LIM/22 - Laboratório de Patolologia Cardiovascular
URI Permanente desta comunidade
O Laboratório de Patologia Cardiovascular é ligado ao Departamento de Patologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP).
Linhas de pesquisa: estudo morfofuncional das alterações cardiovasculares; análise das repercussões hemodinâmicas da insuficiência cardíaca congestiva; estudo do manuseio clínico do paciente internado em unidade de terapia intensiva; resposta das células endoteliais à agressão; biologia das neoplasias adrenocorticais; fisiopatologia do envelhecimento; envelhecimento cerebral e demências.
Site oficial: http://limhc.fm.usp.br/portal/lim22-laboratorio-de-patologia-cardiovascular/
Linhas de pesquisa: estudo morfofuncional das alterações cardiovasculares; análise das repercussões hemodinâmicas da insuficiência cardíaca congestiva; estudo do manuseio clínico do paciente internado em unidade de terapia intensiva; resposta das células endoteliais à agressão; biologia das neoplasias adrenocorticais; fisiopatologia do envelhecimento; envelhecimento cerebral e demências.
Site oficial: http://limhc.fm.usp.br/portal/lim22-laboratorio-de-patologia-cardiovascular/
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- LIM/22 - Laboratório de Patolologia Cardiovascular
- LIM/22 - Laboratório de Patolologia Cardiovascular
- LIM/22 - Laboratório de Patolologia Cardiovascular
Submissões Recentes
Asthma in Brazil: an epidemiological analysis from 2008 to 2021
(2023) PINHEIRO, David Halen Araujo; SOUZA, Joao Victor Hermogenes De; LIMA, Fabiano Francisco De; JUSTO, Alberto Fernando Oliveira; CERVERA, Vitoria Zacarias; CARVALHO-PINTO, Regina Maria; CARVALHO, Celso R. F.
Advances in diffuse glial tumors diagnosis
(2023) GODOY, Luis Filipe de Souza; PAES, Vitor Ribeiro; AYRES, Aline Sgnolf; BANDEIRA, Gabriela Alencar; MORENO, Raquel Andrade; HIRATA, Fabiana de Campos Cordeiro; SILVA, Frederico Adolfo Benevides; NASCIMENTO, Felipe; CAMPOS NETO, Guilherme de Carvalho; GENTIL, Andre Felix; LUCATO, Leandro Tavares; AMARO JUNIOR, Edson; YOUNG, Robert J.; MALHEIROS, Suzana Maria Fleury
In recent decades, there have been significant advances in the diagnosis of diffuse gliomas, driven by the integration of novel technologies. These advancements have deepened our understanding of tumor oncogenesis, enabling a more refined stratification of the biological behavior of these neoplasms. This progress culminated in the fifth edition of the WHO classification of central nervous system (CNS) tumors in 2021. This comprehensive review article aims to elucidate these advances within a multidisciplinary framework, contextualized within the backdrop of the new classification. This article will explore morphologic pathology and molecular/genetics techniques (immunohistochemistry, genetic sequencing, and methylation profiling), which are pivotal in diagnosis, besides the correlation of structural neuroimaging radiophenotypes to pathology and genetics. It briefly reviews the usefulness of tractography and functional neuroimaging in surgical planning. Additionally, the article addresses the value of other functional imaging techniques such as perfusion MRI, spectroscopy, and nuclear medicine in distinguishing tumor progression from treatment-related changes. Furthermore, it discusses the advantages of evolving diagnostic techniques in classifying these tumors, as well as their limitations in terms of availability and utilization. Moreover, the expanding domains of data processing, artificial intelligence, radiomics, and radiogenomics hold great promise and may soon exert a substantial influence on glioma diagnosis. These innovative technologies have the potential to revolutionize our approach to these tumors. Ultimately, this review underscores the fundamental importance of multidisciplinary collaboration in employing recent diagnostic advancements, thereby hoping to translate them into improved quality of life and extended survival for glioma patients.
