Prospective international validation of the predisposition, infection, response and organ dysfunction (PIRO) clinical staging system among intensive care and general ward patients.

BACKGROUND: Stratifying patients with sepsis was the basis of the predisposition, infection, response and organ dysfunction (PIRO) concept, an attempt to resolve the heterogeneity in treatment response. The purpose of this study is to perform an independent validation of the PIRO staging system in an international cohort and explore its utility in the identification of patients in whom time to antibiotic treatment is particularly important. METHODS: Prospective international cohort study, conducted over a 6-month period in five Portuguese hospitals and one Australian institution. All consecutive adult patients admitted to selected wards or the intensive care, with infections that met the CDC criteria for lower respiratory tract, urinary, intra-abdominal and bloodstream infections were included. RESULTS: There were 1638 patients included in the study. Patients who died in hospital presented with a higher PIRO score (10 ± 3 vs 8 ± 4, p < 0.001). The observed mortality was 3%, 15%, 24% and 34% in stage I, II, III and IV, respectively, which was within the predicted intervals of the original model, except for stage IV patients that presented a lower mortality. The hospital survival rate was 84%. The application of the PIRO staging system to the validation cohort resulted in a positive predictive value of 97% for stage I, 91% for stage II, 85% for stage III and 66% for stage IV. The area under the receiver operating characteristics curve (AUROC) was 0.75 for the all cohort and 0.70 if only patients with bacteremia were considered. Patients in stage III and IV who did not have antibiotic therapy administered within the desired time frame had higher mortality rate than those who have timely administration of antibiotic. CONCLUSIONS: To our knowledge, this is the first external validation of this PIRO staging system and it performed well on different patient wards within the hospital and in different types of hospitals. Future studies could apply the PIRO system to decision-making about specific therapeutic interventions and enrollment in clinical trials based on disease stage.

Polypyrrole monolithic extraction phase: From conventional to miniaturized sample preparation techniques.

Monolithic polymers are described as continuous and highly porous materials. They have been gaining popularity as an effective extracting phase for some sample preparation methods, due to their variety of functionalities, such as wide pH range tolerance, good permeability, and its ability to allow changes into their surface. Polypyrrole represents an interesting alternative for the modification in extraction phases due to its well related ability to perform multiple interactions, such as acid-base, π - π, ion exchange, interactions with hydrophobic affinities or polar functional groups. Among the different sample preparation techniques, solid-phase extraction (SPE) is one of the most popular and used; a miniaturized version of SPE is the disposable pipette extraction (DPX). DPX is a recent miniaturized extraction technique that usually employing silica-based sorbents inside a pipette tip (5 or 1 mL). The present study proposes the development of a monolithic extraction phase composed by styrene divinylbenzene (1:1) modified with polypyrrole for SPE and DPX techniques. The efficiency of the material was evaluated in face of the extraction of different samples and analytes, triazine herbicides in water and dexamethasone in synthetic synovial liquid by conventional and miniaturized solid-phase extraction techniques. The extractions performed by SPE and DPX presented absolute recovery values ranging from 74.8 to 105.0%, inter-day precision ranging from 0.6 to 14.0%, and limit of quantification of 0.5 and 5.0 ng.mL-1, respectively. The DPX miniaturized method exhibited results equivalent to the methods reported in the literature for extraction of dexamethasone in synovial fluid samples. Moreover, this technique proved to be quicker and cheaper than SPE, and produced fewer residual volumes, supporting the preference for green chemistry. Monolithic polymers modified with polypyrrole presented to be a feasible alternative extraction phase for miniaturized sample preparation techniques.

Efecto de 24 sesiones de entrenamiento de fuerza en un paciente con gonartrosis bilateral: a propósito de un caso / Efeitos de 24 sessões de treinamento de força em um paciente com gonartrose bilateral: um estudo de caso / Effect of 24 sessions of resistance training in a patient with gonarthrosis bilateral: a case study

Objetivos. Evaluar los efectos de 24 sesiones de ejercicio de fuerza (EF) progresivo, de intensidad moderada/alta sobre la capacidad funcional, la fuerza muscular y la composición corporal de un anciano con gonartrosis (GA) bilateral. Método. La capacidad funcional, la fuerza muscular y las variables antropométricas fueron medidas antes y después de 24 sesiones de entrenamiento. El paciente realizó el EF progresivo entre 8 y 12 repeticiones máximas, utilizando los principales grupos musculares de los miembros superiores e inferiores, 2 veces por semana durante 12 semanas. Resultados. Hubo una mejora en el test de sentarse y levantase (46,1%), en el sentar y alcanzar (33,3%), así como un aumento de la fuerza muscular en todos los ejercicios analizados y mejora de los índices antropométricos. Conclusión. Los resultados de este estudio indican que 24 sesiones de EF progresivo pueden ser eficaces en la mejora de índices antropométricos, la capacidad funcional y la fuerza muscular de un paciente anciano diagnosticado de GA bilateral (AU)

