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1. Associação entre o Perfil Hemodinâmico da Insuficiência Cardíaca à Admissão Hospitalar e Mortalidade - Programa Boas Práticas Clínicas em Cardiologia

Author: André Silva Rodrigues, Fábio Morato de Castilho, Aloisio Joaquim Freitas Ribeiro, Luiz Guilherme Passaglia, Fabio Papa Taniguchi, and Antonio L. Ribeiro
Subjects: Insuficiência Cardíaca, Mortalidade, Hospitalização, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Resumo Fundamento: A insuficiência cardíaca (IC) é responsável por alta carga de internações hospitalares. A sua forma de apresentação está relacionada ao prognóstico da doença. Objetivos: Descrever a associação entre o perfil hemodinâmico de admissão hospitalar na IC aguda, baseado em congestão (úmido ou seco) e perfusão (frio ou quente), e desfechos de mortalidade, tempo de internação e chance de reinternação. Métodos: Estudo de coorte, envolvendo pacientes do projeto "Boas Práticas Clínicas em Cardiologia", internados por IC aguda em hospitais públicos brasileiros, entre março de 2016 a dezembro de 2019, com seguimento de seis meses. Foram realizadas análises das características populacionais e do perfil hemodinâmico de admissão, além de análises de sobrevivência pelos modelos de Cox para associação entre o perfil de admissão e mortalidade, e regressão logística para chance de reinternação, considerando nível de significância estatística de 5%. Resultados: Foram avaliados 1978 pacientes, com idade média foi 60,2 (±14,8) anos e fração de ejeção média do ventrículo esquerdo de 39,8% (±17,3%). Houve altas taxas de mortalidade no seguimento de seis meses (22%), com associação entre os perfis hemodinâmicos frios e a mortalidade hospitalar (HR=1,72; IC95% 1,27-2,31; p < 0,001) e em 6 meses (HR= 1,61, IC 95% 1,29-2,02). A taxa de reinternação em 6 meses foi de 22%, sendo maior para os pacientes admitidos em perfis úmidos (OR 2,30; IC95% 1,45-3,65; p < 0,001). Conclusões: A IC aguda no Brasil apresenta altas taxas de mortalidade e reinternações e os perfis hemodinâmicos de admissão hospitalar são bons marcadores prognósticos dessa evolução.
Published: 2024
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2. Machine Learning na Medicina: Revisão e Aplicabilidade

Author: Gabriela Miana de Mattos Paixão, Bruno Campos Santos, Rodrigo Martins de Araujo, Manoel Horta Ribeiro, Jermana Lopes de Moraes, and Antonio L. Ribeiro
Subjects: Aprendizado de Máquina, Medicina, Cardiologia, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published: 2022
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3. Diagnóstico de Fibrilação Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato: Análise Transversal do ELSA-Brasil

Author: Itamar S. Santos, Paulo A. Lotufo, Luisa Brant, Marcelo M. Pinto Filho, Alexandre da Costa Pereira, Sandhi Maria Barreto, Antonio L. Ribeiro, G Neil Thomas, Gregory Y. H. Lip, and Isabela M. Bensenor
Subjects: Fibrilação Atrial, Epidemiologia, Eletrocardiografia/métodos, Anticoagulantes, Estudo Longitudinal, Idoso, Acidente Vascular Cerebral, Embolia, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Resumo Fundamento: A fibrilação ou flutter atrial (FFA) é a arritmia cardíaca sustentada mais comum. Existem poucos dados sobre a epidemiologia da FFA na América do Sul. Objetivo: O presente estudo procurou descrever a epidemiologia clínica da FFA e o uso de anticoagulantes na avaliação da linha de base do Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil). Métodos: Foram analisados dados de 13.260 participantes do ELSA-Brasil. A FFA foi definida pelo eletrocardiograma ou por autorrelato. Modelos de regressão logística foram construídos para analisar fatores associados à FFA. Este estudo também analisou se idade e sexo estavam associados ao uso de anticoagulantes para evitar acidente vascular cerebral. O nível de significância foi de 5%. Resultados: A idade mediana foi de 51 anos, e 7.213 (54,4%) participantes eram mulheres. A FFA foi detectada em 333 (2,5%) participantes. O aumento da idade (razão de chances [RC]:1,05; intervalo de confiança de 95% [IC95%]: 1,04-1,07), hipertensão (RC:1,44; IC95%:1,14-1,81) coronariopatia (RC: 5,11; IC95%:3,85–6,79), insuficiência cardíaca (RC:7,37; IC95%:5,00–10,87) e febre reumática (RC:3,38; IC95%:2,28–5,02) foram associadas à FFA. Dos 185 participantes com FFA e pontuação no CHA2DS2-VASc≥2, apenas 20 (10,8%) usavam anticoagulantes (50,0% entre aqueles com FFA no eletrocardiograma de linha de base). O uso de anticoagulantes nesse grupo foi associado a maior idade (1,8% vs 17,7% naqueles com idade ≤ 54 e ≥ 65 anos, respectivamente; p=0,013). Observou-se uma tendência ao menor uso de anticoagulantes em mulheres (7,1% vs. 16,4% em mulheres e homens, respectivamente; p=0,055). Conclusões: No recrutamento do ELSA-Brasil, 2,5% dos participantes tinham FFA. O baixo uso de anticoagulantes era comum, o que representa um desafio para os cuidados de saúde nesse cenário.
Published: 2021
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4. Associação entre Bloqueio Atrioventricular e Mortalidade em Pacientes de Atenção Primária: O Estudo CODE

Author: Gabriela Miana de Mattos Paixão, Emilly M. Lima, André B. Quadros, Daniel P. R. Cabral, Renato R. Coelho, Derick M. Oliveira, Jamil de Souza Nascimento, Paulo R. Gomes, and Antonio L. Ribeiro
Subjects: Doenças Cardiovasculares/complicações, Bloqueio Atrioventricular/fisiopatologia, Bloqueio Atrioventricular/complicações, Mortalidade, Diagnóstico por Imagem, Eletrocardiografia/métodos, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Resumo Fundamento O bloqueio atrioventricular (BAV) descreve um comprometimento na condução dos átrios para os ventrículos. Embora o curso clínico do BAV tenha sido avaliado, os achados são de países de alta renda e, portanto, não podem ser extrapolados para a população latina. Objetivo Avaliar a associação entre BAV e mortalidade. Métodos Foram incluídos pacientes do estudo CODE (Clinical Outcomes in Digital Electrocardiology), maiores de 16 anos que realizaram eletrocardiograma (ECG) digital de 2010 a 2017. Os ECGs foram relatados por cardiologistas e por software automatizado. Para avaliar a relação entre BAV e mortalidade, foram utilizados o modelo log-normal e as curvas de Kaplan-Meier com valores de p bicaudais < 0,05 considerados estatisticamente significativos. Resultados O estudo incluiu 1.557.901 pacientes; 40,23% eram homens e a média de idade foi de 51,7 (DP ± 17,6) anos. Durante um seguimento médio de 3,7 anos, a mortalidade foi de 3,35%. A prevalência de BAV foi de 1,38% (21.538). Os pacientes com BAV de primeiro, segundo e terceiro graus foram associados a uma taxa de sobrevida 24% (taxa de sobrevida relativa [RS] = 0,76; intervalo de confiança [IC] de 95%: 0,71 a 0,81; p < 0,001), 55% (RS = 0,45; IC de 95%: 0,27 a 0,77; p = 0,01) e 64% (RS = 0,36; IC de 95%: 0,26 a 0,49; p < 0,001) menor quando comparados ao grupo controle, respectivamente. Os pacientes com BAV 2:1 tiveram 79% (RS = 0,21; IC de 95%: 0,08 a 0,52; p = 0,005) menor taxa de sobrevida do que o grupo controle. Apenas Mobitz tipo I não foi associado a maior mortalidade (p = 0,27). Conclusão BAV foi um fator de risco independente para mortalidade geral, com exceção do BAV Mobitz tipo I.
Published: 2022
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5. Effect of different doses of dexamethasone on labor in Santa Inês ewes and its influence on the onset of labor and the expulsion of fetal membranes

Author: Elisiane S. Santos, Rodrigo F. Bittencourt, Antonio L. Ribeiro Filho, Fernanda T.D. Dantas, Álvaro Alves, João V.G.S. Carvalho, and Maria C.C. Ayres
Subjects: Dexamethasone, labor, Santa Inês ewe, fetal membranes, sheep, parturient, corticoid, reproduction biotechnology, ewe, Veterinary medicine, SF600-1100
Abstract: ABSTRACT: The induction of labor aims to concentrate births to follow up better the parturient and the first care to the neonates. However, even if the labor induction technique with dexamethasone administration has been successfully described since the late 1970s, few studies report the technique of birth development and neonatal vitality in Santa Inês sheep. This study aimed to evaluate the efficiency of dexamethasone use in two doses (8 and 16mg) in labor induction of Santa Inês ewes at 145 days of gestation and to evaluate its effects on the birth characteristics. In this study, 58 ewes were used, raised in an extensive system in the experimental farms of UFBA, with confirmation pregnancy after fixed-time artificial insemination or controlled breeding. These female ewes were separated into three groups according to the dose of dexamethasone administered (G1 = 0mg, G2 = 8mg, and G3 = 16mg). From these births, 79 lambs were born. This study analyzed the period from induction of labor to birth, fetal presentation at birth, the weight of the placenta, and the period for placenta expulsion. The data were analyzed by the Statistical Analysis System (SAS v.9.1.3®, 2002), and the significance level considered for all analyzes was 5%. Births of induced groups occurred on average at 48.4±22.17 hours after induction, while the females with non-induced labor gave birth 131.96±41.9 hours on average after the placebo application (P0.05) between the doses used. There were no differences in delivery about the fetal static relation, time to placental attachment, and weight. With this study, it can be concluded that the induction at 145 days of gestation with eight or 16mg of dexamethasone is a useful technique and does not alter the labor in Santa Inês sheep.
Published: 2020
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6. Accidental monensin poisoning in buffaloes in Bahia, Brazil

Author: Antonio W.O. Silva, Múcio F.F. Mendonça, Moisés D. Freitas, Antonio L. Ribeiro Filho, Ricardo D.G. Silva, Paula V. Leal, Luciano A. Pimentel, and Tiago C. Peixoto
Subjects: Ionophore antibiotics, buffaloes, monensin, iatrogenic intoxication, toxic myopathy, poisoning, necrotic myopathy, cardiomyopathy, Brazil, Veterinary medicine, SF600-1100
Abstract: ABSTRACT: Monensin is an ionophore antibiotic (IA) widely used for growth promotion and weight gain in the production of ruminants. However, it has caused intoxication in several species, including buffaloes, mainly because of the ignorance or disrespect of the recommendations for use in each animal species. The objective of this study was to describe, for the first time, clinical-epidemiological and anatomopathological data of an outbreak of accidental poisoning by monensin in buffalos and rediscuss the recommendation of the use of IA in the production of this species. The outbreak affected 21 adult buffaloes after consumption of remains from a feed formulated on the farm and whose constituents were mixed by hand. Clinical and first death signs were observed 24 hours after ingestion of this food. In general, the clinical picture was characterized by muscle weakness, tremors, difficulty in locomotion, and decubitus. Fifteen buffaloes presented clinical signs of poisoning (71.5% morbidity), followed by death (100% lethality), after acute to subacute evolution (
Published: 2022
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7. Chatbot as a Telehealth Intervention Strategy in the COVID-19 Pandemic

Author: Bruno Azevedo Chagas, Kícila Ferreguetti, Thiago C. Ferreira, Milena S. Marcolino, Leonardo B. Ribeiro, Adriana S. Pagano, Zilma S. N. Reis, Raquel O. Prates, Wagner Meira Jr., and Antonio L. Ribeiro
Subjects: Chatbot, Telehealth, COVID pandemic, Action Research, Electronic computers. Computer science, QA75.5-76.95
Abstract: The COVID-19 pandemic and the need for social distancing have created a demand for new and innovative solutions in healthcare systems worldwide. One of the strategies that have been implemented are chatbots, which can be helpful in providing reliable health information and preventing people from seeking assistance in healthcare centers and being unnecessarily exposed to the virus. In this context, although a high number of chatbots have been implemented worldwide, little has been discussed about the process and challenges in developing and implementing this technology. This paper reports on an action research, which designed a novel chatbot as a prompt response to the COVID-19 pandemic. The chatbot is intended to be a first layer of interaction with the public, performing triage of patients and providing information about COVID-19 on a large scale and without human contact. Our contribution is twofold: (i) we reflected on the development process and discuss lessons learned and recommendations to support a multidisciplinary development and evolution process of the chatbot; and (ii) we identified some interactive and technological features that can be used as a reference framework for this kind of technology. These contributions can be useful to other researchers and multidisciplinary teams facing similar challenges.
Published: 2021
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8. Evaluation of Mortality in Atrial Fibrillation: Clinical Outcomes in Digital Electrocardiography (CODE) Study

