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Anschau F.,Institute Cardiologia Do Rio Grande Do sul | Guimaraes Goncalves M.A.,Grande Rio University
Acta Cytologica | Year: 2011

Objective: Since cytology is the examination utilized for the screening of cervical cancer, it is important to determine its correlation with histologic examination, the gold standard in the diagnosis of cervical disease. Study Design: A retrospective evaluation was made of 431 patients who presented with colposcopic indication for cervical biopsy between 2003 and 2007. Results: In 90.8% (289/318) of the patients, cytology showing cervical intraepithelial neoplasia (CIN) was confirmed as CIN in the histology of the cervix, while 62.8% (71/113) of patients with normal cytology had a confirmation of a normal histology (κ = 0.558). Conclusion: Cytology demonstrated a sensitivity and specificity of 87.3 and 71.0%, respectively. The agreement between cervical cytology and histology, considering the presence of CIN, was moderate. Correlations between accuracy and errors of cytology are discussed with therapeutic emphasis. Copyright © 2011 S. Karger AG, Basel.


Favretto D.C.,Centro Universitario Univates | Pontin B.,Institute Cardiologia do Rio Grande do Sul | Moreira T.R.,Federal University of Rio Grande do Sul
Arquivos de Gastroenterologia | Year: 2013

Context - Constipation is a very common symptom in the general population. One way of non-pharmacological treatment of constipation is through the addition of probiotics to food. Objectives - The aim of this study was to evaluate de effect of the consumption of a fresh cheese, enriched with Bifdobacterium lactis Bi-07 on the symptoms of constipated women. Methods - A randomized controlled trial, carried out in the Basic Health Units of Guaporé's City - RS/Brazil, between january and may 2012, with 30 constipated women. The patients were randomized into two groups whom received, for 30 days, 30 g of fresh cheese enriched with Bifdobacterium lactis Bi-07 (n = 15) or regular fresh cheese (n = 15). Constipation symptoms were evaluated according to ROMA III Consensus, before and after the nutritional intervention. Also, data of clinical and anthropometric characteristics of the individuals were collected. Accepted level of significance 5% (P≤0,05). Results - The medium age of the studied population was 37,5±14,4 years in the intervention group and 40,8±12,8 years in the control group. After 30 days we observed that the ingestion of fresh cheese enriched with Bifdobacterium lactis Bi-07 promoted benefic effects on the symptoms of strength to evacuate. Conclusion - The consumption of 30g/day of a fresh cheese enriched with Bifdobacterium lactis Bi-07 has beneficial effects on constipation symptoms.


Mastalir E.T.,Institute Cardiologia Do Rio Grande Do sul | Carvalhal G.F.,Pontifical Catholic University of Rio Grande do Sul | Portal V.L.,Cardiology Division from Institute Cardiologia Do Rio Grande Do sul
International Journal of Impotence Research | Year: 2011

The aim of the study is to evaluate the effect of simvastatin in erectile dysfunction (ED) secondary to endothelial dysfunction. This study is a double-blind, randomized, placebo-controlled, clinical trial in patients with ED and endothelial dysfunction. Patients were randomized to receive 20 mg simvastatin (n=21) or placebo (n=20) daily for 6 months and subsequently 10 mg of vardenafil on demand for 4 weeks. Serum cholesterol, hormone profile, ultrasensitive C-reactive protein, the International Index of Erectile Dysfunction (IIEF) and the ED Index of Treatment Satisfaction were evaluated. There was a significant reduction in serum cholesterol in the treatment group. The hormonal profile remained unaltered. There was no difference in the IIEF between the groups at follow-up, although, at the beginning, 26% of the patients of both groups presented with mild ED and 74% with moderate-to-severe ED; at the end of the 7th month, all patients from the simvastatin group progressed to mild ED, compared with only 83% in the placebo group. There was no statistically significant difference in penile erection after intake of simvastatin or placebo. This study does not support the use of simvastatin as erectogenic medication. Further studies are necessary to verify if simvastatin has any beneficial effect on ED. © 2011 Macmillan Publishers Limited All rights reserved.


