Correlação entre qualidade de vida e capacidade funcional na insuficiência cardíaca

FUNDAMENTO: Pacientes com insuficiência cardíaca (IC) apresentam progressiva incapacidade e declínio na qualidade de vida, ambos relacionados com dispneia e fadiga. Dessa forma, há interesse crescente em mensurar a qualidade de vida (QV), seja por instrumento genérico, tal como o 36-item Short-Form Health Survey (SF-36), seja por específico, tal como o Minnesota Living with Heart Failure (MLHFQ). OBJETIVO: Este estudo objetivou correlacionar os questionários de QV, SF-36 e MLHFQ, com a capacidade funcional de pacientes com IC, expressa pelo teste cardiopulmonar e o TC6M. MÉTODOS: Utilizaram-se os questionários SF-36 e MLHFQ para avaliação da QV. Para avaliação da capacidade funcional, utilizou-se o teste cardiopulmonar, sendo executado em esteira com protocolo de Weber, bem como a distância percorrida no teste da caminhada de seis minutos (TC6M). RESULTADOS: Foram selecionados 46 pacientes com diagnóstico de IC (22 homens, idade média de 52 anos), classes II e III da New York Heart Association. Observou-se correlação fraca entre os domínios aspectos físico e emocional do SF-36 e o VE/VCO2pico (r=-0,3; p<0,05) e a distância percorrida no TC6M (r=0,4; p<0,05), respectivamente. Observaram-se ainda correlações de fraca a moderada do escore total do MLHFQ com o VO2pico (r=-0,5; p<0,05), o limiar anaeróbio (r=-0,4; p<0,05) e a distância percorrida no TC6M (r=-0,5; p<0,05). CONCLUSÃO: Os dados sugerem que a aplicação de ambos os instrumentos de avaliação da QV, genérico (SF-36) e específico (MLHFQ) em pacientes com IC, evidenciaram de fraca a moderada correlação com as variáveis do teste cardiopulmonar e a distância percorrida no TC6M.

High levels of Bifidobacteria are associated with increased levels of anthocyanin microbial metabolites: a randomized clinical trial.

The health benefits associated with the consumption of polyphenol-rich foods have been studied in depth, however, the full mechanism of action remains unknown. One of the proposed mechanisms is through microbiota interaction. In the present study, we aimed to explore the relationship between changes in fecal microbiota and changes in urinary phenolic metabolites after wine interventions. Nine participants followed a randomized, crossover, controlled interventional trial. After the washout period, they received red wine, dealcoholized red wine or gin for 20 days each. Polyphenol metabolites (n > 60) in urine were identified and quantified by UPLC-MS/MS and the microbial content of fecal samples was quantified by real-time quantitative PCR. Interventions with both red wine and dealcoholized red wine increased the fecal concentration of Bifidobacterium, Enterococcus and Eggerthella lenta, compared to gin intervention and baseline. When participants were categorized in tertiles of changes in fecal bacteria, those in the highest tertile of Bifidobacteria had higher urinary concentration changes in syringic acid, p-coumaric acid, 4-hydroxybenzoic acid and homovanillic acid (all anthocyanin metabolites) than those in tertile 1 (P < 0.05, all). In addition, changes of Bifidobacteria correlated positively with changes of these metabolites (r = 0.5-0.7, P < 0.05, all). Finally, the 68.5% changes in Bifidobacteria can be predicted by syringic acid and 4-hydroxybenzoic acid changes. This study confirms the important role of polyphenols as bacterial substrates and their modulatory capacity as an important field in the research of new products with prebiotic and probiotic characteristics for the food industry.

Determinants of sustained viral suppression in HIV-infected patients with self-reported poor adherence to antiretroviral therapy.

