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Introduction: the constant evolution of cardiovascular medicine has provided significant advances in the treatment of various cardiac conditions, highlighting cardiac catheter ablation as a highly relevant intervention. Over the years, this technique has become an effective alternative for controlling cardiac arrhythmias, offering patients the prospect of an improved quality of life. Objective: this literature review provides updated information on nursing care in cardiac catheter ablation, benefiting healthcare professionals involved in the care of these patients. Methodology: the review was based on the analysis of articles present in the PubMed and Scielo databases. Conclusion: Studies emphasize the crucial role of team assistance in promoting safe recovery by addressing pain, monitoring vital signs, educating patients, and considering the emotional impact of the procedure. The conclusion highlights that, although catheter ablation is a valuable option in the management of arrhythmias, its effectiveness depends on adequate and safe performance, with the implementation of rigorous postoperative care and effective management of complications being essential. [ABSTRACT FROM AUTHOR]

Abstract Objective: to identify the factors contributing to medication non-adherence among patients with heart failure. Method: cross-sectional and analytical study using the Medida de Adesão ao Tratamento [Treatment Adherence Measure] scale to assess medication non-adherence. Independent variables were collected using the European Heart Failure Self-care Behavior Scale and an instrument developed by the authors based on a previous study. Statistical tests were implemented to analyze data with p≤0.05 statistical significance. Results: the sample comprised 340 patients, with 9.4% considered non-adherent. The multiple analysis results showed that one unit increase in an individual’s self-care score led to an 8% increase in the prevalence of non-adherence; patients with a family income above three times the minimum wage presented a prevalence of non-adherence equal to 3.5% of the prevalence of those with up to one times the minimum wage; individuals consuming alcohol or with depression presented 3.49 and 3.69 times higher prevalence of non-adherence, respectively, than individuals not presenting such history. Conclusion: medication non-adherence was associated with self-care, family income, depression, and alcohol consumption.

ABSTRACT Objectives: to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure. Methods: a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers’ contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman’s correlation. Results: the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction. Conclusions: informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.

Heart diseases are potentially fatal pathologies considered a risk factor for anxiety disorders. This paper aims to present a systematic literature review on anxiety in cardiology. Five databases were selected: SciElo, PsycINFO, Web of Science, and PubMed. The descriptors "cardiologia" and "ansiedade" and their equivalents in English, "anxiety" and "cardiology" were used. The inclusion criteria were papers published in Portuguese, English, or Spanish between 2017 and 2021. Twenty-six studies were selected, and four topics stood out: socio-demographic profile; anxiety and cardiac rehabilitation; anxiety-related risk and protective factors; and anxiety and depression. The results indicate that healthy anxiety levels play a protective role in promoting patient self-care. However, maladaptive anxiety levels hinder patients from coping with the disease. [ABSTRACT FROM AUTHOR]

Copyright of Saberes Plurais is the property of Saberes Plurais and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In patients with Chronic Rheumatic Carditis, active carditis is an often underdiagnosed condition. Rheumatic attacks promote the aggravation of existing lesions, leading to a deterioration of the patient’s clinical condition. Thus, reducing the morbidity and mortality of the disease depends, in part, on controlling relapses through secondary prophylaxis. Underdiagnosis is due in part to the occurrence of subclinical rheumatic attacks. This study was carried out with data from patients who were diagnosed with Chronic Rheumatic Carditis and who underwent cardiac surgery for valve replacement or repair, without clinical or laboratory evidence of rheumatic outbreak. A fragment of myocardium was sent for histopathological analysis. Data on the frequency of histopathological alterations compatible with a rheumatic outbreak were analyzed. After analysis, 80% of patients showed changes compatible with inflammatory activity. Of these, 87.5% had lymphocytic infiltrate; 25% had Aschoff’s nodules. The most frequent histopathological findings of chronic disease were myocardial hypertrophy in 56.7% of patients and fibrosis in 53.3%.

ABSTRACT Objective: to construct and validate an educational booklet for self-care of patients in the postoperative period of cardiac surgery Methods: methodological study, including bibliographic survey, construction of the booklet and validation with judges and the target audience. For validation with judges, the Health Educational Content Validation Instrument was used, and with the target audience, an instrument was used with questions related to organization, writing style, appearance and motivation. To analyze the judges’ answers, the content validation index was used Results: the booklet was prepared with 14 topics. The content validation index among the eight judges was 1 and the concordance index among the ten patients was above 80%. The final version of the material was made available in printed format Conclusion: the educational booklet was developed and validated by judges and the target audience, serving as an educational support tool for self-care of patients in the postoperative period of cardiac surgery.

Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Atrial septal aneurysm (ASA) is a rare congenital deformity of variable clinical relevance, often reported in association with patent foramen ovale (PFO). Transthoracic Doppler echocardiography (TTE) is the first choice for diagnosis, but complementary techniques, such as microbubble contrast, should be used. Despite its importance, in Veterinary Medicine, there is little information related to the subject, and the present study is the second report of this condition in dogs. The objective was to report a case of ASA type IV LR associated with PFO in a Shar Pei bitch, diagnosed by a combined approach of transthoracic echocardiography backed by agitated saline solution (microbubbles). During clinical care, the owners reported episodes of seizures as their main complaint. Echocardiographic examination revealed a type 4 LR atrial septal aneurysm and left ventricular systolic dysfunction. The use of microbubble contrast showed right-to-left shunt, confirming PFO. The recommended treatment was medication. It was concluded that the rarity of ASA in dogs may be due to incomplete diagnoses and the transthoracic echocardiographic examination allows its analysis and classification. Furthermore, ASA can be found in animals with or without evidence of heart disease and it should be investigated in patients with neurological alterations.

