264 results match your criteria: "University Hospital Clementino Fraga Filho[Affiliation]"

Aims: To investigate the associations between baseline/changes in serum uric acid (sUA) and the risks for cardiovascular/microvascular outcomes and mortality in a type 2 diabetes cohort.

Methods: Baseline sUA was measured in 685 individuals, and 463 had a second sUA measurement during follow-up; sUA was analyzed as a continuous variable and categorized into sex-specific tertile subgroups and low/high levels (>4.5 mg/dl women; >5.

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Essential Considerations for Radiologists in Diagnosing Hidradenitis Suppurativa.

Radiographics

November 2024

From the Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (C.A.d.A., F.M.C.); Department of Radiology, Centro Universitário de Valença, Valença, Brazil (C.A.d.A.); Diagnósticos da América S/A, Rio de Janeiro, Brazil (C.A.d.A., P.H., F.M.C., J.P., P.A.M., H.W., C.C.M.D.C.); Department of Dermatology, Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil (M.L.); Department of Dermatology, Universidade Federal Fluminense, Niteroi, Brazil (F.B.L.); Bio Design Laboratory, Pontifícia Universidade Católica, Rio de Janeiro, Brazil (G.R., H.W., C.C.M.D.C.); Department of Radiology, Universidade Federal Fluminense, Niteroi, Brazil (C.C.M.D.C.); Department of Radiology, University Hospital Clementino Fraga Filho, R. Prof. Rodolpho Paulo Rocco, 255- Cidade Universitária, Rio de Janeiro, RJ 21941-617, Brazil (C.A.d.A.).

Article Synopsis
  • * Diagnosis is based on recognizing specific characteristics of the lesions and the chronic nature of the disease, without the need for definitive biological tests or biopsies.
  • * Treatment options depend on the disease's severity and can involve antibiotics, hormonal therapies, and surgery, with imaging techniques like high-frequency ultrasound being essential for accurate assessment and monitoring of the condition.
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Article Synopsis
  • - This study explored the significance of the hemoglobin glycation index (HGI) in predicting health outcomes for people with type 2 diabetes, comparing it to the more conventional glycated hemoglobin (HbA1c) measurement.
  • - A total of 687 participants were tracked over a median of 10.6 years, and while both HGI and HbA1c were related to various health risks (like cardiovascular events and organ complications), neither correlated significantly with microalbuminuria or hypoglycemia episodes.
  • - Ultimately, the findings indicated that HGI does not outperform HbA1c in predicting adverse health outcomes for type 2 diabetes patients, suggesting that clinicians should continue to rely on HbA1c
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Article Synopsis
  • WHO Grade 2 meningiomas pose diagnostic and management challenges, with surgery (particularly gross total resection) being essential, often followed by adjuvant radiotherapy, though the effectiveness of this combination is still under investigation.
  • A systematic review analyzed data from 23 studies involving 3,822 patients, comparing outcomes of gross total resection alone versus with adjuvant radiotherapy and found that the combination significantly improved progression-free survival, though overall survival needs more research to determine if there's a substantial benefit.
  • The study concludes that adjuvant radiotherapy enhances progression-free survival for WHO Grade 2 meningiomas, and future treatments should consider molecular characteristics to improve management strategies.
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Clinical features, hemorrhage risk and epilepsy outcomes of familial cerebral cavernous malformation: A 20-year observational pragmatic single-center study.

J Stroke Cerebrovasc Dis

December 2024

Division of Neurosurgery, Federal University of Rio de Janeiro, University Hospital Clementino Fraga Filho, Rio de Janeiro, RJ, Brazil; Rio de Janeiro Neurosurgery Center, Rio de Janeiro, RJ, Brazil.

Introduction: Familial Cerebral Cavernous Malformations (fCCMs) are rare, hereditary conditions characterized by multiple central nervous system lesions. Despite their rarity, CCMs can cause significant clinical challenges when symptomatic, manifesting as seizure and symptomatic hemorrhage (CASH). Guidelines suggest neurosurgical intervention for symptomatic or previously symptomatic lesions, while conservative management is recommended for new-onset epilepsy.

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Early and long-term outcome of surgical versus conservative management for intracranial cerebral cavernous malformation: Meta-analysis of reconstructed time-to-event data.