Author: Gabriela M. M. Paixão, Luis Gustavo S. Silva, Paulo R. Gomes, Emilly M. Lima, Milton P. F. Ferreira, Derick M. Oliveira, Manoel H. Ribeiro, Antonio H. Ribeiro, Jamil S. Nascimento, Jéssica A. Canazart, Leonardo B. Ribeiro, Emelia J. Benjamin, Peter W. Macfarlane, Milena S. Marcolino, and Antonio L. Ribeiro
Subjects: electronic cohort, electrocardiogram, atrial fibrillation, mortality, Diseases of the circulatory (Cardiovascular) system, RC666-701, Public aspects of medicine, RA1-1270
Abstract: Aims: Atrial fibrillation (AF) is a public health problem and its prevalence is increasing worldwide. Electronic cohorts, with large electrocardiogram (ECG) databases linked to mortality data, can be useful in determining prognostic value of ECG abnormalities. Our aim is to evaluate the risk of mortality in patients with AF from Brazil. Methods: This observational retrospective study of primary care patients was developed with the digital ECG database from the Telehealth Network of Minas Gerais, Brazil. ECGs performed from 2010 to 2017 were interpreted by cardiologists and the University of Glasgow automated analysis software. An electronic cohort was obtained linking data from ECG exams and those from a national mortality information system, using standard probabilistic linkage methods. We considered only the first ECG of each patient. Patients under 16 years were excluded. Hazard ratios (HR) for mortality were adjusted for demographic and self-reported clinical factors and estimated with Cox regression. Results: From a dataset of 1,773,689 patients, 1,558,421 were included, mean age 51.6 years; 40.2% male. There were 3.34% deaths from all causes in 3.68 years of median follow up. The prevalence of AF was 1.33%. AF was an independent risk factor for all-cause mortality (HR 2.10, 95%CI 2.03–2.17) and cardiovascular mortality (HR 2.06, 95%CI 1.86–2.29). Females with AF had a higher risk of overall and cardiovascular mortality compared with males (p < 0.001). Conclusions: AF was a strong predictor of cardiovascular and all-cause mortality in a primary care population, with increased risk in women. Condensed abstract To assess risk of mortality in AF patients, an electronic cohort was obtained linking data from ECG exams of Brazilian primary care patients and a national mortality information system. From 1,558,421 patients, AF (prevalence 1.33%) carried a higher risk of overall and cardiovascular mortality, with increased risk in women. What’s New This is the first study with a large Brazilian electronic cohort to evaluate the risk of mortality linked to AF in primary care patients. AF patients from a Brazilian primary care population had a higher risk of death for all causes (HR 2.10, 95%CI 2.03–2.17) and cardiovascular mortality (HR 2.06, 95%CI 1.86–2.29). Female patients with AF had an increased risk of overall and cardiovascular mortality compared with male patients (p < 0.001).
Published: 2020
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9. Investigation of the Familial Risk of Rheumatic Heart Disease with Systematic Echocardiographic Screening: Data from the PROVAR+ Family Study

Author: Juliane Franco, Bruno R. Nascimento, Andrea Z. Beaton, Kaciane K. B. Oliveira, Marcia M. Barbosa, Sanny Cristina C. Faria, Nayana F. Arantes, Luana A. Mello, Maria Cecília L. Nassif, Guilherme C. Oliveira, Breno C. Spolaor, Carolina F. Campos, Victor R. H Silva, Marcelo Augusto A. Nogueira, Antonio L. Ribeiro, Craig A. Sable, Maria Carmo P. Nunes, and On behalf of the PROVAR+ (Programa de RastreamentO da VAlvopatia Reumática e outras Doenças Cardiovasculares) investigators
Subjects: rheumatic heart disease, echocardiography, screening, family, risk, Medicine
Abstract: We aimed to use echocardiographic (echo) screening to evaluate the risk of Rheumatic Heart Disease (RHD) among the relatives of patients with advanced RHD, who were enrolled in the University Hospital’s outpatient clinics from February 2020 to September 2021. Consenting first-degree relatives were invited for echo screening using handheld devices (GE VSCAN) by non-physicians, with remote interpretation. Matched controls (spouses, neighbors) living in the same household were enrolled in a 1:5 fashion. A standard echo (GE Vivid-IQ) was scheduled if abnormalities were observed. In 16 months, 226 relatives and 47 controls of 121 patients were screened, including 129 children, 77 siblings and 20 parents. The mean age was 40 ± 17 years, 67% of the patients were women, and 239 (88%) lived with the index case for >10 years. Echo findings suggestive of RHD were confirmed in zero controls and 14 (7.5%) relatives (p = 0.05): 11 patients had mild/moderate mitral regurgitation, and four were associated with mitral stenosis and abnormal morphology. Two patients had mild aortic regurgitation and abnormal morphology, which were associated with mild aortic and mitral stenosis, and two patients with advanced RHD had bioprostheses in the mitral (2) and aortic (1) positions. In conclusion, first-degree relatives of individuals with clinical RHD are at greater risk of having RHD, on top of socioeconomic conditions.
Published: 2022
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10. Leisure Time Physical Activity and Cardio‐Metabolic Health: Results From the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil)

Author: Xiaochen Lin, Sheila M. Alvim, Eduardo J. Simoes, Isabela M. Bensenor, Sandhi M. Barreto, Maria I. Schmidt, Antonio L. Ribeiro, Francisco Pitanga, Maria Conceição C. Almeida, Simin Liu, and Paulo A. Lotufo
Subjects: Brazil, cardio‐metabolic health, physical exercise, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: BackgroundAlthough increasing effort has been devoted to the promotion of a healthy lifestyle such as leisure time physical activity for cardio‐metabolic health, specific evidence supporting health policy remains sparse, particularly in those ethnically diverse populations where cardio‐metabolic diseases are reaching epidemic proportion and yet are grossly understudied. Methods and ResultsWe conducted a cross‐sectional analysis of the baseline data from 10 585 participants aged 35 to 74 free of cardiovascular diseases in the Brazilian Longitudinal Study of Adult Health. Leisure time physical activity status was defined by the American Heart Association and the World Health Organization recommendations (≥150 min/week moderate activities or 75 min/week vigorous activities). In total, 1183 (21%) women and 1387 (29%) men were active. After accounting for covariates, the favorable effects of leisure time physical activity on cardio‐metabolic parameters were evident. Specifically, the average blood pressure, heart rate, and Framingham Risk Score for cardiovascular diseases of the active were significantly lower within each sex. The ORs comparing the active versus the inactive women were 0.78 (95% CI: 0.66–0.92) for hypertension and 0.78 (95% CI: 0.65–0.93) for cardiovascular diseases in 10 years. Among men, the ORs were 0.75 (95% CI: 0.65–0.87) for hypertension and 0.73 (95% CI: 0.61–0.87) for diabetes. The 10‐year risk of cardiovascular diseases was significantly lower among the active men with a 33% reduction (OR=0.67, 95% CI: 0.57–0.78). ConclusionsWe observed beneficial effects of leisure time physical activity on cardio‐metabolic health in this large Brazilian population that are consistent with studies in North America and Europe.
Published: 2016
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11. Effect of eCG on the follicular dynamics and vascularization of crossbred cows with different circulating progesterone concentrations during synchronization of ovulation in an FTAI protocol

Author: Priscila A. Ferraz, Mariana A.A. Silva, Bia S.S. Carôso, Endrigo A.B. Araujo, Thereza C.B.S.C. Bittencourt, Marcos Chalhoub, Rodrigo F. Bittencourt, and Antonio L. Ribeiro Filho
Subjects: Efeito do eCG, vascularização folicular, vacas mestiças, progesterona, ovulação, protocolo IATF, bovinos, gonadotrofina coriônica equina, sincronização, doppler, clínica, Veterinary medicine, SF600-1100
Abstract: ABSTRACT: This study aimed to evaluate the effect of treatment with equine chorionic gonadotrophin (eCG) on the follicular dynamics and function of crossbred cows with different circulating progesterone (P4) concentrations during synchronization of ovulation in a fixed-time artificial insemination (FTAI) protocol. To this end, 30 crossbred cows were submitted to a pre-synchronization protocol to ensure that all of them presented corpus luteum (CL) at the beginning of the protocol, and were evaluated by transrectal ultrasonography (TRUS) to verify the presence of CL. After that, the animals underwent an ovulation synchronization protocol and evaluation of follicular dynamics and vascularization by B-mode and power-Doppler ultrasound (US). High plasma P4 concentrations at the time of ovulation synchronization negatively influenced follicle diameter on day 10 (D10), preovulatory follicle diameter, and preovulatory follicle wall vascularization area (p0.05) similar to those of animals with low P4 concentration at the time of ovulation synchronization. Therefore, high P4 concentrations at the time of ovulation synchronization negatively influence follicular diameter and vascularization, and eCG can be used as a strategy to favor better follicular and luteal response in crossbred cows with high P4 concentrations submitted to an FTAI protocol.
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12. Avaliação morfofuncional do corpo lúteo para diagnóstico precoce de gestação 20 dias após IATF em vacas mestiças leiteiras

Author: Mariana A.A. Silva, Alexandra S. Rodrigues, Tiago O. Brandão, Luiz Di Paolo Maggitti Junior, Bia S.S. Carôso, Marcos Chalhoub, Rodrigo F. Bittencourt, and Antonio L. Ribeiro Filho
Subjects: Corpus luteum, 20-day pregnancy, diagnosis, IATF, cows, doppler, progesterone, vascularization, pregnancy prediction, morphology, Veterinary medicine, SF600-1100
Abstract: RESUMO: A detecção superprecoce de gestação é de grande relevância quando se trata do aumento da produtividade dos rebanhos, na tentativa de redução do tempo de serviço desses animais. Por tal relevância, objetivou-se utilizar a ultrassonografia (US) Doppler como ferramenta para predição de gestação, avaliando a irrigação do corpo lúteo (CL), vinte dias após IATF. Setenta e três vacas mestiças foram avaliadas 20 dias após IATF por US transretal. Para obtenção do diâmetro do CL (DCL) e sua área (ACL) utilizou-se o modo B, na mensuração da área de vascularização (VCL) e seu percentual no CL (VCL%) empregou-se o Doppler Colorido. As imagens foram classificadas com base na quantidade de pixels coloridos e sua distribuição no CL, em dois grupos: diagnóstico preditivo negativo de gestação (DPN) e preditivo positivo (DPP). No mesmo dia, a funcionalidade do CL foi determinada pela concentração plasmática de P4. O diagnóstico de gestação definitivo foi realizado por US 35 dias após as IATFs. Utilizou-se o teste t de Student (com P
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13. Galectina-3 Associada a Formas Graves e Mortalidade em Longo Prazo em Pacientes com Doença de Chagas

Author: Fábio Fernandes, Carlos Henrique Valente Moreira, Lea Campos Oliveira, Marcela Souza-Basqueira, Barbara Maria Ianni, Claudia di Lorenzo, Felix José Alvarez Ramires, Luciano Nastari, Edecio Cunha-Neto, Antonio L. Ribeiro, Renato Delascio Lopes, Sheila M. Keating, Ester Cerdeira Sabino, and Charles Mady
Subjects: Doença de Chagas, Cardiomiopatia Chagásica, Mortalidade, Galectina 3, Biomarcadores, Eletrocardiografia/métodos, Insuficiência Cardíaca, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Resumo Fundamento As características histopatológicas da doença de Chagas (DCC) são: presença de miocardite, destruição das fibras cardíacas e fibrose miocárdica. A Galectina-3 (Gal-3) é um biomarcador envolvido no mecanismo de fibrose e inflamação que pode ser útil para a estratificação de indivíduos com DCC por risco. Objetivos Nosso objetivo foi avaliar se níveis elevados de Gal-3 estão associados a formas graves de cardiomiopatia chagásica (CC) e são preditivos de mortalidade. Métodos Estudamos doadores de sangue (DS) positivos para anti-T. cruzi: não-CC-DS (187 DS sem CC com eletrocardiograma [ECG] e fração de ejeção do ventrículo esquerdo [FEVE] normais); CC-Não-Dis-DS (46 DS com CC e apresentando ECG anormal, mas FEVE normal); e 153 controles negativos correspondentes. Esta amostra foi composta por 97 pacientes com CC grave (CC-Dis). Usamos as correlações de Kruskall-Wallis e Spearman para testar a hipótese de associações, assumindo um p bicaudal
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14. Abstract P362: Racial Disparities in Cardiovascular Disease Mortality: Mediation by Socioeconomic Factors and Statin Use (The ELSA-Brasil Study)

