The Effect of Aortic Angulation on Clinical Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement

ABSTRACT Introduction: The aim of this study was to assess the impact of aortic angulation (AA) on periprocedural and in-hospital complications as well as mortality of patients undergoing Evolut™ R valve implantation. Methods: A retrospective study was conducted on 264 patients who underwent transfemoral-approach transcatheter aortic valve replacement with self-expandable valve at our hospital between August 2015 and August 2022. These patients underwent multislice computer tomography scans to evaluate AA. Transcatheter aortic valve replacement endpoints, device success, and clinical events were assessed according to the definitions provided by the Valve Academic Research Consortium-3. Cumulative events included paravalvular leak, permanent pacemaker implantation, new-onset stroke, and in-hospital mortality. Patients were divided into two groups, AA ≤ 48° and AA > 48°, based on the mean AA measurement (48.3±8.8) on multislice computer tomography. Results: Multivariable logistic regression analysis was performed to identify predictors of cumulative events, utilizing variables with a P-value < 0.2 obtained from univariable logistic regression analysis, including AA, age, hypertension, chronic renal failure, and heart failure. AA (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 0.89-3.38, P=0.104), age (OR: 1.04, 95% CI: 0.99-1.10, P=0.099), hypertension (OR: 1.66, 95% CI: 0.82-3.33, P=0.155), chronic renal failure (OR: 1.82, 95% CI: 0.92-3.61, P=0.084), and heart failure (OR: 0.57, 95% CI: 0.27-1.21, P=0.145) were not found to be significantly associated with cumulative events in the multivariable logistic regression analysis. Conclusion: This study demonstrated that increased AA does not have a significant impact on intraprocedural and periprocedural complications of patients with new generation self-expandable valves implanted.

A percepção dos estudantes de enfermagem sobre o exame papanicolau para diagnóstico das doenças ginecológicas / The nursing students' viewpoint regarding the papanicolaou test for gynecological diseases diagnosis / La percepción de los estudiantes de enfermería sobre el examen papanicolau para diagnóstico de las enfermedad ginecológicas

Objetivo: Desvelar a percepção dos estudantes de enfermagem sobre o exame Papanicolau no diagnóstico das doenças ginecológicas. Métodos: descritivo e exploratório, com abordagem quali-quantitativa. A pesquisa foi realizada nas Faculdades Integradas de Patos no curso de enfermagem. A amostra composta por 100 estudantes de enfermagem que aceitaram participar da pesquisa. Resultados: Todos os estudantes sabem da eficácia do exame, porém nem todos tiveram a oportunidade de realizar o mesmo durante os estágios, além disso, nota-se que os estudantes sabem a importância do exame Papanicolau e as orientações necessárias para a saúde da mulher. Conclusão: Evidenciou-se a importância do conhecimento teórico e prático dos estudantes e futuros profissionais da enfermagem, sobre a conduta do exame e orientações a serem repassadas para as usuárias que venham a realizar o papanicolau

Objective: The study's purpose has been to present the nursing students' perception with regards to the Papanicolaou test (Pap smear, also called Pap test) for gynecological diseases diagnosis. Methods: It is a descriptive-exploratory study with both qualitative and quantitative approaches. The research was carried out in the Nursing Graduation Course from the Higher Education Institution named Faculdades Integradas de Patos. The sample consisted of 100 nursing students who accepted to participate. Results: The results have shown that all students were aware about the efficacy of the exam, and only 32% did not have the opportunity to do such procedure during the internships. Furthermore, it was noted that students have a positive perception about the Pap smear and the necessary guidelines for promoting women's health. Conclusion: It was possible to underline the importance of both theoretical and practical knowledge of students and future nursing professionals, concerning the exam conduct and also the guidelines to be passed on to the users who will perform the Pap smear

Objetivo: Desvelar la percepción de los estudiantes de enfermería sobre el examen Papanicolau en el diagnóstico de las enfermedades ginecológicas. Métodos: descriptivo y exploratorio, con abordaje cuali-cuantitativo. La investigación fue realizada en las Faculdades Integradas de Patos en el curso de enfermería. La muestra fue compuesta por 100 estudiantes de enfermería que aceptaron participar en la investigación. Resultados: Todos los estudiantes saben de la eficacia del examen, pero no todos tuvieron la oportunidad de realizar lo mismo durante las prácticas, además, se nota que los estudiantes saben de la importancia del examen Papanicolau y las orientaciones necesarias para la salud de la mujer. Conclusión: Se evidenció la importancia del conocimiento téorico y práctico de los estudiantes y futuros profesionales de enfermería, sobre la conducta del examen y orientaciones que van ser repasadas para las usuarias que vengan a realizar el papanicolau

Principais causas da rejeição de rim em pacientes transplantados / Main causes of rejection of rim in transplanted patients

