Value of the Qrs-T Angle in Predicting the Induction of Ventricular Tachyarrhythmias in Patients with Chagas Disease

Background:The QRS-T angle correlates with prognosis in patients with heart failure and coronary artery disease, reflected by an increase in mortality proportional to an increase in the difference between the axes of the QRS complex and T wave in the frontal plane. The value of this correlation in patients with Chagas heart disease is currently unknown.Objective:Determine the correlation of the QRS-T angle and the risk of induction of ventricular tachycardia / ventricular fibrillation (VT / VF) during electrophysiological study (EPS) in patients with Chagas disease.Methods:Case-control study at a tertiary center. Patients without induction of VT / VF on EPS were used as controls. The QRS-T angle was categorized as normal (0-105º), borderline (105-135º) or abnormal (135-180º). Differences between groups for continuous variables were analyzed with the t test or Mann-Whitney test, and for categorical variables with Fisher's exact test. P values < 0.05 were considered significant.Results:Of 116 patients undergoing EPS, 37.9% were excluded due to incomplete information / inactive records or due to the impossibility to correctly calculate the QRS-T angle (presence of left bundle branch block and atrial fibrillation). Of 72 patients included in the study, 31 induced VT / VF on EPS. Of these, the QRS-T angle was normal in 41.9%, borderline in 12.9% and abnormal in 45.2%. Among patients without induction of VT / VF on EPS, the QRS-T angle was normal in 63.4%, borderline in 14.6% and abnormal in 17.1% (p = 0.04). When compared with patients with normal QRS-T angle, those with abnormal angle had a fourfold higher risk of inducing ventricular tachycardia / ventricular fibrillation on EPS [odds ratio (OR) 4; confidence interval (CI) 1.298-12.325; p = 0.028]. After adjustment for other variables such as age, ejection fraction (EF) and QRS size, there was a trend for the abnormal QRS-T angle to identify patients with increased risk of inducing VT / VF during EPS (OR 3.95; CI 0.99-15.82; p = 0.052). The EF also emerged as a predictor of induction of VT / VF: for each point increase in EF, there was a 4% reduction in the rate of sustained ventricular arrhythmia on EPS.Conclusions:Changes in the QRS-T angle and decreases in EF were associated with an increased risk of induction of VT / VF on EPS.

Contribution of Topography and Incident Solar Radiation to Variation of Soil and Plant Litter at an Area with Heterogeneous Terrain

Natural processes that determine soil and plant litter properties are controlled by multiple factors. However, little attention has been given to distinguishing the effects of environmental factors from the effects of spatial structure of the area on the distribution of soil and litter properties in tropical ecosystems covering heterogeneous topographies. The aim of this study was to assess patterns of soil and litter variation in a tropical area that intercepts different levels of solar radiation throughout the year since its topography has slopes predominantly facing opposing geographic directions. Soil data (pH, C, N, P, H+Al, Ca, Mg, K, Al, Na, sand, and silt) and plant litter data (N, K, Ca, P, and Mg) were gathered together with the geographic coordinates (to model the spatial structure) of 40 sampling units established at two sites composed of slopes predominantly facing northwest and southeast (20 units each). Soil and litter chemical properties varied more among slopes within similar geographic orientations than between the slopes facing opposing directions. Both the incident solar radiation and the spatial structure of the area were relevant in explaining the patterns detected in variation of soil and plant litter. Individual contributions of incident solar radiation to explain the variation in the properties evaluated suggested that this and other environmental factors may play a particularly relevant role in determining soil and plant litter distribution in tropical areas with heterogeneous topography. Furthermore, this study corroborates that the spatial structure of the area also plays an important role in the distribution of soil and litter within this type of landscape, which appears to be consistent with the action of water movement mechanisms in such areas.

Excitação eletrônica das moléculas de metacrilato de metila e estireno na região do ultravioleta de vácuo

Angle-resolved electron energy-loss spectra have been measured for the methyl methacrylate (MMA) and styrene molecules in the 0 - 50 eV energy range. The spectra have been obtained at 1 keV incident energy, with an energy resolution of 0.8 eV and covering an angular range of 2.0 to 7.0 degrees. Within our knowledge, this is the first gas-phase excitation spectrum for MMA and styrene in this energy range. The spectra of MMA at small scattering angles are dominated by an intense peak at 6.7 eV followed by a broad band centered at about 16 eV. In the case of styrene, six bands can be observed in the spectra. Based on the angular behaviour of the excitation spectra of these molecules, the low-lying peaks observed are considered to be associated predominantly with dipole-allowed processes. In both cases, new bands can be observed for excitation energies greater than 20 eV. This could be associated with dipole-forbidden transitions to shake-up and doubly-excited states.

