Association between dietary patterns and renal function in a cross-sectional study using baseline data from the ELSA-Brasil cohort

Previous analyses of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) identified four main dietary patterns (DP). The aim of this study was to explore the association between the previously defined DP and renal function (RF). A cross-sectional study using the ELSA-Brasil baseline data was carried out. DP ("traditional", "fruits and vegetables", "bakery", and "low sugar/low fat), metabolic syndrome (MS) using the Joint Interim Statement criteria, microalbuminuria (MA), and glomerular filtration rate (eGFR) through the CKD-EPI equation were evaluated. Abnormal RF was defined as eGFR<60 mL·min-1·(1.73 m2)-1 and MA≥3.0 mg/dL. Factors associated with RF were determined and mediation analysis was performed to investigate the association between DP, MS, and RF. A total of 15,105 participants were recruited, with a mean age of 52±9 years; 8,134 participants (54%) were females. The mediation analysis identified indirect associations between "bakery" and "fruits and vegetables", and both were associated with decreased eGFR and albuminuria in both genders, compared with "traditional" and "low sugar/low fat" patterns in the general population. There was a direct association of the "bakery" pattern with MA in men (OR: 1.17, 95%CI: 1.92-1.48). The "fruits and vegetables" pattern also showed a direct association with reduced eGFR in women (OR: 1.65, 95%CI: 1.28-2.12), although there was no significance after adjustment. The "fruits and vegetables" and "bakery" DPs were associated with renal dysfunction. The only independent, direct association was between "bakery" DP and MA in men, raising concerns about DP and renal damage in men.

Association between cognitive performance and self-reported glaucoma in middle-aged and older adults: a cross-sectional analysis of ELSA-Brasil

Recent evidence suggests that glaucoma and Alzheimer's disease are neurodegenerative diseases sharing common pathophysiological and etiological features, although findings are inconclusive. We sought to investigate whether self-reported glaucoma patients without dementia present poorer cognitive performance, an issue that has been less investigated. We employed cross-sectional data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) and included participants ≥50 years of age without a known diagnosis of dementia and a self-reported glaucoma diagnosis. We excluded those with previous stroke, other eye conditions, and using drugs that could impair cognition. We evaluated cognition using delayed word recall, phonemic verbal fluency, and trail making (version B) tests. We used multinomial linear regression models to investigate associations between self-reported glaucoma with cognition, adjusted by several sociodemographic and clinical variables. Out of 4,331 participants, 139 reported glaucoma. Fully-adjusted models showed that self-reported glaucoma patients presented poorer performance in the verbal fluency test (β=-0.39, 95%CI=-0.64 to -0.14, P=0.002), but not in the other cognitive assessments. Thus, our results support the hypothesis that self-reported glaucoma is associated with poor cognitive performance; however, longitudinal data are necessary to corroborate our findings.

Detección de enfermedad renal crónica oculta en pacientes de las unidades de salud familiar de loma Pyta- asunción / Detection of occult chronic kidney disease in family health units hospital loma Pyta

Introducción: La Enfermedad Renal Crónica (ERC) es una epidemia de salud pública a nivel mundial y su prevalencia aumentó en los últimos años, en relación al aumento de la prevalencia de diabetes, hipertensión arterial y obesidad. Objetivo: Identifcar la frecuencia de Enfermedad Renal Crónica oculta en la población que asiste a control en Atención Primaria de Salud, en las Unidades de Salud Familiar del Hospital Loma Pyta-Asunción y determinar los estadios y las patologías concomitantes. Material y Métodos:Estudio descriptivo de corte transverso en 173 sujetos, >18 años y de ambos sexos. Se analizaron: Edad, Sexo, Antecedentes de consumo crónico de antiinflamatorio y de exposición a agrotóxicos, presión arterial, glicemia, creatinina plasmática, perfl lipídico y proteinuria. Se calculó Indice de Masa Corporal, y Filtrado Glomerular por ecuación MDRD. Resultados: Se encuentran con ERC el 25,5%.El FG fue normal en el 74,5%; en Estadio 1: 15,6% en Estadio 2: 9,2% y en Estadio 3: 0,6%. Se halló HTA y DM como patologías asociadas a ERC, en Estadio1: HTA: 51,8%, DM el 33,3%, con IVU 11,1%. En Estadio 2 con HTA: 12,4%; con DM: 18,5%; solo Obesidad: 18,8% y con proteinuria aislada el 50% y un paciente en Estadio 3 con HTA. Proteinuria en el 32% de los hipertensos y el 24% de los diabeticos y un grupo de pacientes obesos en un 24%. Conclusiones: El hallazgo fue 25,5% de ERC en estadios iniciales, etapa ideal para tratar y evitar la progresión a diálisis, alta frecuencia de DM, HTA y obesidad que son factores de riesgo de enfermedad renal y cardiovascular. Palabras claves: Factores de Riesgo- Enfermedad renal crónica- Atención Primaria de Salud

