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Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery
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Gasperi, Ricardo de

; Bodanese, Luiz Carlos

; Guaragna, João Carlos Vieira da Costa

; Wagner, Mario Bernardes

; Albuquerque, Luciano Cabral

Brazilian Journal of Cardiovascular Surgery

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2023, Volume 38 N. 2 Pages 219 - 226

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Due to Brazilian population aging, prevalence of aortic stenosis, and limited number of scores in literature, it is essential to develop risk scores adapted to our reality and created in the specific context of this disease. Methods: This is an observational historical cohort study with analysis of 802 aortic stenosis patients who underwent valve replacement at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, from 1996 to 2018. With the aid of logistic regression, a weighted risk score was constructed based on the magnitude of the coeficients β of the logistic equation. Two performance statistics were obtained: area under the receiver operating characteristic curve and the chi-square (χ2) of Hosmer-Lemeshow goodness-of-fit with Pearson’s correlation coeficient between the observed events and predicted as a model calibration estimate. Results: The risk predictors that composed the score were valve replacement surgery combined with coronary artery bypass grafting, prior renal failure, New York Heart Association class III/IV heart failure, age > 70 years, and ejection fraction < 50%. The receiver operating characteristic curve area was 0.77 (95% confidence interval: 0.72-0.82); regarding the model calibration estimated between observed/predicted mortality, Hosmer-Lemeshow test χ2 = 3,70 (P=0.594) and Pearson’s coeficient r = 0.98 (P<0.001). Conclusion: We propose the creation of a simple score, adapted to the Brazilian reality, with good performance and which can be validated in other institutions. Introduction aging literature disease Methods 80 Lucas Sul 199 2018 regression equation obtained chisquare chi square χ (χ2 HosmerLemeshow Hosmer Lemeshow goodnessoffit goodness fit Pearsons Pearson s estimate Results grafting failure IIIIV III IV 7 years 50 50% 077 0 77 0.7 95% 95 (95 interval 0.720.82 072082 0.72 0.82 72 82 0.72-0.82) observedpredicted mortality 370 3 3,7 P=0.594 P0594 P 594 (P=0.594 098 98 0.9 P<0.001. P0001 P<0.001 . 001 (P<0.001) Conclusion institutions 8 19 201 (χ 5 07 0. 9 (9 720 0.720.8 07208 072 082 0.8 0.72-0.82 37 3, P=0.59 P059 59 (P=0.59 09 P000 P<0.00 00 (P<0.001 1 20 ( 0.720. 0720 08 0.72-0.8 P=0.5 P05 (P=0.5 P00 P<0.0 (P<0.00 2 0.720 0.72-0. P=0. P0 (P=0. P<0. (P<0.0 0.72-0 P=0 (P=0 P<0 (P<0. 0.72- P= (P= P< (P<0 (P (P<

https://doi.org/10.21470/1678-9741-2022-0254

Avaliação Prognóstica da Reserva de Fluxo Fracionada em Diferentes Estratos nos Pacientes com Doença Arterial Coronariana
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Pellegrini, Denise

; Caramori, Paulo R. A.

; Soccol, Ricardo Czarnobai

; Lasevitch, Ricardo

; Agostini, Gustavo Luís

; Dussin, Alice

; Ferreira, Flavio Vinicius Costa

; Wagner, Mario Bernardes

; Bodanese, Luiz Carlos

Arquivos Brasileiros de Cardiologia

Journal Metrics
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2023, Volume 120 N. 6 elocation e20211051

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

Resumo Fundamento Existem dados limitados sobre a evolução clínica de lesões coronarianas não tratadas de acordo com sua gravidade funcional no mundo real. Objetivo Este estudo teve como objetivo avaliar os resultados clínicos de até 5 anos em pacientes com lesões revascularizadas com reserva de fluxo fracionada (FFR) ≤ 0,8 e em pacientes com lesões não revascularizadas com FFR > 0,8. Métodos A avaliação pelo FFR foi realizada em 218 pacientes seguidos por até 5 anos. Os participantes foram classificados com base na FFR no grupo isquêmico (≤ 0,8, grupo intervenção, n = 55), no grupo FFR normal-baixa (> 0,8-0,9, n = 91) e no grupo FFR normal-alta (> 0,9, n = 72). O desfecho primário foram eventos cardíacos adversos maiores (ECAMs), um composto de morte, infarto do miocárdio e necessidade de nova revascularização. O nível de significância adotado neste estudo foi alfa = 0,05; deste modo, resultados com valores de p < 0,05 foram considerados estatisticamente significativos. Resultados A maioria dos participantes era do sexo masculino (62,8%) com média de idade de 64,1 anos. Diabetes estava presente em 27%. À angiografia coronariana, a gravidade da estenose avaliada foi de 62%, 56,4% e 54,3% nos grupos isquêmico, FFR normal-baixa e FFR normal-alta, respectivamente (p < 0,05). O período médio de acompanhamento foi de 3,5 anos. A incidência ECAM foi de 25,5%, 13,2% e 11,1%, respectivamente (p = 0,037). Não houve diferença na incidência de ECAM entre os grupos FFR normal-baixa e FFR normal-alta (p = NS). Conclusão Pacientes com FFR indicativa de isquemia apresentaram piores desfechos quando comparados aos dos grupos não isquêmicos. Entre os grupos que apresentaram valores de FFR considerados normal-baixo e normal-alto, não houve diferença na incidência de eventos. Há necessidade de estudos de longo prazo e com grande número de pacientes para melhor avaliar os desfechos cardiovasculares em pacientes portadores de estenose coronariana moderada com valores de FFR entre 0,8 e 1,0. real (FFR 08 0 8 0, 21 ( intervenção 55, 55 , 55) normalbaixa normal baixa 0,80,9, 0809 9 0,8-0,9 91 normalalta alta 09 0,9 72. 72 . 72) ECAMs, ECAMs (ECAMs) morte revascularização 005 05 modo 0,0 significativos 62,8% 628 62 (62,8% 641 64 1 64, 27 27% 62% 564 56 4 56,4 543 54 3 54,3 normalalta, alta, 0,05. 0,05) 35 3, 255 25 25,5% 132 13 2 13,2 111 11 11,1% 0,037. 0037 0,037 037 0,037) NS. NS NS) isquêmicos normalbaixo baixo normalalto, normalalto alto, alto normal-alto 10 1,0 80 0,80,9 080 0,8-0, 7 (ECAMs 00 62,8 6 (62,8 56, 54, 25,5 13, 11,1 003 0,03 03 1, 0,80, 0,8-0 62, (62, 25, 11, 0,80 0,8- (62 (6