Schein A.S.O.,Institute Cardiologia Do Rio Grande Do sul | Kerkhoff A.C.,Institute Cardiologia Do Rio Grande Do sul | Kerkhoff A.C.,Federal University of Rio Grande do Sul | Coronel C.C.,Institute Cardiologia Do Rio Grande Do sul | And 4 more authors.
Journal of Hypertension | Year: 2014

BACKGROUND:: Obstructive sleep apnea (OSA) may lead to the development of hypertension and therapy with continuous positive airway pressure (CPAP) can promote reduction in blood pressure. OBJECTIVE:: The objective of this study is to review systematically the effects of CPAP on blood pressure in patients with OSA. METHODS:: The search was conducted in the following databases, from their beginning until February 2013: MEDLINE, Embase, Cochrane CENTRAL, Lilacs and PEDro. In addition, a manual search was performed on references of published studies. Randomized clinical trials (RCTs) that used CPAP compared with placebo CPAP or subtherapeutic CPAP for treatment of patients with OSA and that evaluated office SBP and DBP and 24-h ambulatory blood pressure were selected. RESULTS:: Sixteen RCTs were included among 3409 publications, totaling 1166 patients. The use of CPAP resulted in reductions in office SBP [-3.20mmHg; 95% confidence interval (CI) -4.67 to -1.72] and DBP (-2.87mmHg; 95% CI -5.18 to -0.55); in night-time SBP (-4.92mmHg; 95% CI -8.70 to -1.14); in mean 24-h blood pressure (-3.56mmHg; 95% CI -6.79 to -0.33), mean night-time blood pressure (-2.56mmHg; 95% CI -4.43 to -0.68) and 24-h DBP (-3.46mmHg; 95% CI -6.75 to -0.17). However, no significant change was observed in daytime SBP (-0.74mmHg; 95% CI -3.90 to 2.41) and daytime DBP (-1.86mmHg; 95% CI -4.55 to 0.83). CONCLUSION:: Treatment with CPAP promoted significantly but small reductions in blood pressure in individuals with OSA. Further studies should be performed to evaluate the effects of long-term CPAP and the impact on cardiovascular risk. © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.


Passos-Silva D.G.,Federal University of Minas Gerais | Brandan E.,University of Santiago de Chile | Santos R.A.S.,Federal University of Minas Gerais | Santos R.A.S.,Institute Cardiologia do Rio Grande do Sul
Trends in Pharmacological Sciences | Year: 2015

The renin-angiotensin system (RAS) plays a pivotal role in cardiovascular and hydro-electrolyte homeostasis. Blockade of the RAS as a therapeutic strategy for treating hypertension and related cardiovascular diseases is well established. However, actions of the RAS go far beyond the targets initially described. In this regard, the recent identification of novel components of the RAS, including angiotensin-(1-7) [Ang-(1-7)], Ang-(1-9), and alamandine, have opened new possibilities for interfering with the development and manifestations of cardiovascular and non-cardiovascular diseases. In this article, we briefly review novel targets for angiotensins and its therapeutic implications in diverse areas, including cancer, inflammation, and glaucoma. © 2015 Elsevier Ltd. All rights reserved.


