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OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

https://doi.org/10.6061/clinics/2021/e1991 870 downloads

3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology
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Gualandro, Danielle Menosi

; Yu, Pai Ching

; Caramelli, Bruno

; Marques, André Coelho

; Calderaro, Daniela

; Fornari, Luciana Savoy

; Pinho, Claudio

; Feitosa, Alina Coutinho Rodrigues

; Polanczyk, Carisi Anne

; Rochitte, Carlos Eduardo

; Jardim, Carlos

; Vieira, Carolina L. Z.

; Nakamura, Debora Y. M.

; Iezzi, Denise

; Schreen, Dirk

; Adam, Eduardo Leal

; D’Amico, Elbio Antonio

; Lima, Emerson Q. de

; Burdmann, Emmanuel de Almeida

; Mateo, Enrique Indalecio Pachón

; Marcondes-Braga, Fabiana Goulart

; Machado, Fabio S.

; Paula, Flavio J. de

; Carmo, Gabriel Assis Lopes do

; Feitosa-Filho, Gilson Soares

; Prado, Gustavo Faibischew

; Lopes, Heno Ferreira

; Fernandes, João R. C.

; Lima, José J. G. de

; Sacilotto, Luciana

; Drager, Luciano Ferreira

; Vacanti, Luciano Janussi

; Rohde, Luis Eduardo Paim

; Prada, Luis F. L.

; Gowdak, Luis Henrique Wolff

; Vieira, Marcelo Luiz Campos

; Monachini, Maristela Camargo

; Macatrão-Costa, Milena Frota

; Paixão, Milena Ribeiro

; Oliveira Junior, Mucio Tavares de

; Cury, Patricia

; Villaça, Paula R.

; Farsky, Pedro Silvio

; Siciliano, Rinaldo F.

; Heinisch, Roberto Henrique

; Souza, Rogerio

; Gualandro, Sandra F.M.

; Accorsi, Tarso Augusto Duenhas

; Mathias Júnior, Wilson

Arquivos Brasileiros de Cardiologia

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sep 2017, Volume 109 N. 3 Pages 1 - 104

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20170140 100302 downloads

Persistent infectious and tropical diseases in immigrant correctional populations
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Getaz, L.

; Da Silva-Santos, L.

; Wolff, H.

; Vitoria, M.

; Serre-Delcor, N.

; Lozano-Becerra, J.C.

; Chappuis, F.

; Albajar-Viñas, P.

Revista Española de Sanidad Penitenciaria

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oct 2016, Volume 18 N. 2 Pages 57 - 66

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

A number of infectious diseases amongst travelers and the immigrant populations are a major public health concern. Some have a long incubation period or remain asymptomatic or paucisymptomatic for many years before leading to significant clinical manifestations and/or complications. HIV, hepatitis B and C, tuberculosis or latent syphilis are among the most significant persistent diseases in migrants. Schistosomiasis and strongyloidiasis, for instance, are persistent helminthic infections that may cause significant morbidity, particularly in patients co-infected with HIV, hepatitis B and C. Chagas disease, which was initially confined to Latin America, must also now be considered in immigrants from endemic countries. Visceral leishmaniasis and malaria are other examples of parasitic diseases that must be taken into account by physicians treating incarcerated migrants. The focus of this review article is on the risk of neglected tropical diseases in particularly vulnerable correctional populations and on the risk of infectious diseases that commonly affect migrants but which are often underestimated.

Son muchas las enfermedades en viajeros y poblaciones inmigrantes que suponen un problema de salud pública de primer orden. Algunas tienen un periodo largo de incubación o son asintomáticas o paucisintomático durante muchos años antes de provocar manifestaciones clínicas significativas y/o complicaciones. La infección por VIH, hepatitis B y C, la tuberculosis o la sífilis latente se encuentran entre las enfermedades persistentes más relevantes en población emigrante. La esquistosomiasis y la estrongiloidiasis, por ejemplo, son infecciones helmínticas persistentes que pueden causar importante morbilidad, especialmente en pacientes coinfectados por VIH, hepatitis B y C. La enfermedad de Chagas, que inicialmente se creyó limitada a América Latina, ahora también tiene que ser considerada en los inmigrantes de países endémicos. La leishmaniasis visceral y la malaria son otros ejemplos de enfermedades parasitarias que tienen que tenerse en cuenta cuando se trata con inmigrantes encarcelados. El objetivo de este artículo es revisar el riesgo de las enfermedades tropicales desatendidas en especial dada la vulnerabilidad de la población penitenciaria y el riesgo de las enfermedades infecciosas que normalmente afectan a emigrantes pero que a menudo son infraestimadas.

