Assistência aos portadores de úlceras venosas: proposta de protocolo

Venous ulcers (VU), recurrent chronic wounds resulting from Chronic Venous Insufficiency (CVI), affect different age groups and would severely affect ambulation of patients. The lesions require treatment lasting and complex and are responsible for significant morbidity and mortality. Thus, this study aims to identify the important aspects covered in the scientific literature protocol for assisting patients with venous ulcers, identifying the issues to be proposed by the judges of the study (nurses, doctors and physiotherapists) to the protocol of care provided to patients venous ulcers and present the structure of protocol proposed by the judges of the study to assist patients with venous ulcers treated at a referral hospital of Rio Grande do Norte. This is a descriptive study using a quantitative approach, carried out at the dressings, located in the outpatient surgical clinic of the Hospital University Onofre Lopes (HUOL), located in East Sanitary District, Natal-RN. The sample consisted of 39 professionals, 30 nurses, seven doctors and two physical therapists, team members HUOL surgical clinic and other public and private institutions of Rio Grande do Norte and Jequié/Bahia. These professionals were the judges responsible for selecting the guidelines already proposed in the literature on VU protocols. Approved by the Ethics in Research HUOL (Report n.o 081/07), began the first stage of the study which consisted of reviewing the scientific literature about the relevant aspects to be included in a protocol for assisting patients with VU. These aspects were organized into a proposed questionnaire to the judges of the study. Following examination, held on the content validation with application of the Kappa (K), accepting a score higher than 0.80 and the Likert Scale, whereas rates from 4.0 to 5.0. The data collected were organized in Microsoft Excel and exported into Statistical Package for Social Sciences (SPSS) 15.0. The literature review included national and international scientific articles, thesis, dissertation and institutional protocols. Regarding the characterization of professional nurses predominated (76.1%), between 34 and 45 years (41.0%), female (79.5%), married/consensual union (46.2%), with specialization in VU care (61.5%), working in the hospital network (46.1%), with up to 5 years experience in VU (69.2%) and claiming to feel prepared to care for these injuries (92.3 %). With regard to aspects that had very good agreement (K ≥ 0.81), remained the items found in the literature with some modifications. In the analysis of the proposed evaluation items had very important, ranging from 4.1 (drug treatment) to 4.9 (patient assessment and care of the injury and the injured and perilesional skin). The proposition of the protocol is arranged in eleven items: A) Evaluation of patient and lesion, B) Registration and documentation, C) the wound and perilesional skin, D) an indication of coverage, E) Use of antibiotic and pain treatment, F) Surgical treatment of CVI, G) Drug treatment, H) Improving venous return and prevetion of recurrence, I) Referral of patients, J) Training and K) Reference and counter reference

Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care

Validação de instrumentos para avaliação da habilidade e do conhecimento acerca da medida da pressão arterial

This study aimed to validate tools for evaluating the ability and knowledge about blood pressure (BP) among nursing students. It is a cross-sectional, descriptive, quantitative and methodological study accomplished at the Universidade Federal do Rio Grande do Norte (UFRN), Universidade do Estado do Rio Grande do Norte (UERN) and a private university of the state. The sample consisted of 27 judges of research selected from the inclusion criteria: nursing, teachers of the semiology and/or semiotics discipline, with at least 1 year of experience, being from UFRN, EEN, UERN and private university of the state and and agree to participate voluntarily with the signing of the consent form. The research was development in three stages: construction of two instruments based on the scientific literature, resulting in a structured checklist consists of 28 items and a knowledge questionnaire with 12 questions; submission of the instruments to the judges, in the period from June to September 2012, which should evaluate each item in appropriate , appropriate with changes and inappropriate , addition to making an overall assessment of each instrument based on 10 requirements; validation and verification to the level of agreement among the judges, through the application of Kappa and Content Validity Index (CVI). Was used the consensus level greater than 0.61 (good) to the Kappa index and greater than 0.75 for CVI. Was approved by the Ethics in Research / HUOL. After being coded and tabulated, the data were analyzed using descriptive statistics. Of the 27 judges who evaluated the instrument, 77.8% are female, with a mean age of 36.6 (± 9.0) years, 63.0% worked in UFRN, 74.1% had academic master and 63.0% worked exclusively on teaching. Average length of teaching experience was 7.9 (± 8.0) years and in the semiology and/or semiotics discipline of 5.5 (± 6.7) years. In the judgment of structured checklist and questionnaire of knowledge about blood pressure mensurement any item/question was considered inappropriate since all obtained level of agreement within the indices established (CVI> 0,75 E Kappa> 0.61). In relation to structured checklist, of those 28 items present, 9 showed perfect concordance index (CVI = 1.00, Kappa = 1.00) and another 19 were considered appropriate with changes, especially with regard to clarity and vocabulary. In the questionnaire of knowledge, among the 12 questions that comprised, 7 had perfect concordance index and the others were considered appropriate with changes as requirements as clarity, vocabulary, and feasible sequence of instructional topics. In terms of a overall evaluating of instruments, the structured checklist got CVI of 0.94 and Kappa of 0.89 and the knowledge questionnaire, CVI of 0.97 and a kappa of 0.94. Both instruments proved to be valid as to their content, configuring it as clear and objective tools of assessment of knowledge and ability on blood pressure, being of nursing students as well as others students and health professionals, since the use of valid measures seeking to reduce the risk of distorting the results