Introduction: Chronic kidney disease (CKD) is a public health epidemic worldwide and its prevalence has increased in recent years, probably related to the increased prevalence of diabetes, hypertension and obesity.Objective: To determine frequency of Occult CKD population attending family health units Loma Pyta Hospital, and determine the different stages and comorbidities. Material and Methods: Transverse sectional descriptive study. Universe of 19,100 people; sample of 173,> 18 years and of both sexes. They were analyzed: age, sex, past medical history of chronic inflammatory consumption and exposure to pesticides, blood pressure, blood glucose, blood creatinine and lipid profle. Proteinuria dipstick. Body Mass Index, and glomerular fltration rate calculated by MDRD equation 4.Results: The glomerular fltration rate was normal in 74.5%. The study group, whith CKD are 25.5%, of which in Stage 1: 15.6% (n = 27) in Stage 2 9.2 Stage 3% and 0.6%. Arterial hypertension and Mellitus diabetes was found as pathologies associated with CKD. In Estadio1: hypertension: 51.8%, and 33.3% DM. In Stage 2 with hypertension: 12.4%; and DM: 18.5%; Obesity 18.8% and 50% isolated proteinuria and one patient in stage 3 with hypertension. 32% of hypertensive patients and 24% of diabetics with proteinuria, and there is a group of obese patients, who are not diabetic or hypertensive patients who presented proteinuria 24%, the possibility of rapid progression of renal insuffciency higher in this group of patients. Conclusions: The fnding was 24.5% of ERC ideal to treat and prevent progression to dialysis stage early stages, the high frequency of DM, hypertension and obesity are risk factors for renal and cardiovascular disease is confrmed. Keywords: Risk Factors- occult chronic kidney disease, family health units

Bursectomy for gastric cancer: What does the evidence indicate.

Radical resection of the bursa omentalis (radical bursectomy) as part of a curative resection for gastric cancer has been advised for close to a century. However, the postulated associated morbidity and lack of a clear benefit in terms of survival preclude its routine use. To objectively review the available evidence on the role of bursectomy as part of a curative resection for gastric cancer. A systematic search of the scientific literature was carried out using Embase, PubMed, MedLine and the Cochrane central register of controlled trials for the years 1965‑2013 to obtain access to all publications, especially randomized controlled trials (RCTs), systematic reviews and meta‑analyses involving bursectomy in gastric cancer with the appropriate specific search terms, namely, “bursectomy,” “stomach cancer,” “gastric cancer,” “survival,” “morbidity,” “outcomes” and “RCTs”. Using the above search strategy, a total of 29 publications was retrieved of which five publications were identified describing bursectomy and its outcomes in gastric cancer. These included three retrospective cohort studies and two publications from a single RCT. Bursectomy do not appear to add the morbidity or mortality of the overall surgery. However, it did not appear to significantly improve overall survival neither in the retrospective cohort studies nor in the only RCT. The evidence to date is insufficient to suggest any additional benefit of routine bursectomy to a radical gastrectomy with D2 lymphadenectomy for gastric cancer. Results of an on‑going RCT are awaited to determine if bursectomy may further improve overall survival in patients with advanced T‑stage of disease.

