Burden of non-communicable diseases and the achievement of the sustainable development goals in 2030 in Mercosur countries.

OBJECTIVES: The aims of this article were to analyse the burden of NCDs and their RFs in the Mercosur countries between 1990 and 2019 and to project mortality trends for 2030. STUDY DESIGN: Epidemiological study of time series. METHODS: The present study used data from the Global Burden of Disease study. The absolute number of deaths, mortality rates, disability-adjusted life years, years of life lost, years lived with disability and the burden of premature mortality by NCD attributable to the RFs were evaluated. Projections were made up to 2030. Age-standardised rates were used to draw comparisons by years and by countries. The analysis was conducted using the RStudio software. RESULTS: Between 1990 and 2019, a decrease was found in the premature mortality rates caused by NCDs in all the countries, except for Paraguay, which remained stable. When analysing premature mortality rates due to NCDs up to 2030, it was predicted that none of the countries would achieve the sustainable development goal of a one-third reduction in premature mortality by NCDs. Regarding the impacts of the RFs for NCDs, smoking, dietary risks, high blood pressure (BP) and high body mass index (BMI) were the main risks attributable to premature deaths due to NCDs. CONCLUSIONS: The results showed that mortality rates are declining in Mercosur countries; however, none of the countries are predicted to achieve the sustainable development goal of a one-third reduction in mortality due to NCDs by 2030. In addition to access to adequate treatment, progress is required in public regulation actions to reduce RFs, such as smoking, dietary risks, high BP and high BMI.

Greenhouse gas balance and carbon footprint of pasture-based beef cattle production systems in the tropical region (Atlantic Forest biome).

The production of beef cattle in the Atlantic Forest biome mostly takes place in pastoral production systems. There are millions of hectares covered with pastures in this biome, including degraded pasture (DP), and only small area of the original Atlantic Forest has been preserved in tropics, implying that actions must be taken by the livestock sector to improve sustainability. Intensification makes it possible to produce the same amount, or more beef, in a smaller area; however, the environmental impacts must be assessed. Regarding climate change, the C dynamics is essential to define which beef cattle systems are sustainable. The objectives of this study were to investigate the C balance (t CO2e./ha per year), the intensity of C emission (kg CO2e./kg BW or carcass) and the C footprint (t CO2e./ha per year) of pasture-based beef cattle production systems, inside the farm gate and considering the inputs. The results were used to calculate the number of trees to be planted in beef cattle production systems to mitigate greenhouse gas (GHG) emissions. The GHG emission and C balance, for 2 years, were calculated based on the global warming potential (GWP) of AR4 and GWP of AR5. Forty-eight steers were allotted to four grazing systems: DP, irrigated high stocking rate pasture (IHS), rainfed high stocking rate pasture (RHS) and rainfed medium stocking rate pasture (RMS). The rainfed systems (RHS and RMS) presented the lowest C footprints (-1.22 and 0.45 t CO2e./ha per year, respectively), with C credits to RMS when using the GWP of AR4. The IHS system showed less favorable results for C footprint (-15.71 t CO2e./ha per year), but results were better when emissions were expressed in relation to the annual BW gain (-10.21 kg CO2e./kg BW) because of its higher yield. Although the DP system had an intermediate result for C footprint (-6.23 t CO2e./ha per year), the result was the worst (-30.21 CO2e./kg BW) when the index was expressed in relation to the annual BW gain, because in addition to GHG emissions from the animals in the system there were also losses in the annual rate of C sequestration. Notably, the intensification in pasture management had a land-saving effect (3.63 ha for IHS, 1.90 for RHS and 1.19 for RMS), contributing to the preservation of the tropical forest.

The effect of grazing system intensification on the growth and meat quality of beef cattle in the Brazilian Atlantic Forest biome.

