bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Management of Co-Morbidities in Patients with Heart Failure – Central Sleep Apnoea
Authors: Coats Andrew JS , Shewan Louise G , Abraham William T 
Published: June 2017

Despite many therapeutic advances, heart failure (HF) remains challenging to treat and continues to be associated with high rates of morbidity and mortality. There is an ongoing need to identify co-morbidities that either contribute to the progression of heart failure or limit the therapeutic response to treatment. One area under active investigation is the treatment of central sleep apnoea (CSA). CSA has consistently been shown to be associated with a worse prognosis in HF patients. Thus, understanding how to diagnose and treat CSA is of paramount importance to the HF clinician. Without treatment, HF patients continue to be at risk for the devastating consequences of CSA. Prognosis is very poor with studies consistently demonstrating poor outcomes among HF patients with CSA. Over the course of the night, each discrete event contributes to increased nor- epinephrine levels and hypoxia which are associated with progressive heart failure and arrhythmias. Initial therapeutic options utilized therapies which were developed for obstructive sleep apnoea with limited success or even harm. ASV is now contraindicated in HF patients with an EF &lt; 45% leaving only 2 potential treatment options: CPAP and transvenous phrenic nerve stimulation. Data from the recently presented (post ESC guidelines) trial on transvenous phrenic nerve stimulation demonstrated efficacy without the need for patient compliance or any safety concerns. It is expected that additional studies in CSA will continue to demonstrate the full impact of treating this important co-morbidity on patients with HF.
The Management of Co-Morbidities in Patients with Heart Failure – Potassium Balance
Authors: Jankowska Ewa 
Published: June 2017

Both hypokalaemia and hyperkalaemia are common in HF patients. They are each associated both with HF and with the many drugs used for HF. They are important as they both can aggravate ventricular arrhythmias, both can cause symptoms in HF patients and in the case of hyperkalaemia in particular, are a common reason not to prescribe or reduce the dose of or even cease use of effective medication with life- prolonging benefits in HFrEF, including ACEI’s and MRA’s. Treatment optiosn for bioth hypokalaemia and hyperkalaemia are discussed including the emerging evidence that agents such as patiromer may be safe and effective agents to be used long-term in high-risk patients with HF to allow them to take doses of RAAS inhibitors in particular which they otherwise may not be able to take. This might allow them to continue to receive the mortality morbidity benefits these treatments confer.
The Impact of Maternal Congenital Heart Disease on Pregnancy Outcomes in Malta – a Retrospective Study
Authors: Caruana Maryanne , Gatt Miriam , Aquilina Oscar , Savona Ventura Charles , Grech Victor , Somerville Jane 
Published: June 2017

<p class="AbstractBody"><strong>Background:</strong> Most female patients with congenital heart disease (CHD) are becoming pregnant. Maternal CHD can have a negative impact on mother and foetus. This is the first study investigating pregnancy outcomes in Maltese grown-up congenital heart disease (GUCH) patients and one of few to compare these with outcomes in women without heart disease.</p><p class="AbstractBody"><strong>Methods</strong><strong>:</strong> Known GUCH pregnancies for the period of 2007-2014 were extracted from our database (GUCH cohort) and cardiovascular outcomes retrieved from hospital notes. A control cohort of 540 pregnancies in women without cardiovascular disease was generated through twenty-fold random matching based on subject age from among all pregnancies in Maltese nationals for the same 8-year period. Obstetric and offspring outcomes were compared between the two cohorts.</p><p class="AbstractBody"><strong>Results</strong><strong>:</strong> The GUCH cohort consisted of 27 pregnancies in 24 women. Only 1/27 patients (3.7%) had cardiovascular complications. Elective Caesarean sections were commoner (29.6% vs. 15.4%) and unassisted vaginal deliveries less frequent (51.9% vs. 64.6%) in the GUCH cohort (p=0.02). Obstetric complication rates were similar. GUCH women had smaller babies (median 3030g vs. 3230g; p=0.045) and showed a trend towards more small-for-gestational age babies (18.5% vs. 8.4%; p=0.08) and congenital malformations (7.4% vs. 2.4%; p=0.06).</p><p class="AbstractBody"><strong>Conclusions: </strong>Despite the potential adverse effects of maternal CHD on mother and foetus, most pregnancies are uncomplicated and outcomes comparable to those in women without heart disease, particularly if baseline clinical status is good. Based on our findings, it is being proposed that prospective mothers be counselled about the possibility of having smaller infants.</p>
Early or Delayed Surgery for Infective Endocarditis Complicated by Cerebral Embolism: a Meta-analysis
Authors: Wang Michael Tzu Min , Pemberton James , Wang Tom Kai Ming 
Published: June 2017