Copyright of Avances en Enfermería is the property of Editorial Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Digital health interventions including telehealth, mobile health, artificial intelligence, big data, robotics, extended reality, computational and high-fidelity bench simulations are an integral part of the path toward precision medicine. Current applications encompass risk factor modification, chronic disease management, clinical decision support, diagnostics interpretation, preprocedural planning, evidence generation, education, and training. Despite the acknowledged potential, their development and implementation have faced several challenges and constraints, meaning few digital health tools have reached daily clinical practice. As a result, the Portuguese Society of Cardiology Study Group on Digital Health set out to outline the main digital health applications, address some of the roadblocks hampering large-scale deployment, and discuss future directions in support of cardiovascular health at large., (Copyright © 2024 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: Cardiac rehabilitation (CR) is a central component in the management of cardiovascular disease. While its potential benefits have been extensively explored and confirmed, its implementation is still suboptimal, due to various possible barriers. This study aimed to assess training and attitudes concerning CR among physicians in a Portuguese setting., Methods: An online questionnaire structured in three parts (participant characteristics, training and attitudes concerning CR, and a brief general knowledge assessment) was developed and sent to members of the Portuguese Society of Cardiology. The study population encompassed physicians with a medical specialty or residents from the third year onward of a specialty program., Results: A total of 97 individuals (57.7% male, 61.9% aged ≤50 years) presented valid answers. CR was available at the workplace of 54.6% of participants. Most of them considered that the time allocated to CR training during residency was inadequate, and thought that more time was needed for this purpose. Most had not dedicated (or intended to dedicate) time for CR training, with lack of time being the most frequently attributed reason. In terms of referral, a substantial proportion of subjects did not refer patients, with lack of CR centers and human resources being the most frequent reasons., Conclusions: This survey provides contemporary data on CR training and attitudes, highlighting areas of potential improvement, such as time allocated to training in this area. These results could provide a useful pragmatic framework for optimization of training and awareness in this pivotal field of cardiovascular medicine., (Copyright © 2024 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Resumo: O gap de género é evidente em várias áreas profissionais e também na área da medicina e em particular na área cardiovascular. Fazemos uma breve revisão sobre o tema e analisamos os dados da Revista Portuguesa de Cardiologia relativamente a autorias do género feminino. Abstract: A gender gap is apparent in several professional areas, including in medicine and particularly in the cardiovascular field. We present a brief review of the topic and we analyze data from the Portuguese Journal of Cardiology regarding female authorship..

ABSTRACT: The present study aimed to identify and describe cardiac alterations in sheep experimentally poisoned with Palicourea marcgravii through analysis of serum cardiac biomarkers (serum troponin I and creatine kinase - CK-MB) and electro and echocardiographic assessments to contribute to a better understanding of the poisoning pathophysiology. P. marcgravii is the main plant within a group of 22 species that cause sudden death in Brazil; its toxic principle is sodium monofluoroacetate. Eight healthy crossbreed male sheep, aged between five and twelve months, weighing 14 to 27kg, were evaluated. The animals received 1g kg-1 of P. marcgravii plants orally. The sheep were evaluated before administering the plant (T0) through electro and echocardiography and blood collection to assess cardiac biomarkers (CK-MB and cTnI). Collections and analyses were repeated every four hours until the animal’s death. During the study, there was the presence of extravasation of serum troponin I carried out in a qualitative test, with positive values at time T4, and the serum CK-MB biomarker had a peak at T4 and slightly decreased at T8. The electro and echocardiographic examinations showed that the cause of death in these animals was due to acute heart failure characterized by arrhythmias, tachycardia/ventricular fibrillation, drop in cardiac output, left ventricular (LV) systolic dysfunction by the progressive decrease in the LV ejection fraction (EF), decrease in LV fractional shortening (FS), and decrease in aortic flow velocity and aortic flow gradient. This study seems to be the first to evaluate cardiac alterations in sheep poisoned by P. marcgravii through cardiac biomarkers and electro and echocardiographic exams.

ABSTRACT: Chronic kidney disease (CKD) is characterized by irreversible morphostructural lesions that can progressively evolve to chronic renal insufficiency and kidney failure. It is known that the heart and kidneys are closely related, and that communication between these organs occurs through a variety of pathways; subtle physiological changes in one of them are compensated by the other. Histopathological cardiac evaluation through routine staining presents a limitation to identify specific or discreet lesions in the cardiomyocytes. This study aimed to evaluate serum troponin levels in cats with CKD, associated with clinical and pathological findings, as well as to correlate the morphostructural cardiac lesions to determine their distribution through macroscopic and histological assessments and anti-cardiac troponin C (cTnC) immunohistochemistry (IHC). To this end, 20 cats (18 diagnosed with CKD and two controls) were selected. Anti-human cTnC IHC was conducted after necropsy and separation in eight regions of each collected heart. Heart fragments from two cats without CKD were used as controls. The anti-human cTnC antibody is useful in detecting cardiac lesions and has shown decreased expression in cardiomyocytes of cats with CKD. Serum troponin was above the reference values in 11/18 (61.11%) animals and decreased expression for the cTnC antibody was observed in individual cardiomyocytes in 9/18 (50%) animals. It was verified that the number of regions with decreased expression for the cTnC antibody in cardiomyocytes is significantly correlated with serum troponin. The anti-human cTnC antibody has been found effective in detecting cardiac lesions and has shown decreased expression in the cardiomyocytes of cats with CKD. Correlation was observed between increased serum cTnI and loss of immunoreactivity at anti-cTnC antibody IHC in cats with CKD, which proves damage to cardiomyocytes secondary to kidney disease.

