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- ItemAcesso aberto (Open Access)Avaliação da qualidade da ultrassonografia tridimensional mediante as técnicas Fast, Star e Five D-Heart no rastreamento das doenças cardíacas congênitas(Universidade Federal de São Paulo (UNIFESP), 2020-12-18) Carrilho, Milene Carvalho [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Universidade Federal de São PauloObjective: To compare the quality of standard fetal echocardiographic views obtained by three-dimensional ultrasound with those obtained by the simple targeted arterial rendering (STAR) technique, four-chamber view swing technique (FAST), and fetal intelligent navigation echocardiography (FINE / 5D-Heart®) technique. Methods: This was a cross-sectional prospective study that included pregnant women between 22 and 34 weeks of gestation, with normal fetuses. Fetal heart volumes were acquired using spatio-temporal image correlation (STIC) with the fetal spine between 2 and 9 o’clock. The FAST/STAR techniques consist of the manipulation of STIC volumes by drawing OmniView® lines to obtain echocardiographic views. The FINE technique uses intelligent navigation to automatically generate echocardiographic views. The quality of the images was classified as excellent, good, acceptable, and unacceptable. The analysis was performed using the Bonferroni multiple-comparisons test. Results: The study included 101 pregnant women aged between 16 and 44 years (mean ± standard deviation of 32 ± 6.3) at a gestational age of 20 to 34 weeks (mean ± standard deviation of 26 ± 4.2). There was no mean difference in image quality between fetal spine positions in all views (p>0.05). However, in the five-chamber, left ventricular outflow tract, right ventricular outflow tract, ductal arch, superior vena cava/inferior vena cava, and abdomen/stomach views, there was a statistically significant mean difference between the techniques of reconstruction of the standard echocardiographic views, regardless of the spine position (p<0.05). The best mean image quality was obtained by the FINE technique. Conclusion: The quality of the echocardiographic views obtained using the FINE/5D-Heart® technique was superior to that of those generated by the FAST/STAR techniques in normal fetuses scanned between 20 and 34 weeks of gestation.
- ItemAcesso aberto (Open Access)Comparison between multiplanar and rendering modes in the assessment of fetal atrioventricular valve areas by 3D/4D ultrasonography(Sociedade Brasileira de Cirurgia Cardiovascular, 2012-09-01) Araujo Júnior, Edward [UNIFESP]; Rolo, Liliam Cristine [UNIFESP]; Simioni, Christiane [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Rocha, Luciane Alves da [UNIFESP]; Martins, Wellington P.; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); University of São Paulo Faculty of Medicine of Ribeirão Preto Department of Obstetrics and Gynecology; School of Ultrasound and Medicine of Ribeirão Preto Recycling; National Institute of Science and Technology (INCT) of Hormones and Women's HealthOBJECTIVE: To compare the agreement of multiplanar and rendering modes in the assessment fetal atrioventricular valves (mitral and tricuspid) areas by three-dimensional (3D) ultrasonography using the software spatio-temporal image correlation (STIC). METHODS: We conducted a prospective cross-sectional study with normal pregnant women, with single fetuses, between 18-33 weeks. To measure the areas, we used the plan of four-chamber view. In the case of multiplanar, the plane was rotated on the axis Z form the heart to position at 9h. For rendering, the green line (region of interest - ROI) was placed from the atria of the heart perpendicular to the crux. The agreement was assessed by a Bland-Altman (limits of agreement) using the relative difference between the measures: ((rendering mode) - (multiplanar mode)) / (average). RESULTS: 328 fetuses were evaluated. We have not identified the occurrence of systematic error between methods: the average relative difference was 1.62% (-2.07% to 5.32%, confidence interval 95%) in the mitral and 1.77% (- 1.08% to 4.62%) in the tricuspid valve. The limits of agreement between methods were -65.26% to 68.51% for the mitral and -49.91% to 53.45% for the tricuspid. CONCLUSIONS: There was no systematic error between modes and thus the observed values for the area of fetal atrioventricular valves can be used for comparisons needs to be corrected. However, relatively large variations may be observed when repeating the measurement area by different modes.
- ItemAcesso aberto (Open Access)Sistema tributário norte americano versus sistema tributário brasileiro: uma comparação com enfoque na progressividade e regressividade tributária, retorno à sociedade e transparência(Universidade Federal de São Paulo, 2022-01-29) Silva, Monique Evellyn Tavares da [UNIFESP]; Rabelo, Marcelo Henrique [UNIFESP]; http://lattes.cnpq.br/8872607903177348Um sistema tributário é o meio pelo qual as economias do mundo todo arrecadam recursos financeiros para financiar suas atividades, com o propósito único e exclusivo de fornecer serviços para sua população visando seu bem-estar e desenvolvimento humano. O objetivo central da pesquisa é realizar uma comparação do sistema tributário brasileiro com o sistema tributário norte americano, a fim de identificar o porquê o sistema tributário brasileiro é taxado como extremamente complexo ao passo que o sistema tributário estadunidense é caracterizado por ser um sistema simplificado de cobrança. A análise é feita através de índices estatístico que medem o retorno da cobrança de tributos para a população, o índice de percepção da corrupção e sonegação fiscal, a transparência jurídica e o nível de liberdade econômica. Nota-se, através dessa análise, que os Estados Unidos apresentam um sistema de cobrança próspero e que o Brasil possui altas taxas e pouco retorno a sua população. Como sugestão para as próximas pesquisas, há a possibilidade de ampliar os dados pesquisados para todos os países do continente americano ou, ainda, analisar o sistema tributário brasileiro do ponto de vista dos países latino-americanos, assim permitindo uma análise de países com histórias e economia mais parecidas.