Prognostic Impact of Iron Metabolism Changes in Patients with Acute Coronary Syndrome / Impacto Prognóstico das Alterações do Metabolismo do Ferro em doentes com Síndrome Coronária Aguda

Abstract Background: Iron metabolism disorders have been associated with an increased risk of cardiovascular events. However, the prognostic impact on patients (pts) with acute coronary syndrome (ACS) has yet to be clarified. Objective: To determine the prognostic value of serum iron and ferritin levels in pts with ACS in the short and long-term. Methods: Consecutive pts admitted to a coronary care unit with a diagnosis of ACS, for a period of 2 years, were evaluated. The population was divided into tertiles of serum iron and ferritin distribution. The primary adverse events were the occurrence of in-hospital death or heart failure (HF) and death or HF at 1 year of follow-up. Results: We studied 280 pts (73% males; mean age 68 ± 13 years). The mean levels of serum iron and ferritin were 59 ± 34 mcg/dL and 205 ± 185 ng/mL, respectively. Patients included in the 1st tertile of serum iron (≤ 40 mcg/dL) had a higher rate of adverse events, in-hospital and after 1 year. Lower and higher levels of ferritin (1st and 3rd tertiles, ≤ 110; >219 ng/ml, respectively) were associated with a higher incidence of HF during hospitalization and death at 1 year. A ferritin value >316 ng /mL was an independent risk factor for death at 1 year (adjusted OR: 14; 95%CI: 2.6 to 75.9). Conclusion: In this population, iron metabolism alterations were associated with a higher rate of adverse events and higher ferritin levels constituted an independent mortality predictor in the long-term.

Resumo Fundamento: Alterações do metabolismo do ferro têm sido associadas a um aumento do risco de eventos cardiovasculares. No entanto, o impacto prognóstico em doentes (dts) com síndrome coronária aguda (SCA) encontra-se ainda pouco esclarecido. Objetivo: Determinar o valor prognóstico a curto e longo prazo dos níveis séricos do ferro e ferritina em dts com SCA. Métodos: Foram avaliados doentes consecutivos admitidos numa Unidade Coronária com o diagnóstico de SCA no período de 2 anos. A população foi agrupada segundo os tercis de distribuição de ferro e ferritina. Os eventos adversos primários foram a ocorrência de morte intrahospitalar e a 1 ano, bem como, insuficiência cardíaca (IC) intrahospitalar e a 1 ano de follow-up. Resultados: Estudaram-se 280 dts (73% sexo masculino; idade média de 68 ± 13 anos). O nível médio de ferro sérico e de ferritina foi 59 ± 34 mcg/dl e 205 ± 185 ng/ml, respetivamente. Os doentes incluídos no 1º tercil (≤ 40 mcg/dl) de ferro sérico apresentaram maior percentagem de eventos adversos intrahospitalares e a 1 ano. Níveis mais baixos e mais elevados de ferritina (1º e 3º tercil, respetivamente, ≤ 110; > 219 ng/ml) estiveram associados a uma maior ocorrência de IC em internamento e de morte a 1 ano. Um valor de ferritina > 316 ng/mL constituiu fator de risco independente de morte a 1 ano (OR ajustado 14 IC 95% 2,6-75,9). Conclusão: Nesta população alterações do metabolismo do ferro estiveram associadas a uma maior ocorrência de eventos adversos e níveis elevados de ferritina constituíram preditor independente de mortalidade a longo prazo.

Prognostic Impact of Iron Metabolism Changes in Patients with Acute Coronary Syndrome.

BACKGROUND: Iron metabolism disorders have been associated with an increased risk of cardiovascular events. However, the prognostic impact on patients (pts) with acute coronary syndrome (ACS) has yet to be clarified. OBJECTIVE: To determine the prognostic value of serum iron and ferritin levels in pts with ACS in the short and long-term. METHODS: Consecutive pts admitted to a coronary care unit with a diagnosis of ACS, for a period of 2 years, were evaluated. The population was divided into tertiles of serum iron and ferritin distribution. The primary adverse events were the occurrence of in-hospital death or heart failure (HF) and death or HF at 1 year of follow-up. RESULTS: We studied 280 pts (73% males; mean age 68 ± 13 years). The mean levels of serum iron and ferritin were 59 ± 34 mcg/dL and 205 ± 185 ng/mL, respectively. Patients included in the 1st tertile of serum iron (≤ 40 mcg/dL) had a higher rate of adverse events, in-hospital and after 1 year. Lower and higher levels of ferritin (1st and 3rd tertiles, ≤ 110; >219 ng/ml, respectively) were associated with a higher incidence of HF during hospitalization and death at 1 year. A ferritin value >316 ng /mL was an independent risk factor for death at 1 year (adjusted OR: 14; 95%CI: 2.6 to 75.9). CONCLUSION: In this population, iron metabolism alterations were associated with a higher rate of adverse events and higher ferritin levels constituted an independent mortality predictor in the long-term.

