Abstract The Madeira River basin is an example of an important portion of the Amazon region that is characterized by a high rate of conversion of forest into pastures and urban centers, evidencing an accelerated transformation in land cover and use with significant anthropic activity over the last three decades, which configures a potential impact in terms of modifying the climate behavior of the region. The present work seeks to analyze, in the Madeira River basin, the hydroclimatic impacts through the study of the variability of the two main components of the water balance and the energy balance at the scale of a watershed, namely precipitation and evapotranspiration, with additional emphasis on the temperature, which has served as a world reference to specify and demarcate changes in climate, given its space-time dynamics of anthropic occupation. More specifically, the occupancy history was initially analyzed using MODIS images for the period 2001-2013. In addition, precipitation data from the CHIRPS satellite product (1981-2017), evapotranspiration data determined by the SSEBop algorithm (2002-2017) via the sensor that produces the MODIS image and surface temperature of the MODIS satellite product (2001-2017) were examined, being such information treated as geospatial variables distributed in the study area. An extensive evaluation study regarding the identification of the presence or not of linear hydroclimatic trends in the Madeira River basin was carried out using the Mann-Kendall test. Although some trends were captured in the analyzed time series, the results obtained also showed that, given the limited database currently available, there is not necessarily a direct and clear relationship between the effect of human occupation and the climate regime of the basin, in contrast to the scientific framework recommended worldwide warning of climate change in the Anthropocene. In part, the high climate variability in the study region imposes limits with respect to clearly understand and separate the signals that can be attributed to the change in land cover and use from the signals associated with climate change that act on broader spatio-temporal scales. In this sense, new studies on monitoring hydrometeorological and hydroclimatic phenomena with corresponding measurements at different scales should be encouraged to better understand the processes of aggregation and disaggregation of the physical mechanisms acting at the scale of a watershed.

Resumo A bacia do rio Madeira constitui um exemplo de porção importante da região amazônica que se caracteriza por alta taxa de conversão de floresta em pastagens e núcleos urbanos, evidenciando transformação acelerada na cobertura e uso do solo com atividade antrópica significativa ao longo das três últimas décadas, o que configura potencial impacto quanto à modificação do comportamento climático da região. O presente trabalho busca analisar, na bacia do rio Madeira, os impactos hidroclimáticos por meio do estudo da variabilidade dos dois principais componentes do balanço hídrico e do balanço de energia na escala de uma bacia hidrográfica, nomeadamente precipitação e evapotranspiração, com destaque adicional para a temperatura, que tem servido de referência mundial para precisar e demarcar mudanças no clima, perante a sua dinâmica espaço-temporal de ocupação antrópica. Mais especificamente, analisou-se, inicialmente, o histórico de ocupação usando imagens MODIS para o período 2001-2013. Complementarmente, examinaram-se os dados de precipitação do produto satelital CHIRPS (1981-2017), de evapotranspiração determinados por meio do algoritmo SSEBop (2002-2017) via sensor que produz a imagem MODIS e ainda de temperatura de superfície do produto de satélite MODIS (2001-2017), informações tratadas como variáveis geoespaciais distribuídas na área de estudo. Extenso estudo de avaliação no que tange à identificação de existência ou não de tendências hidroclimáticas lineares na bacia do rio Madeira foi conduzido por meio do teste Mann-Kendall. Embora algumas tendências tenham sido captadas nas séries temporais analisadas, os resultados obtidos também mostraram não haver, necessariamente, face à limitada base de dados disponíveis atualmente, uma relação direta e clara entre o efeito da ocupação antrópica e o regime climático da bacia, em contraste com o quadro científico preconizado mundialmente de alerta quanto a mudanças climáticas no Antropoceno. Em parte, a alta variabilidade climática na região de estudo impõe limites para que se consiga claramente apreender e separar os sinais que podem ser atribuídos à alteração na cobertura e uso do solo dos sinais associados a mudanças climáticas que atuam em escalas espaço-temporais mais abrangentes. Nesse sentido, novos estudos sobre monitoramento de fenômenos hidrometeorológicos e hidroclimáticos com correspondentes medições em diferentes escalas devem ser incentivados para melhor compreender os processos de agregação e desagregação dos mecanismos físicos atuantes na escala de uma bacia hidrográfica.

