The relationship between premature rupture of the membranes and sepsis in preterm neonates

This investigation was designed as a hospital-based, historical cohort study. The objective of the study was to determine the association between premature rupture of the membranes (PROM) and its duration on neonatal sepsis, infection, and mortality. Neonates born alive with gestational ages between 25 and 35 weeks from singleton pregnancies complicated by PROM were selected. Each of the 507 neonates was matched on gestational age, gender, ethnicity, and month of birth with a neonate without the complication of PROM.^ Data were abstracted from deliveries between January 1979 and December 1985 describing the mother's demographics, labor and delivery treatments and complications, the neonate's demographics, infection status, and medical care. The matched pairs analysis reveals a significant increase in risk of neonatal sepsis (RR = 3.5) and neonatal infection (RR = 2.4) among preterm births complicated by PROM, with a PROM exposure contributing an excess 4 to 5 cases of sepsis per 100 infants (RD = 0.04 for infection and RD = 0.05 for sepsis). Generally PROM remains an important risk factor for sepsis and infection when controlling for various other characteristics, and the risk difference remains constant.^ PROM was not significantly associated with neonatal mortality (RR = 1.02). There is an increase in risk difference for mortality associated with PROM among septic and infected infants, but it is not significant.^ A clear increase in risk of sepsis and infection from PROM occurs when durations of PROM are long (more than 48 hours), e.g., for sepsis the RR is 2.42 for short durations and RR is 6.0 for long durations. No such risk with long duration appears for neonatal mortality.^ This study indicates the importance of close observation of neonates with PROM for sepsis and infection so treatment can be initiated early. However, prematurity is the major risk for sepsis and the practice of early delivery to avoid prolonged durations of PROM does not alter the magnitude of risk. The greatest protection against these infection complications was provided when the neonate weighed over 1500 grams or had more than 33 weeks gestation. ^

Paleomegnetic and geochemistry of sediments from the early Aptian Oceanic Anoxic Event

The early Aptian Oceanic Anoxic Event (OAE1a, 120 Ma) represents a geologically brief time interval in the mid-Cretaceous greenhouse world that is characterized by increased organic carbon accumulation in marine sediments, sudden biotic changes, and abrupt carbon-isotope excursions indicative of significant perturbations to global carbon cycling. The brevity of these drastic environmental changes (< 10**6 year) and the typically 10**6 year temporal resolution of the available chronologies, however, represent a critical gap in our knowledge of OAE1a. We have conducted a high-resolution investigation of three widely distributed sections, including the Cismon APTICORE in Italy, Santa Rosa Canyon in northeastern Mexico, and Deep Sea Drilling Project (DSDP) Site 398 off the Iberian margin in the North Atlantic Ocean, which represent a range of depositional environments where condensed and moderately expanded OAE1a intervals are recorded. The objectives of this study are to establish orbital chronologies for these sections and to construct a common, high-resolution timescale for OAE1a. Spectral analyses of the closely-spaced (corresponding to ~5 to 10 kyr) measurements of calcium carbonate content of the APTICORE, magnetic susceptibility (MS) and anhysteretic remanent magnetization (ARM) of the Santa Rosa samples, and MS, ARM and ARM/IRM, where IRM is isothermal remanent magnetization, of Site 398 samples reveal statistically significant cycles. These cycles exhibit periodicity ratios and modulation patterns similar to those of the mid-Cretaceous orbital cycles, suggesting that orbital variations may have modulated depositional processes. Orbital control allows us to estimate the duration of unique, globally identifiable stages of OAE1a. Although OAE1a had a duration of ~1.0 to 1.3 Myr, the initial perturbation represented by the negative carbon-isotope excursion was rapid, lasting for ~27-44 kyr. This estimate could serve as a basis for constraining triggering mechanisms for OAE1a.

