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Ribeiro G.S.,Federal University of Health Sciences, Porto Alegre | Melo R.D.,Federal University of Health Sciences, Porto Alegre | Deresz L.F.,Federal University of Health Sciences, Porto Alegre | Deresz L.F.,Federal University of Juiz de fora | And 5 more authors.
European Journal of Preventive Cardiology | Year: 2017

Background Aortic stenosis is a valvular heart disease characterised by fixed obstruction of the left ventricular outflow. It can be managed by surgical aortic valve replacement (sAVR) or transcatheter aortic valve implantation (TAVI). This review aimed to describe the evidence supporting a cardiac rehabilitation programme on functional capacity and quality of life in aortic stenosis patients after sAVR or TAVI. Methods The search was conducted on multiple databases from January to March 2016. All studies were eligible that evaluated the effects of a post-interventional cardiac rehabilitation programme in aortic stenosis patients. The methodological quality was assessed using the PEDro scale. Meta-analysis was performed separately by procedure and between procedures. The walked distance during the six-minute walk test (6MWD) and Barthel index were evaluated. The analysis was conducted in Review Manager. Results Five studies were included (292 TAVI and 570 sAVR patients). The meta-analysis showed that a cardiac rehabilitation programme was associated with a significant improvement in 6MWD (0.69 (0.47, 0.91); P < 0.001) and Barthel index (0.80 (0.29, 1.30); P = 0.002) after TAVI and 6MWD (0.79 (0.43, 1.15); P < 0.001) and Barthel index (0.93 (0.67, 1.18); P < 0.001) after sAVR. In addition, the meta-analysis showed that the cardiac rehabilitation programme promoted a similar gain in 6MWD (4.28% (-12.73, 21.29); P = 0.62) and Barthel index (-1.52 points (-4.81, 1.76); P = 0.36) after sAVR or TAVI. Conclusions The cardiac rehabilitation programme improved the functional capacity and quality of life in aortic stenosis patients. Patients who underwent TAVI benefitted with a cardiac rehabilitation programme similar to sAVR patients. © European Society of Cardiology 2017.


Barros H.M.T.,Federal University of Health Sciences, Porto Alegre | Stein A.T.,UFCSPA | Da Costa J.S.D.,Programa de Pos Graduacao de Saude Coletiva
Jornal de Pediatria | Year: 2010

Objective: To investigate whether the lack of knowledge of toxic agents in households is a risk factor for individual unintentional childhood poisoning. Methods: The case group (n = 25) was composed of caregivers of children under 60 months of age who underwent accidental oral poisoning and were treated at two reference hospitals in Porto Alegre, southern Brazil, and recorded in the Toxicology Information Center database. The control group (n = 25) was composed of caregivers of children matched for sex, age, and presence in their homes of the same toxic agents found in the case group, who sought emergency medical care at the same hospitals, but for other reasons. A structured questionnaire was administered to verify the following questions: sociodemographic data, clinical history, behavioral antecedents of caregivers, storage of toxic agents, history of previous poisoning accidents. Results: The children's mean age was 31.8 months (±0.97) and mean height was 93 cm (±11). Families, in both groups, were aware of the toxic action of agents available in their homes; however, caregivers in the control group were twice as likely to have such knowledge compared to the case group. Distraction was 15 times more likely to occur among caregivers of children who underwent poisoning compared to the control group. Storage of toxic agents below 150 cm was approximately 17 times more likely to occur in the group of children who underwent poisoning compared to children in the control group. Conclusions: Lack of knowledge of the toxic action of agents stored in households is not a risk factor for childhood poisoning. The attributable risks described in this study indicated that the elimination of other factors, such as distraction and storage below 150 cm, would lead to the prevention of 13 and 19% of poisonings in childhood, respectively. Copyright © 2010 by Sociedade Brasileira de Pediatria.