This study was carried out to evaluate the effects of four levels of intensification of grazing systems: 1) degraded pasture - DP; 2) irrigated pasture with high stocking rate - IHS; 3) dryland pasture with high stocking rate - DHS; 4) dryland pasture with moderate stocking rate - DMS; on growth, muscle development and meat quality of Nellore steers (271±2.2kg of live body weight - BW; 15months old) during two consecutive periods (17 and 15months). The final BW, the average daily BW gain, the hot carcass weight and the dress percentage were greater (P<0.0001), and the ribeye area tended to be greater (P=0.085), in the intensified systems compared to the degraded system. Animals in all systems presented similar back fat. Muscle development increased with the intensification of the grazing systems and meat quality was not affected.

Suitability of lemon balm (Melissa officinalis L.) extract rich in rosmarinic acid as a potential enhancer of functional properties in cupcakes.

Melissa officinalis (lemon balm) and its extracts have been frequently reported as possessing bioactive properties, offering the potential for use in development/enrichment of food products with additional functional capabilities, providing health benefits to consumers. The antioxidant, antibacterial and antifungal activity of lemon balm extract, as well as its potential hepatotoxicity were thoroughly evaluated. The extracts were then incorporated into cupcakes and their preserving effect, chemical composition, colour parameters and antioxidant activity were compared with those provided by potassium sorbate. In general, the variables with the largest differences among different storage times were energy level, sucrose, glucose, palmitic acid (C6:0) and oleic acid (C18:1n9). On the other hand, L∗ (top), a∗ (top), b∗ (top), pH, capric acid (C10:0) and lauric acid (C12:0) showed the greatest variation according to cupcake formulation. The results observed indicate that the lemon balm extract rich in rosmarinic acid can provide advantageous functional properties to bakery products.

Manipulation of primer affinity improves high-resolution melting accuracy for imprinted genes.

High-resolution melting (HRM) is considered an inexpensive, rapid, and attractive methodology for methylation analysis. In the application of the polymerase chain reaction (PCR) to methylation analysis, amplification efficiencies are biased towards unmethylated, rather than methylated, templates: a phenomenon known as PCR bias. To overcome PCR bias, primers that include CpG site(s) and are fully complementary to the methylated sequence have been proposed. However, genes mapped within imprinted regions usually present higher methylation levels, and an unusual PCR bias towards the methylated template can therefore arise. The manipulation of primer affinity attempts to overcome this problem. We attempted to show that mismatches at the primer's methylated binding sites increase the area between the 50 and 100% methylation plots on the melting curves, and may increase HRM accuracy for samples that have high methylation levels. Sets of primers for imprinted genes that included CpG sites at their binding sequences were designed, and were complementary to methylated or unmethylated templates. Primers fully complementary to methylated templates produced a very small area between the 50 and 100% methylation plots. When using primers that were fully complementary to the unmethylated sequence, we were able to increase the area between the 50 and 100% methylation plots. Therefore, when samples are highly methylated, such as targets in genes mapped in imprinted regions, we propose that primers should favor amplification of the rarest, unmethylated sequence. Primers may be designed to include one CpG at its binding site and be fully complementary to the unmethylated template.

Evaluation of the QuEChERS sample preparation approach for the analysis of pesticide residues in olives.

This paper describes the use of a quick, easy, cheap, effective, rugged, and safe (QuEChERS) method for extraction and cleanup of 16 pesticide residues of interest in olives and olive oil. These products contain a high lipid content, which can adversely affect pesticide recoveries and harm traditional chromatographic systems. For extraction, the main factors (oil and water content) were studied and optimized in experiments to maximize pesticide recoveries. Dispersive SPE with different sorbents was also investigated to minimize matrix coextractives and interferences. For analysis, a new automated DSI device was tested in GC-MS to avoid nonvolatile coextractives from contaminating the instrument. LC-MS/MS with positive ESI was used for those pesticides that were difficult to detect by GC-MS. The final method was validated for olives in terms of recoveries, repeatabilities, and reproducibilities using both detection techniques. The results demonstrated that the method achieved acceptable quantitative recoveries of 70-109% with RSDs < 20% for DSI-GC-MS and 88-130% with RSDs < 10% for LC-MS/MS, and LOQ at or below the regulatory maximum residue limits for the pesticides were achieved.

