Basilio de Braganca Pereira

Federal University of Rio de Janeiro | UFRJ · Faculty of Medicine and COPPE

Background Risk stratification is an important step in perioperative evaluation. However, the main risk scores do not incorporate biomarkers in their set of variables. Objective Evaluate the incremental power of troponin to the usual risk stratification Methods A total of 2,230 patients admitted to the intensive care unit after non-cardiac surgery...

Background: Risk stratification is an important step in perioperative evaluation. However, the main risk scores do not incorporate biomarkers in their set of variables. Objective: Evaluate the incremental power of troponin to the usual risk stratification. Methods: A total of 2,230 patients admitted to the intensive care unit after non-cardiac...

Context Both the aging of the population and the increase in noncommunicable diseases may influence the progression and outcomes culminating in death, changing the evolution of ischemic heart diseases (IHDs) and their associated causes. Using the multiple causes of death method could help understand the magnitude of these relationships and enable b...

Background Sudden cardiac death (SCD) risk markers are needed in Chagas cardiomyopathy (CC). Action potential duration restitution (APDR) dynamics is capable of extracting information on cardiac regional heterogeneity. This study intends to develop a patient‐specific variables‐based algorithm to predict SCD in the low‐intermediate subgroups of the...

Objective: To study the impact of the change in the values of the Framingham equation base in the risk prediction of 3 patients (low, medium and high risk). Methods: Use of sensitivity analysis to study the impact of this phenomenon on the change of the values of the Framinghan equation base in the risk prediction of 3 hypothetical patients (low, m...

Context Both the aging of the population and the increase in noncommunicable diseases may influence the progression and outcomes culminating in death, changing the evolution of ischemic heart diseases (IHDs) and their associated causes. Thus, it is essential to understand the process of death from IHD, the diseases associated with IHD, and the dise...

Myocardial injury after noncardiac surgery (MINS) increases mortality within 30 days. We aimed to evaluate the long-term impact of myocardial injury in a large cohort of patients admitted to intensive care after noncardiac surgery. All patients who stayed, at least, overnight with measurement of high-sensitive cardiac troponin were included. Clinic...

Background Myocardial injury is a known complication of COVID-19 and is related to a worse prognosis on admission. However, its impact on 1-year mortality is unknown. Methods Retrospective cohort study with patients admitted to intensive care and confirmed diagnosis of COVID-19 by RT-PCR and with at least one measurement of troponin during hospita...

Background Perioperative Myocardial injury that occurs after non-cardiac surgery (MINS) is prevalent and increases mortality in 30 days. However, few studies have assessed the impact of cardiovascular risk and MINS in long-term mortality. Methods Retrospective study including all non-cardiac surgery patients admitted to a postoperative care unit w...

Background: In Chronic Chagas Cardiomyopathy (CCC), studies are needed to identify arrhythmogenic risk factors in patients in which moderate to severe ventricular dysfunction is not present. Objective: To verify the correlation between frequent ventricular arrhythmias (PVC), left ventricular ejection fraction (LVEF), extension of fibrosis by car...

Background: Some studies have shown a higher prevalence of deaths in patients with cardiovascular risk factors (CRF) during hospitalization for COVID-19. Objectives: To assess the impact of high cardiovascular risk in patients hospitalized in intensive care for COVID-19 Methods: Retrospective study with patients admitted to an intensive care un...

Background: The prognostic importance of the classification 'heart failure (HF) with mid-range ejection fraction (EF)' remains uncertain. Objective: To analyze the clinical characteristics, comorbidities, complications, and in-hospital and late mortality of patients classified as having HF with mid-range EF (HFmrEF - EF: 40%-49%), and to compare...

There is a growing need to improve end-of-life care in cancer patients and to evaluate it through questionnaires is an important tool to assess its results. The aim of this study was to evaluate the effect of the palliative care in the quality of life, distressing symptoms and functional capacity of patients with primary lung cancer with locally ad...

