Biologia comparada e exigências térmicas de Cryptoblabes gnidiella em dieta artificial

O objetivo deste trabalho foi avaliar o desenvolvimento de Cryptoblabes gnidiella em dietas artificiais e conhecer as exigências térmicas da espécie. A biologia do inseto foi estudada em laboratório (26±1ºC, umidade relativa de 70±10% e fotófase de 14 horas), em três dietas artificiais à base de feijão carioca (D1), feijão branco e "pellet" de alfafa (D2) e feijão branco (D3). As exigências térmicas das fases de desenvolvimento foram determinadas em laboratório, tendo-se criado o inseto na D2, nas temperaturas de 18ºC, 22ºC, 26ºC e 30ºC, umidade relativa de 70±10% e fotófase de 14 horas. Com base na tabela de vida de fertilidade, a D2 foi a mais adequada para criação de C. gnidiella em laboratório e proporcionou uma viabilidade total de 53,30%. A temperatura base e a constante térmica para o ciclo total (ovo-adulto) foram 12,26ºC e 569,91 graus-dia, respectivamente. Com base nas exigências térmicas, estimou-se que o inseto completa 3,25 gerações anuais em Caxias do Sul, RS e 9,19 em Petrolina, PE.

Randomized trial of a computerized coronary heart disease risk assessment tool in HIV-infected patients receiving combination antiretroviral therapy.

BACKGROUND: Exposure to combination antiretroviral therapy (cART) can lead to important metabolic changes and increased risk of coronary heart disease (CHD). Computerized clinical decision support systems have been advocated to improve the management of patients at risk for CHD but it is unclear whether such systems reduce patients' risk for CHD. METHODS: We conducted a cluster trial within the Swiss HIV Cohort Study (SHCS) of HIV-infected patients, aged 18 years or older, not pregnant and receiving cART for >3 months. We randomized 165 physicians to either guidelines for CHD risk factor management alone or guidelines plus CHD risk profiles. Risk profiles included the Framingham risk score, CHD drug prescriptions and CHD events based on biannual assessments, and were continuously updated by the SHCS data centre and integrated into patient charts by study nurses. Outcome measures were total cholesterol, systolic and diastolic blood pressure and Framingham risk score. RESULTS: A total of 3,266 patients (80% of those eligible) had a final assessment of the primary outcome at least 12 months after the start of the trial. Mean (95% confidence interval) patient differences where physicians received CHD risk profiles and guidelines, rather than guidelines alone, were total cholesterol -0.02 mmol/l (-0.09-0.06), systolic blood pressure -0.4 mmHg (-1.6-0.8), diastolic blood pressure -0.4 mmHg (-1.5-0.7) and Framingham 10-year risk score -0.2% (-0.5-0.1). CONCLUSIONS: Systemic computerized routine provision of CHD risk profiles in addition to guidelines does not significantly improve risk factors for CHD in patients on cART.

Biologia e tabela de vida de fertilidade de Agrotis ipsilon em dieta artificial

O objetivo deste trabalho foi desenvolver uma dieta artificial para criação de Agrotis ipsilon em laboratório com base em parâmetros biológicos e na tabela de vida de fertilidade. A dieta artificial utilizada continha feijão, caseína, proteína de soja, levedura e germe de trigo como fontes protéicas. Os parâmetros biológicos duração e viabilidade das fases larval e pupal, peso de pupas, de ambos os sexos, com 24 horas de idade, razão sexual, longevidade dos adultos, período de pré-oviposição e número de ovos produzidos por fêmea e a tabela de vida de fertilidade foram avaliados. Foram observados seis ínstares larvais com duração de 25,4 dias e viabilidade de 93%. A duração da fase pupal foi de 12,4 dias e viabilidade de 96%. A viabilidade de ciclo total foi 72%. O peso de pupas foi 387 mg (machos) e 484 mg (fêmeas). A razão sexual foi 0,46. O período de pré-oviposição foi de um dia, com 1.806 ovos por fêmea. Na tabela de vida verificou-se que a taxa líquida de reprodução e a razão finita de aumento foram 616,9 e 1,14, respectivamente. A dieta artificial é adequada à manutenção da criação de A. ipsilon, em laboratório.

