Association between respiratory mechanics and autonomic function in morbid obesity.

This study aimed to investigate the association between respiratory mechanics and autonomic modulation in morbidly obese patients. We evaluated 10 morbidly obese subjects (BMI=52.9±11.2kg/m(2)), aged 23-58 years. Assessment of respiratory mechanics was done by the forced oscillation technique (FOT), and cardiovascular autonomic function was recorded by heart rate variability analysis (HRV). The Pearson correlation coefficient was used to test the associations between respiratory mechanics and HRV variables. There were associations between the standard deviation of all RR intervals (SDNN) and airway resistance (Rm) (r=-0.82; p=0.004), SDNN and respiratory system resistance (R0) (r=-0.79; p=0.006), root mean square of successive differences between adjacent normal RR intervals (rMSSD) and respiratory system resistance (R5) (r=-0.643; p=0.0451), rMSSD and R0 (r=-0.64; p=0.047), and rMSSD and Rm (r=-0.658; p=0.039). We concluded that the airway and respiratory system resistances are negatively associated with parasympathetic activity in patients with morbid obesity.

Simultaneous determination of E-2-nonenal and beta-damascenone in beer by reversed-phase liquid chromatography with UV detection.

A method for the simultaneous determination of E-2-nonenal and beta-damascenone in beer by reversed-phase liquid chromatography using UV detection is presented. The method consists of beer steam distillation, followed by an extraction/concentration step using Sep-Pak Plus C18 RP cartridges and determination by HPLC at 226 nm UV-absorption maximum. The identity of the compounds was confirmed by GC analysis with MS detection of the isolated fractions. A recovery factor of approximately 80% was obtained for beta-damascenone with a R.S.D. of 3%. E-2-Nonenal and beta-damascenone were monitored in a comparative study of fresh and either naturally and forced aged beer. The results obtained show that both compounds have a similar behaviour through an extended storage of beer and consequently can be used as good analytical markers of beer ageing. Nevertheless, the use of beta-damascenone seems to be more convenient because this compound appears in beer in higher concentrations than E-2-nonenal, thus making it easier to measure.

Determination of E-2-nonenal by high-performance liquid chromatography with UV detection assay for the evaluation of beer ageing.

The analysis of E-2-nonenal is of considerable interest for the brewery industry as this compound is claimed to be responsible for a paper/cardboard unpleasant flavour. Usually, the presence of E-2-nonenal can be noticed in aged beers at levels higher than 0.1 microg/l. In this work, an analytical method was developed to determine E-2-nonenal in beer involving steam distillation of beer followed by an extraction/concentration step using solid-phase extraction and determination of E-2-nonenal by HPLC with UV detection. Fastness and simplicity are the main advantages of the proposed method, when compared with other existing methodologies for the determination of E-2-nonenal in beer. Using the developed conditions, the interference of E-2-nonenal formed by degradation of its precursors during steam distillation is almost negligible. The presence of sulphur dioxide at legal levels does not interfere with the assay. The method was used in a comparative study of fresh and either naturally or forced aged beers. A much larger chromatographic peak was found near the peak of E-2-nonenal that correlates well with the peak of E-2-nonenal. Identification of the corresponding compound is currently under investigation, considering its future application on the evaluation of beer ageing.

Double blind, randomized, placebo controlled clinical trial of methotrexate in systemic lupus erythematosus.

OBJECTIVE: To evaluate the capacity of methotrexate (MTX) to control mild activity of systemic lupus erythematosus (SLE), and to evaluate the capacity of MTX to reduce steroid requirement, as well as to evaluate the side effects of MTX in patients with SLE. METHODS: A prospective, randomized, controlled, double blind trial. Forty-one patients with SLE began and 37 completed the 6 months of study. The mean disease duration was 82.5 months. Twenty patients received MTX 15-20 mg/week (MTX group) and 21 received placebo (PL group). The dose of prednisone was maintained, increased, or reduced after the first month, according to monthly clinical and laboratory evaluation. Dose of prednisone, SLE Disease Activity Index (SLEDAI) scores, the score by visual analog scale (VAS) for articular pain, and laboratory results were recorded monthly. Both groups were homogeneous and comparable for clinical manifestations and laboratory results. RESULTS: Two placebo patients dropped out due to severe flare of disease requiring hospitalization, and 2 patients taking MTX dropped out due to side effects (one with pulmonary tuberculosis, one with urticaria and severe dyspepsia). Thirty-seven patients (18 MTX and 19 PL) completed the study. At the end of the study 16 PL patients and one MTX patient presented articular complaints (p < 0.001). VAS scores for pain were significantly higher in the PL group than in the MTX group after the first month of study. Sixteen PL patients and 3 MTX patients presented cutaneous lesions after 6 months of treatment (p < 0.001). At the end of the study 4 MTX patients and 11 PL patients presented hypocomplementemia (p < 0.001). Mean SLEDAI scores in PL patients were significantly higher than in MTX patients at Months 3, 4, 5, and 6. It was possible to decrease the prednisone dose for 13 MTX patients during the study but for only one PL patient (p < 0.001). Fourteen MTX patients (70%) presented side effects, mainly dyspepsia and increase in hepatic enzyme serum levels, and 3 PL patients (14%) presented dyspepsia. CONCLUSION: MTX 15 to 20 mg/week for 6 months was effective in controlling cutaneous and articular activity of SLE and permitted prednisone dose reduction. At these doses MTX presented frequent but mild side effects that did not result in drug discontinuation in the majority of patients.