Biostratigraphy, magnetostratigraphy, granulometry, isotopes and clay mineral composition of ODP Site 188-1165

During Ocean Drilling Program Leg 188 to Prydz Bay, East Antarctica, several of the shipboard scientists formed the High-Resolution Integrated Stratigraphy Committee (HiRISC). The committee was established in order to furnish an integrated data set from the Pliocene portion of Site 1165 as a contribution to the ongoing debate about Pliocene climate and climate evolution in Antarctica. The proxies determined in our various laboratories were the following: magnetostratigraphy and magnetic properties, grain-size distributions (granulometry), near-ultraviolet, visible, and near-infrared spectrophotometry, calcium carbonate content, characteristics of foraminifer, diatom, and radiolarian content, clay mineral composition, and stable isotopes. In addition to the HiRISC samples, other data sets contained in this report are subsets of much larger data sets. We included these subsets in order to provide the reader with a convenient integrated data set of Pliocene-Pleistocene strata from the East Antarctic continental margin. The data are presented in the form of 14 graphs (in addition to the site map). Text and figure captions guide the reader to the original data sets. Some preliminary interpretations are given at the end of the manuscript.

High sensitivity low field magnetically gated resistive switching in CoFe2O4/La0.66Sr0.34MnO3 heterostructure

The phenomenon of resistive switching (RS) has been demonstrated in several non-magnetic and some magnetic oxide systems, however the ``magnetic'' aspect of magnetic oxides has not been emphasized especially in terms of low field tunability. In our work, we examined the CoFe2O4/La0.66Sr0.34MnO3 all-magnetic oxide interface system for RS and discovered a very sharp (bipolar) transition at room temperature that can be gated with high sensitivity by low magnetic fields (similar to 0-100 mT). By using a number of characterizations, we show that this is an interface effect, which may open up interesting directions for manipulation of the RS phenomenon. (C) 2012 American Institute of Physics. http://dx.doi.org/10.1063/1.4707373]

EPR, FT-IR and XRD investigation of soils from Parana, Brazil

Samples of Araucaria area soil from Parana state, Brazil, were separated by particle size fractionation and investigated by electron paramagnetic resonance (EPR) in X-Band of 9.5 GHz at room temperature and 77K, infra-red spectroscopy and X-ray diffractometry. The paramagnetic species in the soil samples were identified by comparison with EPR spectra of some minerals studied recently by our group, several soil types and/or soil components investigated in the literature. The value of g = 2.1 (Delta H = 85 mT) indicated the presence of ferrihydrite. Hematite was identified by g = 2.1 (Delta H = 100 mT) and g = 4.3 for Fe(3+) lines of the concentrated dominium and diluted dominium. Kaolinite was identified by IR and EPR with the resonance at g = 4.3 attributed to Fe(3+) ions in isolated sites of tetrahedral and octahedral symmetry with rhombic distortion. The resonances at g = 3.7 and g = 4.9 were attributed to Fe(3+) in more highly symmetrical environment than rhombic symmetry, but not in axial symmetry. Three signals around g = 2 were attributed to radiation defects, plus additional resonances at g = 2.8 and 9.0. Signals less intense than those at g = 2.1, 3.7, and 6.5, observed for clear grains of soil, were attributed to presence of Fe(3+) in quartz which was identified by IR and XDR. (C) 2011 Elsevier B.V. All rights reserved.

Magnetic properties of basalts and sediments of ODP Leg 135 sites

Paleomagnetic and rock-magnetic investigations of basalts from Hole 834B in the Lau backarc basin and of sediments from Holes 841A and 841B at the Tonga Ridge are reported. Three groups of blocking temperatures in the basalts suggest the presence of at least three magnetic phases: pure magnetite, a Ti-poor titanomagnetite, and a Ti-rich phase. The drill-string-induced remanence in the basalts is typically between three and six times the original normal remanent magnetization intensity, but it is mostly removed by alternating-field (AF) cleaning in 5 mT. Volume susceptibility values range from 0.04 * 10**-3 to 4 * 10**-3 cgs. The modified Q-ratio J5/sus ranges from 0.5 to 10. The drill-string-induced remanence behaves different in the two sediment cores from Holes 841A and 841B, which may be the result of differences in the sediment or caused by the different drilling equipment used. The AF-cleaned inclinations of the sediment in Holes 841A and 841B suggest a slight flattening with increasing depth (up to 6° under a load of 400 m of sediment) to be present. This flattening is likely to be caused by the differential rotation of detrital particles under compaction during diagenesis.

