Tomás Mello - Academia.edu (original) (raw)

Papers by Tomás Mello

Journal of Hypertension, 2021

European Journal of Public Health, 2020

Background The new hypertension (HT) guidelines recommend the use of out-of-office blood pressure... more Background The new hypertension (HT) guidelines recommend the use of out-of-office blood pressure (BP) measures for its diagnosis however, in the scope of public health in Brazil, it is still based on office BP (OBP) for logistical and financial reasons. Furthermore, in our country, it is not yet clear whether the use of out-of-office BP would really be more reliable for the diagnosis. Objective To evaluate the importance of using Home Blood Pressure Monitoring (HBPM) in diagnosing HT in a young adult population in primary care in Brazil. Methods A cross-sectional population study enrolled adults between 20 and 50 years in a primary healthcare unit in Rio de Janeiro. Office BP was the mean value of 2 measures, while the HBPM followed a 7-day protocol. It was considered normal a Home BP < 135x85 mmHg and OBP <140x90 mmHg. Patients were classified into 4 phenotypes: normotension (controlled OBP and HBPM); white coat HT (uncontrolled OBP and controlled HBPM); masked HT (controlle...

Brazilian Journal of Oncology, 2021

Emerging data postulates that cancer is an important risk factor for disease severity and higher ... more Emerging data postulates that cancer is an important risk factor for disease severity and higher in-hospital mortality amongst patients with COVID-19. From a pathophysiological perspective, COVID-19 induces an overproduction of inflammatory cytokines, causing systemic inflammation, hypercoagulability, and multiple organ dysfunction syndrome. The exact pathophysiological mechanisms associated with severe COVID-19 disease in patients with cancer is uncertain. Moreover, the challenge of implementing social distancing in patients requiring specific anticancer treatments urged international societies to issue recommendations regarding the adoption of safety measures to reduce transmission risk and optimize anticancer treatment during the COVID-19 pandemic. We provide an extensive review of the clinical outcomes, prognosis and management of patients with cancer and COVID-19 infection.

International Journal of Cardiovascular Sciences, 2021

Background Although cardiovascular disease is a major cause of death among women, cardiovascular ... more Background Although cardiovascular disease is a major cause of death among women, cardiovascular risk assessment in young women is frequently postponed due to a number of factors. Objectives To assess cardiovascular risk of young adult women living in one of Rio de Janeiro’s Family Health Strategy geographical units in the city’s central area. Materials and Methods populational, cross-sectional study with adults between 20 and 50 years old. Sociodemographic characteristics such as educational level and employment status were recorded. Anthropometric measurements, traditional cardiovascular risk factors, gynecological and gestational history, and selected laboratory exams were assessed. The bivariate analysis compared the baseline characteristics of the population between genders and the prevalence of cardiovascular risk factors in women according to educational level and occupation status, using non-paired Student’s t-test for normal continuous variables, Mann-Whitney test for asymm...

Circulation, 2021

Objective: To evaluate the relationship between the main cardiovascular (CV) risk factors and soc... more Objective: To evaluate the relationship between the main cardiovascular (CV) risk factors and socioeconomic indicators in a population of young adults provided by a Primary Healthcare Center in a large urban area of Brazil. Methods: Cross-sectional population study that included adults aged between 20- and 50-years old provided by a Primary Healthcare Center in Rio de Janeiro, Brazil. Demographic data (gender and age), socioeconomic data (education level, occupation, employment), CV risk factors (smoking, sedentary lifestyle, obesity, hypertension, diabetes, dyslipidemia) were recorded. The metabolic profile was evaluated through laboratory tests. Those who studied up to high school were considered poorly educated. Results: A total of 604 individuals were enrolled [39% male, mean age: 38.8 ± 8,9 years]. The median of schooling was 12 years. In addition, 288 individuals had high schooling, of which 44.5% were male. A total of 130 individuals did not study or work. Women with low educ...

Circulation, 2021

Background: Obesity is increasing in younger populations, and is associated with a high cardiovas... more Background: Obesity is increasing in younger populations, and is associated with a high cardiovascular (CV) risk, however, it is not clear whether metabolically healthy obesity (MHO) may have a lower CV risk or if it is just an earlier stage of the disease. Objective: To evaluate the prevalence and CV risk factors associated with MHO in a young adult population provided by a Primary Healthcare Center in a large urban area of Brazil. Methods: A cross-sectional population study for CV risk assessment in adults aged 20-50 years old provided by a Primary Healthcare Center in Rio de Janeiro, Brazil. Demographic, anthropometric data and CV risk factors were recorded. All underwent office blood pressure (OBP) measurements, laboratory evaluation (lipid and glycemic profile). Obesity was defined as a BMI ≥ 30 kg/m2 and MHO are those who have less than 3 of the following criteria: hypertension, diabetes, total cholesterol ≥ 200 mg/dL, HDL<40 mg/dL (men) and 50 mg/dL (women), triglycerides&...