Clin Neurol Neurosurg

November 2024

Federal University of Rio de Janeiro, University Hospital Clementino Fraga Filho, Department of Neurosurgery, Rio de Janeiro, RJ,  Brazil; Rio de Janeiro Neurosurgery Center, Rio de Janeiro, RJ, Brazil. Electronic address:

Article Synopsis
  • The meta-analysis explores the effectiveness of surgical intervention versus conservative management for symptomatic cerebral cavernous malformations (CCMs), tackling the challenges of uncertain clinical management due to limited trial data.
  • Results indicate that while surgical intervention might lead to more events (neurological deficits or bleeding) in the long run, observational management showed a longer mean time before these events occurred.
  • The study concludes that observational management could offer better long-term outcomes and emphasizes the necessity for more research, including randomized controlled trials, to improve treatment approaches for CCMs.
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Article Synopsis
  • Deep Brain Stimulation (DBS) has been FDA-approved since 2003 and is recommended for treating dystonia after other treatments, like botulinum toxin, fail.
  • A study analyzed the impact of DBS on botulinum toxin dosages in 23 dystonic patients, showing a significant reduction in medication use after surgery.
  • Pre-surgery, patients received a median of 800 units of botulinum toxin, which decreased to 700 units post-surgery, indicating a 12.5% reduction in dosage after DBS treatment.
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Article Synopsis
  • * This commentary covers 24 different topics chosen by board members, focusing on innovations in radiochemistry and the initial human application of new radiopharmaceuticals.
  • * It showcases significant trends in the field, highlighting advancements and hot topics within radiochemistry and radiopharmacy research.
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Article Synopsis
  • Cavernomas are genetic vascular lesions located in the central nervous system that may require alternative treatment options, like Gamma Knife stereotactic radiosurgery (GKSRS), when found in critical areas where surgery is not advisable.
  • A systematic review and meta-analysis of seven studies involving 1,071 patients revealed that GKSRS had an 89.8% events-free rate at two years and 71.3% at ten years following treatment.
  • The findings suggest that GKSRS is a promising alternative for managing symptomatic cavernomas, but further research is necessary to strengthen these conclusions.
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Body weight variability and the risk of liver-related outcomes in type 2 diabetes and steatotic liver disease: a cohort study.

Obesity (Silver Spring)

June 2024

Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Article Synopsis
  • The study aimed to see how body weight variability (BWV) affects liver problems in people with type 2 diabetes and a specific liver disease called MASLD.
  • A group of 549 patients was monitored for changes in body weight over the first two years, and the relationship between BWV and liver issues was analyzed over an average follow-up of 9.7 years.
  • Results showed that higher BWV increased the risk of liver problems particularly in inactive individuals, while physically active participants did not face the same risks.
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Spontaneous rupture of the patellar (PTR) and quadriceps (QTR) tendon is infrequent. Systemic diseases such as diabetes mellitus, CKD, and secondary hyperparathyroidism (SHPT) are risk factors. The present cohort study aimed to evaluate risk factors associated with tendon rupture in hemodialysis (HD) patients with SHPT, as well as outcomes including surgical complications, re-ruptures, and fracture.

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Background: Cerebral Cavernous Malformation (CCM) is one of the most common types of vascular malformation of the central nervous system. Intracerebral hemorrhage, seizures, and lesional growth are the main clinical manifestations. Natural history studies have tried to identify many risk factors; however, the clinical course remains highly unpredictable.

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Article Synopsis
  • Respiratory syncytial virus (RSV) is a major cause of hospitalization in infants and older adults, but its impact on older populations in Latin America is often overlooked.
  • * There is limited research on RSV epidemiology and management among older adults in Latin America, indicating a need for more focused studies and interventions.
  • * This article discusses the challenges in understanding RSV's burden in the region and suggests an expert consensus to enhance disease management and healthcare outcomes for those at risk.*
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Article Synopsis
  • Facial nerve dysfunction is a common and serious issue for patients who have undergone parotidectomy, a surgery to remove the parotid gland.
  • A study comparing rehabilitation outcomes for patients with benign versus malignant neoplasms showed both groups experienced significant improvements in facial function through early, tailored physiotherapy.
  • Factors like previous surgeries and age over 60 were linked to more severe dysfunction and poorer outcomes, but overall, both types of neoplasms benefited similarly from the rehabilitation program.
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Effects of body weight variability on risks of macro- and microvascular outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort.

Diabetes Res Clin Pract

November 2023

Department of Internal Medicine, University Hospital Clementino Fraga Filho, Brazil; School of Medicine, Universidade Federal do Rio de Janeiro, Brazil.

Aims: To investigate the effects of body weight variability (BWV) on macro- and microvascular outcomes in a type 2 diabetes cohort.

