In this work, the local electrochemical activity of the zones coupled by Friction Stir Welding (FSW) of an Al-Cu-Li alloy was studied and the results were correlated to the microstructural characteristics of each zone. Electrochemical studies were carried out in the zones affected by welding using cyclic voltammetry (CV) and scanning electrochemical techniques (namely, SECM - Scanning Electrochemical Microscopy and LEIS - Local electrochemical impedance spectroscopy). The results showed that the welding joint (WJ) is predominantly cathodic relatively to the heat affected zones (HAZ). The HAZ was always anodic and showed the highest electrochemical activities among the tested ones. The high electrochemical activity of the HAZ was associated with the effect of galvanic coupling between the cathodic region (WJ) and the anodic region (HAZ). In addition, the advancing side (AS) presented increased electrochemical activity compared to the retreating one (RS).

Natural dyes can be used in dye sensitized solar cells (DSSCs) to generate low-cost devices, although with low light harvesting because of energy losses from the recombination process. This study investigates recombination reactions in DSSCs with natural dyes extracted from eggplants, plums, and hibiscus flowers. Titanium dioxide films were coated on a fluorine-doped tin oxide glass conductor substrate by the doctor blading method and impregnated in a dye solution for 24 h. Electrodeposited platinum was used as the cathode, and I3–/I– as the redox couple. The techniques employed were: intensity modulated photovoltage spectroscopy, intensity modulated photocurrent spectroscopy, electrochemical impedance spectroscopy, charge extraction, and cyclic voltammetry. The results show that cells containing plum dye exhibited the best photovoltaic parameters, with high values of gap, charge extraction, and potential, being less resistive to charge transfer with an electron lifetime of 0.51 s, collection time of 8.54 ms, and charge efficiency collection of 0.99.

Abstract Civil construction generates the largest amount of construction and demolition waste (CDW), most of which is not reused and is discarded as inert waste in landfills. The purpose of this study was to evaluate the feasibility of reusing gypsum recovered from CDW in the preparation of mortar. This material was examined to determine its specific mass, morphology, elemental composition and particle size distribution. Test specimens were prepared with a mix design of 1:3 (cement:sand), with the gypsum waste substituting part of sand in proportions of 0, 10, 20 and 30% (in volume). The consistency of the fresh mortar was evaluated: the specimens were tested to determine their flexural and compressive strength, apparent density, water absorption, voids index, and specific mass. After 28 days, the mechanical strength of the specimens exceeded the limits specified by NBR 13281 standard, indicating that up to 30% of ground gypsum waste can be included in a mortar.

Resumo As construções históricas possuem elevado significado e importância para a sociedade. Como contribuição à preservação do patrimônio histórico, o presente trabalho apresenta um estudo sobre o comportamento dinâmico de uma edificação histórica, inserida no âmbito do patrimônio histórico da cidade de Sobral, localizada na região norte do estado do Ceará, nomeadamente Igreja de Nossa Senhora das Dores, uma capela do início Século XIX, construída em alvenaria de tijolos maciços. Neste estudo foi realizado o ensaio de vibração ambiental com objetivo de obter as frequências naturais da edificação com foco à calibração do modelo numérico e, a partir dele, com recurso ao software Ansys®, realizar a caracterização modal via Método dos Elementos Finitos (MEF). Os resultados obtidos permitiram analisar o comportamento dinâmico da estrutura, no que se refere à obtenção das frequências naturais, modos de vibração e deslocamentos direcionais.

Abstract Heritage constructions presents high significance and importance for society. As way of contribution for the preservation of the heritage constructions, this paper presents a study on the dynamic behavior of a heritage construction, part of the historic center of Sobral city, located at the north region of Ceará State, namely the Nossa Senhora das Dores Church, a church from the beginning of the 19th century, built in clay brick walls. In this study, ambient vibration tests were performed aiming to obtainment of the natural frequencies of the building focusing the calibration of the numerical model and, from it, proceeding with modal analysis by Finite Element Method (FEM) with recurrence to software Ansys®. The results allowed the analysis of the structural dynamic behavior taking into account natural frequencies, modal shapes and directional displacements.

