Do oral and gut microbiota communicate through redox pathways? A novel asset of the nitrate-nitrite-NO pathway.

Nitrate may act as a regulator of •NO bioavailability via sequential reduction along the nitrate-nitrite-NO pathway with widespread health benefits, including a eubiotic effect on the oral and gut microbiota. Here, we discuss the molecular mechanisms of microbiota-host communication through redox pathways, via the production of •NO and oxidants by the family of NADPH oxidases, namely hydrogen peroxide (via Duox2), superoxide radical (via Nox1 and Nox2) and peroxynitrite, which leads to downstream activation of stress responses (Nrf2 and NFkB pathways) in the host mucosa. The activation of Nox2 by microbial metabolites is also discussed. Finally, we propose a new perspective in which both oral and gut microbiota communicate through redox pathways, with nitrate as the pivot linking both ecosystems.

Maternal diabetes affects rat offspring retinal structure and function: Sex-specific vulnerabilities at infancy.

AIMS: Maternal diabetes negatively impacts the offspring's brain, but little is known about its effects on the retina, which is also part of the central nervous system. We hypothesized that maternal diabetes adversely influences offspring retina development leading to structural and functional deficits. MAIN METHODS: Retinal structure and function were evaluated at infancy, by optical coherence tomography and electroretinography, in male and female offspring of control, diabetic and diabetic-treated with insulin Wistar rats. KEY FINDINGS: Maternal diabetes induced a delay in male and female offspring eye-opening, while insulin treatment expedited it. Structural analysis showed that maternal diabetes decreased the thickness of the inner and outer segment layer of photoreceptors in male offspring. Electroretinography also revealed that maternal diabetes decreased the amplitude of scotopic b-wave and flicker response in males, suggesting bipolar cells and cone photoreceptor dysfunction, an effect not observed in females. Conversely, maternal diabetes decreased cone arrestin protein levels in female retinas, while not affecting cone photoreceptor number. Dam insulin therapy was efficient in preventing the offspring photoreceptor changes. SIGNIFICANCE: Our results suggest that photoreceptors are affected by maternal diabetes, which may account for visual impairments at infancy. Notably, both male and female offspring presented specific vulnerabilities to hyperglycemia in this sensitive period of development.

Optimal Ablation Settings Predicting Durable Scar Detected Using LGE-MRI after Modified Left Atrial Anterior Line Ablation.

(1) Background: The modified anterior line (MAL) has been described as an alternative to the mitral isthmus line. Despite better ablation results, achieving a bidirectional line block can be challenging. We aimed to investigate the ablation parameters that determine a persistent scar on late-gadolinium enhancement magnet resonance imaging (LGE-MRI) as a surrogate parameter for successful ablation 3 months after MAL ablation. (2) Methods: Twenty-four consecutive patients who underwent a MAL ablation have been included. The indication for MAL was perimitral flutter (n = 5) or substrate ablation in the diffuse anterior left atrial (LA) low-voltage area in persistent atrial fibrillation (AF) (n = 19). The MAL was divided into three segments: segment 1 (S1) from mitral annulus to height of lower region of left atrial appendage (LAA) antrum; segment 2 (S2) height of lower region of LAA antrum to end of upper LAA antrum; segment 3 (S3) from end of upper LAA antrum to left superior pulmonary vein. Ablation was performed using a contact force irrigated catheter with a power of 40 Watt and guided by automated lesion tagging and the Ablation Index (AI). The AI target was left to the operator's choice. An inter-lesion distance of ≤6 mm was recommended. The bidirectional block was systematically evaluated using stimulation maneuvers at the end of procedure. All patients underwent LGE-MRI imaging at 3 months, regardless of symptoms, to identify myocardial lesions (scars). (3) Results: Bidirectional MAL block was achieved in all patients. LGE-MRI imaging revealed scarring in 45 of 72 (63%) segments. In all three segments of MAL, ablation time and AI were significantly higher in scarred areas compared with non-scar areas. The mean AI value to detect a durable scar was 514.2 in S1, 486.7 in S2 and 485.9 in S3. The mean ablation time to detect a scar was 20.4 s in S1, 22.1 s in S2 and 20.2 s in S3. Mean contact force and impedance drop were not significantly different between scar and non-scar areas. (4) Conclusions: Targeting optimal AI values is crucial to determine persistent left atrial scars on an LGE-MRI scan 3 months after ablation. AI guided linear left atrial ablation seems to be effective in producing durable lesions.

