One-year Mortality after an Acute Coronary Event and its Clinical Predictors: The ERICO Study

Background:Information about post-acute coronary syndrome (ACS) survival have been mostly short-term findings or based on specialized, cardiology referral centers.Objectives:To describe one-year case-fatality rates in the Strategy of Registry of Acute Coronary Syndrome (ERICO) cohort, and to study baseline characteristics as predictors.Methods:We analyzed data from 964 ERICO participants enrolled from February 2009 to December 2012. We assessed vital status by telephone contact and official death certificate searches. The cause of death was determined according to the official death certificates. We used log-rank tests to compare the probabilities of survival across subgroups. We built crude and adjusted (for age, sex and ACS subtype) Cox regression models to study if the ACS subtype or baseline characteristics were independent predictors of all-cause or cardiovascular mortality.Results:We identified 110 deaths in the cohort (case-fatality rate, 12.0%). Age [Hazard ratio (HR) = 2.04 per 10 year increase; 95% confidence interval (95%CI) = 1.75–2.38], non-ST elevation myocardial infarction (HR = 3.82 ; 95%CI = 2.21–6.60) or ST elevation myocardial infarction (HR = 2.59; 95%CI = 1.38–4.89) diagnoses, and diabetes (HR = 1.78; 95%CI = 1.20‑2.63) were significant risk factors for all-cause mortality in the adjusted models. We found similar results for cardiovascular mortality. A previous coronary artery disease diagnosis was also an independent predictor of all-cause mortality (HR = 1.61; 95%CI = 1.04–2.50), but not for cardiovascular mortality.Conclusion:We found an overall one-year mortality rate of 12.0% in a sample of post-ACS patients in a community, non-specialized hospital in São Paulo, Brazil. Age, ACS subtype, and diabetes were independent predictors of poor one‑year survival for overall and cardiovascular-related causes.

Reverse Auction: A Potential Strategy for Reduction of Pharmacological Therapy Cost

Background:Polypharmacy is a significant economic burden.Objective:We tested whether using reverse auction (RA) as compared with commercial pharmacy (CP) to purchase medicine results in lower pharmaceutical costs for heart failure (HF) and heart transplantation (HT) outpatients.Methods:We compared the costs via RA versus CP in 808 HF and 147 HT patients followed from 2009 through 2011, and evaluated the influence of clinical and demographic variables on cost.Results:The monthly cost per patient for HF drugs acquired via RA was $10.15 (IQ 3.51-40.22) versus $161.76 (IQ 86.05‑340.15) via CP; for HT, those costs were $393.08 (IQ 124.74-774.76) and $1,207.70 (IQ 604.48-2,499.97), respectively.Conclusion:RA may reduce the cost of prescription drugs for HF and HT, potentially making HF treatment more accessible. Clinical characteristics can influence the cost and benefits of RA. RA may be a new health policy strategy to reduce costs of prescribed medications for HF and HT patients, reducing the economic burden of treatment.

Validation of a Brazilian Portuguese Version of the Walking Estimated-Limitation Calculated by History (WELCH)

Abstract Background: The Walking Estimated-Limitation Calculated by History (WELCH) questionnaire has been proposed to evaluate walking impairment in patients with intermittent claudication (IC), presenting satisfactory psychometric properties. However, a Brazilian Portuguese version of the questionnaire is unavailable, limiting its application in Brazilian patients. Objective: To analyze the psychometric properties of a translated Brazilian Portuguese version of the WELCH in Brazilian patients with IC. Methods: Eighty-four patients with IC participated in the study. After translation and back-translation, carried out by two independent translators, the concurrent validity of the WELCH was analyzed by correlating the questionnaire scores with the walking capacity assessed with the Gardner treadmill test. To determine the reliability of the WELCH, internal consistency and test–retest reliability with a seven-day interval between the two questionnaire applications were calculated. Results: There were significant correlations between the WELCH score and the claudication onset distance (r = 0.64, p = 0.01) and total walking distance (r = 0.61, p = 0.01). The internal consistency was 0.84 and the intraclass correlation coefficient between questionnaire evaluations was 0.84. There were no differences in WELCH scores between the two questionnaire applications. Conclusion: The Brazilian Portuguese version of the WELCH presents adequate validity and reliability indicators, which support its application to Brazilian patients with IC.