Biologia e tabela de vida de fertilidade de Hypercompe indecisa em dieta artificial

O objetivo deste trabalho foi estudar a biologia de Hypercompe indecisa e construir a tabela de vida de fertilidade em dieta artificial, para criação em laboratório. Foram determinados: duração e sobrevivência das fases de ovo, larva e pupa; número de estádios larvais; razão sexual; peso de pupas; longevidade; fecundidade; e períodos de pré-oviposição e oviposição. Os períodos embrionário, larval e pupal foram de 6, 25,4 e 64,3 dias, com sobrevivência de 92,7, 92 e 71,9%, respectivamente. Foram observados seis estádios larvais com durações variáveis. O peso de pupas foi: 1,04 g para fêmeas e 0,726 g para machos. O ciclo biológico foi de 95,6 dias com sobrevivência total de 61,3%. As fêmeas colocaram, em média, 1.531 ovos durante 8,3 dias, e com um período de pré-oviposição de dois dias. A longevidade média de machos e fêmeas foi de 21,9 e 21,8 dias, respectivamente, e a razão sexual de machos para fêmeas foi 0,54. A espécie H. indecisa aumentou 283 vezes a cada geração, e a duração média de uma geração é de 98 dias, e a razão finita de aumento é de 1,0593. A dieta artificial utilizada foi adequada para a criação de H. indecisa, em laboratório.

Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality

BACKGROUND: Data on the association between subclinical thyroid dysfunction and coronary heart disease (CHD) and mortality are conflicting. PURPOSE: To summarize prospective evidence about the relationship between subclinical thyroid dysfunction and CHD and mortality. DATA SOURCES: MEDLINE (1950 to January 2008) without language restrictions and reference lists of retrieved articles were searched. STUDY SELECTION: Two reviewers screened and selected cohort studies that measured thyroid function and then followed persons prospectively to assess CHD or mortality. DATA EXTRACTION: By using a standardized protocol and forms, 2 reviewers independently abstracted and assessed studies. DATA SYNTHESIS: Ten of 12 identified studies involved population-based cohorts that included 14 449 participants. All 10 population-based cohort studies examined risks associated with subclinical hypothyroidism (2134 CHD events and 2822 deaths), whereas only 5 examined risks associated with subclinical hyperthyroidism (1392 CHD events and 1993 deaths). In a random-effects model, the relative risk (RR) for subclinical hypothyroidism for CHD was 1.20 (95% CI, 0.97 to 1.49; P for heterogeneity = 0.14; I(2 )= 33.4%). Risk estimates were lower when higher-quality studies were pooled (RR, 1.02 to 1.08) and were higher among participants younger than 65 years (RR, 1.51 [CI, 1.09 to 2.09] for studies with mean participant age <65 years and 1.05 [CI, 0.90 to 1.22] for studies with mean participant age > or =65 years). The RR was 1.18 (CI, 0.98 to 1.42) for cardiovascular mortality and 1.12 (CI, 0.99 to 1.26) for total mortality. For subclinical hyperthyroidism, the RR was 1.21 (CI, 0.88 to 1.68) for CHD, 1.19 (CI, 0.81 to 1.76) for cardiovascular mortality, and 1.12 (CI, 0.89 to 1.42) for total mortality (P for heterogeneity >0.50; I(2 )= 0% for all studies). LIMITATIONS: Individual studies adjusted for different potential confounders, and 1 study provided only unadjusted data. Publication bias or selective reporting of outcomes could not be excluded. CONCLUSION: Subclinical hypothyroidism and hyperthyroidism may be associated with a modest increased risk for CHD and mortality, with lower risk estimates when pooling higher-quality studies and larger CIs for subclinical hyperthyroidism

Crescimento de eucalipto sob efeito de desfolhamento artificial

O objetivo deste trabalho foi avaliar os efeitos do desfolhamento total, realizado após o plantio e ao longo do primeiro ano de cultivo, sobre o crescimento de Eucalyptus grandis, desde a implantação até ao corte do povoamento. Foram avaliados cinco tratamentos: sem desfolhamento; um desfolhamento aos 56 dias após o plantio (DAP); dois desfolhamentos, aos 56 e 143 DAP; dois desfolhamentos, aos 56 e 267 DAP; e três desfolhamentos, aos 56, 143 e 278 DAP. Foram mensurados os diâmetros do tronco a 1,3 m e a altura total de 60 árvores por tratamento, em oito avaliações, do 21º ao 92º mês de cultivo. O crescimento médio em cada tratamento foi descrito por modelos de regressão não lineares e comparados por testes de identidade para comparar as tendências entre a testemunha e os demais tratamentos. O desfolhamento causou reduções significativas nas taxas de crescimento em diâmetro e altura das plantas, e diminuição expressiva no faturamento ao final da rotação, mesmo quando realizado uma única vez, no início do plantio. Maiores danos, no entanto, foram verificados após consecutivos desfolhamentos ao longo do primeiro ano de cultivo. A manutenção de áreas que tenham sofrido desfolhamento total na fase inicial de plantio pode tornar-se uma medida economicamente inviável.