Orbitally tuned time scale and astronomical forcing in the middle Eocene to early Oligocene determined on ODP and IODP sediment cores

Deciphering the driving mechanisms of Earth system processes, including the climate dynamics expressed as paleoceanographic events, requires a complete, continuous, and high-resolution stratigraphy that is very accurately dated. In this study, we construct a robust astronomically calibrated age model for the middle Eocene to early Oligocene interval (31-43 Ma) in order to permit more detailed study of the exceptional climatic events that occurred during this time, including the Middle Eocene Climate Optimum and the Eocene/Oligocene transition. A goal of this effort is to accurately date the middle Eocene to early Oligocene composite section cored during the Pacific Equatorial Age Transect (PEAT, IODP Exp. 320/321). The stratigraphic framework for the new time scale is based on the identification of the stable long eccentricity cycle in published and new high-resolution records encompassing bulk and benthic stable isotope, calibrated XRF core scanning, and magnetostratigraphic data from ODP Sites 171B-1052, 189-1172, 199-1218, and 207-1260 as well as IODP Sites 320-U1333, and -U1334 spanning magnetic polarity Chrons C12n to C20n. Subsequently we applied orbital tuning of the records to the La2011 orbital solution. The resulting new time scale revises and refines the existing orbitally tuned age model and the Geomagnetic Polarity Time Scale from 31 to 43 Ma. Our newly defined absolute age for the Eocene/Oligocene boundary validates the astronomical tuned age of 33.89 Ma identified at the Massignano (Italy) global stratotype section and point. Our compilation of geochemical records of climate-controlled variability in sedimentation through the middle-to-late Eocene and early Oligocene demonstrates strong power in the eccentricity band that is readily tuned to the latest astronomical solution. Obliquity driven cyclicity is only apparent during very long eccentricity cycle minima around 35.5 Ma, 38.3 Ma and 40.1 Ma.

Efeitos adversos da poluição atmosférica em crianças e adolescentes devido a queimadas na Amazônia: uma abordagem de modelos mistos em estudos de painel

