Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia

Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.

Accelerated ageing like a vigour test to diasporas of Myracrodruon urundeuva Fr. Allem

This work established the adequate temperature and the period of exposition for the accelerated ageing test with diasporas of Myracrodruon urundeuva from an area of the Cerrado in the state of Mato Grosso, Brazil. Before and after the ageing, at the temperatures of 40ºC, 41ºC, 42ºC and 45ºC combined with periods of 12, 18, 24, 30 and 36 hours, the water content and germination were evaluated. For each treatment, 12g of diasporas in mini chambers with 40 mL of distilled water were submitted to the accelerated ageing test. A total of 100 diasporas, divided into four replications, in plastic boxes, on two sheets of blotting paper, in germinator at 25ºC and 8 hours of photoperiod were germinated. In all treatments the content of water of the aged diasporas was superior to 20% and this value stabilized itself between 25% and 28%, from the 18 hours of exposition. Independently of the tested periods, the ageing at the temperatures of 40ºC, 41ºC and 42ºC did not affect the germination. After the ageing at 45ºC, the germination did not differ among the periods of 12, 18 and 24 hours of exposition, but in all these periods it was inferior to the control and superior to the periods of 30 and 36 hours. In these last two periods, fungi were observed. The accelerated ageing of diasporas of Myracrodruon urundeuva should be conducted at the temperature of 45ºC, during the exposition periods of 12 to 24 hours.

Validation of a rapid stool antigen test for diagnosis of Helicobacter pylori infection

The aim of this study was to validate the rapid lateral flow Helicobacter pylori stool antigen test (One step H. pylori antigen test, ACON laboratories, San Diego, USA; Prime diagnostics, São Paulo), using 13C-Urea Breath Test as the gold standard for H. pylori infection diagnosis. A total of 98 consecutive patients, asymptomatic or dyspeptic, entered the study. Sixty-nine were women, with a mean age of 45.76 ± 14.59 years (14 to 79 years). In the H. pylori-positive group, the rapid stool antigen test detected H. pylori antigen in 44 of the 50 positive patients (sensitivity 88%; 95% CI: 75.7-95.5%), and six false-negative; and in the H. pylori-negative group 42 presented negative results (specificity 87.5%; 95% CI: 74.7-95.3%), and six false-positive, showing a substantial agreement (Kappa Index = 0.75; p < 0.0001; 95% CI: 0.6-0.9). Forty four of fifty patients that had positive stool antigen were H. pylori-positive, the PPV of the stool antigen test was 88% (95% CI: 75.7-95.5%), and 42 patients with negative stool antigen test were H. pylori-negative, the NPV of the stool antigen test was 87.5% (95% CI: 74.7-95.3%). We conclude that the lateral flow stool antigen test can be used as an alternative to breath test for H. pylori infection diagnosis especially in developing countries.

The thermal stability of yellow fever vaccines

The assessment of yellow fever vaccine thermostability both in lyophilized form and after reconstitution were analyzed. Two commercial yellow fever vaccines were assayed for their thermal stability. Vaccines were exposed to test temperatures in the range of 8 (graus) C to 45 (graus) C. Residual infectivity was measured by a plaque assay using Vero cells. The titre values were used in an accelerated degradation test that follows the Arrhenius equation and the minimum immunizing dose was assumed to be 10 (ao cubo) particles forming unit (pfu)/dose. Some of the most relevant results include that (i) regular culture medium show the same degradation pattern of a reconstituted 17D-204 vaccine; (ii) reconstituted YF-17D-204 showed a predictable half life of more than six days if kept at 0 (graus) C; (iii) there are differences in thermostability between different products that are probably due to both presence of stabilizers in the preparation and the modernization in the vaccine production; (iv) it is important to establish a proper correlation between the mouse infectivity test and the plaque assay since the last appears to be more simple, economical, and practical for small laboratories to assess the potency of the vaccine, and (v) the accelerated degradation test appears to be the best procedure to quantify the thermostability of biological products.

