T-wave alternans: desempenho clínico, limitações, metodologias de análise

Reconhecer com precisão indivíduos com maior risco imediato de morte súbita cardíaca (MSC) ainda é uma questão em aberto. A natureza fortuita dos eventos cardiovasculares agudos não parece se adequar ao conhecido modelo de indução de taquicardia/fibrilação ventricular por um gatilho em sincronia a um substrato arritmogênico estático. Quanto ao mecanismo da MSC, uma instabilidade elétrica dinâmica explicaria melhor a raridade da associação simultânea de um gatilho certo a um substrato cardíaco apropriado. Diversos estudos tentaram medir essa instabilidade elétrica cardíaca (ou um equivalente válido) em uma sequência de batimentos cardíacos no ECG. Dentre os mecanismos possíveis podemos citar o prolongamento do QT, dispersão do QT, potenciais tardios, alternância de onda T ou T-wave alternans (TWA), e turbulência da frequência cardíaca. Este artigo se atém em particular ao papel da TWA no panorama atual da estratificação de risco cardíaco. Os achados sobre TWA ainda são heterogêneos, variando de um desempenho prognóstico muito bom até um quase nulo, dependendo da população clínica observada e protocolo clínico usado. Para preencher as atuais lacunas no conhecimento sobre TWA, profissionais médicos e pesquisadores devem explorar melhor as características técnicas das diversas tecnologias disponíveis para a avaliação de TWA e atentar ao fato de que os valores de TWA respondem a diversos outros fatores, além de medicamentos. Informações sobre mecanismos celulares e subcelulares da TWA estão fora do escopo deste artigo, mas são referenciados alguns dos principais trabalhos sobre este tópico, com o intuito de auxiliar no entendimento dos conceitos e fatos cobertos neste artigo.

Influence of incorporation of fluoroalkyl methacrylates on roughness and flexural strength of a denture base acrylic resin

Fluorinated denture base acrylic resins can present more stable physical properties when compared with conventional polymers. This study evaluated the incorporation of a fluoroalkyl methacrylate (FMA) mixture in a denture base material and its effect on roughness and flexural strength. A swelling behavior assessment of acrylic resin specimens (n=3, per substance) after 12 h of FMA or methyl methacrylate (MMA) immersion was conducted to determine the solvent properties. Rectangular specimens (n=30) were allocated to three groups, according to the concentration of FMA substituted into the monomer component of a heat-polymerized acrylic resin (Lucitone 550), as follows: 0% (control), 10% and 20% (v/v). Acrylic resin mixed with concentrations of 25% or more did not reach the dough stage and was not viable. The surface roughness and flexural strength of the specimens were tested. Variables were analyzed by ANOVA and Tukey's test (a=0.05). Immersion in FMA produced negligible swelling, and MMA produced obvious swelling and dissolution of the specimens. Surface roughness at concentrations of 0%, 10% and 20% were: 0.25 ± 0.04, 0.24 ± 0.04, 0.22 ± 0.03 mm (F=1.78; p=0.189, not significant). Significant differences were found for flexural strength (F=15.92; p<0.001) and modulus of elasticity (F=7.67; p=0.002), with the following results: 96 ± 6, 82 ± 5, 84 ± 6 MPa, and 2,717 ± 79, 2,558 ± 128, 2574 ± 87 MPa, respectively. The solvent properties of FMA against acrylic resin are weak, which would explain why concentrations over 20% were not viable. Surface changes were not detected after the incorporation of FMA in the denture base acrylic resin tested. The addition of FMA into denture base resin may lower the flexural strength and modulus of elasticity, regardless of the tested concentration.

