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Fernandes GDS, Campos D, Ballalai A, Palhares R, Alvares-da-Silva MR, Palhares DMF, Neto BHF, Barros FMDR, Gil RDA, Chagas A, Carrilho FJ. Author Correction: Epidemiological and Clinical Patterns of Newly Diagnosed Hepatocellular Carcinoma in Brazil: the Need for Liver Disease Screening Programs Based on Real-World Data. J Gastrointest Cancer 2020; 52:959. [PMID: 33103212 DOI: 10.1007/s12029-020-00539-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Gustavo Dos Santos Fernandes
- Centro de Oncologia, Hospital Sírio-Libanês, SGAS 613/614, Conjunto E, Lote 95, Brasilia, DF, CEP 70200730, Brazil. .,Sociedade Brasileira de Oncologia Clínica, Sao Paulo, SP, Brazil.
| | | | | | | | - Mario R Alvares-da-Silva
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Daniel M F Palhares
- Centro de Oncologia, Hospital Sírio-Libanês, SGAS 613/614, Conjunto E, Lote 95, Brasilia, DF, CEP 70200730, Brazil
| | - Ben-Hur F Neto
- Consultant Surgeon at Diagnósticos da América SA (DASA) e Associação Brasileira de Linfoma e Leucemia (ABRALE), Sao Paulo, SP, Brazil
| | | | - Roberto de A Gil
- Serviço de Oncologia Clínica do INCA e Oncoclínica Centro de Tratamento Oncológico, Rio de Janeiro, RJ, Brazil
| | - Aline Chagas
- Hospital das Clínicas da Faculdade de Medicina da USP e Instituto do Câncer do Estado de São Paulo (ICESP), Sao Paulo, SP, Brazil
| | - Flair José Carrilho
- Hospital das Clínicas da Faculdade de Medicina da USP e Instituto do Câncer do Estado de São Paulo (ICESP), Sao Paulo, SP, Brazil
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Fernandes GDS, Campos D, Ballalai A, Palhares R, da Silva MRA, Palhares DMF, Neto BHF, Barros FMDR, Gil RDA, Chagas A, Carrilho FJ. Epidemiological and Clinical Patterns of Newly Diagnosed Hepatocellular Carcinoma in Brazil: the Need for Liver Disease Screening Programs Based on Real-World Data. J Gastrointest Cancer 2020; 52:952-958. [PMID: 32918274 PMCID: PMC8376733 DOI: 10.1007/s12029-020-00508-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Purpose Describe sociodemographic and clinical characteristics of patients with hepatocellular carcinoma (HCC) and establish their history in the Brazilian public health system. Methods Retrospective observational study was conducted using the database from the Department of Informatics of the Unified Health System (DataSUS). Patients with at least one claim of HCC between July/2011 and June/2016 were included. A record linkage methodology was performed to obtain longitudinal data across different databases. Demographic and clinical data were evaluated, including the time elapsed between diagnosis of HCC risk-factors and the cancer development. Data was analyzed using descriptive statistics. Results A total of 28,822 HCC cases were identified between July/2011 and June/2016. Mean age was 59.7 years (SD = 14.7), and most patients were men (55.9%). The highest relative number of HCC cases was detected in the south of Brazil (> 20 cases/100,000 inhabitants). About 86.5% of the patients had diagnosis of HCC without previous liver diseases. Only 8% had diagnosis of chronic viral hepatitis and 3.5% cirrhosis. About 76% were diagnosed at an advanced stage, and only 11% of the patients had early stage HCC. Approximately 58% of patients with previous underlying liver diseases were diagnosed at early stages, compared with only 24% of patients without prior record of underlying diseases. Conclusion The diagnosis of HCC in the Brazilian public health is usually made in patients with no previous diagnosis of liver disease and in advanced stages, when no curative treatment is available and survival rates are low. Public health policies are key for the screening and monitoring liver disease and, consequently, HCC.
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Affiliation(s)
- Gustavo Dos Santos Fernandes
- Centro de Oncologia, Hospital Sírio-Libanês, SGAS 613/614, Conjunto E, Lote 95, Brasilia, DF, CEP 70200730, Brazil. .,Sociedade Brasileira de Oncologia Clínica, Sao Paulo, SP, Brazil.
