Comunicación pública en un mundo feliz

Resenha do Livro: Comunicação pública, sociedade e cidadania Autora: Margarida Maria Krohling Kunsch (Org.)Resenha do Livro: Comunicação pública, sociedade e cidadania Autora: Margarida Maria Krohling Kunsch (Org.

Autonomic dysfunction in COVID-19 patients receiving mechanical ventilation: A cross-sectional study

ABSTRACT BACKGROUND: Coronavirus disease 2019 (COVID-19) can damage cardiac tissue by increasing troponin levels and inducing arrhythmias, myocarditis, and acute coronary syndrome. OBJECTIVES: To analyze the impact of COVID-19 on cardiac autonomic control in mechanically ventilated intensive care unit (ICU) patients. DESIGN AND SETTING: This cross-sectional analytical study of ICU patients of both sexes receiving mechanical ventilation was conducted in a tertiary hospital. METHODS: Patients were divided into COVID-19-positive (COVID(+)) and COVID-19-negative (COVID(-)) groups. Clinical data were collected and heart rate variability (HRV) records obtained using a heart rate monitor. RESULTS: The study sample comprised 82 subjects: 36 (44%) in the COVID(-) group (58.3% female; median age, 64.5 years) and 46 (56%) in the COVID(+) group (39.1% females; median age, 57.5 years). The HRV indices were lower than the reference values. An intergroup comparison identified no statistically significant differences in the mean normal-to-normal (NN) interval, standard deviation of the NN interval, or root mean square of successive differences in NN intervals. The COVID(+) group had an increased low frequency (P = 0.05), reduced high frequency (P = 0.045), and increased low frequency/high frequency (LF/HF) ratio (P = 0.048). There was a weak positive correlation between LF/HF and length of stay in the COVID(+) group. CONCLUSION: Patients who received mechanical ventilation had lower overall HRV indices. COVID(+) patients who received mechanical ventilation had lower vagal HRV components. These findings likely indicate clinical applicability, as autonomic control impairments are associated with a greater risk of cardiac death

Jornalismo Público: por uma nova relação com os públicos

Public Journalism (PJ) emerged in the beginning of the 90’s, when the main conceptual values of the informative journalism were discussed. The main aim of PJ is to improve a new way of connection between journalism and the public. More than a strategy to make a reliable media, PJ understands the media like a key instrument to constitute a new post-modern public sphere.El Periodismo Público (PP), surgido al inicio de los años 1990, representa un movimiento de cuestionamiento de los principales valores conceptuales del periodismo informativo. Su principal objetivo es promover una nueva actitud de conexión con los públicos. Más que una estrategia para restablecer la confianza y credibilidad de los medios con sus usuarios, el PP entiende a los medios como pieza clave en la constitución del nuevo espacio público característico de la post-modernidad.O Jornalismo Público (JP), surgido no início dos anos 1990, representa um movimento de questionamento dos principais valores conceituais do jornalismo informativo. Seu principal objetivo é promover uma nova atitude de ligação para com os públicos. Mais do que uma estratégia para restabelecer a confiança e credibilidade dos meios com seus usuários, o JP entende a mídia como peça-chave na constituição do novo espaço público característico da pós-modernidade

Effectiveness of chlorthalidone plus amiloride for the prevention of hypertension the PREVER-Prevention Randomized Clinical Trial

Background-—Prehypertension is associated with higher cardiovascular risk, target organ damage, and incidence of hypertension. The Prevention of Hypertension in Patients with PreHypertension (PREVER-Prevention) trial aimed to evaluate the efficacy and safety of a low-dose diuretic for the prevention of hypertension and end-organ damage. Methods and Results-—This randomized, parallel, double-blind, placebo-controlled trialwas conducted in 21 Brazilian academicmedical centers. Participants with prehypertensionwho were aged 30 to70 years andwho did not reach optimal blood pressure after 3 months of lifestyle intervention were randomized to a chlorthalidone/amiloride combination pill or placebo and were evaluated every 3 months during 18 months of treatment. The primary outcome was incidence of hypertension. Development or worsening of microalbuminuria, new-onset diabetes mellitus, and reduction of left ventricular mass were secondary outcomes. Participant characteristics were evenly distributed by trial arms The incidence of hypertension was significantly lower in 372 study participants allocated to diuretics compared with358 allocated to placebo (hazard ratio 0.56, 95%CI 0.38–0.82), resulting in a cumulative incidence of11.7% in the diuretic arm versus 19.5% in the placebo arm(P=0.004). Adverse events; levels of blood glucose, glycosylated hemoglobin, creatinine, and microalbuminuria; and incidence of diabetes mellitus were no different between the 2 arms. Left ventricular mass assessed through Sokolow-Lyon voltage and voltage-duration product decreased to a greater extent in participants allocated to diuretic therapy compared with placebo (P=0.02). Conclusions-—A combination of low-dose chlorthalidone and amiloride effectively reduces the risk of incident hypertension and beneficially affects left ventricular mass in patients with prehypertension

Effectiveness of chlorthalidone plus amiloride for the prevention of hypertension the PREVER-Prevention Randomized Clinical Trial