Infecçäo diagnosticada em diabéticos durante internaçäo hospitalar / Infection in diabetics during inpatient care

Objetivo. Analisar o perfil de processos infecciosos em diabéticos internados em um hospital geral. Material e Métodos. Foram selecionados, retrospectivamente, 233 prontuários de diabéticos no período de setembro a novembro de 1990. Num total de 38 (16,3 por cento) pacientes com infecçäo, 76,3 por cento (n=29) eram do sexo feminino, com média de idade de 58,9 + 15,3 anos, duraçäo do diabetes de 10,8 + 9,1 anos e predomínio do diabetes melito tipo II na amostra (86,3 por cento, n = 33). Resultados. O principal motivo de internaçäo foi a doença macrovascular de extremidades (42 por cento). Quarenta processos infecciosos foram estudados (dois pacientes apresentavam infecçäo em dois sítios). Foram realizadas culturas em 77,5 por cento dos casos, näo tendo sido observado predomínio de nenhum germe, mesmo nos diferentes sítios. A infecçäo urinária foi a mais freqüente (55 por cento, n = 22, p < 0,01) e, dessa amostra, 86,4 por cento (n = 19) eram do sexo feminino. A sepse ocorreu em 18,4 por cento (n = 7) dos pacientes; destes, a infecçäo pulmonar foi responsável por 71,4 por cento. Todos os casos de sepse foram a óbito. Conclusäo. CCnsiderando as infecçöes um fator agravante no processo mórbido de diabéticos, torna-se importante a realizaçäo de medidas profiláticas a fim de evitar o seu surgimento.

[Infection in hospitalized diabetics]. / Infeccão diagnosticada em diabéticos durante internacão hospitalar.

BACKGROUND: To analyse the infectious diseases of inpatient diabetics in a general hospital. MATERIAL AND METHODS: We selected retrospectively 233 records of diabetics admitted during September, October and November 1990. There were 38 (16.3%) patients with infection, age 58.9 +/- 15.3 years, 29 (76.3%) were female, duration of diabetes were 10.8 +/- 9.1 years and 86.3% (n = 33) were possibly DM type II. RESULTS: Peripheral macrovascular disease was the main cause of admission (42%). Forty infectious processes were analysed (two patients had two sites of infection). Cultures were performed in 77.5% of the cases and no microorganism predominated, even when different sites of infection were analysed. Urinary tract infection were the most frequent one (55%, n = 22), and 86.4% (n = 19) of them were observed in female. Pulmonary infections accounted for 71.4% of the cases of sepsis which occurred in 18.4% (n = 7) of our population. All patients with sepsis died. CONCLUSION: Considering infections a worsening factor for diabetic patients we could conclude that it is important to perform some prophylatic measures to avoid them.

Tratamento prolongado da hipertensao arterial essencial com oxprenolol e clortalidona. Importancia de um preparado de liberacao gradativa (SR). / Long term treatment of essential arterial hypertension with oxprenolol and chlortalidone. Importance of a slow-release preparation (SR)

Foi realizado um ensaio clinico a longo prazo, com a associacao de oxprenolol SR 160 mg + clortalidona 20 mg, em 24 pacientes com hipertensao arterial essencial nao complicada (estagios I e II da OMS). Os pacientes foram submetidos a uma fase inicial com placebo. A seguir receberam 1 dragea de combinacao fixa de oxprenolol de liberacao gradativa 160 mg + clortalidona 20 mg em dose unica diaria, durante 15 dias; apos este periodo a dose seria duplicada caso a PA diastolica fosse superior a 90 mmHg (fase V de Korotkoff). A duracao total do estudo com droga ativa foi de 15 meses. Ao termino do tratamento, 21 pacientes (87,5%) mantinham uma PA diatolica menor ou igual a 90 mmHg (supina). Este estudo demonstrou que a associacao acima e efetiva e bem aceita pelos pacientes com hipertensao arterial essencial nao complicada