Objetivo: descrever as principais causas da rejeição de rim em pacientes transplantados apontadas pela literatura. Metodologia: trata-se de um estudo de revisão. A coleta de dados foi realizada na Literatura Latino-Americana e do Caribe em Ciências da Saúde e na Scientific Electronic Library Online. Para a seleção dos estudos, adotaram-se os seguintes critérios de elegibilidade: artigos no formato texto completo e publicado em língua portuguesa. Foram excluídos os estudos que abordavam a rejeição em outros tipos de transplantes. Resultados: a partir da análise dos estudos evidencia-se que as complicações cardiovasculares, digestivas, tumorais e infecciosas estão com maior incidência entre os pacientes transplantados e que a causa relaciona-se com a terapia imunossupressora. Conclusão: acredita-se que o estudo possa contribuir para as boas práticas assistenciais a tal clientela, e que assim se possam implementar medidas preventivas embasadas nas melhores evidências científicas.

Objective: to describe the main causes of kidney rejection in transplanted patients mentioned at the literature. Methodology: this is a review study. Data collection was carried out in the Latin American and Caribbean Literature in Health Sciences and the Scientific Electronic Library Online. In order to select the studies, the following eligibility criteria were adopted: articles in full text format and published in Portuguese. Studies addressing rejection in other types of transplants were excluded. Results: from the analysis of the studies it is evident that cardiovascular, digestive, tumor and infectious complications are more frequent among transplanted patients and that the cause is related to immunosuppressive therapy. Conclusion: it is believed that the study can contribute to the good practices of assistance to such clientele, and so that preventive measures based on the best scientific evidence can be implemented.

Comparison of Transcatheter Aortic Valve Implantationversus Surgical Aortic Valve Replacement to Improve Quality of Life in Patients >70 Years of Age with Severe Aortic Stenosis

Abstract Objective: Transcatheter aortic valve implantation has recently been used in the treatment of severe aortic valve stenosis, particularly in patients with high mortality and morbidity rates for open surgery. The purpose of this study was to compare quality of life in patients over 70 years of age undergoing surgical or transcatheter aortic valve implantation, before the procedure and in the early post-procedural period. Methods: Seventy-nine patients were included in the study, 38 (48.1%) male and 41 (51.9%) female. Mean age of patients was 74.3±5.2 (70-91) years. The surgical aortic valve replacement group consisted of 51 (64.6%) patients and the transcatheter aortic valve replacement group of 28 (35.4%). Quality of life data before the procedure and at the 3rd month postoperatively in patients aged 70 years and older undergoing surgical or transcatheter aortic valve implantation were assessed using the 36-item Short Form Health Survey form. Results: Positive increases in physical task difficulty (13.2±9.8vs. 5.1±7.3) (P=0.001), emotional task difficulty (14.4±11.9 vs.8.5±6.4) (P=0.035), and mental health (0.4±10.4 vs. 9.6±15.1) (P=0.001; P<0.01) scores in patients undergoing transcatheter aortic valve replacement were significantly higher compared to the surgical aortic valve replacement group. No statistically significant difference was determined between the groups in terms of pain, vitality, social function, physical function or general health scores in the preoperative and postoperative periods. Conclusion: The positive increase in quality of life parameters in the transcatheter aortic valve implantation group at the 3rd month postoperatively was significantly higher compared to the surgical aortic valve replacement group.

Effects of polishing procedures on color stability of composite resins

The purpose of this study was to investigate the effect of different polishing methods on color stability of posterior, universal and nanohybrid composite resin restorative materials upon exposure to a staining agent. Twenty-five specimens were prepared for each of 5 different composite resins (Filtek Z250, Filtek P60, Quadrant LC, Grandio and Filtek Supreme). Specimens were divided into 5 groups and different polishing procedures, including polishing discs (Pd), polishing discs then diamond polishing paste (PdP), polishing discs then a liquid polishing system (Biscover) (PdB), and combinations of these (PdPB) were used. Unpolished specimens served as the control (C). The specimens were stored for 48 h in a coffee solution. The color of all specimens was measured before and after exposure with a colorimeter, and total color change (DE*) were calculated. The data were analyzed with a two-way ANOVA and the means were compared by Tukey HSD test (a=0.05). The lowest color difference was observed in the groups PdP and C, while the highest color difference was observed in PdPB, and PdB. When comparing the five different restorative materials, no significant difference was observed between FiltekP60 and FiltekZ250, and these materials demonstrated significantly less color change than Quadrant LC and the nanohybrid materials (Grandio, Filtek Supreme). The posterior (Filtek P60) and universal (Filtek Z250) composite resin restorative materials, which do not contain tetraethyleneglycol dimethacrylate (TEGDMA), were found to be less stainable than the nanohybrid (Grandio, Filtek Supreme) and universal (Quadrant LC) composite resins, which contain TEGDMA. The use of diamond polishing paste after polishing with polishing discs significantly decreased staining when compared to the groups that used polishing discs alone, for all restorative materials tested. The highest color change values were obtained for the specimens that were polished with the...