Efficiency of coronary artery disease screening guidelines in asymptomatic and atypical chest pain type 2 diabetic patients

RESUME Objectifs. Évaluer la prévalence de maladie coronarienne chez les patients diabétiques de type 2 asymptomatiques ou avec angor atypique selon les recommandations américaines de l'American Diabetes Association et de l'American College of Cardiology. Méthodes. Cent cinquante-quatre patients diabétiques de type 2 asymptomatiques ou avec angor atypique et présentant au minimum 2 facteurs de risque cardio-vasculaires additionnels ont été dépistés par échocardiographie de stress (71%, n=109), scintigraphie myocardique de perfusion (26%, n=40) ou l'association des 2 examens (3%, n=5). Résultats. L'échocardiographie de stress s'est révélée positive chez 16 patients (14%) et 14 ont eu une coronarographie révélant des sténoses significatives chez 12 (86%). La scintigraphie myocardique de perfusion était positive chez 16 patients (36%). Huit patients ont eu une coronarographie et 4 (50%) présentaient des sténoses significatives. Au total, 31 patients (20%) ont montré des signes d'ischémie lors de l'examen non-invasif et 15 (10%) ont présenté des sténoses significatives à la coronarographie. Les facteurs prédictifs indépendants de la maladie coronarienne étaient le tabagisme (OR 6.5, p=0.05), la microalbuminurie (OR 3.9, p=0.03), ainsi que les souffles fémoraux (OR 17.1, p=0.008). Conclusions. En suivant les recommandations américaines, un patient sur cinq présentait une ischémie lors des examens non-invasifs, tandis que 1 sur 10 avait des sténoses significatives à la coronarographie. L'analyse multivariée suggère que des marqueurs des complications micro- et macro-vasculaires en combinaison avec des facteurs de risque cardio-vasculaire classiques pourraient améliorer le pouvoir diagnostic de ces recommandations. SUMMARY Aims. We evaluated the prevalence of coronary artery disease in asymptomatic and atypical chest pain type 2 diabetic patients according to the American Diabetes Association and American College of Cardiology guidelines. Methods. Asymptomatic or atypical chest pain type 2 diabetic patients (n=154), with at least two additional cardiovascular risk factors, were screened for coronary artery disease using stress echocardiography (71%, n=109), myocardial perfusion imaging (26%, n=40) or both (3%, n=5). Results. Stress echocardiography was positive in 16 patients (14%) and 14 had a coronary angiography, revealing significant stenoses in 12 (86%). Myocardial perfusion imaging was positive in 16 patients (36%). Eight patients underwent angiography and 4 (50%) presented significant stenoses. Overall, 31 patients (20%) demonstrated signs of ischemia on non-invasive tests and 15 (10%) presented significant stenoses on coronary angiography. Independent predictors of coronary artery disease were smoking (OR 6.5, p=0.05), microalbuminuria (OR 3.9, p=0.03) and femoral murmur (OR 17.1, p=0.008). Conclusions. Following the guidelines, one in five diabetic patient presented ischemia on noninvasive tests, while one in ten presented significant coronary stenoses. Multivariate analysis suggests that adding markers of micro- and macro-vascular complications to classical cardiovascular risk factors may enhance the diagnostic efficiency of the guidelines.

Evaluating the Trabecular Micro-Bypass Stent Combined with Phacoemulsification Compared to Phacoemulsification Alone.

Aim: The aim of this study was to assess the effect of iStent (trabecular micro-bypass stent) implantation in combination with phacoemulsification on IOP and glaucoma medications and to compare this to the outcome of phacoemulsification alone. Patients and Methods: A retrospective consecutive comparative review was undertaken. 131 eyes with ocular hypertension and medically controlled glaucoma underwent phacoemulsification alone (n201;=201;78 group I) or combined with gonioscopic-guided implantation of one iStent (n201;=201;31, group II) or two iStents (n201;=201;22, group III). Patients were assessed at postoperative weeks 1, 3 and 6, and months 3 and 6. Pre- and post-operative measures included visual acuity, IOP and glaucoma medications. Results: Post-operatively at 6 months, mean IOP decreased from 16.3201;mmHg to 14.2201;mmHg in group I (p201;<201;0.01), from 16.7201;mmHg to 15.1201;mmHg in group II (p201;<201;0.16) and from 17.0 to 13.8 in group III (p201;=201;0.05). Mean glaucoma medication decreased from 1.9 to 1.6 in group I (8202;%, p201;=201;0.12), from 2.5 to 0.8 in group II (27202;%, p201;=201;0.04), and from 2.1 to 1.0 in group III (45202;%, p201;<201;0.01). Conclusions: iStent implantation resulted in similar IOP reduction to phacoemulsification alone but achieved a significantly greater reduction in glaucoma medications. This may improve compliance and quality of life, and reduce health care costs in patients with early to moderate glaucoma.

Algoritmos interactivos para la separación de fuentes y deconvolución de canal mediante Java

El objetivo de estos programas es crear una herramienta que nos permita, de una manera fácil, entender mejor la separación de fuentes y la deconvolución de canal . Por eso se presenta el diseño, mediante Java, de una página web [1]: http//www.uvic.es/projectes/SeparationSources con carácter marcadamente didáctico para el estudio y evaluación de diferentes algoritmos propuestos en la bibliografía.

Micro-implant d'acétonide de fluocinolone (ILUVIEN(®)) pour l'oedème maculaire diabétique chronique [Fluocinolone acetonide (ILUVIEN®) micro-implant for chronic diabetic macular edema].

Diabetic macular edema (DME) is a frequent complication of diabetic retinopathy and may cause severe visual loss. In this article, we examine the pathophysiology of DME and review various treatment options, such as laser photocoagulation, anti-vascular endothelial growth factor (VEGF) receptor antibodies, and steroids including ILUVIEN(®), which is a new sustained-release, non biodegradable, injectable, intravitreal micro-implant containing fluocinolone acetonide. The results of the FAME (Fluocinolone Acetonide in Diabetic Macular Edema) studies, conducted to evaluate the efficacy and safety of ILUVIEN(®) in DME, are discussed.

Nitração do fenol, um método em escala semi-micro para disciplina prática de 4 horas

A procedure for the nitration of phenol in a semi-micro scale, followed by separation of the formed orto- and para-nitrophenol isomers by column chromatography, is described. All the experiment, including determination of the melting point of the isolated products, require a period of 4 hours, and it is suitable for organic chemistry laboratory undergraduate courses.

Extração em fase sólida (SPE) e micro extração em fase sólida (SPME) de piretróides em água

The pyrethroids bifenthrin, permethrin, cypermethrin and deltamethrin were extracted by solid phase extraction (SPE) and solid phase microextraction (SPME). The analysis were performed on a gas chromatograph with electron capture detection (GC-ECD). Octadecil Silano-C18, Florisil and Silica stationary phases were studied for SPE. Better results were obtained for Florisil which gave recoveries from 80% to 108%. Pyrethroids extraction by SPME showed a linear response and a detection limit of 10 pg ml-1. Although the data showed that the two extraction methods were able to isolate the pesticide residues from water samples, the best results were obtained by using SPME which is more sensitive, faster, cheeper, being a more useful technique for the analysis of pyrethroids in drinking water.

Reação de bis-inserção de 1,2-difenilacetileno na ligação Pd-C de ciclometalados

The present paper deals with the bis-insertion reactions of 1,2-diphenylacetylene into Pd-C bond of the cyclopalladated complexes [Pd(dmba)(&micro;-NCO)]2 (1) and [Pd(dmba)(MeCN)2](NO3) (2) (dmba = N,N-dimethylbenzylamine, MeCN = acetonitrile). Two new complexes [Pd{PhC=CPh-CPh=CPhC6H4CH2N(CH 3)2}(NCO)] (3) and [Pd{PhC=CPh-CPh=CPhC6H4CH2N(CH 3)2}(NO3 )] (4) were obtained and characterized by IR and NMR spectroscopy and elemental analysis.

Desenvolvimento de um micro-aquecedor para sistemas de análise química em fluxo: determinação espectrofotométrica de manganês em plantas

In this work a micro-heater device to be used as an integral part of the flow analysis manifold is described. The usefulness of the device was demonstrated using it in the development of a multicommutated flow analysis procedure for the spectrophotometric determination of manganese in plant digest. The method was based on the manganese oxidation by periodate in phosphoric acid medium to form the permanganate anion. The reaction development is dependent on the temperature and it was observed that at 25 °C a time interval of ca. 15 min was necessary for the reaction to attain equilibrium. Setting the temperature to 70 ºC, this time interval could be decreased to ca. 30 s. This condition was easily attained employing the proposed micro-heater device coupled to the manifold. The procedure was applied to manganese determination in soybean digests and results compared with those obtained by inductively coupled argon plasma optical emission spectrometry (ICP-OES). No significant difference at 90% confidence level was observed. A linear response for sample concentrations ranging from 5.0 to 30.00 mg L-1 Mn2+; a relative standard deviation of 1.3% (n = 6) for a typical sample containing 6.3 mg L-1 Mn2+; a sampling rate of 22 determinations per hour; a low reagent consumption, of 12.0 mg NaIO4 per determination; and a detection limit of 1.2 mg L-1 were achieved.

Síntese de novos herbicidas derivados do 1,2alfa,4alfa,5-tetrametil-8-oxabiciclo[3.2.1]oct-6-en-3-ona