Esta tese investiga os efeitos agudos da poluição atmosférica no pico de fluxo expiratório (PFE) de escolares com idades entre 6 e 15 anos, residentes em municípios da Amazônia Brasileira. O primeiro artigo avaliou os efeitos do material particulado fino (PM2,5) no PFE de 309 escolares do município de Alta Floresta, Mato Grosso (MT), durante a estação seca de 2006. Modelos de efeitos mistos foram estimados para toda a amostra e estratificados por turno escolar e presença de sintomas de asma. O segundo artigo expõe as estratégias utilizadas para a determinação da função de variância do erro aleatório dos modelos de efeitos mistos. O terceiro artigo analisa os dados do estudo de painel com 234 escolares, realizado na estação seca de 2008 em Tangará da Serra, MT. Avaliou-se os efeitos lineares e com defasagem distribuída (PDLM) do material particulado inalável (PM10), do PM2,5 e do Black Carbon (BC) no PFE de todos os escolares e estratificados por grupos de idade. Nos três artigos, os modelos de efeitos mistos foram ajustados por tendência temporal, temperatura, umidade e características individuais. Os modelos também consideraram o ajuste da autocorrelação residual e da função de variância do erro aleatório. Quanto às exposições, foram avaliados os efeitos das exposições de 5hs, 6hs, 12hs e 24hs, no dia corrente, com defasagens de 1 a 5 dias e das médias móveis de 2 e 3 dias. No que se refere aos resultados de Alta Floresta, os modelos para todas as crianças indicaram reduções no PFE variando de 0,26 l/min (IC95%: 0,49; 0,04) a 0,38 l/min (IC95%: 0,71; 0,04), para cada aumento de 10g/m3 no PM2,5. Não foram observados efeitos significativos da poluição no grupo das crianças asmáticas. A exposição de 24hs apresentou efeito significativo no grupo de alunos da tarde e no grupo dos não asmáticos. A exposição de 0hs a 5:30hs foi significativa tanto para os alunos da manhã quanto para a tarde. Em Tangará da Serra, os resultados mostraram reduções significativas do PFE para aumentos de 10 unidades do poluente, principalmente para as defasagens de 3, 4 e 5 dias. Para o PM10, as reduções variaram de 0,15 (IC95%: 0,29; 0,01) a 0,25 l/min (IC95%: 0,40 ; 0,10). Para o PM2,5, as reduções estiveram entre 0,46 l/min (IC95%: 0,86 to 0,06 ) e 0,54 l/min (IC95%: 0,95; 0,14). E no BC, a redução foi de aproximadamente 0,014 l/min. Em relação ao PDLM, efeitos mais importantes foram observados nos modelos baseados na exposição do dia corrente até 5 dias passados. O efeito global foi significativo apenas para o PM10, com redução do PFE de 0,31 l/min (IC95%: 0,56; 0,05). Esta abordagem também indicou efeitos defasados significativos para todos os poluentes. Por fim, o estudo apontou as crianças de 6 a 8 anos como grupo mais sensível aos efeitos da poluição. Os achados da tese sugerem que a poluição atmosférica decorrente da queima de biomassa está associada a redução do PFE de crianças e adolescentes com idades entre 6 e 15 anos, residentes na Amazônia Brasileira.

William Herschel Telescope observations of distant comets

We present results from broad-band V- and R-filter observations obtained at the 4.2-m William Herschel Telescope on La Palma on 2002 July 12-14. A total of six comets were imaged, and their heliocentric distances ranged from 2.8 to 6.1 au. The comets observed were 43P/Wolf-Harrington, 129P/Shoemaker-Levy 3, 133P/Elst-Pizarro, 143P/Kowal-Mrkos, P/1998 U4 (Spahr) and P/2001 H5 (NEAT). A detailed surface brightness profile analysis indicates that three of the targeted comets (43P/Wolf-Harrington, 129P/Shoemaker-Levy 3 and P/1998 U4) were visibly active, and the remaining three comets were stellar in appearance. Further analysis shows that for the three `stellar-like' comets the possible coma contribution to the observed flux does not exceed 12.2 per cent, and in the case of comet 143P/Kowal-Mrkos the coma contribution is expected to be as low as 1 per cent, and so the resulting photometry most likely represents that of the projected nucleus surface. Effective radii for the inactive comets range from 1.02 to 4.56 km, and the effective radius upper limits for the active comets range from 1.94 to 4.15 km. We assume an albedo and phase coefficient of 0.04 and 0.035 mag deg-1, respectively, with the exception of comets 133P/Elst-Pizarro and 143P/Kowal-Mrkos for which phase coefficients were previously measured. These values are compared with previous measurements, and for comet 43P/Wolf-Harrington we find that the nucleus axial ratio a/b could be as large as 2.44. For the active comets we measured dust production levels in terms of the Af? quantity. Spectral gradients were extracted for two of the inactive comets from their measured broad-band colour indices, and compared with the rest of the comet population for which (V-R) colour and spectral gradient values exist. We find a spectral gradient for 143P/Kowal-Mrkos of 9.9 +/- 8.1 per cent/100 nm, which is very typical of Jupiter-family comets, the majority of which have reflectivity gradients in the range 0-13 per cent (100 nm)-1. The spectral gradient for comet 133P/Elst-Pizarro is amongst the bluest yet measured. We measure a (V-R) colour index value of 0.14 +/- 0.11 for the nucleus of 133P/Elst-Pizarro which is considerably lower than previous measurements. A possible explanation for this difference is considered.