BACKGROUND: Good adherence to antiretroviral therapy (ART) is critical for successful HIV treatment. However, some patients remain virologically suppressed despite suboptimal adherence. We hypothesized that this could result from host genetic factors influencing drug levels. METHODS: Eligible individuals were Caucasians treated with efavirenz (EFV) and/or boosted lopinavir (LPV/r) with self-reported poor adherence, defined as missing doses of ART at least weekly for more than 6 months. Participants were genotyped for single nucleotide polymorphisms (SNPs) in candidate genes previously reported to decrease EFV (rs3745274, rs35303484, rs35979566 in CYP2B6) and LPV/r clearance (rs4149056 in SLCO1B1, rs6945984 in CYP3A, rs717620 in ABCC2). Viral suppression was defined as having HIV-1 RNA <400 copies/ml throughout the study period. RESULTS: From January 2003 until May 2009, 37 individuals on EFV (28 suppressed and 9 not suppressed) and 69 on LPV/r (38 suppressed and 31 not suppressed) were eligible. The poor adherence period was a median of 32 weeks with 18.9% of EFV and 20.3% of LPV/r patients reporting missed doses on a daily basis. The tested SNPs were not determinant for viral suppression. Reporting missing >1 dose/week was associated with a lower probability of viral suppression compared to missing 1 dose/week (EFV: odds ratio (OR) 0.11, 95% confidence interval (CI): 0.01-0.99; LPV/r: OR 0.29, 95% CI: 0.09-0.94). In both groups, the probability of remaining suppressed increased with the duration of continuous suppression prior to the poor adherence period (EFV: OR 3.40, 95% CI: 0.62-18.75; LPV/r: OR 5.65, 95% CI: 1.82-17.56). CONCLUSIONS: The investigated genetic variants did not play a significant role in the sustained viral suppression of individuals with suboptimal adherence. Risk of failure decreased with longer duration of viral suppression in this population.

Variaciones estacionales en la distribución y biomasa de anchoveta entre 1983 y 2000

Los resultados de 29 cruceros, realizados desde 1983 al 2000, muestran que la anchoveta ha presentado variaciones significativas en su biomasa y distribución, debido a los eventos El Niño 1982-83, 1987, 1992 y 1997-98, que la hicieron replegarse a la costa, migrar hacia el sur y profundizarse hasta lugares inusuales, disminuyendo los valores de las categorías de abundancia. Los mayores estimados de biomasa de anchoveta, se obtuvieron en los cruceros de evaluación hidroacústica de recursos pelágicos 9401-03 (8.700.590 t) y 0001-02 (9.439.027 t). La más alta biomasa estacional promedio por grados de latitud se determinó en primavera en los 8°5 (727.819 t), seguida del verano en los 11°s (701.724 t). Las altas biomasas promedio se encontraron entre los 7°S y 9° S. Los altos desembarques anuales promedio se registraron en verano (1.577.855 1). Los mayores desembarques se obtuvieron en 1994 (9.896.303 t) y en 1996 (7.136.856 t). Según el análisis de los parametros de biomasa y desembarques anuales entre los años de 1983 al 2000, se observa que existe una correlación significativa (r = 0,71) presentando un aceptable ajuste del modelo en R'•0,5 1.

El fitoplancton de invierno en el crucero de estimación de biomasa de anchoveta 0708-09

Los volúmenes de plancton superficial fluctuaron entre 0,06 y 11,14 mL.m-3 localizados frente a Pisco y Paita, respectivamente, registrando un promedio general de 1,34 mL.m-3. El fitoplancton en superficie predominó en el 31% del área evaluada. El microplancton estuvo caracterizado por diatomeas pequeñas de afloramiento (Chaetoceros sociales, Ch. compressus, Ch. lorenzianus, Skeletonema costatum) y por especies de la fase intermedia de la sucesión (Coscinodiscus perforatus, C. centralis, Thalassionema frauenfeldii, Lithodesmium undulatum). La presencia de especies termófilas también fue representativa encontrándose cerca y lejos de la costa, destacando por su abundancia las diatomeas Planktoniella sol, Proboscia alata f. gracillima y Thalasiothrix longissima. La correlación significativa entre la biomasa planctónica y oxígeno (r=>0,5) sugirió una mayor actividad autotrófica en las zonas norte y sur. El indicador de ACF, Protoperidinium obtusum, presentó una distribución costera con una amplitud máxima hasta las 120 mn al sur de Chicama y Atico y C. praelongum indicador de ASS sólo fue registrado a 70 mn frente a Pucusana.