ABSTRACT Rainfall is recognized as the most important driving force of the hydrologic cycle. To accurately represent the spatio-temporal rainfall variability continues to be an enormous hydrological task when using commonly sparse, if available, rain gauges networks. Therefore, the present study devoted a special effort to analyze the robustness of some satellite rainfall products, notably the datasets hereafter named as (i) CHIRP (Climate Hazards Group InfraRed Precipitation), (ii) CHIRPS (Climate Hazards Group InfraRed Precipitation with Station data), (iii) 3B42, and (iv) 3B42RT of the Tropical Rainfall Measuring Mission (TRMM), to adequately represent the pluviometric regime in the Madeira river basin. To assess the accuracy of acquired remotely sensed rainfall products, comparisons to observational available rain gauges usually taken as ground-truth in the literature, despite their well-known limitations, were performed. Wavelet analysis was also used to validate the performance of the referred satellite products by means of extracting the corresponding cycles, frequencies, and tendencies along the available time series across the studied basin. The results showed that the data sources CHIRPS and CHIRP better represent the pluviometric phenomenon by means of their monthly accumulated rainfall in the Madeira river basin when compared to the 3B42 and 3B42RT products taking into account rain gauges as baseline information. The CHIRPS product performed the best among the selected rainfall estimators for the Madeira river basin. Further analysis brought up also another very interesting result related to non-rainfall periods, which is usually not reported. However, such evaluation is quite important in hydrology when examining run sequences of droughts and consequent effects in the water balance at the watershed scale. Highly accurate estimates in the sense of identifying non-rainfall periods by remotely sensed information was achieved, which represents an additional and valuable asset of satellite rainfall products. It is worthwhile to say that this perspective deserves to receive much more attention in the literature in order to deeply discuss the water-energy-food nexus.

RESUMEN La precipitación es el factor más importante del ciclo hidrológico. Representar de manera adecuada la variabilidad espacial y temporal de la precipitación continúa siendo una tarea hidrológica abrumadora cuando se utilizan datos (por lo general escasos, cuando no inexistentes) de redes pluviométricas. Por ello, el presente estudio se enfoca al análisis de la solidez de algunos productos satelitales de precipitación, en especial las bases de datos de: i) Precipitación por Infrarrojos del Grupo de Riesgos Climáticos (CHIRP, por sus siglas en inglés), ii) Precipitación por Infrarrojos del Grupo de Riesgos Climáticos con Datos de Estación (CHIRPS), y iii) 3B42 y iv) 3B42RT, ambos de la Misión para la Medición de Lluvias Tropicales (TRMM), con el fin de representar de forma adecuada el régimen de precipitación de la cuenca del río Madeira. Para valorar la precisión de los productos de precipitación adquiridos por percepción remota, se realizaron comparaciones entre éstos y los datos pluviométricos observacionales disponibles, que por lo general se consideran en la literatura como verdaderos a pesar de sus bien conocidas limitaciones. Se utilizó análisis de ondeletas para validar el desempeño de los productos satelitales mencionados mediante la extracción de los ciclos, frecuencias y tendencias correspondientes de las series de tiempo disponibles en la cuenca en estudio. Los resultados muestran que las bases de datos CHIRPS y CHIRP representan de forma más adecuada el fenómeno pluviométrico en la cuenca del río Madeira mediante sus datos de precipitación acumulada mensual, en comparación con los productos 3B42 y 3B42RT, tomando en cuenta como línea de base la información de pluviómetros. CHIRPS tuvo el mejor desempeño entre los estimadores seleccionados para estudiar la cuenca del río Madeira. Análisis subsiguientes mostraron también otro resultado muy interesante relacionado con periodos sin lluvia, lo cual generalmente no se reporta, a pesar de que dicha evaluación es bastante importante en hidrología cuando se analizan corridas de sequía y sus efectos en el balance hídrico a nivel de cuenca. Se obtuvieron estimaciones de gran precisión para identificar periodos sin lluvia con datos adquiridos mediante percepción remota, lo cual constituye un recurso adicional de gran valor de los productos satelitales de precipitación. Vale la pena destacar que esta perspectiva merece recibir mucha más atención en la literatura con el objeto de analizar a fondo la relación agua-energía-alimentos.