Meningite na infância: uma análise das internações hospitalares no Brasil / Meningitis in childhood: an analysis of hospital hospitalizations in Brazil

Objetivo: Analisar o perfil epidemiológico da meningite em crianças no Brasil. Método: Trata-se de estudo descritivo, cujos dados foram obtidos através de análise documental do Departamento de Informática do Sistema Único de Saúde (DATASUS) por meio de dados disponibilizados pela notificação no Sistema de Informação e Agravos de Notificação (Sinan). Foram utilizados dados da notificação de meningite no período de 2008 a 2019, em crianças até os 14 anos de idade no país. Resultados: Na faixa etária pediátrica, foram notificados 127.508 casos, o equivalente a 55,83% de todos os diagnósticos realizados neste período em todas as faixas etárias. Na amostra, houve maior prevalência da faixa etária entre 1 ano a 4 anos. Em relação ao sexo, o masculino foi o mais prevalente. Quanto à evolução dos casos notificados, a maioria dos pacientes tiveram alta hospitalar. Destes, a faixa etária entre 1 a 4 anos obteve maior prevalência. Quanto aos óbitos por meningite, houve maior prevalência da faixa etária de menores de 1 ano. O método quimiocitológico foi o método diagnóstico mais utilizado, evidenciando principalmente a meningite de etiologia viral. Conclusão: Verifica-se que os casos de meningite são prevalentes na faixa etária pediátrica, havendo predomínio da faixa etária entre 1 a 4 anos e do sexo masculino neste estudo. Ressalta-se a importância de ações preventivas, como a imunização vacinal, sobretudo quando se percebe a maior letalidade da meningite bacteriana

Influence of sleep quality on medical students' academic performance / Influência da qualidade do sono no desempenho acadêmico de estudantes de medicina

Objective: To identify the main factors affecting medical stu- dents' sleep quality and the probable relationship between sleep and academic performance throughout the course. Methods: A cross-sectional qualitative study was carried out at a private higher education institution in the city of Araguari (MG), Brazil. The sample consisted of 110 regularly enrolled medical students. A sociodemographic questionnaire and the Pittsburgh Sleep Quality Index Questionnaire were applied. Statistical analy- sis was performed using the one way analysis of variance test with the post-hoc Tukey test, two way analysis of variance Test, and Student's t-test. Results: Out of the 105 students analyzed, 19.04% (n=20) were classified as "good" sleepers and 80.95% (n=85) as "poor" sleepers. No statistically significant difference was observed between the Pittsburgh Sleep Quality Index Questionnaire scores and the students' grades averages or the students' academic terms. Conclusion: The majority of the students was classified as "poor" sleepers. The use of ener- getic substances and the female sex were the two significant factors that may affect sleep quality. There was no relationship between sleep quality and academic performance.

Objetivo: Identificar os principais fatores que afetam a qualidade do sono de acadêmicos de medicina e a provável relação entre o sono e o desempenho escolar ao longo do curso. Métodos: Estudo transversal de cunho qualiquantitativo realizado em uma institui- ção privada de ensino superior da cidade de Araguari (MG). A amostra foi constituída de 110 acadêmicos do curso de medi- cina regularmente matriculados. Aplicaram-se um questioná- rio sociodemográfico e o Questionário Índice de Qualidade de Sono de Pittsburgh. A análise estatística foi realizada pelo teste de análise de variância one way com post-hoc de Tukey, teste de análise de variância two way e teste t Student. Resultados: Dos 105 estudantes analisados, 19,05% (n=20) foram classificados como bons dormidores e 80,95% (n=85) como maus dormidores. Não houve diferença significativa entre o escore do Questioná- rio Índice de Qualidade de Sono de Pittsburgh e as médias de notas semestrais, tampouco entre o escore do questionário e os períodos letivos. Conclusão: A maioria dos acadêmicos foi clas- sificada como maus dormidores. Uso de substâncias energéticas e sexo feminino foram os fatores significativos que podem afetar a qualidade do sono. Não houve relação entre a qualidade do sono e o desempenho acadêmico.

Population pharmacokinetics and biodistribution of benznidazole in mice.