Perfil químico de cultivares de feijão (phaseolus vulgaris) pela técnica de high resolution magic angle spinning (HR-MAS)

The application of one-dimensional proton high-resolution magic angle spinning (¹H HR-MAS) NMR combined with a typical advantages of solid and liquid-state NMR techniques was used as input variables for the multivariate statistical analysis. In this paper, different cultivars of beans (Phaseolus vulgaris) developed and in development by Embrapa - Arroz e Feijão were analyzed by ¹H HR-MAS, which have been demonstrated to be a valuable tool in its differentiation according chemical composition and avoid the manipulation of the samples as used in other techniques.

Electron transfer by singlet excited state of porphyn and electron acceptor affinity in rigid medium: photoacoustic phase angle analysis

Photoacoustic spectroscopy provides information about both amplitude and phase of the response of a system to an optical excitation process. This paper presents the studies of the phase in the electron transfer process between octaethylporphyn (OEP) and quinone molecules dispersed in a polymeric matrix. It was observed a tendency in the phase behavior to small values only in the spectral region near to 620 nm, while for shorter wavelength did not show any tendency. These measurements suggested that the electron transfer to acceptor occurred with the participation of octaethylporphyn singlet excited state.

VARIATION OF MICROFIBRIL ANGLE OF Pinus radiata D. Don IN RELATION TO TREE SPACING IN CHILEAN PLANTATIONS

ABSTRACTFour stands of 28-year-old radiata pine (Pinus radiata D. Don) grown in the eighth region (Biobio) of Chile were sampled to determine the effect of tree spacing on the microfibril angle. The samples were taken at two different stem levels of the tree, 2.5 m and 7.5 m, with increment strip taken in the Nothern direction. The four experimental stands were characterized by the following spacing 2x2, 2x3, 3x4 and 4x4. The microfibril angle was measured by X-ray diffraction with the SilviScan technology at the FP-Innovation-Paprican Division in Vancouver, Canada. The results showed a significant effect of tree spacing on the microfibril angle in both juvenile wood and mature wood as well as at the two stem levels considered. The minimum (9.42º) was reached in 2x2 stand at 7.5 m in mature wood, while maximum microfibril angle (24.54º) was obtained in 2x3 stand at 2.5 m in juvenile wood. Regarding the effect of tree spacing, 4x4 stand had the lowest microfibril angle,except in mature wood at 7.5 m where 4x4 had the highest microfibril angle (11°) of the four stands.

Annual evolution of global, direct and diffuse radiation and fractions in tilted surfaces

It was evaluated the annual evolution of global, direct and diffuse components of incident solar radiation on tilted surfaces to 12.85, 22.85 and 32.85º, facing north, in Botucatu, state of São Paulo, Brazil. The radiometric fractions were obtained for each component of the radiation in the aforementioned surfaces, through the ratio with the global and top of the atmosphere radiations. Seasonality was evaluated based on monthly averages of daily values. The measures occurred between 04/1998 and 07/2001 at 22.85º; 08/2001 and 02/2003 at 12.85º; and from 03/2003 to 12/2007 at 32.85º, with concomitant measures in the horizontal surface (reference). The levels of global and direct radiation on tilted surfaces were lower in summer and higher in the equinoxes when compared with the horizontal. The diffuse radiation on tilted surfaces was lower in most months, with losses of up to 65%. A trend of increasing differences occurred between horizontal and tilted surfaces with the increase of the angle in all the components and fractions of incident radiation. The annual evolution of rainfall and cloud cover ratio directly affected the atmospheric transmissivity of direct and diffuse components in the region.

Distribution pattern, surface tension and contact angle of herbicides associated to adjuvants on spraying and control of Ipomoea hederifolia under rainfall incidence

ABSTRACTScarlet Morning Glory is considered to be an infesting weed that affects several crops and causes serious damage. The application of chemical herbicides, which is the primary control method, requires a broad knowledge of the various characteristics of the solution and application technology for a more efficient phytosanitary treatment. Therefore this study aimed to characterize the effect of rainfall incidence on the control of Ipomoea hederifolia, considering droplet size, surface tension, contact angle of droplets formed by herbicides liquid on vegetal and artificial surfaces, associated to adjuvants and the volumetric distribution profile of the spray jet. The addition of the adjuvants to the herbicide spraying liquid improved the application quality, as it influenced the angle formed by the spray by broadening the deposition band of the spray nozzle and thus the possible distance between the nozzles on spray boom and due the changes at droplet size, which contribute to a safety application. The rainfall occurrence affected negatively the weed control with the different spraying liquids and also the dry matter weight, suggesting that the phytosanitary product applied was washed off.