Background-—Prehypertension is associated with higher cardiovascular risk, target organ damage, and incidence of hypertension. The Prevention of Hypertension in Patients with PreHypertension (PREVER-Prevention) trial aimed to evaluate the efficacy and safety of a low-dose diuretic for the prevention of hypertension and end-organ damage. Methods and Results-—This randomized, parallel, double-blind, placebo-controlled trialwas conducted in 21 Brazilian academicmedical centers. Participants with prehypertensionwho were aged 30 to70 years andwho did not reach optimal blood pressure after 3 months of lifestyle intervention were randomized to a chlorthalidone/amiloride combination pill or placebo and were evaluated every 3 months during 18 months of treatment. The primary outcome was incidence of hypertension. Development or worsening of microalbuminuria, new-onset diabetes mellitus, and reduction of left ventricular mass were secondary outcomes. Participant characteristics were evenly distributed by trial arms The incidence of hypertension was significantly lower in 372 study participants allocated to diuretics compared with358 allocated to placebo (hazard ratio 0.56, 95%CI 0.38–0.82), resulting in a cumulative incidence of11.7% in the diuretic arm versus 19.5% in the placebo arm(P=0.004). Adverse events; levels of blood glucose, glycosylated hemoglobin, creatinine, and microalbuminuria; and incidence of diabetes mellitus were no different between the 2 arms. Left ventricular mass assessed through Sokolow-Lyon voltage and voltage-duration product decreased to a greater extent in participants allocated to diuretic therapy compared with placebo (P=0.02). Conclusions-—A combination of low-dose chlorthalidone and amiloride effectively reduces the risk of incident hypertension and beneficially affects left ventricular mass in patients with prehypertension

Composição física da carcaça e qualidade da carne de novilhos jovens e superjovens de diferentes grupos genéticos Carcass physical composition and meat quality of steers and young steers of different genetic groups

Objetivou-se, com este estudo, avaliar a composição física da carcaça e as características qualitativas da carne de novilhos jovens (abatidos aos 22,8 meses de idade) e superjovens (abatidos aos 15,2 meses de idade) dos grupos genéticos 5/8 Charolês (CH) 3/8 Nelore (NE) e 5/8NE 3/8CH e a relação entre as variáveis estudadas. Os animais foram terminados em confinamento até atingirem 430 kg. A dieta alimentar continha relação volumoso:concentrado de 60:40 (base na matéria seca), com 10,25% de proteína bruta e 3,18 Mcal de energia digestível/kg de matéria seca. O delineamento experimental foi o inteiramente casualizado, com seis repetições, em arranjo fatorial 2 x 2 (duas categorias x dois grupos genéticos). Animais jovens apresentaram carcaças com maior porcentagem e quantidade total de músculo (66,45% e 153,93 kg vs 60,27% e 141,00 kg), maior relação músculo:gordura (3,64 vs 2,45) e menor porcentagem e quantidade total de gordura (18,59% e 43,59 kg vs 24,78% e 58,07 kg) e carne com menor grau de marmoreio (6,25 vs 8,42 pontos), menor suculência (6,83 vs 7,34 pontos) e menor teor de lipídios (1,01 vs 1,76%) que os superjovens. Animais jovens apresentaram similaridade para cor (4,42 pontos) e maciez da carne, avaliada tanto pelo painel (6,53 e 6,92 pontos) como pela força de cisalhamento (3,84 e 4,22 kgf/cm&sup3;), que os superjovens. Animais 5/8NE 3/8CH apresentaram carcaças com maior percentagem de gordura (22,43 vs 20,95). O grupo genético dos animais não influenciou a qualidade da carne. A maciez da carne foi positivamente correlacionada com a porcentagem (r = 0,27) e quantidade total (r = 0,31) de gordura na carcaça e com a quantidade de marmoreio (r = 0,28). A suculência da carne também correlacionou-se positivamente com o percentual (r = 0,45) e quantidade total (r = 0,47) de gordura na carcaça. A maciez e suculência da carne correlacionaram-se negativamente com a quebra ao descongelamento da carne (r = -0,23 e -0,31, respectivamente).<br>The objective of this trial was to evaluate the carcass physical composition and meat qualitative characteristics of males of two categories, steers (slaughtered at 22.8 months old) and young steers (slaughtered at 15.2 months old), from two genetic groups, 5/8 Charolais (CH) 3/8 Nellore (NE) and 5/8NE 3/8CH, and to evaluate the relationship among the variables studied. The animals were fedlot finished until reaching 430 kg. The diet, roughage:concentrate ratio of 60:40 (dry matter basis), contained 10.25% crude protein and 3.18 Mcal of digestible energy/kg of dry matter. The experiment was analyzed as a complete randomized design with six replicates, according to a 2 x 2 (two categories x two genetic groups) factorial scheme. Steers showed carcasses with higher percentage and total quantity of muscle (66.45% and 153.93 kg vs. 60.27% and 141.00 kg), higher muscle:fat ratio (3.64 vs. 2.45), carcasses with lower percentage and total quantity of fat (18.59% and 43.59 kg vs. 24.78% and 58.07 kg), meat with less marbling (6.25 vs. 8.42 points), less juiciness (6.83 vs. 7.34 points) and lipid content (1.01 vs. 1.76%) than young steers. Steers showed equal meat color (4.42 points) and similar meat tenderness, evaluated by the test panel (6.53 and 6.92 points) and shear force (3.84 and 4.22 kgf/cm&sup3;) in relation to young steers. The 5/8NE 3/8CH animals showed carcasses with higher fat percentage (22.43 vs. 20.95). Meat quality characteristics were not influenced by genetic group. Meat tenderness was positively correlated with percentual (r = 0.27) and total (r = 0.31) carcass fat, and with marbling score (r = 0.28). Meat juiciness showed positive correlation with percentual (r = 0.45) and total (r = 0.47) carcass fat. The two last ones were negatively associated with thawing loss (r = - 0.23 and -0.31, respectively)

Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023

Note: These guidelines are for information purposes and should not replace the clinical judgment of a physician, who must ultimately determine the appropriate treatment for each patient

Núcleos de Ensino da Unesp: artigos 2013: volume 2: metodologias de ensino e a apropriação de conhecimento pelos alunos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP