Detection of coronary artery disease based on the calcification index obtained by helical computed tomography

OBJECTIVE: To assess the relation between coronary artery disease and the calcification index on helical computed tomography. METHOD: We studied 22 patients (ages ranging from 40 to 70 years) who underwent coronary angiography because of chest pain suggestive of angina pectoris. Findings on coronary angiography were classified as follows: significant obstructive disease (stenosis > or = 50%), nonobstructive disease (stenosis <50%), and no disease. With no previous knowledge of the results of the coronary angiography and within 7 days, helical computed tomography of the chest was performed. Then, data of the coronary angiography were correlated with the calcification index obtained by helical computed tomography. RESULTS: The sensitivity of helical computed tomography to the presence of significant obstructive lesions on coronary angiography was 87.5%, specificity was 100%, and negative and positive predictive values were 75% and 100%, respectively. The mean calcification index was greater in patients with severe coronary lesions, mainly when involvement of 2 or 3 vessels occurred, than that in patients with no coronary artery disease or with nonobstructive coronary artery lesions (p<0.05). CONCLUSION: Helical computed tomography is an effective method for detecting and quantifying coronary artery calcification, and it has proved to be sensitive to and specific for the noninvasive diagnosis of coronary artery stenosis.

Left Ventricular Hypertrophy Evaluation in Obese Hypertensive Patients: Effect of Left Ventricular Mass Index Criteria

PURPOSE: To evaluate left ventricular mass (LVM) index in hypertensive and normotensive obese individuals. METHODS: Using M mode echocardiography, 544 essential hypertensive and 106 normotensive patients were evaluated, and LVM was indexed for body surface area (LVM/BSA) and for height² (LVM/h²). The 2 indexes were then compared in both populations, in subgroups stratified according to body mass index (BMI): <27; 27-30; > or = 30kg/m². RESULTS: The BSA index does not allow identification of significant differences between BMI subgroups. Indexing by height² provides significantly increased values for high BMI subgroups in normotensive and hypertensive populations. CONCLUSION: Left ventricular hypertrophy (LVH) has been underestimated in the obese with the use of LVM/BSA because this index considers obesity as a physiological variable. Indexing by height² allows differences between BMI subgroups to become apparent and seems to be more appropriate for detecting LVH in obese populations.

Body Mass Index: A Scientific Evidence-Based Inquiry

OBJECTVE: To objectively and critically assess body mass index and to propose alternatives for relating body weight and height that are evidence-based and that eliminate or reduce the limitations of the body mass index. METHODS: To analyze the relations involving weight and height, we used 2 databases as follows: 1) children and adolescents from Brazil, the United States, and Switzerland; and 2) 538 university students. We performed mathematical simulations with height data ranging from 115 to 190 cm and weight data ranging from 25 to 105 kg. We selected 3 methods to analyze the relation of weight and height as follows: body mass index - weight (kg)/height (m²); reciprocal of the ponderal index - height (cm)/weight1/3 (kg); and ectomorphy. Using the normal range from 20 to 25 kg/m² for the body mass index in the reference height of 170 cm, we identified the corresponding ranges of 41 to 44 cm/kg1/3 for the reciprocal of the ponderal index, and of 1.45 to 3.60 for ectomorphy. RESULTS: The mathematical simulations showed a strong association among the 3 methods with an absolute concordance to a height of 170 cm, but with a tendency towards discrepancy in the normal ranges, which had already been observed for the heights of 165 and 175 cm. This made the direct convertibility between the indices unfeasible. The reciprocal of the ponderal index and ectomorphy with their cut points comprised a larger age range in children and adolescents and a wider and more central range in the university students, both for the reported (current) and desired weights. CONCLUSION: The reciprocal of the ponderal index and ectomorphy are stronger and are more mathematically logical than body mass index; in addition, they may be applied with the same cut points for normal from the age of 5 ½ years on.

Index filicum,sive, Enumeratio omnium generum specierumque filicum et Hydropteridum ab anno 1753 ad finem anni 1905 descriptorium : adjectis synonymis principalibus, area geographica, etc. /Carl Christensen.

Fascicles 1-12, 1753-1906

Index filicum,sive, Enumeratio omnium generum specierumque filicum et Hydropteridum ab anno 1753 ad finem anni 1905 descriptorium : adjectis synonymis principalibus, area geographica, etc. /Carl Christensen.

Suppl. 1906-12

Index filicum,sive, Enumeratio omnium generum specierumque filicum et Hydropteridum ab anno 1753 ad finem anni 1905 descriptorium : adjectis synonymis principalibus, area geographica, etc. /Carl Christensen.

Suppl. prelim. 1913-17

Index filicum,sive, Enumeratio omnium generum specierumque filicum et Hydropteridum ab anno 1753 ad finem anni 1905 descriptorium : adjectis synonymis principalibus, area geographica, etc. /Carl Christensen.