Efeito da enrofloxacina sobre a interação blastocisto endométrio e seu reflexo no desenvolvimento placentário e fetal em ratas / Effect of enrofloxacin on the blastocyst endometrial interactions and their impact on placental and fetal development in rats

Estudos têm mostrado efeitos tóxicos da enrofloxacina em diversos tecidos. Assim, testou-se a hipótese de que a enrofloxacina pode interferir no desenvolvimento placentário e gerar efeitos adversos ao feto. A enrofloxacina (Baytril(r)) foi administrada em ratas, na dose de 5mg/kg, diariamente, IM, durante toda a gestação. As placentas foram analisadas morfologicamente, morfometricamente e imuno-histoquimicamente aos sete, 14 e 21 dias de prenhez. Os resultados mostraram que a enrofloxacina reduziu o número de sítios de implantação, o peso e a área total do disco placentário aos 14 e 21 dias de desenvolvimento, além dos elementos constituintes da placenta. A análise histoquímica não revelou alterações significativas no teor de fibras colágenas, elásticas e reticulares. O teste de Tunel mostrou atividade apoptótica apenas nas placentas com 14 dias de desenvolvimento de ambos os grupos, sendo mais intensa no grupo tratado. Não foi observado nenhum indício de malformação na cabeça, no tronco e nos membros dos neonatos. No entanto, houve uma redução significativa no número e no peso dos neonatos no grupo tratado, porém sem afetar o seu comprimento. Assim, concluiu-se que a enrofloxacina administrada na dosagem de 5mg/kg durante prenhez em ratas interfere no número de embriões implantados e no desenvolvimento placentário. Isto sugere cautela na administração da enrofloxacina durante a gestação, pois a exposição contínua a esse antibiótico pode ter reflexos na redução do número e do peso da prole...

Some studies have shown the toxic effects of enrofloxacin in various tissues. Thus, the hypothesis that enrofloxacin could interfere with placental development and generate adverse effects to the fetus was tested in this study. Enrofloxacin (Baytril(r)) was administered in the dose of 5mg/kg daily, i.m., throughout gestation in rats. The placentas were analyzed morphologically, morphometrically, and immunohistochemically on the 7, 14, and 20th days of pregnancy. The results showed that enrofloxacin reduced the number of implantation sites, weight, and placental disk total area at 14 and 20 days of development, in addition to the element components of the placenta. The histochemical analysis did not reveal significant changes in the content of collagen, reticular, and elastic fibers. The TUNEL test showed apoptosis only in placenta development at 14 days in both groups and more intense in the treated group. Head, trunk, and limb malformations were not observed in the neonates. A significant reduction in the number and weight of neonates were observed in the treated group, however, without affecting their length. Thus, it was concluded that the administration of enrofloxacin, at the dosage of 5 mg/kg during pregnancy in rats, interferes in the number of implanted embryos and placental development. This suggests caution in the administration of enrofloxacin during pregnancy because continuous exposure to this antibiotic may have adverse effects, reducing the number and weight of the offspring...

Mortality rate after open Roux-in-Y gastric bypass: a 10-year follow-up

The prevalence of obesity has increased to epidemic status worldwide. Thousands of morbidly obese individuals undergo bariatric surgery for sustained weight loss; however, mid- and long-term outcomes of this surgery are still uncertain. Our objective was to estimate the 10-year mortality rate, and determine risk factors associated with death in young morbidly obese adults who underwent bariatric surgery. All patients who underwent open Roux-in-Y gastric bypass surgery between 2001 and 2010, covered by an insurance company, were analyzed to determine possible associations between risk factors present at the time of surgery and deaths related and unrelated to the surgery. Among the 4344 patients included in the study, 79% were female with a median age of 34.9 years and median body mass index (BMI) of 42 kg/m2. The 30-day and 10-year mortality rates were 0.55 and 3.34%, respectively, and 53.7% of deaths were related to early or late complications following bariatric surgery. Among these, 42.7% of the deaths were due to sepsis and 24.3% to cardiovascular complications. Male gender, age ≥50 years, BMI ≥50 kg/m2, and hypertension significantly increased the hazard for all deaths (P<0.001). Age ≥50 years, BMI ≥50 kg/m2, and surgeon inexperience elevated the hazard of death from causes related to surgery. Male gender and age ≥50 years were the factors associated with increased mortality from death not related to surgery. The overall risk of death after bariatric surgery was quite low, and half of the deaths were related to the surgery. Older patients and superobese patients were at greater risk of surgery-related deaths, as were patients operated on by less experienced surgeons.