Validação de instrumentos para avaliação do conhecimento e da habilidade acerca da sondagem vesical de demora

That study had the aim to validate an instrument to evaluate the knowledge about the Urinary Catheterization (UC) in males. Cross-sectional, descriptive, quantitative and methodological study, accomplished in Universidade Federal do Rio Grande do Norte (UFRN), Universidade do Estado do Rio Grande do Norte (UERN) and a private university from Rio Grande do Norte. Sample of 27 judges selected from the inclusion criteria: registered nurses, discipline of semiology and/or semiotics teachers, with at least 1 year of experience in the disciplines, to work at UFRN, UERN or in private university and agree to participate voluntarily with the signing of the Consent Form. Study developed in three stages: a) elaboration of twos instruments based on the scientific literature, resulting in a structured observation script type checklist consisting of 36 items and a knowledge questionnaire with 12 questions; b) submission of instruments to judges from June to September 2012, which should evaluate each item in "adequate," "adequate with changes" and "inappropriate", and make an overall evaluation of each instrument based on 10 requirements; c) and validation with a verification of the agreement level among the judges, through the application of Kappa Index (K) and Content Validity Index (CVI). It was used the consensus level higher than 0.60 (good) for Kappa Index and higher than 0.70 for CVI. The research project had favorable opinion from the Ethics in Research/HUOL (CAAE n. 0002.0.294.000-10). After being coded and tabulated, the data were analyzed using descriptive statistics. Of the 27 judges who evaluated the instrument, 77.8% are female, with a mean age of 36.6 (± 9.0) years, 63.0% worked in UFRN, 74.1% had master degree and 63.0% worked exclusively on teaching. The experience time mean in teaching was 7.9 (± 8.0) years and in the disciplines of semiology and/or semiotics in nursing was 5.5 (± 6.7) years. In judgment of the checklist and knowledge questionnaire, no step/question was considered inappropriate, since all achieved level of agreement within the established values. All the checklist steps obtained good to excellent K (between 0.60 and 1.00). Of the 36 items, 25 had excellent K (0.75 ≤ K <1.00) and excellent total K (K = 0.83). Regarding the IVC, all steps reached levels above 0.70 (between 0.74 and 1.00) and CVI total was 0.90. All questionnaire questions evaluated separately (K from 0.60 to 0.93 and CVI from 0.74 to 0.96) and generally (K from 0.79 to 1.00 and CVI from 0.89 to 1.00) had evaluation levels of content validity within the established values. The instruments were reformulated based on the agreement levels between judges and international guidelines, dissertations and scientific articles. Both instruments proved to be valid regarding to their content, allowing a clear and objective evaluation of knowledge and skills about UC, both nursing students as well as other students and health professionals, since the use of valid measures seeking the reduction of the risk of the results distorted

Uma solução para geração automática de trilhas em língua brasileira de sinais em conteúdos multimídia

Deaf people have serious difficulties to access information. The support for sign languages is rarely addressed in Information and Communication Technologies (ICT). Furthermore, in scientific literature, there is a lack of works related to machine translation for sign languages in real-time and open-domain scenarios, such as TV. To minimize these problems, in this work, we propose a solution for automatic generation of Brazilian Sign Language (LIBRAS) video tracks into captioned digital multimedia contents. These tracks are generated from a real-time machine translation strategy, which performs the translation from a Brazilian Portuguese subtitle stream (e.g., a movie subtitle or a closed caption stream). Furthermore, the proposed solution is open-domain and has a set of mechanisms that exploit human computation to generate and maintain their linguistic constructions. Some implementations of the proposed solution were developed for digital TV, Web and Digital Cinema platforms, and a set of experiments with deaf users was developed to evaluate the main aspects of the solution. The results showed that the proposed solution is efficient and able to generate and embed LIBRAS tracks in real-time scenarios and is a practical and feasible alternative to reduce barriers of deaf to access information, especially when human interpreters are not available

Análise e projeto de superfícies seletivas em frequência multibanda e/ou banda larga

Frequency selective surfaces (Frequency Selective Surface - FSS) are often used in various applications in telecommunications. Some of these applications may require that these structures have response with multiple resonance bands. Other applications require that the FSS response have large frequency range, to meet the necessary requirements. FSS to design with these features there are numerous techniques cited in the scientific literature. Thus, the purpose of this paper is to examine some common techniques such as: Overlap of FSS; Elements combined; Elements Elements convolucionados and fractals. And designing multiband FSS and / or broadband selecting simple ways in terms of construction and occupy the smallest possible space, aiming at practical applications. Given these requirements, three projects FSS were performed: a technology applied to IEEE 802.11 a/b/g/n and two projects for application in UWB. In project development, commercial software Ansoft DesignerTM and experimental results were satisfactory was used

Comportamento da produção de espécies reativas de oxigênio em miocárdio de ratos submetidos a treinamento de baixa intensidade em diferentes temperaturas

INTRODUÇÃO: A prática de exercício físico proporciona aumento da produção de espécies reativas de oxigênio (ERO) resultantes do metabolismo aeróbio e, gera uma quantidade significativa de calor, em conseqüência da produção de energia, resultando em sobrecarga orgânica. A associação entre ERO e exercício, e entre exercício e variações da temperatura ambiente têm sido estudadas, contudo, há escassez de informações que considere a associação entre produção de radicais livres no miocárdio e atividade física em temperatura elevada. OBJETIVO: Comparar a produção de ERO em miocárdio de ratos submetidos ao treinamento de baixa intensidade em diferentes temperaturas. MÉTODOS: Foram utilizados 20 ratos Wistar, machos, jovens, peso (250 a 280g), divididos em quatro grupos: G1 (n = 5) expostos ao treinamento e calor (39º ± 1C); G2 (n = 5) expostos somente ao calor durante o mesmo período de G1, sem treinamento; G3 (n = 5) expostos ao treinamento em temperatura ambiente (22º ± 1C); G4 (n = 5) expostos à temperatura ambiente sem treinamento. O treinamento foi realizado em esteira rolante climatizada por cinco semanas, evoluindo 5 minutos a cada duas sessões finalizando em 60 minutos em baixa intensidade 8m/min. O ambiente foi controlado entre 39 ± 1ºC e 22 ± 1ºC e entre 40 e 60 % de umidade relativa. A lipoperoxidação foi avaliada por Quimiluminescência (QL). A análise dos dados foi realizada a partir do teste Two Way ANOVA para análise da QL e t de student para a Capacidade Antioxidante Total (TRAP). RESULTADOS: A análise da QL revelou uma curva de emissão de luz significantemente mais baixa para o grupo exposto ao exercício em normotermia comparado aos sedentários mantidos no calor. A análise da TRAP mostrou diminuição em todos os grupos experimentais em relação ao G4. CONCLUSÃO: Concluiu-se que houve níveis menores de produção de ERO nos grupos submetidos somente ao calor ou somente ao exercício.