<p>Background: Surgery is recommended for infective endocarditis patients who develop cerebral embolism, however the optimal timing of surgery remains controversial. In this meta-analysis, we compared the outcomes of early and delayed cardiac surgery for infective endocarditis in this setting.</p><p> </p><p>Methods: PubMed, MEDLINE, Embase, Cochrane and Scopus databases from 1 January 1980 to 30 June 2016 were searched for original studies. Two authors evaluated these studies for inclusion independently, then extracted and pooled data using random-effects models.</p><p> </p><p>Results: Amongst 2,423 papers obtained from the search, 23 full-texts were reviewed, and 6 studies totalling 701 patients were included for analyses. Rates and pooled odds ratio (95% confidence interval) for operative mortality of early or late surgery set at 7 days were 13.5% vs 10.8%, 1.40 (0.61-3.02); 14 days were 20.7% vs 13.0%, 1.95 (0.95-4.01). Pooled odds ratio of early surgery for long-term mortality was 2.95 (0.35-25.0); and for neurological events, embolic event was 1.22 (0.33-4.56) and intracranial bleeding 1.55 (0.16-15.32).</p><p> </p><p>Conclusion: Although early surgery was not associated with statistically higher rates of mortality or neurological events it does need to be cautiously performed. Data is limited and larger and randomised studies would help to determine the optimal timing.<strong></strong></p>
Long-Term Survival Following Aortic Valve Replacement: the Influence of Age, Prosthesis-Patient Mismatch and Indexed Effective Orifice Area
Authors: Manché Alexander , Casha Aaron , Camilleri Liberato 
Published: June 2017

<p><strong>Background</strong></p><p>Prosthesis-patient mismatch (PPM) has been linked to reduced long-term survival after aortic valve replacement. We studied the influence of age, PPM and indexed effective orifice area (iEOA) in this setting.</p><p> </p><p><strong>Methods</strong></p><p>Patients (n=586) subjected to aortic valve replacement were followed up for a mean of 7.8 years (maximum 20 years). The study population was divided into four equivalent groups according to age. Mortality data was extracted from the National Statistics database. Data pertaining to patient body surface area and valve effective orifice area was collected prospectively and mismatch (moderate or severe) was defined according to established values. The Cox proportional hazard model was used to study the effect of age, mismatch and iEOA on survival. The Log Rank test was used to compare survival curves by age groups.</p><p> </p><p><strong>Results</strong></p><p>The incidence of moderate PPM was 24.6%, and of severe PPM 3.9%. Mismatch increased the hazard of death by 31.2% for moderate PPM and 70.3% for severe PPM but did not reach statistical significance. Mean age of patients with mismatch (n=167) was 2.52 years less than in those without (63.35±10.61 versus 65.87±11.69, p=0.016). Age significantly affected survival, increasing the risk of death by 7.3% for every incremental year. <em> </em>Mean iEOA was 0.94±0.15cm<sup>2</sup>/m<sup>2</sup>; for every 0.1unit increase in iEOA the risk of death decreased by 8.8%.</p><p> </p><p><strong>Conclusion</strong></p><p>Long-term survival was significantly affected by age at operation. Although mismatch increased hazard of death the effect did not reach statistical significance. A larger iEOA had a significant beneficial effect on survival.<em></em></p>
Preferential Vasodilator Effects of Levosimendan in Resistance Pulmonary Arteries in a Rodent Pulmonary Embolism Model
Authors: Bedo Camila , Grignola Juan C 
Published: June 2017

