Pesquisa | SciELO

ABSTRACT Objective: This study aims to investigate the ability of the six-minute walk distance (6MWD) as a prognostic marker for midterm clinical outcomes three months after coronary artery bypass grafting (CABG), to identify possible predictors of fall in 6MWD in the early postoperative period, and to establish the percentage fall in early postoperative 6MWD, considering the preoperative baseline as 100%. Methods: A prospective cohort of patients undergoing elective CABG were included. The percentage fall in 6MWD was assessed by the difference between preoperative and postoperative day (POD) five. Clinical outcomes were evaluated three months after hospital discharge. Results: There was a significant decrease in 6MWD on POD5 compared with preoperative baseline values (percentage fall of 32.5±16.5%, P<0.0001). Linear regression analysis showed an independent association of the percentage fall of 6MWD with cardiopulmonary bypass (CPB) and preoperative inspiratory muscle strength. Receiver operating characteristic curve analysis revealed that the best cutoff value of percentage fall in 6MWD to predict poorer clinical outcomes at three months was 34.6% (area under the curve = 0.82, sensitivity = 78.95%, specificity = 76.19%, P=0.0001). Conclusion: This study indicates that a cutoff value of 34.6% in percentage fall of 6MWD on POD5 was able to predict poorer clinical outcomes at three months of follow-up after CABG. Use of CPB and preoperative inspiratory muscle strength were independent predictors of percentage fall of 6MWD in the postoperative period. These findings further support the clinical application of 6MWD and propose an inpatient preventive strategy to guide clinical management over time.

https://doi.org/10.21470/1678-9741-2022-0459

Cell phenotypes as activity biomarkers in patients with Systemic Lupus Erythematosus
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Loures, Cristina de Mello Gomide

; Guimarães, Tânia Mara Pinto Dabés

; Ferreira, Karine Silveste

; Silva, Marcos Vinicius Ferreira

; Alves, Luan Carlos Vieira

; Cicarini, Walter Batista

; Nunes, Fernanda Freire Campos

; Consoli, Renato Vargas

; Neiva, Cláudia Lopes Santoro

; Pádua, Paulo Madureira de

; Santos, Luara Isabela dos

; Moreira, Josimar Dornelas

; Toledo, Vicente de Paulo Coelho Peixoto de

; Carvalho, Maria das Graças

Brazilian Journal of Pharmaceutical Sciences

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2023, Volume 59 elocation e20052

Resumo: En | Texto: En | PDF: En

Abstract The pathogenesis of systemic lupus erythematosus (SLE) is complex. Few studies in Brazilian population have addressed cell phenotypes associated with immunological responses and their associations with SLE activity. The aim of this study is to investigate cell phenotypes associated to SLE diagnosis, treatment and activity. Twenty-eight SLE female patients (17 inactive, 11 active) and 10 healthy women were included in this study. Markers of natural killer (Nk), T and B cells in peripheral blood were evaluated by flow cytometry. Nkt cells were decreased only in SLE active patients. Activated CD4+, regulatory T FoxP3+ and B cells were decreased in both active and inactive SLE patients, compared to control group. The data corroborate the disruption of immune regulatory response in SLE patients and suggest phenotipic changes as possible biomarkers of SLE activity.

https://doi.org/10.1590/s2175-97902023e20052

Early Six-Minute Walk Test May Predict Midterm Outcomes Following Coronary Artery Bypass Grafting
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Pauletti, Hayanne O.

; Gomes, Walter José

; Rocco, Isadora S.

; Viceconte, Marcela

; Garcia, Bruna Caroline Matos

; Marcondi, Natasha O.

; Bublitz, Caroline B.

; Costa, Ariele dos Santos

; Paiva, Thâmara Pequeno de

; Spina, Giovanna Domingues

; Begot, Isis

; Silva, Célia Camelo

; Moreira, Rita Simone L.

; Branco, João Nelson Rodrigues

; Vargas, Guilherme Flora

; Hossne Jr., Nelson A.

