Monday, April 28, 2014

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Sunday, April 27, 2014

Cid Nogueira na Rev. Bras. CVir Cardiovasc 2011

Como contribuição do Dr. Valério Garcia, ilustre colega da turma de 1960 de minha esposa Dra. Valderês Robionson A., recebi a referência de um artigo sobre o Dr. Cid Nogueira, sobre o qual eu já havia postado duas referências em 2011.
http://amicor.blogspot.com/2011/10/cid-nogueira.html
http://amicor.blogspot.com/2011/10/cid-nogueira-0102011.html

Revista Brasileira de Cirurgia Cardiovascular

Print version ISSN 0102-7638

Rev Bras Cir Cardiovasc vol.26 no.4 São José do Rio Preto Oct./Dec. 2011

http://dx.doi.org/10.5935/1678-9741.20110063 

HOMENAGEM

Dr. Cid Nogueira: um médico pioneiro da cirurgia cardíaca brasileira


Paulo Rodrigues da Silva
Membro Titular da SBCCV


O Dr. Cid Nogueira, cirurgião cardiovascular, nasceu na cidade de Araguari, Minas Gerais, em 6 de maio de 1929, filho de Achileu Nogueira e Carmem Nogueira.
Veio a falecer em Brasília, em 1º de outubro de 2011, aos 82 anos de idade, após alguns problemas de saúde no final de sua vida, quando, devido a uma miocardiopatia, teve que ter um sincronizador e um desfibrilador cardíaco automático implantados.
Diplomou-se como médico pela Faculdade Nacional de Medicina da Universidade Federal no Rio de Janeiro.
Iniciou suas atividades de cirurgião torácico e cardiovascular como Oficial Médico da Marinha, lotado no Hospital Naval Marcílio Dias, do Rio de Janeiro.
Em 1955, foi encaminhado por seu chefe no Hospital Marcílio Dias, Dr. Edídio Guertzenstein, para iniciar residência médica em Cirurgia Torácica e Cardiovascular no St. Vincent Charity Hospital, em Cleveland, Ohio, USA, no Serviço do Dr. Earl B. Kay.
O Dr. Kay já era conhecido e criador do oxigenador de discos para cirurgia cardíaca aberta, modelo Kay-Cross.
No mesmo hospital, sob a chefia do Dr. Earl B. Kay, o Dr. Cid Nogueira teve também a orientação de outros famosos médicos especialistas, como os Drs. Henry A Zimmerman, cardiologista e um dos pioneiros em cateterismo cardíaco no mundo, David Mendelsohn Jr., intensivista e anestesiologista, e Córcoran, que era pesquisador em fisiologia cardiológica.
Em Cleveland, de imediato, o Dr. Cid Nogueira se destacou, tornando-se o 1º Assistente do Serviço do Dr. Kay.
Nós fomos testemunhas desse seu prestígio pessoal e técnico junto ao referido Serviço, quando, em 1960, iniciávamos o nosso treinamento como residente no serviço do Dr. Kay.
Interessante destacar que o Dr. Kay veio ao Brasil em 1956 e realizou, no Rio de Janeiro, cirurgia cardíaca aberta com circulação extracorpórea, quando teve seu primeiro contato com o Dr. Cid Nogueira.
O Presidente da República do Brasil, recém-eleito na ocasião, Dr. Juscelino Kubitschek de Oliveira, que também era médico, foi testemunha desta cirurgia, juntamente com o Professor Dr. José Hilário e o então jovem Dr. Cid Nogueira (Figura 1).