<p><strong>Background:</strong> We compared the vasoactive effects of levosimendan on isolated conduit (CPA) and resistance (RPA) pulmonary arteries versus mesenteric arteries and we assessed the PA vascular function and the PA vasoactive effects of levosimendan in a rodent PE model.</p><p><strong>Methods:</strong> One group of male Wistar rats (200-300 g) was killed by decapitation to obtain pulmonary and mesenteric rings. Another group was assigned to a massive PE or saline solution infusion. After euthanasia mesenteric arteries and CPA (i.d. 1-2 mm) and RPA (≤ 0.5 mm) were dissected and cut into 2-3 mm wide rings recording contractile tension. We obtained the concentration-response curves of cumulative doses of levosimendan on pre-contracted arterial rings from decapitated and sham/embolized animals. A set of RPA rings was exposed to acute hypoxia. The effect of PE on the pulmonary vasoactive function was assessed by dose-response curves of acetylcholine (ACh) and endothelin-1 (ET-1) of PA rings from sham/embolized animals. </p><p><strong>Results:</strong> Levosimendan relaxant potency of RPA was similar to mesenteric arteries and higher than CPA, while mesenteric rings showed the maximal relaxant effect, followed by RPA and CPA, respectively. PE did not affect the vasoactive response of PA rings either to ACh or to ET-1, and the relaxant effects of CPA and RPA to levosimendan were also preserved. Acute hypoxia reduced (<em>P</em>&lt;0.05) but did not avoid the RPA relaxant effect of levosimendan.</p><p><strong>Conclusions: </strong>Levosimendan is a more specific vasodilator of RPA with a similar relaxant potency as mesenteric arteries, which is preserved after PE but significantly reduced during hypoxia.</p>
Preliminary Short-term Results of a Population of Patients Treated with MitraClip Therapy: One Center Experience
Authors: Taravella Rossana , Cellura Melchiorre Gilberto , Cirrincione Giuseppe , Asciutto Salvatore , Caruso Marco , Benedetto Massimo , Alduino Rossella , Novo Salvatore 
Published: June 2017

<p><span>Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effictiveness endpoint.</span></p><p><span>Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR),with increasing real-world cases of functional MR(FMR). In the EVEREST(Endovascular Valve Edge-to-Edge Repair Study)II trial,percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach.</span></p><p><span>Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January2011 to December2016. The study included 62patients[mean age74±11years, 43 men(69%)] with MR of at least grade3+. Most of patients had functional MR, were in New York Heart Association(NYHA) functional class III or IV,with a large portion(78%) of mild-to-moderate Tricuspid Regurgitation(TR). One or more clips were implanted in 67procedures(62 patients).<span> </span></span></p><span>Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+(primary effictiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to &lt;2+ in the great majority of patients,with a large freedom from death, surgery or recurrent MR in a great portion of patients.</span>
Hubungan Shalat Fardu Berjamaah Dengan Kecerdasan Emosional Pada Jamaah Mesjid Al Jihad Banjarmasin
Authors: Jauhari Ahmad , AS Asmaran , Faridah Siti 
Published: June 2017

Al Jihad Mosque Banjarmasin is a mosque that is identical with Muhammadiyah, this mosque is followed by many pilgrims and loyal at the time of the implementation of prayers fardu congregation. Jamaah consists of various groups regardless of background, both in terms of age, economy, organization and even the sick pilgrims (post-stroke) are actively involved in congregation. Active Jamaat prayers in congregation do not only come from residents around the mosque complex, but also many pilgrims who come from outside the mosque complex, even the distance difference between their residence with the mosque a few kilometers. In heavy rainy weather conditions, they still enthusiastically follow the prayers in congregation fardu mosque. In addition, there are things that are felt by pilgrims such as comfort, tranquility of heart and mind, emotional stability, silaturrahim which all is related to emotional intelligence.In this study, the main problem is how is the relationship of prayer in congregation with emotional intelligence in the congregation of Al Jihad Mosque Banjarmasin ?. The method used is quantitative and qualitative descriptive method with methodological arrangement such as approach and type of research, research location, population and sample, data and data source, procedure and data collection, quantitative and qualitative technical data analysis.The result of the study found that there is a correlation between salat fardu congregation with emotional intelligence, this is proved by the data from questionnaires from 30 pilgrims (respondents) that is: able to control the impulse of worldly lusts with the highest opinion is 60% said yes and 40% stated sometimes .Motivating yourself with the highest opinion is 90% states yes and 10% states sometimes. Able to survive in the face of trials with the highest opinion is 86.67 states yes and 13, 33 states sometimes. No exaggeration with the highest opinion is 90% states yes and 10% states sometimes. Being able to set the mood with the highest opinion is 86.33% and 13.33 states sometimes. Keeping the stress burden does not cripple the thinking ability with the highest opinion is 90% states yes and 10% states sometimes. The ability to empathize and pray with the highest opinion is 90% say yes and 10% say sometimes.
"Entre a integridade científica e a possibilidade metodológica": tensões conceituais e metodológicas na atividade regulatória em saúde
Authors: Gamarra Tatiana Pereira das Neves 
Published: June 2017