Low-cost MR-compatible moving heart phantom.

For the development and evaluation of cardiac magnetic resonance (MR) imaging sequences and methodologies, the availability of a periodically moving phantom to model respiratory and cardiac motion would be of substantial benefit. Given the specific physical boundary conditions in an MR environment, the choice of materials and power source of such phantoms is heavily restricted. Sophisticated commercial solutions are available; however, they are often relatively costly and user-specific modifications may not easily be implemented. We therefore sought to construct a low-cost MR-compatible motion phantom that could be easily reproduced and had design flexibility. A commercially available K'NEX construction set (Hyper Space Training Tower, K'NEX Industries, Inc., Hatfield, PA) was used to construct a periodically moving phantom head. The phantom head performs a translation with a superimposed rotation, driven by a motor over a 2-m rigid rod. To synchronize the MR data acquisition with phantom motion (without introducing radiofrequency-related image artifacts), a fiberoptic control unit generates periodic trigger pulses synchronized to the phantom motion. Total material costs of the phantom are US$ < 200.00, and a total of 80 man-hours were required to design and construct the original phantom. With schematics of the present solution, the phantom reproduction may be achieved in approximately 15 man-hours. The presented MR-compatible periodically moving phantom can easily be reproduced, and user-specific modifications may be implemented. Such an approach allows a detailed investigation of motion-related phenomena in MR images.

Predictors of mortality from pump failure and sudden cardiac death in patients with systolic heart failure and left ventricular dyssynchrony: results of the CARE-HF trial.

BACKGROUND: Determining a specific death cause may facilitate individualized therapy in patients with heart failure (HF). Cardiac resynchronization therapy (CRT) decreased mortality in the Cardiac Resynchronization in Heart Failure trial by reducing pump failure and sudden cardiac death (SCD). This study analyzes predictors of specific causes of death. METHODS AND RESULTS: Univariate and multivariate analyses used 8 baseline and 3-month post-randomization variables to predict pump failure and SCD (categorized as "definite," "probable," and "possible"). Of 255 deaths, 197 were cardiovascular. There were 71 SCDs with a risk reduction by CRT of 0.47 (95% confidence interval 0.29-0.76; P = .002) with similar reductions in SCD classified as definite, probable, and possible. Univariate SCD predictors were 3-month HF status (mitral regurgitation [MR] severity, plasma brain natriuretic peptide [BNP], end-diastolic volume, and systolic blood pressure), whereas randomization to CRT decreased risk. Multivariate SCD predictors were randomization to CRT 0.56 (0.53-0.96, P = .035) and 3-month MR severity 1.82 (1.77-2.60, P = .0012). Univariate pump failure death predictors related to baseline HF state (quality of life score, interventricular mechanical delay, end-diastolic volume, plasma BNP, MR severity, and systolic pressure), whereas randomization to CRT and nonischemic cardiomyopathy decreased risk; multivariate predictors of pump failure death were baseline plasma BNP and systolic pressure and randomization to CRT. CONCLUSION: CRT decreased SCD in patients with systolic HF and ventricular dyssynchrony. SCD risk was increased with increased severity of MR (including the 3-month value for MR as a time-dependent covariate) and reduced by randomization to CRT. HF death was increased related to the level of systolic blood pressure, log BNP, and randomization to CRT. These results emphasize the importance and interdependence of HF severity to mortality from pump failure and SCD.

Daily energy expenditure in free-living conditions in obese and non-obese children: comparison of doubly labelled water (2H2(18)O) method and heart-rate monitoring.