Graças à ação do nosso Presidente e de todas estas figuras, incluindo o jovem Dr. Cid Nogueira, o Dr. Earl B. Kay deixou no Brasil um sistema de bomba coração-pulmão de discos, modelo Kay-Cross.
Esta máquina passou a ser usada pelo Dr. Hugo Felipozzi, em São Paulo, iniciando-se naquela cidade a sua produção em série, para todos os cirurgiões cardíacos brasileiros.
O Dr. Cid Nogueira teve uma participação importante na cirurgia cardíaca mundial, especificamente nas cirurgias plásticas valvares cardíacas (aórtica e mitral), assim como nas trocas valvares por próteses.
Importante ressaltar o seu trabalho relativo à ressecção das válvulas aórticas dos pacientes, seguida da substituição das mesmas por cúspides individualizadas protéticas, confeccionadas com tecido plástico de Teflon, recoberto por poliuretano, para que não houvesse vazamento sanguíneo entre as malhas do material plástico.
O Dr. Cid Nogueira, juntamente com outro residente do Dr. Kay, o Dr. Akio Suzuki, japonês de origem, era um dos que manualmente confeccionavam estas próteses valvares.
Em 1958, o Dr. Cid Nogueira, em Congresso Nacional de Cardiologia, no Rio de Janeiro, no Copacabana Palace Hotel, demonstrou como eram confeccionadas e implantadas estas próteses valvares na aorta. Recordo-me, porque lá estávamos, foi uma apresentação muito útil e informativa para todos nós do Brasil.
O Dr. Cid Nogueira, após cinco anos de residência em Cleveland, teve o honroso convite para trabalhar na Holanda, com os grupos médico-cirúrgico de Amsterdan e Utrecht, ocasião em que teve oportunidade de introduzir a cirurgia cardíaca "a céu aberto" das valvas cardíacas mitral e aórtica naquele país.
Em 1966, a convite do professor de Cirurgia Dr. José Hilário, teve a oportunidade de organizar e dirigir o Serviço de Cirurgia Cardiovascular do Departamento de Cirurgia da Faculdade Federal de Medicina em Porto Alegre (UFRGS).
Ficou seis anos trabalhando em Porto Alegre. Foi quem introduziu o emprego de próteses valvares mitral e aórtica naquela cidade.
Em 1968, a convite do professor Dr. Mariano de Andrade, foi trabalhar na Faculdade de Medicina em que tinha se diplomado médico, assim como em vários outros hospitais de ensino no Rio de Janeiro.
Dos Servidores do Estado do Rio de Janeiro, o mesmo foi convidado para operar em Brasília, aonde foi designado como Chefe da Cirurgia Cardiovascular do Estado Maior das Forças Armadas. O Dr. Cid Nogueira, em sua atividade como cirurgião cardíaco, treinou e preparou inúmeros cirurgiões da especialidade no Brasil, a saber, que nos perdoem as eventuais omissões: em Porto Alegre, destacamos os Drs. João Batista Pereira, Felisberto Ferreira, Nelson Pizatto, Ernesto Figueiredo, Ivo Abrahão Nesralla, Polyguara Silveira da Costa, Paulo Prates, Gilberto Venossi Barbosa e Blau Fabrício de Souza; no Rio de Janeiro, os Drs. Antonio Augusto Miana, Alexandre Brick, Eduardo Sergio Bastos e Marco Antonio Cunha, assim como o seu primo, também competente especialista, o Dr. Odilon Nogueira Barbosa, que atualmente é cirurgião cardiovascular do Instituto Nacional de Cardiologia, antigo Hospital de Cardiologia de Laranjeiras.
Devemos ressaltar que alguns dos seus assistentes, além de excelentes especialistas, chegaram à Presidência da Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV).
No período final de sua vida, em Brasília, o Dr. Cid Nogueira foi designado e atuou como médico do Senado.
Além do já mencionado acima, o Dr. Cid Nogueira fez diversas contribuições técnico-cirúrgica importantes, a saber:
a. contribuições para o tratamento cirúrgico das complicações septais e valvares após infarto agudo do miocárdio;
b. contribuições na ressecção dos aneurismas chagásicos de ventrículo esquerdo;
c. "Próteses valvares. Aplicação clínica de válvula de Kay-Suzuki". Título de sua Tese defendida em seu Concurso de Livre Docência de Cirurgia Cardiovascular da Universidade Federal do Rio de Janeiro, em 1970, no qual foi aprovado. Esta tese refere-se à aplicação em 60 pacientes de próteses valvares de disco de carbono pirolítico, cujo disco cursava no ventrículo esquerdo, sem que o mesmo girasse para a posição vertical, ocupando assim o menor espaço no ventrículo esquerdo.
O Dr. Cid Nogueira foi Fundador e Membro Titular da Sociedade Brasileira de Cirurgia Cardiovascular.
Em 1969, no XXV Congresso Brasileiro de Cardiologia, em Belo Horizonte, quando da realização da 1ª Assembleia Geral Ordinária do Departamento de Cirurgia Cardiovascular da Sociedade Brasileira de Cardiologia, o Dr. Cid Nogueira foi eleito para o Conselho Deliberativo da mesma, juntamente com os Drs. Domingos Junqueira de Moraes, Delmont Bittencourt, Luiz Carlos Bento de Souza e Ivo Nesralla.
Complementando, podemos afirmar que a cirurgia cardiovascular do Brasil como um todo lamenta profundamente o falecimento deste brilhante Cirurgião Cardiovascular brasileiro.

