Clinical evolution of patients hospitalized due to the first episode of Acute Coronary Syndrome

AIM: to assess the clinical evolution of patients hospitalized due to the first episode of Acute Coronary Syndrome (ACS) according to its clinical manifestation. METHODS: data were collected from 234 patients, hospitalized between May 2006 and July 2009 due to the first episode of an ACS, by consulting their medical records. RESULTS: 234 patients were hospitalized, 140 (59.8%) due to Acute Myocardial Infarction (AMI). In the group with AMI, 19.3% presented complications, against 12.8% in the group with Unstable Angina (UA) (p=0.19). Angioplasty levels were higher among patients with AMI than with UA (p=0.02) and coronary artery bypass graft surgery was more frequent among UA patients (p=0.03). The majority (227; 97%) survived after the coronary event. Among the seven patients who died during the hospitalization, four had AMI (2.9%) and three UA (3.2%). CONCLUSIONS: A larger number of complications were found among infarction victims and the accomplishment of coronary artery bypass graft surgery differed between the groups.

Nurses and care delivery to elderly women: a social phenomenological approach

OBJECTIVE: To understand how nurses see care delivery to elderly women. METHODS: In this phenomenological study, ten nurses working at Primary Health Care Units were interviewed between September 2010 and January 2011. RESULTS: In care delivery, nurses consider the elderly women's knowledge background and biographical situation, and also value the family's participation as a care mediator. These professionals have the acuity to capture these women's specific demands, but face difficulties to deliver care to these clients. Nurses expect to deliver qualified care to these women. CONCLUSION: The theoretical and methodological approach of social phenomenology permitted revealing that the nurse designs qualified care to elderly women, considering the possibilities in the context. This includes the participation of different social actors and health sectors, assuming collective efforts in action strategies and professional training, in line with the particularities and care needs of elderly women nurses identify.

Endotracheal suction in intubated critically ill adult patients undergoing mechanical ventilation: a systematic review

AIM: identify and analyze in the literature the evidence of randomized controlled trials on care related to the suctioning of endotracheal secretions in intubated, critically ill adult patients undergoing mechanical ventilation. METHOD: the search was conducted in the PubMed, EMBASE, CENTRAL, CINAHL and LILACS databases. From the 631 citations found, 17 studies were selected. RESULTS: Evidence was identified for six categories of intervention related to endotracheal suctioning, which were analyzed according to outcomes related to hemodynamic and blood gas alterations, microbial colonization, nosocomial infection, and others. CONCLUSIONS: although the evidence obtained is relevant to the practice of endotracheal aspiration, the risks of bias found in the studies selected compromise the evidence's reliability.

Influência do preparo do orifício piloto na ancoragem dos parafusos pediculares

OBJETIVO: Avaliamos a influência do diâmetro e do modo de preparação do orifício piloto na resistência ao arrancamento e no torque de inserção dos parafusos pediculares com diâmetro interno cônico. MÉTODOS: Ensaios mecânicos foram realizados com parafusos pediculares com alma cônica e diâmetro de 4,2mm e 5,2mm inseridos nos pedículos vertebrais lombares de suínos. O orifício piloto foi confeccionado com de broca e sondas (pontiaguda e cortante) com diferentes diâmetros. RESULTADOS: Testando o parafuso de 4,2mm a perfuração com orifício igual ou inferior ao menor diâmetro interno do parafuso, aumentou o torque e a resistência ao arrancamento. Perfurações com diferentes instrumentos apresentaram comportamento semelhante. Perfurações com sondas permitiram que orifícios confeccionados com dimensões superiores ao menor diâmetro interno do parafuso apresentassem resistência semelhante a das perfurações com dimensões iguais ao menor diâmetro interno do implante, realizadas com sondas e brocas. CONCLUSÕES: Nos de 4,2 mm o diâmetro e o modo de preparação do orifício influenciam o torque e a resistência, nos de 5,2 mm apenas o torque de inserção. Não há correlação entre força de arrancamento e torque de inserção. Nível de evidência II, Estudos terapêuticos - Investigação dos Resultados do Tratamento.