Methods: BWV parameters were assessed in 684 individuals. Multivariable Cox regressions examined associations between BWV parameters and cardiovascular outcomes (total cardiovascular events [CVEs], major CVEs [MACEs], cardiovascular deaths),all-cause mortality and microvascular outcomes.

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The Herlyn-Werner-Wunderlich syndrome (HWWS) is characterized by the triad of uterus didelphys, obstructed hemivagina, and renal agenesis. The typical clinical presentation involves chronic pelvic pain, dysmenorrhea, and palpable abdominal mass, related to hematocolpos/hematometra. It is a rare disease, with a challenging clinical and radiological diagnosis.

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Article Synopsis
  • The study explored the prognostic significance of mean cumulative ambulatory blood pressures (BPs) in predicting health outcomes for individuals with type 2 diabetes over a median follow-up of 10.6 years.
  • Researchers found that mean cumulative ambulatory BPs showed stronger associations with cardiovascular events and mortality compared to baseline BPs, indicating a higher risk with increased ambulatory BPs.
  • The results highlighted that using mean cumulative ambulatory BPs improved risk prediction for various complications, including major cardiovascular events and microvascular issues, more effectively than traditional clinic-based BP measurements.
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Effects of Weight Loss and Interaction with Physical Activity on Risks of Cardiovascular Outcomes in Individuals with Type 2 Diabetes.

Endocrinol Metab (Seoul)

June 2023

Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Backgruound: This study investigated the effects of weight loss during follow-up on cardiovascular outcomes in a type 2 diabetes cohort and tested interactions with clinical and laboratory variables, particularly physical activity, that could impact the associations.

Methods: Relative weight changes were assessed in 651 individuals with type 2 diabetes and categorized as ≥5% loss, <5% loss, or gain. Associations between weight loss categories and incident cardiovascular outcomes (total cardiovascular events [CVEs], major adverse cardiovascular events [MACEs], and cardiovascular mortality) were assessed using multivariable Cox regression with interaction analyses.

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Despite recent advances in multiple myeloma (MM), the incorporation of novel agents and measurable residual disease (MRD) monitoring in low-income countries remains a challenge. Although lenalidomide maintenance (M-Len) after autologous stem cell transplantation (ASCT) has been associated with improved outcomes and MRD has refined the prognosis of complete response (CR) cases, until now, there have been no data on the benefits of these approaches in Latin America. Here, we evaluate the benefits of M-Len and MRD using next-generation flow cytometry (NGF-MRD) at Day + 100 post-ASCT ( = 53).

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Article Synopsis
  • The study sought to compare the diagnoses of schizophrenia and Bipolar Affective Disorder obtained through standardized diagnostic interviews (SDI) and non-standardized diagnostic interviews (NSDI).
  • Researchers conducted a systematic review and meta-analysis of 22 studies published between 2007 and 2020, analyzing the level of agreement between these two diagnostic methods.
  • The findings revealed a fair level of agreement (kappa = 0.41), but significant variability among studies, indicating potential biases in the diagnostic processes and highlighting the complexities faced by clinicians compared to controlled psychiatry trials.
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Article Synopsis
  • This study explored the prognostic value of central/aortic blood pressures (BPs) versus traditional brachial BPs in patients with resistant hypertension (RHT) and type 2 diabetes (T2D), involving 532 and 467 participants, respectively.
  • The research found that, during follow-up, brachial BPs better predicted cardiovascular events and mortality than aortic BPs for both patient groups, with ambulatory BPs being particularly significant in the RHT cohort.
  • However, specific central hemodynamic parameters like the augmentation index in RHT and the Buckberg index in T2D served as independent predictors of outcomes, suggesting they could enhance risk assessment despite aortic
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Prognostic importance of obstructive sleep apnea and CPAP treatment for cardiovascular and mortality outcomes in patients with resistant hypertension: a prospective cohort study.

Hypertens Res

April 2023

Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

The prognostic importance of obstructive sleep apnea (OSA) severity and other polysomnographic parameters in patients with resistant hypertension (RHT) has never been evaluated. We aimed to assess it in a prospective cohort of 422 individuals with RHT. OSA presence/severity was ascertained by complete polysomnography (PSG) at baseline.

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Aims: To investigate whether tests for cardiovascular autonomic neuropathy (CAN) and 24-hour heart rate variability (HRV) could improve the prediction for outcomes in type 2 diabetes.

Methods: 541 type 2 diabetic individuals performed tests of CAN. A subsample (313) had 24-hour HRV (the standard deviation of all normal RR intervals [SDNN] and the standard deviation of the averaged normal RR intervals for all 5 min segments [SDANN]).

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