Pulmonary hypertension (PH) is a major cause of morbi-mortality among patients with congenital heart disease (CHD) and also a potentially severe complication after surgical repair. Oral citrulline, a precursor to NO synthesis, is safe and efficacious for decreasing the risk of postoperative PH. Objective: The aim of the present study was to investigate in pediatric patients the changes of plasma citrulline, arginine, homocysteine and nitric oxide (NO) metabolites and pulmonary artery pressures (PAP) pre-post cardiac surgery in order to describe our population status with regard to the risk of pulmonary hypertension and look for potential biomarkers for early detection and treatment. Main results/Discussion: 16 Argentine pediatric patients with CHD undergoing cardiopulmonary bypass were randomized in two groups: (A) with and (B) without perioperative citrulline supplementation. We found that plasma citrulline median levels before surgery were lower in both groups respect to referential values, probably due to the poor nutritional status of our patients; only group A surpassed post-surgery the minimum recommended level to avoid PH. Furthermore, none of the patients in group A showed mean PAP higher than 20 mmHg, whereas in group B, 67% of the measurements were ≥ than the reference level. Conclusions: We reaffirm that citrulline supplementation it is effective in reducing postoperative pulmonary hypertension and biomarkers could evidence patient status as a translational medicine application.

Cardiac measurement by chest X-ray is very important in the cardiac characterization of dogs and cats, however, the wild animal clinic has a different reality. Opossums (Didelphis albiventris) are part of the Brazilian fauna and are frequently referred for clinical and radiographic evaluation. The objective of this research was to evaluate the thorax of skunks and establish the average of VHS and VLAS for these animals. Chest radiographs were performed in lateral and ventrodorsal projections to measure the VHS and VLAS, thoracic depth and tracheal diameter. The mean VHS was 7.85 (± 0.3) for males and 8.12 (± 0.5) for females and the measured VLAS was 1.19 (± 0.2) for both sexes. The mean value for thoracic depth was 1.13 (± 0.03) and the ratio between the diameter of the chest inlet and the diameter of the trachea was 0.25 (± 0.02), with no significant differences between the sexes. This is the first study that addresses the thoracic evaluation by tracheal and cardiac measurements of skunks through radiographic examination.

ABSTRACT Teaching with a multisensory approach helps students link new information to prior knowledge and understand relationships between concepts. This study aimed to reflect on convergences between the Multisensory Integration Approach Model with the Learning Assimilation Theory and Meaningful Retention with Bloom’s Cognitive Process Domain, and to propose a taxonomic table of lesson planning for teaching Acute Coronary Syndrome, considering the confluence of these references. The three frameworks consider the importance of students’ prior knowledge, the process of abstraction and generalization of knowledge, and the relationship between working and long-term memory. By observing such convergences and the taxonomic table produced, it is observed that teaching topics of interest to nursing undergraduate students, adopting the Multisensory Integration Approach Model as a taxonomic table component (pre-organizing or recall activities to arouse different sensory perceptions aligned with instructional objectives and forms of assessment), in the light of the Learning Assimilation Theory and Meaningful Retention, has the potential to favor the reception and processing of instructional content.

Objective: To describe the primary cardiovascular disorders manifested in patients infected with the zika virus and understand the pathophysiological process. Methods: This integrative literature review occurred in January 2021 through the PICO strategy, which answered the guiding question: “What are the main cardiovascular disorders manifested in patients infected with zika virus?” For this, a time interval of 5 years was defined, using the descriptors “Zika Virus”,“Heart” and “Cardiovascular Diseases” in English, Portuguese and Spanish. The contemplated databases were MEDLINE, LILACS, and BDENF. Results: There were a total of 77,872 articles, of which, after the exclusion and inclusion processes, it was summarized in eight articles included in this review. The main cardiovascular findings present were apical muscular ventricular septal defect and ostium secundum, in addition to atrial fibrillation and heart failure with reduced ejection fraction. Conclusions: Further studies with more robustness that clearly establish the mechanism of cellular tropism for cardiac muscle cells and involve the pathophysiological process of cardiac alterations more clearly and reliably are needed.

