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Full-Text Articles in Endocrine System Diseases

Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal Apr 2016

Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal

Ahmed Dalmar, MD

Purpose

Kidney transplantation remains the best treatment option for end-stage renal disease. However, despite overall improvements in patient and graft survival rates after kidney transplantation, differences in outcomes still exist among different racial and ethnic groups, with African-Americans having lower graft survival. Gaps continue to exist in the understanding of how demographic factors contribute to the varying outcomes among racial/ethnic groups.

Methods

We retrospectively evaluated kidney transplant outcomes in four racial/ethnic groups over a 12-year period at a large tertiary care center. Primary and secondary study outcomes were patient and graft survival across groups. To determine factors that might predict …


Elevated Serum Glucose Levels And Survival After Acute Heart Failure: A Population-Based Perspective, Benjamin Helfand, Nicholas Maselli, Darleen Lessard, Jorge Yarzebski, Joel Gore, David Mcmanus, Jane Saczynski, Robert Goldberg Jun 2015

Elevated Serum Glucose Levels And Survival After Acute Heart Failure: A Population-Based Perspective, Benjamin Helfand, Nicholas Maselli, Darleen Lessard, Jorge Yarzebski, Joel Gore, David Mcmanus, Jane Saczynski, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Limited data are available about the characteristics, treatment and survival in patients without diabetes mellitus (DM), previously diagnosed DM and patients with hyperglycaemia who present with acute decompensated heart failure (ADHF). Our objectives were to examine differences in these endpoints in patients hospitalized with ADHF. METHODS: Patients hospitalized with ADHF during 1995, 2000, 2002 and 2004 comprised the study population. RESULTS: A total of 5428 non-diabetic patients were hospitalized with ADHF, 3807 with diagnosed DM and 513 with admission hyperglycaemia. Patients with admission hyperglycaemia experienced the highest in-hospital death rates (9.9%) compared to those with diagnosed DM (6.5%) and …


Decade-Long Trends In The Characteristics, Management And Hospital Outcomes Of Diabetic Patients With St-Segment Elevation Myocardial Infarction, Mayra Tisminetzky, Samuel Joffe, David Mcmanus, Chad Darling, Joel Gore, Jorge Yarzebski, Darleen Lessard, Robert Goldberg Nov 2014

Decade-Long Trends In The Characteristics, Management And Hospital Outcomes Of Diabetic Patients With St-Segment Elevation Myocardial Infarction, Mayra Tisminetzky, Samuel Joffe, David Mcmanus, Chad Darling, Joel Gore, Jorge Yarzebski, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

PURPOSE: Our objectives were to describe recent trends in the characteristics and in-hospital outcomes in diabetic as compared with non-diabetic patients hospitalized with ST-segment elevation myocardial infarction (STEMI).

METHODS: We reviewed the medical records of 2537 persons with (n = 684) and without (n = 1853) a history of diabetes who were hospitalized for STEMI between 1997 and 2009 at 11 medical centres in Central Massachusetts.

RESULTS: Diabetic patients were more likely to be older, female and to have a higher prevalence of previously diagnosed comorbidities. Diabetic patients were more likely to have developed important in-hospital complications and to have …


Brazilian Longitudinal Study Of Adult Health (Elsa-Brasil): Objectives And Design., Paulo A. Lotufo Feb 2012

Brazilian Longitudinal Study Of Adult Health (Elsa-Brasil): Objectives And Design., Paulo A. Lotufo

Paulo A Lotufo

The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) aims to contribute relevant information with respect to the development and progression of clinical and subclinical chronic diseases, particularly cardiovascular diseases and diabetes. In this report, the authors delineate the study's objectives, principal methodological features, and timeline. At baseline, ELSA-Brasil enrolled 15,105 civil servants from 5 universities and 1 research institute. The baseline examination (2008-2010) included detailed interviews, clinical and anthropometric examinations, an oral glucose tolerance test, overnight urine collection, a 12-lead resting electrocardiogram, measurement of carotid intima-media thickness, echocardiography, measurement of pulse wave velocity, hepatic ultrasonography, retinal fundus photography, and an …


A Reappraisal In São Paulo, Brazil (2008) Of "The Ecology Of Medical Care:" The "One Per Thousand's Rule"., Adriana Roncoletta, Gustavo D. Gusso, Isabela M. Bensenor, Paulo A. Lotufo Jan 2012

A Reappraisal In São Paulo, Brazil (2008) Of "The Ecology Of Medical Care:" The "One Per Thousand's Rule"., Adriana Roncoletta, Gustavo D. Gusso, Isabela M. Bensenor, Paulo A. Lotufo

