255 results on '"Pio-Abreu A"'
Search Results
2. Can blood pressure decrease after maximal exercise test predict the blood pressure lowering effect of aerobic training in treated hypertensive men?
- Author
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Azevêdo, Luan Morais, Brito, Leandro Campos de, Peçanha, Tiago, Fecchio, Rafael Yokoyama, Rezende, Rafael Andrade, da Silva, Giovânio Vieira, Pio-Abreu, Andrea, Mion Junior, Décio, Halliwill, John Robert, and Forjaz, Cláudia Lúcia de Moraes
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- 2023
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3. Obstructive sleep apnea and hypertension-mediated organ damage in nonresistant and resistant hypertension
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Cabrini, Mayara L., Macedo, Thiago A., Castro, Emerson, de Barros, Silvana, Azam, Indira, Pio-Abreu, Andrea, Silva, Giovanio V., Lorenzi-Filho, Geraldo, Bortolotto, Luiz A., and Drager, Luciano F.
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- 2023
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4. Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório – 2023
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Audes Diogenes de Magalhães Feitosa, Weimar Kunz Sebba Barroso, Decio Mion Junior, Fernando Nobre, Marco Antonio Mota-Gomes, Paulo Cesar Brandão Veiga Jardim, Celso Amodeo, Adriana Camargo Oliveira, Alexandre Alessi, Ana Luiza Lima Sousa, Andréa Araujo Brandão, Andrea Pio-Abreu, Andrei C. Sposito, Angela Maria Geraldo Pierin, Annelise Machado Gomes de Paiva, Antonio Carlos de Souza Spinelli, Carlos Alberto Machado, Carlos Eduardo Poli-de-Figueiredo, Cibele Isaac Saad Rodrigues, Claudia Lucia de Moraes Forjaz, Diogo Pereira Santos Sampaio, Eduardo Costa Duarte Barbosa, Elizabete Viana de Freitas, Elizabeth do Espirito Santo Cestario, Elizabeth Silaid Muxfeldt, Emilton Lima Júnior, Erika Maria Gonçalves Campana, Fabiana Gomes Aragão Magalhães Feitosa, Fernanda Marciano Consolim-Colombo, Fernando Antônio de Almeida, Giovanio Vieira da Silva, Heitor Moreno Júnior, Helius Carlos Finimundi, Isabel Cristina Britto Guimarães, João Roberto Gemelli, José Augusto Soares Barreto-Filho, José Fernando Vilela-Martin, José Marcio Ribeiro, Juan Carlos Yugar-Toledo, Lucélia Batista Neves Cunha Magalhães, Luciano F. Drager, Luiz Aparecido Bortolotto, Marco Antonio de Melo Alves, Marcus Vinícius Bolívar Malachias, Mario Fritsch Toros Neves, Mayara Cedrim Santos, Nelson Dinamarco, Osni Moreira Filho, Oswaldo Passarelli Júnior, Priscila Valverde de Oliveira Vitorino, Roberto Dischinger Miranda, Rodrigo Bezerra, Rodrigo Pinto Pedrosa, Rogerio Baumgratz de Paula, Rogério Toshiro Passos Okawa, Rui Manuel dos Santos Póvoa, Sandra C. Fuchs, Sandro Gonçalves de Lima, Sayuri Inuzuka, Sebastião Rodrigues Ferreira-Filho, Silvio Hock de Paffer Fillho, Thiago de Souza Veiga Jardim, Vanildo da Silva Guimarães Neto, Vera Hermina Kalika Koch, Waléria Dantas Pereira Gusmão, Wille Oigman, and Wilson Nadruz Junior
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2024
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5. Comparative Analysis of Windows for Speech Emotion Recognition Using CNN.
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Felipe L. Teixeira, Salviano Pinto Soares, J. L. Pio Abreu, Paulo Moura Oliveira, and João Paulo Teixeira 0002
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- 2023
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6. Effects of dynamic, isometric and combined resistance training on blood pressure and its mechanisms in hypertensive men
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Fecchio, Rafael Y., de Sousa, Julio C. S., Oliveira-Silva, Laura, da Silva Junior, Natan D., Pio-Abreu, Andrea, da Silva, Giovânio V., Drager, Luciano F., Low, David A., and Forjaz, Cláudia L. M.
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- 2023
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7. F0, LPC, and MFCC Analysis for Emotion Recognition Based on Speech.
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Felipe L. Teixeira, João Paulo Teixeira 0002, Salviano F. P. Soares, and J. L. Pio Abreu
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- 2022
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8. Mechanisms of heart failure and chronic kidney disease protection by SGLT2 inhibitors in nondiabetic conditions.
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Girardi, Adriana C. C., Polidoro, Juliano Z., Castro, Paulo C., Pio-Abreu, Andrea, Noronha, Irene L., and Drager, Luciano F.
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CHRONIC kidney failure ,CARDIO-renal syndrome ,SODIUM-glucose cotransporter 2 inhibitors ,VASCULAR endothelial growth factors ,METABOLIC reprogramming ,SODIUM-glucose cotransporters - Abstract
Sodium-glucose cotransporter 2 inhibitors (SGLT2is), initially developed for type 2 diabetes (T2D) treatment, have demonstrated significant cardiovascular and renal benefits in heart failure (HF) and chronic kidney disease (CKD), irrespective of T2D. This review provides an analysis of the multifaceted mechanisms underlying the cardiorenal benefits of SGLT2i in HF and CKD outside of the T2D context. Eight major aspects of the protective effects of SGLT2i beyond glycemic control are explored: 1) the impact on renal hemodynamics and tubuloglomerular feedback; 2) the natriuretic effects via proximal tubule Na
+ /H+ exchanger NHE3 inhibition; 3) the modulation of neurohumoral pathways with evidence of attenuated sympathetic activity; 4) the impact on erythropoiesis, not only in the context of local hypoxia but also systemic inflammation and iron regulation; 5) the uricosuria and mitigation of the hyperuricemic environment in cardiorenal syndromes; 6) the multiorgan metabolic reprogramming including the potential induction of a fasting-like state, improvement in glucose and insulin tolerance, and stimulation of lipolysis and ketogenesis; 7) the vascular endothelial growth factor A (VEGF-A) upregulation and angiogenesis, and 8) the direct cardiac effects. The intricate interplay between renal, neurohumoral, metabolic, and cardiac effects underscores the complexity of SGLT2i actions and provides valuable insights into their therapeutic implications for HF and CKD. Furthermore, this review sets the stage for future research to evaluate the individual contributions of these mechanisms in diverse clinical settings. [ABSTRACT FROM AUTHOR]- Published
- 2024
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9. Evaluation of central venous catheter and other risk factors for mortality in chronic hemodialysis patients with COVID-19 in Brazil
- Author
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Lugon, Jocemir Ronaldo, Neves, Precil Diego Miranda de Menezes, Pio-Abreu, Andrea, do Nascimento, Marcelo Mazza, and Sesso, Ricardo
