Cardiac cachexia

Patients with chronic heart failure (CHF) may develop a wasting syndrome, termed cardiac cachexia. This condition should be diagnosed when weight loss of more than 7.5% of the premorbid normal weight occurs over a time period of more than 6 months. Although the pathophysiologic causes of body wasting in patients with CHF remain unclear, studies have suggested that reduction of the dietary ingestion, intestinal malabsorption of nutrients, increased resting metabolic rates, and humoral neuroendocrine and immunologic abnormalities may play a role. The development of cachexia in the patients with CHF results in clinical symptoms, adverse consequences on the heart, and impaired survival.

Brazilian consensus on gastroesophageal reflux disease: Proposals for assessment, classification, and management

The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation short Barrett's is not important in terms of management and prognosis. © 2002 by Am. Coll. of Gastroenterology.

The monosodium glutamate (MSG) obese rat as a model for the study of exercise in obesity

Obesity is an increasing problem in several countries, leading to health problems. Physical exercise, in turn, can be used effectively by itself or in combination with dietary restriction to trigger weight loss. The present study was designed to evaluate the effects of aerobic exercise training on lipid profile of obese male Wistar rats in order to verify if this model may be of value for the study of exercise in obesity. Obesity was induced by MSG administration (4mg/g, each other day, from birth to 14 days old) After 14 from drug administration, the rats were separated into two groups: MSG-S (sedentary) and MSG-T (exercise trained). Exercise training consisted in 1h/day, 5 days/week, with an overload of 5% bw, for 10 weeks. Rats of the same age and strain, receiving saline at birth, were used as control (C), and subdivided into two groups: C-S and C-T. At the end of the experimental period, MSG-T and C-T rats showed similar blood lactate and muscle glycogen responses to exercise training and acute exercise. MSG-S rats showed significantly higher carcass fat, serum triacylglycerol, serum insulin and liver total fat than C-S rats. On the other hand, MSG-T rats had lower carcass fat, serum triacylglycerol and liver total fat than MSG-S rats. There were no statistical differences in food intake and serum free fatty acids among the groups studied. These data indicate that this model may be of value for the study of exercise effects on tissue and circulating lipid profile in obesity.

Structural study of aged saturated silica gels obtained from tetramethoxysilane sonohydrolysis with different water/tetramethoxysilane molar ratio

The structural characteristics of saturated silica sonogels were studied by means of small-angle x-ray scattering (SAXS) and thermogravimetric analysis (TG), after a long time of aging in saturated conditions. The sonogels were obtained by a sol-gel routine from ultrasound stimulated tetramethoxysilane (TMOS) hydrolysis carried out with the initial water/TMOS molar ratio (r) ranging from 2 to 10. The saturated sonogel structure can be described as composed by mass fractal-like aggregates (clusters) of primary silica particles, all imbibed in a liquid phase. The values of the mass fractal dimension (D) of the clusters was found all around 2.5, while the characteristic size of the clusters (ξ) was found generally increasing with r, going from approximately 2.3 nm (r = 2) to 4.5 nm (r = 10). The volume fraction of the clusters was estimated from the SAXS data. The results were compared to the values of weight loss fraction at the inflection point that has been found in the derivative of the TG curve, which should accounts for the instant in which the meniscus of the liquid phase penetrates into the clusters under a rapid evaporation process as in a TG test.

Exercício contínuo e intermitente: Efeitos do treinamento e do destreinamento sobre a gordura corporal de ratos obesos

Exercise training is often recommended in prevention and treatment of obesity. The present study was designed to compare the effects of intermittent and continuous exercise on weight loss and carcass composition in obese rats. Obese male Wistar rats (monosodium glutamate [MSG] administration, 4 mg/g of body weight every other day from birth to 14 days old) were used. After drug administration, the rats were separated into three groups: MSG-SED (sedentary), MSG-CONT (continuous, swimming, 45 min/day, 5 days/week, with and overload of 5% body weight for 12 weeks) and MSG-INT (intermittent, 15s swimming intermitted by 15s rest, during 45 min, 5 days/week, with and overload of 15% body weight for 12 weeks). Rats of the same age and strain, administered with saline were used as control (SAL), and subdivided into three groups: SAL-SED, SAL-CONT and SAL-INT. The animals were evaluated at the 10 weeks of training and 8 weeks of its interruption. MSG rats showed higher carcass fat as well as weight and cell size in epididymal adipose tissue than SAL rats, indicting the efficacy of the drug in producing obesity. Intermittent training protocol led to a reduction in blood lactate accumulation during acute exercise and both protocols reduced body weight gain during the experiment in MSG rats. After 8 weeks of training interruption no differences were observed among groups in the examined parameters. Only intermittent exercise training improved aerobic fitness but both protocols were similarly efficient in determining weight loss. However, the effects were transitory, since they disappeared after detraining.

