Exercise training improves neurovascular control and functional capacity in heart failure patients regardless of age

Background: Exercise training is a non-pharmacological strategy for treatment of heart failure. Exercise training improves functional capacity and quality of life in patients. Moreover, exercise training reduces muscle sympathetic nerve activity (MSNA) and peripheral vasoconstriction. However, most of these studies have been conducted in middle-aged patients. Thus, the effects of exercise training in older patients are much less understood. The present study was undertaken to investigate whether exercise training improves functional capacity, muscular sympathetic activation and muscular blood flow in older heart failure patients, as it does in middle-aged heart failure patients. Design: Fifty-two consecutive outpatients with heart failure from the database of the Unit of Cardiovascular Rehabilitation and Physiology Exercise were divided by age (middle-aged, defined as 45-59 years, and older, defined as 60-75 years) and exercise status (trained and untrained). Methods: MSNA was recorded directly from the peroneal nerve using the microneurography technique. Forearm Blood Flow (FBF) was measured by venous occlusion plethysmography. Functional capacity was evaluated by cardiopulmonary exercise test. Results: Exercise training significantly and similarly increased FBF and peak VO2 in middle-aged and older heart failure patients. In addition, exercise training significantly and similarly reduced MSNA and forearm vascular resistance in these patients. No significant changes were found in untrained patients. Conclusion: Exercise training improves neurovascular control and functional capacity in heart failure patients regardless of age.

Ethnobotany of natural fibres - Bactris setosa (tucum) in a traditional rural community

This work aimed to study the characteristics of the fibres of the species Bactris setosa ('tucum') used by close-knit social groups, located in Sorocaba - Sao Paulo - Brazil, in basket-making techniques, for possible applications in textile activity. Optical microscopy (NBR 13 538:1995) and Tensile Properties (ASTM D 3 822-2001) were used to assess properties such as the fibre structre, linear density, breaking force, elongation at break and breaking tenacity of each species. Bactris setosa showed a longitudinal view similar to that of sisal; an average linear density of 41.2 tex, a tenacity average of 11.96 cN/tex, closer to fiberglass, and an elongation ranging between 1.35 and 3.87%. It is important to clarify the delicacy and detail of the tests, and from this we highlight the importance of carrying out these studies, based on which science and technology must be linked with socio-environmental aspects.

Provisional Biopharmaceutical Classification of Some Common Herbs Used in Western Medicine

The aim of this study was to classify some markers of common herbs used in Western medicine according to the Biopharmaceutical Classification System (BCS). The BCS is a scientific approach to classify drug substances based upon their intestinal permeability and their solubility, at the highest single dose used, within the physiologically relevant pH ranges. Known marker components of twelve herbs were chosen from the USP Dietary Supplement Compendium Monographs. Different BCS parameters such as intestinal permeability (P-eff) and solubility (C-s) were predicted using the ADMET Predictor, which is a software program to estimate biopharmaceutical relevant molecular descriptors. The dose number (D-0) was calculated when information from the literature was available to identify an upper dose for individual markers. In these cases the herbs were classified according to the traditional BCS parameters using Peff and Do. When no upper dose could be determined, then the amount of a marker that is just soluble in 250 mL of water was calculated. This value, M-x, defines when a marker is changing from highly soluble to poorly soluble according to BCS criteria. This biopharmaceutically relevant value can be a useful tool for marker selection. The present study showed that a provisional BCS classification of herbs is possible but some special considerations need to be included into the classification strategy. The BCS classification can be used to choose appropriate quality control tests for products containing these markers. A provisional BCS classification of twelve common herbs and their 35 marker compounds is presented.

Mitochondrial Network Size Scaling in Budding Yeast

Mitochondria must grow with the growing cell to ensure proper cellular physiology and inheritance upon division. We measured the physical size of mitochondrial networks in budding yeast and found that mitochondrial network size increased with increasing cell size and that this scaling relation occurred primarily in the bud. The mitochondria-to-cell size ratio continually decreased in aging mothers over successive generations. However, regardless of the mother's age or mitochondrial content, all buds attained the same average ratio. Thus, yeast populations achieve a stable scaling relation between mitochondrial content and cell size despite asymmetry in inheritance.

Social support, socioeconomic and clinical risk: comparison between to neighborhoods in a Brazilian upcountry town

The objective of this study was to compare the perceptions of two families living in two different neighborhoods (rated according to risk levels) regarding social support. A questionnaire was designed to assess social support according to the following dimensions: instrumental, emotional, religious, and support from friends, neighbors and family. The sample was comprised as follows: considering the 114 families living in neighborhood 1, 52 families were interviewed; and among the 162 families living in neighborhood 2, 60 families were interviewed. No significant difference was found related to instrumental, religious and emotional support, including the support from relatives among the families from both neighborhoods. The results disagree with the reviewed literature, which indicated a strong association between social support and families living at socioeconomic risk. In conclusion, social support is important for families, regardless of their risk stratification.

