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Degenerative aortic stenosis is currently a public health problem. Affecting the elderly population, this pathology has been showing an increasing prevalence as a direct result of the population aging. In this context, women have a greater life expectancy, corresponding to most of the population with degenerative aortic stenosis. Specific characteristics of this pathology in females are present in the diagnosis, pathophysiology, anatomical aspects, imaging and in therapeutic approach. Women present a more severe disease with less valve calcification than men, more concentric ventricular remodeling, higher transvalvular gradients, and less myocardial fibrosis. Less evident symptoms mean that these patients are referred later for surgical or percutaneous therapeutic treatment. The greater comorbidity presented by females and possibly due to the smaller body surface, bring specific aspects that affect the surgery results, leading to higher mortality rates and, more often, the prosthesis-patient mismatch. Percutaneous valve implantation is a good alternative, with better results in females, when compared to surgery, both in the treatment of native valves and in the treatment of a previously implanted bioprosthesis' dysfunction. The challenges encountered for the treatment of aortic stenosis in women and their possible solutions are described in this article, focusing on the observed difference of aortic stenosis in females and their possible solutions.

RESUMO

Abstract Degenerative aortic stenosis is currently a public health problem. Affecting the elderly population, this pathology has been showing an increasing prevalence as a direct result of the population aging. In this context, women have a greater life expectancy, corresponding to most of the population with degenerative aortic stenosis. Specific characteristics of this pathology in females are present in the diagnosis, pathophysiology, anatomical aspects, imaging and in therapeutic approach. Women present a more severe disease with less valve calcification than men, more concentric ventricular remodeling, higher transvalvular gradients, and less myocardial fibrosis. Less evident symptoms mean that these patients are referred later for surgical or percutaneous therapeutic treatment. The greater comorbidity presented by females and possibly due to the smaller body surface, bring specific aspects that affect the surgery results, leading to higher mortality rates and, more often, the prosthesis-patient mismatch. Percutaneous valve implantation is a good alternative, with better results in females, when compared to surgery, both in the treatment of native valves and in the treatment of a previously implanted bioprosthesis' dysfunction. The challenges encountered for the treatment of aortic stenosis in women and their possible solutions are described in this article, focusing on the observed difference of aortic stenosis in females and their possible solutions.

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Abstract This study evaluated the relationship between servant leadership and work intentions, mediated by passion for work, in a longitudinal study. Data were collected in three waves, with three-month intervals in between, totaling a six-month data collection period. The total sample consisted of 479 workers of both genders (70.4% women) from all Brazilian regions. The results of the cross-lagged panel analysis showed that the servant leadership positively predicted work intentions. In addition, passion for work partially mediated the relationship between servant leadership and work intentions. However, contrary to expectations, this mediation was negative. The results are discussed according to the Passion for Work Assessment Model, which provided theoretical support for the investigation.

Resumen El estudio evaluó la relación entre el liderazgo de servicio y las intenciones laborales, mediadas por la pasión por el trabajo, en un estudio longitudinal. Los datos se recopilaron en tres oleadas, con intervalos de tres meses entre ellos, totalizando un periodo de recopilación de datos de seis meses. La muestra total estuvo constituida por 479 trabajadores de todas las regiones brasileñas y de ambos sexos (70,4% mujeres). Los resultados del análisis de panel rezagado cruzado mostraron que el liderazgo de servicia predijo positivamente las intenciones de trabajo. Además, la pasión por el trabajo medió parcialmente la relación entre el liderazgo de servicia y las intenciones laborales. Sin embargo, contrariamente a lo esperado, esta mediación fue negativa. Los resultados se discuten a la luz del Modelo de Evaluación de la Pasión por el Trabajo, que brindó soporte teórico para la investigación.

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ABSTRACT Shprintzen-Goldberg craniosynostosis syndrome, characterized by craniosynostosis and marfanoid habitus, is a very rare entity described in 75 individuals worldwide. This study aimed to present a case report of a 6-year-old female Brazilian child with Shprintzen-Goldberg's craniosynostosis syndrome. We described the craniofacial and oral characteristics and its clinical management, comparing to the existing literature. The patient presented with intellectual disability, craniosynostosis, ocular proptosis, low-set anomalous ears, and other skeletal and connective tissue defects. Oral features included malocclusion, micrognathia, pseudo-cleft palate, dental caries, and inefficient biofilm control. The treatment started with guidance on cariogenic foods, oral hygiene, and an indication to discontinue bottle feeding. Subsequently, the carious lesions were restored with composite resins, and the patient was referred for orthopedic surgery, orthodontic treatment, speech therapy, and nutritional counseling. The patient was followed for 5 years. This case report emphasizes the importance of knowing the craniofacial and oral characteristics for the diagnosis and clinical management of a female child with a rare Shprintzen-Goldberg's craniosynostosis syndrome. The case also highlights the need for oral health care in individuals with intellectual disabilities.

