ABSTRACT Introduction: Atrial fibrillation is the main complication in the postoperative period of cardiovascular surgery. Its genesis is multifactorial, so its rapid identification to mitigate the associated risks is essential. Objective: To evaluate the incidence of atrial fibrillation in patients undergoing coronary artery bypass grafting (CABG) and its relationship with other complications in our setting. Methods: This is a multicenter, observational study involving patients undergoing isolated CABG between 2017 and 2019 with data from the Registro Paulista de Cirurgia Cardiovascular (or REPLICCAR II). Variables were prospectively collected in REDCap following the definitions given by version 2.73 of the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Data were collected with prior authorization from the local ethics committee and analyses performed in R software. Results: A total of 3,803 patients were included, of these 605 had postoperative atrial fibrillation (POAF). In order to adjust the groups, propensity score matching was used. Such analyses resulted in 605 patients in each group (without POAF vs. with POAF). Among patients with POAF, the mean age was 67.56 years, with a prevalence of males (73.6%, 445 patients). Patients belonging to the group with POAF had a mortality rate of 9.26% (P=0.007), longer ventilation time (P<0.001), pneumonia (P<0.001), and sepsis (P<0.001). In multiple analysis, acute renal dysfunction (P=0.032) and longer intensive care unit stay (P<0,001) were associated with the presence of POAF. Conclusion: POAF in CABG is associated with longer intensive care unit and hospital stay, as well as renal dysfunction, pneumonia, and in-hospital mortality. Introduction surgery multifactorial essential Objective (CABG setting Methods multicenter 201 or II. II . II) 273 2 73 2.7 Database software Results 3803 3 803 3,80 included 60 (POAF) groups used without vs POAF) 6756 67 56 67.5 years 73.6%, 736 6 (73.6% 44 patients. patients) 926 9 26 9.26 P=0.007, P0007 P P=0.007 , 0 007 (P=0.007) P<0.001, P0001 P<0.001 001 (P<0.001) P<0.001. analysis P=0.032 P0032 032 (P=0.032 P<0,001 (P<0,001 Conclusion inhospital 20 27 7 2. 380 80 3,8 (POAF 675 5 67. 73.6% (73.6 4 92 9.2 P000 P=0.00 00 (P=0.007 P<0.00 (P<0.001 P=0.03 P003 03 (P=0.03 P<0,00 (P<0,00 38 8 3, 73.6 (73. 9. P00 P=0.0 (P=0.00 P<0.0 (P<0.00 (P=0.0 P<0,0 (P<0,0 73. (73 P0 P=0. P<0. (P<0.0 (P=0. P<0, (P<0, (7 P=0 P<0 (P<0. (P=0 (P<0 ( P= P< (P= (P< (P

Abstract Background The COVID-19 pandemic has been a worldwide challenge. In patients with coronary artery disease (CAD), previously submitted to coronary artery bypass graft surgery (CABG), such impact should be analyzed. Objectives Evaluate the impact on quality of life of COVID-19 infection in patients with prior CABG. Methods Patients undergoing isolated CABG between July 2016 and July 2017 were enrolled. This is an observational, cross-sectional, prospective study. Patients were divided into two groups: Group (COVID-19) and Group (No-COVID), for analysis of variables. The World Health Organization’s (WHO) definitions of confirmed cases were used to define the diagnosis of COVID-19 infection. Quality of life was assessed using the Quality of Life in Cardiovascular Surgery (QLCS) questionnaire, applied 30 days, 6 months, 1 year, and 4 years after surgery. The primary endpoint was improvement in quality of life at 4 years after CABG. The local ethics committee approved the study. Continuous variables were described by their means and standard deviations (SD). Categorical variables were described using absolute or relative frequencies. The items that make up the quality of life questionnaire were added together to calculate the score. A linear mixed model was used to assess the effect of time on the score. The significance level adopted was 5%. The analyses were carried out using R software, version 4.2.1. Results The total sample consisted of 434 patients who underwent isolated CABG; the mean age was 63 years, with a prevalence of males (71%). Among the patients followed up at the 4-year follow-up (115), 60 (52%) were positive according to the WHO’s definitions. After multiple comparisons, there was a statistical difference in quality of life in all periods (P<0.001). Between patients with and without COVID-19, a statistical difference was observed at 1 and 4 years (p = 0.0039). Conclusion Patients who underwent CABG and had a history of COVID-19 infection experienced worsening quality of life within 4 years. There was no difference between groups regarding new acute myocardial infarction (AMI), stroke, or hospitalization. COVID19 COVID 19 COVID-1 challenge CAD, CAD , (CAD) CABG, (CABG) analyzed 201 enrolled observational crosssectional, crosssectional cross sectional, sectional cross-sectional study (COVID-19 NoCOVID, NoCOVID No (No-COVID) Organizations Organization s WHO (WHO QLCS (QLCS 3 days months year SD. SD . (SD) frequencies score 5 5% software 421 2 4.2.1 43 71%. 71 71% (71%) 4year followup follow 115, 115 (115) 52% 52 (52% WHOs comparisons P<0.001. P0001 P P<0.001 0 001 (P<0.001) COVID19, 19, p 0.0039. 00039 0.0039 0039 0.0039) AMI, AMI (AMI) stroke hospitalization COVID1 COVID- (CAD (CABG 20 (COVID-1 (No-COVID (SD 42 4.2. 7 (71% 11 (115 (52 P000 P<0.00 00 (P<0.001 0003 0.003 003 (AMI (COVID- 4.2 (71 (11 (5 P00 P<0.0 (P<0.00 000 0.00 (COVID 4. (7 (1 ( P0 P<0. (P<0.0 0.0 P<0 (P<0. 0. P< (P<0 (P< (P

RESUMOA escolha da carreira é uma decisão importante e em geral é feita em um ambiente repleto de incertezas por pessoas relativamente jovens e inexperientes. Neste estudo, buscou-se analisar a decisão de escolha entre uma carreira em uma empresa privada e outra em um órgão público, considerando que existe flexibilidade para migrar do setor privado para o público por meio de concurso. Para tanto, utilizou-se a metodologia das opções reais para modelar essa opção de troca, assumindo-se que os ganhos futuros no setor privado são incertos. Os resultados sugerem que a opção de ingressar na carreira pública pode ter valor significativo em relação à privada.

ABSTRACTCareer choice is an important decision and is usually made in an environment full of uncertainties for relatively young and inexperienced people. In this study, we aimed to analyze the decision to choose between a career in a private company and another in a public agency, considering that there is flexibility to migrate from the private to the public sector, through a civil service exam. Therefore, we used the methodology of real options to model this exchange option, assuming that future gains in the private sector are uncertain. The results suggest that the option of joining the public career may have significant value in relation to the private one.

RESUMENLa elección de la carrera profesional es una decisión importante en la vida del joven que normalmente ocurre en un momento de incertidumbres debido a su relativa inexperiencia. En este estudio se analiza la decisión de elegir entre una carrera en una empresa privada y otra en el sector público, teniendo en cuenta que hay flexibilidad para migrar del sector privado al público por medio de concursos públicos. Para ello, se utilizó la metodología de opciones reales con el fin de configurar esta opción de cambio, asimismo se considera que las futuras ganancias en el sector privado son inciertas. Los resultados sugieren que la opción por la carrera pública puede tener un valor significativo con relación a la carrera privada.

A aspergilose pulmonar compreende uma das formas de infecção por fungo do gênero Aspergillus, tendo diversos modos de apresentação clínica a depender da imunidade e comorbidades. O objetivo deste trabalho é relatar um caso de paciente, imunocompetente e previamente hígido, que desenvolveu uma forma de aspergilose pulmonar crônica e fazer uma breve revisão sobre o assunto.

Pulmonary aspergillosis includes one of the forms of fungal infection due to the genus Aspergillus, and has several modes of clinical presentation that depend on the immunity and comorbidities. The aim of this study was to report on the case of an immunocompetent and previously healthy patient who developed a form of chronic pulmonary aspergillosis, and to make a brief review on the subject.