Intersecção de tratamentos oncológicos e saúde cardiovascular

ABSTRACT In recent years, significant advances in cancer treatment have been observed, but these treatments have also increased the risk of cardiovascular complications. Cardio-oncology has emerged as a field dedicated to the monitoring and cardiovascular care of cancer patients, with the aim of early identification cardiac problems and provide appropriate interventions to minimize adverse impacts. The use of cardiac biomarkers such as troponins plays a key role in early detection and monitoring of cardiac toxicity throughout treatment. Integrated monitoring and intervention strategies, including the use of angiotensin conversion inhibitors to prevent adverse ventricular remodeling, are essential to improve long-term cardiovascular and oncological outcomes for patients.RESUMO Nos últimos anos, observa-se avanços significativos no tratamento do câncer, porém esses tratamentos também aumentaram o risco de complicações cardiovasculares. Dessa forma, a cardio-oncologia emergiu como um campo dedicado ao monitoramento e cuidado cardiovascular de pacientes oncológicos, com o objetivo de identificar precocemente problemas cardíacos e fornecer intervenções adequadas para minimizar impactos adversos. O uso de biomarcadores cardíacos, como troponinas, desempenha um papel fundamental na detecção precoce e no monitoramento da toxicidade cardíaca ao longo do tratamento. Estratégias integradas de monitoramento e intervenção, incluindo o uso de inibidores da conversão da angiotensina para prevenir a remodelação ventricular adversa, são essenciais para melhorar os resultados cardiovasculares e oncológicos dos pacientes a longo prazo.&nbsp

Lúpus Eritematoso Sistêmico e Nefrite Lúpica: Diagnóstico, Manejo e Avanços Terapêuticos

Systemic Lupus Erythematosus (SLE) is an inflammatory autoimmune disease, with an abnormal interaction between innate and adaptive immunity. This study is an integrative review carried out from June to July 2024, based on 10 articles found in PubMed, in the last 10 years. This condition can manifest itself in several organ systems of the body, which can result in fatal complications involving vital organs and tissues. Renal involvement is common among patients with SLE, with the presence of lupus nephritis (LN) being its most evident clinical manifestation, with a difficult diagnosis in both SLE and LN. SLE is associated with several autoantibodies that attack nuclear antigens, causing damage during the course of the disease. LN affects a large proportion of patients with SLE, characterized by complex inflammatory kidney lesions, which, due to limited access to healthcare, can worsen the progression of the disease, progressing to end-stage renal disease (ESRD). LN presents a more complex diagnostic challenge than SLE, due to the possibility of patients being asymptomatic in the early stages of the disease, a time when treatment would be ideal. Renal biopsy is the current standard for diagnosis and is used repeatedly to investigate the evolution of LN. However, there is also disease tracking through biomarkers, which play an important role in analyzing disease activity and response to therapeutic interventions. Another diagnostic mechanism for LN is the urine test, investigating creatinine and proteinuria levels. For effective treatment, prior diagnosis of the disease is extremely necessary, predicting a good long-term renal prognosis if there is an early response.O Lúpus Eritematoso Sistêmico (LES) é uma doença autoimune inflamatória, com interação anormal entre a imunidade inata e adaptativa. Este estudo se trata de uma revisão integrativa feita de junho a julho de 2024, baseando-se em 10 artigos encontrados no PubMed, nos últimos 10 anos. Essa condição pode se manifestar em diversos sistemas de órgãos do corpo, podendo resultar em complicações fatais envolvendo órgãos e tecidos vitais. O envolvimento renal é comum entre pacientes portadores de LES, sendo a presença da nefrite lúpica (NL) sua manifestação clínica mais evidente, com um difícil diagnóstico tanto no LES quanto na NL. O LES está associado a vários auto anticorpos que atacam antígenos nucleares, causando danos durante o curso da doença. A NL afeta grande parte dos pacientes com LES, caracterizada por complexas lesões renais inflamatórias, que devido ao acesso limitado aos cuidados de saúde pode acarretar no agravamento da progressão da doença, evoluindo para doença renal em estágio terminal (DRT). A NL apresenta um desafio diagnóstico mais complexo que o LES, devido a possibilidade dos pacientes serem assintomáticos nos estágios iniciais da doença, momento em que o tratamento seria ideal. A biópsia renal é o padrão atual para diagnóstico, sendo usada de forma repetida para investigar a evolução da NL. Porém, existe também o rastreamento da doença através de biomarcadores, que desempenham um papel importante na análise da atividade da doença e na resposta às intervenções terapêuticas. Outro mecanismo de diagnóstico da NL é o exame de urina, investigando os níveis de creatinina e proteinúria. Para um tratamento eficaz é de extrema necessidade o diagnóstico prévio da doença, prevendo um bom prognóstico renal a longo prazo se houver resposta precoce

