TANIA MARA VAREJAO STRABELLI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
9 resultados
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- Usefulness of PCR for Trypanosoma cruzi DNA in blood and endomyocardial biopsies for detection of Chagas disease reactivation after heart transplantation: A comparative study(2021) BENVENUTI, L. A.; FREITAS, V. L. T.; ROGGéRIO, A.; NISHIYA, A. S.; MANGINI, S.; STRABELLI, T. M. V.Background: Chagas disease reactivation (CDR) after heart transplantation is characterized by relapse of the infectious disease with proliferation and dissemination of Trypanosoma cruzi parasites. Serial blood PCR testing is consensually recommended for CDR monitoring, but there is uncertainty about the incremental value in performing the molecular tests in endomyocardial biopsies (EMB). Methods: We compared qualitative and quantitative results of PCR for T cruzi DNA in 62 pairs of blood and EMB collected with a maximum time interval of 7 days, from 34 heart-transplanted, chagasic patients. Results: Blood PCR resulted positive in 39/62 (62.9%) samples, with PL ranging from 0.14 to 1610.73 (median: 3.31). PCR resulted positive in 8/60 (13.3%) EMB, with PL ranging from 2.82 to 1670.55 (median: 65.63). All blood samples which tested negative presented a paired EMB which also tested negative. However, 31/39 (79.5%) blood samples which tested positive presented a paired EMB which tested negative. There was poor agreement between blood and EMB PCR (kappa = 0.153). CDR affecting the myocardium (myo-CDR) was diagnosed in three occasions. PCR resulted positive in both blood and EMB at the time of myo-CDR, with PL ranging from 0.61 to 1610.73 in blood and 13.8 to 1670.55 in EMB. Conclusions: Negative PCR for T cruzi in blood rules out myo-CDR, with no value of testing EMB. Positive PCR in blood with high PL is diagnostic for myo-CDR. If PCR in blood results positive with low PL, testing EMB is useful: negative PCR turns unlikely, and positive PCR reinforces greatly the possibility of myo-CDR. © 2021 Wiley Periodicals LLC
- Demographic, cardiological, microbiologic, and dental profiles of Brazilian patients who developed oral bacteria-related endocarditis(2021) MONTANO, Tania Cristina Pedroso; WANDERLEY, Marcelo Ivander Andrade; SAMPAIO, Roney Orismar; ALVES, Carolina Guimaraes Bonfim; NEVES, Itamara Lucia Itagiba; LOPES, Marcio Ajudarte; TARASOUTCHI, Flavio; STRABELLI, Tania Mara Varejao; NEVES, Ricardo Simoes; GRINBERG, Max; SANTOS-SILVA, Alan Roger; SICILIANO, Rinaldo FocacciaObjective. Infective endocarditis (IE) may cause devastating complications with high morbidity and mortality rates. The aim of the present study was to study the demographic, cardiological, microbiologic, and dental profiles of patients with oral bacteria-related IE. Study Design. We present a retrospective study of patients with oral bacteria-related IE treated at Instituto do Coracao, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Brazil, between January 2009 and December 2019. Results. Of the 100 patients included, 70% were male with a mean age of 45.4 years at diagnosis. The most affected sites were aortic and mitral valves, 60% in prosthetic heart valves, 34% in native valves, and 3% in pacemakers. The most common cause of valvular disease was rheumatic cardiopathy (51.9%), and the most frequent complications were valvular and perivalvular damage (26%). Streptococcus viridans was the most common species (96%), dental caries were present in 57% of the patients, 78% had tooth loss, 45% had apical periodontitis, and 77% were at high/moderate risk for periodontal disease. Conclusion. Oral bacteria-related IE among Brazilians was predominant in the prosthetic heart valves of young male adults previously affected by rheumatic cardiopathy. Streptococcus viridans was the main cause of IE, which was linked to patients with a poor oral health status.