Comparison of matrix solid-phase dispersion and liquid-liquid extraction for the chromatographic determination of fenthion and its metabolites in olives and olive oils.

Matrix solid-phase dispersion (MSPD) methodology has been developed to extract fenthion and its metabolites from olives and olive oils, and the technique compared with conventional liquid-liquid extraction (LLE). The method was applied to olives and olive oil samples obtained from olive groves treated with fenthion. Pesticide residues were analysed by gas chromatography (GC) using a nitrogen-phosphorus detector. Both extraction methods gave a linear response over the concentration range assayed (0.03-1 mg kg-1 for MSPD and 0.1-1 mg kg-1 for LLE). Recoveries and RSD (n = 6) values in olives were 85-112% and 2-6% for MSPD, and 68-108% and 4-16% for LLE, respectively. In the case of olive oil, recoveries and RSD (n = 6) values were 67-98% and 5-11% for MSPD, and 63-115% and 6-14% for LLE, respectively. When compared to LLE, the newly developed MSPD method was twice as sensitive and required 10 times less sample weight.

Determination of phosmet and its metabolites in olives by matrix solid-phase dispersion and gas chromatography-mass spectrometry.

An accurate method based on matrix solid-phase dispersion (MSPD), and gas chromatography-mass spectrometry (GC/MS) was developed for determination of phosmet residues and its metabolites (phosmet-oxon, phthalimide, N-hydroxymethylphthalimide, and phthalic acid) in olive fruits. After testing different sorbents and eluents for MSPD extraction, C(18) and acetonitrile were found to be the most appropriate for clean-up of the samples, in terms of yields and efficient removal of interfering compounds. All analytes were determined in selective ion monitoring (SIM) mode following a derivatization step with N,O-bis-trimethylsilyltrifluoroacetamide (BSTFA) containing 1% of trimethylchlorosilane (TMCS), except for phosmet and phosmet-oxon which were analyzed directly. The method showed suitable linearity (correlation coefficients higher than 0.8919 for all the compounds) and suitable sensitivity (limit of detection lower than 0.06mg/kg). It was successfully applied in the analysis of olive fruits collected during the preharvest interval and olive oil. Phosmet residues found in all samples were lower than the maximum residue limits established by legislation (2mg/kg).

Free and conjugated biogenic amines in green and roasted coffee beans.

This work reports the composition of arabica and robusta coffees in terms of biogenic amines. The analyses were conducted before and after acid hydrolysis with the aim of the determining both free and conjugated forms in green and roasted coffee beans. The amines (putrescine, cadaverine, serotonin, tyramine, spermidine, and spermine) were determined by reverse-phase high-performance liquid chromatography (RP-HPLC) after derivatization with dansyl chloride. Multivariate analyses were applied in order to evaluate the possible use of these amines as chemical descriptors for arabica and robusta coffees. It was found that putrescine, the main biogenic amine present in the green beans, could be used in the discrimination of the referred species. There is also some evidence that these compounds can be used for discrimination between green coffees subjected to different postharvest processes and that tyramine can be considered a chemical marker for Angolan robustas. The variations in biogenic amine levels after roasts is also discussed, but the statistical significance for species discrimination is reduced.