Transcatheter Aortic Valve Implantation and Morbidity and Mortality-Related Factors: a 5-Year Experience in Brazil

Abstract Background: Transcatheter aortic valve implantation has become an option for high-surgical-risk patients with aortic valve disease. Objective: To evaluate the in-hospital and one-year follow-up outcomes of transcatheter aortic valve implantation. Methods: Prospective cohort study of transcatheter aortic valve implantation cases from July 2009 to February 2015. Analysis of clinical and procedural variables, correlating them with in-hospital and one-year mortality. Results: A total of 136 patients with a mean age of 83 years (80-87) underwent heart valve implantation; of these, 49% were women, 131 (96.3%) had aortic stenosis, one (0.7%) had aortic regurgitation and four (2.9%) had prosthetic valve dysfunction. NYHA functional class was III or IV in 129 cases (94.8%). The baseline orifice area was 0.67 ± 0.17 cm2 and the mean left ventricular-aortic pressure gradient was 47.3±18.2 mmHg, with an STS score of 9.3% (4.8%-22.3%). The prostheses implanted were self-expanding in 97% of cases. Perioperative mortality was 1.5%; 30-day mortality, 5.9%; in-hospital mortality, 8.1%; and one-year mortality, 15.5%. Blood transfusion (relative risk of 54; p = 0.0003) and pulmonary arterial hypertension (relative risk of 5.3; p = 0.036) were predictive of in-hospital mortality. Peak C-reactive protein (relative risk of 1.8; p = 0.013) and blood transfusion (relative risk of 8.3; p = 0.0009) were predictive of 1-year mortality. At 30 days, 97% of patients were in NYHA functional class I/II; at one year, this figure reached 96%. Conclusion: Transcatheter aortic valve implantation was performed with a high success rate and low mortality. Blood transfusion was associated with higher in-hospital and one-year mortality. Peak C-reactive protein was associated with one-year mortality.

Determinação do nível crítico de fósforo do solo com auxílio do P32 (nota prévia)

Na presente nota o autor apresenta os resultados obtidos em um estudo para a determinação do nivel crítico relativo ao fósforo em solos acima do qual nao se deve esperar resposta a adubação fosfatada. O processo utilizado foi o de CATE & NELSON (1965), avaliando-se, porém, o teor de fósforo disponível pela técnica do valor L de LARSEN (1952), modificada, ora considerando a parcela do fosforo do fertilizante padrão fixada pelo solo, ora não.

Acumulação de macronutrientes pelo amendoim(Arachis hypogea L.) cultivado no outono em época da seca

Plantas de amendoim da variedade Tatu (tipo vegetativo Valencia), cultivadas em um latossol-vermelho amarelo,foram colhidas em varios estágios de desenvolvimento. Sobre estas, foram determinadas concentrações e quantidades dos macronutrientes acumulados. Verificou-se que o nitrogênio, o potássio e o cálcio foram os nutrientes que mais se acumularam na planta. Quanto ao potássio, observou-se que este nutriente foi absorvido acen tuadamente apos o florescimento. Constatou-se um decréscimo na quantidade de enxofre na parte aerea apos o florescimento. As quantidades de nutrientes extraidos, em kg/ha, em base a uma população de 160.000 plantas/ha, foram, através das vagens (sementes + cascas): 142 kg N, 15 kg P, 30 kg K, 5 kg Ca, 10 kg Mg e 7,5 kg S e através da parte aerea ou vegetativa: 201 kg N, 16 kg P, 140 kg K, 113 kg Ca, 20 kg Mg e 16 kg S.

Efeitos do ccc no desenvolvimento do algodoeiro (Gossypium hirsutum L. cv. 'IAC-RM3')

Verificou-se o efeito do cloreto de (2-cloroetil) trimetilamônio, quando aplicado em pulverização das plântulas, no desenvolvimento do algodoeiro cultivar 'IAC-RM3' , em condições de casa-de-vegetação. Estudaram-se as concentrações de 0, 20, 200 e 2000 ppm do retardador de crescimento; sendo que os tratamentos diminuíram a altura e o incremento percentual da mesma, com relação ao controle. Pela análise de crescimento verificou-se que a TAL, a TCR e a RAF apresentaram valores decrescentes com relação ao aumento da concentração do regulador de crescimento aplicado.

Efeitos da salinidade em algodoeiros tratados com produtos químicos

Estudaram-se os efeitos de polissulfeto de polietileno (0,5%), o-xietileno docosanol (5%) e ácido succínico - 2,2-dimetil-hidrazida (2000 ppm), aplicados em pulverização, no desenvolvimento de algo-doeiro cultivar 'IAC-RM3', submetido à adubação N-P-K (5:10 5) e à irrigação com solução de NaCl - CaCl2 - MgCl2 (1,000,85:0,15). Os antitranspirantes permitiram aumento em área foliar do algo-doeiro; sendo que o retardador de crescimento provocou redução na área foliar com relação ao controle, em condições de salinidade. Os produtos químicos promoveram maior aumento no peso seco em relação ao controle. A taxa assimilatória líquida e a taxa de crescimento relativo mostraram-se mais altas nas plantas tratadas com produtos químicos em relação ao controle, nas condições de salinidade. N ao ocorreram diferenças marcantes entre as plantas tratadas com antitranspirantes e o controle, com relação à razão de área foliar; sendo que este parâmetro mostrou-se inferior no tratamento com retardador de crescimento.