OBJECTIVE: To compare the heart-rate monitoring with the doubly labelled water (2H2(18)O) method to estimate total daily energy expenditure in obese and non-obese children. DESIGN: Cross sectional study of obese and normal weight children. SUBJECTS: 13 prepubertal children: six obese (4M, 2F, 9.1 +/- 1.5 years, 47.3 +/- 9.7 kg) and seven non-obese (3M, 4F, 9.3 +/- 0.6 years, 31.8 +/- 3.2 kg). MEASUREMENTS: Total daily energy expenditure was assessed by means of the doubly labelled water method (TEEDLW) and of heart-rate monitoring (TEEHR). RESULTS: TEEHR was significantly (P < 0.05) higher than TEEDLW in obese children (9.47 +/- 0.84 MJ/d vs 8.99 +/- 0.63 MJ/d) whereas it was not different in non-obese children (8.43 +/- 2.02 MJ/d vs 8.42 +/- 2.30 MJ/d, P = NS). The difference of TEE assessed by HR monitoring in the obese group averaged 6.2 +/- 4.7%. At the individual level, the degree of agreement (difference between TEEHR and TEEDLW +/- 2s.d.) was low both in obese (-0.36, 1.32 MJ/d) and in non-obese children (-1.30, 1.34 MJ/d). At the group level, the agreement between the two methods was good in nonobese children (95% c.i. for the bias:-0.59, 0.63 MJ/d) but not in obese children (0.04, 0.92 MJ/d). Duration of sleep and energy expenditure during resting and physical activity were not significantly different in the two groups. Patterns of heart-rate (or derived energy expenditure) during the day-time were similar in obese and non-obese children. CONCLUSION: The HR monitoring technique provides an estimation of TEE close to that assessed by the DLW method in non-obese prepubertal children. In comparison with DLW, the HR monitoring method yields a greater TEE value in obese children.

Reduction of respiratory motion artifacts for free-breathing whole-heart coronary MRA by weighted iterative reconstruction.

PURPOSE: To combine weighted iterative reconstruction with self-navigated free-breathing coronary magnetic resonance angiography for retrospective reduction of respiratory motion artifacts. METHODS: One-dimensional self-navigation was improved for robust respiratory motion detection and the consistency of the acquired data was estimated on the detected motion. Based on the data consistency, the data fidelity term of iterative reconstruction was weighted to reduce the effects of respiratory motion. In vivo experiments were performed in 14 healthy volunteers and the resulting image quality of the proposed method was compared to a navigator-gated reference in terms of acquisition time, vessel length, and sharpness. RESULT: Although the sampling pattern of the proposed method contained 60% more samples with respect to the reference, the scan efficiency was improved from 39.5 ± 10.1% to 55.1 ± 9.1%. The improved self-navigation showed a high correlation to the standard navigator signal and the described weighting efficiently reduced respiratory motion artifacts. Overall, the average image quality of the proposed method was comparable to the navigator-gated reference. CONCLUSION: Self-navigated coronary magnetic resonance angiography was successfully combined with weighted iterative reconstruction to reduce the total acquisition time and efficiently suppress respiratory motion artifacts. The simplicity of the experimental setup and the promising image quality are encouraging toward future clinical evaluation. Magn Reson Med 73:1885-1895, 2015. © 2014 Wiley Periodicals, Inc.

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF) inHIV-infected patients. Methods.We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results.We identified 81 patients with a history of a coronary event (prevalence 2.15%); 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus).OtherCVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol ( � = 0.025) and LDLcholesterol ( � = 0.004) was observed. However, the percentage of patients whomaintained LDL-cholesterol > 100mg/dL remained stable (from 46% to 41%, � = 0.103). Patients using protease inhibitors associated with a favorable lipid profile increased over time ( � = 0.028). Conclusions.The prevalence of coronary events in our cohort is low. CVRF prevalence is high and theirmanagement is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients.

Surgical treatment for heart myxomas.

According to unselected autopsy data, primary cardiac tumours are a rare entity. About 80% of the tumours are benign and nearly half of these are myxomas. In clinical practice, when diagnosis of this pathological entity is ascertained, decision for surgical treatment is made in order to prevent thromboembolism and obstruction of the valvular apparatus. Surgical resection including total tumour removal is accompanied by low perioperative mortality. The recidive rate is low in sporadic cases. However, in familial syndrome groups, such as the Swiss-Carney syndrome, the recurrence rate is higher.

Did Dumbo suffer a heart attack? independent association between earlobe crease and cardiovascular disease.