Prontuário eletrônico de pacientes: integrando informações clínicas e imagens médicas / Eletronic patient record: integrating clinical information and image data

O Instituto do Coração tem envidado esforços para integrar todas as informações clínicas dentro da Instituição. Nos últimos anos o InCor implementou com sucesso um sistema para transmissão, arquivamento, recuperação, processamento e visualização de Imagens Médicas e um Sistema de Informações Hospitalares (HIS) que armazena as informações administrativas e clínicas. A integração desses subsistemas forma o Prontuário Eletrônico do Paciente (PEP). O InCor é um dos seis Institutos que compõem o Hospital das Clínicas da Universidade de São Paulo. Como cada um dos Institutos possui o seu próprio sistema de informações, a troca de informações entre os Institutos é também uma questão muito relevante. Este trabalho apresenta a experiência no desenvolvimento de um Prontuário Eletrônico funcional e completo, que inclui controle de acesso, exames laboratoriais, imagens (estáticas, dinâmicas e 3D), laudos, documentos e mesmo sinais vitais de tempo real. Este artigo também discute a modelagem e implantação de um protótipo de um PEP distribuído e homogêneo. Atualmente, um volume superior a 2,5 TB de imagens DICOM já foi armazenado utilizando a arquitetura proposta. Diariamente, o PEP armazena mais de 5GB de dados e tem uma quantidade de acessos superior a 300 usuários. O sistema de armazenamento permite uma visibilidade de seis meses para acesso imediato e mais de dois anos para acesso automático utilizando uma jukebox

The Heart Institute (InCor) of São Paulo has been committed to the goal of integrating all clinical information within the institution. In the last few years, InCor has successfully created a system for transmission, archiving, retrieval, processing and visualization of Medical Images and a Hospital Information System (HIS) that stores the institution administrative and clinical information. These integrated subsystems form InCor's Electronic Patient Record (EPR). Since InCor is one of the six institutes of the University of São Paulo Medical School Hospital (HC) and each institute has its own information system, exchanging information among the institutes is also a very important issue. This work describes the experience in the effort to develop a functional and comprehensive EPR, which includes access control, lab exams, images (static, dynamic and 3D), clinical reports, documents and even real-time vital signals. This paper addresses also the design and prototype for integration of distributed and heterogeneous EPR. Currently, more than 2.5 TB of DICOM images, have been stored using the proposed architecture. The EPR stores more than 5 GB/day of data and presents more than 300 hits per day. The proposed storage subsystem allow six months of visibility for rapid retrieval (online mode) and more than two years for automatic retrieval using the jukebox

Standardization of an isolated pig heart preparation with parabiotic circulation: methodological considerations

In the present study we standardized an experimental model of parabiotic circulation of isolated pig heart. The isolated heart was perfused with arterial blood from a second animal as support and submitted to regional ischemia for 30 min, followed by total ischemia for 90 min and reperfusion for 90 min. Parameters for measurement of ventricular performance using different indices measured directly or indirectly from intraventricular pressure were defined as: maximum peak pressure, final diastolic pressure, pressure developed, first derivative of maximum pressure (dP/dt max), first derivative of minimum pressure (dP/dt min), systolic stress of the left ventricle (sigmas), and maximum elastance of the left ventricle. Isolated hearts subjected to regional and global ischemia presented significant worsening of all measured parameters. Less discriminative parameters were dP/dt max and dP/dt min. Elastance was the most sensitive parameter during the reperfusion period, demonstrating an early loss of ventricular function during reperfusion. The model proved to be stable and reproducible and permitted the study of several variables in the isolated heart, such as ischemia and reperfusion phenomena, the effects of different drugs, surgical interventions, etc. The model introduces an advantage over the classical models which use crystalloid solutions as perfusate, because parabiotic circulation mimics heart surgery with extracorporeal circulation

Standardization of an isolated pig heart preparation with parabiotic circulation: methodological considerations.