Condições de energia de hawking e ellis e a equação de raychaudhuri

In the Einstein s theory of General Relativity the field equations relate the geometry of space-time with the content of matter and energy, sources of the gravitational field. This content is described by a second order tensor, known as energy-momentum tensor. On the other hand, the energy-momentum tensors that have physical meaning are not specified by this theory. In the 700s, Hawking and Ellis set a couple of conditions, considered feasible from a physical point of view, in order to limit the arbitrariness of these tensors. These conditions, which became known as Hawking-Ellis energy conditions, play important roles in the gravitation scenario. They are widely used as powerful tools for analysis; from the demonstration of important theorems concerning to the behavior of gravitational fields and geometries associated, the gravity quantum behavior, to the analysis of cosmological models. In this dissertation we present a rigorous deduction of the several energy conditions currently in vogue in the scientific literature, such as: the Null Energy Condition (NEC), Weak Energy Condition (WEC), the Strong Energy Condition (SEC), the Dominant Energy Condition (DEC) and Null Dominant Energy Condition (NDEC). Bearing in mind the most trivial applications in Cosmology and Gravitation, the deductions were initially made for an energy-momentum tensor of a generalized perfect fluid and then extended to scalar fields with minimal and non-minimal coupling to the gravitational field. We also present a study about the possible violations of some of these energy conditions. Aiming the study of the single nature of some exact solutions of Einstein s General Relativity, in 1955 the Indian physicist Raychaudhuri derived an equation that is today considered fundamental to the study of the gravitational attraction of matter, which became known as the Raychaudhuri equation. This famous equation is fundamental for to understanding of gravitational attraction in Astrophysics and Cosmology and for the comprehension of the singularity theorems, such as, the Hawking and Penrose theorem about the singularity of the gravitational collapse. In this dissertation we derive the Raychaudhuri equation, the Frobenius theorem and the Focusing theorem for congruences time-like and null congruences of a pseudo-riemannian manifold. We discuss the geometric and physical meaning of this equation, its connections with the energy conditions, and some of its several aplications.

Interação entre professora e alunos em salas de aula com proposta pedagógica de educação inclusiva

Correntes teóricas presentes na literatura científica têm demonstrado a importância das relações interpessoais para o processo de construção do conhecimento. É no contexto da interação professor e aluno que se configura a relação entre as necessidades educacionais dos alunos e as respostas pedagógicas a elas disponibilizadas, o que envolve o domínio do conhecimento pelo professor, sua capacitação técnico-científica, a competência de ensinar pesquisando, as características sócio-culturais e o perfil psicológico dos atores sociais envolvidos- professor e aluno. Buscando melhor compreender este universo, elaborou-se este estudo que teve como objetivo descrever as interações ocorridas entre uma professora, e seus alunos, em classes em que se propunha adotar uma prática pedagógica inclusiva. Os dados foram coletados em 2 salas de aula, em escola estadual de Ensino Fundamental, no município de Bauru. O processo de coleta de dados se deu através do registro da realidade de sala de aula em vídeo tape. Optou-se por este método, por permitir a recuperação posterior dos dados. A coleta se deu no transcorrer do 1º semestre do ano letivo de 2001. A análise fundamentou-se em sistema prévio de categorias, e tratou os dados quantitativa e qualitativamente. Os resultados demonstraram peculiaridades e diferenças nas interações da professora com os seus alunos, em função da presença ou ausência da deficiência. Indicaram, também, que a interação vem demonstrando avanços na prática educacional, no que diz respeito à atenção pedagógica, da professora, ao aluno com deficiência.