Montagem de um sistema para medidas galvanostáticas simultâneas em mais de uma célula

The present work deals with the design and construction of an equipment for muti-cell accelerated stability test measurements (AST) of dimensionally stable anodes (DSA). The equipment was built using only components that were available in the laboratory. Measurements of three electrochemical cells can be performed using the developed software. The acquisition time interval and the cut-off potencial can be set by the user. Experimental data for RuO2 electrodes obtained with the built equipment are in agreement with the literature.

Comparação dos métodos de determinação da estabilidade oxidativa de biodiesel B100, em mistura com antioxidantes sintéticos: aplicação do delineamento simplex-centroide com variável de processo

The Rancimat and accelerated stove tests were used to determine the oxidative stability of B100 biodiesel mixed with synthetic antioxidants. The predictive equations, with process variable, were obtained by applying a simplex-centroid design. Regardless of the antioxidant used, all assays carried out with the accelerated stove test presented storage time longer than 177.88 d, the greatest value obtained by applying the Rancimat test. The t test, applied to the parameters containing the process variable, showed a statistically significant difference (at the level of 5%) between the methods used.

PHYSIOLOGICAL QUALITY OF SOYBEAN SEEDS DEPENDING ON THE PREHARVEST DESICCATION

ABSTRACTDepending on the cultivar, the use of desiccants in the preharvest can favor maintenance of physiological quality. The objective of the study was to assess the physiological quality of soybean seeds as due to the use of apreharvest desiccant and desiccation time in two harvests (2011/12 and 2012/13). The treatments were five soybean cultivars, two growth stages of application, a control (without desiccant application), and three desiccants (glufosinate-ammonium, carfentrazone-ethyl and paraquat) (2011/12 harvest). In the 2012/13 harvest the carfentrazone-ethyl desiccant was replaced by diquat. The physiological quality of seeds was assessed by the percentage of viability and vigor (cold test, tetrazolium test and accelerated aging test). In 2011/12 harvest, there was an early harvest in six days with the use of glufosinate-ammonium and paraquat desiccants, when desiccation was done in stage R7.1, with maintenance of seed quality; however it was dependent on the cultivar. In the 2012/13 harvest there was no early harvesting due to the presence of rain in the preharvest and the use of desiccation did not affect the physiological quality of the seeds either. Cultivar NA5909 RG was more tolerant to remaining in the cultivation environment and maintained higher viability than 90% and greater vigor of 71% by the cold test compared to cultivar BMX Turbo (2011/12 harvest). It is concluded that desiccation can be a viable alternative to the soybean early harvesting, but it depends on the cultivar, the time of desiccation, the active principle of the desiccant and the absence of rain in preharvest.

Tolerance level of green seed in soybean seed lots after storage

The occurrence of green soybean seed due to forced maturation or premature plant death caused by drought or foliar and/or root diseases has been common in several Brazilian production areas. Physiological quality of seed lots with green seed may have their germination and vigor potentials affected and therefore discarded by the grain industry. The objective of this experiment was to determine the maximum tolerated level of green seed in soybean seed lots, which is information of major importance for seed producers when taking the decision whether to sell these lots. Soybean seed of the cultivars CD 206, produced in Ubirata, Parana, and ‘FMT Tucunare,’ produced in Alto Garças, Mato Grosso, were used in the study. Green seed and yellow seed of both cultivars were mixed in the following proportions: 0%, 3%, 6%, 9%, 12%, 15%, 20%, 30%, 40%, 50%, 75% and 100%. Seed quality was evaluated by the germination, accelerated aging, tetrazolium and electrical conductivity tests. The contents of a, b and total chlorophyll in the seed were also determined. A complete randomized block design in a factorial scheme (two cultivars x 12 levels of green seed) was used. Seed quality was negatively affected and chlorophyll contents incremented with the increase in the percentage of green seed. Seed germination, viability and vigor, measured by the accelerated aging test, were not reduced with levels of up to 3% green seed, for both cultivars. Levels above 6% green seed significantly reduced the quality of the seed. The quality of seed lots with 9% or more green seed was significantly reduced to the point that their commercialization is not recommended.