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- 2022
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10. High frequency of Obstructive Sleep Apnea in consecutive patients with primary hyperaldosteronism: preliminary results
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Giampá, S., primary, Pio-Abreu, A., additional, Cabrini, M., additional, Bortolotto, L., additional, Lorenzi-Filho, G., additional, Almeida, M., additional, and Drager, L., additional
- Published
- 2024
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11. Diretrizes Brasileiras de Hipertensão Arterial – 2020
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Weimar Kunz Sebba Barroso, Cibele Isaac Saad Rodrigues, Luiz Aparecido Bortolotto, Marco Antônio Mota-Gomes, Andréa Araujo Brandão, Audes Diógenes de Magalhães Feitosa, Carlos Alberto Machado, Carlos Eduardo Poli-de-Figueiredo, Celso Amodeo, Décio Mion Júnior, Eduardo Costa Duarte Barbosa, Fernando Nobre, Isabel Cristina Britto Guimarães, José Fernando Vilela-Martin, Juan Carlos Yugar-Toledo, Maria Eliane Campos Magalhães, Mário Fritsch Toros Neves, Paulo César Brandão Veiga Jardim, Roberto Dischinger Miranda, Rui Manuel dos Santos Póvoa, Sandra C Fuchs, Alexandre Alessi, Alexandre Jorge Gomes de Lucena, Alvaro Avezum, Ana Luiza Lima Sousa, Andrea Pio-Abreu, Andrei Carvalho Sposito, Angela Maria Geraldo Pierin, Annelise Machado Gomes de Paiva, Antonio Carlos de Souza Spinelli, Armando da Rocha Nogueira, Nelson Dinamarco, Bruna Eibel, Cláudia Lúcia de Moraes Forjaz, Claudia Regina de Oliveira Zanini, Cristiane Bueno de Souza, Dilma do Socorro Moraes de Souza, Eduardo Augusto Fernandes Nilson, Elisa Franco de Assis Costa, Elizabete Viana de Freitas, Elizabeth da Rosa Duarte, Elizabeth Silaid Muxfeldt, Emilton Lima Júnior, Erika Maria Gonçalves Campana, Evandro José Cesarino, Fabiana Marques, Fábio Argenta, Fernanda Marciano Consolim-Colombo, Fernanda Spadotto Baptista, Fernando Antonio de Almeida, Flávio Antonio de Oliveira Borelli, Flávio Danni Fuchs, Frida Liane Plavnik, Gil Fernando Salles, Gilson Soares Feitosa, Giovanio Vieira da Silva, Grazia Maria Guerra, Heitor Moreno Júnior, Helius Carlos Finimundi, Isabela de Carlos Back, João Bosco de Oliveira Filho, João Roberto Gemelli, José Geraldo Mill, José Marcio Ribeiro, Leda A. Daud Lotaif, Lilian Soares da Costa, Lucélia Batista Neves Cunha Magalhães, Luciano Ferreira Drager, Luis Cuadrado Martin, Luiz César Nazário Scala, Madson Q. Almeida, Marcia Maria Godoy Gowdak, Marcia Regina Simas Torres Klein, Marcus Vinícius Bolívar Malachias, Maria Cristina Caetano Kuschnir, Maria Eliete Pinheiro, Mario Henrique Elesbão de Borba, Osni Moreira Filho, Oswaldo Passarelli Júnior, Otavio Rizzi Coelho, Priscila Valverde de Oliveira Vitorino, Renault Mattos Ribeiro Junior, Roberto Esporcatte, Roberto Franco, Rodrigo Pedrosa, Rogerio Andrade Mulinari, Rogério Baumgratz de Paula, Rogério Toshiro Passos Okawa, Ronaldo Fernandes Rosa, Sandra Lia do Amaral, Sebastião R. Ferreira-Filho, Sergio Emanuel Kaiser, Thiago de Souza Veiga Jardim, Vanildo Guimarães, Vera H. Koch, Wille Oigman, and Wilson Nadruz
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
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12. A Narrative Review of Speech and EEG Features for Schizophrenia Detection: Progress and Challenges
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Felipe Lage Teixeira, Miguel Rocha e Costa, José Pio Abreu, Manuel Cabral, Salviano Pinto Soares, and João Paulo Teixeira
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schizophrenia ,speech ,EEG ,ERP ,features ,emotional state ,Technology ,Biology (General) ,QH301-705.5 - Abstract
Schizophrenia is a mental illness that affects an estimated 21 million people worldwide. The literature establishes that electroencephalography (EEG) is a well-implemented means of studying and diagnosing mental disorders. However, it is known that speech and language provide unique and essential information about human thought. Semantic and emotional content, semantic coherence, syntactic structure, and complexity can thus be combined in a machine learning process to detect schizophrenia. Several studies show that early identification is crucial to prevent the onset of illness or mitigate possible complications. Therefore, it is necessary to identify disease-specific biomarkers for an early diagnosis support system. This work contributes to improving our knowledge about schizophrenia and the features that can identify this mental illness via speech and EEG. The emotional state is a specific characteristic of schizophrenia that can be identified with speech emotion analysis. The most used features of speech found in the literature review are fundamental frequency (F0), intensity/loudness (I), frequency formants (F1, F2, and F3), Mel-frequency cepstral coefficients (MFCC’s), the duration of pauses and sentences (SD), and the duration of silence between words. Combining at least two feature categories achieved high accuracy in the schizophrenia classification. Prosodic and spectral or temporal features achieved the highest accuracy. The work with higher accuracy used the prosodic and spectral features QEVA, SDVV, and SSDL, which were derived from the F0 and spectrogram. The emotional state can be identified with most of the features previously mentioned (F0, I, F1, F2, F3, MFCCs, and SD), linear prediction cepstral coefficients (LPCC), linear spectral features (LSF), and the pause rate. Using the event-related potentials (ERP), the most promissory features found in the literature are mismatch negativity (MMN), P2, P3, P50, N1, and N2. The EEG features with higher accuracy in schizophrenia classification subjects are the nonlinear features, such as Cx, HFD, and Lya.
- Published
- 2023
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13. Obstructive sleep apnea and ambulatory blood pressure monitoring: current evidence and research gaps
- Author
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Pio-Abreu, Andrea, Moreno, Jr, Heitor, and Drager, Luciano F.
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- 2021
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14. Renal Function Evolution and Hypoaldosteronism Risk After Unilateral Adrenalectomy for Primary Aldosteronism.
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Queiroz, Nara L., Stumpf, Matheo A. M., Souza, Victor C. M., Maciel, Ana Alice W., Fagundes, Gustavo F. C., Okubo, Jessica, Srougi, Victor, Tanno, Fabio Y., Chambo, Jose L., Pereira, Maria Adelaide A., Pio-Abreu, Andrea, Bortolotto, Luiz A., Latronico, Ana Claudia, Barisson Villares Fragoso, Maria Candida, Drager, Luciano F., Mendonça, Berenice B., and Almeida, Madson Q.