875 downloads

Piperamides from Piper ottonoides by NMR and GC-MS Based Mixture Analysis
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Wolff, Thiago

; Santos, Priscila F. P.

; Valente, Ligia M. M.

; Magalhães, Alvicler

; Tinoco, Luzineide W.

; Pereira, Rita C. A.

; Guimarães, Elsie F.

Journal of the Brazilian Chemical Society

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nov 2015, Volume 26 N. 11 Pages 2321 - 2330

Abstract: En | Text: En | PDF: En

The species Piper ottonoides Yuncker (Piperaceae), known as “joão-brandim”, is a shrub that occurs in the Brazilian Amazon rainforest. Its roots and leaves are used in traditional medicine as local anesthetic to treat toothache and sore throat. In this study, the structural characterization in mixture of isobutyl amides present in semi-purified fractions from fruits, leaves, stems and roots of P. ottonoides was achieved by employing gas chromatography-mass spectrometry (GC-MS) and a combination of nuclear magnetic resonance (NMR) techniques (1H, 1H-1H COSY, 1H-13C HSQC, 1H-13C HMBC, TOCSY and 1H-1H J-RES). The MS fragmentation patterns and the NMR chemical shifts, multiplicities, coupling constants and the signal correlations in the two-dimensional spectra were carefully analyzed also taking into account some key elements of differentiation among the compounds. The data set allowed identifying unequivocally the new amide N-isobutyl-7-(4’- methoxyphenyl)-2E,4E-heptadienamide, which we named ottonoidenamide as well as piperovatine and chingchengenamide A in all parts of the plant, the additional presence of pipercallosine and pipercallosidine in roots and of dihydropiperlonguminine in fruits and leaves. The presence of piperovatine and pipercallosine in P. ottonoides should be associated to its traditional use.

https://doi.org/10.5935/0103-5053.20150226 1318 downloads

Confiança dentro das organizações da Nova Economia: uma análise empírica sobre as conseqüências da incerteza institucional
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Zanini, Marco Tulio F.

; Lusk, Edward J.

; Wolff, Birgitta

Revista de Administração Contemporânea

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mar 2009, Volume 13 N. 1 Pages 72 - 91

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Este estudo investiga os efeitos de diferentes arcabouços institucionais sobre os níveis de confiança interpessoal dentro de hierarquias. Seguindo as tendências apresentadas por estudiosos da Nova Economia e por relatórios da Organização Internacional do Trabalho [OIT] que apontam significativas mudanças no modelo de contrato de trabalho, este estudo investiga possíveis diferenças nos níveis de confiança entre dois paradigmas: a Velha Economia ea Nova Economia. Mudanças institucionais ocorridas na Nova Economia, que resultaram em alta incerteza institucional, influenciam consideravelmente o desenvolvimento da confiança interpessoal dentro das empresas. Utilizando um questionário manual, aplicado dentro de sete empresas privadas brasileiras, o estudo buscou mensurar a confiança como uma variável dependente. Da revisão da literatura especializada e observação empírica da realidade destas organizações, as empresas foram identificadas e classificadas dentro de diferentes grupos. O estudo conclui que a relativa alta incerteza ambiental limita consideravelmente o desenvolvimento de níveis de confiança dentro das empresas que operam na Nova Economia.

This study investigates the effects of different institutional frameworks on the levels of trust within hierarchies. Following the insight into the changing of labour contracts provided by New Economy theorists and International Labour Organization [ILO] reports, this study investigates the possible differences in the levels of trust between two paradigms: the Old Economy and the New Economy. We argue that singular institutional changes which better characterize the New Economy in the form of environmental uncertainty set considerable constrains on trust development. By approaching trust as a dependent variable in a cross-industrial comparison, a questionnaire survey was carried out in Brazil accessing the levels of trust within seven Brazilian private companies. From the literature review and empirical observation of the reality of these organizations, companies were identified and classified into different groups. The study concludes that relative high institutional uncertainty considerably limits the development of trust levels within those companies operating in the New Economy.

