RESUMO A crotalária (Crotalaria spectabilis) é amplamente utilizada na correção e cobertura do solo, mas ainda é necessário determinar as características que influenciam no armazenamento de suas sementes. Objetivou-se avaliar a qualidade fisiológica de sementes de crotalária durante o armazenamento, em condições de ambiente não controlado e em câmara climatizada. O delineamento experimental foi o inteiramente casualizado, com quatro repetições, em subparcelas divididas no tempo. As avaliações foram realizadas em sementes recém-colhidas e aos 90, 180 e 270 dias de armazenamento, por meio de germinação, primeira contagem de germinação, índice de velocidade de germinação, emergência de plântulas a campo, envelhecimento acelerado, teste de frio e crescimento de plântulas. O ambiente e o tempo de armazenamento influenciaram significativamente na germinação e vigor das sementes. As sementes apresentaram elevado desempenho fisiológico nas duas condições de ambiente, mantendo a capacidade de produzir plântulas normais até por volta de 150 dias de armazenamento, deteriorando-se posteriormente, porém, sem perder a capacidade de germinação até 270 dias de armazenamento.

ABSTRACT Sunn hemp (Crotalaria spectabilis) is widely used for soil correction and cover, but it is still necessary to know the characteristics that influence the storage of its seeds. This study aimed to evaluate the physiological quality of sunn hemp seeds under uncontrolled environmental conditions and in acclimatization chamber. A completely randomized experimental design was used, with four replicates, in subplots evaluated in different periods. Freshly harvested seeds and seeds at 90, 180 and 270 days of storage were evaluated for germination, first germination count, germination speed index, seedling emergence in the field, accelerated aging, cold test and seedling growth. The environment and storage time significantly influenced the seed germination and vigor. The seeds showed a high physiological performance for both the environmental conditions, maintaining the ability to produce normal seedlings up to approximately 150 days of storage, deteriorating afterwards, although without losing their germination capacity up to 270 days of storage.

Resumo Abordagens do funcionamento da ideologia, da discursividade e da subjetividade foram desenvolvidas e convergiram nos estudos cinematográficos nos anos 1970, na França e na Grã-Bretanha. Tais desenvolvimentos e convergência sucederam com o engajamento político de intelectuais, a partir da influência de Louis Althusser e Jacques Lacan. Esta retrospectiva resgata uma das principais perspectivas na história dos Estudos Cinematográficos, a Screen Theory, através das ideias dos editores da Screen Magazine nos anos 1970, Colin MacCabe e Stephen Heath. Explicita-se nela a influência do filósofo francês Michel Pêcheux, até então ignorada no Brasil e na França, e as consequências de sua “posição-sujeito” nos debates sobre a Screen Theory. A crítica da relação entre o Outro em Lacan e o Sujeito Universal em Althusser, e seu desdobramento no conceito de “posição-sujeito” em Pêcheux, são contribuições fundamentais dessa experiência para a perspectiva brasileira dos estudos materialistas da discursividade.

Abstract The development of approaches around ideology functioning, discourse, and subjectivity converged into the cinematographic studies in the 1970s, in France and Great Britain. Such development and convergence happened with the political engagement of intellectuals, starting from the influence of Louis Althusser and Jacques Lacan. This retrospective brings back one of the most important perspectives in the Cinematographic Studies, the Screen Theory, which emerges from the aforementioned decade through the ideas of two Screen Magazine editors, Colin MacCabe and Stephen Heath. In this theory it is made explicit the influence of the French philosopher Michel Pêcheux and the consequences of his "subject position" in Screen Theory’s theoretical debates. The re-evaluation of Lacan's Other and Althusser's Universal Subject, and its development into Pêcheux's "subject position" concept, are paramount contributions to the Brazilian materialistic perspective of discursivities.