- Subjects
KIDNEY physiology ,ADRENALECTOMY ,HYPERALDOSTERONISM ,GLOMERULAR filtration rate ,ANALYSIS of covariance - Abstract
Few studies demonstrated a percentage decrease in the estimated glomerular filtration rate (eGFR) at a single time and the rate of hypoaldosteronism after adrenalectomy for primary aldosteronism (PA). Our aim was to investigate the evolution of renal function and the hypoaldosteronism risk after adrenalectomy for PA. Aldosterone, renin, eGFR, and electrolyte levels were determined before and at 1 week, 1, 3 and 6 months after unilateral adrenalectomy in 94 PA patients (40 men and 54 women). The main outcome was the postoperative eGFR decline using analysis of covariance with the preoperative eGFR as a covariate. eGFR decreased during first postoperative week compared to 3 months before surgery. During the first 6 months, eGFR remained stable at similar levels to the first week after surgery. Age (p=0.001), aldosterone levels (p=0.021) and eGFR 3 months before surgery (p+<+0.0001) had a significant correlation with eGFR during first postoperative week. High aldosterone levels at diagnosis were correlated with decline in renal function in the univariate model (p=0.033). In the multivariate analysis, aldosterone levels at diagnosis had a tendency to be an independent predictor of renal function after surgery (p=0.059). Postoperative biochemical hypoaldosteronism was diagnosed in 48% of the cases after adrenalectomy, but prolonged hyperkalemia occurred in only 4 cases (4.5%). Our findings showed a decrease of eGFR after unilateral adrenalectomy for PA. Additionally, aldosterone levels at diagnosis correlated with postoperative renal function. Postoperative biochemical hypoaldosteronism occurred in almost half of the patients, but prolonged hyperkalemia with fludrocortisone replacement was less frequent. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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15. Effects of ACEi and ARB on post-exercise hypotension induced by exercises conducted at different times of day in hypertensive men
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Leandro C. Brito, Luan Azevêdo, Tiago Peçanha, Rafael Yokoyama Fecchio, Rafael Andrade Rezende, Giovânio Vieira da Silva, Andrea Pio-Abreu, Décio Mion, John R. Halliwill, and Claudia L. M. Forjaz
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blood pressure ,hypertension ,aerobic exercise ,circadian rhythm ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Post-exercise hypotension (PEH) is greater after evening than morning exercise, but antihypertensive drugs may affect the evening potentiation of PEH. Objective: To compare morning and evening PEH in hypertensives receiving angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB). Methods Hypertensive men receiving ACEi (n = 14) or ARB (n = 15) underwent, in a random order, two maximal exercise tests (cycle ergometer, 15 watts/min until exhaustion) with one conducted in the morning (7 and 9 a.m.) and the other in the evening (8 and 10 p.m.). Auscultatory blood pressure (BP) was assessed in triplicate before and 30 min after the exercises. Changes in BP (post-exercise – pre-exercise) were compared between the groups and the sessions using a two-way mixed ANOVA and considering P
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- 2020
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16. Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023
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Feitosa, Audes Diogenes de Magalhães, primary, Barroso, Weimar Kunz Sebba, additional, Mion Junior, Decio, additional, Nobre, Fernando, additional, Mota-Gomes, Marco Antonio, additional, Jardim, Paulo Cesar Brandão Veiga, additional, Amodeo, Celso, additional, Oliveira, Adriana Camargo, additional, Alessi, Alexandre, additional, Sousa, Ana Luiza Lima, additional, Brandão, Andréa Araujo, additional, Pio-Abreu, Andrea, additional, Sposito, Andrei C., additional, Pierin, Angela Maria Geraldo, additional, Paiva, Annelise Machado Gomes de, additional, Spinelli, Antonio Carlos de Souza, additional, Machado, Carlos Alberto, additional, Poli-de-Figueiredo, Carlos Eduardo, additional, Rodrigues, Cibele Isaac Saad, additional, Forjaz, Claudia Lucia de Moraes, additional, Sampaio, Diogo Pereira Santos, additional, Barbosa, Eduardo Costa Duarte, additional, Freitas, Elizabete Viana de, additional, Cestario, Elizabeth do Espirito Santo, additional, Muxfeldt, Elizabeth Silaid, additional, Lima Júnior, Emilton, additional, Campana, Erika Maria Gonçalves, additional, Feitosa, Fabiana Gomes Aragão Magalhães, additional, Consolim-Colombo, Fernanda Marciano, additional, Almeida, Fernando Antônio de, additional, Silva, Giovanio Vieira da, additional, Moreno Júnior, Heitor, additional, Finimundi, Helius Carlos, additional, Guimarães, Isabel Cristina Britto, additional, Gemelli, João Roberto, additional, Barreto-Filho, José Augusto Soares, additional, Vilela-Martin, José Fernando, additional, Ribeiro, José Marcio, additional, Yugar-Toledo, Juan Carlos, additional, Magalhães, Lucélia Batista Neves Cunha, additional, Drager, Luciano F., additional, Bortolotto, Luiz Aparecido, additional, Alves, Marco Antonio de Melo, additional, Malachias, Marcus Vinícius Bolívar, additional, Neves, Mario Fritsch Toros, additional, Santos, Mayara Cedrim, additional, Dinamarco, Nelson, additional, Moreira Filho, Osni, additional, Passarelli Júnior, Oswaldo, additional, Vitorino, Priscila Valverde de Oliveira, additional, Miranda, Roberto Dischinger, additional, Bezerra, Rodrigo, additional, Pedrosa, Rodrigo Pinto, additional, Paula, Rogerio Baumgratz de, additional, Okawa, Rogério Toshiro Passos, additional, Póvoa, Rui Manuel dos Santos, additional, Fuchs, Sandra C., additional, Lima, Sandro Gonçalves de, additional, Inuzuka, Sayuri, additional, Ferreira-Filho, Sebastião Rodrigues, additional, Fillho, Silvio Hock de Paffer, additional, Jardim, Thiago de Souza Veiga, additional, Guimarães Neto, Vanildo da Silva, additional, Koch, Vera Hermina Kalika, additional, Gusmão, Waléria Dantas Pereira, additional, Oigman, Wille, additional, and Nadruz Junior, Wilson, additional
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- 2024
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17. Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório – 2023
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Feitosa, Audes Diogenes de Magalhães, primary, Barroso, Weimar Kunz Sebba, additional, Mion Junior, Decio, additional, Nobre, Fernando, additional, Mota-Gomes, Marco Antonio, additional, Jardim, Paulo Cesar Brandão Veiga, additional, Amodeo, Celso, additional, Oliveira, Adriana Camargo, additional, Alessi, Alexandre, additional, Sousa, Ana Luiza Lima, additional, Brandão, Andréa Araujo, additional, Pio-Abreu, Andrea, additional, Sposito, Andrei C., additional, Pierin, Angela Maria Geraldo, additional, Paiva, Annelise Machado Gomes de, additional, Spinelli, Antonio Carlos de Souza, additional, Machado, Carlos Alberto, additional, Poli-de-Figueiredo, Carlos Eduardo, additional, Rodrigues, Cibele Isaac Saad, additional, Forjaz, Claudia Lucia de Moraes, additional, Sampaio, Diogo Pereira Santos, additional, Barbosa, Eduardo Costa Duarte, additional, Freitas, Elizabete Viana de, additional, Cestario, Elizabeth do Espirito Santo, additional, Muxfeldt, Elizabeth Silaid, additional, Lima Júnior, Emilton, additional, Campana, Erika Maria Gonçalves, additional, Feitosa, Fabiana Gomes Aragão Magalhães, additional, Consolim-Colombo, Fernanda Marciano, additional, Almeida, Fernando Antônio de, additional, Silva, Giovanio Vieira da, additional, Moreno Júnior, Heitor, additional, Finimundi, Helius Carlos, additional, Guimarães, Isabel Cristina Britto, additional, Gemelli, João Roberto, additional, Barreto-Filho, José Augusto Soares, additional, Vilela-Martin, José Fernando, additional, Ribeiro, José Marcio, additional, Yugar-Toledo, Juan Carlos, additional, Magalhães, Lucélia Batista Neves Cunha, additional, Drager, Luciano F., additional, Bortolotto, Luiz Aparecido, additional, Alves, Marco Antonio de Melo, additional, Malachias, Marcus Vinícius Bolívar, additional, Neves, Mario Fritsch Toros, additional, Santos, Mayara Cedrim, additional, Dinamarco, Nelson, additional, Moreira Filho, Osni, additional, Passarelli Júnior, Oswaldo, additional, Vitorino, Priscila Valverde de Oliveira, additional, Miranda, Roberto Dischinger, additional, Bezerra, Rodrigo, additional, Pedrosa, Rodrigo Pinto, additional, Paula, Rogerio Baumgratz de, additional, Okawa, Rogério Toshiro Passos, additional, Póvoa, Rui Manuel dos Santos, additional, Fuchs, Sandra C., additional, Lima, Sandro Gonçalves de, additional, Inuzuka, Sayuri, additional, Ferreira-Filho, Sebastião Rodrigues, additional, Fillho, Silvio Hock de Paffer, additional, Jardim, Thiago de Souza Veiga, additional, Guimarães Neto, Vanildo da Silva, additional, Koch, Vera Hermina Kalika, additional, Gusmão, Waléria Dantas Pereira, additional, Oigman, Wille, additional, and Nadruz Junior, Wilson, additional
- Published
- 2024
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18. Efficacy of oral furosemide test for primary aldosteronism diagnosis
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Freitas, Thais C, primary, Maciel, Ana Alice W, additional, Fagundes, Gustavo F C, additional, Petenuci, Janaina, additional, Santana, Lucas S, additional, Guimaraes, Augusto G, additional, Freitas-Castro, Felipe, additional, Srougi, Victor, additional, Tanno, Fabio Y, additional, Chambo, Jose L, additional, Pereira, Maria Adelaide A, additional, Brito, Luciana P, additional, Pio-Abreu, Andrea, additional, Bortolotto, Luiz A, additional, Latronico, Ana Claudia, additional, Fragoso, Maria Candida B V, additional, Drager, Luciano F, additional, Mendonca, Berenice B, additional, and Almeida, Madson Q, additional
- Published
- 2023
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19. O Descenso Noturno Atenuado pode ser um Preditor de Gravidade e Complexidade da Doença Arterial Coronariana em Pacientes Internados com Síndrome Coronariana Aguda?
