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[PMID]:28457798
[Au] Autor:Tabit CE; Coplan MJ; Spencer KT; Alcain CF; Spiegel T; Vohra AS; Adelman D; Liao JK; Sanghani RM
[Ad] Endereço:Section of Cardiology, Department of Medicine, The University of Chicago Medical Center, Ill.
[Ti] Título:Cardiology Consultation in the Emergency Department Reduces Re-hospitalizations for Low-Socioeconomic Patients with Acute Decompensated Heart Failure.
[So] Source:Am J Med;130(9):1112.e17-1112.e31, 2017 Sep.
[Is] ISSN:1555-7162
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Re-hospitalization after discharge for acute decompensated heart failure is a common problem. Low-socioeconomic urban patients suffer high rates of re-hospitalization and often over-utilize the emergency department (ED) for their care. We hypothesized that early consultation with a cardiologist in the ED can reduce re-hospitalization and health care costs for low-socioeconomic urban patients with acute decompensated heart failure. METHODS: There were 392 patients treated at our center for acute decompensated heart failure who received standardized education and follow-up. Patients who returned to the ED received early consultation with a cardiologist; 392 patients who received usual care served as controls. Thirty- and 90-day re-hospitalization, ED re-visits, heart failure symptoms, mortality, and health care costs were recorded. RESULTS: Despite guideline-based education and follow-up, the rate of ED re-visits was not different between the groups. However, the rate of re-hospitalization was significantly lower in patients receiving the intervention compared with controls (odds ratio 0.592), driven by a reduction in the risk of readmission from the ED (0.56 vs 0.79, respectively). Patients receiving the intervention accumulated 14% fewer re-hospitalized days than controls and 57% lower 30-day total health care cost. Despite the reduction in health care resource consumption, mortality was unchanged. After accounting for the total cost of intervention delivery, the health care cost savings was substantially greater than the cost of intervention delivery. CONCLUSION: Early consultation with a cardiologist in the ED as an adjunct to guideline-based follow-up is associated with reduced re-hospitalization and health care cost for low-socioeconomic urban patients with acute decompensated heart failure.
[Mh] Termos MeSH primário: Cardiologia/normas
Serviço Hospitalar de Emergência/utilização
Insuficiência Cardíaca/terapia
Educação de Pacientes como Assunto/organização & administração
Readmissão do Paciente/estatística & dados numéricos
[Mh] Termos MeSH secundário: Doença Aguda
Idoso
Cardiologia/economia
Cardiologia/métodos
Estudos de Casos e Controles
Chicago
Controle de Custos/métodos
Controle de Custos/normas
Serviço Hospitalar de Emergência/economia
Serviço Hospitalar de Emergência/organização & administração
Feminino
Insuficiência Cardíaca/economia
Seres Humanos
Masculino
Meia-Idade
Estudos de Casos Organizacionais
Alta do Paciente/economia
Alta do Paciente/normas
Alta do Paciente/estatística & dados numéricos
Educação de Pacientes como Assunto/economia
Educação de Pacientes como Assunto/métodos
Readmissão do Paciente/economia
Guias de Prática Clínica como Assunto
Pontuação de Propensão
Encaminhamento e Consulta/economia
Encaminhamento e Consulta/normas
Estudos Retrospectivos
Fatores Socioeconômicos
Centros de Atenção Terciária/economia
Centros de Atenção Terciária/organização & administração
Saúde da População Urbana/economia
Saúde da População Urbana/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:29428011
[Au] Autor:Rubenstein R; Cowan SW; Yeo CJ; Entwistle JW
[Ti] Título:René Gerónimo Favaloro (1923-2000): A Man Who Struggled with Matters of the Heart.
[So] Source:Am Surg;84(1):7-11, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:René Gerónimo Favaloro prided himself on being a "simple country doctor." Born in La Plata, Argentina, Dr. Favaloro had an interest in Argentina's sociopolitical and healthcare systems beginning at a young age. He began his medical education at La Universidad Nacional de La Plata, graduating in 1949 with plans to continue his medical education in the field of surgery; however, in 1950, Dr. Favaloro temporarily resigned from his position as a surgeon to work as a country doctor in a small province of La Pampa, Argentina. It was during this time that Dr. Favaloro became acutely aware of the overwhelmingly poor state of the healthcare system in Argentina. In 1962, Dr. Favaloro redirected his focus back to his surgical interests and moved to the United States to work at the Cleveland Clinic, where he discovered the use of the saphenous vein graft for revascularization of the coronary arteries. Despite a productive medical career in the United States, Dr. Favaloro eventually brought his work back to Argentina, where his heart had always remained. Throughout the incredible milestones of his life, Dr. René Gerónimo Favaloro consistently remained a humble, gracious, and simple country doctor.
[Mh] Termos MeSH primário: Cardiologia/história
Ponte de Artéria Coronária/história
Assistência à Saúde/história
Metáfora
Veia Safena
Cirurgiões/história
[Mh] Termos MeSH secundário: Argentina
Educação Médica/história
História do Século XX
Seres Humanos
Masculino
Editoração/história
Veia Safena/transplante
Estados Unidos
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE; PORTRAITS
[Ps] Nome de pessoa como assunto:Favaloro RG
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


