OBJETIVO: O presente artigo tem como objetivo revisar dados da literatura sobre o tema Esofagite Eosinofílica (EE), visando, por meio de conceitos atualizados, ampliar o conhecimento da doença através de seus aspectos etiológicos e fisiopatológicos, bem como discutir sua incidência e prevalência no Brasil. MÉTODOS: Trata-se de uma revisão sistemática de literatura, na modalidade exploratória. Os trabalhos encontrados foram submetidos, de forma integral, a uma análise crítica que discutiam a história natural da Esofagite Eosinofílica, suas etiologias, fisiopatologia e manifestações clínicas além de sua incidência e prevalência no Brasil. RESULTADOS: A partir das bases de dados Scielo, PubMed, Medline e BVS, foram identificados 26 estudos para a composição desta revisão de literatura, dos quais 17 foram incluídos para sua versão definitiva. CONCLUSÃO: A Esofagite Eosinofílica é uma doença em plena ascensão no Brasil, notoriamente subnotificada e que apresenta grande impacto na vida diária da comunidade. A partir de uma interação entre antígenos e o epitélio esofágico são desencadeados sintomas como a disfagia crônica, impactação alimentar e vômitos. Verificou-se ainda uma associação entre indivíduos atópicos e o maior desenvolvimento de Esofagite Eosinofílica. Por fim, a formulação de novas pesquisas sistemáticas e metanálises se fazem necessárias para promover um maior conhecimento da Esofagite Eosinofílica, a fim de subsidiar o arcabouço propedêutico dos médicos generalistas, sobretudo na atenção primária.

No abstract

inverse correlation to other measures of functional capacity and quality of life. Although the NYHA-FC is a good indicator of patient status, the variability in assessment should be considered when using this scale as an outcome measure in randomized clinical trials. P128/10374Primary care physicians and the management of heart failure in Argentina M. Ciruzzi, J. Cuba, S. Soifer, C. Patemo, P. Forcada, M. Villahermosat , H. Schargrodsky. Buenos Aires, Argentina; 'Paris, France Heart Failure is a major cause of cardiovascular morbidity and mortality. Most patients with this disease are treated primarily by primary care physician (PCP). The aim of this study was to analyze, through the information provided from patients medical records, the knowledge and management of heart failure by PCPs.Methods: Three Buenos Aires cardiologists coordinated 30 PCPs (ten each one). Each PCP completed a questionnaire with information from medical records of 9 patients, including those with diagnosis of heart failure and those at high risk for left ventricular dysfunction and future heart failure (patients with history of AMI). The data of 274 medical records patients was analyzed.Results: Twelve patients had a history of alcohol intake and in 25% this data was not recorded in medical records. Seventeen percent were smokers and in 20% of the cases this data was not recorded. In 23% the last weight in medical records was unknown. During the last visit 23% were at class III or higher according to NYHA and in 45% of the cases this data was not unknown. In the PCPs opinion the most important factors contributing to development of heart failure were hypertension (39%) and myocardial infarction (30%). Most of the patients were in sinus rhythm (65%) and most showed heart enlargement in the chest X-ray (77%). The tests copied in the medical records were the following: electrocardiogram (ECG) 70%, Chest X-ray 57%, and two dimension echocardiogram 19%.Conclusions: This sutdy shows that patients with heart failure are not being adequately studied by PCPs. Tbis data demosntrate that there is a considerable potential for PCP to improve the management of heart failure in Argentina. Introduction: About 40% of patients with heart failure (HF) have preserved left ventricle (LV) systolic function. The diagnosis of left ventricle systolic dysfunction (LSVD) is usually based on echocardiography and is the cornerstone for a correct therapeutic approach. Objectives: To determine if clinical parameters, ECG and chest radiograph allow to distinguish patients with LVSD from patients with a preserved LV function.Material and methods: This study included 124 patients with the diagnosis of HF based on the European Society of Cardiology criteria. The clinical, electrocardiographic and roentnographic characteristics of patients with echoeardiography determined ejection fraction (EF) < 40% were compared with those from patients with EF >= 40%. Variables with p < 0.10 on bivariate analysis were included into a logistic regression model to determine their independ...

27ergo spirometery with systolic and diastolic function evaluated from echocardiography. Diastolic function was also evaluated by pulmonary artery catheterisation.Results: There was a strong correlation between %PPVO2 and achieved peak VO2 (r = 0.804, p = <0.0001). Forty-six patients did not reach 50% of predicted peak VO2 and 27 patients had >50% of predicted peak VO2. The deceleration time of the E-wave (DT) (p = 0.0016), and heart rate adjusted DT (DT/*RR) (p = 0.0006) were shorter and LVEF (p = 0.0209) was lower in the group with low oxygen uptake compared to the group with higher oxygen uptake. The univariate analysis of the complete material confirms a significant correlation between %PPVO2 and LVEF (p = 0.0003), DT (p = 0.0074), and DT/*RR (p = 0.0037). A significant contribution to lowering of VO2 was detected in multivariate analysis of systolic (LVEF, p= 0,0021) as well as diastolic (DT/*RR, p= 0.0268) function. Conclnsion:We cannot exclude systolic function at rest, nor the diastolic part of the cardiac cycle at rest as factors influencing exercise tolerance in patients with severe heart failure. On the contrary, some of the diastolic variables were strong predictors exercise capacity, as the DT/*RR, while others were poor, as the E/A-ratio. Thus, our study provides evidence that both systolic (LVEF) and diastolic (DT/*RR) variables are important determinants of exercise tolerance in patients with severe heart failure.of our study was to evaluate the association between the inflammation markers and the occurrence of early LVD in patients with A/VII.Methods: We evaluated prospectively 76 nonthrombolysed patients hospitalized for AMI. The neutrophils percentage, the value of C reactive protein (CRP) and of tumor necrosis factor-alpha (TNF-alpha) were recorded in the first 24 h. The episodes of new LVD or of worsening LVD were echocardiographieally documented in the first 7 days after admission. Results:The results are included in the Conclusions: ( Aim of the study was to ascertain as to whether the evaluation of the coupling between tight ventricular function and pulmonary artery pressure may improve the prognostic assessment in pts with congestive heart failure (CHF).Methods. Between 1992 and 1998, 379 consecutive pts (mean age 51 years) with chronic CHF due to severe left ventricular systolic dysfunction (LVEF < 35%) underwent right heart catheterization; all pts received an optimized pharmacological treatment. Etiology was primary dilated cardiomyopathy (DCM) in 66% and ischemic heart disease (IHD) in 34% of pts; pts with Valvular heart disease or miscellaneous etiology were excluded. Results.In the whole population an inverse relationship was observed between thermodilution-derived right ventricular ejection fraction (RVEF) and mean pulmonary artery pressure (PAPm), with an "r" coefficient of -0.66 (p < 0.001); this relationship was similar in DCM and in IHD pts. During a follow-up period of 17 4-9 months 104 pts died. The population was subdivided into 4 groups according to the presence or absence...

No abstract