cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14316901.v1
title: Ser49Gly Beta1-Adrenergic Receptor Genetic Polymorphism as a Death Predictor in Brazilian Patients with Heart Failure

description: Abstract Background The role of Ser49Gly beta1-adrenergic receptor genetic polymorphism (ADBR1-GP-Ser49Gly) as a predictor of death in heart failure (HF) is not established for the Brazilian population. Objectives To evaluate the association between ADBR1-GP-Ser49Gly and clinical outcomes in individuals with HF with reduced ejection fraction. Methods Secondary analysis of medical records of 178 patients and genotypes of GPRβ1-Ser49Gly variants, classified as Ser-Ser, Ser-Gly and Gly-Gly. To evaluate their association with clinical outcome. A significance level of 5% was adopted. Results Cohort means were: clinical follow-up 6.7 years, age 63.5 years, 64.6% of men and 55.1% of whites. HF etiologies were predominantly ischemic (31.5%), idiopathic (23.6%) and hypertensive (15.7%). The genetic profile was distributed as follows: 122 Ser-Ser (68.5%), 52 Ser-Gly (28.7%) and 5 Gly-Gly (2.8%). There was a significant association between these genotypes and mean NYHA functional class at the end of follow-up (p = 0.014) with Gly-Gly being associated with less advanced NYHA. In relation to the clinical outcomes, there was a significant association (p = 0.026) between mortality and GPRβ1-Ser49Gly: the number of deaths in patients with Ser-Gly (12) or Gly-Gly (1) was lower than in those with Ser-Ser (54). The Gly allele had an independent protective effect maintained after multivariate analysis and was associated with a reduction of 63% in the risk of death (p = 0.03; Odds Ratio 0.37 – CI 0.15–0.91). Conclusion The presence of β1-AR-GP Gly-Gly was associated with better clinical outcome evaluated by NYHA functional class and was a predictor of lower risk of mortality, regardless of other factors, in a 6.7-year of follow-up. (Arq Bras Cardiol. 2020; 114(4):613-615)
DOI: 10.6084/m9.figshare.14316901
title: Ser49Gly Beta1-Adrenergic Receptor Genetic Polymorphism as a Death Predictor in Brazilian Patients with Heart Failure

description: Abstract Background The role of Ser49Gly beta1-adrenergic receptor genetic polymorphism (ADBR1-GP-Ser49Gly) as a predictor of death in heart failure (HF) is not established for the Brazilian population. Objectives To evaluate the association between ADBR1-GP-Ser49Gly and clinical outcomes in individuals with HF with reduced ejection fraction. Methods Secondary analysis of medical records of 178 patients and genotypes of GPRβ1-Ser49Gly variants, classified as Ser-Ser, Ser-Gly and Gly-Gly. To evaluate their association with clinical outcome. A significance level of 5% was adopted. Results Cohort means were: clinical follow-up 6.7 years, age 63.5 years, 64.6% of men and 55.1% of whites. HF etiologies were predominantly ischemic (31.5%), idiopathic (23.6%) and hypertensive (15.7%). The genetic profile was distributed as follows: 122 Ser-Ser (68.5%), 52 Ser-Gly (28.7%) and 5 Gly-Gly (2.8%). There was a significant association between these genotypes and mean NYHA functional class at the end of follow-up (p = 0.014) with Gly-Gly being associated with less advanced NYHA. In relation to the clinical outcomes, there was a significant association (p = 0.026) between mortality and GPRβ1-Ser49Gly: the number of deaths in patients with Ser-Gly (12) or Gly-Gly (1) was lower than in those with Ser-Ser (54). The Gly allele had an independent protective effect maintained after multivariate analysis and was associated with a reduction of 63% in the risk of death (p = 0.03; Odds Ratio 0.37 – CI 0.15–0.91). Conclusion The presence of β1-AR-GP Gly-Gly was associated with better clinical outcome evaluated by NYHA functional class and was a predictor of lower risk of mortality, regardless of other factors, in a 6.7-year of follow-up. (Arq Bras Cardiol. 2020; 114(4):613-615)
DOI: 10.6084/m9.figshare.14316903
title: Extent of Left Atrial Ablation Lesions and Atrial Fibrillation Recurrence after Catheter Ablation - A Systematic Review and Meta-Analysis

