Adrenocorticotropin stimulation tests in patients with hypothalamic-pituitary disease: low dose, standard high dose and 8-h infusion tests

Objectives Low doses of ACTH [1-24] (0.1, 0.5 and 1.0 mug per 1.73 m(2)) may provide a more physiological level of adrenal stimulation than the standard 250 mug test, but not all studies have concluded that the 1.0 fig is a more sensitive screening test for central hypoadrenalism. Eight-hour infusions of high dose ACTH [1-24] have also been suggested as a means of assessing the adrenals' capacity for sustained cortisol secretion. In this study, we compared the diagnostic accuracy of three low dose ACTH tests (LDTs) and the 8-h infusion with the standard 250 jig test (HDT) and the insulin hypoglycaemia test (IHT) in patients with hypothalamic-pituitary disease. Subjects and design Three groups of subjects were studied. A healthy control group (group 1, n=9) and 33 patients with known hypothalamic or pituitary disease who were divided into group 2 (n=12, underwent IHT) and group 3 (n=21, IHT contraindicated). Six different tests were performed: a standard IHT (0.15 U/kg soluble insulin); a 60-minute 250 mug HDT; three different LDTs using 0.1 mug, 0.5 mug and 1.0 mug (all per 1.73 m(2)); and an 8-h infusion test (250 mug ACTH [1-24] at a constant rate over 8 h). Results Nine out of the 12 patients in group 2 failed the IHT. Three out of 12 patients from group 2 who clearly passed the IHT, also passed all the ACTH [1-24] stimulation tests. Seven of the 9 patients who failed the lHT, failed by a clear margin (peak cortisol

Brazilian multicenter study on efficacy and tolerability of trandolapril in mild-to-moderate essential arterial hypertension. EMBATHE substudy with ambulatory blood pressure monitoring

OBJECTIVE: A double-blind, placebo-controlled multicenter study involving 34 centers from different Brazilian regions was performed to evaluate the antihypertensive efficacy and tolerability of trandolapril, an angiotensin I converting enzyme inhibitor, in the treatment of mild-to-moderate systemic arterial hypertension. METHODS: Of 262 patients enrolled in this study, 127 were treated with trandolapril 2 mg/day for 8 consecutive weeks, and the remaining 135 patients received placebo for the same period of time. Reduction in blood pressure (BP) and the occurrence of adverse events during this period were evaluated in both groups. RESULTS: Significant reductions in both systolic and diastolic pressures were observed in patients treated with trandolapril when compared with those on placebo. Antihypertensive efficacy was achieved in 57.5% of the patients on trandolapril and in 42% of these normal values of BP were obtained. The efficacy of trandolapril was similar in all centers, regardless of the area of the country. In a subset of 30 patients who underwent ABPM, responders showed a significant hypotensive effect to trandolapril throughout the 24 hour day. The adverse event profile was similar in both trandolapril and placebo groups. CONCLUSION: Our results demonstrate, for the first time in a large group of hypertensive patients from different regions in Brazil, good efficacy and tolerability of trandolapril during treatment of mild-to-moderate essential systemic hypertension.

Chronic Stress Improves NO- and Ca2+ Flux-Dependent Vascular Function: A Pharmacological Study

Background: Stress is associated with cardiovascular diseases. Objective: This study aimed at assessing whether chronic stress induces vascular alterations, and whether these modulations are nitric oxide (NO) and Ca2+ dependent. Methods: Wistar rats, 30 days of age, were separated into 2 groups: control (C) and Stress (St). Chronic stress consisted of immobilization for 1 hour/day, 5 days/week, 15 weeks. Systolic blood pressure was assessed. Vascular studies on aortic rings were performed. Concentration-effect curves were built for noradrenaline, in the presence of L-NAME or prazosin, acetylcholine, sodium nitroprusside and KCl. In addition, Ca2+ flux was also evaluated. Results: Chronic stress induced hypertension, decreased the vascular response to KCl and to noradrenaline, and increased the vascular response to acetylcholine. L-NAME blunted the difference observed in noradrenaline curves. Furthermore, contractile response to Ca2+ was decreased in the aorta of stressed rats. Conclusion: Our data suggest that the vascular response to chronic stress is an adaptation to its deleterious effects, such as hypertension. In addition, this adaptation is NO- and Ca2+-dependent. These data help to clarify the contribution of stress to cardiovascular abnormalities. However, further studies are necessary to better elucidate the mechanisms involved in the cardiovascular dysfunction associated with stressors. (Arq Bras Cardiol. 2014; [online].ahead print, PP.0-0)

Prevention of vitamin K deficiency bleeding with three oral mixed micellar phylloquinone doses: results of a 6-year (2005-2011) surveillance in Switzerland.

