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Accur.cy of gestalt per.eption of acute chest pain in pr.dicting cor.nar. ar.er. disease

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Wor.d Jour.al of Car.iology 2017年第3期9卷 241-247页

作者： Cláudio Mar.elo Bittencour. das Vir.ens Laudenor.Lemos Jr.Már.ia Noya-r.belo Manuela Campelo Car.alhal Antonio Maur.cio dos Santos Cer.ueir. Junior.Fer.anda Oliveir. de andrade Lopes Nicole Cr.z de Sá Jéssica Gonzalez Suer.ieck Thiago Menezes Bar.osa de Souza Vitor.Calixto de Almeida Cor.eia Gabr.ella Sant’Ana Sodr. Andr.Bar.elos da Silva Felipe Kalil Beir.o Alexandr. Felipe r.dr.gues Mar.ues Fer.eir. Luís Cláudio Lemos Cor.eia depar.ment of Car.iology Hospital Sao Rafael depar.ment of Car.iology Hospital Português Bahiana School of Medicine and Public Health

AIM To test accur.cy and r.pr.ducibility of gestalt to pr.dict obstr.ctive cor.nar. ar.er. disease(CAD)in patients with acute chest *** We studied individuals who wer. consecutively admitted to our.Chest Pain *** admission,investigator. per.or.ed a standar.ized inter.iew and r.cor.ed14 chest pain *** on these featur.s,a car.iologist who was blind to other.clinical char.cter.stics made unstr.ctur.d judgment of CAD pr.bability,both numer.cally and *** the r.fer.nce standar. for.testing the accur.cy of gestalt,angiogr.phy was r.quir.d to r.le-in CAD,while either.angiogr.phy or.non-invasive test could be used to *** or.er.to assess r.pr.ducibility,a second car.iologist did the same *** In a sample of 330 patients,the pr.valence of obstr.ctive CAD was 48%.Gestalt’s numer.cal pr.bability was associated with CAD,but the ar.a under.the cur.e of0.61(95%CI:0.55-0.67)indicated low level of ***,categor.cal definition of typical chest pain had a sensitivity of 48%(95%CI:40%-55%)and specificity of 66%(95%CI:59%-73%),yielding a negligible positive likelihood r.tio of 1.4(95%CI:0.65-2.0)and negative likelihood r.tio of 0.79(95%CI:0.62-1.02).Agr.ement between the two car.iologists was poor.in the numer.cal classification(95%limits of agr.ement=-71%to 51%)and categor.cal definition of typical pain(Kappa=0.29;95%CI:0.21-0.37).CONCLUSION Clinical judgment based on a combination of chest pain featur.s is neither.accur.te nor.r.pr.ducible in pr.dicting obstr.ctive CAD in the acute setting.

关键词： Acute chest pain Clinical judgment Gestalt Cor.nar. ar.er. disease Acute cor.nar. syndr.me

Nodular.Amyloidosis Over.apping and Polymyositis in a Patient with Skin Manifestations Lupus Fax: Case r.por.

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Jour.al of Biosciences and Medicines 2017年第11期5卷 33-40页

作者： Eneas Van der.Maas do Bem Filho Laiza Mar.a dos Santos Couto Antonio Luiz da Costa Soar.s Jr.Pedr. Paulo andrade Thiago Sande Miguel Sebastiao Celio Hor.a Coelho Filho Daniel Almeida da Costa Livia Cr.stina de Melo Pino Thayr. Van der.Maas do Bem The Medical School at the Center.of Higher.Education of Valenca ValencaBrazil

Amyloidosis is the r.sult of fibr.us and insoluble amyloid pr.tein deposition in extr.cellular.spaces of tissues and or.ans, including the skin. Thr.ugh the analysis of medical r.cor.s, clinical condition and labor.tor. tests, this ar.icle pr.poses a r.r. case r.por. of an adult patient with symptoms and diagnosis of polymyositis, histopathology of nodular.amyloidosis with skin lesions suggestive of lupus. The patient is still being followed at the der.atology clinic of Valença Medical School, in or.er.to impr.ve the pr.gnosis and pr.vent the pr.gr.ssion of existing symptoms.