Avaliação da qualidade de vida infantil: o inventário sistémico de qualidade de vida para crianças / Children's quality of life assessment: child quality of life systemic inventory

A avaliação da qualidade de vida infantil apresenta especificidades metodológicas. O objetivo do presente estudo é analisar as características psicométricas da versão portuguesa do Inventaire Systémique de Qualité de Vie pour Enfants (ISQV-C), que assenta numa abordagem conceptual e metodológica inovadora para a autoavaliação da qualidade de vida, por ser interativo e lúdico, possuir uma psicometria que explora diversas pontuações e permitir uma análise de cada domínio de vida. Participaram do estudo 120 crianças portuguesas, dos 8 aos 12 anos de idade. Os resultados apontam para uma consistência interna satisfatória das quatro pontuações do ISQV-C (Estado, Objetivo, Importância e Qualidade de Vida), atestam validade convergente ao instrumento, não sendo favoráveis à existência de uma estrutura fatorial. Demonstra-se a adequação psicométrica e o interesse da versão portuguesa do ISQV-C.

The assessment of children's quality of life presents specific methodological aspects. The objective of this study was to examine the psychometric properties of the Portuguese version of the Child Quality of Life Systemic Inventory (CQLSI). It is based on an innovative conceptual and methodological approach to quality of life self-assessment. It is interactive and playful, has a psychometry which operates several scores, and allows the analysis of each domain of life. One hundred twenty Portuguese children, from 8 to 12 years old, participated in the study. Results show that internal consistency of the four scores of the CQLSI (State, Goal, Rank and Gap) is satisfactory and all scores have their own specificity. Findings reveal the feasibility of this self-assessment instrument for children's quality of life, demonstrating psychometric adequacy of the Portuguese version.

Avaliação da qualidade de vida infantil: o inventário sistémico de qualidade de vida para crianças / Children's quality of life assessment: child quality of life systemic inventory

A avaliação da qualidade de vida infantil apresenta especificidades metodológicas. O objetivo do presente estudo é analisar as características psicométricas da versão portuguesa do Inventaire Systémique de Qualité de Vie pour Enfants (ISQV-C), que assenta numa abordagem conceptual e metodológica inovadora para a autoavaliação da qualidade de vida, por ser interativo e lúdico, possuir uma psicometria que explora diversas pontuações e permitir uma análise de cada domínio de vida. Participaram do estudo 120 crianças portuguesas, dos 8 aos 12 anos de idade. Os resultados apontam para uma consistência interna satisfatória das quatro pontuações do ISQV-C (Estado, Objetivo, Importância e Qualidade de Vida), atestam validade convergente ao instrumento, não sendo favoráveis à existência de uma estrutura fatorial. Demonstra-se a adequação psicométrica e o interesse da versão portuguesa do ISQV-C.(AU)

The assessment of children's quality of life presents specific methodological aspects. The objective of this study was to examine the psychometric properties of the Portuguese version of the Child Quality of Life Systemic Inventory (CQLSI). It is based on an innovative conceptual and methodological approach to quality of life self-assessment. It is interactive and playful, has a psychometry which operates several scores, and allows the analysis of each domain of life. One hundred twenty Portuguese children, from 8 to 12 years old, participated in the study. Results show that internal consistency of the four scores of the CQLSI (State, Goal, Rank and Gap) is satisfactory and all scores have their own specificity. Findings reveal the feasibility of this self-assessment instrument for children's quality of life, demonstrating psychometric adequacy of the Portuguese version.(AU)

Inducing surface hydrophobization on cornstarch film by SF6 and HMDSO plasma treatment.

The development of thermoplastic materials based on starch has become a promising alternative for reducing plastic waste. To this end, plasma treatments were used to enhance the hydrophobicity of cornstarch films. Cornstarch films plasticized using glycerol and distilled water were prepared by casting. A surface modification method was employed using different precursor gases, HMDSO and SF(6), and a combined treatment using HMDSO followed by SF(6) (HMDSO/SF(6)) and then the reverse, using SF(6) first followed by HMDSO (SF(6)/HMDSO). The results indicated that the induced surface morphology determines the contact angle. It was observed that all films became hydrophobic, and films that were initially treated with SF(6) showed the greatest hydrophobicity if no further coating was applied, or if the treated surface was further coated using HMDSO. Under both of these treatment conditions the contact angle was greater than 110°.

Estructura Metodológica en la Redacción del Artículo Científico / Methodological structure for writing scientific papers

Los manuscritos presentados en reuniones no califican necesariamente como artículo científico, ya que no se ajustan a los objetivos y estructuras requeridas. De este análisis se concretó que el artículo científico es una parte esencial del proceso de investigación científica, y que ésta no está completa mientras sus resultados no se publican. Por tal razón nos movió a realizar este estudio, con el fin de actualizar la estructura metodológica del artículo científico, que permita a aquellos profesionales de enfermería que se dedican a la revisión y elaboración de estos textos, desarrollen habilidades en este sentido, proporcionando el aumento en número y calidad de los artículos que se publicarán. Esta revisión bibliográfica o documental se efectuó mediante estudios de documentos de la OPS y otros autores cubanos que dedican su tiempo al estudio de estos aspectos. Dicha revisión nos permitirá contribuir en mejorar el conocimiento en este campo, en el personal de enfermería y a su vez actualizarlo acerca de la estructura metodológica del artículo científico, mediante esta información esquemática. Esto influirá en la calidad, nivel científico-técnico y proyección nacional e internacional en la Revista Cubana de Enfermería