Prote��na C Reativa pr��-operat��ria prediz infec����o respirat��ria ap��s cirurgia de revasculariza����o mioc��rdica

FUNDAMENTO: N��veis elevados de prote��na C reativa de alta sensibilidade (PCRas) na avalia����o pr��-operat��ria para cirurgia de revasculariza����o do mioc��rdio (CRM) t��m sido associados a maus desfechos no p��s-operat��rio. OBJETIVO: Avaliar a associa����o entre n��veis elevados de PCRas e os desfechos em curto prazo ap��s cirurgia card��aca. M��TODOS: Coorte prospectivo com 331 pacientes submetidos �� CRM com circula����o extracorp��rea (CEC) em nossa institui����o. Os pacientes foram divididos em dois grupos de acordo com os n��veis de PCRas, medidos antes da cirurgia: normal (grupo N), n��vel menor que 3 mg/l PCRas, e elevado (grupo A), n��vel maior ou igual a 3 mg/l PCRas. O grupo N apresentou uma sensibilidade e uma especificidade de 60% para a previs��o de infec����o respirat��ria, com uma aproxima����o de 90%. Os pacientes foram acompanhados durante o per��odo em que permaneceram hospitalizados. RESULTADOS: A idade m��dia foi de 60 anos, e 71,6% dos pacientes eram do sexo masculino. A PCRas estava elevada (grupo A) em 144 pacientes (43,5%). A mortalidade hospitalar foi de 4,8%, e as complica����es mais frequentes nos dois grupos foram: infec����es em geral (18%), infec����es respirat��rias (16%), fibrila����o atrial (15%) e infarto agudo do mioc��rdio (7,6%). A incid��ncia de infec����es p��s-operat��rias gerais foi de 14,4% no grupo N e de 23,6% no grupo A (p = 0,046). As infec����es respirat��rias tamb��m foram mais frequentes no grupo A (21,5% vs. 11,8%; p = 0,024). As an��lises multivariadas mostraram que o n��vel de PCRas representou um preditor independente para a infec����o respirat��ria no p��s-operat��rio (RC = 2,08, CI de 95% = 1,14 - 3,79). CONCLUS��O: O alto n��vel de PCRas no pr��-operat��rio �� um preditor independente para infec����es respirat��rias no per��odo de m��dio prazo do p��s-operat��rio de cirurgia de revasculariza����o do mioc��rdio eletiva.

Short Guide to Hepatitis C

Hepatitis C is a rapidly developing area of medicine ��� diagnostic tools are ever more refined, and entirely new treatments and treatment strategies are arriving, with more on the horizon. And because the virus affects such a large and varying population ��� up to 170 million at last count ��� we think it is important to have a pocket reference especially devoted to hepatitis C. We look forward to your comments on the usefulness of our 2014 Short Guide to Hepatitis C, which is an expansion and update of the HCV chapters in Hepatology ��� A Clinical Textbook (2014), also published by Flying Publisher. As always, we invite qualified people everywhere to translate this book into other languages, and make them available widely. This web-based free-of- harge concept is made possible by unrestricted educational grants from the pharmaceutical industry and has allowed the material to reach countries usually not covered by print media. We are convinced that this new pocket guide concept, focusing here on hepatitis C, will become a valuable source of information for our readers.

The last of the Arctic voyages; being a narrative of the expedition in H. M. S. Assistance, under the command of Captian Sir Edward Belcher, C. B., in search of Sir John Franklin, during the years 1852-53-54. With notes on the natural history, by Sir John Richardson, Professor Owen, Thomas Bell, J. W. Salter and Lovell Reeve.

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The last of the Arctic voyages; being a narrative of the expedition in H. M. S. Assistance, under the command of Captian Sir Edward Belcher, C. B., in search of Sir John Franklin, during the years 1852-53-54. With notes on the natural history, by Sir John Richardson, Professor Owen, Thomas Bell, J. W. Salter and Lovell Reeve.

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Narrative of the expedition of an American squadron to the China Seas and Japan : performed in the years 1852, 1853, and 1854, under the command of Commodore M.C. Perry, United States Navy, by order of the Government of the United States /

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