Paulo A Lotufo

This paper reassessed in Brazil, the concept of "Medical ecology" i introduced in 1961 to describe the relationship and utilization of health care services by a given population. This was a cross-sectional telephone survey among a random sample of people enrolled in a private HMO. We interviewed a random sample of non-pregnant adults over age 18 using 10 questions about symptoms and health care use during the month prior to interview. The final sample consisted of 1,065 participants (mean age 68 years, 68% female). From this sample, 424 (39.8%) reported the presence of symptoms, 311 (29.2%) had a medical office …


Hypothyroidism In The Elderly, Paulo A. Lotufo Jan 2012

Hypothyroidism In The Elderly, Paulo A. Lotufo

Paulo A Lotufo

An overview adressing observational and randomized clinical trials about hypothyroidism in the elderly.


Chronic Non-Communicable Diseases In Brazil: Priorities For Disease Management And Research, Bruce B. Duncan, Dora Chor, Estela M. Aquino, Isabela M. Bensenor, J.Geraldo Mill, M.Ines Schmidt, Paulo A. Lotufo, Alvaro Vigo, Sandhi M. Barreto Jan 2012

Chronic Non-Communicable Diseases In Brazil: Priorities For Disease Management And Research, Bruce B. Duncan, Dora Chor, Estela M. Aquino, Isabela M. Bensenor, J.Geraldo Mill, M.Ines Schmidt, Paulo A. Lotufo, Alvaro Vigo, Sandhi M. Barreto

Paulo A Lotufo

Chronic Non-Communicable Diseases are the main source of disease burden in Brazil. In 2011, the Brazilian Ministry of Health launched the Strategic Plan of Action for Management of Chronic Non-Communicable Diseases focusing on population-based interventions to manage cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases mainly through fi ghting tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol. Although a signifi cant number of scientifi c studies on chronic diseases and their risk factors have been undertaken in Brazil, few are of cohort design. In this context, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort …


Elsa-Brasil: Historico [In Portuguese], Paulo A. Lotufo Nov 2011

Elsa-Brasil: Historico [In Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Vigilância Em Doença Cerebrovascular [Portuguese], Paulo A. Lotufo Nov 2011

Vigilância Em Doença Cerebrovascular [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Prevalence Of Thyroid Disorders Among Older People: Results From The São Paulo Ageing & Health Study, Paulo A. Lotufo Jan 2011

Prevalence Of Thyroid Disorders Among Older People: Results From The São Paulo Ageing & Health Study, Paulo A. Lotufo

Paulo A Lotufo

This study aimed to estimate prevalence of thyroid disorders in the São Paulo Ageing & Health Study, an epidemiological study addressing several health-adverse outcomes among elderly people living in a poor area of São Paulo, Brazil. All participants answered a questionnaire and had a blood sample collected to assess levels of tireotropic hormone and free-thyroxine. Among 1,373 people (60.8% women), prevalence rates (95% confidence interval) for thyroid dysfunction (%) were: overt hyperthyroidism, 0.7% (0.2-1.1) [women: 0.8% (0.2-1.5); men: 0.4% (0.01-0.9)]; overt hypothyroidism, 5.7% (4.5-6.9) [women: 5.9% (4.3-7.5); men: 5.4% (3.5-7.3)]; subclinical hyperthyroidism, 2.4% (1.6-3.2) [women: 2.8% (1.6-3.9); men: 1.9% (0.7-3.0)]; …


Pufa And Vitamin D And Type 2 Diabetes Inflammatory Markers, Paulo A. Lotufo Nov 2010

Pufa And Vitamin D And Type 2 Diabetes Inflammatory Markers, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo Jun 2010

Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Non-Inferiority Trials [In Portuguese], Paulo A. Lotufo May 2010

Non-Inferiority Trials [In Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo May 2010

Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo

Paulo A Lotufo

Cancer are not surpassing Cardiovascular Diseases. Here you have an evaluation of mortality in Brazil. The debate was ignited by paper from IARC (International Agency for Research on Cancer) that forecasts cancer deaths surpassing heart diseases rates during de 2020’s. There is no dispute about the fact that - at least in the US and other countries - the decline of mortality deaths for heart diseases presenting a faster pace compared to cancer death rates. It is an epidemiological evidence that must be analyzed and some headline fueling hype as “heart diseases as an old agenda of public health and …


Gender Differences Of Case-Fatality Rate In A Brazilian Stroke Registry, Paulo A. Lotufo Feb 2010