Transpupillary thermotherapy for choroidal melanoma:Tumor control and visual results in 100 consecutive cases

Objective: The authors evaluated the results of primary transpupillary thermotherapy for choroidal melanoma in 100 cases. Design: Prospective nonrandomized analysis of treatment method. Participants: One hundred patients with choroidal melanoma were studied. Main Outcome Measures: Tumor response, ocular side effects, and visual results. Results: Of 100 consecutive patients with choroidal melanoma treated with transpupillary thermotherapy, the mean tumor basal diameter was 7.1 mm and tumor thickness was 2.8 mm. The tumor margin touched the optic disc in 34 eyes (34%) and was beneath the fovea in 42 eyes (42%). Documented growth was present in 64 eyes (64%), and known clinical risks for growth were present in all of the remaining 36 eyes (36%), with an average of 4 of 5 statistical risk factors for growth per tumor. After a mean of three treatment sessions and 14 months of follow-up, the mean tumor thickness was reduced to 1.4 mm. Treatment was successful in 94 eyes (94%) and failed in 6 eyes (6%). Three patients with amelanotic tumors showed no initial response to thermotherapy, but subsequent intravenous indocyanine green administration during thermotherapy resulted in improved heat absorption and tumor regression to a flat scar. The six eyes classified as treatment failures included four eyes with tumors that showed partial or no response to thermotherapy, thus requiring plaque radiotherapy or enucleation, and two eyes with recurrence, subsequently controlled with additional thermotherapy. After treatment, the visual acuity was the same (within 1 line) or better than the pretreatment visual acuity in 58 eyes (58%) and worse in 42 eyes (42%). The main reasons for poorer vision included treatment through the foveola for subfoveal tumor (25 eyes), retinal traction (10 eyes), retinal vascular obstruction (5 eyes), optic disc edema (1 eye), and unrelated ocular ischemia (1 eye). Temporal location (versus nasal and superior, P = 0.02) and greater distance from the optic disc (P = 0.04) were risks for retinal traction. Conclusions: Transpupillary thermotherapy may be an effective treatment for small posterior choroidal melanoma, especially those near the optic disc and fovea. Despite satisfactory local tumor control, ocular side effects can result in decreased vision. Longer follow- up will be necessary to assess the impact of thermotherapy on ultimate local tumor control and metastatic disease.

A pilot study to evaluate aflatoxin exposure in a rural Ugandan population

Objectives: The fungal metabolite aflatoxin is a common contaminant of foodstuffs, especially when stored in damp conditions. In humans, high levels can result in acute hepatic necrosis and death, while chronic exposure is carcinogenic. We conducted a pilot study nested within an existing population cohort (the General Population Cohort), to assess exposure to aflatoxin, among people living in rural south-western Uganda. Methods: Sera from 100 adults and 96 children under 3 years of age (85 male, 111 female) were tested for aflatoxin-albumin adduct (AF-alb), using an ELISA assay. Socio-demographic and dietary data were obtained for all participants; HIV serostatus was available for 90 adults and liver function tests (LFTs) for 99. Results: Every adult and all but four children had detectable AF-alb adduct, including five babies reported to be exclusively breastfed. Levels ranged from 0 to 237.7 pg/mg albumin and did not differ significantly between men and women, by age or by HIV serostatus; 25% had levels above 15.1 pg/mg albumin. There was evidence of heterogeneity between villages (P = 0.003); those closest to trading centres had higher levels. Adults who consumed more Matooke (bananas) had lower levels of AF-alb adduct (P = 0.02) than adults who did not, possibly because their diet contained fewer aflatoxin-contaminated foods such as posho (made from maize). Children who consumed soya, which is not grown locally, had levels of AF-alb adduct that were almost twice as high as those who did not eat soya (P = 0.04). Conclusions: Exposure to aflatoxin is ubiquitous among the rural Ugandans studied, with a significant number of people having relatively high levels. Sources of exposure need to be better understood to instigate practical and sustainable interventions. © 2014 John Wiley & Sons Ltd.

Optical and near-infrared observations of SN 2011dh - The first 100 days

We present optical and near-infrared (NIR) photometry and spectroscopy of the Type IIb supernova (SN) 2011dh for the first 100 days. We complement our extensive dataset with Swift ultra-violet (UV) and Spitzer mid-infrared (MIR) data to build a UV to MIR bolometric lightcurve using both photometric and spectroscopic data. Hydrodynamical modelling of the SN based on this bolometric lightcurve have been presented in Bersten et al. (2012, ApJ, 757, 31). We find that the absorption minimum for the hydrogen lines is never seen below ~11 000 km s-1 but approaches this value as the lines get weaker. This suggests that the interface between the helium core and hydrogen rich envelope is located near this velocity in agreement with the Bersten et al. (2012) He4R270 ejecta model. Spectral modelling of the hydrogen lines using this ejecta model supports the conclusion and we find a hydrogen mass of 0.01-0.04 M⊙ to be consistent with the observed spectral evolution. We estimate that the photosphere reaches the helium core at 5-7 days whereas the helium lines appear between ~10 and ~15 days, close to the photosphere and then move outward in velocity until ~40 days. This suggests that increasing non-thermal excitation due to decreasing optical depth for the γ-rays is driving the early evolution of these lines. The Spitzer 4.5 μm band shows a significant flux excess, which we attribute to CO fundamental band emission or a thermal dust echo although further work using late time data is needed. Thedistance and in particular the extinction, where we use spectral modelling to put further constraints, is discussed in some detail as well as the sensitivity of the hydrodynamical modelling to errors in these quantities. We also provide and discuss pre- and post-explosion observations of the SN site which shows a reduction by ~75 percent in flux at the position of the yellow supergiant coincident with SN 2011dh. The B, V and r band decline rates of 0.0073, 0.0090 and 0.0053 mag day-1 respectively are consistent with the remaining flux being emitted by the SN. Hence we find that the star was indeed the progenitor of SN 2011dh as previously suggested by Maund et al. (2011, ApJ, 739, L37) and which is also consistent with the results from the hydrodynamical modelling. Figures 2, 3, Tables 3-10, and Appendices are available in electronic form at http://www.aanda.orgThe photometric tables are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (ftp://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/562/A17

The Influence of Performance Level, Age and Gender on Pacing Strategy During a 100-km Ultramarathon

The aim of this study is to analyse the influence of performance level, age and gender on pacing during a 100-km ultramarathon. Results of a 100-km race incorporating the World Masters Championships were used to identify differences in relative speeds in each 10-km segment between participants finishing in the first, second, third and fourth quartiles of overall positions (Groups 1, 2, 3 and 4, respectively). Similar analyses were performed between the top and bottom 50% of finishers in each age category, as well as within male and female categories. Pacing varied between athletes achieving different absolute performance levels. Group 1 ran at significantly lower relative speeds than all other groups in the first three 10-km segments (all P < 0.01), and significantly higher relative speeds than Group 4 in the 6th and 10th (both P < 0.01), and Group 2 in the 8th (P = 0.04). Group 4 displayed significantly higher relative speeds than Group 2 and 3 in the first three segments (all P < 0.01). Overall strategies remained consistent across age categories, although a similar phenomenon was observed within each category whereby ‘top’ competitors displayed lower relative speeds than ‘bottom’ competitors in the early stages, but higher relative speeds in the later stages. Females showed lower relative starting speeds and higher finishing speeds than males. ‘Top’ and ‘bottom’ finishing males displayed differing strategies, but this was not the case within females. Although pacing remained consistent across age categories, it differed with level of performance within each, possibly suggesting strategies are anchored on direct competitors. Strategy differs between genders and differs depending on performance level achieved in males but not females.

