A review on cardiovascular risk in rheumatoid arthritis

A systemic inflammatory disease known as rheumatoid arthritis (RA) is distinguished by excessive cardiovascular disease (CVD) morbidity and death. Traditional CV risk factors may partially contribute to CV disease in RA. Shared inflammatory mediators, post-translational modifications of peptides/proteins and subsequent immune responses, changes in the composition and function of lipoproteins, increased oxidative stress, and endothelial dysfunction are some of the mechanisms that link RA and CVD. The detailed pathogenetic pathway by which this association between RA and CVD might be explained is still not entirely known. It is crucial for controlling cardiovascular risk in people with RA. Optimizing care of traditional risk factors in addition to those inherent to RA is necessary to lessen the burden caused by CVD. The potential effect of planned Cardiac risk management in these individuals is highlighted by findings for under diagnosis and inadequate treatment of conventional CVD risk factors in RA. Present cardiovascular standards suggest RA patients to be examined for and treated for CVD risk factors without appropriate treatment goals. Utilizing potent anti-rheumatic medications that can reduce disease activity and treating the conventional CV risk factors should both be part of the therapy of CV risk in RA. There is currently insufficient scientific data to develop therapy targets for RA-related CVD risk factors. Thus, more study is required on the traditional CVD risk factor screening and management in RA patients.

Review on stroke induced depression

One of the frequent and dangerous aftereffects of stroke is post-stroke depression (PSD). About one in three stroke survivors had depression following their stroke. It had a significant impact on functional recovery, which resulted in a low standard of living. Even worse, there is a clear correlation between it and a high death rate. Our goal in doing this evaluation was to come up with a thorough and cohesive knowledge of PSD based on both recently released research and well-known works. We discovered that the incidence of PSD varies from 11 to 41% within a two-year period, based on a significant number of researches. The severity of the stroke, the location of the lesion, past history of depression, and other factors all has a role in the development of PSD. The DSM criteria are currently the primary basis for diagnosing PSD, and they are often coupled with different depression scales. However, there isn't a single, cohesive process that explains PSD which now include aberrant neurotrophic response, elevated inflammatory markers, lowered monoamine levels, glutamate-mediated excitotoxicity, and dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis. Pharmacotherapy and psychosocial therapies are currently used in the treatment of PSD. Even though researchers have made significant progress, many problems still need to be solved. In particular, the PSD's mechanism is not entirely understood.

Substituição parcial do milho por sorgo granífero na alimentação de matrizes suínas primíparas durante a lactação / Partial substitution of corn by sorghum in the feeding of primiparous female pigs during lactation

Avaliou-se o efeito da substituição parcial do milho por sorgo granífero na dieta de matrizes suínas híbridas durante as fases de lactação e pós-desmame. Foram utilizadas 25 fêmeas, distribuídas em três tratamentos, com porcentagens crescentes de sorgo granífero - 0 por cento, 25 por cento e 50 por cento - em substituição ao milho. Os animais foram avaliados durante as fases de lactação e pós-desmame, tendo sido mensurados o peso vivo (PV) e a espessura de toucinho (ET) ao parto, ao oitavo, 16º e 25º dias de lactação - desmame. Nesses momentos, foram realizadas colheitas de amostras de leite para análise bioquímica. As leitegadas foram pesadas no mesmo intervalo de tempo. No estro pós-desmame (RE), determinou-se o intervalo estro-cobertura (dias), PV e ET. Quanto às fêmeas, não ocorreram efeitos sobre o PV e a ET. Quanto ao número e ao peso dos leitões, as fêmeas do grupo controle apresentaram maior número de leitões nascidos vivos. O GPD dos leitões foi maior nas leitegadas dos tratamentos com 50 por cento de sorgo. Não houve diferença para as análises do leite. No RE, não ocorreram efeitos. Dessa forma, conclui-se que o sorgo granífero pode substituir o milho em até 50 por cento na dieta de fêmeas suínas durante lactação, sem comprometer os parâmetros produtivos e reprodutivos...