Gender Differences Of Case-Fatality Rate In A Brazilian Stroke Registry, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Characteristics Of Small Areas With A Higher Stroke Mortality, Paulo A. Lotufo Feb 2010

Characteristics Of Small Areas With A Higher Stroke Mortality, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Higher Frequency Of Stroke Deaths On Monday And Saturday, Paulo A. Lotufo Feb 2010

Higher Frequency Of Stroke Deaths On Monday And Saturday, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Social Inequalities And The Decline Of Stroke Mortality In The City Of Sao Paulo, Brazil, Paulo A. Lotufo Feb 2010

Social Inequalities And The Decline Of Stroke Mortality In The City Of Sao Paulo, Brazil, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Subclinical Hyperthyroidism And Dementia: The Sao Paulo Ageing & Health Study (Spah), Paulo A. Lotufo Jan 2010

Subclinical Hyperthyroidism And Dementia: The Sao Paulo Ageing & Health Study (Spah), Paulo A. Lotufo

Paulo A Lotufo

Background: Several epidemiologic studies have shown a possible association between thyroid function and cognitive decline. Our aim was to evaluate the association of subclinical hyperthyroidism and dementia in a population sample of older people. Methods: A cross-sectional study - São Paulo Ageing & Health Study (SPAH) - in a population sample of low-income elderly people ≥ 65 years-old to evaluate presence of subclinical thyroid disease as a risk factor for dementia. Thyroid function was assessed using thyrotropic hormone and free-thyroxine as well as routine use of thyroid hormones or antithyroid medications. Cases of dementia were assessed using a harmonized one-phase …


Nutritional Evaluation Of The Patients With Head And Neck Squamous Cell Carcinoma [Portuguese], Paulo A. Lotufo Jan 2009

Nutritional Evaluation Of The Patients With Head And Neck Squamous Cell Carcinoma [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

Patients with head and neck squamous cell carcinoma (HNSCC) usually present nutritional disorders, secondary to the upper aerodigestive tract involvement or due to the treatment sequels. Objective: To assess the nutritional status of patients with HNSCC in different phases of the disease treatment. Methods: Cross-sectional study with 155 patients divided in 4 groups: 103 patients with HNSCC (29 before treatment, 47 post-treatment with no recurrence and 27 post treatment with recurrent disease) and 52 controls without HNSCC. Clinical and epidemiological data were collected and a nutrition assessment was performed from anthropometric parameters (weight, height and Body Mass Index – BMI), …


Patterns Of Viral Load In Chronic Hepatitis B Patients In Brazil And Their Association Withalt Levels And Hbeag Status, Paulo A. Lotufo Jan 2009

Patterns Of Viral Load In Chronic Hepatitis B Patients In Brazil And Their Association Withalt Levels And Hbeag Status, Paulo A. Lotufo

Paulo A Lotufo

Serum hepatitis B virus (HBV) DNA level is a predictor of the development of cirrhosis and hepatocellular carcinoma in chronic hepatitis B patients. Nevertheless, the distribution of viral load levels in chronic HBV patients in Brazil has yet to be described. This cross-sectional study included 564 participants selected in nine Brazilian cities located in four of the five regions of the country using the database of a medical diagnostics company. Admission criteria included hepatitis B surface antigen seropositivity, availability of HBV viral load samples and age >or=18 years. Males comprised 64.5% of the study population. Mean age was 43.7 years. …


Measurements Of Adiposity And High Blood Pressure Among Children And Adolescents Living In Belo Horizonte, Paulo A. Lotufo Dec 2008

Measurements Of Adiposity And High Blood Pressure Among Children And Adolescents Living In Belo Horizonte, Paulo A. Lotufo

Paulo A Lotufo

Abstract Objective: To verify an association, if it exists, between obesity and blood pressure raised beyond the 90th percentile in children and adolescents, and to determine the measure of adiposity that best correlates with blood pressure in these subjects. Design: Cross-sectional study. Setting: A school-based study in Belo Horizonte, Brazil. Participants: We selected randomly 1,403 students, aged from 6 to 18 years, from 545,046 students attending 521 public and private schools. Those selected completed the study. Main measures of outcome: We recorded the weight, height, skin fold in the triceps, subscapular, and suprailiac areas, waist and hip circumference, body-mass index, …


Estudo Longitudinal De Saúde Do Adulto -Elsa-Brasil [English], Paulo A. Lotufo Sep 2008

Estudo Longitudinal De Saúde Do Adulto -Elsa-Brasil [English], Paulo A. Lotufo

Paulo A Lotufo

Presentation update on September, 2011.


