Preditores de fibrilação atrial de novo em unidade de cuidados intensivos não cardíaca

OBJECTIVE: To assess the predictors of de novo atrial fibrillation in patients in a non-cardiac intensive care unit. METHODS: A total of 418 hospitalized patients were analyzed between January and September 2016 in a non-cardiac intensive care unit. Clinical characteristics, interventions, and biochemical markers were recorded during hospitalization. In-hospital mortality and length of hospital stay in the intensive care unit were also evaluated. RESULTS: A total of 310 patients were included. The mean age of the patients was 61.0 ± 18.3 years, 49.4% were male, and 23.5% presented de novo atrial fibrillation. The multivariate model identified previous stroke (OR = 10.09; p = 0.016) and elevated levels of pro-B type natriuretic peptide (proBNP, OR = 1.28 for each 1,000pg/mL increment; p = 0.004) as independent predictors of de novo atrial fibrillation. Analysis of the proBNP receiver operating characteristic curve for prediction of de novo atrial fibrillation revealed an area under the curve of 0.816 (p 5,666pg/mL. There were no differences in mortality (p = 0.370), but the lengths of hospital stay (p = 0.002) and stay in the intensive care unit (p = 0.031) were higher in patients with de novo atrial fibrillation. CONCLUSIONS: A history of previous stroke and elevated proBNP during hospitalization were independent predictors of de novo atrial fibrillation in the polyvalent intensive care unit. The proBNP is a useful and easy- and quick-access tool in the stratification of atrial fibrillation risk.Objetivo: Avaliar quais os preditores de fibrilação atrial de novo em doentes de uma unidade de cuidados intensivos não cardíaca. Métodos: Foram analisados 418 doentes internados entre janeiro e setembro de 2016 em uma unidade de cuidados intensivos não cardíaca. Registaram-se as características clínicas, as intervenções efetuadas e os marcadores bioquímicos durante a internação. Avaliaram-se ainda a mortalidade hospitalar e o tempo de internação hospitalar e na unidade de cuidados intensivos. Resultados: Foram incluídos 310 doentes, com média de idades de 61,0 ± 18,3 anos, 49,4% do sexo masculino, 23,5% com fibrilação atrial de novo. O modelo multivariável identificou acidente vascular cerebral prévio (OR de 10,09; p = 0,016) e valores aumentados de proBNP (OR de 1,28 por cada aumento em 1.000pg/mL; p = 0,004) como preditores independentes de fibrilação atrial de novo. A análise por curva Característica de Operação do Receptor do proBNP para predição de fibrilação atrial de novo revelou área sob a curva de 0,816 (p 5.666pg/mL. Não se verificaram diferenças na mortalidade (p = 0,370), porém a duração da internação hospitalar (p = 0,002) e na unidade de cuidados intensivos (p = 0,031) foi superior nos doentes com fibrilação atrial de novo. Conclusões: História de acidente vascular cerebral prévio e proBNP elevado em internação constituíram preditores independentes de fibrilação atrial de novo na unidade de cuidados intensivos polivalente. O proBNP pode constituir ferramenta útil, de fácil e rápido acesso na estratificação do risco de fibrilação atrial.info:eu-repo/semantics/publishedVersio

Statistical stability of equilibrium states for interval maps

We consider families of multimodal interval maps with polynomial growth of the derivative along the critical orbits. For these maps Bruin and Todd have shown the existence and uniqueness of equilibrium states for the potential $\phi_t:x\mapsto-t\log|Df(x)|$, for $t$ close to 1. We show that these equilibrium states vary continuously in the weak$^*$ topology within such families. Moreover, in the case $t=1$, when the equilibrium states are absolutely continuous with respect to Lebesgue, we show that the densities vary continuously within these families.Comment: More details given and the appendices now incorporated into the rest of the pape

Switching a spin-valve back and forth by current-induced domain wall motion

We have studied the current-induced displacement of a domain wall (DW) in the permalloy (Py) layer of a Co/Cu/Py spin valve structure at zero and very small applied field. The displacement is in opposite direction for opposite dc currents, and the current density required to move DW is only of the order of 10^6 A/cm^2. For H = 3 Oe, a back and forth DW motion between two stable positions is observed. We also discuss the effect of an applied field on the DW motion.Comment: 4 pages, 3 figure

The compound Poisson limit ruling periodic extreme behaviour of non-uniformly hyperbolic dynamics

We prove that the distributional limit of the normalised number of returns to small neighbourhoods of periodic points of non-uniformly hyperbolic dynamical systems is compound Poisson. The returns to small balls around a fixed point in the phase space correspond to the occurrence of rare events, or exceedances of high thresholds, so that there is a connection between the laws of Return Times Statistics and Extreme Value Laws. The fact that the fixed point in the phase space is a repelling periodic point implies that there is a tendency for the exceedances to appear in clusters whose average sizes is given by the Extremal Index, which depends on the expansion of the system at the periodic point. We recall that for generic points, the exceedances, in the limit, are singular and occur at Poisson times. However, around periodic points, the picture is different: the respective point processes of exceedances converge to a compound Poisson process, so instead of single exceedances, we have entire clusters of exceedances occurring at Poisson times with a geometric distribution ruling its multiplicity. The systems to which our results apply include: general piecewise expanding maps of the interval (Rychlik maps), maps with indifferent fixed points (Manneville-Pomeau maps) and Benedicks-Carleson quadratic maps.Comment: To appear in Communications in Mathematical Physic

Avaliação Tóxica, Citotóxica e Mutagênica de Arilaminonaftoquinonas Sintéticas

Profa. Dra. Maria do Carmo Pimentel Batitucci, orientador - UFES 2- Profa. Dra. Flávia de Paula, examinador interno - UFES 3- Profa. Dra. Maria Aparecida Marin Morales, examinador externo - UNESP - Rio Claro

Electrical current-driven pinhole formation and insulator-metal transition in tunnel junctions

Current Induced Resistance Switching (CIS) was recently observed in thin tunnel junctions (TJs) with ferromagnetic (FM) electrodes and attributed to electromigration of metallic atoms in nanoconstrictions in the insulating barrier. The CIS effect is here studied in TJs with two thin (20 \AA) non-magnetic (NM) Ta electrodes inserted above and below the insulating barrier. We observe resistance (R) switching for positive applied electrical current (flowing from the bottom to the top lead), characterized by a continuous resistance decrease and associated with current-driven displacement of metallic ions from the bottom electrode into the barrier (thin barrier state). For negative currents, displaced ions return into their initial positions in the electrode and the electrical resistance gradually increases (thick barrier state). We measured the temperature (T) dependence of the electrical resistance of both thin- and thick-barrier states ($R_b$ and R$_B$ respectively). Experiments showed a weaker R(T) variation when the tunnel junction is in the $R_b$ state, associated with a smaller tunnel contribution. By applying large enough electrical currents we induced large irreversible R-decreases in the studied TJs, associated with barrier degradation. We then monitored the evolution of the R(T) dependence for different stages of barrier degradation. In particular, we observed a smooth transition from tunnel- to metallic-dominated transport. The initial degradation-stages are related to irreversible barrier thickness decreases (without the formation of pinholes). Only for later barrier degradation stages do we have the appearance of metallic paths between the two electrodes that, however, do not lead to metallic dominated transport for small enough pinhole radius.Comment: 10 pages, 3 figure