The sertraline vs. electrical current therapy for treating depression clinical study: results from a factorial, randomized, controlled trial.

Importance: Transcranial direct current stimulation (tDCS) trials for major depressive disorder (MDD) have shown positive but mixed results.

Objective: To assess the combined safety and efficacy of tDCS vs a common pharmacological treatment (sertraline hydrochloride, 50 mg/d).

Design: Double-blind, controlled trial.

Calcium score to evaluate chest pain in the emergency room.

Some authors have suggested that a zero calcium score (CAC) can be used to rule out the diagnosis of acute coronary syndrome. Objective this study is to evaluate the diagnostic accuracy of a zero CAC when compared to the coronary computed tomography angiography (CCTA) at the emergency department. 135 symptomatic patients with no previous coronary heart disease (CHD) who presented to the emergency department were submitted to CAC and CCTA to rule out CHD.

Acute working memory improvement after tDCS in antidepressant-free patients with major depressive disorder.

Based on previous studies showing that transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique that employs weak, direct currents to induce cortical-excitability changes, might be useful for working memory (WM) enhancement in healthy subjects and also in treating depressive symptoms, our aim was to evaluate whether tDCS could acutely enhance WM in depressed patients. Twenty-eight age- and gender-matched, antidepressant-free depressed subjects received a single-session of active/sham tDCS in a randomized, double-blind, parallel design. The anode was positioned over the left and the cathode over the right dorsolateral prefrontal cortex.

Bifrontal tDCS prevents implicit learning acquisition in antidepressant-free patients with major depressive disorder.

The findings for implicit (procedural) learning impairment in major depression are mixed. We investigated this issue using transcranial direct current stimulation (tDCS), a method that non-invasively increases/decreases cortical activity. Twenty-eight age- and gender-matched, antidepressant-free depressed subjects received a single-session of active/sham tDCS.

Potent antiretroviral therapy for human immunodeficiency virus infection increases aortic stiffness.

Background: Highly active antiretroviral therapy for AIDS is known to increase cardiovascular risk, but the effects of potent antiretroviral agents according to gender are unknown.

Objective: The present study evaluated the impact of HIV infection treatment on aortic stiffness according to gender.

Methods: From university-affiliated hospitals, we recruited 28 AIDS patients undergoing highly active antiretroviral treatment (HAART), 28 treatment-naïve HIV-infected patients, 44 patients with type 2 diabetes, and 30 controls.

Validation of the short-version of Rose Angina Questionnaire in Brazil.

Background: Stable angina pectoris is a serious condition with few epidemiological studies in Brazil.

Objective: To validate the short-version of the Rose angina questionnaire in Brazilian Portuguese for its implementation in surveys and longitudinal studies.

Methods: A total of 116 consecutive patients from an outpatient clinic without prior myocardial infarction and/or coronary revascularization were enrolled for application of three questions of the Rose angina questionnaire addressing chest pain after exertion.

Early stroke case-fatality rates in three hospital registries in the Northeast and Southeast of Brazil.

Unlabelled: Few studies have addressed early cerebrovascular lethality in Brazil.

Objective: To evaluate 10 and 28-day stroke case-fatality rates in three hospitals in three Brazilian cities.

Methods: We described the stroke registries in São Paulo, João Pessoa, and Natal.

Atrial fibrillation and dementia: results from the Sao Paulo ageing & health study.

Background: Atrial fibrillation (AF) is a controversial risk factor for dementia.

Objective: The objective of this study was to assess the association between AF and dementia in the "Sao Paulo Ageing & Health" (SPAH) study participants.

Methods: SPAH is a cross-sectional, population-based study of elderly people living in a deprived neighborhood in Sao Paulo, Brazil.

Household income, sex and respiratory mortality in São Paulo, Brazil, 1996-2010.

Setting: Respiratory mortality rates are declining in several countries, including Brazil; however, the effect of socio-economic indicators and sex is unclear.

Objective: To identify differences in mortality trends according to income and sex in the city of São Paulo, Brazil.

Design: We performed a time-trend analysis of all respiratory diseases, including chronic obstructive pulmonary disease (COPD), lung cancer and tuberculosis, using Joinpoint regression comparing high, middle and low household income levels from 1996 to 2010.

A systematic review of non-invasive brain stimulation therapies and cardiovascular risk: implications for the treatment of major depressive disorder.

Major depressive disorder (MDD) and cardiovascular diseases are intimately associated. Depression is an independent risk factor for mortality in cardiovascular samples. Neuroendocrine dysfunctions in MDD are related to an overactive hypothalamus-pituitary-adrenal (HPA) axis and increased sympathetic activity.

CYP2C9 and VKORC1 polymorphisms influence warfarin dose variability in patients on long-term anticoagulation.

Objectives: The main aim of this study was to determine whether CYP2C9 and VKORC1 polymorphisms influence warfarin dose variability during initial dose-finding phase and during maintenance treatment after 360 days.