Villela D.C.,Federal University of Minas Gerais | Passos-Silva D.G.,Federal University of Minas Gerais | Santos R.A.S.,Federal University of Minas Gerais | Santos R.A.S.,Institute Cardiologia Do Rio Grande Do sul
Current Opinion in Nephrology and Hypertension | Year: 2014

Purpose of review In this article, we review the recent findings regarding a new derivative of angiotensin-(1-7) [Ang-(1-7)], alamandine, and its receptor, the Mas-related G-coupled receptor type D (MrgD) with a special emphasis on its role and how it can be formed. Recent findings Over the last decade, there have been significant conceptual changes regarding the understanding of the renin-angiotensin system (RAS). A cardioprotective axis has been elucidated by the discovery of the Mas receptor for the biologically active Ang-(1-7), and the angiotensin-converting enzyme 2 (ACE2) that coverts Ang II into Ang-(1-7). In addition, several components of the system, such as Ang-(1-12), Angiotensin A (Ang A) and the newly discovered peptide, alamandine, have been identified. Alamandine is generated by catalysis of Ang A via ACE2 or directly from Ang-(1-7). Summary Alamandine is a vasoactive peptide with similar protective actions as Ang-(1-7) that acts through the MrgD and may represent another important counter-regulatory mechanism within the RAS. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Sbruzzi G.,Institute Cardiologia do Rio Grande do Sul | Coronel C.C.,Institute Cardiologia do Rio Grande do Sul | Plentz R.D.M.,Federal University of Health Sciences, Porto Alegre
Brazilian Journal of Cardiovascular Surgery | Year: 2012

Objectives: To evaluate the effects of transcutaneous electric nerve stimulation (TENS) on pain and pulmonary function during the postoperative period after thoracic surgery by performing a systematic review and meta-analysis of randomized trials. Methods: The search strategy included MEDLINE, PEDro, Cochrane CENTRAL, EMBASE and LILACS, in addition to a manual search, from inception to August, 2011. Randomized trials were included, comparing TENS associated or not with pharmacological analgesia vs. placebo TENS associated or not with pharmacological analgesia or vs. pharmacological analgesia alone to assess pain (visual analog scale - VAS) and/or pulmonary function represented by forced vital capacity (FVC) in postoperative thoracic surgery patients (pulmonary or cardiac with approach by thoracotomy or sternotomy). Results: Of the 2.489 articles identified, 11 studies were included. In the approach by thoracotomy, TENS associated with pharmacological analgesia reduced pain compared to the placebo TENS associated with pharmacological analgesia (VAS -1.29; 95%CI: -1.94 to - 0.65). In the approach by sternotomy, TENS associated with pharmacological analgesia also reduced pain compared to the placebo TENS associated with pharmacological analgesia (VAS -1.33; 95%CI: -1.89 to -0.77) and compared to pharmacological analgesia alone (VAS -1.23; 95%CI: -1.79 to -0.67). There was no significant improvement in FVC (0.12 L; 95%CI: - 0.27 to 0.51). Conclusion: TENS associated with pharmacological analgesia provides pain relief compared to the placebo TENS in postoperative thoracic surgery patients both approached by thoracotomy and sternotomy. In sternotomy it also provides more effective pain relief compared to pharmacological analgesia alone, but it has no significant effect on pulmonary function.


Cecchetto F.H.,Institute Cardiologia Do Rio Grande Do sul | Pellanda L.C.,Institute Cardiologia Do Rio Grande Do sul
Jornal de Pediatria | Year: 2014

Objectives To develop and analyze the reliability and validity of a questionnaire on the knowledge of healthy habits and risk factors for cardiovascular disease (CARDIOKID) to be used in schoolchildren. Methods The study included 145 children aged 7 to 11 years. The measured factors were the knowledge of healthy habits and risk factors for cardiovascular disease. Cronbach's alpha and intra-class correlation coefficient (ICC) were used to verify reliability, and exploratory factor analysis was used to assess the validity of the questionnaire. Results The sample consisted of 60% females and 40% males. In factorial analysis, the Kaiser-Meyer-Olkin (KMO) test result was measures of sampling adequacy (MSA) = 0.81 and Bartlett's test of sphericity was X2 = (66) = 458.64 (p < 0.001). In the factorial analysis with varimax rotation, two dimensions were defined. The "healthy habits" dimension was composed of five factors (ICC = 0.87 and α = 0.93) and the "cardiovascular risk factors" dimension was composed of seven factors (ICC = 0.83 and α = 0.91). In the individual factor analysis, Cronbach's alphas were between 0.93 and 0.91. Total variance was 46.87%. There were no significant differences between test and retest applications. Conclusion The questionnaire presented satisfactory validity and reliability (internal consistency and reproducibility), allowing for its use in children. © 2014 Sociedade Brasileira de Pediatria.