Escolha de parceiros na adolescência

Mate choice is a component of sexual selection. Trying to understand the patterns of this process, several studies have emphasized the adaptive value of sexual differences and their influence on the assessment of the market value. The pattern for adults presented on the scientific literature, which is based on the preference for certain characteristics, shows that men search a partner who shows high value of fecundity and fertility, thus looking for partners with the ability of being pregnant and nursing their offspring. On the other hand, women look for partners with high socioeconomic status, which is strongly associated with the ability to protect and provide resources for them and their offspring. Surprisingly, there is few works that investigated the mate choice patterns during the beginning of the period of sexual differentiation on the morphological, physiological and behavioral traits. The aim of this study was to investigate mate choice patterns in adolescence in order to describe their preferences and contribute to the understanding of human reproductive behavior. Took part of this research 1,232 students from educational institutions of Natal, Brazil, and visitors to the Scientific, Technological and Cultural Fair UFRN. In the Experimental Study 1, we applied a questionnaire to evaluate the importance of certain characteristics, assessed the degree of romantic involvement and real and ideal partners age preference. In the Experimental Study 2, we did a survey of characteristics considered relevant and evaluate the importance of these characteristics in mate choice. The Experimental Study 3 brought an investigation of mate choice patterns based on self-assessment of adolescents, evaluating ideal partner for a short-term and long-term relationships and actual partner. We found that adolescents are motivated to live romantic experiences. We also observed a preference for partners of similar age to that described for adults. Finally, we found similarities and differences in the preferences for characteristics in real and ideal partners in relation to the adult pattern. In addition, we observed high similarity on the self-assessment and assessment of real and ideal partners. We suggest that in the mate choice, adolescents are similar to young adults in some aspects but not all. Our results show the relevance of the reproductive behavior investigation in this human developmental period and reinforce that further studies should contribute to the understanding of human behavior in terms of ontogenetic development and their evolutionary history.

Compromisso social do psicólogo em artigos publicados em periódicos científicos no Brasil

Psychologist s social commitment in scientific articles published in scientific papers in Brazil. A situation analysis of the scientific production concerning psychologist s social commitment can aid the historical constitution of this theme and also subsidize reflections about the course of this profession in Brazil. In order to contribute to this debate, the theme social commitment of psychologist was analyzed in the scientific literature concerning psychologist profession in the country. Specifically, papers about the profession that mentioned the theme social commitment were characterized and their approach of this matter was analyzed. In order to accomplish these goals, two research stages were fulfilled: first, in a systematic search for scientific literature in internet databases, studies about the psychologist profession in the country were gathered; in the second stage, scientific papers relating to social commitment in their titles, abstracts or keywords were selected. 61 papers were retrieved, organized in electronic database and full-text analyzed, based in two axis: scientometric and thematic. The papers were identified, in general, as recent, of theoretic character and aligned with several Psychology subareas; mainly produced in public universities, in country s southwest; were of conjunctural interest to the authors research projects, individually published, by professors in touch with post-graduation; published in open access journals, with high Qualis evaluation. It was verified that there is no consensus on the meaning of the theme, prevailing definitions concerning the understanding of the social reality, to the majority of people or to a progressive-aligned professional performance. Are adduced as committed agents: the psychologist (sometimes together with other kinds of professionals or with users), the academia, and the representative entities of the profession. Depending on the subareas and the nature of study, all papers mentioned at least one of the following criteria: expansion of target-audience, renewal of practices, political direction, defined theoretical approach or adequate technical competence, sometimes relating each other. In short, psychologist s social commitment is a contradictory issue which have earned projection in scientific literature, reiterating the historical custom of evaluate the psychologist profession. As conclusion, it is regarded as indispensable to intensify the reflection about the role whose psychologist plays in a class-cleaved society and the limits and potentials of his performing in that framework.

Early echocardiographic predictors of increased left ventricular end-diastolic pressure three months after myocardial infarction in rats

Background: The objective of this study was to determine the early echocardiographic predictors of elevated left ventricular end-diastolic pressure (LVEDP) after a long follow-up period in the infarcted rat model.Material/Methods: Five days and three months after surgery, sham and infarcted animals were subjected to transthoracic echocardiography. Regression analysis and receiver-operating characteristic (ROC) curve were performed for predicting increased LVEDP 3 months after MI.Results: Among all of the variables, assessed 5 days after myocardial infarction, infarct size (OR: 0.760; CI 95% 0.563-0.900; p=0.005), end-systolic area (ESA) (OR: 0.761; Cl 95% 0.564-0.900; p=0.008), fractional area change (FAC) (OR: 0.771; CI 95% 0.574-0.907; p=0.003), and posterior wall-shortening velocity (PWSV) (OR: 0.703; CI 95% 0.502-0.860; p=0.048) were predictors of increased LVEDP. The LVEDP was 3.6 +/- 1.8 mmHg in the control group and 9.4 +/- 7.8 mmHg among the infarcted animals (p=0.007). Considering the critical value of predictor variables in inducing cardiac dysfunction, the cut-off value was 35% for infarct size, 0.33 cm(2) for ESA, 40% for FAC, and 26 mm/s for PWSV.Conclusions: Infarct size, FAC, ESA, and PWSV, assessed five days after myocardial infarction, can be used to estimate an increased LVEDP three months following the coronary occlusion.