BACKGROUND: Earlobe crease (ELC) has been associated with cardiovascular diseases (CVD) or risk factors (CVRF) and could be a marker predisposing to CVD. However, most studies studied only a small number of CVRF and no complete assessment of the associations between ELC and CVRF has been performed in a single study. METHODS: Population-based study (n = 4635, 46.7 % men) conducted between 2009 and 2012 in Lausanne, Switzerland. RESULTS: Eight hundred six participants (17.4 %) had an ELC. Presence of ELC was associated with male gender and older age. After adjusting for age and gender (and medication whenever necessary), presence of ELC was significantly (p < 0.05) associated with higher levels of body mass index (BMI) [adjusted mean ± standard error: 27.0 ± 0.2 vs. 26.02 ± 0.07 kg/m(2)], triglycerides [1.40 ± 0.03 vs. 1.36 ± 0.01 mmol/L] and insulin [8.8 ± 0.2 vs. 8.3 ± 0.1 μIU/mL]; lower levels of HDL cholesterol [1.61 ± 0.02 vs. 1.64 ± 0.01 mmol/L]; higher frequency of abdominal obesity [odds ratio and (95 % confidence interval) 1.20 (1.02; 1.42)]; hypertension [1.41 (1.18; 1.67)]; diabetes [1.43 (1.15; 1.79)]; high HOMA-IR [1.19 (1.00; 1.42)]; metabolic syndrome [1.28 (1.08; 1.51)] and history of CVD [1.55 (1.21; 1.98)]. No associations were found between ELC and estimated cardiovascular risk, inflammatory or liver markers. After further adjustment on BMI, only the associations between ELC and hypertension [1.30 (1.08; 1.56)] and history of CVD [1.47 (1.14; 1.89)] remained significant. For history of CVD, further adjustment on diabetes, hypertension, total cholesterol and smoking led to similar results [1.36 (1.05; 1.77)]. CONCLUSION: In this community-based sample ELC was significantly and independently associated with hypertension and history of CVD.

Cost-effectiveness analysis of cardiac resynchronization therapy in patients with NYHA I and NYHA II heart failure in Spain

Objectives: The aim of the study was to combine clinical results from the European Cohort of the REVERSE study and costs associated with the addition of cardiac resynchronization therapy (CRT) to optimal medical therapy (OMT) in patients with mild symptomatic (NYHA I-II) or asymptomatic left ventricular dysfunction and markers of cardiac dyssynchrony in Spain. Methods: A Markov model was developed with CRT + OMT (CRT-ON) versus OMT only (CRT-OFF) based on a retrospective cost-effectiveness analysis. Raw data was derived from literature and expert opinion, reflecting clinical and economic consequences of patient"s management in Spain. Time horizon was 10 years. Both costs (euro 2010) and effects were discounted at 3 percent per annum. Results: CRT-ON showed higher total costs than CRT-OFF; however, CRT reduced the length of hospitalization in ICU by 94 percent (0.006 versus 0.091 days) and general ward in by 34 percent (0.705 versus 1.076 days). Surviving CRT-ON patients (88.2 percent versus 77.5 percent) remained in better functional class longer, and they achieved an improvement of 0.9 life years (LYGs) and 0.77 years quality-adjusted life years (QALYs). CRT-ON proved to be cost-effective after 6 years, except for the 7th year due to battery depletion. At 10 years, the results were 18,431 per LYG and 21,500 per QALY gained. Probabilistic sensitivity analysis showed CRT-ON was cost-effective in 75.4 percent of the cases at 10 years. Conclusions: The use of CRT added to OMT represents an efficient use of resources in patients suffering from heart failure in NYHA functional classes I and II.

Dinâmica de cobertura de dossel de povoamento de clone de Eucalyptus grandis W. Hill ex-Maiden submetidos a desrama artificial a desbaste

A dinâmica de copa foi avaliada através do índice de área foliar (IAF), transmitância da radiação fotossinteticamente ativa (t%) e índice de cobertura do dossel (ICD), entre 55 e 68 meses de idade, em povoamentos de clone de Eucalyptus grandis desramados entre 16 e 45 meses de idade até a altura de 6 m. Esses povoamentos foram submetidos a desbaste (0 e 35% do número total de mudas plantadas), aos 55 meses de idade, em Abaeté, MG. Não foi observada diferença significativa (P>0,05) entre os tratamentos de desrama, para IAF, t% e ICD, entre 55 e 68 meses de idade, em razão da elevada capacidade de recomposição de copa desse clone. Porém, observou-se mudança significativa (P<0,05) nesses parâmetros entre as idades de avaliação, e houve redução de IAF e ICD e aumento de t% imediatamente após o desbaste, tendo havido pronta recomposição da copa seis meses após o desbaste, nas três idades de primeira intervenção de desrama. Aos 68 meses de idade, o IAF e o ICD do povoamento desbastado foram significativamente (P<0,05) maiores, enquanto t% foi significativamente menor do que do povoamento não-desbastado. Os resultados de IAF e t% indicaram que essas informações podem ser utilizadas para avaliação da dinâmica de copa, sendo os dados de IAF mais consistentes do que os de t%. A utilização de fotografia digital apresenta potencial para avaliar a dinâmica de cobertura do dossel, em razão de ser um método de uso fácil e barato, embora ainda requeira aperfeiçoamentos.