Author: Aline Pedroso-Camargos, Luisa C Brant, Antonio L Ribeiro, Luana Giatti, Lidyane V Camelo, Maria de Fatima H Diniz, Sandhi M Barreto, and Roberta C Figueiredo
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Background: Statins are an effective strategy to reduce CVD risk, however, treatment goals are not achieved especially among Blacks and “Pardos” in Brazil. Hypothesis: Socioeconomic differences and lack of statin treatment for primary CVD prevention can explain part of the elevated mortality risk of Blacks and “Pardos”. Methods: Data from the ELSA-Brasil cohort (15,105 civil servants, from 6 state capital cities), excluding Asians, Indigenous, those with prevalent CVD and missing information about race or statin use. Race was self-reported as Black, “Pardo” or White. Brazilian guidelines at baseline (2008) were used to define those eligible for statin treatment. Cox survival analysis determined the risk of CVD mortality for Black and “Pardo” compared to White (adjusted by age, sex, hypertension, diabetes, LDL-c, BMI and smoking). We used inverse odds ratio weighting technique to calculate mediation for socioeconomic factors (SEF) (education, income, and having health insurance) and statin use when indicated to determine the natural direct and indirect effects of race on CVD mortality. We estimated the percent mediation as the percent change between β coefficients with and without weights applied. Results: Among the 13,396 individuals, the mean age was 52±9 years, 55.2% were women, 54.2% were White, and 10.2% were taking statins. Adjusted Black and “Pardo”/White CVD mortality HR was 1.91 (CI 95% = 1.30-2.81, p95% = 0.86-2.19) and considering the weight of statin use was 2.01 (CI 95% =1.36-2.98). SEF explained 51.5% (CI 95% = 17.0-60.2) and not using statins when indicated explained 7.8% (CI 95% = 4.2-23.3) of the racial inequality observed in CVD mortality risk (Table 1). Conclusions: The higher Black and “Pardo”/White CVD mortality risk is primarily explained by racial differences in SEF. Not using statins when there is indication for treatment increases in about 8% the CVD mortality risk for Blacks and “Pardos” compared to Whites.
Published: 2023

15. DH-452784-1 UNSUPERVISED MACHINE LEARNING IDENTIFIES PROGNOSTICALLY SIGNIFICANT PHENOGROUPS FROM NEURAL NETWORK-DERIVED ECG FEATURES

Author: Arunashis Sau, Antônio H. Ribeiro, Kathryn McGurk, Libor Pastika, Nikesh Bajaj, Jun Yu Chen, Huiyi Wu, Xili Shi, Katerina Hnatkova, Sean Zheng, Annie Briton, Martin Shipley, Irena Andršová, Tomáš Novotný, Ester Sabino, Jonathan W. Waks, Daniel B. Kramer, Danilo Mandic, Nicholas S. Peters, Marek Malik, James S. Ware, Antonio L. Ribeiro, and Fu Siong Ng
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Published: 2023

16. Association between Atrioventricular Block and Mortality in Primary Care Patients: The CODE Study

Author: Gabriela Miana de Mattos Paixão, Emilly M. Lima, André B. Quadros, Daniel P. R. Cabral, Renato R. Coelho, Derick M. Oliveira, Jamil de Souza Nascimento, Paulo R. Gomes, and Antonio L. Ribeiro
Subjects: Bloqueio Atrioventricular/fisiopatologia, Diagnostic Imaging, Bloqueio Atrioventricular/complicações, Cardiovascular Diseases/complications, Electrocardiography/methods, Diagnóstico por Imagem, Eletrocardiografia/métodos, Atrioventricular Block/physiopathology, Mortalidade, Atrioventricular Block/complications, Mortality, Cardiology and Cardiovascular Medicine, Doenças Cardiovasculares/complicações
Abstract: Resumo Fundamento O bloqueio atrioventricular (BAV) descreve um comprometimento na condução dos átrios para os ventrículos. Embora o curso clínico do BAV tenha sido avaliado, os achados são de países de alta renda e, portanto, não podem ser extrapolados para a população latina. Objetivo Avaliar a associação entre BAV e mortalidade. Métodos Foram incluídos pacientes do estudo CODE (Clinical Outcomes in Digital Electrocardiology), maiores de 16 anos que realizaram eletrocardiograma (ECG) digital de 2010 a 2017. Os ECGs foram relatados por cardiologistas e por software automatizado. Para avaliar a relação entre BAV e mortalidade, foram utilizados o modelo log-normal e as curvas de Kaplan-Meier com valores de p bicaudais < 0,05 considerados estatisticamente significativos. Resultados O estudo incluiu 1.557.901 pacientes; 40,23% eram homens e a média de idade foi de 51,7 (DP ± 17,6) anos. Durante um seguimento médio de 3,7 anos, a mortalidade foi de 3,35%. A prevalência de BAV foi de 1,38% (21.538). Os pacientes com BAV de primeiro, segundo e terceiro graus foram associados a uma taxa de sobrevida 24% (taxa de sobrevida relativa [RS] = 0,76; intervalo de confiança [IC] de 95%: 0,71 a 0,81; p < 0,001), 55% (RS = 0,45; IC de 95%: 0,27 a 0,77; p = 0,01) e 64% (RS = 0,36; IC de 95%: 0,26 a 0,49; p < 0,001) menor quando comparados ao grupo controle, respectivamente. Os pacientes com BAV 2:1 tiveram 79% (RS = 0,21; IC de 95%: 0,08 a 0,52; p = 0,005) menor taxa de sobrevida do que o grupo controle. Apenas Mobitz tipo I não foi associado a maior mortalidade (p = 0,27). Conclusão BAV foi um fator de risco independente para mortalidade geral, com exceção do BAV Mobitz tipo I. Abstract Background Atrioventricular block (AVB) describes an impairment of conduction from the atria to the ventricles. Although the clinical course of AVB has been evaluated, the findings are from high-income countries and, therefore, cannot be extrapolated to the Latinx population. Objective Evaluate the association between AVB and mortality. Methods Patients from the CODE (Clinical Outcomes in Digital Electrocardiology) study, older than 16 years who underwent digital electrocardiogram (ECG) from 2010 to 2017 were included. ECGs were reported by cardiologists and by automated software. To assess the relationship between AVB and mortality, the log-normal model and the Kaplan-Meier curves were used with two-tailed p-values < 0.05 considered statistically significant. Results The study included 1,557,901 patients; 40.2% were men, and mean age was 51.7 (standard deviation ± 17.6) years. In a mean follow-up of 3.7 years, the mortality rate was 3.35%. The AVB prevalence was 1.38% (21,538). Patients with first-, second-, and third-degree AVB were associated with 24% (relative survival rate [RS] = 0.76; 95% confidence interval [CI]: 0.71-0.81; p < 0.001), 55% (RS = 0.45; 95% CI: 0.27-0.77; p = 0.01), and 64% (RS = 0.36; 95% CI: 0.26-0.49; p < 0.001) lower survival rate when compared to the control group, respectively. Patients with 2:1 AVB had 79% (RS = 0.21; 95% CI: 0.08-0.52; p = 0.005) lower survival rate than the control group. Only Mobitz type I was not associated with higher mortality (p = 0.27). Conclusion AVB was an independent risk factor for overall mortality, with the exception of Mobitz type I.
Published: 2022

17. PO-05-058 PROGNOSTIC EVALUATION OF PATIENTS WITH ICD IN A LATIN AMERICAN TERTIARY CENTER

Author: Anna T. Franca, Antonio L. Ribeiro, Andre A. Carmo, Fábio M. Castilho, Henrique B. Moreira, Reynaldo Miranda, Marcos Roberto Q. Franca, Leandro Garambone, and Vitor F. Fontes
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Published: 2023

18. COMBINATION OF TELE-CARDIOLOGY TOOLS FOR CARDIOVASCULAR RISK STRATIFICATION IN PRIMARY CARE

Author: Bruno Ramos Nascimento, Cassia Silva, Isabely Karoline Da Silva Ribeiro, Gabriela Aparecida Da Silva, GUSTAVO GALVAO CUNHA, Allan De Morais Bessa, Wanessa Vinhal, Magda Pires, Kaciane Krauss Bruno Oliveira Lourenço, Juliane Franco, Maria Carmo Pereira Nunes, Lucas Fraga, Lucas Ruback, Bruno Galdino, Luiza Santos, Craig A. Sable, Andrea Beaton, Antonio L. Ribeiro, and Clareci Cardoso
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023

19. EFFICACY AND SAFETY OF CATHETER ABLATION FOR ATRIAL FIBBRILATION IN ELDERLY PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Author: Marcos Franca, Bruno Ramos Nascimento, Carlos A. Morillo, Marina Mayrink, Reynaldo Castro Miranda, Andre Naback, Alexandre Ferreira, Beatriz Costa, Mauro Silva, Andre Carmo, and Antonio L. Ribeiro
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023

20. Comprehensive Cardiac Rehabilitation Effectiveness in a Middle-Income Setting

Author: Raquel Rodrigues Britto, Gabriela Chaves, Sherry L. Grace, Paul Oh, Antonio L. Ribeiro, and Gabriela Lima de Melo Ghisi
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Health Behavior, 030204 cardiovascular system & hematology, Mean difference, law.invention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Humans, Exercise, Depressive symptoms, Cardiac Rehabilitation, Rehabilitation, business.industry, Middle income, medicine.disease, Exercise Therapy, 030228 respiratory system, Income, Quality of Life, Cardiology and Cardiovascular Medicine, business, Brazil
Abstract: PURPOSE The impact of comprehensive cardiac rehabilitation (CCR) in Latin America is not well known. Herein, the pre-specified tertiary outcomes of a cardiac rehabilitation (CR) trial are reported: disease-related knowledge, depressive symptoms, and heart-health behaviors (exercise, diet, and smoking). METHODS This was a single-blinded, single-center (Brazil) randomized trial with three parallel arms: CCR (exercise + education) versus exercise-only CR versus wait-list control. Eligible patients were randomized in blocks of four with 1:1:1 concealed allocation. The CR program was 6 mo long. Participants randomized to exercise-only CR received 36 exercise classes; the CCR group also received 24 educational sessions, including a workbook. All outcomes were assessed at pre-test and 6-mo later (blinded). Analysis of covariance was performed by intention-to-treat (ITT) and per-protocol (PP). RESULTS A total of 115 (89%) patients were randomized; 93 (81%) were retained. There were significant improvements in knowledge with CCR (ITT [51.2 ± 11.9 pre and 60.8 ± 13.2 post] and PP; P < .01), with significantly greater knowledge with CCR versus control (ITT mean difference [MD] = 9.5, 95% CI, 2.3-16.8) and CCR vs exercise-only CR at post-test (ITT MD = 6.8, 95% CI, 0.3-14.0). There were also significant improvements in self-reported exercise with CCR (ITT [13.7 ± 15.8 pre and 32.1 ± 2 5.7 post] and PP; P < .001), with significantly greater exercise with CCR versus control at post-test (ITT MD = 7.6, 95% CI, 3.8-11.4). Also, there were significant improvements in diet with CCR (PP: 3.4 ± 7.5 pre and 8.0 ± 7.0 post; P < .05). CONCLUSIONS In this first-ever randomized trial of CR for coronary artery disease in Latin America, the benefits of CCR have been supported.
Published: 2020

21. Intoxicação acidental por monensina em búfalos na Bahia, Brasil

Author: Antonio W.O. Silva, Múcio F.F. Mendonça, Moisés D. Freitas, Antonio L. Ribeiro Filho, Ricardo D.G. Silva, Paula V. Leal, Luciano A. Pimentel, and Tiago C. Peixoto
Subjects: Antibióticos ionóforos, General Veterinary, Brasil, Veterinary medicine, cardiomiopatia necrótica, intoxicação iatrogênica, búfalos, miopatia, poisoning, monensina, monensin, buffaloes, iatrogenic intoxication, SF600-1100, Ionophore antibiotics, necrotic myopathy, miopatia tóxica, cardiomyopathy, Brazil, toxic myopathy
Abstract: Monensin is an ionophore antibiotic (IA) widely used for growth promotion and weight gain in the production of ruminants. However, it has caused intoxication in several species, including buffaloes, mainly because of the ignorance or disrespect of the recommendations for use in each animal species. The objective of this study was to describe, for the first time, clinical-epidemiological and anatomopathological data of an outbreak of accidental poisoning by monensin in buffalos and rediscuss the recommendation of the use of IA in the production of this species. The outbreak affected 21 adult buffaloes after consumption of remains from a feed formulated on the farm and whose constituents were mixed by hand. Clinical and first death signs were observed 24 hours after ingestion of this food. In general, the clinical picture was characterized by muscle weakness, tremors, difficulty in locomotion, and decubitus. Fifteen buffaloes presented clinical signs of poisoning (71.5% morbidity), followed by death (100% lethality), after acute to subacute evolution (
Published: 2022

22. Machine Learning in Medicine: Review and Applicability

Author: Gabriela Miana de Mattos Paixão, Bruno Campos Santos, Rodrigo Martins de Araujo, Manoel Horta Ribeiro, Jermana Lopes de Moraes, and Antonio L. Ribeiro
Subjects: Machine Learning, Aprendizado de Máquina, Medicina, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, Cardiologia
Published: 2022

23. Abstract 13250: Factors Associated With Improvement of Left Ventricular Function After Catheter Ablation for Atrial Fibrillation in Patients With Heart Failure