Copyright of Health Sciences Journal / Revista Ciências em Saúde is the property of Hospital de Clinicas de Itajuba - Associacao de Integracao Social de Itajuba and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUÇÃO: Diretrizes Clínicas devem ser documentos elaborados de forma sistemática que visam em primeiro lugar apoiar com a melhor informação médica disponível a decisão de um paciente e de um profissional de saúde. Adicionalmente também podem ser utilizadas pelo gestor para a formulação de políticas públicas. OBJETIVO: Avaliar a qualidade metodológica de 3 Diretrizes Clínicas da Sociedade Brasileira de Cardiologia (SBC) segundo uma ferramenta aceita internacionalmente para esta finalidade, e sugerir melhorias na elaboração deste tipo de documento. MÉTODOS: 12 avaliadores independentes (4 por documento) utilizaram a ferramenta AGREE II para avaliar metodologicamente três Diretrizes Clínicas da SBC que abordam assuntos de extrema importância e prevalência na população mundial: Hipertensão Arterial, Diabetes e Dislipidemia. RESULTADOS: Segundo a avaliação das 3 Diretrizes, pelos baixos escores recebidos principalmente nos domínios de Envolvimento das Partes Interessadas, Aplicabilidade da Diretriz e em especial no Rigor do Desenvolvimento, 2 delas foram consideradas com uma metodologia de elaboração insatisfatória. CONCLUSÃO: A qualidade metodológica das Diretrizes Clínicas da SBC foi considerada insatisfatória. Sugerimos neste artigo estratégias para aprimorar o processo de elaboração de futuros documentos.

Introduction and Objectives: Digital health (DH) is a broad concept, bringing together technology and healthcare, that is playing an increasingly important role in the daily routine of healthcare professionals (HCPs) and promises to contribute to the prevention and treatment of cardiovascular disease. There are no solid data on the position of Portuguese HCPs toward the implementation of DH in cardiovascular medicine. This national cross-sectional study aims to provide a snapshot of DH implementation in Portuguese cardiovascular HCP routines and to identify both expectations and barriers to its adoption., Methods: An 18-question survey was created specifically for this study and distributed to 1174 individuals on the Portuguese Society of Cardiology mailing list., Results: We collected 117 valid responses (response rate 10%). Almost all participants had smartphones and laptops, and two-thirds had tablets. Electronic medical information systems were the most used DH tool (84% of respondents) and were considered the most important for improving cardiovascular care. Implantable technologies (sensors and devices), telemedicine and social media were used by more than two out of three respondents and considered «very important» or «extremely important» by most of them. Most participants showed positive expectations regarding the impact of DH in cardiovascular medicine: 78% agreed that DH could improve health outcomes, 64% that it promotes health literacy and 63% that it could decrease healthcare costs. The top-rated barriers were patients' inability to use smartphones, limited access to electronic devices, and lack of legal regulation of DH., Conclusion: Most Portuguese cardiovascular HCPs had at least three electronic devices (mainly smartphones, laptops and tablets) and showed positive expectations regarding DH's current and future impact on cardiovascular medicine. Patient DH literacy, technology adoption, and DH regulation were identified as the most important barriers to increasing the adoption of DH tools in cardiovascular medicine., (Copyright © 2024 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)

ABSTRACT: Pulmonary hypertension (PH) in dogs is a syndrome that can occur secondary to several causes, including left heart disease (postcapillary) and chronic respiratory disease (precapillary). This study evaluates morphological and functional consequences in the right ventricle (RV) of dogs with pre- and postcapillary PH through echocardiography, and also considers the severity of PH (mild, moderate or severe). Echocardiography was performed on 66 dogs of various breeds and weights (age >3 years old) which were assigned to three groups: postcapillary PH, which included mitral valve disease/endocardiosis, precapillary PH, which included chronic respiratory diseases (bronchitis, collapse of the trachea and primary lung cancer or metastasis), and finally, a healthy group of controls. The parameters for RV morphology were RV1, RV2, and RV3 for systole and diastole. The following measurements were used to assess RV systolic function: tricuspid annular plane systolic excursion (TAPSE), TAPSE:Ao (aorta), maximum velocity of the tricuspid systolic wave obtained by tissue Doppler (S’), S’:Ao, right ventricle end-diastolic area (RVEDA); RVEDA:BSA (body surface area); flow velocity integral (FVI) and FVI:Ao. The variables were assessed using ANOVA. The results showed that RV3d, RV1s, S’:Ao, S’, and FVI were able to distinguish cases of pre- and postcapillary PH in this study. Remodeling of the RV of dogs with PH was observed, which can be influenced by the pre- or postcapillary origin of the PH, with dilation in dogs with postcapillary PH and severe PH. The results for RV systolic function were similar, with FVI and FVI:Ao showing that RV ejection function is reduced in dogs with postcapillary PH and with severe PH.

Objective: Prototype a digital game for the study of Cardiology by health professionals and students. Methods: Research of applied purpose of the exploratory type and of technological development. Developed in partnership between the Faculty of Nursing Nossa Senhora das Graças of the University of Pernambuco and the Faculty Nova Roma, from February to September 2018. For the construction, it was used the platform Unity version 2017.1, and the Scrum methodology. Results: The game is a quiz with questions and answers that generate scores to advance in seven levels. To test their knowledge in cardiology, players will be using a three-dimensional universe, with playful characteristics and moving through a scenario similar to a hospital emergency, meeting challenges based on the clinical needs of patients. Conclusion: The construction of the Heart Quiz brought an innovative proposal for studies in cardiology, being applicable in contexts of different interests, undergraduate or graduate. [ABSTRACT FROM AUTHOR]

