In-Hospital Management and Long-term clinical outcomes and adherence in patients with acute decompensated heart failure: primary results of the first brazilian registry of heart failure (BREATHE)

BACKGROUND: Heart failure (HF), a common cause of hospitalization, is associated with poor short-term clinical outcomes. Little is known about the long-term prognosis of patients with HF in Latin America. METHODS: BREATHE was the first nationwide prospective observational study in Brazil that included patients hospitalized due to acute HF. Patients were included during 2 time periods: February 2011-December 2012 and June 2016-July 2018. In-hospital management and 12-month clinical outcomes were assessed, and adherence to evidence-based therapies was evaluated. RESULTS: A total of 3013 patients were enrolled at 71 centers in Brazil. At hospital admission, 83.8% had clear signs of pulmonary congestion. The main cause of decompensation was poor adherence to HF medications (27.8%). Among patients with reduced ejection fraction, concomitant use of beta-blockers, renin-angiotensin-aldosterone inhibitors, and spironolactone numerical decreased from 44.5% at hospital discharge to 35.2% at 3 months. The cumulative incidence of mortality at 12 months was 27.7%, with 24.3% readmission at 90 days and 44.4% at 12 months. CONCLUSIONS: In this large national prospective registry of patients hospitalized with acute HF, rates of mortality and readmission were higher than those reported globally. Poor adherence to evidence-based therapies was common at hospital discharge and 12 months of follow-up.

Información general sobre vinazas originadas en procesos industriales amilaceo-azucarero

Informa de la composición de vinazas de la industria del azucar. Estudia sus efectos sobre el medio ambiente donde sera evacuado el efluente. Fija una determinación del grado de contaminación y riesgos ecológicos que genera. Plantea el empleo de vinaza como fertilizante y la producción de biomasa fungica a partir de la vinaza. Explica el proceso de digestión anaeróbica, tratamiento, concentración y combustión de las vinazas

Información general sobre vinazas originadas en procesos industriales amilaceo-azucarero

Informa de la composición de vinazas de la industria del azucar. Estudia sus efectos sobre el medio ambiente donde sera evacuado el efluente. Fija una determinación del grado de contaminación y riesgos ecológicos que genera. Plantea el empleo de vinaza como fertilizante y la producción de biomasa fungica a partir de la vinaza. Explica el proceso de digestión anaeróbica, tratamiento, concentración y combustión de las vinazas