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Background Despite its great relevance, there are no studies in our country evaluating the application of the 2012 guidelines for the appropriate use of cardiac diagnostic catheterization. Objective To analyze the adequacy of coronary angiography performed in two hospitals in the southern region of Brazil. Methods This is a multicenter cross-sectional study, which analyzed indications, results and proposals for the treatment of 737 coronary angiograms performed in a tertiary hospital with multiple specialties (Hospital A) and a tertiary cardiology hospital (Hospital B). Elective or emergency coronary angiographies were included, except for cases of acute myocardial infarction with ST segment elevation. The level of statistical significance adopted was 5% (p < 0.05). Results Of the 737 coronary angiograms, 63.9% were performed in male patients. The mean age was 61.6 years. The indication was acute coronary syndrome in 57.1%, and investigation of coronary artery disease in 42.9% of the cases. Regarding appropriation, 80.6% were classified as appropriate, 15.1% occasionally appropriate, and 4.3% rarely appropriate. The proposed treatment was clinical for 62.7%, percutaneous coronary intervention for 24.6%, and myocardial revascularization surgery for 12.7% of the cases. Of the coronary angiographies classified as rarely appropriate, 56.2% were related to non-performance of previous functional tests, and 21.9% showed severe coronary lesions. However, regardless of the outcome of coronary angiography, all patients in this group were indicated for clinical treatment. Conclusion We observed a low number of rarely appropriate coronary angiograms in our sample. The guideline recommendation in these cases was adequate, and no patient required revascularization treatment. Most of these cases are due to non-performance of functional tests.

Avaliação do conhecimento dos pais sobre segurança no transporte de crianças em veículos automotores e motocicletas ABSTRACTObjective: To evaluate parents' knowledge on safe transport of children in motor vehicles and motorcycles.Methods: Cross-sectional study that applied a questionnaire to parents and guardians who were accompanying children in the waiting room for outpatient public and private services. To evaluate knowledge on safe transport of children, the recommendations of the Brazilian Association on Traffic Medicine were used. Data analysis was performed using the chi-square and Mann-Whitney tests for categorical and numerical variables respectively, being significant p<0.05.Results: The sample consisted of 248 parents, 119 from private and 129 public medical services. Among the issues related to motorcycles, 76% of those who usually carry children in this vehicle answered correctly the minimum age allowed for that, however more than 30% of them did not know the safest position to carry children on motorcycles. Considering the automobile transport, the question with the highest percentage of correct answers was about the minimum age to use the front seat, with 64% of correct answers. In other issues, the percentage of correct answers ranged from 24 to 46%. Conclusions:Knowledge of the studied population about safe transport of children in motor vehicles is poor, especially regarding the use of the restraint system, the prerequisites for front seat use, as well the age and the correct form of transporting children on motorcycles.Key-words: motor vehicles; child; safety. RESUMOObjetivo: Avaliar o nível de conhecimento dos pais sobre segurança no transporte de crianças em veículos automotores e motocicletas.Métodos: Estudo transversal, realizado por meio de questionário autoaplicável em pais e responsáveis que acompanhavam crianças na sala de espera de ambulatórios público e privado. Para avaliar os conhecimentos sobre segurança no transporte de crianças, foram utilizadas as recomendações da Associação Brasileira de Medicina do Tráfego. A análise dos dados foi realizada por meio do teste do qui-quadrado e as variáveis quantitativas testadas por Mann-Whitney, sendo significante p<0,05. Luiza do Nascimento G. Pereira et alResultados: A amostra foi composta por 248 pais, sendo 119 da rede privada e 129 da rede pública. Dentre as questões relacionadas com motocicletas, 76% daqueles que costumam transportar crianças nesse veículo acertaram a idade mínima permitida, todavia mais de 30% não acertaram a posição segura para tal. Quanto ao transporte em automóveis, a questão com maior percentual de respostas corretas foi referente à idade mínima para utilizar o banco da frente, com 64% de acertos. Nas demais questões, estes variaram de 24 a 46%.Conclusões: O conhecimento da população estudada sobre a segurança no transporte de crianças em veículos automotores é deficiente, tanto no emprego de dispositivos de retenção, pré-requisitos para o uso do banco da frente, bem como idade e forma de transporte de crianças em...

Background: The radial approach has been increasingly used worldwide for diagnostic and therapeutic cardiac catheterization. The radial artery caliber is one of the limitations of its use. The objective of this study was to describe the anatomy of the radial and ulnar arteries, as well as to develop a radial artery diameter prediction score using clinical and anthropometric criteria. Methods: Using vascular ultrasound with bilateral radial and ulnar artery measurements, 1,180 patients who underwent cardiac catheterization or angioplasty procedures were prospectively evaluated. Using the patients' variables, a radial artery diameter prediction score was developed in a cross-sectional fashion, using half of the sample. The score was validated with the half not used for deriving the model. Results: A total of 1,180 patients were evaluated. The mean internal diameter of the right and left radial arteries was 2.69±0.69mm and 2.53±0.64mm (p<0.01), and the mean internal diameter of the right and left ulnar arteries was 2.09±0.59mm and 2.10±0.60mm (p=0.76), respectively. The factors that positively correlated with arterial size were male sex, previous catheterization, height, weight, and body surface area. The risk score developed using clinical and anthropometric variables had unsatisfactory discriminatory capacity (c-statistics 0.64). Conclusion: The right radial artery is the largest forearm artery in most cases. Men and patients who had previously undergone catheterization have a larger mean radial artery diameter. The artery diameter prediction score has modest accuracy for clinical use. RESUMO -Introdução:A via de acesso transradial tem crescido em utilização mundialmente para cateterismo cardíaco diagnóstico e terapêutico. O calibre da artéria radial é um dos limitadores de seu uso. O objetivo deste estudo foi descrever a anatomia das artérias radiais e ulnares, bem como desenvolver um escore de predição de diâmetro da artéria radial, utilizando critérios clínicos e antropométricos. Métodos: Usando ultrassonografia vascular, com mensuração de artérias radiais e ulnares, bilateralmente, foram prospectivamente avaliados 1.180 pacientes, que foram submetidos a procedimentos de cateterismo cardíaco ou angioplastia. Usando as variáveis dos pacientes, foi transversalmente elaborado um escore de predição de diâmetro de artéria radial, utilizando-se metade da amostra. O escore foi validado com a metade da população não utilizada para a formulação do escore. Resultados: Foram avaliados 1.180 pacientes. O diâmetro interno médio das artérias radiais direita e esquerda foram 2,69±0,69mm e 2,53±0,64mm (p<0,01), e das artérias ulnares direita e esquerda foram 2,09±0,59mm e 2,10±0,60mm (p=0,76). Os fatores que se correlacionaram positivamente com o tamanho arterial foram sexo masculino, cateterismo prévio, altura, peso e área de superfície corporal. O escore de risco desenvolvido utilizando variáveis clínicas e antropométricas teve capacidade discriminatória não satisfatória (estatística-c 0,64). Conclusão: A artéria radial dire...

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