Dispersion of the QT Interval in Subjects with Frequent Nonsustained Ventricular Arrhythmias and No Underlying Heart Disease: Arrhythmogenic Substrate or Mechanoelectrical Feedback of Arrhythmias?

Background: QT dispersion (QTd) on the ECG is thought to reflect the temporal and spatial inhomogeneity of repolarization in the underlying myocardium. In myocardial infarction, ischemia, and long QT syndromes, an increased QTd is associated with a propensity for malignant ventricular arrhythmias and sudden cardiac death. We investigated this feature of the repolarization process in subjects with frequent ventricular arrhythmias and structurally normal hearts. Methods: Forty-nine patients referred for frequent, nonsustained ventricular arrhythmias (45 ± 14 years, ×± SD, 61% female) had normal ventricular dimensions and function, no late potentials, and normal ECG. They were compared with 30 controls (42 ± 13 years, 50% female). QTd was measured as the difference between the longest and the shortest QT in the six precordial leads at a paper speed of 50 mm/s. Results: In patients, QTc was similar to that of controls: 395 ± 21 versus 386 ± 20. However, QTd was greater: 49 ± 20 ms versus 32 ± 14 ms, P < 001. Moreover, 18 patients (36%) had QTd exceeding 60 ms—a value superior to the mean normal value of 2 SD—compared to only 1 control (3%) (P < 0.01). Finally, patients with more frequent ventricular arrhythmias had larger QTd. Conclusions: In patients with frequent nonsustained ventricular arrhythmias and otherwise normal hearts, QT interval dispersion is increased. We speculate that, instead of representing a specific electrophysiological substrate of arrhythmias, QT dispersion in this specific population could result from arrhythmias themselves through a possible mechanoelectrical feedback

A proteção dos Direitos Humanos na regulação dos resíduos sólidos: o caso do Bairro Camargos em Belo Horizonte

A proteção dos Direitos Humanos na regulação dos resíduos sólidos: o caso do Bairro Camargos em Belo Horizonte RESUMOO presente trabalho busca expor um tema bastante sério e preocupante, ou seja, o destino do lixo que é produzido. Desta forma, pretende-se abordar o viés da proteção dos Direito Humanos na regulação dos resíduos sólidos, porém, para que isso seja possível, o trabalho faz considerações sobre as diversas formas de destino do lixo como, por exemplo, a incineração, a compostagem, a reciclagem, o lixão e etc. Num segundo momento trata especificamente sobre a incineração do lixo e aborda um tema que trouxe consigo graves violações aos Direitos Humanos, ou seja, o caso de Camargos na cidade de Belo Horizonte. Por fim, aborda a solução dada pela Lei de resíduos sólidos, como também a coleta seletiva como forma de inclusão dos catadores e respeito aos Direitos Humanos. Assim, objetivo geral deste artigo é expor a situação do lixo no Brasil e seu objetivo específico é demonstrar que a Lei de resíduos sólidos e a inclusão dos catadores estão colaborando com a promoção dos Direitos Humanos, para tanto, a metodologia utilizada foi exclusivamente bibliográfica. Por fim, o tema traz indagações sobre a eficiência das formas de eliminação atualmente existentes como problemática.PALAVRAS-CHAVES: incineração de lixo; Direitos Humanos; resíduos sólidos. The protection of human rights in the regulation of solid waste: The case of the Camargos Neighborhood in Belo HorizonteABSTRACT The present work seeks to expose a very serious and worrying theme, that is, the destination of the garbage that is produced. In this way, it is intended to address the bias of the protection of human rights in the regulation of solid waste, but for this to be possible, the work makes considerations about the various forms of waste disposal, such as incineration, composting, Recycling, the dump and etc. In a second moment, it deals specifically with the incineration of garbage and addresses a theme that has brought with it serious violations of human rights, that is, the case of Camargos in the city of Belo Horizonte. Finally, it addresses the solution given by the Solid Waste Law, as well as the selective collection as a way of including collectors and respect for Human Rights. Thus, the general objective of this article is to expose the situation of garbage in Brazil and its specific objective is to demonstrate that the Law of solid waste and the inclusion of collectors are collaborating with the promotion of Human Rights, for that, the methodology used was exclusively bibliographical. Finally, the theme raises questions about the efficiency of the existing forms of elimination as problematic.KEYWORDS: waste incineration; Human rights; solid waste. Enviado em: 15-12-2016Aprovado em: 10-02-201

Proposta de uma ferramenta para classificação arquivística com base em ontologias