In 2003, the Swiss guidelines to prevent vitamin K deficiency bleeding (VKDB) were adapted. As two oral doses (2 mg, hour/day 4) of mixed micellar VK preparation had failed to abolish late VKDB, a third dose (week 4) was introduced. This report summarizes the new guidelines acceptance by Swiss pediatricians and the results of a prospective 6-year surveillance to study their influence on the incidence of VKDB. The new guidelines acceptance by Swiss pediatricians was evaluated by a questionnaire sent to all pediatricians of the Swiss Society of Paediatrics. With the help of the Swiss Paediatric Surveillance Unit, the incidence of VKDB was monitored prospectively from July 1, 2005 until June 30, 2011. Over a 6-year period (458,184 live births), there was one case of early and four cases of late VKDB. Overall incidence was 1.09/10(5) (95 % confidence intervals (CI) 0.4-2.6). Late VKDB incidence was 0.87/10(5) (95 % CI 0.24-2.24). All four infants with late VKDB had an undiagnosed cholestasis at the time of bleeding; parents of 3/4 had refused VK prophylaxis, and in 1/4, the third VK dose had been forgotten. Compared with historical control who had received only two oral doses of mixed micellar VK (18 cases for 475,372 live births), the incidence of late VKDB was significantly lower with three oral doses (Chi(2),Yates correction, P = 0.007). CONCLUSION: VKDB prophylaxis with 3 × 2 mg oral doses of mixed micellar VK seems to prevent adequately infants from VKDB. The main risk factors for VKDB in breast-fed infants are parental VK prophylaxis refusal or an unknown cholestasis.

Repeated exposure to Ochratoxin A generates a neuroinflammatory response, characterized by neurodegenerative M1 microglial phenotype.

Neurotoxic effects of the environmentally abundant mycotoxin Ochratoxin A (OTA) were studied in histotypic 3D rat brain cell cultures, comprising all brain cell types. Cultures were exposed to nanomolar OTA concentrations and samples were collected 48h after a single exposure, or after 10 days of repeated administration. OTA-induced changes in gene- and protein expression, as well as alterations in cell morphology were assessed. Forty-eight-hour OTA exposure resulted in a disruption of the neuronal cytoskeleton and reduced expression of several oligodendrocyte-specific markers indicative of demyelination. Astrocyte disturbances were revealed by a decrease in two astrocytic proteins involved in regulation of inflammatory responses, metallothioneins I and II. Repeated OTA administration induced a neuroinflammatory response, as visualized by an increase of isolectin B4 labelled cells, increased expression of pro-inflammatory cytokines, and detection of macrophagic ED1/CD68 positive cells, as well as an upregulation of neurodegenerative M1 microglial phenotype markers. Partial recovery from OTA-induced deleterious effects on oligodendrocytes and astrocytes was achieved by co-treatment with sonic hedgehog (SHH). In addition, metallothionein I and II co-treatment partially restored OTA-induced effects on oligodendrocytes after 48h, and modulated microglial reactivity after 10 days. These results suggest that OTA-exposure affects Shh-signalling, which in turn may influence both oligodendrocytes and astrocytes. Furthermore, the primarily astrocytic proteins MTI/MTII may affect microglial activation. Thus the neuroinflammatory response appears to be downstream of OTA-induced effects on demyelination, axonal instabilities and astrocytes disturbances. In conclusion, repeated OTA-exposure induced a secondary neuroinflammatory response characterized by neurodegenerative M1 microglial activation and pro-inflammatory response that could exacerbate the neurodegenerative process.

Extended access cocaine self-administration differentially activates dorsal raphe and amygdala corticotropin-releasing factor systems in rats.