Background: Myocardial injury that occurs after non-cardiac surgery (MINS) increases mortality in 30 days. However, few studies have assessed the impact of MINS occurrence on long-term mortality. Methods: Retrospective study including all non-cardiac surgery patients admitted to an postoperative care unit who stayed at least one night in this unit...

Background Some studies have shown a higher prevalence of deaths in patients with cardiovascular risk factors (CRF) during hospitalization for COVID-19. The impact of high cardiovascular risk on hospital mortality has not been evaluated. Methods Retrospective study with patients admitted to intensive care and confirmed diagnosis of COVID-19 by RT-...

Background Describe echocardiographic characteristics in patients admitted to an intensive care unit by COVID-19 and identify clinical and laboratory findings associated with an abnormal echocardiogram and its association with in-hospital mortality. Methods Included all patients with RT-PCR-confirmed COVID-19 who underwent echocardiography during...

Background Early identification of patients with infective endocarditis (IE) at higher risk for in-hospital mortality is essential to guide management and improve prognosis. Methods Retrospective analysis of a cohort of patients followed up from 1978 to 2015, classified according to the modified Duke criteria. Clinical parameters, echocardiographi...

In December of 2019, a new coronavirus was discovered in the city of Wuhan, China. The World Health Organization officially named this coronavirus as COVID-19. Since its discovery, the virus has spread rapidly around the world and is currently one of the main health problems, causing an enormous social and economic burden. Due to this, there is a g...

Although Model for End-Stage Liver Disease (MELD) score is adopted worldwide for liver transplant allocation, but it has prognostic limitations. The aim of this study was to apply the survival tree analysis to evaluate interaction between variables related to mortality in cirrhotics patients enlisted for liver transplantation, and to develop a new...

Introduction In 2016, the European Society of Cardiology published a new concept of heart failure (HF) inbetween HF with reduced ejection fraction (EF) (HFrEF; EF<40%) and HF with preserved EF (HFpEF; EF>50%), the HF with mid-range EF (HFmrEF; EF between 40% and 49%). There are few studies evaluating its distinct clinical characteristics, especiall...

Purpose. We aimed to identify prognostic factors for survival and recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) for patients with HCC and hepatitis C virus-related cirrhosis (HCV-cirrhosis). Methods. This retrospective cohort study followed all adult patients with HCV-cirrhosis who underwent LT because of HCC or had...

Statistical Learning using Neural Networks: A Guide for Statisticians and Data Scientists with Python introduces artificial neural networks starting from the basics and increasingly demanding more effort from readers, who can learn the theory and its applications in statistical methods with concrete Python code examples. It presents a wide range of...

Este artigo modela a variabilidade da inflação por meio de passeio aleatório paramétrico, utilizando um modelo autorregressivo integrado generalizado, condicionalmente heterocedástico. O gráfico de variância mostra o efeito de 5 (cinco) planos de estabilização no Brasil, que consistiam principalmente em controle de preços e de depósitos em bancos,...

Identificar e descrever padrões sazonais de nascimento por parto normal e cesariana no Estado do Rio de Janeiro, no período de 01 de janeiro de 1994 a 31 de dezembro de 2005. Estudo de séries temporais com base de dados de nascimentos do Estado do Rio de Janeiro, obtidos do Sistema de Informação sobre Nascidos Vivos (SINASC), constituída por 1.535....

O modelo de riscos competitivos envolve situações nas quais um indivíduo pode sofrer mais do que um tipo de evento de interesse. O uso de metodos padrão de análise de sobrevivência, tais como o estimador de Kaplan-Meier e modelos de riscos proporcionais de Cox, para descrever os dados de riscos competitivos pode conduzir a estimativas enviesadas. N...

Introduction Recurrent syncope takes a serious toll on quality of life, being compared to chronic diseases, particularly on the elderly. Objectives Identify recurrence predictors in patients treated attended at syncope units (SU). Method Study involving patients attended at SUs in the emergency care units of 11 hospitals over the period from May...