This article describes and demonstrates a tool developed to reduce the subjective aspect inherent to archival classification, making it more consistent. Taking into account that classification errors can affect several other archival functions, especially appraisal and description, we’ve developed a software that we called Ontological Classifier (OntoClass). This software, through the creation of an ontology based on the classification scheme of a corporate body, is able to determine the class to which a document belongs based on terms arranged in a list. The theoretical basis was carried out through a bibliographic research and the development of the tool was made using the Python 3.7 programming language and the SPARQL query language. We conclude that although OntoClass reaches its goal, it is still necessary to test it in real situations and there are some requirements that must be met in order to achieve the desired results.Buscou-se construir e demonstrar uma ferramenta desenvolvida a fim de reduzir o aspecto subjetivo inerente à classificação arquivística, tornando-a mais consistente. Tendo-se em conta que erros de classificação podem prejudicar a grande maioria das funções arquivísticas, especialmente a avaliação e a descrição, foi elaborado um software denominado Ontological Classifier (OntoClass). Esse software, por meio da criação de uma ontologia a partir do plano de classificação de uma entidade produtora de documentos, é capaz de determinar a classe à qual um documento pertence com base em termos autorizados dispostos em uma lista. A fundamentação teórica foi realizada por meio de uma pesquisa bibliográfica e o desenvolvimento da ferramenta foi feito com uso da linguagem de programação Python 3.7 e da linguagem de consulta SPARQL. A partir de testes realizados com uma ontologia simples criada especificamente para este trabalho, conclui-se que o OntoClass alcança seu objetivo, apesar de ainda serem necessários testes em situações reais e apesar de haver alguns requisitos a cumprir para obter resultados positivos de sua utilização

Apparently Spontaneous Partial Rupture of Anterolateral Papillary Muscle Requiring Urgent Surgery

Papillary muscle rupture is a rare complication of myocardial infarction. Here we describe a case of an apparently spontaneous rupture of papillary muscle, not associated with coronary obstruction. The patient was a 73-year-old man admitted to our hospital for diabetic ketoacidosis complicated by acute pulmonary edema and cardiogenic shock. Transthoracic and transesophageal echocardiography showed partial rupture of papillary muscle leading to severe mitral regurgitation. Urgent cardiac surgery with mitral valve replacement was performed

Renal function impairment predicts mortality in patients with chronic heart failure treated with resynchronization therapy

Background: The use of cardiac resynchronization therapy (CRT) and implantable cardioverter- defibrillator (ICD) for advanced heart failure (HF) is increasing. Renal dysfunction is a common condition in HF which is associated with a worse survival. The study aims at identifying in patients with advanced HF treated with CRT the effect of baseline glomerular filtration rate (GFR), GFR improvement and left ventricular ejection fraction (LVEF) change, after 6-months of CRT implant, on survival. Methods: The study population consisted of 375 advanced HF patients who received a CRT between 1999 and 2009, of these 277 received also an ICD implant. Clinical characteristics (New York Heart Association [NYHA] functional class, ischemic vs. non-ischemic etiology, atrial fibrillation, diabetes, hypertension, LVEF, QRS duration and GFR were recorded. The use of common used drugs was evaluated. Cox proportional hazards analysis was calculated in order to evaluate variables associated to mortality. Results: During a median follow-up of 43.0 months, 93 (24.8%) patients died. Patients deceased during the study had at baseline higher NYHA class and lower LVEF and GFR. In Cox regression analysis, GFR predicts long-term mortality (hazard ratio [HR] 0.983; 95% confidence interval [CI] 0.969–0.998; p = 0.023) independently from the effect of others covariates. In addition, a positive GFR improvement 6 months after CRT implant is significantly associated with a lower hazard of mortality (for each 10 mL/min of GFR improvement HR 0.86; 95% CI 0.75–0.99; p = 0.038). Conclusions: GFR is a significant predictor of mortality in advanced HF patients who received CRT. A GFR improvement 6 months after CRT implant is significantly associated with a lower hazard of mortality.

Prognostic role of CMR in acute myocardial infarction

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Organización del conocimiento y Archivística : enfoques metodológicos