Resumen Abordajes del funcionamiento de la ideología, de la discursividad y de la subjetividad fueron desarrolladas y convergieron en estudios cinematográficos en los años 1970, en Francia y Gran Bretaña. Tales desarrollos y convergencia sucedieron con el encajamiento político de intelectuales, desde la influencia de Louis Althusser y Jacques Lacan. Esa retrospectiva rescata una de las principales perspectivas en la historia de los Estudios Cinematográficos, la Screen Theory, a través de las ideas de los editores de la Screen Magazine en los años 1970, Colin MacCabe y Stephen Heath. Se hace explicita em ella la influencia del filósofo francés Michel Pêcheux, hasta entonces ignorada en Brasil y Francia, y las consecuencias de su “posición-sujeto” en debates sobre la Screen Theory. La crítica de la relación entre el Otro en Lacan y el Sujeto Universal en Althusser, y su desdoblamiento en el concepto de “posición-sujeto” en Pêcheux son contribuciones fundamentales de esa experiencia para la perspectiva brasileña de los estudios materialistas de la discursividad.

Abstract INTRODUCTION: Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by reactivation of JC virus (JCV). METHODS: We described the profile of laboratory-confirmed PML cases among AIDS patients. RESULTS: A total of 43 HIV patients with clinical conditions compatible with PML were obtained; 5 cases were confirmed by JCV testing. The main clinical finding was mental confusion. Median CD4 count was 54 cells/mm³. CONCLUSIONS: Three of the five confirmed PML cases died; the time between diagnosis and death was 2, 5, and 6 months. It is important to consider JCV infection as a differential diagnosis.

Resumo: A produtividade da canola é responsiva à aplicação de N e o efeito de N depende de S. Além disso, o armazenamento pode influenciar o vigor das sementes. O objetivo do presente estudo foi avaliar o efeito da fertilização com nitrogênio e enxofre na qualidade fisiológica de sementes de canola. Todas as combinações de quatro doses de N (0, 40, 80 e 120 kg.ha-1) e cinco doses de S (0, 30, 60, 90 e 120 kg.ha-1) foram avaliadas com quatro repetições em delineamento de blocos casualizados, em um solo Latossolo Vermelho distroférrico. Os efeitos dos nutrientes e suas combinações sobre o potencial fisiológico das sementes de canola foram avaliados imediatamente após a colheita e após 180 dias de armazenamento pelo teste de germinação, envelhecimento acelerado, emergência em campo e desempenho de plântulas. A aplicação de N associada com S apresentou um efeito positivo na qualidade fisiológica de canola. A aplicação da dose de 120 kg.ha-1 de N, associada à dose de 80 kg.ha-1 de S, promoveu maior germinação e vigor das sementes de canola. O armazenamento das sementes por um período de 180 dias proporcionou uma redução acentuada no potencial fisiológico das sementes de canola.

Abstract: The productivity of the oilseed rape crop is responsive to the application of nitrogen (N) and the effect of N is sulfur (S)-dependent. In addition, storage may influence seed vigor. The aim of the present study was to assess the effect of fertilization with nitrogen and sulfur on the physiological quality of rapeseeds. All combinations of four doses of N (0, 40, 80, and 120 kg.ha-1) and five of S (0, 30, 60, 90, and 120 kg.ha-1) were evaluated with four replications each distributed in a randomized block design in a distroferric Red Latosol soil. The effects of the nutrients and their combinations on the physiological potential of rapeseeds were evaluated even immediately after harvest and 180 days of storage through the germination test, accelerated aging, field emergence and seedling performance. The application of N associated with S had a positive effect on the physiological quality of the seeds. The application of the 120 kg.ha-1 dose of N and the 80 kg.ha-1 dose of S promoted the highest germination and vigor of the seeds. Seed storage for a period of 180 days led to a drastic reduction in the physiological potential of the rapeseeds.