Abstract Background There are limited real-world data on the clinical course of untreated coronary lesions according to their functional severity. Objective To evaluate the 5-year clinical outcomes of patients with revascularized lesions with fractional flow reserve (FFR) ≤ 0.8 and patients with non-revascularized lesions with FFR > 0.8. Methods The FFR assessment was performed in 218 patients followed for up to 5 years. Participants were classified based on FFR into ischemia group (≤ 0.8, intervention group, n = 55), low-normal FFR group (> 0.8-0.9, n = 91), and high-normal FFR group (> 0.9, n = 72). The primary endpoint was major adverse cardiac events (MACEs), a composite of death, myocardial infarction, and need for repeat revascularization. The significance level was set at 0.05; therefore, results with a p-value < 0.05 were considered statistically significant. Results Most patients were male (62.8%) with a mean age of 64.1 years. Diabetes was present in 27%. On coronary angiography, the severity of stenosis was 62% in the ischemia group, 56.4% in the low-normal FFR group, and 54.3% in the high-normal FFR group (p<0.05). Mean follow-up was 3.5 years. The incidence of MACEs was 25.5%, 13.2%, and 11.1%, respectively (p=0.037). MACE incidence did not differ significantly between the low-normal and high-normal FFR groups. Conclusion Patients with FFR indicative of ischemia had poorer outcomes than those in non-ischemia groups. There was no difference in the incidence of events between the low-normal and high-normal FFR groups. Long-term studies with a large sample size are needed to better assess cardiovascular outcomes in patients with moderate coronary stenosis with FFR values between 0.8 and 1.0. realworld real world 5year year (FFR 08 0 8 0. nonrevascularized non 21 years ( 55, 55 , 55) lownormal low normal 0.80.9, 0809 9 0.8-0.9 91, 91 91) highnormal high 09 0.9 72. 72 . 72) MACEs, (MACEs) death infarction revascularization 005 05 therefore pvalue p value 0.0 significant 62.8% 628 62 (62.8% 641 64 1 64. 27 27% angiography 564 56 4 56.4 543 54 3 54.3 p<0.05. p005 p<0.05 (p<0.05) followup follow 35 3. 255 25 25.5% 132 13 2 13.2% 111 11 11.1% p=0.037. p0037 p=0.037 037 (p=0.037) groups nonischemia Longterm Long term 10 1.0 80 0.80.9 080 0.8-0. 7 (MACEs 00 62.8 6 (62.8 56. 54. p00 p<0.0 (p<0.05 25.5 13.2 11.1 p003 p=0.03 03 (p=0.037 1. 0.80. 0.8-0 62. (62. p0 p<0. (p<0.0 25. 13. 11. p=0.0 (p=0.03 0.80 0.8- (62 p<0 (p<0. p=0. (p=0.0 (6 p< (p<0 p=0 (p=0. (p< p= (p=0 (p (p=

https://doi.org/10.36660/abc.20211051

Tendência temporal de atividade física em adolescentes brasileiros: análise da Pesquisa Nacional de Saúde do Escolar de 2009 a 2019 brasileiros 200 201 20 2
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Soares, Carlos Alex Martins

; Leão, Otávio Amaral de Andrade

; Freitas, Matheus Pintanel

; Hallal, Pedro Curi

; Wagner, Mário Bernardes

Cadernos de Saúde Pública

Journal Metrics
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- SciELO Analytics

2023, Volume 39 N. 10 elocation e00063423

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

Resumen: El objetivo de este estudio fue analizar la tendencia de la actividad física del alumnado brasileño y sus asociaciones con las variables demográficas, socioeconómicas y de comportamiento mediante la Encuesta Nacional de Salud del Escolar (PeNSE) en sus cuatro ediciones (de 2009, 2012, 2015 y 2019). Se utilizaron los datos del alumnado (13-17 años) que participó en las cuatro ediciones de la PeNSE (n = 392.922). Se describieron el porcentaje de valores activos, la media y los valores percentiles de actividad física de intensidad moderada a vigorosa en minutos/semana. La regresión de Poisson se ajustó según sexo, edad, color de la piel, puntuación de activos y comportamiento sedentario (≥ 2 horas/día para ver televisión y ≥ 3 horas/día sentado). Como limitación, la muestra de la PeNSE/2009 se refiere únicamente a las capitales brasileñas. El porcentaje de activos disminuyó del 43,1% en 2009 al 18,2% en 2019. La media de actividad física de intensidad moderada a vigorosa de la PeNSE/2009 (media = 318,4 minutos/semana; IC95%: 313,4-323,4) tuvo una reducción de un 50% en 2019. En educación física, el promedio semanal en actividad física de intensidad moderada a vigorosa de las niñas fue menos de 50 minutos, y el de los niños llegó a 60 minutos en las cuatro ediciones de la PeNSE, además, el 22,7% de las niñas y el 19,7% de los niños (PeNSE/2019) informaron no haber tomado clases de educación física. Hubo una disminución en el comportamiento sedentario de ver televisión, pero el tiempo sentado aumentó del 50,1% (IC95%: 48,9-51,3) al 54% (IC95%: 53,1-54,9) entre la PeNSE/2009 y la PeNSE/2019. El descenso de los niveles de actividad física lleva a la necesidad de desarrollar políticas públicas que promuevan la actividad física, incluido el incremento de las clases de educación física en las escuelas al menos tres veces por semana. Resumen demográficas (PeNSE 2012 201 2019 . 2019) 1317 13 17 (13-1 años n 392.922. 392922 392.922 392 922 392.922) minutossemana semana minutos/semana sexo edad piel ( horasdía horas día sentado. sentado) limitación PeNSE2009 PeNSE/200 brasileñas 431 43 1 43,1 200 182 18 18,2 3184 318 4 318, IC95% IC95 IC 313,4323,4 31343234 313,4 323,4 313 323 313,4-323,4 5 6 además 227 22 7 22,7 197 19 19,7 PeNSE/2019 PeNSE2019 (PeNSE/2019 501 50,1 (IC95% 48,951,3 489513 48,9 51,3 48 9 51 48,9-51,3 54 53,154,9 531549 53,1 54,9 53 53,1-54,9 20 131 (13- 39292 392.92 39 92 PeNSE200 PeNSE/20 43, 18, 31 IC9 4323 313,4323, 3134323 3134 313, 3234 323, 32 313,4-323, 22, 19, PeNSE/201 PeNSE201 (PeNSE/201 50, (IC95 951 48,951, 48951 489 48, 513 51, 48,9-51, 154 53,154, 53154 531 53, 549 54, 53,1-54, (13 3929 392.9 PeNSE20 PeNSE/2 432 313,4323 313432 313,4-323 (PeNSE/20 (IC9 95 48,951 4895 48,9-51 15 53,154 5315 53,1-54 (1 392. PeNSE2 PeNSE/ 313,432 31343 313,4-32 (PeNSE/2 (IC 48,95 48,9-5 53,15 53,1-5 313,43 313,4-3 (PeNSE/ 48,9- 53,1- 313,4-

