Adaptação e aplicabilidade de um algoritmo de diurético para pacientes com insuficiência cardíaca

FUNDAMENTO: Estados congestivos podem ser identificados e manejados através de algoritmos como o Diuretic Treatment Algorithm (DTA) para ajuste de diurético por telefone, com enfoque na avaliação clínica. Porém, o DTA está disponível somente em língua inglesa. OBJETIVO: Adaptar o DTA e testar sua aplicabilidade para uso no Brasil em pacientes ambulatoriais com IC. MÉTODOS: Seguiram-se as etapas de tradução, síntese, retrotradução, avaliação por comitê de especialistas e pré-teste (aplicabilidade clínica por meio de ensaio clínico randomizado). O DTA foi denominado, na versão para o Brasil, algoritmo de ajuste de diurético (AAD). Os pacientes foram randomizados para grupo intervenção (GI) - ajuste de diurético conforme o AAD - ou grupo controle (GC) - ajuste convencional. Foi avaliado o escore clínico de congestão (ECC) e o peso para ambos os grupos. RESULTADOS: Foram realizadas 12 modificações no DTA. Incluíram-se 34 pacientes. Para aqueles congestos, o aumento de diurético guiado pelo AAD resultou em maior resolução da congestão, com redução de dois pontos no ECC para 50% da amostra -2 (-3,5; -1,0), enquanto a mediana para o GC foi 0 (-1,25; -1,0), (p < 0,001). A mediana de variação de peso foi maior no GI -1,4 (-1,7; -0,5) quando comparado ao GC 0,1 (1,2; -0,6), p = 0,001. CONCLUSÕES: O ADD mostrou-se aplicável na prática clínica após adaptação e parece resultar em melhor controle da congestão em pacientes com IC. A efetividade clínica da ferramenta merece ser testada em amostra maior de pacientes visando sua validação para uso no Brasil (Universal Trial Number: U1111-1130-5749) (Arq Bras Cardiol. 2013; [online]. ahead print, PP.0-0).

Simulationssystem für granulare Aufschüttungen aus Teilchen variabler Form

Granular matter, simulation, molecular dynamics, stress tensor, preasure, silo, elasticity

Right Ventricular Doppler Echocardiographic Study of Indeterminate Form of Chagas Disease

Background: Patients with indeterminate form of Chagas disease/cardiac normality (ICD/CN) exhibited normal electrocardiograms and chest X-rays; however, more sophisticated tests detected some degree of morphological and functional changes in the heart. Objective: To assess the prevalence of systolic and diastolic dysfunction of the right ventricle (RV) in patients with ICD/CN. Methods: This was a case–control and prevalence study. Using Doppler two-dimensional echocardiography (2D), 92 patients were assessed and divided into two groups: group I (normal, n = 31) and group II (ICD/CN, n = 61). Results: The prevalence of RV systolic dysfunction in patients in groups I and II was as follows: fractional area change (0.0% versus 0.6%), mobility of the tricuspid annulus (0.0% versus 0.0%), and S-wave tissue Doppler (6.4% versus 26.0%, p = 0.016). The prevalence of global disorders such as the right myocardial performance index using tissue Doppler (16.1% versus 27.8%, p = 0.099) and pulsed Doppler (61.3% versus 68%, p = 0.141) and diastolic disorders such as abnormal relaxation (0.0% versus 6.0%), pseudonormal pattern (0.0% versus 0.0%), and restrictive pattern (0.0% versus 0.0%) was not statistically different between groups. Conclusion: The prevalence of RV systolic dysfunction was estimated to be 26% (S wave velocity compared with other variables), suggesting incipient changes in RV systolic function in the ICD/CN group.

Ecological sustainability and urban form

One controversial idea present in the debate on urban sustainability is that urban sprawl is an ecological stressing problem. We have tested this popular assumption by measuring the ecological footprint of commuting and housing of the 163 municipalities of the Barcelona Metropolitan Region and by relating the estimated values with residential density and accessibility, the fundamental determinant of residential density according to the Monocentric City Model.