conferenceObject Characteristics and Outcomes of Heart Transplant Recipients with Coronavirus-19 Disease(2021) MARCONDES-BRAGA, F. G.; MURAD, C. M.; BELFORT, D. D.; DANTAS, R. C.; LIRA, M. S.; ARAGAO, C.; SICILIANO, R. F.; MANGINI, S.; SEGURO, L.; CAMPOS, I. W. de; AVILA, M. S.; BELLO, M. V.; BARONE, F.; STRABELLI, T. M.; GAIOTTO, F. A.; BACAL, F.- Position Statement on Indications and the Safe Reintroduction of Cardiovascular Imaging Methods in the COVID-19 Scenario-2021(2021) BECK, Adenalva Lima de Souza; BARBERATO, Silvio Henrique; ALMEIDA, Andre Luiz Cerqueira de; GRAU, Claudia R. Pinheiro de Castro; LOPES, Marly Maria Uellendahl; LIMA, Ronaldo de Souza Leao; CERCI, Rodrigo Julio; ALBRICKER, Ana Cristina Lopes; BARROS, Fanilda Souto; OLIVEIRA, Alessandra Joslin; LIRA, Edgar Bezerra de; MIGLIORANZA, Marcelo Haertel; VIEIRA, Marcelo Luiz Campos; PENA, Jose Luiz Barros; STRABELLI, Tania Mara Varejao; BIHAN, David Costa de Souza Le; TSUTSUI, Jeane Mike; ROCHITTE, Carlos Eduardo
- Impact of COVID-19 Pandemic in a Pediatric and Congenital Cardiovascular Surgery Program in Brazil(2021) MIANA, Leonardo A.; MANUEL, Valdano; CANEO, Luiz Fernando; STRABELLI, Tania Mara Varejao; ARITA, Elisandra Trevisan; MONTEIRO, Rosangela; JATENE, Marcelo Biscegli; JATENE, Fabio B.Introduction: The coronavirus disease 2019 (COVID-19) has negatively impacted healthcare services worldwide. We hypothesized that the pandemic would affect our case mix and mortality. Our objective was to study this impact. Methods: We retrospectively studied all patients who underwent congenital heart surgeries from March 21st to August 21st in 2019 and 2020 using the institutional electronic database. We compared demographic data, preoperative and postoperative length of stay (LOS), risk stratification using Risk Adjustment for Congenital Heart Surgery (RACHS) classification and outcomes in both periods. Results: We observed a 66.7% decrease in our surgical volume (285 x 95 patients). Patients operated in the pre-pandemic period were older (911.3 [174.8 - 5953.8] days-old) compared to the pandemic period (275 days-old; P<0.05). When the case mix was compared between periods, the percentage of neonatal surgery was increased in the pandemic era (8% x 21.1%; P<0.05), and the number of RACHS 1-2 surgeries decreased significantly (60.7 x 27.4%; P<0.05). Preoperative LOS was increased in the pandemic period (1.2 x 7 days; P=0.001). There was no significant increment in mortality (P=0.1). Two patients tested positive for COVID-19 in the postoperative period and both died. Conclusion: Our program observed a sudden decrease in surgical volume and a consequent increase in surgical complexity. There was a non-significant increment in mortality.
conferenceObject Neurochagas: A Rare Case of Reactivation of Chagas Disease after Heart Transplantation(2021) ARAGAO, C. A.; CAMPOS, I. W.; DANTAS, R. T.; LIRA, M. T.; BELFORT, D. S.; MURAD, C. M.; AVILA, M. S.; SEGURO, L. F.; MANGINI, S.; STRABELLI, T. V.; BRAGA, F. M.; BACAL, F.- Transplantation for Chagas Heart Disease: a Comprehensive Review(2021) BACAL, Fernando; MURAD, Ciro Mancilha; ARAGAO, Carlos Aurelio dos Santos; CAMPOS, Iascara Wozniak de; SEGURO, Luis Fernando Bernal da Costa; AVILA, Monica Samuel; MANGINI, Sandrigo; GAIOTTO, Fabio Antonio; STRABELLI, Tania Varejao; MARCONDES-BRAGA, Fabiana G.Purpose of Review Chagas cardiomyopathy (CC) has a worse prognosis than other forms of cardiomyopathy and up to 10% of patients may progress to end-stage heart failure. In this article, we have performed a comprehensive literature review of heart transplantation (HT) for CC, including results after HT, management of immunosuppression, and Chagas disease (CD) reactivation. Recent Findings CD used to be considered a contraindication to HT due to the risks of disease reactivation with immunosuppression. Nonetheless, multiple reports have consistently demonstrated the feasibility and safety of HT for refractory CC. CD reactivation must be routinely screened in the first-year post-transplant, and in recent years, polymerase chain reactions (PCR)-based techniques have been used more often. HT is now considered the best treatment for end-stage Chagas heart disease. In addition, studies of immunosuppressive medications have shown that these patients require a lesser degree of immunosuppression, mainly to balance reactivation risks.
conferenceObject Change in the Clinical-Demographic Profile of Chagasic Patients Who are Candidates for Heart Transplantation in Recent Years(2021) ARAGAO, C. A.; CAMPOS, I. W.; LIRA, M. T.; DANTAS, R. T.; MURAD, C. M.; BELFORT, D. S.; MANGINI, S.; STRABELLI, T. V.; BRAGA, F. M.; SEGURO, L. F.; AVILA, M. S.; GAIOTTO, F. A.; BACAL, F.bookPart Mediastinites(2021) UIP, David Everson; STRABELLI, Tânia Mara Varejão; ZEIGLER, Rogério