Predictors of in-hospital mortality in patients with ST-segment elevation myocardial infarction undergoing pharmacoinvasive treatment

OBJECTIVES: To identify predictors of in-hospital mortality in patients with acute myocardial infarction undergoing pharmacoinvasive treatment. METHODS: This was an observational, prospective study that included 398 patients admitted to a tertiary center for percutaneous coronary intervention within 3 to 24 hours after thrombolysis with tenecteplase. ClinicalTrials.gov: NCT01791764. RESULTS: The overall in-hospital mortality rate was 5.8%. Compared with patients who survived, patients who died were more likely to be older, have higher rates of diabetes and chronic renal failure, have a lower left ventricular ejection fraction, and demonstrate more evidence of heart failure (Killip class III or IV). Patients who died had significantly lower rates of successful thrombolysis (39% vs. 68%; p = 0.005) and final myocardial blush grade 3 (13.0% vs. 61.9%; p,0.0001). Based on the multivariate analysis, the Global Registry of Acute Coronary Events score (odds ratio 1.05, 95% confidence interval (CI) 1.02-1.09; p = 0.001), left ventricular ejection fraction (odds ratio 0.9, 95% CI 0.89-0.97; p = 0.001), and final myocardial blush grade of 0-2 (odds ratio 8.85, 95% CI 1.34-58.57; p = 0.02) were independent predictors of mortality. CONCLUSIONS: In this prospective study that evaluated patients with ST-segment elevation myocardial infarction treated by a pharmacoinvasive strategy, the in-hospital mortality rate was 5.8%. The Global Registry of Acute Coronary Events score, left ventricular ejection fraction, and myocardial blush were independent predictors of mortality in this high-risk group of acute coronary syndrome patients

Morphological and Postural changes in the foot during pregnancy and puerperium : a longitudinal study

The aim of this study is to observe the morphological and postural changes to the foot that take place during pregnancy and the puerperium. Method: In this descriptive, observational, longitudinal study, we analysed 23 pregnant women, with particular attention to morphological and postural aspects of the foot, at three time points during and after pregnancy: in weeks 9-13 of gestation, weeks 32-35 of gestation and weeks 4-6 after delivery. The parameters considered were changes in foot length, the Foot Posture Index (FPI) and the Hernández Corvo Index, which were analysed using a pedigraph and taking into account the Body Mass Index (BMI). The same procedure was conducted in each review. Results: The statistical analyses obtained for each foot did not differ significantly between the three measurement times. A pronator-type footprint was most frequently observed during the third trimester of pregnancy; it was predominantly neutral during the postpartum period. Statistically significant differences between the measurement times were obtained in the right foot for cavus vs. neutral foot type (between the first and third trimesters and also between the first trimester and the puerperium) (in both cases, p < 0.0001). Conclusions: Foot length increases in the third trimester and returns to normal in the puerperium. According to FPI findings, the third trimester of pregnancy is characterised by pronation, while the posture returns to neutrality during the postpartum period. During pregnancy, the plantar arch flattens, and this persists during the puerperium. The incidence of cavus foot increases significantly in the third trimester and in the puerperium

Epidemiological overview of HIV/AIDS in pregnant women from a state of northeastern Brazil

ABSTRACT Objective: To learn the epidemiological characteristics of HIV infection in pregnant women. Method: Descriptive study with quantitative approach. The study population was composed of pregnant women with HIV/AIDS residing in the state of Alagoas. Data were organized into variables and analyzed according to the measures of dispersion parameter relevant to the arithmetic mean and standard deviation (X ± S). Results: Between 2007 and 2015, 773 cases of HIV/AIDS were recorded in pregnant women in Alagoas. The studied variables identified that most of these pregnant women were young, had low levels of education and faced socioeconomic vulnerability. Conclusion: It is necessary to include actions aimed at increasing the attention paid to women, once the assurance of full care and early diagnosis of HIV are important strategies to promote adequate treatment adherence and reduce the vertical transmission

Epidemiological overview of HIV/AIDS in pregnant women from a state of northeastern Brazil

<div><p>ABSTRACT Objective: To learn the epidemiological characteristics of HIV infection in pregnant women. Method: Descriptive study with quantitative approach. The study population was composed of pregnant women with HIV/AIDS residing in the state of Alagoas. Data were organized into variables and analyzed according to the measures of dispersion parameter relevant to the arithmetic mean and standard deviation (X ± S). Results: Between 2007 and 2015, 773 cases of HIV/AIDS were recorded in pregnant women in Alagoas. The studied variables identified that most of these pregnant women were young, had low levels of education and faced socioeconomic vulnerability. Conclusion: It is necessary to include actions aimed at increasing the attention paid to women, once the assurance of full care and early diagnosis of HIV are important strategies to promote adequate treatment adherence and reduce the vertical transmission.</p></div

Autonomic Modulation Analysis In Active And Sedentary Kidney Transplanted Recipients.