Administração de antibióticos por via subcutânea: uma revisão integrativa da literatura

OBJETIVO: Caracterizar os artigos científicos relacionados ao uso de antibióticos por via subcutânea em pacientes com difícil acesso venoso em cuidados paliativos quanto à tolerância local e eficácia terapêutica. MÉTODOS: Revisão integrativa da literatura realizada nas bases de dados LILACS, CINAHL, PUBMED, EMBASE e Biblioteca Cochrane, utilizando-se como referencial teórico a Prática Baseada em Evidências. RESULTADOS: 17 artigos foram selecionados com dez antibióticos diferentes, sendo o Ceftriaxona, o antibiótico mais estudado. Constatou-se a eficácia terapêutica com base nos parâmetros farmacocinéticos e clínicos. A tolerância local esteve associada à maior diluição dos antibióticos. Com administração de aminoglicosídeos, observaram-se lesões graves e necrose tecidual. A baixa tolerância reforça a restrição de uso apenas para essa classe de antibióticos. CONCLUSÃO: As previsões de eficácia terapêutica e a boa tolerância sugerem uma possibilidade a ser considerada quando se deseja uma via de administração parenteral alternativa, porém recomenda-se cautela, visto que nenhum dos estudos avaliou pacientes em cuidados paliativos.

Mycobacterium bovis infection in goats from the Northeast Region of Brazil

A total of 8,058 male and female mixed-breed goats and 1-4 years of age were slaughtered over a period of 7 months at the public slaughterhouse of Patos city, Paraíba state, in the Northeast region of Brazil; 822 animals were inspected for gross lesions of tuberculosis, and 12 (1.46%) had lesions suggestive of tuberculosis in the mammary gland, lungs, liver and mediastinal, mesenteric, submandibular, parotid and prescapular lymph nodes. Presence of granulomatous lesions was confirmed in the submandibular lymph node of one (8.3%) goat at the histopathological examination and at the mycobacterium culture the same sample was confirmed positive. Isolate was confirmed as belonging to the M. tuberculosis complex by PCR restriction enzyme analysis (PRA). Spoligotyping identified the isolate into spoligotype SB0295 on the M. bovis Spoligotype Database website (www.mbovis.org), and it was classified as M. bovis. The occurrence of M. bovis in goats in this study suggests that this species may be a potential source of infection for humans and should be regarded as a possible problem in the advancement of control and eradication program for bovine tuberculosis in Brazil.

Produkte der solaren kosmischen Strahlung in Meteoriten

In dieser Arbeit wurde der Aufbau und der Einsatz einer Laser-Extraktionsanlage für Edelgase dargestellt. Diese neue Anlage stellt eine Erweiterung eines bereits bestehenden Edelgas-Massenspektrometers dar. Ein Großteil der Arbeit befasste sich mit dem Aufbau und der Abschätzung der Einsatzmöglichkeiten. Erste Untersuchungen waren Tiefenprofile an Meteoriten. Dabei stand die Unterscheidung der zwei Komponenten der kosmischen Strahlung im Mittelpunkt. Es ist erstmalig gelungen einen Beitrag zur Produktion von stabilen Nukliden durch die 'solare kosmische Strahlung' direkt nachzuweisen. Ebenfalls konnten die zwei unterschiedlichen Komponenten gegeneinander abgeschätzt und eine zweistufige Bestrahlung belegt werden. An Hand eines zweistufigen Modells wurde gezeigt, dass der Nachweis eines SCR-Beitrags durch Radionuklide deutlicher ausfallen muss, als der über stabile Nuklide. Der direkte Nachweis durch die Analyse der Neon-Isotope ist somit bei einer 'ungewöhnlichen' Bestrahlungsgeschichte erfolgt. Die empirischen Produktionsraten (Eugster) wurden so interpretiert, dass sie eine Superposition der Produkte aus galaktischer- und solarer kosmischer Strahlung darstellen, welche von den 'theoretischen' Modellen vorhergesagt werden.

Imaging di risonanza magnetica nucleare nello studio del tumore della prostata

Aim of the present study was to evaluate the accuracy of transrectal ultrasound biopsy (TRUS-biopsy) directed to regions with abnormal MRI and/or MRSI (magnetic resonance spectroscopic imaging ) for both the transition (TZ) and the peripheral (PZ) zones in patients who presented with persistent suspect for prostate cancer and with prior negative biopsy. We also evaluated relationship between MRSI results and histopathological findings of biopsy. 54 patients with the aforementioned characteristics underwent MRI/MRSI at least 6 months after prior negative biopsy; interval between MRI/3D-MRSI and the further TRUS-biopsy was less than 3 months. The prostate was divided in 12 regions both for imaging interpretation and biopsy. Moreover one to three cores more were taken from each region with abnormal MRI and/or 3D-MRSI. Twenty-two out of 54 patients presented cancer at MRI/MRSI-directed-TRUS-biopsy. On a patient basis the highest accuracy was obtained by assigning malignancy on a positive finding with MRSI and MRI even though it was not significantly greater than that obtained using MRI alone (area under the ROC curve, AUC: 0.723 vs. 0.676). On a region (n=648) basis the best accuracy was also obtained by considering positive both MRSI and MRI for PZ (0.768) and TZ (0.822). Twenty-eight per cent of cores with prostatitis were false positive findings on MRSI, whereas only 2.7% of benign prostatic hyperplasia was false positive. In conclusion the accuracy of MRI/MRSI-directed biopsies in localization of prostate cancer is good in patient and region analyses. The combination of both MRI and MRSI results makes TRUS-biopsy more accurate particularly in the TZ (0.822) for patients with prior negative biopsies. Histopathological analysis showed that the main limitation of MRSI is the percentage of false positive findings due to prostatitis.