Avaliação da deposição da calda de pulverização em função da densidade populacional de Brachiaria plantaginea, do volume e do ângulo de aplicação: effects of density, volume and spraying angle

O presente trabalho teve por objetivo avaliar a quantidade de calda de pulverização depositada nas folhas de Brachiaria plantaginea, em aplicações de pós-emergência precoce, em que se variou o volume de calda de pulverização, a densidade de plantas m-2 e o ângulo de posicionamento da ponta de pulverização na barra de aplicação. Para isso, foram conduzidos três experimentos em condições de laboratório. Nestes estudos, o volume de calda de pulverização foi obtido por meio da variação da velocidade de deslocamento de um veículo composto por plataforma e quatro rolamentos tracionados por um motor elétrico. Foi utilizada a ponta de pulverização XR Teejet 8001 EVS, na pressão de 241,4 kPa. O delineamento experimental utilizado foi o inteiramente casualizado, com cinco repetições. No primeiro experimento, os volumes utilizados foram de 1147,57; 860,68; 573,78; 459,02; 344,27; 229,51; 114,75; e 57,37 L ha-1 de calda de pulverização, com densidade de 600 plantas m-2. No segundo experimento foram estudadas as densidades de 300, 600, 900 e 1.200 plantas m-2; neste caso, utilizou-se o volume de 229,51 L ha-1 de calda de pulverização. No terceiro experimento avaliou-se o posicionamento do ângulo da ponta de pulverização na barra de aplicação e utilizou-se a densidade de 600 plantas m-2. Estudaram-se os ângulos de -30º, -15º, 90º, +15º e +30º e os volumes de calda de pulverização de 198,76; 221,69; 229,51; 221,69; e 198,76 L ha-1, respectivamente. Foram adotados sinais negativos para o sentido de deslocamento do veículo e sinais positivos para o sentido contrário ao deslocamento. As avaliações do depósito de calda de pulverização, na planta e no solo, foram feitas utilizando-se condutividade elétrica. A porcentagem de depósito de calda de pulverização nas plantas de B. plantaginea foi incrementada com a redução do volume de calda pulverizada por hectare. O depósito de calda por planta foi maior nas densidades maiores de plantas. O ângulo de posicionamento da ponta de pulverização na barra de aplicação incrementou o depósito de calda nas plantas de B. plantaginea, quando comparado com o ângulo de 90º.

Variants of transcription factor 7-like 2 (TCF7L2) gene and incident glucose intolerance in Japanese-Brazilians

Common variants of the transcription factor 7-like 2 (TCF7L2) gene have been found to be associated with type 2 diabetes in different ethnic groups. The Japanese-Brazilian population has one of the highest prevalence rates of diabetes. Therefore, the aim of the present study was to assess whether two single-nucleotide polymorphisms (SNPs) of TCF7L2, rs7903146 and rs12255372, could predict the development of glucose intolerance in Japanese-Brazilians. In a population-based 7-year prospective study, we genotyped 222 individuals (72 males and 150 females, aged 56.2 ± 10.5 years) with normal glucose tolerance at baseline. In the study population, we found that the minor allele frequency was 0.05 for SNP rs7903146 and 0.03 for SNP rs12255372. No significant allele or genotype association with glucose intolerance incidence was found for either SNP. Haplotypes were constructed with these two SNPs and three haplotypes were defined: CG (frequency: 0.94), TT (frequency = 0.027) and TG (frequency = 0.026). None of the haplotypes provided evidence for association with the incidence of glucose intolerance. Despite no associations between incidence of glucose intolerance and SNPs of the TCF7L2 gene in Japanese-Brazilians, we found that carriers of the CT genotype for rs7903146 had significantly lower insulin levels 2 h after a 75-g glucose load than carriers of the CC genotype. In conclusion, in Japanese-Brazilians, a population with a high prevalence of type 2 diabetes, common TCF7L2 variants did not make major contributions to the incidence of glucose tolerance abnormalities.

Effect of image resolution manipulation in rearfoot angle measurements obtained with photogrammetry

The aim of this study was to investigate the influence of image resolution manipulation on the photogrammetric measurement of the rearfoot static angle. The study design was that of a reliability study. We evaluated 19 healthy young adults (11 females and 8 males). The photographs were taken at 1536 pixels in the greatest dimension, resized into four different resolutions (1200, 768, 600, 384 pixels) and analyzed by three equally trained examiners on a 96-pixels per inch (ppi) screen. An experienced physiotherapist marked the anatomic landmarks of rearfoot static angles on two occasions within a 1-week interval. Three different examiners had marked angles on digital pictures. The systematic error and the smallest detectable difference were calculated from the angle values between the image resolutions and times of evaluation. Different resolutions were compared by analysis of variance. Inter- and intra-examiner reliability was calculated by intra-class correlation coefficients (ICC). The rearfoot static angles obtained by the examiners in each resolution were not different (P > 0.05); however, the higher the image resolution the better the inter-examiner reliability. The intra-examiner reliability (within a 1-week interval) was considered to be unacceptable for all image resolutions (ICC range: 0.08-0.52). The whole body image of an adult with a minimum size of 768 pixels analyzed on a 96-ppi screen can provide very good inter-examiner reliability for photogrammetric measurements of rearfoot static angles (ICC range: 0.85-0.92), although the intra-examiner reliability within each resolution was not acceptable. Therefore, this method is not a proper tool for follow-up evaluations of patients within a therapeutic protocol.