De modo geral, a atividade regulatória em saúde é subsidiada por evidências científicas. Qualquer evidência possui uma série de incertezas, contudo, raramente estas incertezas são explicitadas e/ou avaliadas. Esta omissão das incertezas das evidências no processo regulatório produz implicações muitas vezes prejudiciais à defesa do interesse público. Nessa perspectiva, este estudo teórico discutirá esta questão além de apresentar ferramentas metodológicas para enfrentar esta situação. Estas estratégias metodológicas permitem uma maior discussão das incertezas e contribuem para decisões regulatórias mais adequadas, uma vez que podem facilitar o diálogo entre tomadores de decisão e demais atores sociais.
Práticas educativas em ortopedia e traumatologia: análise dos enfermeiros da Estratégia de Saúde da Família
Authors: De Sousa Gutembergue Santos , Ferreira Maria Goreth Silva , Costa Monroe Kátia Cristina Muradas 
Published: June 2017

Introdução: a prática educativa deve ser considerada uma ação que provoca ou sugere uma reação, promovendo uma maior participação dos sujeitos nos processos de tomadas de decisão. Objetivo: analisar as práticas educativas em ortopedia e traumatológica desenvolvidas por enfermeiros que atuam na estratégia de saúde da família. Método: estudo descritivo, com abordagem quantitativa, realizado com Enfermeiros atuantes nas ESF do município de Altamira-Pa. Utilizou-se o questionário semiestruturado, permitindo o levantamento do perfil dos entrevistados bem como do seu conhecimento acerca do objeto de estudo. A análise dos dados deu-se através de estatística descritiva simples. Resultados: 22% (n=2) dos Enfermeiros pós graduados são especialistas em saúde da família; é marcante a ausência de curso introdutório para as ESF, sendo que 11% da amostra afirmou ter recebido tal curso antes de ingressar no saúde da família; identificou-se que 45% dos entrevistados afirmam conhecer pouco sobre ortopedia e traumatologia e 67% afirmam não trabalhar tal temática por não se tratar de nenhum programa do Ministério da Saúde e por não considerarem existir relação entre ortopedia e traumatologia e os programas de saúde desenvolvidos pela unidade de saúde; apesar disso, 89% afirmam ser importante o desenvolvimento de práticas educativas focadas na ortopedia e traumatologia. Descritores: Educação em Saúde; Ortopedia; Traumatologia; Enfermagem; Saúde da Família.
Avaliação do consumo de água, energia, papel a4 e do recolhimento de recicláveis após atividades educativas
Authors: Carvalho Luciana Silami , Vimieiro Gisele Vidal 
Published: June 2017

Consumo sustentável é aquele que atende às necessidades atuais, sem comprometer o atendimento das demandas futuramente. O Decreto 5940/2006 institui a separação dos resíduos recicláveis em órgãos públicos federais e sua destinação a associações de catadores. Sabendo que o consumo gera impactos ambientais negativos, pretendeu-se avaliar o impacto da realização de atividades diversas de educação ambiental no consumo de água, energia, papel A4 e na quantidade de materiais recicláveis recolhidos. As etapas realizadas foram: medida da quantidade mensal de papel A4 consumido e cálculo do indicador “número de pacotes de papel A4/ocupante”; acompanhamento do consumo mensal de energia elétrica/água e cálculo dos indicadores “Kwh/ocupante” e “L/ocupante”; pesagem da quantidade semanal de material reciclável enviada para reciclagem e cálculo do indicador “material total/ocupante”; elaboração de materiais e sensibilização para a coleta seletiva e redução do consumo de água, papel e energia elétrica, com utilização de variados instrumentos de comunicação; elaboração de enquete sobre o consumo de água, luz e papel. Verificou-se oscilação de valores, não sendo possível traçar uma tendência de redução nos citados consumos. Entretanto, os resultados têm sido positivos, motivando a continuação do projeto.
Inovações tecnológicas para o ensino da promoção da saúde e enfermagem brasileira.
Authors: Serpa Maria da Glória Noronha 
Published: June 2017

A utilização de recursos informatizados, notadamente, o uso das redes de comunicação têm-se propagado progressivamente no âmbito da educação universitária, nos mais diferentes campos do saber. A inserção das novas tecnologias na educação aponta alternativas para a melhoria da educação e sua democratização, mas ao mesmo tempo, trazem novos desafios e questionamentos a serem enfrentados pelo professores e demais profissionais envolvidos na construção de atividades educacionais.
Estresse ocupacional crônico e o setor de atuação dos profissionais de enfermagem da rede hospitalar
Authors: França Flávia Maria de , Ferrari Rogério 
Published: June 2017