- Author
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Andrea Pio-Abreu
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Pressão Arterial ,Descenso Noturno ,Hipertensão Arterial ,Síndrome Coronariana Aguda ,Doença Arterial Coronariana ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2022
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20. Pruritus, Allergy and Autoimmunity: Paving the Way for an Integrated Understanding of Psychodermatological Diseases?
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Bárbara Roque Ferreira, José Luís Pio-Abreu, Américo Figueiredo, and Laurent Misery
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allergy and immunology ,autoimmunity ,pruritus ,psychological stress ,skin diseases ,psychodermatology ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Pruritus is a key symptom in allergology and dermatology, contributing to the global and huge impact on quality of life related to skin disorders, both those which are not related to a primary dermatosis (illness) and those which are linked with primary skin lesions (disease). This is particularly evident within psychophysiological dermatoses, a group of psychodermatological diseases where there is a primary dermatosis, where psychological stress plays a role, and where pruritus may represent a major and shared symptom. The etiopathogenesis of pruritus in those disorders sheds light on the link among psychopathological features, psychological stress and the subtle interface between allergic and autoimmune mechanisms, where mast cells play a pivotal role. Allergy has long been recognised as an altered reactivity to exogenous antigens (allergens), defined as an immediate hypersensitivity mediated by immunoglobulin E (IgE). In turn, the immunological understanding of atopy is related to an immediate hypersensitivity reaction to environmental antigens involving T-helper 2 (Th2) responses and the IgE production. Mast cells are major cells in the early phase of allergy, releasing the mediators involved in the symptoms associated with the allergic disease, including pruritus, when the allergen cross-links with IgE, whose mechanisms can be observed in acute urticaria and atopy. Some allergic reactions may persist and allergy may eventually lead to autoimmunity, with the development of a T-helper 1 (Th1) and then IgE-independent inflammation. For instance, in chronic spontaneous urticaria, the mast cell activation may include autoimmune mechanisms, where autoantibodies against the extracellular α subunit of the high-affinity IgE receptor (FcεRIα) and to IgE are observed, with the involvement of Th1 lymphocytes and the production of interferon-γ (INF-γ). The role of autoimmunity is also suggested in the etiopathogenesis of other psychophysiological dermatoses, namely psoriasis, atopic dermatitis and alopecia areata. In the latter, for example, mast cells were reported to be linked with the loss of immune privilege and they are the key cells involved in the experience of pruritus, whose intensity was reported to precede and be correlated with the onset of the hair loss. Furthermore, considering that the role of hair and skin is wide, from psychosocial aspects (communication and social interaction) to vital functions (such as, temperature control), it is straightforward that they are central in our interactions and synchronization with others and the world; thereby, we may admit that the psychophysiological dermatoses could represent a loss of such synchronization. Furthermore, they are often linked with psychopathology which strongly connects with the concept of desynchronization, namely, sleep disorders and depressive symptoms, the clinical expression of a dysfunction in the interplay among mast cells, pineal gland and melatonin, thus the circadian rhythm, as well as their connection with the hypothalamic corticotrophin-releasing hormone (CRH), well-known for its key role in stress response. Moreover, increasing evidence has supported the existence of cutaneous equivalents for these mechanisms, connecting with those central pathways. Thereby, taking all these concepts into consideration, this review intends to look into the updated evidence on the shared biological mechanisms between allergy and autoimmunity, underlining pruritus as a core element, then revisiting the key role of mast cells and discussing the connection with melatonin and immune-inflammatory pathways in the physiopathology of psychophysiological dermatoses, thus paving the way for the understanding of their psychosomatic correlates and a comprehensive psychodermatological approach.
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- 2021
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21. The effect of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea and uncontrolled hypertension - Study design and challenges during the COVID-19 pandemic
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Fernanda C.S.G. Cruz, Luciano F. Drager, Daniel B.C. Queiróz, Gabriela A. Souza, Rodrigo P. Pedrosa, Tarcya L.G Couto Patriota, Egidio L. Dórea, Marcelo Luiz C. Vieira, Camila G. Righi, Denis Martinez, Geruza A. da Silva, Giovanio V. Silva, Andrea Pio-Abreu, Paulo A. Lotufo, Isabela M. Benseãor, Luiz A. Bortolotto, Flávio D. Fuchs, and Geraldo Lorenzi-Filho
- Subjects
Obstructive Sleep Apnea ,Hypertension ,CPAP ,Medicine (General) ,R5-920 - Abstract
OBJECTIVES: To describe the MORPHEOS (Morbidity in patients with uncontrolled HTN and OSA) trial, and describe the challenges imposed by the COVID-19 pandemic. METHODS: MORPHEOS is a multicenter (n=6) randomized controlled trial designed to evaluate the blood pressure (BP) lowering effects of treatment with continuous positive airway pressure (CPAP) or placebo (nasal strips) for 6 months in adult patients with uncontrolled hypertension (HTN) and moderate-to-severe obstructive sleep apnea (OSA). Patients using at least one antihypertensive medication were included. Uncontrolled HTN was confirmed by at least one abnormal parameter in the 24-hour ABPM and ≥80% medication adherence evaluated by pill counting after the run-in period. OSA was defined by an apnea-hypopnea index ≥15 events/hours. The co-primary endpoints are brachial BP (office and ambulatory BP monitoring, ABPM) and central BP. Secondary outcomes include hypertension-mediated organ damage (HMOD) to heart, aorta, eye, and kidney. We pre-specified several sub-studies from this investigation. Visits occur once a week in the first month and once a month thereafter. The programmed sample size was 176 patients but the pandemic prevented this final target. A post-hoc power analysis will be calculated from the final sample. ClinicalTrials.gov: NCT02270658. RESULTS: The first 100 patients are predominantly males (n=69), age: 52±10 years, body mass index: 32.7±3.9 kg/m2 with frequent co-morbidities. CONCLUSIONS: The MORPHEOS trial has a unique study design including a run-in period; pill counting, and detailed analysis of hypertension-mediated organ damage in patients with uncontrolled HTN that will allow clarification of the impact of OSA treatment with CPAP.
