Jefferson Gomes Fernandes

Medical Association of São Paulo · Institute of Higher Education

Objective: To assist clinicians to make adequate interpretation of scientific evidence from studies that evaluate diagnostic tests in order to allow their rational use in clinical practice. Methods: This is a narrative review focused on the main concepts, study designs, the adequate interpretation of the diagnostic accuracy data, and making infe...

Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological...

Errata for corrected authorship, affiliations and funding statements.

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). ME...

Progress towards the Sustainable Development Goals.

The supplementary results offer additional results tables and figures, as well as more detailed methodological figures.

This methods appendix provides further methodological detail for the health-related Sustainable Development Goals (SDGs). The appendix is organized into broad sections following the structure of the main paper. The supplementary results offer additional results tables and figures, as well as more detailed methodological figures.

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in contex...

Background: Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Developmen...

Background: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2...

Background: Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Inj...

This is a duplicate entry.

This appendix provides methodological detail, supplemental figures, and more detailed results for disability‐adjusted life years and healthy life expectancy. The appendix is organized into broad sections following the structure of the main paper.

Supplementary appendix

Supplementary appendix.

Background: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generat...

Objective To systematically review the literature on the efficacy and/or safety of endovascular thrombectomy in AIS compared to standard treatment and to identify ongoing randomized controlled trials (RCTs). Method Searches for RCTs were performed in Medline/Embase, and for ongoing trials: International Clinical Trial Registry Platform, Clinicaltr...

BACKGROUND: Global stroke epidemiology is changing rapidly. Although age-standardized rates of stroke mortality have decreased worldwide in the past 2 decades, the absolute numbers of people who have a stroke every year, and live with the consequences of stroke or die from their stroke, are increasing. Regular updates on the current level of stroke...

BACKGROUND: Recent evidence suggests that stroke is increasing as a cause of morbidity and mortality in younger adults, where it carries particular significance for working individuals. Accurate and up-to-date estimates of stroke burden are important for planning stroke prevention and management in younger adults. OBJECTIVES: This study aims to est...

BACKGROUND: World mapping is an important tool to visualize stroke burden and its trends in various regions and countries. OBJECTIVES: To show geographic patterns of incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke and hemorrhagic stroke in the world...

BACKGROUND: Accurate information on stroke burden in men and women are important for evidence-based healthcare planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality rates were greater in men. However, sex differences i...

BACKGROUND: Accurate information on stroke burden in men and women are important for evidence-based healthcare planning and resource allocation. Previously, limited research suggested that the absolute number of deaths from stroke in women was greater than in men, but the incidence and mortality rates were greater in men. However, sex differences i...

BACKGROUND: There is increasing recognition of stroke as an important contributor to childhood morbidity and mortality. Current estimates of global childhood stroke burden and its temporal trends are sparse. Accurate and up-to-date estimates of childhood stroke burden are important for planning research and the resulting evidence-based strategies f...

Background: Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 18...

Background: Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess wh...

Intravenous immunoglobulins (IVIG) have been used for several licensed and off-label indications. Each IVIG product is a unique formulation of IgG and excipients, making them distinct products. How these differences impact on individual IVIG product efficacy and safety are not well established but can be investigated by head-to-head randomized cont...

Introduction: Stroke is a main cause of death in Brazil, and the first cause of permanent incapacitation. The Hospital Alemão Oswaldo Cruz (HAOC) has developed a telestroke program for the improvement of acute stroke care in public hospitals in association with the Ministry of Health through the Program for the Institutional Development of the Braz...

Introduction:Cerebrovascular diseases are among the leading causes of death in Brazil. According to DATASUS there was an increase of 32% in death for stroke from 2007 to 2013. In 2013, in São Paulo stroke was responsible for 21% of deaths. To provide the best care for people with stroke the Hospital Alemão Oswaldo Cruz created its Acute Stroke Unit...

Introduction: Cerebrovascular related diseases have been the main cause of death in the last few years for Brazilians. Nearly 100,000 people died in 2013, which is a 17% increase in relation to the previous year(1). The Telemedicine for stroke project was developed at Hospital Alem?o Oswaldo Cruz (São Paulo-SP) in conjunction with the Ministry of H...

Objectives: To evaluate the prevalence of stroke and its risk factors in a population of vulnerable communities of southern Brazil. Methods: Population-based crosssectional study with systematic sampling. Individuals aged 20 and over were included (n=3,391). Individuals with previous diagnosis of stroke or identified by a validate stroke questionn...

The second part of these Guidelines covers the topics of antiplatelet, anticoagulant, and statin therapy in acute ischemic stroke, reperfusion therapy, and classification of Stroke Centers. Information on the classes and levels of evidence used in this guideline is provided in Part I. A translated version of the Guidelines is available from the Bra...

Thirteen years after the New England Journal of Medicine published a pivotal study from the National Institute of Neurological Disorders and Stroke (NINDS),¹ neurologists universally recognize that the thrombolytic agent alteplase (recombinant tissue plasminogen activator, or rtPA) is well tolerated and effective for the treatment of acute ischemic...

Breast cancer (BC) is a major public health problem, with rising incidence in many regions of the globe. Although mortality has recently dropped in developed countries, death rates are still increasing in some developing countries, as seen in Brazil. Among the reasons for this phenomenon are the lack of structured screening programs, a long waiting...

The rapid evolution of telecommunication technology has enabled advances to be made in low cost video-conferencing through the improvement of high speed computer communication networks and the enhancement of Internet security protocols. As a result of this progress, eHealth education programs are becoming a reality in universities, providing the op...

Stroke is a major health problem in Latin American and Caribbean countries. In this paper, we review the epidemiology, aetiology, and management of stroke in the region based on a systematic search of articles published in Spanish, Portuguese, and English. Stroke mortality is higher than in developed countries but rates are declining. Population-ba...