Framingham Score For Cardiovascular Diseases [Portuguese], Paulo A. Lotufo Jan 2008

Framingham Score For Cardiovascular Diseases [Portuguese], Paulo A. Lotufo

Paulo A Lotufo

Review about cardiovascular risk factors.


Race, Gender And Stroke Subtypes Mortality In Sao Paulo, Brazil., Paulo A. Lotufo Jan 2007

Race, Gender And Stroke Subtypes Mortality In Sao Paulo, Brazil., Paulo A. Lotufo

Paulo A Lotufo

Stroke mortality rates have a discrepant distribution according to socioeconomic variables as social exclusion in Brazil. Recently, data from race has been available from the official health statistics considering five categories: White, Mixed, Black, Asian and Native. We addressed in the city of São Paulo, Brazil, an analysis of cerebrovascular mortality according to race (excluding Asian and Native due to small number of events) and gender during 1999-2001 for people aged 30 to 79 years-old. For all cerebrovascular diseases, age-adjusted mortality rates (x 100,000) for men were higher for Black (150.2), intermediate for Mixed (124.2) and lower for White (104.5) …


Aterosclerose: Comparando Brasil E Estados Unidos, Paulo A. Lotufo Dec 2006

Aterosclerose: Comparando Brasil E Estados Unidos, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Sunshine And Suicide At The Tropic Of Capricorn, São Paulo, Brazil, 1996–2004, Paulo A. Lotufo Dec 2006

Sunshine And Suicide At The Tropic Of Capricorn, São Paulo, Brazil, 1996–2004, Paulo A. Lotufo

Paulo A Lotufo

Several studies have confi rmed seasonal variation in suicide rates according to hours of sunshine. The suicide pattern was assessed in São Paulo, southeastern Brazil, at the tropic of Capricorn from 1996 to 2004. Poisson regression was employed to estimate parameters of seasonality, as well as to verify associations for each day between daylight duration and suicide. During the nine-year study period, there were 3,984 suicides (76.9% in men; median age=38.7 years old). Seasonal averages of suicides were similar, as were monthly averages. Poisson regression did not reveal any association between suicide rates and hours of sunshine (p=0.45) for both …


Air Pollutants And Respiratory Symptoms Among Adults, Paulo A. Lotufo Jan 2006

Air Pollutants And Respiratory Symptoms Among Adults, Paulo A. Lotufo

Paulo A Lotufo

Air pollutants are associated with adverse respiratory effects mainly in susceptible groups such as children, elderly people and people with pre-existent respiratory disease. This study was designed to assess the impact of the inorganic composition of particulate matter on 33 adult asthmatics respiratory functions in São Paulo city, Brazil. From May to July 2002, fine and coarse particulate matter fractions were collected and trace metals (Fe2+, Mn2+, Zn2+, Pb2+, Cu2+) and major ions (Na+, Mg2+, K+, Ca2+, NH4 +, Cl-, NO3-, SO42-) composition was determined in each aqueous-extract fraction by Atomic Absorption Spectrometry with Graphite Furnace (AAS-GF) and Ion Chromatography, …


The Acute-Phase Proteins Serum Amyloid A And C Reactive Protein In Transudates And Exudates, Paulo A. Lotufo Jan 2006

The Acute-Phase Proteins Serum Amyloid A And C Reactive Protein In Transudates And Exudates, Paulo A. Lotufo

Paulo A Lotufo

The distinction between exudates and transudates is very important in the patient management. Here we evaluate whether the acute-phase protein serum amyloid A (SAA), in comparison with C reactive protein (CRP) and total protein (TP), can be useful in this discrimination. CRP, SAA, and TP were determined in 36 exudate samples (27 pleural and 9 ascitic) and in 12 transudates (9 pleural and 3 ascitic). CRP, SAA, and TP were measured. SAA present in the exudate corresponded to 10% of the amount found in serum, that is, the exudate/serum ratio (E/S) was 0.10±0.13. For comparison, the exudate/serum ratio for CRP …


Epidemiological Studies In The Information And Genomics Era: Experience Of The Clinical Genome Of Cancer Project In São Paulo, Brazil, V Wunsch, Jose Eluf-Neto, Paulo A. Lotufo, Marco A. Zago Jan 2006

Epidemiological Studies In The Information And Genomics Era: Experience Of The Clinical Genome Of Cancer Project In São Paulo, Brazil, V Wunsch, Jose Eluf-Neto, Paulo A. Lotufo, Marco A. Zago

Paulo A Lotufo

No abstract provided.