Bernardi J.R.,Federal University of Health Sciences, Porto Alegre | De Cezaro C.,UFCSPA | Fisberg R.M.,University of Sao Paulo | Fisberg M.,Federal University of São Paulo | Vitolo M.R.,Federal University of Health Sciences, Porto Alegre
Jornal de Pediatria | Year: 2010

Objective: To estimate the energy and macronutrient intake at home and at all-day in the kindergarten programs in children aged 2 to 6 and to investigate differences in consumption and intake between children at public and private kindergartens. Methods: This was a cross-sectional study of 362 preschool children from Caxias do Sul, Brazil. Nutritional status was assessed in terms of weight to height ratios. Foods consumed in the kindergarten were evaluated by weighing the actual foods eaten by the children and home intakes were calculated from a food diary kept by parents or guardians. Statistical analyses were performed using the Mann-Whitney U test (p < 0.05). Results: It was found that 28 children (7.7%) were overweight, 92 (25.4%) were at risk of becoming overweight and seven (1.9%) were classified as having wasting. Analysis of 24-hour nutritional intake demonstrated that 51.3% of the energy, 60.3% of the lipids and 51.6% of the proteins consumed by children were eaten at home, despite the children spending the whole day in the kindergarten programs. Preschool children at kindergartens ate greater quantities of energy (p = 0.001), carbohydrates (p < 0.001), and lipids (p = 0.04) than did children at public kindergartens, but their total daily intakes were similar, irrespective of which type of kindergarten program children attended. Conclusions: The findings suggest that these children eat proportionally more energy, proteins and lipids in their extra meals at home than they do in their daytime meals in the kindergarten programs. Despite the differences in intake between public and private kindergarten, daily intakes were similar. Copyright © 2010 by Sociedade Brasileira de Pediatria.


Rosa R.F.M.,Hospital Materno Infantil Presidente Vargas HMIPV | Rosa R.C.M.,UFCSPA | Zen P.R.G.,UFCSPA | Graziadio C.,UFCSPA | Paskulin G.A.,Federal University of Rio Grande do Sul
Revista Paulista de Pediatria | Year: 2013

Objective: To review the clinical, etiological, diagnostic, and prognostic characteristics of trisomy 18 (Edwards syndrome). Data sources: Scientific articles in the MedLine, Lilacs, and SciELO databases were searched using the descriptors 'trisomy 18' and 'Edwards syndrome'. The research was not limited to a specific time period and included all articles in such databases. Data synthesis: Edwards syndrome is a disease characterized by a broad clinical picture and a very reserved prognosis. There are descriptions of more than 130 different anomalies, which can involve virtually all organs and systems. Its findings are the result of the presence of three copies of chromosome 18. The main chromosomal constitution observed among these patients is a free trisomy of chromosome 18, which is associated with the phenomenon of nondisjunction, especially in maternal gametogenesis. Most fetuses with Edwards syndrome die during the embryonic and fetal life. The median of survival among live births has usually varied between 2.5 and 14.5 days. Conclusions: Knowledge on the clinical picture and on the prognosis of Edwards syndrome patients is of great importance regarding the neonatal care and the decisions about invasive treatments. The speed to have a confirmed diagnosis is important for making decisions about medical procedures. Often, interventions are performed under emergency conditions, without many opportunities for discussion, and they involve difficult medical and ethical issues.


Tamajusuku A.S.K.,Federal University of Rio Grande do Sul | Villodre E.S.,Federal University of Rio Grande do Sul | Paulus R.,Federal University of Rio Grande do Sul | Coutinho-Silva R.,Federal University of Rio de Janeiro | And 3 more authors.
Journal of Cellular Biochemistry | Year: 2010