Background: Heart failure (HF) is a multifactorial syndrome with repercussions on quality of life (QoL). Objectives: To investigate the main interacting factors responsible to worsen quality of life of outpatients with HF. Methods: Cross-sectional observational study with 99 patients of both genders, attending a HF outpatient clinic at a unive...

The clinical picture of patients with sickle cell anemia (SCA) is associated with several complications some of which could be fatal. The objective of this study is to analyze the causes of death and the effect of sex and age on survival of Brazilian patients with SCA. Data of patients with SCA who were seen and followed at HEMORIO for 15 years wer...

This paper proposes a stochastic shortest path approach to find an optimal sequence of tests to confirm or discard a disease, for any prescribed optimality criterion. The idea is to select the best sequence in which to apply a series of available tests, with a view at reaching a diagnosis with minimum expenditure of resources. The proposed approach...

Conference for the Position of Titular Professor - published in Encyclopedia of Biostatistics Wiley

RESUMO: Testes para famílias separadas de hipóteses foram inicialmente considerados por Cox (1961, 1962). Neste artigo, examinamos o teste de signi�cância totalmente Bayesiano, o FBST, para discriminar entre os modelos lognormal e Weibull cujas famílias de distribuições são separadas. Aqui, o problema é abordado num contexto de mistura linear dos m...

Background: It has been difficult to prove that the "catecholamine-induced cardiomyopathy" contributes to the mechanism of sudden cardiac death in Chagas heart disease. Also, it is almost impossible to rule out the possibility that is not involved in the process. More importantly, the vagal-cholinergic pathway in the ventricle plays a direct role...

Background: Cardiovascular disease is the main cause of morbidity and mortality in the world and oxidative stress has been implicated in the pathogenesis. Cardiac rehabilitation in patients with coronary artery disease submitted to coronary artery bypass grafting may prevent cardiovascular events probably through the attenuation of oxidative stress...

Background: Anaerobic threshold (AT) is recognized as objective and direct measurement that reflects variations in metabolism of skeletal muscles during exercise. Its prognostic value in heart diseases of non-chagasic etiology is well established. However, the assessment of risk of death in Chagas heart disease is relatively well established by Ra...

Introduction The anaerobic threshold (AT) is an objective and direct measurement that reflects variations in metabolism of skeletal muscles during exercise. Its prognostic value in heart disease of non-Chagas etiology is well established. The risk of mortality in Chagas cardiomyopathy is relatively well assessed by the Rassi score. However, the add...

Introduction: Nutritional status has been implicated in the modulation of the immune response, possibly augmenting the pathogenesis of Chagas disease (Cd). We evaluated diet quality and nutritional status in adults and elderly patients with chronic Cd in a tertiary hospital. Methods: A case-control study of Cd patients was conducted, paired for...

Tests of separate families of hypotheses were initially considered by Cox (1961,1962) In this work, the Fully Bayesian Significance Test, FBST, is evaluated for discriminating between the lognormal, gamma and Weibull models whose families of distributions are separate. Considering a linear mixture model including all candidate distributions, the FB...

An evaluation of FBST, Fully Bayesian Significance Test, restricted to survival models is the main objective of the present paper. A Survival distribution should be chosen among the tree celebrated ones, lognormal, gamma, and Weibull. For this discrimination, a linear mixture of the three distributions, for which the mixture weights are defined by...

Background Major Depressive Disorder (MDD) is one of the most common mental illnesses in psychiatry, being considered a risk factor for Acute Coronary Syndrome (ACS). Objective To assess the prevalence of MDD in ACS patients, as well as to analyze associated factors through the interdependence of sociodemographic, lifestyle and clinical variables....

