971 resultados para Radioterapia, CBCT, DICOM, I.G.R.T., immagine portale
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Triglycerides are transported in plasma by specific triglyceride-rich lipoproteins; in epidemiological studies, increased triglyceride levels correlate with higher risk for coronary artery disease (CAD). However, it is unclear whether this association reflects causal processes. We used 185 common variants recently mapped for plasma lipids (P < 5 × 10(-8) for each) to examine the role of triglycerides in risk for CAD. First, we highlight loci associated with both low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, and we show that the direction and magnitude of the associations with both traits are factors in determining CAD risk. Second, we consider loci with only a strong association with triglycerides and show that these loci are also associated with CAD. Finally, in a model accounting for effects on LDL-C and/or high-density lipoprotein cholesterol (HDL-C) levels, the strength of a polymorphism's effect on triglyceride levels is correlated with the magnitude of its effect on CAD risk. These results suggest that triglyceride-rich lipoproteins causally influence risk for CAD.
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BACKGROUND: Cigarette smoking is associated with lower body mass index (BMI), and a commonly cited reason for unwillingness to quit smoking is a concern about weight gain. Common variation in the CHRNA5-CHRNA3-CHRNB4 gene region (chromosome 15q25) is robustly associated with smoking quantity in smokers, but its association with BMI is unknown. We hypothesized that genotype would accurately reflect smoking exposure and that, if smoking were causally related to weight, it would be associated with BMI in smokers, but not in never smokers. METHODS: We stratified nine European study samples by smoking status and, in each stratum, analysed the association between genotype of the 15q25 SNP, rs1051730, and BMI. We meta-analysed the results (n = 24 198) and then tested for a genotype × smoking status interaction. RESULTS: There was no evidence of association between BMI and genotype in the never smokers {difference per T-allele: 0.05 kg/m(2) [95% confidence interval (95% CI): -0.05 to 0.18]; P = 0.25}. However, in ever smokers, each additional smoking-related T-allele was associated with a 0.23 kg/m(2) (95% CI: 0.13-0.31) lower BMI (P = 8 × 10(-6)). The effect size was larger in current [0.33 kg/m(2) lower BMI per T-allele (95% CI: 0.18-0.48); P = 6 × 10(-5)], than in former smokers [0.16 kg/m(2) (95% CI: 0.03-0.29); P = 0.01]. There was strong evidence of genotype × smoking interaction (P = 0.0001). CONCLUSIONS: Smoking status modifies the association between the 15q25 variant and BMI, which strengthens evidence that smoking exposure is causally associated with reduced BMI. Smoking cessation initiatives might be more successful if they include support to maintain a healthy BMI.
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Background There are only a few trials for the very elderly population (>79 years). No consensus, which blood pressure (BP) goals and substances should be applied, has been found yet. This survey was undertaken to investigate how octogenarians are treated and attain BP targets in the Swiss primary care. Methods Data from 4594 hypertensive patients were collected within 7 days. Eight hundred and seventy-seven patients met the requirement to be >79 years. We assessed substances/combinations and investigated pulse pressure and target blood pressure attainment (TBPA) using three different recommendations [Canadian Hypertension Education Program (CHEP), Swiss Society of Hypertension (SSH), European Society of Hypertension-European Society of Cardiology (ESH-ESC)]. Secondarily, we compared TBPA attained by angiotensin-converting enzyme inhibitor (ACEI)/diuretic (D), angiotensin receptor blocker (ARB)/D and calcium channel blocker (CCB)/D with any other dual therapy and investigated whether Ds/beta-blockers (BBs) or Ds/renin angiotensin-converting enzyme inhibitors (RAAS-Is) lead to higher TBPA. Finally, we assessed the impact of drug administration, practical work experience, location and specialization of GPs on TBPA. Results Octogenarians attained target blood pressure (TBP) between 44% (ESH-ESC) and 74% (SSH). Optimal/normal BP was reached in 22.8% of patients. Pulse pressure <65 mmHg was shown in 66.4% of patients. Monotherapy was most commonly applied followed by dual single-pill combination with ARB/D (46.5%) or ACEI/D (36.0%). No benefit in TBPA was found comparing a RAASI/D and CCB/D treatment with any other dual combination. There was also no difference between BB/D and RAAS-I/D combination therapy and between single-pill combination and dual free combinations. Conclusions GPs adhere to the use of substances proven in outcome trials and attain high TBP. No difference in meeting BP goals could be found using different drug classes. There is an unmet need to harmonize recommendations and to add additional information for the treatment of octogenarians.
