Fundamento: Os modelos prognósticos disponíveis para Síndrome Coronariana Aguda (SCA) podem ter limitações de performance, por terem sido elaborados há vários anos, ou problemas de aplicabilidade. Objetivos: Elaborar escores para predição de eventos desfavoráveis em 30 dias e 6 meses, em pacientes com SCA, com ou sem Supradesnivelamento de ST (SST), atendida em hospital privado terciário. Métodos: Coorte prospectiva de pacientes consecutivos com SCA admitidos entre agosto/2009 a junho/2012. O desfecho primário composto foi a ocorrência de óbito, infarto ou reinfarto, Acidente Vascular Cerebral (AVC), parada cardiorrespiratória e sangramento maior. As variáveis preditoras foram selecionadas de dados clínicos, laboratoriais, eletrocardiográficos e da terapêutica. O modelo final foi obtido por meio de regressão logística e submetido a validação interna, utilizando-se bootstraping. Resultados: Incluímos 760 pacientes, 132 com SCA com SST e 628 sem SST. A idade média foi 63,2 ± 11,7 anos, sendo 583 homens (76,7%). O modelo final para eventos em 30 dias contém cinco preditores: idade ≥ 70 anos, antecedente de neoplasia, Fração de Ejeção do Ventrículo Esquerdo (FEVE) < 40%, troponinaI > 12,4 ng/mL e trombólise. Na validação interna, o modelo mostrou ter boa performance com área sob a curva de 0,71.Os preditores do modelo para 6 meses são: antecedente de neoplasia, FEVE < 40%, trombólise, troponina I > 14,3 ng/mL, creatinina > 1,2 mg/dL, antecedente de doença pulmonar obstrutiva crônica e hemoglobina < 13,5 g/dL. Na validação interna, o modelo apresentou boa performance com área sob a curva de 0,69. Conclusões: Desenvolvemos escores de fácil utilização e boa performance para predição de eventos adversos em 30 dias e 6 meses em pacientes com SCA.

Background: Available predictive models for acute coronary syndromes (ACS) have limitations as they have been elaborated some years ago or limitations with applicability. Objectives: To develop scores for predicting adverse events in 30 days and 6 months in ST-segment elevation and non-ST-segment elevation ACS patients admitted to private tertiary hospital. Methods: Prospective cohort of ACS patients admitted between August, 2009 and June, 2012. Our primary composite outcome for both the 30-day and 6-month models was death from any cause, myocardial infarction or re-infarction, cerebrovascular accident (CVA), cardiac arrest and major bleeding. Predicting variables were selected for clinical, laboratory, electrocardiographic and therapeutic data. The final model was obtained with multiple logistic regression and submitted to internal validation with bootstrap analysis. Results: We considered 760 patients for the development sample, of which 132 had ST-segment elevation ACS and 628 non-ST-segment elevation ACS. The mean age was 63.2 ± 11.7 years, and 583 were men (76.7%). The final model to predict 30-day events is comprised by five independent variables: age ≥ 70 years, history of cancer, left ventricular ejection fraction (LVEF) < 40%, troponin I > 12.4 ng /ml and chemical thrombolysis. In the internal validation, the model showed good discrimination with C-statistic of 0.71. The predictors in the 6-month event final model are: history of cancer, LVEF < 40%, chemical thrombolysis, troponin I >14.3 ng/ml, serum creatinine>1.2 mg/dl, history of chronic obstructive pulmonary disease and hemoglobin < 13.5 g/dl. In the internal validation, the model had good performance with C-statistic of 0.69. Conclusion: We have developed easy to apply scores for predicting 30-day and 6-month adverse events in patients with ST-elevation and non-ST-elevation ACS.

This article analyzes the editions published from May 2010 to January 2011 of Folha Universal, the weekly newspaper of the Universal Church of the Kingdom of God in Brazil, with a circulation of 2.7 million, and O Mensageiro da Paz, the Assembly of God's monthly publication. During Brazil's last elections, the Evangelicals' political force and their capacity to define the agenda of the Presidential campaign attracted constant news attention in the lay press. However, little was said about this world's internal diversity or the different ways these religious people think of politics. Wagering on a dialectic interweaving worldview and communication, we focused on the symbolic expressiveness of these publications as a window on the way politics was portrayed and experienced by the two main forces in the Brazilian Evangelical/Pentecostal community during the last electoral campaign.

Dans cet article, on analyse les éditions à partir de mai 2010 jusqu'à janvier 2011 de Folha Universal (hébdomadaire de l'Église Universelle tiré à 2,7 millions d'exemplaires) et de Mensageiro da Paz (publication mensuelle de l'Assemblée de Dieu). Pendant les dernières élections, la force politique des évangéliques et leur capacité de modeler la campagne présidentielle ont été objet de nouvelles difusées par les médias laïques. Mais on a très peu parlé de la diversité à l'intérieur de cet univers et des différentes formes de la pensée politique de ces réligieux. Tout en croyant à l'incorporation dialectique entre perception du monde et communication, on part de l'expressivité symbolique de ces médias et on les prend comme une fenêtre sur le mode comment la politique a été représentée et vécue pendant la dernière période électorale entre les deux grandes factions du segment évangélique/ pentecôtiste brésilien.