Resumo Fundamento: A síndrome de Brugada é um distúrbio arritmogênico hereditário caracterizado pela presença de características eletrocardiográficas específicas com ou sem sintomas. Os pacientes apresentam risco aumentado de morte súbita por fibrilação ventricular. A prevalência desse padrão eletrocardiográfico difere de acordo com a região estudada. Porém, informações epidemiológicas, incluindo a população brasileira, são escassas. Objetivo: Avaliar a prevalência do padrão eletrocardiográfico da síndrome de Brugada e o perfil epidemiológico associado a ela. Métodos: Estudo transversal que incluiu 846.533 registros ECG de 716.973 pacientes do banco de dados de eletrocardiograma (ECG) da Rede de Telemedicina de Santa Catarina por um período de quatro anos. Todos os exames foram ECG de 12 derivações convencionais (sem V1 e V2 em posições altas). Os exames identificados com o diagnóstico de “Síndrome de Brugada” (tipos 1 e 2) foram revisados por um eletrofisiologista. Foram considerados significativos valores de p<0,05. Resultados: Apresentavam padrão potencialmente consistente com ECG do tipo Brugada 83 pacientes. Destes, 33 foram confirmados com padrão de Brugada tipo 1, e 22 com tipo 2, após reavaliação. A prevalência de ECG do tipo 1 de Brugada foi de 4,6 por 100.000 pacientes. O ECG do tipo Brugada 1 foi associado ao sexo masculino (81,8% vs. 41,5%, p<0,001) e menor prevalência de obesidade (9,1% vs. 26,4%, p=0,028). Conclusões: Este estudo mostrou baixa prevalência de ECG do tipo Brugada no sul do Brasil. A presença de ECG com padrão Brugada tipo 1 esteve associada ao sexo masculino e menor prevalência de obesidade que a população geral.

Abstract Background: Brugada Syndrome is an inherited arrhythmogenic disorder characterized by the presence of specific electrocardiographic features with or without clinical symptoms. The patients present increased risk of sudden death due to ventricular fibrillation. The prevalence of this electrocardiographic pattern differs according to the studied region. However, epidemiological information including the Brazilian population is scarce. Objectives: To assess the prevalence of the electrocardiographic pattern of Brugada syndrome and the epidemiological profile associated with it. Methods: Cross-sectional study that included 846,533 ECG records of 716,973 patients from the electrocardiogram (ECG) database from the Santa Catarina Telemedicine Network over a 4-year period. All tests were 12-lead conventional ECG (without V1 and V2 in high positions). The tests revealing “Brugada Syndrome” diagnosis (Types 1 and 2) were reviewed by a cardiac electrophysiologist. The level of significance was set at p<0.05. Results: In total, 83 patients had a pattern potentially consistent with Brugada-type pattern ECG. Of these, 33 were confirmed having Brugada-type 1, and 22 with type 2 ECG after reevaluation. The prevalence of Brugada-type 1 ECG was 4.6 per 100,000 patients. Brugada-type 1 ECG was associated with the male gender (81.8% vs. 41.5%, p<0.001) and a lower prevalence of obesity diagnosis (9.1% vs. 26.4%, p=0.028). Conclusions: This study showed low prevalence of Brugada-type ECG in Southern Brazil. The presence of Brugada-type 1 ECG was associated with the male gender and lower prevalence of obesity diagnosis comparing to the general population.

RESUMO Radares altimétricos são equipamentos que permitem a obtenção da elevação da superfície, especialmente nos oceanos ou geleiras. O uso de dados de altimetria em cursos d’água continentais envolve desafios metodológicos, como a frequência de passagem do satélite (27 a 35 dias tipicamente), acurácia de decímetros, manipulação e processamento dos dados, especialmente para rios mais estreitos (largura < 1 km) como o Rio São Francisco. A altimetria por satélite radar propicia ganhos como a cobertura espacial e referência altimétrica global dos dados, que seriam impensáveis para a rede de monitoramento fluviométrico in situ convencional. Assim, os dados altimétricos deveriam ser usados como uma fonte complementar e/ou alternativa aos dados in situ. Neste contexto, este trabalho se propõe a consolidar e avaliar séries altimétricas de cinco diferentes missões: Envisat nas duas órbitas, Saral, Sentinel 3-A e Sentinel 3-B. Para análise do desempenho dos altímetros, 17 séries de nível d’água foram comparadas aos dados de estações fluviométricas niveladas viabilizando o cálculo do erro absoluto e relativo. Os erros encontrados são compatíveis aos encontrados na literatura, variando entre 0.13 m a 0.36 m nos melhores casos (41%). Os satélites Sentinel-3 apresentaram os melhores resultados de RMSE absoluto/relativo: 0.95/0.49 m (S-3A) e 0.96/0.52 m (S-3B). Na sequência, Envisat-X (1.39/0.50 m), Envisat (1.87/0.56 m) e Saral (1.74/0.60 m).