Resumo: O objetivo deste trabalho foi avaliar características agronômicas do milho em um cultivo submetido a diferentes doses de N, nas safras de outono-inverno (safrinha) e primavera-verão, e a recuperação do N do fertilizante. O experimento foi disposto em blocos ao acaso, com quatro repetições, em arranjo fatorial 5x2, com os seguintes tratamentos: cinco doses de N em cobertura - 0, 30, 60, 90 e 120 kg ha-1 -, com uso de ureia como fonte; e duas estações de cultivo, outono-inverno e primavera-verão. As seguintes variáveis foram determinadas: altura de planta, altura da inserção da primeira espiga, número de grãos por espiga, diâmetro e comprimento da espiga, massa de 1.000 grãos, concentração de N nas folhas e nos grãos, concentração de proteína nos grãos, produtividade de grãos, recuperação de N do fertilizante e suprimento de N pelo solo. As taxas de N do fertilizante na estação outono-inverno não influenciaram a produtividade de grãos, embora as características agronômicas do milho tenham apresentado maior dependência do N do fertilizante naquela estação do que na primavera-verão, que é uma estação associada a uma maior capacidade do solo de fornecer N para as plantas. A quantificação do suprimento de N pelo solo permitiu saber a dinâmica do nutriente durante a safrinha e a safra de primavera-verão, o que pode ser útil para guiar a fertilização nitrogenada do milho.

Abstract: The objective of this work was to evaluate corn agronomic traits in a cultivation subjected to different N rates, during the fall-winter (off-season) and spring-summer crop seasons, and N recovery from fertilizer. The experiment was set up in a randomized complete block design with four replicates, in a 5x2 factorial arrangement, with the following treatments: five N topdressing rates - 0, 30, 60, 90, and 120 kg ha-1 -, using urea as source; and two crop seasons, fall-winter and spring-summer. The following variables were determined: plant height, height of the first ear insertion, number of grains per ear, diameter and length of ear, 1,000-grain weight, N concentration in the leaves and grains, grain-protein concentration, grain yield, N recovery from fertilizer, and soil-N supply. Nitrogen rates in the fertilizer in the fall-winter season had no effect on grain yield, although corn agronomic traits showed a greater reliance on fertilizer-N rates in that season than in the spring-summer, which is a season associated to a greater capacity of soil-N supply to plants. The quantification of soil-N supply enabled knowing the nutrient dynamics during the fall-winter and the spring-summer seasons, which may be useful to guide N fertilization of corn.

Abstract Objective: Elaboration and internal validation of the Quality of Life in Cardiovascular Surgery (QLCS) questionnaire adapted to the reality of Brazilian cardiovascular surgery. Methods: Cross-sectional pilot study of a prospective cohort included in the Documentation and Surgical Registry Center (CEDREC) for internal validation of the QLCS questionnaire. Four hundred forty-five patients submitted to cardiovascular surgery and who answered a QLCS questionnaire 30 days after hospital discharge were included. It was applied via telephone. To verify the questions' internal consistency, Cronbach's alpha was used. The total QLCS score was calculated as the sum of 5 questions, ranging from 5 to 25 points. Mann-U-Whitney test was used to relate the symptoms with the quality of life (QoL). Level of significance was 5%. Results: After 30 days of surgery, about 95% of the patients had already returned to normal routine and 19% of them were already performing physical activity. In the evaluation of the QLCS's internal consistency, a Cronbach's alpha of 0.74 was found, suggesting that this was probably an adequate questionnaire to evaluate QoL in this population. In the comparison between the presence and absence of symptoms and the median of QoL, the presence of pain at the incision (P=0.002), chest pain (P<0.001), shortness of breath (P<0.001), and return to physical activity (P<0.001) were statistically significant. Conclusion: The process of elaboration and validation of questionnaires includes a series of steps. The QLCS questionnaire is probably an adequate tool for the evaluation of QoL in the postoperative patient of cardiovascular surgery, in this first stage of internal validation.