The aim of this research was to evaluate the effect of partial substitution of corn with sorghum on the diets of hybrid female pigs during lactation and post-weaning. Twenty-five females were distributed in three treatments with increasing levels of grain sorghum - 0 percent, 25 percent and 50 percent - as partial substitute of the corn. The females were evaluated during the lactation and post-weaning phases, measuring live weight (LW) and age at puberty and LW and backfat thickness (BT). The females were weighed on the 8th, 16th and 25th days of lactation (weaning), simultaneously with the measurement of BT and milk samples for biochemical analysis. Also, the litters were weighed at the same interval. The estrus detection after weaning was determined by the range-topping estrus (days), LW and BT. As for females, there was no effect on LW and BT. As to the piglets number and weight, the females in the control group had a high number of piglets born alive. The daily gain of piglets was higher in litters with treatment with 50 percent sorghum. There was no difference in the milk analysis. In the post-weaning there were no effects. Thus, it was concluded that grain sorghum can replace corn by 50 percent on the diet of female pigs during lactation without compromising the productivity and reproductive parameters...

Substituição parcial do milho por sorgo granífero na alimentação de matrizes suínas primíparas nos períodos de puberdade e gestação / Partial substitution of corn by sorghum in the feeding of primiparous female pigs during puberty and pregnancy

Avaliou-se o efeito da substituição parcial do milho por sorgo granífero na dieta de matrizes suínas híbridas durante a puberdade e a gestação. Foram utilizadas 25 leitoas, distribuídas em três tratamentos com porcentagens crescentes de sorgo granífero - 0%, 25% e 50% - em substituição ao milho. As fêmeas foram avaliadas durante as fases de pré-puberdade, puberdade e gestação, tendo sido mensurados o peso vivo (PV) e a idade à puberdade nas jovens e o PV e a espessura de toucinho (ET) nas fêmeas gestantes - à cobrição e aos 30, 60, 90 e 110 dias de prenhez. Na fase de pré-puberdade, o ganho de peso diário diminuiu com o aumento da utilização do sorgo, e durante a puberdade não houve efeito dos tratamentos. Houve efeito linear da substituição sobre o PV aos 90 dias de gestação. Nos demais períodos, não foram encontrados efeitos significativos. Conclui-se que o sorgo granífero pode substituir o milho em até 50% na dieta de fêmeas suínas durante a puberdade e a gestação, sem comprometer as variáveis produtivas e reprodutivas.

The effect of partial substitution of corn by sorghum on the diets of hybrid female pigs during puberty and pregnancy was evaluated. Twenty-five females were distributed in three treatments with increasing percentage of grain sorghum - 0%, 25% and 50% - as a partial substitute for corn. The females were evaluated during the growth, puberty and pregnancy phases, measuring live weight (LW) and age at puberty in young females and LW and backfat thickness (BT) during gestation - at mating, 30, 60, 90 and 110 days of pregnancy. During the growth period, daily gain decreased with increased use of sorghum and there was no effect of treatments on puberty. For pregnancy, there was a linear effect on LW at day 90. Thus, it was concluded that grain sorghum can replace corn up to 50% on the diet of female pigs during puberty, pregnancy and lactation without compromising the productivity and reproductive variables.

Anthropogenic influences on Cd, Cr,Cu, Ni, Pb and Zn concentrations in soils and sediments in a watershed with sugar cane crops at Sao Paulo state, Brazil

The use of fertilizers NPK and amendments in sugar cane crops may change the heavy metals concentrations in soils, making them available for plants and, consequently, they can be transferred to the human food chain. This study describes the redistribution of heavy metals [Cd, Cr, Cu, Ni, Pb and Zn] in soils with sugar cane crops due to fertilizers NPK and amendments at Corumbatai River basin, Sao Paulo State. The heavy metals concentrations were determined in samples of fertilizers NPK [5:25:25] and amendments [limestones, KCl, and phosphogypsum] by atomic absorption spectrometry [AAS]. Heavy metals incorporated in fertilizers NPK and amendments are annually added in the sugar cane crops, but if utilized in accordance with the recommended rates, they do not raise the concentration levels in soils up to hazards values. Those applications promote the decrease of heavy metals concentration in soils profiles with sugar cane crops due to their fractionation to water soluble and/or exchangeable fractions, and the results still indicate that the profiles do not possess hazard levels in relation to heavy metals concentration. In relation to metals concentration in a sediment core, Cu, Ni, Pb and Zn values increased progressively from 1974 to 2000 due to anthropogenic activities, mainly sugar cane crops, indicating adverse biological effects to the aquatic environment and to organisms living in or having direct contact with sediments

Risk of infection in Central Venous Catheter: review study to nursing care / Risco de infecção no Cateter Venoso Central - revisão da literatura