Thermal and moisture content effects on storability and seed dormancy releasing on Brachiaria brizantha cultivars

Brachiaria species normally show a double seed dormancy mechanism, mainly on fresh-harvested seeds, leading to germination percentages lower than those of viability detected by tetrazolium test (TZ) and causing problems as to storage, trading and seed inspection activities. The adoption of the methodology to detect the constants of the viability equation (high storage temperatures and fixed moisture contents) made feasible in this research to isolate the effects of 40, 50 and 65°C on B. brizantha cultivars Marandu, Mulato 1 and Mulato 2 seed dormancy releasing, after storage with moisture contents ranging from 1.9 and 17.8%. Seed samples presented high dormancy levels, detected by TZ and it was complete and partially released by chemical scarification and accelerated ageing test, respectively. No statistical differences were observed as to the speed of germination (T50); however, differences among cultivars were detected as to number of seed per gram. Sorption and desorption isotherm curves were similar for the cultivars. Seed dormancy releasing was better achieved at 40 and 50°C with mc ranging from 7.6 to 10.8%. The temperature of 50°C appears to be adequate for seed dormancy releasing in all mc analyzed. No significant seed dormancy releasing result was observed at 65°C. The cultivar Marandu presented the highest storability throughout the experiment.

Hydric restriction as vigor assessment method of soybean seeds

The objective of this study was to investigate the possibility of using hydric restriction as a method for evaluating vigor of soybean seeds. The soybean seeds, cultivar BRS 245RR, represented by four different seed lots, were characterized by germination and vigor. For the treatment of hydric restriction and temperature, the combination of substrate water potential and temperature were the following: deionized water (0.0 MPa); polyethylene glycol (PEG 6000) aqueous solution (-0.1, -0.3 and -0.5 MPa); and four temperatures (20 ºC, 25 ºC, 30 ºC, and 35 ºC), respectively. A completely randomized experimental design was used, with four replications per treatment, and the ANOVA was performed individually for each combination of temperature and water potential of substrate. According to results obtained, the test of hydric restriction has the same efficiency of the accelerated aging test in estimating vigor of soybean seeds, cv. BRS 245RR, when water potentials of -0.1 MPa or -0.3 MPa at a temperature of 25 ºC, or -0.3 MPa at a temperature of 30 ºC are used.

Seed quality parameters of three interspecific hybrids of elephant grass x pearl millet

An interspecific hybrid resulting from the crossing of elephant grass (Pennisetum purpureum Schumach) x pearl millet (Pennisetum glaucum (L.) R. Brown) has been developed. This hybrid, however, revealed low phenotypic uniformity and low production of pure seeds. Through recurrent selection, two improved populations were obtained (genotypes Corte and Pastoreio). The aim of this study was assessing seed quality of the three hybrids (genotypes Corte, Pastoreio and Paraiso) by tests of: seed purity; seed germination; accelerated aging test, at 42 ºC; 1,000 seeds weight; drying curves; and sorption and desorption isotherms. Recurrent selection altered the seed size and increased initial quality of population for genotype Pastoreio. Drying curves for the three hybrids have shown similar behavior and reached moisture contents of 2.1%, 1.9%, and 1.8%, respectively, after 63 days. The accelerated aging test showed that hybrid Pastoreio was the most vigorous.

