A controlled clinical trial on the effects of motor intervention on balance and cognition in institutionalized elderly patients with dementia

Purpose: To analyse the effects of two interventions on the cognition and balance of institutionalized elderly people with mixed dementia.Methods: Fifty-four participants were allocated into three groups. Group 1 was assisted by an interdisciplinary programme comprising physiotherapy, occupational therapy and physical education. A physiotherapist alone carried out the intervention in group 2. Group 3 was considered as control. Assessors were blinded to guarantee the absence of bias. Cognitive functions were analysed with the Mini-Mental State Examination and the Brief Cognitive Screening Battery. Balance was assessed with the Berg Balance Scale and the Timed Get-Up-and-Go Test. Multiple analysis of variance (MANOVA) was used to test possible main effects of the interventions.Results: The results showed benefits on the balance of subjects in both groups 1 (F=3.9, P < 0.05) and 2 (F= 3.1, P < 0.05), compared with group 3. MANOVA did not indicate benefits on the cognitive functions between groups 1 and 3 (F= 1.1, P > 0.05) and groups 2 and 3 (F= 1.6, P > 0.05). However, univariate analysis indicated some benefits of the interdisciplinary intervention on two specific domains measured by the Brief Cognitive Screening Battery (F=26.5, P < 0.05; F= 4.4, P < 0.05).Conclusion: Six months of multidisciplinary or physiotherapeutic intervention were able to improve a person's balance. Although global cognition did not improve through treatment, when the intervention was carried out on a multidisciplinary basis we observed an attenuation in the decline of global cognition on two specific cognitive domains. Exercises applied in different contexts may have positive outcomes for people with dementia.

Grading and staging chronic hepatitis C and its relation to genotypes and epidemiological factors in brazilian blood donors

Progression of chronic hepatitis C is known to be associated with some factors, but influence of HCV genotypes is still controversial. Association between HCV genotypes and other risk factors was examined to determine which factors are associated with progression of infection. One hundred consecutive anti-HCV positive volunteer blood donors were evaluated for several risk factors, examined for HCV genotypes, and submitted to hepatic biopsy and biochemical exams.HCV genotyping were carried out in 89 patients and hepatic biopsy in 78. Transmission routes were found to be illicit intravenous drug use (26%), Gluconergan® use in a non-safe manner (48%) and blood transfusion (15%). HCV genotype was 1 in 45%, 3 in 40%, and it was not associated with the stage of fibrosis or with inflammatory activity. There was no significant association of factors related to infection, chronic alcohol use, or duration of illness, with progression of the lesion. There was a significant association of aminotransferase levels and the fibrosis stage. Univariate analysis showed that the age at contamination, patient's age, GT-gamma, and aminotransferase levels over three times the upper normal limits, were associated with fibrosis stages 2 to 4. Multivariate analysis detected age (odds ratio=1.19), and GT-gamma (odds ratio=2.02) as independent factors.

Estimates of covariance functions for growth from birth to 630 days of age in Nelore cattle

Weight records of Brazilian Nelore cattle, from birth to 630 d of age, recorded every 3 mo, were analyzed using random regression models. Independent variables were Legendre polynomials of age at recording. The model of analysis included contemporary groups as fixed effects and age of dam as a linear and quadratic covariable. Mean trends were modeled through a cubic regression on orthogonal polynomials of age. Up to four sets of random regression coefficients were fitted for animals' direct and maternal, additive genetic, and permanent environmental effects. Changes in measurement error variances with age were modeled through a variance function. Orders of polyno-mial fit from three to six were considered, resulting in up to 77 parameters to be estimated. Models fitting random regressions modeled the pattern of variances in the data adequately, with estimates similar to those from corresponding univariate analysis. Direct heritability estimates decreased after birth and tended to be lowest at ages at which maternal effect estimates tended to be highest. Maternal heritability estimates increased after birth to a peak around 110 to 120 d of age and decreased thereafter. Additive genetic direct correlation estimates between weights at standard ages (birth, weaning, yearling, and final weight) were moderate to high and maternal genetic and environmental correlations were consistently high. © 2001 American Society of Animal Science. All rights reserved.