[Illustrations des Oeuvres.] / Pierre de Ronsard, aut. du texte

Comprend : [Fig. p. de titre :] Porto omnia mea mecum. [Cote : microfilm R 1138] ; [Portrait en médaillon, en reg. Préface de Marc Antoine de Muret :] Mureti Effigies. [Cote : microfilm R 1138] ; [Portrait en médaillon, en reg. p.1, Ronsard]. [Cote : microfilm R 1138] ; [Portrait en médaillon, en reg. p.407, de Charles IX]. [Cote : microfilm R 1138] ; [Portrait en médaillon, en reg. p.471, de :] Henri III, roi de France et de Pologne. [Cote : microfilm R 1138]

[Illustrations de Regule florum musices] / [Non identifié] ; Petrus de Canuntiis, aut. du texte

Comprend : [Pl. en reg. Folio aii : le frère Pierre de Canuntis enseignant la musique.] [Cote : Res V 528/Microfilm R 21020] ; [Fig.: Orphée charmant les animaux ? Châpitre sur les ténors et les contres.] [Cote : Res V 528/Microfilm R 21020] ; [Pl. en reg. Folio bii : notes et tons. Théorisation de la musique.] [Cote : Res V 528/Microfilm R 21020] ; [Pl. en reg. Folio d : théorisation de la musqiue. Schéma illustrant les consonnances.] [Cote : Res V 528/Microfilm R 21020] ; [Pl. après folio gii : théorisation de la musique. Notes et tons.] [Cote : Res V 528/Microfilm R 21020]

Impact, challenges and perspectives of Euromelanoma, a pan-European campaign of skin cancer prevention.

The serotonin-2A receptor (5-HT(2A)R) has been implicated in the pathogenesis of schizophrenia and related inhibitory gating and behavioral inhibition deficits of schizophrenia patients. The hallucinogen psilocybin disrupts automatic forms of sensorimotor gating and response inhibition in humans, but it is unclear so far whether the 5-HT(2A)R or 5-HT(1A)R agonist properties of its bioactive metabolite psilocin account for these effects. Thus, we investigated whether psilocybin-induced deficits in automatic and controlled inhibition in healthy humans could be attenuated by the 5-HT(2A/2C)R antagonist ketanserin. A total of 16 healthy participants received placebo, ketanserin (40 mg p.o.), psilocybin (260 μg/kg p.o.), or psilocybin plus ketanserin in a double-blind, randomized, and counterbalanced order. Sensorimotor gating was measured by prepulse inhibition (PPI) of the acoustic startle response. The effects on psychopathological core dimensions and behavioral inhibition were assessed by the altered states of consciousness questionnaire (5D-ASC), and the Color-Word Stroop Test. Psilocybin decreased PPI at short lead intervals (30 ms), increased all 5D-ASC scores, and selectively increased errors in the interference condition of the Stroop Test. Stroop interference and Stroop effect of the response latencies were increased under psilocybin as well. Psilocybin-induced alterations were attenuated by ketanserin pretreatment, whereas ketanserin alone had no significant effects. These findings suggest that the disrupting effects of psilocybin on automatic and controlled inhibition processes are attributable to 5-HT(2A)R stimulation. Sensorimotor gating and attentional control deficits of schizophrenia patients might be due to changes within the 5-HT(2A)R system.

The release of antidiuretic hormone is appropriate in response to hypovolemia and/or sodium administration in children with severe head injury: a trial of lactated Ringer's solution versus hypertonic saline.