| | | | | | | | - Mario R A da Silva
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Daniel M F Palhares
- Centro de Oncologia, Hospital Sírio-Libanês, SGAS 613/614, Conjunto E, Lote 95, Brasilia, DF, CEP 70200730, Brazil
| | - Ben-Hur F Neto
- Consultant Surgeon at Diagnósticos da América SA (DASA) e Associação Brasileira de Linfoma e Leucemia (ABRALE), Sao Paulo, SP, Brazil
| | | | - Roberto de A Gil
- Serviço de Oncologia Clínica do INCA e Oncoclínica Centro de Tratamento Oncológico, Rio de Janeiro, RJ, Brazil
| | - Aline Chagas
- Hospital das Clínicas da Faculdade de Medicina da USP e Instituto do Câncer do Estado de São Paulo (ICESP), Sao Paulo, SP, Brazil
| | - Flair José Carrilho
- Hospital das Clínicas da Faculdade de Medicina da USP e Instituto do Câncer do Estado de São Paulo (ICESP), Sao Paulo, SP, Brazil
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Palhares DMF, Marcolino MS, Santos TMM, da Silva JLP, Gomes PR, Ribeiro LB, Macfarlane PW, Ribeiro ALP. Normal limits of the electrocardiogram derived from a large database of Brazilian primary care patients. BMC Cardiovasc Disord 2017; 17:152. [PMID: 28610624 PMCID: PMC5470250 DOI: 10.1186/s12872-017-0572-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 05/16/2017] [Indexed: 11/30/2022] Open
Abstract
Background Knowledge of the normal limits of the electrocardiogram (ECG) is mandatory for establishing which patients have abnormal ECGs. No studies have assessed the reference standards for a Latin American population. Our aim was to establish the normal ranges of the ECG for pediatric and adult Brazilian primary care patients. Methods This retrospective observational study assessed all the consecutive 12-lead digital electrocardiograms of primary care patients at least 1 year old in Minas Gerais state, Brazil, recorded between 2010 and 2015. ECGs were excluded if there were technical problems, selected abnormalities were present or patients with selected self-declared comorbidities or on drug therapy. Only the first ECG from patients with multiple ECGs was accepted. The University of Glasgow ECG analysis program was used to automatically interpret the ECGs. For each variable, the 1st, 2nd, 50th, 98th and 99th percentiles were determined and results were compared to selected studies. Results A total of 1,493,905 ECGs were recorded. 1,007,891 were excluded and 486.014 were analyzed. This large study provided normal values for heart rate, P, QRS and T frontal axis, P and QRS overall duration, PR and QT overall intervals and QTc corrected by Hodges, Bazett, Fridericia and Framingham formulae. Overall, the results were similar to those from other studies performed in different populations but there were differences in extreme ages and specific measurements. Conclusions This study has provided reference values for Latinos of both sexes older than 1 year. Our results are comparable to studies performed in different populations.
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Affiliation(s)
- Daniel M F Palhares
- Telehealth Network of Minas Gerais, Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, 1º Andar, Ala Sul, Sala 107, Belo Horizonte, 30130-100, Minas Gerais, Brazil.,Medical School, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Milena S Marcolino
- Telehealth Network of Minas Gerais, Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, 1º Andar, Ala Sul, Sala 107, Belo Horizonte, 30130-100, Minas Gerais, Brazil.,Medical School, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Thales M M Santos
- Telehealth Network of Minas Gerais, Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, 1º Andar, Ala Sul, Sala 107, Belo Horizonte, 30130-100, Minas Gerais, Brazil.,Medical School, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - José L P da Silva
- Telehealth Network of Minas Gerais, Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, 1º Andar, Ala Sul, Sala 107, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Paulo R Gomes
- Telehealth Network of Minas Gerais, Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, 1º Andar, Ala Sul, Sala 107, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Leonardo B Ribeiro
- Telehealth Network of Minas Gerais, Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, 1º Andar, Ala Sul, Sala 107, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Peter W Macfarlane
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Antonio L P Ribeiro
- Telehealth Network of Minas Gerais, Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, 1º Andar, Ala Sul, Sala 107, Belo Horizonte, 30130-100, Minas Gerais, Brazil. .,Medical School, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, Belo Horizonte, 30130-100, Minas Gerais, Brazil.
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Marcolino MS, Palhares DMF, Benjamin EJ, Ribeiro AL. Atrial fibrillation: prevalence in a large database of primary care patients in Brazil. Europace 2015; 17:1787-90. [PMID: 26056188 PMCID: PMC4700731 DOI: 10.1093/europace/euv185] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 05/01/2015] [Indexed: 02/07/2023] Open
Abstract
AIMS Although an increasing prevalence of atrial fibrillation (AF) has been reported worldwide, there are few studies from low- and middle-income countries. Our objective is to assess the prevalence of AF and the associated medical conditions in Brazilian primary care patients. METHODS AND RESULTS This is an observational retrospective study. Patients ≥5 years of age from primary care centres of 658 municipalities in Minas Gerais, Brazil, who performed digital electrocardiograms (ECGs) by a public telehealth service in 2011 were assessed. Clinical data were self-reported, and ECGs were interpreted by a team of trained cardiologists using standardized criteria. To assess the relation between clinical characteristics and AF, odds ratios were estimated by logistic regression. A total of 262 685 primary care patients were included, mean (SD) age of 50.3 (19.3) years, 59.6% female. Hypertension was reported in 32.0%, family history of coronary heart disease in 15.0%, diabetes in 5.4%, hyperlipidaemia in 2.8%, Chagas disease in 2.9%, and 7.1% reported current smoking. The prevalence of AF was 1.8% overall: 2.4% in men (ranging from 0.001% from 5-19 years old to 14.6% in nonagenarians) and 1.3% in women (ranging from 0.001% from 5-19 years old to 8.7% in nonagenarians) (P < 0.001). The prevalence of AF increased with advancing age. The comorbidities associated with AF were Chagas disease, previous myocardial infarction, hypertension, and chronic obstructive pulmonary disease. Vitamin K antagonist use was reported by 1.5% of patients. CONCLUSION The prevalence and age distribution of AF were similar to studies in high-income countries. The proportion of patients who reported the use of anticoagulants was alarmingly low. Our findings point out the necessity to formulate effective treatment strategies for AF in Brazilian primary care settings.
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Affiliation(s)
- Milena S Marcolino
- Department of Internal Medicine, Medical School and University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 Room 246, CEP 30130-100 Belo Horizonte, Brazil Telehealth Network of Minas Gerais, Belo Horizonte, Brazil
| | - Daniel M F Palhares
- Department of Internal Medicine, Medical School and University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 Room 246, CEP 30130-100 Belo Horizonte, Brazil Telehealth Network of Minas Gerais, Belo Horizonte, Brazil
| | - Emelia J Benjamin
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Antonio L Ribeiro
- Department of Internal Medicine, Medical School and University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 Room 246, CEP 30130-100 Belo Horizonte, Brazil Telehealth Network of Minas Gerais, Belo Horizonte, Brazil
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