Objective: To identify scientific productions on palliative care with hospitalized children with heart disease. Methods: This is an integrative review for the identification of national and international scientific productions about palliative care with children with heart disease, conducted in 2019. To selection of the scientific articles the following descriptors were used: child; congenic cardiopatics; palliative care; patient care; nursing and cardiology. From the material obtained, 67 articles were read, highlighting eight articles which met the eligibility criteria. Results: Palliative care are approached at diagnosis and continues even if the patient receives curative treatment or not, with the progression of the disease, there is an increase in palliative care assistance, from which they extend to mourning, the integration between curative and palliative treatment improves care coordination, avoids fragmentation of care, bringing as much physical, emotional, social and spiritual well-being as possible to the child and family. Conclusion: Despite the increase in Brazilian publications on pediatric palliative care, scientific studies on child care in palliative care are still scarce considering other diseases besides cancer and reporting the importance of the entire health team for the humanization of care. [ABSTRACT FROM AUTHOR]

Objective: To identify the association between risk factors and postoperative complications in patients undergoing cardiac surgery. Methods: Documentary, retrospective, analytical, quantitative study with 388 medical records of patients undergoing cardiac surgery. Data collection was carried out between August and September 2018. To check associations between risk factors and complications in the immediate postoperative period, Pearson's chi-square test was used. It used a p-value <0.05. Results: There was a significant association between risk factors for acute myocardial infarction, heart failure, chronic renal failure, ischemic heart disease, intra-aortic balloon, chronic obstructive pulmonary disease and diabetes mellitus with complications in the immediate postoperative period. Conclusion: By knowing the risk factors of patients undergoing cardiac surgery with an association with postoperative complications, nurses will be able to carry out an individual care plan in addition to actions to prevent risk factors. [ABSTRACT FROM AUTHOR]

Abstract Huge variations exist in cardiology training programs across the world. In developing (middle-income) countries, such as Brazil, to find the right balance between training improvements and social and economic conditions of the country may be a difficult task. Adding more training years or different mandatory rotations, for instance, may be costly and not have an immediate direct impact on enhancing patient care or public health. In this text, we compare the Brazilian cardiology training system with other proposals implemented in developed countries from North America and Europe, aiming to point out issues worth of future discussion. Factors such as training rotations and competencies, and program duration and distribution across the countries are presented. The number of first year cardiology trainees per inhabitants is similar between Brazil and the United States (0.24 medical residents/100,000 inhabitants in Brazil and 0.26 medical residents/100,000 inhabitants in the USA). These numbers should be analyzed considering the inequality in training program distribution across Brazil, since most centers are located in the Southeast and South regions. Having more residency programs in distant areas could improve cardiovascular care in these areas. Duration of cardiology Residency Training is shorter in Brazil (two years) in comparison with developed countries (> 3 years). Brazilian residency programs give less emphasis to scientific research and diagnostic methods. Unifying minimum training requirements across the globe would facilitate the development of international learning opportunities and even professional exchange around the world.

The scattered radiation from interventional procedures is an important source of radiological risk for the medical staff. Considering all affected organs, the eye lens are among the most critical organs. As pointed out by several studies, even for low radiation doses, the appearance of cataract may occur. Considering this scenario, the radiation doses to the eye lens were determined using three different lead eyewear models commonly employed. The fluoroscopist was represented by an adult virtual anthropomorphic phantom (MASH3), coupled to the Monte Carlo code MCNP6.1™, in a typical cardiac interventional radiology procedure. The eyewear had thickness 0.5 mmPb each, and the evaluation was carried out for four different beam angulations (PA, LAO90, LAO65 e RAO65), 80 kVp of tube voltage and HVL of 4 mmAl. The results pointed out that the shielding efficiency has a strong dependence on the eyewear type utilized, which may be very useful for the decision-making during the acquisition of such equipments.

This study compared the effects of using continuous and interval aerobic exercise during concurrent training on cardiorespiratory adaptations in women. Thirty-two participants were randomly assigned into one of the following groups: continuous running and resistance training (C-RUN, n = 10), interval running and resistance training (I-RUN, n = 11), or control group that performed resistance training only (RT, n = 11). Each group trained twice a week during 11 weeks. Oxygen uptake corresponding to the first ventilatory threshold (VO2VT1), second ventilatory threshold (VO2VT2) and maximal effort (VO2max) was measured in a maximal incremental test performed before and after training. Significant increases in VO2VT1, VO2VT2 and VO2max were observed in all training groups. VO2VT2 and VO2max presented time-group interactions, indicating that the magnitude of the increase in these variables was dependent on the training group (VO2VT2: C-Run = 6.6%, I-Run = 15.7%, RT = 1.7%; VO2max: C-Run = 7.2%, I-Run = 14.3%, RT = 2.7%). The effect size observed for post-training values comparing C-RUN and RT groups was d = 0.566 for VO2VT2 and d = 0.442 for VO2max. On the other hand, values of d = 0.949 for VO2VT2 and d = 1.189 for VO2max were verified between I-RUN and RT groups. In conclusion, the use of continuous and interval aerobic exercise during concurrent training improved different cardiorespiratory parameters in women, but in a greater magnitude when interval aerobic exercise was performed simultaneously to resistance training.