; Arena, Ross

; Guizilini, Solange

Brazilian Journal of Cardiovascular Surgery

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2023, Volume 38 Nº 4 elocation e20220459

Resumo: En | Texto: En | PDF: En

https://doi.org/10.21470/1678-9741-2022-0459

Antiulcer mechanisms of the hydroalcoholic extract from Aztec marigolds’ medicinal and edible flowers (Tagetes erecta L.)
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MEURER, MARIANE

; FELISBINO, FABIULA

; MÜLLER, FABIANA B.

; SOMENSI, LINCON B.

; CURY, BENHUR J.

; JERÔNIMO, DANIELE T.

; VENZON, LARISSA

; FRANÇA, TAUANI C.S.

; MARIOTT, MARIHÁ

; SANTOS, ANA C.

; NUNES, RUAN KAIO S.

; BOEING, THAISE

; BELLA-CRUZ, ALEXANDRE

; SOUZA, PRISCILA DE

; ROMAN-JUNIOR, WALTER A.

; ARUNACHALAM, KARUPPUSAMY

; OLIVEIRA, RUBERLEI G.

; SILVA, LUISA M.

Anais da Academia Brasileira de Ciências

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2023, Volume 95 Supl. 1 elocation e20220427

Resumo: En | Texto: En | PDF: En

Abstract The antiulcer mechanisms of the dry extract of T. erecta flowers (DETe) were studied here. The acute ulcers induced by acidified ethanol or indomethacin were reproduced in mice pretreated with DETe (3 - 300 mg/kg). The antiulcer activity of DETe was also verified in mice pretreated with NEM, L-NAME, indomethacin, or yohimbine. The antisecretory effect of DETe was verified in rats, and its anti-Helicobacter pylori activity was determined in vitro. DETe (300 mg/kg, p.o) reduced the ethanol- or indomethacin-induced ulcer by 49 and 93%, respectively. The pre-treatment with L-NAME, NEM or yohimbine abolished the gastroprotective effect of DETe. However, DETe did not change the volume, acidity, or peptic activity in rats and did not affect H. pylori. This study expands knowledge about the antiulcerogenic potential of DETe, evidencing the role of nitric oxide, non-protein sulfhydryl groups, α2 adrenergic receptors, and prostaglandins, but not antisecretory or anti-H. pylori properties.

https://doi.org/10.1590/0001-3765202320220427

Guidelines on vascular access for hemodialysis from the Brazilian Society of Angiology and Vascular Surgery
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Harduin, Leonardo de Oliveira

; Barroso, Thiago Almeida

; Guerra, Julia Bandeira

; Filippo, Marcio Gomes

; Almeida, Leonardo Cortizo de

; Castro-Santos, Guilherme de

; Oliveira, Fabio Augusto Cypreste

; Cavalcanti, Douglas Eduardo Tavares

; Procopio, Ricardo Jayme

; Lima, Eduardo Cavalcanti

; Pinhati, Matheus Eduardo Soares

; Reis, Jose Maciel Caldas dos

; Moreira, Barbara D’Agnoluzzo

; Galhardo, Adriano Martins

; Joviliano, Edwaldo Edner

; Araujo, Walter Junior Boim de

; Oliveira, Julio Cesar Peclat de

Jornal Vascular Brasileiro

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2023, Volume 22 elocation e20230052

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo A doença renal crônica é um problema de saúde pública global e em seu estágio terminal está associada à necessidade de terapia dialítica. A grande maioria dos pacientes que necessitam realizar a terapia renal substitutiva, a fazem através da hemodiálise. Portanto, o acesso vascular é de extrema importância para a população dialítica, implicando diretamente na qualidade de vida e na morbimortalidade deste grupo de pacientes. Sendo a confecção, gerenciamento e resgate dos acessos vasculares uma das áreas de atuação do cirurgião vascular, é de grande importância a elaboração de uma diretriz que oriente o especialista no manejo mais adequado do acesso vascular para hemodiálise. Assim, o objetivo desta diretriz é apresentar um conjunto de recomendações para guiar as decisões na referenciação, avaliação, escolha, vigilância e gestão das complicações do acesso vascular para hemodiálise. dialítica substitutiva hemodiálise Portanto confecção Assim referenciação avaliação escolha

