Estudo retrospectivo da incidência de fatores de risco em portadores da doença arterial coronariana / Retrospective study of the incidence of risk factors in carriers of coronary arterial disease

Objetivou-se caracterizar o perfil do paciente portador de Doença Arterial Coronária (DAC) atendido no Instituto Paulista de Doenças Cardiovasculares, no que se refere aos fatores de risco. Para o estudo, cinquenta prontuários de pacientes com DAC foram selecionados aleatoriamente. Laudos de cateterismo (CATE), descrição de sintomas clínicos, e conduta terapêutica, foram coletados para caracterização clínica dos pacientes. O percentual dos fatores de risco obtidos por análise retrospectiva da descrição médica, durante o diagnóstico de DAC, apontou: sedentarismo (92%); Hipertensão Arterial Sistêmica (HAS) (90%); Dislipidemia (DLP) (82%); Diabetes Mellitus (DM) (50%); tabagismo (14%); etilismo (6%); história familiar (14%); e obesidade (18%). Constatou-se uma alta prevalência de fatores de risco para DAC e sobreposição de dois ou mais fatores modificáveis, mostrando a necessidade do incremento de medidas preventivas, a fim de resultar, em uma menor taxa de morbi-mortalidade cardiovascular

Implante de cardioversor-desfibrilador subcutâneo: relato de caso de paciente com taquicardia ventricular induzida por esforço

As complicaçoes relacionadas ao cardioversor-desfibrilador implantável em geral estao relacionadas a implante de cabo-eletrodo transvenoso, fratura do condutor ou ruptura do isolamento de silicone, além de infecçoes. Essas complicaçoes podem ser evitadas com o implante do sistema de cardioversor-desfibrilador implantável totalmente subcutâneo. Relatamos o caso de um paciente de 60 anos de idade, assintomático, com antecedentes de morte súbita cardíaca na família, submetido ao primeiro implante de cardioversor-desfibrilador implantável subcutâneo no Brasil

Regional differences in clinical care among patients with type 1 diabetes in Brazil: Brazilian Type 1 Diabetes Study Group

Background\ud To determine the characteristics of clinical care offered to type 1 diabetic patients across the four distinct regions of Brazil, with geographic and contrasting socioeconomic differences. Glycemic control, prevalence of cardiovascular risk factors, screening for chronic complications and the frequency that the recommended treatment goals were met using the American Diabetes Association guidelines were evaluated.\ud \ud Methods\ud This was a cross-sectional, multicenter study conducted from December 2008 to December 2010 in 28 secondary and tertiary care public clinics in 20 Brazilian cities in north/northeast, mid-west, southeast and south regions. The data were obtained from 3,591 patients (56.0% females and 57.1% Caucasians) aged 21.2 ± 11.7 years with a disease duration of 9.6 ± 8.1 years (<1 to 50 years).\ud \ud Results\ud Overall, 18.4% patients had HbA1c levels <7.0%, and 47.5% patients had HbA1c levels ≥ 9%. HbA1c levels were associated with lower economic status, female gender, age and the daily frequency of self-blood glucose monitoring (SBGM) but not with insulin regimen and geographic region. Hypertension was more frequent in the mid-west (32%) and north/northeast (25%) than in the southeast (19%) and south (17%) regions (p<0.001). More patients from the southeast region achieved LDL cholesterol goals and were treated with statins (p<0.001). Fewer patients from the north/northeast and mid-west regions were screened for retinopathy and nephropathy, compared with patients from the south and southeast. Patients from the south/southeast regions had more intensive insulin regimens than patients from the north/northeast and mid-west regions (p<0.001). The most common insulin therapy combination was intermediate-acting with regular human insulin, mainly in the north/northeast region (p<0.001). The combination of insulin glargine with lispro and glulisine was more frequently used in the mid-west region (p<0.001). Patients from the north/northeast region were younger, non-Caucasian, from lower economic status, used less continuous subcutaneous insulin infusion, performed less SBGM and were less overweight/obese (p<0.001).\ud \ud Conclusions\ud A majority of patients, mainly in the north/northeast and mid-west regions, did not meet metabolic control goals and were not screened for diabetes-related chronic complications. These results should guide governmental health policy decisions, specific to each geographic region, to improve diabetes care and decrease the negative impact diabetes has on the public health system.We thank Mrs. Karianne Aroeira Davidson, Mrs. Anna Maria Ferreira, Mrs. Elisangela Santos and Sandro Sperandei for their technical assistance.This work was supported by grants from Farmanguinhos/Fundação Oswaldo Cruz/National Health Ministry, the Brazilian Diabetes Society, Fundação do Amparo à Pesquisa do Estado do Rio de Janeiro, and Conselho Nacional de Desenvolvimento Científico e Tecnológico do Brasil

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ

Análise do Kahoot! como jogo educativo para o ensino de Química: um estudo com alunos universitários

O ensino de Química no Brasil enfrenta uma série de desafios que impactam negativamente o aprendizado dos alunos. Essas dificuldades estão associadas a diferentes fatores, como a infraestrutura precária de algumas escolas brasileiras e a abordagem utilizada no ensino de Química, em que os conteúdos são apresentados de forma fragmentada, focando principalmente na memorização de fórmulas e conceitos isolados sem fazer nenhum tipo de contextualização com a vivência ou cotidiano dos alunos, dentre outros. Essa abordagem limitada torna a disciplina desinteressante e desmotivadora para os estudantes. Para tentar superar esses obstáculos, professores procuram usar diversas metodologias e estratégias, tentando promover um ensino mais efetivo e interessante para os estudantes. Uma dessas estratégias é o uso de jogos educativos digitais, pois assim pode-se trabalhar com o lúdico e com a tecnologia que é tão presente na vida da maior parte dos estudantes. Nesse contexto, essa monografia teve como objetivo investigar a utilização do Kahoot!® como um jogo educativo no ensino de Química. Em uma metodologia de pesquisa mista, realizada com 26 alunos cursando o primeiro período dos cursos de Química oferecidos pela Universidade Federal Fluminense (Niterói, RJ), de maneira remota os alunos realizaram uma atividade utilizando o Kahoot!®, que envolveu a elaboração e resolução de Quizzes. Os alunos responderam a dois formulários, um antes da intervenção com o Kahoot!® e um depois, buscando saber suas motivações para estudar química, para usar jogos digitais, Quizzes, e como foram suas percepções após a atividade. Os dados da pesquisa mostram que a maioria dos estudantes gostaria que jogos digitais fossem mais utilizados em sala de aula, pois eles se sentem mais motivados para aprender o conteúdo, além de se sentirem motivados ao responder Quizzes. A pesquisa também indicou que a maioria dos alunos prefere jogos colaborativos do que competitivo e além disso, foi possível perceber que de maneira geral, os estudantes tiveram uma percepção positiva com a atividade, apesar de alguns terem relatado dificuldades com a usabilidade da plataforma. Foi possível averiguar que o Kahoot!® não auxiliou no ganho de conhecimento da maneira como a atividade foi conduzida, mas que na percepção dos alunos, é um jogo motivador.The teaching of Chemistry in Brazil faces a series of challenges that negatively impact students' learning. These difficulties are associated with different aspects, such as the precarious infrastructure of some Brazilian schools and the approach used in Chemistry education, in which the contents are presented in a fragmented way, focusing mainly on memorizing formulas and isolated concepts without doing any kind of contextualization with the experience or daily life of the students, among others. This limited approach makes the subject uninteresting and demotivating for students. In an attempt to overcome these obstacles, teachers seek to use various methodologies and strategies to promote more effective and engaging teaching for students. One of these strategies is the use of digital educational games, as they allow for the incorporation of playfulness and technology, which are highly present in the lives of most students. In this context, this monograph aimed to investigate the use of Kahoot!® as an educational game in Chemistry education. Through a mixed-method research approach, conducted with 26 students in the first semester of Chemistry courses offered by the Federal Fluminense University (Niterói, RJ), students remotely participated in the proposed activity using Kahoot!®, which involved the creation and resolution of quizzes. The students completed two questionnaires, one before the intervention with Kahoot!® and one after, aiming to understand how motivated they felt to study chemistry, use digital games, quizzes, and their feelings after the activity. The research data show that the majority of students would like to see more use of digital games in the classroom, as they feel more motivated to learn the content and enjoy responding to quizzes. The research also indicated that most students prefer collaborative games over competitive ones. Furthermore, it was possible to perceive that, in general, students had a positive perception of the activity, although some reported difficulties with the usability of the platform. It was found that Kahoot!® did not contribute to knowledge acquisition in the way the activity was conducted, but according to the students' perception, it is a motivating game.54 p