Malignant neoplasm of breast in Brazilian women: A cross-sectional study from 2008 to 2019
(2023) JUSTO, Alberto Fernando O.; COLLACO, Rita de Cassia; LESCANO, Caroline Honaiser; OLIVEIRA, Ivan Pires de
Objective: Breast cancer is the most lethal malignancy for women worldwide. Developed countries, such as Portugal, Spain, and the United States, have declining mortality rates due to breast cancer; however, in developing countries, the epidemiological reports are scarce. In this context, the aims of this study are to describe and discuss the female breast cancer profile of hospitalization and mortality according to age and geographic region in Brazil from 2008 to 2019.Methods: Data were obtained from the National Health System Department of Informatics (DATASUS), maintained by the Brazilian Ministry of Health, which includes the registers of hospitalization and mortality by malignant neoplasm of breast (code C50, ICD-10). Proportional rates of hospitalization and deaths were estimated per 100,000 inhabitants according to respective subjects' age, region, and year of the occurrence.Results: From 2008 to 2019, 643,822 hospital admissions due to malignant neoplasm of breast were reported in Brazil, of which the South and Southeast regions were the most prevalent. Higher hospitalization rates were seen in subjects aged 50-79-years-old. Regarding mortality, 53,480 deaths by breast cancer were reported; similarly to hospitalization, the Southeast and South were the most affected regions. Mortality rates have increased over time in different magnitudes depending on subjects' age.Conclusion: We have shown an increase in morbidity and mortality over time, which is dependent on patients' age and region. The results presented here may contribute to the ongoing discussion about the role and future perspectives of the Brazilian health care system, especially regarding to the strategies for the prevention, control, and treatment of breast cancer.
Priorities for research on neuromodulatory subcortical systems in Alzheimer's disease: Position paper from the NSS PIA of ISTAART
(2023) EHRENBERG, Alexander J.; KELBERMAN, Michael A.; LIU, Kathy Y.; DAHL, Martin J.; WEINSHENKER, David; FALGAS, Neus; DUTT, Shubir; MATHER, Mara; LUDWIG, Mareike; BETTS, Matthew J.; WINER, Joseph R.; TEIPEL, Stefan; WEIGAND, Alexandra J.; ESCHENKO, Oxana; HAEMMERER, Dorothea; LEIMAN, Marina; COUNTS, Scott E.; SHINE, James M.; ROBERTSON, Ian H.; LEVEY, Allan I.; LANCINI, Elisa; SON, Gowoon; SCHNEIDER, Chrisoph; EGROO, Maxime Van; LIGUORI, Claudio; WANG, Qin; VAZEY, Elena M.; RODRIGUEZ-PORCEL, Federico; HAAG, Lena; BONDI, Mark W.; VANNESTE, Sven; FREEZE, Whitney M.; YI, Yeo-Jin; MALDINOV, Mihovil; GATCHEL, Jennifer; SATPATI, Abhijit; BABILONI, Claudio; KREMEN, William S.; HOWARD, Robert; JACOBS, Heidi I. L.; GRINBERG, Lea T.
The neuromodulatory subcortical system (NSS) nuclei are critical hubs for survival, hedonic tone, and homeostasis. Tau-associated NSS degeneration occurs early in Alzheimer's disease (AD) pathogenesis, long before the emergence of pathognomonic memory dysfunction and cortical lesions. Accumulating evidence supports the role of NSS dysfunction and degeneration in the behavioral and neuropsychiatric manifestations featured early in AD. Experimental studies even suggest that AD-associated NSS degeneration drives brain neuroinflammatory status and contributes to disease progression, including the exacerbation of cortical lesions. Given the important pathophysiologic and etiologic roles that involve the NSS in early AD stages, there is an urgent need to expand our understanding of the mechanisms underlying NSS vulnerability and more precisely detail the clinical progression of NSS changes in AD. Here, the NSS Professional Interest Area of the International Society to Advance Alzheimer's Research and Treatment highlights knowledge gaps about NSS within AD and provides recommendations for priorities specific to clinical research, biomarker development, modeling, and intervention. HighlightsNeuromodulatory nuclei degenerate in early Alzheimer's disease pathological stages.Alzheimer's pathophysiology is exacerbated by neuromodulatory nuclei degeneration.Neuromodulatory nuclei degeneration drives neuropsychiatric symptoms in dementia.Biomarkers of neuromodulatory integrity would be value-creating for dementia care.Neuromodulatory nuclei present strategic prospects for disease-modifying therapies.
Neuronal and glial vulnerability of the suprachiasmatic nucleus in tauopathies: evidence from human studies and animal models
(2024) SON, Gowoon; NEYLAN, Thomas C.; GRINBERG, Lea T.
Tauopathies, a group of neurodegenerative diseases that includes Alzheimer's disease, commonly lead to disturbances in sleep-wake patterns and circadian rhythm disorders. The circadian rhythm, a recurring 24-hour cycle governing human biological activity, is regulated by the hypothalamic suprachiasmatic nucleus (SCN) and endogenous transcriptional-translational feedback loops. Surprisingly, little attention has been given to investigating tauopathy-driven neuropathology in the SCN and the repercussions of SCN and circadian gene dysfunction in the human brain affected by tauopathies. This review aims to provide an overview of the current literature on the vulnerability of the SCN in tauopathies in humans. Emphasis is placed on elucidating the neuronal and glial changes contributing to the widespread disruption of the molecular circadian clock. Furthermore, this review identifies areas of knowledge requiring further investigation.