Estudio de la adición de K+ y LiNbO3 en las propiedades finales del relaxor PMN procesado por mezcla de polvos

PMN ceramic relaxor has been investigated by several researchers and many aspects of this material, like powder morphology, phase decomposition, weight loss during sintering process, densification, between others, still are investigated. PMN powder preparation has been shown more efficient when synthesized by columbite route, however lead addition stage for the PMN powder synthesis remains problematical. Therefore, this work proposes a new association of methodologies, using columbite route and the hydroxide precipitation method. Through use of the powder mixture technique, which permitted to obtain good green and sintered densities, was possible to observe K+ y Li + dopants reduce weight loss in sintering process and change significantly the dielectric properties. Addition of LiNbO3 seeds in conformation stage, which react in a distinct way as a function of the particle size, promotes the formation of differenced grains in the ceramic bulk. Consequently, very different dielectrics properties from conventional PMN ceramic were obtained.

Pediatras e os distúrbios respiratórios do sono na criança

OBJECTIVES. assessment of opinions and practices of pediatricians concerning sleep-disordered breathing (SDB) in children. Methods. randomly 516 pediatricians were selected in the state of São Paulo, Brazil. A survey mailed to them included questions regarding: their professional profile, knowledge about SDB in childhood, opinions and practices for diagnosis and treatment of these diseases. RESULTS. 112 anonymous completed surveys were returned (21.7%). The teaching of SDB during medical school and pediatric residency training was considered unsatisfactory respectively by 65.2% and 34.8% of the pediatricians. Forty-nine respondents (43.8%) rated their knowledge about SDB in children as regular, 39 (34.8%) as good and 17 (15.2%) as unsatisfactory. The most important sleep-related questions were: mouth breathing, breathing pauses, sleep amount, excessive daytime sleepiness and nocturnal wheezing. Clinical aspects regarded as the most significant for suspecting obstructive sleep apnea syndrome (OSAS) were: breathing pauses, adenoid hypertrophy, mouth breathing, craniofacial anomaly and snoring. The most frequent practices for evaluation of OSAS in children were: cavum radiography with referral to an otorhinolarnygologist (25%) and nocturnal pulse oximetry (14.2%). Only 11.6% of pediatricians recommended overnight polysomnography and 4.5%, nap polysomnography. The most effective practices for SDB were considered to be: adenoidectomy and adenotonsillectomy, parents counseling, weight loss and sleep hygiene. CONCLUSIONS. there is a gap between research on SDB in childhood and pediatric practice. © 2006 Associação Médica Brasileira.

Minimally processed guava Fruits (Psidium guaiava L.)

'Paluma' guavas, after internal quality evaluation using magnetic resonance tomography, were used to produce fresh-cut product. Fruits were peeled or not, cut in halves and seed removed, and they were packaged in polystyrene trays covered with PVC film or in a PET container with a lid. These packages were stored for 12 days at 5°C, 10°C and ambient temperature (22.6°C). Tomography evaluation verified that impacts produced internal bruising with loss of cellular integrity and liquefication of the placenta tissues. Compression was more evident on the pericarp and cutting promoted superficial deformation. Storage temperature affected the weight loss, with fruit packaged in the polystyrene tray having a greater weight loss. The peeling did not influence weight loss. Product stored at 5°C and 10°C for 8 days had low microbial growth (<103 UFC.g-1) and no coliforms. Rapid spoilage and a short shelf life (3-4 days) occurred when the product was stored at ambient temperature. Peeling reduced ascorbic acid concentration and total soluble solids. Use of calcium to protect fresh-cut products was not efficient. Calcium absorption capacity of 'Pedro Sato' guava was tested using 45Ca. Fruits treated with 2% CaCl2, with or without the radioisotope, were divided in four layers (epicarp, mesocarp, endocarp and seed) and analyzed for the total and 45Ca calcium. It was observed that the applied calcium remained in superficial layers of45fruits, which was confirmed by autoradiography. Internal layers did not contain 45Ca, indicating that calcium was not distributed into different parts of the fruit.

