Sudden Cardiac Death in Brazil: Study Based on Physicians' Perceptions of the Public Health Care System

Background: There are no available statistical data about sudden cardiac death in Brazil. Therefore, this study has been conducted to evaluate the incidence of sudden cardiac death in our population and its implications. Methods: The research methodology was based on Thurstone's Law of Comparative Judgment, whose premise is that the more an A stimulus differs from a B stimulus, the greater will be the number of people who will perceive this difference. This technique allows an estimation of actual occurrences from subjective perceptions, when compared to official statistics. Data were collected through telephone interviews conducted with Primary and Secondary Care physicians of the Public Health Service in the Metropolitan Area of Sao Paulo (MASP). Results: In the period from October 19, 2009, to October 28, 2009, 196 interviews were conducted. The incidence of 21,270 cases of sudden cardiac death per year was estimated by linear regression analysis of the physicians responses and data from the Mortality Information System of the Brazilian Ministry of Health, with the following correlation and determination coefficients: r = 0.98 and r2= 0.95 (95% confidence interval 0.81.0, P < 0.05). The lack of waiting list for specialized care and socioadministrative problems were considered the main barriers to tertiary care access. Conclusions: The incidence of sudden cardiac death in the MASP is high, and it was estimated as being higher than all other causes of deaths; the extrapolation technique based on the physicians perceptions was validated; and the most important bureaucratic barriers to patient referral to tertiary care have been identified. (PACE 2012; 35:13261331)

Structure and luminescent investigation of the Ln(III)-beta-diketonate complexes containing tertiary amides

The synthesis and photoluminescent properties of Ln(III)-thenoyltrifluoroacetonate and dibenzoylmethanate complexes (Ln = Eu(III) and Gd(III) ions) containing tertiary amides such as dimethylacetamide (DMA), dimethylformamide (DMF), and dimethylbenzamide (DMB) as neutral ligands are reported. The Ln complexes were characterized by elemental analysis, complexometric titration with EDTA, and infrared spectroscopy. Single-crystal X-ray structure data of the [Eu(DBM)(3).(DMA)] compound indicates that this complex crystallizes in the triclinic system, space group PT with the following cell parameters: a = 10.2580(3) angstrom, b = 10.3843(2) angstrom, c= 22.3517(5) angstrom, alpha = 78.906(2)degrees, beta = 78.049(2)degrees, lambda= 63.239(2)degrees, V= 2066.41(9) angstrom(3), and Z = 2. The coordination polyhedron for the Eu(III) complex may be described as an approximate C-2v distorted monocapped trigonal prism. The optical properties of the Eu(III) complexes were studied based on the intensity parameters and luminescence quantum yield (q). The values of the ohm(2) parameter of the Eu-DBM complexes are larger than those for the Eu-TTA complexes, indicating that the Eu(III) ion is in a more polarizable chemical environment in the former case. The geometries of the complexes have been optimized by using the Sparkle Model, and the results have been used to perform theoretical predictions of the ligand-to-metal energy transfer via direct and exchange Coulomb mechanisms. (C) 2012 Elsevier Ltd. All rights reserved.