EVELINDA MARRAMON TRINDADE
Índice h a partir de 2011
11
Projetos de Pesquisa
Unidades Organizacionais
PAHC, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
conferenceObject Impact of Histidine-Tryptophan-Ketoglutarate Preservation Solution in Heart Transplantation with Extended Distance(2021) GONCALVES, F. A. Rodrigues; TRINDADE, E. M.; MANGINI, S.; GAIOTTO, F. A.; BACAL, F.- COVID-19-related hospital cost-outcome analysis: The impact of clinical and demographic factors(2021) MIETHKE-MORAIS, Anna; CASSENOTE, Alex; PIVA, Heloisa; TOKUNAGA, Eric; COBELLO, Vilson; GONCALVES, Fabio Augusto Rodrigues; LOBO, Renata dos Santos; TRINDADE, Evelinda; D'ALBUQUERQUE, Luiz Augusto Carneiro; HADDAD, LucianaIntroduction: Although patients' clinical conditions have been shown to be associated with coronavirus disease (COVID-19) severity and outcome, their impact on hospital costs are not known. This economic evaluation of COVID-19 admissions aimed to assess direct and fixed hospital costs and describe their particularities in different clinical and demographic conditions and outcomes in the largest public hospital in Latin America, located in Sao Paulo, Brazil, where a whole institute was exclusively dedicated to COVID-19 patients in response to the pandemic. Methods: This is a partial economic evaluation performed from the hospital's perspective and is a prospective, observational cohort study to assess hospitalization costs of suspected and confirmed COVID-19 patients admitted between March 30 and June 30, 2020, to Hospital das Clinicas of the University of Sao Paulo Medical School (HCFMUSP) and followed until discharge, death, or external transfer. Micro- and macro-costing methodologies were used to describe and analyze the total cost associated with each patient's underlying medical conditions, itinerary and outcomes as well as the cost components of different hospital sectors. Results: The average cost of the 3254 admissions (51.7% of which involved intensive care unit stays) was US$12,637.42. The overhead cost was its main component. Sex, age and underlying hypertension (US$14,746.77), diabetes (US$15,002.12), obesity (US$18,941.55), chronic renal failure (US$15,377.84), and rheumatic (US$17,764.61), hematologic (US $15,908.25) and neurologic (US$15,257.95) diseases were associated with higher costs. Age strata >69 years, reverse transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19, comorbidities, use of mechanical ventilation or dialysis, surgery and outcomes remained associated with higher costs. Conclusion: Knowledge of COVID-19 hospital costs can aid in the development of a comprehensive approach for decision-making and planning for future risk management. (C) 2021 Sociedade Brasileira de Infectologia.
- Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study(2021) GONCALVES, Fabio Augusto Rodrigues; BESEN, Bruno Adler Maccagnan Pinheiro; LIMA, Clarice Antunes de; CORA, Aline Pivetta; PEREIRA, Antonio Jose Rodrigues; PERAZZIO, Sandro Felix; GOUVEA, Christiane Pereira; FONSECA, Luiz Augusto Marcondes; TRINDADE, Evelinda Marramon; SUMITA, Nairo Massakazu; DUARTE, Alberto Jose da Silva; LICHTENSTEIN, ArnaldoOBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. METHODS: Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. RESULTS: Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level >= 4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level >= 220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level >= 4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level >= 220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p <0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor. CONCLUSION: D-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.
- Aerobic exercise and inspiratory muscle training increase functional capacity in patients with univentricular physiology after Fontan operation: A randomized controlled trial(2021) TURQUETTO, Aida Luiza Ribeiro; SANTOS, Marcelo Rodrigues dos; AGOSTINHO, Daniela Regina; SAYEGH, Ana Luiza Carrari; SOUZA, Francis Ribeiro de; AMATO, Luciana Patrick; BARNABE, Milena Schiezari Ru; OLIVEIRA, Patricia Alves de; LIBERATO, Gabriela; BINOTTO, Maria Angelica; NEGRAO, Carlos Eduardo; CANEO, Luiz Fernando; TRINDADE, Evelinda; JATENE, Fabio Biscegli; JATENE, Marcelo BiscegliBackground: The effect of exercise training and its mechanisms on the functional capacity improvement in Fontan patients (FP) are virtually unknown. This trial evaluated four-month aerobic exercise training and inspiratory muscle training on functional capacity, pulmonary function, and autonomic control in patients after Fontan operation. Methods: A randomized controlled clinical trial with 42 FP aged 12 to 30 years and, at least, five years of Fontan completion. Twenty-seven were referred to a four-months supervised and personalized aerobic exercise training (AET) or an inspiratory muscle training (IMT). A group of non-exercise (NET) was used as control. The effects of the exercise training in peak VO2; pulmonary volumes and capacities, maximal inspiratory pressure (MIP); muscle sympathetic nerve activity (MSNA); forearm blood flow (FBF); handgrip strength and cross-sectional area of the thigh were analyzed. Results: The AET decreased MSNA (p = 0.042), increased FBF (p 0.012) and handgrip strength (p = 0.017). No significant changes in autonomic control were found in IMT and NET groups. Both AET and IMT increased peak VO2, but the increase was higher in the AET group compared to IMT (23% vs. 9%). No difference was found in the NET group. IMT group showed a 58% increase in MIP (p = 0.008) in forced vital capacity (p = 0.011) and forced expiratory volume in the first second (p = 0.011). No difference in pulmonary function was found in the AET group. Conclusions: Both aerobic exercise and inspiratory musde training improved functional capacity. The AET group developed autonomic control, and handgrip strength, and the IMT increased inspiratory muscle strength and spirometry.
bookPart Farmacoeconomia em Anestesia(2021) MELO, Daniela Oliveira de; TRINDADE, Priscila de Arruda; TRINDADE, Evelinda