Chagas disease (CD) continues to be a major public health burden in Latina America. Information on the interplay between COVID-19 and CD is lacking. Our aim was to assess clinical characteristics and in-hospital outcomes of patients with CD and COVID-19, and to compare it to non-CD patients. Consecutive patients with confirmed COVID-19 were included from March to September 2020. Genetic matching for sex, age, hypertension, diabetes mellitus and hospital was performed in a 4:1 ratio. Of the 7018 patients who had confirmed COVID-19, 31 patients with CD and 124 matched controls were included (median age 72 (64–80) years-old, 44.5% were male). At baseline, heart failure (25.8% vs. 9.7%) and atrial fibrillation (29.0% vs. 5.6%) were more frequent in CD patients than in the controls (p < 0.05). C-reactive protein levels were lower in CD patients compared with the controls (55.5 [35.7, 85.0] vs. 94.3 [50.7, 167.5] mg/dL). In-hospital management, outcomes and complications were similar between the groups. In this large Brazilian COVID-19 Registry, CD patients had a higher prevalence of atrial fibrillation and chronic heart failure compared with non-CD controls, with no differences in-hospital outcomes. The lower C-reactive protein levels in CD patients require further investigation.
Voltage-gated calcium channels (VGCCs) are targeted to treat pain conditions. Since the discovery of their relation to pain processing control, they are investigated to find new strategies for better pain control. This review provides an overview of naturally based and synthetic VGCC blockers, highlighting new evidence on the development of drugs focusing on the VGCC subtypes as well as mixed targets with pre-clinical and clinical analgesic effects.
Objective: Chagas disease (CD) continues to be a major public health burden in Latina America, where co-infection with SARS-CoV-2 can occur. However, information on the interplay between COVID-19 and Chagas disease is lacking. Our aim was to assess clinical characteristics and in-hospital outcomes of patients with CD and COVID-19, and to compare it to non-CD patients. Methods: Patients with COVID-19 diagnosis were selected from the Brazilian COVID-19 Registry, a prospective multicenter cohort, from March to September, 2020. CD diagnosis was based on hospital record at the time of admission. Study data were collected by trained hospital staff using Research Electronic Data Capture (REDCap) tools. Genetic matching for sex, age, hypertension, DM and hospital was performed in a 4:1 ratio. Results: Of the 7,018 patients who had confirmed infection with SARS-CoV-2 in the registry, 31 patients with CD and 124 matched controls were included. Overall, the median age was 72 (64.-80) years-old and 44.5% were male. At baseline, heart failure (25.8% vs. 9.7%) and atrial fibrillation (29.0% vs. 5.6%) were more frequent in CD patients than in the controls (p<0.05 for both). C-reactive protein levels were lower in CD patients compared with the controls (55.5 [35.7, 85.0] vs. 94.3 [50.7, 167.5] mg/dL). Seventy-two (46.5%) patients required admission to the intensive care unit. In-hospital management, outcomes and complications were similar between the groups. Conclusions: In this large Brazilian COVID-19 Registry, CD patients had a higher prevalence of atrial fibrillation and chronic heart failure compared with non-CD controls, with no differences in-hospital outcomes. The lower C-reactive protein levels in CD patients require further investigation.
Objetivo: Analisar os desfechos dos diferentes tipos de abordagens cirúrgicas – cirurgia minimamente invasiva versus laparotomia – em mulheres com câncer cérvico-uterino (CCU), fazendo uma comparação entre estudos novos e antigos (antes e depois de 2018) e analisando taxas de recorrência, sobrevida e complicações recorrentes em cada técnica. Revisão bibliográfica: Trata-se de uma revisão narrativa dos desfechos de diferentes técnicas cirúrgicas na abordagem do câncer de colo de útero. Sabe-se que o CCU é causado pela infecção persistente por alguns tipos do Papilomavírus Humano (HPV). Novos estudos trouxeram informações contrárias às preconizadas anteriormente, concluindo que, comparado à laparotomia, a taxa de sobrevida da cirurgia minimamente invasiva foi menor – gerando novos debates para a cirurgia oncológica. Porém, a escolha de cirurgia minimamente invasiva para histerectomia radical continua a ganhar popularidade sobre a laparotomia. O principal motivo para isso são os benefícios operacionais e perioperatórios da abordagem laparoscópica, além da menor incidência de complicações infecciosas e não-infecciosas no pós-operatório. Considerações finais: Conclui-se que as técnicas analisadas são seguras e possuem indicações bem esclarecidas, mas ainda é necessário um número maior de estudos detalhados para se chegar a um consenso final sobre uma maior efetividade entre uma ou outra abordagem.
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