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Comment on the study Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the Bypass Registry that was presented at the 46th Congress of the Brazilian Society of Cardiovascular Surgery, Nova Lima, BH, Brazil, April 5 and 6, 2019
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Dallan, Luís Alberto O.
; Paez, Rodrigo Pereira
; Hossne Junior, Nelson Américo
; Santo, José Amalth do Espírito
; Berwanger, Otavio
; Santos, Renato Hideo Nakagawa
; Kalil, Renato Abdala Karam
; Jatene, Fabio B.
; Cavalcanti, Alexandre Biasi
; Zilli, Alexandre Cabral
; Bettiati Jr, Luiz Carlos
; Figueira, Fernando Augusto Marinho dos Santos
; D’Azevedo, Stephanie Steremberg Pires
; Soares, Marcelo José Ferreira
; Fernandes, Marcio Pimentel
; Ardito, Roberto Vito
; Bogdan, Renata Andrea Barberio
; Campagnucci, Valquíria Pelisser
; Nakasako, Diana
; Rodrigues, Clarissa Garcia
; Rodrigues Junior, Anilton Bezerra
; Cascudo, Marcelo Matos
; Atik, Fernando Antibas
; Lima, Elson Borges
; Nina, Vinicius José da Silva
; Heluy, Renato Albuquerque
; Azeredo, Lisandro Gonçalves
; Henrique Junior, Odilon Silva
; Mendonça, José Teles de
; Silva, Katharina Kelly de Oliveira Gama
; Pandolfo, Marcelo
; Lima Júnior, José Dantas de
; Faria, Renato Max
; Santos, Jonas Gonçalves dos
; Coelho, Guilherme Henrique Biachi
; Pereira, Sergio Nunes
; Senger, Roberta
; Buffolo, Enio
; Caputi, Guido Marco
; Oliveira, Juliana Aparecida Borges de
; Gomes, Walter J.
.
Brazilian Journal of Cardiovascular Surgery
- Métricas do periódico
https://doi.org/10.21470/1678-9741-2019-0606
335 downloads
2.
Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry
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Paez, Rodrigo Pereira
; Hossne Junior, Nelson Américo
; Santo, José Amalth do Espírito
; Berwanger, Otavio
; Santos, Renato Hideo Nakagawa
; Kalil, Renato Abdala Karam
; Jatene, Fabio B.
; Cavalcanti, Alexandre Biasi
; Zilli, Alexandre Cabral
; Bettiati Jr, Luiz Carlos
; Figueira, Fernando Augusto Marinho dos Santos
; D'Azevedo, Stephanie Steremberg Pires
; Soares, Marcelo José Ferreira
; Fernandes, Marcio Pimentel
; Ardito, Roberto Vito
; Bogdan, Renata Andrea Barberio
; Campagnucci, Valquíria Pelisser
; Nakasako, Diana
; Rodrigues, Clarissa Garcia
; Rodrigues Junior, Anilton Bezerra
; Cascudo, Marcelo Matos
; Atik, Fernando Antibas
; Lima, Elson Borges
; Nina, Vinicius José da Silva
; Heluy, Renato Albuquerque
; Azeredo, Lisandro Gonçalves
; Henrique Junior, Odilon Silva
; Mendonça, José Teles de
; Silva, Katharina Kelly de Oliveira Gama
; Pandolfo, Marcelo
; Lima Júnior, José Dantas de
; Faria, Renato Max
; Santos, Jonas Gonçalves dos
; Coelho, Guilherme Henrique Biachi
; Pereira, Sergio Nunes
; Senger, Roberta
; Buffolo, Enio
; Caputi, Guido Marco
; Oliveira, Juliana Aparecida Borges de
; Gomes, Walter J.
.
Brazilian Journal of Cardiovascular Surgery
- Métricas do periódico
Abstract Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective: To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods: A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results: Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion: CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.
https://doi.org/10.21470/1678-9741-2018-0313
1270 downloads
3.