description: Abstract Background: Atrial fibrillation (AF) is known to induce atrial remodeling, which promotes fibrosis related to arrhythmogenesis. Accordingly, since scars induced by catheter ablation (CA) can reduce unablated fibrotic areas, greater extent of left atrial (LA) scarring may be associated with less AF recurrence after CA. Objectives: This study aims to investigate, through systematic review and meta-analysis, whether the amount of LA scarring, seen on late gadolinium enhancement magnetic resonance imaging, is associated with less AF recurrence after CA. Methods: The recommendations of the MOOSE guideline were followed. Database search was conducted in PubMed and Cochrane Central Register of Controlled Trials (comentário 1) until January 2019 (comentário 2). Two authors performed screening, data extraction, and quality evaluation. All studies were graded as good quality. A funnel plot was generated, showing no publication bias. Statistical significance was defined as p value &lt; 0.05. Results: Eight observational studies were included in the systematic review, four of which were included in the meta-analysis. Six of the eight studies included in the systematic review showed that greater extension of LA scarring is associated with less AF recurrence after CA. Meta-analysis showed that greater extension of LA scarring is associated with less AF recurrence (SMD = 0.52; 95% CI 0.27 - 0.76; p &lt; 0.0001). Conclusion: Greater extension of LA scarring is possibly associated with less AF recurrence after CA. Randomized studies that explore ablation methods based on this association are fundamental.
DOI: 10.6084/m9.figshare.14316903.v1
title: Extent of Left Atrial Ablation Lesions and Atrial Fibrillation Recurrence after Catheter Ablation - A Systematic Review and Meta-Analysis

description: Abstract Background: Atrial fibrillation (AF) is known to induce atrial remodeling, which promotes fibrosis related to arrhythmogenesis. Accordingly, since scars induced by catheter ablation (CA) can reduce unablated fibrotic areas, greater extent of left atrial (LA) scarring may be associated with less AF recurrence after CA. Objectives: This study aims to investigate, through systematic review and meta-analysis, whether the amount of LA scarring, seen on late gadolinium enhancement magnetic resonance imaging, is associated with less AF recurrence after CA. Methods: The recommendations of the MOOSE guideline were followed. Database search was conducted in PubMed and Cochrane Central Register of Controlled Trials (comentário 1) until January 2019 (comentário 2). Two authors performed screening, data extraction, and quality evaluation. All studies were graded as good quality. A funnel plot was generated, showing no publication bias. Statistical significance was defined as p value &lt; 0.05. Results: Eight observational studies were included in the systematic review, four of which were included in the meta-analysis. Six of the eight studies included in the systematic review showed that greater extension of LA scarring is associated with less AF recurrence after CA. Meta-analysis showed that greater extension of LA scarring is associated with less AF recurrence (SMD = 0.52; 95% CI 0.27 - 0.76; p &lt; 0.0001). Conclusion: Greater extension of LA scarring is possibly associated with less AF recurrence after CA. Randomized studies that explore ablation methods based on this association are fundamental.
DOI: 10.6084/m9.figshare.14316904
title: Prognostic Value of NT-proBNP versus Killip Classification in Patients with Acute Coronary Syndromes

description: Abstract Background: Plasma levels of brain natriuretic peptides have better diagnostic accuracy compared to clinical-radiologic judgment for acute heart failure. In acute coronary syndromes (ACS), the prognostic value of acute heart failure is incorporated into predictive models through Killip classification. It is not established whether NT-proBNP could increment prognostic prediction. Objective: To evaluate whether NT-proBNP, as a measure of left ventricular dysfunction, improves the in-hospital prognostic value of the GRACE score in ACS. Methods: Patients admitted due to acute chest pain, with electrocardiogram and/or troponin criteria for ACS were included in the study. The plasma level of NT-proBNP was measured at hospital admission and the primary endpoint was defined as cardiovascular death during hospitalization. P-value &lt; 0.05 was considered as significant. Results: Among 352 patients studied, cardiovascular mortality was 4.8%. The predictive value of NT-proBNP for cardiovascular death was shown by a C-statistic of 0.78 (95% CI = 0.65-0.90). After adjustment for the GRACE model subtracted by Killip variable, NT-proBNP remained independently associated with cardiovascular death (p = 0.015). However, discrimination by the GRACE-BNP logistic model (C-statistics = 0.83; 95%CI = 0.69-0.97) was not superior to the traditional GRACE Score with Killip (C-statistic = 0.82; 95%CI = 0.68-0.97). The GRACE-BNP model did not provide improvement in the classification of patients to high risk by the GRACE Score (net reclassification index = - 0.15; p = 0.14). Conclusion: Despite the statistical association with cardiovascular death, there was no evidence that NT-proBNP increments the prognostic value of GRACE score in ACS.
DOI: 10.6084/m9.figshare.14316904.v1
title: Prognostic Value of NT-proBNP versus Killip Classification in Patients with Acute Coronary Syndromes

