Navegando por Palavras-chave "Anticoagulação"

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    Diretrizes para o tratamento da síndrome do anticorpo antifosfolipídeo
    (Sociedade Brasileira de Reumatologia, 2013-04-01) Danowski, Adriana; Rego, Jozelia; Kakehasi, Adriana Maria; Funke, Andreas; Carvalho, Jozelio Freire de; Lima, Isabella Vargas de Souza; Souza, Alexandre Wagner Silva de [UNIFESP]; Levy, Roger Abramino; Hospital Federal dos Servidores do Estado; Universidade Federal de Goiás Faculdade de Medicina; Universidade Federal de Minas Gerais Faculdade de Medicina Departamento Locomotor; Universidade Federal do Paraná Hospital de Clínicas; Centro Médico Aliança; IUniversidade Federal da Bahia; Universidade Federal de São Paulo (UNIFESP); Universidade do Estado do Rio de Janeiro
    The antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial and venous thrombosis, gestational morbidity and presence of elevated and persistently positive serum titers of antiphospholipid antibodies. The treatment of APS is still controversial, because any therapeutic decision potentially faces the risk of an insufficient or excessive antithrombotic coverage associated with anticoagulation and its major adverse effects. This guideline was elaborated from nine relevant clinical questions related to the treatment of APS by the Committee of Vasculopathies of the Brazilian Society of Rheumatology. Thus, this study aimed at establishing a guideline that included the most relevant and controversial questions in APS treatment, based on the best scientific evidence available. The questions were structured by use of the PICO (patient, intervention or indicator, comparison and outcome) process, enabling the generation of search strategies for evidence in the major primary scientific databases (MEDLINE/PubMed, Embase, Lilacs, Scielo, Cochrane Library, Premedline via OVID). A manual search for evidence and theses was also conducted (BDTD and IBICT). The evidence retrieved was selected based on critical assessment by using discriminatory instruments (scores) according to the category of the therapeutic question (JADAD scale for randomized clinical trials and Newcastle-Ottawa scale for non-randomized studies). After defining the potential studies to support the recommendations, they were selected according to level of evidence and grade of recommendation, according to the Oxford classification.
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    Estudo do perfil demográfico e do risco tromboembólico associados à fibrilação atrial na atenção básica do sistema único de saúde brasileiro utilizando-se a tecnologia da telemedicina
    (Universidade Federal de São Paulo (UNIFESP), 2018-12-10) Moraes, Eraldo Ribeiro Ferreira Leao de [UNIFESP]; Paola, Angelo Amato Vincenzo de [UNIFESP]; http://lattes.cnpq.br/6259836166380719; http://lattes.cnpq.br/8936079749176279; Universidade Federal de São Paulo (UNIFESP)
    Background: The worldwide prevalence of atrial fibrillation (AF) varies between 0.1% and 4.0% and has been increasing. Little is known about the prevalence, stroke risk assessment and treatment of AF in Brazil. Methods: Our objective was to estimate the general prevalence of AF in several regions of Brazil using recordings of longdistance electrocardiogram (ECG) transmission. Patients from 125 outpatient general practitioner units covered by the telemedicine service of the Federal University of São Paulo were included. Only one ECG was considered per patient. A scripted telephone interview was also performed. Using the Brazilian Institute of Geography and Statistics (IBGE) method, we analyzed the data to project the prevalence of AF in the Brazilian population and estimate it for the year 2025. Results: Based on 676,621 ECG exams from January 2009 through April 2016, the mean age (±SD) of patients was 51.4 (±19.1) years, with 57.5% being female. The 7year period prevalence of AF was 2.2% (n=14,968). Based on the IBGE method, the prevalence of AF countrywide was projected to be 1.5% in 2016 and 1.7% in 2025. In the subset of patients with AF who were interviewed (n=301), 91 (30.2%) were not receiving any type of treatment for rate or rhythm control. Overall, 136 (64.7%) of the patients were on acetylsalicylic acid alone, 39 (18.7%) were using oral anticoagulants (OACs), and 7 (3.3%) reported concomitant use of acetylsalicylic acid and an OAC. Among patients interviewed, 189 (62.8%) were at high risk for stroke; only 28 (14.8%) were regular OAC users. Conclusions: Our study highlights the importance of screening for AF in the primary care setting in Brazil and identifies important gaps in the treatment of AF in this population.