Associaton between violence and drug consumption with suicide in lesbians, gays, bisexuals, transvestites, and transsexuals: cross-sectional study
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Albuquerque, Grayce Alencar
; Figueiredo, Francisco Winter dos Santos
; Paiva, Laércio da Silva
; Araújo, Márcio Flávio Moura de
; Maciel, Erika da Silva
; Adami, Fernando
.
Abstract: Introduction: Lesbian, gay, bisexual, transvestite, and transgender (LGBT) people are affected by prejudice and psychological, physical, and/or sexual violence due to their sexual orientation. Objective: To analyze the association between violence, drug use, and suicide in LGBT people. Method: We interviewed 316 LGBT people from two cities of the Brazilian Northeast by means of a structured instrument. This included questions about sociodemographic data, sexual orientation, type of violence, type and quantity of drugs consumed, and suicide. Results: There was a positive association between physical violence and anabolic consumption (p = .001) and tranquilizers (p = .012). In relation to psychological and verbal violence, there was a positive association with the use of tranquilizers (p = .021) and negative with the use of amphetamines (p = .027). Suicide attempts were associated with having experienced physical (p = .03) and sexual (p = .037) violence. Drug use, especially ecstasy, cocaine, marijuana, and tranquilizers, was also associated with suicide attempts (p = .002, p = .031, p < .001, p < .001, respectively). The participants who had already attempted suicide were more vulnerable to experience violence and consume drugs within 30 days prior to the interview (p < .001). Discussion and conclusion: Psychological/verbal violence showed to be associated with the use of amphetamines, while physical violence was associated with a higher consumption of tranquilizers and anabolic steroids. Suicide attempts were more common among participants who had suffered physical violence and who were users of substances such as ecstasy, cocaine, marijuana, and tranquilizers.
Resumen: Introducción: Las personas lesbianas, gays, bisexuales, travestis y transexuales (LGBT) se ven afectadas por juicios y violencia psicológica, física y/o sexual debido a su orientación sexual. Objetivo: Analizar la asociación entre violencia, uso de drogas y suicidio en personas LGBT. Método: Entrevistamos a 316 personas LGBT de dos ciudades del Noreste brasileño por medio de un instrumento estructurado. Esto incluyó preguntas sobre datos sociodemográficos, orientación sexual, tipo de violencia, tipo y cantidad de drogas consumidas y suicidio. Resultados: Se encontró una asociación positiva entre la violencia física y el consumo de anabólicos (p = .001) y tranquilizantes (p = .012). En relación con la violencia psicológica y verbal, hubo una asociación positiva con el uso de tranquilizantes (p = .021) y negativa con el uso de anfetaminas (p = .027). Los intentos de suicidio se asociaron con la violencia física (p = .03) y sexual (p = .037). El consumo de drogas, especialmente éxtasis, cocaína, marihuana y tranquilizantes, se asoció también con intentos de suicidio (p = .002, p = .031, p < .001, p < .001, respectivamente). Los participantes que ya habían intentado suicidarse eran más vulnerables a experimentar violencia y consumir drogas dentro de los 30 días previos a la entrevista (p < .001). Discusión y conclusión: La violencia psicológica/verbal se asoció con el uso de anfetaminas, mientras que la violencia física se asoció con un mayor consumo de tranquilizantes y esteroides anabólicos. Los intentos de suicidio fueron más comunes entre los participantes que habían sufrido violencia física y que consumían sustancias como el éxtasis, la cocaína, la marihuana y los tranquilizantes.
https://doi.org/10.17711/sm.0185-3325.2018.015
1659 downloads
4.