Posttraumatic stress disorder: prevalences, comorbidities and quality of life in a community sample of young adults

Objectives To verify the prevalence of current posttraumatic stress disorder (PTSD) in young adults, the occurrence of comorbidities and its association with quality of life. Methods This is a cross-sectional population-based study. The targeted population consisted on individuals aged 18 to 24 years old, who lived in the urban area of Pelotas-RS, Brazil. Cluster sampling was applied. PTSD and its comorbidities were assessed using the Mini International Neuropsychiatric Interview (MINI 5.0), whereas quality of life was evaluated with the eight domains of the Medical Outcomes Survey Short-form General Health Survey (SF-36). Results A total of 1,762 young adults were selected. The prevalence of PTSD was 2.1% and current episode of depression was the most prevalent comorbidity (71.9%). The individuals with PTSD had lower scores in all domains of quality of life. Conclusion These findings indicate that PTSD is associated with other psychopathologies, especially depression, and it has a substantial impact over quality of life in a sample of young adults.

Stress During ACLS Courses: Is it Important for Learning Skills?

OBJECTIVE: To determine the influence of stress on teaching medical emergencies in an Advanced Cardiac Life Support (ACLS) course and to verify this influence on learning, and the efficiency of emergency care training. METHODS: Seventeen physicians signed up for an ACLS course. Their pulses were taken and blood pressure (BP) verified on the first day, before the beginning of the course, and on the second day, during the theoretical and practical test (TPT). Variations in pulse rates and BP were compared with students' test grades. Then, students answered a questionnaire of variables (QV) about the amount of sleep they had during the course, the quantity of study material and the time spent studying for the course, and a stress scale graphic. RESULTS: Seven students had a pulse variation less than 10% between the 2 periods and 10 had a 10% or more variation. Grades on TPT were, respectively, 91.4±2.4 and 87.3±5.2 (p<0.05). Six students had a BP variation less than 20 mmHg, and in 11 it varied more than 21 mmHg. Grades on the TPT were 92.3±3.3 and 86.2± 8.1, respectively (p<0.05). The QV dates did not significantly influence grades. CONCLUSION: Stress, as an isolated variable, had a negative influence on the learning process and on the efficiency of emergency training in this situation.

Stress, coping and presenteeism in nurses assisting critical and potentially critical patients

Objective to verify the associations between stress, Coping and Presenteeism in nurses operating on direct assistance to critical and potentially critical patients. Method this is a descriptive, cross-sectional and quantitative study, conducted between March and April 2010 with 129 hospital nurses. The Inventory of stress in nurses, Occupational and Coping Questionnaire Range of Limitations at Work were used. For the analysis, the Kolmogorov-Smirnov test, correlation coefficient of Pearson and Spearman, Chi-square and T-test were applied. Results it was observed that 66.7% of the nurses showed low stress, 87.6% use control strategies for coping stress and 4.84% had decrease in productivity. Direct and meaningful relationships between stress and lost productivity were found. Conclusion stress interferes with the daily life of nurses and impacts on productivity. Although the inability to test associations, the control strategy can minimize the stress, which consequently contributes to better productivity of nurses in the care of critical patients and potentially critical.


Avaliação da velocidade de processamento de processadoras automáticas ultilizado o método "STEP test"

A avaliação do processamento radiográfico utilizando o "STEP test" ("sensitometric test for the evaluation of processing") tem como objetivo a identificação de desvios importantes no sistema processadora-químicos-filmes. Neste tipo de avaliação são estabelecidas as condições ideais para o processamento. Um filme padrão é revelado de acordo com as condições do fabricante, ou seja, com padrão igual a 100. O filme é exposto à luz de um sensitômetro calibrado e os valores dos degraus são avaliados com o uso de um densitômetro, sendo obtida sua curva característica (densidade óptica × degrau). O desvio porcentual máximo deve ser de 20% quando comparado com a curva padrão. Este método é útil na identificação de problemas no processamento radiográfico. Várias processadoras de hospitais públicos/universitários foram avaliadas empregando este método, e verificou-se que aproximadamente 33% das instalações apresentam condições inadequadas de processamento.