In the present study we standardized an experimental model of parabiotic circulation of isolated pig heart. The isolated heart was perfused with arterial blood from a second animal as support and submitted to regional ischemia for 30 min, followed by total ischemia for 90 min and reperfusion for 90 min. Parameters for measurement of ventricular performance using different indices measured directly or indirectly from intraventricular pressure were defined as: maximum peak pressure, final diastolic pressure, pressure developed, first derivative of maximum pressure (dP/dt max), first derivative of minimum pressure (dP/dt min), systolic stress of the left ventricle (sigmas), and maximum elastance of the left ventricle. Isolated hearts subjected to regional and global ischemia presented significant worsening of all measured parameters. Less discriminative parameters were dP/dt max and dP/dt min. Elastance was the most sensitive parameter during the reperfusion period, demonstrating an early loss of ventricular function during reperfusion. The model proved to be stable and reproducible and permitted the study of several variables in the isolated heart, such as ischemia and reperfusion phenomena, the effects of different drugs, surgical interventions, etc. The model introduces an advantage over the classical models which use crystalloid solutions as perfusate, because parabiotic circulation mimics heart surgery with extracorporeal circulation.

Anastomose cólon-trígono vesical em cäes / Colonic-trigonal anastomosis in dogs

Realizou-se anastomose cólon-trígono vesical em 12 cäes adultos (cinco machos e sete fêmeas), sem raça definida e clinicamente normais. Todos os animais mantiveram a continência urinária imediatamente após a cirurgia. Amostras da regiäo de transiçäo cólon-trígono vesical foram colhidas aos 30 e 60 dias após a cirurgia para exames histopatológicos. Observou-se infiltrado inflamatório mononuclear na regiäo de anastomose com invasäo do epitélio de transiçäo da bexiga sobre a mucosa do fragmento intestinal. A técnica mostrou-se simples e eficiente para a reparaçäo da bexiga, com o cólon funcionando como substituto da bexiga, preservando as funçöes renal e vesical

Definition and application of a five-parameter characterization of one-dimensional cellular automata rule space.

Cellular automata (CA) are important as prototypical, spatially extended, discrete dynamical systems. Because the problem of forecasting dynamic behavior of CA is undecidable, various parameter-based approximations have been developed to address the problem. Out of the analysis of the most important parameters available to this end we proposed some guidelines that should be followed when defining a parameter of that kind. Based upon the guidelines, new parameters were proposed and a set of five parameters was selected; two of them were drawn from the literature and three are new ones, defined here. This article presents all of them and makes their qualities evident. Then, two results are described, related to the use of the parameter set in the Elementary Rule Space: a phase transition diagram, and some general heuristics for forecasting the dynamics of one-dimensional CA. Finally, as an example of the application of the selected parameters in high cardinality spaces, results are presented from experiments involving the evolution of radius-3 CA in the Density Classification Task, and radius-2 CA in the Synchronization Task.

Three case studies of the GasNet model in discrete domains.

A new neural network model - the GasNet - has been recently reported in the literature, which, in addition to the traditional electric type, point-to-point communication between units, also uses communication through a diffilsable chemical modulator. Here we assess the applicability of this model in three different scenarios, the XOR problem, a food gathering task for a simulated robot, and a docking task for a virtual spaceship. All of them represent discrete domains, a contrast with the one where the GasNet was originally introduced, which had an essentially continuous nature. These scenarios are well-known benchmark problems from the literature and, since they exhibit varying degrees of complexity, they impose distinct performance demands on the GasNet. The experiments were primarily intended to better understand the model, by extending the original problem domain where GasNet was introduced. The results reported point at some difficulties with the current GasNet model.

Real time information from bedside monitors as part of a web-based patient record.

Traditional paper-based Medical Records, and even most of their digital counterparts, represent historical patient information. On the other hand new generations of Point-of-Care devices can be connected to standard networks and deliver streams of real time data through an Intranet, or even the Internet. Vital signs provided by IP-based devices can then be viewed at remote stations. Merging both worlds, real time and historical, in the pursuit of a comprehensive EPR is the main challenge of the present project. The basic infra-structure is composed of three main components: an existing Web-based EPR viewing station1 (Web-EPR); a fully integrated HIS/PACS system1; and a monitoring network (Siemens Infinity Network 2). Communication between the components was obtained by developing interfaces based on both HL7 and Siemens protocols the later only for waveforms. For the graphical display a web-browser-based application of the streamed signals was developed and integrated into the existing Web-EPR. This addition expanded the Web-EPR capabilities providing means to include real time signals and calculated parameters on the set of information already available. Some extra features of this project include: one-way SMS messaging of the parameters, interactive WAP access and a DICOM compliant storage of signal waveforms.