RESUMO No presente trabalho objetivou-se avaliar a degradabilidade ruminal da matéria seca (MS), o desaparecimento da fibra de detergente neutro (FDN) do feno de Tifton 85, e os parâmetros de fermentação (pH e nitrogênio amoniacal ruminal) de ovinos alimentados com a inclusão de grãos de cártamo (0, 7,50 e 15%) na dieta. Foram utilizados 3 cordeiros SRD (sem raça definida) com peso vivo médio de 35,50 ± 1,50 kg. A degradabilidade ruminal da matéria seca e da FDN do feno de Tifton 85, foi realizada através do desaparecimento de MS e FDN, e os parâmetros cinéticos de degradação ajustados conforme modelo assintótico de primeira ordem. As amostras foram incubadas no rúmen em ordem decrescente (96, 48, 24, 12, 6, 3 e 0 horas). A determinação do pH ruminal e nitrogênio amoniacal ruminal (NAR) foi realizada antes da alimentação, 2, 4, 6 e 8 horas após alimentação. Os dados de fermentação ruminal foram submetidos à análise de variância através de medidas repetidas no tempo, a 5% de probabilidade. Os valores de pH ruminal não houve diferença estatística. Ao avaliar o NAR, houve diferença significativa entre os tempos e tratamentos para a dieta de 15% de inclusão de cártamo. As dietas apresentaram baixa degradabilidade efetiva da MS e FDN com valores médios de 18,02% e 47,40%, respectivamente. O grão de cártamo pode ser utilizado até 7,50% nas dietas, sem alterar a degradabilidade e a fermentação ruminal.

SUMMARY This study aimed to evaluate the rumen degradability of dry matter (DM), disappearance of neutral detergent fiber (NDF) of Tifton 85 hay, and fermentation parameters (pH and ruminal ammonia nitrogen) of sheep fed diets with inclusion of safflower grains (0, 7.50 and 15%). Three mixed breed lambs with average body weight of 35.50± 1.50 kg were used. The rumen degradability of dry matter and NDF of the Tifton 85 haywas analyzedby the disappearance of DM and NDF, and the kinetic parameters adjusted according to the first order asymptotic model. The samples were incubated in the rumen in descending order (96, 48, 24, 12, 6, 3, 0 hours). The determination of ruminal pH and ruminal ammonia nitrogen (RAN) was performed before feeding and 2, 4, 6 and 8 hours after feeding. Data of ruminal fermentation were tested by analysis of variance with repeated measures in time, at 5% probability. Ruminal pH values were not statistically different. When evaluating the RAN, there was a significant difference between the times and treatments for the diet with 15% safflower. The diets presented low effective degradability of DM and NDF with mean values of 18.02% and 47.40%, respectively. The safflower grain can be used up to 7.50% in the diets without altering the degradability and ruminal fermentation.

Abstract This paper reviews the National Youth Conferences in Brazil in order to discover the demands and perceptions of young militants regarding their rights, especially those related to education and work. The objective is to analyze how the building of an institutional and legal field has worked as a mobilization tool for young people in the general fight for the expansion of their rights. The final conclusion is that the listening process of organized youth is an important contribution to the debate, especially by expanding themes and bring to light new legal subjects that arose in the recent cycle of public policies for youth in the country, which seems to end in 2016 with the rupture that occurred in the Federal Government and the consequent extinction of numerous pro-grams and policies that were ensuring, albeit timidly, the expansion of young Brazilians rights.

Resumo Este trabalho revisita as Conferências Nacionais de Juventude no Brasil para conhecer as demandas e percepções sobre direitos de jovens militantes, especialmente os direitos relativos à educação e trabalho. O objetivo é pensar de que modo a construção de um campo institucional e legal tem funcionado como instrumento de mobilização para os jovens, em geral, lutarem pela ampliação de seus direitos. A conclusão é que o processo de escuta da juventude organizada é uma importante contribuição ao debate, sobretudo por ampliar temáticas e visibilizar os novos sujeitos de direitos surgidos no ciclo recente de políticas públicas de juventude no país, que parece se encerrar em 2016 com a ruptura ocorrida no Governo Federal e a consequente extinção de inúmeros programas e políticas que vinham garantindo, ainda que timidamente, a expansão dos direitos dos jovens brasileiros.

