16 research outputs found

    Registro Brasileiro de Marcapassos: Resultados Obtidos no Primeiro Quadrimestre de 1995 - Departamento de Estimulaçao Cardíaca Artificial (Deca)

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    O Registro Brasileiro de Marcapassos (RBM) é uma base de dados nacional. que tem por finalidade coletar e divulgar informaçoes concernentes aos procedimentos cirúrgicos realizados em pacientes que utilizam a estimulação cardíaca artificial permanente em todo o Brasil. No período de 01/01/95 a 31/04/95 foram recebidos 2620 formulários enviados por 113 hospitais e 228 médicos diferentes. Os procedimentos referiam-se a 1911 implantes iniciais (74,1 %); 650 reoperações (25,2%) e 17 formulários exibiam esse campo de cadastramento como dado nao disponível (0,7%). Dos 1911 pacientes submetidos a implante inicial, 50,6% eram do sexo masculino e 77,9% eram da raça branca. Sintomas de hipofluxo cerebral justificaram o implante em 80,6% dos pacientes e a insuficiência cardíaca congestiva esteve presente em 89,2%. Os achados eletrocardiográficos predominantes foram: bloqueio atrioventricular total (58,6%); disfunçao do nó sinusal (15,8%), bloqueio AV do 2º grau (13,5%) e flütter ou fibrilaçao atrial com baixa resposta ventricular (6,9%). A doença de Chagas foi a etiologia predominante (32,5%). Foi realizado implante de marcapasso ventricular em 79,2% dos pacientes e atrioventricular em 20,5%. Dos 650 casos de reoperações informados, 73,9% ocorreram por problema no gerador de pulsos. O tempo transcorrido entre o implante inicial e a cirurgia descrita variou de 1 mês a 25 anos com média de 12,6 anos. A substituição do gerador de pulsos foi informada em 584 pacientes (89,9% dos casos de reoperaçao); sendo a principal causa de troca o esgotamento por fim de vida do gerador em 82,4%. A substituiçao de eletrodo atrial foi relatada em 7 pacientes e de eletrodo ventricular em 100 pacientes

    Pervasive gaps in Amazonian ecological research

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    Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

    Pervasive gaps in Amazonian ecological research

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    Pervasive gaps in Amazonian ecological research

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    Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

    Pervasive gaps in Amazonian ecological research

    Get PDF
    Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

    Experiência brasileira com uso de marcapasso cardíaco artificial: resultados atuais obtidos pelo Registro Brasileiro de Marcapassos - RBM Brazilian permanent cardiac pacemaker implantation experience: results obtained from the Brazilian Pacemaker Register's data