We conducted an open, randomized, and prospective study to determine the effect of hypertonic saline on the secretion of antidiuretic hormone (ADH) and aldosterone in children with severe head injury (Glasgow coma scale <8). Thirty-one consecutive patients at a level III pediatric intensive care unit at a children's hospital received either lactated Ringer's solution (Ringer's group, n = 16) or hypertonic saline (Hypertonic Saline group, n = 15) over a 3-day period. Serum ADH levels were significantly larger in the Hypertonic Saline group as compared with the Ringer's group (P = 0.001; analysis of variance) and were correlated to sodium intake (Ringer's group: r = 0.39, R(2) = 0.15, P = 0.02; Hypertonic Saline group: r = 0.42, R(2) = 0.18, P = 0.02) and volume of fluids given IV (Ringer's group: r = 0.38, R(2) = 0.15, P = 0.02; Hypertonic Saline group: r = 0.32, R(2) = 0.1, P = not significant). Correlation of ADH to plasma osmolality was significant if plasma osmolality was >280 mOsm/kg (r = 0.5, R(2) = 0.25, P = 0.06), indicating an osmotic threshold for ADH release. Serum aldosterone levels were larger on the first day than during Days 2 and 3 in both groups and inversely correlated to serum sodium levels only in the Ringer's group (r = -0.55, R(2) = 0.3, P < 0.001). This group received a significantly larger fluid volume on Day 1 (P = 0.05, Mann-Whitney U-test) than did patients in the Hypertonic Saline group, indicating hypovolemia during the first day. Head-injured children have appropriate levels of ADH. They may be hypovolemic during the first day of treatment, especially if they receive lactated Ringer's solution. IMPLICATIONS: In head-injured patients, we recommend fluid restriction to avoid inappropriate secretion of antidiuretic hormone. In a prospective, randomized, and controlled study in 31 children, we were able to show that the antidiuretic hormone levels are appropriate in response to hypovolemia, sodium load, or both.

Cerebral oxygenation during the Richalet hypoxia sensitivity test and cycling time-trial performance in severe hypoxia.

BACKGROUND: The Richalet hypoxia sensitivity test (RT), which quantifies the cardiorespiratory response to acute hypoxia during exercise at an intensity corresponding to a heart rate of ~130 bpm in normoxia, can predict susceptibility of altitude sickness. Its ability to predict exercise performance in hypoxia is unknown. OBJECTIVES: Investigate: (1) whether cerebral blood flow (CBF) and cerebral tissue oxygenation (O2Hb; oxygenated hemoglobin, HHb; deoxygenated hemoglobin) responses during RT predict time-trial cycling (TT) performance in severe hypoxia; (2) if subjects with blunted cardiorespiratory responses during RT show greater impairment of TT performance in severe hypoxia. STUDY DESIGN: Thirteen men [27 ± 7 years (mean ± SD), Wmax: 385 ± 30 W] were evaluated with RT and the results related to two 15 km TT, in normoxia and severe hypoxia (FIO2 = 0.11). RESULTS: During RT, mean middle cerebral artery blood velocity (MCAv: index of CBF) was unaltered with hypoxia at rest (p > 0.05), while it was increased during normoxic (+22 ± 12 %, p < 0.05) and hypoxic exercise (+33 ± 17 %, p < 0.05). Resting hypoxia lowered cerebral O2Hb by 2.2 ± 1.2 μmol (p < 0.05 vs. resting normoxia); hypoxic exercise further lowered it to -7.6 ± 3.1 μmol below baseline (p < 0.05). Cerebral HHb, increased by 3.5 ± 1.8 μmol in resting hypoxia (p < 0.05), and further to 8.5 ± 2.9 μmol in hypoxic exercise (p < 0.05). Changes in CBF and cerebral tissue oxygenation during RT did not correlate with TT performance loss (R = 0.4, p > 0.05 and R = 0.5, p > 0.05, respectively), while tissue oxygenation and SaO2 changes during TT did (R = -0.76, p < 0.05). Significant correlations were observed between SaO2, MCAv and HHb during RT (R = -0.77, -0.76 and 0.84 respectively, p < 0.05 in all cases). CONCLUSIONS: CBF and cerebral tissue oxygenation changes during RT do not predict performance impairment in hypoxia. Since the changes in SaO2 and brain HHb during the TT correlated with performance impairment, the hypothesis that brain oxygenation plays a limiting role for global exercise in conditions of severe hypoxia remains to be tested further.

