IntroductionChagas disease represents an important health problem with socioeconomic impacts in many Latin-American countries. It is estimated that 20% to 30% of the people infected by Trypanosoma cruzi will develop chronic Chagas cardiomyopathy (CCC), which is generally accompanied by heart failure (HF). Cardiac resynchronization therapy (CRT) may be indicated for patients with HF and electromechanical dysfunctions.ObjectiveThe primary endpoint of this study was to analyze the response to CRT in patients with CCC, while the secondary endpoint was to estimate the survival rates of CRT responder patients.MethodsThis is an observational, cross-sectional and retrospective study. The records of 50 patients with CRT pacing devices implanted between June 2009 and March 2017 were analyzed. For statistical analyses, Pearson's correlation was used along with Student's t-test, and survival was analyzed using the Kaplan-Meier method. A P value of <0.05 was considered significant.ResultsOut of 50 patients, 56% were male, with a mean age of 63.4±13.3 years and an average CRT duration of 61.2±21.7 months. The mean QRS duration was 150.12±12.4 ms before and 116.04±2.2 ms after the therapy (P<0.001). The mean left ventricular ejection fractions (LVEF) were 29±7% and 39.1±12.2% before and after CRT, respectively (P<0.001). A total of 35 (70%) patients had a reduction of at least one New York Heart Association (NYHA) functional class after six months of therapy (P=0.014). The survival rate after 72 months was 45%.ConclusionThis study showed clinical improvement and a nonsignificant survival rate in patients with CCC after the use of CRT.
Percepção de homens após infartoRev Bras Promoç Saúde, Fortaleza, 30(3): 1-9, jul./set., 2017 1
Objetivo: apresentar uma revisão crítica do traumatismo cranioencefálico infantil, na tentativa de eleger os principais aspectos investigados ultimamente. Método: trata-se de estudo de revisão bibliográfica dos artigos publicados na base de dados Scielo no período de 2000 a 2010. Resultados: foram analisados 10 artigos, dos quais emergiram quatro categorias: causas de TCE infantil, prognóstico de crianças vítimas de TCE, tratamento de crianças vítimas de TCE e complicações da terapêutica empregada a crianças vítimas de TCE. Conclusões: há consenso entre os autores pesquisados que os fatores relacionados com o melhor prognóstico de crianças vítimas de TCE, ainda permanecem vago e incerto. Acrescentam ainda que o sucesso do atendimento desta clientela relaciona ao controle das complicações oriundas do trauma cerebral e que em sua grande maioria estes são corrigíveis ou evitável.
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