Artigos Mestrado CC
URI Permanente para esta coleção
Navegar
Submissões Recentes
1 - 5 de 72
- ItemIncreased Cardiometabolic Risk in Dynapenic Obesity: Results from the Study of Workers' Health (ESAT)(Life, 2024)Background: The coexistence of obesity and low muscle strength-denoted dynapenic obesity (DO)-has been associated with an unhealthy metabolic profile and increased risk for metabolic syndrome. However, there is a lack on studies investigating if DO exhibits higher cardiometabolic risk than non-dynapenic obesity. Objectives: To assess if individuals with DO exhibit elevated cardiometabolic risk compared to non-dynapenic obesity. Methods: a cross-sectional study that analyzed the data of workers from a quaternary care hospital collected between November 2018 and March 2020. Participants were stratified into the following anthropometrical and peripheral muscle strength profiles: non-obese/non-dynapenic (NOND), non-obese/dynapenic (NOD), obese/non-dynapenic (OND), and obese dynapenic (OD). Cardiovascular risk was evaluated by Atherogenic Index (AI), Plasma Atherogenic Index (PAI), Hypertriglyceridemic Waist (HW), A Body Shape Index (ABSI), Atherogenic Dyslipidemia (AD), Castelli Indices I and II, and Framingham Score (FS). Results: the OD group had significantly lower HDL compared to all others (p = 0.009), and despite exhibited lower prevalence of HW compared to OND (p < 0.01), a higher cardiometabolic risk compared to OND profile was observed assessing AI (p = 0.05), Castelli I (p < 0.05) and Castelli II (p < 0.05) scores. Conclusions: in the studied population, individuals with DO exhibit elevated cardiometabolic risk compared to other anthropometrical and peripheral muscle strength profiles.
- ItemEffect of an exercise-based cardiac rehabilitation program on quality of life of patients with chronic Chagas cardiomyopathy: results from the PEACH randomized clinical trial(Sientific Reports, 2024)To investigate the effect of an exercise-based cardiac rehabilitation program on the quality of life (QoL) of patients with chronic Chagas cardiomyopathy (CCC). PEACH study was a single-center, superiority randomized clinical trial of exercise training versus no exercise (control). The sample comprised Chagas disease patients with CCC, left ventricular ejection fraction < 45%, without or with HF symptoms (CCC stages B2 or C, respectively). QoL was assessed at baseline, after three months, and at the end of six months of follow-up using the SF-36 questionnaire. Patients randomized for the exercise group (n = 15) performed exercise training (aerobic, strength and stretching exercises) for 60 min, three times a week, during six months. Patients in the control group (n = 15) were not provided with a formal exercise prescription. Both groups received identical nutritional and pharmaceutical counseling during the study. Longitudinal analysis of the effects of exercise training on QoL, considering the interaction term (group × time) to estimate the rate of changes between groups in the outcomes (represented as beta coefficient), was performed using linear mixed models. Models were fitted adjusting for each respective baseline QoL value. There were significant improvements in physical functioning (β = + 10.7; p = 0.02), role limitations due to physical problems (β = + 25.0; p = 0.01), and social functioning (β = + 19.2; p < 0.01) scales during the first three months in the exercise compared to the control group. No significant differences were observed between groups after six months. Exercise-based cardiac rehabilitation provided short-term improvements in the physical and mental aspects of QoL of patients with CCC.