Disfunção autonômica e doença vascular periférica em pacientes com diabete melito tipo 2

A disfunção autonômica está associada com aumento da mortalidade em pacientes diabéticos, especialmente naqueles com doença cardiovascular. Neuropatia periférica, mau controle glicêmico, dislipidemia e hipertensão são alguns dos fatores de risco para o desenvolvimento de doença vascular periférica (DVP) nestes pacientes. O objetivo deste estudo foi avaliar os fatores de risco associados com a presença de DVP em pacientes com DM tipo 2. Um estudo transversal foi realizado em 84 pacientes com DM tipo 2 ( 39 homens, idade média de 64,9 ± 7,5 anos). Os pacientes foram submetidos a uma avaliação clínica e laboratorial. A presença de DVP foi definida, utilizando-se um um aparelho manual de ultrasom com doppler (índice perna-braço < 0,9). A atividade autonômica foi avaliada através da análise da variabilidade da freqüência cardíaca (HRV) por métodos no domínio do tempo e da freqüência (análise espectral), e pelo mapa de retorno tridimensional durante o período do dia e da noite. Para a análise da HRV, um eletrocardiograma de 24 horas foi gravado e as fitas analisadas em um analisador de Holter Mars 8000 (Marquete). A potência espectral foi quantificada pela área em duas bandas de freqüência: 0,04-0,15 Hz – baixa freqüência (BF), 0,015-0,5 Hz – alta freqüência (AF). A razão BF/AF foi calculada em cada paciente. O mapa de retorno tridimensional foi construído através de um modelo matemático onde foram analisados os intervalos RR versus a diferença entre os intervalos RR adjacentes versus o número de contagens verificadas, e quantificado por três índices refletindo a modulação simpática (P1) e vagal (P2 e P3). DVP estava presente em 30 (36%) pacientes. Na análise univariada, pacientes com DVP apresentaram índices que refletem a modulação autonômica (análise espectral) diminuídos quando comparados aos pacientes sem DVP, respectivamente: BF = 0,19 ± 0,07 m/s2 vs. 0,29 ± 0,11 m/s2 P = 0,0001; BF/AF = 1,98 ± 0,9 m/s2 vs. 3,35 ± 1,83 m/s2 p = 0,001. Além disso, o índice que reflete a atividade simpática no mapa de retorno tridimensional (P1), foi mais baixo em pacientes com DVP (61,7 ± 9,4 vs. 66,8 ± 9,7 unidades arbitrárias, P = 0,04) durante a noite, refletindo maior ativação simpática neste período. Estes pacientes também apresentavam uma maior duração do diabetes (20 ± 8,1 vs. 15,3 ± 6,7 anos, P = 0,006), níveis de pressão arterial sistólica (154 ± 20 vs. 145 ± 20 mmHg, P = 0,04), razão cintura-quadril ( 0,98 ± 0,09 vs.0,92 ± 0,08, P = 0,01), e níveis de HbA1c mais elevados (7,7 ± 1,6 vs. 6,9 ± 1,7 %, P = 0,04), bem como valores de triglicerídeos ( 259 ± 94 vs. 230 ± 196 mg/dl, P= 0,03) e de excreção urinária de albumina ( 685,5 ± 1359,9 vs. 188,2 ± 591,1 μ/min, P = 0,02) superiores aos dos pacientes sem DVP.. Nos pacientes com DVP observou-se uma presença aumentada de nefropatia diabética (73,3% vs. 29,6% P = 0,0001), de retinopatia (73,3% vs. 44,4% P = 0,02) e neuropatia periférica (705 vs. 35,1% P = 0,006). Os grupos não diferiram quanto à idade, índice de massa corporal, tabagismo e presença de doença arterial coronariana. Na análise logística multivariada, a DVP permaneceu associada com a disfunção autonômica, mesmo após ter sido controlada pela pressão arterial sistólica, duração do DM, HbA1c, triglicerídeos e excreção urinária de albumina. Concluindo, pacientes com DVP e DM tipo 2 apresentam índices que refletem a modulação autonômica diminuídos, o que pode representar um fator de risco adicional para o aumento da mortalidade nestes pacientes.