RESUMO Sistemas óticos são reconhecidos como uma importante ferramenta para a monitorização estrutural, especialmente para avaliação da segurança em tempo real, devido a configuração simplificada e o baixo custo destes sistemas quando comparado com sistemas usuais, nomeadamente sistemas elétricos. Este trabalho tem por objetivo apresentar um caso de estudo sobre monitorização estrutural focado na avaliação da fiabilidade através da utilização de um sistema sensorial ótico simplificado. Dessa forma, um reservatório elevado de água de concreto armado foi instrumentado com um acelerómetro ótico biaxial e monitorado desde janeiro de 2014. Tendo em conta os dados de aceleração, as frequências naturais e os deslocamentos relativos foram calculados. Neste trabalho, a análise de fiabilidade é realizada baseada na distribuição de valores extremos e os resultados obtidos são ainda utilizados para a predição sobre a segurança estrutural do reservatório de água para os próximos 100 anos. Os resultados mostraram que o sistema ótico de monitorização implementado neste trabalho combinado com a análise por distribuição dos valores extremos pode fornecer dados adequados para a avaliação da fiabilidade estrutural.

ABSTRACT Optical systems are recognized to be an important tool for structural health monitoring, especially for real time safety assessment, due to simplified system configuration and low cost when compared to regular systems, namely electrical systems. This work aims to present a case study on structural health monitoring focused on reliability assessment and applying data collected by a simplified optical sensing system. This way, an elevated reinforced concrete water reservoir was instrumented with a bi-axial optical accelerometer and monitored since January 2014. Taking into account acceleration data, the natural frequencies and relative displacements were estimated. The reliability analysis was performed based on generalized extreme values distribution (GEV) and the results were employed to build a forecast of the reliability of the water elevated reservoir for the next 100 years. The results showed that the optical system combined with GEV analysis, implemented in this experimental work, can provide adequate data for structural reliability assessment.

Resumo A hidroxiapatita sintética (Ca10(PO4)6(OH)2; HA) devido à propriedade de biocompatibilidade com o tecido ósseo tornou-se um material cerâmico amplamente utilizado na reconstrução óssea. A biocompatibilidade assim como outras propriedades físico-químicas da hidroxiapatita podem ser modificadas por meio da adição de diferentes íons na sua estrutura. O íon nióbio (V) não tem sido empregado comumente na síntese de hidroxiapatitas. O objetivo deste trabalho foi verificar o emprego da rota hidrotérmica na síntese de hidroxiapatita dopada com íon nióbio (V). A rota empregada utiliza o complexo di-hidrogeno tris(oxalato) oxiniobato (V) de amônio trihidratado (NH4H2[NbO(C2O4)3].3H2O), como precursor de íon nióbio (V). A adição de ácido cítrico e ureia na rota hidrotérmica é usada para o controle do pH da síntese e da taxa de precipitação. Amostras pura e aditivada com 5,3 ppm de íon nióbio (V) foram obtidas. A coexistência de outras fases além da hidroxiapatita não foi observada em ambas amostras por meio dos empregos das técnicas de difração de raios X e espectroscopia no infravermelho. Por meio da técnica de FTIR observou-se a presença de grupos funcionais característicos da hidroxiapatita. Na análise por microscopia eletrônica de varredura, verificou-se a formação de aglomerados compostos por partículas arredondadas confirmadas pela técnica de microscopia eletrônica de transmissão. A análise espectroscópica de fluorescência de raios X detectou a presença de nióbio na amostra aditivada obtida. Os resultados apontam que podem ser sintetizadas hidroxiapatitas aditivadas com íon nióbio (V) por meio da rota hidrotérmica, podendo ser considerado como enorme o potencial para a aplicação em biocerâmicas.

Abstract Synthetic hydroxyapatite (Ca10(PO4)6(OH)2; HA) has become a widely used ceramic material for bone reconstruction due to its biocompatibility with the bone tissue. This biocompatibility as well as other physical and chemical properties of the hydroxyapatite can be modified by the addition of different ions to its structure. Niobium (V) ion has not been commonly used in the hydroxyapatite synthesis. The objective of this study was to evaluate the use of hydrothermal route in the niobium (V) doped hydroxyapatite synthesis. The route used the niobium ammonium oxalate (NH4H2[NbO(C2O4)3].3H2O) complex as a niobium (V) ion precursor. The addition of citric acid and urea in the hydrothermal route is used for the control of synthesis pH and precipitation rate. Pure sample and sample added with 5.3 ppm of niobium (V) ion were prepared. The coexistence of other phases besides the hydroxyapatite was not observed in any of the samples through the use of X-ray diffraction and infrared spectroscopy (FTIR) techniques. The FTIR technique revealed the presence of hydroxyapatite characteristic functional groups. The scanning electron microscopy analysis showed the formation of agglomerates composed of round particles, confirmed by the transmission electron microscopy technique. The X-ray fluorescence spectroscopic analysis detected the presence of niobium in the doped sample. The results showed that niobium (V) doped hydroxyapatite can be synthesized by means of hydrothermal route, which may be considered as huge potential for future application in bioceramics.

