Data analytics for data variety

A internet fez com que os gestores das organizações tivessem acesso a grandes quantidades de dados e esses dados são apresentados em diferentes formatos, em concreto, estruturados, semiestruturados e não estruturados. Esta variedade de dados é essencialmente proveniente das redes sociais, mas não só, também são provenientes da Internet of Things. Verifica-se para os dados estruturados que existem técnicas validadas, estudadas e maduras, mas para os outros tipos de dados, ou seja, semiestruturados e não estruturados tal já não se verifica. Neste poster, é apresentado um conjunto de técnicas de análise de dados para os dados semiestruturados e não estruturados, utilizando como principal bibliografia conferências de investigação na área de análise de dados.Through the Internet, the organizations managers had access to massive amounts of data and these data are presented in different formats, namely, structured, semi-structured and unstructured. These variety of data is essentially generated from social networks, but not only, they also are generated from the Internet of Things, from machines, sensors, among others. While the structured data has techniques well studied, mature and validated, otherwise the other types of techniques, semi-structured and unstructured, this is no longer true. In this poster, a set of data analysis techniques is presented for the semi-structured and unstructured data by using as main bibliography data analytics conferences.(undefined)info:eu-repo/semantics/publishedVersio

Treatment of patients with aortic atherosclerotic disease with paclitaxel-associated lipid nanoparticles

OBJECTIVE: The toxicity of anti-cancer chemotherapeutic agents can be reduced by associating these compounds, such as the anti-proliferative agent paclitaxel, with a cholesterol-rich nanoemulsion (LDE) that mimics the lipid composition of low-density lipoprotein (LDL). When injected into circulation, the LDE concentrates the carried drugs in neoplastic tissues and atherosclerotic lesions. In rabbits, atherosclerotic lesion size was reduced by 65% following LDE-paclitaxel treatment. The current study aimed to test the effectiveness of LDE-paclitaxel on inpatients with aortic atherosclerosis. METHODS: This study tested a 175 mg/m2 body surface area dose of LDE-paclitaxel (intravenous administration, 3/3 weeks for 6 cycles) in patients with aortic atherosclerosis who were aged between 69 and 86 yrs. A control group of 9 untreated patients with aortic atherosclerosis (72-83 yrs) was also observed. RESULTS: The LDE-paclitaxel treatment elicited no important clinical or laboratory toxicities. Images were acquired via multiple detector computer tomography angiography (64-slice scanner) before treatment and at 1-2 months after treatment. The images showed that the mean plaque volume in the aortic artery wall was reduced in 4 of the 8 patients, while in 3 patients it remained unchanged and in one patient it increased. In the control group, images were acquired twice with an interval of 6-8 months. None of the patients in this group exhibited a reduction in plaque volume; in contrast, the plaque volume increased in three patients and remained stable in four patients. During the study period, one death unrelated to the treatment occurred in the LDE-paclitaxel group and one death occurred in the control group. CONCLUSION: Treatment with LDE-paclitaxel was tolerated by patients with cardiovascular disease and showed the potential to reduce atherosclerotic lesion size

Integrações terapêuticas em cirurgia oral de paciente idoso e sistemicamente comprometido: Relato de caso/ Therapeutic integrations in oral surgery of an elderly and systemically compromised patient: Case report