Patients with intermediate probability of coronary disease are a diagnostic challenge and it is precisely in this population where the degree of uncertainty is greater that the diagnostic tests have their greater applicability. However, according to the current definition, subjecting to tests a population with a disease probability between 10 and 9...

This chapter presents frequentist statistical methods. Hypothesis tests, namely, the Cox test and alternatives, are described. An interpretation of the test results is provided. Applications to the exponential , gamma , Weibull , and lognormal distributions are presented. Misspecification and the efficiencies of false regression models are studied....

This chapter addresses the pure likelihood approach to model choice . The concepts of normalized , adjusted , relative , and profile likelihood are introduced. A relative likelihood approach for discriminating separate models is presented using an example. The concepts of computer simulations , the Monte Carlo method, Monte Carlo simulations , and...

In this chapter, the model choice problem is stated, and applications in several areas are presented. The definition of separate or nonnested models is given. The alternative approaches proposed by Cox (1961, 1962) for choosing among such models are presented. General references to the subject are mentioned, as are areas not covered in this book, n...

Bayesian methods of model discrimination are discussed in this chapter. Alternative Bayes factors are presented for when improper priors are used and the usual Bayes factor cannot be specified. The concepts of imaginary training sample and minimal training samples and of partial , fractional , intrinsic and posterior Bayes factors are defined. Appl...

This book discusses the problem of model choice when the statistical models are separate, also called nonnested. Chapter 1 provides an introduction, motivating examples and a general overview of the problem. Chapter 2 presents the classical or frequentist approach to the problem as well as several alternative procedures and their properties. Chapte...

Objectives: Molecular tests show low sensitivity for smear-negative pulmonary tuberculosis (PTB). A screening and risk assessment system for smear-negative PTB using artificial neural networks (ANNs) based on patient signs and symptoms is proposed. Methods: The prognostic and risk assessment models exploit a multilayer perceptron (MLP) and inspired...

Despite medical advances, mortality due to acute coronary syndrome remains high. For this reason, it is important to identify the most critical factors for predicting the risk of death in patients hospitalized with this disease. To improve medical decisions, it is also helpful to construct models that enable us to represent how the main driving fac...

This book discusses the problem of model choice when the statistical models are separate, also called nonnested. Chapter 1 provides an introduction, motivating examples and a general overview of the problem. Chapter 2 presents the classical or frequentist approach to the problem as well as several alternative procedures and their properties. Chapte...

Background: Familial amyloidotic polyneuropathy (FAP) is a rare disease diagnosed in Brazil and worldwide. The frequency of cardiovascular involvement in Brazilian FAP patients is unknown. Objective: Detect the frequency of cardiovascular involvement and correlate the cardiovascular findings with the modified polyneuropathy disability (PND) scor...

Objective: To determine the frequency of episodes of laryngeal penetration and aspiration in chronic Chagas patients and to evaluate the interpreted relationship not only with the patterns displayed in videofluoroscopy and manometry, but also with clinical screening and structural and functional phonoaudiological evaluation. Method: Clinical and ph...

Objective: To determine the frequency of episodes of laryngeal penetration and aspiration in chronic Chagas patients and to evaluate the interpreted relationship not only with the patterns displayed in videofluoroscopy and manometry, but also with clinical screening and structural and functional phonoaudiological evaluation. Method: Clinical and ph...

Background: Cardiac magnetic resonance imaging provides detailed anatomical information on infarction. However, few studies have investigated the association of these data with mortality after acute myocardial infarction. Objective: To study the association between data regarding infarct size and anatomy, as obtained from cardiac magnetic resonanc...

Patients with chronic Chagas disease have a higher prevalence of premature ventricular contraction (PVC) because of immunoinflammatory response magnified by the increased oxidative stress. Thus, the sequential treatment with benznidazole (BZN) and antioxidants can reduce the prevalence of PVC. We wish to establish whether the etiological treatment...

