ABORDAGEM TERAPÊUTICA NO PROCESSO DE ESVAZIAMENTO UTERINO

Objetivos: identificar a terapêutica utilizada no processo de esvaziamento uterino e traçar o perfil obstétrico das mulheres assistidas nesse processo. Método: pesquisa quantitativa, retrospectiva, de caráter exploratório-descritivo, constituída por 466 prontuários de mulheres internadas para esvaziamento uterino, no período de junho de 2015 a junho de 2016. Resultados: a idade variou entre 14 e 43 anos, o principal diagnóstico foi o aborto incompleto, responsável por 44,85% das internações, a terapêutica inicial mais utilizada foi o misoprostol (57,71%) e o tempo de internação até o esvaziamento uterino variou entre 0,20 e 137 horas. Conclusão: o perfil obstétrico da mulher que vivencia a perda gestacional não difere do encontrado nacionalmente; a curetagem foi a terapêutica final mais utilizada acrescida de alguns desfechos desfavoráveis, como maior tempo de internação e exposição excessiva a medicação.Descritores: Saúde da mulher. Abortamento. Métodos terapêuticos. Assistência à saúd

Use of propensity score in cost-effectiveness analysis using drug-eluting and bare metal stents

ABSTRACTBACKGROUNDStudies on the cost-effectiveness ratio of drug-eluting stents (DES) are rare. Our objective was to evaluate the results and compare costs (incremental cost-effectiveness ratio – ICER) per restenosis avoided between DES and bare metal stents (BMS) using the propensity score.METHODSTwo hundred and twenty consecutive patients were included in the study, of which 111 were treated with DES and 109 with BMS. The propensity score was used to adjust the effect of the intervention, by means of matching, stratification and weighing.RESULTSMost patients were male (67.7% vs. 66.9%; P = 0.53), with a mean age of 65.9 years. Patients treated with the DES had a higher rate of diabetes (54% vs. 17.4%; P < 0.001), three-vessel disease (18.9% vs. 10.1%; P = 0.029) and poor ventricular function (54.1% vs. 22%; P < 0.0001). The diameter of stents was 2.76 ± 0.35mm vs. 2.91 ± 0.47mm (P = 0.006) and the sum of the lengths of stents was 37.6 ± 23mm vs. 24.8 ± 15.8mm (P < 0.0001). Restenosis was observed on 6.3% vs. 12.8% of the patients (P = 0.099) and in 4.1% vs. 9.8% of the lesions (P = 0.048). There was an incremental cost of R$9,500.00 and the ICER was R$ 147,538.00 per restenosis avoided (above the World Health Organization threshold). However, when the propensity score was used, the variables that best classified patients for DES and had a maximum ICER of R$ 4,776.96 were age > 72 years, diabetes and lesions with diameter < 3.2mm and length > 18mm.CONCLUSIONSAlthough DES were not cost-effective in the overall population, the propensity score showed that in elderly patients, diabetics and patients with long lesions or small vessels, the use of DES was cost-effective

The AlfaCrux CubeSat mission description and early results

On 1 April 2022, the AlfaCrux CubeSat was launched by the Falcon 9 Transporter-4 mission, the fourth SpaceX dedicated smallsat rideshare program mission, from Space Launch Complex 40 at Cape Canaveral Space Force Station in Florida into a Sun-synchronous orbit at 500 km. AlfaCrux is an amateur radio and educational mission to provide learning and scientific benefits in the context of small satellite missions. It is an opportunity for theoretical and practical learning about the technical management, systems design, communication, orbital mechanics, development, integration, and operation of small satellites. The AlfaCrux payload, a software-defined radio hardware, is responsible for two main services, which are a digital packet repeater and a store-and-forward system. In the ground segment, a cloud-computing-based command and control station has been developed, together with an open access online platform to access and visualize the main information of the AlfaCrux telemetry and user data and experiments. It also becomes an in-orbit database reference to be used for different studies concerned with, for instance, radio propagation, attitude reconstruction, data-driven calibration algorithms for satellite sensors, among others. In this context, this paper describes the AlfaCrux mission, its main subsystems, and the achievements obtained in the early orbit phase. Scientific and engineering assessments conducted with the spacecraft operations to tackle unexpected behaviors in the ground station and also to better understand the space environment are also presented and discussed.Fundação de Apoio à Pesquisa del Distrito Federal (FAPDF), Brasil | Ref. N/