Study of electrochemical oxidation and determination of albendazole using a glassy carbon-rotating disk electrode

In this work, electrochemical oxidation of albendazole (ABZ) was carried out using a glassy carbon-rotating disk electrode. Development of electroanalytical methodology for ABZ quantification in pharmaceutical formulations was also proposed by using linear sweep voltammetric technique. Electrochemical oxidation is observed for ABZ at E 1/2 = 0.99:V vs. Ag/AgCl sat, when an anodic wave is observed. Kinetic parameters obtained for ABZ oxidation exhibited a standard heterogeneous rate constant for the electrodic process equal to (1.51 ± 0.07) ± 10 -5:cm:s -1, with a αn a value equal to 0.76. Limiting current dependence against ABZ concentration exhibited linearity on 5.0 ± 10 -5 to 1.0 ± 10 -2:mol:l -1 range, being obtained a detection limit of 2.4 ± 10 -5:mol:l -1. Proposed methodology was applied to ABZ quantification in pharmaceutical formulations. © 2005 Elsevier SAS. All rights reserved.

Thermoeconomic model considering the environment impacts on thermoelectric power plants: Natural gas versus diesel

In this paper a comparative analysis of the environmental impact caused by the use of natural gas and diesel in thermoelectric power plants utilizing combined cycle is performed. The objective is to apply a thermoeconomical analysis in order to compare the two proposed fuels. In this analysis, a new methodology that incorporates the economical engineering concept to the ecological efficiency once Cardu and Baica [1, 2], which evaluates, in general terms, the environmental impacts caused by CO2, SO2, NOx and Particulate Matter (PM), adopting as reference the air quality standards in vigour is employed. The thermoeconomic model herein proposed utilizes functional diagrams that allow the minimization the Exergetic Manufacturing Cost, which represents the cost of production of electricity incorporating the environmental impact effects to study the performance of the thermoelectric power plant [3,4], It follows that it is possible to determine the environmental impact caused by thermoelectric power plants and, under the ecological standpoint, the use of natural gas as a fuel is the best option compared to the use of the diesel, presenting ecological efficiency values of 0.944 and 0.914 respectively. From the Exergoeconomic point of view of, it was found out that the EMC (Exergetic Manufacturing Cost) is better when natural gas is used as fuel compared to the diesel fuel. Copyright © 2006 by ASME.

Variação genética para compostos bioquímicos em sementes de duas populações naturais de Genipa americana L.: 1-análises individuais e univariada

Brazil is one of the world's richest countries in forest biodiversity. This has a great importance for humanity for sheltering essential scientific potential for the improvement in the quality of living beings. It also contributes to the preservation of natural resources and the environment. Among Brazil's forest species, jenipapo (Genipa americana L.) is commonly found in riparian vegetation. The objective of this work was to quantify the genetic variability of biochemical traits of seeds, as a support for in situ and ex situ conservation of natural populations of G. americana L. Two populations of the species were studied: one from Ilha Solteira, SP region (ISA) and other from Mogi Guaçu, SP (MOG). In the ISA population, seeds were collected from 30 trees, and in the MOG population, from 22 trees. These seeds were analyzed for chemical composition: content of proteins, carbohydrates, lipids and starch. The two populations of G. americana studied had a great genetic variation for these traits. The population ISA had an additive and phenotypic correlation, which was negative and high for starch with lipid; and positive and medium, for lipid with prolamine, as well as for globulin with prolamine. The population MOG presented additive and phenotypic correlations: positive and medium for gluteline with globulin. In these populations, narrow sense heritability estimates of progenies were moderate (0.69 for carbohydrates in the population ISA) to high (0.81 to 0.99 for the other traits in the two populations), indicating that much progress can be expected with selection strategies.

Relevãncia do padrão de remodelamento ventricular no modelo de infarto do miocárdio em ratos