Problem: The use of central venous catheters in intensive care units has been identified as an important risk factor for infection in the bloodstream. Objective: To examine the evidence in the literature about the indications and uses of central venous catheter insertion, the risk of infection, the professional conduct in relation to safe practices related to this type of device. Methods: Narrative review, which assesses the risk of infection in central venous catheters in intensive care units; by bibliographic study in database of BVS, in the time gap from 2005 to 2010 using the keywords: infection, intensive care unit , central venous catheterization and nursing care. Results: The analysis identified 03 thematic units: 1. Complications associated with central venous catheter, which evaluates the evidence from a framework of systemic infection where vascular access is implicated as a possible source, and lists the factors that influence the onset of complications associated; 2. Adoption of the correct technique of catheter-related coverage, which recommends to use the coverage appropriate to prevent skin toxicity, and increases patient comfort and satisfaction, besides attention to time of the use and signs of inflammation, 3. Realization of safe practices for the maintenance of the catheter, involving the manipulation control and use of protocols. Conclusion: We conclude that the quality of care for patients with this device is directly related to controlling the risks of infection; where efforts, not only the nurse, but the health team will be enable the application of evidence to guide a safe clinical practice and contribute to improving the quality of health care and nursing.

Problema: A utilização de Cateteres Venosos Central em Unidades de terapia intensiva tem sido apontada como importante fator de risco para infecção na corrente sanguínea. Objetivo: examinar as evidências encontradas na literatura sobre as indicações e formas de utilização do Cateter venoso central, sua inserção, o risco de infecção, as condutas profissionais em relação as práticas seguras relacionados a este tipo de dispositivo. Metodologia: Revisão narrativa, que avalia o risco de infecção em Cateteres Venosos Central em Unidades de terapia intensiva; de cunho bibliográfico realizado nas bases de dados da BVS, no hiato temporal de 2005 a 2010, utilizando os descritores: infecção, centro de terapia intensiva, cateterismo venoso central e cuidados de enfermagem. Resultados: A análise dos resultados permitiu identificar 03 unidades temáticas: 1. Complicações inerentes ao cateter venoso central; que avalia as evidências a partir de um quadro de infecção sistêmica no qual o acesso vascular é implicado como possível fonte; relaciona os fatores que influenciam no aparecimento de complicações associadas; 2. Adoção da técnica correta relacionada a cobertura do cateter, que recomenda a utilização de cobertura e trocas adequadas para prevenir a toxicidade cutânea, e aumenta a satisfação e o conforto do paciente; além de estar atento ao tempo de utilização e sinais flogísticos; 3. Realização de práticas seguras para a manutenção do cateter, onde identificamos que as práticas seguras para a manutenção do Cateter envolvem o controle na manipulação e o uso de protocolos. Conclusão: Conclui que a qualidade da assistência à pacientes com este dispositivo está diretamente relacionada ao controle dos riscos de infecção; onde esforços, não somente da enfermeira, mas de toda a equipe de saúde envolvida a fim de viabilizar a aplicação das evidências para nortear uma prática clínica segura que contribua para a melhoria da qualidade da assistência à saúde e de enfermagem.

A comparative study of the peak expiratory flow rate of Indian and Nepalese young adults in a teaching institute.

Peak expiratory flow rate (PEFR) measurement is the easiest and cheapest method to evaluate respiratory functions. So, the study was carried out to evaluate PEFR of healthy Nepalese adults and compare their values with healthy Indian counterparts to know whether Indian prediction equations for PEFR can be used for Nepalese adult population or not. One hundred twenty-three healthy, young, non smoker adult Indian (64: 28 Males, 36 Females) and Nepalese (59: 32 Males, 27 Females) medical students of 18 to 20 years of age participated in the study. The mean PEFR of Indian (male: 490.4 liter/min, female: 386.0 liter/min) and Nepalese (male: 485.9 liter/min, Female: 365.2 liter/min) young adults were found to have no significant differences. As there is no significant difference in the mean PEFR of Indian and Nepalese young adults, prediction equations made for Indian adults can be used to predict PEFR of Nepalese subjects. Therefore, an attempt has been made to formulate a regression equation from the combined Indian and Nepalese subjects. A stepwise, multiple, linear, regression analysis was performed for this purpose. The analysis showed that height is the best predictor for PEFR in the present study. The regression equation based on height for the combined Indian and Nepalese young adults is calculated as: PEFR = 5.687 x Height (cm) - 495.787. However, a stepwise, multiple, linear, regression equation with residual analysis for the best fit model was performed to formulate prediction equation for PEFR and this showed a change of the earlier regression equation to PEFR = 5.930 x Height (cm) - 536.131.