- ItemSelf-Reported Dyspnea Is Associated with Reduced Health-Related Quality of Life in Quaternary Hospital Workers 1 Year Post Mild COVID-19 Infection(Healthcare, 2024)Background/objectives: The COVID-19 pandemic had significant implications for healthcare workers (HWs), especially those that work in hospitals. This study evaluated health related quality of life (HRQOL) and its relationship with dyspnea approximately one year after COVID-19 infection in HWs. Methods: HWs with previous COVID-19 infections were interviewed, and the EuroQol five-dimensional three-level questionnaire (EQ-5D-3L) with a visual analog scale (VAS) was used to evaluate HRQOL. Self-reported clinical and sociodemographic data were also obtained. Data were stratified by the presence of self-reported dyspnea in the moment of the study interview. The association between self-reported dyspnea and HRQOL was evaluated by regression models, either unadjusted or adjusted for potential confounders (for age and sex, marital status, work category, number of comorbidities, and number of days between diagnosis and evaluation). Results: A total of 109 HWs were interviewed; the median number of days post COVID-19 diagnosis for this group was 400 (IIQ 25-75% 321-428). The majority were women (67.9%); the median age was 44 (IIQ 25-75% 38-52) years. Overall, the median EQ-5D-3L score was 0.79 (IIQ 25-75% 0.74-0.85), and the median VAS score was 80 (IIQ 25-75% 70-90). Self-reported dyspnea was indicated by 22 individuals (20.2%). Self-reported dyspnea was associated with lower EQ-5D-3L and VAS scores, both in adjusted and non-adjusted models. In addition, self-reported dyspnea was associated with more problems in carrying out usual activities in both the non-adjusted and adjusted models (p < 0.01). Conclusions: Our results underscore the long-term implications of COVID-19, based on persistent perceptions of self-reported dyspnea and its relationship with HRQOL in HWs. Future studies, with extended follow-up and the employment of cardiopulmonary and mental health testing, may help to elucidate the nature and extent of COVID-19 sequelae.
- ItemSevere, rapidly evolving infective endocarditis as a complication of elective surgery: a case report(Heart, Vessels and Transplantation, 2024)Worldwide, virulent staphylococci represent one of the main causative agents of infective endocarditis (IE), and fighting this infection represents one of the main challenges in public health services (1).The diagnosis of IE is based on major criteria patterns (bacteremia and images showing endocardial changes) and minor criteria (2). Staphylococcus aureus bacteremia and specially endocarditis is associated with a high mortality (3). The diagnosis of IE entails prolonged administration of antibiotics and rapid assessment for the need for heart valve surgery (4). If Staphylococcus aureus bacteremia is confirmed, the risk of IE is variable and dependent on factors related to both bacteremia and the patient (5). The main risk factors related to the patient are: previous heart disease, illicit intravenous drug use, heart valve surgery and use of cardiac implanted electronic devices (6-8). The main factors related to bacteremia refer to the bacterial load, expressed as blood culture shorter times to positivity and persistent bacteremia (9).
- ItemReduced systemic microvascular function in patients with resistant hypertension and microalbuminuria: an observational study(2024)Resistant hypertension (RH) may be associated with microalbuminuria (MAU), a marker of cardiovascular risk and target organ damage, and both may be related to microvascular damage. Laser speckle contrast imaging (LSCI) is an innovative approach for noninvasively evaluating systemic microvascular endothelial function useful in the context of RH with or without MAU. Microalbuminuria was defined as a urine albumin-to-creatinine ratio between 30 and 300 mg/g. Microvascular reactivity was evaluated using LSCI to perform noninvasive measurements of cutaneous microvascular perfusion changes. Pharmacological (acetylcholine [ACh], or sodium nitroprusside [SNP]) and physiological (postocclusive reactive hyperemia [PORH]) stimuli were used to evaluate vasodilatory responses. Thirty-two patients with RH and a normal urine albumin-to-creatinine ratio (RH group) and 32 patients with RH and microalbuminuria (RH + MAU) were evaluated. Compared with patients without MAU, patients with RH + MAU showed reduced endothelial-dependent systemic microvascular reactivity, as demonstrated by an attenuation of microvascular vasodilation induced by PORH. On the other hand, ACh-induced vasodilation did not differ between groups. The results also revealed reduced endothelial-independent (SNP-induced) microvascular reactivity in hypertensive patients with MAU compared with patients without MAU. In this study, there was evidence of endothelial dysfunction associated with impaired microvascular smooth muscle function in patients with RH + MAU. This may suggest that patients with RH need more intensive therapeutic strategies for the control of blood pressure to avoid further vascular damage and the resulting consequences.