O envelhecimento é um processo natural e gradativo que gera limitações morfológicas, funcionais e bioquímicas no organismo, tornando-o vulnerável ao desenvolvimento de doenças. O idoso apresenta diversas necessidades cirúrgicas, contudo, a presença de alterações sistêmicas, deficiências nutricionais e idade torna o caso especial, necessitando abordagem integral, personalizada e multiprofissional. Diante da variabilidade de doenças e individualidade que o idoso apresenta, o presente estudo tem por objetivo relatar um caso clínico que se fez necessário integrações terapêuticas na cirurgia oral de uma paciente idosa com doenças sistêmicas. Paciente, gênero feminino, 74 anos, hipertensa e diabética, foi encaminhada pelo cardiologista ao ambulatório de Cirurgia Oral da Faculdade Adventista da Bahia, queixando-se de dor em região posterior de mandíbula. Ao exame físico intraoral, notou-se: prótese total superior e inferior, dente 48 semi incluso, cariado e trauma entre mucosa pericoronária e prótese. Na radiografia panorâmica foi observado sinais sugestivos de proximidade do dente com o canal mandibular e base da mandíbula, indicando risco de parestesia e fratura em tentativa de exodontia. Solicitou-se tomografia computadorizada, que confirmou a intima relação. Foi adotado como conduta a coronectomia, sob anestesia local, aplicação de laser vermelho 2J/cm2, em quatro pontos, por 30 segundos no pós operatório imediato seguido de orientação dietética e indicação de fisioterapia. O acompanhamento clínico radiográfico, constatou-se boa cicatrização tecidual e reparo ósseo adequado, evidenciando eficácia da terapêutica aplicada

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Relatório da prática de ensino supervisionada

Nas últimas décadas, a preocupação com o controlo do treino tem aumentado. Hoje em dia, os olhos não estão apernas virados para os aspetos técnicos e táticos do jogo. A condição física e disposição para a prática do atleta, são variáveis que entram na equação da gestão da equipa e do plantel. O avanço científico e tecnológico nesta área, vem comprovar esta evolução.N/

Prognostic risk stratification in Chagas cardiomyopathy through myocardial fibrosis evaluation by cardiac magnetic resonance