Background: The relevance of the remodeling pattern in the model of infarcted rats is not known. Objective: To analyze the presence of different patterns of remodeling in this model and its functional implications. Methods: Infarcted rats (n=47) have been divided according to the geometry pattern, analyzed by echocardiogram: normal (normal mass index and normal relative thickness), concentric remodeling (normal mass index and increased relative thickness), concentric hypertrophy (increased mass index and increased relative thickness) and eccentric hypertrophy (increased mass index and normal relative thickness). Data are median and interquartile range. Results: Infarcted rats showed only two of the four geometric patterns: normal pattern (15%) and eccentric hypertrophy - EH (85%). Groups of normal pattern and EH showed no differences in the values of fractional area change (Normal = 32.1-28.8 to 50.7; EH = 31.3-26.5 to 36.7; p = 0.343). Out of the infarcted animals, 34 (74%) had systolic dysfunction, detected by fractional area change. Considering these two geometry patterns, 77% of animals with eccentric hypertrophy and 57% with normal geometry presented systolic dysfunction (p=0.355). The relative wall thickness, the geometric patterns and the body mass index were not predictors of ventricular dysfunction (p>0.05). On the other hand, infarct size was a predictive factor for ventricular dysfunction in univariate analysis (p<0.001) and multivariate analysis (p = 0.004). Conclusion: Rats that underwent coronary occlusion showed two different patterns of remodeling, which do not constitute a predictor of ventricular dysfunction.

Could albumin level explain the higher mortality in hemodialysis patients with pulmonary hypertension?

Background: The pathogenesis of pulmonary hypertension (PH) in hemodialysis is still unclear. The aim of thisstudy was to identify the risk factors associated with the presence of PH in chronic hemodialysis patients and toverify whether these factors might explain the highest mortality among them.Methods: We conducted a retrospective study of hemodialysis patients who started treatment from August 2001to October 2007 and were followed up until April 2011 in a Brazilian referral medical school. According to theresults of echocardiography examination, patients were allocated in two groups: those with PH and those withoutPH. Clinical parameters, site and type of vascular access, bioimpedance, and laboratorial findings were comparedbetween the groups and a logistic regression model was elaborated. Actuarial survival curves were constructed andhazard risk to death was evaluated by Cox regression analysis.Results: PH > 35 mmHg was found in 23 (30.6%) of the 75 patients studied. The groups differed in extracellularwater, ventricular thickness, left atrium diameter, and ventricular filling. In a univariate analysis, extracellular waterwas associated with PH (relative risk = 1.194; 95% CI of 1.006 1.416; p = 0.042); nevertheless, in a multiple model,only left atrium enlargement was independently associated with PH (relative risk =1.172; 95% CI of 1.010 1.359;p = 0.036). PH (hazard risk = 3.008; 95% CI of 1.285 7.043; p = 0.011) and age (hazard risk of 1.034 per year of age;95% CI of 1.000 7.068; p = 0.047) were significantly associated with mortality in a multiple Cox regression analysis.However, when albumin was taken in account the only statistically significant association was between albuminlevel and mortality (hazard risk = 0.342 per g/dL; 95% CI of 0.119 0.984; p = 0.047) while the presence of PH lost itsstatistical significance (p = 0.184). Mortality was higher in patients with PH (47.8% vs 25%) who also had astatistically worse survival after the sixth year of follow up.Conclusions: PH in hemodialysis patients is associated with parameters of volume overload that sheds light on itspathophysiology. Mortality is higher in hemodialysis patients with PH and the low albumin level can explain thisassociation.© 2012 Greenfield et al.; licensee BioMed Central Ltd.

Long-term outcome of patients followed by nephrologists after an acute tubular necrosis episode

Aims of our study were to describe the long-term survival in patients surviving an acute tubular necrosis (ATN) episode and determine factors associated with late mortality. We performed a prospective cohort study that evaluated the long-term outcome of 212 patients surviving an ATN episode. Mortality at the end of followup was 24.5%, and the probability of these patients being alive 5 years after discharge was 55%. During the followup, 4.7% of patients needed chronic dialysis. Univariate analysis showed that previous CKD (P = 0.0079), cardiovascular disease (P = 0.019), age greater than 60 years (P < 0.0001), and higher SCr baseline (P = 0.001), after 12 months (P = 0.0015) and 36 months (P = 0.004), were predictors of long-term mortality. In multivariate analysis, older age (HR = 6.4, CI 95% = 1.2-34.5, P = 0.02) and higher SCr after 12 months (HR = 2.1, 95% CI 95% = 1.14-4.1, P = 0.017) were identified as risk factors associated with late mortality. In conclusion, 55% of patients surviving an ATN episode were still alive, and less than 5% required chronic dialysis 60 months later; older age and increased Scr after 12 months were identified as risk factors associated with late death. © 2012 G. A. Brito et al.