Cocaine-induced neuroadaptation of stress-related circuitry and increased access to cocaine each putatively contribute to the transition from cocaine use to cocaine dependence. The present study tested the hypothesis that rats receiving extended versus brief daily access to cocaine would exhibit regional differences in levels of the stress-regulatory neuropeptide corticotropin-releasing factor (CRF). A secondary goal was to explore how CRF levels change in relation to the time since cocaine self-administration. Male Wistar rats acquired operant self-administration of cocaine and were assigned to receive daily long access (6 hours/day, LgA, n = 20) or short access (1 hour/day, ShA, n = 18) to intravenous cocaine self-administration (fixed ratio 1, ∼0.50 mg/kg/infusion). After at least 3 weeks, tissue CRF immunoreactivity was measured at one of three timepoints: pre-session, post-session or 3 hours post-session. LgA, but not ShA, rats showed increased total session and first-hour cocaine intake. CRF immunoreactivity increased within the dorsal raphe (DR) and basolateral, but not central, nucleus of the amygdala (BLA, CeA) of ShA rats from pre-session to 3 hours post-session. In LgA rats, CRF immunoreactivity increased from pre-session to 3 hours post-session within the CeA and DR but tended to decrease in the BLA. LgA rats showed higher CRF levels than ShA rats in the DR and, pre-session, in the BLA. Thus, voluntary cocaine intake engages stress-regulatory CRF systems of the DR and amygdala. Increased availability of cocaine promotes greater tissue CRF levels in these extrahypothalamic brain regions, changes associated here with a model of cocaine dependence.

1C.06: Ambulatory pulse pressure is negatively associated with excretions of urinary caffeine and its metabolites

OBJECTIVE: Systolic blood pressure (BP) has been associated with urinary caffeine and its metabolites such as paraxanthine and theophylline. Caffeine and caffeine metabolites could influence arterial pulse pressure (PP) via sympathomimetic effects, smooth muscle relaxation, and phosphodiesterase inhibition. The purpose of this analysis was to explore the association of ambulatory PP with urinary caffeine and its related metabolites in a large population-based sample. DESIGN AND METHOD: Families were randomly selected from the general population of three Swiss cities (2009-2013). Ambulatory BP monitoring was conducted using validated Diasys Integra devices. PP was defined as the difference between the systolic and diastolic ambulatory BP. Urinary caffeine, paraxanthine, theophylline, and theobromine excretions were measured in 24 h urine using ultra-high performance liquid chromatography tandem mass spectrometry. Urinary excretions were log-transformed to satisfy regression assumptions. We used linear mixed models to explore the associations of urinary caffeine and caffeine metabolite excretions with 24-hour, day- and night-time PP while adjusting for major confounders. RESULTS: The 836 participants (48.9% men) included in this analysis had mean (±SD) age of 47.8 (±17.5), and mean 24-hour systolic and diastolic BP of 120.1 mmHg (±13.9) and 78.0 (±8.6). Except theobromine, log transformed urinary caffeine and caffeine metabolite excretions were associated negatively with 24-hour, daytime and night-time ambulatory PP. 24-hour, daytime, and night-time ambulatory PP decreased by -0.804 mmHg (SE, 0.209), -0.749 (0.215), and -0.968 (0.243) (all P values <0.005), for each doubling excretion of caffeine. Strong negative associations with night-time ambulatory PP were observed for paraxanthine and theophylline.(Figure is included in full-text article.) CONCLUSIONS: : The negative associations of PP with caffeine, paraxanthine, and theophylline excretions suggest that caffeine and its metabolites do lower BP, possibly by modifying arterial stiffness.

Effect of increased milk intake combined with endurance exercise training on body composition, blood-lipids and inflammatory markers in overweight young males

Consuming low-fat milk (LFM) after resistance training leads to improvements in body composition. Habitual aerobic exercise and dairy intake are relatively easy lifestyle modifications that could benefit a population at risk for becoming obese. Thus, the purpose of this study was to investigate combining increased LFM intake with endurance exercise on body composition, blood-lipid profile and metabolic markers. 40 young males were randomized into four groups: one ingesting 750mL LFM immediately post-exercise, the other 6hrs post-exercise; and two isocaloric carbohydrate groups ingesting at the two different times. Participants completed a 12 week endurance-training program (cycling 1 hour/day at ~60%VO2peak, 5 days/week). 23 participants completed the study. Increases in lean mass (p < 0.05), and decreases in anti-inflammatory marker adiponectin (p < 0.05) were seen in all groups. No other significant changes were observed. Future analyses should focus on longer duration exercise and include a larger sample.

