Vascular Voices: Erich De Paula, M.D., Ph.D. (Brazil)

In this new series, World Thrombosis Day (WTD) shares interviews with members of its scientific Steering Committee. In today’s profile, learn about Erich De Paula, M.D., Ph.D., Vice Dean and Associate Professor of Hematology at the University of Campinas School of Medicine in Brazil.

Why did you choose to pursue a career in the hematology field?

I believe it was the possibility of integrating in a more straightforward fashion, research, laboratory and clinical activities. The fact the whole process, from diagnostic reasoning to laboratory evaluation, to treatment, can be performed by the hematologist was one of the main aspects that initially attracted me. The fact that hematologists also have to deal with severe diseases also played a role since I have always believed that I could communicate well with patients in these conditions, and hopefully help them.

With time, I learned that irrespective of disease severity, we can always help patients by actually listening to them. Finally, I also believed that hematology was an area that would allow me more research opportunities, and this was certainly the case in the institution where I obtained my medical degree.

What is an average day like for you in the clinic? What type of patients do you see?

My days do not only involve seeing patients. I spend a lot of time in academic management, since I currently hold a position in our medical school that oversees the medical curriculum, as well as other aspects of management. However, I do have clinical appointments. I mostly see patients with venous thromboembolism or acquired bleeding disorders. It is an outpatient clinic, and I work alongside medical students and residents.

What inspired you to join the World Thrombosis Day Steering Committee, and then become Vice Chair?

I wanted to contribute to the dissemination of scientific knowledge beyond academia, and I think that this is at the core of WTD mission. This was also the reason why I applied for the Vice Chair position, so that I could contribute more intensively to this goal. I can also reinforce the importance that this message reaches broader audiences in countries with comparatively less access to educational material for patients/families, less good quality and updated information for healthcare professionals and less access to information about thrombosis by policy makers.

How do you rate awareness of thrombosis in Brazil? Is it generally understood among the public?

Even though the COVID-19 pandemic brought the issue of thrombosis to everyone’s lips, there is still a lot to improve in terms of the quality of information. Besides, knowledge by hospitalized patients that they need a VTE risk assessment is probably very limited. In summary, thrombosis is a well-known term, but the quality of information, and in particular of information that can actually benefit patients by changing their behavior, is very low.

What are the biggest challenges you see in thrombosis treatment and prevention?

First, we would be much better off if we had a clearer view of the epidemiology of thrombosis and its complications (and I refer specifically to venous thromboembolism) in different countries and settings. Lack of precise data hampers our decision-making process when it reaches beyond the issue of anticoagulant treatment/prevention of VTE, which have been adequately studied.

For example, the impact of non-pharmacological and even of pharmacological preventive strategies on a population scale have not been fully clarified. Even the impact of long-term post-VTE complications is not clear, so that it is hard to mobilize resources to address these issues, again, when they fall beyond the use of antithrombotic agents.

Are you working on any interesting research projects right now?

My current projects address how inflammatory conditions, either infectious or non-infectious, influence the risk of thrombosis. And also, whether microthrombosis contributes to the mechanisms by which some of these disease cause organ damage. I believe that this is a very interesting field!

What do you enjoy doing outside of work?

I love to spend time with my two sons at home, restaurants, cafes, movies, theaters and museums. We live close to Sao Paulo, which is a huge city with lots of cultural options, and we frequently go there on weekends. I also enjoy listening to good music, in bars and shows, and to play the piano. I love to read and to travel to the mountains around the city where we live. I also try to keep healthy by swimming twice a week and going often to the gym.