Objective. To evaluate the effects of 24 moderate-high intensity progressive Resistance Training (RT) on functional capacity, muscle strength and body composition in an elderly patient with gonarthrosis (GA) bilateral. Methods. Functional capacity, muscle strength and anthropometric variables were measured before and after 24 training sessions. The patient performed a 12-weeks progressive RT (2 times/week), between 8 and 12 repetitions maximum, using the major muscle groups of the upper and lower limbs. Results. There was an improvement in the sit-to-stand test (46,1%), in sit and reach test (33,3%), the muscle strength increased in all exercises analyzed and the anthropometric indices enhanced. Conclusion. The results of this study indicate that 24 sessions of progressive RT, can be effective in improving anthropometric indices, functional capacity and muscle strength of elderly patients diagnosed with GA bilateral (AU)

Objetivo: Avaliar os efeitos de 24 sessões de treinamento de força (TF) progressivo de intensidade moderada/alta sobre a capacidade funcional, força muscular e composição corporal de um idoso diagnosticado com gonartrose (GA) bilateral. Métodos: A capacidade funcional, força muscular e as variáveis antropométricas foram avaliadas antes e após 24 sessões de treinamento. O paciente realizou o TF progressivo entre 8-12 repetições máximas, utilizando os principais grupamentos musculares dos membros superiores e inferiores, duas vezes por semana, durante 12 semanas. Resultados: Ocorreu melhora no teste de sentar e levantar (46,1%), teste de sentar e alcançar (33,3%), assim como, os índices antropométricos e níveis de força aumentaram em todos os exercícios realizados. Conclusão: Os resultados deste estudo indicam que 24 sessões de TF progressivo podem ser eficazes na melhora dos índices antropométricos, capacidade funcional e força muscular de um paciente idoso diagnosticado com GA bilateral

Enhanced peroxisomal ß-oxidation is associated with prevention of obesity and glucose intolerance by fish oil-enriched diets.

OBJECTIVE: The effects of different amounts of omega 3-polyunsaturated fatty acids in diets with normal or high content of fat on lipid and carbohydrate metabolism were investigated. DESIGN AND METHODS: Mice were fed for 8 weeks on diets enriched with fish oil or lard at 10% or 60% of energy. Energy balance and energy expenditure were analyzed. Fatty acid (FA) oxidative capacity of the liver and the activity of enzymes involved in this pathway were assessed. RESULTS: Fish oil-fed mice had lower body weight and adiposity compared with lard-fed animals, despite having lower rates of oxygen consumption. Mice fed diets containing fish oil also displayed lower glycemia, reduced fat content in the liver, and improved glucose tolerance compared with lard-fed animals. The fish oil-containing diets increased markers of hepatic peroxisomal content and increased the generation of metabolites derived from FA ß-oxidation in liver homogenates. In contrast, no changes were observed in the content of mitochondrial electron transport chain proteins or carnitine palmitoyl transferase-1 in the liver, indicating little direct effect of fish oil on mitochondrial metabolism. CONCLUSION: Collectively, our findings suggest that the energy inefficient oxidation of FAs in peroxisomes may be an important mechanism underlying the protection against obesity and glucose intolerance of fish oil administration.

Changes in food intake, metabolic parameters and insulin resistance are induced by an isoenergetic, medium-chain fatty acid diet and are associated with modifications in insulin signalling in isolated rat pancreatic islets.

Long-chain fatty acids are capable of inducing alterations in the homoeostasis of glucose-stimulated insulin secretion (GSIS), but the effect of medium-chain fatty acids (MCFA) is poorly elucidated. In the present study, we fed a normoenergetic MCFA diet to male rats from the age of 1 month to the age of 4 months in order to analyse the effect of MCFA on body growth, insulin sensitivity and GSIS. The 45% MCFA substitution of whole fatty acids in the normoenergetic diet impaired whole body growth and resulted in increased body adiposity and hyperinsulinaemia, and reduced insulin-mediated glucose uptake in skeletal muscle. In addition, the isolated pancreatic islets from the MCFA-fed rats showed impaired GSIS and reduced protein kinase Ba (AKT1) protein expression and extracellular signal-related kinase isoforms 1 and 2 (ERK(1/2)) phosphorylation, which were accompanied by increased cellular death. Furthermore, there was a mildly increased cholinergic sensitivity to GSIS. We discuss these findings in further detail, and advocate that they might have a role in the mechanistic pathway leading to the compensatory hyperinsulinaemic status found in this animal model.