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[PMID]:28450664
[Au] Autor:Hiro T
[Ad] Endereço:Division of Cardiology, Department of Medicine, Nihon University School of Medicine.
[Ti] Título:Report of the Annual Scientific Sessions of the American College of Cardiology (ACC), Washington DC.
[So] Source:Circ J;81(6):777-782, 2017 May 25.
[Is] ISSN:1347-4820
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:The 66 Annual Scientific Sessions and Expo of the American College of Cardiology (ACC) were held at the Walter E. Washington Convention Center, Washington DC, from March 17 to 19 , 2017. This meeting offered 23 Late-Breaking Clinical Trial (LBCT) presentations, 17 Featured Clinical Research presentations with and without LBCT, and 2,572 abstracts presented in oral and poster sessions by over 2,000 experts. This report presents the highlights of this meeting, including the opening showcase, several important LBCTs and some international joint symposiums.
[Mh] Termos MeSH primário: Cardiologia
Doenças Cardiovasculares
Sociedades Médicas
[Mh] Termos MeSH secundário: Congressos como Assunto
District of Columbia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1253/circj.CJ-17-0416


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[PMID]:28460026
[Au] Autor:Perrino C; Barabási AL; Condorelli G; Davidson SM; De Windt L; Dimmeler S; Engel FB; Hausenloy DJ; Hill JA; Van Laake LW; Lecour S; Leor J; Madonna R; Mayr M; Prunier F; Sluijter JPG; Schulz R; Thum T; Ytrehus K; Ferdinandy P
[Ad] Endereço:Department of Advanced Biomedical Sciences, Federico II University, Via Pansini 5, 80131 Naples, Italy.
[Ti] Título:Epigenomic and transcriptomic approaches in the post-genomic era: path to novel targets for diagnosis and therapy of the ischaemic heart? Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart.
[So] Source:Cardiovasc Res;113(7):725-736, 2017 Jun 01.
[Is] ISSN:1755-3245
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Despite advances in myocardial reperfusion therapies, acute myocardial ischaemia/reperfusion injury and consequent ischaemic heart failure represent the number one cause of morbidity and mortality in industrialized societies. Although different therapeutic interventions have been shown beneficial in preclinical settings, an effective cardioprotective or regenerative therapy has yet to be successfully introduced in the clinical arena. Given the complex pathophysiology of the ischaemic heart, large scale, unbiased, global approaches capable of identifying multiple branches of the signalling networks activated in the ischaemic/reperfused heart might be more successful in the search for novel diagnostic or therapeutic targets. High-throughput techniques allow high-resolution, genome-wide investigation of genetic variants, epigenetic modifications, and associated gene expression profiles. Platforms such as proteomics and metabolomics (not described here in detail) also offer simultaneous readouts of hundreds of proteins and metabolites. Isolated omics analyses usually provide Big Data requiring large data storage, advanced computational resources and complex bioinformatics tools. The possibility of integrating different omics approaches gives new hope to better understand the molecular circuitry activated by myocardial ischaemia, putting it in the context of the human 'diseasome'. Since modifications of cardiac gene expression have been consistently linked to pathophysiology of the ischaemic heart, the integration of epigenomic and transcriptomic data seems a promising approach to identify crucial disease networks. Thus, the scope of this Position Paper will be to highlight potentials and limitations of these approaches, and to provide recommendations to optimize the search for novel diagnostic or therapeutic targets for acute ischaemia/reperfusion injury and ischaemic heart failure in the post-genomic era.
[Mh] Termos MeSH primário: Cardiologia/normas
Epigênese Genética
Epigenômica/normas