Background: End-stage kidney disease patients continue to have markedly increased cardiovascular disease morbidity and mortality. Analysis of genetic factors connected with the renin-angiotensin system that influences the survival of the patients with end-stage kidney disease supports the ongoing search for improved outcomes. Objective: To assess...

Background: Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. Objective: To quantify fibrosis by using late gadolinium enhancement CMR in patient...

Introduction: The Val30Met transthyretin-related familial amyloidotic polyneuropathy (ATTR) is the most common of the hereditary amyloidosis, Mainly with the neurological phenotypical presentation. It is Believed que the prevalence of its cardiovascular manifestations may be underestimated in Brazil Methods.: Echocardiographic studies Were Performe...

The suppression of erythropoiesis by Hydroxyurea (HU) therapy is associated with increase in mean corpuscular volume, in addition to the increase in Hb F. Monitoring the mean corpuscular volume values and the presence of macrocytosis are effective tools of adherence to the treatment with HU in patients with sickle cell anemia. The aim of this study...

The prognostic importance of tight clinic blood pressure (BP) control is controversial in diabetic patients. The objective was to investigate the prognostic impact of clinic and ambulatory BPs for cardiovascular morbidity and mortality in type 2 diabetes. In a prospective cohort study, 565 type 2 diabetic patients had clinical, laboratory and ambul...

Background: Poststroke depression (PSD) is the most common neuropsychiatric consequence of stroke. A large number of studies have focused on the pathogenesis of PSD, but only a few aimed to characterize its psychopathology; these studies yielded results that are difficult to compare because of the different methods utilized. The current study aime...

Resumo Fundamentos: A letalidade dos pacientes em hemodiálise (HD) é alta. Apenas os fatores de risco cardiovascular tradicionais não são capazes de explicar essa elevada taxa. Objetivo: Avaliar a sobrevida e sua associação com o polimorfismo dos genes do sistema renina-angiotensina (SRA): inserção/deleção da ECA e o M235T do angiotensinogênio em p...

Background: Sudden death is the leading cause of death in Chagas' disease, affecting patients even in the early stages of the disease. The impairment of the autonomic nervous system in this disease has been recognized, as well as its potential as a trigger for malignant arrhythmias when associated with structural or metabolic changes. Objective:...

MELD score is a formula based on laboratory variables used as a predictor of short-term mortality index in cirrhotic patients. It is applied to allocate patients in liver transplantation waiting list in many countries. However, MELD score cutoff point accuracy to predict long term mortality has not been statistically evaluated. The aim of this stud...

The indeterminate form of Chagas disease represents the most common chronic presentation. The aim of this study was to assess cardiovascular autonomic system function with I-123 metaiodobenzylguanidine (MIBG) scintigraphy in chagasic patients with normal or "borderline" electrocardiographic alterations and preserved left ventricular function evalua...

This study used dynamic linear models to analyze the dynamics of tuberculosis (TB) mortality in São Paulo State, Brazil. The study confirms previous findings of a decline in TB mortality in State in the last decade, while pointing to an increase in deaths beginning in 2005. Analysis of the two most frequent underlying causes pointed to HIV/TB co-in...

The aim of this study is to describe the distribution of the platelet blood group A antigenicity in Euro-Brazilians (EUBs) and Afro-Brazilians (AFBs). A small but significant proportion of individuals express high levels of A or B antigen on their platelets corresponding to the erythrocyte ABO group. The mechanism of increased antigen expression ha...

Sudden death is the major cause of death among chagasic patients. A significant number of fatal events in patients without apparent heart disease and borderline electrocardiogram, but with contractile ventricular dysfunction, have been documented. This work aimed to determine the association between regional dysfunction and the presence of ventricu...

In order to demonstrate how DEA modeling can be helpful to aid decision making relative to the Brazilian Teaching Hospital Policy by means of hospital performance assessment, we develop a case study with 30 general hospitals linked to Brazilian Federal Universities. We consider data on medical care (Medical Model—MM), teaching and research (Teachin...

