IntroductionFluid overload is a clinical problem frequently related to cardiac and renal dysfunction. The aim of this study was to evaluate fluid overload and changes in serum creatinine as predictors of cardiovascular mortality and morbidity after cardiac surgery.MethodsPatients submitted to heart surgery were prospectively enrolled in this study from September 2010 through August 2011. Clinical and laboratory data were collected from each patient at preoperative and trans-operative moments and fluid overload and creatinine levels were recorded daily after cardiac surgery during their ICU stay. Fluid overload was calculated according to the following formula: (Sum of daily fluid received (L) - total amount of fluid eliminated (L)/preoperative weight (kg) × 100). Preoperative demographic and risk indicators, intra-operative parameters and postoperative information were obtained from medical records. Patients were monitored from surgery until death or discharge from the ICU. We also evaluated the survival status at discharge from the ICU and the length of ICU stay (days) of each patient.ResultsA total of 502 patients were enrolled in this study. Both fluid overload and changes in serum creatinine correlated with mortality (odds ratio (OR) 1.59; confidence interval (CI): 95% 1.18 to 2.14, P = 0.002 and OR 2.91; CI: 95% 1.92 to 4.40, P <0.001, respectively). Fluid overload played a more important role in the length of intensive care stay than changes in serum creatinine. Fluid overload (%): b coefficient = 0.17; beta coefficient = 0.55, P <0.001); change in creatinine (mg/dL): b coefficient = 0.01; beta coefficient = 0.11, P = 0.003).ConclusionsAlthough both fluid overload and changes in serum creatinine are prognostic markers after cardiac surgery, it seems that progressive fluid overload may be an earlier and more sensitive marker of renal dysfunction affecting heart function and, as such, it would allow earlier intervention and more effective control in post cardiac surgery patients.

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Background: Cardiovascular and periodontal diseases are common inflammatory conditions. In atherosclerosis, inflammation plays a continuous role in the development, destabilization, and rupture of atheromas. There is controversial scientific evidence regarding the association between chronic periodontitis and coronary artery disease (CAD). The objective of this study was to assess the association between chronic periodontitis and CAD in this practice. Methods: This was a cross-sectional controlled study of 206 patients with no prior CAD and for whom coronary angiography was indicated; the data included clinical history, physical examination and blood sample collection to test for blood glucose, lipid profile, and C-reactive protein levels. The presence of chronic periodontitis was determined by clinical examination performed by a periodontist. The levels of bacterial plaque, gingival calculus, bleeding, exudate, and classical signs of inflammation were recorded. Results: The mean age was 60.3 ± 10.1 years, and 60.2% of the subjects were male. CAD was present in 126 patients (61.2%). There was an association between CAD and gender [male gender, odds ratio (OR) 2.18; P = 0.0075], age (61-70 years, OR 5.63; P = 0.0007), and educational level (higher educational level, OR 2.08; P = 0.02). Inflammatory biomarkers did not differ between the groups with and without CAD. Signs of inflammation and bacterial plaque were present in 88% of patients with CAD, slightly higher than the rate observed in patients without

Compression of the lower limbs is very effective to render the TT negative in patients with a diagnosis of VS.

Após a redemocratização do país, institucionalizada pela Constituição Federal de 1988, em que grau os militares brasileiros continuam politizados? Qual é o poder de fato que o Clube Militar possui diante da democracia brasileira? Através da publicação de seus artigos disponíveis online, continuaria esse segmento militar a demonstrar continuar apresentando interesses sobre as instituições políticas democráticas? Qual a nova estratégia para que suas reivindicações sejam atendidas?  A associação militar teria influenciado a crise política, institucional e econômica da democracia brasileira – evidenciada pelo impeachment da Presidente da República Dilma Rousseff e a consequente vitória do candidato de extrema-direita Jair Bolsonaro nas eleições de 2018? Relacionando-se com a teoria do poder moderador militar de Alfred Stepan e demais autores, este capítulo de livro tem como objetivo analisar, discutir, debater estas questões atuais, que são de extrema importância para tentar compreender um fenômeno que ocorre na política brasileira – sua eventual militarização.