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- 2021
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22. FRI143 Serum Aldosterone Levels Predict Decline In Renal Function After Unilateral Adrenalectomy For Primary Aldosteronism
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Stumpf, Matheo A M, primary, Queiroz, Nara L, additional, Souza, Victor C M, additional, Maciel, Ana Alice W, additional, Fagundes, Gustavo F C, additional, Srougi, Victor, additional, Tanno, Fabio Y, additional, Chambo, Jose L, additional, Pereira, Maria Adelaide A, additional, Pio-Abreu, Andrea, additional, Bortolotto, Luiz A, additional, Claudia Latronico, Ana, additional, Fragoso, Maria Candida B V, additional, Drager, Luciano F, additional, Mendonca, Berenice B, additional, and Almeida, Madson Q, additional
- Published
- 2023
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23. THU587 High Prevalence Of Primary Aldosteronism Diagnosis In Patients With Papillary Thyroid Cancer And Hypertension: A Cross-sectional Case-control Study
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Ana Wolf, Ana Alice Wolf Maciel, primary, Freitas, Thais, additional, Seguro Danilovic, Debora Lucia, additional, Cardoso Fagundes, Gustavo Freitas, additional, Freitas-Castro, Felipe, additional, Santana, Lucas, additional, Guimaraes, Augusto, additional, Pio-Abreu, Andrea, additional, Silveira, João V, additional, Consolim-Colombo, Fernanda M, additional, Bortolotto, Luiz, additional, Barisson Villares Fragoso, Maria Candida, additional, Latronico, Ana Claudia, additional, Drager, Luciano F, additional, Bilharinho Mendonca, Berenice, additional, Oliveira Hoff, Ana, additional, and Almeida, Madson Q, additional
- Published
- 2023
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24. FRI158 Efficacy Of Oral Furosemide Test For Primary Aldosteronism Diagnosis
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de Freitas, Thaís Castanheira, primary, Maciel, Ana Alice W, additional, Cardoso Fagundes, Gustavo Freitas, additional, Petenuci, Janaina, additional, Santana, Lucas, additional, Guimaraes, Augusto, additional, Freitas-Castro, Felipe, additional, Srougi, Victor, additional, Tanno, Fabio, additional, Chambo, Jose, additional, Adelaide Pereira, Maria, additional, Coelho, Fernando, additional, Pinto Brito, Luciana, additional, Cavalcante, Aline, additional, Pilan, Bruna, additional, Carnevale, Francisco, additional, Pio-Abreu, Andrea, additional, Bortolotto, Luiz A, additional, Claudia Latronico, Ana, additional, Villares Fragoso, Maria Candida Barisson, additional, Drager, Luciano, additional, Bilharinho Mendonca, Berenice, additional, and Almeida, Madson Q, additional
- Published
- 2023
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25. Post-dynamic, isometric and combined resistance exercise responses in medicated hypertensive men
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Oliveira-Silva, Laura, primary, Fecchio, Rafael Yokoyama, additional, Silva Junior, Natan Daniel da, additional, Pio-Abreu, Andrea, additional, Silva, Giovânio Vieira da, additional, Drager, Luciano Ferreira, additional, Silva de Sousa, Julio Cesar, additional, and Forjaz, Cláudia Lúcia de Moraes, additional
- Published
- 2023
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26. Effects of dynamic, isometric and combined resistance training on blood pressure and its mechanisms in hypertensive men
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Rafael Y. Fecchio, Julio C. S. de Sousa, Laura Oliveira-Silva, Natan D. da Silva Junior, Andrea Pio-Abreu, Giovânio V. da Silva, Luciano F. Drager, David A. Low, and Cláudia L. M. Forjaz
- Subjects
Physiology ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
27. High mortality of CKD patients on hemodialysis with Covid-19 in Brazil
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Pio-Abreu, Andrea, do Nascimento, Marcelo Mazza, Vieira, Marcos Alexandre, de Menezes Neves, Precil Diego Miranda, Lugon, Jocemir Ronaldo, and Sesso, Ricardo
- Published
- 2020
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28. Capacity for the management of kidney failure in the International Society of Nephrology Latin America region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)
- Author
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Calice-Silva, Viviane, Neyra, Javier A., Ferreiro Fuentes, Alejandro, Singer Wallbach Massai, Krissia Kamile, Arruebo, Silvia, Bello, Aminu K., Caskey, Fergus J., Damster, Sandrine, Donner, Jo-Ann, Jha, Vivekanand, Johnson, David W., Levin, Adeera, Malik, Charu, Nangaku, Masaomi, Okpechi, Ikechi G., Tonelli, Marcello, Ye, Feng, Madero, Magdalena, Tzanno Martins, Carmen, Alvarez, Guillermo, Amouzegar, Atefeh, Arellano-Mendez, Denisse, Martinez, Gustavo Aroca, Ferrari, Roger Ayala, Bonano, Carlos, Velarde, Edwin Castillo, Chavez Iñiguez, Jonathan Samuel, Cho, Yeoungjee, Claure-Del Granado, Rolando, Correa-Rotter, Ricardo, Cueto Manzano, Alfonso M., Cusumano, Ana Maria, Davids, M. Razeen, Davison, Sara N., Diongole, Hassane M., Divyaveer, Smita, Ekrikpo, Udeme E., Ethier, Isabelle, Figueiredo, Ana Elizabeth, Wing-Shing Fung, Winston, Garcia, Guillermo Garcia, Ghimire, Anukul, Gomez, Martin, Gonzalez Bedat, Maria Carlota, Houston, Ghenette, Htay, Htay, Ibrahim, Kwaifa Salihu, Irish, Georgina, Jindal, Kailash, Kelly, Dearbhla M., Lalji, Rowena, Moura-Neto, José A., Nalado, Aisha M., Neuen, Brendon L., Noboa, Oscar, Noronha, Irene L., Olanrewaju, Timothy O., Osman, Mohamed A., Pastor Ludena, Ana Cecilia, Petrova, Anna, Pio-Abreu, Andrea, Riaz, Parnian, Rico-Fontalvo, Jorge, Rosa-Diez, Guillermo, Saad, Syed, Sakajiki, Aminu Muhammad, Santacruz, Angel Cristóbal, Santacruz, Juan, See, Emily, Soares dos Santos Junior, Augusto Cesar, Sola, Laura, Sozio, Stephen M., Tiv, Sophanny, Trimarchi, Hernan, Tungsanga, Somkanya, Viecelli, Andrea, Wainstein, Marina, Yeung, Emily K., and Zaidi, Deenaz
- Abstract
Successful management of chronic kidney disease (CKD) in Latin America (LA) continues to represent a challenge due to high disease burden and geographic disparities and difficulties in terms of capacity, accessibility, equity, and quality of kidney failure care. Although LA has experienced significant social and economic progress over the past decades, there are still important inequities in health care access. Through this third iteration of the International Society of Nephrology Global Kidney Health Atlas, the indicators regarding kidney failure care in LA are updated. Survey responses were received from 22 of 31 (71%) countries in LA representing 96.5% of its total population. Median CKD prevalence was 10.2% (interquartile range: 8.4%–12.3%), median CKD disability-adjusted life year was 753.4 days (interquartile range: 581.3–1072.5 days), and median CKD mortality was 5.5% (interquartile range: 3.2%–6.3%). Regarding dialysis modality, hemodialysis continued to be the most used therapy, whereas peritoneal dialysis reached a plateau and kidney transplantation increased steadily over the past 10 years. In 20 (91%) countries, >50% of people with kidney failure could access dialysis, and in only 2 (9%) countries, people who had access to dialysis could initiate dialysis with peritoneal dialysis. A mix of public and private systems collectively funded most aspects of kidney replacement therapy (dialysis and transplantation) with many people incurring up to 50% of out-of-pocket costs. Few LA countries had CKD/kidney replacement therapy registries, and almost no acute kidney injury registries were reported. There was large variability in the nature and extent of kidney failure care in LA mainly related to countries’ funding structures and limited surveillance and management initiatives.
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- 2024
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29. Bariatric Surgery for Resistant Hypertension: Working in Progress!
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Schiavon, Carlos A., Pio-Abreu, Andrea, and Drager, Luciano F.
- Published
- 2020
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30. Is Hypertension a Real Risk Factor for Poor Prognosis in the COVID-19 Pandemic?
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Drager, Luciano F., Pio-Abreu, Andrea, Lopes, Renato D., and Bortolotto, Luiz A.
- Published
- 2020
- Full Text
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31. Efficacy of Oral Furosemide Test for Primary Aldosteronism Diagnosis.