Author: Marcos Roberto Q França, Bruno R Nascimento, Reynaldo C Miranda, Gustavo A Silva, Anna Terra França, Henrique B Moreira, Vitor F Fontes, Antonio L Ribeiro, and Andre A Carmo
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Introduction: Catheter ablation is a well-established therapy for atrial fibrillation (AF), and studies have shown positive outcomes in patients with heart failure (HF). We aimed to evaluate the impact of AF ablation on echocardiographic and clinical parameters in patients with HF in Brazil, and to assess factors associated with improvement of the left ventricular ejection fraction (LVEF). Methods: Consecutive patients diagnosed with HF and LVEF Results: From 2018 to 2020, 44 patients were included, being 28 (64%) males, mean age 66±11 years. Of these, 12 were in NYHA functional class 3/4, 35 had persistent AF, and only 3 had previous ablations. Mean pre-procedural LVEF was 38±7%, with 13 (30%) having LVEF Conclusion: AF ablation in patients with HF resulted in remarkable echocardiographic and functional improvement, with low complication rates. Less clinical severity and less morpho-functional impairment were associated with LVEF normalization.
Published: 2021

24. Abstract 11802: Evaluation of Family Risk of Rheumatic Heart Disease With Systematic Echocardiographic Screening: Data From the Provar+ Study

Author: Juliane Franco, Bruno R Nascimento, Kaciane Oliveira, Marcia Barbosa, Nayana F Arantes, Andrea Z Beaton, Luana A Mello, Maria Cecília L Nascif, Guilherme C Oliveira, Breno C Camargos Mucelli Spolaor, Carolina F Campos, Victor R Silva, Marcelo Augusto A Nogueira, Antonio L Ribeiro, Craig A Sable, and Maria P Nunes
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Introduction: Rheumatic Heart Disease (RHD) is determined by a complex interaction between socioeconomic environment and host susceptibility. Relatives of patients with advanced RHD share both, and may be at high-risk. We aimed to use echocardiographic (echo) family screening to evaluate the risk of RHD among 1 st degree relatives of patients with advanced RHD. Methods: From Feb 2020 - Jun 2021 patients with advanced RHD were consecutively enrolled in the University Hospital’s outpatient clinics. Consented 1 st degree relatives were invited for echo screening (2012 World Heart Federation Criteria) utilizing handheld devices (GE VSCAN) by non-physicians, with telemedicine interpretation by 2 experts. Matched controls (spouses, neighbors) living in the same household were also enrolled in a 1:5 fashion. A confirmatory full echo (GE Vivid IQ) was scheduled if abnormalities were observed, and all positive RHD cases were referred for follow-up. Results: In 16 months, 202 relatives and 42 controls of 117 patients were screened, including 114 children, 68 siblings and 20 parents. Mean age was 41±18 years, 62% were women and 214 (88%) lived with the index case for >10 years. At total 51 (21%) individuals had hypertension, 17 (7%) diabetes, 5 reported a previous stroke and only 5 (all relatives) had personal history of RHD. Among index cases, 73% reported current or past prescription of Penicillin. Echo findings suggestive of RHD were observed in 0 controls and 14 (7%) relatives (p=0.08), being 11 with mitral valve (MV) disease and 3 with mixed (mitral and aortic valve (AV)) disease. Eleven patients had mild/moderate MV regurgitation, 4 with associated MV stenosis and abnormal morphology. Two patients had mild AV regurgitation and abnormal AV morphology, associated with mild AV and MV stenosis, and 1 patient had bioprostheses in the MV and AV. One case of mild left ventricular dysfunction was observed, and 1 patient had indication of commissurotomy for MV stenosis at the time of diagnosis. Conclusions: First-degree relatives of individuals with clinical RHD are at greater risk of having RHD and family screening should be considered. Genotyping studies are warranted to better understand individual and family susceptibility to RHD, in addition to socioeconomic conditions.
Published: 2021

25. Association between Atrioventricular Block and Mortality in Primary Care Patients: The CODE Study

Author: Gabriela Miana de Mattos, Paixão, Emilly M, Lima, André B, Quadros, Daniel P R, Cabral, Renato R, Coelho, Derick M, Oliveira, Jamil de Souza, Nascimento, Paulo R, Gomes, and Antonio L, Ribeiro
Subjects: Male, Electrocardiography, Primary Health Care, Risk Factors, Humans, Female, Middle Aged, Atrioventricular Block
Abstract: Atrioventricular block (AVB) describes an impairment of conduction from the atria to the ventricles. Although the clinical course of AVB has been evaluated, the findings are from high-income countries and, therefore, cannot be extrapolated to the Latinx population.Evaluate the association between AVB and mortality.Patients from the CODE (Clinical Outcomes in Digital Electrocardiology) study, older than 16 years who underwent digital electrocardiogram (ECG) from 2010 to 2017 were included. ECGs were reported by cardiologists and by automated software. To assess the relationship between AVB and mortality, the log-normal model and the Kaplan-Meier curves were used with two-tailed p-valueslt; 0.05 considered statistically significant.The study included 1,557,901 patients; 40.2% were men, and mean age was 51.7 (standard deviation ± 17.6) years. In a mean follow-up of 3.7 years, the mortality rate was 3.35%. The AVB prevalence was 1.38% (21,538). Patients with first-, second-, and third-degree AVB were associated with 24% (relative survival rate [RS] = 0.76; 95% confidence interval [CI]: 0.71-0.81; plt; 0.001), 55% (RS = 0.45; 95% CI: 0.27-0.77; p = 0.01), and 64% (RS = 0.36; 95% CI: 0.26-0.49; plt; 0.001) lower survival rate when compared to the control group, respectively. Patients with 2:1 AVB had 79% (RS = 0.21; 95% CI: 0.08-0.52; p = 0.005) lower survival rate than the control group. Only Mobitz type I was not associated with higher mortality (p = 0.27).AVB was an independent risk factor for overall mortality, with the exception of Mobitz type I.O bloqueio atrioventricular (BAV) descreve um comprometimento na condução dos átrios para os ventrículos. Embora o curso clínico do BAV tenha sido avaliado, os achados são de países de alta renda e, portanto, não podem ser extrapolados para a população latina.Avaliar a associação entre BAV e mortalidade.Foram incluídos pacientes do estudo CODE (Clinical Outcomes in Digital Electrocardiology), maiores de 16 anos que realizaram eletrocardiograma (ECG) digital de 2010 a 2017. Os ECGs foram relatados por cardiologistas e por software automatizado. Para avaliar a relação entre BAV e mortalidade, foram utilizados o modelo log-normal e as curvas de Kaplan-Meier com valores de p bicaudaislt; 0,05 considerados estatisticamente significativos.O estudo incluiu 1.557.901 pacientes; 40,23% eram homens e a média de idade foi de 51,7 (DP ± 17,6) anos. Durante um seguimento médio de 3,7 anos, a mortalidade foi de 3,35%. A prevalência de BAV foi de 1,38% (21.538). Os pacientes com BAV de primeiro, segundo e terceiro graus foram associados a uma taxa de sobrevida 24% (taxa de sobrevida relativa [RS] = 0,76; intervalo de confiança [IC] de 95%: 0,71 a 0,81; plt; 0,001), 55% (RS = 0,45; IC de 95%: 0,27 a 0,77; p = 0,01) e 64% (RS = 0,36; IC de 95%: 0,26 a 0,49; plt; 0,001) menor quando comparados ao grupo controle, respectivamente. Os pacientes com BAV 2:1 tiveram 79% (RS = 0,21; IC de 95%: 0,08 a 0,52; p = 0,005) menor taxa de sobrevida do que o grupo controle. Apenas Mobitz tipo I não foi associado a maior mortalidade (p = 0,27).BAV foi um fator de risco independente para mortalidade geral, com exceção do BAV Mobitz tipo I.
Published: 2021

26. IMPACT OF THE COVID-19 PANDEMIC ON HOSPITAL ADMISSIONS AND MORTALITY ASSOCIATED WITH CORONARY EVENTS IN THE BRAZILIAN PRIVATE HEALTH

Author: Bruno Ramos Nascimento, Luiz Eduardo V. Froes, Ana Cristina T. Castro, Eduardo Tomaz Froes, Luisa Caldeira Brant, Antonio L. Ribeiro, Larissa V. Cruz, Cynthia B. Araújo, Charles F. Souza, Renato A. Teixeira, Andrea Z. Beaton, Craig A. Sable, Felipe L. Gomes, and Soraya D. Souza
Subjects: Cardiology and Cardiovascular Medicine
Published: 2022

27. BURDEN OF CARDIOVASCULAR DISEASES ATTRIBUTABLE TO RISK FACTORS IN PORTUGUESE-SPEAKING COUNTRIES: DATA FROM THE GLOBAL BURDEN OF DISEASE 2019 STUDY

Author: Bruno Ramos Nascimento, Luisa Caldeira Brant, André D. Naback, Guilherme Augusto Veloso, Carisi A. Polanczyk, Antonio L. Ribeiro, Deborah C. Malta, Albano Vicente L. Ferreira, and Gláucia Maria M. Oliveira
Subjects: Cardiology and Cardiovascular Medicine
Published: 2022

28. Electrocardiogram report system: the importance of decision-making tools

Author: Paulo R. Gomes, Gabriela M. Paix, Emilly M. Lima, Milena S. Marcolino, Leonardo B. Ribeiro, Graziela Chequer, Maria B.M. Alkmim, Peter W. Macfarlane, and Antonio L. Ribeiro
Subjects: Cardiology and Cardiovascular Medicine
Published: 2021

29. Machine Learning in Medicine: Review and Applicability

Author: Gabriela Miana de Mattos, Paixão, Bruno Campos, Santos, Rodrigo Martins de, Araujo, Manoel Horta, Ribeiro, Jermana Lopes de, Moraes, and Antonio L, Ribeiro
Subjects: Machine Learning, Artificial Intelligence, Humans
Published: 2019

30. Accuracy of Self-Reported Weight Collected Through a Web-Based Platform in a Weight Loss Trial: Validation Study of the POEmaS Clinical Trial

Author: Alline M, Beleigoli, Andre Q, Andrade, Maria, de Fátima H Diniz, Roberta S, Alvares, Marina H, Ferreira, Leticia A, Silva, Marcia C, Rodrigues, Luma, Jacomassi, Amanda G, Cerqueira, and Antonio L, Ribeiro
Subjects: Internet, Body Weight, Weight Loss, Humans, Self Report, Body Height, Randomized Controlled Trials as Topic
Abstract: Self-reported anthropometric data in web-based weight loss interventions may be inaccurate. We studied the agreement between online self-reported and measured weight in the course of the POEmaS randomized controlled trial. Measured weight was not different from reported one (-0.4 kg; 95%CI -0.93 to 0.12). 95.6% of the cases were within the limits of agreement (Bland-Altman method). Self-reported weight collected online was accurate, which suggests that interventions and outcomes assessment can rely on these data.
Published: 2019

31. Utilização e percepção de impacto de aplicativos de mensagem instantânea para smartphones na prática médica

Author: João Antonio de Queiroz Oliveira, Milena Soriano Marcolino, Israel Júnior Borges do Nascimento, Antonio L. Ribeiro, Iago Souza Wolff, Maíra Viana Souza e Silva, and Laura Derfensor Ribeiro
Published: 2019

32. Desenvolvimento, implementação e avaliação da usabilidade de um aplicativo baseado em suporte à decisão para rastreamento de Hipertensão Arterial e Diabetes Mellitus: um subestudo do Projeto Healthrise

Author: Antonio L. Ribeiro, Laura Defensor Ribeiro de Melo, João Antonio de Queiroz Oliveira, Júnia Xavier Maia, Christiane Correa Rodrigues cimini, Milena Soriano Marcolino, and Thábata Queiroz Vivas de Sá
Published: 2019

33. Telehealth solutions to enable global collaboration in rheumatic heart disease screening

Author: Andrea Beaton, Maria do Carmo Pereira Nunes, Cassio M Oliveira, Antonio L. Ribeiro, Bruno R Nascimento, Kaciane K.B. Oliveira, Alison Tompsett, Lindsay Perlman, Adriana C Diamantino, Eduardo L Lopes, Craig Sable, Leonardo Bonisson, and Julia P Santos
Subjects: medicine.medical_specialty, Telemedicine, Inservice Training, Time Factors, Heart disease, Cross-sectional study, Health Informatics, Telehealth, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, medicine, Humans, Mass Screening, Prospective Studies, 030212 general & internal medicine, Computer Security, Mass screening, Remote Consultation, business.industry, Rheumatic Heart Disease, Cloud Computing, medicine.disease, Outreach, Cross-Sectional Studies, Echocardiography, Physical therapy, Medical emergency, business, Brazil
Abstract: Background The global burden of rheumatic heart disease is nearly 33 million people. Telemedicine, using cloud-server technology, provides an ideal solution for sharing images performed by non-physicians with cardiologists who are experts in rheumatic heart disease. Objective We describe our experience in using telemedicine to support a large rheumatic heart disease outreach screening programme in the Brazilian state of Minas Gerais. Methods The Programa de Rastreamento da Valvopatia Reumática (PROVAR) is a prospective cross-sectional study aimed at gathering epidemiological data on the burden of rheumatic heart disease in Minas Gerais and testing of a non-expert, telemedicine-supported model of outreach rheumatic heart disease screening. The primary goal is to enable expert support of remote rheumatic heart disease outreach through cloud-based sharing of echocardiographic images between Minas Gerais and Washington. Secondary goals include (a) developing and sharing online training modules for non-physicians in echocardiography performance and interpretation and (b) utilising a secure web-based system to share clinical and research data. Results PROVAR included 4615 studies that were performed by non-experts at 21 schools and shared via cloud-telemedicine technology. Latent rheumatic heart disease was found in 251 subjects (4.2% of subjects: 3.7% borderline and 0.5% definite disease). Of the studies, 50% were preformed on full functional echocardiography machines and transmitted via Digital Imaging and Communications in Medicine (DICOM) and 50% were performed on handheld echocardiography machines and transferred via a secure Dropbox connection. The average time between study performance date and interpretation was 10 days. There was 100% success in initial image transfer. Less than 1% of studies performed by non-experts could not be interpreted. Discussion A sustainable, low-cost telehealth model, using task-shifting with non-medical personal in low and middle income countries can improve access to echocardiography for rheumatic heart disease.
Published: 2016