Perfilação da Expressão Gênica/normas
Isquemia Miocárdica/genética
Medicina de Precisão/normas
Transcriptoma
[Mh] Termos MeSH secundário: Biologia Computacional/normas
Bases de Dados Genéticas/normas
Marcadores Genéticos
Predisposição Genética para Doença
Seres Humanos
Isquemia Miocárdica/diagnóstico
Isquemia Miocárdica/terapia
Seleção de Pacientes
Fenótipo
Valor Preditivo dos Testes
Prognóstico
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Nm] Nome de substância:
0 (Genetic Markers)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1093/cvr/cvx070


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[PMID]:28453734
[Au] Autor:Hausenloy DJ; Garcia-Dorado D; Bøtker HE; Davidson SM; Downey J; Engel FB; Jennings R; Lecour S; Leor J; Madonna R; Ovize M; Perrino C; Prunier F; Schulz R; Sluijter JPG; Van Laake LW; Vinten-Johansen J; Yellon DM; Ytrehus K; Heusch G; Ferdinandy P
[Ad] Endereço:The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK; The National Institute of Health Research University College London Hospitals Biomedical Research Centre, 149 Tottenham Court Road London, W1T 7DN, UK; Cardiovascular and Metabolic Disorders Program
[Ti] Título:Novel targets and future strategies for acute cardioprotection: Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart.
[So] Source:Cardiovasc Res;113(6):564-585, 2017 May 01.
[Is] ISSN:1755-3245
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Ischaemic heart disease and the heart failure that often results, remain the leading causes of death and disability in Europe and worldwide. As such, in order to prevent heart failure and improve clinical outcomes in patients presenting with an acute ST-segment elevation myocardial infarction and patients undergoing coronary artery bypass graft surgery, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury (IRI). During the last three decades, a wide variety of ischaemic conditioning strategies and pharmacological treatments have been tested in the clinic-however, their translation from experimental to clinical studies for improving patient outcomes has been both challenging and disappointing. Therefore, in this Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart, we critically analyse the current state of ischaemic conditioning in both the experimental and clinical settings, provide recommendations for improving its translation into the clinical setting, and highlight novel therapeutic targets and new treatment strategies for reducing acute myocardial IRI.
[Mh] Termos MeSH primário: Cardiologia/métodos
Fármacos Cardiovasculares/uso terapêutico
Ponte de Artéria Coronária/efeitos adversos
Insuficiência Cardíaca/prevenção & controle
Precondicionamento Isquêmico/métodos
Traumatismo por Reperfusão Miocárdica/prevenção & controle
Intervenção Coronária Percutânea/efeitos adversos
Infarto do Miocárdio com Supradesnível do Segmento ST/terapia
Pesquisa Médica Translacional/métodos
[Mh] Termos MeSH secundário: Animais
Cardiologia/normas
Fármacos Cardiovasculares/efeitos adversos
Ponte de Artéria Coronária/normas
Modelos Animais de Doenças
Insuficiência Cardíaca/etiologia
Insuficiência Cardíaca/patologia
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Pós-Condicionamento Isquêmico/métodos
Precondicionamento Isquêmico/efeitos adversos
Precondicionamento Isquêmico/normas
Precondicionamento Isquêmico Miocárdico/métodos
Traumatismo por Reperfusão Miocárdica/etiologia
Traumatismo por Reperfusão Miocárdica/patologia
Traumatismo por Reperfusão Miocárdica/fisiopatologia
Intervenção Coronária Percutânea/normas
Fatores de Proteção
Fatores de Risco
Infarto do Miocárdio com Supradesnível do Segmento ST/complicações
Infarto do Miocárdio com Supradesnível do Segmento ST/patologia
Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia
Pesquisa Médica Translacional/normas
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Nm] Nome de substância:
0 (Cardiovascular Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/cvr/cvx049