description: Abstract Background: Plasma levels of brain natriuretic peptides have better diagnostic accuracy compared to clinical-radiologic judgment for acute heart failure. In acute coronary syndromes (ACS), the prognostic value of acute heart failure is incorporated into predictive models through Killip classification. It is not established whether NT-proBNP could increment prognostic prediction. Objective: To evaluate whether NT-proBNP, as a measure of left ventricular dysfunction, improves the in-hospital prognostic value of the GRACE score in ACS. Methods: Patients admitted due to acute chest pain, with electrocardiogram and/or troponin criteria for ACS were included in the study. The plasma level of NT-proBNP was measured at hospital admission and the primary endpoint was defined as cardiovascular death during hospitalization. P-value &lt; 0.05 was considered as significant. Results: Among 352 patients studied, cardiovascular mortality was 4.8%. The predictive value of NT-proBNP for cardiovascular death was shown by a C-statistic of 0.78 (95% CI = 0.65-0.90). After adjustment for the GRACE model subtracted by Killip variable, NT-proBNP remained independently associated with cardiovascular death (p = 0.015). However, discrimination by the GRACE-BNP logistic model (C-statistics = 0.83; 95%CI = 0.69-0.97) was not superior to the traditional GRACE Score with Killip (C-statistic = 0.82; 95%CI = 0.68-0.97). The GRACE-BNP model did not provide improvement in the classification of patients to high risk by the GRACE Score (net reclassification index = - 0.15; p = 0.14). Conclusion: Despite the statistical association with cardiovascular death, there was no evidence that NT-proBNP increments the prognostic value of GRACE score in ACS.
DOI: 10.6084/m9.figshare.14316907
title: Galectin-3 Levels in Patients with Chronic Constrictive Pericarditis

description: Abstract Background Galectin-3 (Gal-3) is a proinflammatory, profibrotic molecule implicated in the pathogenesis of heart failure. The role of Gal-3 in patients with chronic constrictive pericarditis (CCP) is not clear. Objective The aim of this study was to assess plasma Gal-3 in patients with CCP and correlate it with clinical, functional and histologic parameters. Methods We prospectively evaluated 25 symptomatic patients with CCP referred for pericardiectomy and 21 healthy controls. Patients underwent clinical assessment, Gal-3 and B-type natriuretic peptide (BNP) measurements, echocardiography, cardiac magnetic resonance imaging and cardiopulmonary exercise test (CPET) at baseline. Six months after pericardiectomy CPET was repeated. An alpha error &lt; 5% was considered statistically significant, with a confidence interval of 95%. Results Twenty-five patients with a median age of 45 years were included. Etiology was mainly idiopathic (n = 19, 76%); and 14 (56%) patients had NYHA functional class III/IV. Median BNP and Gal-3 were 143 (89-209) pg/dL and 14.8 (9.7-17.2) ng/mL, respectively. Gal-3 levels were not significantly higher in CCP patients than in control (p = 0.22). There were no significant correlations of Gal-3 with BNP, echocardiographic and cardiac magnetic resonance measures and histological findings. After pericardiectomy, it was found a statistically significant correlation between Gal-3 and the CPTE measures test duration (r = –0.79; p &lt; 0.001) and exercise time (r = –0.79; p &lt; 0.001). Conclusions Patients with CCP had normal levels of Gal-3 as compared to the controls. Gal-3 did not correlate with morphological and functional measures before pericardiectomy. However, the associations between Gal-3 and exercise intolerance after pericardiectomy may suggest a role of Gal-3 in prognosis prediction after pericardiectomy. (Arq Bras Cardiol. 2020; 114(4):683-689)
DOI: 10.6084/m9.figshare.14316907.v1
title: Galectin-3 Levels in Patients with Chronic Constrictive Pericarditis