Resumo: O objetivo do estudo foi analisar a tendência de atividade física dos escolares brasileiros e as associações com variáveis demográficas, socioeconômicas e comportamentais, por meio da Pesquisa Nacional de Saúde do Escolar (PeNSE) em suas quatro edições - 2009, 2012, 2015 e 2019. Foram usados dados dos escolares (13-17 anos) participantes das quatro edições da PeNSE (n = 392.922). Descrevemos o percentual de ativos, a média e valores percentuais da atividade física de intensidade moderada à vigorosa em minutos/semana. A regressão de Poisson foi ajustada para sexo, idade, cor da pele, escore de bens e comportamento sedentário (≥ 2 horas/dia para assistir TV e ≥ 3 horas/dia de tempo sentado). Como limitação, a amostra da PeNSE/2009 refere-se apenas às capitais brasileiras. O percentual de ativos reduziu de 43,1% em 2009 para 18,2% em 2019. A média em atividade física de intensidade moderada à vigorosa da PeNSE/2009 (média = 318,4 minutos/semana; IC95%: 313,4-323,4) reduziu 50% em 2019. Na educação física, a média semanal em atividade física de intensidade moderada à vigorosa das meninas foi menor que 50 minutos, ao passo que a dos meninos foi maior que 60 minutos, nas quatro edições da PeNSE. Ainda, 22,7% das meninas relataram (PeNSE/2019) não ter tido aulas de educação física, enquanto o mesmo é relatado por 19,7% dos meninos. O comportamento sedentário sofreu redução no hábito de assistir TV, porém o tempo sentado aumentou de 50,1% (IC95%: 48,9-51,3) para 54% (IC95%: 53,1-54,9) entre a PeNSE/2009 e a PeNSE/2019. Como consequência da queda nos níveis de atividade física, são necessárias políticas públicas que promovam a atividade física, como aumentar as aulas de educação física na escola para, no mínimo, três vezes por semana. Resumo demográficas comportamentais (PeNSE 2012 201 2019 1317 13 17 (13-1 anos n 392.922. 392922 392.922 . 392 922 392.922) minutossemana minutos semana minutos/semana sexo idade pele ( horasdia horas dia sentado. sentado) limitação PeNSE2009 PeNSE/200 referese refere se brasileiras 431 43 1 43,1 200 182 18 18,2 3184 318 4 318, IC95% IC95 IC 313,4323,4 31343234 313,4 323,4 313 323 313,4-323,4 5 6 Ainda 227 22 7 22,7 PeNSE/2019 PeNSE2019 (PeNSE/2019 197 19 19,7 501 50,1 (IC95% 48,951,3 489513 48,9 51,3 48 9 51 48,9-51,3 54 53,154,9 531549 53,1 54,9 53 53,1-54,9 mínimo 20 131 (13- 39292 392.92 39 92 PeNSE200 PeNSE/20 43, 18, 31 IC9 4323 313,4323, 3134323 3134 313, 3234 323, 32 313,4-323, 22, PeNSE/201 PeNSE201 (PeNSE/201 19, 50, (IC95 951 48,951, 48951 489 48, 513 51, 48,9-51, 154 53,154, 53154 531 53, 549 54, 53,1-54, (13 3929 392.9 PeNSE20 PeNSE/2 432 313,4323 313432 313,4-323 (PeNSE/20 (IC9 95 48,951 4895 48,9-51 15 53,154 5315 53,1-54 (1 392. PeNSE2 PeNSE/ 313,432 31343 313,4-32 (PeNSE/2 (IC 48,95 48,9-5 53,15 53,1-5 313,43 313,4-3 (PeNSE/ 48,9- 53,1- 313,4-

Abstract: This study aimed to analyze the physical activity trend of Brazilian schoolchildren and the associations with demographic, socioeconomic, and behavioral variables by using the Brazilian National Survey of School Health (PeNSE) in its four editions - 2009, 2012, 2015, and 2019. Data from students (13-17 years old) participating in the four editions of the PeNSE (n = 392,922) were used. We describe the percentage of active, mean, and percentile values of moderate to vigorous intensity physical activity in minutes/week. Poisson’s regression was adjusted for gender, age, skin color, goods score, and sedentary behavior (≥ 2 hours/day watching TV and ≥ 3 hours/day sitting time). As a limitation, the PeNSE/2009 sample refers only to the Brazilian capital cities. The percentage of active students decreased from 43.1% in 2009 to 18.2% in 2019. The mean moderate to vigorous intensity physical activity of PeNSE/2009 (mean = 318.4 minutes/week; 95%CI: 313.4-323.4) decreased 50% in 2019. In physical education, the weekly average in moderate to vigorous intensity physical activity of girls is less than 50 minutes and boys is greater than 60 minutes in the four editions of PeNSE, also 22.7% of girls reported (PeNSE/2019) not having taken physical education classes whereas the same thing is reported by 19.7% of boys. Sedentary behavior reduced regarding time watching TV, but sitting time increased by 50.1% (95%CI: 48.9-51.3) and 54% (95%CI: 53.1-54.9) between PeNSE/2009 and PeNSE/2019. As a consequence of the drop in physical activity levels, public policies that promote physical activity are necessary, including increasing physical education classes at school to at least three times a week. Abstract demographic socioeconomic (PeNSE 2012 2015 2019 1317 13 17 (13-1 old n 392,922 392922 392 922 used minutesweek week minutes/week Poissons Poisson s gender age color score ( hoursday hours day time. . time) limitation PeNSE2009 PeNSE/200 cities 431 43 1 43.1 200 182 18 18.2 3184 318 4 318. 95%CI 95CI CI 95 313.4323.4 31343234 313.4 323.4 313 323 313.4-323.4 5 6 227 22 7 22.7 PeNSE/2019 PeNSE2019 (PeNSE/2019 197 19 19.7 501 50.1 (95%CI 48.951.3 489513 48.9 51.3 48 9 51 48.9-51.3 54 53.154.9 531549 53.1 54.9 53 53.1-54.9 levels necessary 201 131 (13- 392,92 39292 39 92 PeNSE200 PeNSE/20 43. 20 18. 31 4323 313.4323. 3134323 3134 313. 3234 323. 32 313.4-323. 22. PeNSE/201 PeNSE201 (PeNSE/201 19. 50. 951 48.951. 48951 489 48. 513 51. 48.9-51. 154 53.154. 53154 531 53. 549 54. 53.1-54. (13 392,9 3929 PeNSE20 PeNSE/2 432 313.4323 313432 313.4-323 (PeNSE/20 48.951 4895 48.9-51 15 53.154 5315 53.1-54 (1 392, PeNSE2 PeNSE/ 313.432 31343 313.4-32 (PeNSE/2 48.95 48.9-5 53.15 53.1-5 313.43 313.4-3 (PeNSE/ 48.9- 53.1- 313.4-

https://doi.org/10.1590/0102-311xpt063423

Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery
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Gasperi, Ricardo de