ABSTRACT Radar altimeters are instruments carried on space missions and allow for determination of heights, particularly in oceans and ice sheets. The use of altimetry data on continental waters involves several challenges, such as the revisit frequency (typically 27 to 35 days), an accuracy of decimeters, data handling and processing, particularly for narrow rivers such as the São Francisco River (width<1km). Radar satellite altimetry has advantages over the conventional in situ monitoring network, including in terms of spatial coverage and global altimetric reference of data. Thus, altimetry data should be used as a complementary and/or alternative source to in situ data. In this context, this study consolidates and evaluates the altimetric series of five different altimetry missions: Envisat in two orbits, Saral, Sentinel 3-A, and Sentinel 3-B. The altimetry water level time series of 17 Virtual stations were compared with leveled gauging stations series to calculate absolute and relative errors. Ultimately, the errors varied from 0.13 m to 0.36 m in the best cases (41%), in line with recent literature. Sentinel-3 satellites showed the best RMSE absolute/relative results: 0.95/0.49 m (S-3A) and 0.96/0.52 m (S-3B). The second best RMSEs was Envisat-X (1.39/0.50 m), then Envisat (1.87/0.56 m) and Saral (1.74/0.60 m).

RESUMO CONTEXTO: O uso do balão intragástrico (BIG) é indicado para pacientes cujo IMC contraindica a cirurgia bariátrica ou que necessitam perder peso antes da cirurgia. É um procedimento minimamente invasivo e atualmente existem dois modelos principais de BIG - o balão intragástrico não ajustável (BINA), implantado por seis meses, e o balão intragástrico ajustável (BIA), por até 12 meses. OBJETIVO: Analisar os fatores associados aos resultados clínicos comparando o uso de balão intragástrico não ajustável com o uso de balão intragástrico ajustável. MÉTODOS: Estudo transversal em 470 pacientes, com sobrepeso ou obesidade, submetidos ao tratamento entre outubro 2011 e julho de 2018. A associação entre as porcentagens da perda de excesso de peso (%PEP) e da perda do peso total (%PPT) com as variáveis demográficas e clínicas foram calculados com o teste qui-quadrado (P<0,05). Foi utilizado o teste t de Student para amostras independentes para comparar variáveis quantitativas, com IC 95%. O cálculo do excesso de peso foi estimado em peso ideal correspondente a um IMC de 24.99 kg/m2. RESULTADOS: Um total de 414 pacientes realizaram o tratamento até o final, com %PPT média de 15,4±7 no BINA e 15,5±9,6 no BIA. Os com sobrepeso apresentaram maiores %PEP no BIA (157,2±82,5) e os obesos maiores %PEP no BINA (56±29,7), com P<0,001. Mulheres (65,6±62,2) apresentaram maiores %PEP do que homens (48±27,1), com P<0,001. Os indivíduos que atenderam a >4 consultas com nutricionista obtiveram %PPT >18% (60,8%), com P<0,001. CONCLUSÃO: Obesos e mulheres tiveram maiores perdas ponderais. Maior perda de peso foi identificada em pacientes com sobrepeso que utilizaram BIA e em obesos os quais utilizaram BINA. O BINA esteve associado com maiores taxas de %PEP. O acompanhamento nutricional impactou positivamente na %PPT.

ABSTRACT BACKGROUND: Intragastric balloon (IGB) use is indicated for patients whose BMI precludes the option of bariatric surgery or who need to lose weight prior to undergoing surgery. It is a minimally invasive procedure and currently there are two main models of IGBs in use, the non-adjustable intragastric balloon (NIB), implanted for six months, and the adjustable intragastric balloon (AIB), implanted for up to 12 months. OBJECTIVE: Analyze clinical characteristics between patients receiving non-adjustable gastric balloon and the adjustable (prolonged implantation) intragastric balloon. METHODS: This was a cross-sectional study of 470 patients diagnosed as obese or overweight who had balloon implantation from October 2011 to July 2018. The associations between percentage excess weight loss versus clinical and demographic variables were calculated using the chi-squared test. Independent samples were submitted to the Student’s t test to determine the quantitative variables, with a confidence interval of 95%. Calculation of excess weight was based on an estimated ideal weight that would correspond to a BMI of 24.99 kg/m2. RESULTS: A total of 414 patients completed the treatment achieving an average total body weight loss (%TBWL) of 15.4±7 with the NIB and 15.5±9.6 with the AIB. Overweight patients achieved higher excess weight loss (%EWL) values using AIBs (157.2±82.5) and obese patients did so with NIB use (56±29.7). Women achieved higher %EWL values (65.6±62.2) than men (48±27.1). Individuals who attended >4 consultations with a nutritionist (60.8%) achieved TBWL >18%. All of those P-values were <0.001. CONCLUSION: Obese individuals and women registered the greatest weight losses. Overweight patients achieved greater losses using AIB and obese patients did so using NIBs. NIB use was associated with higher EWL percentages. Nutritional accompaniment had a positive impact on the %TBWL.

