JEFFERSON LUIS VIEIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
conferenceObject Chagas' cardiomyopathy mortality in the 21st century: seven years prospective follow up(2016) SOUZA, G. E. Germano Emilio; VIEIRA, J. L.; CASOLATO, A. T.; MORAES, L. R.; BRAGA, G. A.; ISSA, V. S.; AYUB-FERREIRA, S. M.; CHIZZOLA, P. R.; BOCCHI, E. A.; MELO, L. M. Pessoa DeconferenceObject RESPIRATORY MASK-FILTER PREVENTS CARDIOVASCULAR EFFECTS ASSOCIATED WITH DIESEL EXHAUST EXPOSURE: A RANDOMIZED, PROSPECTIVE, DOUBLE-BLIND, CONTROLLED, CROSSOVER STUDY IN HEART FAILURE (FILTER-HF TRIAL)(2015) VIEIRA, Jefferson L.; GUIMARAES, Guliherme V.; ANDRE, Paulo A. de; SALDIVA, Paulo H. N.; BOCCHI, Edimar A.- Docinhos e ensaios de não inferioridade: uma experiência pedagógica criativa(2014) MORAES, David William; MOREIRA, Daniel Medeiros; VIEIRA, Jefferson Luís; PICCOLI JR., Antonio Luiz; PELLANDA, Lucia CamposNew challenges in education parallel with knowledge expansion. New research techniques have enabled major discoveries in science, together with a growing complexity of the studied themes. Students, part of the dynamic universe of the Internet, have also evolved and no longer fit the requirements of traditional pedagogy. For these new realities the way to educate in the twenty-first century requires a creative effort from educators, in order to convey knowledge that is increasingly complex. As an illustration of this new situation, we bring the report of a pedagogical experiment that sought, with the creativity of a fictitious intervention, to support the teaching of non-inferiority clinical trials. The experiment managed to show the usefulness of such clinical trials when there is the need to test the efficacy of treatments. The use of sweets and the participation of students as the test subjects constitute an active methodology, bringing students closer to their subject of study. The exercise conducted is in line with the pedagogical models suggested by the meaningful learning theory and can be used as a benchmark for similar initiatives.
conferenceObject Effects of Reducing Exposure to Air Pollution With a Filter on Exercise: A Randomized, Prospective, Double-Blind, Controlled Study of Heart Failure(2015) VIEIRA, Jefferson L.; GUIMARAES, Guilherme V.; ANDRE, Paulo A. de; SALDIVA, Paulo H.; BOCCHI, Edimar A.conferenceObject Chagas' cardiomyopathy mortality in the 21st century: seven years prospective follow up(2016) SOUZA, G. E.; VIEIRA, J. L.; MELO, L. M. Pessoa De; BRAGA, G. A.; MORAES, L. R.; ISSA, V. S.; BOCCHI, E. A.; RAMIRES, J. A. F.- Respiratory Filter Reduces the Cardiovascular Effects Associated With Diesel Exhaust Exposure A Randomized, Prospective, Double-Blind, Controlled Study of Heart Failure: The FILTER-HF Trial(2016) VIEIRA, Jefferson L.; GUIMARAES, Guilherme V.; ANDRE, Paulo A. de; CRUZ, Fatima D.; SALDIVA, Paulo H. Nascimento; BOCCHI, Edimar A.OBJECTIVES The goal of this study was to test the effects of a respiratory filter intervention (filter) during controlled pollution exposure. BACKGROUND Air pollution is considered a risk factor for heart failure (HF) decompensation and mortality. METHODS This study was a double-blind, randomized to order, controlled, 3-way crossover, single-center clinical trial. It enrolled 26 patients with HF and 15 control volunteers. Participants were exposed in 3 separate sessions to clean air, unfiltered diesel exhaust exposure (DE), or filtered DE. Endpoints were endothelial function assessed by using the reactive hyperemia index (RHi), arterial stiffness, serum biomarkers, 6-min walking distance, and heart rate variability. RESULTS In patients with HF, DE was associated with a worsening in RHi from 2.17 (interquartile range [IQR]: 1.8 to 2.5) to 1.72 (IQR: 1.5 to 2.2; p = 0.002) and an increase in B-type natriuretic peptide (BNP) from 47.0 pg/ml (IQR: 17.3 to 118.0 pg/ml) to 66.5 pg/ml (IQR: 26.5 to 155.5 pg/ml; p = 0.004). Filtration reduced the particulate concentration (325 +/- 31 mu g/m(3) vs. 25 +/- 6 mu g/m(3); p < 0.001); in the group with HF, filter was associated with an improvement in RHi from 1.72 (IQR: 1.5 to 2.2) to 2.06 (IQR: 1.5 to 2.6; p = 0.019) and a decrease in BNP from 66.5 pg/ml (IQR: 26.5 to 155.5 pg/ml) to 44.0 pg/ml (IQR: 20.0 to 110.0 pg/ml; p = 0.015) compared with DE. In both groups, DE decreased the 6-min walking distance and arterial stiffness, although filter did not change these responses. DE had no effect on heart rate variability or exercise testing. CONCLUSIONS To our knowledge, this trial is the first to show that a filter can reduce both endothelial dysfunction and BNP increases in patients with HF during DE. Given these potential benefits, the widespread use of filters in patients with HF exposed to traffic-derived air pollution may have beneficial public health effects and reduce the burden of HF. (Effects of Air Pollution Exposure Reduction by Filter Mask on Heart Failure; NCT01960920) (C) 2016 by the American College of Cardiology Foundation.