Abstract Introduction: Active infective endocarditis is associated with high morbidity and mortality. Surgery is indicated in high-risk conditions, and the main determinants of mortality in surgical treatment should be evaluated. Objective: To identify mortality predictors in the surgical treatment of active infective endocarditis in a long-term follow-up. Methods: This prospective observational study involved 88 consecutive patients diagnosed with active infective endocarditis, who underwent surgery between January 2005 and December 2015. Fifty-eight (65.9%) patients were male, the mean age was 50.87±16.15 years. A total of 31 (35.2%) patients had a history of rheumatic fever; 48 (54.5%) had had heart surgery with prosthetic valve implantation; 45 (93.8%) had biological prosthetic valve endocarditis and 3 (6.3%) mechanical prosthetic valve; 40 (45.5%) patients had the disease in their native valve. The mean EuroSCORE II was 8.9±6.5%, and the main surgical indication was refractory heart failure in 38 (43.2%) patients. A total of 68 bioprosthesis (36 aortic, 32 mitral) and 29 mechanical prostheses (12 aortic, 17 mitral) were implanted and three mitral valve plasties performed. A total of 25 (28.4%) patients underwent double or triple valve procedures. Aortic annulus reconstruction by abscess was performed in 18 (20.5%) and six (6.81%) patients had combined procedure. The mean surgery time was 359±97.6 minutes. Results: The overall survival in up to a 10-year follow-up period was 79.5%. In the univariate analysis, the main mortality predictors were positive blood cultures (P=0.003), presence of typical microorganisms (P=0.008), most frequently Streptococcus viridans (12 cases; 25%); C-reactive protein (hazard ratio [HR] 1.034, 95% confidence interval [CI] 1.000 to 1.070, P=0.04); creatinine clearance (HR 0.977, 95% CI 0.962 to 0.993, P=0.005); length of surgery: every five minutes multiplies the chance of death 1.005-fold (HR 1.005, 95% CI 1.001 to 1.009, P=0.0307); age (HR 1.060, 95% CI 1.026 to 1.096, P=0.001); and EuroSCORE II (HR 1.089, 95% CI 1.030 to 1.151, P=0.003). Conclusion: A positive blood culture with typical microorganism, C-reactive protein, age, EuroSCORE II, total surgical time and the presence of postoperative complications were the major predictors of mortality and significantly impacted survival in up to a 10-year follow-up period.

Abstract Mechanized operations on soils with inadequate moisture cause compaction and are deleterious to soil quality. The aim of this study was to evaluate the influence of different oilseed crop successions on the structural quality of a clayey Rhodic Hapludox. Sunflower (Helianthus annuus L.), canola (Brassica napus L. and Brassica rapa), safflower (Carthamus tinctorius L.), crambe (Crambe abyssinica Hochst.), and niger (Guizotia abyssinica) were sown in autumn/winter in a no-tillage system in succession to corn grown in the summer and soybean/corn grown in summer/autumn-winter. When the autumn-winter crops began to grow, soil samples were collected in metallic cylinders at 0.0–0.05 m and 0.05–0.10 m depths. Analyses of the optimal water interval in each crop succession at the 0.0–0.05 m layer indicated that the corn/safflower and corn/crambe successions reduced the structural quality of the soil. The autumn-winter niger crop in succession to summer corn improved the soil structure at 0.0–0.05 m and 0.05–0.10 m when compared with the soil cultivated with the soybean/corn succession. The niger crop is an effective crop rotation alternative that improves the physical quality of the soil under no-tillage systems.

Resumen Las operaciones mecanizadas en suelos con humedad inadecuada causan compactación y son perjudiciales para la calidad del suelo. El objetivo de este estudio fue evaluar la influencia de diferentes sucesiones de cultivos de semillas oleaginosas sobre la calidad estructural de un hapludo rubio arcilloso. Se sembraron girasol (Helianthus annuus L.), canola (Brassica napus L. y Brassica rapa), cártamo (Carthamus tinctorius L.), crambe (Crambe abyssinica Hochst.) Y niger (Guizotia abyssinica) en otoño/invierno Sistema de labranza cero en sucesión al maíz cultivado en verano y soja/maíz cultivado en verano/otoñoinvierno. Cuando comenzaron a crecer los cultivos de otoño-invierno, se recogieron muestras de suelo en cilindros metálicos de 0.0-0.05 m y 0.05-0.10 m de profundidad. Los análisis del intervalo óptimo de agua en cada sucesión de cultivos en la capa 0.0-0.05 m indicaron que las sucesiones de maíz/cártamo y maíz/crambe redujeron la calidad estructural del suelo. La cosecha niger de otoño-invierno en sucesión al maíz de verano mejoró la estructura del suelo a 0.0-0.05 m y 0.05-0.10 m en comparación con el suelo cultivado con la sucesión soja/maíz. El cultivo de níger es una alternativa eficaz de rotación de cultivos que mejora la calidad física del suelo bajo sistemas de labranza cero.