Abstract Background: Cardiovascular diseases, such as acute myocardial infarction, are the main causes of death in the world. The flavonoids present in chocolate can have benefits for people who have risk factors to the development of cardiovascular diseases and have a coadjuvant effect on known therapies. Objective: To analyze the association between chocolate consumption, severity of coronary lesions, risk factors and severity of the first infarction in patients attended at the Cardiology Institute of Santa Catarina and other hospitals in the State of Santa Catarina. Methods: Subanalysis of the Catarina Heart Study cohort, evaluated 350 patients with first myocardial infarction. We evaluated clinical, echocardiographic, hemodynamic laboratorial variables. We used chi square test to evaluate qualitative variables, t student test in the case of parametric variables and U Mann Whitney test in non-parametric variables. We considered significant p < 0,05. Results: Lower prevalence of hypertension (43.2% % vs. 62.3% p = 0.003), diabetes mellitus (13.5% vs. 25.7%, p = 0.027) and smoking (24.3% vs. 37.7%, p = 0.032) among those who consume chocolate. Higher use of alcohol (40.5% vs. 26.4%, p = 0.018) and drugs (9.5% vs. 3.3%, p = 0.023) among those who consumed chocolate. Among the patients who consumed chocolate, there was a negative correlation between amount consumed and Syntax (r = -0.296, p = 0.019). Conclusion: There was association between chocolate consumption and lower prevalence of hypertension, diabetes and smoking. There was no association between amount of chocolate consumed and post-infarction ventricular function and TIMI frame count. Higher prevalence of alcohol and drug use among those who consume chocolate. Negative correlation between Syntax and the amount of chocolate consumed.

Resumo A bacia hidrográfica do rio Machadinho é um exemplo de ocupação desordenada presente na região amazônica, na qual foram desmatadas grandes áreas com consequente conversão da floresta em pastagens e em núcleos urbanos. O presente trabalho tem o objetivo de analisar os impactos na hidrologia (vazão, precipitação e evapotranspiração) da bacia do rio Machadinho diante de sua dinâmica de ocupação antrópica. Primeiramente, analisaram-se mudanças na cobertura da terra usando imagens do sensor Landsat 5-TM para os anos 1984, 1997 e 2011. A variável vazão foi avaliada quanto a sua sensibilidade mediante o emprego do modelo SWAT para determinar a descarga líquida fixando-se os padrões climáticos e variando-se os cenários históricos de cobertura da terra. A precipitação, obtida por meio de dados do CHIRPS para o período de 1981 a 2017, e a evapotranspiração, estimada via dados do SSEBop entre os anos de 2002 a 2017, foram tratadas como variáveis geoespaciais distribuídas na bacia, com tendências de comportamento de suas séries históricas aferidas por meio do teste Mann-Kendal. Os resultados obtidos mostraram que a ocupação da bacia deu-se de maneira desordenada, cuja área com pastagem passou de 2,6% no ano de 1984 para 45,9% no ano de 2011, sendo a maior conversão observada na nascente do corpo hídrico principal, o que evidenciou uma maior produção de vazão pelo modelo SWAT, que adequadamente captou a variação dessa variável. Adicionalmente, observou-se tendência de redução pluviométrica nos meses mais chuvosos, enquanto detectou-se elevação da evapotranspiração nos meses mais quentes. Nesse sentido, é importante ressaltar que o desmatamento da região tende a reduzir a disponibilidade hídrica para a bacia.

