Efficacy versus Effectiveness We underlined that efficacy and effectiveness describe two different types of information: efficacy is the demonstration that a new principle can theoretically work, which comes from studies under ideal controlled conditions; effectiveness is how the concept proven by efficacy studies works under real world conditions (RWC)., For demonstration of efficacy, one should select the optimal scenario for the proof of principle. It requires an experimental study design, with random allocation of treatments, to eliminate confounding bias and […]

Introduction Research and innovation help to drive economic growth and address socioeconomic challenges like poverty and health. Many developed and developing countries have introduced policies and systems to increase research and innovation. In Brazil, a system was created on 1951 with the objectives of improving technology and innovation and strengthening scientific research., Similar to postgraduate doctorate programs in developed countries, postgraduate programs with broader and more in-depth scientific research objectives have been developed in Brazil. In fact, a linear relationship […]

Abstract Background: Schools have become a key figure for the promotion of health and obesity interventions, bringing the development of critical awareness to the construction and promotion of a healthy diet, physical activity, and the monitoring of the nutritional status in childhood and adolescence. Objectives: To describe a study protocol to evaluate the effectiveness of an intervention designed to improve knowledge of food choices in the school environment. Methods: This is a cluster-randomized, parallel, two-arm study conducted in public elementary […]

Abstract Background: The best way to select individuals for lipid-lowering treatment in the population is controversial. Objective: In healthy individuals in primary prevention: Methods: In individuals aged 40-75 years consecutively submitted to routine health assessment at one single center, four criteria of eligibility for statin were defined: BR-1, BR-2 (LDL-c above or at least 30 mg/dL above the goal recommended by the Brazilian Guideline, respectively), USA-1 and USA-2 (10-year risk estimated by the PCE ≥ 5.0% or ≥ 7.5%, respectively). […]

Abstract Background: There is controversy whether management of blood cholesterol should be based or not on LDL-cholesterol (LDL-c) target concentrations. Objectives: To compare the estimated impact of different lipid-lowering strategies, based or not on LDL-c targets, on the risk of major cardiovascular events in a population with higher cardiovascular risk. Methods: We included consecutive individuals undergoing a routine health screening in a single center who had a 10-year risk for atherosclerotic cardiovascular disease (ASCVD) ≥ 7.5% (pooled cohort equations, ACC/AHA, […]

Abstract Background: Subjects with levels of non-HDL-C 30 mg/dL above those of LDL-C (lipid discordance) or with high remnant cholesterol levels could have a greater residual cardiovascular risk. Objectives: Methods: Primary prevention patients without diabetes or lipid-lowering therapy were included. Regardless of the LDL-C level, we define “lipid discordance” if the non-HDL-C value exceeded 30 mg/dL that of LDL-C. Remnant cholesterol was calculated as total cholesterol minus HDL-C minus LDL-C when triglycerides were < 4.0 mmol/L. Ultrasound was used to [...]

Abstract Background: Systemic Arterial Hypertension (SAH) in the Brazilian population, in populations not exposed to Césio-137, presents a prevalence of 28% nationwide. However, in the group of radioactivity victims, these values are unknown. Objective: To analyze the prevalence of hypertension in patients exposed to Cesium-137 in Goiânia, enrolled in the Sistema de Monitoramento dos Radioacidentados (SISRAD) (Radioactivtity Victims Monitoring System) of the Centro de Assistência aos Radioacidentados (C.A.R.A) (Assistence Center for Radioactivity Victims). Methods: This is a descriptive, observational cross-sectional […]

Abstract Background: Baroreceptors act as regulators of blood pressure (BP); however, its sensitivity is impaired in hypertensive patients. Among the recommendations for BP reduction, exercise training has become an important adjuvant therapy in this population. However, there are many doubts about the effects of resistance exercise training in this population. Objective: To evaluate the effect of resistance exercise training on BP and baroreceptor sensitivity in spontaneously hypertensive rats (SHR). Method: Rats SHR (n = 16) and Wistar (n = 16) […]

Abstract Background: Chagas disease continues to be a serious public health problem, and accounts for 25-30% of the indications for cardiac stimulation in Brazil. Objective: To assess clinical and epidemiological characteristics of patients with Chagas disease, younger than 18 years, who had undergone pacemaker implantation in Brazil between 1994 and 2011, and its temporal trend. Methods: This was a cross-sectional analysis of data from the Brazilian Pacemaker Registry database. The following variables were analyzed: year when pacemaker was implanted, location, […]

Abstract Background: Cardiac Magnetic Resonance is in need of a simple and robust method for diastolic function assessment that can be done with routine protocol sequences. Objective: To develop and validate a three-dimensional (3D) model-based volumetric assessment of diastolic function using cardiac magnetic resonance (CMR) imaging and compare the results obtained with the model with those obtained by echocardiography. Methods: The study participants provided written informed consent and were included if having undergone both echocardiography and cine steady-state free precession […]

Introduction Hepatic cirrhosis is the final spectrum of several aggressions to the liver, with great relevance to public healthcare. National data estimate a prevalence of 0.14% to 0.35%, mortality of 3 to 35 per 100,000 individuals and an annual average of 30,000 hospital admissions in Brazil., With the ageing population, the prevalence of chronic liver diseases, in particular steatohepatitis associated to obesity and metabolic syndrome, results in an increase in the number of hepatic cirrhosis cases. Cardiac manifestations of hepatic […]

Clinical data A premature female twin (33-week gestation), weighing at birth 1935 g, remained hospitalized for one month due to the diagnosis of atrial septal defect (ASD) + ventricular septal defect (VSD) + persistence of ductus arteriosus (PDA). The patient gained less weight than the average children, but maintained full and similar activity, receiving furosemide and captopril, up to the age of 3 years, when her mother noticed cyanosis. […]

Introduction The myocardial bridge is one of the most prevalent congenital anomalies that involve the coronary circulation, and its incidence in the general population is high, affecting from 23 to 55% in necropsy studies.The impairment of the anterior descending artery is more frequent, on its proximal 2/3.In most patients, the myocardial bridges do not cause symptoms, because in order to have ischemia, there must be an imbalance between supply and consumption of oxygen. The superficial bridges, with small or slender […]

A 56-year-old Caucasian male, came to our hospital complaining of thoracic oppression at exertion and sometimes occurring at rest, lasting for a few minutes. The patient was an active smoker, with a moderate alcohol consumption habit and had had an episode of unstable angina two months earlier. At that episode, two drug-eluting stents were implanted, one in the distal anterior descending artery and the other in the proximal first diagonal artery. The ECG showed mild ST-elevation in V1-V3 and a […]

August issue of 2012, vol. 99 (2), Suppl. 2, pages 1-28 In “First Brazilian Guidelines for Familial Hypercholesterolemia”, consider Lottenberg AM as the correct form for the name of the author Ana Maria Lottenberg. […]