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[PMID]:29195003
[Au] Autor:Daily JA; Bolin E; Eble BK
[Ad] Endereço:Arkansas Children's Hospital, Little Rock, Arkansas, USA.
[Ti] Título:Teaching pediatric cardiology with meaning and sense.
[So] Source:Congenit Heart Dis;13(1):154-156, 2018 Jan.
[Is] ISSN:1747-0803
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pediatric cardiologists teach complicated concepts to a diverse group of learners that include medical students, nurses, residents, fellows, patients, and parents. Unfortunately, much of what is taught is not retained. In order to increase the likelihood of long-term retention, a cardiologist should teach with both meaning and sense. The authors provide a review of these concepts and give specific examples of how to teach in ways that both make sense and are meaningful to a cardiologist's leaners.
[Mh] Termos MeSH primário: Cardiologia/educação
Competência Clínica
Currículo/normas
Internato e Residência
Pediatria/educação
Estudantes de Medicina
Ensino/normas
[Mh] Termos MeSH secundário: Criança
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1111/chd.12561


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[PMID]:29181874
[Au] Autor:Neal AE; Lehto E; Miller KH; Ziegler C; Davis E
[Ad] Endereço:Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, USA.
[Ti] Título:Using a statewide survey methodology to prioritize pediatric cardiology core content.
[So] Source:Congenit Heart Dis;13(1):147-153, 2018 Jan.
[Is] ISSN:1747-0803
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Although pediatrician-reported relevance of Canadian cardiology-specific objectives has been studied, similar data are not available for the 2016 American Board of Pediatrics (ABP) cardiology-specific objectives. This study asked Kentucky trainees, pediatricians, and pediatric cardiologists to identify "most important" content within these objectives. DESIGN, METHODS, OUTCOME MEASURES: This cross-sectional study used an original, online survey instrument based on the 2016 ABP cardiology-specific objectives. We collected quantitative data (numerical indications of importance) and qualitative data (open-ended replies regarding missing content and difficulty in teaching and learning). Respondents indicated the top two choices of most important items within eight content areas. Descriptive statistics (frequencies and percentages) and chi-square analysis were calculated. Content within categories was organized using naturally occurring "clusters" and "gaps" in scores. Common themes among open-ended qualitative responses were identified using Pandit's version of Glaser and Strauss Grounded theory (constant comparison). RESULTS: Of the 136 respondents, 23 (17%) were residents, 15 (11%) fellows, 85 (62%) pediatricians, and 13 (10%) pediatric cardiologists. Of attendings, 80% reported faculty/gratis faculty status. Naturally occurring clusters in respondent-designated importance resulted in ≤3 "most selected" objectives per content area. Objectives in "most selected" content pertained to initial diagnosis (recognition of abnormality/disease) (n = 16), possible emergent/urgent intervention required (n = 14), building a differential (n = 8), and planning a workup (n = 4). Conversely, themes for "least selected" content included comanagement with subspecialist (n = 15), knowledge useful in patient-family communication (n = 9), knowledge that can be referenced (as needed) (n = 7), and longitudinal/follow-up concerns (n = 5). CONCLUSIONS: This study demonstrated the utility of an online survey methodology to identify pediatric cardiology content perceived most important. Learners and faculty generally provided concordant responses regarding most important content within the cardiology-specific ABP objectives. Medical educators could apply this methodology to inform curriculum revision.
[Mh] Termos MeSH primário: Cardiologia/educação
Currículo
Educação de Pós-Graduação em Medicina/organização & administração
Cardiopatias
Pediatria/educação
Inquéritos e Questionários/utilização
[Mh] Termos MeSH secundário: Adulto
Criança
Estudos Transversais
Feminino
Seres Humanos
Kentucky
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1111/chd.12559