34. Using the Behaviour Change Wheel for Designing an Online Platform for Healthy Weight Loss - 'POEmaS'

Author: Alline M, Beleigoli, Andre Q, Andrade, Maria de Fátima H, Diniz, Roberta S, Alvares, Marina H, Ferreira, Leticia A, Silva, Marcia C, Rodrigues, Luma, Jacomassi, Amanda G, Cerqueira, and Antonio L, Ribeiro
Subjects: Adult, Male, Motivation, Behavior Therapy, Weight Loss, Humans, Female, Obesity, Brazil
Abstract: Behaviour change is a key point in weight management. Digital health interventions are attractive tools to deliver behaviour interventions for weight loss, due to the potential to reach a large number of people. We aimed to report how the Behaviour Change Wheel (BCW) was used to develop and implement a web platform to promote weight loss in Brazilian adults with overweight and obesity. Moreover, we aimed to describe the first 12 weeks of usage of the platform in a randomized controlled trial.The BCW framework was used to define intake of fruit/vegetables, ultra-processed products and sweetened beverages, leisure physical activity and sitting time as target behaviours. The BCW components of behaviour-capability, opportunity and motivation were used to make a behaviour diagnosis of the population and BCW second layer oriented the selection of information, goal setting, self-monitoring, feedback, social support and incentives as behaviour techniques. Using these behaviour techniques, a 24-week behaviour intervention delivered by seven different platform functionalities was developed. The platform was tested in a three-arm parallel (basic platform versus enhanced platform versus minimal intervention control group) randomized controlled trial from September 2017 to April 2018. In the present analysis, we classified the platform functionalities according to the BCW behaviour component (capability, opportunity and behaviour) and used descriptive statistics and Spearman correlations to report functionalities usage according to the BCW behaviour component over the first 12 weeks of the trial. The study was approved by the Ethics Committee of the Federal University of Minas Gerais, Brazil and was registered under NCT 03435445.Over the first 12 weeks of the RCT, the 809 participants (619, 76.5% women; mean age 33.7 years, SD 10.3; mean BMI 29.9 kg/msup2/sup, SD 4.3) were enrolled for use of the basic and enhance versions of the platform. Capability-driven functionalities were accessed by 455 (56.2%) users with median access of 1 (IQR 1-6) times, whereas opportunity-driven platform functionalities were accessed by 592 participants with 8 (IQR 1-27) median access times and motivation-driven functionalities were accessed by 560 (69.2%) participants with 13 (IQR 1-30) median times of access. Spearman correlations between the use of capability and opportunity functionalities, capability and motivation functionalities and opportunity and motivation functionalities were 0.74 (95% CI 0.70-0.77), 0.74 (95% CI 0.70-0.78), 0.89 (95% CI 0.87-0.91), respectively.BCW provided a systematic approach to planning, designing and implementing a complex weight loss intervention based on behaviour change. Moreover, it promoted a clear understanding of the relation between platform functionalities and behaviour determinants. The low use of the capability-driven functionalities might have been related to lack of accuracy in the behaviour diagnosis, as well as to implementation issues. The high correlation between the functionalities use suggests that the BCW approach did not determine the platform usage profile.The BCW provided a framework for an evidence-based intervention on weight loss delivered by a web platform. Using the framework led to a clear understanding of the behaviour determinants and their relation to the platform features.
Published: 2018

35. Consumo máximo de oxigênio durante o teste incremental de caminhada em uma população predominantemente feminina com cardiopatia chagásica

Author: Rafael, Alves, Marcia M, Lima, Cheyenne, Fonseca, Rodrigo, Dos Reis, Pedro H, Figueiredo, Henrique, Costa, Lucas, Kreuser, Maria C, Nunes, and Antonio L, Ribeiro
Subjects: Chagas Cardiomyopathy, Reproducibility of Results, Walk Test, Recovery of Function, Walking, Teste de Exercício, Middle Aged, Cardimiopatia de Chagas, Cohort Studies, Oxygen Consumption, Sex Factors, Capacidade Residual Funcional, Humans, Regression Analysis, Female, Aged
Abstract: BACKGROUND: Chagas heart disease (CHD) patients may have a reduced functional capacity (FC). Field tests, as the Incremental Shuttle Walk Test (ISWT), can estimate peak oxygen uptake (VO2 peak). However, the relationship between the ISWT and the Cardiopulmonary Exercise Testing (CPET), the gold standard in the assessment of FC, is not well established in CHD patients. AIM: This study aimed to evaluate the FC of CHD patients by ISWT with direct measurement of VO2 peak and to compare these findings with data obtained from CPET. A secondary goal was to derive a regression equation to calculate the VO2 peak by ISWT. DESIGN: Cross-sectional and correlative study. SETTING: Research laboratory setting. POPULATION: Thirty-two CHD patients (58.8±9.0 years, 81.3% women) participated in this study. METHODS: Eligible patients underwent clinical evaluation, echocardiography, CPET by ramp protocol and ISWT according to current guidelines. RESULTS: The distance walked in ISWT showed a positive correlation with VO2 peak from CPET and ISWT (r=0.456, P=0.009 and r=0.869, P
Published: 2016

36. Abstract 18811: Improving the Practicality of Echocardiographic Screening for Rheumatic Heart Disease: Performance of Non-expert Users Following Completion of a Standardized Computer-based Training Curriculum

Author: Andrea Beaton, Bruno R Nascimento, Adriana C Diamantino, Gabriel T Pereira, Eduardo L Lopes, Cassio O Miri, Kaciane K Bruno, Graziela Chequer, Camila G Ferreira, Luciana C Lafeta, Hedda Richards, Lindsay Perlman, Catherine Webb, Antonio L Ribeiro, Craig Sable, and Maria do Carmo P Nunes
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Background: Echocardiography (echo) is the most sensitive tool for rheumatic heart disease (RHD) detection. However, widespread screening programs are non-existent due to lack of financial and expert human resources in endemic areas. Task-shifting to non-experts to perform RHD screening is promising; however, investigations into workforce composition and replicable training schemes are needed. Objective: Test non-experts’ ability to conduct RHD screening following a brief, standardized, computer-based training course. Methods: Six non-experts with a variety of backgrounds (nurses, health technicians, medical students) and echo experience (6 wks-1 yr) completed a 3-module computer-based curriculum focusing on simplified criteria for RHD screening (mitral regurgitation (MR) ≥1.5cm and/or any aortic regurgitation). Following training, two teams of 3 non-experts were placed in school screening environments. Gold-standard diagnoses of RHD (2012, World Heart Federation criteria) were made by cardiologists using standard portable echo equipment. Children diagnosed with RHD and 25% of the general screening population was blindly evaluated by each non-expert using the simplified criteria with handheld echo. Results: Screening was performed in 1,381 children, with 397 (47 borderline RHD, 6 definite RHD, 336 normal & 8 other) referred for handheld echo (209 Team 1 & 188 Team 2). Age ranged from 5-18 years (mean 13.6); 59% were female. Overall sensitivity of the simplified approach was 90.8% (95% CI 85.4-94.6%; range 75-100%), with an overall specificity of 82.4% (95% CI 79.9-84.7%; range 75-89%). The most common reasons for false-negative screens (n=16) were missed MR (44%) and MR ≤1.5cm (29%), and for false-positive screens (n=179) included identification of erroneous color jets (25%), incorrect MR measurement (24%), and appropriate application of simplified guidelines (MR between 1.5 and 2.0 cm, 39.4%). Conclusions: A short, computer-based curriculum can be successfully used to train a heterogeneous group of non-experts to preform large-scale RHD screening. This simplified approach addresses prohibitive financial and workforce barriers to widespread RHD screening and holds the potential to significantly reduce the global burden of RHD.
Published: 2015

37. Abstract 13345: Efficacy and Safety of an Anticoagulation Clinic in Low-income Brazilian Patients With Heart Disease: a Randomized Clinical Trial

Author: Maria A Martins, João A Oliveira, Daniel D Ribeiro, Cibele C César, Vandack A Nobre, Daniel M Palhares, Manoel O Rocha, and Antonio L Ribeiro
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Introduction: Anticoagulation clinics (AC) have better impact on anticoagulation control than usual medical care (UMC). However, there is no randomized trial testing the results of AC in low-income realities. We sought to examine the performance of an AC in a group of patients treated at a Brazilian public hospital. Hypothesis: The assistance provided by AC presents difference in TTR when compared to the UMC. Methods: This was a randomized clinical trial to test the efficacy and safety of a recently-implemented AC over UMC in a group of outpatients with heart disease. The primary and secondary endpoints were time in the therapeutic range (TTR) and warfarin-associated complications, respectively. Overall, 280 patients were enrolled and randomly assigned to one of the two arms: group A: one year at AC (A1: first semester; A2: second semester); and group B: one semester receiving UMC (B1) and other at AC (B2). Results: The mean age was 56.8±13.1 years and patients were mostly female (54.6%). The median monthly income was 464 US dollars. Low literacy was predominant in this group of studied patients (>68%). A1 showed higher TTR (62.4±20.8%) than B1 (55.1±28.5%) (p=0.014). An improvement of TTR was observed within group B, rising from 55.1±28.5% (B1) to 62.2±23.1% (B2) (p=0.008). A1 showed lower incidence rate (IR) per patients-year (p-y) of total bleedings than B1 (incidence rate ratio (IRR): 0.78; p=0.041) and a decline in the IR p-y was found for intra-group comparisons, both presenting IRR 0.58; p Conclusions: AC helped increase TTR and reduce warfarin-complications, even in low-income settings. Extending this assistance to similar populations in other Latin American countries could reduce hospitalizations and deaths related to warfarin use.
Published: 2014

38. Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors

Author: Antonio L Ribeiro, Ester C Sabino, Milena S Marcolino, Vera M C Salemi, Barbara M Ianni, Fábio Fernandes, Luciano Nastari, André Antunes, Márcia Menezes, Cláudia Di Lorenzo Oliveira, Vandana Sachdev, Danielle M Carrick, Michael P Busch, Eduard L Murphy, NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II), International Component, and Debrabant, Alain
Subjects: Chagas Cardiomyopathy, Male, Antibodies, Protozoan, Blood Donors, Cardiovascular, Medical and Health Sciences, Electrocardiography, Myocardial infarction, International Component, screening and diagnosis, Ejection fraction, medicine.diagnostic_test, lcsh:Public aspects of medicine, Atrial fibrillation, Heart, Right bundle branch block, Middle Aged, Biological Sciences, Detection, Heart Disease, Infectious Diseases, Protozoan, Cardiology, cardiovascular system, Medicine, Female, Left anterior fascicular block, medicine.symptom, Brazil, 4.2 Evaluation of markers and technologies, Research Article, Neglected Tropical Diseases, NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II), Adult, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, Trypanosoma cruzi, Asymptomatic, Antibodies, QRS complex, Clinical Research, Internal medicine, Tropical Medicine, medicine, Humans, Chagas Disease, cardiovascular diseases, NHLBI Retrovirus Epidemiology Donor Study-II, Retrospective Studies, business.industry, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, medicine.disease, business
Abstract: Background Blood donor screening leads to large numbers of new diagnoses of Trypanosoma cruzi infection, with most donors in the asymptomatic chronic indeterminate form. Information on electrocardiogram (ECG) findings in infected blood donors is lacking and may help in counseling and recognizing those with more severe disease. Objectives To assess the frequency of ECG abnormalities in T.cruzi seropositive relative to seronegative blood donors, and to recognize ECG abnormalities associated with left ventricular dysfunction. Methods The study retrospectively enrolled 499 seropositive blood donors in São Paulo and Montes Claros, Brazil, and 483 seronegative control donors matched by site, gender, age, and year of blood donation. All subjects underwent a health clinical evaluation, ECG, and echocardiogram (Echo). ECG and Echo were reviewed blindly by centralized reading centers. Left ventricular (LV) dysfunction was defined as LV ejection fraction (EF), Author Summary Chagas disease (ChD), caused by the protozoa Trypanosoma cruzi, is endemic in most Latin America countries and may be transmitted via blood transfusions. Cardiac disease is a major feature of chronically infected patients and may be lethal. Universal blood bank screening for ChD has been established in most Latin American countries, as well as in non-endemic countries with large immigrant populations, including the United States, Canada, Spain and Portugal. Blood donor screening leads to large numbers of new diagnoses of chronic T. cruzi infection. Counseling these individuals should address the recognition of those with more severe disease that deserve to be rigorously evaluated by experienced cardiologists and treated more promptly. The electrocardiogram is an important exam that can help in the recognition of cardiac disease and the evaluation of prognosis in ChD patients, but its role in blood donors has not been studied. The authors describe some electrocardiographic abnormalities that are typical of the infected blood donors, as well ECG abnormalities that help in the identification of those with severe cardiac involvement. These results may guide the evaluations of patients with incidentally detected T. cruzi infection from blood bank testing or public health screening.
Published: 2013