; Bodanese, Luiz Carlos

; Guaragna, João Carlos Vieira da Costa

; Wagner, Mario Bernardes

; Albuquerque, Luciano Cabral

Brazilian Journal of Cardiovascular Surgery

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2023, N. ahead

Abstract: En | Text: En | PDF: En

https://doi.org/10.21470/1678-9741-2022-0254

Tendência temporal de atividade física em adolescentes brasileiros: análise da Pesquisa Nacional de Saúde do Escolar de 2009 a 2019
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Soares, Carlos Alex Martins

; Leão, Otávio Amaral de Andrade

; Freitas, Matheus Pintanel

; Hallal, Pedro Curi

; Wagner, Mário Bernardes

Cadernos de Saúde Pública

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2023, Volume 39 N. 10 elocation e00063423

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

https://doi.org/10.1590/0102-311xpt063423

Healthy and Safe School Cafeteria Program: a randomized controlled study
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BALESTRIN, Mariana

; KIRSTEN, Vanessa Ramos

; WAGNER, Mario Bernardes

Revista de Nutrição

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2022, Volume 35 elocation e210265

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

RESUMO Objetivo Avaliar o efeito de um programa de intervenção educacional nas condições de risco à saúde com base na avaliação das condições higiênicas e na qualidade dos alimentos comercializados em cantinas escolares. Métodos Este é um estudo comunitário, controlado, paralelo, randomizado, dois braços. As escolas de Ensino Fundamental e Médio, públicas e privadas, que possuíam cantinas, foram convidadas a participar. Este estudo foi realizado em 27 cantinas escolares do norte e noroeste do Rio Grande do Sul, sul do Brasil. Representantes da comunidade escolar das cantinas do grupo intervenção receberam um programa educacional composto por um treinamento a distância de 160 horas. Os principais desfechos avaliados foram avaliação das condições higiênicas e composição dos alimentos vendidos nas cantinas escolares. Todos os resultados foram analisados como intenção de tratar e per protocolo. Para análise dos dados contínuos, com distribuição normal, utilizou-se a análise de covariância e o Modelo Linear Generalizado. O nível de significância estatística considerado foi p<0,05 para um intervalo de confiança de 95%. Resultados Não foi observada diferença estatisticamente significativa entre o grupo intervenção e o grupo controle nos desfechos estudados. Houve redução de 76,2 pontos no escore das condições higiênicas de manipulação (IC 95%: -205 a 357; p=0,581). Em relação à composição dos cardápios, a diferença entre os grupos foi de 0,48% (IC 95%: -2,69 a 3,64; p=0,760) para os alimentos ultraprocessados, 0,23% (IC 95%: -1,13 a 1,60; p=0,740) para os alimentos processados e 1,02% (IC 95%: -2,59 a 4,64; p=0,581) para os alimentos in natura. Conclusão Não há evidências suficientes para concluir que a intervenção teve impacto positivo em nenhum dos desfechos estudados.

ABSTRACT Objective To assess the effect of an educational intervention program focused on health risk conditions, based on an assessment of the hygiene and quality of food sold in school cafeterias. Methods This is a controlled, parallel, randomized, two-arm, community study. Public and private schools with cafeterias were invited to participate. This study was conducted in 27 school cafeterias in northern and northwestern Rio Grande do Sul, a state in southern Brazil. Representatives of the school communities in the intervention group received an educational program consisting of 160-hour distance training. The most relevant outcomes were the assessment of the hygienic conditions and composition of the menus sold in school cafeterias. All outcomes were analyzed as intention-to-treat and per-protocol. For the analysis of continuous data with normal distribution, an analysis of covariance and the Generalized Linear Model were used. The level of statistical significance considered was p<0.05 for a 95% CI. Results No statistically significant difference was observed between the intervention group and the control group in the studied outcomes. There was a reduction of 76.2 points in the score for hygienic handling conditions (95% CI: -205 to 357; p=0.581). Regarding menu composition, the difference between groups was 0.48% (95% CI: -2.69 to 3.64; p=0.760) for ultra-processed foods, 0.23% (95% CI: -1.13 to 1.60; p=0.740) for processed foods, and 1.02% (95% CI: -2.59 to 4.64; p=0.581) for fresh foods. Conclusion There is not enough evidence to conclude that the intervention had a positive impact on any of the outcomes studied.

https://doi.org/10.1590/1678-9865202235e210265

Risk Score Elaboration for Stroke in Cardiac Surgery
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Magedanz, Ellen Hettwer

; Guaragna, João Carlos Vieira da Costa

; Albuquerque, Luciano Cabral

; Wagner, Mario Bernardes

; Chieza, Fernanda Lourega

; Bueno, Natalia Lamas

; Bodanese, Luiz Carlos

Brazilian Journal of Cardiovascular Surgery

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dec 2021, Volume 36 N. 6 Pages 788 - 795

Abstract: En | Text: En | PDF: En

Abstract Introduction: Stroke is a complication that causes considerable morbidity and mortality during the heart surgery postoperative period (incidence: 1.3 to 5%; mortality: 13 to 41%). Models for assessing the risk of stroke after heart surgery have been proposed, but most of them do not evaluate postoperative morbidity. The aim of this study was to develop a risk score for postoperative stroke in patients who undergo heart surgery with cardiopulmonary bypass. Methods: A cohort study was conducted with data from 4,862 patients who underwent surgery from 1996 to 2016. Logistic regression was used to assess relationships between risk factors and stroke. Data from 3,258 patients were used to construct the model. The model’s performance was then validated using data from the remainder of the patients (n=1,604). The model’s accuracy was tested using the area under the receiver operating characteristic (ROC) curve. Results: The prevalence of stroke during the postoperative period was 3% (n=149); 59% of the patients who exhibited this outcome were male, 51% were aged ≥ 66 years, and 31.5% of the patients died. The variables that remained as independent predictors of the outcome after multivariate analysis were advanced age, urgent/emergency surgery, peripheral arterial occlusive disease, history of cerebrovascular disease, and cardiopulmonary bypass time ≥ 110 minutes. The area under the ROC curve was 0.71 (95% confidence interval 0.66 - 0.75). Conclusion: We were able to develop a risk score for stroke after heart surgery. This score classifies patients as low, medium, high, or very high risk of a surgery-related stroke.

