ALEXANDRE DE MATOS SOEIRO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
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- Artrite reumatoide e doença cardiovascular: o que sabemos e o que podemos fazer pelo paciente na atualidade?(2012) SOEIRO, Alexandre de Matos; HADDAD, Michel; ALMEIDA, Maria Carolina Feres de; RUPPERT, Aline D.; SERRANO JR., Carlos V.There is increasing interest in autoimmune diseases, especially their relationship with cardiovascular disease. Rheumatoid arthritis in particular has been considered an independent risk factor for coronary artery disease in recent years. Various studies have aimed to clarify important aspects of risk stratification and treatment options in patients with rheumatoid arthritis, and specific therapies are being studied that promise to reduce their long-term cardiovascular risk. We performed a wide-ranging review of the literature to highlight the importance of atherosclerotic and inflammatory mechanisms in coronary artery disease. We also suggest strategies for risk stratification and treatment of cardiovascular disease in patients with rheumatoid arthritis.
- Rare Manifestation of Acute Pulmonary Edema Associated with Acute Lupus Myocarditis(2012) SOEIRO, Alexandre de Matos; BERGAMIN, Fabricio Sanchez; ALMEIDA, Maria Carolina Feres de; SERRANO JR., Carlos Vicente; FALCAO, Breno Alencar de Araripe; GANEM, FernandoSystemic Lupus Erythematosus (SLE) is the most common systemic autoimmune disease, occurring more frequently in women, usually aged between 16 and 55 years1,2. Although classically the kidneys are the organs most affected in SLE, cardiopulmonary circulation and the heart may also be affected significantly3. In this context, the occurrence of acute pulmonary edema associated with lupus myocarditis is rare and specific immunosuppressive therapy remains unclear.
- Postmortem diagnosis of acute myocardial infarction in patients with acute respiratory failure - demographics, etiologic and pulmonary histologic analysis(2012) SOEIRO, Alexandre de Matos; RUPPERT, Aline D.; CANZIAN, Mauro; CAPELOZZI, Vera L.; SERRANO JR., Carlos V.OBJECTIVES: Acute respiratory failure is present in 5% of patients with acute myocardial infarction and is responsible for 20% to 30% of the fatal post-acute myocardial infarction. The role of inflammation associated with pulmonary edema as a cause of acute respiratory failure post-acute myocardial infarction remains to be determined. We aimed to describe the demographics, etiologic data and histological pulmonary findings obtained through autopsies of patients who died during the period from 1990 to 2008 due to acute respiratory failure with no diagnosis of acute myocardial infarction during life. METHODS: This study considers 4,223 autopsies of patients who died of acute respiratory failure that was not preceded by any particular diagnosis while they were alive. The diagnosis of acute myocardial infarction was given in 218 (4.63%) patients. The age, sex and major associated diseases were recorded for each patient. Pulmonary histopathology was categorized as follows: diffuse alveolar damage, pulmonary edema, alveolar hemorrhage and lymphoplasmacytic interstitial pneumonia. The odds ratio of acute myocardial infarction associated with specific histopathology was determined by logistic regression. RESULTS: In total, 147 men were included in the study. The mean age at the time of death was 64 years. Pulmonary histopathology revealed pulmonary edema as well as the presence of diffuse alveolar damage in 72.9% of patients. Bacterial bronchopneumonia was present in 11.9% of patients, systemic arterial hypertension in 10.1% and dilated cardiomyopathy in 6.9%. A multivariate analysis demonstrated a significant positive association between acute myocardial infarction with diffuse alveolar damage and pulmonary edema. CONCLUSIONS: For the first time, we demonstrated that in autopsies of patients with acute respiratory failure as the cause of death, 5% were diagnosed with acute myocardial infarction. Pulmonary histology revealed a significant inflammatory response, which has not previously been reported.
- Association between Immunological Diseases and their Similar Clinical Manifestations(2012) SOEIRO, Alexandre de Matos; ALMEIDA, Maria Carolina Feres de; ACCORSI, Tarso Augusto Duenhas; SPINA, Guilherme Sobreira; SERRANO JR., Carlos Vicente; TARASOUTCHI, FlavioWe report on a 30-year-old female patient, with biological mitral valve prosthesis due to symptomatic mitral stenosis and a history of acute myocardial infarction and generalized tonic-clonic seizure episodes, visual hallucinations, cerebral thromboembolic events and, at present, chorea and acute carditis. The patient was diagnosed with active rheumatic fever (RF), systemic lupus erythematosus (SLE) and Antiphospholipid syndrome (APS). The combination of three unusual diagnoses in the same patient makes this a unique case, modifying patient treatment and prognosis.
conferenceObject Pulmonary anatomopathologic analysis and clinical manifestations related to different diseases in patients with pulmonary thromboembolism. An autopsy study(2012) SOEIRO, A.; RUPPERT, A. D.; CANZIAN, M.; ALMEIDA, M. C. F. De; SERRANO JR., C. V.; CAPELOZZI, V. L.Purpose: Patients who died due to pulmonary thromboembolism (PTE), may present different clinical manifestations and symptoms depending on their underlying diseases. The anatomopathological findings are still unknown in literature. The objective of this study was describing demographic and etiologic data, anatomic pathological findings and in-vivo manifestations (Acute Respiratory Failure [ARF], Hemodynamic Instability [HI] or Sudden Death) associated to the variety of diagnosis extracted from autopsy reports of PTE patients. Methods: From 2,000 to 2,008, were reviewed 291 autopsies of patients whose cause of death was PTE. The following data were obtained: age, sex, clinical in-vivo manifestations, post-mortem pathological patterns and main associated underlying diseases. The pulmonary histopathological changes were categorized in: diffuse alveolar damage (DAD), pulmonary edema (PE), alveolar hemorrhage (AH) and lympho/plasmacytic interstitial pneumonia (LPIP). Odds ratios of certain associated diseases developing a specific clinical manifestation and/or a specific pulmonary histological finding were determined by logistic regression. Moreover, the relation between certain clinical manifestation and a specific anatomic pathologic pattern was analysed too. Odds ratio was considered significative when p < 0,05. Results: A total of 127 (43,6%) men were studied. The median age was 64 years. Neoplasies were present in 49.1% of cases and 31.2% of patients developed PTE in postsurgical period, mainly from abdominal and neurosurgery.The most common clinical manifestation was ARF (28,9%), followed by PCR (27,5%) and HI (26,8%). The most prevalent pulmonary finding was PE (26.8%). Chronic Obstructive Pulmonary Disease was positively correlated to LPIP (p = 0,04). Linking in-vivo manifestations to pulmonary changes were found significative relations between: ARF and PE (OR, 2,99; 95% IC, 1,25 – 7,21; p = 0,014); ARF and AH (OR, 2,70; 95% IC, 1,02 – 7,20; p = 0,04); ARF and DAD (OR, 8,79; 95% IC, 1,11 – 69,42; p = 0,039); HI and HA (OR, 3,38; 95% IC, 1,27 – 8,99; p = 0,015) and HI and DAD (OR, 11,43; 95% IC, 1,46 – 89,46; p = 0,02). The multivariated analysis didn’t exhibited significant association between different clinical manifestations and specific diseases. Conclusions: In autopsies of patients with PTE, the most prevalent disease was neoplasy. The most associated histological finding was PE. The most frequent clinical manifestation was ARF. We noticed important relation between COPD an LPIP. ARF was positively related to PE, AH and DAD; as well HI to AH and DAD.