OBJECTIVES: To evaluate the population pharmacokinetics of different benznidazole treatment regimens and the drug's biodistribution in mice. METHODS: Two hundred mice were divided into five groups according to benznidazole dosing regimens: (1) 100 mg/kg/day for 20 days; (2) 100 mg/kg/day for 40 days; (3) 200 mg/kg/day for 20 days; (4) 40 mg/kg/day for 20 days; or (5) 40 mg/kg/day for 40 days. The mice were euthanized and blood, heart, liver, colon and brain were collected. Samples were prepared by liquid-liquid extraction and analysed by HPLC-diode-array detection. The pharmacokinetic analysis of benznidazole was evaluated via non-linear mixed-effects modelling using the NONMEN program. RESULTS: Our results demonstrate that mouse weight allometrically influences benznidazole clearance; the AUC curve and the highest plasma concentration are dose proportional; benznidazole does not influence its own metabolism; its tissue distribution is limited; and the standard treatment regimen for Chagas' disease in mice (100 mg/kg/day for 20 days) is inadequate from a pharmacokinetic standpoint, as are the other regimens tested in this study (100 mg/kg/day for 40 days, 200 mg/kg/day for 20 days and 40 mg/kg/day for 20 or 40 days). CONCLUSIONS: Benznidazole reformulations that allow better tissue penetration and plasma and tissue exposure should be evaluated to enable higher cure rates in both animals and patients. The population pharmacokinetic model developed here can allow optimization of the dosing regimen of benznidazole to treat experimental Chagas' disease. Determining appropriate treatment regimens in animals allows translation of these to clinical studies.

Influence of sleep quality on academic performance of medical students / Influência da qualidade do sono no desempenho acadêmico de estudantes de medicina

Objective: To know the prevalence of "poor" sleepers among medical students, to identify the main factors affecting sleep quality in this population, and the probable relationship between sleep and academic performance throughout the course. Methods: This is a cross-sectional qualitative and quantitative study carried out at a higher education private institution in the city of Araguari (MG) Brazil. The sample consisted of 110 medical students. A sociodemographic questionnaire and the Pittsburgh Sleep Quality Index were applied. Statistical analysis was performed using ANOVA one-way test with the post-hoc Tukey test, two-way ANOVA test and Student's t test. Results: Of the 105 students analyzed, 19.05% (n=20) were classified as "good" sleepers, and 80.95% (n=85) as poor sleepers. No statistically significant difference was observed between the Pittsburgh Sleep Quality Index scores and the students' grade averages or the students' academic terms. Conclusion: The majority of the students was classified as poor sleepers. The consumption of energetic substances and the female sex were the two significant factors that could affect sleep quality. There was no relationship between sleep quality and academic performance.

Objetivo: Conhecer a prevalência de maus dormidores, identificar os principais fatores que afetam a qualidade do sono dessa população e a provável relação entre o sono e o desempenho escolar ao longo do curso de medicina. Métodos: Estudo transversal de cunho qualiquantitativo, realizado em uma instituição privada de Ensino Superior da cidade de Araguari (MG). A amostra foi constituída de 110 acadêmicos do curso de medicina regularmente matriculados. Aplicaram-se um questionário sociodemográfico e o Índice de Qualidade do Sono de Pittsburgh. A análise estatística foi realizada pelo ANOVA one-way com post-hoc de Tukey, teste ANOVA two-way e teste t de Student. Resultados: Dos 105 estudantes analisados, 19,05% (n=20) foram classificados como bons dormidores e 80,95% (n=85) como maus dormidores. Não houve diferença significativa entre o escore do Índice de Qualidade do Sono de Pittsburgh e as médias de notas semestrais, tampouco entre o escore do Índice de Qualidade do Sono de Pittsburgh e os períodos letivos. Conclusão: A maioria dos acadêmicos foi classificada como maus dormidores. O uso de substâncias energéticas e o sexo feminino foram os fatores significativos que podem afetar a qualidade do sono. Não houve relação entre a qualidade do sono e o desempenho acadêmico.

The use of adenosine to identify dormant conduction after accessory pathway ablation: a single center experience and literature review.