Gliomas have one of the worst prognosis among cancers. Their resistance to cell death induced by endogenous neurotoxic agents, such as extracellular ATP, seems to play an important role in their pathobiology since alterations in the degradation rate of extracellular ATP drastically affects glioma growth in rats. In the present work we characterized the mechanisms of cell death induced by extracellular ATP in a murine glioma cell line, GL261. ATP and BzATP, a P2X7 agonist, induced cell death at concentrations that are described to activate the P2X7 receptor in mouse. oATP, an antagonist of P2X7, blocked the ATP-induced cell death. Agonists of purinergic receptors expressed in GL261 such as adenosine, ADP, UTP did not cause any cell death, even at mM concentrations. A sub-population of cells more sensitive to ATP expressed more P2X7 when compared to a less sensitive subpopulation. Accordingly, RNA interference of the P2X7 receptor drastically reduced ATP-induced cell death, suggesting that this receptor is necessary for this effect. The mechanism of ATP-induced cell death is predominantly necrotic, since cells presented shrinkage accompanied by membrane permeabilization, but not apoptotic, since no phosphatidylserine externalization or caspase activity was observed. These data show the importance of P2X7 in ATP-induced cell death and shed light on the importance of ATP-induced cell death in glioma development. © 2010 Wiley-Liss, Inc.


Goltz F.R.,Federal University of Health Sciences, Porto Alegre | Stenzel L.M.,UFCSPA | Schneider C.D.,Federal University of Health Sciences, Porto Alegre
Revista Brasileira de Psiquiatria | Year: 2013

Objective: To identify disordered eating behaviors and body image dissatisfaction, as well as their relationship to body fat (BF), among male athletes in high risk sports for eating disorders. Methods: One hundred and fifty-six male athletes were divided into the following categories: weightclass sports, sports where leanness improves performance, and sports with aesthetic ideals. BF was assessed and three questionnaires were used: the Eating Attitudes Test; the Bulimic Investigatory Test, Edinburgh; the Body Shape Questionnaire. Results: Disordered eating behaviors and body image dissatisfaction were found in 43 (27.6%) and 23 athletes (14.7%), respectively, and an association was detected between the two variables (p, 0.001). Athletes with and without disordered eating behaviors did not differ in %BF (11.065.2% and 9.864.0%, respectively; p = 0.106). However, athletes with body image dissatisfaction had higher %BF than those who were satisfied (12.665.9% and 9.763.9%, respectively; p = 0.034). There were no differences in BF, frequency of disordered eating behaviors, and body image dissatisfaction between sports categories. Conclusion: Nearly one-quarter of athletes showed disordered eating behaviors, which was associated with body image dissatisfaction. Athletes with higher %BF were more likely to be dissatisfied with body image. There was no difference in eating behavior and body image between athletes from different sports categories. © 2013 Associação Brasileira de Psiquiatria.


Sitta A.,Hospital Of Clinicas Of Porto Alegre | Ribas G.S.,Hospital Of Clinicas Of Porto Alegre | Mescka C.P.,Federal University of Rio Grande do Sul | Barschak A.G.,UFCSPA | And 4 more authors.
Cellular and Molecular Neurobiology | Year: 2014

Maple syrup urine disease (MSUD) is a metabolic disease caused by a deficiency in the branched-chain α-keto acid dehydrogenase complex, leading to the accumulation of branched-chain keto acids and their corresponding branched-chain amino acids (BCAA) in patients. Treatment involves protein-restricted diet and the supplementation with a specific formula containing essential amino acids (except BCAA) and micronutrients, in order to avoid the appearance of neurological symptoms. Although the accumulation of toxic metabolites is associated to appearance of symptoms, the mechanisms underlying the brain damage in MSUD remain unclear, and new evidence has emerged indicating that oxidative stress contributes to this damage. In this context, this review addresses some of the recent findings obtained from cells lines, animal studies, and from patients indicating that oxidative stress is an important determinant of the pathophysiology of MSUD. Recent works have shown that the metabolites accumulated in the disease induce morphological alterations in C6 glioma cells through nitrogen reactive species generation. In addition, several works demonstrated that the levels of important antioxidants decrease in animal models and also in MSUD patients (what have been attributed to protein-restricted diets). Also, markers of lipid, protein, and DNA oxidative damage have been reported in MSUD, probably secondary to the high production of free radicals. Considering these findings, it is well-established that oxidative stress contributes to brain damage in MSUD, and this review offers new perspectives for the prevention of the neurological damage in MSUD, which may include the use of appropriate antioxidants as a novel adjuvant therapy for patients. © 2013 Springer Science+Business Media.