Form, entwicklung und funktion der hypodermalen druesen von rhinocricus padbergii (Diplopoda)

Es werden die hypodermalen Druesen von rhinocricus padbergii (Diplopoda) histologisch beschrieben, sowie ihre Bildung in der Hypodermis sich frisch haeutender Tiere dargestellt. 1. Die Druesen bestehen aus vier wohldifferenzierten Zellen, von denen zwei als Kanalzellen und zwei als Druesenzellen funktionieren. 2. Die Druesenzellen entleeren ihr Sekret durch einen langen, sehr duennen Kanal auf die Oberflaeche der Cuticula im Anfang ihrer Neubildung, wo das Sekret hoechst wahrscheinlich zur Bildung der neuen Epicuticula beitraegt. 3. Der Ausleitungsapparat besteht aus einem in den beiden kanalzellen durch zwei aeussere Spiralfaeden verstaerkten, sehr duennen Kanal, der an der Basalflaeche der zweiten Kanalzelle eine klammerartige Verdickung zeigt. Er setzt sich als sehr duennhaeutiger, dehnbarer kanal in die erste Druesenzelle fort, an deren Basisflaeche er sich in zwei kurze Zweige aufteilt, von denen einer in die zweite Druesenzelle reicht. Um die offene Endigung der Zweige bildet sich eine kugelfoermige, radialstrahlige Ausfuehrzone, die vermutlich aus Mikrovilli aufgebaut ist. 4. Das Sekret kann in dem dehnbaren Teil des kanals innerhalb der ersten Druesenzelle gespeichert werden. Sein Austritt wird durch die Elastizitaet der erwaehnten Klammer des Kanals geregelt. 5. Die vier Kerne des Druesenkomplexes bilden sich durch zweifache amitotische Teilung aus einer Hypodermiszelle, besonders an den hinteren Raendern der Sklerite. 6. Der Ausfuehrkanal bildet sich als Invagination der aeussersten Ektocuticularlamelle.

The isolation of the perfect form of Microsporum Gypseum, Nannizzia Gypsea, Stockdale, 1963, from brazilian soil

Our work is on the isolation from brazilian soil of the perfect stage of Microsporum gypseum, Nannizzia gypsea, Stock., 1963, using cut sterilized children hair as bait.

Differential effect of culture epimastigotes and blood-form Trypamastigotes on normal mouse splenocyte responsiveness to mitogens

Blood form trypomastigotes of the Y strain of T. cruzi, produced a strong inhibition of the blastogenic response to T and B cell mitogens, of the C3H/He, C57BLand BALB/cJ strains of mice, while culture epimastigotes of the Y strain kept in a medium that allows parasite growth at 26°. 30° and 37°C produced a strong stimulatory effect that was even higher than the effect of the mitogens alone. Both the inhibitory or the stimulatory effects were dose-dependent. The stimulatory effect of epimastigotes was also temperature-dependent producing increasedstimulation indexes as the temperature of parasite cultures was raised. Metabolically active,living parasites seemed to be necessary for an improved lymphocyte stimulation suggesting a potential role of secreted metabolites as polyclonal activators of mouse lymphocytes.

Dasyrhynchus pacificus Robinson, 1965 (Trypanorhyncha: Dasyrhynchidae) description of the adult form

One out of four specimens of sharks, Carcharhinus brachyurus (Günther, 1860), captured off the southern Brazilian Coast, harboured cestodes identified as Dasyrhynchus pacificus Robinson, 1965, of which the adult form is now described and referred as ocurring in Brazil.

Extending contingency: the impact of strategy, technology, size and business environment on the organisational form of small Chinese firms

This paper is inspired by articles in the last decade or so that have argued for more attention to theory, and to empirical analysis, within the well-known, and long-lasting, contingency framework for explaining the organisational form of the firm. Its contribution is to extend contingency analysis in three ways: (a) by empirically testing it, using explicit econometric modelling (rather than case study evidence) involving estimation by ordered probit analysis; (b) by extending its scope from large firms to SMEs; (c) by extending its applications from Western economic contexts, to an emerging economy context, using field work evidence from China. It calibrates organizational form in a new way, as an ordinal dependent variable, and also utilises new measures of familiar contingency factors from the literature (i.e. Environment, Strategy, Size and Technology) as the independent variables. An ordered probit model of contingency was constructed, and estimated by maximum likelihood, using a cross section of 83 private Chinese firms. The probit was found to be a good fit to the data, and displayed significant coefficients with plausible interpretations for key variables under all the four categories of contingency analysis, namely Environment, Strategy, Size and Technology. Thus we have generalised the contingency model, in terms of specification, interpretation and applications area.

