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Search Results: 1 - 10 of 115368 matches for " Germano Emilio Concei??o;Bocchi "
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Utilidade clínica da angiografia coronariana em pacientes com disfun??o ventricular esquerda
Melo, Rodrigo Morel Vieira de;Melo, Eduardo Fran?a Pessoa de;Biselli, Bruno;Souza, Germano Emilio Concei??o;Bocchi, Edimar Alcides;
Arquivos Brasileiros de Cardiologia , 2012, DOI: 10.1590/S0066-782X2012005000035
Abstract: background: performing a coronary angiography in patients with heart failure of unknown etiology is often justified by the diagnostic assessment of ischemic heart disease. however, the clinical benefit of this strategy is not known. objective: to evaluate the prevalence of ischemic heart disease by angiographic criteria in patients with heart failure and reduced ejection fraction of unknown etiology, as well as its impact on therapy decisions. methods: consecutive outpatients with heart failure and systolic dysfunction, who had an indication for coronary angiography to clarify the etiology of heart disease were assessed from 1 january 2009 to december 31, 2010. patients diagnosed with coronary artery disease, positive serology for chagas disease, congenital heart disease, valve disease or patients undergoing cardiac transplantation were excluded from the analysis. the sample was divided into two groups according to the indication for catheterization. group-1: symptomatic due to angina or heart failure. group-2: presence of > 2 risk factors for coronary artery disease results: one hundred and seven patients were included in the analysis, with 51 (47.7%) patients in group 1 and 56 (52.3%) in group 2. the prevalence of ischemic heart disease was 9.3% (10 patients), and all belonged to group 1 (p = 0.0001). during follow-up, only 4 (3.7%) were referred for cabg; 3 (2.8%) patients had procedure-related complications. conclusion: in our study, coronary angiography in patients with heart failure and systolic dysfunction of unknown etiology, although supported by current guidelines, did not show benefits when performed only due to the presence of risk factors for coronary artery disease.
Importancia da toxicidade pulmonar pela amiodarona no diagnóstico diferencial de paciente com dispnéia em fila para transplante cardíaco
Silva, Christiano Pereira;Bacal, Fernando;Pires, Philippe Vieira;Drager, Luciano F.;Souza, Germano Emílio Concei??o;Fajardo, Ginny Michele G.;Demarchi, Léa Maria Macruz F.;Bocchi, Edimar Alcides;
Arquivos Brasileiros de Cardiologia , 2006, DOI: 10.1590/S0066-782X2006001600026
Abstract: amiodarone is a class iii antiarrhythmic medication used extensively to treat ventricular arrhythmias1. it is pharmacologically classified as a cationic amphiphilic drug due to its polar and apolar components. during the past few years, amiodarone has proved to be an effective treatment therapy for patients with ventricular dysfunctions, regardless of the etiology, and in particular ventricular arrhythmia associated with chagas disease2. nevertheless, despite its hemodynamic and electrophysiological benefits, amiodarone produces serious collateral effects such as a bluish skin discoloration, photosensitivity, thyroid dysfunction, corneal deposit, peripheral neuropathy, bone marrow suppression, hepatitis, heart blocks, pneumonitis, among others3. the objective of this case report is to discuss one of the most serious complications related to amiodarone, pulmonary toxicity, which is described as a differential diagnosis for a chagasic patient that was on the waiting list for a heart transplant. amiodarone pneumonitis is a relevant differential diagnosis for heart failure (hf) patients using amiodarone that are admitted to the emergency ward with dyspnea.
Perfil do tratamento da insuficiência cardíaca na era dos betabloqueadores
Silva, Christiano Pereira;Bacal, Fernando;Pires, Philippe Vieira;Mangini, Sandrigo;Issa, Victor Sarli;Moreira, Silvia Ferreira Ayub;Chizzola, Paulo Roberto;Souza, Germano Emílio Concei??o;Guimar?es, Guilherme Veiga;Bocchi, Edimar Alcides;
Arquivos Brasileiros de Cardiologia , 2007, DOI: 10.1590/S0066-782X2007000400018
Abstract: objectives: the inhibition of the rennin-angiotensin-aldosterone system (raas) and sympathetic autonomous nervous system has increased the perspective of survival in these patients, as well as allowing the improvement of the quality of life. the aim of this study was to evaluate the reality of the treatment employed and its impact on the disease in patients followed at a specialized heart failure (hf) outpatient clinic. methods: a sample of 96 patients followed at the hf and transplant outpatient clinic of heart institute of the university of s?o paulo school of medicine (incor -hcfmusp) were evaluated. the data were collected during the ambulatory consultation from the medical files and through physical examination. patients were randomly selected for the study. results: most of the patients were functional class ii (42.3%) and evolution stage c (94.9%). the medical prescription given to the patients was quite similar to the one recommended by the directives. approximately 95% of them received raas inhibitors (ace inhibitor - enalapril and captopril - or angiotensin receptor antagonist - losartan), whereas 85% of the patients additionally received beta blockers (carvedilol). the mean dose prescribed was also similar to the one used in large studies and reached more than 60% of the maximum dose for each medication. the hemodynamic data show that patients were stable, despite the intensity of the dysfunction and ventricular remodeling observed in these patients. conclusion: patients with hf followed by a specialized medical team receive a medical prescription that is closer to the recommended one. these patients, despite the marked characteristics of disease severity, achieve hemodynamic and clinical stability with an adequate therapeutic optimization.
