LUIS FERNANDO BERNAL DA COSTA SEGURO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Prevalence of Cognitive Impairment in Heart Transplant Waiting-List Patients in a Developing Country(2020) OLIVEIRA, F. M. de; IKEDA, E. T.; AVILA, M.; WOZNIAK, I.; SEGURO, L.; SANTOS, M.; FELTRIM, M.; BARONE, F.; ISSA, V.; LAGE, S.; BACAL, F.; BOCCHI, E.; GAIOTTO, F.; NOMURA, C.; MARCONDES-BRAGA, F.; MANGINI, S.conferenceObject LET'S TALK ABOUT LUPUS: SCOPE AND IMPACT OF A COMPREHENSIVE ONLINE EDUCATIONAL PROGRAM FOR LAY PEOPLE WITH LUPUS(2020) FUENTES-SILVA, Y.; PONS-ESTEL, B.; ELERA-FITZCARRALD, C.; REATEGUI-SOKOLOV, C.; IBANEZ, S.; SEGURO, L.; REIS-NETO, E. Tones dos; ACOSTA, C.; GARROT, L. Ferreyra; MARRERO, W. Bermudez; BONFA, E.; SATO, E.; DRENKARD, C.- Bone Metabolism Impairment in Heart Transplant: Results From a Prospective Cohort Study(2020) SEGURO, Luis F. B. C.; PEREIRA, Rosa M. R.; SEGURO, Luciana P. C.; CAPARBO, Valeria F.; AVILA, Monica S.; MANGINI, Sandrigo; CAMPOS, Iascara W.; GAIOTTO, Fabio A.; MARCONDES-BRAGA, Fabiana G.; BACAL, FernandoBackground. Data on the prevention of fractures after heart transplant (HTx) are controversial in the literature. Understanding the effects of HTx on bone may guide appropriate treatments in this high-risk population. Methods. Seventy adult HTx patients were followed for 12 months. Clinical and laboratory parameters, bone mineral density, microarchitecture, and vertebral fractures were assessed at baseline (after intensive care unit discharge) and at 6 and 12 months. Patients received recommendations regarding calcium intake and vitamin D supplementation after HTx. Results. At baseline, 27% of patients had osteoporosis, associated with the length of hospitalization before HTx (P = 0.001). Bone mineral density decreased in the first 6 months, with partial recovery later. Bone microarchitecture deteriorated, mainly in the trabecular bone in the first 6 months and cortical bone in the subsequent 6 months. At baseline, 92.9% of patients had vitamin D levels <30 ng/mL and 20.0% <10 ng/mL. Patients also had calcium at the lower limit of normal, high alkaline phosphatase, and high bone resorption biomarker. These abnormalities were suggestive of impaired bone mineralization and normalized at 6 months with correction of vitamin D deficiency. The majority of vertebral fractures were identified at baseline (23% of patients). After multivariate analyses, only a lower fat mass persisted as a risk factor for vertebral fractures (odds ratio, 1.23; 95% confidence interval, 1.04-1.47; P = 0.012). Conclusions. High frequencies of densitometric osteoporosis, vitamin D deficiency, bone markers abnormalities, and vertebral fractures were observed shortly after HTx. Calcium and vitamin D supplementation should be the first step in correcting bone mineralization impairment before specific osteoporosis treatment.
- Epipericardial fat necrosis as cause of chest pain in patient after heart transplantation(2020) CAFEZEIRO, Caio Reboucas Fonseca; LOPES, Mariana Pezzute; SILVA, Caio Tavares; AVILA, Monica Samuel; SEGURO, Luis Fernando B. C.; MANGINI, Sandrigo; CAMPOS, Iascara Wozniak; GAIOTTO, Fabio A.; MARCONDES-BRAGA, Fabiana G.; BACAL, FernandoEpipericardial fat necrosis is an uncommon clinical condition of unknown etiology. It typically presents as acute pleuritic chest pain and should be differentiated from acute pulmonary embolism and acute coronary syndrome. This condition is diagnosed by characteristic chest computed tomography findings of an ovoid mediastinal fatty lesion with intrinsic and surrounding soft-tissue stranding. Treatment of epipericardial fat necrosis includes the administration of anti-inflammatory agents, and symptoms usually resolve within a few days after treatment initiation. This disease entity has rarely been reported since it was first described in 1957. Most current knowledge of epipericardial fat necrosis is based on case reports that describe this condition in previously healthy individuals. We present the case of a 39-year-old woman with a history of heart transplant, who presented with chest pain secondary to epipericardial fat necrosis. Serial computed tomography revealed lesion resolution after appropriate treatment.