Brazilian guidelines for the diagnosis and treatment of cystic fibrosis
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Athanazio, Rodrigo Abensur
; Silva Filho, Luiz Vicente Ribeiro Ferreira da
; Vergara, Alberto Andrade
; Ribeiro, Antônio Fernando
; Riedi, Carlos Antônio
; Procianoy, Elenara da Fonseca Andrade
; Adde, Fabíola Villac
; Reis, Francisco José Caldeira
; Ribeiro, José Dirceu
; Torres, Lídia Alice
; Fuccio, Marcelo Bicalho de
; Epifanio, Matias
; Firmida, Mônica de Cássia
; Damaceno, Neiva
; Ludwig-Neto, Norberto
; Maróstica, Paulo José Cauduro
; Rached, Samia Zahi
; Melo, Suzana Fonseca de Oliveira
; Pinto, Leonardo Araújo
; Monte, Luciana Freitas Velloso
; Higa, Laurinda Yoko Shinzato
; Folescu, Tania Wrobel
; Marson, Fernando Augusto de Lima
; Sad, Isabela
; Servidoni, Maria de Fátima Correa Pimenta
; Kussek, Paulo
; Raskin, Salmo
; Zuana, Adriana Della
; Augustin, Albin
; Hoffmann, Anneliese
; Barbisan, Beatriz
; Hochhegger, Bruno
; Levy, Carlos Emilio
; Veiga, Claudine Sarmento da
; Ricachinevsky, Claudio
; Esposito, Concetta
; Escuissato, Dante
; Brandemburgo, Diego
; Marques, Elisabeth
; Aquino, Evanirso de
; Fischer, Gilberto Bueno
; Rodrigues, Joaquim Carlos
; Machado, Leticia
; Muramato, Lucia
; Costa, Lusmaia Damasceno Camargo
; Donadio, Marcio
; Castro, Marcos César Santos de
; Ribeiro, Maria Angela
; Santana, Maria Angélica
; Canan, Mariane
; Almeida, Marina Buarque de
; Britto, Murilo
; Dalcin, Paulo Roth Tarso
; Ramos, Regina Terse Trindade
; Chiba, Sonia
; Martins, Valéria de Carvalho
; Lacerda, Claudine
; Barbosa, Eliana
; Guimarães, Elizabet Vilar
; Hessel, Gabriel
; Gurmini, Jocemara
; Neri, Lenycia
; Nogueira, Marcelo Coelho
; Wayhs, Mônica Chang
; Simon, Miriam Isabel Santos
; Fernandes, Arlene Gonçalves dos Santos
; Silva, Claudia de Castro de
; Albuquerque, Cristiano Túlio Maciel
; Souza, Edna Lúcia
; Silva, Fernando Antonio de Abreu e
; Dalcin, Paulo de Tarso
; Noronha, Renata Maria de
; Teixeira, Ricardo
; Machado, Sandra Helena
; Camargo, Spencer Marcantonio
; Rozov, Tatiana
; Rodrigues, Ticiana da Costa
.
RESUMO A fibrose cística (FC) é uma doença genética autossômica recessiva caracterizada pela disfunção do gene CFTR. Trata-se de uma doença multissistêmica que ocorre mais frequentemente em populações descendentes de caucasianos. Nas últimas décadas, diversos avanços no diagnóstico e tratamento da FC mudaram drasticamente o cenário dessa doença, com aumento expressivo da sobrevida e qualidade de vida. Atualmente, o Brasil dispõe de um programa de ampla cobertura para a triagem neonatal de FC e centros de referência distribuídos na maior parte desses estados para seguimento dos indivíduos. Antigamente confinada à faixa etária pediátrica, tem-se observado um aumento de pacientes adultos com FC tanto pelo maior número de diagnósticos de formas atípicas, de expressão fenotípica mais leve, assim como pelo aumento da expectativa de vida com os novos tratamentos. Entretanto, ainda se observa uma grande heterogeneidade no acesso aos métodos diagnósticos e terapêuticos para FC entre as diferentes regiões brasileiras. O objetivo dessas diretrizes foi reunir as principais evidências científicas que norteiam o manejo desses pacientes. Um grupo de 18 especialistas em FC elaborou 82 perguntas clínicas relevantes que foram divididas em cinco categorias: características de um centro de referência; diagnóstico; tratamento da doença respiratória; tratamento gastrointestinal e nutricional; e outros aspectos. Diversos profissionais brasileiros atuantes na área da FC foram convidados a responder as perguntas formuladas pelos coordenadores. A literatura disponível foi pesquisada na base de dados PubMed com palavras-chave, buscando-se as melhores respostas às perguntas dos autores.