https://doi.org/10.21470/1678-9741-2020-0331

Risk Score for Prolonged Mechanical Ventilation in Coronary Artery Bypass Grafting
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Dallazen-Sartori, Fernanda

; Albuquerque, Luciano Cabral

; Guaragna, João Carlos Vieira da Costa

; Magedanz, Ellen Hettwer

; Petracco, João Batista

; Bodanese, Rodrigo

; Wagner, Mario Bernardes

; Bodanese, Luiz Carlos

International Journal of Cardiovascular Sciences

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jun 2021, Volume 34 N. 3 Pages 264 - 271

Abstract: En | Text: En | PDF: En

Abstract Background Prolonged mechanical ventilation (MV) after cardiac surgery imposes a significant burden on the patient in terms of morbidity and financial hospital costs. Objective To develop a risk score model to predict prolonged MV in patients undergoing coronary artery bypass grafting (CABG) surgery. Methods This was a historical cohort study of 4165 adult patients undergoing CABG between January 1996 and December 2016. MV for periods ≥ 12 hours was considered prolonged. Logistic regression was used to examine the relationship between risk predictors and prolonged MV. The variables were scored according to the odds ratio. To build the risk score, the database was randomly divided into 2 parts: development data set (2/3) with 2746 patients and internal validation data set (1/3) with 1419 patients. The final score was validated in the total database and the model's accuracy was tested by performance statistics. Significance was established at p < 0.05. Results Prolonged MV was observed in 783 (18.8%) patients. Predictors of risk were age ≥ 65 years, urgent/emergency surgery, body mass index ≥ 30 kg/m2, chronic kidney disease, chronic obstructive pulmonary disease, and cardiopulmonary bypass time ≥ 120 minutes. The area under the ROC curve was 0.66 (95% CI, 0.64-0.68; p<0.001), the Hosmer-Lemeshow chi-square test was χ2: 3.38 (p=0.642), and Pearson's correlation was r = 0.99 (p<0.001), indicating the model’s satisfactory ability to predict the occurrence of prolonged MV. Conclusion Selected variables allowed the construction of a simplified risk score for daily practice, which may classify the patients as having low, moderate, high, and very high risk. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

https://doi.org/10.36660/ijcs.20200068 30 downloads

Red reflex test at the maternity hospital: results from a tertiary hospital and variables associated with inconclusive test results,
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Baldino, Vinicius Mac Cord Lanes

; Eckert, Gabriela Unchalo

; Rossatto, Juliana

; Wagner, Mário Bernardes

Jornal de Pediatria

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dec 2020, Volume 96 N. 6 Pages 748 - 754

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

Resumo Objetivos: Descrever os resultados do teste do reflexo vermelho em recém-nascidos a termo. Identificar fatores associados ao resultado do teste do reflexo vermelho e comparar o tempo de internação entre pacientes com teste do reflexo vermelho duvidoso e normal. Métodos: Estudo transversal descritivo dos resultados do teste do reflexo vermelho feito em maternidade de hospital terciário entre 2014 e 2018. Foi ainda feito estudo de caso-controle aninhado para pesquisa de variáveis antropométricas, gestacionais e neonatais associadas ao resultado do teste do reflexo vermelho. Resultados: Foram identificados 121 casos de teste do reflexo vermelho duvidoso em 11.833 recém-nascidos. Foram confirmadas 16 alterações, 4 consideradas graves: 2 casos de glaucoma congênito, um de catarata e um de coloboma. As médias de peso de nascimento (p = 0,04), comprimento (p = 0,03) e perímetro cefálico (p = 0,02) foram menores nos pacientes com teste do reflexo vermelho duvidoso, entretanto sem um tamanho de efeito relevante (d = -0,21; -0,22 e -0,25; respectivamente). A proporção de pacientes brancos, pardos e negros foi estatisticamente diferente entre os grupos (p < 0,001), com maior chance de resultado duvidoso para pardos (OR = 2,22) e negros (OR = 3,37) em comparação a brancos. O teste do reflexo vermelho duvidoso levou a um aumento no tempo de internação de 62 para 82 horas (p < 0,001). Conclusões: O teste do reflexo vermelho foi capaz de identificar 4 alterações graves em 11.833 recém-nascidos (0,03%). Nos 121 recém-nascidos em que o teste do reflexo vermelho foi classificado como duvidoso, houve aumento de 20 horas no tempo de internação hospitalar, porém se confirmou alteração grave em apenas 3,3% deles. Diferenças no reflexo vermelho entre brancos, pardos e negros devem ser consideradas.

Abstract Objectives: Describe the results of the red reflex test in full-term newborns, as well as identify factors associated with red reflex test outcome and compare hospital length of stay between patients with inconclusive and normal red reflex test results. Methods: Descriptive cross-sectional study of the results of the red reflex test performed in a tertiary hospital maternity unit between 2014 and 2018. A nested case-control study was also performed to search for anthropometric, gestational, and neonatal variables associated with the outcome of the red reflex test. Results: There were121 identified cases of inconclusive red reflex test in 11,833 newborns. Sixteen alterations were confirmed, four considered severe: two cases of congenital glaucoma, one of cataract, and one of coloboma. Mean birth weight (p = 0.04), length (p = 0.03), and head circumference (p = 0.02) were lower in patients with inconclusive red reflex test; however without a relevant effect size (d = −0.21, −0.22, and −0.25, respectively).The proportion of white, mixed-race, and black patients was significantly different between the groups (p < 0.001), with a higher chance of inconclusive results in mixed-race (OR = 2.22) and black (OR = 3.37) patients when compared to whites. An inconclusive red reflex test led to an increase in hospital length of stay from 62 to 82 hours (p < 0.001). Conclusions: The red reflex test was able to identify four severe alterations in 11,833 newborns (0.03%). In the 121 newborns in which the red reflex test was classified as inconclusive, there was a 20-hour increase in the hospital length of stay, but a severe alteration was confirmed in only 3.3% of them. Differences in red reflex between white, mixed-race, and black patients should be considered.

https://doi.org/10.1016/j.jped.2019.08.007 408 downloads

10.