Gabriel García Márquez interview to Paris Review


Where Fiction Flirts with Fact and Feeling

The late Gabriel García Márquez on cartoons, carpentry, literary creation and why his interview tape recorder was always so darn dusty.  [Paris Review]

HISTORY

Founded in Paris by Harold L. Humes, Peter Matthiessen, and George Plimpton in 1953, The Paris Review began with a simple editorial mission: “Dear reader,” William Styron wrote in a letter in the inaugural issue, “The Paris Review hopes to emphasize creative work—fiction and poetry—not to the exclusion of criticism, but with the aim in mind of merely removing criticism from the dominating place it holds in most literary magazines and putting it pretty much where it belongs, i.e., somewhere near the back of the book. I think The Paris Review should welcome these people into its pages: the good writers and good poets, the non-drumbeaters and non-axe-grinders. So long as they're good.”

2651 - AMICOR 16


George Orwell’s  Animal Farm  Illustrated by Ralph Steadman

by 
“I do not wish to comment on the work; if it does not speak for itself, it is a failure.”





Feira do Livro de Santa Maria

Aloyzio AchuttiemAMICOR - Há 13 minutos
*Meu primo José Antônio Brenner patrono da Feira do Livro de Santa Maria*

Friendship

Aloyzio AchuttiemAMICOR - Há 28 minutos
Love Undetectable: Andrew Sullivan on Why Friendship Is a Greater Gift Than Romantic Love*by Maria Popova* *Reflections on the cornerstone of our flourishing.* *“A principal fruit of friendship,”* Francis Bacon observed, *“is the ease and discharge of the fulness and swellings of the heart, which passions of all kinds do cause and induce.”* Thoreau would“sometimes awake in the night and think of friendship and its possibilities.” St. Augustine described friendship as “sweet beyond the sweetness of life.” But what exactly *is* friendship — what defines its singular hallmark? Shortly af... mais »

Biophosphonartes and AF

Aloyzio AchuttiemAMICOR - Há 23 horas
Bisphosphonates May Increase Risk of Atrial FibrillationFor patients who have osteoporosis, the use of bisphosphonates appears to increase the risk of serious atrial fibrillation, according to a meta-analysis.

Net-Ativismo

Aloyzio AchuttiemAMICOR - Há 23 horas
Net-ativismo e as novas práticas de democracia são temas de estudo | 25.04.2014 Programa veiculado no dia 25 de abril de 2014 O sociólogo italiano Massimo di Felice, coordenador do Centro de Pesquisa Atopos da Escola de Comunicações e Artes da Universidade de São Paulo (ECA-USP), conversa no estúdio da USP FM sobre o estudo *Net Ativismo: ações colaborativas em redes digitais*, que investiga o papel da internet para o ativismo e as novas práticas de democracia.

brain-machine interface

Aloyzio AchuttiemAMICOR - Há um dia
How to build a brain-machine interface04/25/2014You are subscribed to Discoveries - All NSF Discoveries for National Science Foundation Update. This information has recently been updated, and is now available. How to build a brain-machine interface [image: Illustration of an eyeball with retinal implant]New-generation brain technologies are now in use thanks to new body-compatible materials, smaller electronics and better sensors designed by engineers More at http://www.nsf.gov/discoveries/disc_summ.jsp?cntn_id=131214&WT.mc_id=USNSF_1 This is an NSF Discoveries item.

