Background: Neurotropism of the hepatitis C virus (HCV) can be the source of subtle neuropsycholo... more Background: Neurotropism of the hepatitis C virus (HCV) can be the source of subtle neuropsychological symptoms in non-cirrhotic patients. Age is a risk factor for cognitive impairment (CI). Thus, asymptomatic elderly people who carry HCV might be at a greater risk of CI. Education can influence test performance. Objectives: (1) To verify whether elderly people with HCV performed poorer than controls on cognitive tests. (2) To analyze how education affects performance. (3) To verify whether the extent of the effect of education on performance depends on the group (HCV vs. controls) and the type of cognitive test. Methods: Asymptomatic HCV carriers older than 60 years (n = 41) were matched with 41 corresponding controls. All participants performed the following tests: Mini-Cog, Mini Mental State Examination, clock drawing test (CDT), and verbal fluency. Results: (1) There were no significant differences in cognitive performance between the two groups. (2) Higher education was always ...
Previous studies have shown that COVID-19 inpatients exhibited significant attentional deficits o... more Previous studies have shown that COVID-19 inpatients exhibited significant attentional deficits on the day of discharge. However, the presence of gastrointestinal symptoms (GIS) has not been evaluated. Here, we aimed to verify: (1) whether COVID-19 patients with GIS exhibited specific attention deficits; (2) which attention subdomain deficits discriminated patients with GIS and without gastrointestinal symptoms (NGIS) from healthy controls. On admission, the presence of GIS was recorded. Seventy-four physically functional COVID-19 inpatients at discharge and sixty-eight controls underwent a Go/No-go computerized visual attentional test (CVAT). A Multivariate Analysis of Covariance (MANCOVA) was performed to examine group differences in attentional performance. To discriminate which attention subdomain deficits discriminated GIS and NGIS COVID-19 patients from healthy controls, a discriminant analysis was applied using the CVAT variables. The MANCOVA showed a significant overall effe...
This study is aimed at assessing differences in basic attentional functioning between substantial... more This study is aimed at assessing differences in basic attentional functioning between substantial and minimal work-related exposure to COVID-19 patients in professionals working in a tertiary referral hospital in Rio de Janeiro, Brazil. Therefore, hospital employees performed a Continuous Visual Attention Test. This test consisted of a 90-second Go/No-Go task with 72 (80%) targets and 18 (20%) nontargets. For each participant, reaction time and intraindividual variability of reaction times of all correct target responses, as well as the number of omission and commission errors, were evaluated. Participants were divided into 2 groups based on their exposure to COVID-19 patients (substantial versus minimal exposure). The substantial exposure group consisted of participants with 24 hours/week or more direct contact with COVID-19 patients. This cut-off was based on the clear division between professionals working and not working with COVID-19 patients and considered that 12-hour and 24-...
Few studies have reported specific attention deficits in post-COVID-19 patients. Attention consis... more Few studies have reported specific attention deficits in post-COVID-19 patients. Attention consists of different subdomains. Disruptions to specific attention subdomains might impair a wide range of everyday tasks, including road safety. As there are millions of COVID-19 patients with different socio-economic backgrounds, screening of attentional performance less dependent on education is needed. Here, we verified if physically recovered COVID-19 inpatients showed specific attention decrements at discharge. The Continuous Visual Attention Test (CVAT) is a Go/No-go task which is independent of participants’ schooling. It detects visuomotor reaction time (RT = intrinsic alertness), variability of reaction time (VRT = sustained attention), omission (focused-attention), and commission errors (response-inhibition). Thirty physically functional COVID-19 inpatients at discharge and 30 non-infected controls underwent the CVAT. A MANCOVA was performed to examine differences between controls and patients, followed by post-hoc ANCOVAs. Then, we identified the percentile score for each patient within the distribution of the CVAT performance of 211 subjects mentally capable of driving (reference group). COVID-19 patients at discharge showed greater RT and VRT, and more omission errors than controls. Twenty-two patients (73%) had performance below the 5th percentile of the reference group in one or more subdomains. As slow visuomotor RT and deficits in focusing and keeping visual attention are associated with traffic accidents, we concluded that most COVID-19 patients at discharge had deficits that may increase the risk of road injuries. As these deficits will probably affect other daily activities, a routine assessment with the CVAT could provide useful information on whom to send to post-COVID centers.