A cromagem é uma opção que a indústria de metal mecânica tem encontrado para aumentar a resistência à corrosão de peças metálicas, porém esse revestimento apresenta a desvantagem de ser tóxico ao ser humano e ao meio ambiente. Para se alcançar um novo tratamento de superfície, pode-se aplicar planejamento experimental, a fim de otimizar os experimentos, principalmente quando há diversas variáveis para se chegar ao processo ou produto final. O objetivo principal deste trabalho é utilizar planejamento experimental para se obter um revestimento cerâmico à base de óxido de nióbio para ligas de alumínio 3003 e compará-lo ao revestimento de Cr (III), no mesmo substrato metálico. As técnicas empregadas foram polarização potenciodinâmica anódica, espectroscopia de impedância eletroquímica, microscopia eletrônica de varredura e mapeamento por espectroscopia de energia dispersiva. Utilizou-se um planejamento experimental 2³, no qual as variáveis foram velocidade de imersão, tempo de repouso após imersão e emersão na solução sol-gel à base de óxido de nióbio (razões molares n/n ácido cítrico/etilenoglicol 1:4, ácido e o complexo amoniacal de nióbio 10:1). Registrou-se uma tendência nas superfícies de respostas estudadas, sugerindo que em 5 min de imersão e emersão e na velocidade de 18 cm/min, o filme gerado apresenta uma maior resistência à corrosão. Os resultados de impedância eletroquímica e polarização potenciodinâmica anódica mostraram que o filme de óxido de nióbio apresenta maior resistência à corrosão que o revestimento utilizado industrialmente. Sendo assim, esse novo tratamento de superfície torna-se uma opção de substituição do revestimento a base de Cr (III).

The plating is an option that the metalworking industry has been found to increase the corrosion resistance of metal parts, but this coating is toxic to humans and to the environment. To achieve a new surface treatment the experimental design may be applied to optimize the experiments, especially when there are many variables to obtain at the final product or process. The main objective of this paper is to use experimental design to obtain a ceramic coating based on niobium oxide over 3003 aluminum alloys and to compare it to the Cr (III) coating, in the same metallic substrate. The techniques employed were anodic potentiodynamic polarization, electrochemical impedance spectroscopy, scanning electron microscopy and mapping by energy dispersive spectroscopy. An experimental design 23was used, where the variables were sol-gel sink rate, settling time after immersion and emersion in the base solution of niobium oxide (molar ratios n/n citric acid/ethylene glycol 1:4 acid and niobium ammonium complex 10:1). A tendency on the responses of the surfaces was detected, suggesting that at 5 min of immersion and emersion time and speed of 18 cm/min, the film achieved a higher corrosion resistance. The results of potentiodynamic polarization and electrochemical impedance spectroscopy showed that the anodic film of niobium oxide is more resistant than the coating used industrially, so that new surface treatment becomes a replacement option for Cr (III) coating.

OBJECTIVES: Anemia is a common complication among chronic kidney disease patients on hemodialysis, occurring mostly due to erythropoietin deficiency. This randomized noninferiority trial sought to compare the efficacy and safety of a new epoetin formulation developed by Bio-Manguinhos, a biologics manufacturer affiliated with the Brazilian government, with those of a commercially available product currently used in Brazil (a biosimilar epoetin formulation). METHODS: The sample size needed to enable demonstration of noninferiority with a statistical power of 85% for a between-group difference in hemoglobin levels of no more than 1.5 g/dL was calculated. In total, 74 patients were randomly assigned to receive the epoetin formulation from Bio-Manguinhos (n = 36) or the biosimilar epoetin formulation (n = 38) in a double-blind fashion. The inclusion criteria were current epoetin therapy and stable hemoglobin levels for at least 3 months prior to the study. The primary and secondary outcomes were mean monthly hemoglobin levels and safety, respectively. The dose was calculated according to international criteria and adjusted monthly in both groups according to hemoglobin levels and at the assistant physicians' discretion. Iron storage was estimated at baseline and once monthly. Clinicaltrials.gov: NCT01184495. RESULTS: The study was conducted for 6 months after randomization. The mean baseline hemoglobin levels were 10.9±1.2 and 10.96±1.2 g/dL (p = 0.89) in the Bio-Manguinhos epoetin and biosimilar epoetin groups, respectively. During the study period, there was no significant change in hemoglobin levels in either group (p = 0.055, ANOVA). The epoetin from Bio-Manguinhos was slightly superior in the last 3 months of follow-up. The adverse event profiles of the two formulations were also similar. CONCLUSIONS: The epoetin formulations tested in this study are equivalent in efficacy and safety.