Contribuiçã ao estudo de caracterizaçã de depó formados no papel

Deposits formed on the surface of. paper were analysed in order to identify the sources of the defects, as well as to solve the problems associated with performance and adjustments at the wet end of the paper forming process. Standard paper samples containing deposits were collected and analysed by comparing the microstructure and composition of the deposit with paper regions adjacent to it. Optical microscopy (OM). energy dispersive X-ray microanalysis (EDX) X-ray powder diffraction (XRD). thermogravimetric analysis (TGA) and scanning electron microscopy (SEM) were the techniques used in this study. The results obtained from the EDX, XRD. and TG techniques allowed concluding that the calcium carbonate content in the farm of calcite is 1.6 times higher in the formed deposit them the quantity expected in the standard paper composition. The paper sample microstructure revealed by the SEM images indicates the presence of irregular spherical aggregates up to 20μm in diameter in the deposit region. containing larger amount of calcium carbonate as well as in the regions adjacent to the deposit. These spherical aggregates seem to be absorbed and integrated into the pulp fibres and present characteristics similar to those of partially cooked cationic starch. The analysed deposits are characterised by a dense and thick substance, forming a plate with highly adhesive property. This adhesive substance has a characteristic similar to glue with a large amount of organic matter due to the high weight loss shown by the TG curve. The results are consistent with the interaction ofparticles of negatively charged calcium carbonate and cationic starch, forming sterically stabilized deposits, which firmly adhere to the paper microstructure.

Bone regeneration in cranioplasty and clinical complications in rabbits with alloxan-induced diabetes

This research evaluated the bone repair process in surgical defects created on the parietal bones of diabetic rabbits using the guided bone regeneration technique to observe the effects of alloxan in the induction of diabetes mellitus. Twenty-four adult rabbits were divided into three study groups: control (C), diabetic (D) and diabetic associated to polytetrafluoroethylene (PTFE) membrane (D-PTFE). For diabetes induction the animals received one dose of monohydrated alloxan (90 mg/kg) by intravenous administration in the auricular or femoral vein. In group D-PTFE the membrane covered both the floor and the surface of the bone defect. In groups D and C, the bone defect was filled up with blood clot. The specimens were fixed in 10% formol and prepared for histomorphometric analysis. The results showed that the 90 mg/kg dose of monohydrate alloxan was sufficient to promote diabetes mellitus when administered in the auricular vein. Bone regeneration was slower in the diabetic group when compared with the control and diabetic-PTFE groups, but there was no significant statistical difference between the two experimental groups (D and D-PTFE). The oral and general clinical complications among the diabetics were weight loss, polyuria, polyphagia and severe chronic gingivitis.

α-SiAION: Development and machining test on gray cast iron

The α-SiAlON ceramic cutting tool insert is developed. Silicon nitride and additives powders are pressed and sintered in the form of cutting tool inserts at temperature of 1900 °C. The physics and mechanical properties of the inserts like green density, weight loss, relative density, hardness and fracture toughness are evaluated. Machining studies are conducted on grey cast iron workpiece to evaluate the performance of α-SiAlON ceramic cutting tool. In the paper the cutting tool used in higher speed showed an improvement in the tribological interaction between the cutting tools and the grey cast iron workpiece resulted in a significant reduction of flank wear and roughness, because of better accommodation and the presence of the graphite in gray cast iron. The above results are discussed in terms of their affect at machining parameters on gray cast iron.