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Freitas, Thais C, Maciel, Ana Alice W, Fagundes, Gustavo F C, Petenuci, Janaina, Santana, Lucas S, Guimaraes, Augusto G, Freitas-Castro, Felipe, Srougi, Victor, Tanno, Fabio Y, Chambo, Jose L, Pereira, Maria Adelaide A, Brito, Luciana P, Pio-Abreu, Andrea, Bortolotto, Luiz A, Latronico, Ana Claudia, Fragoso, Maria Candida B V, Drager, Luciano F, Mendonca, Berenice B, and Almeida, Madson Q
- Subjects
ORAL examinations (Education) ,HYPERALDOSTERONISM ,ESSENTIAL hypertension ,DIAGNOSIS ,RENIN - Abstract
Context Confirmatory tests represent a fundamental step in primary aldosteronism (PA) diagnosis, but they are laborious and often require a hospital environment due to the risks involved. Objective To evaluate the efficacy of oral furosemide as a new confirmatory test for PA diagnosis. Methods We prospectively evaluated the diagnostic performance of 80 mg of oral furosemide in 64 patients with PA and 22 with primary hypertension (controls). Direct renin concentration (DRC) was measured before, and 2 hours and 3 hours after the oral furosemide. In addition, the oral furosemide test was compared with 2 other confirmatory tests: the furosemide upright test (FUT) and saline infusion test (SIT) or captopril challenge test (CCT) in all patients with PA. Results The cut-off of 7.6 µU/mL for DRC at 2 hours after oral furosemide had a sensitivity of 92%, specificity of 82%, and accuracy of 90% for PA diagnosis. In 5 out of 6 controls with low-renin hypertension, which might represent a PA spectrum, renin remained suppressed. Excluding these 6 controls with low-renin hypertension, the DRC cut-off of 10 µU/mL at 2 hours after oral furosemide had a sensitivity of 95.3%, specificity of 93.7% and accuracy of 95% for PA diagnosis. DRC after 3 hours of oral furosemide did not improve diagnostic performance. Using the cut-off of 10 µU/mL, the oral furosemide test and the FUT were concordant in 62 out of 64 (97%) patients with PA. Only 4 out of 64 cases with PA (6.4%) ended the oral furosemide test with potassium <3.5 mEq/L. Hypotension was not evidenced in any patient with PA during the test. Conclusion The oral furosemide test was safe, well-tolerated and represents an effective strategy for PA investigation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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32. Can blood pressure decrease after maximal exercise test predict the blood pressure lowering effect of aerobic training in treated hypertensive men?
- Author
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Azevêdo, LM, Brito, LCD, Peçanha, T, Fecchio, RY, Rezende, RA, da Silva, GV, Pio-Abreu, A, Mion Junior, D, Halliwill, JR, Forjaz, CLDM, Azevêdo, LM, Brito, LCD, Peçanha, T, Fecchio, RY, Rezende, RA, da Silva, GV, Pio-Abreu, A, Mion Junior, D, Halliwill, JR, and Forjaz, CLDM
- Abstract
The acute decrease in blood pressure (BP) observed after a session of exercise (called post-exercise hypotension) has been proposed as a tool to predict the chronic reduction in BP induced by aerobic training. Therefore, this study investigated whether post-exercise hypotension observed after a maximal exercise test is associated to the BP-lowering effect of aerobic training in treated hypertensives. Thirty hypertensive men (50 ± 8 years) who were under consistent anti-hypertensive treatment underwent a maximal exercise test (15 watts/min until exhaustion), and post-exercise hypotension was determined by the difference between BP measured before and at 30 min after the test. Subsequently, the patients underwent 10 weeks of aerobic training (3 times/week, 45 min/session at moderate intensity), and the BP-lowering effect of training was assessed by the difference in BP measured before and after the training period. Pearson correlations were employed to evaluate the associations. Post-maximal exercise test hypotension was observed for systolic and mean BPs (−8 ± 6 and −2 ± 4 mmHg, all P < 0.05). Aerobic training reduced clinic systolic/diastolic BPs (−5 ± 6/−2 ± 3 mmHg, both P < 0.05) as well as awake and 24 h mean BPs (−2 ± 6 and −2 ± 5 mmHg, all P < 0.05). No significant correlation was detected between post-exercise hypotension and the BP-lowering effect of training either for clinic or ambulatory BPs (r values ranging from 0.00 to 0.32, all p > 0.05). Post-exercise hypotension assessed 30 min after a maximal exercise test cannot be used to predict the BP-lowering effect of aerobic training in treated hypertensive men.
- Published
- 2023
33. Effects of dynamic, isometric, and combined resistance training on ambulatory blood pressure in treated men with hypertension: a randomized controlled trial
- Author
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Silva de Sousa, Julio Cesar, Fecchio, Rafael Yokoyama, Oliveira-Silva, Laura, Pio-Abreu, Andrea, da Silva, Giovânio Vieira, Drager, Luciano F., Low, David A., and de Moraes Forjaz, Cláudia Lúcia
- Abstract
Ambulatory blood pressure (ABP) monitoring is a widespread recommendation for the diagnosis and management of hypertension. Dynamic resistance training (DRT) and isometric handgrip training (IHT) have been recommended for hypertension treatment, but their effects on ABP have been poorly studied. Additionally, combined dynamic and isometric handgrip resistance training (CRT) could produce an additive effect that has yet to be tested. Thus, this randomized controlled trial was designed to evaluate the effects of DRT, IHT and CRT on mean ABP and ABP variability. Fifty-nine treated men with hypertension were randomly allocated to 1 of four groups: DRT (8 dynamic resistance exercises, 50% of 1RM, 3 sets until moderate fatigue), IHT (4 sets of 2 min of isometric handgrip at 30% of MVC), CRT (DRT + IHT) and control (CON – 30 min of stretching). Interventions occurred 3 times/week for 10 weeks, and ABP was assessed before and after the interventions. ANOVAs and ANCOVAs adjusted for pre-intervention values were employed for analysis. Mean 24-h, awake and asleep BPs did not change in either group throughout the study (all, P > 0.05). Nocturnal BP fall as well as the standard deviation, coefficient of variation and the average real variability of ABP also did not change significantly in either group (all, P < 0.05). Changes in all these parameters adjusted to the pre-intervention values were also similar among the four groups (all, p > 0.05). In treated men with hypertension, 10 weeks of DRT, IHT or CRT does not decrease ABP levels nor change ABP variability.
