Resumo A vitamina D (1,25-dihidroxicolecalciferol) é um pró-hormônio que tem despertado a atenção de pesquisadores após estudos demonstrarem que seus efeitos não estão restritos ao metabolismo ósseo. Assim, a presente revisão sintetiza os achados mais recentes e discute a utilidade da prescrição de vitamina D e seus análogos no tratamento e prevenção de afecções cardiovasculares e disfunção endotelial. Este trabalho consiste em uma revisão narrativa da literatura feita a partir da seleção de artigos publicados no período de 2012 a 2019. Estudos demonstraram efeitos benéficos da vitamina D3 e seus análogos sobre a função endotelial; no entanto, tais resultados mostram-se controversos, visto que pesquisas com maior amostragem e duração não encontraram redução na morbimortalidade ou nos fatores de risco cardiovascular após o uso de tais substâncias. Frente ao estado atual da arte, não existe embasamento científico claro para suplementação de vitamina D ou seus análogos para tratamento de disfunção endotelial ou doenças cardiovasculares.

SUMMARY INTRODUCTION: Coarctation of the aorta is a congenital heart disease characterized by a narrowing that occurs in the aortic artery. This constriction can occur anywhere along its entire length; however, it is more common between the origin of the left subclavian artery and the ductus arteriosus. Its incidence corresponds to 3 cases per 10,000 births. Thus, it is a common cardiopathy, but with high mortality and morbidity rates, which are related to a failure in the early diagnosis. METHOD: In the research, articles of the national and international literature in Pubmed, Scielo and Lilacs databases were selected using the following descriptors: coarctation, aorta, diagnosis, heart diseases, congenital abnormalities. RESULTS: The pathophysiology of CoA and its systemic implications in the life of newborn and adults are well elucidated. However, due to the lack of habit to palpate pulses and to check the blood pressure in both upper and lower limbs during the physical examination, it is still a pathology little diagnosed in childhood. There are several techniques used in the repair of coarctation, each with their specifics, although, when not treated, aneurysms, heart failure, coronary diseases, and stroke are the main complications arising from the evolution of this pathology, which explains the low survival rate of these patients. CONCLUSION: Coarctation of the aorta is, therefore, a cardiac malformation of significant importance due to its incidence and its significant mortality risk. In this sense, the early diagnosis stands out as an essential piece for better prognosis of the patient.

OBJECTIVE:The aim of this study was to highlight the differences between the cardiometabolic effects and the cardiovascular risk of physical inactivity and sedentary behavior. METHODS:A narrative bibliographic review was conducted. In the research, national and international articles were selected from the PubMed, SciELO, and LILACS databases using the descriptors "sedentary lifestyle, cardiovascular risk, physical inactivity, sedentary behavior, and cardiovascular risks." DISCUSSION: Both physical inactivity and sedentary behavior are related to metabolic and organic changes, promoting a chronic proinflammatory state, cardiac remodeling, increased body adiposity, and skeletal muscle dysfunction. It is possibly stated that both of them result in a higher risk of developing chronic diseases, resulting in higher global and cardiovascular morbidity and mortality, with nuances in their intrinsic effects. CONCLUSIONS:It is inferred that both physical inactivity and sedentary behavior are cardiovascular risk factors that can be modified with the correct clinical approach. It is necessary to differentiate physically inactive individuals from those with a high number of sedentary behaviors. These concepts need better clinical applicability to improve the prevention of primary and secondary cardiovascular risks.

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Resumo Objetivo Determinar a concordância entre os instrumentos de mensuração short test of functional health literacy in adults (S-TOFHLA) e short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18) como estratégia para estimar a validade concorrente. Métodos Estudo transversal, com usuários do Sistema Único de Saúde. Para testar a validade concorrente, aplicou-se abordagem de concordância com teste de Kappa ponderado para dados qualitativos. Resultados Participaram 372 indivíduos, dos quais 66% e 62% não apresentaram nível de letramento adequado, segundo o SAHLPA-18 e o S-TOFHLA, respectivamente. Observou-se correlação forte entre os instrumentos (p<0,001; r=0,60); e a concordância de acertos encontrada, 65,3% (Kappa=0,35; p<0,001), foi considerada fraca. Conclusão Os instrumentos SAHLPA-18 e S-TOFHLA apresentam constructos diferentes e fraca concordância. É indicado o uso de diferentes instrumentos em pesquisas de mensuração do nível de letramento; e desenvolvimento de instrumentos específicos às condições de saúde que permitam obter resultado próximo ao real contexto dos indivíduos.

Background: The assessment of intravascular volume and fluid responsiveness is challenging in the management of critically ill patients. Diagnostic methods of hemodynamic monitoring must be safe, reproducible, and practical. Objective: To describe the applicability of ultrasound indices of the inferior vena cava in the assessment of intravascular volume and prediction of fluid responsiveness in critically ill patients. Method: A systematic review performed of the PubMed®, Latin American and Caribbean Health Sciences Literature, and Scientific Electronic Library Online databases for articles published in the previous five years. The descriptors used were “inferior vena cava,” “ultrasonography,” “fluid responsiveness,” and “volume status.” Results: The search identified 13 relevant articles. The collapsibility index of the inferior vena cava was 25%–50% as the cutoff point for defining hypovolemia and showed applicability in predicting fluid responsiveness in patients breathing spontaneously with cutoff points of 25%–57%. In mechanical ventilation scenarios, the distensibility index of the inferior vena cava was more effective at predicting fluid responsiveness than the other measurements with variation of 10.2%–20.5%. The inferior vena cava/aorta diameter index was especially useful in the pediatric population for defining intravascular volume; however, in adults, there were many divergences in its applicability. Conclusion: The assessment of intravascular volume and fluid responsiveness through ultrasound indices of the inferior vena cava is applicable and safe for diagnosing and monitoring hemodynamic instability. However, studies of value standardization are necessary due to divergences in the cutoff points used in each index.

Severe Acute Respiratory Syndrome Coronavirus 2 is part of the Cononaviridae family and is the causative agent of the 2019 Coronavirus pandemic declared by the World Health Organization in March, 2020. This virus has a high rate of transmission, affecting several individuals, and has caused thousands of deaths. The clinical manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 infection are not restricted only to the respiratory tract, and there is an express involvement of the cardiovascular system with a higher risk of death in this group. In such patients there is an overactivation of renin-angiotensin-aldosterone system, which promotes an increase in the expression of angiotensin-converting enzyme -2 that acts as a receptor for the SPIKE protein expressed by the virus and enables the interaction between the host cell and Severe Acute Respiratory Syndrome Coronavirus 2. This process of infection causes a hyperinflammatory state that increases the inflammatory markers of cardiac injury. Hence, an adequate understanding and clinical guidance regarding the monitoring, and controlling the damage in these patients is essential to avoid worsening of their clinical condition and to prevent death.

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