description: Abstract Background Galectin-3 (Gal-3) is a proinflammatory, profibrotic molecule implicated in the pathogenesis of heart failure. The role of Gal-3 in patients with chronic constrictive pericarditis (CCP) is not clear. Objective The aim of this study was to assess plasma Gal-3 in patients with CCP and correlate it with clinical, functional and histologic parameters. Methods We prospectively evaluated 25 symptomatic patients with CCP referred for pericardiectomy and 21 healthy controls. Patients underwent clinical assessment, Gal-3 and B-type natriuretic peptide (BNP) measurements, echocardiography, cardiac magnetic resonance imaging and cardiopulmonary exercise test (CPET) at baseline. Six months after pericardiectomy CPET was repeated. An alpha error &lt; 5% was considered statistically significant, with a confidence interval of 95%. Results Twenty-five patients with a median age of 45 years were included. Etiology was mainly idiopathic (n = 19, 76%); and 14 (56%) patients had NYHA functional class III/IV. Median BNP and Gal-3 were 143 (89-209) pg/dL and 14.8 (9.7-17.2) ng/mL, respectively. Gal-3 levels were not significantly higher in CCP patients than in control (p = 0.22). There were no significant correlations of Gal-3 with BNP, echocardiographic and cardiac magnetic resonance measures and histological findings. After pericardiectomy, it was found a statistically significant correlation between Gal-3 and the CPTE measures test duration (r = –0.79; p &lt; 0.001) and exercise time (r = –0.79; p &lt; 0.001). Conclusions Patients with CCP had normal levels of Gal-3 as compared to the controls. Gal-3 did not correlate with morphological and functional measures before pericardiectomy. However, the associations between Gal-3 and exercise intolerance after pericardiectomy may suggest a role of Gal-3 in prognosis prediction after pericardiectomy. (Arq Bras Cardiol. 2020; 114(4):683-689)
DOI: 10.6084/m9.figshare.14316909.v1
title: Absence of Nocturnal Fall in Blood Pressure Detected by Ambulatory Blood Pressure Monitoring in Acute Chagas Disease Patients with Oral Infection

description: Abstract Background The involvement of the autonomic nervous system is one of the mechanisms proposed to explain the progression of myocardial lesion in Chagas disease. Evidences have shown changes in sympathetic and parasympathetic nervous system since the acute phase of the disease, and studies to clarify the pathophysiological and prognostic value of these changes are needed. Objetives To assess blood pressure profile by ambulatory blood pressure monitoring (ABPM) in normotensive patients with acute Chagas disease (ACD) without apparent cardiac damage, and the influence of the infection on nocturnal blood pressure fall. Methods ABPM was performed with 54 patients with ACD and a control group composed of 54 age- and sex-matched normotensive individuals. The alpha level of significance (type I error rate) was set at 5%. Results In the total of 54 patients, 74.0% did not show nocturnal fall in systolic blood pressure, 53.7% did not show nocturnal fall in diastolic blood pressure, and lack of both nocturnal fall in SBP and DBP was observed in 51.8% (*p&lt;0.05). In 12.9% of patients, there was an increase in SBP and in 18.5% increase in DBP (p&lt;0.05). Conclusions In patients with acute Chagas disease, a significant absence of the physiological fall in both systolic and diastolic blood pressure was observed during sleep, and some of the patients showed nocturnal increase in these parameters. These findings suggest autonomic changes in the acute phase of Chagas disease. (Arq Bras Cardiol. 2020; 114(4):711-715)
DOI: 10.6084/m9.figshare.14316909
title: Absence of Nocturnal Fall in Blood Pressure Detected by Ambulatory Blood Pressure Monitoring in Acute Chagas Disease Patients with Oral Infection

description: Abstract Background The involvement of the autonomic nervous system is one of the mechanisms proposed to explain the progression of myocardial lesion in Chagas disease. Evidences have shown changes in sympathetic and parasympathetic nervous system since the acute phase of the disease, and studies to clarify the pathophysiological and prognostic value of these changes are needed. Objetives To assess blood pressure profile by ambulatory blood pressure monitoring (ABPM) in normotensive patients with acute Chagas disease (ACD) without apparent cardiac damage, and the influence of the infection on nocturnal blood pressure fall. Methods ABPM was performed with 54 patients with ACD and a control group composed of 54 age- and sex-matched normotensive individuals. The alpha level of significance (type I error rate) was set at 5%. Results In the total of 54 patients, 74.0% did not show nocturnal fall in systolic blood pressure, 53.7% did not show nocturnal fall in diastolic blood pressure, and lack of both nocturnal fall in SBP and DBP was observed in 51.8% (*p&lt;0.05). In 12.9% of patients, there was an increase in SBP and in 18.5% increase in DBP (p&lt;0.05). Conclusions In patients with acute Chagas disease, a significant absence of the physiological fall in both systolic and diastolic blood pressure was observed during sleep, and some of the patients showed nocturnal increase in these parameters. These findings suggest autonomic changes in the acute phase of Chagas disease. (Arq Bras Cardiol. 2020; 114(4):711-715)
DOI: 10.6084/m9.figshare.14316913
title: Medical Students' Perceptions of the Diagnostic Process