Fixação de fósforo por um latossolo e determinação do valor «X»

Este trabalho se refere a um ensaio conduzido em laboratório para avaliar a capacidade de fixação de fosfato dos horizontes A1 (0.22cm), A3 (22-56cm) e B22 (155-200cm) de Lotossolo Roxo Distrófico. Foi, também, determinado o valor "X" de WAUGH & FITTS (1966) dos três horizontes. Os principais resultados são apresentados a seguir: 1 - O horizonte B22 foi o que apresentou maior capacidade de fixação de fósforo, seguido pelo A3 e, finalmente, pelo A1 . 2 - Os valores "X" encontrados foram: 350 ppm, 225 ppm e 175 ppm para os horizontes B22 , A3 e A2, respectivamente. 3 - Houve uma relação muito estreita entre as quantidades de R adicionadas e as fixadas pelos três horizontes.

Fixação de fósforo por um latossolo do estado de Minas Gerais

Foi estudada a adsorção do fósforo por amostras de três horizontes, A1 (0-22cm), A3 (22-56cm) e B22 (155-200cm), de um Latossolo do Estado de Minas Gerais por meio da isoterma de Langmuir. Os valores de adsorção máxima (b) e da constante de seletividade (K) calculados a partir da forma linear da equação de Langmuir foram correlacionados com algumas características físicas e químicas apresentadas pelos citados horizontes. Os resultados encontrados permitiram concluir que: a - As isotermas de adsorção mostraram duas regiões distintas: aquela em que o fosfato é fortemente retido foi convenientemente descrita pela equação de Langmuir. b - Em virtude da diversidade das características físicas e químicas dos horizontes houve grande variação nos valores de adsorção máxima (b) e da constante de seletividade (K).

Extração de várias formas de fósforo em alguns solos do estado de São Paulo, utilizando vários métodos químicos

Vários métodos de extração para o P solúvel, o P orgânico e o P total foram comparados em 5 (cinco) solos do Estado de São Paulo, que são: a) areia quartzosa (Entissol); b) podzolisado vermelho amarelo, variação Lara (Ultissol); c) latossol vermelho (Oxissol); d) podzolisado vermelho amarelo, variação Piracicaba (Ultissol); e) terra Roxa Estruturada (Alfissol). De acordo com os dados, as seguintes conclusões foram tiradas: 1. Os melhores extratores para o P solúvel foram H2SO4 0,05 N (método -IAC) e H2SO4 0,025 N + HC1 0,05 N (método Mehlich). 2. Para remover e medir o P orgânico, os extratores foram equivalentes. 3. 0 método químico de Sommers e Nelson e aquele de Jackson foram os melhores para o P total no solo.

Dial behavioral responses of Metamysidopsis elongata atlantica (Crustacea, Mysida) to gradients of salinity and temperature

Metamysidopsis atlantica elongata (Bascescu, 1968) is a common mysid in the surf zone of sandy beaches from the state of Rio Grande do Sul, Brazil, where it is frequently recorded forming dense aggregations. Trough laboratory trials, behavioral responses to salinity (10, 20, 25, 28, 30, 40 e 45), temperature (10, 15, 20, 30±1ºC) and light (yes/no) were tested using adult males, adult females and juveniles. Although there was no response to temperature, the species showed clear response to salinity and light. In the presence of light, organisms remained in the bottom of the aquaria, but moved to surface when bottom salinities were increased. In the absence of light, adults moved to the surface. However, juveniles moved down to or remained on the bottom, maybe as a response to avoid adult predation.

New species of Eupalaestrus from Argentina (Araneae, Theraphosidae, Theraphosinae)

A new species of Eupalaestrus Pocock, 1901 from northern Argentina is described and illustrated. Males and females of Eupalaestrus larae sp. nov. differ from those all other species of the genus by the color with distinct two parallel longitudinal stripes on the femora, patellae, tibiae and one longitudinal stripe reaching half of metatarsi; the presence of a thickened femur and tibia IV; a straight embolus of the male palpal bulb and retrolateral keel pronounced. Specimens were captured in Chaco province, inhabiting unflooded flat grasslands open areas inside forest in transitional Chaco eco-region.

Description of two new species of Plesiopelma (Araneae, Theraphosidae, Theraphosinae) from Argentina

Two new species of Plesiopelma Pocock, 1901 from northern Argentina are described and diagnosed based on males and habitat descriptions are presented. Males of Plesiopelma paganoi sp. nov. differ from most of species by the absence of spiniform setae on the retrolateral face of cymbium, aspect of the palpal bulb. Plesiopelma aspidosperma sp. nov. differs from most species of the genus by the presence of spiniform setae on the retrolateral face of cymbium and it can be distinguished from P. myodes Pocock, 1901, P. longisternale (Schiapelli & Gerschman, 1942) and P. rectimanum (Mello-Leitão, 1923) by the separated palpal bulb keels and basal nodule of metatarsus I very developed. It differs from P. minense (Mello-Leitão, 1943) by the shape of the palpal bulb and basal nodule on metatarsus I well developed. Specimens were captured in Salta province, Argentina, inhabiting high cloud forests of Yungas eco-region.