OBJETIVOS: Avaliar a prevalência e a circulação dos genótipos de rotavírus, antes e após a introdução da vacina oral contra rotavírus humano, bem como verificar uma possível mudança na faixa etária de ocorrência da infecção pelo RV-A. MÉTODOS: Trata-se de um estudo transversal realizado no período de 2002 a 2011, em Juiz de Fora, MG. Foram avaliados 1.144 espécimes fecais diarreicos, obtidos de crianças de 0 a cinco anos não hospitalizadas, que foram analisadas por PAGE e RT-PCR. Os dados relativos à prevalência e distribuição etária dos casos de rotavirose foram analisados pelo teste χ2 (p < 0,05), utilizando-se o programa SPSS, versão 13.0. RESULTADOS: Infecções por rotavírus foram detectadas em 9,35% (107/1.144) das amostras, com prevalências variando de 11,12% (90/809) no período pré-vacinal a 5,07% (17/335) no pós-vacinal (p = 0,001). Dentre as amostras caracterizadas, os genótipos mais frequentemente detectados foram G1P[6] (6/33 = 18,2%) no período 2002-2005 e G2P[4] no ano de 2006 (11/33 = 33,3%) e no período 2007-2011 (5/33 = 15,2%). Observou-se, ainda, uma redução significativa no número de casos de rotavirose em crianças de 0 a 36 meses, após a introdução da vacina. CONCLUSÕES: O estudo revelou queda significativa na prevalência de rotavírus, principalmente na faixa etária de 0 a 36 meses, no período 2007-2011, bem como redução na circulação do genótipo G1.

OBJECTIVES: To evaluate the prevalence and circulation of rotavirus genotypes before and after the introduction of oral vaccine against human rotavirus (OVHR), and to check for a possible change in the age of occurence of the infection by RV-A. METHODS: This was a cross-sectional study conducted between 2002-2011, in the city of Juiz de Fora, state of Minas Gerais, Brazil. A total of 1,144 diarrheal stool specimens were obtained from nonhospitalized children aged between 0 and 5 years, and analyzed by polyacrylamide gel electrophoresis and reverse-transcription polymerase chain reaction for genotype characterization. Data on prevalence and age distribution of rotavirus cases were analyzed through the chi-squared test (p < 0.05), using SPSS, release 13.0. RESULTS: Rotavirus infection was detected in 9.35% (107/1,144) samples, with prevalence rates ranging from 11.12% (90/809) in the pre-vaccine to 5.07% (17/335) in the post-vaccine period (p = 0.001). Among the samples tested, the most frequently detected genotypes were G1P[6] (6/33 = 18.2%) in the period between 2002 and 2005 and G2P[4] in 2006 (11/33 = 33.3%) and in the period between 2007 and 2011 (5/33 = 15.2%). There was also a significant reduction in the number of cases of rotavirus disease in children aged between 0 and 36 months after the vaccine introduction. CONCLUSIONS: The study evidenced a significant decrease in the prevalence of rotavirus, mainly in children aged between 0 and 36 months in the 2007-2011 period, as well as a reduction in G1 genotype circulation.