Suppl. 3 1917-33

Index filicum,sive, Enumeratio omnium generum specierumque filicum et Hydropteridum ab anno 1753 ad finem anni 1905 descriptorium : adjectis synonymis principalibus, area geographica, etc. /Carl Christensen.

Suppl. 4 1934-60

Tradução e validação para o português do Medication Regimen Complexity Index

FUNDAMENTO: A complexidade da farmacoterapia consiste de múltiplas características do regime prescrito, incluindo o número de diferentes medicações no esquema, o número de unidades de dosagem por dose, o número total de doses por dia e os cuidados na administração dos medicamentos. O Medication Regimen Complexity Index (MRCI) é um instrumento específico, validado e utilizado para medir a complexidade da farmacoterapia, desenvolvido originalmente em língua inglesa. OBJETIVO: Tradução transcultural e validação desse instrumento para o português do Brasil. MÉTODOS: Foi desenvolvido um estudo transversal envolvendo 95 pacientes com diabete do tipo 2 utilizando múltiplas medicações. O processo de validação teve início pela tradução, retrotradução e pré-teste do instrumento, gerando uma versão adaptada chamada Índice de Complexidade da Farmacoterapia (ICFT). Em seguida foram analisados parâmetros psicométricos, incluindo validade convergente, validade divergente, confiabilidade entre avaliadores e teste-reteste. RESULTADOS: A complexidade da farmacoterapia medida pelo ICFT obteve média de 15,7 pontos (desvio padrão = 8,36). O ICFT mostrou correlação significativa com o número de medicamentos em uso (r = 0,86; p < 0,001) e a idade dos pacientes (r = 0,28; p = 0,005). A confiabilidade entre avaliadores obteve correlação intraclasse igual a 0,99 (p < 0,001) e a confiabilidade teste-reteste obteve correlação de 0,997 (p < 0,001). CONCLUSÃO: Os resultados demonstraram que o ICFT apresenta bom desempenho de validade e confiabilidade, podendo ser utilizado como ferramenta útil na prática clínica e em pesquisas envolvendo análise da complexidade da terapia.

Index animalium; sive, Index nominum quae ab A. D. MDCCLVIII generibus et speeiebus animalium imposita sunt,

sec.1:pt.1-2=pp.1-1195 [Index]

Defining habitat characteristics influencing the distribution, density and growth of Plaice (Pleuronectes Platessa) and Dab (Limanda Limanda) on west of Ireland nursery grounds

Plaice (Pleuronectes platessa, L.) and dab (Limanda limanda, L.) are among the most abundant flatfishes in the north-eastern Atlantic region and the dominant species in shallow coastal nursery grounds. With increasing pressures on commercial flatfish stocks in combination with changing coastal environments, better knowledge of population dynamics during all life stages is needed to evaluate variability in year-class strength and recruitment to the fishery. The aim of this research was to investigate the complex interplay of biotic and abiotic habitat components influencing the distribution, density and growth of plaice and dab during the vulnerable juvenile life stage and to gain insight in spatial and temporal differences in nursery habitat quality along the west coast of Ireland. Intraspecific variability in plaice diet was observed at different spatial scales and showed a link with condition, recent growth and morphology. This highlights the effect of food availability on habitat quality and the need to consider small scale variation when attempting to link habitat quality to feeding, growth and condition of juvenile flatfish. There was evidence of trophic, spatial and temporal resource partitioning between juvenile plaice and dab allowing the co-existence of morphologically similar species in nursery grounds. In the limited survey years there was no evidence that the carrying capacity of the studied nursery grounds was reached but spatial and interannual variations in fish growth indicated fluctuating environments in terms of food availability, predator densities, sediment features and physico-chemical conditions. Predation was the most important factor affecting habitat quality for juvenile plaice and dab with crab densities negatively correlated to fish condition whereas shrimp densities were negatively associated with densities of small-sized juveniles in spring. A comparison of proxies for fish growth showed the advantage of Fulton’s K for routine use whereas RNA:DNA ratios proved less powerful when short-term environmental fluctuations are lacking. This study illustrated how distinct sets of habitat features can drive spatial variation in density and condition of juvenile flatfish highlighting the value of studying both variables when modeling habitat requirements. The habitat models generated in this study also provide a powerful tool to predict potential climate and anthropogenic impacts on the distribution and condition of juveniles in flatfish nurseries. The need for effective coastal zone management was emphasized to ensure a sustainable use of coastal resources and successful flatfish recruitment to the fishery.

Tourism Climate Index in Batumi

ნაშრომში მოცემულია ბათუმისათვის ტურიზმის კლიმატური პოტენციალის შეფასება სხვადასხვა ქვეყანაში ხშირად ხმარებული “ტურიზმის კლიმატური ინდექსის” შესაბამისად