Circulation and salt intrusion in the Piaçaguera Channel, Santos (SP)

A análise de dados termohalinos e correntes medidos em uma estação fixa no Canal de Piaçaguera (Estuário de Santos) no inverno foi feita em termos de condições cíclicas da maré (quadratura e sizígia) e quase-estacionária, com o objetivo de caracterizar a estratificação da massa de água estuarina, sua circulação e transporte de sal forçados pela modulação quinzenal da maré. Foram utilizados métodos clássicos de análise de dados observacionais horários e quase sinóticos e de simulações analíticas de perfis estacionários de salinidade e do componente longitudinal da velocidade. Durante o ciclo de maré de quadratura as velocidades de enchente (v<0) e vazante (v>0) variaram de -0.20 m/s a 0.30 m/s, associadas à pequena variação de salinidade entre a superfície e o fundo (26.4 psu a 30.7 psu). No ciclo de sizígia a velocidade aumentou de -0.40 m/s a 0.45 m/s, mas a estratificação de salinidade permaneceu praticamente a mesma. Os perfis estacionários teóricos de salinidade e de velocidade apresentaram boa concordância (Skill próximo a 1,0) quando comparados aos perfis observacionais. Durante a modulação quinzenal da maré não houve alteração na classificação do canal estuarino (tipo 2a-parcialmente misturado e fracamente estratificado), pois a taxa de aumento da energia potencial não foi suficiente para ocasionar a erosão da haloclina. Esses resultados, associados à alta estabilidade vertical (RiL >20) e ao número de Richardson estuarino (1,6), permitem as seguintes conclusões: i) o mecanismo que forçou a circulação e os processos de mistura foi principalmente o balanço da descarga fluvial com a maré, associado ao componente baroclínico da força de gradiente de pressão; ii) não houve variações nas principais características termohalinas e da circulação devido à modulação quinzenal da maré; e iii) os perfis quase estacionários de salinidade e da velocidade foram adequadamente simulados com um modelo analítico clássico.

Predictors of Beta-Blocker Intolerance and Mortality in Patients After Acute Coronary Syndrome

Purpose: To investigate the predictors of intolerance to beta-blockers treatment and the 6-month mortality in hospitalized patients with acute coronary syndrome (ACS).Methods: This was a single-center, prospective, and longitudinal study including 370 consecutive ACS patients in Killip class I or II. BBs were prescribed according to international guidelines and withdrawn if intolerance occurred. The study was approved by the institutional ethics committee of our university. Statistics: the clinical parameters evaluated at admission, and the related intolerance to BBs and death at 6 months were analyzed using logistic regression (p<0.05) in PATIENTS.Results: BB intolerance was observed in 84 patients and was associated with no prior use of statins (OR: 2.16, 95%CI: 1.26-3.69, p= 0.005) and Killip class II (OR: 2.5, 95%CI: 1.30-4.75, p=0.004) in the model adjusted for age, sex, blood pressure, and renal function. There was no association with ST-segment alteration or left anterior descending coronary artery plaque. Intolerance to BB was associated with the greatest risk of death (OR: 4.5, 95%CI: 2.15-9.40, p<0.001).Conclusions: After ACS, intolerance to BBs in the first 48 h of admission was associated to non previous use of statin and Killip class II and had a high risk of death within 6 months.

Sildenafil citrate on retrobulbar and retinal circulation of rabbits

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Analysis of renal function after on and off pump coronary artery bypass grafting

Cardiopulmonary bypass (CPB) is often associated with renal dysfunction, as measured by plasma creatinine levels and hemodialysis rates. Aim. To compare creatinine clearance (CrCl), estimated with the Cockroft and Gault formula, between patients undergoing off-pump coronary artery bypass grafting (OPCAB) versus on-pump CABG (on-CAB). Material and methods. Between April 2008 and April 2009, 119 patients underwent coronary bypass graft surgery. Fifty-eight (58) of these patients underwent OPCAB while 61 had on-CAB. Creatinine clearance, plasma creatinine levels, and clinical outcome were compared between the groups. A creatinine clearance value of 50 mL/minute was accepted as the lowest limit of normal renal function. Results. There were two hospital deaths caused by sepses after pulmonary infection. Creatinine clearance (Preoperative OPCAB 73,64±33,72 x on-CAB 75,70±34,30mL/min; discharge OPCAB 75,73±35,07 x on-CAB 79,07±34,71 mL/ min; p=0,609), and creatinine levels (Preoperative OPCAB 1,04±0,38 x on-CAB 1,13±0,53 mg/dL; discharge OPCAB 1,12±0,79 x on-CAB 1,04±0,29mg/dL; p=0,407) did not show statistically inter-group differences. Conclusion. Deterioration in renal function is associated with higher rates of postoperative complications. No significant difference in CrCl could be demonstrated between the groups.