Proteína bruta e energia metabolizável para codornas de corte de um a 14 dias de idade / Crude protein and metabolizable energy for meat quail from 1 to 14 days of age

Com o objetivo de avaliar diferentes níveis de proteína bruta e de energia metabolizável para codornas de corte de um a 14 dias de idade, foi realizado um estudo utilizando 840 codornas de corte, mistas. As aves foram distribuídas em arranjo fatorial (2x5) constituído por 10 tratamentos (dois níveis de energia metabolizável - 2800 e 3000kcal/kg e cinco níveis de proteína bruta - 22,0; 24,0; 26,0; 28,0 e 30,0por cento), sete repetições com 12 aves cada. Foram avaliados os seguintes parâmetros: consumo de ração, ganho em peso aos sete e 14 dias de idade, conversão alimentar aos 14 dias e viabilidade. Verificou-se que codornas alimentadas com dietas com o nível energético mais baixo, 2800kcal/kg, apresentaram maior consumo. As aves que consumiram ração com menor nível de energia apresentaram maior peso aos sete dias de idade independentemente do nível de proteína bruta utilizado. O peso aos 14 dias de idade apresentou resposta quadrática com o acréscimo de proteína bruta na ração, sendo que dietas contendo 28,86 por cento de PB proporcionaram melhor ganho independentemente do nível de energia utilizado. A conversão alimentar apresentou melhores resultados com o aumento do nível de proteína bruta da ração, independentemente do nível de energia metabolizável utilizado. Não foram observados efeitos significativos dos níveis de proteína e energia ou de sua interação sobre a viabilidade das aves. Rações contendo 30,0 por cento de proteína bruta e 2800 ou 3000kcal/kg de energia metabolizável proporcionam satisfatórios resultados de desempenho para codornas de corte de um a 14 dias de idade...

Aiming to evaluate the effect of different levels of crude protein and metabolizable energy for quails from 1 to 14 days of age, a study was conducted using 840 quails, mixed. The birds were distributed in a factorial arrangement (2x5) consisting of 10 treatments (two levels of metabolizable energy - 2,800 and 3,000kcal/kg and 5 levels of crude protein - 22.0, 24.0, 26.0, 28.0 and 30.0 percent), 7 repetitions with 12 birds each. We evaluated the following parameters: feed intake, weight gain at 7 and 14 days of age, feed conversion at 14 days and viability. It was found that quail fed diets with the lowest energy level, 2,800kcal/kg, showed higher consumption. Birds fed diets with lower energy level had greater weight at 7 days of age regardless of the level of crude protein used. The weight at 14 days of age showed a quadratic response with the addition of crude protein in feed, showing that diets containing 28.86 percent CP provide better gain regardless of the level of energy used. The feed showed better results with the increased level of dietary CP, regardless of level of metabolizable energy used. There were no significant effects of protein and energy levels or their interaction on viability. Diets with 30.0 percent crude protein and 2,800 or 3,000kcal/kg metabolizable energy provide satisfactory performance results for quails from 1 to 14 days of age...

Níveis de treonina digestível para codorna japonesa na fase de produção / Digestible threonine levels for laying japanese quail

Avaliou-se a exigência de treonina digestível para a codorna japonesa em postura. Foram utilizadas 400 codornas, durante 63 dias. Utilizou-se delineamento inteiramente ao acaso, com cinco tratamentos, oito repetições e 10 aves por unidade experimental. A dieta basal foi deficiente em treonina, contendo 17,8% de proteína bruta, 2.900kcal de EM/kg, sendo suplementada com quatro níveis de L- treonina 98% (0,000; 0,052; 0,104; 0,156 e 0,208%), correspondendo à relação treonina digestível:lisina digestível de 0,55; 0,60; 0,65; 0,70 e 0,75, respectivamente. Os parâmetros estudados foram: consumo de ração, consumo de treonina, produção de ovo, peso do ovo, massa de ovos, conversão alimentar por massa de ovos, conversão alimentar por dúzia de ovos, componentes dos ovos (gema, albúmen e casca) e gravidade específica. Observou-se aumento linear (P<0,01) somente para o consumo de treonina. Conclui-se que, para proporcionar os melhores resultados de desempenho e qualidade de ovos, a codorna japonesa exige 0,55% de treonina digestível, para um consumo diário de 144,61mg de treonina digestível/ave, correspondendo à relação treonina digestível: lisina digestível de 0,55.