Introdução: A miocardiopatia chagásica (MC) apresenta pior prognóstico que as etiologias isquêmica e não isquêmica de miocardiopatia, e acarreta alto custo. A fibrose miocárdica (FM) detectada pela Ressonância Magnética Cardíaca (RMC) mostrou-se um fator preditor independente de risco aumentado em diversas etiologias de insuficiência cardíaca. Na MC, a FM foi associada com marcadores conhecidos de pior prognóstico, como a disfunção ventricular esquerda e arritmia ventricular. Nossa hipótese é que a FM é um fator preditor independente de pior prognóstico na MC. Objetivos: Buscamos estabelecer o valor prognóstico da FM detectada pela RMC na predição de uma combinação de desfechos duros ou do desfecho secundário mortalidade por todas as causas. Adicionalmente, avaliamos se o valor prognóstico da FM é independente do Escore de Rassi. Métodos: Pacientes com MC foram incluídos retrospectivamente após a realização da RMC, que avaliou volumes e função cardíacos, além de quantificar a FM. Dados clínicos, de imagem e seguimento foram registrados, e o desfecho primário foi a combinação de mortalidade por todas as causas, transplante cardíaco, terapia antitaquicardia ou choque apropriado pelo cardiodesfibrilador implantável e morte súbita cardíaca abortada; o desfecho secundário foi mortalidade por todas as causas. Resultados: Foram incluídos no estudo130 pacientes, a maioria de mulher (53,9%), com idade média de 53,6±11,5 anos. A maioria dos pacientes (68,4%) não tinha sintomas de insuficiência cardíaca, apesar da dilatação ventricular esquerda (54%) e alterações da contratilidade (65,9%) serem comuns. A RMC mostrou dilatação do ventrículo esquerdo (volume diastólico final indexado médio de 118,6±50,5ml/m²) e disfunção sistólica (fração de ejeção média de 43,2±16,3%) e a FM foi identificada em 76,1%, massa média de 15,2±16,5g. Ao longo do seguimento médio de 6,8 anos, 58 (44,6%) pacientes atingiram o desfecho combinado e 45 (34,6%) faleceram. A MF associou-se ao desfecho primário como variável contínua (Razão de risco (RR) ajustada 1,031 (Intervalo de Confiança (IC) 95% 1,013-1,049; p=0.001) e nos pacientes com FM extensa ( >= 12,3g) (RR ajustado 2,107 (IC 95% 1,111-3,994I; p=0,022)) de forma independente ao Escore de Rassi. A FM expressa como variável contínua também se associou à morte por todas as causas (RRajustado1,028 (IC 95% 1,005-1,051; p=0,017)) de forma independente do Escore de Rassi, exceto quando analisada como variável categórica. Conclusões: A fibrose miocárdica é um preditor independente de pior prognóstico na miocardiopatia chagásica. Nossos dados apoiam o uso da RMC para estratificar melhor o risco nessa população e, possivelmente, guiar o tratamentoBackground: Chagas cardiomyopathy (CC) portends worse prognosis than ischemic and other non-ischemic cardiomyopathies and carries a high economic burden. Myocardial fibrosis (MF) detected by cardiac magnetic resonance (CMR) has been demonstrated as an independent predictor of increased risk in several etiologies of heart failure. In CC, MF has been associated with know risk factors of poor outcome, such as left ventricular dysfunction and ventricular arrhythmia. We hypothesized that MF is an independent predictor of worse prognosis in CC. Objectives: we sought to determine the prognostic value of MF detected by CMR in predicting a combined endpoint of hard events or the secondary outcome of all-cause mortality. In addition, we evaluated if the prognostic value of MF is independent of the Rassi risk score. Methods: patients with CC were retrospectively followed after CMR evaluation of cardiac volumes, function and MF quantification. Clinical, imaging and follow-up data were recorded and the primary outcome was a combination of all-cause mortality, heart transplantation, anti-tachycardia pacing or appropriate shock from an implantable cardiac defibrillator and aborted sudden cardiac death; the secondary outcome was all-cause death. Results: 130 patients were included in the study, with a majority of females (53.9%) and a mean age of 53.6±11.5 years. Most patients (68.4%) had no symptoms of heart failure, even though left ventricular dilatation (54%) and wall-motion abnormalities (65.9%) were common. On CMR, left ventricular dilatation (mean end-diastolic volume index 118.6±50.5ml/m²) and dysfunction (mean ejection fraction 43.2±16.3%) were observed and MF was found in 76.1%, with a mean mass of 15.2±16.5g. Over a mean follow-up of > 6.2 years, 58 (44.6%) patients reached the combined endpoint and 45 (34.6%) patients died. Myocardial fibrosis mass was associated with the primary outcome both as continuous variable (adjusted HR 1.031 (1.013-1.049 95% CI; p=0.001) and in patients with extensive MF ( >= 12.3g) (adjusted HR 2.107 (1.111-3.994 95% CI; p=0.022), independently from the Rassi Score. Myocardial fibrosis mass expressed as a continuous variable was also associated with all-cause death (adjusted HR 1.028 (1.005-1.051 95% CI; p=0.017) independently from the Rassi Score, but not when analyzed as a categorical variable. Conclusions: Myocardial fibrosis is an independent predictor of adverse outcome in Chagas cardiomyopathy. Our data support the use of CMR in better stratifying risk in this population and possibly guiding therap

Prognostic risk stratification in Chagas cardiomyopathy through myocardial fibrosis evaluation by cardiac magnetic resonance

Introdução: A miocardiopatia chagásica (MC) apresenta pior prognóstico que as etiologias isquêmica e não isquêmica de miocardiopatia, e acarreta alto custo. A fibrose miocárdica (FM) detectada pela Ressonância Magnética Cardíaca (RMC) mostrou-se um fator preditor independente de risco aumentado em diversas etiologias de insuficiência cardíaca. Na MC, a FM foi associada com marcadores conhecidos de pior prognóstico, como a disfunção ventricular esquerda e arritmia ventricular. Nossa hipótese é que a FM é um fator preditor independente de pior prognóstico na MC. Objetivos: Buscamos estabelecer o valor prognóstico da FM detectada pela RMC na predição de uma combinação de desfechos duros ou do desfecho secundário mortalidade por todas as causas. Adicionalmente, avaliamos se o valor prognóstico da FM é independente do Escore de Rassi. Métodos: Pacientes com MC foram incluídos retrospectivamente após a realização da RMC, que avaliou volumes e função cardíacos, além de quantificar a FM. Dados clínicos, de imagem e seguimento foram registrados, e o desfecho primário foi a combinação de mortalidade por todas as causas, transplante cardíaco, terapia antitaquicardia ou choque apropriado pelo cardiodesfibrilador implantável e morte súbita cardíaca abortada; o desfecho secundário foi mortalidade por todas as causas. Resultados: Foram incluídos no estudo130 pacientes, a maioria de mulher (53,9%), com idade média de 53,6±11,5 anos. A maioria dos pacientes (68,4%) não tinha sintomas de insuficiência cardíaca, apesar da dilatação ventricular esquerda (54%) e alterações da contratilidade (65,9%) serem comuns. A RMC mostrou dilatação do ventrículo esquerdo (volume diastólico final indexado médio de 118,6±50,5ml/m²) e disfunção sistólica (fração de ejeção média de 43,2±16,3%) e a FM foi identificada em 76,1%, massa média de 15,2±16,5g. Ao longo do seguimento médio de 6,8 anos, 58 (44,6%) pacientes atingiram o desfecho combinado e 45 (34,6%) faleceram. A MF associou-se ao desfecho primário como variável contínua (Razão de risco (RR) ajustada 1,031 (Intervalo de Confiança (IC) 95% 1,013-1,049; p=0.001) e nos pacientes com FM extensa ( >= 12,3g) (RR ajustado 2,107 (IC 95% 1,111-3,994I; p=0,022)) de forma independente ao Escore de Rassi. A FM expressa como variável contínua também se associou à morte por todas as causas (RRajustado1,028 (IC 95% 1,005-1,051; p=0,017)) de forma independente do Escore de Rassi, exceto quando analisada como variável categórica. Conclusões: A fibrose miocárdica é um preditor independente de pior prognóstico na miocardiopatia chagásica. Nossos dados apoiam o uso da RMC para estratificar melhor o risco nessa população e, possivelmente, guiar o tratamentoBackground: Chagas cardiomyopathy (CC) portends worse prognosis than ischemic and other non-ischemic cardiomyopathies and carries a high economic burden. Myocardial fibrosis (MF) detected by cardiac magnetic resonance (CMR) has been demonstrated as an independent predictor of increased risk in several etiologies of heart failure. In CC, MF has been associated with know risk factors of poor outcome, such as left ventricular dysfunction and ventricular arrhythmia. We hypothesized that MF is an independent predictor of worse prognosis in CC. Objectives: we sought to determine the prognostic value of MF detected by CMR in predicting a combined endpoint of hard events or the secondary outcome of all-cause mortality. In addition, we evaluated if the prognostic value of MF is independent of the Rassi risk score. Methods: patients with CC were retrospectively followed after CMR evaluation of cardiac volumes, function and MF quantification. Clinical, imaging and follow-up data were recorded and the primary outcome was a combination of all-cause mortality, heart transplantation, anti-tachycardia pacing or appropriate shock from an implantable cardiac defibrillator and aborted sudden cardiac death; the secondary outcome was all-cause death. Results: 130 patients were included in the study, with a majority of females (53.9%) and a mean age of 53.6±11.5 years. Most patients (68.4%) had no symptoms of heart failure, even though left ventricular dilatation (54%) and wall-motion abnormalities (65.9%) were common. On CMR, left ventricular dilatation (mean end-diastolic volume index 118.6±50.5ml/m²) and dysfunction (mean ejection fraction 43.2±16.3%) were observed and MF was found in 76.1%, with a mean mass of 15.2±16.5g. Over a mean follow-up of > 6.2 years, 58 (44.6%) patients reached the combined endpoint and 45 (34.6%) patients died. Myocardial fibrosis mass was associated with the primary outcome both as continuous variable (adjusted HR 1.031 (1.013-1.049 95% CI; p=0.001) and in patients with extensive MF ( >= 12.3g) (adjusted HR 2.107 (1.111-3.994 95% CI; p=0.022), independently from the Rassi Score. Myocardial fibrosis mass expressed as a continuous variable was also associated with all-cause death (adjusted HR 1.028 (1.005-1.051 95% CI; p=0.017) independently from the Rassi Score, but not when analyzed as a categorical variable. Conclusions: Myocardial fibrosis is an independent predictor of adverse outcome in Chagas cardiomyopathy. Our data support the use of CMR in better stratifying risk in this population and possibly guiding therap