Dynamic management and restoration of virtual paths in broadband networks based on distributed software agents

La gestió de xarxes és un camp molt ampli i inclou molts aspectes diferents. Aquesta tesi doctoral està centrada en la gestió dels recursos en les xarxes de banda ampla que disposin de mecanismes per fer reserves de recursos, com per exemple Asynchronous Transfer Mode (ATM) o Multi-Protocol Label Switching (MPLS). Es poden establir xarxes lògiques utilitzant els Virtual Paths (VP) d'ATM o els Label Switched Paths (LSP) de MPLS, als que anomenem genèricament camins lògics. Els usuaris de la xarxa utilitzen doncs aquests camins lògics, que poden tenir recursos assignats, per establir les seves comunicacions. A més, els camins lògics són molt flexibles i les seves característiques es poden canviar dinàmicament. Aquest treball, se centra, en particular, en la gestió dinàmica d'aquesta xarxa lògica per tal de maximitzar-ne el rendiment i adaptar-la a les connexions ofertes. En aquest escenari, hi ha diversos mecanismes que poden afectar i modificar les característiques dels camins lògics (ample de banda, ruta, etc.). Aquests mecanismes inclouen els de balanceig de la càrrega (reassignació d'ample de banda i reencaminament) i els de restauració de fallades (ús de camins lògics de backup). Aquests dos mecanismes poden modificar la xarxa lògica i gestionar els recursos (ample de banda) dels enllaços físics. Per tant, existeix la necessitat de coordinar aquests mecanismes per evitar possibles interferències. La gestió de recursos convencional que fa ús de la xarxa lògica, recalcula periòdicament (per exemple cada hora o cada dia) tota la xarxa lògica d'una forma centralitzada. Això introdueix el problema que els reajustaments de la xarxa lògica no es realitzen en el moment en què realment hi ha problemes. D'altra banda també introdueix la necessitat de mantenir una visió centralitzada de tota la xarxa. En aquesta tesi, es proposa una arquitectura distribuïda basada en un sistema multi agent. L'objectiu principal d'aquesta arquitectura és realitzar de forma conjunta i coordinada la gestió de recursos a nivell de xarxa lògica, integrant els mecanismes de reajustament d'ample de banda amb els mecanismes de restauració preplanejada, inclosa la gestió de l'ample de banda reservada per a la restauració. Es proposa que aquesta gestió es porti a terme d'una forma contínua, no periòdica, actuant quan es detecta el problema (quan un camí lògic està congestionat, o sigui, quan està rebutjant peticions de connexió dels usuaris perquè està saturat) i d'una forma completament distribuïda, o sigui, sense mantenir una visió global de la xarxa. Així doncs, l'arquitectura proposada realitza petits rearranjaments a la xarxa lògica adaptant-la d'una forma contínua a la demanda dels usuaris. L'arquitectura proposada també té en consideració altres objectius com l'escalabilitat, la modularitat, la robustesa, la flexibilitat i la simplicitat. El sistema multi agent proposat està estructurat en dues capes d'agents: els agents de monitorització (M) i els de rendiment (P). Aquests agents estan situats en els diferents nodes de la xarxa: hi ha un agent P i diversos agents M a cada node; aquests últims subordinats als P. Per tant l'arquitectura proposada es pot veure com una jerarquia d'agents. Cada agent és responsable de monitoritzar i controlar els recursos als que està assignat. S'han realitzat diferents experiments utilitzant un simulador distribuït a nivell de connexió proposat per nosaltres mateixos. Els resultats mostren que l'arquitectura proposada és capaç de realitzar les tasques assignades de detecció de la congestió, reassignació dinàmica d'ample de banda i reencaminament d'una forma coordinada amb els mecanismes de restauració preplanejada i gestió de l'ample de banda reservat per la restauració. L'arquitectura distribuïda ofereix una escalabilitat i robustesa acceptables gràcies a la seva flexibilitat i modularitat.