39. Differentiation of patients with leprosy from non-infected individuals by the chemokine eotaxin/CCL11

Author: Vanessa A, Mendonça, Luiz C, Malaquias, Gustavo E, Brito-Melo, Alexandre, Castelo-Branco, Carlos M, Antunes, Antonio L, Ribeiro, Mauro M, Teixeira, and Antonio L, Teixeira
Subjects: Chemokine CCL11, Chemokines, CC, Leprosy, Humans, False Positive Reactions, Sensitivity and Specificity, Chemokine CCL3
Abstract: Diagnosis of leprosy is usually made clinically and there are no tests available for the routine laboratory diagnosis of the disease. The aim of this study was to investigate the potential role of chemokines as biologic markers of disease activity. We used an enzyme-linked immunosorbent assay to measure chemokines in plasma of patients with leprosy (LE) and non-infected (NI) individuals. There were significantly greater concentrations of the chemokines CCL3 and CCL11 in plasma of LE patients than in NI individuals. When the use of CCL11 to differentiate LE patients versus NI individuals was evaluated, the area under the receiver-operator-characteristic curve was 0.95 +/- 0.03 (P0.0001). In a group of selected individuals, CCL11 was useful in diagnosis of leprosy, thereby suggesting that measurement of this chemokine may be useful as an aid in diagnosing leprosis.
Published: 2007

40. Declining antibody levels to Trypanosoma cruzi correlate with polymerase chain reaction positivity and electrocardiographic changes in a retrospective cohort of untreated Brazilian blood donors.

Author: Lewis F Buss, Léa Campos de Oliveira-da Silva, Carlos H V Moreira, Erika R Manuli, Flavia C Sales, Ingra Morales, Clara Di Germanio, Cesar de Almeida-Neto, Sonia Bakkour, Paul Constable, Marcelo M Pinto-Filho, Antonio L Ribeiro, Michael Busch, and Ester C Sabino
Subjects: Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract: BackgroundAlthough infection with Trypanosoma cruzi is thought to be lifelong, less than half of those infected develop cardiomyopathy, suggesting greater parasite control or even clearance. Antibody levels appear to correlate with T. cruzi (antigen) load. We test the association between a downwards antibody trajectory, PCR positivity and ECG alterations in untreated individuals with Chagas disease.Methodology/principal findingsThis is a retrospective cohort of T. cruzi seropositive blood donors. Paired blood samples (index donation and follow-up) were tested using the VITROS Immunodiagnostic Products Anti-T.cruzi (Chagas) assay (Ortho Clinical Diagnostics, Raritan NJ) and PCR performed on the follow-up sample. A 12-lead resting ECG was performed. Significant antibody decline was defined as a reduction of > 1 signal-to-cutoff (S/CO) unit on the VITROS assay. Follow-up S/CO of < 4 was defined as borderline/low. 276 untreated seropositive blood donors were included. The median (IQR) follow-up was 12.7 years (8.5-16.9). 56 (22.1%) subjects had a significant antibody decline and 35 (12.7%) had a low/borderline follow-up result. PCR positivity was lower in the falling (26.8% vs 52.8%, p = 0.001) and low/borderline (17.1% vs 51.9%, p < 0.001) antibody groups, as was the rate of ECG abnormalities. Falling and low/borderline antibody groups were predominantly composed of individuals with negative PCR and normal ECG findings: 64% and 71%, respectively.Conclusions/significanceLow and falling antibody levels define a phenotype of possible spontaneous parasite clearance.
Published: 2020
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41. Morbidity and prognostic factors in chronic chagasic cardiopathy

Author: Manoel Otávio C Rocha, Maria Carmo P Nunes, and Antonio L Ribeiro
Subjects: Chagas disease, prognosis, morbidity, heart failure, arrhythmias, Microbiology, QR1-502, Infectious and parasitic diseases, RC109-216
Abstract: Chagas disease is a pleomorphic clinical entity that has several unique features. The aim of this study is to summarise some of the recent contributions from our research group to knowledge of the morbidity and prognostic factors in Chagas heart disease. A retrospective study suggested that ischaemic stroke associated with left ventricular (LV) apical thrombi is the first clinical manifestation of Chagas disease observed in a large proportion of patients. LV function and left atrial volume (LAV) are independent risk factors for ischaemic cerebrovascular events during follow-up of Chagas heart disease patients. Pulmonary congestion in Chagas-related dilated cardiomyopathy is common but usually mild. Although early right ventricular (RV) involvement has been described, we have shown by Doppler echocardiography that RV dysfunction is evident almost exclusively when it is associated with left ventricle dilatation and functional impairment. In addition, RV dysfunction is a powerful predictor of survival in patients with heart failure secondary to Chagas disease. We have also demonstrated that LAV provides incremental prognostic information independent of clinical data and conventional echocardiographic parameters that predict survival.
Published: 2009
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42. Genome wide association study (GWAS) of Chagas cardiomyopathy in Trypanosoma cruzi seropositive subjects.

Author: Xutao Deng, Ester C Sabino, Edecio Cunha-Neto, Antonio L Ribeiro, Barbara Ianni, Charles Mady, Michael P Busch, Mark Seielstad, and REDSII Chagas Study Group from the NHLBI Retrovirus Epidemiology Donor Study-II Component International
Subjects: Medicine, Science
Abstract: BACKGROUND:Familial aggregation of Chagas cardiac disease in T. cruzi-infected persons suggests that human genetic variation may be an important determinant of disease progression. OBJECTIVE:To perform a GWAS using a well-characterized cohort to detect single nucleotide polymorphisms (SNPs) and genes associated with cardiac outcomes. METHODS:A retrospective cohort study was developed by the NHLBI REDS-II program in Brazil. Samples were collected from 499 T. cruzi seropositive blood donors who had donated between 1996 and 2002, and 101 patients with clinically diagnosed Chagas cardiomyopathy. In 2008-2010, all subjects underwent a complete medical examination. After genotype calling, quality control filtering with exclusion of 20 cases, and imputation of 1,000 genomes variants; association analysis was performed for 7 cardiac and parasite related traits, adjusting for population stratification. RESULTS:The cohort showed a wide range of African, European, and modest Native American admixture proportions, consistent with the recent history of Brazil. No SNPs were found to be highly (P
Published: 2013
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43. C-reactive protein and B-type natriuretic peptide yield either a non-significant or a modest incremental value to traditional risk factors in predicting long-term overall mortality in older adults.

Author: Alline M Beleigoli, Eric Boersma, Maria de Fátima H Diniz, Pedro G Vidigal, Maria Fernanda Lima-Costa, and Antonio L Ribeiro
Subjects: Medicine, Science
Abstract: BACKGROUND: New biomarkers may aid in preventive and end-of-life decisions in older adults if they enhance the prognostic ability of traditional risk factors. We investigated whether C-reactive protein (CRP) and/or B-type natriuretic peptide (BNP) improve the ability to predict overall mortality among the elderly of the Bambuí, Brazil Study of Aging when added to traditional risk factors. METHODS: From 1997 to 2007, 1,470 community-dwelling individuals (≥60 years) were followed-up. Death was ascertained by continuous verification of death certificates. We calculated hazard ratios per 1 standard deviation change (HR) of death for traditional risk factors only (old model), and traditional risk factors plus CRP and/or BNP (new models) and assessed calibration of the models. Subsequently, we compared c-statistic of each of the new models to the old one, and calculated integrated discriminative improvement (IDI) and net reclassification improvement (NRI). RESULTS: 544 (37.0%) participants died in a mean follow-up time of 9.0 years. CRP (HR 1.28, 95% CI 1.17-1.40), BNP (HR 1.31 95% CI 1.19-1.45), and CRP plus BNP (HR 1.26, 95% CI 1.15-1.38, and HR 1.29, 95% CI 1.16-1.42, respectively) were independent determinants of mortality. All models were well-calibrated. Discrimination was similar among the old (c-statistic 0.78 [0.78-0.81]) and new models (p=0.43 for CRP; p=0.57 for BNP; and p=0.31 for CRP plus BNP). Compared to the old model, CRP, BNP, and CRP plus BNP models led to an IDI of 0.009 (p
Published: 2013
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44. Overweight and class I obesity are associated with lower 10-year risk of mortality in Brazilian older adults: the Bambuí Cohort Study of Ageing.

Author: Alline M Beleigoli, Eric Boersma, Maria de Fátima H Diniz, Maria Fernanda Lima-Costa, and Antonio L Ribeiro
Subjects: Medicine, Science
Abstract: BACKGROUND: Prospective studies mostly with European and North-American populations have shown inconsistent results regarding the association of overweight/obesity and mortality in older adults. Our aim was to investigate the relationship between overweight/ obesity and mortality in an elderly Brazilian population. METHODS AND FINDINGS: Participants were 1,450 (90.2% from total) individuals aged 60 years and over from the community-based Bambuí (Brazil) Cohort Study of Ageing. From 1997 to 2007, 521 participants died and 89 were lost, leading to 12,905 person-years of observation. Body mass index (BMI) and waist circumference (WC) were assessed at baseline and at the 3rd and 5th years of follow-up. Multiple imputation was performed to deal with missing values. Hazard ratios (HR) of mortality for BMI or WC alone (continuous and categorical), and BMI and WC together (continuous) were estimated by extended Cox regression models, which were fitted for clinical, socioeconomic and behavioral confounders. Adjusted absolute rates of death at 10-year follow-up were estimated for the participants with complete data at baseline. Continuous BMI (HR 0.85; 95% CI 0.80-0.90) was inversely related to mortality, even after exclusion of smokers (HR 0.85; 0.80-0.90), and participants who had weight variation and died within the first 5 years of follow-up (HR 0.83; CI 95% 0.73-0.94). Overweight (BMI 25-30 kg/m(2)) was inversely (HR 0.76; 95%CI 0.61-0.93) and obesity (BMI ≥ 30 kg/m(2); HR 0.85; 95% CI 0.64-1.14) not significantly associated with mortality. Subjects with BMI between 25-35 kg/m(2) (23.8-25.9%) had the lowest absolute rates of death at 10-years follow-up. The association between WC and death was not significant, except after adjusting WC for BMI levels, when the relationship turned into marginally positive (HR 1.01; CI 95% 1.00-1.02). CONCLUSIONS: The usual BMI and WC cut-off points should not be used to guide public health and clinical weight control interventions in elderly in Brazil.
Published: 2012
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45. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015