[High output heart failure due to coronary fistula]. / Insuficiência cardíaca de alto débito devida a fístula coronária.

A 45 year-old woman complaining of heart failure symptoms (New York Heart Association--class III) and a non typical thoracic pain was submitted to a transthoracic echocardiogram which showed a very dilated coronary artery and a fistula to the right atrium. The angiograms confirmed the same findings. She underwent open heart surgery which confirmed the diagnosis. Fistula ligation was then undertaken. She remains symptom-free three years after the operation.

Carcinoma de próstata com metástase óssea em cäo / Prostate carcinoma with bone metastasis in a dog

This report describes a case of prostate carcinoma with metastasis to bone and other organs in a 10-year old Cocker Spaniel dog. The animal had history of difficult walking and evacuation and hind limbs flaccid paralysis. Clinically, abdominal pain and very full urinary bladder, were found. The urine had cloudy aspect and phosphate crystals and granular casts. The radiologic examination of abdominal cavity showed and enlargement of the prostate and lost radiologic density of the last lumbar vertebra. The animal was euthanized. Grossly, the prostate was enlarged, irregular, nodular and asymmetrical, with firm consistence. On cut surface, it was whitish with brown spots. The neoplastic tissue involved the iliac lymph nodes and last lumbar vertebra besides the pulmonary metastasis. This mass reached the urethra and urinary bladder inducing unilateral hydronephrosis in the left kidney. Histologically, the diagnosis of poorly differentiated prostate carcinoma was made

[Use of a thin retrocardiac drain after open heart surgery. Description of the technique]. / Uso de dreno fino retrocardíaco em pós-operatório de cirurgia cardíaca. Descrição de técnica.

PURPOSE: To describe a technique with a thin drainage system placed behind the heart, avoiding reoperation caused by tamponade due to pericardial effusion in patients who undergo open heart surgery. METHODS: We studied 59 patients, average age of 50 years. Twenty-six (44%) patients had undergone CABG, 25 (42%) valvar procedures and 8 (14%) different procedures. The control group were 20 patients, average age 44 years. Nine (45%) underwent CABG, 6 (30%) valvar procedures and 5 (25%) other procedures. Every patient was submitted to echocardiographic study to verify presence of pericardial effusion after operation. RESULTS: There was one patient with pericardial effusion with 8mm in the study group. Six patients showed pericardial effusion in the control group. The control group had mean drainage flow of 320 +/- 110ml and average permanence time was 45 +/- 10h. The study group had mean drainage flow of 410 +/- 122ml, the average permanence time was 46 +/- 10h. There was statistic difference between both groups when we compared the frequency of pericardial effusion. CONCLUSION: This drainage system reduces pericardial effusion comparing with the literature and causes little discomfort to the patient. The fixed rule to remove the drains did not present more discomfort to the patient and there were no complications related to its permanence.

-Rate-responsive pacemaker with an unexpected chronotropic response-. / Marcapasso responsivo com resposta cronotrópica inesperada.

The pacemaker with rate-responsiveness was a great advance in cardiac stimulation, however, the choice of the best biosensor is still object of research. A 35 year-old woman with a responsive pacemaker implanted due to a complete heart block after interventricular septal defect surgical correction was admitted. The pacemaker showed improper cronothropic response with high frequency due to biosensing malfunction. Malfunction related to muscle stimulation in the generator pocket and a high response rate. A palliative procedure was made until the end of pregnancy, by reducing the sensitivity of biosensing.