Navegando por Autor "Costa, Alberto Freire Sampaio"

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Análise do perfil clínico em pacientes com insuficiência cardíaca atendidos no Centro de Especialidades Médicas do CESUPA no município de Belém-Pará
(Centro Universitário do Estado do Pará, 2020) Dourado, Breno Gurgel; Ferreira, Lucas Afonso Maia; Costa, Alberto Freire Sampaio; Lima, Jackson Cordeiro; http://lattes.cnpq.br/5898669844844564; http://lattes.cnpq.br/8830564785408868
INTRODUCTION: Heart failure is a disease of high prevalence in Brazil and a great burden for health systems. The Disease has a wide and disabling clinic and an obscure prognosis if not treated correctly. Local knowledge of the variables of patients with the disease is essential for improving the quality of care and improving the life expectancy of patients. OBJECTIVE: Analyze and document the clinical-epidemiological profile of patients with Heart Failure (CH) treated at the Centro de Especialidades Médicas do Centro Universitário do Estado do Pará (CEMEC). METHODS: The information was collected from 62 medical records of patients diagnosed with Chronic Heart Failure enrolled at CEMEC based at CESUPA Campus in Belém-PA, using a protocol made by the researchers for the collection of epidemiological data of these patients. Medical records of all patients registered at CEMEC with a diagnosis of HF who had described the results of at least one echocardiographic examination were included, excluding those with loss of follow-up greater than 3 years in the ambulatory and those ones with severe comorbidities that would hinder the objective analysis of the results. For quantitative statistical analysis, the Biostat 5.3 program was used. RESULTS: 54% of the patients are male (n = 34/62), with an average age of 68 years. Systemic arterial hypertension (SAH) was found in 93.5% (n = 58/62) of these patients, being the main comorbidity, followed by dyslipidemia (43.5%; n = 27/62). 58.1% had heart failure with preserved ejection fraction – HFPEF (n = 36/62), and 37.1% (n = 23/62) being in NYHA I functional class and 22.6% (n = 14 / 62) in NYHA III. It was found that 48.3% of these patients have a very high cardiovascular risk. Regarding therapy, 90.3% use ACE inhibitors or ARBs, with Losartan being the main representative (79%; n = 49/62). 85.5% use beta blockers, with carvedilol being the most used (69.4%; n = 43/62). Spironolactone is used by 43.5% of patients (n = 27/62). Statins are used by 72.6% of patients. CONCLUSION: The study confirmed that the clinical-epidemiological profile of patients seen at the cardiology ambulatory of CEMEC is compatible with the epidemiology described in other studies, being mostly composed of elderly men, with multiple comorbidities, with SAH being the main one. It was also found that the treatment proposed by the outpatient professionals is in accordance with that recommended by the Brazilian guideline for heart failure, as well as being supported by systematic reviews with meta-analyzes. The absence of documentation of echocardiographic examinations in some medical records was noted, as well as a lack of data such as the functional classification of the patient and the HF phenotype.
Análise dos indicadores epidemiológicos e da curva de mortalidade por doenças agudas isquêmicas do coração na região metropolitana I do estado do Pará entre 2008 e 2017
(Centro Universitário do Estado do Pará, 2020) Silva Júnior, Gilvaldo dos Santos; Cavalcante, Lucas dos Santos; Costa, Alberto Freire Sampaio; Neves, Dilma Costa de Oliveira; http://lattes.cnpq.br/7230812534416350; http://lattes.cnpq.br/8830564785408868
Introduction: In Brazil, the cardiovascular diseases represents the main case of mortality since 1990 and the highest goverment cost rates in the health system. Ischemic cardiomyopathy, which covers codes from I20 to I25 International Statistical Classification of Diseases and Related Health Problems (ICD-10), is the most common cause of death in cardiovascular diseases group Objectives: Analyze the trend of mortality from acute ischemic heart deseases in Metropolitan Regian I of Pará state between 2008 and 2017 Methodology: Observational-descriptive, ecology, study, based on DATASUS informations. Specific instrument was used to collect data on the variables of interest, and all death certificates were selected through ICDs from I20 to I23 - angina pectoris, acute myocardial infarction, subsequent myocardial infarction and certain current complications following acute myocardial infarction, respectively - localizaded on basics cause or consequencial and direct death mechanism, age from 20 years and tem years interval, between 2008 and 2017. Results: There was an increase in the mortality rate, showing the growing trend, with the highest absolute rates observed in the age group of 80 years or older, however, percentage the age group between 20 and 39 years showed the biggest increase in this group of causes. There is a parallel between men and women, with a higher trend in males, with a high risk of death from ischemic cardiovascular disease in males, especially in the elderly between 60 and 79 and 80 years old or more. The sociodemographic variable did not show any significant difference in relation to skin color, marital status, education and occupation. However, when comparing the specific causes of ischemic diseases and such variables, there was a predominance of Acute Myocardial Infarction (MI), but only in terms of marital status, education and occupation, such data are significant in relation to the average of the event in the population. Conclusion: The issue of equity in access to health services must be more adequate, due to the fact that the basic units are the patient's first contact with the public health system and this is the place where the main modifiable risk factors will be diagnosed and treated, for example, systemic arterial hypertension, smoking and obesity. Since the responsability for changing the status of desease, with reflection even on the future demands, is in the perspective of preventive actions.
Avaliação do risco cardiovascular em pacientes com lúpus eritematoso sistêmico atendidos no CEMEC
(Centro Universitário do Estado do Pará, 2019-05-20) Borborema, Augusto Lopes Pereira de; Santos, Felipy Chaves dos; Cristino, Sônia Conde; Rodrigues, Fabíola Brasil Barbosa; http://lattes.cnpq.br/2425897539868497; http://lattes.cnpq.br/7942684022038270; Ohashi, Claudia Barros; http://lattes.cnpq.br/0889116450004563; Costa, Alberto Freire Sampaio; http://lattes.cnpq.br/8830564785408868
Introduction: Systemic Lupus Erythematosus - SLE is a disease of autoimmune origin with a large number of clinical and laboratory manifestations. The pathophysiological nature of lupus involves both chronic and atherosclerotic inflammatory processes, which gives pathology an important role in the genesis of changes related to the cardiovascular system. In this context, it is essential to use the Framingham score in an attempt to estimate the cardiovascular risk in lupus patients and the interaction with traditional and non-traditional risk factors. Objectives: General: To evaluate cardiovascular risk in patients with Systemic Lupus Erythematosus in follow-up at CEMEC. Specific: To establish the prevalence of cardiovascular risk factors in SLE patients followed at CEMEC; 3) To characterize the epidemiological profile of patients with SLE treated at CEMEC; 4) Describe the characteristics of patients with SLE treated at CEMEC and relate it to cardiovascular risk. Methods: A research protocol was developed in which patient information is fundamental to the research: age, sex, time of illness, smoking, systolic blood pressure, total cholesterol, HDL, diabetes, medications in use and type of SLE. The search for data was based on the analysis of medical records of patients with SLE treated at CEMEC. Subsequently, these data were applied to the Framingham score. Results: It was observed that of the 68 patients who met the inclusion and exclusion criteria, 88.2% were female, 33.8% were in the age group below 30 years of age and 44.1% (n = 30) present a disease time between 6 and 10 years. Cutaneous involvement was the most prevalent, with 88.2% of cases. Regarding cardiovascular risk, 94.1% of the patients presented low risk, 1.5% medium risk and 4.4% high risk. The Immunossupressor / Immunomodulator class is part of the treatment of 92.6% of the patients. Conclusion: The study concludes that the Framingham score was not able to correctly identify cardiovascular risk in SLE patients.
O diagnóstico acurado de hipertensão arterial resistente na melhora do prognóstico cardiovascular: uma revisão sistemática de literatura
(Centro Universitário do Estado do Pará, 2021) Araújo, Thales Djalon Chagas de; Costa, Maria Elizabeth Navegantes Caetano; http://lattes.cnpq.br/3143608318773439; Costa, Alberto Freire Sampaio; http://lattes.cnpq.br/8830564785408868; Bastos, Fabíola de Arruda; http://lattes.cnpq.br/9386935778704228
INTRODUCTION: Resistant arterial hypertension has been considered an important risk factor for the development of cardiovascular diseases. As a result, several studies seek to systematize therapeutic measures to reduce the burden of resistant hypertensive patients. In this sense, the scientific literature in the area highlights that the diagnosis has been instrumental in improving the prognosis of these patients, since there are external conditions that influence the increase in blood pressure and contribute to the conclusion of a false diagnosis of resistant arterial hypertension. PROBLEMATIZATION: Therefore, the question is: to what extent can the accurate diagnosis of Resistant Arterial Hypertension (RAH) improve the cardiovascular prognosis? What factors influence the diagnosis of Resistant Arterial Hypertension? What measures should be taken for an accurate assessment of Resistant Arterial Hypertension? OBJECTIVE: For all of the above, this research aims to analyze how the accurate diagnosis of Resistant Arterial Hypertension (RAH) can improve cardiovascular prognosis. METHODOLOGY: The research is conducted methodologically by the principles of systematic literature review. RESULTS AND DISCUSSIONS: 19 studies were found, through a systematic literature review, seeking to map clinical conditions that interfere in the diagnosis of resistant hypertension, such as Pseudoresistance; effect of the white coat and secondary causes. The scientific literature points out that it is necessary to systematically assess such external conditions of elevated Blood Pressure, excluding them when necessary to effectively conclude the accurate diagnosis of resistant hypertension. Thus, it is observed that the effective management of resistant hypertension requires, firstly, a careful examination and exclusion of the factors associated with Pseudoresistance and, secondly, the identification and, when possible, the modification of the factors related to the true elevations of the Pressure Arterial. After these factors are successfully managed, an aggressive treatment regimen designed to compensate for all mechanisms of elevating blood pressure should be promoted and, consequently, moving towards effective blood pressure control for most patients. FINISH CONSIDERATIONS: Therefore, in terms of conclusion, the research corroborates with the literature in that it points to the accurate diagnosis as a determinant for the improvement of the cardiovascular prognosis of the patient with resistant hypertension.