This experiment was conducted to determine the digestible threonine requirement for laying Japanese quail. Four hundred quails were used during 63 days. A completely randomized experimental design was used with five treatments, eight replicates and ten quails per experimental unit. The basal diet was deficient in threonine, containing 17.8% crude protein, 2.900kcal of ME/kg and supplied with four levels of L-threonine 98% (0.000; 0.052; 0.104; 0.156 and 0.208%), corresponding digestible threonine: digestible lysine ratio 0.55; 0.60; 0.65; 0.70 and 0.75, respectively. The following parameters were evaluated: feed intake, threonine intake, egg production, egg weight, egg mass, feed conversion per egg mass, feed conversion per egg dozen, egg quality (yolk, albumen and shell) and specific gravity. Linear increase (P<0.01) was only observed in the threonine intake. The conclusion is that the Japanese quail demand 0.55% of digestible threonine to provide the best productive performance and quality of eggs, a daily consumption of 144.61 mg of digestible threonine/quail, corresponding to the digestible threonine: digestible lysine ratio of 0.55.

Epidemiology of recurrent venous thrombosis

Venous thrombosis, including deep vein thrombosis and pulmonary embolism, is a common disease that frequently recurs. Recurrence can be prevented by anticoagulants, but this comes at the risk of bleeding. Therefore, assessment of the risk of recurrence is important to balance the risks and benefits of anticoagulant treatment. This review briefly outlines what is currently known about the epidemiology of recurrent venous thrombosis, and focuses in more detail on potential new risk factors for venous recurrence. The general implications of these findings in patient management are discussed.

Leveduras no rúmen de caprinos e bovinos de corte criados em pastagem tropicais / Yeasts in the rumen of beef steers and goats raised on tropical pasture

Yeasts suplemented in the rumen have been produced benefic interations in the digestion and in the health of the ruminants. This study aimed to quantify, to isolate and, to identify aerobic fungi and yeasts naturally present in the rumen of goats and cattle raised on tropical pastures of the North of Minas Gerais State, Brazil. Samples of 15mL of ruminal juice from 18 hibrid goats and 31 crossbred Nellore steers were used. The physico-chemical characteristics of the samples were evaluated and mycological culture, quantification, and identification of the aerobic fungi were performed. The results indicated the absence of yeasts in the ruminal fluid of steers. However, theses microorganisms were cultured from ruminal juice for all evaluated goats, at an average concentration of 3.2 x 10VCFU/mL. The species Pichia membranifaciens was the most frequently identified yeast, suggesting its participation in the ruminal microbiot of theses small ruminants.

Teores de cálcio em dietas para codornas japonesas no terço final de postura (45 a 57 semanas de idade) / Levels of calcium in diets for Japanese quails in the third end of posture (45 - 57 weeks of age)

Verificou-se o efeito dos teores de cálcio (Ca) na dieta sobre o desempenho e a qualidade dos ovos de codornas japonesas durante o terço final do ciclo de produção. Foram utilizadas 350 codornas, com 313 dias de idade, distribuídas em 35 unidades experimentais de 10 aves. O delineamento foi inteiramente ao acaso, composto de cinco níveis de Ca - 2,2; 2,6; 3,0; 3,4; 3,8 por cento -, com sete repetições. O aumento do Ca na dieta melhorou linearmente a conversão por massa e por dúzia de ovos, melhorou a espessura de casca e influenciou o peso da gema e da casca dos ovos, além da porcentagem da casca. Observou-se redução nos teores de P, Ca e Mg na casca com o aumento dos níveis de Ca da dieta. Para os demais parâmetros, não houve efeito do teor de Ca da dieta. Considerando-se a importância da conversão alimentar, em termos econômicos e de desempenho, o teor de 3,8 por cento de Ca na dieta mostrou-se satisfatório em atender às demais variáveis relacionadas com a qualidade dos ovos. Dieta que contenha 3,8 por cento de Ca, correspondendo ao consumo diário de 982mg por ave, melhora a conversão alimentar e a qualidade da casca dos ovos de codornas japonesas no terço final do ciclo de produção (45 a 57 semanas de idade).

The effect of calcium (Ca) levels in the diet on performance and egg quality of Japanese quail during the final third of the production cycle was evaluated. A total of 350 313-day-old quails was used. They were distributed in 35 experimental units of 10 birds. The design was completely randomized, composed of five levels of Ca (2.2, 2.6, 3.0, 3.4 and 3.8 percent), with seven replications. The increase of Ca in the diet linearly improved the feed conversion per dozen eggs, improved the shell thickness, and influenced the weight of yolk and egg shell as well the percentage of shell. There was reduction in levels of P, Ca, and Mg in the shell with increasing levels of Ca in the diet. For other parameters, no effect of calcium levels in the diet was recorded. Considering the importance of feed conversion in economic terms and performance, the level of 3.8 percent Ca in diet showed satisfactory to meet the other variables related to egg quality. Diet containing 3.8 percent Ca, corresponding to a daily intake of 982mg per bird, improves feed conversion and egg shell quality of Japanese quails in the final third of the production cycle (45-57 weeks old).