5089 downloads

Nesting biology of Trypoxylon (Trypargilum) lactitarse Saussure (Hymenoptera, Crabronidae) in trap-nests in Southern Brazil
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Buschini, M. L. T.

; Niesing, F.

; Wolff, L. L.

Brazilian Journal of Biology

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aug 2006, Volume 66 N. 3 Pages 919 - 929

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Esse estudo foi realizado no Parque Municipal das Araucárias, no Município de Guarapuava (PR), Sul do Brasil. Trezentos e sessenta e cinco ninhos de T. lactitarse foram obtidos utilizando-se ninhos armadilhas de 0,7, 1,0 e 1,3 cm de diâmetro. Todos apresentaram arquitetura similar, independente de seus diâmetros, sendo formados por uma série linear de células, cujo número médio foi de 3,3, 4,0 e 3,6 para os ninhos com 0,7, 1,0 e 1,3 cm de diâmetro, respectivamente. Os ninhos ocorreram com maior frequência no verão. T. lactitarse teve dois tipos de ciclo: um direto sem diapausa, e outro mais longo com entrada em diapausa. Seus inimigos naturais foram: Chrysididae, Sarcophagidae, Dolichopodidae e Ichneumonidae. Das 1.353 aranhas identificadas, 1.313 foram da família Araneidae.

This study was carried in the Parque Municipal das Araucárias in the municipality of Guarapuava, state of Paraná, Southern Brazil. Three hundred and sixty five nests of T. lactitarse were obtained using trap-nests of 0.7, 1.0, and 1.3 cm in diameter. All of them had similar architecture, regardless of the diameter of the trap-nest. Completed nests consisted of a linear series of brood cells whose average number per nest was of 3.3, 4.0 and 3.6 for the nests with 0.7 cm, 1.0 cm and 1.3 cm in diameter, respectively. They were constructed more often during the summer. T. lactitarse had two types of life cycles: direct development (without diapause), and delayed development (with diapause during winter). Natural enemies included Chrysididae, Sarcophagidae, Dolichopodidae and Ichneumonidae. Out of 1,353 identified spider prey, 1,313 belonged to the Araneidae family.

2337 downloads Cited 1 time in SciELO

Ionization and dissociation of the formic acid molecule by protons and electrons
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Pilling, S.

; Santos, A. C. F.

; Boechat-Roberty, H. M.

; Souza, G. G. B. de

; Sant' Anna, M. M.

; Barros, A. L. F.

; Wolff, W.

; Faria, N. V. de Castro

Brazilian Journal of Physics

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jun 2006, Volume 36 N. 2b Pages 538 - 540

Abstract: En | Text: En | PDF: En

Ionization and dissociation of the formic acid molecule (HCOOH) by energetic charged particles have been studied for 1 keV electrons and nearly equivelocity 2 MeV protons. Whereas the fragmentation pattern induced by impact of electron and proton show close similarities, some distinctions in the fragmentation yields were observed for these equivelocity projectiles.

2481 downloads

Application of interval analysis for gibbs and helmholtz free energy global minimization in phase stability analysis
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Souza, A. T.

; Cardozo-Filho, L.

; Wolff, F.

; Guirardello, R.

Brazilian Journal of Chemical Engineering

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mar 2006, Volume 23 N. 1 Pages 117 - 124

Abstract: En | Text: En | PDF: En

The tangent plane criterion has become important for a correct solution evaluation phase and chemical of equilibrium problem. This method, applicable to single and multiphase systems, is mainly used for a single equation of state modeling all phases involved. The present work is mainly concerned with the application of interval analysis methods for global energy minimization in high-pressure phase stability problems. Two approaches are applied: (i) the Gibbs free energy global minimization under conditions of constant temperature and pressure and (ii) the Helmholtz free energy density global minimization under conditions of constant temperature and volume. Five case studies, one ternary and four binary systems, are analyzed in connection with the Peng-Robinson equation of state (PREOS) model. Five more case studies, for the CO2 + trans-2-hexen-1-ol system at high pressures, are used to compare different methods of phase equilibrium calculation with the approach using interval analysis. Finally, a complex system, clove oil + CO2, is analyzed. The results indicate that the interval analysis method is robust and reliable for all the problems studied.