A 33-year-old obese patient (body mass index=32.7), without other comorbidities, was admitted to ... more A 33-year-old obese patient (body mass index=32.7), without other comorbidities, was admitted to our hospital with complaints of severe low back pain radiating to the hypogastric region. The pain had started about 8 hours before admission. Additionally, 11 days before admission, he had experienced dry cough, a fever of 38.2°C, and fatigue and was diagnosed with SARS-CoV-2 infection by nasopharyngeal swab testing.
Objetivos: descrever a frequência de depressão em pacientes com hepatite C (HCV) e relacionar com... more Objetivos: descrever a frequência de depressão em pacientes com hepatite C (HCV) e relacionar com as variáveis biológicas e função hepática. Métodos: estudo transversal, descritivo, de abordagem quantitativa, que avaliou a depressão utilizando os critérios do Manual de diagnóstico e estatístico de transtornos mentais (DSM-V) e a associação com as variáveis biológicas e de função hepática em 85 pacientes com HCV crônica indicados para a terapia antiviral de ação direta (DAA) entre maio de 2018 e 2019. Resultados: detectou-se depressão em 47,1% dos pacientes, predominantemente depressão leve (95%). Entretanto a depressão ocorreu de forma independente das características biológicas, como sexo, idade, escolaridade, comorbidades associadas e da função hepática, como grau de fibrose e genótipo viral. Conclusões: a frequência de depressão foi alta em pacientes com HCV e não teve relação estatística com as características biológicas e função hepática, sugerindo a busca ativa da depressão co...
F u n d a m e n t o s : A d m i t e-s e q u e o s r i s c o s d e complicações pós-operatórias se... more F u n d a m e n t o s : A d m i t e-s e q u e o s r i s c o s d e complicações pós-operatórias sejam maiores na angina instável pós-infarto. Objetivo: Verificar se a angina instável (AI) pósinfarto (classe C de Braunwald) aumenta o risco de eventos cardiovasculares maiores (ECMA) na cirurgia de revascularização miocárdica (CRVM) em comparação às síndromes coronarianas estáveis. Métodos: Em pacientes submetidos consecutivamente à CRVM isolada, durante um período de dois anos, comparou-se a incidência de ECMA [morte, infarto agudo do miocárdio com onda Q (IAM) e acidente vascular encefálico (AVE)] entre aqueles com síndromes coronarianas estáveis (G1) e aqueles com AI classe B (G2) e AI classe C (G3) de Braunwald. Resultados: De 333 pacientes operados no período, 238 (71,0%) compunham o G1, 56 (17,0%) o G2 e 39 (1 2 , 0 %) o G 3. M a i s p a c i e n t e s d o s G 2 e G 3 apresentavam DPOC (12,5% e 10,0% vs 2,9%, p=0,005) e necessidade de cirurgia de urgência/ emergência (18,0% e 33% vs 0,4%; p=0,0001) do que o G1. Não houve diferença significativa na morte hospitalar (4
Revista da Sociedade Brasileira de Medicina Tropical
Acquired immunodeficiency syndrome (AIDS) is being increasingly reported among the elderly and ma... more Acquired immunodeficiency syndrome (AIDS) is being increasingly reported among the elderly and major depression (MD) may be associated with suboptimal adherence to treatment. Cross-sectional study on factors associated with MD among 72 HIV-infected elderly individuals. Twenty (27.7%) patients were found to have MD. The female gender (odds ratio [OR] = 10.65; p = 0.00586), a low CD4 count during the study (OR = 1.005247; p = 0.01539), and current smoking status (OR = 12.89; p = 0.01693) were independently associated with MD. Our data underscore the need to attentively search and treat MD among HIV-infected elderly patients.