Fungos anaeróbios do rúmen de bovinos e caprinos de corte criados em pastagens tropicais / Ruminal anaerobic fungi of beef cattle and beef goats raised on tropical pastures

The presence of anaerobic fungi structures was evaluated in ruminal juice of beef goats and beef cattle raised in the North of Minas Gerais, Brazil. The strains were collected from 18 Anglo-Nubian crossbred male goats and 23 Nellore crossbred steers during the dry period of the year. Physical-chemical characteristics of the juice were evaluated and direct examination with KOH digestion was performed for anaerobic fungi detection. Structures of these fungi were detected in samples of 14 (77.8 percent) goats and 17 (73.9 percent) steers. The monocentric fungi frequency (56.5 percent) was significantly higher in cattle than polycentric fungi frequency (26.1 percent). This study is the first report of anaerobic ruminal fungi in these ruminants in Brazil and showed high prevalence of theses microorganisms in the ruminal ecosystem of both animals.

Neurotransmitter evaluation in the hippocampus of rats after intracerebral injection of TsTX scorpion toxin

TsTX is an á-type sodium channel toxin that stimulates the discharge of neurotransmitters from neurons. In the present study we investigated which neurotransmitters are released in the hippocampus after TsTX injection and if they are responsible for electrographic or histopathological effects. Microdialysis revealed that the toxin increased glutamate extracellular levels in the hippocampus; however, levels of gamma-aminobutyric acid (GABA), glycine, 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA) and 3,4-dihydroxyphenylacetic acid (DOPAC) were not significantly altered. Neurodegeneration in pyramidal cells of hippocampus and electroencephalographic alterations caused by the toxin were blocked by pretreatment with riluzole, a glutamate release inhibitor. The present results suggest a specific activity of TsTX in the hippocampus which affects only glutamate release.

Respostas cardiovasculares durante a postura sentada da Reeducação Postural Global (RPG) / Cardiovascular responses in the seated posture of the Global Postural Reeducation (GPR) method

OBJETIVO: Avaliar as respostas da freqüência cardíaca (FC), pressão arterial sistólica (PAS), diastólica (PAD), média (PAM) e duplo produto (DPr), durante a postura sentada do método de Reeducação Postural Global (RPG). MATERIAIS E MÉTODOS: Nove voluntárias saudáveis (23±2,1 anos, 56,4±7,8kg, 1,61±0,05m, 21,6±2,4kg.m2-1), inexperientes na prática do método RPG, foram submetidas a uma sessão de RPG na postura sentada, realizada em três fases: repouso pré-postura, execução da postura e recuperação pós-postura. No repouso e na recuperação, as voluntárias permaneceram sentadas por 20 minutos, sendo PA e FC verificadas a cada cinco minutos. A fase de execução da postura foi realizada em três séries e mantida por três minutos cada, com intervalo de um minuto entre elas. A verificação da PA e da FC foi realizada a cada um minuto e 30 segundos de execução da postura. RESULTADOS: Os valores de PAS, PAD, PAM e DPr foram significativamente maiores (p<0,05) do terceiro ao nono minuto da execução da postura (154±14, 107±11, 122±9mmHg e 16.478±2.802mmHg.min-1) quando comparados aos valores de repouso pré-postura (109±10, 74±7, 85±8mmHg e 9.374±1.687mmHg.min-1) e aos valores de recuperação pós-postura. Porém, estes valores retornaram aos valores de repouso nos primeiros cinco minutos de recuperação pós-postura. Durante a execução da postura, a FC não foi estatisticamente diferente da FC de repouso pré-postura. CONCLUSÕES: Elevações significativas da PAS, PAD, PAM e DPr foram observadas durante a execução da postura sentada da RPG empregada nesse estudo, mas retornaram aos valores de repouso nos primeiros cinco minutos de recuperação pós-postura.

