Two-dimensional speckle tracking echocardiography demonstrates no effect of active acromegaly on left ventricular strain.

Background: Speckle tracking echocardiography (STE) allows for the study of myocardial strain (ε), a marker of early and subclinical ventricular systolic dysfunction. Cardiac disease may be present in patients with acromegaly; however, STE has never been used to evaluate these patients.

Objective: To evaluate left ventricular (LV) global longitudinal strain in patients with active acromegaly with normal LV systolic function.

Latin America: the next region for haematopoietic transplant progress.

Haematopoietic cell transplant activity in the 28 countries comprising Latin America is poorly defined. We conducted a voluntary survey of members of the Latin American Bone Marrow Transplantation Group regarding transplant activity 2009-2012. Collated responses were compared with data of transplant rates from the Worldwide Network for Blood and Marrow Transplantation for other geographic regions.

Diagnosis and treatment of chronic lymphocytic leukemia: recommendations from the Brazilian Group of Chronic Lymphocytic Leukemia.

Chronic lymphocytic leukemia is characterized by clonal proliferation and progressive accumulation of B-cell lymphocytes that typically express CD19, CD5 and CD23. The lymphocytes usually infiltrate the bone marrow, peripheral blood, lymph nodes, and spleen. The diagnosis is established by immunophenotyping circulating B-lymphocytes, and prognosis is defined by two staging systems (Rai and Binet) established by physical examination and blood counts, as well as by several biological and genetic markers.

Online training for health professionals in three regions of Brazil.

Objective:: to describe online training experience aimed at professionals working in the public health service in 27 Neonatal and Pediatric Intensive Care Units, and to reflect concerning the training process and possible improvements in this process.

Method:: this is an experience report study about the online training with multidisciplinary content, planned from the situational diagnosis of 27 institutions. The training target set was 10 participants per institution and per module, including the following topics: Indicators of Quality as a Management Tool, Hand Hygiene, Patient Safety, Intravenous Therapy and Patients' Chart Record.

Transcultural adaptation of the Johns Hopkins Fall Risk Assessment Tool.

Objective: to perform the transcultural adaptation and content validity analysis of the Johns Hopkins Fall Risk Assessment Tool to assess both fall risk and fall-related injury risk for hospitalized elderly in Brazil.

Method: the transcultural adaptation consisted of translating the scale to Portuguese (Brazil), back-translating it into its language of origin, establishing a consensus version, and having an expert committee verify its transcultural equivalence. Content assessment was conducted by a committee of judges, ending with the calculation of the items and scales' content validity index.

Metabolic syndrome and cardiovascular disease following hematopoietic cell transplantation: screening and preventive practice recommendations from CIBMTR and EBMT.

Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus and all cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with the estimated prevalence of MetS being 31-49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality.

Mechanical Ventilation in Sepsis: A Reappraisal.

Sepsis is the main cause of close to 70% of all cases of acute respiratory distress syndromes (ARDS). In addition, sepsis increases susceptibility to ventilator-induced lung injury. Therefore, the development of a ventilatory strategy that can achieve adequate oxygenation without injuring the lungs is highly sought after for patients with acute infection and represents an important therapeutic window to improve patient care.

Effects of Organizational Characteristics on Outcomes and Resource Use in Patients With Cancer Admitted to Intensive Care Units.

Purpose: To investigate the impact of organizational characteristics and processes of care on hospital mortality and resource use in patients with cancer admitted to intensive care units (ICUs).

Patients And Methods: We performed a retrospective cohort study of 9,946 patients with cancer (solid, n = 8,956; hematologic, n = 990) admitted to 70 ICUs (51 located in general hospitals and 19 in cancer centers) during 2013. We retrieved patients' clinical and outcome data from an electronic ICU quality registry.

Anatomic pulmonary resection by video-assisted thoracoscopy: the Brazilian experience (VATS Brazil study).

Objective: The objective of this study was to describe the results of anatomic pulmonary resections performed by video-assisted thoracoscopy in Brazil.

Methods: Thoracic surgeons (members of the Brazilian Society of Thoracic Surgery) were invited, via e-mail, to participate in the study. Eighteen surgeons participated in the project by providing us with retrospective databases containing information related to anatomic pulmonary resections performed by video-assisted thoracoscopy.

Metabolic Syndrome and Cardiovascular Disease after Hematopoietic Cell Transplantation: Screening and Preventive Practice Recommendations from the CIBMTR and EBMT.

Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus, and all-cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with an estimated prevalence of MetS of 31% to 49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality.

Effect of a Quality Improvement Intervention With Daily Round Checklists, Goal Setting, and Clinician Prompting on Mortality of Critically Ill Patients: A Randomized Clinical Trial.

Importance: The effectiveness of checklists, daily goal assessments, and clinician prompts as quality improvement interventions in intensive care units (ICUs) is uncertain.