Exposure time and ventricular remodeling induced by tobacco smoke exposure in rats

Background: We investigated the effects of length of exposure to tobacco smoke on the cardiac remodeling process induced by exposure to cigarette smoke in rats.Material/Methods: Rats were separated into 4 groups: nonsmoking (NS) 2 (n=25; control animals not exposed to tobacco smoke for 2 months), smoking (S)2 (n=22; rats exposed to smoke from 40 cigarettes/d for 2 months), NS6 (n=18; control animals not exposed to tobacco smoke for 6 months), and S6 (n=25; rats exposed to smoke from 40 cigarettes/d for 6 months). All animals underwent echocardiographic, isolated heart, and morphometric studies. Data were analyzed with a 2-way analysis of variance.Results: No interaction among the variables was found; this suggests that length of exposure to tobacco smoke did not influence the effects of exposure to smoke. Values for left ventricular diastolic diameter/body weight and left atrium/body weight were higher (p=0.023 and p=0.001, respectively) in smoking (S2 and S6) than in nonsmoking animals (NS2 and NS6). Left ventricular mass index was higher (p=0.048) in smoking than in nonsmoking animals. In the isovolumetrically beating ventricle, peak systolic pressure was higher (p=0.034) in smoking than in nonsmoking animals. Significantly higher values were found for left ventricular weight (p=0.017) and right ventricular weight (p=0.001) adjusted for body weight in smoking as opposed to nonsmoking animals. Systolic pressure was higher (p=0.001) in smoking (128 +/- 14 mm Hg) than in nonsmoking animals (112 +/- 11 mm Hg).Conclusions: Length of exposure to cigarette smoke did not influence cardiac remodeling caused by exposure to sm oke in rats.

Prevalence and predictors of ventricular remodeling after anterior myocardial infarction in the era of modern medical therapy

Background: The consequences of aggressive therapy following a myocardial infarction (MI) on ventricular remodeling are not well established. Thus, the objective of this study was to analyze the prevalence, clinical characteristics, and predictors of left ventricular remodeling in the era of modern medical therapy.Material/Methods: Clinical characteristics and echocardiographic data were analyzed in 66 consecutive patients with anterior infarction at admission and at 6-month follow-up. Ventricular remodeling was defined as an increase of 10% in ventricular end-systolic or end-diastolic diameter.Results: In our study, 58% of patients presented with ventricular remodeling. Patients with remodeling possessed higher total plasma creatine kinase (CPK), MB-fraction (CPK-MB), heart rate, heart failure, shortness of breath, and reperfusion therapy than patients without remodeling. In contrast, patients with remodeling had a smaller ejection fraction, E-Wave deceleration time (EDT), and early (E' Wave) and late (A' Wave) diastolic mitral annulus velocity (average of septal and lateral walls), but a higher E/E' than patients without remodeling. Patients with remodeling used more diuretics, digoxin, oral anticoagulants and aldosterone antagonists than patients without remodeling. In the multivariate analyses, only E' Wave was an independent predictor of ventricular remodeling. Each 1 unit increase in the E' Wave was associated with a 59% increased odds of ventricular remodeling.Conclusions: In patients with anterior MI, despite contemporary treatment, ventricular remodeling is still a common event. In addition, diastolic function can have an important role as a predictor of remodeling in this scenario.

Combined exercise training in asymptomatic elderly with controlled hypertension: Effects on functional capacity and cardiac diastolic function

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)