OBJECTIVE: To evaluate heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and double product (DP) responses in the seated posture of the Global Postural Reeducation (GPR) method. METHODS: Nine healthy female volunteers (23±2.1 years; 56.4±7.8kg; 1.61±0.05m, 21.6±2.4kg/m²), without experience of the GPR, method underwent a treatment session in the seated posture. It was a three-step experiment: pre-posture resting, posture maintenance and post-posture recovery. In both the resting and the recovery step, the volunteers remained seated for 20 minutes and arterial pressure and HR were measured every five minutes. The posture maintenance step lasted for three minutes and was implemented three times with one-minute intervals between implementations. Arterial pressure and HR were measured every 1.5 minutes, while the posture was being maintained. RESULTS: The SAP, DAP, MAP and DP values were significantly greater (p<0.05) from the third to the ninth minute of maintaining the posture (154±14, 107±11, 122±9mmHg and 16,478±2,802mmHg/min) in comparison with the pre-posture resting values (109±10, 74±7, 85±8mmHg and 9,374±1,687mmHg/min) and the post-posture recovery values. However, these values returned to the resting values within the first five minutes of post-posture recovery. The HR while maintaining the posture was not statistically different from the pre-posture resting HR. CONCLUSIONS: Significant increases in SAP, DAP, MAP and DP were observed while maintaining the seated posture of the GPR method that was used in this study, but these values returned to the resting values within the first five minutes of post-posture recovery.

Mecanismos de resistência do enterococcus / Mechanisms of resistance of the enterococcus

Os Enterococos são cocos gram-positivos com baixo potencial de causar doenças. No entanto, tornaram-se temidos nas últimas décadas devido ao desenvolvimento de cepas bastante resistentes aos aminoglicosídeos, à ampicilina, penicilina e vancomicina. Os locais de infecções enterocócicas mais comuns são as vias urinárias e a corrente sangüínea. O controle e a prevenção dessas infecções é difícil devido ao elevado grau de resistência, o que torna importante a restrição da antibioticoterapia e o controle de pacientes infectados para reduzir a disseminação dessas bactérias

Fatores de virulência da Pseudomonas aeruginosa / Virulence factors of Pseudominas aeruginosa

A Pseudomonas aeruginosa é uma bactéria gram-negativaque causa infecções em diversos tecidos e órgãos, atravésdos fatores de virulência, que são os contribuintes principais para a habilidade desta bactéria em causar doença. A virulência da P. aeruginosa é multifatorial, por isso é difícil definir o papel específico de cada fator. Alguns fatores dessas bactérias, como componentes estruturais, toxinas e enzimas são bem definidos como agentes causadores de doenças, porém ainda existem muitos outros em estudo. Os principais fatores de virulência da P. aeruginosa e alguns de seus reguladores foram enfocados neste trabalho

Factors associated with emergency department visits due to acute asthma

It is important to identify characteristics related to poor disease control and frequent visits to the emergency department (ED). The objective of the present study was to compare the characteristics of patients attending the adult ED for treatment of asthma exacerbation with those attending an asthma specialist clinic (AC) in the same hospital, and to determine the factors associated with frequent visits to the ED. We conducted a cross-sectional survey of consecutive patients (12 years and older) attending the ED (N = 86) and the AC (N = 86). Significantly more ED patients than AC patients reported ED visits in the past year (95.3 vs 48.8 percent; P < 0.001) and had difficulty performing work (81.4 vs 49.4 percent; P < 0.001. Significantly more AC than ED patents had been treated with inhaled corticosteroids (75.6 vs 18.6 percent; P < 0.001) used to increase or start steroid therapy when an attack was perceived (46.5 vs 20.9 percent; P < 0.001) and correctly used a metered-dose inhaler (50.0 vs 11.6 percent; P < 0.001). The history of hospital admissions (odds ratio, OR, 4.00) and use of inhaled corticosteroids (OR, 0.27) were associated with frequent visits to the ED. In conclusion, ED patients were more likely than AC patients to be dependent on the acute use of the ED, were significantly less knowledgeable about asthma management and were more likely to suffer more severe disease. ED patients should be considered an important target for asthma education. Facilitating the access to ambulatory care facilities might serve to reduce asthma morbidity.

Sildenafil no tratamento da hipertensão arterial pulmonar / Sildenafil in the treatment of arterial pulmonary hypertension

É abordado, de forma concisa, o papel do sildenafil, um inibidor das isoenzimas fosfodiesterases (PDE) tipos 5/6, para o tratamento da hipertensão arterial pulmonar. São apresentados alguns ensaios clínicos que têm justificado a indicação deste fármaco no manejo da HPP.