ABSTRACT Cystic fibrosis (CF) is an autosomal recessive genetic disorder characterized by dysfunction of the CFTR gene. It is a multisystem disease that most often affects White individuals. In recent decades, various advances in the diagnosis and treatment of CF have drastically changed the scenario, resulting in a significant increase in survival and quality of life. In Brazil, the current neonatal screening program for CF has broad coverage, and most of the Brazilian states have referral centers for the follow-up of individuals with the disease. Previously, CF was limited to the pediatric age group. However, an increase in the number of adult CF patients has been observed, because of the greater number of individuals being diagnosed with atypical forms (with milder phenotypic expression) and because of the increase in life expectancy provided by the new treatments. However, there is still great heterogeneity among the different regions of Brazil in terms of the access of CF patients to diagnostic and therapeutic methods. The objective of these guidelines was to aggregate the main scientific evidence to guide the management of these patients. A group of 18 CF specialists devised 82 relevant clinical questions, divided into five categories: characteristics of a referral center; diagnosis; treatment of respiratory disease; gastrointestinal and nutritional treatment; and other aspects. Various professionals working in the area of CF in Brazil were invited to answer the questions devised by the coordinators. We used the PubMed database to search the available literature based on keywords, in order to find the best answers to these questions.
https://doi.org/10.1590/s1806-37562017000000065
75529 downloads
5.
The Brazilian Registry of Adult Patient Undergoing Cardiovascular Surgery, the BYPASS Project: Results of the First 1,722 Patients
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Gomes, Walter J.
; Moreira, Rita Simone
; Zilli, Alexandre Cabral
; Bettiati Jr, Luiz Carlos
; Figueira, Fernando Augusto Marinho dos Santos
; D' Azevedo, Stephanie Steremberg Pires
; Soares, Marcelo José Ferreira
; Fernandes, Marcio Pimentel
; Ardito, Roberto Vito
; Bogdan, Renata Andrea Barberio
; Campagnucci, Valquíria Pelisser
; Nakasako, Diana
; Kalil, Renato Abdala Karam
; Rodrigues, Clarissa Garcia
; Rodrigues Junior, Anilton Bezerra
; Cascudo, Marcelo Matos
; Atik, Fernando Antibas
; Lima, Elson Borges
; Nina, Vinicius José da Silva
; Heluy, Renato Albuquerque
; Azeredo, Lisandro Gonçalves
; Henrique Junior, Odilon Silva
; Mendonça, José Teles de
; Silva, Katharina Kelly de Oliveira Gama
; Pandolfo, Marcelo
; Lima Júnior, José Dantas de
; Faria, Renato Max
; Santos, Jonas Gonçalves dos
; Paez, Rodrigo Pereira
; Coelho, Guilherme Henrique Biachi
; Pereira, Sergio Nunes
; Senger, Roberta
; Buffolo, Enio
; Caputi, Guido Marco
; Santo, José Amalth do Espírito
; Oliveira, Juliana Aparecida Borges de
; Berwanger, Otavio
; Cavalcanti, Alexandre Biasi
; Jatene, Fabio B.
.
Brazilian Journal of Cardiovascular Surgery
- Métricas do periódico
Abstract Objective: To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Methods: Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1). The study population consists of patients over 18 years of age, and the types of operations recorded were: coronary artery bypass graft (CABG), mitral valve, aortic valve (either conventional or transcatheter), surgical correction of atrial fibrillation, cardiac transplantation, mechanical circulatory support and congenital heart diseases in adults. Results: 83.1% of patients came from the public health system (SUS), 9.6% from the supplemental (private insurance) healthcare systems; and 7.3% from private (out-of -pocket) clinic. Male patients comprised 66%, 30% were diabetics, 46% had dyslipidemia, 28% previously sustained a myocardial infarction, and 9.4% underwent prior cardiovascular surgery. Patients underwent coronary artery bypass surgery were 54.1% and 31.5% to valve surgery, either isolated or combined. The overall postoperative mortality up to the 7th postoperative day was 4%; for CABG was 2.6%, and for valve operations, 4.4%. Conclusion: This first report outlines the consecution of the Brazilian surgical cardiac database, intended to serve primarily as a tool for providing information for clinical improvement and patient safety and constitute a basis for production of research protocols.
https://doi.org/10.21470/1678-9741-2017-0053
1883 downloads
6.