Association between APOE-ε4 allele and cognitive function is mediated by Alzheimer's disease pathology: a population-based autopsy study in an admixed sample
(2023) PARADELA, Regina Silva; JUSTO, Alberto Fernando Oliveira; PAES, Vitor Ribeiro; LEITE, Renata E. P.; PASQUALUCCI, Carlos A.; GRINBERG, Lea T.; NASLAVSKY, Michel Satya; ZATZ, Mayana; NITRINI, Ricardo; JACOB-FILHO, Wilson; SUEMOTO, Claudia Kimie
Background: Apolipoprotein E epsilon 4 allele (APOE-epsilon 4) is the main genetic risk factor for late-onset Alzheimer's disease (AD) and may impact cognitive function also via other neuropathological lesions. However, there is limited evidence available from diverse populations, as APOE associations with dementia seem to differ by race. Therefore, we aimed to evaluate the pathways linking APOE-epsilon 4 to cognitive abilities through AD and non-AD neuropathology in an autopsy study with an admixed sample.Methods: Neuropathological lesions were evaluated following international criteria using immunohistochemistry. Participants were classified into APOE-epsilon 4 carriers (at least one epsilon 4 allele) and non-carriers. Cognitive abilities were evaluated by the Clinical Dementia Rating Scale sum of boxes. Mediation analyses were conducted to assess the indirect association of APOE-epsilon 4 with cognition through AD-pathology, lacunar infarcts, hyaline arteriosclerosis, cerebral amyloid angiopathy (CAA), Lewy body disease (LBD), and TAR DNA-binding protein 43 (TDP-43).Results: We included 648 participants (mean age 75 +/- 12 years old, mean education 4.4 +/- 3.7 years, 52% women, 69% White, and 28% APOE-epsilon 4 carriers). The association between APOE-epsilon 4 and cognitive abilities was mediated by neurofibrillary tangles (beta = 0.88, 95% CI = 0.45; 1.38, p < 0.001) and neuritic plaques (beta = 1.36, 95% CI = 0.86; 1.96, p < 0.001). Lacunar infarcts, hyaline arteriosclerosis, CAA, LBD, and TDP-43 were not mediators in the pathway from APOE-epsilon 4 to cognition.Conclusion: The association between APOE-epsilon 4 and cognitive abilities was partially mediated by AD-pathology. On the other hand, cerebrovascular lesions and other neurodegenerative diseases did not mediate the association between APOE-epsilon 4 and cognition.
Aren't you forgetting something? Cognitive screening beyond delirium in the emergency department
(2023) MORAES, Gabriel Stanziola de; CURIATI, Pedro K.; AVELINO-SILVA, Thiago Junqueira; MORINAGA, Christian V.; APOLINARIO, Daniel; SUEMOTO, Claudia Kimie; ALIBERTI, Marlon Juliano Romero
Untangle the relationship of muscle mass and bone mineral content on handgrip strength: Results of ELSA-Brasil
(2023) TAVARES, Nayranne Hivina Carvalho; RODRIGUES, Brena Custodio; ARRUDA, Soraia P. M.; SZLEJF, Claudia; SUEMOTO, Claudia Kimie; GRIEP, Rosane Harter; DINIZ, Maria de F. H. S.; GIATTI, Luana; BARRETO, Sandhi M.; FORTUNATO, Larissa
The study aims to investigate the independent association of muscle mass (MM) and bone mineral content (BMC) in the performance of the handgrip strength (HGS) test and whether there is effect modification by sex and age. In 12,491 participants from the ELSA-Brasil we estimated the associations between MM, BMC and HGS using linear regression models. All the analyses were performed for total population, also stratified for sex and age. For total population an interaction term was included between each explanatory variable of interest with sex and age to verify the presence of effect modification. We observed that the higher quintiles of MM and BMC were associated to an increasing in the mean of HGS compared to the first quintile, with greater magnitudes in men compared to women, also adults compared to elderly. When we estimated the independent effect of each exposure of interest, MM showed stronger effect in HGS in women, men and adults then BMC. In conclusion, we observed that higher amounts of MM and BMC are associated with higher HGS, regardless of sociodemographic characteristics, health conditions and lifestyle, with this effect being greater in men and adults.
Risk factors for dementia in Brazil: Differences by region and race
(2023) SUEMOTO, Claudia K.; MUKADAM, Naaheed; BRUCKI, Sonia M. D.; CARAMELLI, Paulo; NITRINI, Ricardo; LAKS, Jerson; LIVINGSTON, Gill; FERRI, Cleusa P.