Serum Metalloproteinases 2 and 9 as Predictors of Gait Status, Pressure Ulcer and Mortality after Hip Fracture

Introduction: The aim of this study is to evaluate the serum activity of metalloproteinases (MMPs) -2 and -9 as predictors of pressure ulcer (PU), gait status and mortality 6 months after hip fracture. Methods: Eighty-seven patients over the age of 65 admitted to the orthopedic unit from January to December 2010 with hip fracture were prospectively evaluated. Upon admission, patient demographic information, including age, gender and concomitant diseases, was recorded. Blood samples were taken for analysis of MMP -2 and -9 activity by gel zymography and for biochemical examination within the first 72 hours of the patient's admission, after clinical stabilization. The fracture pattern (neck, trochanteric or subtrochanteric), time from admission to surgery, surgery duration and length of hospital stay were also recorded. Results: Two patients were excluded due to the presence of pathological fractures (related to cancer), and three patients were excluded due to the presence of PU before admission. Eighty-two patients, with a mean age of 80.4 ± 7.3 years, were included in the analysis. Among these patients, 75.6% were female, 59.8% had PU, and 13.4% died 6 months after hip fracture. All patients underwent hip fracture repair. In a univariate analysis, there were no differences in serum MMP activity between hip fracture patients with or without PU. In addition, the multiple logistic regression analysis models, which were adjusted by age, gender, length of hospital stay and C-reactive protein, showed that the pro-MMP-9 complexed with neutrophil gelatinase-associated lipocalin form (130 kDa) was associated with gait status recovery 6 months after hip fracture. Conclusions: In conclusion, serum pro-MMP-9 is a predictor of gait status recovery 6 months after hip fracture. © 2013 Gumieiro et al.

Evaluation of Sperm Kinetics and Plasma Membrane Integrity of Frozen Equine Semen in Different Storage Volumes and Freezing Conditions

In the present study, different freezing systems (Styrofoam box and Mini Digitcool ZH 400) and storage volumes (0.5- and 0.25-mL straws) were compared with regard to sperm kinetics and plasma membrane integrity of frozen and thawed semen. For that, three ejaculates from four animals were frozen in Styrofoam box and Mini Digitcool ZH 400 machine. The 0.5-mL straws were thawed at 46°C for 20 seconds, and the 0.25-mL straws were thawed at 46°C for 12 seconds. Statistical analysis was performed using program R of descriptive analysis box plot, followed by analysis of variance using PROC MIXED of SAS 9.1 package. Variances of 5% were considered as different. There was no interaction between the straw sizes and volumes; however, statistical differences were observed between the semen storage volumes. The 0.5-mL straws had higher total motility (%), progressive motility (%), average path velocity (μm/s), straight-line velocity (μm/s), curvilinear velocity (μm/s), and rapid sperm percentage (%) than the 0.25-mL straws. However, plasma membrane integrity analysis did not differ between the two straws. Thus, it is possible to conclude that equine sperm cryopreserved in 0.5-mL straws has better sperm kinetics than when stored in 0.25-mL straws. Additionally, it is possible to conclude that automated systems that enable faster freezing rates result in a seminal quality that is similar to the one obtained by the conventional system using Styrofoam boxes. © 2013 Elsevier Inc.

Atrophic gastritis: Risk factor for esophageal squamous cell carcinoma in a Latin-American population

AIM: To study the association between atrophic gastritis (AG) and esophageal squamous cell carcinoma (ESCC) in a Latin-America population. METHODS: A case-control study was performed at two reference Brazilian hospitals including patients diagnosed with advanced ESCC and dyspeptic patients who had been subjected to upper gastrointestinal endoscopy, with biopsies of the gastric antrum and body. All cases with ESCC were reviewed by a single pathologist, who applied standard criteria for the diagnosis of mucosal atrophy, intestinal metaplasia, and dysplasia, all classified as AG. The data on the patients' age, sex, smoking status, and alcohol consumption were collected from clinical records, and any missing information was completed by telephone interview. The association between AG and ESCC was assessed by means of univariate and multiple conditional logistic regressions. RESULTS: Most patients were male, and the median age was 59 years (range: 37-79 years) in both the ESCC and control groups. Univariate analysis showed that an intake of ethanol greater than 32 g/d was an independent risk factor that increased the odds of ESCC 7.57 times (P = 0.014); upon multiple analysis, alcohol intake of ethanol greater than 32 g/d exhibited a risk of 4.54 (P = 0.081), as adjusted for AG and smoking. Smoking was shown to be an independent risk factor that increased the odds of ESCC 14.55 times (P = 0.011) for individuals who smoked 0 to 51 packs/year and 21.40 times (P = 0.006) for those who smoked more than 51 packs/year. Upon multiple analyses, those who smoked up to 51 packs/year exhibited a risk of 7.85 (P = 0.058), and those who smoked more than 51 packs/year had a risk 11.57 times higher (P = 0.04), as adjusted for AG and alcohol consumption. AG proved to be a risk factor that increased the odds of ESCC 5.33 times (95%CI: 1.55-18.30, P = 0.008) according to the results of univariate conditional logistic regression. CONCLUSION: There was an association by univariate conditional logistic regression between AG and ECSS in this sample of Latin-American population. © 2013 Baishideng.