This article aims at investigating facial expressions - coordinated movements which involve the arching of the eyebrows and the displacement of the lower jaw observed when cardiologists provide diagnostic information to cardiac patients who are being discharged. The analyzes show that facial expressions display some degree of epistemic alteration of the patient about their heart condition; moreover, they demonstrate the patient's orientation towards the diagnosis communication sequence (DCOS) as progressing or, otherwise, finished. Difference in orientation depends on the interactional resources deployed during or after the previously described face configuration. Supported by the theoretical- methodological framework of Multimodal Conversation Analysis (Goodwin; Goodwin, 1982; 1984; Sacks, 1992; Schegloff, 2007, Mondada, 2014), the study is based on naturally occurring interactions recorded on video and transcribed (Jefferson, 1984; Mondada, 2019). The data analyzed in the study originate from a 350-minute corpus of face-to-face interactions between health professionals and cardiac patients (25 consultations) in the context of hospital care of cardiac patients in Brazil. In an unprecedented way, the bodies of participants have been made available for analysis (Andrade, 2016). This work is expected to contribute to the expansion of the multimodal interactive analytical scope involving facial expressions, especially in the context of health care interactions. Furthermore, this article seeks to contribute to raising health professionals' awareness of multimodal interactive resources triggered by patients in the context of DCOS and beyond. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is in an increasing pattern worldwide, especially in the Arab world. Objective: The aim of this article is to assess AF research activity in the Arab countries over the past 16 years, taking into consideration the population size, gross domestic product (GDP) and disability-adjusted life years (DALY). Methods: Atrial fibrillation related research articles published from Arab countries between 2004 and 2019 were collected from the MEDLINE database and are cited online on PubMed. Medical Subject Heading (MeSH) terms related to the subject, the origin and the date of publication were used to search for the published articles. Results: The number of AF related publications in the Arab world over the past 16 years was only 283 (0.73%) out of a total of 38,983 publications worldwide. Saudi Arabia ranked first in terms of number of AF related publications, followed by Egypt. Lebanon is the country with the highest number of publications per USD billion GDP, while Egypt and Saudi Arabia have the highest number of publications per 1% DALYs. According to the population size, Qatar and Bahrain produced the highest number of publications per million persons (PPMP). A strong and positive correlation was found between the number of publications and the GDP. The population size and the percentage of DALY showed positive yet weak correlation. Conclusion: A slight increase in AF related publications is observed. Nonetheless, AF research activity in the Arab world is still insufficient.

The purpose of this study was to identify the characteristics of international scientific publications on the theme of hospital management, from the perspective of performance evaluation. The research is characterized as exploratory-descriptive and has the Knowledge Development Process- Constructivist (ProKnow-C) as an intervention instrument. The results are: (i) a Bibliographic Portfolio (BP) of 29 articles, aligned with the view adopted by the researchers; (ii) the author featured in the BP was John S. Rumsfeld, with three articles; (iii) the most cited article: "A framework for assessing the performance of health systems", with 1.121 citations on Google Scholar; (iv) the Journal of the American College of Cardiology is the journal that published the most publications on the topic (iv) the collaboration network of authors involves four countries - United States, Malawi, Switzerland and the Netherlands; (v) the most frequent keywords: "human", "healt" "care quality" and "hospital. [ABSTRACT FROM AUTHOR]

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), also called Boxer Cardiomyopathy, is known to affect mainly dogs of this breed. This disease is hereditary and characterized by the replacement of cardiomyocytes of the right ventricle by fibrous fatty tissue. This condition leads to a derangement in the conduction of electrical impulses, resulting in arrhythmias, which is one of the main clinical signs observed in this disease, a condition that can lead to sudden death of the patient. The animals affected by this disease can vary from asymptomatic to asymptomatic cases, presenting syncopes and a small portion develops Congestive Heart Failure (CHF). [ABSTRACT FROM AUTHOR]

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Introduction and Objectives: Heart failure (HF) is a complex clinical syndrome that is a significant burden in hospitalisations, morbidity, and mortality. Although a significant effort has been made to better understand its consequences and current barriers in its management, there are still several gaps to address. The present work aimed to identify the views of a multidisciplinary group of health care professionals on HF awareness and literacy, diagnosis, treatment and organization of care, identifying current challenges and providing insights into the future., Methods: A steering committee was established, including members of the Heart Failure Study Group of the Portuguese Society of Cardiology (GEIC-SPC), the Heart Failure Study Group of the Portuguese Society of Internal Medicine (NEIC-SPMI) and the Cardiovascular Study Group (GEsDCard) of the Portuguese Association of General and Family Medicine (APMGF). This steering committee produced a 16-statement questionnaire regarding different HF domains that was answered to by a diversified group of 152 cardiologists, internists, general practitioners, and nurses with an interest or dedicated to HF using a five-level Likert scale. Full agreement was defined as ≥80% of level 5 (fully agree) responses., Results: Globally, consensus was achieved in all but one of the 16 statements. Full agreement was registered in seven statements, namely 3 of 4 statements for patient education and HF awareness and 2 in 4 statements of both HF diagnosis and healthcare organization, with proportions of fully agree responses ranging from 82.9% to 96.7%. None of the HF treatment statements registered full agreement but 3 of 4 achieved ≥80% of level 4 (agree) responses., Conclusion: This document aims to be a call-to-action to improve HF patients' quality of life and prognosis, by promoting a change in HF care in Portugal., (Copyright © 2023. Publicado por Elsevier España, S.L.U.)