INTRODUCTION: Atrio-ventricular reentrant tachycardias (AVRT) represent around 40 percent of supraventricular tachycardias. After ablation, recurrence rates are around 10 percent. Adenosine has been described as a useful tool to assess presence of dormant conduction and predict recurrence after apparently successful ablation. We reviewed the patients of our service and assessed the role of adenosine in predicting dormant conduction and factors that could influence recurrence rates. METHODS: We retrospectively reviewed electrophysiologic studies and medical charts of 65 patients who had AVRT ablation and had adenosine used to assess dormant conduction at a single quaternary center between 2011 and 2015. Dormant conduction was defined as transient recovery of the preexcitation (for pathways with antegrade conduction) or return of the retrograde conduction through an apparently successfully ablated concealed accessory pathway (AP). RESULTS: One patient was found to have dormant conduction (1.5%) with early recurrence that was not further ablated due to the difficult location of the AP. The overall recurrence rate was 4.6%. General features like location of AP's, their properties, ablation times and technique were assessed. CONCLUSION: Similar to its use in identifying other arrhythmias, adenosine may be useful in identifying dormant conduction for further ablation during initial ablation of an accessory pathway; however, the absence of dormant conduction on adenosine testing does not reliably predict non-recurrence. The low recurrence rates in our service may be related to the frequent use of irrigated tip catheters, 3D mapping and long average ablation time over the successful site of ablation.

Catheter ablation of atrial fibrillation-A key role in heart failure therapy?

Atrial fibrillation (AF) and heart failure (HF) are epidemic cardiac diseases and are often detected in the same patient. Recent evidence suggests that this is not a mere coincidence but that the strategy of AF treatment may impact HF development. This review comprehensively summarizes current trial data on rhythm and rate control strategies in atrial fibrillation with a special focus on catheter ablation of AF in HF patients. For a long time, rate and rhythm control strategies for AF have been regarded as equal regarding long term mortality. Decision making has been based on the symptoms of patients. Current trials, however, show that the treatment strategy of AF and its effectiveness may significantly impact survival of HF patients. The benefits of rhythm control in HF patients may have been masked by side effects of antiarrhythmic drugs. If rhythm control, however, is achieved by catheter ablation, a reduction of HF related mortality can be observed. As catheter ablation of AF may reduce mortality in HF patients, AF ablation should be preferred over medical treatment in HF patients. In general, HF patients may profit most from rigorous AF treatment.

Conjuntura brasileira no séc. XXI: o nó da nossa solidão / Brazilian conjuncture in the 21th Century: the knot of our loneliness

O propósito deste artigo é o de propor uma análise que contribua para apreensão dos principais elementos que determinam a conjuntura brasileira atual, desde as principais dinâmicas econômicas que evidenciam o painel da barbárie que acompanha a tentativa de retomada do circuito de valorização do capital até os elementos mais coetâneos, que atam este contexto mais amplo com os particulares acontecimentos e processos que podem distinguir a atual conjuntura brasileira. Ademais, o objetivo adicional deste artigo é o de pensarmos sobre os processos de resistência, tendo como referência temporal o ano de 2019.

The purpose of this paper is to propose an analysis that contributes to the apprehension of the main elements that determinates the current Brazilian conjuncture, from the main economic dynamics that evidences the barbarism panel that follows the attempt of restarting the capital appreciation cycle to the most contemporaneous elements, which ties this broader context with particular events and processes that can distinguish the current Brazilian conjuncture. Moreover, the additional objective of this article is to think about the resistance processes, having as a temporal reference the year 2019.

Ainda sobre os 80 anos do serviço social: direitos sociais em tempos de ruptura democrática / More about the 80th anniversary of social services: social rights in times of democratic breakdown

O artigo possui como feixe temático o processo contemporâneo que reedita o ciclo de ruptura da institucionalidade democrática no Brasil, desencadeado pelas forças reacionárias/conservadoras de agosto de 2016. Para as classes trabalhadoras estão em curso duras consequências da crise econômica mundial, combinadas com a disputa política decorrentes de uma governabilidade ilegítima: desemprego massivo, contenção salarial, perda de históricos direitos trabalhistas e garantias sociais recém-conquistadas, em suma, agravamento da pauperização no cenário histórico da superexploração e dependência. Com esses vetores de análise, o fio condutor da reflexão versa sobre as contradições que sobredeterminam os direitos sociais e as políticas sociais na periferia do capitalismo, atentando para as modulações dos direitos sociais no contexto da programática neodesenvolvimentista e de seu desmonte, bem como acerca dos dilemas contemporâneos do serviço social na intrincada conjuntura de afirmação/regressão dos direitos sociais.

This article focuses on the current process that is reshaping the cycle of democratic breakdown in Brazil, triggered by the reactionary/conservative forces of August 2016. The working classes are experiencing the harsh consequences of the global economic crisis combined with the political dispute arising from illegitimate governance: massive unemployment, wage restraint, loss of historic labor rights and recently gained social guarantees; in short, worsening poverty against a historic backdrop of overexploitation and dependency. Based on these vectors of analysis, this article reflects on the contradictions that govern social rights and social policy on the periphery of capitalism, centering on variations in social rights within neodevelopmentalist framework and its breakdown, as well as the contemporary dilemmas faced by social services in the complex affirmation/regression of social rights.