Evolução da perda de peso entre indivíduos da fila de espera para a cirurgia bariátrica em um ambulatório multidisciplinar de atenção secundária à saúde

Objective: The objective of this study is to characterize the assistance and analyze patient's adherence to nutritional follow-up while in the waiting line for bariatric surgery in a multidisciplinary, secondary healthcare outpatient clinic. Methods: This retrospective study was based on the nutritional records of 59 patients subjected to bariatric surgery at the Hospital das Clinics de Botucatu, from 2001 to 2008. The population studied was distributed into 8 groups and analyzed according to follow-up duration. The analysis took into account the evolution of body weight and the number of follow-up visits in a given period. The Kruskal-Wallis test was used to compare data between groups while Spearman's coefficient was used to test correlations. Results: Among the 59 studied patients, 42 (71.2%) returned to the clinic at least once in six months. Of these, 67.8% lost weight while in the waiting line and 27.1% of them lost more than 10% of their body weight. The greatest weight losses in the preoperative period were found in the groups that had more than six months of nutrition follow-up. There was a mean delay of three months between return visits, which could have contributed to the low adherence to follow-up. Conclusion: The patients in the waiting line for surgery analyzed in this study presented low adherence to the long-spaced return visits. The greatest weight losses were observed in groups that had been followed for more than six months. This shows that, to achieve the desired weight loss and an adequate education process before surgery, at least six months of follow-up and regular visits are necessary.

Effects of physical exercise and cinnamon extract on blood chemistry of type 1 diabetic rats

The present study was designed to analyze the effects of the association between cinnamon extract and aerobic exercise on the glycemic control and serum lipid profile of diabetic rats. Fifty Wistar male rats divided into five groups: control (C), sedentary nondiabetic rats; diabetic (D), sedentary diabetic rats; diabetic cinnamon (DC), sedentary diabetic rats that received cinnamon extract; diabetic exercise (DE), sedentary diabetic rats subjected to physical training; and diabetic cinnamon exercise (DCE), diabetic rats that received cinnamon extract and were subjected to physical training. For the induction of diabetes, the rats received alloxan. The cinnamon was administered to once a day for four weeks. The groups performed swimming exercises for one hour each day with lead overloads (3% - 5% of b.w) for five days a week for four weeks. Body weight loss was lower in the DE group compared to the other diabetic groups. The basal serum glucose of all the diabetic groups was higher compared to the control group. Group D had higher serum cholesterol concentrations compared to the DE and DCE groups. The resting blood lactate in group D was higher than the resting blood lactate in the DC and DE groups. Aerobic exercise partially counteracted the diabetic effects on body weight, serum cholesterol and blood lactate concentrations. No additional beneficial effects of cinnamon extract and aerobic exercise were observed on the parameters studied.

Effectiveness of three solvents and two associations of solvents on gutta-percha and Resilon

This study evaluated the effectiveness of 3 solvents (Citrol orange oil, Eucalyptol and Tetrachloroethylene) and 2 associations of solvents (Citrol orange oil+Tetrachloroethylene and Eucalyptol+Tetrachloroethylene) on 3 types of gutta-percha (conventional, thermoplastic and EndoREZ) and Resilon. Ten discs (10 mm diameter x 1 mm thick) from each material were prepared using standard metallic molds. Each specimen was weighed to determinate its initial mass. The specimens were immersed in the solvents for 10 min, followed by immersion in distilled water for 20 min, and were then reweighed to obtain the final mass. The mean weight loss determined the solvent capacity. Data were analyzed by ANOVA and Tukey's test at 5% significance level. Tetrachloroethylene was the most effective on conventional gutta-percha (p<0.05). Tetrachloroethylene was also the most effective on thermoplastic gutta-percha, but it was not significantly different (p>0.05) from Eucalyptol+Tetrachloroethylene, Citrol+Tetrachloroethylene, and Citrol. All solvents and associations presented little effectiveness on Resilon. The association Eucalyptol+Tetrachloroethylene was the most effective on EndoREZ, but it did not differ significantly (p>0.05) from Citrol+Tetrachloroethylene and Tetrachloroethylene. All evaluated substances presented solvent action. Tetrachloroethylene improved the effectiveness of both Citrol and Eucalyptol.

Renal cell carcinoma with cutaneous metastasis in a dog

The present report describes the occurrence of skin metastasis in a dog with primary renal carcinoma. The clinical findings included progressive weight loss, inappetence, palpable abdominal mass and cutaneous nodules. The histopathological examination was carried out after unilateral nephrectomy and was confirmed by immunohistochemistry. The immunohistochemical and histopathological findings characterized this case as renal cell carcinoma with skin metastasis.