Estimativas de parâmetros genéticos para características de crescimento em ovinos da raça somalis brasileira

The aim of this study was to estimate genetic parameters for growth traits in Somalis Brasileira hair sheep breed. The data used in this study were from the flock of Embrapa Caprinos and Ovinos, located in the city of Sobral - CE, Brazil. Data contained records of 1,120 animals in the pedigree file. The analyzed traits were birth weight (PN), weaning weight (PD), weight gain from birth to weaning (GND) and adult weight (PA). Estimates of (co)variances and genetic parameters were obtained by Derivative Free Restricted Maximum Likelihood Method (DFREML) using the MTDFREML software. The heritabilities were low to moderate in univariate analysis. The maternal heritabilities were higher than direct heritabilities. The heritabilities in multivariate analysis exceeded those in univariate analysis. The values of genetic correlations varied widely.

Induction of ankylosis in the incisor for orthodontic tooth movement in rats

Background/Aim: The present research evaluated the induction of ankylosis and the eruption rate in rat incisors, with the aim of achieving stable anchorage for orthodontic tooth movement (OTM) of the molars. Material and methods: Fifteen male Wistar rats were used. In the Experimental group, the right superior incisor of each animal was extracted, denuded of the PDL and the dental papilla, and reimplanted. The Control group was the left superior incisors. The eruption rate was measured at 7, 10, 12, 14, and 16 days after replantation. NiTi closed springs with a 50cN release force were installed for additional 9 days, and the eruption rate was determined. Then, the rats were sacrificed, and ankylosis was examined by microscopic analysis. Differences with P < 0.01 were defined as statistically significant. Results: The eruption rates were 0 and 0.39 mm day-1 in the Experimental group and Control group, respectively. All incisors of the Experimental group showed ankylosis according to histological analysis. Conclusions: The methodology used to induce ankylosis in this study was effective for anchoring the incisors during the OTM of rat molars, eliminating the undesirable effects consequent to continuous eruption. © 2013 John Wiley & Sons A/S.

Prognostic factors associated with time to hCG remission in patients with low-risk postmolar gestational trophoblastic neoplasia

Objective The purpose of this study was to identify the clinical factors associated with time to hCG remission among women with low-risk postmolar GTN. Methods This study included a non-concurrent cohort of 328 patients diagnosed with low-risk postmolar GTN according to FIGO 2002 criteria. Associations of time to hCG remission with history of prior mole, molar histology, time to persistence, use of D&C at persistence, presence of metastatic disease, FIGO score, hCG values at persistence, type of first line therapy and use of multiagent chemotherapy were investigated with both univariate and multivariate analyses. Results Overall median time to remission was 46 days. Ten percent of the patients required multi-agent chemotherapy to achieve hCG remission. Multivariate analysis incorporating the variables significant on univariate analysis confirmed that complete molar histology (HR 1.45), metastatic disease (HR 1.66), use of multi-agent therapy (HR 2.00) and FIGO score (HR 1.82) were associated with longer time to remission. There was a linear relationship between FIGO score and time to hCG remission. Each 1-point increment in FIGO score was associated with an average 17-day increase in hCG remission time (95% CI: 12.5-21.6). Conclusions Complete mole histology prior to GTN, presence of metastatic disease, use of multi-agent therapy and higher FIGO score were independent factors associated with longer time to hCG remission in low-risk GTN. Identifying the prognostic factors associated with time to remission and effective counseling may help improve treatment planning and reduce anxiety in patients and their families. © 2013 Elsevier Inc. All rights reserved.