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Recent data for the global burden of disease reflect major demographic and lifestyle changes, leading to a rise in non-communicable diseases. Most countries with high levels of tuberculosis face a large comorbidity burden from both non-communicable and communicable diseases. Traditional disease-specific approaches typically fail to recognise common features and potential synergies in integration of care, management, and control of non-communicable and communicable diseases. In resource-limited countries, the need to tackle a broader range of overlapping comorbid diseases is growing. Tuberculosis and HIV/AIDS persist as global emergencies. The lethal interaction between tuberculosis and HIV coinfection in adults, children, and pregnant women in sub-Saharan Africa exemplifies the need for well integrated approaches to disease management and control. Furthermore, links between diabetes mellitus, smoking, alcoholism, chronic lung diseases, cancer, immunosuppressive treatment, malnutrition, and tuberculosis are well recognised. Here, we focus on interactions, synergies, and challenges of integration of tuberculosis care with management strategies for non-communicable and communicable diseases without eroding the functionality of existing national programmes for tuberculosis. The need for sustained and increased funding for these initiatives is greater than ever and requires increased political and funder commitment.
New genetic loci implicated in fasting glucose homeostasis and their impact on type 2 diabetes risk.
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Levels of circulating glucose are tightly regulated. To identify new loci influencing glycemic traits, we performed meta-analyses of 21 genome-wide association studies informative for fasting glucose, fasting insulin and indices of beta-cell function (HOMA-B) and insulin resistance (HOMA-IR) in up to 46,186 nondiabetic participants. Follow-up of 25 loci in up to 76,558 additional subjects identified 16 loci associated with fasting glucose and HOMA-B and two loci associated with fasting insulin and HOMA-IR. These include nine loci newly associated with fasting glucose (in or near ADCY5, MADD, ADRA2A, CRY2, FADS1, GLIS3, SLC2A2, PROX1 and C2CD4B) and one influencing fasting insulin and HOMA-IR (near IGF1). We also demonstrated association of ADCY5, PROX1, GCK, GCKR and DGKB-TMEM195 with type 2 diabetes. Within these loci, likely biological candidate genes influence signal transduction, cell proliferation, development, glucose-sensing and circadian regulation. Our results demonstrate that genetic studies of glycemic traits can identify type 2 diabetes risk loci, as well as loci containing gene variants that are associated with a modest elevation in glucose levels but are not associated with overt diabetes.
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Recent genome-wide association studies have described many loci implicated in type 2 diabetes (T2D) pathophysiology and β-cell dysfunction but have contributed little to the understanding of the genetic basis of insulin resistance. We hypothesized that genes implicated in insulin resistance pathways might be uncovered by accounting for differences in body mass index (BMI) and potential interactions between BMI and genetic variants. We applied a joint meta-analysis approach to test associations with fasting insulin and glucose on a genome-wide scale. We present six previously unknown loci associated with fasting insulin at P < 5 × 10(-8) in combined discovery and follow-up analyses of 52 studies comprising up to 96,496 non-diabetic individuals. Risk variants were associated with higher triglyceride and lower high-density lipoprotein (HDL) cholesterol levels, suggesting a role for these loci in insulin resistance pathways. The discovery of these loci will aid further characterization of the role of insulin resistance in T2D pathophysiology.
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This article documents the addition of 229 microsatellite marker loci to the Molecular Ecology Resources Database. Loci were developed for the following species: Acacia auriculiformis x Acacia mangium hybrid, Alabama argillacea, Anoplopoma fimbria, Aplochiton zebra, Brevicoryne brassicae, Bruguiera gymnorhiza, Bucorvus leadbeateri, Delphacodes detecta, Tumidagena minuta, Dictyostelium giganteum, Echinogammarus berilloni, Epimedium sagittatum, Fraxinus excelsior, Labeo chrysophekadion, Oncorhynchus clarki lewisi, Paratrechina longicornis, Phaeocystis antarctica, Pinus roxburghii and Potamilus capax. These loci were cross-tested on the following species: Acacia peregrinalis, Acacia crassicarpa, Bruguiera cylindrica, Delphacodes detecta, Tumidagena minuta, Dictyostelium macrocephalum, Dictyostelium discoideum, Dictyostelium purpureum, Dictyostelium mucoroides, Dictyostelium rosarium, Polysphondylium pallidum, Epimedium brevicornum, Epimedium koreanum, Epimedium pubescens, Epimedium wushanese and Fraxinus angustifolia.