Author: Lim, Stephen S, Allen, Kate, Bhutta, Zulfiqar A, Dandona, Lalit, Forouzanfar, Mohammad H, Fullman, Nancy, Gething, Peter W, Goldberg, Ellen M, Hay, Simon I, Holmberg, Mollie, Kinfu, Yohannes, Kutz, Michael J, Larson, Heidi J, Liang, Xiaofeng, Lopez, Alan D, Lozano, Rafael, McNellan, Claire R, Mokdad, Ali H, Mooney, Meghan D, Naghavi, Mohsen, Olsen, Helen E, Pigott, David M, Salomon, Joshua A, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulle, Abdishakur M, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen ME, Abyu, Gebre Yitayih, Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Afanvi, Kossivi Agbelenko, Afshin, Ashkan, Agarwal, Arnav, Agrawal, Anurag, Kiadaliri, Aliasghar Ahmad, Ahmadieh, Hamid, Ahmed, Kedir Yimam, Akanda, Ali Shafqat, Akinyemi, Rufus Olusola, Akinyemiju, Tomi F, Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Uzma, Alasfoor, Deena, AlBuhairan, Fadia S, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alemu, Zewdie Aderaw, Ali, Raghib, Alkerwi, Ala'a, Alkhateeb, Mohammad AB, Alla, Francois, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amegah, Adeladza Kofi, Amini, Heresh, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Benjamin O, Anderson, Gregory M, Antonio, Carl Abelardo T, Anwari, Palwasha, Arnlov, Johan, Artaman, Al, Asayesh, Hamid, Asghar, Rana Jawad, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barber, Ryan, Barker-Collo, Suzanne L, Barnighausen, Till, Barrero, Lope H, Barrientos-Gutierrez, Tonatiuh, Basu, Sanjay, Bayou, Tigist Assefa, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Beghi, Ettore, Bejot, Yannick, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Berhane, Adugnaw, Bernabe, Eduardo, Bernal, Oscar Alberto, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Bhala, Neeraj, Bhatt, Samir, Biadgilign, Sibhatu, Bienhoff, Kelly A, Bikbov, Boris, Binagwaho, Agnes, Bisanzio, Donal, Bjertness, Espen, Blore, Jed, Bourne, Rupert RA, Brainin, Michael, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas JK, Broday, David M, Brugha, Traolach S, Buchbinder, Rachelle, Butt, Zahid A, Cahill, Leah E, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Carabin, Helene, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel, Caso, Valeria, Castaneda-Orjuela, Carlos A, Castillo Rivas, Jacqueline, Catala-Lopez, Ferran, Cavalleri, Fiorella, Cecilio, Pedro, Chang, Hsing-Yi, Chang, Jung-Chen, Charlson, Fiona J, Che, Xuan, Chen, Alan Zian, Chiang, Peggy Pei-Chia, Chibalabala, Mirriam, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christensen, Hanne, Ciobanu, Liliana G, Cirillo, Massimo, Coates, Matthew M, Coggeshall, Megan, Cohen, Aaron J, Cooke, Graham S, Cooper, Cyrus, Cooper, Leslie Trumbull, Cowie, Benjamin C, Crump, John A, Damtew, Solomon Abrha, Dandona, Rakhi, Dargan, Paul I, das Neves, Jose, Davis, Adrian C, Davletov, Kairat, de Castro, E Filipa, De Leo, Diego, Degenhardt, Louisa, Del Gobbo, Liana C, Deribe, Kebede, Derrett, Sarah, Jarlais, Don C Des, Deshpande, Aniruddha, Deveber, Gabrielle A, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Ding, Eric L, Dorsey, E Ray, Doyle, Kerrie E, Driscoll, Tim R, Duan, Leilei, Dubey, Manisha, Duncan, Bruce Bartholow, Ebrahimi, Hedyeh, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Farid, Talha A, Sofia e Sa Farinha, Carla, Faro, Andre, Farvid, Maryam S, Farzadfar, Farshad, Feigin, Valery L, Mendonca Felicio, Manuela, Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G, Fernandes, Joao C, Ferrari, Alize J, Fischer, Florian, Fitchett, Joseph RA, Fitzmaurice, Christina, Foigt, Nataliya, Foreman, Kyle, Fowkes, F Gerry R, Franca, Elisabeth Barboza, Franklin, Richard C, Fraser, Maya, Friedman, Joseph, Frostad, Joseph, Furst, Thomas, Gabbe, Belinda, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebru, Alemseged Aregay, Gessner, Bradford D, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Giussani, Giorgia, Godwin, William, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Graetz, Nicholas, Greenwell, Karen Fern, Griswold, Max, Gugnani, Harish, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gutierrez, Reyna A, Gyawali, Bishal, Haagsma, Juanita A, Haakenstad, Annie, Hafezi-Nejad, Nima, Haile, Demewoz, Hailu, Gessessew Bugssa, Halasa, Yara A, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Hankey, Graeme J, Harb, Hilda L, Haro, Josep Maria, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmus, Heredia-Pi, Ileana Beatriz, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hoy, Damian G, Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Iburg, Kim Moesgaard, Idrisov, Bulat T, Inoue, Manami, Islami, Farhad, Jacobs, Troy A, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Jansen, Henrica AFM, Javanbakht, Mehdi, Jayaraman, Sudha P, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Ying, Jibat, Tariku, Jin, Ye, Jonas, Jost B, Kabir, Zubair, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Kandel, Amit, Karch, Andre, Karema, Corine Kakizi, Karimkhani, Chante, Karunapema, Palitha, Kasaeian, Amir, Kassebaum, Nicholas J, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khan, Gulfaraz, Khang, Young-Ho, Khoja, Tawfi K Ahmed Muthafer, Khosravi, Ardeshir, Khubchandani, Jagdish, Kieling, Christian, Kim, Cho-Il, Kim, Daniel, Kim, Sungroul, Kim, Yun Jin, Kimokoti, Ruth W, Kissoon, Niranjan, Kivipelto, Miia, Knibbs, Luke D, Kokubo, Yoshihiro, Kolte, Dhaval, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Krueger, Hans, Defo, Barthelemy Kuate, Kuchenbecker, Ricardo S, Kuipers, Ernst J, Kulikoff, Xie Rachel, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Kyu, Hmwe H, Lal, Aparna, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lan, Qing, Langan, Sinead M, Larsson, Anders, Laryea, Dennis Odai, Latif, Asma Abdul, Leasher, Janet L, Leigh, James, Leinsalu, Mall, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Lind, Margaret, Linn, Shai, Lipshultz, Steven E, Liu, Patrick Y, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Lo, Loon-Tzian, Logroscino, Giancarlo, Lotufo, Paulo A, Lucas, Robyn M, Lunevicius, Raimundas, Abd El Razek, Mohammed Magdy, Magis-Rodriguez, Carlos, Mahdavi, Mahdi, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mapoma, Chabila C, Margolis, David Joel, Martin, Randall V, Martinez-Raga, Jose, Masiye, Felix, Mason-Jones, Amanda J, Massano, Joao, Matzopoulos, Richard, Mayosi, Bongani M, McGrath, John J, Mckee, Martin, Meaney, Peter A, Mehari, Alem, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Mensink, Gert BM, Meretoja, Atte, Meretoja, Tuomo J, Mesfin, Yonatan Moges, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Mirarefi, Mojde, Misganaw, Awoke, Mitchell, Philip B, Mock, Charles N, Mohammadi, Alireza, Mohammed, Shafi U, Monasta, Lorenzo, De la Cruz Monis, Jonathan, Montanez Hernandez, Julio Cesar, Montico, Marcella, Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich O, Murdoch, Michele E, Murimira, Brighton, Murray, Joseph, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naidoo, Kovin S, Naldi, Luigi, Nangia, Vinay, Neal, Bruce, Nejjari, Chakib, Newton, Charles R, Newton, John N, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Nguyen, Quyen Le, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Nolte, Sandra, Nomura, Marika, Norheim, Ole F, Norrving, Bo, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Oladimeji, Olanrewaju, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Ota, Erika, Owolabi, Mayowa O, Mahesh, PA, Park, Eun-Kee, Park, Hye-Youn, Parry, Charles D, Parsaeian, Mahboubeh, Patel, Tejas, Patel, Vikram, Caicedo, Angel J Paternina, Patil, Snehal T, Patten, Scott B, Patton, George C, Paudel, Deepak, Pedro, Joao Mario, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frederic B, Pillay, Julian David, Pinho, Christine, Pishgar, Farhad, Polinder, Suzanne, Poulton, Richie G, Pourmalek, Farshad, Qorbani, Mostafa, Rabiee, Rynaz HS, Radfar, Amir, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajsic, Sasa, Raju, Murugesan, Ram, Usha, Rana, Saleem M, Ranabhat, Chhabi Lal, Ranganathan, Kavitha, Rao, Puja C, Refaat, Amany H, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L, Rios Blancas, Maria Jesus, Roba, Hirbo Shore, Roberts, Bayard, Rodriguez, Alina, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nobhojit, Sackey, Ben Benasco, Sagar, Rajesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Santos, Joao Vasco, Santomauro, Damian F, Santos, Itamar S, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Sawyer, Susan M, Schmidhuber, Josef, Schmidt, Maria Ines, Schneider, Ione JC, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya, Shaheen, Amira, Shaikh, Masood Ali, Levy, Teresa Shamah, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Sheth, Kevin N, Shey, Muki, Shi, Peilin, Shibuya, Kenji, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Silpakit, Naris, Santos Silva, Diego Augusto, Silverberg, Jonathan I, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Skirbekk, Vegard, Sligar, Amber, Soneji, Samir, Soreide, Kjetil, Sorensen, Reed JD, Soriano, Joan B, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stahl, Hans-Christian, Stanaway, Jeff rey D, Stathopoulou, Vasiliki, Steckling, Nadine, Steel, Nicholas, Stein, Dan J, Steiner, Caitlyn, Stockl, Heidi, Stranges, Saverio, Strong, Mark, Sun, Jiandong, Sunguya, Bruno F, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra EI, Tabares-Seisdedos, Rafael, Tabb, Karen M, Talongwa, Roberto Tchio, Tarawneh, Mohammed Rasoul, Tavakkoli, Mohammad, Taye, Bineyam, Taylor, Hugh R, Tedla, Bemnet Amare, Tefera, Worku, Tegegne, Teketo Kassaw, Tekle, Dejen Yemane, Shifa, Girma Temam, Terkawi, Abdullah Sulieman, Tessema, Gizachew Assefa, Thakur, JS, Thomson, Alan J, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Fotis, Tran, Bach Xuan, Truelsen, Thomas, Dimbuene, Zacharie Tsala, Tura, Abera Kenay, Tuzcu, Emin Murat, Tyrovolas, Stefanos, Ukwaja, Kingsley Nnanna, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Uthman, Olalekan A, van Donkelaar, Aaron, Varakin, Yuri Y, Vasankari, Tommi, Nogales Vasconcelos, Ana Maria, Veerman, J Lennert, Venketasubramanian, Narayanaswamy, Verma, Raj Kumar, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Volkow, Patricia, Vollset, Stein Emil, Wagner, Gregory R, Wallin, Mitchell T, Wang, Linhong, Wanga, Valentine, Watkins, David A, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Wiysonge, Charles Shey, Wolfe, Charles DA, Wolfe, Ingrid, Won, Sungho, Woolf, Anthony D, Workie, Shimelash Bitew, Wubshet, Mamo, Xu, Gelin, Yadav, Ajit Kumar, Yakob, Bereket, Yalew, Ayalnesh Zemene, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zambrana-Torrelio, Carlos, Zapata, Tomas, Zegeye, Elias Asfaw, Zhao, Yi, Zhou, Maigeng, Zodpey, Sanjay, Zonies, David, Murray, Christopher JL, Collaborators, GBD 2015 SDG, Stephen S., Lim, Kate, Allen, Zulfi 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A., Bourne, Michael, Brainin, Michael, Brauer, Alexandra, Brazinova, Nicholas J. 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A., Fitchett, Christina, Fitzmaurice, Nataliya, Foigt, Kyle, Foreman, F. 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S., Rabiee, Amir, Radfar, Vafa Rahimi, Movaghar, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rahman, Rajesh Kumar, Rai, Sasa, Rajsic, Murugesan, Raju, Usha, Ram, Saleem M., Rana, Chhabi Lal, Ranabhat, Kavitha, Ranganathan, Puja C., Rao, Amany H., Refaat, Marissa B., Reitsma, Giuseppe, Remuzzi, Serge, Resnikoff, Antonio L., Ribeiro, Maria Jesus Rios, Blanca, Hirbo Shore, Roba, Bayard, Robert, Alina, Rodriguez, David Rojas, Rueda, Luca, Ronfani, Gholamreza, Roshandel, Gregory A., Roth, Dietrich, Rothenbacher, Ambuj, Roy, Nobhojit, Roy, Ben Benasco, Sackey, Rajesh, Sagar, Muhammad Muhammad, Saleh, Juan R., Sanabria, Damian F., Santomauro, Itamar S., Santo, Rodrigo Sarmiento, Suarez, Benn, Sartoriu, Maheswar, Satpathy, Miloje, Savic, Monika, Sawhney, Susan M., Sawyer, Josef, Schmidhuber, Maria Inês, Schmidt, Ione J. C., Schneider, Aletta E., Schutte, David C., Schwebel, Soraya, Seedat, Sadaf G., Sepanlou, Edson E., Servan Mori, Katya, Shackelford, Amira, Shaheen, Masood Ali, Shaikh, Teresa Shamah, Levy, Rajesh, Sharma, Jun, She, Sara, Sheikhbahaei, Jiabin, Shen, Kevin N., Sheth, Muki, Shey, Peilin, Shi, Kenji, Shibuya, Mika, Shigematsu, Min Jeong, Shin, Rahman, Shiri, Kawkab, Shishani, Ivy, Shiue, Inga Dora, Sigfusdottir, Naris, Silpakit, Diego Augusto Santos, Silva, Jonathan I., Silverberg, Edgar P., Simard, Shireen, Sindi, Abhishek, Singh, Gitanjali M., Singh, Jasvinder A., Singh, Om Prakash, Singh, Prashant Kumar, Singh, Vegard, Skirbekk, Amber, Sligar, Samir, Soneji, Kjetil, Søreide, Reed J. 