Brazilian consensus on gastroesophageal reflux disease: Proposals for assessment, classification, and management

The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation short Barrett's is not important in terms of management and prognosis. © 2002 by Am. Coll. of Gastroenterology.

Dynamic and isometric protocols of knee extension: Effect of fatigue on the EMG signal

The objective of this study was to analyze the electromyographic (EMG) signal behavior of rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL) and biceps femoris (caput longum) (BFCL) from nine women during fatiguing dynamic and isometric knee extensions tests and to determine their EMGFT (Electromyographic Fatigue Threshold). Surface electrodes, biological signal acquisition module, analogical-digital converter board and specific software were used. The RMS (Root Mean Square) values obtained from concentric phase (80 to 30 degrees) of the dynamic knee extension andfrom isometric contraction were correlated with time on each load by linear regression analysis. The respective slopes were correlated with the correspondent load to determine the EMGFT. Force (Kgf) and median frequency - MF (Hz) obtained during MIVC (Maximal Isometric Voluntary Contraction) performed before and after the fatiguing tests were calculated in Matlab environment. The results demonstrated that the endurance time decreases with higher loads the EMG amplitude increase with time and was greater at higher loads, between muscles in dynamic exercise the RF and VL showed higher slopes, and in isometric exercise the VL showed the same behavior The EMGFT values were similar in both exercises; the force values predominantly decreased after fatiguing tests; however the MF only decreased after some loads. The protocols proposed allowed standardizing protocols at least to induce the fatigue process and to determine the EMGFT as an endurance indicative, which may be used to evaluate the effectiveness of rehabilitative or training interventions indicated to reduce muscle weakness and fatigue.

Metabolic syndrome signs in Wistar rats submitted to different high-fructose ingestion protocols

In search of an adequate model for the human metabolic syndrome, the metabolic characteristics of Wistar rats were analysed after being submitted to different protocols of high fructose ingestion. First, two adult rat groups (aged 90 d) were studied: a control group (C1; n 6) received regular rodent chow (Labina, Purina) and a fructose group (F1; n 6) was fed on regular rodent chow. Fructose was administered as a 10 % solution in drinking water. Second, two adult rat groups (aged 90 d) were evaluated: a control group (C2; n 6) was fed on a balanced diet (AIN-93G) and a fructose group (F2; n 6) was fed on a purified 60 % fructose diet. Finally, two young rat groups (aged 28 d) were analysed: a control group (C3; n 6) was fed on the AIN-93G diet and a fructose group (F3; n 6) was fed on a 60 % fructose diet. After 4-8 weeks, the animals were evaluated. Glucose tolerance, peripheral insulin sensitivity, blood lipid profile and body fat were analysed. In the fructose groups F2 and F3 glucose tolerance and insulin sensitivity were lower, while triacylglycerolaemia was higher than the respective controls C2 and C3 (P < 0.05). Blood total cholesterol, HDL and LDL as well as body fat showed change only in the second protocol. In conclusion, high fructose intake is more effective at producing the signs of the metabolic syndrome in adult than in young Wistar rats. Additionally, diet seems to be a more effective way of fructose administration than drinking water.

Comparison between protocols for the determination of anaerobic threshold in adolescent swimmers

Aim. The purpose of this study was to compare the anaerobic threshold speed (AT) obtained from fixed lactate blood concentrations (AT 4 mM and AT 3.5 mM), lactate minimum speed (LM) and critical speed (CS), determined from different distances in fifteen Brazilian national level swimmers (10 boys = 14.8 ± 0.6 years old and 5 girls = 14.6 ±0.8 year-old). Methods. The tests to determine the AT 4 mM, AT 3.5 mM, LM and CS were performed in a 25 m swimming pool and consisted of 7 or 8 evaluations separated by 24-48 h intervals. Data were submitted to analysis of variance (ANOVA) for repeated measures, followed by the post hoc Scheffé test and Pearson correlation coefficients. Significance was set at P<0.01. Results. There were no significant differences among the values for AT 4 mM and CS1 (1.34 ± 0.05 vs. 1.33 ± 0.05 m.s -1, respectively). However, AT 4 mM and CS1 were significantly higher than AT 3.5 mM (1.28 ± 0.04 m.s -1), LM (1.27 ± 0.05 m.s -1), CS2 (1.26 ± 0.06 m.s -1), CS3 (1.27 ± 0.06 m.s -1) and CS4 (1.25 ± 0.07 m.s -1). There were no significant differences among the values for AT 3.5 mM, LM, CS2, CS3 and CS4. Conclusion. The results obtained in this study suggest that the anaerobic threshold determined by a fixed lactate concentration of 3.5 mM, as well as the LM and the CS methods determined by different distances, seem to be the most appropriate indexes for the evaluation of aerobic capacity in adolescent swimmers.