RESUMO A síndrome Shprintzen-Goldberg é uma entidade muito rara descrita em 75 pessoas, caracterizada por craniossinostose e habitus marfanóide. O objetivo deste estudo é apresentar o relato de um caso clínico de uma criança brasileira de 6 anos com síndrome da craniossinostose de Shprintzen-Goldberg, apresentando as características craniofaciais e orais e seu manejo clínico, comparando com a literatura. O paciente apresentava deficiência intelectual, craniossinostose, proptose ocular, orelhas anômalas de implantação baixa e outros defeitos esqueléticos e do tecido conjuntivo. As características orais incluíram má oclusão, micrognatia, pseudo fenda palatina, atividade de cárie e controle ineficiente do biofilme. O tratamento foi iniciado com orientações sobre alimentos cariogênicos, higiene oral e indicação de suspensão do uso de mamadeira. Em seguida, as lesões cariosas foram restauradas com resina composta e o paciente encaminhado para cirurgia ortopédica, tratamento ortodôntico, fonoaudiologia e nutricionista. O paciente foi acompanhado periodicamente por 5 anos. Este relato de caso enfatiza a importância do conhecimento das características craniofaciais e orais para o diagnóstico e manejo clínico de uma criança do sexo feminino com síndrome de craniossinostose de Shprintzen-Goldberg rara, destacando a necessidade de cuidados com a saúde bucal em indivíduos com deficiência intelectual.

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O engajamento na carreira associa-se a comportamentos proativos capazes de intensificar o desenvolvimento da carreira. Este estudo buscou reunir evidências de validade de estrutura interna da Escala de Engajamento na Carreira e de suas relações com variáveis externas, em contexto militar. A amostra foi composta por 467 militares do Exército Brasileiro, de ambos os sexos (94,4% do sexo masculino), majoritariamente pertencentes à linha bélica (82,4%) e provenientes de diferentes estados, com destaque para o Rio de Janeiro (39,2%). Os participantes responderam a escalas de engajamento na carreira, adaptabilidade de carreira, autoeficácia geral percebida, satisfação com a carreira e percepção atual do desenvolvimento profissional, de forma on-line. As análises fatoriais confirmatórias evidenciaram que o modelo de dois fatores de 1ª ordem com um fator de 2ª ordem apresentou os melhores índices de ajustes, diferindo do modelo original do instrumento. A Escala de Engajamento na Carreira obteve correlação significativa e positiva alta com a adaptabilidade de carreira e significativa e positiva moderada com a autoeficácia, a satisfação com a carreira e o desenvolvimento profissional. Concluiu-se que as evidências de validade obtidas possibilitam o uso futuro da escala na avaliação do engajamento na carreira no contexto militar.(AU)

Career engagement is associated with proactive behaviors capable of enhancing career development. The study sought to gather evidence of the internal structure validity of the Career Engagement Scale and its relations to external variables in a military context. The sample consisted of 467 soldiers of the Brazilian Army, of both sexes (94.4% male), belonging mainly to the war line (82.4%) and coming from different states, with emphasis on Rio de Janeiro (39.2%). The participants answered on-line the scales for measuring career engagement, career adaptability, perceived general self-efficacy, satisfaction with the career and current perception of professional development. The confirmatory factor analyses showed that the model of two factors of 1st order with a factor of 2nd order was the one that presented the best fit indexes, differing from the original model of the instrument. The Career Engagement Scale obtained a significant and positive high correlation with career adaptability and a significant and positive moderate correlation with self-efficacy, career satisfaction, and professional development. We concluded that the validity evidence obtained allow the future use of the scale for evaluating career engagement in the military context.(AU)

El compromiso profesional se asocia con comportamientos proactivos capaces de mejorar el desarrollo profesional. El estudio buscó recolectar evidencias de validez de la estructura interna de la Escala de Compromiso Profesional y de sus relaciones con variables externas en un contexto militar. La muestra estaba compuesta por 467 soldados del Ejército Brasileño, de ambos sexos (94,4% hombres), en su mayoría pertenecientes a la línea de guerra (82,4%), provenientes de diferentes estados, con énfasis en Río de Janeiro (39,2%). Los participantes respondieron a las escalas de compromiso profesional, adaptabilidad profesional, autoeficacia general percibida, satisfacción con la carrera y percepción actual del desarrollo profesional en línea. Los análisis factoriales confirmatorios mostraron que el modelo de dos factores de 1er orden con un factor de 2do orden fue el que presentó mejores índices de ajustes, diferenciándose del modelo original del instrumento. La Escala de Compromiso Profesional obtuvo una alta correlación significativa y positiva con la adaptabilidad a la carrera y una correlación significativa y positiva moderada con la autoeficacia, la satisfacción profesional y el desarrollo profesional. Se concluyó que las evidencias de validez de la escala permiten su uso futuro en la evaluación del compromiso profesional, en el contexto militar.(AU)