Automatic analysis of macroarrays images.

The analysis of dot blot (macroarray) images is currently based on the human identification of positive/negative dots, which is a subjective and time consuming process. This paper presents a system for the automatic analysis of dot blot images, using a pre-defined grid of markers, including a number of ON and OFF controls. The geometric deformations of the input image are corrected, and the individual markers detected, both tasks fully automatically. Based on a previous training stage, the probability for each marker to be ON is established. This information is provided together with quality parameters for training, noise and classification, allowing for a fully automatic evaluation of a dot blot image.

Automatic detection of molecular markers in digital images.

Labeled molecular markers are an important tool in molecular biology. This work presents a method for the automatic identification of molecular markers in dot blot images. The method detects the location of markers in the image and their size. An experiment was made with 6 test images, which were used to produce an additional set of 222 images with various rotation, translation, contrast and noise levels. Over 7500 markers were identified automatically and compared with reference values obtained manually. The RMS error for the marker positioning in the original test images were between 1.1 and 3.8 pixels, which is about 1/10 of the typical radius (26 pixels). The method proposed was found to be almost insensitive to grid rotation and translation, and reasonably robust to image contrast changes and presence of noise.

Swim training applied at early age is critical to adrenal medulla catecholamine content and to attenuate monosodium L-glutamate-obesity onset in mice.

Exercise has been recommended as a remedy against a worldwide obesity epidemic; however, the onset of excessive weight gain is not fully understood, nor are the effects of exercise on body weight control. Activity deficits of the sympathetic nervous system, including the sympathoadrenal axis, have been suggested to contribute to high fat accumulation in obesity. In the present work, swim training was used to observe fat accumulation and adrenal catecholamine stocks in hypothalamic-obese mice produced by neonatal treatment with monosodium L-glutamate (MSG). MSG-treated and normal mice swam for 15 min/day, 3 days a week, from weaning up to 90 days old (EXE 21-90); from weaning up to 50 days old (EXE 21-50) and from 60 up to 90 days old (EXE 60-90). Sedentary MSG and normal mice (SED groups) did not exercise at all. Animals were sacrificed at 90 days of age. MSG treatment induced obesity, demonstrated by a 43.08% increase in epididymal fat pad weight; these adult obese mice presented 27.7% less catecholamine stocks in their adrenal glands than untreated mice (p<0.001). Exercise reduced fat accumulation and increased adrenal catecholamine content in EXE 21-90 groups. These effects were more pronounced in MSG-mice than in normal ones. Halting the exercise (EXE 21-50 groups) still changed fat accretion and catecholamine stocks; however, no effects were recorded in the EXE 60-90 groups. We conclude that metabolic changes imposed by early exercise, leading to an attenuation of MSG-hypothalamic obesity onset, are at least in part due to sympathoadrenal activity modulation.

Pontes de miocárdio em bovinos azebuados / Miocardial bridges in zebu bovines

Estudou-se em 30 coraçöes de bovinos azebuados, machos, com idade variando de 30 a 50 meses, a frequência, a largura, a posiçäo e a vasculotopia das pontes de miocárdio, mediante injeçäo das artérias coronárias com soluçäo de Neoprene látex 450 e posterior dissecaçäo. Os resultados indicam frequência de 100 por cento de coraçöes com pontes e 56,6 por cento das peças apresentaram pontes múltiplas. A largura das pontes variou de 0,3 cm a 6,2 cm com média de 1,62 cm e estas localizaram-se com maior frequência na regiäo média (36,8 por cento) do ventrículo. O ramo interventricular paraconal foi o que apresentou maior número e frequência de pontes

Aspectos de pelvimetria e pelviologia em fêmeas de bovinos da raça Guzerá (Bos indicus - Linnaeus, 1758) / Pelvimetry and pelvilogy aspects in Guzera females (Bos indicus - Linnaeus, 1758)

Foram medidos os diâmetros bi-ilíaco superior (dorsal), bi-ilíaco inferior (ventral) e vertical da pelve em 273 fêmeas de bovinos da raça Guzerá (Bos indicus), bem como testadas suas eventuais correlaçöes com a idade, altura, comprimento, perímetro torácico e peso do animal. As avaliaçöes foram feitas in vivo com o auxílio do aparelho preconizado por MENISSIER; VISSAC5 (1971). No cômputo geral foram obtidas as seguintes médias: diâmetro bi-ilíaco superior, 14,55 cm; diâmetro bi-ilíaco inferior, 13,39 cm e diâmetro vertical, 18,60 cm; tendo o teste de correlaçäo entre o valor dos diâmetros e outras mensuraçöes bem como a variaçäo dos diâmetros bi-ilíacos, superior e inferior, indicado interdependência