Sutura simples e âncora em quadris de coelhos

OBJETIVO: Por meio de ensaios biomecânicos, comparar as capsulorrafias com sutura simples e com âncoras, em quadris de coelhos. MÉTODO: Foram utilizados 13 coelhos, 26 quadris, todos machos da raça Nova Zelândia albinos (Oryctolaguscuniculus). Inicialmente, realizamos um projeto piloto em três coelhos (seis quadris). Este experimento constou de 10 coelhos, divididos em 2 grupos: o Grupo 1 submetido à capsulorrafia (quadris direito e esquerdo) com sutura simples utilizando fio absorvível de ácido poliglicólico e o Grupo 2 submetido a capsulorrafia (quadris direito e esquerdo) com âncora de titânio. Após o período de quatro semanas de operados, todos animais foram submetidos à eutanásia e seus quadris congelados. Após um descongelamento prévio das peças, no mesmo dia das análises biomecânicas, foram avaliados os parâmetros de rigidez, força máxima, deformidade máxima e energia. RESULTADOS: Não houve diferença estatisticamente significante em relação à força no limite de proporcionalidade, rigidez e força máxima entre os grupos com sutura simples e com âncora. CONCLUSÃO: Por meio dos ensaios biomecânicos, tendo como parâmetro a rigidez, a força máxima, a deformidade máxima e a energia, ficou demonstrado que as capsulorrafias em quadris de coelhos com sutura simples e com âncora são semelhantes entre si. Nível de Evidência II, Estudo Prospectivo Comparativo.

Saliva and dental erosion

Dental erosion is a multifactorial condition. The consideration of chemical, biological and behavioral factors is fundamental for its prevention and therapy. Among the biological factors, saliva is one of the most important parameters in the protection against erosive wear. Objective: This review discusses the role of salivary factors on the development of dental erosion. Material and Methods: A search was undertaken on MeDLINe website for papers from 1969 to 2010. The keywords used in the research were "saliva", "acquired pellicle", "salivary flow", "salivary buffering capacity" and "dental erosion". Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. Results: Several characteristics and properties of saliva play an important role in dental erosion. Salivary clearance gradually eliminates the acids through swallowing and saliva presents buffering capacity causing neutralization and buffering of dietary acids. Salivary flow allows dilution of the acids. In addition, saliva is supersaturated with respect to tooth mineral, providing calcium, phosphate and fluoride necessary for remineralization after an erosive challenge. Furthermore, many proteins present in saliva and acquired pellicle play an important role in dental erosion. Conclusions: Saliva is the most important biological factor affecting the progression of dental erosion. Knowledge of its components and properties involved in this protective role can drive the development of preventive measures targeting to enhance its known beneficial effects.

In-situ XANES experiments on Ni K-edge in mesoporous ZrO2-CeO2:Ni.

Ordered mesoporous ZrO2-CeO2 mixed oxides are potential candidates for catalytic applications. These systems, used as anodes in solid oxide fuel cells (SOFC), may lead to better performance of SOFCs, due to an enhancement on surface area, aiming to achieve a lower working temperature. The aim of this studies is to evaluate the reduction capacity of Ni2+ to Ni in ZrO2-x(mol)%CeO2 (x=50 and 90) samples impregnated with 60(wt.)%NiO. The synthesis was made with Zr and Ce chloride precursors, HCl aqueous solution, Pluronic P123, NH4OH to adjust the pH (3-4) and a teflon autoclave to perform a hydrothermal treatment (80oC/48h). The samples were dried and calcined, until 540oC in N2 and 4 hours in air. The NiO impregnation was made with an ethanol dispersion of Ni(NO3)£6H2O. The powder was calcinated in air until 350oC for 2 hours. Temperature-resolved XANES data at the Ni K-edge were collected at the DXAS beam line of the LNLS in transmission mode, using a Si(111) monochromator and a CCD detector. Sample preparation consisted of mixing »6mg of the powder samples with boron nitride and pressing into pellets. The data were acquired during an experiment of temperature programmed reduction (TPR) under a 5% H2/He until 600oC and mixtures of 20%CH4:5%O2/He, at temperatures from 400 to 600oC. All the reactions were monitored with a mass spectrometer. The data was analyzed with a linear combination fit of 2 standards for each valence number using Athena software. The Ni K-edge experiments demonstrated that for both contents of CeO2, NiO embedded in the porous zirconia-ceria matrix reduces at lower temperatures than pure NiO, revealing that the ZrO2-CeO2 support improves the reduction of impregnated NiO. Ni was oxidized to NiO after all reactions with methane and oxygen. Hydrogenated carbonaceous species were detected, but under reducing conditions, the hydrocarbon compounds are removed. The reaction of total oxidation of methane CH4:O2 (1:2 ratio) was observed at lower temperatures (around 400oC) for both samples.

