MARIA HELENA SAMPAIO FAVARATO

(Fonte: Lattes)
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina

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  • bookPart
    Cateterização venosa central
    (2015) FAVARATO, Maria Helena Sampaio
  • article 0 Citação(ões) na Scopus
  • article 2 Citação(ões) na Scopus
    Risk of osteoporotic fracture in women using the FRAX tool with and without bone mineral density score in patients followed at a tertiary outpatient clinic-An observational study
    (2022) FAVARATO, Maria Helena Sampaio; ALMEIDA, Maria Flora de; LICHTENSTEIN, Arnaldo; MARTINS, Milton de Arruda; FERREIRA JUNIOR, Mario
    Objectives: Fragility fractures increase morbidity and mortality. Adding assessment of clinical risk factors independently or as a previous step to Bone Densitometry (BD) should provide better accuracy in fracture risk prediction. FRAX tool might be used to stratify patients in order to rationalize the need for BD and risk classification. The primary objective of this study is to describe and perform comparisons between the estimated risk of fractures in 10 years using the FRAX calculator based on clinical factors with and without BD results for women aged 40 or more with clinical diseases monitored in tertiary care service in internal medicine. Methods: Cross-sectional. Women over 40 years with BD in the previous year. After medical chart review, identification of risk factors and risk estimations using FRAX-BRAZIL with (FRAX BDI) and without (FRAX BDNI) the inclusion of T-score. Results: 239 women. Age 65 +/- 10.35 years. BMI 29.68 +/- 6.27kg/m2. Risk factors: 32(13.4%) previous fractures; 23 (9.6%) current smoking; 78 (32.6%) corticosteroids use; 44 (18.4%) rheumatoid arthritis; 38 (15.9%) secondary causes; FRAX scores were higher when BD was not included. Spearman correlation coefficients between FRAX BDNI and FRAX BDI for major fractures r = 0.793 (95% CI 0.7388-0.836). For hip fractures r = 0.6922 (95% CI 0.6174-0.75446) Conclusion: Using FRAX to estimate 10-year fracture risk without BD data might be a reliable tool for screening, even for patients with a high prevalence of risk factors, improving accessibility and equity in health systems. The present study's data suggest an overestimation of fracture risk with FRAX BDNI, suggesting that it is safe to be widely used as a screening tool.
  • bookPart
    Hipertensão essencial
    (2015) FAVARATO, Maria Helena Sampaio
  • article 31 Citação(ões) na Scopus
    Hypertension and diabetes significantly enhance the risk of cardiovascular disease in patients with psoriatic arthritis
    (2014) FAVARATO, M. H.; MEASE, P.; GONCALVES, C. R.; SAAD, C. Goncalves; SAMPAIO-BARROS, P. D.; GOLDENSTEIN-SCHAINBERG, C.
    Objective New evidence has lightened the linkage between psoriatic arthritis (PsA) and the development of atherosclerosis and cardiovascular disease (CVD). We aimed to describe the prevalence of cardiovascular events and associated risk factors among patients with PsA. Methods Retrospective evaluation of medical records from consecutive PsA patients who fulfilled the CASPAR criteria for PsA attending a specialised spondyloarthritis clinic at a single referral centre. CVD was defined based on the occurrence of coronary artery disease (CAD) or cerebrovascular ischaemic disease events. Results We evaluated 158 PsA patients, 48.7% females and 51.3% males, aged 53.7+/-13.9 yrs. Mean PsA duration was 13.7+/-8.9 yrs and polyarticular subtype affected 66(42%) patients. According to drug therapy, 85 (54%) were using NSAIDs and 21 (13%) low-dose prednisone; 32 (20%) were on anti-TNF agents, 94 (60%) metothrexate, 18 (11%) leflunomide, 13 (8%) sulfasalazine, 5 (3%) other immunossupressors and 4 (2.5%) were on chloroquine. Over half patients (87, 55%) had arterial hypertension (AH); 51 (32%) had dyslipidaemia (DLP), 38 (29%) hypertriglyceridaemia and 36(23%) diabetes mellitus (DM). Lipid profile was similar for both genders with mean total cholesterol= 186.5+/-38.6mg/dl, LDL=112.3+/-30.6 mg/dl, HDL=47.89+/-14.6 and triglycerides=127.4+/-65.6 mg/dl. Of note, 14% PsA patients have had CVD, namely cerebrovascular or coronary heart disease. Sex, age, disease duration, joint involvement subtype, disease activity, CRP and lipid levels were similar among patients with and without CVD. The prevalence of All (95% vs. 45%, p<0.001), DLP (75% vs. 27.7%, p<0.001) and DM (60% vs. 19%, p<0.001) were significantly greater in PsA patients who have had CVD compared to those without CVD, conferring an odds ratio of 21.0 for All and of 5.4 for DM. Conclusion The high prevalence of CVD in PsA patients is influenced by increased All and DM. Hence early recognition and specific treatment is mandatory in order to reduce the risk for CVD, avoiding early morbidity and mortality.