Fetal Heart Disease

Aloyzio AchuttiemAMICOR - Há um dia
April 25, 2014AHA Issues Fetal Heart Disease GuidanceRecognizing the fetus as a patient, the American Heart Association has released a scientific statement that addresses the diagnosis and treatment of fetal cardiac disease. Read more

Memory

Aloyzio AchuttiemAMICOR - Há 3 dias
The Science of Memory Managing editor Sandra Upson introduces the May/June 2014 issue of*Scientific American MIND* May 1, 2014 |By Sandra Upson [image: Sandra Upson] *Credit: Sean McCabe* More In This Article - [image: Rebuilding Memories Makes Them Stick]Rebuilding Memories Makes Them Stick - [image: What Does the Hippocampus Do?]What Does the Hippocampus Do? - [image: How Dads Influence Teens' Happiness]How Dads Influence Teens' Happiness - [image: Designing Cameras That Work Like Eyes]Designing Cameras That Work Like Eyes - [image: Stem Cell Therapy Coul... mais »

5% Misdiagnostics in 240 million outpatients care

Aloyzio AchuttiemAMICOR - Há 3 dias
Misdiagnoses All Too Common: 1 in 20 US Adult Patients Diedtra Henderson April 22, 2014 EDITORS' RECOMMENDATIONS - Medicare Doc Pay Change Would Boost Patient Coordination - Dermatology Consults Halt Cellulitis Misdiagnoses - Autopsy Study Shows Misdiagnoses Are Common in ICU At least 1 in 20 US adults receiving outpatient care, or 12 million patients annually, are misdiagnosed, and half of these medical errors could be harmful, according to a population-based estimate. The authors hope the study prompts systematic measurement and reduction of medical errors. Hardeep Singh, MD... mais »

Inequity in Health

Aloyzio AchuttiemAMICOR - Há 4 dias
The equity action spectrum: taking a comprehensive approach. Guidance for addressing inequities in health *Download* English (PDF), 380.3 KB By Margaret Whitehead, Sue Povall and Belinda Loring 2014, v + 29 pages ISBN 978 92 890 5045 6 Free of charge While population health indicators have improved across Europe overall, that improvement has not been experienced equally everywhere, or by all. This is one of a series of policy briefs that describe practical actions to address health inequities, especially in relation to tobacco, alcohol, obesity and injury, the priority public health cha... mais »

50 Years of Poverty

Aloyzio AchuttiemAMICOR - Há 5 dias
50 Years of Poverty While government programs have kept millions of people, especially the elderly, from falling into poverty, rates remain high for many groups of Americans, including children, blacks and Hispanics. JAN. 4, 2014 RELATED ARTICLE –0.1 Low-Income Home Energy Assistance Program (Liheap) –0.1 Food aid for mothers and children under 5 (WIC) –0.2 Temporary Assistance for Needy Families (T.A.N.F.) –0.8 Unemployment insurance –0.9 Housing subsidies –1.1 Supplemental Security Income (S.S.I.) –1.6 Food stamps (SNAP) –3.0 Refundable tax credits Effect of government programs on p... mais »

Physicians: $1.6 Trillion in Economic Activity:

Aloyzio AchuttiemAMICOR - Há 5 dias
Medscape Medical News Physicians Generate $1.6 Trillion in Economic Activity: AMA Mark Crane April 18, 2014 EDITORS' RECOMMENDATIONS - Spending on Physician Services Rose 4% in 2012 - Healthcare Spending Growth Rate Projected to Rise in 2014 - Medical Practice Management News & Perspectives Physicians engaged in patient care generated $1.6 trillion in economic activity and supported 10 million jobs nationwide in 2012, according to a new report by the American Medical Association (AMA). The study found that physicians had a greater national economic impact than counterparts in ... mais »

kindergarten Friedrich Froebel

Aloyzio AchuttiemAMICOR - Há 5 dias
Friedrich FroebelArticle Free Pass - Article - Web sites - Bibliography - Related Content - Recent Edits - Contributors *Friedrich Froebel**,* Froebel also spelled Fröbel, in full Friedrich Wilhelm August Froebel (born April 21, 1782, Oberweissbach, Thuringia, Ernestine Saxony [now in Germany]—died June 21, 1852, Marienthal, near Bad Liebenstein, Thuringia), German educator who was founder of thekindergarten and one of the most influential educational reformers of the 19th century. Froebel was the fifth child in a clergyman’s family. His mother died when he wa... mais »