QUALIDADE DE FRUTOS PROCESSADOS ARTESANALMENTE DE AÇAÍ (Euterpe oleracea MART.) E BACABA (Oenocarpus bacaba MART.)

RESUMO Os frutos do açaizeiro (Euterpe oleracea Mart.) e da bacabeira ( MOenocarpus bacabaart), duas palmeiras tropicais nativas e socioeconomicamente importantes para os estados Amazônicos, são utilizados na produção de polpas processadas em sistemas agrofamiliares. Nesse sentido, o presente estudo objetivou a avaliação da qualidade físico-química e funcional de polpas de açaí e bacaba processadas artesanalmente. Os frutos foram coletados em propriedades rurais do município do Cantá/Roraima (bacaba) e Boa Vista/ Roraima (açaí). Para a constituição do experimento, as polpas processadas foram armazenadas em pequenas embalagens de politereftalato de etileno (PET) transparente e com tampa (mesmo material), com capacidade de 145 mL e refrigeradas a 3 ± 0,2°C e 45% de U.R., durante 5 dias. Foram analisados os seguintes parâmetros: pH, acidez titulável (AT), sólidos solúveis (SS), relação SS/AT, açúcares totais e redutores, pectinas totais e solúveis, teor de antocianinas e fenólicos totais. Ao final, para as polpas de açaí, levando-se em consideração os limites estabelecidos pelo Padrão de Identidade e Qualidade (PIQ), apenas o parâmetro AT apresentou-se fora da instrução normativa. Entretanto, a inexistência de padrões para bacaba inviabilizou tal comparação. Quanto ao teor das pectinas totais, pode-se concluir que ambas as polpas apresentam baixas concentrações desse componente, não sendo indicadas para produção de doces e geleias sem adição de agentes geleificantes. Os teores de compostos fenólicos e de antocianinas, em ambas as polpas, apesar de diminuir com o período de armazenamento refrigerado, apresentam altas concentrações quando em comparação a outros alimentos com apelo funcional.

Desenvolvimento das fissuras cerebrais fetais: avaliação com ultrassonografia tridimensional

OBJETIVO: avaliar a distância das fissuras cerebrais fetais à borda interna da calota craniana por meio da ultrassonografia tridimensional (US3D). MÉTODOS: realizou-se um estudo de corte transversal em 80 gestantes normais entre a 21ª e 34ª semanas de gestação. Avaliou-se a distância entre a tábua óssea interna da calota craniana fetal e as fissuras de Sylvius, parieto-occipital, hipocampo e calcarina. Para a obtenção desta distância para as três primeiras fissuras, realizou-se uma varredura tridimensional através do plano axial (nível dos ventrículos laterais). Para a obtenção da distância da fissura calcarina utilizou-se uma varredura coronal (nível dos lobos occiptais). Para avaliar a correlação entre as fissuras e a idade gestacional foram realizadas regressões de primeiro grau, sendo os ajustes calculados pelo coeficiente de determinação (R²). Foram determinados percentis 5, 50 e 95 para cada fissura. Avaliou-se ainda a correlação entre a distância destas fissuras com os diâmetros biparietal (DBP) e circunferência craniana (CC) utilizando o coeficiente de correlação de Pearson (r). RESULTADOS: todas as medidas das fissuras apresentaram correlação linear com a idade gestacional (Sylvius: R²=0,5; parieto-occipital: R²=0,7; hipocampo: R²=0,3 e calcarina: R²=0,3). A média da distância das fissuras variou de 7,0 a 14,0 mm, 15,9 a 28,7 mm, 15,4 a 25,4 mm e 15,7 a 24,8 mm para as fissuras de Sylvius, parieto-occipital, hipocampo e calcarina, respectivamente. As fissuras de Sylvius e parieto-occipital apresentaram as maiores correlações com o DBP (r=0,8 e 0,7, respectivamente) e a CC (r=0,7 e 0,8, respectivamente). CONCLUSÕES: a distância das fissuras cerebrais fetais à borda interna da calota craniana por meio da US3D apresentou correlação positiva com a idade gestacional.