- Published
- 2024
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34. The concept of meaning: The key to clarify the human cognition and psychopathology
- Author
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Pio-Abreu, J.L., Ferreira, Bárbara Roque, and Januário, Cristina
- Published
- 2015
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35. Intra-individual Variability of Serum Aldosterone and Implications for Primary Aldosteronism Screening
- Author
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Maciel, Ana Alice W, primary, Freitas, Thais C, additional, Fagundes, Gustavo F C, additional, Petenuci, Janaina, additional, Vilela, Leticia A P, additional, Brito, Luciana P, additional, Goldbaum, Tatiana S, additional, Zerbini, Maria Claudia N, additional, Ledesma, Felipe L, additional, Tanno, Fabio Y, additional, Srougi, Victor, additional, Chambo, Jose L, additional, Pereira, Maria Adelaide A, additional, Coelho, Fernando M A, additional, Cavalcante, Aline C B S, additional, Carnevale, Francisco C, additional, Pilan, Bruna, additional, Pio-Abreu, Andrea, additional, Silveira, João V, additional, Consolim-Colombo, Fernanda M, additional, Bortolotto, Luiz A, additional, Latronico, Ana Claudia, additional, Fragoso, Maria Candida B V, additional, Drager, Luciano F, additional, Mendonca, Berenice B, additional, and Almeida, Madson Q, additional
- Published
- 2022
- Full Text
- View/download PDF
36. Oral Fludrocortisone Test for Salt-Sensitive Screening in Hypertensive Patients: A Randomized Crossover Trial
- Author
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Andrea Pio-Abreu, Isac de Castro, Giovanio Vieira da Silva, Katia Coelho Ortega, and Decio Mion
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background. Salt sensitivity is associated with an increased cardiovascular risk, but the gold standard method (diet cycles) requires 24-h urine samples and has poor patient compliance. Objectives. Test the hypothesis that oral fludrocortisone (0.4 mg per day for 7 days) is a good alternative in identifying salt-sensitive patients. Methodology. We conducted a randomized crossover study with 30 hypertensive individuals comprising the following steps: (1) washout; (2) phase A (low- and high-sodium diet cycles); (3) washout 2; (4) phase B (fludrocortisone test). Phase A and B steps were performed in a random way. Consistent with the literature, we found that 53.3% were salt-sensitive according to the reference test. Using the ROC curve, the fludrocortisone test defined salt sensitivity by a median blood pressure increase of ≥3 mmHg. A good accuracy of fludrocortisone in detecting salt sensitivity was observed (AUC: 0.732±0.065; p
- Published
- 2018
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37. Comparison of morning versus evening aerobic-exercise training on heart rate recovery in treated hypertensive men: a randomized controlled trial
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Tiago Peçanha, Décio Mion-Junior, Rafael Yokoyama Fecchio, John R. Halliwill, Giovânio Vieira da Silva, Cláudia Lúcia de Moraes Forjaz, Leandro C Brito, and Andrea Pio-Abreu
- Subjects
Male ,Evening ,education ,Assessment and Diagnosis ,Autonomic Nervous System ,law.invention ,Randomized controlled trial ,Heart Rate ,law ,Heart rate ,Internal Medicine ,Humans ,Medicine ,Aerobic exercise ,Exercise ,Morning ,Advanced and Specialized Nursing ,EXERCÍCIO FÍSICO ,business.industry ,Training (meteorology) ,General Medicine ,Blood pressure ,Anesthesia ,Hypertension ,Exercise Test ,Analysis of variance ,Cardiology and Cardiovascular Medicine ,business - Abstract
Heart rate recovery (HRR) is a marker of cardiac autonomic regulation and an independent predictor of mortality. Aerobic-exercise training conducted in the evening (evening training) produces greater improvement in resting cardiac autonomic control in hypertensives than morning training, suggesting it may also result in a faster autonomic restoration postexercise. This study compared the effects of morning training and evening training on HRR in treated hypertensive men. Forty-nine treated hypertensive men were randomly allocated into three groups: morning training, evening training and control. Training was conducted three times/week for 10 weeks. Training groups cycled (45 min, moderate intensity) while control group stretched (30 min). In the initial and final assessments of the study, HRR60s and HRR300s were evaluated during the active recovery (30 W) from cardiopulmonary exercise tests (CPET) conducted in the morning and evening. Between-within ANOVAs were applied (P ≤ 0.05). Only evening training increased HRR60s and HRR300 differently from control after morning CPET (+4 ± 5 and +7 ± 8 bpm, respectively, P < 0.05) and only evening training increased HRR300s differently from morning training and control after evening CPET (+8 ± 6 bpm, P < 0.05). Evening training improves HRR in treated hypertensive men, suggesting that this time of day is better for eliciting cardiac autonomic improvements via aerobic training in hypertensives.
- Published
- 2021
38. Intra-individual Variability of Serum Aldosterone and Implications for Primary Aldosteronism Screening.
- Author
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Maciel, Ana Alice W., Freitas, Thais C., Fagundes, Gustavo F. C., Petenuci, Janaina, Vilela, Leticia A. P., Brito, Luciana P., Goldbaum, Tatiana S., Zerbini, Maria Claudia N., Ledesma, Felipe L., Tanno, Fabio Y., Srougi, Victor, Chambo, Jose L., Pereira, Maria Adelaide A., Coelho, Fernando M. A., Cavalcante, Aline C. B. S., Carnevale, Francisco C., Pilan, Bruna, Pio-Abreu, Andrea, Silveira, João V., and Consolim-Colombo, Fernanda M.
- Subjects
HYPERALDOSTERONISM ,IMMUNOASSAY ,ALDOSTERONE - Abstract
Context: Primary aldosteronism (PA) screening relies on an elevated aldosterone to renin ratio with a minimum aldosterone level, which varies from 10 to 15 ng/dL (277-415.5 pmol/L) using immunoassay. Objective: To evaluate intra-individual coefficient of variation (CV) of aldosterone and aldosterone to direct renin concentration ratio (A/DRC) and its impact on PA screening. Methods: A total of 671 aldosterone and DRC measurements were performed by the same chemiluminescence assays in a large cohort of 216 patients with confirmed PA and at least 2 screenings. Results: The median intra-individual CV of aldosterone and A/DRC was 26.8% and 26.7%. Almost 40% of the patients had at least one aldosterone level <15 ng/dL, 19.9% had at least 2 aldosterone levels <15 ng/dL, and 16.2% had mean aldosterone levels <15 ng/dL. A lower cutoff of 10 ng/dL was associated with false negative rates for PA screening of 14.3% for a single aldosterone measurement, 4.6% for 2 aldosterone measurements, and only 2.3% for mean aldosterone levels. Considering the minimum aldosterone, true positive rate of aldosterone thresholds was 85.7% for 10 ng/dL and 61.6% for 15 ng/dL. An A/DRC >2 ng/dL/µIU/mL had a true positive rate for PA diagnosis of 94.4% and 98.4% when based on 1 or 2 assessments, respectively. CV of aldosterone and A/DRC were not affected by sex, use of interfering antihypertensive medications, PA lateralization, hypokalemia, age, and number of hormone measurements. Conclusion: Aldosterone concentrations had a high CV in PA patients, which results in an elevated rate of false negatives in a single screening for PA. Therefore, PA screening should be based on at least 2 screenings with concomitant aldosterone and renin measurements. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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39. Resistant Hypertension: Time to Consider the Best Fifth Anti-Hypertensive Treatment
- Author
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Pio-Abreu, Andrea and Drager, Luciano F.
- Published
- 2018
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40. Can Attenuated Nocturnal Dipping be a Predictor of the Severity and Complexity of Coronary Artery Disease in Hospitalized Patients with Acute Coronary Syndrome?
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Andrea, Pio-Abreu
- Subjects
Hypertension ,Humans ,Blood Pressure ,Coronary Artery Disease ,Acute Coronary Syndrome ,Blood Pressure Monitoring, Ambulatory - Published
- 2022
41. On measuring tele
- Author
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Pio-Abreu, José Luís and Oliveira, Cristina Villares
- Published
- 2016
- Full Text
- View/download PDF
42. Tourette's syndrome and associated disorders: a systematic review
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Bárbara R. Ferreira, J. L. Pio-Abreu, and Cristina Januário
- Subjects
Perturbação de déficit de atenção com hiperatividade ,comorbidades ,perturbação obsessivo-compulsiva ,tiques ,síndrome de Tourette ,Psychiatry ,RC435-571 - Abstract
Objective: To compile data on Tourette's syndrome (TS), tics and associated disorders.Methods: A systematic review of the literature was conducted using the 5S levels of organization of healthcare research evidence (systems, summaries, synopses, syntheses, studies), based on the model described by Haynes. The search keywords were Tourette, tics and comorbidity, which were cross-referenced. Studies provided by publishers and articles being processed on July 31, 2013, were also included.Results: Of all studies retrieved during the search, 64 were selected because they analyzed the epidemiology, clinical features and etiopathogenesis of TS and its comorbidities. TS is classified as a hyperkinetic movement disorder, and at least 90% of the patients have neuropsychiatric comorbidities, of which attention deficit hyperactivity and obsessive-compulsive disorders are the most common. The syndrome is clinically heterogeneous and has been associated with a dysfunction of cortico-striatal-thalamic-cortical circuits involving various neurotransmitters. Although its genetic etiology has been widely studied, other factors may be important to understand this syndrome and its associated disorders.Conclusions: TS is a neurodevelopmental disorder that results from the impact of stress factors on a vulnerable biological substrate during the critical periods of neurodevelopment. The study of TS and its comorbidities may contribute, at different levels, to the understanding of several neuropsychiatric disorders of clinical and therapeutic relevance.