Background: The management of unstable angina (UA) presents a challenge due to its subjective diagnosis and limited representation in randomized clinical trials that inform current practices., Objectives: This study aims to identify key factors associated with the indication for invasive versus non-invasive stratification in this population and to evaluate factors associated with stratification test results., Methods: This retrospective cohort study included patients hospitalized with UA over a consecutive 20-month period. To assess factors associated with stratification strategies, patients were divided into invasive stratification (coronary angiography) and non-invasive stratification (other methods) groups. For the analysis of factors related to changes in stratification tests, patients were categorized into groups with or without obstructive coronary artery disease (CAD) or ischemia, as per the results of the requested tests. Comparisons between groups and multiple logistic regression analyses were performed, with statistical significance set at a 5% level., Results: A total of 729 patients were included, with a median age of 63 years and a predominance of males (64.6%). Factors associated with invasive stratification included smoking (p = 0.001); type of chest pain (p < 0.001); "crescendo" pain (p = 0.006); TIMI score (p = 0.006); HEART score (p = 0.011). In multivariate analysis, current smokers (OR 2.23, 95% CI 1.13-4.8), former smokers (OR 2.19, 95% CI 1.39-3.53), and type A chest pain (OR 3.39, 95% CI 1.93-6.66) were independently associated. Factors associated with obstructive CAD or ischemia included length of hospital stay (p < 0.001); male gender (p = 0.032); effort-induced pain (p = 0.037); Diamond-Forrester score (p = 0.026); TIMI score (p = 0.001). In multivariate analysis, only chest pain (type B chest pain: OR 0.6, 95% CI 0.38-0.93, p = 0.026) and previous CAD (OR 1.42, 95% CI 1.01-2.0, p = 0.048) were independently associated., Conclusion: The type of chest pain plays a crucial role not only in the diagnosis of UA but also in determining the appropriate treatment. Our results highlight the importance of incorporating pain characteristics into prognostic scores endorsed by guidelines to optimize UA management.

Background: Tele-cardiology tools are valuable strategies to improve risk stratification., Objective: We aimed to evaluate the accuracy of tele-electrocardiography (ECG) to predict abnormalities in screening echocardiography (echo) in primary care (PC)., Methods: In 17 months, 6 health providers at 16 PC units were trained on simplified handheld echo protocols. Tele-ECGs were recorded for final diagnosis by a cardiologist. Consented patients with major ECG abnormalities by the Minnesota code, and a 1:5 sample of normal individuals underwent clinical questionnaire and screening echo interpreted remotely. Major heart disease was defined as moderate/severe valve disease, ventricular dysfunction/hypertrophy, pericardial effusion, or wall-motion abnormalities. Association between major ECG and echo abnormalities was assessed by logistic regression as follows: 1) unadjusted model; 2) model 1 adjusted for age/sex; 3) model 2 plus risk factors (hypertension/diabetes); 4) model 3 plus history of cardiovascular disease (Chagas/rheumatic heart disease/ischemic heart disease/stroke/heart failure). P-values < 0.05 were considered significant., Results: A total 1,411 patients underwent echo; 1,149 (81%) had major ECG abnormalities. Median age was 67 (IQR 60 to 74) years, and 51.4% were male. Major ECG abnormalities were associated with a 2.4-fold chance of major heart disease on echo in bivariate analysis (OR = 2.42 [95% CI 1.76 to 3.39]), and remained significant after adjustments in models (p < 0.001) 2 (OR = 2.57 [95% CI 1.84 to 3.65]), model 3 (OR = 2.52 [95% CI 1.80 to3.58]), and model 4 (OR = 2.23 [95%CI 1.59 to 3.19]). Age, male sex, heart failure, and ischemic heart disease were also independent predictors of major heart disease on echo., Conclusions: Tele-ECG abnormalities increased the likelihood of major heart disease on screening echo, even after adjustments for demographic and clinical variables.

Introduction and Objectives: Cardiology has not been seen as an attractive specialty, and women have avoided it for many years. Some surveys have been performed in other countries, but in Portugal, the situation is largely unknown., Methods: An online survey on perceptions of cardiology and professional preferences was sent to 1371 members of the Portuguese Society of Cardiology, of whom 18.2% completed the survey., Results: We included 219 cardiologists or cardiology trainees, of whom 50.2% were female, with decreasing proportions from younger to older age groups, in which males still predominate. Women are less often married and more frequently childless, particularly those working in an invasive subspecialty, where they represent only 16% of all respondents working in these areas. Men's perception is that women do not choose these areas due to family reasons, radiation concerns and difficult working conditions, but from the female perspective, male dominance, lack of female role models and restricted access are the main barriers. Women consider it is difficult for them to obtain a leadership role, but men do not think the same (75.5% vs. 27.5%)., Conclusion: In Portugal, females predominate in younger age groups, suggesting a paradigm change. Women are less frequently married and more frequently childless, particularly women working in invasive subspecialties. Women consider that it is more difficult for them to obtain a leadership role. Moreover, the barriers reported by women are substantially different from men regarding the reasons for not choosing an invasive subspecialty., (Copyright © 2023 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To evaluate the need to develop an application with information about the measles vaccine for Warao indigenous people., Methods: This was a quantitative study conducted at the Espaço de Acolhimento Tapanã refugee shelter in the city of Belém, Pará, Brazil. The study sample was selected for convenience. Data were analyzed descriptively using Bioestat 5.0 software., Results: Twenty-one Warao indigenous individuals were interviewed. It was identified that 91% (n=20) had lost their vaccination card; 91% (n=20) stated they had lost their vaccination card more than three times, and 91% expressed interest in an application to store their vaccination information., Conclusions: The research provided important information for the development of a health application named WaraoMedI (Warao Measles Diversity Indigenous), as well as offered nursing professionals evidence about the challenges Warao indigenous refugees face in self-managing their vaccination information.

