ORCID Profile
0000-0002-2343-9097
Current Organisations
Universidade de São Paulo
,
Centro Hospitalar Lisboa Norte
,
Universidade de São Paulo Escola Politécnica
,
EGT Engenharia
,
Instituto de Medicina Molecular
,
Universidade de Lisboa Faculdade de Medicina
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Publisher: FapUNIFESP (SciELO)
Date: 10-2014
DOI: 10.1590/S1983-41952014000500002
Abstract: This paper presents an investigation on the safety of structural elements submitted to pure bending, produced in reinforced concrete, in steel and steel-concrete composites, and designed according to Brazilian codes NBR8681:2003, NBR6118:2007 and NBR8800:2008. The study allows a comparison of the relative safety of beams produced with these materials and designed using these codes. Comparative studies between the performances of different materials are difficult to find in the published literature. The present study shows that reliability indexes for reinforced concrete beams are satisfactory however, results for steel beams are below limit values established in international design standards. Reliability indexes found herein for steel-concrete composite beams are intermediate to concrete and steel beams.
Publisher: Wiley
Date: 06-09-2010
Publisher: Massachusetts Medical Society
Date: 16-05-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2022
DOI: 10.1161/STROKEAHA.122.039575
Abstract: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0–2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94–194). Two patients died during follow-up (3% [95% CI, 1%–11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%–94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up.
Publisher: SAGE Publications
Date: 05-2007
DOI: 10.1111/J.1747-4949.2007.00111.X
Abstract: Epidemiological studies suggest that raised plasma concentrations of total homocysteine (tHcy) may be a common, causal and treatable risk factor for atherothromboembolic ischaemic stroke, dementia and depression. Although tHcy can be lowered effectively with small doses of folic acid, vitamin B 12 and vitamin B 6 , it is not known whether lowering tHcy, by means of B vitamin therapy, can prevent stroke and other major atherothromboembolic vascular events. To determine whether the addition of B-vitamin supplements (folic acid 2 mg, B 6 25 mg, B 12 500 μg) to best medical and surgical management will reduce the combined incidence of stroke, myocardial infarction (MI) and vascular death in patients with recent stroke or transient ischaemic attack (TIA) of the brain or eye. A prospective, international, multicentre, randomised, double blind, placebo-controlled clinical trial. One hundred and four medical centres in 20 countries on five continents. Eight thousand (6600 recruited as of 5 January, 2006) patients with recent (7 months) stroke (ischaemic or haemorrhagic) or TIA (brain or eye). Randomisation and data collection are performed by means of a central telephone service or secure internet site. One tablet daily of either placebo or B vitamins (folic acid 2mg, B 6 25 mg, B 12 500 μg). The composite of stroke, MI or death from any vascular cause, whichever occurs first. Outcome and serious adverse events are adjudicated blinded to treatment allocation. TIA, unstable angina, revascularisation procedures, dementia, depression. With 8000 patients followed up for a median of 2 years and an annual incidence of the primary outcome of 8% among patients assigned placebo, the study will have at least 80% power to detect a relative reduction of 15% in the incidence of the primary outcome among patients assigned B vitamins (to 6·8%/year), applying a two-tailed level of significance of 5%. VITATOPS aims to recruit and follow-up 8000 patients between 1998 and 2008, and provide a reliable estimate of the safety and effectiveness of folic acid, vitamin B 12 , and vitamin B 6 supplementation in reducing recurrent serious vascular events among a wide range of patients with TIA and stroke throughout the world.
Publisher: FapUNIFESP (SciELO)
Date: 10-2015
Publisher: S. Karger AG
Date: 2008
DOI: 10.1159/000131083
Abstract: This article represents the update of the European Stroke Initiative Recommendations for Stroke Management. These guidelines cover both ischaemic stroke and transient ischaemic attacks, which are now considered to be a single entity. The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 16-01-2019
DOI: 10.1212/WNL.0000000000006851
Abstract: To explore genetic and lifestyle risk factors of MRI-defined brain infarcts (BI) in large population-based cohorts. We performed meta-analyses of genome-wide association studies (GWAS) and examined associations of vascular risk factors and their genetic risk scores (GRS) with MRI-defined BI and a subset of BI, namely, small subcortical BI (SSBI), in 18 population-based cohorts (n = 20,949) from 5 ethnicities (3,726 with BI, 2,021 with SSBI). Top loci were followed up in 7 population-based cohorts (n = 6,862 1,483 with BI, 630 with SBBI), and we tested associations with related phenotypes including ischemic stroke and pathologically defined BI. The mean prevalence was 17.7% for BI and 10.5% for SSBI, steeply rising after age 65. Two loci showed genome-wide significant association with BI: FBN2, p = 1.77 × 10 −8 and LINC00539/ZDHHC20, p = 5.82 × 10 −9 . Both have been associated with blood pressure (BP)–related phenotypes, but did not replicate in the smaller follow-up s le or show associations with related phenotypes. Age- and sex-adjusted associations with BI and SSBI were observed for BP traits ( p value for BI, p [BI] = 9.38 × 10 −25 p [SSBI] = 5.23 × 10 −14 for hypertension), smoking ( p [BI] = 4.4 × 10 −10 p [SSBI] = 1.2 × 10 −4 ), diabetes ( p [BI] = 1.7 × 10 −8 p [SSBI] = 2.8 × 10 −3 ), previous cardiovascular disease ( p [BI] = 1.0 × 10 −18 p [SSBI] = 2.3 × 10 −7 ), stroke ( p [BI] = 3.9 × 10 −69 p [SSBI] = 3.2 × 10 −24 ), and MRI-defined white matter hyperintensity burden ( p [BI] = 1.43 × 10 −157 p [SSBI] = 3.16 × 10 −106 ), but not with body mass index or cholesterol. GRS of BP traits were associated with BI and SSBI ( p ≤ 0.0022), without indication of directional pleiotropy. In this multiethnic GWAS meta-analysis, including over 20,000 population-based participants, we identified genetic risk loci for BI requiring validation once additional large datasets become available. High BP, including genetically determined, was the most significant modifiable, causal risk factor for BI.