Abstract Chronic kidney disease is a worldwide public health problem, and end-stage renal disease requires dialysis. Most patients requiring renal replacement therapy have to undergo hemodialysis. Therefore, vascular access is extremely important for the dialysis population, directly affecting the quality of life and the morbidity and mortality of this patient population. Since making, managing and salvaging of vascular accesses falls within the purview of the vascular surgeon, developing guideline to help specialists better manage vascular accesses for hemodialysis if of great importance. Thus, the objective of this guideline is to present a set of recommendations to guide decisions involved in the referral, evaluation, choice, surveillance and management of complications of vascular accesses for hemodialysis. problem endstage end stage Therefore population making surgeon importance Thus referral evaluation choice

https://doi.org/10.1590/1677-5449.202300522

Congenitally Corrected Transposition of the Great Arteries in the Adult
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Amaral, Fernando

; Valente, Anne Marie

; Manso, Paulo Henrique

; Gali, Luiz Gustavo

; Braggion-Santos, Maria Fernanda

; Rocha, Julia Mignot

; Vicente, Walter Vilella de Andrade

; Schmidt, André

Brazilian Journal of Cardiovascular Surgery

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Ago 2022, Volume 37 Nº 4 Páginas 534 - 545

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: Congenitally corrected transposition of the great arteries (CCTGA) is a rare anomaly. Current data available regarding adult cases is derived from small series, information simultaneously presented in pediatric publications, and one classical multicenter study. This review, not aimed to exhaust the subject, has the purpose to examine the literature addressing presentation, diagnostic methodology, and management of afflicted adult patients. Methods: A comprehensive search was undertaken in three major databases (PubMed, Cochrane, SciELO), using the keywords “congenitally corrected transposition of the great arteries” and “adults”. Relevant articles in English, Spanish, and Portuguese were extracted and critically appraised in this review. Steps for study selection were: (1) identification of titles of records through databases searching, (2) removal of duplicates, (3) screening and selection of abstracts, (4) final inclusion in the study. Results: Four hundred sixty-five publications on CCTGA in adult patients were retrieved, and 166 were excluded; 299 studies were used for this review including 76 full-text articles, 70 studies related to general aspects of the subject, and, due to the small number of publications, 153 case reports. Sixty-one articles referring to combined experiences in pediatric and adult patients and judged to be relevant, but retrieved from another sources, were also included. Conclusion: Albeit clinical presentation and diagnostic criteria have been well stablished, there seems to be room for discussion related to clinical and surgical management of CCTGA in adults. Considering the rarity of the disease, well designed multicenter studies may provide answers.

https://doi.org/10.21470/1678-9741-2021-0528

Inspiratory Muscle Weakness is Related to Poor Short-Term Outcomes for Heart Transplantation
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Begot, Isis

; Gomes, Walter J.

; Rocco, Isadora S.

; Bublitz, Caroline

; Gonzaga, Laion R. A.

; Bolzan, Douglas W.

; Santos, Vinicius Batista

; Moreira, Rita Simone Lopes

; Breda, João R.

; Almeida, Dirceu Rodrigues de

; Arena, Ross

; Guizilini, Solange

Brazilian Journal of Cardiovascular Surgery

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Jun 2021, Volume 36 Nº 3 Páginas 308 - 317

Resumo: En | Texto: En | PDF: En

Abstract Introduction: In heart transplantation (HT) recipients, several factors are critical to promptly adopting appropriate rehabilitation strategies and may be important to predict outcomes way after surgery. This study aimed to determine preoperative patient-related risk factors that could adversely affect the postoperative clinical course of patients undergoing HT. Methods: Twenty-one hospitalized patients with heart failure undergoing HT were evaluated according to respiratory muscle strength and functional capacity before HT. Mechanical ventilation (MV) time, reintubation rate, and intensive care unit (ICU) length of stay were recorded, and assessed postoperatively. Results: Inspiratory muscle strength as absolute and percentpredicted values were strongly correlated with MV time (r=-0.61 and r=-0.70, respectively, at P<0.001). Concerning ICU length of stay, only maximal inspiratory pressure (MIP) absolute and percent-predicted values were significantly associated. The absolute |MIP| was significantly negatively correlated with ICU length of stay (r=-0.58 at P=0.006) and the percent-predicted MIP was also significantly negatively correlated with ICU length of stay (r=-0.68 at P=0.0007). No associations were observed between preoperative functional capacity, age, sex, and clinical characteristics and MV time and ICU length of stay in the cohort included in this study. Patients with respiratory muscle weakness had a higher prevalence of prolonged MV, reintubation, and delayed ICU length of stay. Conclusion: An impairment of preoperative MIP was associated with poorer short-term outcomes following HT. As such, inspiratory muscle strength is an important clinical preoperative marker in patients undergoing HT.