Abstract The Machadinho river basin is an example of disorderly occupation present in the Amazon region, where large areas were deforested and consequently the forest was converted into pastures and urban centers. The present work has the objective of analyzing the impacts in hydrology (streamflows, precipitation and evapotranspiration) of the Machadinho river basin due to its dynamics of anthropic occupation. First, the land cover change was analyzed using Landsat 5-TM images for the years 1984, 1997 and 2011. The streamflow variable was evaluated for its sensitivity by using the SWAT model to determine net discharge by setting the weather patterns and by varying the historical land cover scenarios. The precipitation, obtained by data from the CHIRPS for the period from 1981 to 2017, and evapotranspiration, estimated by the SSEBop data between 2002 and 2017, were treated as distributed geospatial variables in the basin, with behavioral trends of their corresponding historical series measured by means of the Mann-Kendal test. The results showed that the occupation of the basin occurred in a disorderly way, where the pasture area increased from 2.6% in 1984 to 45.9% in 2011, with the highest conversion observed at the spring of the main water body, which accounted for a higher flow production by the SWAT model that adequately described the variable. In addition, trends of rainfall reduction were observed in wetter months, while trends of evapotranspiration elevation were detected in warmer months. Therefore, it is noteworthy to register that deforestation in the region tends to reduce water availability to the basin.

Abstract Background: Smoking is the most important risk factor for coronary heart disease (CHD) and ischemic events; alcohol consumption, on the other hand, appears to have a protective role. Objective: Assess the association between smoking and alcohol consumption with the severity of coronary artery injuries in patients with acute myocardial infarction (AMI). Methods: Cross-sectional study, performed in Santa Catarina. Variables were evaluated using the Chi-squared T/Fisher’s exact test, Kendall’s correlation coefficient, Student’s t test or Mann-Whitney U test. Values of p < 0.05 were considered significant. Results: Between August 2016 to June 2017, 226 patients were evaluated with first episode of AMI. There was a difference in sex distribution, showing that 59.7% of men and 85.4% of women were not alcoholic (p < 0.001). There was a higher prevalence of non-hypertensive patients who consumed alcohol than hypertensive ones (40.7% vs. 24.4% and p = 0.010) and patients without diabetes who had drinking habits than those diabetic (36.4% vs. 12.0% and p = 0.001). There was also a higher prevalence of non-diabetic patients who smoked than diabetic ones (38.1% vs. 22.0% and p = 0.035). A weak and negative correlation was found between the number of cigarettes per day and the pack-year with the TIMI frame count (r = -0.174 and p = 0.041 and r = -0.192 and p = 0.027, respectively). The other associations did not show statistical significance. Conclusion: The study showed that the number of cigarettes consumed per day and the pack-year is related to a smaller TIMI frame count, i.e., to a better coronary flow, which may be related to the Smoker’s Paradox. There was no correlation between the beverage type and quantity with the SYNTAX score, Ejection fraction and TIMI frame count.

Abstract Background: Acute myocardial infarction is one of the main causes of morbidity and mortality in the world, and one of the factors with the greatest prognostic impact is early specialist care, but there are still many factors that delay patient's arrival at the hospital. Objective: To correlate social, educational, cognitive and clinical factors with time to hospital arrival after the onset of acute myocardial infarction's first symptoms. Methods: Time interval to search for medical care was measured by patient's report of the onset of infarction's first symptoms and hospital admission verified through electronic medical data of the emergency service. The correlation between delta-T and other variables was performed through Kendall's correlation. Values of p < 0.05 were considered statistically significant. Results: There was no correlation between delta-T and scholarity, or between delta - T and Mini Mental State Examination performance, as well as no association between the presence of hypertension, diabetes mellitus, dyslipidemia, family history, sedentary lifestyle or smoking with arrival time at the hospital. Comparisons between delta-T and marital status were also not statistically significant. Transfer from another health service and city of origin were the most determinant delay factors in our population's arrival at the hospital. Conclusion: The present study suggests that, in our population, educational, social and cognitive factors are not directly related to the delay in arriving at the hospital.