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[PMID]:29247335
[Au] Autor:Stöllberger C; Finsterer J
[Ad] Endereço:Krankenanstalt Rudolfstiftung, Juchgasse 25, 1030, Vienna, Austria. claudia.stoellberger@chello.at.
[Ti] Título:Biomarkers of Cardiac Disease in Duchenne Muscular Dystrophy are Insufficient in the Absence of Clinical Cardiologic and Neurologic Assessment.
[So] Source:Pediatr Cardiol;39(1):202-203, 2018 01.
[Is] ISSN:1432-1971
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Cardiologia
Distrofia Muscular de Duchenne
[Mh] Termos MeSH secundário: Biomarcadores
Cardiopatias
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1007/s00246-017-1790-7


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[PMID]:29187107
[Au] Autor:Kirsch RE; Coronado J; Roeleveld PP; Tweddell J; Mott AM; Roth SJ
[Ad] Endereço:1 Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
[Ti] Título:The Burdens of Offering: Ethical and Practical Considerations.
[So] Source:World J Pediatr Congenit Heart Surg;8(6):715-720, 2017 11.
[Is] ISSN:2150-136X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We reflect upon highlights of a facilitated panel discussion from the 2016 Pediatric Cardiac Intensive Care Society Meeting. The session was designed to explore challenges, share practical clinical experiences, and review ethical underpinnings surrounding decisions to offer intensive, invasive therapies to patients who have a poor prognosis for survival or are likely to be burdened with multiple residual comorbidities if survival is achieved. The discussion panel was representative of a variety of disciplines including pediatric cardiology, cardiac intensive care, nursing, and cardiovascular surgery as well as different health-care delivery systems. Key issues discussed included patient's best interests, physician obligations, moral distress, and communication in the context of decisions about providing therapy for patients with a poor prognosis.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/ética
Cardiologia/ética
Cuidados Críticos/ética
Tomada de Decisões/ética
Ética Médica
Pediatria/ética
[Mh] Termos MeSH secundário: Criança
Congressos como Assunto
Cardiopatias Congênitas
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1177/2150135117733940


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[PMID]:29187102
[Au] Autor:McBride ME; Beke DM; Fortenberry JD; Imprescia A; Callow L; Justice L; Bronicki RA
[Ad] Endereço:1 Division of Cardiology and Critical Care Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA.
[Ti] Título:Education and Training in Pediatric Cardiac Critical Care.
[So] Source:World J Pediatr Congenit Heart Surg;8(6):707-714, 2017 11.
[Is] ISSN:2150-136X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pediatric cardiac critical care is a new and emerging field. There is no standardization to the current education provided, and high-quality patient outcomes require such standardization. For physicians, this includes fellowship training, specific competencies, and a certification process. For advanced practice providers, a standardized curriculum as well as a certification process is needed. There is evidence that supports a finding that critical care nursing experience may have a positive impact on outcomes from pediatric cardiac surgery. A rigorous orientation and meaningful continuing education may augment that. For all disciplines and levels of expertise, simulation is a useful modality in the education in pediatric cardiac critical care.
[Mh] Termos MeSH primário: Cardiologia/educação
Cuidados Críticos
Educação Médica/organização & administração
Pediatria/educação
[Mh] Termos MeSH secundário: Criança
Avaliação Educacional
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1177/2150135117727258



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