Debarba H.G.,Federal University of Rio Grande do Sul | Grandi J.,Federal University of Rio Grande do Sul | MacIel A.,Federal University of Rio Grande do Sul | Zanchet D.,UFCSPA
Studies in Health Technology and Informatics | Year: 2012

Hepatectomies are resections in which segments of the liver are extracted. While medical images are fundamental in the surgery planning procedure, the process of analysis of such images slice-by-slice is still tedious and inefficient. In this work we propose a strategy to efficiently and semi-automatically segment and classify patient-specific liver models in 3D through a mobile display device. The method is based on volume visualization of standard CT datasets and allows accurate estimation of functional remaining liver volume. Experiments showing effectiveness of the method are presented, and quantitative and qualitative results are discussed. © 2012 The authors and IOS Press. All rights reserved.


PubMed | Federal University of Health Sciences, Porto Alegre and UFCSPA
Type: Journal Article | Journal: Trends in psychiatry and psychotherapy | Year: 2017

Pregnancy is characterized by a high prevalence of mental disorders. Depression is the most common of these disorders and it is a risk factor for negative maternal and child development outcomes. Psychotherapy and pharmacotherapy are conventional and well-established therapeutic options, but some clients fail to respond and the safety of using some pharmacological agents during pregnancy is unclear. Some neuromodulation techniques, such as repetitive transcranial magnetic stimulation (rTMS), have been studied in depressed pregnant women.To evaluate the safety and efficacy of rTMS for major depression in pregnant women.The LILACS and PubMed databases were reviewed using the search terms depression, pregnancy and magnetic stimulation. Texts including primary data, published in Portuguese, Spanish, or English, between 1995 and 2014, that evaluated depressed pregnant women and used rTMS as the intervention were selected. Papers lacking sufficient data were excluded. Twenty-two texts were initially identified; after applying the inclusion criteria, 12 were selected and analyzed.The studies reviewed reported satisfactory responses to rTMS in acute depressive episodes, as measured using depressive symptom scales. Remission of symptoms was achieved in many cases. The procedure was well tolerated and there were no reports of damage/complications to unborn children.The data available at this time support the efficacy and tolerability of rTMS for depression in pregnant women. Controlled studies should corroborate this conclusion. This review only included studies in three languages and the resulting sample size was not large enough to conduct a meta-analysis.


PubMed | Federal University of Health Sciences, Porto Alegre and UFCSPA
Type: | Journal: European journal of preventive cardiology | Year: 2017

Background Aortic stenosis is a valvular heart disease characterised by fixed obstruction of the left ventricular outflow. It can be managed by surgical aortic valve replacement (sAVR) or transcatheter aortic valve implantation (TAVI). This review aimed to describe the evidence supporting a cardiac rehabilitation programme on functional capacity and quality of life in aortic stenosis patients after sAVR or TAVI. Methods The search was conducted on multiple databases from January to March 2016. All studies were eligible that evaluated the effects of a post-interventional cardiac rehabilitation programme in aortic stenosis patients. The methodological quality was assessed using the PEDro scale. Meta-analysis was performed separately by procedure and between procedures. The walked distance during the six-minute walk test (6MWD) and Barthel index were evaluated. The analysis was conducted in Review Manager. Results Five studies were included (292 TAVI and 570 sAVR patients). The meta-analysis showed that a cardiac rehabilitation programme was associated with a significant improvement in 6MWD (0.69 (0.47, 0.91); P<0.001) and Barthel index (0.80 (0.29, 1.30); P=0.002) after TAVI and 6MWD (0.79 (0.43, 1.15); P<0.001) and Barthel index (0.93 (0.67, 1.18); P<0.001) after sAVR. In addition, the meta-analysis showed that the cardiac rehabilitation programme promoted a similar gain in 6MWD (4.28% (-12.73, 21.29); P=0.62) and Barthel index (-1.52 points (-4.81, 1.76); P=0.36) after sAVR or TAVI. Conclusions The cardiac rehabilitation programme improved the functional capacity and quality of life in aortic stenosis patients. Patients who underwent TAVI benefitted with a cardiac rehabilitation programme similar to sAVR patients.

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