Effects of axial length on retinal nerve fiber layer and macular ganglion cell-inner plexiform layer measured by spectral-domain OCT
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Francisconi, Carolina Lampert Monte

; Wagner, Mário Bernardes

; Ribeiro, Roberto Vanin Pinto

; Freitas, André Moraes

Arquivos Brasileiros de Oftalmologia

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aug 2020, Volume 83 N. 4 Pages 269 - 276

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

RESUMO Objetivo: Avaliar a influência do comprimento axial ocular na espessura da camada de fibras nervosas da retina peripapilar e na espessura da camada de células ganglionares-plexiforme interna em olhos saudáveis após correção para efeito de magnificação ocular. Métodos: Neste estudo transversal, avaliamos 120 olhos de 60 participantes voluntários (míopes, emétropes e hipermétropes). A espessura da camada de fibras nervosas da retina peripapilar e da camada de células ganglionares-plexiforme interna foram medidas usando a tomografia de coerência óptica espectral (OCT)-Cirrus HD-OCT e correlacionada com o comprimento axial ocular. O ajuste para a magnificação ocular foi realizado aplicando a fórmula de Littmann. Resultados: Antes do ajuste para magnificação ocular, a análise de modelos mistos ajustada por idade demonstrou uma correlação negativa significante entre o comprimento axial e a espessura média da camada de fibras nervosas da retina peripapilar (r=-0,43; p<0,001), espessura da camada de fibras nervosas da retina peripapilar inferior (r=-0,46; p <0,001), espessura da camada de fibras nervosas da retina peripapilar superior (r=-0,31; p<0,05), espessura da camada de fibras nervosas da retina peripapilar nasal (r=-0,35; p<0,001) e espessura média das células ganglionares-plexiforme interna (r=-0,35; p<0,05). No entanto, após a correção do efeito de magnificação, os resultados foram consideravelmente diferentes, revelando apenas uma correlação positiva entre o comprimento axial e a espessura temporal da camada de fibras nervosas da retina(r=0,42; p<0,001). Além disso, demonstramos uma correlação positiva entre o comprimento axial e a espessura média das células ganglionares-plexiforme interna (r=0,48; p<0,001). Todas as outras correlações não foram consideradas estatisticamente significativas. Conclusão: Antes do ajuste para o efeito de magnificação ocular, o comprimento axial estava negativamente correlacionado com a espessura da camada de fibras nervosas da retina peripapilar e das células ganglionares-plexiforme interna medido pelo Cirrus-OCT. Atribuimos esse efeito à magnificação ocular associada a comprimentos axiais maiores, o que foi corrigido com a fórmula de Littman. Mais estudos são necessários para investigaro impactoda correçãoda magnificação ocular na acurácia diagnóstica do Cirrus-OCT.

ABSTRACT Purpose: To evaluate the influence of ocular axial length on circumpapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness in healthy eyes after correcting for ocular magnification effect. Methods: In this cross-sectional study, we evaluated 120 eyes from 60 volunteer participants (myopes, emmetropes, and hyperopes). The thickness of the circumpapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer were measured using the spectral optical coherence tomography (OCT)-Cirrus HD-OCT and correlated with ocular axial length. Adjustment for ocular magnification was performed by applying Littmann’s formula. Results: Before the adjustment for ocular magnification, age-adjusted mixed models analysis demonstrated a significant negative correlation between axial length and average circumpapillary retinal nerve fiber layer thickness (r=-0.43, p<0.001), inferior circumpapillary retinal nerve fiber layer thickness (r=-0.46, p<0.001), superior circumpapillary retinal nerve fiber layer thickness (r=-0.31, p<0.05), nasal circumpapillary retinal nerve fiber layer thickness (r=-0.35, p<0.001), and average ganglion cell-inner plexiform layer thickness (r=-0.35, p<0.05). However, after correcting for magnification effect, the results were considerably different, revealing only a positive correlation between axial length and temporal retinal nerve fiber layer thickness (r=0.42, p<0.001). Additionally, we demonstrated a positive correlation between axial length and average ganglion cell-inner plexiform layer thickness (r=0.48, p<0.001). All other correlations were not found to be statistically significant. Conclusions: Before adjustment for ocular magnification, axial length was negatively correlated with circumpapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness measured by Cirrus-OCT. We attributed this effect to ocular magnification associated with greater axial lengths, which was corrected with the Littman’s formula. Further studies are required to investigate the impact of ocular magnification correction on the diagnostic accuracy of Cirrus-OCT.

https://doi.org/10.5935/0004-2749.20200039 882 downloads

11.

Epidemiologia e desfecho dos pacientes de alto risco cirúrgico admitidos em unidades de terapia intensiva no Brasil
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Silva Júnior, João Manoel

; Chaves, Renato Carneiro de Freitas

; Corrêa, Thiago Domingos

; Assunção, Murillo Santucci Cesar de

; Katayama, Henrique Tadashi

; Bosso, Fabio Eduardo

; Amendola, Cristina Prata

; Serpa Neto, Ary

; Malbouisson, Luiz Marcelo Sá

; Oliveira, Neymar Elias de

; Veiga, Viviane Cordeiro

; Rojas, Salomón Soriano Ordinola

; Postalli, Natalia Fioravante

; Alvarisa, Thais Kawagoe

; Lucena, Bruno Melo Nobrega de

; Oliveira, Raphael Augusto Gomes de

; Sanches, Luciana Coelho

; Silva, Ulysses Vasconcellos de Andrade e

; Nassar Junior, Antonio Paulo

; Réa-Neto, Álvaro

; Amaral, Alexandre

; Teles, José Mário

; Freitas, Flávio Geraldo Rezende de

; Bafi, Antônio Tonete

; Pacheco, Eduardo Souza

; Ramos, Fernando José

; Vieira Júnior, José Mauro

; Pereira, Maria Augusta Santos Rahe

; Schwerz, Fábio Sartori

; Menezes, Giovanna Padoa de

; Magalhães, Danielle Dourado

; Castro, Cristine Pilati Pileggi

; Henrich, Sabrina Frighetto

; Toledo, Diogo Oliveira

; Parra, Bruna Fernanda Camargo Silva

; Dias, Fernando Suparregui

; Zerman, Luiza

; Formolo, Fernanda

; Nobrega, Marciano de Sousa

; Piras, Claudio

; Piras, Stéphanie de Barros

; Conti, Rodrigo

; Bittencourt, Paulo Lisboa

; D’Oliveira, Ricardo Azevedo Cruz

; Estrela, André Ricardo de Oliveira

; Oliveira, Mirella Cristine de

; Reese, Fernanda Baeumle

; Motta Júnior, Jarbas da Silva

; Câmara, Bruna Martins Dzivielevski da

; David-João, Paula Geraldes

; Tannous, Luana Alves

; Chaiben, Viviane Bernardes de Oliveira

; Miranda, Lorena Macedo Araújo

; Brasil, José Arthur dos Santos

; Deucher, Rafael Alexandre de Oliveira

; Ferreira, Marcos Henrique Borges

; Vilela, Denner Luiz

; Almeida, Guilherme Cincinato de

; Nedel, Wagner Luis

; Passos, Matheus Golenia dos

; Marin, Luiz Gustavo

; Oliveira Filho, Wilson de

; Coutinho, Raoni Machado

; Oliveira, Michele Cristina Lima de

; Friedman, Gilberto

; Meregalli, André

; Höher, Jorge Amilton

; Soares, Afonso José Celente

; Lobo, Suzana Margareth Ajeje

Revista Brasileira de Terapia Intensiva

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mar 2020, Volume 32 N. 1 Pages 17 - 27