Students' perceptions on diagnosis and treatment of occlusal surface of first molars

Introduction: Accurate diagnosis of dental caries is a fundamental requirement in health care. Objective: The aim of this study was to evaluate the opinions of undergraduates concerning different conditions of the occlusal surface of permanent first molar. Material and methods: Two experienced and trained examiners, using visual and radiographic examinations, classified five occlusal surfaces of permanent first molars. The surfaces were photographed and presented to students with a questionnaire about classification of occlusal surfaces, methods used to aid caries diagnosis and type of treatment to be applied. The answers were classified as correct and incorrect and submitted to Chi-square test (p < 0.05). Results: The results showed a higher percentage of correct answers regarding to dentine caries (87.95%) and no caries (84.34%). For all surface conditions, the methods most commonly used to aid diagnose were professional prophylaxis, good lighting, drying and dental probe. Considering the treatment, a greater number of correct answers were obtained for the surface with dentine caries, with indication of conventional (65.06%) and/or preventive restoration (33.73%) and no caries without treatment need or sealant (53.01%). For students at 6th, 7th and 8th semesters, the percentage of correct answers for classification and treatment was 72.31%, 58.33% and 62.94%, respectively, without statistically significant differences (p < 0.05). Conclusion: It was concluded that the opinion of students differed regarding to the diagnosis and treatment mainly when the occlusal surface showed early stages of dental caries.

Insuficiência cardíaca com fração de ejeção preservada: Abordagem atual / Heart failure with preserved ejection fraction: Current Approach

A insuficiência cardíaca com fração de ejeção preservada é uma síndrome clínica caracterizada por sinais e sintomas de insuficiência cardíaca, fração de ejeção do ventrículo esquerdo dentro dos limites da normalidade e alteração da função diastólica do ventrículo esquerdo. A incidência vem crescendo e é mais frequente em pacientes idosos, mulheres, hipertensos e em portadores de fibrilação atrial. O prognóstico é algo melhor que pacientes com insuficiência cardíaca reduzida, porém ainda ruim...

Análise de um modelo de risco pré-operatório específico para cirurgia valvar e a relação com o tempo de internação em unidade de terapia intensiva / Analysis of specific pre-operative model to valve surgery and relationship with the length of stay in intensive care unit

OBJETIVOS: O tempo de internação prolongado após cirurgia cardíaca é associado a resultados imediatos ruins e aumento dos custos. O objetivo deste estudo foi analisar o poder preditor do escore de Ambler na previsão do tempo de internação em unidade de terapia intensiva. MÉTODOS: Estudo de coorte retrospectiva com dados coletados de 110 pacientes submetidos à cirurgia de troca valvar isolada ou associada. Os valores do escore aditivo e logístico do escore de Ambler e as performances preditivas do escore de Ambler foram obtidos por meio da curva ROC. A estadia em unidade de terapia intensiva definiu-se como normal <3 dias e prolongada >3 dias. A área sobre as curvas dos modelos aditivo e logístico foram comparadas por meio do teste de Hanley-MacNeil. RESULTADOS: A média de permanência em unidade de terapia intensiva foi de 4,2 dias. Sessenta e três pacientes pertenciam ao sexo masculino. O modelo logístico apresentou área sob a curva ROC de 0,73 e 0,79 para internação >3 dias e <3 dias, respectivamente, apresentando bom poder discriminatório. No modelo aditivo, as áreas foram 0,63 e 0,59 para internação >3 dias e <3 dias, respectivamente, sem bom poder discriminatório. CONCLUSÕES: Em nossa base de dados, o tempo de internação prolongado em unidade de terapia intensiva foi positivamente correlacionado com o escore de Ambler logístico. O desempenho do escore de Ambler logístico teve bom poder preditor para correlação do tempo de internação em unidade de terapia intensiva.