An axiomatization of difference-form contest success functions

This paper presents an axiomatic characterization of difference-form group contests, that is, contests fought among groups and where their probability of victory depends on the difference of their effective efforts. This axiomatization rests on the property of Equalizing Consistency, stating that the difference between winning probabilities in the grand contest and in the smaller contest should be identical across all participants in the smaller contest. This property overcomes some of the drawbacks of the widely-used ratio-form contest success functions. Our characterization shows that the criticisms commonly-held against difference-form contests success functions, such as lack of scale invariance and zero elasticity of augmentation, are unfounded.By clarifying the properties of this family of contest success functions, this axiomatization can help researchers to find the functional form better suited to their application of interest.

Análisis de rendimiento de aplicaciones paralelas de memoria compartida: problema N-body

Este trabajo analiza el rendimiento de cuatro nodos de cómputo multiprocesador de memoria compartida para resolver el problema N-body. Se paraleliza el algoritmo serie, y se codifica usando el lenguaje C extendido con OpenMP. El resultado son dos variantes que obedecen a dos criterios de optimización diferentes: minimizar los requisitos de memoria y minimizar el volumen de cómputo. Posteriormente, se realiza un proceso de análisis de las prestaciones del programa sobre los nodos de cómputo. Se modela el rendimiento de las variantes secuenciales y paralelas de la aplicación, y de los nodos de cómputo; se instrumentan y ejecutan los programas para obtener resultados en forma de varias métricas; finalmente se muestran e interpretan los resultados, proporcionando claves que explican ineficiencias y cuellos de botella en el rendimiento y posibles líneas de mejora. La experiencia de este estudio concreto ha permitido esbozar una incipiente metodología de análisis de rendimiento, identificación de problemas y sintonización de algoritmos a nodos de cómputo multiprocesador de memoria compartida.

Some progress on the chemistry of natural bioactive terpenoids form Chinese medicinal plants

(1) Pseudolaric acids - Novel diterpenes, Pseudolaric acid A, B, C and D were isolated from Pseudolarix kaempferi Gorden (pinaceae). Their structures were assigned by spectroscopic data and chemical correlations. In the contineous studies, the absolute configurations, the conformations in the solutions, the framentation mechanisms of MS and assigments of all NMR spectral signals were also reported. They showed the antifungal and cytotoxic activities. (2) Daphnane diterpenes - In the further studies on the plants of Thymelaeaceae, besides 10 known diterpenes, 16 new daphnane diterpenes were isolated from Daphne genkwa, D. tangutica, D. giraldii, Wikstroemie chamaedaphne. They showed the antifertilities activities. (3) Tripterygium diterpenes 14 new diterpenes were isolated from Triperygium wilfordii, T. regeli and T. hypoglaucum. Some of them showed the antitumor activities. The CD spectra showed that A/B ring of all compoundshave trans configuration as same as tripdiolide and triptolide determined by X-ray diffraction (4) Pregnane glycosides from Marsdenia koi - Two new pregnane glycosides marsdenikoiside A and marsdenikoiside B which can terminate the early pregnancy were isolated from Marsdeia koi. Their structures were elucidated by hydrolysis and spectroscopic methods.

A medium for inducing conversion of Histoplasma capsulatum var. capsulatum into its yeast-like form

Histoplasma capsulatum var. capsulatum is a dimorphic fungus that, under special conditions, converts from its more common mycelial form to a yeast-like form. Achieving this conversion, however, has been problematical for researchers. The present study tested conversion rates in ten Histoplasma capsulatum var. capsulatum strains using seven culture media, four of wich were conventional and three novel. One of our novel media, MLGema, induced complete conversion, of two strains within five days of incubation at 35 degrees centigrades, and of all strains that eventually converted by the time of the second subculturing transfer, under defined experimental conditions. MLGema is also inexpensive and easy to produce.