The coronary artery disease equivalent revisited

(1) To study the prevalence and severity of coronary artery disease (CAD) in diabetic patients. (2) To provide a detailed characterization of the coronary atherosclerotic burden, including the localization, degree of stenosis and plaque composition by coronary computed tomography angiography (CCTA). Single center prospective registry including a total of 581 consecutive stable patients (April 2011-March 2012) undergoing CCTA (Dual-source CT) for the evaluation of suspected CAD without previous myocardial infarction or revascularization procedures. Different coronary plaque burden indexes and plaque type and distribution patterns were compared between patients with (n = 85) and without diabetes (n = 496). The prevalence of CAD (any plaque; 74.1 vs. 56 %; p = 0.002) and obstructive CAD (≥50 % stenosis; 31.8 vs. 10.3 %; p<0.001) were significantly higher in diabetic patients. The remaining coronary atherosclerotic burden indexes evaluated (plaque in LM-3v-2v with prox. LAD; SIS; SSS; CT-LeSc) were also significantly higher in diabetic patients. In the per segment analysis, diabetics had a higher percentage of segments with plaque in every vessel (2.6/13.1/7.5/10.5 % for diabetics vs. 1.4/7.1/3.3/4.4 % for nondiabetics for LM, LAD, LCx, RCA respectively; p<0.001 for all) and of both calcified (19.3 vs. 9.2 %, p<0.001) and noncalcified or mixed types (14.4 vs. 7.0 %; p<0.001); the ratio of proximal-to-distal relative plaque distribution (calculated as LM/proximal vs. mid/distal/branches) was lower for diabetics (0.75 vs. 1.04; p = 0.009). Diabetes was an independent predictor of CAD and was also associated with more advanced CAD, evaluated by indexes of coronary atherosclerotic burden. Diabetics had a significantly higher prevalence of plaques in every anatomical subset and for the different plaque composition. In this report, the relative geographic distribution of the plaques within each subgroup, favored a more mid-to-distal localization in the diabetic patients.publishersversionpublishe

Unilateral versus Bilateral Landing after Spike Jumps in Male and Female Volleyball: A Systematic Review

Background: The spike is a key action in volleyball, and the landing technique and its asymmetries are commonly associated with an increased risk of injury. Objectives: The aim of this systematic review was to assess how male and female volleyball players land (i.e., unilaterally, or bilaterally) after spike jumps in matches and analytical settings (field or laboratory). Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines were followed, with eligibility criteria defined according to participants, interventions, comparators, study design (PICOS): (p) healthy indoor volleyball players of any sex, age group, or competitive level; (i) exposure to landing after spike actions during official matches AND/OR simulated 6 vs. 6 games AND/OR analytical training conditions AND/OR laboratorial experiments; (c) not mandatory; (o) data on landing mechanics after spike actions, including reporting of whether the landing was unilateral or bilateral; (s) no restrictions imposed on study design. Searches were performed in seven electronic databases (Cochrane Library, EBSCO, PubMed, Scielo, Scopus, SPORTDiscus, and Web of Science) on 23 April 2021. Results: Automated searches provided 420 results. Removal of 119 duplicates resulted in 301 records being screened for titles and abstracts. A total of 25 studies were eligible for full-text analysis. Of these, eight studies were deemed eligible for inclusion in the review. Studies showed that (i) attackers landed asymmetrically 68% of the times (61% left leg, 7% right leg); (ii) bilateral asymmetries were observed for the hip, knee, and ankle joints; (iii) bilateral asymmetries were observed even when players were instructed to land evenly on two feet; (iv) landing contact of the leg opposite to the hitting arm preceded the contact of the homolateral leg. One match analysis study showed that men landed more often on the left (31.5%) or right foot (8.5%) than women (23.7% and 1.6%). Conclusions: Studies analyzing spike landing showed a prevalence of unilateral landings (mostly the left leg first, for right-handed players) in men and women but more prevalently in men. Registration INPLASY202140104, DOI: 10.37766/inplasy2021.4.010

Geotraverse south (B-1) : (excursion guidebook. Day 1)

The purpose of this excursion is to make a quick geological reconnaissance of the main stratigraphic and tectonic characteristics of the terranes in the southern part of the Iberian Peninsula, starting with the Alcudian Terrane (days 1 and 2), Obejo-Valseguillo (day 2), Hornachos (day 2), Valencia de las Torres (day 3), Sierra Albarrana (day 3), Olivenza-Monesterio (days 4 and 5), Barrancos (day 5), Aracena (day 5), Pule do Lobo (day 5), and South Portuguese (day 6), by visiting strategic outcrops where the main points and problems can be discussed

Comparative serology techniques for the diagnosis of Trypanosoma cruzi infection in a rural population from the state of Querétaro, Mexico

Immunological diagnostic methods for Trypanosoma cruzi depend specifically on the presence of antibodies and parasitological methods lack sensitivity during the chronic and “indeterminate” stages of the disease. This study performed a serological survey of 1,033 subjects from 52 rural communities in 12 of the 18 municipalities in the state of Querétaro, Mexico. We detected anti-T. cruzi antibodies using the following tests: indirect haemagglutination assay (IHA), indirect immunofluorescence assay (IFA), ELISA and recombinant ELISA (rELISA). We also performed Western blot (WB) analysis using iron superoxide dismutase (FeSOD), a detoxifying enzyme excreted by the parasite, as the antigen. Positive test results were distributed as follows: ELISA 8%, rELISA 6.2%, IFA and IHA 5.4% in both cases and FeSOD 8%. A comparative study of the five tests was undertaken. Sensitivity levels, specificity, positive and negative predictive values, concordance percentage and kappa index were considered. Living with animals, trips to other communities, gender, age, type of housing and symptomatology at the time of the survey were statistically analysed using SPSS software v.11.5. Detection of the FeSOD enzyme that was secreted by the parasite and used as an antigenic fraction in WBs showed a 100% correlation with traditional ELISA tests

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities