Hydra Socinianismi expugnata: sive, Johannis Volkelii Misnici, De vera religione, (ut falsò inscribuntur) libri quinque : quibus præfixus est Johannis Crellii Franci (ejusdem commatis) liber de Deo & ejus attributis, ita ut unum cum illis opus (integrumq́[ue], Socinianæ impietatis systema) constituat: cum eorundem refutatione exacta per additas annotationes & censuras necessarias /

Title vignettes; initials.

The diary of William Bentley, D. D.,

Index at end of each volume: Classified subject index to the set at end of v. 4.

Nonbreeding Eastern Curlews Numenius madagascariensis Do Not Increase the Rate of Intake or Digestive Efficiency before Long-Distance Migration because of an Apparent Digestive Constraint

The possibility of premigratory modulation in gastric digestive performance was investigated in a long-distance migrant, the eastern curlew (Numenius madagascariensis), in eastern Australia. The rate of intake in the curlews was limited by the rate of digestion but not by food availability. It was hypothesized that before migration, eastern curlews would meet the increased energy demand by increasing energy consumption. It was predicted that (1) an increase in the rate of intake and the corresponding rate of gastric throughput would occur or (2) the gastric digestive efficiency would increase between the mid-nonbreeding and premigratory periods. Neither crude intake rate (the rate of intake calculated including inactive pauses; 0.22 g DM [grams dry mass] or 3.09 kJ min(-1)) nor the rate of gastric throughput (0.15 g DM or 2.85 kJ min(-1)) changed over time. Gastric digestive efficiency did not improve between the periods (91%) nor did the estimated overall energy assimilation efficiency (63% and 58%, respectively). It was concluded that the crustacean-dominated diet of the birds is processed at its highest rate and efficiency throughout a season. It appears that without a qualitative shift in diet, no increase in intake rate is possible. Accepting these findings at their face value poses the question of how and over what time period the eastern curlews store the nutrients necessary for the ensuing long, northward nonstop flight.

1H-1,3-Diazepines, 5H-1,3-diazepines, 1,3-diazepinones, and 2,4-diazabicyclo[3.2.0]heptenes

Tetrazolo[1,5-a] pyridines/ 2-azidopyridines 1 undergo photochemical nitrogen elimination and ring expansion to 1,3-diazacyclohepta-1,2,4,6-tetraenes 3, which react with alcohols to afford 2-alkoxy-1H-1,3-diazepines 4 (5), with secondary amines to 2-dialkylamino-5H-1,3-diazepines 16, sometimes via isolable 2-dialkylamino-1H-1,3-diazepines 15, and with water to 1,3-diazepin-2-ones 19. The latter are also obtained by elimination of isobutene or propene from 2-tert-butoxy- or 2-isopropoxy-1H-1,3-diazepines 4 or 5. 1,3-Diazepin-2-one 22B and 1,3-diazepin-4-one 24 were obtained from hydrolysis of the corresponding 4-chlorodiazepines. Diazepinones 19 undergo photochemical ring closure to diazabicycloheptenones 25 in high yields. The 2-alkoxy-1H-1,3-diazepines 4 and 5 interconvert by rapid proton exchange between positions N1 and N3. The free energies of activation for the proton exchange were measured by the Forsen - Hoffman method as DeltaGdouble dagger(298) = 16.2 +/- 0.6 kcal mol(-1) as an average for 4a - c in CD2Cl2, acetone-d(6), and methanol-d(4), and 14.1 +/- 0.6 kcal mol(-1) for 4c in acetone/D2O. The structures of 2-methoxy-5,6-bis( trifluoromethyl)-1H-1,3-diazepine 4k, 1,2-dihydro-4-diethylamino-5H-1,3-diazepin-2-one 22bB, and diazabicycloheptanone 26 were determined by X-ray crystallography. The former represents the first reported X-ray crystal structure of any monocyclic N-unsubstituted 1H-azepine.

Factors associated with degeneration of the thallus centre in foliose lichens

Degeneration of the older parts of foliose lichen thalli often lead to the formation of a space or 'window' in the centre of the colonies. The percentage of thalli of different size which exhibited 'windows' was studied in twenty saxicolous lichen populations in south Gwynedd, Wales. The proportion of thalli with 'windows' increased with thallus size. The size class at which 50% and 100% of thalli exhibited 'windows' varied between populations. Differences between populations were not correlated with distance from the sea, aspect, slope or porosity of the substrate or the total number of lichen species present. However, a higher percentage of smaller thalli had 'windows' on rock surfaces with a greater lichen cover. There were no significant differences in the levels of Ca, Mg, Cu or Zn in large (>4 cm) and small (<2 cm) Parmelia conspersa (Ehrh. ex Ach.) Ach. thalli or in the centres and marginal lobes of these thalli. The concentration of ribitol, arabitol and mannitol was significantly reduced in the centre of large thalli compared with the margin of large thalli and the centre of small thalli. However, carbohydrate levels were similar in the centre of large thalli and the margin of small thalli. The data suggest that loss of the thallus centre is a degenerative process related to thallus size. In the field, the formation of 'windows' may be related to the intensity of competition on a substrate. Central degeneration was not associated with a deficiency or an accumulation of Ca, Mg, Cu and Zn in the thallus centre. However, degeneration may be associated with a reduction in carbohydrates in the centre compared with the marginal lobes.

Peroxisome Proliferator-Activated Receptor-γ Coactivator 1-α (PPARGC1A) Genetic Associations with Type 2 Diabetes in Three Ethnicities

Genetic heterogeneity, lifestyle factors, gene-gene or gene-environment interactions are the determinants of T2D which puts Hispanics and populations with African ancestry at higher risk of developing T2D. In this dissertation, the genetic associations of PPARGC1A polymorphisms with T2D and its related phenotypes (metabolic markers) in Haitian Americans (cases=110, controls=116), African Americans (cases=120, controls=124) and Cuban Americans (cases=160, controls=181) of South Florida were explored. Five single nucleotide polymorphisms of gene PPARGC1A were evaluated in each ethnicity for their disease association. In Haitian Americans, rs7656250 (OR= 0.22, pp=0.03) had significant protective association with T2D but had risk association in African Americans for rs7656250 (OR=1.02, p=0.96) and rs4235308 (OR=2.53, p=0.03). We found that in Haitian American females, both rs7656250 (OR=0.23, pp=0.03) had protective association with T2D. In African American females, rs7656250 (OR=1.14, p=0.78) had risk association whereas in males, it had significant protective effect (OR=0.37, p=0.04). However, the risk association exhibited by rs4235308 was stronger in African American females (OR=2.69, p=0.03) than males (OR=1.16, p=0.72). In Cuban Americans, only rs7656250 showed significant risk association with T2D (OR=6.87, p=0.02) which was stronger in females alone (OR=7.67, p=0.01). We also observed significant differences among correlations of PPARGC1A SNPs and T2D phenotypes. Positive correlation was observed for log Hs-CRP with rs3774907 (pp=0.03) in Cuban Americans respectively. Correlation of log A1C with rs7656250 (p=0.02) was positive in Cuban Americans while it was negative for rs3774907 in Haitian Americans (ppPPARGC1A correlations with T2D and its phenotypes among the three ethnicities studied (ii) the associations of PPARGC1A SNPs showed significant effect modification by sex. The findings suggest that variations in effects of PPARGC1A gene polymorphisms among three ethnicities and between sexes may have biomedical implications for the development of T2D as well as the phenotypes related to T2D.

Exploring the potential of clumped isotope thermometry on coccolith-rich sediments as a sea surface temperature proxy

Understanding past changes in sea surface temperatures (SSTs) is crucial; however, existing proxies for reconstructing past SSTs are hindered by unknown ancient seawater composition (foraminiferal Mg/Ca and d18O), or reflect subsurface temperatures (TEX86) or have a limited applicable temperature range (Uk'37). We examine clumped isotope (D47) thermometry to fossil coccolith-rich material as an SST proxy, as clumped isotopes are independent of original seawater composition and applicable to a wide temperature range and coccolithophores are widespread and dissolution resistant. The D47-derived temperatures from <63, <20, <10 and 2-5 µm size fractions of two equatorial Pacific late Miocene-early Pliocene sediment samples (c1; c2) range between ~18-29 {degree sign}C, with c1 temperatures consistently above c2. Removing the >63 µm fraction removes most non-mixed layer components; however, the D47-derived temperatures display an unexpected slight decreasing trend with decreasing size fraction. This unexpected trend could partly arise because larger coccoliths (5-12 µm) are removed during the size fraction separation process. The c1 and <63 µm c2 D47-derived temperatures are comparable to concurrent Uk'37 SSTs. The <20, <10 and 2-5 µm c2 D47-derived temperatures are consistently cooler than expected. The D47-Uk'37 temperature offset is probably caused by abiotic/diagenetic calcite present in the c2 2-5 µm fraction (~53% by area), which potentially precipitated at bottom water temperatures of ~6 {degree sign}C . Our results indicate that clumped isotopes on coccolith-rich sediment fractions have potential as an SST proxy, particularly in tropical regions, providing that careful investigation of the appropriate size fraction for the region and timescale is undertaken.

(Table 1, page 1169) Chemical composition of land (fossil) manganese deposits rich in todorokite

Chemical, x-ray and other data are given for todorokite, (Mn, Mg, Ca, Ba, Na, K)2.Mn5O12.3H2O, from Charco Redondo, Cuba, Farragudo, Portugal, and Hüttenberg, Austria. Additional localities at Romanèche, France, Saipan Island, Bahia, Brazil and Sterling Hill, New Jersey, are noted. Delatorreite of Simon and Straczek (1958) is identical with todorokite.

Influence d'un incitatif financier destiné aux médecins de famille sur la gestion du diabète des Néo-Brunswickois

Résumé: Problématique : En réponse à la prévalence accrue de la maladie du diabète et au fardeau économique important que représente cette maladie sur le système de santé international, des programmes incitatifs pour les maladies chroniques furent instaurés à travers le monde. Ces programmes visent à inciter les médecins à appliquer les lignes directrices chez leurs patients avec besoin complexe en vue d’améliorer la santé des patients et par la suite de réduire les coûts incombés par le système de santé. Les programmes incitatifs étant nombreux et différents d’un pays à l’autre, les études actuelles ne semblent pas s’entendre sur les répercussions de tels programmes sur la santé des patients atteints de diabète. L’objectif de cette étude est d’évaluer les retombées d’un incitatif financier sur le contrôle glycémique de la population atteinte de diabète du Nouveau-Brunswick, au Canada. Méthodes : Cette étude transversale répétée et de cohorte a été menée grâce à des bases de données administratives du Nouveau-Brunswick contenant des données sur dix ans pour 83 580 patients adultes atteints de diabète et 583 médecins de famille éligibles. La santé des patients a été évaluée au niveau du contrôle glycémique, en mesurant les valeurs moyennes d’A1C annuelles à l’aide de régressions linéaires multivariées. Afin d’évaluer si les médecins changeaient leur pratique avec l’implantation du programme incitatif, nous regardions au niveau de la probabilité de recours annuel à au moins deux tests d’A1C en utilisant des régressions logistiques multivariées. Résultats : La probabilité de recours annuel à au moins deux tests d’A1C était plus élevée dans quatre sous-groupes étudiés : les patients nouvellement diagnostiqués après l’implantation du programme avaient des cotes plus élevées comparées aux nouveaux patients avant l’implantation du programme (OR=1.23 [1.18-1.28]); les patients pour lesquels un médecin avait réclamé l’incitatif comparés aux patients pour lesquels aucun médecin n’avait réclamé l’incitatif (OR=2.73 [2.64-2.81]); les patients pour lesquels un médecin avait réclamé l’incitatif avaient des cotes plus élevées après l’implantation du programme comparé à avant (OR=1.89 [1.80-1.98]); et finalement, les patients suivis par un médecin de famille qui a déjà réclamé l’incitatif avaient des cotes 24% plus élevées (OR=1.24 [1.15-1.34]). Il n’y avait pas de différence dans les valeurs d’A1C annuelles entre les 4 sous-groupes étudiés. Conclusion : L’implantation du programme incitatif a démontré que les médecins ont une meilleure probabilité de prescrire au moins deux tests d’A1C, ce qui suggère une meilleure prise en charge des patients. Cependant, le manque de changement au niveau du contrôle glycémique du patient suggère que l’étude des répercussions de l’incitatif devra être poursuivie afin de voir si elle mène à une amélioration d’issues cliniques chez les patients.

Aferição das dificuldades/competências na área da Endodontia percepcionadas pelos alunos do 4º e 5º anos da FCS-UFP

Introdução: Com uma consciencialização cada vez maior das populações para a preservação dos dentes naturais, a Endodontia tem assumido uma importância crescente, tendo por objectivo principal a manutenção de dentes funcionais, sem prejudicar a saúde dos pacientes. Estes devem beneficiar de um tratamento segundo o “standard of care”, proporcionado por profissionais competentes. Vários estudos demonstram que a Endodontia é considerada uma área difícil e stressante para os estudantes, exibindo um sentimento de menor confiança na prática clínica, sobretudo no que diz respeito a procedimentos mais complexos, nomeadamente, no tratamento de dentes posteriores. Em 2010, na tentativa de homogeneizar as competências adquiridas pelos Médicos Dentistas (MD), a Associação para a Educa��ão Dentária Europeia (AEDE) definiu critérios para a sua formação pré-graduada, indicando que o MD recém-graduado deve ter adquirido competências e capacidades técnicas que lhe permita começar a sua prática clínica de forma independente. Objectivos: Analisar os conhecimentos adquiridos e as dificuldades sentidas na área da Endodontia pelos alunos do 4º e 5º anos do Mestrado Integrado em Medicina Dentária da Faculdade de Ciências de Saúde (FCS) da Universidade Fernando Pessoa (UFP), fazendo, igualmente, uma abordagem ao ensino ministrado na área da Endodontia face aos resultados obtidos. Materiais e Métodos: Este trabalho está dividido em duas partes: revisão bibliográfica e investigação científica. A revisão bibliográfica do tema engloba o ensino graduado em Medicina Dentária, o uso de isolamento absoluto (IA) na prática clínica de Endodontia, a instrumentação manual versus rotatória, a influência no sucesso do tratamento endodôntico (TE) da sua execução por estudantes do 4º e 5º ano, as Guidelines para o TE e o ensino de Endodontia na UFP. A pesquisa bibliográfica foi efectuada através da base de dados PubMed, tendo sido utilizadas, em diferentes combinações, as seguintes palavras-chave: ”Endodontics”, “teaching”; “pre-clinical”; “undergraduate”; “Clinical”; “treatment” e “Europe”. O trabalho de investigação consistiu na elaboração, aprovação pela Comissão de Ética da UFP e posterior aplica��ão de um questionário destinado aos alunos do 4º e 5º ano do Mestrado Integrado em Medicina Dentária da FCS-UFP. A população estimada de alunos do 4º ano foi de 190 alunos e a de 5º ano de 150 alunos, o que perfaz um total de 340 alunos. Dos inquéritos respondidos, apenas foram considerados 338, uma vez que dois foram anulados pois continham respostas inválidas. Resultados: A “condição socioeconómica do paciente” foi considerada a causa menos relevante para avaliar um caso endodôntico, tendo sido apontada por 34,3% dos alunos. Assinala-se que 92% dos alunos de 4º ano e 93,3% dos alunos de 5º ano consideram que os molares superiores são os dentes mais difíceis de tratar, sendo a visibilidade uma das principais razões para esta opinião. O grau de dificuldade para a coloca��ão do IA é definido como “Elevado” para a maioria dos alunos de 4º ano. A maior parte dos alunos de 5º ano considera que o grau de dificuldade para a “Determinação do tipo de reconstrução/prótese fixa mais indicada” é “Elevado”. O passo do TE onde os alunos do 4º ano se sentem mais confiantes é no “Diagnóstico de ca��rie”, sendo que os alunos do 5º ano se sentem mais confiantes ao realizar o “TE em dentes com 1 ou 2 canais”. O “Conteúdo leccionado nas aulas teóricas” foi considerado o principal aspecto positivo do ensino endodôntico. Por outro lado, o “Número de actos clínicos realizados” foi considerado o principal aspecto negativo, tanto para alunos de 4º como de 5º ano. Em ambos os anos, os principais pontos que os alunos acham que devem ser melhorados são o “Número de pacientes nas aulas clínicas” e a “Aprendizagem da técnica de instrumentação mecanizada/obturação termoplástica���. As principais preocupações referidas, tanto por alunos de 4º como de 5º anos, foram a “Insegurança na prática clínica��� e a “Dificuldade em encontrar ofertas profissionais”. Relativamente à qualidade dos seus TE existe um número significativo de alunos do 5º ano que já se auto-avaliam como “Bons” (33,6%), por comparação com os do 4º ano (21,2%), sendo a auto-avaliação de “Razoável” dominante em ambos os anos de formação. Conclusões: Conclui-se que na disciplina de Endodontia na FCS-UFP, são seguidas as Guidelines da European Society of Endodontology (ESE), sendo que estas indicam o protocolo mais correcto a seguir durante o Tratamento Endodôntico Não-Cirúrgico (TENC). Contudo, o reduzido número de actos clínicos e a consequente falta de prática faz com que os alunos se sintam pouco confiantes ao iniciar a sua actividade profissional.

Desenvolvimento e caracterização de micropartículas de amido reticuladas com agente fosfatado e avaliação da adsorção do azul de metileno

Starch has properties that make it one of the most studied biopolymers today. It is biodegradable, biocompatible, stable and non-toxic. This work has synthesis of starch and tapioca microparticles, through chemical modification by crosslinking with sodium tripolyphosphate agent in concentrations 7.5 and 15% (m / m). The amylose content was measured for starch and commercial cassava starch at 21.8% and 28.6%, respectively. According to the solubility index, processing in basic medium does not change the solubility of the material, but the addition of crosslinking agent increases this index, which changed from 12.8% for the control unprocessed, to 22.4% for the A5R15 sample. Soluble starch-based materials had a significant increase in the crosslinking density by increasing the concentration of crosslinker, from 1.4 in A5R7,5 sample, to 1.9 in A5R15. The cassava starch-based materials exhibited an opposite behavior: to increase the concentration of crosslinker crosslinking density decreased significantly in F5R7.5 from 2.9, to 1.9 in F5R15 sample. The point of zero charge (PZC) shows that below pH 4 the surface is positively charged. The surface area data is between 3,04 and 1,15 m2.g-1. The pore volume between 2.94 and 1.33 cm3.g-1 and pore size around 1.5 nm. The SEM indicates uneven distribution of microparticles, which are smooth, with no ridges. The maximum adsorption capacity of the materials were tested at pH 7.7 and for A5R15 and CA sample, at pH 2, 5, 6 and 9. It is noted that the processing in basic medium reduces the adsorption capacity of CA and CF in respect fo A and F. The adsorption in A5R15 sample has great dependency on the pH, reaching a value of 587 μg.g-1 in pH 7.7. The samples A5R15 and F5R7,5 adsorbed similar amounts, according to the statistical analysis, and significantly higher than their respective controls and showed lower desorption, indicating that the modification process was effective to control the release of methylene blue. The infrared spectra not show the characteristic bands of the phosphate bonds to the material formed, however, developments in hydroxyl characteristic band suggest modification in the way this group was linked after the reaction. After adsorption, the infrared spectra show different format in the band of hydroxyl. PCA analysis shows that the greatest changes observed in the IR spectra are observed in the region of 3500 cm-1. Thermal analysis showed three thermal events related to dehydration and material degradation. It is observed that the processing increases the temperature to the first mass loss, fixed at 12%, but not observed increased stability due to the presence of crosslinker or process.

Preparación y caracterización de biomateriales híbridos de hidroxiapatito con fosfonato (2-Hidroxi fosfonoacetato)

El hidroxiapatito es el biomineral de los tejidos duros de los mamíferos y por ello ha sido ampliamente estudiado como biomaterial en cementos óseos, recubrimientos de metales implantables y scaffold en ingeniería de tejidos. En este trabajo, se estudia un proceso síntesis y caracterización de un derivado de este material, donde el ion fosfonato: 2- hidroxifosfonoacetato sustituye parcialmente al ion fosfato [1-10%]. El proceso de síntesis de hidroxiapatito consiste en dos etapas: (1) una reacción a 100ºC entre el ácido fosfórico (añadido lentamente) y una mezcla de hidróxido de calcio + 2-hidroxifosfonoacetato de calcio (Relación Ca/P=1.67). (2) un tratamiento térmico de los sólidos obtenidos en (1) a 150ºC. Los productos finales se han caracterizado mediante análisis químico, análisis termogravimétrico, difracción de rayos-X con análisis de Rietveld, microscopía SEM y determinación de la superficie específica y porosidad. En las fases cristalinas, el grado de pureza de los hidroxiapatitos oscila entre 91-100%. Todos presentan estructura monoclínica, en contraste con la estructura hexagonal que habitualmente se obtiene aplicando métodos de síntesis similares. Esta variación se atribuye a la presencia de fosfonato. El contenido de éste también influye en la morfología y en la porosidad de los materiales, siendo las muestras con más fosfonato las más porosas. Los materiales, al menos aquellos con una cantidad menor o igual 5% de fosfonato, muestran una biocompatibilidad similar a un material de hidroxiapatito de referencia.

Asociación entre nutrientes y hemoglobina glicosilada en diabéticos tipo 2

Introducción: la hiperglicemia es la característica principal de la diabetes (DM). La restricción de CHO en la dieta presenta el mayor efecto en la disminución de los niveles de glucosa en sangre tanto en DM 1 y 2. Objetivo: asociar la ingesta de macro y micronutrientes con el control metabólico de pacientes con diabetes tipo 2. Material y métodos: se entrevistó a 714 pacientes diabéticos tipo 2 de ambos sexos, entre 27 y 90 años, en centros de salud familiar de Santiago de Chile. Se les aplicó una encuesta alimentaria y una evaluación antropométrica. Se realizó prueba de regresión logística, se estimó además el valor del Odds Ratio (OR) y su correspondiente intervalo de confianza (IC). Resultados: el IMC promedio fue de 30,8 ± 5,7 kg/m², el 29,8% de los sujetos tenía una HbA1c compensada. Se puede observar que solo la ingesta elevada de carbohidratos (percentil 75) se asoció con un incremento en el riesgo de tener HbA1c elevada OR = 2,7 (IC 95% 1,5-4,8; p < 0,001). Conclusiones: la ingesta elevada de carbohidratos de rápida absorción, altos en sacarosa y bajos en fibra se asocia como factor de riesgo en el incremento de HbA1c. La ingesta total de energía y el patrón de alimentación saludable se debe priorizar sobre la distribución de macronutrientes. Es importante la asesoría de un experto en nutrición especializado en diabetes quien, en colaboración con el equipo médico, debe determinar el tratamiento para cumplir con los objetivos individuales del paciente.

Interacção de complexos de vanádio-citrato com a bomba de cálcio de retículo sarcoplasmático

Dissertação de mest. em Biotecnologia, Departamento de Química e Bioquímica da Faculdade de Ciêicias e Tecnologia, Univ. do Algarve, 2004

Estudio de casos y controles sobre factores asociados a retinopatía en pacientes con diabétes mellitus tipo 2 Fundación DONUM 2000-2005

Se trata de un estudio de casos y controles, pareado con edad, ocupación y sexo, realizado en pacientes diabéticos atendidos en la Fundación DONUM de la ciudad de Cuenca. De las 1.100 historias clínicas existntes en el período comprendido entre enero de 2001 y julio del 2005, se eligieron 408, de las cuales 101 pertenecieron a los casos (diabéticos con retinopatía) y 307 a controles (diabéticos sin retinopatía); se identificaron como variables independientes, la evolución en años de la diabetees, dislipidemia e hipertensión arterial; hemoglobina glucosilada, concentración de glicemia, colesterol, triglicéridos y colesterol LDL. Resultados: no hubo diferencia entre los casos y controles en edad, ocupación y sexo. Entre los factores de riesgo asociados de manera significativa, se encontraron la evolución de más de 10 años de diabetes OR (Odds ratio) 10.63, IC 95(intervalo de confianza) 6.16-10.43; más de 5 años de dislipidemia OR 10.29, IC 85(3.82-13.40); presión arterial sistólica>- 130 mmHG. OR 2.91, IC 95(1.74-4.90); colesterol total >- 200mg/dl OR 1.97, IC 95(1.17-3.31); presión arterial diastolica >- 80mmHG. [OR 1.87, IC 95(1.09-3-23). Entre los factores asociados de manera no significativa están: colesterol LDL >- 100 mg/dl OR 1.90, IC 95(0.98-3.73); índice de masa corporal>- 30 Kg/m2 OR 1.43, IC 95(0.87-2.34). Conclusión: los factores asociados a retinopatía de manera significativa son tiempo de evolución de diabetes, de dislipidemia, de hieprtensión arterial, presión arterial sistólica>- 130mmHG., colesterol total >- 200mg/dl y presión arterial diastólica >- 80mmHG