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    FUNDAMENTOS: Registro Brasileiro de Marcapassos (RBM) é uma base nacional de dados que tem por finalidade coletar e divulgar informações concernentes aos procedimentos cirúrgicos realizados em pacientes com estimulação cardíaca artificial permanente em todo o Brasil. OBJETIVO: Apresentar os resultados obtidos no período de junho a dezembro de 1994. CASUÍSTICA: No período de 1/6/94 a 31/12/94 foram recebidos 4696 formulários enviados por 130 hospitais e 287 médicos. Os procedimentos referiam-se a 3403 (72,5%) implantes iniciais a 1053 (22,4%) reoperações e 240 (5,1%) formulários exibiam este campo de cadastramento como dado não disponível. RESULTADOS: Dos 3403 pacientes submetidos a implante inicial, 52,8% eram do sexo masculino e 73,7% eram da raça branca. Sintomas de hipofluxo cerebral justificaram o implante em 76,4% dos pacientes e a insuficiência cardíaca congestiva esteve presente em 85,0% dos casos, sendo que em 266 (7,9%) pacientes foi a causa principal para a operação. Os achados eletrocardiográficos predominantes foram: bloqueio atrioventricular total (57,7%); disfunção do nó sinusal (13,9%), bloqueio AV do 2º grau (13,8%); e flütter ou fibrilação atrial com baixa resposta ventricular (6,6%). A doença de Chagas foi a etiologia predominante (30,4%). Implante de marcapasso ventricular foi realizado em 83,6% dos pacientes e atrioventricular em 16,1%. Dos 1053 casos de reoperações informados, 50,4% ocorreram por problemas no gerador de pulsos. O tempo transcorrido entre o implante inicial e a cirurgia atual variou de 1 mês a 24 anos, com média de 7,1 anos. A susbstituição do gerador de pulsos foi informada em 917 pacientes (87,0% dos casos de reoperação); sendo a principal causa de troca o esgotamento por fim de vida em 65,7%. A substituição de eletrodo atrial foi relatada em 21 pacientes e de eletrodo ventricular em 203 pacientes. CONCLUSÕES: A participação ativa de todos os membros do Departamento de Estimulação Cardíaca Artificial (DECA), com o apoio das empresas fornecedoras de marcapasso, e o respaldo do Ministério da Saúde permitiram que a implantação do RBM ocorresse da forma mais tranqüila possível. Hoje se dispõe de uma estatística nacional, volumosa e confiável, sobre a cirurgia de marcapasso no Brasil. As dificuldades enfrentadas estão relacionadas, principalmente, à estrutura individual de coleta de dados e a graus variados de familiaridade com o formulário, dificuldades estas que, com o tempo, tenderão a desaparecer.BACKGROUND: Brazilian Pacemaker Registry (RBM) is a nationwide database to collect informations about all permanent pacemaker procedures performed in Brazil. It is a task force composed by Medical Society, Health Ministeryand Pacemaker Companies. OBJECTIVE: To report the data obtained from June to December, 1994. METHODS: From June 1 st to December 31,1994,4696 surgical procedures for permanent cardiac pacing were informed. These procedures were 3403 (72,5%) initial implantations, 1053 (22.4%) re-operations and in 240 cases this information was non-available. RESULTS: From 3403 initial implantations informed, 52.8% were males and 73.7% Caucasians. Preoperative dizziness or syncopes were refered in 76.4% and congestive heart failure in 85.0% of the patients. EKG evaluation showed 3rd degree atrioventricular (AV) block in 57.7%, sick sinus syndrome in 13.9%, 2nd degree AV block in 13.8%, and high degree AV block and flutter or atrial fibrillation in 6.6% of patients. Chaga's disease was the prédominât ethiology (30.4%). Ventricular pacemakers were implanted in 83.6% of cases, atrioventricular in 16.1 % and atrial pacing in 0.3%. In the 1053 cases of re-operation, the interval between the initial implantation and the present procedure ranged from 1 month to 24 years (M=7.1 years). Pulse generator replacements were refered in 917 patients (87.0% of re-operation procedures), 65.7% of them at the end of life. Atrial lead replacement were performed in 21, and ventricular lead replacement in 203 patients

    Marcapasso bi-atrial epicárdico subxifóide na obstrução da veia cava superior Bi-atrial subxiphoid epicardial pacemaker in superior vena cava syndrome

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    Um paciente portador de marcapasso definitivo bi-atrial-ventricular por fibrilação atrial paroxística e bradicardia sinusal, em uso crônico de anticoagulante oral, apresentou sinais clínicos da síndrome da veia cava superior. A venografia por subtração digital mostrou obstrução total do tronco braquiocefálico venoso direito e grande dificuldade de fluxo sangüíneo da veia inominada para a veia cava superior. A abordagem terapêutica constou da remoção completa do sistema transvenoso seguida de reimplante do sistema bi-atrial-ventricular por técnica epimiocárdica pela via subxifóide assistida por fluoroscopia.<br>A patient with a bi-atrial-ventricular permanent pacemaker due to paroxystic atrial fibrillation associated to sinus bradycardia, in chronic use of oral anticoagulant, presented clinical signs of superior vena cava syndrome. Digital subtraction venography showed total obstruction of the right brachiocephalic venous trunk and severe stenosis of the connection of the left trunk to the superior vena cava. The therapeutic approach consisted of complete removal of transvenous system followed by re-implant of the bi-atrial-ventricular system using an epicardial subxiphoid access with fluoroscopic assistanc
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