Abstract Introduction: Replacement of the aortic valve in patients with a small aortic annulus is associated with increased morbidity and mortality. A prosthesis-patient mismatch is one of the main problems associated with failed valves in this patient population. Objective: To evaluate the long-term mortality predictors in patients with a small aortic annulus undergoing aortic valve replacement with a bioprosthesis. Methods: In this retrospective observational study, a total of 101 patients undergoing aortic valve replacement from January 2000 to December 2010 were studied. There were 81 (80.19%) women with a mean age of 52.81±18.4 years. Severe aortic stenosis was the main indication for surgery in 54 (53.4%) patients. Posterior annulus enlargement was performed in 16 (15.8%) patients. Overall, 54 (53.41%) patients underwent concomitant surgery: 28 (27.5%) underwent mitral valve replacement, and 13 (12.7%) underwent coronary artery bypass graft surgery. Results: Mean valve index was 0.82±0.08 cm2/m2. Overall, 17 (16.83%) patients had a valve index lower than 0.75 cm2/m2, without statistical significance for mortality (P=0.12). The overall 10-year survival rate was 83.17%. The rate for patients who underwent isolated aortic valve replacement was 91.3% and 73.1% (P=0.02) for patients who underwent concomitant surgery. In the univariate analysis, the main predictors of mortality were preoperative ejection fraction (P=0.02; HR 0.01) and EuroSCORE II results (P=0.00000042; HR 1.13). In the multivariate analysis, the main predictors of mortality were age (P=0.01, HR 1.04) and concomitant surgery (P=0.01, HR 5.04). Those relationships were statistically significant. Conclusion: A valve index of < 0.75 cm2/m2 did not affect 10-year survival. However, concomitant surgery and age significantly affected mortality.

Introdução: O implante por cateter de prótese aórtica (TAVI, do inglês transcatheter aortic valve implantation) constitui tratamento alternativo para pacientes com estenose aórtica de alto risco cirúrgico ou inoperáveis. Para adquirir competência, o grupo multidisciplinar deve receber treinamento específico e acumular experiência na execução do TAVI. Contudo, sua curva de aprendizado não está bem estabelecida. Nosso objetivo foi analisar o impacto da curva de aprendizado na seleção de pacientes, nos aspectos técnicos e nos resultados clínicos do TAVI. Métodos: Estudo observacional e prospectivo dos primeiros 150 pacientes submetidos a TAVI por via femoral, entre janeiro de 2009 e dezembro de 2013 divididos em tercis (n = 50) de acordo com a data do procedimento. Os desfechos foram definidos conforme os critérios Valve Academic Research Consortium-2 (VARC-2). Resultados: A idade foi de 82,5 ± 6,7 anos, sendo 44% homens e 75% em classe NYHA III/IV. O EuroSCORE (24,2 ± 13% vs. 21,2 ± 10,8% vs. 23,4 ± 14,3%) e o STS Score (5,9 ± 2,9% vs. 6,7 ± 4,3% vs. 5,8 ± 3,1%) foram similares entre os grupos. Observou-se redução gradativa nos tempos do procedimento (107,2 ± 48,1 minutos vs. 90,3 ± 42,2 minutos vs. 76,6 ± 37,7 minutos; p < 0,01) e de fluoroscopia (31,3 ± 9,6 minutos vs. 25,4 ± 8,7 minutos vs. 17,2 ± 6,2 minutos; p = 0,01), e no volume de contraste (145,5 ± 70,9 mL vs. 123,2 ± 87,8 mL vs. 101,1 ± 50 mL; p = 0,01). A mortalidade reduziu-se de forma progressiva (20% vs. 10% vs. 4%; p = 0,047), e menores taxas de sangramentos e de refluxo paraprotético de grau moderado/grave foram observadas no terceiro tercil (14% e 4%, respectivamente). Não ocorreram casos de reintervenção, acidente vascular cerebral e nem outros eventos clínicos entre a alta hospitalar e o 30º dia pós-implante. Conclusões: A competência para o TAVI aumentou progressivamente com o número de pacientes tratados, associando-se a melhores desfechos clínicos.