Assessment of a five-year survival on hemodialysis in Brazil: a cohort of 3,082 incident patients

Brazil has the third largest contingent of patients on maintenance hemodialysis (HD) worldwide. However, little is known regarding survival rate and predictors of mortality risk in that population, which are the purposes of this study. A total of 3,082 patients incident on HD, from 2000 to 2004, at 25 dialysis facilities distributed among 7 out of 26 states of Brazil were followed-up until 2009. Patients were 52 ± 16 years-old, 57.8% men, and 20.4%, diabetics. The primary outcome was all causes of mortality. Data were censored at five years of follow-up. The global five-year survival rate was 58.2%. In the Cox proportional model, variables associated with risk of death were: age (hazard ratio - HR = 1.44 per decade, p < 0.0001), diabetes (HR = 1.51, p < 0.0001), serum albumin (HR = 0.76 per g/dL, p = 0.001), creatinine (HR = 0.92 per mg/dL, p < 0.0001), and phosphorus (HR = 1.06 per mg/dL, p = 0.04). The present results show that the mortality rate on HD in this Brazilian cohort was relatively low, but the population is younger and with a lower prevalence of diabetes than the ones reported for developed countries.

Early changes in serum albumin: impact on 2-year mortality in incident hemodialysis patients

AbstractIntroduction/objective:We evaluated the predictability of early changes in serum albumin (sAlb) on the two-year mortality of incident hemodialysis patients.Methods:Observational, longitudinal retrospective study using the database of Fresenius Medical Care of Latin America. Adult patients starting dialysis from January/2000 to June/2004, from 25 centers were included. Changes in sAlb during the first 3 months on hemodialysis were used as the main predictor. The outcome was death from any cause.Results:1,679 incident patients were included. They were 52 ± 15 years old, 58.7% male and 21.5% diabetic, with a median sAlb of 38 g/L (bromocresol green). 923 patients had sAlb < 38 g/L (Low sAlb Group) and 756 ones had sAlb > 38.0 g/L (Adequate sAlb Group). The mortality was significantly higher in Low sAlb Group (17% vs. 11%, p < 0.001). Early changes in sAlb significantly affected two-year mortality. Factoring the Kaplan Meier curve of Low sAlb Group by the presence of an increase in sAlb uncovered of a statistically significant difference in mortality favoring the ones whose sAlb went up (19% vs. 15%, p = 0.043). Differently, patients from Adequate sAlb Group with a decrease in their sAlb had a statistically higher mortality rate (13% vs. 8%, p = 0.029).Conclusions:Early sAlb changes showed a significant predictive power on mortality at 2 years in incident hemodialysis patients. Those with low initial sAlb may have a better prognosis if their sAlb rises. In contrast, patients with satisfactory initial levels can have a worsening of their prognosis in the case of an early reduction in sAlb.

Troponin I serum levels predict the need of dialysis in incident sepsis patients with acute kidney injury in the intensive care unit

Abstract Introduction: Sepsis, an extremely prevalent condition in the intensive care unit, is usually associated with organ dysfunction, which can affect heart and kidney. Objective: To determine whether the cardiac dysfunction and the Troponin I forecast the occurrence of acute renal failure in sepsis. Methods: Cardiac dysfunction was assessed by echocardiography and by the serum troponin I levels, and renal impairment by AKIN criteria and the need of dialysis. Twenty-nine patients with incident sepsis without previous cardiac or renal dysfunction were enrolled. Results and Discussion: Patients averaged 75.3 ± 17.3 years old and 55% were male. Median APACHE II severity score at ICU admission was 16 (9.7 - 24.2) and mortality rate in 30 days was 45%. On the fifth day, 59% had ventricular dysfunction. Troponin serum levels on day 1 in the affected patients were 1.02 ± 0.6 ng/mL compared with 0.23 ± 0.18 ng/mL in patients without heart dysfunction (p = 0.01). Eighteen out of 29 patients (62%) underwent renal replacement therapy (RRT) and the percent of patients with ventricular dysfunction who required dialysis was higher (94% vs. 16%, p = 0.0001). Values of troponin at day 1 were used to develop a ROC curve to determine their ability to predict the need of dialysis. The area under the curve was 0.89 and the cutoff value was 0.4 ng/mL. Conclusion: We found that an elevation in serum troponin levels, while guarding a relationship with ventricular dysfunction, can be a precious tool to predict the need for dialysis in sepsis patients.