Colon extended physiologically based extraction test (CE-PBET) increases bioaccessibility of soil-bound PAH

Assessment of the risk to human health posed by contaminated land may be seriously overestimated if reliant on total pollutant concentration. In vitro extraction tests, such as the physiologically based extraction test (PBET), imitate the physicochemical conditions of the human gastro-intestinal tract and offer a more practicable alternative for routine testing purposes. However, even though passage through the colon accounts for approximately 80% of the transit time through the human digestive tract and the typical contents of the colon in vivo are a carbohydrate-rich aqueous medium with the potential to promote desorption of organic pollutants, PBET comprises stomach and small intestine compartments only. Through addition of an eight-hour colon compartment to PBET and use of a carbohydrate-rich fed-state medium we demonstrated that colon-extended PBET (CE-PBET) in- creased assessments of soil-bound PAH bioaccessibility by up to 50% in laboratory soils and a factor of 4 in field soils. We attribute this increased bioaccessibility to a combination of the additional extraction time and the presence of carbohydrates in the colon compartment, both of which favor PAH desorption from soil. We propose that future assessments of the bioaccessibility of organic pollutants in soils using physiologically based extraction tests should have a colon compartment as in CE-PBET.

Purification and analysis of protein synthetic initiation factors from Volvox Carteri

Volvox carteri, a multi-celled green algae, can grow synchronously given a sixteen hour light period followed by an eight hour dark period, a cycle which is repeated for a 48 hour growth cycle total. Near the end of each light period, reproductive cells divide rapidly resulting in the differentiation of ceIls. When the dark period begins, this differentiation stops and the cells remain dormant with little protein synthesis or differentiation occurring. Immediately after the lights come back on, however, the cells again undergo rapid protein synthesis and complete their differentiation. Previous studies have concluded that Volvox carteri discontinue protein synthesis during the dark phase due to regulation at the translational level and not the transcriptional level. Therefore, the inhibition of protein synthesis does not lie in the transfer of the protein coding sequence from DNA to mRNA, but rather in the transfer of this information from the mRNA to the ribosomes. My research examined this translational regulation to determine the factor(s) causing the discontinuation of protein synthesis during the dark phase. Evidence from other research further suggests that the control of translation lies in the initiation step rather than the elongation step. Eukaryotic initiation factors aid in the binding of the ribosomal subunits to the mRNA to initiate protein synthesis. It is known that initiation factors can be modified by phosphorylation, regulating their activity. Therefore, my study focused upon isolating some of these initiation factors in order to determine whether or not such modifications are responsible for the inhibition of dark phase protein synthesis in Volvox carteri.

O espelho de Glatzel na avaliação da permeabilidade nasal em adultos

Introdução O espelho de Glatzel (EG) é correntemente utilizado em consultórios fonoaudiológicos para a avaliação rápida da permeabilidade nasal. O mesmo foi descrito inicialmente em 1898 por Zwaardemaker. Porém, estudos de validação inexistem na literatura. Este estudo teve por objetivos verificar a reprodutibilidade do EG e a correlação intra-sujeito entre área de condensação e percepção subjetiva de permeabilidade nasal. Material e Métodos Vinte e cinco sujeitos foram avaliados com o EG por cinco minutos consecutivos (475 medidas por sujeito); cada meia hora por quatro horas; cada dia no início da tarde, por cinco dias e toda a quinta-feira por cinco semanas consecutivas. Utilizou-se uma escala análoga visual para avaliar a percepção de respiração nos períodos de horas, dias e semanas. Resultados O coeficiente de correlação total (área direita mais esquerda) encontrado entre área de condensação e percepção subjetiva foi de r=0,04 (p=0,3761). No lado esquerdo foi de r=0,08 (p=0,0984) e no lado direito de r=0,05 (p=0,2862). Os coeficientes de variação unilaterais medianos foram menores que 15% e os totais menores que 12%, independente do intervalo de tempo entre teste e re-teste. Conclusão Não se evidenciou correlação significativa entre a percepção subjetiva e a área de condensação nasal. A variabilidade unilateral foi maior do que quando considerados os valores totais (direito mais esquerdo) e não houve diferença na variabilidade das medidas de área de condensação nasal nos diferentes momentos do tempo.