Quality of life and menopausal symptoms in women with liver transplants

PURPOSE: To assess quality of life and climacteric symptoms in women with and without liver transplants. METHODS: This was a cross-sectional study of 52 women undergoing follow-up at a university hospital in southeastern Brazil from February 4th, 2009 to January 5th, 2011. Twenty-four of these women were 35 years old or older and had undergone liver transplantation at least one year before study entry. The remaining 28 women had no liver disease and were matched by age and menstrual patterns to the patients with transplants. The abbreviated version of the World Health Organization (WHOQOL-BREF) questionnaire was used to assess quality of life. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). Statistical analysis was carried out by Student's t-test, Mann-Whitney test and analysis of variance. Correlations between MRS and the WHOQOL-BREF were established by correlation coefficients. RESULTS: The mean age of the women included in the study was 52.2 (±10.4) years and the mean time since transplantation was 6.1 (±3.3) years. Women with liver transplants had better quality of life scores in the environment domain (p=0.01). No difference was noted between the two groups in any domain of the MRS. For women in the comparison group, there was a strongly negative correlation between somatic symptoms in the MRS and the physical domain of the WHOQOL-BREF (p<0.01; r=-0.8). In contrast, there was only a moderate association for women with liver transplants (p<0.01; r=-0.5). CONCLUSIONS: Women with liver transplants had better quality of life scores in the domain related to environment and did not exhibit more intense climacteric symptoms than did those with no liver disease. Climacteric symptoms negatively influenced quality of life in liver transplant recipients, although less intensely than in women without a history of liver disease.

Fatores associados ao falso diagnóstico pré-natal da restrição de crescimento fetal

OBJETIVO: Descrever os fatores relacionados ao falso diagnóstico de restrição de crescimento fetal (RCF).MÉTODOS: Foram incluídas 48 gestantes encaminhadas ao nosso serviço com suspeita de RCF, não confirmada após o nascimento. Estas foram comparadas ao grupo de gestantes com RCF confirmada e foram descritas características relacionadas a esses falso-positivos. Os dados foram analisados utilizando-se o programa Statplus para Mac(r), versão 5.8. Os resultados obtidos no estudo foram divididos em variáveis categóricas e contínuas para análise. Para comparação entre proporções, foi aplicado o teste do χ2 ou o teste exato de Fisher. O nível de significância foi estabelecido em p<0,05 para todos os testes.RESULTADOS: As gestantes com falso diagnóstico de restrição de crescimento fetal apresentavam as seguintes características: chegaram ao serviço em idade gestacional mais precoce (média de 32,8 semanas); entre 2 e 6 exames de ultrassonografia antes da matrícula no hospital terciário (média 3,8); foram submetidas à ultrasonografia até a 12ª semana em apenas 25% dos casos; tinham medida da altura uterina normal em 66,7% dos casos; foram submetidas a pelo menos 1 ultrassonografia com percentil normal em 52,1% dos casos; tinham a última ultrassonografia (média de 36 semanas) com percentil médio de 18; foram submetidas em média a 5 exames de ultrassonografia e 4,6 exames de vitalidade após ingressarem no serviço.CONCLUSÃO: O falso diagnóstico da RCF envolve custos hospitalares altos e demanda maior de especialistas. Deve-se valorizar a medida da altura uterina, por meio de exame físico cuidadoso e confirmar esse diagnóstico com a ultrassonografia nas últimas semanas de gestação, antes que a conduta obstétrica seja tomada.