International Journal of Cardiovascular Sciences, 2020

Hypertension, 2021

Background: In this young and apparently healthy population, it is important to identify early CV... more Background: In this young and apparently healthy population, it is important to identify early CV risk factors and subclinical target organ damage (TOD) with low complexity procedures, aiming regression, control and primary prevention with future reduction of CV morbidity and mortality. Objectives: To evaluate subclinical TOD using Ankle-Brachial Index (ABI), Office and Home Pulse Pressure (PP), identifying arterial stiffness. Methods: A cross-sectional population study for CV risk assessment in adults aged 20-50 years old provided by a Primary Healthcare Center in Brazil. A total of 632 individuals were evaluated (40% male; mean age 36 ± 9 years). Socio-demographic, anthropometric data, and lifestyle evaluation were recorded. All underwent Office Blood Pressure (OBP) measurements in the 4 limbs to calculate the ABI and office PP. All received the Home Blood Pressure Monitoring (HBPM) device (7 days protocol) and the mean of the general BP and the calculation of the PP were evaluate...

Journal of Human Hypertension, 2020

Circulation, 2021

Introduction: Dyslipidemia, Glucose Intolerance (GI), Diabetes Mellitus (DM), and Metabolic Syndr... more Introduction: Dyslipidemia, Glucose Intolerance (GI), Diabetes Mellitus (DM), and Metabolic Syndrome (MS) are metabolic conditions often asymptomatic and related to high cardiovascular (CV) morbidity and mortality. Nonetheless, these conditions are not commonly screened in younger adults. The LapARC cohort Study is a population-based study to assess CV risk profile in a young adult population. Objective: To evaluate the prevalence of dyslipidemia, DM, GI, and MS in a young adult population enrolled in the Family Health Strategy (FHS) in the center of Rio de Janeiro, Brazil. Methods: Cross-sectional population study that enrolled individuals aged 20-50 years registered in an FHS unit in Rio de Janeiro. Sociodemographic, anthropometric characteristics, and CV risk factors were recorded. Office blood pressure (BP) was obtained by the average of 2 measurements obtained on two different occasions. All participants underwent laboratory evaluation (lipid and glycemic profile) and home bloo...

Journal of Hypertension, 2021

European Journal of Public Health, 2020

Background The new hypertension (HT) guidelines recommend the use of out-of-office blood pressure... more Background The new hypertension (HT) guidelines recommend the use of out-of-office blood pressure (BP) measures for its diagnosis however, in the scope of public health in Brazil, it is still based on office BP (OBP) for logistical and financial reasons. Furthermore, in our country, it is not yet clear whether the use of out-of-office BP would really be more reliable for the diagnosis. Objective To evaluate the importance of using Home Blood Pressure Monitoring (HBPM) in diagnosing HT in a young adult population in primary care in Brazil. Methods A cross-sectional population study enrolled adults between 20 and 50 years in a primary healthcare unit in Rio de Janeiro. Office BP was the mean value of 2 measures, while the HBPM followed a 7-day protocol. It was considered normal a Home BP < 135x85 mmHg and OBP <140x90 mmHg. Patients were classified into 4 phenotypes: normotension (controlled OBP and HBPM); white coat HT (uncontrolled OBP and controlled HBPM); masked HT (controlle...

Brazilian Journal of Oncology, 2021

Emerging data postulates that cancer is an important risk factor for disease severity and higher ... more Emerging data postulates that cancer is an important risk factor for disease severity and higher in-hospital mortality amongst patients with COVID-19. From a pathophysiological perspective, COVID-19 induces an overproduction of inflammatory cytokines, causing systemic inflammation, hypercoagulability, and multiple organ dysfunction syndrome. The exact pathophysiological mechanisms associated with severe COVID-19 disease in patients with cancer is uncertain. Moreover, the challenge of implementing social distancing in patients requiring specific anticancer treatments urged international societies to issue recommendations regarding the adoption of safety measures to reduce transmission risk and optimize anticancer treatment during the COVID-19 pandemic. We provide an extensive review of the clinical outcomes, prognosis and management of patients with cancer and COVID-19 infection.