4625 downloads Cited 2 times in SciELO

Modeling the supercritical desorption of orange essential oil from a silica-gel bed
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Silva, E.A.

; Cardozo-Filho, L.

; Wolff, F.

; Meireles, M.A.A.

Brazilian Journal of Chemical Engineering

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sep 2000, Volume 17 N. 3 Pages 283 - 296

Abstract: En | Text: En | PDF: En

One of the most important byproducts of the orange juice industry is the oil phase. This is a mixture of terpenes, alcohols, and aldehydes, dissolved in approximately 96% limonene. To satisfactorily use oil phase as an ingredient in the food and cosmetics industries separation of the limonene is required. One possibility is to use a fixed bed of silica gel to remove the light or aroma compounds from the limonene. The aroma substances are then extracted from the bed of silica gel using supercritical carbon dioxide. This work deals with the modeling of the desorption step of the process using mass balance equations coupled with the Langmuir equilibrium isotherm. Data taken from the literature for the overall extraction curves were used together with empirical correlations to calculate the concentration profile of solute in the supercritical phase at the bed outlet. The system of equations was solved by the finite volume technique. The overall extraction curves calculated were in good agreement with the experimental ones.

2449 downloads

10.

Bem-morar em São Paulo, 1880-1910: Ramos de Azevedo e os modelos europeus
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Wolff de Carvalho, Maria Cristina

Anais do Museu Paulista: História e Cultura Material

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1996, Volume 4 N. 1 Pages 165 - 200

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A arquitetura doméstica tem um grande impulso no século XIX. Da Europa são difundidos, para todo mundo, os modelos conformados à nova ordem social e à industrialização. A residência se transforma numa preocupação central dos arquitetos. Desenvolvem-se novos conceitos para casa ideal para todas as camadas sociais: operários, classe média, burguesia. Este artigo retrata, em São Paulo, a introdução de padrões formais e princípios (de higiene, salubridade, conforto, ritos sociais e domésticos, as aparências). a partir da atividade de F. P. Ramos de Azevedo (1851-19201. Analisam-se os principais projetos que ele desenvolveu para a burguesia local.

Domestic architecture achieves a great impulse in the second half of XIXth-century. From Europe to the whole world, models are conformed to the new social order and spread as industrialization takes command. Dwelling becomes the main concern among architects. New concepts are developed for the ideal house for 011 social strata: working class, middle-class, bourgeoisie. This essay traces the introduction in São Paulo of European formal patterns and principies Ihygiene, salubrity, comfort, social and domestic rites, social visibility) through the activity of F. P. Ramos de Azevedo! 1851-19281. The main projects he conceived for the local bourgeoisie are analysed.

7398 downloads

11.

A programme for computer aided identification of Phlebotomine sandflies of the Americas (CIPA): presentation and check-list of American species
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Bermudez, H.

; Dedet, J. P.

; Duncan, M.

; Falcão, A. L.

; Feliciangeli, M. D.

; Ferro, C.

; Galati, E. A. B.

; Gomez-Landires, E. A.

; Herrero, M. V.

; Hervas, D.

; Lebbe, J.

; Morales, A.

; Ogusuku, E.

; Perez, J. E.

; Rangel, E. F.

; Sherlock, I. A.

; Torrez, M.

; Vignes, R.

; Wolff, M.

; Young, D. G.

Memórias do Instituto Oswaldo Cruz

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jun 1993, Volume 88 N. 2 Pages 221 - 230

Abstract: En | Text: En | PDF: En

The CIPA programme is a collaborative project including two entomologists from France and seven South and Central America countries. Its objective is the development of an expert system for computer aided identification of phlebotomine sandflies from the Americas. It also includes the formation of data bases for bibliographic, taxonomic and biogeographic data. Participant consensus on taxonomic prerequisites, standardization in bibliographic data collections and selection of descriptive variables for the final programme has been established through continous communication among participants and annual meetings. The adopted check-list of American sandflies presented here includes 386 specific taxa, ordered into genera and 28 sub-genera or species groups.

1473 downloads Cited 1 time in SciELO

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