Animal Farm

George Orwell’s Animal FarmIllustrated by Ralph Steadman

by 
“I do not wish to comment on the work; if it does not speak for itself, it is a failure.”
In 1995, more than twenty years after hisirreverent illustrations for Alice in Wonderland, the beloved British cartoonistRalph Steadman put his singular twist on a very different kind of literary beast, one of the most controversial books ever published. To commemorate the 50th anniversary of the first American publication of George Orwell’s masterpiece, which by that point had sold millions of copies around the world in more than seventy languages, Steadman illustrated a special edition titled Animal Farm: A Fairy Story (public library), featuring 100 of his unmistakable full-color and halftone illustrations.
Accompanying Steadman’s illustrations is Orwell’s proposed but unpublished preface to the original edition, titled “The Freedom of the Press” — a critique of how the media’s fear of public opinion ends up drowning out the central responsibility of journalism. Though aimed at European publishers’ self-censorship regarding Animal Farm at the time, Orwell’s words ring with astounding prescience and timeliness in our present era of people-pleasing “content” that passes for journalism:/.../

Feira do Livro de Santa Maria

Meu primo José Antônio Brenner patrono da Feira do Livro de Santa Maria

Friendship

Love Undetectable: Andrew Sullivan on Why Friendship Is a Greater Gift Than Romantic Love

by 
Reflections on the cornerstone of our flourishing.
“A principal fruit of friendship,” Francis Bacon observed“is the ease and discharge of the fulness and swellings of the heart, which passions of all kinds do cause and induce.” Thoreau would“sometimes awake in the night and think of friendship and its possibilities.” St. Augustine described friendship as “sweet beyond the sweetness of life.” But what exactly is friendship — what defines its singular hallmark? Shortly after his dear friend Patrick’s death, Andrew Sullivan — one of the deepest thinkers and most enchanting writers of our time — was gripped with grief so all-consuming that it led him to examine the nature of friendship itself, a bond so special that its forceful breakage could induce pain of such unbearable proportions. In the altogether fantastic 1998 volume Love Undetectable: Notes on Friendship, Sex, and Survival (public library), he considers the inner workings of friendship and argues that its gift is far greater than that of romantic love, despite our cultural bias for the latter.
Sullivan writes:
For me, friendship has always been the most accessible of relationships — certainly far more so than romantic love. Friendship, I learned, provided a buffer in the interplay of emotions, a distance that made the risk of intimacy bearable, a space that allowed the other person to remain safely another person./.../

Saturday, April 26, 2014

Biophosphonartes and AF

Bisphosphonates May Increase Risk of Atrial Fibrillation
For patients who have osteoporosis, the use of bisphosphonates appears to increase the risk of serious atrial fibrillation, according to a meta-analysis.

Net-Ativismo

Net-ativismo e as novas práticas de democracia são temas de estudo | 25.04.2014

Programa veiculado no dia 25 de abril de 2014
O sociólogo italiano Massimo di Felice, coordenador do Centro de Pesquisa Atopos da Escola de Comunicações e Artes da Universidade de São Paulo (ECA-USP), conversa no estúdio da USP FM sobre o estudo Net Ativismo: ações colaborativas em redes digitais, que investiga o papel da internet para o ativismo e as novas práticas de democracia.

brain-machine interface

How to build a brain-machine interface
04/25/2014
You are subscribed to Discoveries - All NSF Discoveries for National Science Foundation Update. This information has recently been updated, and is now available.

Illustration of an eyeball with retinal implantNew-generation brain technologies are now in use thanks to new body-compatible materials, smaller electronics and better sensors designed by engineers
More at http://www.nsf.gov/discoveries/disc_summ.jsp?cntn_id=131214&WT.mc_id=USNSF_1

This is an NSF Discoveries item.