Fundamento: O enxerto de artéria radial (AR) foi o segundo enxerto arterial a ser introduzido na prática clínica para revascularização miocárdica. A técnica de esqueletização da artéria torácica interna esquerda (ATIE) pode, de fato, alterar a capacidade de fluxo do enxerto com potenciais vantagens, o que leva à suposição de que o comportamento da AR, como enxerto coronariano, seja semelhante ao da ATIE esqueletizada. Objetivo: Este estudo avaliou enxertos aortocoronários "livres" de AR, quer esqueletizados, quer com tecidos adjacentes. Métodos: Foi realizado um estudo prospectivo randomizado comparando 40 pacientes distribuídos em dois grupos. No grupo I, foram utilizadas artérias radiais esqueletizadas (20 pacientes), e no grupo II, artérias radiais com tecidos adjacentes (20 pacientes). Após o procedimento cirúrgico, os pacientes foram submetidos a medidas da velocidade de fluxo. Resultados: As principais variáveis cirúrgicas foram: diâmetro interno, comprimento e fluxo sanguíneo livre da AR. Os diâmetros médios dos enxertos de AR calculados através de angiografia quantitativa no pós-operatório imediato foram semelhantes, assim como as variáveis de medidas de velocidade de fluxo. Por outro lado, a cinecoronariografia mostrou a presença de oclusão em um enxerto de AR e estenose em cinco enxertos de AR no GII, enquanto que apenas um caso de estenose em um enxerto de AR no GI (p = 0,045). Conclusão: Os resultados mostram que tanto as características morfológicas e anatomopatológicas quanto o desempenho hemodinâmico dos enxertos livres de artéria radial, quer preparados de forma esqueletizada ou com tecidos adjacentes, são semelhantes. Entretanto, pode-se observar um maior número de lesões não obstrutivas quando a AR é preparada com tecidos adjacentes.

Background: Radial artery (RA) was the second arterial graft introduced in clinical practice for myocardial revascularization. The skeletonization technique of the left internal thoracic artery (LITA) may actually change the graft's flow capacity with potential advantages. This leads to the assumption that the behavior of the RA, as a coronary graft, is similar to that of the LITA, when skeletonized. Objective: This study evaluated 'free' aortic-coronary radial artery (RA) grafts, whether skeletonized or with adjacent tissues. Methods: A prospective randomized study comparing 40 patients distributed into two groups was conducted. In group I, we used skeletonized radial arteries (20 patients), and in group II, we used radial arteries with adjacent tissues (20 patients). After the surgical procedure, patients underwent flow velocity measurements. Results: The main surgical variables were: RA internal diameter, RA length, and free blood flow in the radial artery. The mean RA graft diameters as calculated using quantitative angiography in the immediate postoperative period were similar, as well as the flow velocity measurement variables. On the other hand, coronary cineangiography showed the presence of occlusion in one RA graft and stenosis in five RA grafts in GII, while GI presented stenosis in only one RA graft (p = 0.045). Conclusion: These results show that the morphological and pathological features, as well as the hemodynamic performance of the free radial artery grafts, whether prepared in a skeletonized manner or with adjacent tissues, are similar. However, a larger number of non-obstructive lesions may be observed when RA is prepared with adjacent tissues.