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A., Wolfe, Ingrid, Wolfe, Sungho, Won, Anthony D., Woolf, Shimelash Bitew, Workie, Mamo, Wubshet, Gelin, Xu, Ajit Kumar, Yadav, Bereket, Yakob, Ayalnesh Zemene, Yalew, Lijing L., Yan, Yuichiro, Yano, Mehdi, Yaseri, Pengpeng, Ye, Paul, Yip, Naohiro, Yonemoto, Seok Jun, Yoon, Mustafa Z., Youni, Chuanhua, Yu, Zoubida, Zaidi, Maysaa El Sayed, Zaki, Carlos Zambrana, Torrelio, Tomas, Zapata, Elias Asfaw, Zegeye, Yi, Zhao, Maigeng, Zhou, Sanjay, Zodpey, David, Zonie, Christopher J. L., Murray, Lim, Stephen S, Allen, Kate, Bhutta, Zulfiqar A, Dandona, Lalit, Forouzanfar, Mohammad H, Fullman, Nancy, Gething, Peter W, Goldberg, Ellen M, Hay, Simon I, Holmberg, Mollie, Kinfu, Yohanne, Kutz, Michael J, Larson, Heidi J, Liang, Xiaofeng, Lopez, Alan D, Lozano, Rafael, Mcnellan, Claire R, Mokdad, Ali H, Mooney, Meghan D, Naghavi, Mohsen, Olsen, Helen E, Pigott, David M, Salomon, Joshua A, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulle, Abdishakur M, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen M E, Abyu, Gebre Yitayih, Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Afanvi, Kossivi Agbelenko, Afshin, Ashkan, Agarwal, Arnav, Agrawal, Anurag, Kiadaliri, Aliasghar Ahmad, Ahmadieh, Hamid, Ahmed, Kedir Yimam, Akanda, Ali Shafqat, Akinyemi, Rufus Olusola, Akinyemiju, Tomi F, Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Uzma, Alasfoor, Deena, Albuhairan, Fadia S, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alemu, Zewdie Aderaw, Ali, Raghib, Alkerwi, Ala'A, Alkhateeb, Mohammad AB, Alla, Françoi, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Altirkawi, Khalid A, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amegah, Adeladza Kofi, Amini, Heresh, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Benjamin O, Anderson, Gregory M, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Artaman, Al, Asayesh, Hamid, Asghar, Rana Jawad, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barber, Ryan, Barker-Collo, Suzanne L, Bärnighausen, Till, Barrero, Lope H, Barrientos-Gutierrez, Tonatiuh, Basu, Sanjay, Bayou, Tigist Assefa, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Beghi, Ettore, Béjot, Yannick, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Berhane, Adugnaw, Bernabé, Eduardo, Bernal, Oscar Alberto, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Bhala, Neeraj, Bhatt, Samir, Biadgilign, Sibhatu, Bienhoff, Kelly A, Bikbov, Bori, Binagwaho, Agne, Bisanzio, Donal, Bjertness, Espen, Blore, Jed, Bourne, Rupert R A, Brainin, Michael, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Broday, David M, Brugha, Traolach S, Buchbinder, Rachelle, Butt, Zahid A, Cahill, Leah E, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Carabin, Hélène, Cárdenas, Rosario, Carrero, Juan Jesu, Carter, Austin, Casey, Daniel, Caso, Valeria, Castañeda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Catalá-López, Ferrán, Cavalleri, Fiorella, Cecílio, Pedro, Chang, Hsing-Yi, Chang, Jung-Chen, Charlson, Fiona J, Che, Xuan, Chen, Alan Zian, Chiang, Peggy Pei-Chia, Chibalabala, Mirriam, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christensen, Hanne, Ciobanu, Liliana G, Coates, Matthew M, Coggeshall, Megan, Cohen, Aaron J, Cooke, Graham S, Cooper, Cyru, Cooper, Leslie Trumbull, Cowie, Benjamin C, Crump, John A, Damtew, Solomon Abrha, Dandona, Rakhi, Dargan, Paul I, Neves, José da, Davis, Adrian C, Davletov, Kairat, de Castro, E Filipa, De Leo, Diego, Degenhardt, Louisa, Del Gobbo, Liana C, Deribe, Kebede, Derrett, Sarah, Des Jarlais, Don C, Deshpande, Aniruddha, Deveber, Gabrielle A, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Ding, Eric L, Dorsey, E Ray, Doyle, Kerrie E, Driscoll, Tim R, Duan, Leilei, Dubey, Manisha, Duncan, Bruce Bartholow, Ebrahimi, Hedyeh, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Farid, Talha A, Farinha, Carla Sofia e Sa, Faro, André, Farvid, Maryam S, Farzadfar, Farshad, Feigin, Valery L, Felicio, Manuela Mendonca, Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G, Fernandes, Joao C, Ferrari, Alize J, Fischer, Florian, Fitchett, Joseph R A, Fitzmaurice, Christina, Foigt, Nataliya, Foreman, Kyle, Fowkes, F Gerry R, Franca, Elisabeth Barboza, Franklin, Richard C, Fraser, Maya, Friedman, Joseph, Frostad, Joseph, Fürst, Thoma, Gabbe, Belinda, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebru, Alemseged Aregay, Gessner, Bradford D, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Godwin, William, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Graetz, Nichola, Greenwell, Karen Fern, Griswold, Max, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gutiérrez, Reyna A, Gyawali, Bishal, Haagsma, Juanita A, Haakenstad, Annie, Hafezi-Nejad, Nima, Haile, Demewoz, Hailu, Gessessew Bugssa, Halasa, Yara A, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Hankey, Graeme J, Harb, Hilda L, Haro, Josep Maria, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmu, Heredia-Pi, Ileana Beatriz, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hoy, Damian G, Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Iburg, Kim Moesgaard, Idrisov, Bulat T, Inoue, Manami, Islami, Farhad, Jacobs, Troy A, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Jansen, Henrica A F M, Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Ying, Jibat, Tariku, Jin, Ye, Jonas, Jost B, Kabir, Zubair, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Kandel, Amit, Karch, André, Karema, Corine Kakizi, Karimkhani, Chante, Karunapema, Palitha, Kasaeian, Amir, Kassebaum, Nicholas J, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Françoise, Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khan, Gulfaraz, Khang, Young-Ho, Khoja, Tawfik Ahmed Muthafer, Khosravi, Ardeshir, Khubchandani, Jagdish, Kieling, Christian, Kim, Cho-il, Kim, Daniel, Kim, Sungroul, Kim, Yun Jin, Kimokoti, Ruth W, Kissoon, Niranjan, Kivipelto, Miia, Knibbs, Luke D, Kokubo, Yoshihiro, Kolte, Dhaval, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Krueger, Han, Defo, Barthelemy Kuate, Kuchenbecker, Ricardo S, Kuipers, Ernst J, Kulikoff, Xie Rachel, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Kyu, Hmwe H, Lal, Aparna, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lan, Qing, Langan, Sinead M, Larsson, Ander, Laryea, Dennis Odai, Latif, Asma Abdul, Leasher, Janet L, Leigh, Jame, Leinsalu, Mall, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Lind, Margaret, Linn, Shai, Lipshultz, Steven E, Liu, Patrick Y, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Lo, Loon-Tzian, Logroscino, Giancarlo, Lotufo, Paulo A, Lucas, Robyn M, Lunevicius, Raimunda, El Razek, Mohammed Magdy Abd, Magis-Rodriguez, Carlo, Mahdavi, Mahdi, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mapoma, Chabila C, Margolis, David Joel, Martin, Randall V, Martinez-Raga, Jose, Masiye, Felix, Mason-Jones, Amanda J, Massano, João, Matzopoulos, Richard, Mayosi, Bongani M, Mcgrath, John J, Mckee, Martin, Meaney, Peter A, Mehari, Alem, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Mensink, Gert B M, Meretoja, Atte, Meretoja, Tuomo J, Mesfin, Yonatan Moge, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Mirarefin, Mojde, Misganaw, Awoke, Mitchell, Philip B, Mock, Charles N, Mohammadi, Alireza, Mohammed, Shafiu, Monasta, Lorenzo, de la Cruz Monis, Jonathan, Hernandez, Julio Cesar Montañez, Montico, Marcella, Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich O, Murdoch, Michele E, Murimira, Brighton, Murray, Joseph, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Sriniva, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naidoo, Kovin S, Naldi, Luigi, Nangia, Vinay, Neal, Bruce, Nejjari, Chakib, Newton, Charles R, Newton, John N, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Le Nguyen, Quyen, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Nolte, Sandra, Nomura, Marika, Norheim, Ole F, Norrving, Bo, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Oladimeji, Olanrewaju, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Ota, Erika, Owolabi, Mayowa O, Pa, Mahesh, Park, Eun-Kee, Park, Hye-Youn, Parry, Charles D, Parsaeian, Mahboubeh, Patel, Teja, Patel, Vikram, Caicedo, Angel J Paternina, Patil, Snehal T, Patten, Scott B, Patton, George C, Paudel, Deepak, Pedro, João Mário, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frédéric B, Pillay, Julian David, Pinho, Christine, Pishgar, Farhad, Polinder, Suzanne, Poulton, Richie G, Pourmalek, Farshad, Qorbani, Mostafa, Rabiee, Rynaz H S, Radfar, Amir, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajsic, Sasa, Raju, Murugesan, Ram, Usha, Rana, Saleem M, Ranabhat, Chhabi Lal, Ranganathan, Kavitha, Rao, Puja C, Refaat, Amany H, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L, Blancas, Maria Jesus Rio, Roba, Hirbo Shore, Roberts, Bayard, Rodriguez, Alina, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nobhojit, Sackey, Ben Benasco, Sagar, Rajesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Santomauro, Damian F, Santos, Itamar S, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Sawyer, Susan M, Schmidhuber, Josef, Schmidt, Maria Inê, Schneider, Ione J C, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya, Shaheen, Amira, Shaikh, Masood Ali, Levy, Teresa Shamah, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Sheth, Kevin N, Shey, Muki, Shi, Peilin, Shibuya, Kenji, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Silpakit, Nari, Silva, Diego Augusto Santo, Silverberg, Jonathan I, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Skirbekk, Vegard, Sligar, Amber, Soneji, Samir, Søreide, Kjetil, Sorensen, Reed J D, Soriano, Joan B, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stahl, Hans-Christian, Stanaway, Jeffrey D, Stathopoulou, Vasiliki, Steckling, Nadine, Steel, Nichola, Stein, Dan J, Steiner, Caitlyn, Stöckl, Heidi, Stranges, Saverio, Strong, Mark, Sun, Jiandong, Sunguya, Bruno F, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tabb, Karen M, Talongwa, Roberto Tchio, Tarawneh, Mohammed Rasoul, Tavakkoli, Mohammad, Taye, Bineyam, Taylor, Hugh R, Tedla, Bemnet Amare, Tefera, Worku, Tegegne, Teketo Kassaw, Tekle, Dejen Yemane, Shifa, Girma Temam, Terkawi, Abdullah Sulieman, Tessema, Gizachew Assefa, Thakur, J.S., Thomson, Alan J, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Tran, Bach Xuan, Dimbuene, Zacharie Tsala, Tura, Abera Kenay, Tuzcu, Emin Murat, Tyrovolas, Stefano, Ukwaja, Kingsley Nnanna, Undurraga, Eduardo A, Uneke, Chigozie Jesse, Uthman, Olalekan A, van Donkelaar, Aaron, Varakin, Yuri Y, Vasankari, Tommi, Vasconcelos, Ana Maria Nogale, Veerman, J Lennert, Venketasubramanian, Narayanaswamy, Verma, Raj Kumar, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Volkow, Patricia, Vollset, Stein Emil, Wagner, Gregory R, Wallin, Mitchell T, Wang, Linhong, Wanga, Valentine, Watkins, David A, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Wiysonge, Charles Shey, Wolfe, Charles D A, Wolfe, Ingrid, Won, Sungho, Woolf, Anthony D, Workie, Shimelash Bitew, Wubshet, Mamo, Xu, Gelin, Yadav, Ajit Kumar, Yakob, Bereket, Yalew, Ayalnesh Zemene, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, El Sayed Zaki, Maysaa, Zambrana-Torrelio, Carlo, Zapata, Toma, Zegeye, Elias Asfaw, Zhao, Yi, Zhou, Maigeng, Zodpey, Sanjay, Zonies, David, and Murray, Christopher J L
Subjects: Conservation of Natural Resources, spline regressions, Health Status, Global Health, Goal, Health Statu, Cost of Illness, Risk Factors, Universal Health Insurance, Quality-Adjusted Life Year, health-related SDG performance indicators, socio-demographic index, Health Status Indicators, Humans, Conservation of Natural Resource, Disabled Persons, Health Status Indicator, Medicine(all), Insurance, Health, Risk Factor, Medicine (all), Public Health, Global Health, Social Medicine and Epidemiology, Articles, Cost of Illne, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Disabled Person, Quality-Adjusted Life Years, Universal Coverage, Goals, Human
Abstract: Summary Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8–61·8) and varied widely by country, ranging from 85·5 (84·2–86·5) in Iceland to 20·4 (15·4–24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0·88) and the MDG index (r2=0·92), whereas the non-MDG index had a weaker relation with SDI (r2=0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0–10·4), and gains on the MDG index (a median change of 10·0 [6·7–13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1–8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs. Funding Bill & Melinda Gates Foundation.
Published: 2016

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