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Avila MS, Belfort DDSP. Há uma Função para o Telemonitoramento na Insuficiência Cardíaca? Arq Bras Cardiol 2022; 118:605-606. [PMID: 35319610 PMCID: PMC8959035 DOI: 10.36660/abc.20220034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Avila MS, Belfort DDSP, Leite VDV, Demarche LMMF, Ayub-Ferreira SM. Cardiac graft loss in transplant recipient with Chagas disease. Am J Transplant 2022. [PMID: 35239239 DOI: 10.1111/ajt.16919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Léa Maria Macruz Ferreira Demarche
- Pathology Department, Heart Institute (InCor), do Jospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
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Belfort DDSP, Marcondes-Braga FG, Mangini S, Cafezeiro CRF, Furlan DAG, Bacal F. Aortic and Renal Artery Thrombosis as the First Clinical Manifestation of COVID-19 in a Heart Transplant Recipient. Arq Bras Cardiol 2021; 117:1045-1047. [PMID: 34817016 PMCID: PMC8682100 DOI: 10.36660/abc.20201210] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/24/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Deborah de Sá Pereira Belfort
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Fabiana G Marcondes-Braga
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Sandrigo Mangini
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Caio Rebouças Fonseca Cafezeiro
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Diógenes Amauri Gonçalves Furlan
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
| | - Fernando Bacal
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil
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Belfort DDSP, Biselli B, Ávila MS, Lira MTSDS, Galas FRBG, Steffen SP, Gaiotto FA, Jatene FB, Bocchi EA, Ferreira SMA. COVID-19 complicating perioperative management of LVAD implantation: A case report and systematic review. J Card Surg 2021; 36:3405-3409. [PMID: 34091934 PMCID: PMC8242914 DOI: 10.1111/jocs.15690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/14/2021] [Accepted: 05/23/2021] [Indexed: 01/05/2023]
Abstract
The coronavirus 2019 disease (COVID-19) affected 125 million people worldwide and caused 2.7 million deaths. Some comorbidities are associated with worse prognosis and left ventricular assist device (LVAD) recipients are probably part of this high-risk population. We report a 31-year-old male patient who developed COVID-19 during LVAD implantation. His postoperative period was complicated by severe pneumonia and mechanical ventilation (MV) leading to right ventricular failure (RVF) and inotrope necessity. He experienced multiple complications, but eventually recovered. We present a systematic review of LVAD recipients and COVID-19. Among 14 patients, the mean age was 62.7 years, 78.5% were male. A total of 5 patients (35.7%) required MV and 3 patients (21.4%) died. A total of 2 patients (14.2%) had thromboembolic events. This case and systematic review suggest LVAD recipients are at particular risk of unfavorable outcomes and they may be more susceptible to RVF in the setting of COVID-19, particularly during perioperative period.
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Affiliation(s)
- Deborah de Sá Pereira Belfort
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Bruno Biselli
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Mônica Samuel Ávila
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Maria Tereza Sampaio de Sousa Lira
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Filomena Regina Barbosa Gomes Galas
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Samuel Padovani Steffen
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Fabio Antonio Gaiotto
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Fabio Biscegli Jatene
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Edimar Alcides Bocchi
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Silvia Moreira Ayub Ferreira
- Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
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Accorsi TAD, Brigido ARD, De Amicis K, Belfort DDSP, Habrum FC, Scarpanti FG, Magalhães IR, Silva Filho JRDO, Sampaio LPC, Lira MTSDS, Morbeck RA, Pedrotti CHS, Racy FDCJ, Cordioli E. Clinical features of a series of patients in life-threatening situations at a COVID-19 pandemic field hospital, evaluated by teleconsultation: evidence for Telemedicine expansion. Einstein (Sao Paulo) 2021; 19:eCE6370. [PMID: 34133667 PMCID: PMC8169026 DOI: 10.31744/einstein_journal/2021ce6370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/04/2021] [Indexed: 01/08/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Fábio de Castro Jorge Racy
- Instituto Israelita de Responsabilidade Social, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Affiliation(s)
- Mônica Samuel Avila
- Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Instituto do Coração, São Paulo, SP - Brasil
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Accorsi TAD, Amicis KD, Brígido ARD, Belfort DDSP, Habrum FC, Scarpanti FG, Magalhães IR, Silva Filho JRDO, Sampaio LPC, Lira MTSDS, Morbeck RA, Pedrotti CHS, Cordioli E. Assessment of patients with acute respiratory symptoms during the COVID-19 pandemic by Telemedicine: clinical features and impact on referral. Einstein (Sao Paulo) 2020; 18:eAO6106. [PMID: 33295428 PMCID: PMC7690926 DOI: 10.31744/einstein_journal/2020ao6106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022] Open
Abstract
Objective: To characterize variables associated with referral to the emergency department following Telemedicine consultation during the COVID-19 pandemic. Methods: Cross-sectional retrospective study conducted between March and May 2020, with a sample of 500 adult patients. The inclusion criterion was the manifestation of respiratory symptoms, regardless of type. Results: The mean age of patients was 34.7±10.5 years, and 59% were women. Most patients (62.6%) perceived their own health status as malaise and some (41.4%) self-diagnosed COVID-19. Cough (74.4%), rhinorrhea (65.6%), sore throat (38.6%) and sneezing (20.6%) were the most common infection-related symptoms. Overall, 29.4% and 16% of patients reported dyspnea and chest pain, respectively. The Roth score was calculated for a sizeable number of patients (67.6%) and was normal, moderately altered or severely altered in 83.5%, 10.7% and 5.6% of patients, respectively. The percentage of suspected COVID-19 cases was 67.6%. Of these, 75% were managed remotely and only one quarter referred for emergency assessment. Conclusion: Telemedicine assessment is associated with reclassification of patient's subjective impression, better inspection of coronavirus disease 2019 and identification of risk patients. Referral is therefore optimized to avoid inappropriate in-person assessment, and low-risk patients can be properly guided. Telemedicine should be implemented in the health care system as a cost-effective strategy for initial assessment of acute patients.
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Ferreira CCG, de Sá Pereira Belfort D, Neto PMC, Gouveia PADC. Reversible Pulmonary Hypertension Secondary to Scurvy in a Patient with a Psychiatric Disorder: a Case Report and Literature Review. Eur J Case Rep Intern Med 2020; 7:001404. [PMID: 32133311 PMCID: PMC7050966 DOI: 10.12890/2020_001404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 11/21/2019] [Accepted: 11/30/2019] [Indexed: 01/22/2023] Open
Abstract
Pulmonary hypertension (PH) can be related to several diseases, such as connective tissue disorders and pulmonary embolism, or to drugs; it may also be idiopathic. Few cases have been reported demonstrating an association between ascorbic acid deficiency and reversible PH. We report the case of a patient who arrived at the emergency department with dyspnoea, tachycardia and lower limb perifollicular haemorrhage. Examinations, including a transthoracic echocardiogram, revealed enlarged right chambers and an estimated pulmonary artery systolic pressure of 61 mmHg. Further evaluation revealed poor food intake due to paranoid personality disorder, leading to ascorbic acid deficiency and manifestations of scurvy.
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Affiliation(s)
| | - Deborah de Sá Pereira Belfort
- Internal Medicine Service, Federal University of Pernambuco, Recife, Brazil.,Heart Institute (InCor), University of São Paulo, São Paulo, Brazil
| | - Paulo Miranda Cavalcante Neto
- Internal Medicine Service, Federal University of Pernambuco, Recife, Brazil.,Respiratory Diseases Service, Institute of Medical Assistance to the State Public Servant, São Paulo, Brazil
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