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

RESUMO Objetivo: Definir o perfil epidemiológico e os principais determinantes de morbimortalidade dos pacientes cirúrgicos não cardíacos de alto risco no Brasil. Métodos: Estudo prospectivo, observacional e multicêntrico. Todos os pacientes cirúrgicos não cardíacos admitidos nas unidades de terapia intensiva, ou seja, considerados de alto risco, no período de 1 mês, foram avaliados e acompanhados diariamente por, no máximo, 7 dias na unidade de terapia intensiva, para determinação de complicações. As taxas de mortalidade em 28 dias de pós-operatório, na unidade de terapia intensiva e hospitalar foram avaliadas. Resultados: Participaram 29 unidades de terapia intensiva onde foram realizadas cirurgias em 25.500 pacientes, dos quais 904 (3,5%) de alto risco (intervalo de confiança de 95% - IC95% 3,3% - 3,8%), tendo sido incluídos no estudo. Dos pacientes envolvidos, 48,3% eram de unidades de terapia intensiva privadas e 51,7% de públicas. O tempo de internação na unidade de terapia intensiva foi de 2,0 (1,0 - 4,0) dias e hospitalar de 9,5 (5,4 - 18,6) dias. As taxas de complicações foram 29,9% (IC95% 26,4 - 33,7) e mortalidade em 28 dias pós-cirurgia 9,6% (IC95% 7,4 - 12,1). Os fatores independentes de risco para complicações foram Simplified Acute Physiology Score 3 (SAPS 3; razão de chance − RC = 1,02; IC95% 1,01 - 1,03) e Sequential Organ Failure Assessment Score (SOFA) da admissão na unidade de terapia intensiva (RC =1,17; IC95% 1,09 - 1,25), tempo de cirurgia (RC = 1,001; IC95% 1,000 - 1,002) e cirurgias de emergências (RC = 1,93; IC95% 1,10 - 3,38). Em adição, foram associados com mortalidade em 28 dias idade (RC = 1,032; IC95% 1,011 - 1,052) SAPS 3 (RC = 1,041; IC95% 1,107 - 1,279), SOFA (RC = 1,175; IC95% 1,069 - 1,292) e cirurgias emergenciais (RC = 2,509; IC95% 1,040 - 6,051). Conclusão: Pacientes com escores prognósticos mais elevados, idosos, tempo cirúrgico e cirurgias emergenciais estiveram fortemente associados a maior mortalidade em 28 dias e mais complicações durante permanência em unidade de terapia intensiva.

ABSTRACT Objective: To define the epidemiological profile and the main determinants of morbidity and mortality in noncardiac high surgical risk patients in Brazil. Methods: This was a prospective, observational and multicenter study. All noncardiac surgical patients admitted to intensive care units, i.e., those considered high risk, within a 1-month period were evaluated and monitored daily for a maximum of 7 days in the intensive care unit to determine complications. The 28-day postoperative, intensive care unit and hospital mortality rates were evaluated. Results: Twenty-nine intensive care units participated in the study. Surgeries were performed in 25,500 patients, of whom 904 (3.5%) were high-risk (95% confidence interval - 95%CI 3.3% - 3.8%) and were included in the study. Of the participating patients, 48.3% were from private intensive care units, and 51.7% were from public intensive care units. The length of stay in the intensive care unit was 2.0 (1.0 - 4.0) days, and the length of hospital stay was 9.5 (5.4 - 18.6) days. The complication rate was 29.9% (95%CI 26.4 - 33.7), and the 28-day postoperative mortality rate was 9.6% (95%CI 7.4 - 12.1). The independent risk factors for complications were the Simplified Acute Physiology Score 3 (SAPS 3; odds ratio - OR = 1.02; 95%CI 1.01 - 1.03) and Sequential Organ Failure Assessment Score (SOFA) on admission to the intensive care unit (OR = 1.17; 95%CI 1.09 - 1.25), surgical time (OR = 1.001, 95%CI 1.000 - 1.002) and emergency surgeries (OR = 1.93, 95%CI, 1.10 - 3.38). In addition, there were associations with 28-day mortality (OR = 1.032; 95%CI 1.011 - 1.052), SAPS 3 (OR = 1.041; 95%CI 1.107 - 1.279), SOFA (OR = 1.175, 95%CI 1.069 - 1.292) and emergency surgeries (OR = 2.509; 95%CI 1.040 - 6.051). Conclusion: Higher prognostic scores, elderly patients, longer surgical times and emergency surgeries were strongly associated with higher 28-day mortality and more complications during the intensive care unit stay.

https://doi.org/10.5935/0103-507x.20200005 1048 downloads

12.

Consumo de alimentos ultraprocessados entre crianças de uma Unidade Básica de Saúde
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Sparrenberger, Karen

; Friedrich, Roberta Roggia

; Schiffner, Mariana Dihl

; Schuch, Ilaine

; Wagner, Mário Bernardes

Jornal de Pediatria

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dec 2015, Volume 91 N. 6 Pages 535 - 542

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

Resumo Objetivos Avaliar a contribuição dos alimentos ultraprocessados no consumo alimentar de crianças pertencentes à área de abrangência de uma unidade básica de saúde e os fatores associados. Método Estudo transversal com amostra de conveniência de 204 crianças, entre dois a 10 anos, no Sul do Brasil. O consumo alimentar das crianças foi obtido por meio do Recordatório Alimentar de 24 horas e, posteriormente, os alimentos foram classificados em minimamente processados, processados para culinária e ultraprocessados. Um questionário semiestruturado foi aplicado para a coleta das variáveis sociodemográficas e antropométricas. O excesso de peso das crianças foi definido por meio do escore Z > 2 para menores de cinco anos e Z > +1 para entre cinco e 10 anos segundo o Índice de Massa Corporal para idade. Resultados A frequência de excesso de peso foi de 34% (IC95%: 28% a 41%). O consumo médio de energia foi de 1.672,3 kcal/dia, 47% (IC95%: 45% a 49%) provenientes dos ultraprocessados. No modelo de regressão linear múltipla, a escolaridade materna (r = 0,23; p = 0,001) e a idade da criança (r = 0,40; p < 0,001) foram associados à maior contribuição percentual dos ultraprocessados na alimentação (R = 0,42; p < 0,001). Adicionalmente foi observada uma tendência linear significativa para maior consumo de ultraprocessados quando os dados foram estratificados pela idade da criança e nível de escolaridade materna (p < 0,001). Conclusões A contribuição dos ultraprocessados é expressiva na alimentação infantil e a idade da criança mostrou-se como fator associado mais importante para o consumo desses produtos.

