Correlação e concordância entre medidas ecocardiográficas obtidas durante o exame no ecocardiógrafo com medidas de imagens digitalizadas: estudo transversal

OBJETIVO: Avaliar a correlação e concordância entre medidas ecocardiográficas das dimensões cardíacas, obtidas através do aplicativo Echo off-line (programa para obtenção de medidas de imagens digitalizadas em estação de trabalho dedicada), com as realizadas convencionalmente. MÉTODOS: Estudo transversal, contemporâneo, sendo randomizados 56 pacientes. Através do programa Echo off-line foram mensuradas as medidas ao modo M e 2D ao nível dos ventrículos, do átrio esquerdo e da aorta. Estas medidas foram comparadas às realizadas por outro profissional, através do teste de correlação de Pearson (r), com alfa crítico de 0,05 e pela análise de concordância (Bland e Altman). RESULTADOS: As mensurações realizadas no sistema Echo off-line demonstraram r de 0,85 a 0,98. A análise de concordância mostrou que, para a maioria das medidas, a diferença média entre os métodos foi aproximadamente zero. A variação de valores absolutos não apresentou, em média, significância clínica. O aplicativo Echo off-line permite uma redução de, aproximadamente, 30% no tempo para realização das medidas. CONCLUSÃO: Este trabalho demonstrou a acurácia do programa Echo off-line para mensurar as dimensões cardíacas em estação de trabalho dedicada, podendo ser utilizado rotineiramente nos laboratórios de ecocardiografia

Results of the surgical treatment of chronic atrial fibrillation

OBJECTIVE: Report clinical experience in surgical treatment of atrial fibrillation (AF) by Cox-maze procedure. METHODS: 61 patients underwent surgical treatment for AF. Two had primary AF and 59 AF secondary to heart disease (2 atrial septal defects, 57 mitral). Ages ranged from 20 to 74 years (mean = 49). There were 44 females (72%). The surgical technique employed was Cox 3 without cryoablation. The patients were follow-up in specific at patient clinics and underwent periodical ECG, exercise tests, echocardiogram and Holter monitoring. RESULTS: In-hospital mortality was 4.9% and late mortality 1.6%. A temporary pacemaker was used in 28 (46%) and a definitive in 7 patients (11.4%). On hospital discharge, AF remained in 17%; 63.9% had sinus rhythm, 6.9% atrial rhythm, 1.7% junctional rhythm, and 10.3% had pacemaker rhythm. In the last evaluation, AF was present in 19.5%; (70.5% sinus rhythm, 4% atrial rhythm, 2% atrial tachycardia, and 4% pacemaker rhythm). There was no report of thromboembolic episodes. Chronotropic response was considered adequate in 19%, intermediate in 29%, and inadequate in 42%. In Holter monitoring, the mean heart rate was 82±8 bpm, with a minimum of 57±7 bpm and maximum of 126±23 bpm, with supraventricular extrasystoles in 2.3±5.5% of the total heartbeats and ventricular extrasystoles in 0.8±0.5%. In the echocardiogram, the A wave was present in the left atrium in 87.5%. CONCLUSION: Maze procedure is effective and has acceptable surgical risk. Atrial or sinus rhythms remain stable with a small but remarkable frequency of atrial and ventricular arrhythmias. Left atrial contraction is present, although attenuated, as well as the chronotropic response to exercise

The Ethical Compass: Establishing ethical guidelines for research practices in sports medicine and exercise science

Objective: Research in sports medicine and exercise science has experienced significant growth over recent years. With this expansion, there has been a concomitant rise in ethical challenges specific to these disciplines. While various ethical guidelines exist for numerous scientific fields, a comprehensive set tailored specifically for sports medicine and exercise science is lacking. Aiming to bridge this gap, this paper proposes a comprehensive, updated set of ethical guidelines specifically targeted at researchers in sports medicine and exercise science, providing them with a thorough framework to ensure research integrity. Methods: A collaborative approach was adopted, involving contributions from a diverse group of international experts in the field. A thorough review of existing ethical guidelines was conducted, followed by the identification and detailed examination of 15 specific ethical topics relevant to the discipline. Each topic was discussed in terms of its definition, consequences, and preventive measures. Results: The research in sports medicine and exercise science has grown significantly, bringing to the fore ethical challenges unique to these disciplines. Our comprehensive review identifies 15 key ethical challenges: plagiarism, data falsification, role of artificial intelligence chatbots in academic writing, overstating results, excessive/strategic self-citation, duplicate publications, non-disclosure of conflicts of interest, image manipulation, misuse of peer review, ghost and gift authorship, inadequate data retention, data fabrication, falsification of IRB approvals, lack of informed consent, and unethical human or animal experimentation. For each identified challenge, we propose practical solutions and best practices, enriched by the diverse perspectives of our collaborative international expert panel. This endeavor aims to offer a foundational set of ethical guidelines tailored to the nuanced needs of sports medicine and exercise science, ensuring research integrity and promoting ethical responsibility across these vital fields. Conclusion: This article represents a seminal contribution to the establishment of essential ethical guidelines specifically designed for the fields of sports medicine and exercise science. This article charts a clear course for researchers, clinicians, and policymakers by integrating these ethical principles at the heart of our scholarly and clinical activities. Consequently, it envisions a future where the principles of research integrity and ethical responsibility consistently inform every scientific discovery and every clinical engagement