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Roland L. Weinsier, M.D., Dr.P.H., devoted himself to the fields of nutrition and obesity for more than 35 years. He contributed outstanding work related to the treatment of obesity through dietary and lifestyle change; metabolic/energetic influences on obesity, weight loss, and weight regain; body composition changes accompanying weight loss and regain; the health benefits and risks of weight loss; nutrition education for physicians; and nutrition support of sick patients. He served on the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) National Task Force on Prevention and Treatment of Obesity, as Chair of the University of Alabama at Birmingham's Department of Nutrition Sciences, and as Founder and Director of its NIDDK-funded Clinical Nutrition Research Center. He was a long-time and active member of NAASO, serving in the roles of Councilor, Publications Committee Chair, Continuing Medical Education Course Director, Public Relations Committee Chair, and Membership Committee Co-Chair, to name just a few. He was well respected as a staunch defender of NAASO's scientific integrity in these roles. Sadly, Roland Weinsier died on November 27, 2002. He will be missed and remembered by many as a revered and beloved teacher, mentor, healer, and scholar.
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Pouco se conhece sobre os solos desenvolvidos ou influenciados por materiais máficos na Zona da Mata de Minas Gerais, embora muitos estudos tenham sido efetuados nos domínios cristalinos gnáissicos, notadamente com Latossolos e Podzólicos de terraço. Para preencher esta lacuna, foram amostrados os horizontes A e B ou A e C de solos em duas topolitosseqüências. A primeira, localizada na Serra de Guiricema, com drenagem orientada para a bacia do Rio Paraíba do Sul, compreendeu um Latossolo Vermelho-Amarelo (LVA) no topo da serra, um Chernossolo Argilúvico (MT), um Vertissolo (V) e um Nitossolo Vermelho (NV) no terço médio. Da segunda topolitosseqüência, localizada na Depressão de Ponte Nova, com drenagem para a bacia do Rio Doce, fizeram parte um Latossolo Vermelho-Amarelo, dois Nitossolos Vermelhos, um Chernossolo Argilúvico, um Argissolo Vermelho-Amarelo (PVA), um Gleissolo (GX) e um Neossolo Flúvico (RU). Adicionalmente, foi coletado, no Planalto de Viçosa, o horizonte B de um Latossolo Vermelho-Amarelo sobre intrusão de anfibolito, fora das duas topolitosseqüências já citadas, para efeito de comparação. Os solos desenvolvidos a partir dos anfibolitos/diabásio (NV, MT e V) tenderam a ser eutróficos e cauliníticos, com a participação de argilominerais 2:1 (ilita e esmectita, possivelmente como interestratificados), quando menos intemperizados. A baixa relação Feo/Fed nos Latossolos estudados indica o predomínio de formas de ferro de maior grau de cristalinidade, sendo mais elevada no caso dos Nitossolos, em consonância com o menor grau de evolução destes. O Latossolo coletado sobre dique de material máfico apresentou características químicas similares às dos Latossolos desenvolvidos de gnaisse da região, indicando tratar-se de solo proveniente desta rocha, cobrindo o dique como material retrabalhado. A biotita e o anfibólio presentes no gnaisse são os minerais que contribuem para os teores de Fe2O3 acima de 11 dag kg-1, nos Latossolos da região estudada. Os solos com argila de atividade alta (V e MT) têm a gênese e a estabilidade da esmectita e, possivelmente, do interestratificado ilita-esmectita, explicadas pela riqueza do material de origem em minerais ferromagnesianos, pelo relevo que propicia ambiente concentrador e, em certos casos, pela exposição norte do perfil, favorecendo maior evapotranspiração. No caso do Gleissolo, tanto o ambiente concentrador como a drenagem deficiente parecem ser as causas principais da ocorrência de argilominerais 2:1 expansivos. O Argissolo Vermelho-Amarelo, ainda que também ocorra em ambiente concentrador de terraço, não apresentou argilominerais 2:1, destacando-se, entretanto, os altos teores de Fe2O3 destes solos, o que confirma os resultados obtidos por outros autores para solos semelhantes na região de Viçosa.