https://doi.org/10.21470/1678-9741-2020-0344 14 downloads

Soil fertility and yield of ‘Paluma’ guava fertilized with phosphorus, cattle manure, and boron
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Santos, Gaudêncio P. dos

; Pereira, Walter E.

; Lima, Rosiane de L. S. de

; Brito Neto, José F. de

; Dias, Bruno de O.

; Dias, Thiago J.

Revista Brasileira de Engenharia Agrícola e Ambiental

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Abr 2021, Volume 25 Nº 4 Páginas 228 - 234

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO A baixa fertilidade do solo associada à falta de manejo adequado da irrigação são fatores que mais limitam a produção das culturas. Diante disso, objetivou-se avaliar os atributos químicos de um Oxisol e a produtividade da goiabeira ‘Paluma’ sob irrigação com água salina e adubada com fósforo, esterco bovino e boro. Os tratamentos foram distribuídos em blocos ao acaso, com quatro repetições e duas plantas por parcela, incluindo bordaduras nas laterais da área útil experimental, utilizando um esquema fatorial de (5 × 2) + 1, referentes a cinco doses de fósforo (0, 0.08, 0.16, 0.24 e 0.32 kg de P2O5 planta-1), duas doses de esterco bovino, 0 e 30 kg por planta e um tratamento adicional composto por 0.16 kg de P2O5 mais 30 kg de esterco bovino e 1.0 g de boro, utilizando como fonte o bórax. No solo avaliaram-se pH, fósforo, potássio, cálcio, magnésio e a capacidade de troca catiônica nas camadas de 0-20 cm e de 20-40 cm. Nas plantas, estimou-se a produtividade média por hectare em duas safras. O pH diminuiu com as doses de fósforo sem esterco bovino e no tratamento com boro na camada de 20-40 cm. A capacidade de troca catiônica aumentou com aplicação das doses de fósforo associadas ao esterco e diminuiu nas duas camadas do solo com a presença do boro. Os macronutrientes avaliados não foram influenciados pelo boro. As doses de fósforo associadas ao esterco bovino aumentaram a produtividade superando a média de 50 t ha-1 ano-1 determinada para a goiabeira ‘Paluma’, enquanto que o boro não aumentou a produtividade.

ABSTRACT The low soil fertility associated with the lack of adequate irrigation management are factors that most limit crop production. Therefore, the study aimed to evaluate the chemical attributes of an Oxisol and the yield of ‘Paluma’ guava under irrigation with saline water and fertilized with phosphorus, cattle manure, and boron. The treatments were distributed in randomized blocks, with four repetitions and two plants per plot, including borders on the sides of the useful experimental area, arranged in a factorial scheme (5 × 2) + 1, referring to five phosphorus doses (0, 0.08, 0.16, 0.24 and 0.32 kg of P2O5 plant-1), two doses of cattle manure, 0 and 30 kg per plant and an additional treatment consisting of 0.16 kg of P2O5 plus 30 kg of cattle manure and 1.0 g of boron, using as source the borax. In the soil, pH, phosphorus, potassium, calcium, magnesium, and the cation exchange capacity were evaluated in the 0-20 cm and 20-40 cm layers. In plants, the average yield per hectare in two harvests was estimated. The pH decreased with phosphorus doses without cattle manure and in the treatment with boron in the 20-40 cm layer. The cation exchange capacity increased with the application of phosphorus doses associated with manure and decreased in both soil layers with boron. The macronutrients evaluated were not influenced by boron. Phosphorus doses associated with cattle manure increased yield, exceeding the average of 50 t ha-1 year-1 determined for ‘Paluma’ guava. In contrast, boron did not increased the yield.

https://doi.org/10.1590/1807-1929/agriambi.v25n4p228-234 381 downloads

Valve Heart Surgery in Brazil - The BYPASS Registry Analysis
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Zilli, Alexandre Cabral

; Guizilini, Solange

; Rocco, Isadora S.