Publisher: Oxford University Press (OUP)
Date: 23-09-2016
DOI: 10.1093/EJCTS/EZW313
Publisher: Elsevier BV
Date: 07-2018
Publisher: SAGE Publications
Date: 06-01-2023
DOI: 10.1177/23969873221148267
Abstract: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke in young adults. We aimed to determine the impact of age, gender and risk factors (including sex-specific) on CVT onset. We used data from the BEAST (Biorepository to Establish the Aetiology of Sinovenous Thrombosis), a multicentre multinational prospective observational study on CVT. Composite factors analysis (CFA) was performed to determine the impact on the age of CVT onset in males and females. A total of 1309 CVT patients (75.3% females) aged ⩾18 years were recruited. The overall median (IQR-interquartile range) age for males and females was 46 (35–58) years and 37 (28–47) years ( p 0.001), respectively. However, the presence of antibiotic-requiring sepsis ( p = 0.03, 95% CI 27–47 years) among males and gender-specific risk factors like pregnancy ( p 0.001, 95% CI 29–34 years), puerperium ( p 0.001, 95% CI 26–34 years) and oral contraceptive use ( p 0.001, 95% CI 33–36 years) were significantly associated with earlier onset of CVT among females. CFA demonstrated a significantly earlier onset of CVT in females, ~12 years younger, in those with multiple (⩾1) compared to ‘0’ risk factors ( p 0.001, 95% CI 32–35 years). Women suffer CVT 9 years earlier in comparison to men. Female patients with multiple (⩾1) risk factors suffer CVT ~12 years earlier compared to those with no identifiable risk factors.
Publisher: Wiley
Date: 29-09-2021
DOI: 10.1002/ANA.26205
Abstract: Cerebral venous thrombosis (CVT) is an uncommon form of stroke affecting mostly young in iduals. Although genetic factors are thought to play a role in this cerebrovascular condition, its genetic etiology is not well understood. A genome‐wide association study was performed to identify genetic variants influencing susceptibility to CVT. A 2‐stage genome‐wide study was undertaken in 882 Europeans diagnosed with CVT and 1,205 ethnicity‐matched control subjects ided into discovery and independent replication datasets. In the overall case–control cohort, we identified highly significant associations with 37 single nucleotide polymorphisms (SNPs) within the 9q34.2 region. The strongest association was with rs8176645 (combined p = 9.15 × 10 −24 odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.76–2.31). The discovery set findings were validated across an independent European cohort. Genetic risk score for this 9q34.2 region increases CVT risk by a pooled estimate OR = 2.65 (95% CI = 2.21–3.20, p = 2.00 × 10 −16 ). SNPs within this region were in strong linkage disequilibrium (LD) with coding regions of the ABO gene. The ABO blood group was determined using allele combination of SNPs rs8176746 and rs8176645. Blood groups A, B, or AB, were at 2.85 times (95% CI = 2.32–3.52, p = 2.00 × 10 −16 ) increased risk of CVT compared with in iduals with blood group O. We present the first chromosomal region to robustly associate with a genetic susceptibility to CVT. This region more than doubles the likelihood of CVT, a risk greater than any previously identified thrombophilia genetic risk marker. That the identified variant is in strong LD with the coding region of the ABO gene with differences in blood group prevalence provides important new insights into the pathophysiology of CVT. ANN NEUROL 2021 :777–788
Publisher: SAGE Publications
Date: 30-09-2016
Abstract: Systemic thrombolysis with rt-PA is contraindicated in patients with acute ischemic stroke anticoagulated with dabigatran. This expert opinion provides guidance on the use of the specific reversal agent idarucizumab followed by rt-PA and/or thrombectomy in patients with ischemic stroke pre-treated with dabigatran. The use of idarucizumab followed by rt-PA is covered by the label of both drugs.
Publisher: Oxford University Press (OUP)
Date: 27-08-2016
No related grants have been discovered for José Ferro.