Resumo Fundamentos: A atividade física reduz o risco de doença coronariana, uma das principais causas de morte no mundo. Objetivos: Este estudo pretende correlacionar as atividades físicas com variáveis clínicas de pacientes internados em hospitais públicos de Santa Catarina após o primeiro infarto agudo do miocárdio. Métodos: Os pacientes selecionados foram submetidos a questionário que engloba diferentes variáveis clínicas. A atividade física foi mensurada através do Escore de Baecke. Os dados obtidos foram tabulados e analisados através do software SPSS 13.0 for Windows. A avaliação da normalidade foi realizada pelo teste de Kolmogorov-Smirnov. A correlação entre duas variáveis quantitativas foi avaliada pela Correlação de Pearson. Foram considerados significativos valores de p < 0,05. Resultados: O estudo evidenciou uma correlação positiva fraca entre o escore de Baecke e anos de escolaridade com r = 0,361 (p = 0,001). Houve uma correlação negativa fraca entre o escore de Baecke e o escore de depressão PHQ9 com r = -0,252 (p = 0,009). O estudo também apresentou correlação negativa fraca entre o escore de depressão PHQ9 e o Mini Mental com r = -0,258 (p = 0,007), assim como uma correlação negativa fraca entre o PHQ9 e os anos de escolaridade com r = -0,199 (p = 0,039). Conclusões: Existe uma correlação positiva entre atividade física e anos de escolaridade em pacientes internados com o primeiro infarto agudo do miocárdio. Há também uma correlação negativa entre atividade física e depressão nesses pacientes, assim como uma correlação negativa entre depressão e o Mini-Mental, e depressão e anos de escolaridade.

Abstract Background: Physical activity reduces the risk of coronary heart disease, one of the leading causes of death in the world. Objectives: This study intends to correlate physical activity and clinical variables of the patients hospitalized in public hospitals of Santa Catarina after the first acute myocardial infarction. Methods: The selected patients answered a questionnaire on different clinical variables. Physical activity was measured using the Baecke's questionnaire. Data were tabulated and analyzed using the SPSS 13.0 for Windows software. Normality was assessed using the Kolmogorov-Smirnov test. Correlations between two quantitative variables were evaluated by Pearson's correlation. Values of p < 0.05 were considered statistically significant. Results: The study showed a weak positive correlation between the Baecke score and years of schooling (r = 0.361; p = 0.001). There was a weak negative correlation between the Baecke score and the PHQ9 depression score (r = -0.252; p = 0.009). The study also showed a weak negative correlation between the PHQ9 depression score and the Mini Mental score (r = -0.258; p = 0.007), as well as a weak negative correlation between PHQ9 and schooling years with (r = -0.199, p = 0.039). Conclusions: There is a positive correlation between physical activity and years of schooling in hospitalized patients with first acute myocardial infarction. Negative correlations were found between physical activity and depression, between depression and the Mini-Mental State Examination, and between depression and years of schooling in these patients.

Os novos desafios na área da educação surgem com o próprio desenvolvimento do conhecimento. Novas técnicas de pesquisa possibilitaram grandes descobertas na ciência e, com isso, uma crescente complexificação dos temas estudados. Os alunos, inseridos no universo dinâmico da internet, também evoluíram e não se encaixam mais nas prescrições da pedagogia tradicional. Para essas novas realidades, a forma de educar no século XXI exige dos educadores um esforço de criatividade para transmitir um conhecimento cada vez mais complexo. Para ilustrar essa nova situação, relatamos uma experiência pedagógica que buscou, com a criatividade de uma intervenção fictícia, favorecer o ensino dos ensaios clínicos de não inferioridade. A experiência demonstra a utilidade de tais ensaios clínicos quando se necessita testar a eficácia de tratamentos. A utilização dos docinhos e a participação dos alunos como sujeitos do ensaio configuraram-se como uma metodologia ativa, de aproximação entre os educandos e seu objeto de estudo. O exercício realizado está de acordo com os modelos pedagógicos sugeridos pela teoria da aprendizagem significativa e pode servir de referência para iniciativas semelhantes.

New challenges in education parallel with knowledge expansion. New research techniques have enabled major discoveries in science, together with a growing complexity of the studied themes. Students, part of the dynamic universe of the Internet, have also evolved and no longer fit the requirements of traditional pedagogy. For these new realities the way to educate in the twenty-first century requires a creative effort from educators, in order to convey knowledge that is increasingly complex. As an illustration of this new situation, we bring the report of a pedagogical experiment that sought, with the creativity of a fictitious intervention, to support the teaching of non-inferiority clinical trials. The experiment managed to show the usefulness of such clinical trials when there is the need to test the efficacy of treatments. The use of sweets and the participation of students as the test subjects constitute an active methodology, bringing students closer to their subject of study. The exercise conducted is in line with the pedagogical models suggested by the meaningful learning theory and can be used as a benchmark for similar initiatives.