Objective: To determine whether a multifaceted quality improvement intervention reduces the mortality of critically ill adults.

Design, Setting, And Participants: This study had 2 phases.

Longitudinal associations between stressors and work ability in hospital workers.

This study sought to assess associations between work stressors and work ability in a cohort (2009-2012) of 498 hospital workers. Time-dependent variables associated with the Work Ability Index (WAI) were evaluated using general linear mixed models. Analyses included effects of individual and work characteristics.

Haematopoietic cell transplants in Latin America.

Haematopoietic cell transplants are done by more than 1500 transplant centres in 75 countries, mostly for life-threatening haematological disorders. However, transplant technology and access are not uniformly distributed worldwide. Most transplants are done predominately in Europe, North America and some Asian countries.

Hematopoietic stem cell transplantation activity worldwide in 2012 and a SWOT analysis of the Worldwide Network for Blood and Marrow Transplantation Group including the global survey.

Data on 68 146 hematopoietic stem cell transplants (HSCTs) (53% autologous and 47% allogeneic) gathered by 1566 teams from 77 countries and reported through their regional transplant organizations were analyzed by main indication, donor type and stem cell source for the year 2012. With transplant rates ranging from 0.1 to 1001 per 10 million inhabitants, more HSCTs were registered from unrelated 16 433 donors than related 15 493 donors.

Association between work ability and fatigue in Brazilian nursing workers.

Background: Impaired work ability is associated with work-related illnesses, early retirement and rising pension costs.

Objective: To investigate the association between work ability and fatigue in nursing workers.

Methods: Cross-sectional study conducted with 100 nursing workers from two inpatient units at a public teaching hospital in Sao Paulo, Brazil.

Electrocardiographic abnormalities in the early stage following traumatic spinal cord injury.

Study Design: Retrospective cohort study.

Objective: Although cardiac arrhythmias are relatively well recognized in the chronic stage after spinal cord injury (SCI), little is known regarding its occurrence during the early stage. The objective of this study was to examine electrocardiogram changes within the first 72 h after acute traumatic SCI.

Robotic-assisted laparoscopic prostatectomy (RALP): a new way to training.

The implementation of RALP program is usually associated with a steep learning curve (LC). Fellows are proctored for few cases, with long operating times, inferior outcomes and an increased number of complications. We report the initial results of 100 RALP procedures performed in Rio de Janeiro, Brazil, with the implementation of a structured program.

Inequality in pediatric kidney transplantation in Brazil.

Background: The aim of this study was to describe the access and factors associated with kidney transplantation for children in different regions of Brazil.

Methods: We analyzed a cohort of 1211 children enrolled on the transplant list from January 2011 to December of 2013. We fitted regression models to investigate factors associated with: (a) undergoing kidney transplantation from a deceased donor, and (b) being removed from the waiting list.

Prognostic Value of Real Time Myocardial Contrast Echocardiography after Percutaneous Coronary Intervention.

Real time myocardial contrast echocardiography (RTMCE) is a cost-effective and simple method to quantify coronary flow reserve (CFR). We aimed to determine the value of RTMCE to predict cardiac events after percutaneous coronary intervention (PCI). We have studied myocardial blood volume (A), velocity (β), flow indexes (MBF, A × β), and vasodilator reserve (stress-to-rest ratios) in 36 patients with acute coronary syndrome (ACS) who underwent PCI.

Pediatric Chronic Dialysis in Brazil: Epidemiology and Regional Inequalities.

Introduction: There are few reports in the literature estimating the epidemiologic characteristics of pediatric chronic dialysis. These patients have impaired physical growth, high number of comorbidities and great need for continuous attention of specialized services with high demand for complex and costly procedures.

Objective: The aim of this study was to estimate the incidence and prevalence rates and describe the characteristics of children and adolescents undergoing chronic dialysis treatment in a Brazilian demographic health survey.

Long-segment thoracoabdominal aortic coarctation in a child with Down syndrome.

Midaortic syndrome is a rare vascular anomaly characterized by coarctation of the descending thoracic and abdominal aorta. Down syndrome is associated with multiple congenital cardiac malformations but is rarely associated with developmental vascular anomalies. Midaortic syndrome may result in severe renovascular hypertension that requires early intervention to prevent life-threatening complications.

Collaborative Brazilian Pediatric Renal Transplant Registry (CoBrazPed-RTx): A Report From 2004 to 2013.

Background: The Collaborative Brazilian Pediatric Renal Transplant Registry started in 2004 as a multicenter initiative aiming to analyze, report, and share the results of pediatric kidney transplantation in Brazil. Data from all pediatric kidney transplants performed between January 2004 and December 2013 were recorded electronically and periodically updated. All patients under 18 years old from the participating centers were enrolled.