In this paper we report the synthesis of biologically active compounds through a [3+4] cycloaddition reaction to produce the main frame structure, followed by several conventional transformations. The 1,2alpha,4alpha,5-tetramethyl-8-oxabicyclo[3.2.1]oct-6-en-3-one (11) obtained from a [3+4] cycloaddition reaction was converted into 1,2alpha,4alpha,5-tetramethyl-6,7-exo-isopropylidenedioxi-8 -oxabicyclo[3.2.1]octan-3-one (13) in 46% yield. This was further converted into the alcohols 1,2alpha,4alpha,5-tetramethyl-6,7-exo-isopropylidenedioxi-8-oxabicyclo[3.2.1]octan-3 alpha-ol (14), 1,2alpha,4alpha,5-tetramethyl-6,7-exo-isopropylidenedioxi-8 -oxabicyclo[3.2.1]octan-3beta-ol (15), 1,2alpha,4alpha,5-tetramethyl-3-butyl-6,7-exo-isopropylidenedioxi-8-oxabicyclo[3.2.1]octan-3 alpha-ol (17), 1,2alpha,4alpha,5-tetramethyl-3-hexyl-6,7-exo-isopropylidenedioxi-8-oxabicyclo[3.2.1]octan-3 alpha-ol (18) and 1,2alpha,4alpha,5-tetramethyl-3-decyl-6,7-exo-isopropylidenedioxi-8-oxabicyclo[3.2.1]octan-3 alpha-ol (19). Dehydration of 17, 18 and 19 with thionyl chloride in pyridine resulted in the alkenes 20, 21 and 22 in ca. 82% - 89% yields from starting alcohols. The herbicidal activity of the compounds synthesized was evaluated at a concentration of 100 &micro;g g-1. The most active compound was 21 causing 42,7% inhibition against Cucumis sativus L.

Remoção de Cu+2 de soluções aquosas em zeólita NaX: efeito da granulometria

The present study consists in evaluating the NaX zeolite efficiency in removing Cu2+ from aqueous solutions, for future use of NaX in removing metals from wastewaters. The experiments were performed in batch systems (with shaking and continous stirring) and for different time intervals (1 to 24 h). Three particle sizes were employed: < 850 &micro;m, 850 &micro;m - 1 mm and 3 mm. It has been concluded that it is possible to employ the NaX zeolite for metal removal and the particle size plays an important role in the adsorption process. Specifically, NaX zeolites of smaller particle size achieved the maximum adsorption capacity of 152.36 mg of Cu2+/g of zeolite at pH = 4.5.

Preparação de amostra de fígado bovino e estudo de micro homogeneidade para a determinação de Cd E Pb por espectrometria de absorção atômica com atomização eletrotérmica e amostragem direta de sólido

This work describes a systematic study for bovine liver sample preparation for Cd and Pb determination by solid sampling electrothermal atomic absorption spectrometry. Samples were prepared using different procedures: (1) drying in a household microwave oven followed by drying in a stove at 60 ºC until constant mass, and (2) freeze-drying. Ball and cryogenic mills were used for grinding. Particle size, sample size and micro sample homogeneity were investigated. All prepared samples showed good homogeneity (He < 10) even for low sample mass, but samples dried in a microwave oven/stove and ground in a ball mill presented the best homogeneity.

Aplicação catalítica de peneiras moleculares básicas micro e mesoporosas

Catalysis by solid acids has received much attention due to its importance in petroleum refining and petrochemical processes. Relatively few studies have focused on catalysis by bases and even les on using basic molecular sieves. This paper deals with the potential application of micro and mesoporous molecular sieves in base catalysis reactions. The paper is divided in two parts, the first one dedicated to the design of the catalysts and the second to some relevant examples of catalytic reactions, which find a huge field of applications essentially in the synthesis of fine chemicals. Here, recent developments in catalysis by basic molecular sieves and the perspectives of applications in correlated catalytic processes are described.

Special issue on evolving the e-marketing mindset towards the social web model - Editorial Part 2

In the previous issue of IJEMR, we introduced the general framework and the main ideas justifying this special editorial project. To avoid repetition of the background themes to the current issue, the reader should consult the previous edition. Here, we present the second part of contributions selected for publication.

Determinação espectrofotométrica de hexametilenotetramina (HMT) em medicamentos, utilizando ácido cromotrópico e forno de micro-ondas

This paper proposes a methodology for spectrophotometric determination of hexamethylenetetramine (HMT) by using chromotropic acid in a phosphoric acid media employing a domestic microwave oven as a source of heating. The reddish-purple soluble product is quantitatively formed after 30 s of irradiation and obeys the Beer´s law in the range between 0.1-1.2 mg L-1 HMT (r = 0.99925). The method was applied successfully in commercial pharmaceutical preparations containing dyes in their composition. The results showed that the method proposed is feasible for simplicity, speed, low cost, precision and accuracy when compared with United States Pharmacopeia official method.

Isolamento e seleção de micro-organismos resistentes e capazes de volatilizar mercúrio

Mercury (Hg) occurs in the environment as a natural and anthropogenic element, and through the years the accumulation of mercury has affected the integrity of ecosystems and human health. This study presents a screening of microorganisms resistant to organic and inorganic mercury, the determination of the minimum inhibitory concentration of Hg, the estimation of the mercury volatilization by selected microorganisms and the dynamics of volatilization. Eight Gram-negative bacteria resistant to high concentrations of mercury (60 to 210 mg L-1) were selected, and these isolates showed ability to volatilize the metal. The dynamics of the volatilization of the Proteus mirabilis M50C demonstrated that in only 4 h of incubation it was possible to volatilize 72% of the mercury present in the culture. The results showed promising application for bioremediation strategies.