Biomarcadores na Doença Renal Crônica: Papel Clínico e Relevância Prognóstica

In summary, articles in Portuguese and English published between 2015 and 2024 were searched, with 11 articles accessed through the VHL, in the databases at the USA National Library of Medicine (PubMed), being selected. It was clear that the diagnosis of kidney disease is resolved when there is kidney damage for at least 3 months, confirmed by biopsy kidney disease or markers of kidney damage. After establish this diagnosis, it is necessary classify the disease into one of five stages. Furthermore, it is also important to say that. There are studies that confirm the relationship between CKD with cardiovascular diseases, osteoporosis and history of bone fractures. It follows then that it is extremely important that some biomarkers are evaluated for thus have a good prognosis.Em resumo, foi pesquisado artigos nos idiomas português e inglês publicados no período de 2015 a 2024, sendo selecionados 11 artigos acessados através da BVS, nas bases de dados na USA National Library of Medicine (PubMed) . Com isso, foi notório que o diagnóstico de doença renal é resolvido quando há dano renal por pelo menos 3 meses, confirmado por biópsia renal ou marcadores de dano renal. Após estabelecer esse diagnóstico, é necessário classificar a doença em um dos cinco estágios. Além disso, é importante também dizer que já existem pesquisas que confirmam a relação de DRC com doenças cardiovasculares, osteoporose e histórico de fraturas ósseas. Conclui-se então que é de extrema importância que alguns biomarcadores sejam avaliados para ter assim um bom prognóstico

ANÁLISE DO PERFIL EPIDEMIOLÓGICO DE PACIENTES PORTADORES DE HIPERTENSÃO ARTERIAL SISTÊMICA NA REGIÃO SUDESTE BRASILEIRA ENTRE 2019 A 2024

Systemic Arterial Hypertension (SAH) is a multifactorial clinical condition, composed of a sustained increase in arterial pressure levels. Aspects such as regulated diet, daily physical exercise, control of stress factors, reduction of alcohol and tobacco consumption are lifestyle changes that improve blood pressure reduction and should be encouraged with the intention of reducing associated morbidity and mortality. . The main complications of SAH are: Heart Failure (HF), Acute Myocardial Infarction (AMI), Stroke (CVA) and Chronic Renal Failure (CRF). The support of a qualified team makes an essential contribution to better regulation and monitoring of these patients. Therefore, the objective of the present work is to describe the epidemiological profile of patients diagnosed with SAH in the southeastern region of Brazil between 2019 and 2024.A Hipertensão Arterial Sistêmica (HAS) é uma condição clínica, multifatorial, composta por elevação sustentada dos níveis pressóricos arteriais. Aspectos, como alimentação regulada, prática de exercícios físicos cotidianamente, controle de fatores de estresse, redução do consumo de álcool e tabaco são alterações do estilo de vida que melhoram a redução da pressão arterial e devem ser encorajados com intenção de reduzir morbidade e mortalidade associadas. As principais complicações da HAS são: Insuficiência Cardíaca (IC), Infarto Agudo do Miocárdio (IAM), Acidente Vascular Encefálico (AVE) e Insuficiência Renal Crônica (IRC). O apoio de uma equipe capacitada, contribui de maneira imprescindível para a melhor regulação e acompanhamento destes pacientes. Dessa forma, o objetivo do presente trabalho é descrever o perfil epidemiológico de pacientes diagnosticados com HAS na região sudeste brasileira entre 2019 a 2024

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Brazilian consensus recommendations on the diagnosis and treatment of autoimmune encephalitis in the adult and pediatric populations

Background Autoimmune encephalitis (AIE) is a group of inflammatory diseases characterized by the presence of antibodies against neuronal and glial antigens, leading to subacute psychiatric symptoms, memory complaints, and movement disorders. The patients are predominantly young, and delays in treatment are associated with worse prognosis

Complete genome sequence of the sugarcane nitrogen-fixing endophyte gluconacetobacter diazotrophicus PAL5

17 p. : il.Background: Gluconacetobacter diazotrophicus Pal5 is an endophytic diazotrophic bacterium that lives in association with sugarcane plants. It has important biotechnological features such as nitrogen fixation, plant growth promotion, sugar metabolism pathways, secretion of organic acids, synthesis of auxin and the occurrence of bacteriocins. Results: Gluconacetobacter diazotrophicus Pal5 is the third diazotrophic endophytic bacterium to be completely sequenced. Its genome is composed of a 3.9 Mb chromosome and 2 plasmids of 16.6 and 38.8 kb, respectively. We annotated 3,938 coding sequences which reveal several characteristics related to the endophytic lifestyle such as nitrogen fixation, plant growth promotion, sugar metabolism, transport systems, synthesis of auxin and the occurrence of bacteriocins. Genomic analysis identified a core component of 894 genes shared with phylogenetically related bacteria. Gene clusters for gum-like polysaccharide biosynthesis, tad pilus, quorum sensing, for modulation of plant growth by indole acetic acid and mechanisms involved in tolerance to acidic conditions were identified and may be related to the sugarcane endophytic and plant-growth promoting traits of G. diazotrophicus. An accessory component of at least 851 genes distributed in genome islands was identified, and was most likely acquired by horizontal gene transfer. This portion of the genome has likely contributed to adaptation to the plant habitat. Conclusion: The genome data offer an important resource of information that can be used to manipulate plant/bacterium interactions with the aim of improving sugarcane crop production and other biotechnological applications