Mode of Death on Chagas Heart Disease: Comparison with Other Etiologies. A Subanalysis of the REMADHE Prospective Trial
Silvia M. Ayub-Ferreira ,Sandrigo Mangini,Victor S. Issa,Fátima D. Cruz,Fernando Bacal,Guilherme V. Guimar?es,Paulo R. Chizzola,Germano E. Concei??o-Souza,Fabiana G. Marcondes-Braga,Edimar A. Bocchi
PLOS Neglected Tropical Diseases , 2013, DOI: 10.1371/journal.pntd.0002176
Abstract: Background Sudden death has been considered the main cause of death in patients with Chagas heart disease. Nevertheless, this information comes from a period before the introduction of drugs that changed the natural history of heart failure. We sought to study the mode of death of patients with heart failure caused by Chagas heart disease, comparing with non-Chagas cardiomyopathy. Methods and results We examined the REMADHE trial and grouped patients according to etiology (Chagas vs non-Chagas) and mode of death. The primary end-point was all-cause, heart failure and sudden death mortality; 342 patients were analyzed and 185 (54.1%) died. Death occurred in 56.4% Chagas patients and 53.7% non-Chagas patients. The cumulative incidence of all-cause mortality and heart failure mortality was significantly higher in Chagas patients compared to non-Chagas. There was no difference in the cumulative incidence of sudden death mortality between the two groups. In the Cox regression model, Chagas etiology (HR 2.76; CI 1.34–5.69; p = 0.006), LVEDD (left ventricular end diastolic diameter) (HR 1.07; CI 1.04–1.10; p<0.001), creatinine clearance (HR 0.98; CI 0.97–0.99; p = 0.006) and use of amiodarone (HR 3.05; CI 1.47–6.34; p = 0.003) were independently associated with heart failure mortality. LVEDD (HR 1.04; CI 1.01–1.07; p = 0.005) and use of beta-blocker (HR 0.52; CI 0.34–0.94; p = 0.014) were independently associated with sudden death mortality. Conclusions In severe Chagas heart disease, progressive heart failure is the most important mode of death. These data challenge the current understanding of Chagas heart disease and may have implications in the selection of treatment choices, considering the mode of death. Trial Registration ClinicalTrails.gov NCT00505050 (REMADHE)
Estudo de fatores pró-trombóticos e pró-inflamatórios na cardiomiopatia chagásica
Melo, Leila Maria Magalh?es Pessoa de;Souza, Germano Emílio Concei??o;Valim, Leandro Richa;Moreira, Luiz Felipe Pinho;Damico, Elbio Antonio;Rocha, Tania Rubia Flores da;Barretto, Antonio Carlos Pereira;Strunz, Celia Maria Cassaro;Bocchi, Edimar Alcides;Ramires, José Antonio Franchini;
Arquivos Brasileiros de Cardiologia , 2010, DOI: 10.1590/S0066-782X2010005000146
Abstract: background: the relationship between inflammatory and prothrombotic activity in chagas cardiomyopathy and in other etiologies is unclear. objective: to study the profile of pro-thrombotic and pro-inflammatory markers in patients with chagas' heart failure and compare them with patients of non-chagas etiology. methods: cross-sectional cohort. inclusion criteria: left ventricle ejection fraction (lvef) < 45% and onset time to symptoms > one month. the patients were divided into two groups: group 1 (g1) - seropositive for chagas - and group 2 (g2) - seronegative for chagas. pro-inflammatory factor: ultra-sensitive crp. pro-thrombotic factors: thrombin-antithrombin factor, fibrinogen, von willebrand factor antigen, plasma p-selectin and thromboelastography. sample calculated for 80% power, assuming a standard deviation difference of 1/3; significant p if it is < 0.05. statistical analysis: fisher's exact test for categorical variables; unpaired student's t-test for parametric continuous variables and mann-whitney test for nonparametric continuous variables. results: between january and june 2008, 150 patients were included, 80 in g1 and 70 in g2. both groups maintained the averages of high sensitivity crp above baseline values, however, there was no significant difference (p = 0.328). the fibrinogen levels were higher in g2 than in g1 (p = 0.015). among the thromboelastography variables, the parameters ma (p=0.0013), g (p=0.0012) and tg (p =0.0005) were greater in g2 than in g1. conclusion: there is no evidence of greater pro-thrombotic status among patients with chagas disease. the levels of fibrinogen and the ma, g and tg parameters of the thromboelastography point to pro-thrombotic status among non-chagas patients. both groups had increased inflammatory activity.