Heat treatment of a direct composite resin: influence on flexural strength

The purpose of this study was to evaluate the flexural strength of a direct composite, for indirect application, that received heat treatment, with or without investment. One indirect composite was used for comparison. For determination of the heat treatment temperature, thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) were performed, considering the initial weight loss temperature and glass transition temperature (Tg). Then, after photoactivation (600 mW/cm² - 40 s), the specimens (10 x 2 x 2 mm) were heat-treated following these conditions: 170ºC for 5, 10 or 15 min, embedded or not embedded in investment. Flexural strength was assessed as a means to evaluate the influence of different heat treatment periods and investment embedding on mechanical properties. The data were analyzed by ANOVA and Tukey's test (α = 0.05). TGA showed an initial weight loss temperature of 180ºC and DSC showed a Tg value of 157°C. Heat treatment was conducted in an oven (Flli Manfredi, Italy), after 37°C storage for 48 h. Flexural strength was evaluated after 120 h at 37°C storage. The results showed that different periods and investment embedding presented similar statistical values. Nevertheless, the direct composite resin with treatments presented higher values (178.7 MPa) compared to the indirect composite resin (146.0 MPa) and the same direct composite submitted to photoactivation only (151.7 MPa). Within the limitations of this study, it could be concluded that the heat treatment increased the flexural strength of the direct composite studied, leading to higher mechanical strength compared to the indirect composite.

Flexural strength and hardness of direct and indirect composites

The objective of this study was to evaluate the flexural strength (σf) and hardness (H) of direct and indirect composites, testing the hypotheses that direct resin composites produce higher σf and H values than indirect composites and that these properties are positively related. Ten bar-shaped specimens (25 mm x 2 mm x 2 mm) were fabricated for each direct [D250 - Filtek Z250 (3M-Espe) and D350 - Filtek Z350 (3M-Espe)] and indirect [ISin - Sinfony (3M-Espe) and IVM - VitaVM LC (Vita Zahnfabrik)] materials, according to the manufacturer's instructions and ISO4049 specifications. The σf was tested in three-point bending using a universal testing machine (EMIC DL 2000) at a crosshead speed of 0.5 mm/min (ISO4049). Knoop hardness (H) was measured on the specimens' fragments resultant from the σf test and calculated as H = 14.2P/l², where P is the applied load (0.1 kg; dwell time = 15 s) and l is the longest diagonal of the diamond shaped indent (ASTM E384). The data were statistically analyzed using Anova and Tukey tests (α = 0.05). The mean σf and standard deviation values (MPa) and statistical grouping were: D250 - 135.4 ± 17.6a; D350 - 123.7 ± 11.1b; ISin - 98.4 ± 6.4c; IVM - 73.1 ± 4.9d. The mean H and standard deviation values (kg/mm²) and statistical grouping were: D250 - 98.12 ± 1.8a; D350 - 86.5 ± 1.9b; ISin - 28.3 ± 0.9c; IVM - 30.8 ± 1.0c. The direct composite systems examined produce higher mean σf and H values than the indirect composites, and the mean values of these properties were positively correlated (r = 0.91), confirming the study hypotheses.

Flexural and diametral tensile strength of composite resins

This study evaluated the flexural strength (sf) and the diametral tensile strength (st) of light-cured composite resins, testing the hypothesis that there is a positive relation between these properties. Twenty specimens were fabricated for each material (Filtek Z250- 3M-Espe; AM- Amelogen, Ultradent; VE- Vit-l-escence, Ultradent; EX- Esthet-X, Dentsply/Caulk), following ISO 4049 and ANSI/ADA 27 specifications and the manufacturers’ instructions. For the st test, cylindrical shaped (4 mm x 6 mm) specimens (n = 10) were placed with their long axes perpendicular to the applied compressive load at a crosshead speed of 1.0 mm/min. The sf was measured using the 3-point bending test, in which bar shaped specimens (n = 10) were tested at a crosshead speed of 0.5 mm/min. Both tests were performed in a universal testing machine (EMIC 2000) recording the fracture load (N). Strength values (MPa) were calculated and statistically analyzed by ANOVA and Tukey (a = 0.05). The mean and standard deviation values (MPa) were Z250-45.06 ± 5.7; AM-35.61 ± 5.4; VE-34.45 ± 7.8; and EX-42.87 ± 6.6 for st; and Z250-126.52 ± 3.3; AM-87.75 ± 3.8; VE-104.66 ± 4.4; and EX-119.48 ± 2.1 for sf. EX and Z250 showed higher st and sf values than the other materials evaluated (p < 0.05), which followed a decreasing trend of mean values. The results confirmed the study hypothesis, showing a positive relation between the material properties examined.