Modulation of the autonomic nervous system on heart rate can be compromised in chronic kidney disease and may result in changes in the frequency and duration of the cardiac cycle. The aim of this study was to evaluate autonomic modulation in active and sedentary renal transplant recipients. Twenty renal-transplanted individuals were analyzed at the Centro de Prevenção de Doenças Renais (Kidney Disease Education Centre), in the academic hospital of Universidade Federal do Maranhão, and were divided into the active group (AG) and the sedentary group (SG). The AG comprised of six men and four women (age 43.10 ± 13.02) and was in regular concurrent training intervention for 8 weeks, while the SG was composed of three men and seven women (age 36.8 ± 9.26). Analysis of heart rate (HR) variability in time and frequency domain demonstrated that HR mean values in the SG and AG were 787.32 ± 79.60 and 870 ± 106.66 ms, respectively. Differences were observed in the time domain and frequency domain. The total index of low frequency and high frequency showed no differences between the SG and AG. Biochemical variables presented significantly lower levels after 8 weeks of training. Higher heart rate variability in the time domain and greater vagal modulation was observed in the AG. The AG ad greater vagal modulation when compared to the SG, with removal of the sympathetic and increased parasympathetic in the behaviour was confirmed by sympatho-vagal balance. The AG also presented significant improvements in the frequency domain.421239-124

Efeito de extratos vegetais no controle de Fusarium oxysporum f. sp tracheiphilum em sementes de caupi Effect of naturals extracts on the control of Fusarium oxysporum f. sp tracheiphilum in cowpea seeds

A fusariose é uma doença de grande importância para a cultura do feijoeiro em virtude da redução da produtividade. O controle da doença vem sendo realizado com aplicações indiscriminadas de fungicidas químicos, acarretando problemas ao homem e ao meio ambiente. Objetivou-se, no presente trabalho, avaliar o efeito de extratos vegetais no controle de Fusarium oxysporum f. sp tracheiphilum, proveniente de sementes de caupi, comparando-se com o efeito do fungicida químico. Utilizaram-se extratos de alho, angico e manjericão, isolados ou combinados entre si e ou em associação ao fungicida Mancozeb. Uma alíquota de 50 µL de cada tratamento foi adicionada em orifício feito no centro das placas de Petri com BDA, sobre o qual depositou-se um disco de micélio do fungo. Avaliou-se durante sete dias, medindo-se o crescimento micelial do patógeno. Sementes de caupi foram desinfestadas com hipoclorito de sódio a 4,0%, semeadas em sacos de polietileno contendo solo autoclavado. Oito dias após germinação, efetuaram-se ferimentos no colo das plântulas, aplicando-se suspensão de esporos do fungo (1,4 x 10-5 con/mL). As avaliações de severidade da doença foram realizadas diariamente durante 30 dias após a inoculação, utilizando-se escala de notas. Os extratos combinados de alho + manjericão e angico + manjericão não inibiram o crescimento micelial do fungo, enquanto o extrato de manjericão isoladamente, proporcionou o menor crescimento micelial, indicando a ação fungicida e inibitória desse tratamento sobre o fungo F. oxysporum f. sp tracheiphilum nas condições analisadas. O fungicida Mancozeb + o extrato de angico proporcionou menor média de severidade nas plantas avaliadas.<br>Wilt caused by Fusarium sp. in cowpea crop is a disease of great importance because it causes yield decrease. The control of this disease has been accomplished with uncontrolled applications of chemical fungicides causing problems for humans and environment. The present work had the objective to compare the effect of natural extracts on the control of Fusarium oxysporum f. sp tracheiphlum, originated from seeds of cowpea (Vigna unguiculata L), compared to chemical fungicide effect. Extracts of Allium sativum, Anadenanthera colubrine, and Ocimum basilicum were used alone or in combination with Mancozeb. A 50 µL aliquot of each treatment was added in a hole (6 mm of diameter) made in the center of Petri dishes with BDA and a fungus mycelia disk was inoculated on it. Evaluations were done during seven days, measuring the pathogen mycelial growth. Seeds of cowpea were disinfected with sodium hypochlorite, sowed in plastic bags with autoclaved soil. Eight days after germination, wounds were made on the basal part of the plantlets, and fungus spore suspension (1.4 x 10-5 con/mL) was applied on it. Evaluations of the disease severity were accomplished daily during 30 days after inoculation, using a disease index. Combination of extracts of A. sativum + Ocimum basilicum and Anadenanthera colubrina + Ocimum basilicum did not reduce fungus mycelial growth, whereas Ocimum basilicum extract alone showed minor mycelial growth, indicating fungicide action of this treatment on F. oxysporum f. sp tracheipphlum under the conditions studied. Combination of Mancozeb + Anadenanthera colubrina was responsible for lower average of severity on the evaluated plants