Left ventricular false aneurysm characterized by cardiovascular magnetic resonance and late enhancement technique

Left ventricular pseudoaneurysm is a rare complication of myocardial infarction. Differentiation between true and false aneurysms, although difficult, is crucial, because of the different treatment options they entail. We present a rare case of a giant pseudoaneurysm of the left ventricle related with a previous myocardial infarction. The present case highlights the pivotal role of magnetic resonance imaging for differential diagnosis between these entities

Left ventricular false aneurysm characterized by cardiovascular magnetic resonance and late enhancement technique

Left ventricular pseudoaneurysm is a rare complication of myocardial infarction. Differentiation between true and false aneurysms, although difficult, is crucial, because of the different treatment options they entail. We present a rare case of a giant pseudoaneurysm of the left ventricle related with a previous myocardial infarction. The present case highlights the pivotal role of magnetic resonance imaging for differential diagnosis between these entities

A parallel finite volume method for incompressible and slightly compressible reactive flows

Copyright © 2022 The Authors. In this article, a parallel formulation of the finite volume method is presented for solving three-dimensional, turbulent, mixed, reactive, and slightly compressible flows. It can also be used for incompressible laminar/turbulent flows. The method is designed for nonorthogonal meshes, and oscillations caused by the advective terms are treated by a deferred correction technique. The chosen finite volume scheme is cell centered. The studied fluid is a single-phase multicomponent gas with Newtonian behavior. The focus is mainly on gas mixtures with predominance of N 2 , since the chemical reaction of greatest interest is the combustion process in the air. The buoyancy is caused by the gradient of the specified mass, which is a function of the temperature and the composition of the gas mixture. The mathematical model uses an approximation for low Mach numbers, describing slightly compressible flows. The coupling between the fluid dynamic equations is given by the nonlinear Picard's method, with the pressure-velocity coupling treatment given by the SIMPLE algorithm (semi-implicit method for pressure-linked equations). The complete mathematical model includes the sensitive enthalpy equation for the conservation of energy. The LES (large eddy simulation) model is used for modeling the turbulence. The chemical reactions are implemented using the EDC (eddy dissipation concept) and the EDM (eddy dissipation model) approaches. The parallel strategy is based on a subdomain-by-subdomain approach, and uses the MPI and OpenMP standards in a hybrid parallel scheme. Compressed data structures are used to store the matrix coefficients.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, Brazil), Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES, Brazil)

Plasmacytoma of the lumbar spine

Solitary bone plasmacytoma is a plasma cell disorder characterized by the formation of a single tumor in the bone. Most commonly, the tumor develops in the spine, and is progressively less frequent in the pelvis, ribs, upper extremities, skull, femur and sternum. Symptoms are mainly local. In most cases, multiple myeloma ensues, conferring it a poor prognosis. The authors describe the case of a 53-year-old male patient who presented with persistent low back pain without apparent cause until a radiography of the lumbar spine was performed. It revealed a lytic lesion, which was proven to be a plasmacytoma after a computed tomography guided biopsy

Perfil da fluência: comparação entre falantes do Português Brasileiro e do Português Europeu