OBJECTIVES: The length of stay after prolonged cardiac surgery has been associated with poor immediate outcomes and increased costs. This study aimed to evaluate the predictive power of the Ambler Score to anticipate the length of stay in the intensive care unit. METHODS: This was a retrospective cohort study based on data collected from 110 patients undergoing valve replacement surgery alone or in combination with other procedures. Additive and logistic Ambler Scores were obtained and their predictive performances calculated using the Receiver Operating Characteristic curve. The normal length stay in the intensive care unit was assumed to be <3 days and prolonged >3 days. The areas under the receiver operating curves for both the additive and logistic models were compared using the Hanley-MacNeil test. RESULTS: The mean intensive care unit length of stay was 4.2 days. Sixty-three patients were male. The logistic model showed areas under the receiver operating characteristic curve of 0.73 and 0.79 for hospitalization > 3 days and < 3 days, respectively, showing good discriminative power. For the additive model, the areas were 0.63 and 0.59 for hospitalization > 3 days and < 3 days, respectively, a poor discriminative power. CONCLUSIONS: In our database, prolonged length of stay in the intensive care unit was positively correlated with the logistic Ambler score. The performance of the logistic Ambler Score had good discriminative power for correlation with the intensive care unit length of stay.

Sociodemographic factors and depressive symptoms in hospitalized patients with heart failure.

OBJECTIVE: To determine the differences in depressive symptoms (DS) among a sample of patients hospitalized with heart failure (HF). DESIGN: A descriptive, cross-sectional design was used. METHODS: The Beck Depression Inventory was used to measure DS, and HF severity was assessed using the New York Heart Association (NYHA) classification system. The sociodemographic and clinical variables examined include age, sex, education, marital status, fixed monthly income, habitation, living arrangement and HF severity. The differences between the presence and absence of the variables were evaluated using the Student's t test. RESULTS: The sample included 103 patients with a mean age of 65.4 years: 38 (36.9%) were men and 65 (63.1%) were women. Forty-three patients (41.7%) were in NYHA class III, and approximately one-half of the patient sample (49.5%) were married. Patients with NYHA class IV HF had significantly more DS than patients with NYHA class II or III. Age was correlated with scores of DS (P=0.002). There were significant differences in DS among the variables of marital status, habitation and living arrangement. CONCLUSIONS: Depression is a common and treatable clinical finding in hospitalized patients, requiring an early diagnosis and appropriate treatment for effective management. The implementation and monitoring of treatment are necessary to reduce the costs of treatment of HF.

Não campactação isolada do miocárdio ventricular esquerdo: relato de caso / Isolated non-compaction of left ventricular myocardium: case report

Mulher de 35 anos solicitou serviço de cardiologia para avaliação clínica. Apresentava dispneia aos grandes esforços, palpitações e síncope. O eletrocardiograma apresentava extrassístoles ventriculares monomórficas e alteração de repolarização ventricular difusa em parede anterior. A ecocardiografia evidenciou não compactação isolada de miocárdio de ventrículo esquerdo, confirmado pela ressonância magnética. Prescreveu-se atenolol e foi indicado estudo eletrofisiológico e posterior ablação com melhora eletrocardiográfica. A conduta após resolução foi acompanhamento clínico, encontrando-se a paciente assintomática e sem medicações. São discutidos mecanismos fisiopatológicos relacionados a não compactação isolada de miocárdio ventrícular esquerdo, implicações clínicas e abordagem diagnóstica terapêutica.

Analysis of specific pre-operative model to valve surgery and relationship with the length of stay in intensive care unit. / Análise de um modelo de risco pré-operatório específico para cirurgia valvar e a relação com o tempo de internação em unidade de terapia intensiva.

OBJECTIVES: The length of stay after prolonged cardiac surgery has been associated with poor immediate outcomes and increased costs. This study aimed to evaluate the predictive power of the Ambler Score to anticipate the length of stay in the intensive care unit. METHODS: This was a retrospective cohort study based on data collected from 110 patients undergoing valve replacement surgery alone or in combination with other procedures. Additive and logistic Ambler Scores were obtained and their predictive performances calculated using the Receiver Operating Characteristic curve. The normal length stay in the intensive care unit was assumed to be <3 days and prolonged >3 days. The areas under the receiver operating curves for both the additive and logistic models were compared using the Hanley-MacNeil test. RESULTS: The mean intensive care unit length of stay was 4.2 days. Sixty-three patients were male. The logistic model showed areas under the receiver operating characteristic curve of 0.73 and 0.79 for hospitalization > 3 days and < 3 days, respectively, showing good discriminative power. For the additive model, the areas were 0.63 and 0.59 for hospitalization > 3 days and < 3 days, respectively, a poor discriminative power. CONCLUSIONS: In our database, prolonged length of stay in the intensive care unit was positively correlated with the logistic Ambler score. The performance of the logistic Ambler Score had good discriminative power for correlation with the intensive care unit length of stay.