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BACKGROUND: Procedural improvements combined with the contemporary clinical profile of patients undergoing transcatheter aortic valve replacement (TAVR) may have influenced the incidence and outcomes of infective endocarditis (IE) following TAVR. We aimed to determine the temporal trends, characteristics, and outcomes of IE post-TAVR. METHODS: Observational study including 552 patients presenting definite IE post-TAVR. Patients were divided in 2 groups according to the timing of TAVR (historical cohort [HC]: before 2014; contemporary cohort [CC]: after 2014). RESULTS: Overall incidence rates of IE were similar in both cohorts (CC vs HC: 5.45 vs 6.52 per 1000 person-years; P = .12), but the rate of early IE was lower in the CC (2.29‰ vs 4.89‰, P < .001). Enterococci were the most frequent microorganism. Most patients presented complicated IE (CC: 67.7%; HC: 69.6%; P = .66), but the rate of surgical treatment remained low (CC: 20.7%; HC: 17.3%; P = .32). The CC exhibited lower rates of in-hospital acute kidney injury (35.1% vs 44.6%; P = .036) and in-hospital (26.6% vs 36.4%; P = .016) and 1-year (37.8% vs 53.5%; P < .001) mortality. Higher logistic EuroScore, Staphylococcus aureus etiology, and complications (stroke, heart failure, and acute renal failure) were associated with in-hospital mortality in multivariable analyses (P < .05 for all). CONCLUSIONS: Although overall IE incidence has remained stable, the incidence of early IE has declined in recent years. The microorganism, high rate of complications, and very low rate of surgical treatment remained similar. In-hospital and 1-year mortality rates were high but progressively decreased over time.

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This study examined the relationship between person-organization fit and turnover intentions, along with the moderating effect of organizational trust. The sample consisted of 381 workers of both genders (61% female) and average age of 39.23, who answered the on-line versions of organizational values, organizational trust and turnover intention measures. The results showed that the higher the person-organization fit related to conservatism and harmony values, the lower the turnover intention. Trust in the organization's ethical standards moderated the relationship between person-organization fit related to dominance and autonomy values and turnover intention. It was concluded that a reduced trust in the organization's ethical standards contributes to accentuate the negative relation between person-organization fit associated with such values and turnover intention. (AU)

O estudo investigou a relação da compatibilidade indivíduo-organização com a intenção de rotatividade, e o efeito moderador da confiança do empregado na organização. A amostra compôs-se de 381 trabalhadores de ambos os sexos (61% do sexo feminino), com idade média de 39,23 anos, que responderam às versões on-line de medidas de valores organizacionais, de confiança do empregado na organização e de intenção de rotatividade. Os resultados indicaram que quanto maior a compatibilidade entre o indivíduo e a organização, relacionada aos valores de conservadorismo e harmonia, menor a intenção de rotatividade. A confiança nos padrões éticos da organização moderou a relação da compatibilidade indivíduo-organização associada aos valores de autonomia e de domínio com a intenção de rotatividade. Concluiu-se que a baixa confiança nos padrões éticos da organização contribui para acentuar a relação negativa entre a compatibilidade associada a tais valores e a intenção de rotatividade. (AU)

El estudio examinó la relación entre la compatibilidad individuo-organización e la intención de salida, moderada por la confianza en la organización. La muestra fue compuesta por 381 trabajadores de ambos sexos (61% sexo femenino) con edad media de 39,23 años. Los participantes respondieron a la versión online de los instrumentos de valores organizacionales, confianza del empleado en la organización e intención de salida. Los resultados indicaron que cuanto mayor es la compatibilidad individuo-organización en lo que se refiere a valores de conservadurismo y armonía, menor es la intención de rotatividad. La confianza en los patrones éticos de la organización moderó la relación de la compatibilidad individuo-organización asociada a los valores de autonomía y dominio y la intención de rotatividad. Se concluyó que la baja confianza en los patrones éticos de la organización contribuye a acentuar la relación negativa entre la compatibilidad asociada a tales valores y la intención de rotatividad. (AU)

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