Introduction Twelve risk factors (RFs) account for 40% of dementia cases worldwide. However, most data for population attributable fractions (PAFs) are from high-income countries (HIC). We estimated how much these RFs account for dementia cases in Brazil, stratifying estimates by race and socioeconomic level. Methods We calculated the prevalence and communalities of 12 RFs using 9412 Brazilian Longitudinal Study of Aging participants, then stratified according to self-reported race and country macro-regions. Results The overall weighted PAF was 48.2%. Less education had the largest PAF (7.7%), followed by hypertension (7.6%), and hearing loss (6.8%). PAF was 49.0% and 54.0% in the richest and poorest regions, respectively. PAFs were similar among White and Black individuals (47.8% and 47.2%, respectively) but the importance of the main RF varied by race. Discussion Brazil's potential for dementia prevention is higher than in HIC. Education, hypertension, and hearing loss should be priority targets.
Clinical characteristics and outcomes of COVID-19 patients with preexisting dementia: a large multicenter propensity-matched Brazilian cohort study
(2024) BICALHO, Maria Aparecida Camargos; ALIBERTI, Marlon Juliano Romero; DELFINO-PEREIRA, Polianna; CHAGAS, Victor Schulthais; ROSA, Patryk Marques da Silva; PIRES, Magda Carvalho; RAMOS, Lucas Emanuel Ferreira; BEZERRA, Adriana Falangola Benjamin; FERES, Ana Beatriz de Castro; GOMES, Angelica Gomides dos Reis; BHERING, Angelinda Rezende; PESSOA, Bruno Porto; SILVA, Carla Thais Candida Alves da; CIMINI, Christiane Correa Rodrigues; SUEMOTO, Claudia Kimie; DIAS, Cristiana Andrade Coelho; CARAZAI, Daniela dos Reis; PONCE, Daniela; RIOS, Danyelle Romana Alves; MANENTI, Euler; ANSCHAU, Fernando; BATISTA, Joanna d'Arc Lyra; ALVARENGA, Joice Coutinho de; VIGUINI, Julia Avancini; ZANELLATO, Julia Mariot; RUGOLO, Juliana Machado; RUSCHEL, Karen Brasil; NASCIMENTO, Leticia do; MENEZES, Luanna Silva Monteiro; OLIVEIRA, Lucas Moyses Carvalho de; CASTRO, Luis Cesar de; NASI, Luiz Antonio; CARNEIRO, Marcelo; FERREIRA, Maria Angelica Pires; GODOY, Mariana Frizzo de; GUIMARAES-JUNIOR, Milton Henriques; OLIVEIRA, Neimy Ramos de; ZIEGELMANN, Patricia Klarmann; PORTO, Paula Fonseca; MENDES, Paulo Mascarenhas; PARAISO, Pedro Gibson; REIS, Priscilla Pereira dos; FRANCISCO, Saionara Cristina; ARAUJO, Silvia Ferreira; AVELINO-SILVA, Thiago Junqueira; MARCOLINO, Milena Soriano
Background Although dementia has emerged as an important risk factor for severe SARS-CoV-2 infection, results on COVID-19-related complications and mortality are not consistent. We examined the clinical presentations and outcomes of COVID-19 in a multicentre cohort of in-hospital patients, comparing those with and without dementia.Methods This retrospective observational study comprises COVID-19 laboratory-confirmed patients aged >= 60 years admitted to 38 hospitals from 19 cities in Brazil. Data were obtained from electronic hospital records. A propensity score analysis was used to match patients with and without dementia (up to 3:1) according to age, sex, comorbidities, year, and hospital of admission. Our primary outcome was in-hospital mortality. We also assessed admission to the intensive care unit (ICU), invasive mechanical ventilation (IMV), kidney replacement therapy (KRT), sepsis, nosocomial infection, and thromboembolic events.Results Among 1,556 patients included in the study, 405 (4.5%) had a diagnosis of dementia and 1,151 were matched controls. When compared to matched controls, patients with dementia had a lower frequency of dyspnoea, cough, myalgia, headache, ageusia, and anosmia; and higher frequency of fever and delirium. They also had a lower frequency of ICU admission (32.7% vs. 47.1%, p < 0.001) and shorter ICU length of stay (7 vs. 9 days, p < 0.026), and a lower frequency of sepsis (17% vs. 24%, p = 0.005), KRT (6.4% vs. 13%, p < 0.001), and IVM (4.6% vs. 9.8%, p = 0.002). There were no differences in hospital mortality between groups.Conclusion Clinical manifestations of COVID-19 differ between older inpatients with and without dementia. We observed that dementia alone could not explain the higher short-term mortality following severe COVID-19. Therefore, clinicians should consider other risk factors such as acute morbidity severity and baseline frailty when evaluating the prognosis of older adults with dementia hospitalised with COVID-19.