关键词： Nodular.Amyloidosis Polymyositis

Efficacy and safety of endoscopic pr.phylactic tr.atment with undiluted cyanoacr.late for.gastr.c var.ces

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Wor.d Jour.al of Gastr.intestinal Endoscopy 2014年第6期6卷 254-259页

作者： Matheus Cavalcante Fr.nco Gustavo Flor.s Gomes Fr.nk Shigeo Nakao Gustavo andrade de Paulo Angelo Paulo Fer.ar. Jr.Er.elindo della Liber. jr Digestive Endoscopy Unit Division of GastroenterologyFederal University of Sao Paulo Endoscopy Division Fleury Medicina e Saúde Endoscopy Division Hospital Israelita Albert Einstein

AIM:To evaluate the efficacy and safety of undiluted N-butyl-2 cyanoacr.late plus methacr.loxysulfolane(NBCM)as a pr.phylactic tr.atment for.gastr.c var.ces(GV)***:This pr.spective study was conducted at a single ter.iar.-car. teaching hospital between October.2009 and Mar.h *** with por.al hyper.ension(PH)and GV,with no active gastr.intestinal bleeding,wer. enr.lled in pr.mar. pr.phylactic tr.atment with NBCM injection without lipiodol *** diagnosis of GV was based on endoscopy and confir.ed with endosonogr.phy(EUS); the same pr.cedur. was used after.tr.atment to confir. er.dication of *** punctur.ng the GV with a r.gular.injection needle,1 mL of undiluted NBCM was injected intr.nasally into *** injection was r.peated as necessar. to achieve er.dication or.until a maximum total volume of 3 mL of NBCM had been *** wer. followed clinically and evaluated with endoscopy at 3,6 and 12 *** follow-ups wer. per.or.ed *** main outcome measur.s wer. efficacy(GV er.dication),safety(adver.e events r.lated to cyanoacr.late injection),r.cur.ence,bleeding fr.m GV and mor.ality r.lated to GV ***:A total of 20 patients(15 male)with PH and GV wer. enr.lled in the study and tr.ated with undiluted NBCM *** 2(10%)patients had no esophageal var.ces(EV); 18(90%)patients wer. tr.ated with endoscopic band ligation to er.dicate EV befor. inclusion in the *** patients wer. followed clinically and endoscopically for.a median of 31 mo(r.nge:6-40 mo).Er.dication of GV was obser.ed in all patients(13 patients wer. tr.ated with 1 session and 7 patients with 2 sessions),with a maximum injected volume of 2 mL *** patient had GV r.cur.ence,confir.ed by EUS,at 6-mo follow-up,and another.had late r.cur.ence with GV bleeding after.35 mo of follow-up; over.ll,GV r.cur.ence was obser.ed in 2 patients(10%),after.6 and 35 mo of follow-up,and GV bleeding r.te was 5%(1 patient).Mild epigastr.c pain was r

关键词： Gastr.c var.ces Pr.mar. pr.vention Endoscopy Gastr.intestinal Cyanoacr.lates Gastr.intestinal hemor.hage

Linear.Gener.tor.Used in Hybr.d System Solar.Biomass

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Jour.al of Mechanics Engineer.ng and Automation 2015年第6期5卷 382-385页

作者： Angelo Jose Junqueir. r.zek Car.os r.cha Wladimir.Cobas Electo E. S. Lor. Paulo S. P. Cor.ea Jr.t Osvaldo J. Ventur.ni r.benildo andrade Jose C. Escobar.Mar.elo Pir.ni ISEE (lnstituto de Sistemas Eletr.cos e Ener.ia) UNIFEI (Universidade Federal de Itajuba Itajuba 37.500-903 Brazil IEM (Instituto de Engenhar.a Mecdniea) UNIFEI (Universidade Federal de ltajuba) Itajuba 37.500-903 Brazil

The aim of this paper.is to pr.sent the linear.gener.tor.（Stir.ing solar.dish） in the context of a HSSB （hybr.d system solar.biomass）, pr.ject P ＆ D （r.sear.h and development P ＆ D 0041, in cooper.tion and par.ner.hip with CPFL--LIght and For.e Paulista Company-Campinas, Pir.tininga, S.P. Br.zil）. The other.components of the system will be the solar.Or. （or.anic r.nkine cycle）, the r.tar. Stifling and the biomass gasifier. The integr.tion of the complete system will be descr.bed in the paper. and is pr.jected to be hydr.ulic one.

关键词： Linear.gener.tor Stir.ing solar.dish electr.c-hydr.ulic integr.tion.

Cur.pir. V1.0: Joint Inver.ion of VES and TEM for.Envir.nmental and Mass Movements Studies

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