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Classic climatic models use constitutive laws without any response time. A more realistic approach to the natural processes governing climate dynamics must introduce response time for heat and radiation fluxes. Extended irreversible thermodynamics (EIT) is a good thermodynamical framework for introducing nonclassical constitutive laws. In the present study EIT has been used to analyze a Budyko–Sellers one-dimensional energybalance model developed by G. R. North. The results present self-sustained periodic oscillations when the response time is greater than a critical value. The high-frequency (few kiloyears) damped and nondamped oscillations obtained can be related to abrupt climatic changes without any variation in the external forcing of the system
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A utilização do pH SMP na estimativa da acidez potencial tem vantagens em relação ao método do acetato de cálcio 0,5 mol L-1, pH 7, mas requer regionalização edafológica prévia para estimar, com segurança, os valores de H + Al. Na região noroeste do Paraná, encontram-se solos originários de uma rocha sedimentar arenosa da Formação Caiuá, denominada Arenito Caiuá, do período Cretáceo. Esses solos são caracterizados pelos baixos teores de argila, matéria orgânica e baixo tamponamento, diferindo da maioria dos solos existentes no estado. Este estudo teve por objetivo comparar os métodos do pH SMP e o do acetato de cálcio 0,5 mol L-1, pH 7, visando estabelecer uma equação que estime a acidez potencial dos solos dessa área, por meio da obtenção do pH de equilíbrio da suspensão com a solução SMP. Cento e cinqüenta amostras de solos daquela área foram submetidas a análises de regressão, utilizando três modelos que foram avaliados, quanto à qualidade das estimativas, pelas estatísticas dos seus coeficientes e pelo comportamento dos seus resíduos (medido-estimado). A equação linear H + Al = 20,1925 - 2,6484 pH SMP (R² = 0,9051) foi a que melhor estimou a acidez potencial dos solos pertencentes à Formação Caiuá.
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Pouco se conhece sobre a diversidade de solos em ambientes altimontanos do Brasil apesar da acentuada valorização ecoturística atual. Foram estudados atributos químicos, físicos, mineralógicos e micromorfológicos de dez perfis de solos altimontanos em dois transectos do domínio quartzítico do Parque Estadual do Ibitipoca, em MG, relacionando-os com a pedogênese nos diferentes pedoambientes. Nesse local, a formação dos solos é mais influenciada por elementos lito-estruturais (presença de rochas xistosas ou quartzíticas, falhas e fraturas) do que por variações topográficas. Os solos estudados são álicos, com saturação por Al superior a 60 % em superfície, eletronegativos e com acentuado distrofismo. A CTC é quase exclusivamente atribuível à fração orgânica, em virtude da atividade muito baixa da fração argila dos solos. Os resultados indicaram a presença destacada de formas pouco cristalinas de Fe, comuns em complexos rupestres de altitude, onde o acúmulo de carbono orgânico inibe a cristalização de óxidos de Fe ou Al. Os solos são cauliníticos, inclusive o Espodossolo Ferrocárbico, e alguns perfis evidenciam a ocorrência de minerais 2:1 do grupo das ilitas/micas e vermiculitas com hidróxi-entrecamadas (VHE), denotando a resistência desses minerais em condições de acentuado intemperismo de micas, presentes no quartzito. Análises micromorfológicas do Espodossolo mostram feições típicas do processo de podzolização: predomínio de grãos minerais quartzosos entremeados de fragmentos polimórficos de matéria orgânica em superfície, microestrutura em grãos simples com recobrimentos em Bh e Bs. Observou-se a presença de "ortstein" no horizonte espódico (Bs), formado por material organomineral ou mineral, monomórfico e fraturado, com Al, Si e Fe amorfos, co-precipitados. As feições micropedológicas do Bs são semelhantes às de horizontes plácicos, com duas gerações de deposição ferruginosa: uma mais avermelhada (ferridrita-hematita) e outra xantizada (goethita). O plasma intergranular do horizonte espódico apresenta zonas plásmicas diferenciadas, uma mais aluminosa, de composição caulinítica, e outra mais ferruginosa, rica em sílica, revelando uma participação de sílica coloidal amorfa na cimentação dos "ortstein" (ou horizontes plácicos) em associação ao cimento ferruginoso, no Espodossolo.