Background: This study analyzed the phase-angle (PA) values of hospitalized HVI-infected patients by comparing them with those reported for a healthy population and investigated their relation with nutritional parameters. Methods: This is a cross-sectional study including 101 hospitalized patients diagnosed with HIV infection and evaluated by bioimpedance, anthropometry and biochemical tests. The phase angle values, weight loss percentage (%WL), body mass index (BMI), arm muscle circumference (AMC), tricipital skinfold (TSF), body fat percentage (%BF) and albumin were considered. In order to compare with values for the healthy population, the PA z-score of the patients under study was calculated. Spearman's correlation and the multiple linear regression model were used to identify nutritional parameters associated with the PA z-score. Results: The patients showed a mean PA z-score of -2.6 ± 1.5, and only 6.6% of them with a positive value. The PA z-score values correlated with %WL (r = -0.51; p < 0.0001), albumin (r = 0.49; p < 0.0001), BMI (r = 0.58; p < 0.0001), AMC (r = 0.41; p < 0.0001), TSF (r = 0.47; p < 0.001) and %BF (r = 0.48, p < 0.0001). In multiple analysis %WL (p = 0.008), albumin (p = 0.01), AMC (p < 0.0001) and %BF (p = 0.0003) remained associated with the score. Conclusions: Low PA z-score values were observed, suggesting a worse clinical prognosis for the patients. The inclusion of the PA z-score as a nutritional indicator during care provision to HIV-infected patients is recommended.

Antecedentes: Este estudio analizaba los valores del ángulo de fase (AF) de pacientes hospitalizados e infectados por el VIH al compararlos con los notificados para un población sana e investigaba su relación con los parámetros nutricionales. Métodos: Se trataba de un estudio transversal que incluyó a 101 pacientes hospitalizados diagnosticados de infección por el VIH y en los que se evaluó la bioimpedancia, la antropometría y parámetros bioquímicos. Se consideraron los valores del ángulo de fase, el porcentaje de pérdida de peso (%PP), el índice de masa corporal (IMC), la circunferencia muscular del brazo (CMB), el pliegue tricipital (PT), el porcentaje de grasa corporal (%GC) y la albúmina. Para compararlos con los de una población sana, se calcularon las puntuaciones z del AF de los pacientes estudiados. Se emplearon la correlación de Spearman y el modelo de regresión linear múltiple para identificar los parámetros nutricionales asociados con la puntuación z del AF. Resultados: Los pacientes mostraron una puntuación z del AF de -2,6 ± 1,5, el 23,7% de ellos tenían un valor superior a -1,65 y sólo el 6,6% un valor positivo. Los valores de las puntuaciones z del AF se correlacionaron con el %PP (r = -0,51; p < 0,0001), la albúmina (r = 0,49; p < 0,0001), el IMC (r = 0,58; p < 0,0001), la CMB (r = 0,41; p < 0,0001), el PT (r = 0,47; p < 0,001) y el %GC (r = 0,48, p < 0,0001). En el análisis múltiple, el %PP (p = 0,008), la albúmina (p = 0,01), la CMB (p < 0,0001) y el %GC (p = 0,0003) seguían asociándose con la puntuación z. Conclusiones: Obtuvimos unos valores bajos de puntuación z del AF, lo que sugiere un peor pronóstico clínico en los pacientes. Recomendamos la inclusión de la puntuación z del AF como un indicador nutricional durante la provisión de la atención sanitaria a los pacientes infectados por el VIH.

Numerical simulation of realistic compressible flows is very important and requires accurate and flexible tridimensional formulations, which should furthermore be robust and efficient. In this work we describe the development of a computational tool for numerical simulation of inviscid compressible 3-D fluid flow problems. This tool uses as the main building block an edge-based Galerkin FEM (Finite Element Method) together with a MUSCL (Monotonic Upstream-centered Schemes for Conservations Laws) approach to get a higher-order scheme with LED (Local Extremum Diminishing) property. The code is particularly developed for the simulation of supersonic and hypersonic flow regimes and several important (sometimes unavoidable) numerical procedures incorporated to increase its robustness are described. Some aspects related to the adoption of an edge-based data structure and other implementation issues are also described. Finally, some numerical model problems are analyzed and compared with results found in the literature demonstrating the effectiveness of the developed tool.

A toxicological study was performed in Beagle dogs treated for 180 days with the product João da Costa e Associações. Were used six males and six females distributed in control and treated groups (n=3). We used a dose of 566 mg/kg of the product according to preclinical study in rodents. The animals were weighed and evaluated by clinical and laboratory aspects. The product did not cause mortality or alter the normal behavior of animals, but interfered with the weight gain on males in the middle phase of the treatment. The group treated had a lower incidence of clinical abnormalities compared to control, checked by veterinary consultations. Laboratory data showed elevated blood glucose levels perhaps due to the high amount of sucrose present in the product; about the histopathological data no significant change was found. We conclude that the product Joao da Costa and Associações, at the dose tested, has low toxicity in Beagle dogs treated chronically.