conferenceObject ACUTE CARDIOVASCULAR CHANGES TO CONTROLLED DIESEL EXHAUST EXPOSURE IN HEALTH SUBJECTS: A POOLED SYSTEMATIC REVIEW AND META-ANALYSIS OF 373 PARTICIPANTS FROM RANDOMIZED CONTROLLED TRIALS(2016) VIEIRA, Jefferson Luis; MACEDO, Francisco; BENJO, Alexandre M.; GUIMARAES, Guilherme V.; CONTRERAS, Johanna P.; BOCCHI, Edimar A.conferenceObject Effects of air pollution exposure reduction by filter mask on heart failure: a prospective randomized double-blind controlled trial(2014) VIEIRA, J. L.; GUIMARAES, G. V.; ANDRE, P. A. De; SALDIVA, P. H. N.; BOCCHI, E. A.- Role of Vascular Inflammation in Coronary Artery Disease: Potential of Anti-inflammatory Drugs in the Prevention of Atherothrombosis(2015) MOREIRA, Daniel Medeiros; SILVA, Roberto Leo da; VIEIRA, Jefferson Luis; FATTAH, Tammuz; LUENEBERG, Maria Emilia; GOTTSCHALL, Carlos Antonio MasciaCoronary artery disease (CAD) and acute myocardial infarction (AMI) are inflammatory pathologies, involving interleukins (ILs), such as IL-1 beta, IL-6 and tumor necrosis factor (TNF)-alpha, and acute phase proteins production, such as for C reactive protein (CRP). The process begins with retention of low-density lipoprotein (LDL) and its oxidation inside the intima, with the formation of the ""foam cells."" Toll-like receptors and inflamassomes participate in atherosclerosis formation, as well as in the activation of the complement system. In addition to innate immunity, adaptive immunity is also associated with atherosclerosis through antigen-presenting cells, T and B lymphocytes. AMI also increases the expression of some ILs and promotes macrophage and lymphocyte accumulation. Reperfusion increases the expression of anti-inflammatory ILs (such as IL-10) and generates oxygen free radicals. Although CAD and AMI are inflammatory disorders, the only drugs with anti-inflammatory effect so far widely used in ischemic heart disease are aspirin and statins. Some immunomodulatory or immunosuppressive promising therapies, such as cyclosporine and colchicine, may have benefits in CAD. Methotrexate also has potential cardioprotective anti-inflammatory effects, through increased adenosine levels. The TETHYS trial (The Effects of mETHotrexate Therapy on ST Segment Elevation MYocardial InfarctionS trial) will evaluate low-dose methotrexate in ST elevation AMI. The CIRT (Cardiovascular Inflammation Reduction Trial), in turn, will evaluate low-dose methotrexate in patients with a high prevalence of subclinical vascular inflammation. The CANTOS (The Canakinumab Antiinflammatory Thrombosis Outcomes Study) will evaluate canakinumab in patients with CAD and persistently elevated CRP. The blockage of other potential targets, such as the IL-6 receptor, CC2 chemokine receptor and CD20, could bring benefits in CAD.
conferenceObject Echocardiography parameters, respiratory eficiency, and quality of life in patients with permanent atrial fibrillation and heart failure: effect of exercise training. A randomized controlled trial(2018) ALVES, L. Silva; SALEMI, V. M. C.; ROCON, C.; MELO, M. D. T.; CHIZZOLA, P. R.; AMATO, J. F.; VIEIRA, J. L.; BOCCHI, E. A.; GUIMARAES, G. V.