Scales for the assessment of neurological impairment are employed in clinical trials, outcome evaluation and in therapeutic decisions. We evaluated the reliability of the Portuguese version of the Rankin Scale (RS), Barthel Index (BI) and the NIHSS (National Institute of Health Stroke Scale) in 51 stroke patients, estimating the agreement of the re...

Escalas de comprometimento neurológico são utilizadas na avaliação de novos tratamentos, no acompanhamento da evolução clínica e em decisões terapêuticas. Estudamos a confiabilidade de três escalas: a Escala de Rankin (ER), o Índice de Barthel (IB) e a National Institute of Health Stroke Scale (NIHSS) versadas em português, em 51 indivíduos com aci...

The Brazilian Stroke Society constituted a committee composed by specialists from different areas of Brazil that emitted a viewpoint called "National Opinion," considering the interventional procedures and thrombolysis in the treatment of the acute ischemic stroke. This study presents the conclusions of this committee.

Este artigo apresenta as conclusões sobre revascularização clínica e intervencionista no acidente vascular cerebral isquêmico agudo, um dos temas discutidos na reunião "Opinião Nacional sobre o Tratamento do AVC". Tratou-se de reunião promovida e coordenada pela Sociedade Brasileira de Doenças Cerebrovasculares, com neurologistas especializados em...

To assess the role of this procedure to prevent hemorrhage in cerebral arteriovenous malformations (cAVM). Between 1992 and 2000, we studied 104 patients submitted to embolization as the main treatment. Patients were followed until hemorrhage or death. Follow-up ranged from 1.6 months to 8 years. The most frequent presentations were hemorrhage (50%...

OBJETIVO: Avaliar a existência de associação independente entre a presença de efeito de contraste espontâneo na aorta e eventos isquêmicos encefálicos recentes. MÉTODOS: Estudados com ecocardiograma transesofágico 224 indivíduos com diagnóstico de eventos isquêmicos encefálicos recente 5 e 85 controles que realizaram o exame por diversas doenças ca...

To assess the independent association between the presence of spontaneous echo contrast in the aorta and recent stroke events. Two hundred and twenty-four individuals with a diagnosis of recent stroke and 85 control individuals who were examined due to various present/suspected heart diseases were studied through transesophageal echocardiography. T...

One third of cases of cerebral ischemia have no clear etiology. A humoral response to the atherosclerotic plaques components beta2-glycoprotein l (beta2-gpl) and heat-shock proteins (Hsp) might be involved in the pathogenesis of stroke. This case-control study includes a complete profile of anti-beta2-gpl antibodies and testing of IgG antibodies to...

This consensus is the result of a recent meeting to establish the ideal approach for thrombolysis in acute stroke patients in Brazil. Some peculiarities concerning the emergency rooms, stroke units, available equipments and stroke teams are considered in order to characterize the stroke centers. Protocols concerning the use of thrombolytic drugs ar...

The cerebrovascular diseases have a high incidence, and they cause an enormous social and economic burden. With the increasing knowledge of the pathophysiology of the ischemic insult, and the possibility of the thrombolysis in the acute phase, the management of the stroke patients is considered an emergency. This consensus is the result of a recent...

Psychiatric morbidity studies in developing countries have used diagnostic procedures of low reliability, without a clinical definition of caseness, producing descriptive data with limited application for mental health planning. A two-stage cross-sectional design (with a sample size of 6476) was conducted to estimate the prevalence of DSM-III psych...

Alcohol abuse is one of the most serious problems in public health and the Wernicke-Korsakoff syndrome is one of the gravest consequences of alcoholism. The pathology is often undiagnosed in its less evident presentations, therefore an accurate diagnostic approach is a critical step in treatment planning. Treatment is based on restoration of thiami...

Alcohol abuse is one of most serious problems in public health and the Wernicke-Korsakoff syndrome one of the gravest consequences of alcoholism. The pathology is often undiagnosed in its less evident presentations, therefore an accurate diagnostic approach is a critical step in planning treatment. Besides new pharmacological proposals, treatment i...

O abuso de álcool é um dos mais sérios problemas de saúde pública e a síndrome de Wernicke-Korsakoff é uma das mais graves conseqüências do alcoolismo. Esta patologia é infreqüentemente diagnosticada nas suas apresentações menos evidentes, razão pela qual uma abordagem diagnóstica apropriada é importante passo para seu tratamento. Entre as novas pr...

Principal Components Analysis is a multivariate statistical technique for the purpose of examining the interdependence among variables. The main characteristic of this technique is the ability to reduce data, and it is currently used as an adjunct for the development of psychiatric research tools and the classification of psychiatric disorders. It...

A análise de componentes principais é uma técnica de estatística multivariada utilizada para examinar a interdependência entre variáveis. A sua principal característica é a capacidade de reduzir dados, e tem sido usada para o desenvolvimento de instrumentos de pesquisas psiquiátricas e na classificação dos transtornos psiquiátricos. Esta técnica fo...

From 16 to 18 days of fetal life (fl) the subfornical organ (SFO) of the rat shows diffuse acetylcholinesterase (AChE) activity. From 21 fl its definitive pattern begins to be organized and is achieved at 30 days of postnatal life (pl). This pattern is characterized by a homogeneous AChE activity in the rostral region, a ring-like distribution in t...

The daily intraperitoneal injection to rats of doses of metrazol (30 mg/Kg), strychnin sulfate (1 mg/Kg) or picrotoxin (1.2 mg/Kg) that were initially subconvulsant, caused after a number of days which varied with the drug, clonic convulsions in a high percentage of the animals. However, after 18 daily injections of saline there was a similar incre...