; Santo, José Amalth do Espírito

; Berwanger, Otavio

; Kalil, Renato Abdala Karam

; Jatene, Fabio Biscegli

; Cavalcanti, Alexandre Biasi

; Santos, Renato Hideo Nakagawa

; Gomes, Walter J.

Brazilian Journal of Cardiovascular Surgery

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Jan 2020, Volume 35 Nº 1 Páginas 82 - 90

Resumo: En | Texto: En | PDF: En

Abstract Objective: To analyze the profile and outcomes of patients who underwent valve heart surgery in Brazil, using information retrieved from the Brazilian Registry of Cardiovascular Surgeries in Adults (BYPASS Registry) database. Methods: This is a multicenter cohort study, evaluating 920 patients submitted to heart valve surgery. Demographics and postoperative clinical outcomes were assessed and compared to estimate mortality risk using the European System for Cardiac Operative Risk Evaluation (EuroSCORE). Results: Isolated aortic valve replacement was the most frequently performed surgery (34%), followed by isolated mitral valve replacement (24.9%). Valve repair was performed in 21% of mitral procedures. Minimally invasive access was performed in 1.6% and the most frequent postoperative complications were arrhythmias (22.6%), infections (5.7%), and low-output syndrome (5.1%). Operations covered by the public health system accounted for 80.8% and the hospital mortality rate was 7.3%. Conclusion: The most frequent isolated valve surgery in Brazil is the aortic valve replacement by conventional open access and the rheumatic disease is still the main etiology for valve surgery. The BYPASS Registry has a fundamental role to provide information on the profile of patients with valve heart disease in our country in order to delineate adequate strategies for health promotion and resource allocation for cardiac surgery.

https://doi.org/10.21470/1678-9741-2019-0408 311 downloads

10.

Comment on the study Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the Bypass Registry that was presented at the 46th Congress of the Brazilian Society of Cardiovascular Surgery, Nova Lima, BH, Brazil, April 5 and 6, 2019
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Dallan, Luís Alberto O.

; Paez, Rodrigo Pereira

; Hossne Junior, Nelson Américo

; Santo, José Amalth do Espírito

; Berwanger, Otavio

; Santos, Renato Hideo Nakagawa

; Kalil, Renato Abdala Karam

; Jatene, Fabio B.

; Cavalcanti, Alexandre Biasi

; Zilli, Alexandre Cabral

; Bettiati Jr, Luiz Carlos

; Figueira, Fernando Augusto Marinho dos Santos

; D’Azevedo, Stephanie Steremberg Pires

; Soares, Marcelo José Ferreira

; Fernandes, Marcio Pimentel

; Ardito, Roberto Vito

; Bogdan, Renata Andrea Barberio

; Campagnucci, Valquíria Pelisser

; Nakasako, Diana

; Rodrigues, Clarissa Garcia

; Rodrigues Junior, Anilton Bezerra

; Cascudo, Marcelo Matos

; Atik, Fernando Antibas

; Lima, Elson Borges

; Nina, Vinicius José da Silva

; Heluy, Renato Albuquerque

; Azeredo, Lisandro Gonçalves

; Henrique Junior, Odilon Silva

; Mendonça, José Teles de

; Silva, Katharina Kelly de Oliveira Gama

; Pandolfo, Marcelo

; Lima Júnior, José Dantas de

; Faria, Renato Max

; Santos, Jonas Gonçalves dos

; Coelho, Guilherme Henrique Biachi

; Pereira, Sergio Nunes

; Senger, Roberta

; Buffolo, Enio

; Caputi, Guido Marco

; Oliveira, Juliana Aparecida Borges de

; Gomes, Walter J.