ABSTRACT Objectives: To estimate the content validity of the Symptom Control nursing outcome for heart failure patients in palliative care and to analyze the influence of experts' experience in the judgment of the relevance of indicators. Methods: A methodological study conducted in São Paulo in 2018, with an adaptation of Fehring's validation model. The relevance of the 11 outcome indicators was assessed by 19 experts by means of an electronically submitted survey. The influence of the experts' experience on judgment was analyzed by the Wilcoxon-Mann-Whitney test and by Kendall's Tau correlation. Results: The indicators were considered pertinent; with 54.5% classified as critical. There was no association between the weighted means of the indicators and the experts' experience. Conclusions: The indicators analyzed are relevant for the evaluation of the Symptom Control outcome in this group of patients. The experts' judgment was not influenced by their area of clinical experience or by their experience with the Nursing Outcomes Classification (NOC).

The objectives of this study were to evaluate the accuracy of thoracic radiology as a screening test for congenital heart diseases in dogs, to identify the main contributions and limitations of this modality, and to verify the reproducibility of the evaluations by three observers with different levels of training. An interobserver, observational, retrospective and prospective study was carried out, including ninety dogs: thirty healthy animals, thirty with acquired heart diseases and thirty with congenital heart diseases, which all had thoracic radiographs and a confirmed echocardiographic diagnosis. The cases were separated and randomized by a mediator who did not participate in the reading of the radiographic examinations, and no evaluator had access to the patients' data. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of each observer were calculated in relation to the correct classification of dogs to groups of normal or acquired and congenital heart diseases, as well as identification of enlargement of the cardiac silhouette and large vessels of dogs with congenital heart diseases. Finally, the Kappa coefficient was obtained between the observers to verify the reproducibility of the radiological evaluations performed. In general, sensitivity, PPV and accuracy were unsatisfactory ( 70%), and the agreement ranged from poor to reasonable (between 0 and 0.39). Although greater accuracy was achieved in the differentiation of healthy dogs from those with acquired and congenital heart diseases by thoracic radiography, when compared to the other studies, the modality was able only to identify healthy patients, and could not differentiate the individuals with different forms of heart disease or define the cardiac malformations. In addition, there was low reproducibility between observers, therefore, this technique should not be used as a sole screening method in dogs with suspected congenital heart diseases.

ABSTRACT Aim: To analyze the behavior of B-type natriuretic peptide (BNP) in the presence of defining characteristics (DCs) of the nursing diagnosis Excess fluid volume (00026) in patients hospitalized for acute decompensated heart failure. Methods: Cohort study of patients admitted with acute decompensated heart failure (September 2015 to September 2016) defined by Boston Criteria. Patients hospitalized for up to 36 h with BNP values ≥ 100 pg/ml were included; BNP values at baseline-final assessment were compared by Wilcoxon test, the number of DCs at baseline-final assessment was compared by paired t-test. Results: Sixty-four patients were included; there was a significant positive correlation between delta of BNP and the number of DCs present at initial clinical assessment. Conclusions: The behavior of BNP was correlated to the DCs indicating congestion. With clinical compensation, DCs and BNP decreased. The use of this biomarker may provide additional precision to the nursing assessment.

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), also called Boxer Cardiomyopathy, is known to affect mainly dogs of this breed. This disease is hereditary and characterized by the replacement of cardiomyocytes of the right ventricle by fibrous fatty tissue. This condition leads to a derangement in the conduction of electrical impulses, resulting in arrhythmias, which is one of the main clinical signs observed in this disease, a condition that can lead to sudden death of the patient. The animals affected by this disease can vary from asymptomatic to asymptomatic cases, presenting syncopes and a small portion develops Congestive Heart Failure (CHF). [ABSTRACT FROM AUTHOR]

Electrocardiogram is a useful tool for the diagnosis of acute coronary syndrome. In recent years, ST-segment changes in aVR have been shown to provide valuable information about coronary anatomy and early risk stratification of this condition.

Lymphoma is a very common lymphoid malignancy in dogs, but cardiac involvement is rare. Primary cardiac lymphoma is defined as lymphoma involving the heart, the pericardium, or both, and is classified as extranodal anatomical form. The present report describes the cases of three animals with cardiac lymphoma. All cases presented moderate to severe pericardial effusion and cardiac tamponade. The cytological analysis of the effusion was consistent with the diagnosis of cardiac lymphoma. The anatomopathological evaluation of the tumor extracted from the heart of one of the animals, after euthanasia, was consistent with cardiac lymphoma. The other two animals were treated with Madison-Wisconsin chemotherapy protocol and survived between 6 to 8 months. This report emphasizes the importance of pericardial effusion cytology for the diagnosis, appropriate treatment approach and monitoring of cardiac tumors in dogs and cats.