MARCIO NATTAN PORTES SOUZA
Índice h a partir de 2011
4
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Update on Idiopathic Intracranial Hypertension Management(2022) SOUZA, Marcio Nattan Portes; COSTA, Barbara de Alencar Leite; SANTOS, Felipe Reinaldo Deus Ramos; FORTINI, IdaBackground: Idiopathic Intracranial Hypertension (IIH) is a secondary headache with a steadily growing incidence. Currently, there is little evidence to guide the treatment of IIH. Objective: To review the pathophysiology of IIH, with focus on the role of obesity as a risk factor, and the implications for new therapeutic perspectives. Methods: In this narrative review, we summarized the current knowledge on treatment options highlighting available evidence for managing intracranial hypertension, obesity, and headache. Results: Clinical Presentation: headache is the most common symptom and a significant cause of quality-of-life impairment. Visual loss is common in the diagnosis. Pathophysiology: There is no unified theory able to explain all symptoms and the evolution of the disease.There is growing data pointing to metabolic changes and obesity with a central role in IIH pathophysiology. Treatment: Most published data on IIH treatment is related to pressure control and protection from visual loss. Acetazolamide and cerebrospinal fluid diversion are the best options available. Optic nerve sheath fenestration might be useful to temporally control the pressure over the optic nerve and thus protect from visual deterioration. Recently, venous sinus stenting has proven to be a safe option in selected cases. Finally, bariatric surgery has proven to effectively control elevated intracranial pressure. Conclusion: IIH is a potential cause of high disability. Early recognition is important, and treatment should be tailored to the needs of each case. There is a lack of research on headache management, which might persist after ICP control.
- Bridging the gaps of headache care for underserved populations: Current status of the headache field in Latin America(2022) LISICKI, Marco; SOUZA, Marcio Nattan Portes; OLIVEIRA, Arao Belitardo de; RUBIO-BELTRAN, Eloisa; LABASTIDA-RAMIREZ, Alejandro; ASHINA, Messoud; PERES, MarioObjective To evaluate the current status of specialized headache care and research in Latin America. Background Latin America corresponds to about 9% of the global population. There is considerably limited access to headache services, and very few resources are allocated to headache research in this region. Methods The study consisted of two parts. First, in order to evaluate headache-related scientific output from Latin American countries we performed a 10-year bibliometric analysis and contrasted the results with a human developmental index-adjusted projection model. Secondly, we conducted a survey addressing different aspects of headache research, education, clinical practice, and awareness among members of the Latin American Headache Society. Results During the last 10 years 70% of Latin American countries published less than three articles regarding headache disorders. This contrasts with an average expected publication rate of 889 scientific papers. Indeed, none of the countries fulfilled their human developmental index - adjusted projected scientific output, with Brazil being the closest reaching 84.1% of what would be considered optimal according to the model. From the 86 headache-dedicated professionals that responded to the survey, most (64%) reported not having a headache specialization programme of any kind available in their countries. The biggest impediments towards conducting research observed by participants were the lack of time (39%), resources (22%), and training (21%). Conclusions Latin American countries have a considerable gap in headache-related scientific production, and also in formal education, research, and implementation of multidisciplinary services. Access to specialized headache care is particularly limited for patients with lower economic income.
- Burden of migraine in Brazil: A cross-sectional real-world study(2022) SOUZA, Marcio Nattan Portes; COHEN, Joshua M. M.; PIHA, Tony; RIBALOV, Rinat; LENGIL, Tamar; LAAN, Andressa van der; CALDERARO, Marcelo; LEE, Lulu K. K.ObjectiveTo assess the burden and consequences of migraine in Brazil in terms of health-related quality of life (HRQoL), work productivity and daily activities, and healthcare resource utilization (HRU). BackgroundDespite existing data on how migraine affects populations worldwide, there are limited data on the burden of migraine in Latin America. MethodsThis cross-sectional study used patient-reported data from the 2018 Brazil National Health and Wellness Survey. HRQoL scores (EuroQol 5-dimension 5-level [EQ-5D-5L]; 36-item Short Form Health Survey, version 2 [SF-36v2]; and Short Form 6-dimension [SF-6D]), impairments to work productivity and daily activities (Work Productivity and Activity Impairment questionnaire), and all-cause HRU were compared between migraine respondents and matched non-migraine controls. ResultsOf the 12,000 total respondents in the survey database, 1643 self-reported a physician diagnosis of migraine and were propensity score matched 1:1 with controls without migraine. HRQoL was lower in patients with migraine versus non-migraine controls, with significantly lower SF-36v2 physical (mean [+/- SD] 50.3 [7.5] vs. 52.0 [7.6]) and mental component (mean [+/- SD] 42.9 [10.2] vs. 46.0 [9.9]) summary scores and SF-6D (mean [+/- SD] 0.7 [0.1] vs. 0.7 [0.1]) and EQ-5D-5L (mean [+/- SD] 0.7 [0.2] vs. 0.8 [0.2]) utility scores (all p < 0.001). Patients with migraine reported higher levels of work productivity loss (mean [+/- SD], 40.6% [31.4%] vs. 28.6% [30.9%], including absenteeism 12.8% [19.1%] vs. 8.4% [17.1%] and presenteeism 35.0% [28.7%] vs. 24.8% [28.0%]; all p < 0.001); activity impairment (mean [+/- SD] 36.0% [28.8%] vs. 25.5% [28.1%]; p < 0.001); and significantly higher HRU in the past 6 months (healthcare provider and emergency department visits [mean [+/- SD] 7.2 [9.5] vs. 4.5 [6.3] and 1.7 [3.8] vs. 0.9 [2.2]; both p < 0.001] and hospitalizations [mean [+/- SD] 0.4 [2.7] vs. 0.2 [1.1]; p = 0.002]) than controls. ConclusionMigraine is associated with poorer HRQoL, higher all-cause HRU, and greater activity impairment and work productivity loss versus non-migraine controls in Brazil.