Messung der semileptonischen Ξ°-Zerfälle mit dem NA48/1-Detektor

Im Jahre 2002 wurde mit dem NA48/1-Detektor eine Datennahme mit hoher Intensität von K_S-Mesonen und neutralen Hyperonen durchgeführt, bei der unter anderem etwa 10^9 Xi^0-Zerfallskandidaten aufgezeichnet wurden. Im Rahmen dieser Arbeit wurden aus diesem Datensatz 6657 Xi^0 -> Sigma^+ e^- Anti-nü und 581 Anti-Xi^0 -> Anti-Sigma^+ e^+ nü-Ereignisse ausgewählt und damit die Verzweigungsverhältnisse BR1(Gamma(Xi^0 -> Sigma^+ e^- Anti-nü)/Gamma(Xi^0 total))=( 2.533 +-0.032(stat) -0.076+0.089(syst) )10^-4 und BR2(Gamma(Anti-Xi^0 -> Anti-Sigma^+ e^+ nü)/Gamma(Anti-Xi^0 total))= ( 2.57 +-0.12(stat) -0.09+0.10(syst) )10^-4 bestimmt. Dieses Ergebnis für BR1 ist etwa 3.5-mal genauer als die bisher veröffentlichte Messung. Die Analyse der Anti-Xi^0-Beta-Zerfälle stellt die erste Messung von BR2 dar. Beide Ergebnisse stimmen mit der theoretischen Vorhersage von 2.6*10^-4 überein. Aus dem Xi^0-Beta-Verzweigungsverhältnis folgt unter Verwendung des experimentellen Wertes des Formfaktorverhältnisses g1/f1 für das CKM-Matrixelement |Vus| = 0.209 +- 0.004(exp) +- 0.026(syst), wobei die dominierende Unsicherheit von g1/f1 herrührt. Außerdem wurden in dieser Arbeit 99 Xi^0 -> Sigma^+ mu^- Anti-nü Zerfallskandidaten mit einem abgeschätzten Untergrund von 30 Ereignissen rekonstruiert und daraus ebenfalls das Verzweigungsverhältnis extrahiert: BR3(Gamma(Xi^0 -> Sigma^+ mu^- Anti-nü)/Gamma(Xi^0 total)) = ( 2.11 +- 0.31(stat) +- 0.15(syst) )10^-6.

Referral practice among Swiss and non-Swiss walk-in patients in an urban surgical emergency department

To assess the relationship between nationality, gender and age and use of health services among patients visiting an urban university hospital emergency department (ED).

Prognosis of patients with HIV-1 infection starting antiretroviral therapy in sub-Saharan Africa: a collaborative analysis of scale-up programmes

Background Prognostic models have been developed for patients infected with HIV-1 who start combination antiretroviral therapy (ART) in high-income countries, but not for patients in sub-Saharan Africa. We developed two prognostic models to estimate the probability of death in patients starting ART in sub-Saharan Africa. Methods We analysed data for adult patients who started ART in four scale-up programmes in Côte d'Ivoire, South Africa, and Malawi from 2004 to 2007. Patients lost to follow-up in the first year were excluded. We used Weibull survival models to construct two prognostic models: one with CD4 cell count, clinical stage, bodyweight, age, and sex (CD4 count model); and one that replaced CD4 cell count with total lymphocyte count and severity of anaemia (total lymphocyte and haemoglobin model), because CD4 cell count is not routinely measured in many African ART programmes. Death from all causes in the first year of ART was the primary outcome. Findings 912 (8·2%) of 11 153 patients died in the first year of ART. 822 patients were lost to follow-up and not included in the main analysis; 10 331 patients were analysed. Mortality was strongly associated with high baseline CD4 cell count (≥200 cells per μL vs <25; adjusted hazard ratio 0·21, 95% CI 0·17–0·27), WHO clinical stage (stages III–IV vs I–II; 3·45, 2·43–4·90), bodyweight (≥60 kg vs <45 kg; 0·23, 0·18–0·30), and anaemia status (none vs severe: 0·27, 0·20–0·36). Other independent risk factors for mortality were low total lymphocyte count, advanced age, and male sex. Probability of death at 1 year ranged from 0·9% (95% CI 0·6–1·4) to 52·5% (43·8–61·7) with the CD4 model, and from 0·9% (0·5–1·4) to 59·6% (48·2–71·4) with the total lymphocyte and haemoglobin model. Both models accurately predict early mortality in patients starting ART in sub-Saharan Africa compared with observed data. Interpretation Prognostic models should be used to counsel patients, plan health services, and predict outcomes for patients with HIV-1 infection in sub-Saharan Africa.