Augustin A.C.,Institute Cardiologia do Rio Grande do Sul | Quadros A.S.d.,Institute Cardiologia do Rio Grande do Sul | Sarmento-Leite R.E.,Institute Cardiologia do Rio Grande do Sul
International Journal of Nursing Studies | Year: 2010

Introduction: Despite recent technical improvements and device developments, post-percutaneous coronary intervention care in patients submitted to this procedure performed through the femoral approach remains almost unchanged. An earlier sheath removal and ambulation could help to cut costs, save health system resources and prevent patient discomfort. However, this approach has not yet been well assessed. Objectives: The main objective of this paper was to evaluate a strategy of post-procedure immediate sheath removal and early ambulation. Methods: A randomised trial was conducted in 347 patients submitted to percutaneous coronary intervention that used a 6 French gauge arterial sheath. The intervention group (IG, n = 172) had the arterial sheath removed immediately after the procedure and ambulated after 3 h of bed rest. The control group (CG, n = 175) had the arterial sheath removed 4 h after the end of the angioplasty and rested for an additional 6 h. The primary end point was the development of major vascular complications: hematoma > 10 cm, pseudo-aneurism and arterial bleeding after or during ambulation. Secondary end points were minor vascular complications: hematoma < 10 cm, vasovagal reactions after sheath removal, and assessment of patient's comfort during the peri-operative period. Results: Baseline characteristics did not differ statistically between groups, as major bleeding (IG = 1.7% vs. CG = 0.6%; p = 0.31). Regarding other vascular complications and vasovagal reactions, there were also no significant differences. Patients of IG had less pain (26% vs. 41%, p = 0.004) than CG, but the frequency of urinary retention was the same in both groups. Conclusion: This study, although underpowered, indicates that immediate arterial sheath removal with early ambulation after PCI was not significantly associated with an increase in major vascular complications and was associated with increased patient comfort. Although further studies with larger samples are necessary to confirm these results, this study suggests that immediate arterial sheath removal with early ambulation may be an alternative for selected elective patients submitted to percutaneous coronary interventions and for those with difficulties to endure prolonged bed rest. © 2010 Elsevier Ltd. All rights reserved.


Leiria T.L.,Institute Cardiologia do Rio Grande do Sul
Arquivos brasileiros de cardiologia | Year: 2010

BACKGROUND: Oral anticoagulants are broadly used in cardiology. However, it is still necessary to evaluate their use in clinical practice. OBJECTIVES: To describe the differences in the maintenance of anticoagulation control, as well as the incidence of hemorrhagic and thromboembolic events among users of warfarin and phenprocoumon. METHODS: Non-concurrent cohort study of 127 patients using oral anticoagulation. RESULTS: Phenprocoumon was the most frequently used anticoagulant in 60% of the patients. The prevalence of RNI<2 at the last medical appointment was higher among warfarin users (46% vs. 19.5%; p<0.001). During the follow-up, Phenprocoumon users were within the therapeutic range during 60.7% of the period, in comparison with 45.6% of warfarin users (OR:1.84; 95%CI:1.59-2.13; P<0.001). The incidence of bleeding was 5.3/100 patients/year in the phenprocoumon group versus 18.8/100 patients/year in the warfarin group (RR: 3.5; 95%CI: 1.87-6.48; P<0.001). CONCLUSION: Patients that used Warfarin remained at subtherapeutic levels for a longer period; however, they also presented more hemorrhagic events. Phenprocoumon users were younger and had been using oral anticoagulation for longer periods, presenting fewer drug-related adverse events.

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