Introdução: Busca-se neste artigo discutir aspectos e pontos de contato entre a Organização e Representação do Conhecimento e Arquivologia, tendo por base os textos publicados no âmbito da International Society for Knowledge Organization, especialmente no que se relaciona à classificação e descrição, construindo um paralelo teórico-conceitual, sobre seus pontos de contato. Objetivos: sistematizar as relações entre a Organização e Representação do Conhecimento e Arquivologia no âmbito da classificação e da descrição. Metodologia: Foi feita uma pesquisa bibliográfica na literatura da ISKO e da literatura da Arquivologia sobre as relações entre essas áreas. Por intermédio da sistematização, foi possível compreender como tem se dado e poderia ser aprofundada as relações entre essas áreas. A Organização e Representação do Conhecimento é uma área que contribui de forma fundamental para o desenvolvimento de metodologias para o acesso à informação. Resultados: Foram apresentadas uma série de desdobramentos para o desenvolvimento de linguagens, estruturas, classificações, ou seja, sistemas de Organização e Representação do Conhecimento. A Arquivologia tem se desenvolvido de forma paralela, mas em muitos momentos buscando interlocuções ainda que superficiais ou até não intencionais com a área de Organização e Representação do Conhecimento. Conclusões: É fundamental a aproximação das áreas para o desenvolvimento da classificação e descrição arquivísticas, visando a construção de ontologias, taxonomias, vocabulários controlados, dentre outros. Essas aproximações, que são recentes, devem-se as mudanças, ocorrida nos últimos vinte anos, em relação à gestão administrativa e à forma com que as pessoas constroem conhecimento e buscam informação.This article discusses the aspects and points of contact between the Knowledge Organization and the Archives, based on the texts published in the scope of the International Society of Organization of Knowledge especially in relation to classification and description, constructing a theoretical-conceptual parallel about their points of contact. Objectives: To systematize the relations between knowledge and archivology within the scope of classification and description. Methodology: bibliographic research in ISKO literature and archival literature. Results: Through systematization, it was possible to apply for and could be deepened between the two areas. The organization and the extension of an area of knowledge are fundamental for the development of methodologies of access to information, in this sense, they have been presented in a series of unfolding for the development of languages, structures, classifications, that is, systems of organization of knowledge. On the other hand, Archival has a parallelism of formation, but in many moments seeking interlocutions although superficial or even unintentional with an area of knowledge organization. Conclusions: An area focus for the development of archival classification and description is essential for the construction of ontologies, taxonomies, controlled vocabularies, among others. These approximations, which are recent, must have occurred with the changes that have occurred in the last 20 years in relation to a management and a way in which people build knowledge and seek information.Introducción: Este artículo analiza los aspectos y puntos de contacto entre la Organización del Conocimiento y los Archivos, basándose en los textos publicados en elámbito de la Sociedad Internacional de Organización del Conocimiento, especialmente en relación con la clasificación y la descripción, construyendo un paralelo teóricoconceptual. sobre sus puntos de contacto. Objetivos: sistematizar las relaciones entre conocimiento y archivología dentro del alcance de la clasificación y descripción. Metodología: investigación bibliográfica en literatura ISKO y literatura de archivo. Resultados: a través de la sistematización, fue posible solicitar y profundizar entre las dos áreas. La organización y la extensión de un área de conocimiento son fundamentales para el desarrollo de metodologías de acceso a la información, en este sentido, se han presentado en una serie de despliegues para el desarrollo de lenguajes, estructuras, clasificaciones, es decir, sistemas de organización del conocimiento. Por otro lado, La archivística tiene un paralelismo de formación, pero en muchos momentos busca interlocuciones aunque superficiales o incluso involuntarias con un área de organización del conocimiento. Conclusiones: Un área de enfoque para el desarrollo de la clasificación y descripción de archivos es esencial para la construcción de ontologías, taxonomías, vocabularios controlados, entre otros. Estas aproximaciones, que son recientes, deben haberse producido con los cambios que se han producido en los últimos 20 años en relación con una gestión y una forma en que las personas construyen

Therapeutic efficacy of 3,4-Diaminopyridine phosphate on neuromuscular junction in Pompe disease

3,4-Diaminopyridine (3,4-DAP) and its phosphate form, 3,4-DAPP have been used efficiently in the past years to treat muscular weakness in myasthenic syndromes with neuromuscular junctions (NMJs) impairment. Pompe disease (PD), an autosomal recessive metabolic disorder due to a defect of the lysosomal enzyme α-glucosidase (GAA), presents some secondary symptoms that are related to neuromuscular transmission dysfunction, resulting in endurance and strength failure. In order to evaluate whether 3,4-DAPP could have a beneficial effect on this pathology, we took advantage of a transient zebrafish PD model that we previously generated and characterized. We investigated presynaptic and postsynaptic structures, NMJs at the electron microscopy level, and zebrafish behavior, before and after treatment with 3,4-DAPP. After drug administration, we observed an increase in the number of acetylcholine receptors an increment in the percentage of NMJs with normal structure and amelioration in embryo behavior, with recovery of typical movements that were lost in the embryo PD model. Our results revealed early NMJ impairment in Pompe zebrafish model with improvement after administration of 3,4-DAPP, suggesting its potential use as symptomatic drug in patients with Pompe disease