Navegando por Assunto "Anti-hipertensivos"

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    Avaliação do uso de hidroclorotiazida em pacientes com carcinoma basocelular atendidos em ambulatório de dermatologia
    (Centro Universitário do Estado do Pará, 2019-11-20) Rodrigues, Pedro Henrique Pantoja Souza; Franco, Rodrigo Carneiro; Amin, Gabriela Athayde; Carneiro, Francisca Regina Oliveira; http://lattes.cnpq.br/1387234135281918; http://lattes.cnpq.br/8604283847300465; Bittencourt, Maraya de Jesus Semblano; http://lattes.cnpq.br/6566823528602319; Lima, Caren dos Santos; http://lattes.cnpq.br/6225022147519510
    Introduction: According to the National Cancer Institute (INCA), nonmelanoma skin cancer represents 30% of all malignant neoplasm in Brazil. These tumors have low lethality but high morbidity, so recognition of risk factors and early diagnosis are determinant for prognosis. Basal cell carcinoma arises from non-keratinized cells from the basal layer of the epidermis and represents 76% of all non-melanoma skin cancer (CPNM). In Brazil, approximately 165,580 new cases of this neoplasm were estimated, with tendency to increase this rate for the next years. It is locally invasive, usually nonagressive and destructive of skin, despite its low metastatic potential, being more common among the elderly, white populations and male. Its main clinical presentation is a papule ou nodule with a pearly aspect, often with typical telangectasy located mainly in the head and neck region. Some studies have related hydrochlorothiazide, one of the main antihypertensive drugs used in Brazil, as a potential risk factor for the development of Basal Cell Carcinoma (CBC). This led the National Health Surveillance Agency (ANVISA) to release a note informing about the increased risk of nonmelanoma skin cancer with the use of the drug and recommending that physicians report this risk to patients, as well to guide patients for regular self-examination of the skin looking for new lesions. Current studies, however, are recent and conflicts about this association. Objective: Evaluate the relationship between hydrochlorothiazide use and the risk of developing basal cell carcinoma. Materials and Methods: A population-based case-control study was conducted, collecting cases (histopathological CBC confirmations) of the Pathology Laboratory of the Dermatology Service of the Center for Medical Specialties of the University Center of Pará (CESUPA). Controls were matched 3:1 by age and sex. Data was obtained from medical record or interview. Analytical statistics were used to evaluate the results of the categorical variables of the sample through the G and Chi-squared tests adherence and independence. Odds Ratio was calculated using Logistic Regression, with a 95% confidence interval. Results: We obtained 36 cases of BCC and 108 controls. The use of hydrochlorothiazide increased the risk of developing basal cell carcinoma (Odds Ratio 2.53 and 95% CI 1.04 - 6.14). There seems to be a cumulative dose relationship, evidenced by Odds ratio 2.80 and 95% CI 1.01 - 7.77 for doses greater than or equal to 27,000mg, corresponding to 3 years or more of use, which is not observed at doses lower than this. Conclusion: The use of hydrochlorothiazide increase the risk of developing basal cell carcinoma.
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    Efeito protetor do uso de bloqueadores de receptores de angiotensina 2 contra desfechos graves da COVID-19 em pacientes hipertensos: revisão sistemática com metanálise
    (Centro Universitário do Estado do Pará, 2022-11-07) Miranda, Anna Luiza Alves de Oliveira; Beltrão, Letícia Viana Martins; Texeira, Cláudio Eduardo Corrêa; http://lattes.cnpq.br/7448998858430931; Maia, Matheus Rocha; http://lattes.cnpq.br/6118052846256806; Pereira, Raphael do Nascimento; http://lattes.cnpq.br/4495343513171099
    There are several records in the literature that show the non-association between the use of antihypertensive drugs that inhibit the action of angiotensin II (ANGII) and the occurrence of serious outcomes of COVID-19 in hypertensive patients, which suggests that these drugs potentially exert a protective effect. However, there are no studies in the literature that have investigated this potential considering in an isolated way the effect of different classes of these antihypertensive drugs. Analyse if the use of ANGII type I receptor inhibitors (ARBs) is more protective than that of Angiotensin I Converting Enzyme (ACEi) inhibitors against critical COVID-19 outcomes in hypertensive patients. A systematic review was carried out with a random effect meta-analysis, following the PRISMA model (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes), and using the PubMed, Lilacs and Scielo platforms to collect papers. Twelve of 122 studies were selected, totaling 130,243 patients. In the data analysis, treatment with ARB was considered as intervention/exposure and treatment with ACEI as control/non-exposure. The I2 statistic was used to measure the heterogeneity among the selected works. The results show that, although statistically it is not possible to prove the hypothesis, the summary statistics show a clear trend of: greater hospital admission of patients using ACEI (Standardized Mean Deviation [SMD]: -0.16, interval of 95% confidence [95%CI]: -0.34 to 0.01); higher number of ICU admissions of patients using ACEI (DMP: -0.28, 95%CI: -0.63 to 0.06); higher number of deaths of patients using ACE inhibitors (DMP: -0.15, 95%CI: -0.39 to 0.08). It was not possible to associate concomitant deaths with critical events with the use of ARBs or ACEIs (DMP: -0.10, 95%CI: -0.37 to 0.17). Statistically, it was not possible to associate, in an isolated way, the use of antihypertensive drugs that inhibit the action of ANGII with the protective effect against serious outcomes reported in the literature. However, it was possible to observe a protective tendency for the use of ARBs.