Revista Brasileira de Geriatria e Gerontologia, 2010
INTRODUÇÃO: Com o envelhecimento da população, os distúrbios de memória têm-se tornado patologias... more INTRODUÇÃO: Com o envelhecimento da população, os distúrbios de memória têm-se tornado patologias cada vez mais frequentes. Com exceção de uma minoria dos casos cujas causas são reversíveis, estas doenças possuem prognóstico desanimador, curso inexorável e opções terapêuticas muito limitadas. O medicamento fitoterápico mais frequentemente utilizado para distúrbios de memória é o extrato seco de ginkgo biloba (GB). Suas ações antioxidantes, antiagregantes e vasodilatadoras têm encorajado diversos profissionais a utilizarem-no neste tratamento, porém não há registros convincentes que comprovem a eficácia do uso desta substância para tal fim. OBJETIVOS: Avaliar a eficácia do GB na prevenção e no tratamento de distúrbios de memória. MÉTODOS: Revisão sistemática da literatura dos últimos dez anos dos estudos clínicos duplo-cegos, randomizados, placebo-controlados, publicados na língua inglesa. RESULTADOS E CONCLUSÕES: Embora tenhamos obtido poucos ensaios controlados sobre o tema, não há...
Since its inception in December 2019, Covid-19 has challenged the global scientific community. So... more Since its inception in December 2019, Covid-19 has challenged the global scientific community. Some treatments were used in this infection, but doubts still persist regarding the use of medications 1. More severe cases complicate with endothelial dysfunction, excess thrombin synthesis and decreased fibrinolysis which, associated with hypoxemia, lead to a hypercoagulability state 2 and some authors indicate the use of anticoagulants for these 3. For mild cases, doubts remain regarding this indication. We will report the case of a patient with mild symptoms of covid-19, complicated by inferior mesenteric vein thrombosis.
Background: Neurotropism of the hepatitis C virus (HCV) can be the source of subtle neuropsycholo... more Background: Neurotropism of the hepatitis C virus (HCV) can be the source of subtle neuropsychological symptoms in non-cirrhotic patients. Age is a risk factor for cognitive impairment (CI). Thus, asymptomatic elderly people who carry HCV might be at a greater risk of CI. Education can influence test performance. Objectives: (1) To verify whether elderly people with HCV performed poorer than controls on cognitive tests. (2) To analyze how education affects performance. (3) To verify whether the extent of the effect of education on performance depends on the group (HCV vs. controls) and the type of cognitive test. Methods: Asymptomatic HCV carriers older than 60 years (n = 41) were matched with 41 corresponding controls. All participants performed the following tests: Mini-Cog, Mini Mental State Examination, clock drawing test (CDT), and verbal fluency. Results: (1) There were no significant differences in cognitive performance between the two groups. (2) Higher education was always ...
Previous studies have shown that COVID-19 inpatients exhibited significant attentional deficits o... more Previous studies have shown that COVID-19 inpatients exhibited significant attentional deficits on the day of discharge. However, the presence of gastrointestinal symptoms (GIS) has not been evaluated. Here, we aimed to verify: (1) whether COVID-19 patients with GIS exhibited specific attention deficits; (2) which attention subdomain deficits discriminated patients with GIS and without gastrointestinal symptoms (NGIS) from healthy controls. On admission, the presence of GIS was recorded. Seventy-four physically functional COVID-19 inpatients at discharge and sixty-eight controls underwent a Go/No-go computerized visual attentional test (CVAT). A Multivariate Analysis of Covariance (MANCOVA) was performed to examine group differences in attentional performance. To discriminate which attention subdomain deficits discriminated GIS and NGIS COVID-19 patients from healthy controls, a discriminant analysis was applied using the CVAT variables. The MANCOVA showed a significant overall effe...