O estudo teve como objetivo avaliar o estresse ocupacional crônico, conhecido como Síndrome de Burnout, entre os profissionais de enfermagem de dois hospitais de médio porte de Cáceres – MT, e conhecer os setores de atuação da rede hospitalar onde os profissionais são mais acometidos. Trata-se de um estudo epidemiológico do tipo transversal, com abordagem quantitativa. A amostra do estudo foi composta por 141 profissionais de enfermagem, pertencentes aos três níveis hierárquicos: auxiliar de enfermagem, técnico de enfermagem e enfermeiro. Como instrumento foi utilizado um questionário para o levantamento dos aspectos sócio-demográficos e laborais, acrescido do Maslach Burnout Inventory (MBI). Os resultados apontam que dos 141 profissionais, 13 (9,58%) estão em estado de Burnout. Observou-se maior incidência da síndrome entre os profissionais lotados no setor administrativo (40,0%) se comparado ao setor aberto (6,97%) e fechado (2,85%). Apresentando diferença estatisticamente significante entre os setores administrativo X aberto (ρ = 0, 01) e setor administrativo X fechado (ρ= 0, 039). Portanto, considera-se imprescindível refletir e desenvolver novos estudos a respeito dessa temática para melhor compreender os fatores que contribuem para o processo saúde-doença, dos trabalhadores de enfermagem em instituições hospitalares.
Percepção dos enfermeiros frente à sistematização da assistência de enfermagem na UTI Neonatal do Hospital Regional em Cáceres - Mato Grosso
Authors: Porto Eliene De Souza , De França Flávia Maria , Da Costa Evellen Cristina Ferreira , Greve Poliana Roma 
Published: June 2017

RESUMOEstudo exploratório de abordagem qualitativa, com perfil descritivo do tipo Estudo de Caso. Objetivo geral: análise da implementação da SAE, na UTIN do hospital Regional em Cáceres- Mato Grosso. Os dados foram obtidos por meio de entrevistas, somando cinco profissionais enfermeiros da UTI – Neonatal. Utilizado questionário contendo perguntas abertas e fechadas e análise de 1 prontuário. Os resultados demonstraram que os enfermeiros operacionalizam, conhecem e percebem a importância da SAE como instrumento metodológico que orienta a prática do cuidado e como reconhecimento profissional, porém a prática deste processo não estavam suas fases inter-relacionadas e que existia falta de coerência das ações prescritas com o estado de saúde do paciente. Á analise do prontuário demonstrou que não existe sistematização da assistência de enfermagem nesta clinica. Dos 707 dias analisados houve apenas 30 registros de Investigação de enfermagem ou 4.24% dos cuidados voltado para essa fase, diagnóstico e planejamento 0%, implementação 57 dias ou 8.26%, e avaliação houve 23 dias ou 3.24% nos quais a enfermagem registrou seus cuidados, somando 15.55% de assistência registrada em prontuário.Descritores: Enfermagem, Assistência, Prontuário.
Estratégias intersetoriais de promoção da saúde de idosos no Centro Sul Fluminense, Brasil: relato de experiência
Authors: Machado Wiliam César Alves , Moutinho José Assunção , Figueiredo Nébia Maria Almeida de 
Published: June 2017

Objetivo: Discutir os reflexos das estratégias intersetoriais de promoção da saúde de idosos adotadas na região Centro Sul Fluminense, considerando-se a gradativa redução dos procedimentos hospitalares de média e alta complexidade para essas pessoas. Método: Trata-se de relato de experiência desenvolvido no primeiro semestre de 2012, a partir dos dados cadastrais referentes ao período de 2008 a 2011, disponíveis no Sistema de Indicadores de Saúde e Acompanhamento de Políticas do Idoso, e no Sistema de Informações Hospitalares Descentralizado – SIHD2. Resultados: Houve redução média de 63,13% nos casos de hipertensão arterial sistêmica; 69,89% nos casos de diabetes; 47,67% de quedas e suas complicações; 31,80% das pneumonias; e 79,20% nos diagnósticos de urgências clínicas e cirúrgica. Conclusão: Constatou-se gradativa redução nos procedimentos hospitalares de média e alta complexidade, possibilitando substantiva melhoria da qualidade de vida e saúde dos idosos da região.