Treatment of patients with aortic atherosclerotic disease with paclitaxel-associated lipid nanoparticles

OBJECTIVE: The toxicity of anti-cancer chemotherapeutic agents can be reduced by associating these compounds, such as the anti-proliferative agent paclitaxel, with a cholesterol-rich nanoemulsion (LDE) that mimics the lipid composition of low-density lipoprotein (LDL). When injected into circulation, the LDE concentrates the carried drugs in neoplastic tissues and atherosclerotic lesions. In rabbits, atherosclerotic lesion size was reduced by 65% following LDE-paclitaxel treatment. The current study aimed to test the effectiveness of LDE-paclitaxel on inpatients with aortic atherosclerosis. METHODS: This study tested a 175 mg/m2 body surface area dose of LDE-paclitaxel (intravenous administration, 3/3 weeks for 6 cycles) in patients with aortic atherosclerosis who were aged between 69 and 86 yrs. A control group of 9 untreated patients with aortic atherosclerosis (72-83 yrs) was also observed. RESULTS: The LDE-paclitaxel treatment elicited no important clinical or laboratory toxicities. Images were acquired via multiple detector computer tomography angiography (64-slice scanner) before treatment and at 1-2 months after treatment. The images showed that the mean plaque volume in the aortic artery wall was reduced in 4 of the 8 patients, while in 3 patients it remained unchanged and in one patient it increased. In the control group, images were acquired twice with an interval of 6-8 months. None of the patients in this group exhibited a reduction in plaque volume; in contrast, the plaque volume increased in three patients and remained stable in four patients. During the study period, one death unrelated to the treatment occurred in the LDE-paclitaxel group and one death occurred in the control group. CONCLUSION: Treatment with LDE-paclitaxel was tolerated by patients with cardiovascular disease and showed the potential to reduce atherosclerotic lesion size

Fibrose miocárdica em pacientes com cardiomiopatia hipertrófica com alto risco para morte súbita cardíaca Fibrosis miocárdica en pacientes con cardiomiopatía hipertrófica con alto riesgo para muerte súbita cardíaca Myocardial fibrosis in patients with hypertrophic cardiomyopathy and high risk for sudden death