Air quality and acute respiratory disorders in children
Amaury de Souza,Hamilton Germano Pav?o,Giancarlo Lastoria,Antonio Concei??o Paranhos Filho
Revista Brasileira em Promo??o da Saúde , 2011,
Abstract: Objective: To evaluate the relationship between air pollution and acute respiratory disorders in children. Methods: An ecological study of time series conducted in public health units in the city of Campo Grande-MS, Brazil, from January 1, 2004 to December 31, 2007. Dailydata of O3 (ozone) were analyzed and, as outcome variables, 16,981 emergency pediatric consultations for respiratory symptoms; including in control model the variables related to time trend; seasonality; minimum, maximum and average temperature; relative humidity;rainfall and respiratory infections. We determined the Pearson correlation coefficient of respiratory diseases in relation to climatic parameters for the years 2004-2007. Results: Only O3 had a positive and statistically significant association, both with all emergency care attendances for respiratory complaints, as with these due to symptoms in lower airways. The daily average concentrations of O3 did not exceed the recommended daily limits. Conclusion: We found associations between air pollution and the number of emergencypediatric consultations for respiratory causes in Campo Grande, although the levels of monitored pollutant ozone remained below recommended levels throughout the study period.
Eficiência de sanificantes alternativos sobre frutos contaminados artificialmente com Escherichia coli
Josidel Concei??o OLIVER, Jaqueline de Lima GERMANO, Sandra Maria Oliveira Morais VEIGA
Revista da Universidade Vale do Rio Verde , 2012,
Paraconsistent Algorithm Extractor of Contradiction Effects - Paraextrctrctr  [PDF]
Joao Inacio Da Silva Filho, Germano Lambert-Torres, Luiz Fernando Pompeo Ferrara, Maurício Concei??o Mário, Marcos Rosa dos Santos, Alexandre Shozo Onuki, José de Melo Camargo, Alexandre Rocco
Journal of Software Engineering and Applications (JSEA) , 2011, DOI: 10.4236/jsea.2011.410067
Abstract: Nowadays networks of analyses based in non-classic logics are used with success in the treatment of uncertainties. The characteristic of accepting the contradiction in his structure is the main cause of the methodologies based in Paraconsistent Logic is ideals for applications in systems of analyses and decision making. In this work we presented an algorithm based in Paraconsistent logic capable to extract in a gradual way the effects of the contradiction in originated signals of information of uncertain knowledge database. The Algorithm Paraconsistent Extractor of Contradiction effects - Paraextrctrctr is formed with base in fundamental concepts of the Paraconsistent Annotated Logic with annotation of two values (PAL2v) it can be applied in filters of networks of analyses of signal information where uncertain and contradictory signals can be present. The process of extraction of the effect of the contradiction is always begun by the largest inconsistency degree among two signals that belong to the group that is in analysis. In the end of the analysis it is found a consensus value. In this work we presented numeric example and one example of application of the Paraextrctrctr in Load Profile Forecast used in support to decision of the operation in an Electric Power System, but his application potentiality is demonstrated in several fields of the Artificial Intelligence.
Representation formulas for the moments of the density of zeros of orthogonal polynomial sets
Bruna Germano,Paolo Emilio Ricci
Le Matematiche , 1993,
Abstract: The moments of the density of zeros of orthogonal polynomial systems generated by athree-term recurrence relation are represented by Lucas polynomials of the first kind and by Bell polynomials.
Amending Contracts for Choreographies
Laura Bocchi,Julien Lange,Emilio Tuosto
Electronic Proceedings in Theoretical Computer Science , 2011, DOI: 10.4204/eptcs.59.10
Abstract: Distributed interactions can be suitably designed in terms of choreographies. Such abstractions can be thought of as global descriptions of the coordination of several distributed parties. Global assertions define contracts for choreographies by annotating multiparty session types with logical formulae to validate the content of the exchanged messages. The introduction of such constraints is a critical design issue as it may be hard to specify contracts that allow each party to be able to progress without violating the contract. In this paper, we propose three methods that automatically correct inconsistent global assertions. The methods are compared by discussing their applicability and the relationships between the amended global assertions and the original (inconsistent) ones.
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