This study is aimed at assessing differences in basic attentional functioning between substantial... more This study is aimed at assessing differences in basic attentional functioning between substantial and minimal work-related exposure to COVID-19 patients in professionals working in a tertiary referral hospital in Rio de Janeiro, Brazil. Therefore, hospital employees performed a Continuous Visual Attention Test. This test consisted of a 90-second Go/No-Go task with 72 (80%) targets and 18 (20%) nontargets. For each participant, reaction time and intraindividual variability of reaction times of all correct target responses, as well as the number of omission and commission errors, were evaluated. Participants were divided into 2 groups based on their exposure to COVID-19 patients (substantial versus minimal exposure). The substantial exposure group consisted of participants with 24 hours/week or more direct contact with COVID-19 patients. This cut-off was based on the clear division between professionals working and not working with COVID-19 patients and considered that 12-hour and 24-...
Few studies have reported specific attention deficits in post-COVID-19 patients. Attention consis... more Few studies have reported specific attention deficits in post-COVID-19 patients. Attention consists of different subdomains. Disruptions to specific attention subdomains might impair a wide range of everyday tasks, including road safety. As there are millions of COVID-19 patients with different socio-economic backgrounds, screening of attentional performance less dependent on education is needed. Here, we verified if physically recovered COVID-19 inpatients showed specific attention decrements at discharge. The Continuous Visual Attention Test (CVAT) is a Go/No-go task which is independent of participants’ schooling. It detects visuomotor reaction time (RT = intrinsic alertness), variability of reaction time (VRT = sustained attention), omission (focused-attention), and commission errors (response-inhibition). Thirty physically functional COVID-19 inpatients at discharge and 30 non-infected controls underwent the CVAT. A MANCOVA was performed to examine differences between controls and patients, followed by post-hoc ANCOVAs. Then, we identified the percentile score for each patient within the distribution of the CVAT performance of 211 subjects mentally capable of driving (reference group). COVID-19 patients at discharge showed greater RT and VRT, and more omission errors than controls. Twenty-two patients (73%) had performance below the 5th percentile of the reference group in one or more subdomains. As slow visuomotor RT and deficits in focusing and keeping visual attention are associated with traffic accidents, we concluded that most COVID-19 patients at discharge had deficits that may increase the risk of road injuries. As these deficits will probably affect other daily activities, a routine assessment with the CVAT could provide useful information on whom to send to post-COVID centers.
A 33-year-old obese patient (body mass index=32.7), without other comorbidities, was admitted to ... more A 33-year-old obese patient (body mass index=32.7), without other comorbidities, was admitted to our hospital with complaints of severe low back pain radiating to the hypogastric region. The pain had started about 8 hours before admission. Additionally, 11 days before admission, he had experienced dry cough, a fever of 38.2°C, and fatigue and was diagnosed with SARS-CoV-2 infection by nasopharyngeal swab testing.
Objetivos: descrever a frequência de depressão em pacientes com hepatite C (HCV) e relacionar com... more Objetivos: descrever a frequência de depressão em pacientes com hepatite C (HCV) e relacionar com as variáveis biológicas e função hepática. Métodos: estudo transversal, descritivo, de abordagem quantitativa, que avaliou a depressão utilizando os critérios do Manual de diagnóstico e estatístico de transtornos mentais (DSM-V) e a associação com as variáveis biológicas e de função hepática em 85 pacientes com HCV crônica indicados para a terapia antiviral de ação direta (DAA) entre maio de 2018 e 2019. Resultados: detectou-se depressão em 47,1% dos pacientes, predominantemente depressão leve (95%). Entretanto a depressão ocorreu de forma independente das características biológicas, como sexo, idade, escolaridade, comorbidades associadas e da função hepática, como grau de fibrose e genótipo viral. Conclusões: a frequência de depressão foi alta em pacientes com HCV e não teve relação estatística com as características biológicas e função hepática, sugerindo a busca ativa da depressão co...