FUNDAMENTO: A estratificação de risco para morte súbita na cardiomiopatia hipertrófica (CMH), continua a ser um verdadeiro desafio devido à grande heterogeneidade da sua apresentação, em que a maioria dos indivíduos permanecem assintomáticos por toda sua vida e outros apresentam a morte súbita como primeiro sintoma. Recentes trabalhos vêm sugerindo que a fibrose miocárdica pode constituir-se em um importante substrato para as arritmias ventriculares malignas, responsáveis pela morte súbita nesta doença. OBJETIVO: Avaliação da prevalência e quantificação da fibrose miocárdica (FM), em pacientes com CMH com alto risco ou recuperados de morte súbita, portadores de cardiodesfibrilador implantável (CDI). MÉTODOS: Vinte e oito pacientes com CMH portadores de CDI foram submetidos à tomografia computadorizada com múltiplos detectores, para realização da técnica de realce tardio, e avaliação da fibrose miocárdica. RESULTADOS: 96% dos pacientes apresentavam fibrose miocárdica (20,38 ± 15,55 gramas) correspondendo a 15,96 ± 10,20% da massa miocárdica total. A FM foi significativamente mais prevalente que os demais fatores de risco clássicos para morte súbita. CONCLUSÃO: Concluímos que existe uma alta prevalência de fibrose miocárdica em pacientes com cardiomiopatia hipertrófica de alto risco ou recuperados de morte súbita, como neste grupo - portadores de cardiodesfibrilador implantável. A maior prevalência da fibrose miocárdica comparada aos fatores de risco de pior prognóstico levantam a hipótese de que a fibrose miocárdica possa ser um importante substrato potencialmente necessário na gênese das arritmias desencadeadoras da morte súbita.<br>FUNDAMENTO: La estratificación de riesgo para muerte súbita en la cardiomiopatía hipertrófica (CMH), sigue siendo un verdadero reto debido a la gran heterogeneidad de su presentación, cuya mayoría de los individuos permanecen asintomáticos por toda su vida y otros expresan la muerte súbita como primer síntoma. Trabajos recientes vienen sugiriendo que la fibrosis miocárdica puede constituirse en un importante sustrato para las arritmias ventriculares malignas, responsables de la muerte súbita en esta enfermedad. OBJETIVO: Evaluación de la prevalencia y cuantificación de la fibrosis miocárdica (FM), en pacientes con CMH con alto riesgo o recuperados de muerte súbita, portadores de cardiodesfibrilador implantable (CDI). MÉTODOS: Un total de 28 pacientes con CMH portadores de CDI fueron sometidos a la tomografía computadorizada con múltiples detectores, para la realización de la técnica de realce tardío, y evaluación de la fibrosis miocárdica. RESULTADOS: El 96% de los pacientes presentaba fibrosis miocárdica (20,38 ± 15,55 gramos) y correspondía a 15,96 ± 10,20% de la masa miocárdica total. La FM fue significativamente más prevalente que los demás factores de riesgo clásicos para muerte súbita. CONCLUSIÓN: Concluimos que existe una alta prevalencia de fibrosis miocárdica en pacientes con cardiomiopatía hipertrófica de alto riesgo o recuperados de muerte súbita, como en este grupo - portadores de cardiodesfibrilador implantable. La mayor prevalencia de la fibrosis miocárdica comparada a los factores de riesgo de peor pronóstico levanta la hipótesis de que la fibrosis miocárdica pueda ser un importante sustrato potencialmente necesario en la génesis de las arritmias desencadenadoras de la muerte súbita.<br>BACKGROUND: The stratification of risk for sudden death in hypertrophic cardiomyopathy (HCM) continues to be a true challenge due to the great heterogeneity of this disease's presentation, as most individuals remain asymptomatic during their entire lives and others present sudden death as first symptom. Recent studies have suggested that myocardial fibrosis may represent an important substrate for the malignant ventricular arrhythmias, that are responsible for the cases of sudden death related to this disease. OBJECTIVE: To assess the prevalence and quantification of myocardial fibrosis (MF) in hypertrophic cardiomyopathy (HCM) patients with implantablecardioverter - defibrillator (ICD) indicated due to their high risk or recovered from cardiac sudden death. METHODS: Twenty-eight HCM patients with ICD were submitted to multidetector computed tomography to assess myocardial fibrosis by delayed enhancement technique. RESULTS: Myocardial fibrosis was present in 96% of these HCM patients with (20.38 ± 15.55 g) comprising 15.96 ± 10.20% of the total myocardial mass. MF was observed in a significantly higher prevalence as compared to other classical risk factors for sudden death. CONCLUSION: It is possible to conclude that there is a high prevalence of myocardial fibrosis in hypertrophic cardiomyopathy patients with high-risk or recovered from cardiac sudden death, like those with clinical indication to implantable cardioverter -defibrillator. The higher prevalence of myocardial fibrosis in comparison to classical risk factors of worse prognosis raise the hypothesis that the myocardial fibrosis may be an important substrate in the genesis of lifethreatening arrhythmias in these high risk HCM population