Mortality & Morbidity – ABC CARDIOL

IJCS

Case Report

Acute Myocardial Infarction as the Initial Clinical Manifestation of Pernicious Anemia

Leonardo Marostica Alves Silva et al. Assis Xavier da Silva Barros Junior João Antonio de Toledo Galina Alexandre Rodrigues … Igor Ribeiro de Castro Bienert Pedro Beraldo de Andrade

Introduction

Despite its lower prevalence in young individuals, acute myocardial infarction (AMI) causes significant morbidity and socioeconomic impact when occurs in this group. In 2010, considering only the hospitals accredited by the Brazilian Unified Health System, there were 8,368 hospitalizations and 2,556 deaths from ischemic heart diseases among patients younger than 40 years. Although hospitalization rates are lower at this age range, the importance of this theme lies mainly in the absolute numbers of cases.

Acute coronary syndrome (ACS) in young patients has characteristics that differ from older patients. Although coronary atherosclerotic disease is a common cause, the prevalence of AMI without obstruction in the coronary arteries is higher among the young. Among the causes of AMI without atheromatous disease, thromboembolism is a differential diagnosis, with hypercoagulability correlated with formation of coronary embolism. Thus, it is important to identify alternative etiologies in the approach of AMI in young patients since modifiable factors can be diagnosed and treated. In this article, we present a case in which an autoimmune disease may be the cause of ACS in a young patient with few attributable risk factors for cardiovascular disease.

[…]

Read Full Article

IJCS

Original Article

Factors Associated to the Knowledge of Cardiac Arrest by Health Professionals

Eduardo Moreira Novaes Neto et al. Kátia Santana Freitas

Abstract

Background:

Knowledge of cardiac arrest by health professionals is associated with sociodemographic, occupational and training characteristics.

Objectives:

To evaluate the factors associated with the knowledge of health professionals on Cardiac Arrest.

Methods:

A cross-sectional study conducted in a large public hospital in the countryside of Bahia – Brazil. The sample consisted of 18 doctors, 32 nurses and 50 nursing technicians. To evaluate the knowledge of the professionals, a questionnaire was constructed according to the current guidelines for resuscitation of the American Heart Association of 2015, and after that, it was submitted to three judges with expertise in PCR to verify content validity. Data were analyzed through descriptive statistics with univariate, bivariate and multivariate analyses using the logistic regression model. A value of p < 0.05 was adopted as level of significance.

Results:

The prevalence of insufficient knowledge of cardiac arrest among health professionals was 78%. After logistic regression, belonging to the professional category of nursing technician (p = 0.003) and nurse (p = 0.001) and working in the form of on-call duty for 24h (p = 0.005) was associated to insufficient knowledge.

Conclusions:

Insufficient knowledge of cardiac arrest among health professionals is high, which is a problem that requires urgent interventions in order to guarantee the quality of care. These actions should be based on realistic scenarios involving theoretical and practical activities. The periodicity of training should be short, given the deterioration of knowledge. The creation and validation of the data collection instrument allows for its applicability in other studies.

Read Full Article

IJCS

Editorial

Diabetes Mellitus, Insulin Use, and Infective Endocarditis

Rubens Antunes Cruz Filho

The prevalence of diabetes mellitus (DM) is very high in Brazil and worldwide. It is estimated that there are now more than 12 million diabetics in Brazil, not counting those who already have the disease but have not yet been diagnosed. Since the introduction of insulin, the treatment of DM has been constantly changing, according to treatment guidelines proposed by diabetes societies, from the diagnosis to more advanced stages of the disease. More stable insulins, as well as incretin-based therapy for subcutaneous use, have been proposed in the treatment of type 2 DM patients. These therapies have not only contributed to the better treatment of the most prevalent type of diabetes, but also introduced the use of a parenteral medication other than insulin.

Infective endocarditis (IE) is a relatively rare, serious cardiovascular disease with a hospital mortality rate of 17-25%, despite all therapeutic advances. In an observational study by Bezerra et al., published in this issue of the IJCS, the association between the use of insulin and IE is discussed. In this retrospective study involving 211 patients, 17 with DM (nine insulin users), there was a higher proportion of S. aureus infection in diabetics using insulin. However, mortality rate was not higher among diabetics when compared to non-diabetics. There is a lack of studies on IE in DM and regarding the use of insulin and IE, data are even more scarce. So, the study by Bezerra et al., assumes an importance in this area of knowledge, since we are talking about a highly prevalent disease (DM) and a serious comorbidity (IE) with a still high risk of mortality.

[…]

Read Full Article

ABC

Editorial

Group Means and Inter-Individual Analysis in Post-exercise Hypotension: Effects of Citrulline Malate Oral Supplementation

Leandro C. Brito

Hypertension is pointed out as one of the most aggressive risk factor for cardiovascular morbidity and mortality, since it is directly associated with nearly 8 million obits per year related to cardiovascular diseases such as cardiac arrest or stroke. Hypertensives with low levels of physical activity present higher risk of cardiovascular morbidity and mortality even when receiving anti-hypertensive medication. The regular practice of exercise, mainly aerobic exercises, is highly recommended due to its hypotensive effect. Actually, a single session of exercise is already able to promote a sustained reduction of blood pressure, this phenomenon is called post-exercise hypotension (PEH).^–

Kenney and Seals were the first to term the most accepted version of PEH as a phenomenon – It is the decrease of systolic and/or diastolic blood pressure after an acute session of exercise to below a control value followed by no clinical hypotensive symptom. PEH has been faced as a clinically relevant tool, mainly due to its known magnitude and for lasting many hours. In this context, a meta-analysis including 65 studies recently showed reductions of blood pressure averaging from 6/4 mmHg for systolic/diastolic after aerobic exercise session, while hour-to-hour analysis reported a decrease for 16 hours.

[…]

Read Full Article

Acute Myocardial Infarction as the Initial Clinical Manifestation of Pernicious Anemia

Introduction

Factors Associated to the Knowledge of Cardiac Arrest by Health Professionals

Abstract

Background:

Objectives:

Methods:

Results:

Conclusions:

Diabetes Mellitus, Insulin Use, and Infective Endocarditis

Group Means and Inter-Individual Analysis in Post-exercise Hypotension: Effects of Citrulline Malate Oral Supplementation

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)