acute ischemic stroke or transient ischemic attack. Subjects were divided into an original set (admissions from May 2009 to October 2010) and a validation set (admissions from November 2010 to April 2013). The study was designed as a cohort, with clinical and echocardiographic findings compared between patients with and without atrial fibrillation. A multivariable model was built, and independent predictive factors were used to produce a predictive grading score for atrial fibrillation (Acute Stroke AF Score-ASAS). RESULTS: A total of 257 patients were evaluated from May 2009 to October 2010 and included in the original set. Atrial fibrillation was diagnosed in 17.5% of these patients. Significant predictors of atrial fibrillation in the multivariate analysis included age, National Institutes of Health Stroke Scores, and the presence of left atrial enlargement. These predictors were used in the final logistic model. For this model, the area under the receiver operating characteristic curve was 0.79. The score derived from the logistic regression analysis was The model developed from the original data set was then applied to the validation data set, showing the preserved discriminatory ability of the model (c statistic = 0.76). CONCLUSIONS: Our risk score suggests that the individual risk for atrial fibrillation in patients with acute ischemic stroke can be assessed using simple data, including age, National Institutes of Health Stroke Scores at admission, and the presence of left atrial enlargement

Prevenção na escola: IMAMA e NUDEC no IFRS Bento Gonçalves

Trabalho apresentado no 31º SEURS - Seminário de Extensão Universitária da Região Sul, realizado em Florianópolis, SC, no período de 04 a 07 de agosto de 2013 - Universidade Federal de Santa Catarina.Com o intuito de conscientizar a comunidade a importância sobre cuidados com a saúde em geral, o grupo enfoca os temas: câncer de mama, por ser altamente incidente na nossa região e associado a altas taxas de mortalidade; doenças sexualmente transmissíveis e gravidez na adolescência; a importância dos adolescentes se tornarem doadores; fatores que levam ao tabagismo na adolescência e suas consequências. Uma equipe formada por servidores e alunos do IFRS-BG desenvolve um programa de conscientização dentro da escola, estendendo-se a outras escolas e comunidades adjacentes. O grupo utiliza uma metodologia própria, como oficinas de conscientização, apresentação de peças teatrais e o uso de recursos didáticos confeccionados de forma artesanal pela equipe. Atentando a inovação e sustentabilidade aproveitam-se sobras de material para a confecção do chaveiro do IMAMA e de bolsas confeccionadas com banners descartados, levando mensagens dos temas acima citados e da importância de ações conscientes. A fisiologia da mama é explicada mostrando-se a mama táctil, também confeccionada pelo grupo e com identificações em Braille, oportunizando-se assim também a compreensão das pessoas com deficiência visual. Pequenas peças teatrais com temas relacionados a sexualidade, a gravidez na adolescência, ao câncer de mama são apresentadas com o intuito de provocar uma interação com o público. E a partir disto, propicia-se uma reflexão sobre situações de risco e vulnerabilidade relacionadas ao comportamento sexual e a importância de hábitos saudáveis. Investe-se na atuação desses jovens tendo a certeza de que as mensagens estão sendo absorvidas e hábitos simples e saudáveis estão sendo introduzidos nas rotinas de quem os assiste e de suas famílias, o que lhes assegurarão qualidade de vida

Genetic susceptibility to Chagas disease cardiomyopathy: involvement of several genes of the innate immunity and chemokine-dependent migration pathways

Abstract\ud \ud Background\ud Chagas disease, caused by the protozoan Trypanosoma cruzi is endemic in Latin America. Thirty percent of infected individuals develop chronic Chagas cardiomyopathy (CCC), an inflammatory dilated cardiomyopathy that is, by far, the most important clinical consequence of T. cruzi infection. The others remain asymptomatic (ASY). A possible genetic component to disease progression was suggested by familial aggregation of cases and the association of markers of innate and adaptive immunity genes with CCC development. Migration of Th1-type T cells play a major role in myocardial damage.\ud \ud \ud Methods\ud Our genetic analysis focused on CCR5, CCL2 and MAL/TIRAP genes. We used the Tag SNPs based approach, defined to catch all the genetic information from each gene. The study was conducted on a large Brazilian population including 315 CCC cases and 118 ASY subjects.\ud \ud \ud Results\ud The CCL2rs2530797A/A and TIRAPrs8177376A/A were associated to an increase susceptibility whereas the CCR5rs3176763C/C genotype is associated to protection to CCC. These associations were confirmed when we restricted the analysis to severe CCC, characterized by a left ventricular ejection fraction under 40%.\ud \ud \ud Conclusions\ud Our data show that polymorphisms affecting key molecules involved in several immune parameters (innate immunity signal transduction and T cell/monocyte migration) play a role in genetic susceptibility to CCC development. This also points out to the multigenic character of CCC, each polymorphism imparting a small contribution. The identification of genetic markers for CCC will provide information for pathogenesis as well as therapeutic targets.FAPES