Risco de fibrilação atrial em longevos

Background: Ageing is an important risk factor for Atrial Fibrillation (AF) and Cardioembolic Stroke. Objectives: To access, in the very elderly, the AF prevalence and risk using a new method and to estimate the embolic risk by a clinical score. Methods: Elderly aged 80 and over were included from a geriatric outpatient assistance. AF risk was estimated using an automated analysis system from a 60- minute electrocardiogram (Stroke Risk Analysis - SRAÒ). The patients were classified according to the exam as low risk (LR), elevated risk (ER) or manifested AF (mAF). We calculated the presumed cardioembolic stroke risk using CHADS2 and CHA2DS2- VASc scores. Results: Data from 307 patients were analyzed, being 237 of them female (77,2%). The mean age was 86,8 years old. mAF was detected in 16 patients (5,2%), ER in 131 (42,7%) and LR in 160 of them (52,1%). For each year old, they were 9% more likely to present ER (p=0,002) and increased 18% the risk of mAF (p=0,017). A high-risk score, whereas CHADS2 ≥ 2 and CHA2DS2-VASc ≥ 4, was identified in 254 (82,7%) and in 247 (80,5%) participants, respectively. Conclusion: In this very elderly population, the AF risk was elevated, as well as the presumed stroke risk. Our results corroborate the importance of the active AF screening and the SRA might be a promising method for this aim.Fundamentos: A idade é um importante fator de risco tanto para a Fibrilação Atrial (FA) quanto para o Acidente Vascular Cerebral (AVC) embólico associado a essa arritmia. Objetivos: Avaliar, em idosos longevos, a prevalência de FA e do risco de FA paroxística (FAP) por um novo método e estimar o escore de risco de eventos embólicos. Métodos: Foram incluídos indivíduos com 80 anos ou mais, de um ambulatório terciário de geriatria de um hospital universitário. O risco de FA foi avaliado por um sistema automatizado (Stroke Risk Analysis - SRAÒ) que utiliza a monitorização eletrocardiográfica de 60 minutos. Os participantes foram classificados como Risco Baixo (RB) ou Elevado (RE) de FAP ou FA manifesta (FAm), conforme o resultado do exame. O risco presumido de embolia foi calculado pelos escores de CHADS2 e CHA2DS2-VASc. Resultados: Foram avaliados 307 longevos, com idade média de 86,8 anos, sendo 237 (77,2%) mulheres. FAm estava presente em 16 (5,2%), RE em 131 (42,7%) e RB em 160 (52,1%) participantes. Cada ano de vida aumentou em 9% o risco de ser classificado como RE (p=0,002) e em 18% o risco de FAm (p=0,017). Escore de alto risco, considerando ≥ 2 no CHADS2 e ≥ 4 no CHA2DS2- VASc, foi identificado em 254 (82,7%) e em 247 (80,5%) participantes, respectivamente. Conclusão: Nessa população de muito idosos, o risco de FAp foi elevado, assim como o risco presumido de embolia. Esses resultados corroboram com a importância da busca ativa pela FA, sendo o SRA um método promissor para essa finalidade.Dados abertos - Sucupira - Teses e dissertações (2019