International Journal of Cardiovascular Sciences, 2021

Background Although cardiovascular disease is a major cause of death among women, cardiovascular ... more Background Although cardiovascular disease is a major cause of death among women, cardiovascular risk assessment in young women is frequently postponed due to a number of factors. Objectives To assess cardiovascular risk of young adult women living in one of Rio de Janeiro’s Family Health Strategy geographical units in the city’s central area. Materials and Methods populational, cross-sectional study with adults between 20 and 50 years old. Sociodemographic characteristics such as educational level and employment status were recorded. Anthropometric measurements, traditional cardiovascular risk factors, gynecological and gestational history, and selected laboratory exams were assessed. The bivariate analysis compared the baseline characteristics of the population between genders and the prevalence of cardiovascular risk factors in women according to educational level and occupation status, using non-paired Student’s t-test for normal continuous variables, Mann-Whitney test for asymm...

Circulation, 2021

Objective: To evaluate the relationship between the main cardiovascular (CV) risk factors and soc... more Objective: To evaluate the relationship between the main cardiovascular (CV) risk factors and socioeconomic indicators in a population of young adults provided by a Primary Healthcare Center in a large urban area of Brazil. Methods: Cross-sectional population study that included adults aged between 20- and 50-years old provided by a Primary Healthcare Center in Rio de Janeiro, Brazil. Demographic data (gender and age), socioeconomic data (education level, occupation, employment), CV risk factors (smoking, sedentary lifestyle, obesity, hypertension, diabetes, dyslipidemia) were recorded. The metabolic profile was evaluated through laboratory tests. Those who studied up to high school were considered poorly educated. Results: A total of 604 individuals were enrolled [39% male, mean age: 38.8 ± 8,9 years]. The median of schooling was 12 years. In addition, 288 individuals had high schooling, of which 44.5% were male. A total of 130 individuals did not study or work. Women with low educ...

Circulation, 2021

Background: Obesity is increasing in younger populations, and is associated with a high cardiovas... more Background: Obesity is increasing in younger populations, and is associated with a high cardiovascular (CV) risk, however, it is not clear whether metabolically healthy obesity (MHO) may have a lower CV risk or if it is just an earlier stage of the disease. Objective: To evaluate the prevalence and CV risk factors associated with MHO in a young adult population provided by a Primary Healthcare Center in a large urban area of Brazil. Methods: A cross-sectional population study for CV risk assessment in adults aged 20-50 years old provided by a Primary Healthcare Center in Rio de Janeiro, Brazil. Demographic, anthropometric data and CV risk factors were recorded. All underwent office blood pressure (OBP) measurements, laboratory evaluation (lipid and glycemic profile). Obesity was defined as a BMI ≥ 30 kg/m2 and MHO are those who have less than 3 of the following criteria: hypertension, diabetes, total cholesterol ≥ 200 mg/dL, HDL<40 mg/dL (men) and 50 mg/dL (women), triglycerides&...

International Journal of Cardiovascular Sciences, 2020

Hypertension, 2021

Background: In this young and apparently healthy population, it is important to identify early CV... more Background: In this young and apparently healthy population, it is important to identify early CV risk factors and subclinical target organ damage (TOD) with low complexity procedures, aiming regression, control and primary prevention with future reduction of CV morbidity and mortality. Objectives: To evaluate subclinical TOD using Ankle-Brachial Index (ABI), Office and Home Pulse Pressure (PP), identifying arterial stiffness. Methods: A cross-sectional population study for CV risk assessment in adults aged 20-50 years old provided by a Primary Healthcare Center in Brazil. A total of 632 individuals were evaluated (40% male; mean age 36 ± 9 years). Socio-demographic, anthropometric data, and lifestyle evaluation were recorded. All underwent Office Blood Pressure (OBP) measurements in the 4 limbs to calculate the ABI and office PP. All received the Home Blood Pressure Monitoring (HBPM) device (7 days protocol) and the mean of the general BP and the calculation of the PP were evaluate...

Journal of Human Hypertension, 2020

Circulation, 2021

Introduction: Dyslipidemia, Glucose Intolerance (GI), Diabetes Mellitus (DM), and Metabolic Syndr... more Introduction: Dyslipidemia, Glucose Intolerance (GI), Diabetes Mellitus (DM), and Metabolic Syndrome (MS) are metabolic conditions often asymptomatic and related to high cardiovascular (CV) morbidity and mortality. Nonetheless, these conditions are not commonly screened in younger adults. The LapARC cohort Study is a population-based study to assess CV risk profile in a young adult population. Objective: To evaluate the prevalence of dyslipidemia, DM, GI, and MS in a young adult population enrolled in the Family Health Strategy (FHS) in the center of Rio de Janeiro, Brazil. Methods: Cross-sectional population study that enrolled individuals aged 20-50 years registered in an FHS unit in Rio de Janeiro. Sociodemographic, anthropometric characteristics, and CV risk factors were recorded. Office blood pressure (BP) was obtained by the average of 2 measurements obtained on two different occasions. All participants underwent laboratory evaluation (lipid and glycemic profile) and home bloo...