Determination of 5-aminosalicylic acid in pharmaceutical formulations by square wave voltammetry at pencil graphite electrodes

An analytical method for the determination of the anti-inflammatory drug 5-aminosalicylic acid (5-ASA) in pharmaceutical formulations using square wave voltammetry at pencil graphite electrodes was developed. After the optimization of the experimental conditions, calibration curves were obtained in the linear concentration range from 9.78 × 10-7 to 7.25 × 10-5 mol L-1 resulting in a limit of detection of 2.12 ± 0.05 x 10-8 mol L-1. Statistical tests showed that the concentrations of 5-ASA in commercial tablets and enemas obtained with the proposed voltammetric method agreed with HPLC values at a 95% confidence level.

Brazilian offshore wave climate based on NWW3 reanalysis

This paper provides a description of the wave climate off the Brazilian coast based on an eleven-year time series (Jan/1997-Dec/2007) obtained from the NWW3 operational model hindcast reanalysis. Information about wave climate in Brazilian waters is very scarce and mainly based on occasional short-term observations, the present analysis being the first covering such temporal and spatial scales. To define the wave climate, six sectors were defined and analyzed along the Brazilian shelf-break: South (W1), Southeast (W2), Central (W3), East (W4), Northeast (W5) and North (W6). W1, W2 and W3 wave regimes are determined by the South Atlantic High (SAH) and the passage of synoptic cold fronts; W4, W5 and W6 are controlled by the Intertropical Convergence Zone (ITCZ) and its meridional oscillation. The most energetic waves are from the S, generated by the strong winds associated to the passage of cold fronts, which mainly affect the southern region. Wave power presents a decrease in energy levels from south to north, with its annual variation showing that the winter months are the most energetic in W1 to W4, while in W5 and W6 the most energetic conditions occur during the austral summer. The information presented here provides boundary conditions for studies related to coastal processes, fundamental for a better understanding of the Brazilian coastal zone.

Evaluation of left ventricular diastolic echocardiographic parameters in healthy dogs by pulsed-wave Doppler

Left ventricular diastolic dysfunction plays an important role on heart failure progression. In order to obtain additional reference values of left ventricular diastolic parameters and investigate influence of common variables, peak E wave (peak E), peak A wave (peak A), E/A ratio (E/A), E wave deceleration time (EDT) and isovolumic relaxation time (IRVT) were studied in 40 clinically healthy dogs, by pulsed wave Doppler. The following values were obtained: peak E = 0.747 ± 0.117 m/s, peak A = 0.487 ± 0.062 m/s, E/A = 1.533 ± 0.198, EDT = 88.7 ± 9.2 ms and IRVT = 0.080 ± 0.009 s. Some parameters were influenced by heart rate (peak E, peak A and IRVT), by age (peak A and E/A) and by body weight (TRIV). Gender influence was absent. Values obtained can be used as reference for canine specimens but its interpretation should consider on the influence of related variables.

Matter-wave two-dimensional solitons in crossed linear and nonlinear optical lattices

The existence of multidimensional matter-wave solitons in a crossed optical lattice (OL) with a linear optical lattice (LOL) in the x direction and a nonlinear optical lattice (NOL) in the y direction, where the NOL can be generated by a periodic spatial modulation of the scattering length using an optically induced Feshbach resonance is demonstrated. In particular, we show that such crossed LOLs and NOLs allow for stabilizing two-dimensional solitons against decay or collapse for both attractive and repulsive interactions. The solutions for the soliton stability are investigated analytically, by using a multi-Gaussian variational approach, with the Vakhitov-Kolokolov necessary criterion for stability; and numerically, by using the relaxation method and direct numerical time integrations of the Gross-Pitaevskii equation. Very good agreement of the results corresponding to both treatments is observed.

Spin-wave fluctuations in ferrimagnetic Mg(x)Fe(3-x)O(4) nanoparticles

We have performed a systematic study of the magnetic properties of a series of ferrimagnetic nanoparticles of Mg(x)Fe(3-x)O(4) (0.8 <= x <= 1.5) prepared by the combustion reaction method. The magnetization data can be well fitted by Bloch's law with T(3/2). Bloch's constant B determined from the fitting procedure was found to increase with Mg content x from similar to 3.09 X 10(-5) K(-3/2) for x = 0.8 to 6.27 X 10(-5) K(-3/2) for x=1.5. The exchange integral J(AB) and the spin-wave stiffness constant D of Mg(x)Fe(3-x)O(4) nanoparticles were also determined as similar to 0.842 and 0.574 meV and 296 and 202 meV angstrom(2) for specimens with x=0.8 and 1.5, respectively. These results are discussed in terms of cation redistribution among A and B sites on these nanostructured spinel ferrites. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3359709]

Nonmonotonic thickness dependence of spin wave energy in ultrathin Fe films: Experiment and theory

High wave-vector spin waves in ultrathin Fe/W(110) films up to 20 monolayers (MLs) thick have been studied using spin-polarized electron energy-loss spectroscopy. An unusual nonmonotonous dependence of the spin wave energies on the film thickness is observed, featuring a pronounced maximum at 2 ML coverage. First-principles theoretical study reveals the origin of this behavior to be in the localization of the spin waves at the surface of the film, as well as in the properties of the interlayer exchange coupling influenced by the hybridization of the electron states of the film and substrate and by the strain.

Electromagnetic Wave Scattering by Schwarzschild Black Holes

We analyze the scattering of a planar monochromatic electromagnetic wave incident upon a Schwarzschild black hole. We obtain accurate numerical results from the partial wave method for the electromagnetic scattering cross section and show that they are in excellent agreement with analytical approximations. The scattering of electromagnetic waves is compared with the scattering of scalar, spinor, and gravitational waves. We present a unified picture of the scattering of all massless fields for the first time.

Scalar resonances in a unitary pi pi S-wave model for D(+)->pi(+)pi(-)pi(+)

We propose a model for D(+)->pi(+)pi(-)pi(+) decays following experimental results which indicate that the two-pion interaction in the S wave is dominated by the scalar resonances f(0)(600)/sigma and f(0)(980). The weak decay amplitude for D(+)-> R pi(+), where R is a resonance that subsequently decays into pi(+)pi(-), is constructed in a factorization approach. In the S wave, we implement the strong decay R ->pi(+)pi(-) by means of a scalar form factor. This provides a unitary description of the pion-pion interaction in the entire kinematically allowed mass range m(pi pi)(2) from threshold to about 3 GeV(2). In order to reproduce the experimental Dalitz plot for D(+)->pi(+)pi(-)pi(+), we include contributions beyond the S wave. For the P wave, dominated by the rho(770)(0), we use a Breit-Wigner description. Higher waves are accounted for by using the usual isobar prescription for the f(2)(1270) and rho(1450)(0). The major achievement is a good reproduction of the experimental m(pi pi)(2) distribution, and of the partial as well as the total D(+)->pi(+)pi(-)pi(+) branching ratios. Our values are generally smaller than the experimental ones. We discuss this shortcoming and, as a by-product, we predict a value for the poorly known D ->sigma transition form factor at q(2)=m pi(2).

Gravitational wave recoil in Robinson-Trautman spacetimes

We consider the gravitational recoil due to nonreflection-symmetric gravitational wave emission in the context of axisymmetric Robinson-Trautman spacetimes. We show that regular initial data evolve generically into a final configuration corresponding to a Schwarzschild black hole moving with constant speed. For the case of (reflection-)symmetric initial configurations, the mass of the remnant black hole and the total energy radiated away are completely determined by the initial data, allowing us to obtain analytical expressions for some recent numerical results that have appeared in the literature. Moreover, by using the Galerkin spectral method to analyze the nonlinear regime of the Robinson-Trautman equations, we show that the recoil velocity can be estimated with good accuracy from some asymmetry measures (namely the first odd moments) of the initial data. The extension for the nonaxisymmetric case and the implications of our results for realistic situations involving head-on collision of two black holes are also discussed.

Radio-frequency spectroscopy of (6)Li p-wave molecules: Towards photoemission spectroscopy of a p-wave superfluid

We study rf spectroscopy of a lithium gas with the goal to explore the possibilities for photoemission spectroscopy of a strongly interacting p-wave Fermi gas. Radio-frequency spectra of quasibound p-wave molecules and of free atoms in the vicinity of the p-wave Feshbach resonance located at 159.15G are presented. The spectra are free of detrimental final-state effects. The observed relative magnetic-field shifts of the molecular and atomic resonances confirm earlier measurements realized with direct rf association. Furthermore, evidence of molecule production by adiabatically ramping the magnetic field is observed. Finally, we propose the use of a one-dimensional optical lattice to study anisotropic superfluid gaps as most direct proof of p-wave superfluidity.