São Paulo medical journal = Revista paulista de medicina
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Review
Targeting stroke risk and improving outcomes in patients with atrial fibrillation in Latin America.
To examine stroke risk factors, including atrial fibrillation, management and prevention, and stroke outcomes across Latin America. ⋯ Atrial fibrillation-related stroke carries a heavy burden. Non-vitamin K antagonist oral anti-coagulants provide options for reducing the risk of atrial fibrillation-related stroke. However, cost-effectiveness comparisons with warfarin are warranted before observational health-economics study results can be applied clinically. Initiatives to remedy inequalities and improve access to care across Latin America should accompany risk factor modification and guideline-based prevention.
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Multicenter Study
"EMMA Study: a Brazilian community-based cohort study of stroke mortality and morbidity".
Stroke has a high burden of disability and mortality. The aim here was to evaluate epidemiology, risk factors and prognosis for stroke in the EMMA Study (Study of Stroke Mortality and Morbidity). ⋯ Over the long term, the EMMA database will provide additional information for planning resources destined for the public healthcare system.
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Biopsies are used after liver transplantation to evaluate fibrosis. This study aimed to evaluate the elasticity of transplanted livers by means of a non-invasive examination, acoustic radiation force imaging (ARFI) elastography, correlating the results with the histological analysis. ⋯ The values obtained from elastography were not affected by inflammatory reaction or anatomical alterations. A cutoff point of 1.29 m/s separating patients with or without significant fibrosis was identified.
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In elderly people, measurement of several anthropometric parameters may present complications. Although neck circumference measurements seem to avoid these issues, the cutoffs and cardiovascular risk factors associated with this parameter among elderly people remain unknown. This study was developed to identify the cutoff values and cardiovascular risk factors associated with neck circumference measurements among elderly people. ⋯ The data indicate that neck circumference can be used as a screening tool to identify overweight/obesity in older people. Moreover, large neck circumference values may be associated with cardiovascular risk factors.
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Healthcare professionals need to instill the process of prevention, control and treatment of people infected with HIV into care practice. Through maintaining preventive treatment among HIV-infected pregnant women, it has been demonstrated that prophylactic antiretroviral therapy, scheduled cesarean section and the prohibition of breastfeeding significantly reduce vertical HIV transmission. This study aimed to assess the rates of vertical HIV transmission in a specialized service and identify the factors associated with it. ⋯ The vertical transmission rate was high and the recommended intervention measures were not adopted in full. Adequate prophylactic measures need to be implemented in HIV-positive pregnant women prenatally and during the antenatal, delivery and postpartum periods.