Wednesday, April 23, 2014

Memory

The Science of Memory

Managing editor Sandra Upson introduces the May/June 2014 issue ofScientific American MIND
Sandra Upson



Credit: Sean McCabe

More In This Article

When I was eight years old, my family moved out of our 100-year-old house in the Netherlands. Its ivy-covered brick walls, dark green door and matching window shutters remain vivid to me. I still keep a framed photo of my golden retriever and me scampering down the pebble driveway, which led past rhododendrons to a separate garage. Behind it rose a majestic dune.
The passing of decades inevitably weakens the brain connections that hold such slices of time in place. Yet as I learned in this issue's special report, “How We Remember,” revisiting one's recollections helps the brain rebuild aging neural links. In “The Engine of Memory,” psychologist Donald G. MacKay describes his discovery of several ways the mind repairs and strengthens reminiscences.
Also in the report, cognitive scientist Felipe De Brigard delves into the mystery of the hippocampus, a brain region viewed as the seat of memory. People with damage to this area develop amnesia—but also suffer deficits of imagination, sight and other core mental functions. Connecting with our past makes it easier to envision the future, it seems. See “The Anatomy of Amnesia.”
Memory is not the only faculty vulnerable to the ravages of time and disease. New hope for treating disorders in which brain cells perish, such as Parkinson's, is now emerging in the form of stem cell therapies. Journalist Lydia Denworth reports on stunning progress in cultivating replacement neurons. The advances she describes in “The Regenerating Brain” demanded many years of painstaking research—a reminder that the passage of time also brings us breakthroughs that improve human lives.
Last October, I paid a brief visit to the house in the Netherlands, my first trip back in decades. I recognized the facade, but gone were the green shutters and the ivy, as well as the detached garage. The gardens had been transformed. The building was a stranger now, not a friend. Yet it dawned on me that my beloved childhood home still stood safely in my memories. By carrying the past forward with us, our present and future become all the richer.
This article was originally published with the title "Keeping Memories Alive."

5% Misdiagnostics in 240 million outpatients care

Misdiagnoses All Too Common: 

1 in 20 US Adult Patients

Diedtra Henderson
April 22, 2014
At least 1 in 20 US adults receiving outpatient care, or 12 million patients annually, are misdiagnosed, and half of these medical errors could be harmful, according to a population-based estimate.
The authors hope the study prompts systematic measurement and reduction of medical errors.
Hardeep Singh, MD, MPH, from the Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, and coauthors published their results online April 17 in BMJ Quality and Safety.
Because definitions of medical errors vary, Dr. Singh and colleagues synthesized 3 studies that used "conceptually similar" definitions. Two of the studies used electronic triggers to spot unexpected return visits by patients who had been seen by their primary care clinician or troubling lack of follow-up by patients whose clinical findings for colorectal cancer, such as documented hematochezia, should have served as "red flags." The third study they analyzed involved consecutive cases of lung cancer, with abnormal chest X-rays serving as a red flag. In all 3 studies, diagnostic errors were confirmed through chart review.
The estimated diagnostic error rate yielded in the primary care study was 5.06% compared with 0.007% for the colorectal cancer study and 0.013% for the lung cancer study.
"Combining estimates from the three studies yields a rate of outpatient diagnostic errors of 5.08%, or approximately 12 million US adults every year. Based on our previous work, we estimated that about one-half of errors would have the potential to lead to severe harm," Dr. Singh and coauthors write.

"[W]e estimate the frequency of diagnostic error to be at least 5% in US outpatient adults, a number that entails a substantial patient safety risk," the authors conclude. "This population-based estimate should provide a foundation for policymakers, healthcare organisations and researchers to strengthen efforts to measure and reduce diagnostic errors."
The authors note that the contribution of the cancer misdiagnoses to the overall estimate was small, but potent, because delayed cancer diagnoses are thought to be the "most harmful and costly types of diagnostic error in the outpatient setting," and can have a ripple effect on such issues as malpractice claims.