OBJETIVO: Determinar a prevalência da doença celíaca e descrever as alterações histológicas, manifestações clínicas e condições associadas de um grupo de familiares de primeiro grau de celíacos na cidade de Recife (PE), Nordeste do Brasil. MÉTODO: O estudo foi realizado em ambulatórios de gastropediatria da cidade de Recife. Foram incluídos no estudo 174 familiares de primeiro grau submetidos à pesquisa do anticorpo antitransglutaminase IgA. Os familiares com sorologia positiva foram convidados a realizar biópsia do intestino delgado (classificadas segundo Marsh) e avaliação do peso, estatura, manifestações clínicas e condições associadas à doença celíaca. Foram utilizados os testes do qui-quadrado e de Fisher para avaliar as diferenças, considerando-se significativo o valor de p < 0,05. RESULTADOS: O anticorpo antitransglutaminase IgA foi positivo em 20,1% (34/174) dos familiares (IC95% 14,6-26,5). Não se observou diferença na positividade da sorologia quanto ao grau de parentesco, nem quanto ao sexo. Vinte e dois pacientes submeteram-se a biópsia. Treze apresentaram alterações histológicas grau III de Marsh; sete, grau I; e dois, grau zero, conferindo uma prevalência presumível de 11,5%. Todos os pacientes, exceto um, eram sintomáticos; o único paciente sem sintomas tinha baixa estatura. CONCLUSÃO: A prevalência de doença celíaca nesse grupo de familiares foi elevada. Todos os novos casos identificados tinham sintomas ou condições associadas. Nesse grupo, houve uma frequência elevada de indivíduos com sorologia positiva, sintomatologia sugestiva de doença celíaca e sem evidência de atrofia vilositária na mucosa intestinal.

OBJECTIVE: To determine the prevalence of celiac disease and to describe the histological alterations, clinical manifestations, and conditions associated with a group of first-degree relatives of celiac disease patients in the municipality of Recife, Northeast Brazil. METHOD: The study was conducted in outpatient clinics of pediatric gastroenterology located in Recife. We included in the study 174 first-degree relatives who were screened for the anti-transglutaminase IgA antibody. Those relatives who had positive serological tests were invited to undergo a small intestine biopsy (classified according to Marsh). They were also evaluated regarding weight, height, clinical symptoms and conditions associated with celiac disease. The chi-square test and Fisher's exact test were used to assess the differences with a significance level of p < 0.05. RESULTS: The anti-transglutaminase IgA antibody was positive for 20.1% (34/174) of the relatives (95%CI 14.6-26.5). There was no difference in terms of positive serological tests regarding either degree of kinship or sex. Twenty-two patients underwent biopsy. Thirteen had histological alterations classified as Marsh stage 3; seven had stage 1; and two had stage zero, with a probable prevalence of 11.5%. All patients, except for one, had symptoms; the only patient with no symptoms was short. CONCLUSION: Celiac disease prevalence in this group of relatives was high. All new cases identified were symptomatic or had associated conditions. In this group, there was a high frequency of individuals with positive serological tests, symptoms suggestive of celiac disease, and no evidence of villous atrophy in the intestinal mucosa.

FUNDAMENTO: Embora as doenças cardiovasculares sejam a maior causa de morbimortalidade em todo Brasil, o acesso das populações de cidades pequenas à eletrocardiografia e à avaliação cardiológica é limitado. O uso da telecardiologia para facilitar o acesso da população de municípios remotos à eletrocardiografia e à segunda opinião em cardiologia é promissora, entretanto não foi formalmente testada. OBJETIVO: Avaliar a viabilidade de se implantar o sistema público de telecardiologia de baixo custo em pequenas cidades brasileiras. MÉTODOS: Foram selecionadas 82 cidades do Estado de Minas Gerais, com população < 10.500 habitantes, > 70% de cobertura pelo Programa Saúde da Família (PSF), com interesse do gestor e acesso pela internet. Em cada município foi instalado um aparelho de eletrocardiógrafo (ECG) digital, com subsequente treinamento da equipe. A implantação foi coordenada pelo HC/UFMG, em conjunto com outros quatro hospitais universitários mineiros (UFU, UFTM, UFJF e UNIMONTES). Os ECGs foram realizados nos municípios e enviados pela internet para análise imediata em plantão de telecardiologia. Realizaram-se discussões de casos médicos on-line e off-line e cursos de atualização via web. RESULTADOS: No período de implantação, foram treinados 253 profissionais de saúde. De julho de 2006 a novembro de 2008, o projeto atendeu 42.664 pacientes, realizando 62.865 ECGs. Foram efetuados 2.148 atendimentos de urgência e 420 teleconsultorias. A avaliação intermediária apontou boa aceitação da tecnologia implantada e uma diminuição de 70% de encaminhamentos de pacientes para outros centros de referência. CONCLUSÃO: É factível a utilização de recursos habituais de informática para facilitar o acesso de populações de cidades pequenas à eletrocardiografia e avaliação cardiológica especializada.