Traffic-Related Air Pollution Effect on Fast Glycemia of Aged Obese Type 2 Diabetic Mice

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-05-29T15:56:48Z No. of bitstreams: 1 Matsuda M traffic-related-air-pollution-effect-on-fast-glycemia-of-aged-obese-type-2-diabetic-mice-2155-9880.1000255.pdf: 651133 bytes, checksum: 949d59d733374dfc48fd0fb9d2ef07e8 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-05-29T16:20:38Z (GMT) No. of bitstreams: 1 Matsuda M traffic-related-air-pollution-effect-on-fast-glycemia-of-aged-obese-type-2-diabetic-mice-2155-9880.1000255.pdf: 651133 bytes, checksum: 949d59d733374dfc48fd0fb9d2ef07e8 (MD5)Made available in DSpace on 2017-05-29T16:20:38Z (GMT). No. of bitstreams: 1 Matsuda M traffic-related-air-pollution-effect-on-fast-glycemia-of-aged-obese-type-2-diabetic-mice-2155-9880.1000255.pdf: 651133 bytes, checksum: 949d59d733374dfc48fd0fb9d2ef07e8 (MD5) Previous issue date: 2013Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Grant 2008/57717-6 and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) grant 2008/57717-6.University of São Paulo Medical School. Laboratory of Investigation in Ophthalmology. São Paulo, SP, BrasiUniversity of São Paulo Medical School. Experimental Air Pollution Laboratory of Pathology Department. São Paulo, SP, BrasilFederal University of Bahia. Medical School. Department of Pathology and Forensic Medicine. Salvador, BA, BrazilFederal University of Bahia. Medical School. Department of Pathology and Forensic Medicine. Salvador, BA, BrazilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, BrasilUniversity of São Paulo Medical School. Experimental Air Pollution Laboratory of Pathology Department. São Paulo, SP, BrasilUniversity of São Paulo Medical School. Experimental Air Pollution Laboratory of Pathology Department. São Paulo, SP, Brasil / Pro-Sangue Foundation. São Paulo, SP, BrasilRecent experimental data have provided associations between ambient PM2.5 (fine particulate matter; diameter ≤ 2.5 μm) and propensity to inflammation and chronic diseases especially among susceptible groups, such as elderly people. There is cumulative evidence that type-2 diabetes mellitus is a chronic inflammatory state aggravated by factors that promote endothelium inflammation. Accordingly our hypothesis that the exposure of aged obese population to PM2.5 might aggravate type-2 diabetes, we used a model of aged, diet-induced obese mice. C57BL6 male mice were fed with regular chow (n=30; RC) or high-fat chow (n=36; HF) during one-year and randomly assigned to filtered (FA-RC, n=16; FA-HF, n=19) or PM2.5 concentrated air (600 μg.m-3) (EXP-RC, n=14; EXPHF, n=17) chambers to have a daily 1 hour exposition during consecutive 30- days. Fast glycemia was measured before the animals were euthanized. The Institution’s Ethics Committee approved all experimental procedures. Heart mRNA content of selected migration, signalization and adhesion proteins were measured by SYBR Green fluorescence Real Time RT-PCR protocol using appropriate primers. There were no difference between RC-EXP and RC-FA nor between HF-EXP and HF-FA body weight. Regarding fast glycemia, both, RC and HF groups, were diabetic, but only the HF group was affected by acute exposure to PM2.5 (mean ± SD, EXP-HF vs FA- HF, 172.8 ± 23.4 vs 156.7 ± 17.6, p <0.05; EXP-RC vs FA-RC, 149.8 ± 19.2, 139.7 ± 15.3, ns; ANOVA). The gene expression profile of E-selectin, IL-6, VCAM-1, ICAM-1 and MMP-9, was differently affected by PM2.5 in heart and lung. Proteins activated by inflammatory stimuli involved in the inhibition of insulin signaling are being investigated