Introduction We aimed to identify predictors of morbidity and mortality in patients undergoing isolated mitral valve replacement. Methods This is a retrospective cohort study with 164 patients who underwent isolated mitral valve replacement at a referral hospital for cardiovascular diseases, which were performed from January 2011 to December 2016. Data were obtained from medical records, including preoperative, intraoperative, and postoperative information. Statistical analysis was performed to calculate odds ratio (OR), unpaired Student's t -test, and binary logistic regression. P -values < 0.05 were considered significant. Results A total of 69.5% (n=114) of the patients had a diagnosis of rheumatic disease prior to surgery. Mortality rate was 6.7% (n=11). The most observed complication was the occurrence of postoperative arrhythmias (19.5%). On average, patients remained 5.34 days in the intensive care unit. There was a statistically significant enhanced risk of death among patients with previous diagnosis of endocarditis (OR 5.22, 95% confidence interval [CI] 1,368-19,915; P =0.008), reduced ejection fraction (EF) (< 50%) (OR 9.46, 95% CI 2,61-34,35; P <0.001), and mitral regurgitation (MR) (OR 7.7, 95% CI 1.576-37.545; P =0.004). Patients who died were older than those who survived surgery ( P <0.001) and had lower preoperative serum hemoglobin levels ( P =0.018). Logistic regression showed age and reduced EF at preoperative evaluation as predictors of death. Conclusion Older age, reduced serum hemoglobin levels, preoperative diagnosis of endocarditis, reduced EF, and MR were associated with postoperative mortality. Age and reduced EF were predictors of death.

Cardiovascular disease (CVD) is the leading cause of death in developed countries 1 and, in Brazil, despite regional differences, CVD kills more than any other cause. 2 CVD is also the leading cause of death among women, and usually occurs 7-10 years later than men. 1 However, the prevalence of this disease increases in the postmenopausal period, possibly due to the decrease in estrogen hormone levels.There are few data in the literature about the assessment of risk factors and treatment of CVDs in women, as compared to men, including in Brazil. This leads to a delay in the institution of appropriate therapies, so that women often receive less aggressive treatments and are less likely than their male counterparts to be managed following recommended guidelines. 3 Mitral valve disease is the most common valvular heart disease. In developing countries, the main cause of mitral valve stenosis is rheumatic fever, and mitral valve replacement is currently one of the most common

Cardiovascular disease (CVD) is the leading cause of death worldwide. For many years, it was believed that CVD was much more prevalent in men, probably due to the lack of studies that addressed this issue in women and their risk factors, according to their biological particularities. 1 Cardiovascular risk factors common to both genders have been identified. However, some studies have shown that these factors are associated with worse outcomes in women in comparison to men. [2][3][4] In general, women usually develop CVD 10 years later than men, so that the prevalence of CVD increases in the postmenopausal period, probably due to the decline in estrogen hormone levels. 5

Systemic hypertension (SH) is an important risk factor for cardiovascular events, especially stroke, which justifies the relevance of its proper management. In a meta-analysis conducted by Sarki et al., 1 the results showed a prevalence of 32.3% of SH, and Latin America was as one of the regions with the highest estimates (39.1%). 1 According to data from the American Heart Association, specifically in the African-American population, the prevalence of SH reaches 44.9% for black men, and 46.1% for black women. 2 A higher prevalence of SH in blacks was also identified in Brazilian studies. 3-5 Despite this high prevalence, pressure control is achieved in most cases with the appropriate choice of antihypertensive drugs. 6 However, still 9-18% of individuals with SH have blood pressure levels resistant to pharmacological treatment, which characterizes resistant hypertension (RH). 6-8

<p><strong>Introdução</strong>: fraturas ósseas extensas representam grande causa de morbidade e geram custos para o serviço de saúde. A vibração<br />de baixa magnitude e alta frequência foi proposta como um tratamento alternativo para aumentar a massa óssea. <strong>Objetivo</strong>: Avaliar<br />histomorfologicamente o reparo inicial de defeitos ósseos críticos após aplicação de ondas mecânicas vibratórias <strong>Metodologia</strong>:<br />foram utilizados 10 Rattus norvegicus. Confeccionou-se defeitos críticos de 8,5 mm de diâmetro na calvária dos ratos. Os animais<br />foram distribuídos em dois grupos: Grupo Controle de Defeito Ósseo (GCDO) e Grupo Experimental de Vibração Imediata (GEVI).<br />Animais do GEVI foram submetidos a ondas vibratórias de 60 Hz e aceleração vertical de 0,3 g; elas foram aplicadas três vezes/<br />semana, durante vinte minutos. Após quinze dias do ato operatório, os animais foram eutanasiados para a mensuração da extensão<br />do defeito. Considerando que estes defeitos tinham o mesmo diâmetro inicial, admitiu-se como indicador indireto de deposição<br />osteóide, a redução da extensão linear final dos mesmos. <strong>Resultados</strong>: observou-se neoformação de matriz osteoide, restrita às<br />bordas ósseas, em ambos os grupos. A média de extensão linear, em milímetros, do defeito ósseo do GEVI foi de 5,83 (DP=0,79) e<br />no GCDO, foi de 6,62 (DP= 0,63). Não houve diferença estatisticamente significante entre as médias (U=8,00, z=-1,604, p=0,132).<br /><strong>Conclusão</strong>: evidenciou-se resposta osteogênica a partir da utilização da terapêutica vibratória, contudo de forma estatisticamente<br />não-significante. Deste modo, o presente estudo demonstrou que a utilização das ondas vibratórias não favoreceu um reparo ósseo<br />estatisticamente significante, no período e regime vibratório estudados.</p>