Brazilian Journal of Cardiovascular Surgery

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Ago 2019, Volume 34 Nº 4 Páginas 504 - 506

Resumo: En | Texto: En | PDF: En

https://doi.org/10.21470/1678-9741-2019-0606 335 downloads

11.

Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry
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Paez, Rodrigo Pereira

; Hossne Junior, Nelson Américo

; Santo, José Amalth do Espírito

; Berwanger, Otavio

; Santos, Renato Hideo Nakagawa

; Kalil, Renato Abdala Karam

; Jatene, Fabio B.

; Cavalcanti, Alexandre Biasi

; Zilli, Alexandre Cabral

; Bettiati Jr, Luiz Carlos

; Figueira, Fernando Augusto Marinho dos Santos

; D'Azevedo, Stephanie Steremberg Pires

; Soares, Marcelo José Ferreira

; Fernandes, Marcio Pimentel

; Ardito, Roberto Vito

; Bogdan, Renata Andrea Barberio

; Campagnucci, Valquíria Pelisser

; Nakasako, Diana

; Rodrigues, Clarissa Garcia

; Rodrigues Junior, Anilton Bezerra

; Cascudo, Marcelo Matos

; Atik, Fernando Antibas

; Lima, Elson Borges

; Nina, Vinicius José da Silva

; Heluy, Renato Albuquerque

; Azeredo, Lisandro Gonçalves

; Henrique Junior, Odilon Silva

; Mendonça, José Teles de

; Silva, Katharina Kelly de Oliveira Gama

; Pandolfo, Marcelo

; Lima Júnior, José Dantas de

; Faria, Renato Max

; Santos, Jonas Gonçalves dos

; Coelho, Guilherme Henrique Biachi

; Pereira, Sergio Nunes

; Senger, Roberta

; Buffolo, Enio

; Caputi, Guido Marco

; Oliveira, Juliana Aparecida Borges de

; Gomes, Walter J.

Brazilian Journal of Cardiovascular Surgery

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Abr 2019, Volume 34 Nº 2 Páginas 142 - 148

Resumo: En | Texto: En | PDF: En

Abstract Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective: To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods: A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results: Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion: CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.

https://doi.org/10.21470/1678-9741-2018-0313 1270 downloads

12.

Hemodynamic Changes During Heart Displacement in Aorta No-Touch Off-Pump Coronary Artery Bypass Surgery: A Pilot Study
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Carvalho, Alexandre R.

; Guizilini, Solange

; Murai, Gustavo M.

; Begot, Isis

; Rocco, Isadora S.

; Hossne Jr, Nelson A.

; Chamlian, Eduardo G.

; Santos, João Manoel T.

; Macedo, Ricardo A.

; Lisboa, Gustavo C.O.

; Nasciutti, Alberto C.

; Santos, Carlos Eduardo R.

; Figueiredo, João Paulo M.

; Gomes, Walter J.

Brazilian Journal of Cardiovascular Surgery

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Out 2018, Volume 33 Nº 5 Páginas 469 - 475

Resumo: En | Texto: En | PDF: En

Abstract Objective: To evaluate the sequential changes of hemodynamic and metabolic parameters in patients who underwent aorta no-touch off-pump coronary artery bypass surgery (OPCAB). Methods: Prospective study involving twenty-seven consecutive patients who underwent aorta no-touch OPCAB. The FloTrac/PreSep/Vigileo™ system (Edwards Lifesciences) was used to continuously record heart rate (HR), mean arterial blood pressure (MABP), central venous pressure (CVP), continuous cardiac index (FCI), stroke volume (SV), stroke volume variation (SVV), and central venous oxygen saturation (ScvO2). The parameters were assessed 5 min before, during and 5 min after each anastomosis (left anterior descending [LAD], posterior descending [PD], obtuse marginal [OM] and diagonal [Dg]). Postoperative lactate was also evaluated. Results: There was no significant change in HR and MABP for all anastomoses, except for MABP during PD grafting (-10.1±2.7 mmHg, P=0.03). There was a significant decrease in ScvO2 only during PD and OM anastomoses (-9.4±0.4, P=0.03; -4.4±0.4, P=0.02; respectively). CVP drop after PD manipulation was strongly associated with a higher lactate during the first hours after surgery (r=-0.82; P=0.001). These hemodynamic changes were transient and entirely recovered after the heart was returned to its anatomical position. No significant differences were observed in FCI, SVV, or the systemic vascular resistance index (SVRI) during all anastomoses, except for a drop in SVRI during PD grafting (-8.03±2.3, P=0.007). SV tended to decrease during the procedure in all territories, but with statistically significant drop only in PD and OM grafting (-10.4±1.2, P=0.02; -13.6±5.1, P=0.007; respectively). Conclusion: Heart displacement for performing aorta no-touch OPCAB is well tolerated, with transient and endurable hemodynamic variations.

