São Paulo medical journal = Revista paulista de medicina
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Severe pulmonary arterial hypertension (PAH) is a contraindication for heart transplantation (HT). It has been correlated with increased early and late mortality, mainly associated with right ventricular failure. Ventricular assistance devices (VADs) can promote reduction of intracardiac pressures and consequent reduction of PAH over the medium and long terms, thus enabling future candidature for HT. The diminution of early pulmonary pressure within this scenario remains unclear. ⋯ VAD implantation can reduce PAH levels. Early reduction occurred in all patients. Thus, use of VAD is an important bridge tool for enabling candidature for HT among patients with constantly severe PAH.
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Acute ischemic stroke (AIS) is the most common type of stroke. Inflammation is the primary factor in the pathogenesis of atherosclerosis. Use of immature granulocytes (IGs) has been recommended as a new indicator of systemic inflammation. However, data on the association between echocardiographic epicardial fat tissue thickness (EFT) and IGs in patients with AIS are limited. ⋯ IG and echocardiographic EFT are clinical markers that can be used to predict AIS risk.
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Randomized Controlled Trial
A randomized clinical trial on inhaled ciclesonide for managing acute asthma in the emergency room.
Use of inhaled corticosteroids for managing acute asthma exacerbations has been tested since the 1990s. ⋯ Inhaled ciclesonide was not inferior to systemic hydrocortisone for managing acute asthma exacerbations, and it improved both clinical and spirometric parameters.
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Multicenter Study
Management strategies for implementing a multicenter cross-sectional study: lessons from the ADHERE Brazil study.
Epidemiological studies involving large samples usually face financial and operational challenges. ⋯ http://clinicaltrials.gov/ on October 10, 2013; NCT02066935.
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The legacies of colonization and of policies of forced assimilation continue to be a cause of intergenerational trauma, manifested through feelings of marginality, depression, anxiety and confusion, which place indigenous peoples at increased risk of suicide. ⋯ The study protocol is registered in the international prospective register of systematic reviews (PROSPERO); no. CRD42019141754.