BACKGROUND: Although cardiovascular diseases are the main cause of morbimortality in Brazil, the access of small-town populations to electrocardiography and cardiology assessment is limited. The use of telecardiology to assist the access of distant towns to electrocardiography and a second opinion in cardiology is promising; however, it has not been formally assessed. OBJECTIVE: To assess the feasibility of implementing a low-cost public telecardiology system in small Brazilian towns. METHODS: A total of 82 towns in the state of Minas Gerais, with a population < 10,500 inhabitants, presenting > 70% coverage by the Family Health Program (Programa Saude da Familia - PSF), local government compliance and internet access, were selected. Each town was supplied with digital electrocardiography (ECG) device and a team was trained. The implementation was coordinated by HC/UFMG, together with four university hospitals in the state of Minas Gerais (UFU, UFTM, UFJF and UNIMONTES). The ECG assessments were carried out in the towns and sent through the Internet for prompt analysis by an on-duty telecardiology team. Online and offline discussions on the medical cases were carried out through the Internet, as well as refreshment courses. RESULTS: During the implementation period, a total of 253 health professionals were trained. From July 2006 to November 2008, the project assisted 42,664 patients, with a total of 62,865 ECG assessments being performed. A total of 2,148 emergency cases were treated, as well as 420 teleconsultations. The intermediate evaluation showed good acceptance of the implemented technology and a 70% decrease in patient referrals to other reference centers. CONCLUSION: The use of the customary resources in informatics to assist the access of small-town populations to electrocardiography and specialized cardiology assessment is feasible.

FUNDAMENTO: Aunque las enfermedades cardiovasculares sean la mayor causa de morbimortalidade en todo Brasil, el acceso de las poblaciones de ciudades pequeñas a la electrocardiografía y a la evaluación cardiológica es limitado. El uso de la telecardiología para facilitar el acceso de la población de municipios remotos a la electrocardiografía y a la segunda opinión en cardiología es promisoria, sin embargo no fue formalmente testado. OBJETIVO: Evaluar la viabilidad de implantar el sistema público de telecardiología de bajo costo en pequeñas ciudades brasileñas. MÉTODOS: Fueron seleccionadas 82 ciudades del Estado de Minas Gerais, con población < 10.500 habitantes, > 70% de cobertura por el Programa Salud de la Familia (PSF), con interés del gestor y acceso por internet. En cada municipio fue instalado un aparato de electrocardiógrafo (ECG) digital, con subsecuente entrenamiento del equipo. La implantación fue coordinada por el HC/UFMG, en conjunto con otros cuatro hospitales universitarios mineros (UFU, UFTM, UFJF y UNIMONTES). Los ECGs fueron realizados en los municipios y enviados por internet para análisis inmediato en guardia de telecardiología. Se realizaron discusiones de casos médicos on-line y off-line y cursos de actualización vía web. RESULTADOS: En el período de implantación, fueron entrenados 253 profesionales de la salud. De julio de 2006 a noviembre de 2008, el proyecto atendió 42.664 pacientes, realizando 62.865 ECGs. Fueron efectuadas 2.148 atenciones de urgencia y 420 teleconsultorías. La evaluación intermediaria señaló buena aceptación de la tecnología implantada es una disminución de 70% de encaminamientos de pacientes para otros centros de referencia. CONCLUSIÓN: Es factible la utilización de recursos habituales de informática para facilitar el acceso de poblaciones de ciudades pequeñas a la electrocardiografía y evaluación cardiológica especializada.