Keskikaide- ja leveän keskimerkinnän kohteet Uudenmaan ELY-keskuksen alueella : Esiselvitys

Työn tavoitteena oli selvittää kustannustehokkaat, tien nykyiseen poikkileikkaukseen toteutettavissa olevat keskikaide- ja leveän keskimerkinnän kohteet Uudenmaan ELY-keskuksen maantieverkolla. Tarkastelussa olivat mukana kaikki Uudenmaan ELY-keskuksen yksiajorataiset maantiet, jotka täyttivät vaaditut kriteerit. Yksi tärkeimmistä rajausperusteista oli tien poikkileikkaus, ja lisäksi tierekisteritiedoista otettiin huomioon mm. liikennemäärä, nopeusrajoitus ja yhtäjaksoisen osuuden pituus. Leveän keskialueen tiemerkinnän vaikutuksia liikenneturvallisuuteen kartoittaneessa Liikenneviraston selvityksessä suositellaan, että leveän keskimerkinnän kohteissa käytetään vähintään metrin levyistä keskialuetta ja kaistanleveyttä 3,25–3,5 metriä sekä vähintään 0,75 metrin päällystettyä piennarta. Tässä työssä leveän keskialueen tiemerkinnän kohteeksi katsottiin näin ollen soveltuvan tie, jonka päällysteen leveys on vähintään 9,5 metriä. Liikenneviraston laatiman tien poikkileikkauksen suunnitteluohjeen mukaisesti 1+1- keskikaideteiden poikkileikkauksen minimiarvo on 10,0 metriä ja ohjearvo 12,5 metriä. Päällysteen leveyden minimiarvo on 9,5 metriä ja ohjearvo 12,0 metriä. Tierekisteritietojen perusteella noin 30 mahdollista kohdetta tarkasteltiin maastossa, jolloin voitiin täydentää ja korjata tierekisteritietoja sekä ehdottaa kohteeseen soveltuvaa toimenpidettä. Maastokäyntihavaintojen perusteella valituille kohteille laadittiin onnettomuusanalyysi, jossa selvitettiin mm. onnettomuustiheys ja -aste sekä tiettyjen onnettomuusluokkien yleisyys tieosuudella (kohtaamis- ja ohitusonnettomuudet sekä vasemmalle suistumiset, joihin keskikaiteella ja leveällä keskimerkinnällä pyritään erityisesti vaikuttamaan). Soveltuvat kohteet priorisoitiin kolmeen luokkaan mm. onnettomuustietojen ja liikennemäärän perusteella. Mahdollisiksi keskikaidekohteiksi työssä esitettiin valtatietä 2 välillä Nummela-valtatie 25, valtatietä 5 välillä Tuusjärvi-Paaso sekä kantatietä 50 Espoossa välillä Kirkkonummi-Kauklahti. Valtatie 5 priorisoitiin luokkaan I, valtatie 2 luokkaan II ja kantatie 50 luokkaan III. Keskikaidekohteiden yhteispituus oli noin 17 km. Leveän keskimerkinnän kohteita esitettiin yhteensä 15 tielle, joista valtateitä olivat tiet 2, 4, 6, 24 ja 25. Korkeimpaan priorisointiluokkaan I määritettiin valtatie 2 välillä Nummela-Vihti, valtatie 4 välillä Lusi-Hartola, valtatie 25 välillä Nummela- Rajamäki ja Hyvinkää-Mäntsälä, kantatie 50 välillä Kirkkonummi-Kauklahti, kantatie 51 välillä Kirkkonummi-Siuntio sekä maantie 132 välillä Klaukkala-Röykkä. Priorisointiluokan I keskimerkintäkohteiden yhteispituus oli noin 140 km. Soveltuville kohteille määritettiin suuntaa-antava kustannusarvio perustuen olemassa oleviin suunnitelmiin ja selvityksiin sekä asiantuntija- arvioihin. Lisäksi kohteille määritettiin laskennallinen henkilövahinkoon johtaneiden onnettomuuksien vähenemä.