Modelling the surface circulation and thermal structure of a tropical reservoir using three-dimensional hydrodynamic lake model and remote-sensing data

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A Randomized Trial of the Topical Effect of Antifibrinolytic Epsilon Aminocaproic Acid on Coronary Artery Bypass Surgery Without Cardiopulmonary Bypass

We assessed the effect of the topical application of epsilon-aminocaproic antifibrinolytic acid (EACA) on the pericardium of patients submitted to coronary artery bypass graft (CABG) without the use of cardiopulmonary bypass (CPB). This is a prospective, randomized, and double-blind study. We evaluated 26 patients with chronic coronary heart disease indicated for CABG without CPB (EACA and placebo groups). The analysis of the postoperative hematological results showed no difference between groups in hemoglobin and hematocrit. There was no difference between the groups regarding the postoperative bleeding through the drains in the first 24 hours, 48 hours, and accumulated loss until removal of drains. The use of EACA in patients undergoing CABG without CPB presented no difference in the reduction of the amount of bleeding and the need for blood transfusions.

Frequency and clinical predictors of coronary artery disease in chronic renal failure renal transplant candidates

Background/aims: Cardiovascular diseases are major causes of mortality in chronic renal failure patients before and after renal transplantation. Among them, coronary disease presents a particular risk; however, risk predictors have been used to diagnose coronary heart disease. This study evaluated the frequency and importance of clinical predictors of coronary artery disease in chronic renal failure patients undergoing dialysis who were renal transplant candidates, and assessed a previously developed scoring system. Methods: Coronary angiographies conducted between March 2008 and April 2013 from 99 candidates for renal transplantation from two transplant centers in Sao Paulo state were analyzed for associations between significant coronary artery diseases (>= 70% stenosis in one or more epicardial coronary arteries or >= 50% in the left main coronary artery) and clinical parameters. Results: Univariate logistic regression analysis identified diabetes, angina, and/or previous infarction, clinical peripheral arterial disease and dyslipidemia as predictors of coronary artery disease. Multiple logistic regression analysis identified only diabetes and angina and/or previous infarction as independent predictors. Conclusion: The results corroborate previous studies demonstrating the importance of these factors when selecting patients for coronary angiography in clinical pretransplant evaluation.

Influence of cardiac rehabilitation in Primigravida with spontaneous coronary artery dissection during postpartum

The physical exercise consists of trainable physical abilities such as strength and endurance. It can be inferred that the individual cardiac patient is dependent on it as an associated therapy to the drug treatment for a rapid and lasting improvement of their overall clinical status. The patient - with Spontaneous Coronary Artery Dissection Postpartum period - was subjected to 21 sessions of cardiac rehabilitation. A physical evaluation was performed, before and after the treatment period, for data collection: anthropometric values, flexibility, aerobic capacity and strength of grip. The patient had a positive response in aerobic capacity, flexibility and grip strength and the anthropometric values were kept in short term rehabilitation.

Analgesia controlada pelo paciente comparada a analgesia padrão na função pulmonar, força muscular respiratória e dor no pós-operatório e revascularização do miocárdio: ensaio clínico randonizado

Pós-graduação em Bases Gerais da Cirurgia - FMB

An Intercomparison of Regional Atmospheric Circulation and the Melt Season Loss of Arctic Snow Cover and Sea Ice Extent Across the Land-Ocean Boundary

This study is designed to compare the monthly continental snow cover and sea ice extent loss in the Arctic with regional atmospheric conditions including: mean sea level pressure, 925 hPa air temperature, and mean wind direction among others during the melt season (March-August) over the 29-year study period 1979-2007. Little research has gone into studying the concurrent variations in the annual loss of continental snow cover and sea ice extent across the land-ocean boundary, since these data are largely stored in incompatible formats. However, the analysis of these data, averaged spatially over three autonomous study regions located in Siberia, North America, and Western Russia, reveals a distinct difference in the response of snow and sea ice to the atmospheric forcing. On average, sea ice extent is lost earlier in the year, in May, than snow cover, in June, although Arctic sea ice is located farther north than continental snow in all three study regions. Once the loss of snow and ice extent begins, snow cover is completely removed sooner than sea ice extent, even though ice loss begins earlier in the melt season. Further, the analysis of the atmospheric conditions surrounding loss of snow and ice cover over the independent study regions indicates that conditions of cool temperatures with strong northeasterly winds in the later melt season months are effective at removing sea ice cover, likely through ice divergence, as are warmer temperatures via southerly winds directly forcing melt. The results of this study set the framework for further analysis of the direct influence of snow cover loss on later melt season sea ice extents and the predictability of snow and sea ice extent responses to modeled future climate conditions