Effect of simvastatin in the autonomic system is dependent on the increased gain/sensitivity of the baroreceptors

A number of mechanisms have been proposed to explain the pleiotropic effect of statin therapy to reduce sympathetic outflow in cardiovascular disease. We tested the hypothesis that statin treatment could improve baroreflex gain-sensitivity triggered by morphological adaptations in the mechanoreceptor site, thus reducing sympathetic activity, regardless of arterial pressure (AP) level reduction. Male spontaneously hypertensive rats (SHR) were divided into control (SHR, n = 8) and SHR-simvastatin (5 mg/kg/day, for 7 days) (SHR-S, n = 8). After treatment, AP, baroreflex sensitivity (BRS) in response to AP-induced changes, aortic depressor nerve activity, and spectral analyses of pulse interval (PI) and AP variabilities were performed. Internal and external carotids were prepared for morphoquantitative evaluation. Although AP was similar between groups, sympathetic modulation, represented by the low frequency band of PI (SHR: 6.84 ± 3.19 vs. SHR-S: 2.41 ± 0.96 msec2) and from systolic AP variability (SHR: 3.95 ± 0.36 vs. SHR-S: 2.86 ± 0.18 mmHg2), were reduced in treated animals. In parallel, simvastatin induced an increase of 26% and 21% in the number of elastic lamellae as well as a decrease of 9% and 25% in the carotid thickness in both, external and internal carotid, respectively. Moreover, improved baroreceptor function (SHR: 0.78 ± 0.03 vs. SHR-S: 1.06 ± 0.04% mv/mmHg) was observed in addition to a 115% increase in aortic depressor nerve activity in SHR-S rats. Therefore, our data suggest that the reduction of sympathetic outflow in hypertension by simvastatin treatment may be triggered by structural changes in the carotid arteries and increased BRS in response to an improvement of the baroreceptors discharge and consequently of the afferent pathway of the baroreflex arch.

Investigation of Ground- and Excited-State Photophysical Properties of 5,10,15,20-Tetra(4-pyridyl)-21H,23H-porphyrin with Ruthenium Outlying Complexes

The present work employs a set of complementary techniques to investigate the influence of outlying Ru(II) groups on the ground- and excited-state photophysical properties of free-base tetrapyridyl porphyrin (H(2)TPyP). Single pulse and, pulse train Z-scan techniques used M association with laser flash photolysis, absorbance and fluorescence spectroscopy, and fluorescence decay measurements, allowed us to conclude that the presence of outlying Ru(II) groups causes significant changes on both electronic structure and vibrational properties of porphyrin. Such modifications take place mainly due to the activation of. nonradiative decay channels responsible for the emission, quenching, as well as by favoring some vibrational modes in the light absorption process, It is also observed that, differently from what happens when the Ru(II) is placed at the center of the macrocycle, the peripheral groups cause an increase of the intersystem crossing processes, probably due to the structural distortion of the ring that implies a worse spin orbit coupling, responsible for the intersystem crossing mechanism.

5-(1-(4-phenyl)-3-(4-nitrophenyl)triazene)-10,15,20-triphenylporphyrin: a new triazene-porphyrin dye and its spectroelectrochemical properties

The new triazene-porphyrin dye 5-(1-(4-phenyl)-3-(4-nitrophenyl)triazene)-10,15,20-triphenylporphyrin, encompassing a reactive protonated triazene moiety, was prepared starting from meso-tetraphenylporphyrin (H2TPP), first converting it to the 5-(4-nitrophenyl)-10,15,20-triphenylporphyrin, then reducing to the 5-(4-aminophenyl)-10,15,20-tri(phenyl) porphyrin intermediate, and reacting with the diazonium salt of 4-nitroaniline; and characterized by spectroscopic and electrochemical methods. The absorption spectrum of the neutral species resembled the sum of H2TPP and of 1,3-bis(4-nitrophenyl) triazene spectrum, but the deprotonated anionic species showed more delocalized frontier orbitals, behaving as a push-pull system exhibiting triazenide-to-porphyrin charge-transfer transitions.