Abstract Objectives To evaluate the contribution of ultra-processed food (UPF) on the dietary consumption of children treated at a Basic Health Unit and the associated factors. Methodology Cross-sectional study carried out with a convenience sample of 204 children, aged 2-10 years old, in Southern Brazil. Children's food intake was assessed using a 24-h recall questionnaire. Food items were classified as minimally processed, processed for culinary use, and ultra-processed. A semi-structured questionnaire was applied to collect socio-demographic and anthropometric variables. Overweight in children was classified using a Z score >2 for children younger than 5 and Z score >+1 for those aged between 5 and 10 years, using the body mass index for age. Results Overweight frequency was 34% (95% CI: 28-41%). Mean energy consumption was 1672.3 kcal/day, with 47% (95% CI: 45-49%) coming from ultra-processed food. In the multiple linear regression model, maternal education (r = 0.23; p = 0.001) and child age (r = 0.40; p < 0.001) were factors associated with a greater percentage of UPF in the diet (r = 0.42; p < 0.001). Additionally, a statistically significant trend for higher UPF consumption was observed when data were stratified by child age and maternal educational level (p < 0.001). Conclusions The contribution of UPF is significant in children's diets and age appears to be an important factor for the consumption of such products.

https://doi.org/10.1016/j.jped.2015.01.007 18591 downloads

13.

Contrast-induced nephropathy after computed tomography
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Selistre, Luciano da Silva

; Souza, Vandréa Carla de

; Dubourg, Laurence

; Wagner, Mário Bernardes

; Hoefel Filho, João Rubião

; Saitovitch, David

Brazilian Journal of Nephrology

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mar 2015, Volume 37 N. 1 Pages 27 - 31

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

Introdução: Nefropatia induzida por contraste é a terceira causa de lesão renal aguda em pacientes hospitalizados. Ela é definida como: um aumento absoluto da creatinina sérica ≥ 0,5 mg/dL e relativo em ≥ 25%. Objetivo: Nós estudamos os fatores de risco associados à nefropatia do contraste após tomografia computadorizada. Métodos: Analisamos prospectivamente 400 pacientes submetidos ao contraste endovenoso na tomografia computadorizada. Resultados: A incidência de nefropatia por contraste variou de 4 a 13,9%, conforme o critério de aumento da creatinina sérica. Diabetes e insuficiência cardíaca foram associados significativamente no aumento absoluto da creatinina sérica (O.R.: 3,5 [95% CI: 1,92-6,36], p < 0,01, 2,61 [95% CI: 1,14-6,03%], p < 0,05, respectivamente). Conclusão: Encontramos uma relação direta da infusão de contraste endovenoso na tomografia computadorizada e injúria renal, notadamente com diabetes e insuficiência cardíaca.

Introduction: Contrast induced nephropathy is the third most prevalent preventable cause of acute kidney injury in hospitalized patients. It defined as an absolute increase in serum creatinine ≥ 0.5 mg/dL and relative ≥ 25% increase. Objective: We studied the risk factors to intravenous injection contrast nephropathy after computed tomography. Methods: We studied 400 patients prospectively. Results: The incidence of contrast induced nephropathy, with an absolute or a relative increase were 4.0% and 13.9%, respectively. Diabetes and cardiac failure were independent risk factors for CIN a relative increase de serum creatinine (O.R.: 3.5 [95% CI: 1.92-6.36], p < 0.01, 2.61 [95% CI: 1.14-6.03%], p < 0.05, respectively). Conclusions: We showed association between uses of intravenous injection contrast after computed tomography with acute injury renal, notably with diabetes and heart failure.

https://doi.org/10.5935/0101-2800.20150005 7847 downloads

14.

Effect of intervention programs in schools to reduce screen time: a meta-analysis
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Friedrich, Roberta Roggia

; Polet, Jéssica Pinto

; Schuch, Ilaine

; Wagner, Mário Bernardes

Jornal de Pediatria

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jun 2014, Volume 90 N. 3 Pages 232 - 241

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

OBJETIVO: avaliar os efeitos das estratégias dos programas de intervenção sobre o tempo dedicado a atividades como assistir à televisão, jogar videogame e usar computador em escolares.FONTE DOS DADOS: foi realizada busca de estudos controlados randomizados, disponíveis nas bases de dados eletrônicas PubMed, Lilacs, Embase, Scopus, Web of Sciencee Cochrane Library, com os descritores: randomized controlled trial, intervention studies, sedentary lifestyle, screen timee school. Medida de sumário baseada na diferença das médias padronizadas foi usada com intervalo de confiança de 95%.SÍNTESE DOS DADOS: foram identificados 1.552 estudos, dos quais 16 foram incluídos na metaanálise. As intervenções nos estudos controlados randomizados (n = 8.785) apresentaram efeito significativo na redução do tempo em frente à tela, com diferença das médias padronizadas (efeito randômico): -0,25 (-0,37; -0,13), p < 0,01.CONCLUSÃO: as intervenções mostraram efeitos positivos na redução do tempo em frente à tela em escolares.

OBJECTIVE:to evaluate the effects of intervention program strategies on the time spent on activities such as watching television, playing videogames, and using the computer among schoolchildren.SOURCES:a search for randomized controlled trials available in the literature was performed in the following electronic databases: PubMed, Lilacs, Embase, Scopus, Web of Science, and Cochrane Library using the following Keywords randomized controlled trial, intervention studies, sedentary lifestyle, screen time, and school. A summary measure based on the standardized mean difference was used with a 95% confidence interval.DATA SYNTHESIS: a total of 1,552 studies were identified, of which 16 were included in the meta-analysis. The interventions in the randomized controlled trials (n = 8,785) showed a significant effect in reducing screen time, with a standardized mean difference (random effect) of: -0.25 (-0.37, -0.13), p < 0.01.CONCLUSION:interventions have demonstrated the positive effects of the decrease of screen time among schoolchildren.

https://doi.org/10.1016/j.jped.2014.01.003 3819 downloads

15.

Effect of intervention programs in schools to reduce screen time: a meta-analysis
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Friedrich, Roberta Roggia

; Polet, Jéssica Pinto

; Schuch, Ilaine

; Wagner, Mário Bernardes

Jornal de Pediatria

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apr 2014, Volume 90 N. 2 Pages 232 - 241

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

https://doi.org/10.1016/j.jped.2014.01.003 2184 downloads Cited 8 times in SciELO

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