The purpose of the study was to compare the speech fluency of Brazilian Portuguese speakers with that of European Portuguese speakers. The study participants were 76 individuals of any ethnicity or skin color aged 18–29 years. Of the participants, 38 lived in Brazil and 38 in Portugal. Speech samples from all participants were obtained and analyzed according to the variables of typology and frequency of speech disruptions and speech rate. Descriptive and inferential statistical analyses were performed to assess the association between the fluency profile and linguistic variant variables. We found that the speech rate of European Portuguese speakers was higher than the speech rate of Brazilian Portuguese speakers in words per minute (p=0.004). The qualitative distribution of the typology of common dysfluencies (p<0.001) also discriminated between the linguistic variants. While a speech fluency profile of European Portuguese speakers is not available, speech therapists in Portugal can use the same speech fluency assessment as has been used in Brazil to establish a diagnosis of stuttering, especially in regard to typical and stuttering dysfluencies, with care taken when evaluating the speech rate.O objetivo do estudo foi comparar a fluência de fala de falantes do Português Brasileiro com a de falantes do Português Europeu. Participaram deste estudo 76 indivíduos, sem distinção de raça e cor, com idades entre 18 e 29 anos, sendo 38 residentes no Brasil e 38 em Portugal. Foram obtidas amostras de fala de todos os participantes e analisadas segundo as variáveis de tipologia e frequência das disfluências e velocidade de fala. Foi realizada análise estatística descritiva e inferencial para verificar a associação entre as variáveis do perfil da fluência e da variante linguística. Foi observado que a velocidade de fala dos falantes do Português Europeu em palavras por minuto (p=0,004) é maior que a dos falantes do Português Brasileiro. A distribuição qualitativa das tipologias das disfluências comuns (p<0,001) também diferencia as variantes linguísticas. Enquanto não há um perfil de fluência de fala dos falantes do Português Europeu, para se estabelecer um diagnóstico de gagueira, os fonoaudiólogos podem utilizar em Portugal a mesma avaliação de fluência de fala utilizada no Brasil, principalmente no que se refere às disfluências comuns e gagas, tendo cuidado apenas no que se refere à velocidade de falaFundação de Amparo à Pesquisa do Estado de Minas Gerais (CDS – APQ – 02141-11)info:eu-repo/semantics/publishedVersio

Evolução na utilização e nos gastos de uma operadora de saúde

Brazil’s aging population and the rising number of people reliant upon the country’s supplementary healthcare system have elicited the concern of public and private managers regarding the increase in healthcare costs. In this paper, the costs per gender, per type of medical expenses and per age group of a major Brazilian self-managed healthcare provider between 2007 and 2013 were analyzed. This healthcare provider is of interest because, besides portraying a single condition of revenue growth restricted to the existing contributors, it also replicates the demographic profile expected for Brazil in 2050, when approximately one-third of its population will be over 60 years of age. The analyses confirm the current literature as they show an increase in healthcare plan usage by the elderly and the difference between admission rates by gender. They also reveal an increase in average length of stay in hospital and the increase in medical costs far above inflation, especially for materials and medicines. It is hoped that this study will help scholars and others interested in comparisons of medical expense trends, especially by age and sex, and that it encourages further collaboration on the sustainability of health insurance providers in Brazil

Evaluation of record linkage of two large administrative databases in a middle income country: stillbirths and notifications of dengue during pregnancy in Brazil

BACKGROUND: Due to the increasing availability of individual-level information across different electronic datasets, record linkage has become an efficient and important research tool. High quality linkage is essential for producing robust results. The objective of this study was to describe the process of preparing and linking national Brazilian datasets, and to compare the accuracy of different linkage methods for assessing the risk of stillbirth due to dengue in pregnancy. METHODS: We linked mothers and stillbirths in two routinely collected datasets from Brazil for 2009–2010: for dengue in pregnancy, notifications of infectious diseases (SINAN); for stillbirths, mortality (SIM). Since there was no unique identifier, we used probabilistic linkage based on maternal name, age and municipality. We compared two probabilistic approaches, each with two thresholds: 1) a bespoke linkage algorithm; 2) a standard linkage software widely used in Brazil (ReclinkIII), and used manual review to identify further links. Sensitivity and positive predictive value (PPV) were estimated using a subset of gold-standard data created through manual review. We examined the characteristics of false-matches and missed-matches to identify any sources of bias. RESULTS: From records of 678,999 dengue cases and 62,373 stillbirths, the gold-standard linkage identified 191 cases. The bespoke linkage algorithm with a conservative threshold produced 131 links, with sensitivity = 64.4% (68 missed-matches) and PPV = 92.5% (8 false-matches). Manual review of uncertain links identified an additional 37 links, increasing sensitivity to 83.7%. The bespoke algorithm with a relaxed threshold identified 132 true matches (sensitivity = 69.1%), but introduced 61 false-matches (PPV = 68.4%). ReclinkIII produced lower sensitivity and PPV than the bespoke linkage algorithm. Linkage error was not associated with any recorded study variables. CONCLUSION: Despite a lack of unique identifiers for linking mothers and stillbirths, we demonstrate a high standard of linkage of large routine databases from a middle income country. Probabilistic linkage and manual review were essential for accurately identifying cases for a case-control study, but this approach may not be feasible for larger databases or for linkage of more common outcomes