OBJETIVOS: O objetivo primário deste estudo é identificar preditores de óbito hospitalar em pacientes submetidos à cirurgia de aorta. O objetivo secundário é identificar fatores associados ao desfecho clínico composto hospitalar (óbito, sangramento, disfunção ventricular ou complicações neurológicas). MÉTODOS: Delineamento transversal com componente longitudinal; por meio de revisão de prontuários, foram incluídos 257 pacientes. Os critérios de inclusão foram: dissecção crônica de aorta tipo A de Stanford e aneurisma de aorta ascendente. Foram excluídos casos de dissecção aguda de aorta, qualquer tipo, e aneurisma de aorta não envolvendo segmento ascendente. As variáveis avaliadas foram demografia, fatores pré, intra e pós-operatórios. RESULTADOS: Variáveis com risco aumentado de óbito hospitalar (RC; IC95%; P valor): etnia negra (6,8; 1,54 30,2; 0,04), doença cerebrovascular (10,5; 1,12-98,7; 0,04), hemopericárdio (35,1; 3,73-330,2; 0,002), operação de Cabrol (9,9; 1,47-66,36; 0,019), cirurgia de revascularização miocárdica simultânea (4,4; 1,31-15,06; 0,017), revisão de hemostasia (5,72; 1,29-25,29; 0,021) e circulação extracorpórea (CEC) [min] (1,016; 1,007-1,026; 0,001). Dor torácica associou-se com risco reduzido de óbito hospitalar (0,27; 0,08-0,94; 0,04). Variáveis com risco aumentado do desfecho clínico composto hospitalar foram: uso de antifibrinolítico (3,2; 1,65-6,27; 0,0006), complicação renal (7,4; 1,52-36,0; 0,013), complicação pulmonar (3,7; 1,5-8,8; 0,004), EuroScore (1,23; 1,08-1,41; 0,003) e tempo de CEC [min] (1,01; 1,00-1,02; 0,027). CONCLUSÃO: Etnia negra, doença cerebrovascular, hemopericárcio, operação de Cabrol, revascularização miocárdica simultânea, revisão de hemostasia e tempo de CEC associaram-se com risco aumentado de óbito hospitalar. Dor torácica associou-se com risco reduzido de óbito hospitalar. Uso de antifibrinolítico, complicação renal, complicação pulmonar, EuroScore e tempo de CEC associaram-se ao desfecho clínico composto hospitalar.

OBJECTIVES: The primary objective was to identify predictors of hospital mortality in patients undergoing aortic surgery. The secondary objective was to identify factors associated with clinical outcome composed hospital (death, bleeding, neurologic complications or ventricular dysfunction). METHODS: A cross-sectional design with longitudinal component. Through chart review, 257 patients were included. Inclusion criteria were: aortic dissection Stanford type A and ascending aortic aneurysm. Exclusion criteria were acute aortic dissection, of any kind, and no aortic aneurysm involving the ascending segment. Variables assessed: demographics, preoperative factors, intraoperative and postoperative. RESULTS: Variables with increased risk of hospital mortality (OR, 95% CI, P value): black ethnicity (6.8, 1.54-30.2; 0.04), cerebrovascular disease (10.5, 1.12-98.7; 0.04), hemopericardium (35.1, 3.73-330.2; 0.002), Cabrol operation (9.9, 1.47-66.36; 0.019), CABG simultaneous (4.4; 1.31 to 15.06; 0.017), bleeding (5.72, 1.29-25.29; 0.021) and cardiopulmonary bypass (CPB) time [min] (1.016; 1.0071.026; 0.001). Thoracic pain was associated with reduced risk of hospital death (0.27, 0.08-0.94, 0.04). Variables with increased risk of hospital clinical outcome compound were: use of antifibrinolytic (3.2, 1.65-6.27; 0.0006), renal complications (7.4, 1.52-36.0; 0.013), pulmonary complications (3.7, 1.58.8, 0.004), EuroScore (1.23; 1.08-1.41; 0.003) and CPB time [min] (1.01; 1.00 to 1.02; 0.027). CONCLUSION: Ethnicity black, cerebrovascular disease, hemopericardium, Cabrol operation, CABG simultaneous, hemostasis review and CPB time was associated with increased risk of hospital death. Chest pain was associated with reduced risk of hospital death. Use of antifibrinolytic, renal complications, pulmonary complications, EuroScore and CPB time were associated with clinical outcome hospital compound.