Correlation between Cardiomegaly on Chest X-Ray and Left Ventricular Diameter on Echocardiography in Patients with Chagas Disease.

Background: Cardiomegaly on chest X-ray is an independent predictor of death in individuals with chronic Chagas cardiomyopathy (CCC). However, the correlation between increased cardiothoracic ratio (CTR) on chest X-ray and left ventricular end-diastolic diameter (LVEDD) on echocardiography is not well established in this population.

Objectives: To assess the relationship between chest X-ray and LVEDD on echocardiography in patients with Chagas disease and its applicability to the Rassi score.

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements.

There is ample experimental and clinical evidence of functional and structural microvascular abnormalities occurring in patients with Chagas cardiomyopathy, possibly due to the inflammatory process and/or autonomic disturbances caused by Trypanosoma cruzi infection. Those microvascular derangements are likely to constitute at least an ancillary factor that potentiates and amplifies the chronic inflammation in myocardial tissue. It is possible to devise appropriate therapeutic interventions aimed at reverting or slowing the progression of the microvascular abnormalities to positively affect the natural history of Chagas cardiomyopathy.

[Evaluation of preoperative anxiety and depression in patients undergoing invasive cardiac procedures].

Background And Objectives: Specific assessment of anxiety and depression is not included in routine preoperative evaluation; therefore, in cases of cardiac diseases in which the emotional status of the patient may be modified by the disease those disorders may not be diagnosed. The objective of the present study was to compare the level and prevalence of anxiety and depression in patients with cardiac disease undergoing invasive and/or surgical procedures using the Hospital Anxiety and Depression Scale - HAD.

Methods: After approval by the Ethics Committee, 96 patients, physical status ASA II and III, were divided in three groups: electrophysiological study (EPS), pacemaker (PM) placement, and myocardial revascularization (MR).

[A retrospective search for maternal transmission of Chagas infection from patients in the chronic phase].

Maternal transmission of Trypanosoma cruzi from 278 children of 145 mothers, chronically infected with this protozoan, to their offspring was investigated. This study was based upon serological tests. In only two cases (2/278 = 0.

[The impact of the extensive chemical control of Triatoma infestans on the incidence of acute cases and the prevalence of human Chagas disease. The example of Montalvânia, Minas Gerais State].

From the emergency of acute cases of Chagas Disease in Montalvânia, Minas Gerais, Brazil, with the implementation of triatomine chemical control, the disappearing of these cases and the immediate reduction of incidence of the infection in the municipality are verified. The evolution of the dispersion and control of Triatoma infestans in Montalvânia and the evolution of the serology in general population during the last thirty years are showed.

[Artificial cardiac pacemaker: pre and intraoperative considerations.].

Background And Objectives: Technological medical diagnosis advances in cardiology have markedly increased indications for temporary or permanent artificial cardiac pacemakers (PM). This means that, in addition to cardiologists, other specialists have become involved in the handling of these devices. When PM patients undergo surgery, anesthesiologists participation may be decisive for the success of the procedure.

[Treatment of chronic Chagas' disease with an association of nifurtimox and corticoid].

Ten patients with chronic Chagas' disease were treated with nifurtimox (8-9 mg/kg/day) associated with betamethasone (9 mg/day initially and then gradually reduced) during 60 days, with one exception. It was intended to combine the respective anti-parasitic and anti-inflammatory actions of these drugs. The expected stimulating effect of betamethasone on the infection could possibly enhance the anti-Trypanosoma cruzi action of nifurtimox.