https://doi.org/10.21470/1678-9741-2018-0090 665 downloads

13.

The Brazilian Registry of Adult Patient Undergoing Cardiovascular Surgery, the BYPASS Project: Results of the First 1,722 Patients
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Gomes, Walter J.

; Moreira, Rita Simone

; Zilli, Alexandre Cabral

; Bettiati Jr, Luiz Carlos

; Figueira, Fernando Augusto Marinho dos Santos

; D' Azevedo, Stephanie Steremberg Pires

; Soares, Marcelo José Ferreira

; Fernandes, Marcio Pimentel

; Ardito, Roberto Vito

; Bogdan, Renata Andrea Barberio

; Campagnucci, Valquíria Pelisser

; Nakasako, Diana

; Kalil, Renato Abdala Karam

; Rodrigues, Clarissa Garcia

; Rodrigues Junior, Anilton Bezerra

; Cascudo, Marcelo Matos

; Atik, Fernando Antibas

; Lima, Elson Borges

; Nina, Vinicius José da Silva

; Heluy, Renato Albuquerque

; Azeredo, Lisandro Gonçalves

; Henrique Junior, Odilon Silva

; Mendonça, José Teles de

; Silva, Katharina Kelly de Oliveira Gama

; Pandolfo, Marcelo

; Lima Júnior, José Dantas de

; Faria, Renato Max

; Santos, Jonas Gonçalves dos

; Paez, Rodrigo Pereira

; Coelho, Guilherme Henrique Biachi

; Pereira, Sergio Nunes

; Senger, Roberta

; Buffolo, Enio

; Caputi, Guido Marco

; Santo, José Amalth do Espírito

; Oliveira, Juliana Aparecida Borges de

; Berwanger, Otavio

; Cavalcanti, Alexandre Biasi

; Jatene, Fabio B.

Brazilian Journal of Cardiovascular Surgery

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Abr 2017, Volume 32 Nº 2 Páginas 71 - 76

Resumo: En | Texto: En | PDF: En

Abstract Objective: To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Methods: Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1). The study population consists of patients over 18 years of age, and the types of operations recorded were: coronary artery bypass graft (CABG), mitral valve, aortic valve (either conventional or transcatheter), surgical correction of atrial fibrillation, cardiac transplantation, mechanical circulatory support and congenital heart diseases in adults. Results: 83.1% of patients came from the public health system (SUS), 9.6% from the supplemental (private insurance) healthcare systems; and 7.3% from private (out-of -pocket) clinic. Male patients comprised 66%, 30% were diabetics, 46% had dyslipidemia, 28% previously sustained a myocardial infarction, and 9.4% underwent prior cardiovascular surgery. Patients underwent coronary artery bypass surgery were 54.1% and 31.5% to valve surgery, either isolated or combined. The overall postoperative mortality up to the 7th postoperative day was 4%; for CABG was 2.6%, and for valve operations, 4.4%. Conclusion: This first report outlines the consecution of the Brazilian surgical cardiac database, intended to serve primarily as a tool for providing information for clinical improvement and patient safety and constitute a basis for production of research protocols.

https://doi.org/10.21470/1678-9741-2017-0053 1883 downloads

14.