Mineralogia, geoquímica e evolução da lateritização em Apuí, sudeste do Amazonas
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Análises químicas, DRX e MEV realizadas em bauxitas, crostas ferruginosas e ferro-alumino-silicosas, aliadas ao estudo do relevo, tiveram por objetivo discutir os processos que levaram a formação e preservação das crostas lateríticas ao longo do tempo geológico no sudeste do Amazonas. As crostas são maciças, pisolíticas, brechóides e vermiformes, sustentam platôs e colinas com altitudes entre 200 e 320 m e 140 e 200 m, e desenvolveram-se a partir de rochas ígneas e sedimentares dos grupos Colíder e Alto Tapajós e do Supergrupo Sumaúma. A correlação entre os produtos da lateritização e as rochas identificou três associações: (1) congrega arenitos, vulcânicas e siltitos em razão da associação SiO2-Ba-Rb; (2) agrupa bauxitas e solos relacionados Al2O3-TiO2-PF-Y-Ta-Nb-U-Th-Ga-Hf-Zr-ETR; (3) reúne a bauxita pisolítica, crostas ferruginosas e ferro-alumino-silicosas vinculadas a Fe2O3-Ag-As-Ni-Pb-V. Aspectos geoquímicos e a ausência de seixos quartzosos indicam que o protólito da bauxita maciça e do solo sobrejacente é a rocha vulcânica, enquanto a bauxita pisolítica e a crosta vermiforme ferro-alumino-silicosa derivam dos arenitos do Supergrupo Sumaúma, e as demais crostas ferruginosas a ferro-alumino-silicosas correlacionam-se ao Grupo Alto Tapajós. As ações erosivas foram facilitadas pela incisão dos rios Aripuanã, Acari e Sucunduri; pelo condicionamento de grábens e horsts; e pelas épocas mais secas no Quaternário Amazônico, que resultaram em relevo dissecado, perfis truncados, formação de linhas de pedra e solo pouco espesso.
Chemical analysis, XRD and SEM carried out in bauxites, Fe-rich and siliceous Fe-Al duricrusts of southeast of Amazonas state, associated to relief study, aimed to discuss the process that led to the formation and preservation of crusts through the geologic time. The crusts are massive, pisolitic, fragmental and vermiform textures, and support plateaus and hills with elevation between 200 to 320 m and 140 to 200 m, and developed from igneous and sedimentary rocks of Colíder and Alto Tapajós Group's and Supergroup Sumaúma. The correlation among lateritization products and rocks were defined for three main geochemistry associations: (1) that includes sandstones, volcanics and siltstones due to the association SiO2-Ba-Rb; (2) gathers bauxites and soils related to Al2O3-TiO2-PF-Y-Ta-Nb-U-Th-Ga-Hf-Zr-ETR; (3) brings together the pisolitic bauxite, Fe-rich and siliceous Fe-Al duricrusts assigned to Fe2O3- Ag-As-Ni-Pb-V. Geochemistry aspects and absence of quartz pebbles were used to recognize the protolith of bauxites and lateritic duricrusts, therefore massive bauxite and the overlapped soil belong to volcanics rocks. Sandstones of Supergroup Sumaúma are correlated with pisolitic bauxites and vermiform siliceous Fe-Al duricrust, however Alto Tapajós Group is related to the other crusts. The erosion was facilitated by the incision of Aripuanã, Acari and Sucunduri rivers; by the conditioning of grabens and horsts; and by dry seasons in Quaternary Amazonian that promoted the formation of truncated profiles with stone line exposures, dissected relief and thin soil.
https://doi.org/10.1590/2317-488920150030281
3202 downloads
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