F u n d a m e n t o s : A d m i t e-s e q u e o s r i s c o s d e complicações pós-operatórias se... more F u n d a m e n t o s : A d m i t e-s e q u e o s r i s c o s d e complicações pós-operatórias sejam maiores na angina instável pós-infarto. Objetivo: Verificar se a angina instável (AI) pósinfarto (classe C de Braunwald) aumenta o risco de eventos cardiovasculares maiores (ECMA) na cirurgia de revascularização miocárdica (CRVM) em comparação às síndromes coronarianas estáveis. Métodos: Em pacientes submetidos consecutivamente à CRVM isolada, durante um período de dois anos, comparou-se a incidência de ECMA [morte, infarto agudo do miocárdio com onda Q (IAM) e acidente vascular encefálico (AVE)] entre aqueles com síndromes coronarianas estáveis (G1) e aqueles com AI classe B (G2) e AI classe C (G3) de Braunwald. Resultados: De 333 pacientes operados no período, 238 (71,0%) compunham o G1, 56 (17,0%) o G2 e 39 (1 2 , 0 %) o G 3. M a i s p a c i e n t e s d o s G 2 e G 3 apresentavam DPOC (12,5% e 10,0% vs 2,9%, p=0,005) e necessidade de cirurgia de urgência/ emergência (18,0% e 33% vs 0,4%; p=0,0001) do que o G1. Não houve diferença significativa na morte hospitalar (4
Revista da Sociedade Brasileira de Medicina Tropical
Acquired immunodeficiency syndrome (AIDS) is being increasingly reported among the elderly and ma... more Acquired immunodeficiency syndrome (AIDS) is being increasingly reported among the elderly and major depression (MD) may be associated with suboptimal adherence to treatment. Cross-sectional study on factors associated with MD among 72 HIV-infected elderly individuals. Twenty (27.7%) patients were found to have MD. The female gender (odds ratio [OR] = 10.65; p = 0.00586), a low CD4 count during the study (OR = 1.005247; p = 0.01539), and current smoking status (OR = 12.89; p = 0.01693) were independently associated with MD. Our data underscore the need to attentively search and treat MD among HIV-infected elderly patients.
Revista Brasileira de Geriatria e Gerontologia, 2010
INTRODUÇÃO: Com o envelhecimento da população, os distúrbios de memória têm-se tornado patologias... more INTRODUÇÃO: Com o envelhecimento da população, os distúrbios de memória têm-se tornado patologias cada vez mais frequentes. Com exceção de uma minoria dos casos cujas causas são reversíveis, estas doenças possuem prognóstico desanimador, curso inexorável e opções terapêuticas muito limitadas. O medicamento fitoterápico mais frequentemente utilizado para distúrbios de memória é o extrato seco de ginkgo biloba (GB). Suas ações antioxidantes, antiagregantes e vasodilatadoras têm encorajado diversos profissionais a utilizarem-no neste tratamento, porém não há registros convincentes que comprovem a eficácia do uso desta substância para tal fim. OBJETIVOS: Avaliar a eficácia do GB na prevenção e no tratamento de distúrbios de memória. MÉTODOS: Revisão sistemática da literatura dos últimos dez anos dos estudos clínicos duplo-cegos, randomizados, placebo-controlados, publicados na língua inglesa. RESULTADOS E CONCLUSÕES: Embora tenhamos obtido poucos ensaios controlados sobre o tema, não há...
Since its inception in December 2019, Covid-19 has challenged the global scientific community. So... more Since its inception in December 2019, Covid-19 has challenged the global scientific community. Some treatments were used in this infection, but doubts still persist regarding the use of medications 1. More severe cases complicate with endothelial dysfunction, excess thrombin synthesis and decreased fibrinolysis which, associated with hypoxemia, lead to a hypercoagulability state 2 and some authors indicate the use of anticoagulants for these 3. For mild cases, doubts remain regarding this indication. We will report the case of a patient with mild symptoms of covid-19, complicated by inferior mesenteric vein thrombosis.
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