Multielement Determination of Macro and Micro Contents in Medicinal Plants and Phytomedicines from Brazil by ICP OES
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Santos Júnior, Aníbal de F.

; Matos, Rafael A.

; Andrade, Eberson M. J.

; Santos, Walter N. L. dos

; Magalhães, Hemerson I. F.

; Costa, Fernanda do N.

; Korn, Maria das Graças A.

Journal of the Brazilian Chemical Society

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Fev 2017, Volume 28 Nº 2 Páginas 376 - 384

Resumo: En | Texto: En | PDF: En

In this study, the elemental composition of nine medicinal plants and phytomedicines was evaluated by using axial view inductively coupled plasma optical emission spectrometry (ICP OES) after three digestion procedures: dry ashing (DA) and two wet digestions with a mineral acid (HNO3/H2O2) mixture on a conventional hot plate (CD), besides microwave digestion (MW). Accuracy was assessed from spinach leaves (CRM 1570a) and recovery values were in the range of 82 to 113.8%. Precisions, such as relative standard deviation (RSD), below 10% were reached. The MW procedure was preferred for its accuracy (recovery values of 94 to 102%), reduced contamination, increase in the efficiency of the decomposition process, lower residual acidity and reduced time required for digestion. The concentrations of analytes in the samples (minimum-maximum in μg g-1) were: Ca (100.71-462.20), Co (0.54-0.85), Cu (0.32-7.82), Fe (2.74-18.03), Mg (18.40-521.28), Mn (0.17-55.14), Ni (0.56-1.25) and Zn (2.96-20.92). The levels of Al, Ba, Cd, Cr, Mo, Pb, Se and V in all investigated samples were found to be below the limit of detection of ICP OES. The multielement analysis by ICP OES showed that the method is simple, fast and reliable for the multielement determination in medicinal plants and phytomedicines.

https://doi.org/10.5935/0103-5053.20160187 2495 downloads

15.

A Cycle Ergometer Exercise Program Improves Exercise Capacity and Inspiratory Muscle Function in Hospitalized Patients Awaiting Heart Transplantation: a Pilot Study
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Forestieri, Patrícia

; Guizilini, Solange

; Peres, Monique

; Bublitz, Caroline

; Bolzan, Douglas W.

; Rocco, Isadora S.

; Santos, Vinícius B.

; Moreira, Rita Simone L.

; Breda, João R.

; Almeida, Dirceu R. de

; Carvalho, Antonio Carlos de C.

; Arena, Ross

; Gomes, Walter J.

Brazilian Journal of Cardiovascular Surgery

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Out 2016, Volume 31 Nº 5 Páginas 389 - 395

Resumo: En | Texto: En | PDF: En

Abstract Objective: The purpose of this study was to evaluate the effect of a cycle ergometer exercise program on exercise capacity and inspiratory muscle function in hospitalized patients with heart failure awaiting heart transplantation with intravenous inotropic support. Methods: Patients awaiting heart transplantation were randomized and allocated prospectively into two groups: 1) Control Group (n=11) - conventional protocol; and 2) Intervention Group (n=7) - stationary cycle ergometer exercise training. Functional capacity was measured by the six-minute walk test and inspiratory muscle strength assessed by manovacuometry before and after the exercise protocols. Results: Both groups demonstrated an increase in six-minute walk test distance after the experimental procedure compared to baseline; however, only the intervention group had a significant increase (P =0.08 and P =0.001 for the control and intervention groups, respectively). Intergroup comparison revealed a greater increase in the intervention group compared to the control (P <0.001). Regarding the inspiratory muscle strength evaluation, the intragroup analysis demonstrated increased strength after the protocols compared to baseline for both groups; statistical significance was only demonstrated for the intervention group, though (P =0.22 and P <0.01, respectively). Intergroup comparison showed a significant increase in the intervention group compared to the control (P <0.01). Conclusion: Stationary cycle ergometer exercise training shows positive results on exercise capacity and inspiratory muscle strength in patients with heart failure awaiting cardiac transplantation while on intravenous inotropic support.

https://doi.org/10.5935/1678-9741.20160078 2469 downloads

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