- Published
- 2014
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43. O Descenso Noturno Atenuado pode ser um Preditor de Gravidade e Complexidade da Doença Arterial Coronariana em Pacientes Internados com Síndrome Coronariana Aguda?
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Pio-Abreu, Andrea, primary
- Published
- 2022
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44. ACUTE POST-DYNAMIC, ISOMETRIC AND COMBINED RESISTANCE EXERCISE HYPOTENSION IN PATIENTS WITH HYPERTENSION: A RANDOMIZED STUDY
- Author
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Forjaz, Claudia Lucia De Moraes, primary, Oliveira-Silva, Laura G, additional, Silva-Junior, Natan D., additional, Pio-Abreu, Andrea, additional, Silva, Giovanio V., additional, Drager, Luciano L., additional, Sousa, Julio S., additional, and Fecchio, Rafael Y., additional
- Published
- 2022
- Full Text
- View/download PDF
45. Intraindividual variability of serum aldosterone and its implication for primary aldosteronism screening
- Author
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Ana Alice W Maciel, Thais C Freitas, Gustavo F C Fagundes, Janaina Petenuci, Leticia A P Vilela, Luciana P Brito, Tatiana S Goldbaum, Maria Claudia N Zerbini, Felipe L Ledesma, Fabio Y Tanno, Victor Srougi, Jose L Chambo, Maria Adelaide A Pereira, Fernando M A Coelho, Aline C B S Cavalcante, Francisco C Carnevale, Bruna Pilan, Andrea Pio-Abreu, João V Silveira, Fernanda M Consolim-Colombo, Luiz A Bortolotto, Ana Claudia Latronico, Maria Candida B V Fragoso, Luciano F Drager, Berenice B Mendonca, and Madson Q Almeida
- Subjects
Endocrinology ,Endocrinology, Diabetes and Metabolism ,Biochemistry (medical) ,Clinical Biochemistry ,Biochemistry - Abstract
Context Primary aldosteronism (PA) screening relies on an elevated aldosterone to renin ratio with a minimum aldosterone level, which varies from 10 to 15 ng/dL (277-415.5 pmol/L) using immunoassay. Objective To evaluate intra-individual coefficient of variation (CV) of aldosterone and aldosterone to direct renin concentration ratio (A/DRC) and its impact on PA screening. Methods A total of 671 aldosterone and DRC measurements were performed by the same chemiluminescence assays in a large cohort of 216 patients with confirmed PA and at least 2 screenings. Results The median intra-individual CV of aldosterone and A/DRC was 26.8% and 26.7%. Almost 40% of the patients had at least one aldosterone level 2 ng/dL/µIU/mL had a true positive rate for PA diagnosis of 94.4% and 98.4% when based on 1 or 2 assessments, respectively. CV of aldosterone and A/DRC were not affected by sex, use of interfering antihypertensive medications, PA lateralization, hypokalemia, age, and number of hormone measurements. Conclusion Aldosterone concentrations had a high CV in PA patients, which results in an elevated rate of false negatives in a single screening for PA. Therefore, PA screening should be based on at least 2 screenings with concomitant aldosterone and renin measurements.
- Published
- 2022
46. Directly observed therapy for resistant/refractory hypertension diagnosis and blood pressure control
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Pio-Abreu, Andrea, primary, Trani-Ferreira, Fernanda, additional, Silva, Giovanio V, additional, Bortolotto, Luiz A, additional, and Drager, Luciano F, additional
- Published
- 2022
- Full Text
- View/download PDF
47. On measuring tele
- Author
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Pio-Abreu, José Luís, primary and Oliveira, Cristina Villares, additional
- Published
- 2016
- Full Text
- View/download PDF
48. Directly observed therapy for resistant/refractory hypertension diagnosis and blood pressure control
- Author
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Andrea Pio-Abreu, Fernanda Trani-Ferreira, Giovanio V Silva, Luiz A Bortolotto, and Luciano F Drager
- Subjects
Male ,Systole ,Hypertension ,Humans ,Female ,Blood Pressure ,Cardiology and Cardiovascular Medicine ,Antihypertensive Agents ,Directly Observed Therapy - Abstract
ObjectiveTo test the impact of directly observed therapy (DOT) at hospital for checking not only adherence/diagnosis in patients with resistant (RHTN) and refractory (RefHTN) hypertension but also blood pressure (BP) control after hospital discharge.MethodsDuring 2 years, Brazilian patients with clinical suspicion of RHTN/RefHTN after several attempts (≥3) to control BP in the outpatient setting were invited to perform DOT (including low-sodium diet and supervised medications intake) at the hospital. RHTN and RefHTN were categorised using standard definitions. After hospital discharge, we evaluated the BP values and the number of antihypertensive drugs prescribed by physicians who were not involved with the investigation.ResultsWe studied 83 patients clinically suspected for RHTN (31%) and RefHTN (69%) (mean age: 53 years; 76% female; systolic BP 177±28 mm Hg and diastolic BP 106±21 mm Hg; number of antihypertensive drugs: 5.3±1.3). DOT confirmed RHTN in 77%, whereas RefHTN was confirmed in only 32.5%. The number of antihypertensive drugs reduced to 4.5±1.3 and systolic/diastolic BP at hospital discharge reduced to 131±17 mm Hg/80±12 mm Hg. After hospital discharge, systolic BP remained significantly lower than the last outpatient visit prehospital admission (delta changes (95% CI): 1 month: −25.7 (−33.8 to −17.6) mm Hg; 7 months: −27.3 (−35.5 to −19.1) mm Hg) despite fewer number of antihypertensive classes (1 month: −1.01 (−1.36 to −0.67); 7 months: −0.77 (−1.11 to −0.42)). Similar reductions were observed for diastolic BP.ConclusionsDOT at hospital is helpful not only in confirming/excluding RHTN/RefHTN phenotypes, but also in improving BP values and BP control and in reducing the need for antihypertensive drugs after hospital discharge.
- Published
- 2022
49. Eletroconvulsoterapia no tratamento da psicose puerperal
- Author
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Nuno Madeira, Tiago Santos, João Santos Relvas, José Luís Pio Abreu, and Cristina Villares Oliveira
- Subjects
Eletroconvulsoterapia ,psicose puerperal ,psicose pós-parto ,Psychiatry ,RC435-571 - Abstract
A psicose puerperal (PP) é um quadro clínico exuberante, com uma frequência estimada de 1 caso por cada 1.000 puerpérios, e que tem sido associado com maior consistência ao espectro bipolar. A evidência científica disponível é escassa, nomeadamente no respeitante à orientação terapêutica. Os autores apresentam o caso clínico de uma mulher primípara de 28 anos, sem antecedentes psiquiátricos, que iniciou nas primeiras semanas de puerpério um quadro psicótico florido, composto por agitação psicomotora, confusão, desorganização do pensamento e comportamento, sintomatologia psicótica e insônia grave. Por ausência de resposta ao tratamento farmacológico, houve recurso à eletroconvulsoterapia (ECT), com melhoria clínica rápida e evidente. Nesse contexto, os autores realizaram uma apreciação da literatura e evidência referentes ao uso de ECT na psicose puerperal.
- Published
- 2012
- Full Text
- View/download PDF
50. Comunicação Médico-Doente no Cenário COVID-19
- Author
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Pio Abreu, José Luís
- Subjects
Coronavírus ,Coronavirus ,Pandemia ,Relação Médico-Doente ,Physician-Patient Relations ,Infecção por Coronavírus ,Coronavirus Infection ,Pandemics - Abstract
Medicina Interna, 2020: Publicação Especial - COVID 19
- Published
- 2021
- Full Text
- View/download PDF
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