description: Abstract: The purpose of this study was to asses the patterns of medical students’ responses to the Diagnostic Thinking Inventory (DTI) at the University of Brasília. The inventory was administred within an 11 year timeframe to 677 students of both sexes early in their clinical experience. Statical procedures were used to identify interrlated item sets and groups with similar response patterns, as well as diferences between groups and their relationships with distinctive features. Results of the analyses revealed six salent DTI dimensions designeted as follows: diligente procedure, easy grasp, flexibility of conception, comparative appraisal, abstraction of meaning, and perception of uncertainty. Six studentclassification groups were identified based on clustering of the dimensions índices. Studens’ DTI índices and respective group affiliation were related to theis inclusion period in the study timeframe, early clinical achievement-gradient, sel-efficacy level, and two-semester frequency of peer tutoring after the DTI appraisal. In conclusion, medical students differ in their perceptions of the diagnostic process as entalled by the DTI, and the patterns of perceptions have meaningful relationships with theur learning progress and options.
DOI: 10.6084/m9.figshare.14316913.v1
title: Medical Students' Perceptions of the Diagnostic Process

description: Abstract: The purpose of this study was to asses the patterns of medical students’ responses to the Diagnostic Thinking Inventory (DTI) at the University of Brasília. The inventory was administred within an 11 year timeframe to 677 students of both sexes early in their clinical experience. Statical procedures were used to identify interrlated item sets and groups with similar response patterns, as well as diferences between groups and their relationships with distinctive features. Results of the analyses revealed six salent DTI dimensions designeted as follows: diligente procedure, easy grasp, flexibility of conception, comparative appraisal, abstraction of meaning, and perception of uncertainty. Six studentclassification groups were identified based on clustering of the dimensions índices. Studens’ DTI índices and respective group affiliation were related to theis inclusion period in the study timeframe, early clinical achievement-gradient, sel-efficacy level, and two-semester frequency of peer tutoring after the DTI appraisal. In conclusion, medical students differ in their perceptions of the diagnostic process as entalled by the DTI, and the patterns of perceptions have meaningful relationships with theur learning progress and options.
DOI: 10.6084/m9.figshare.14316916
title: Graduation Program Revision and lnstitutional Development: An Experience in Faculdade de Medicina do Triângulo Mineiro

description: Abstract: The aim of this evaluative research work was to obtain data and informations about the program of the Pathofogy Graduation Course of Faculdade de Medicina do Triângulo Mineiro (PGC/FMTM) in Uberaba (MG) and evaluate the effiCIency, efficacy and qualIty levels, in addition to their relationships with the institutional development. The authors perfomed a retrospective study related to life histories, program proposals, docent and discent numbers, theses, research lines, physical spaces, and academic infra structural resources. The data obtained were analysed focusing the context and endresults, using avaliation criteria for program efficiency and efficacy. With respect to program quality, reputation, resources, results and aggregated values were all considered in the evaluation. The results were discussed and their correlation with the institutional development was also performed. The resulls of this work favor the importance of a regular revision in the postgraduatíon programs of brazilian superior teaching institutions in general, and particularfy in PGC/FMTM.
DOI: 10.6084/m9.figshare.14316916.v1
title: Graduation Program Revision and lnstitutional Development: An Experience in Faculdade de Medicina do Triângulo Mineiro

description: Abstract: The aim of this evaluative research work was to obtain data and informations about the program of the Pathofogy Graduation Course of Faculdade de Medicina do Triângulo Mineiro (PGC/FMTM) in Uberaba (MG) and evaluate the effiCIency, efficacy and qualIty levels, in addition to their relationships with the institutional development. The authors perfomed a retrospective study related to life histories, program proposals, docent and discent numbers, theses, research lines, physical spaces, and academic infra structural resources. The data obtained were analysed focusing the context and endresults, using avaliation criteria for program efficiency and efficacy. With respect to program quality, reputation, resources, results and aggregated values were all considered in the evaluation. The results were discussed and their correlation with the institutional development was also performed. The resulls of this work favor the importance of a regular revision in the postgraduatíon programs of brazilian superior teaching institutions in general, and particularfy in PGC/FMTM.