  • bookPart
    Vaculites medicamentosas
    (2015) FAVARATO, Maria Helena Sampaio
  • bookPart
    Doença mista do tecido conjuntivo
    (2015) FAVARATO, Maria Helena Sampaio
  • article 35 Citação(ões) na Scopus
    I Guideline for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Brazilian Society of Cardiology: Executive Summary
    (2013) GONZALEZ, Maria Margarita; TIMERMAN, Sergio; OLIVEIRA, Renan Gianotto de; POLASTRI, Thatiane Facholi; DALLAN, Luis Augusto Palma; ARAUJO, Sebastiao; LAGE, Silvia Gelas; SCHMIDT, Andre; BERNOCHE, Claudia San Martin de; CANESIN, Manoel Fernandes; MANCUSO, Frederico Jose Neves; FAVARATO, Maria Helena
    Despite advances related to the prevention and treatment in the past few years, many lives are lost to cardiac arrest and cardiovascular events in general in Brazil every year. Basic Life Support involves cardiovascular emergency treatment mainly in the pre-hospital environment, with emphasis on the early recognition and delivery of cardiopulmonary resuscitation maneuvers focused on high-quality thoracic compressions and rapid defibrillation by means of the implementation of public access-to-defibrillation programs. These aspects are of the utmost importance and may make the difference on the patient's outcomes, such as on hospital survival with no permanent neurological damage. Early initiation of the Advanced Cardiology Life Support also plays an essential role by keeping the quality of thoracic compressions; adequate airway management; specific treatment for the different arrest rhythms; defibrillation; and assessment and treatment of the possible causes during all the assistance. More recently, emphasis has been given to post-resuscitation care, with the purpose of reducing mortality by means of early recognition and treatment of the post-cardiac arrest syndrome. Therapeutic hypothermia has provided significant improvement of neurological damage and should be performed in comatose individuals post-cardiac arrest. For physicians working in the emergency department or intensive care unit, it is extremely important to improve the treatment given to these patients by means of specific training, thus giving them the chance of higher success and of better survival rates.
  • article 1 Citação(ões) na Scopus
    External validity of type 2 diabetes clinical trials on cardiovascular outcomes for a multimorbid population
    (2021) LAZAR NETO, Felippe; MENDES, Thiago Bosco; MATOS, Paulo Marcelo Pontes Gomes; OLIVEIRA, Julio Cesar de; FAVARATO, Maria Helena Sampaio; LIN, Chin An; MARTINS, Milton Arruda
    Aim: To investigate the external validity of recent antihyperglycaemic trials evaluating cardiovascular outcomes in a multimorbid population. Materials and Methods: Selection criteria of 15 randomized controlled trials from the 2020 American Diabetes Association Standard of Care statement were applied in a stepwise manner to tertiary care patients with type 2 diabetes. Primary outcomes were the number of patients eligible per individual trial and for the aggregate of trials. Secondary outcomes included patient predictors of trial eligibility. Results: Of 1059 patients, the mean (SD) age was 66 (10.74) years, the median (IQR) Charlson index was 2 (2, 3) and 458 (43%) had documented cardiovascular disease. The median (IQR) number of patients included in individual trials was 263 (174.25-308.75) and 795 (75.1%) of them were eligible for at least one trial. Among those 264 ineligible, 127 (48.1%) had an HbA1c level of 7% or less and no cardiovascular disease; 53.5% and 34.4% of the patients were eligible for two and three different classes of drugs, respectively. The strongest predictor of trial eligibility was cardiovascular disease (risk ratio 2.17, 95% CI 2.01-2.35). Conclusions: A considerable proportion of multimorbid patients would be eligible for recent antihyperglycaemic trials. This positive finding can be attributed to development guidance in diabetes trials and the different approach we took, in which we evaluated inclusion by trials as an aggregate.
  • article 14 Citação(ões) na Scopus
    Medical Student Skill Retention After Cardiopulmonary Resuscitation Training A Cross-Sectional Simulation Study
    (2019) SAAD, Rafael; FAVARATO, Maria Helena Sampaio; PAIVA, Edison Ferreira de; NUNES, Maria do Patrocinio Tenorio
    Introduction The retention of cardiopulmonary resuscitation skills and the ideal frequency of retraining remain unanswered. This study investigated the retention of cardiopulmonary resuscitation skills by medical students for up to 42 months after training. Methods In a cross-sectional study, 205 medical students received 10 hours of training in basic life support in 3 practical classes, during their first semester at school. Then, they were divided into 4 groups, according to the time elapsed since the training: 73 after 1 month, 55 after 18 months, 41 after 30 months, and 36 after 42 months. Nineteen cardiopulmonary resuscitation skills and 8 potential technical errors were evaluated by mannequin-based simulation and reviewed using filming. Results The mean retention of the skills was 90% after 1 month, 74% after 18 months, 62% after 30 months, and 61% after 42 months (P < 0.001). The depth of chest compressions had the greatest retention over time (87.8%), with no significant differences among groups. Compressions performed greater than 120 per minute were less likely to be done with adequate depth. Ventilation showed a progressive decrease in retention from 93% (n = 68) after 1 month to 19% (n = 7) after 42 months (P < 0.001). All 205 students were able to turn the automated external defibrillator on and deliver the shock. Conclusions The depth of chest compressions and the use of an automated external defibrillator were the skills with the highest retention over time. Based on a skills retention prediction curve, we suggest that 18 to 24 months as the minimum retraining interval to maintain at least 70% of skills.