Testes bioquímicos para avaliação do vigor em sementes de Mimosa caesalpiniaefolia Benth

Mimosa caesalpiniaefolia Benth. is a forest species of the Mimosaceae family, recommended for recovery of degraded areas. The evaluation of vigor by biochemical tests have been an important tool in the control of seed quality programs, and the electrical conductivity and potassium leaching the most efficient in the verifying the physiological potential. The objective, therefore, to adjust the methodology of the electrical conductivity test for seeds of M. caesalpiniaefolia, for then compare the efficiency of this test with the potassium in the evaluation of seed vigor of different lots of seeds M. caesalpiniaefolia. To test the adequacy of the electrical conductivity were used different combinations of temperatures , 25 °C and 30 ºC, number of seeds , 25 and 50, periods of imbibition , 4 , 8 , 12 , 16 and 24 hours , and volumes deionized water, 50 mL and 75mL. For potassium leaching test, which was conducted from the results achieved by the methodology of the adequacy of the electrical conductivity test, to compare the efficiency of both tests , in the classification of seeds at different levels of vigor, and the period 4 hours also evaluated because the potassium leaching test can be more efficient in the shortest time . The best combination obtained in experiment of electrical conductivity is 25 seeds soaked in 50 mL deionized or distilled water for 8 hours at a temperature of 30 ° C. Data were subjected to analysis of variance, the means were compared with each other by F tests and Tukey at 5 % probability, and when necessary polynomial regression analysis was performed. The electrical conductivity test performed at period eight hour proved to be more efficient in the separation of seed lots M. caesalpiniaefolia at different levels of vigor compared to the potassium test

Efeito dos substratos e temperaturas na germinação de sementes de Cnidosculus phyllacanthus Pax & K. Hoffm. (Faveleira)

Este trabalho foi conduzido com o objetivo estudar diferentes substratos e temperaturas para germinação de sementes de faveleira. Foram testadas as temperaturas constantes de 25º e 30ºC e alternadas com amplitudes de 5ºC (30-35ºC), 10ºC (20-30º e 25-35ºC) e 15ºC (20-35ºC), e fotoperíodo de oito horas para a temperatura mais elevada e dezesseis horas para a temperatura mais baixa. Os substratos papel de filtro, areia, vermiculita e papel germitest, foram umedecidos com solução de nistatina 0,2%. Para o teste de germinação em laboratório para sementes de faveleira pode-se recomendar os substratos areia, vermiculita, papel germitest e papel filtro combinado com temperaturas alternadas de 20ºC -30ºC. Para o teste de vigor, velocidade de germinação de sementes de faveleira, pode-se recomendar o substrato papel filtro combinado com as temperaturas alternadas de 20ºC -30ºC.

Germinação de sementes de pau-ferro submetidas a diferentes condições de armazenamento, escarificação química, temperatura e luz

Caesalpinia leiostachya (Benth.) Ducke (pau-ferro) é uma planta arbórea nativa do Brasil, cujas sementes possuem dormência causada pela impermeabilidade do tegumento à água. Neste trabalho foram conduzidos dois experimentos, nos quais foram utilizados diferentes períodos de escarificação em ácido sulfúrico concentrado para superar a dormência das sementes. No primeiro experimento, sementes coletadas em agosto de 1997 foram armazenadas por oito meses em ambiente não controlado no interior do próprio fruto, e em câmara seca após serem extraídas dos frutos; a seguir, elas foram imersas em ácido sulfúrico por 0, 10, 20, 40, 60 e 80min e colocadas para germinar nas temperaturas constante de 25ºC e alternada de 20-30°C, sob fotoperíodo de 8h. No segundo experimento, sementes extraídas de frutos recém-coletados em agosto de 1998 foram imersas em ácido sulfúrico por 0, 10, 20, 30, 40 e 60min, seguido do teste de germinação conduzido nas mesmas temperaturas do experimento anterior, na ausência e presença de luz. Foram avaliados a porcentagem final e o índice de velocidade de germinação das sementes. Os resultados mostraram que (a) a manutenção das sementes no interior dos frutos é uma alternativa viável para o armazenamento durante o período adotado; (b) as sementes recém-coletadas são indiferentes à luz, nas duas temperaturas testadas; (c) as sementes recém-coletadas e as armazenadas germinam em maior velocidade a 25ºC; (d) em sementes armazenadas, a imersão em ácido sulfúrico por 10min é suficiente para superar a dormência; (e) em sementes recém-coletadas, a imersão em ácido sulfúrico por 20 a 30min favorece a porcentagem e a velocidade de germinação.