The paper proposes the use of Kohonen's Self Organizing Map (SOM), and supervised neural networks to find clusters in samples of gamma-ray burst (GRB) using the measurements given in BATSE GRB. The extent of separation between clusters obtained by SOM was examined by cross val-idation procedure using supervised neural networks for classification. A...

Many studies have shown the consequent gustatory alteration caused by ear surgeries. However, few have reported this alteration in patients with chronic otitis media (COM), prior to surgical treatment. to identify gustatory alterations due to chorda tympani nerve involvement in patients with COM without prior surgery. Clinical essay, with tests bas...

Background and Objective: The survival-agreement plot was proposed and improved to assess the reliability of a quantitative measure. We propose the use of survival analysis as an alternative non-parametric approach for comparison of ordinal qualitative data. Study Design and Setting: Two case studies were presented. The first one is related to a ra...

OBJETIVO: O presente estudo comparou a eficácia do tratamento da síndrome do olho seco em pacientes infectados pelo HIV com suplementação lacrimal (carboximetilcelulose sódica 0,5%) ou com suplementação lacrimal associada à terapia anti-inflamatória (carboximetilcelulose sódica 0,5% e ciclosporina 0,05%). MÉTODOS: Vinte pacientes portadores do víru...

Purpose: This study evaluates the use of topical cyclosporine 0.05% and sodium carboxymethylcellulose 0.5% for the treatment of dry eye disease in patients infected with the human immunodeficiency virus. Methods: Twenty HIV-positive-patients were selected from the Department of Infectious Diseases of the Federal University of Rio de Janeiro Hospita...

This paper aims to describe and discuss a minimization procedure specifically designed for a clinical trial that evaluates treatment efficacy for OCD patients. Aitchison's compositional distance was used to calculate vectors for each possibility of allocation in a covariate adaptive method. Two different procedures were designed to allocate patient...

OBJETIVO: Avaliar o efeito clínico e topográfico da reticulação do colágeno corneano (crosslinking) em pacientes com ceratocone pertencentes à população brasileira. MÉTODOS: Trinta e sete olhos de 37 pacientes (22 mulheres e 15 homens) com diagnóstico de ceratocone em progressão e com espessura mínima de 395 micra, foram submetidos à técnica de ind...

PURPOSE: Assess the clinical and topographical effects of corneal collagen crosslinking in patients with keratoconus on Brazilian population. METHODS: Thirty seven eyes of 37 patients (22 female and 15 male) with diagnosis of progressive keratoconus and corneal paquimetry higher than 395 micra, were treated with riboflavin and ultraviolet A radiati...

In controlled clinical trials, each of several prognostic factors should be balanced across the trial arms. Traditional restricted randomization may be proved inadequate especially with small sample sizes. In psychiatric disorders such as obsessive compulsive disorder (OCD), small trials prevail. Therefore, procedures to minimize the chance of imba...

Although asbestos causes asbestosis, lung cancer, and mesothelioma, it remains widely used in Brazil, mostly in cement-fiber products. We report the Brazilian mesothelioma mortality trend 1980-2003, using records of the national System of Mortality Information of DATASUS, including all deaths with IX International Disease Classification (ICD9) code...

Our aim was to determine the frequencies of the angiotensin-converting enzyme (ACE) gene alleles D and I and any associations to cardiovascular risk factors in a population sample from Rio de Janeiro, Brazil. Eighty-four adults were selected consecutively during a 6-month period from a cohort subgroup of a previous large cross-sectional survey in R...

OBJETIVO: Avaliar a prevalência de doença arterial coronariana (DAC) na valvopatia de etiologia reumática e não-reumática, examinando possíveis fatores preditivos da presença da doença. MÉTODOS: Estudo transversal, de série de casos obtidos em população pré-definida. Foram avaliados 1.412 pacientes com indicação de cirurgia cardíaca por qualquer et...