Methods: Two hundred and six consecutive patients who were beginning warfarin therapy were selected. They were assessed for general and clinical characteristics; prescribed warfarin dose; response to therapy on days 7-10, 30, 60, 180, and 360; adverse events; and CYP2C9 2, 3, 5, 6, 8, 11, and VKORC1 1639G >A assays.

Temporal trends of asthma mortality rates in Brazil from 1980 to 2010.

Objective: Mortality from asthma has varied among countries during the last several decades. This study aimed to identify temporal trends of asthma mortality in Brazil from 1980 to 2010.

Method: We analyzed 6840 deaths of patients aged 5-34 years that occurred in Brazil with the underlying cause of asthma.

Educational levels and the functional dependence of ischemic stroke survivors.

We evaluated the functional dependence of stroke survivors from the Study of Stroke Mortality and Morbidity, using the Rankin Scale. Out of 355 ischemic stroke survivors (with a mean age of 67.9 years), 40% had some functional dependence at 28 days and 34.

Income and heart disease mortality trends in Sao Paulo, Brazil, 1996 to 2010.

Background: Reductions in heart disease mortality rates are variable according to socioeconomic status.

Methods: We performed a time trend analysis of all heart diseases (all circulatory diseases, except rheumatic, cerebrovascular, and aortic diseases) comparing three different household income levels (high, middle, and low) in the city of Sao Paulo from 1996 to 2010.

Results: A total of 197,770 deaths were attributed to heart diseases; 62% of them were due to coronary diseases.

Use of demonstrably effective therapies in the treatment of acute coronary syndromes: comparison between different Brazilian regions. Analysis of the Brazilian Registry on Acute Coronary Syndromes (BRACE).

Background: Little is known in our country about regional differences in the treatment of acute coronary disease.

Objective: To analyze the behavior regarding the use of demonstrably effective regional therapies in acute coronary disease.

Methods: A total of 71 hospitals were randomly selected, respecting the proportionality of the country in relation to geographic location, among other criteria.

Causes of recurrent or persistent anemia in older people from the results of the São Paulo Ageing & Health Study.

Aim: Anemia is a prevalent condition in older people, and associated with increased morbidity and mortality. Previous studies identified various causes of anemia in this population. We aimed to determine the frequency and main causes of persistent or recurrent anemia in participants 2 years after their inclusion in the São Paulo Ageing & Health Study (SPAH).

Polarity- and valence-dependent effects of prefrontal transcranial direct current stimulation on heart rate variability and salivary cortisol.

Recent evidence has supported the notion that the hypothalamic-pituitary-adrenal (HPA) and the sympatho-adreno-medullary (SAM) systems are modulated by cortical structures such as the prefrontal cortex. This top-down modulation may play a major role in the neuroendocrine changes associated with stressful events. We aimed to investigate further this hypothesis by modulating directly prefrontal cortex excitability using transcranial direct current stimulation (tDCS) - a non-invasive, neuromodulatory tool that induces polarity-dependent changes in cortical excitability - and measuring effects on salivary cortisol and heart rate variability as proxies of the HPA and SAM systems.

Hypothyroidism in the elderly: diagnosis and management.

Thyroid disorders are highly prevalent, occurring most frequently in aging women. Thyroid-associated symptoms are very similar to symptoms of the aging process; thus, improved methods for diagnosing overt and subclinical hypothyroidism in elderly people are crucial. Thyrotropin measurement is considered to be the main test for detecting hypothyroidism.

A reappraisal in São Paulo, Brazil (2008) of "The Ecology of Medical Care:" The "One Per Thousand's Rule".

Background And Objectives: Medical ecology is a conceptual framework introduced in 1961 to describe the relationship and utilization of health care services by a given population. We applied this conception to individuals enrolled in a private health maintenance organization (HMO) in Sao Paulo, Brazil, with the aim of describing the utilization of primary health care, verifying the frequency of various symptoms, and identifying the roles of different health care sources.

Methods: This was a cross-sectional telephone survey among a random sample of people enrolled in a private HMO.

Intervention to reduce C-reactive protein determination requests for acute infections at an emergency department.

Introduction: C-reactive protein (CRP) levels rise during inflammatory processes and have been ordered for rheumatic disease follow-up since the 1950s. The number of tests ordered in the emergency setting has increased, but without evident improvement in medical care quality.

Objective: To determine the pattern of CRP determinations in the emergency department (ED) of a university hospital in Sao Paulo, Brazil, and to evaluate the effect of an intervention with staff and students about the best use of the test in the ED.

Cardiovascular risk factors in patients with first-episode psychosis in São Paulo, Brazil.

Objective: The objective was to evaluate the cardiovascular profile of first-episode psychosis patients in São Paulo, Brazil, an issue that has not been sufficiently explored in low-/middle-income countries.

Method: A cross-sectional study was performed 1 to 3 years after an initial, larger survey that assessed first-episode psychosis in São Paulo. We evaluated cardiovascular risk factors and lifestyle habits using standard clinical examination and laboratory evaluation.