Barbados: public-private sector partnership

Includes bibliography

Neither plasma progesterone concentrations nor exogenous eCG affects rates of ovulation or pregnancy in fixed-time artificial insemination (FTAI) protocols for puberal Nellore heifers

The objective was to evaluate the effects of plasma progesterone (P4) concentrations and exogenous eCG on ovulation and pregnancy rates of pubertal Nellore heifers in fixed-time artificial insemination (FTAI) protocols. In Experiment 1 (Exp. 1), on Day 0 (7 d after ovulation), heifers (n = 15) were given 2 mg of estradiol benzoate (EB) im and randomly allocated to receive: an intravaginal progesterone-releasing device containing 0.558 g of P4 (group 0.5G, n = 4); an intravaginal device containing 1 g of P4 (group 1G, n = 4); 0.558 g of P4 and PGF2α (PGF; 150 μg d-cloprostenol, group 0.5G/PGF, n = 4); or 1 g of P4 and PGF (group 1G/PGF, n = 3). On Day 8, PGF was given to all heifers and intravaginal devices removed; 24 h later (Day 9), all heifers were given 1 mg EB im. In Exp. 2, pubertal Nellore heifers (n = 292) were treated as in Exp. 1, with FTAI on Day 10 (30 to 36 h after EB). In Exp. 3, pubertal heifers (n = 459) received the treatments described for groups 0.5G/PGF and 1G/PGF and were also given 300 IU of eCG im (groups 0.5G/PGF/eCG and 1G/PGF/eCG) at device removal (Day 8). In Exp. 1, plasma P4 concentrations were significantly higher in heifers that received 1.0 vs 0.588 g P4, and were significantly lower in heifers that received PGF on Day 0. In Exp. 2 and 3, there were no significant differences among groups in rates of ovulation (65-77%) or pregnancy (Exp. 2: 26-33%; Exp. 3: 39-43%). In Exp. 3, diameter of the dominant ovarian follicle on Day 9 was larger in heifers given 0.558 g vs 1.0 g P4 (10.3 ± 0.2 vs 9.3 ± 0.2 mm; P < 0.01). In conclusion, lesser amounts of P4 in the intravaginal device or PGF on Day 0 decreased plasma P4 from Days 1 to 8 and increased diameter of the dominant follicle on Day 9. However, neither of these nor 300 IU of eCG on Day 8 significantly increased rates of ovulation or pregnancy. © 2011.

Measurement of melatonin in body fluids: Standards, protocols and procedures

Background and Purpose: The circadian rhythm of melatonin in saliva or plasma, or of the melatonin metabolite 6-sulfatoxymelatonin (a6MTs) in urine, is a defining feature of suprachiasmatic nucleus (SCN) function, the body's endogenous oscillatory pacemaker. The primary objective of this review is to ascertain the clinical benefits and limitations of current methodologies employed for detection and quantification of melatonin in biological fluids and tissues. Data Identification: A search of the English-language literature (Medline) and a systematic review of published articles were carried out. Study Selection: Articles that specified both the methodology for quantifying melatonin and indicated the clinical purpose were chosen for inclusion in the review. Data Extraction: The authors critically evaluated the methodological issues associated with various tools and techniques (e.g. standards, protocols, and procedures). Results of Data Synthesis: Melatonin measurements are useful for evaluating problems related to the onset or offset of sleep and for assessing phase delays or advances of rhythms in entrained individuals. They have also become an important tool for psychiatric diagnosis, their use being recommended for phase typing in patients suffering from sleep and mood disorders. Additionally, there has been a continuous interest in the use of melatonin as a marker for neoplasms of the pineal region. Melatonin decreases such as found with aging are or post pinealectomy can cause alterations in the sleep/wake cycle. The development of sensitive and selective methods for the precise detection of melatonin in tissues and fluids has increasingly been shown to have direct relevance for clinical decision making. Conclusions: Due to melatonin's low concentration, as well as the coexistence of numerous other compounds in the blood, the routine determination of melatonin has been an analytical challenge. The available evidence indicates however that these challenges can be overcome and consequently that evaluation of melatonin's presence and activity can be an accessible and useful tool for clinical diagnosis. © Springer-Verlag 2010.

Responses of blood lactate concentration in aerobic and anaerobic training protocols at different swimming exercise intensities in rats

A swimming periodized experimental training model in rats in which different training protocols (TP) were classified in aerobic (A) and anaerobic (AN) intensity levels. The purpose of the present study was to verify if the classification of the TP used in the periodized training experimental model presented the blood lactate concentration [La] response adequate to the aerobic and anaerobic intensities levels. Twenty three male Wistar rats were divided into three groups. Two groups of swimming training (continuous, CT, n = 7, and periodized training, PET, n = 7) rats were evaluated during 5 weeks in eight different TP (TP-1 to TP-8) through the analysis of the [La] response. The third group was the sedentary control (SC, n = 9). The TP were classified in five intensity levels, three aerobic (A-1, A-2, A-3) and two anaerobic (AN-1, AN-2). Analysis of variance (ANOVA one-way, P<0.05) indicated significant differences in the [La] among the TP and among the five intensity levels. All TP of the A-2 and A-3 intensity levels differed from the A-1 and AN-1. The A-1 and AN-1 also differed among them. These findings demonstrate that the TP were classified properly at different levels of aerobic and anaerobic intensities, as based on the [La] response in a way similar to that of high performance swimming with humans. The results offer new perspectives for the study of exercise training in swimming rats at different levels intensity for performance or for health.

Urban consensus: contributions from the Latin American and the Caribbean Regional Plan of Action on Human Settlements

Includes bibliography

Consensus for the diagnosis, prognosis and treatment of canine mammary tumors

The purpose of this paper is to establish criteria that could guide the diagnosis, prognosis and treatment of canine mammary neoplasias. It was elaborated during the Mammary Pathology Meeting: Diagnosis, Prognosis and Treatment of the Canine Mammary Neoplasm, held on November 6 th and 7 th, 2010 in Belo Horizonte - MG, Brazil, sponsored by the Laboratory of Comparative Pathology - UFMG, with the support of the Brazilian Association of Veterinary Pathology (ABPV) and Brazilian Association of Veterinary Oncology (ABROVET). Academics from several regions of Brazil were present and contributed to this work.

Development of heterogeneous node network using microcontroller with protocols CAN and Zigbee

In this paper was proposed the development of an heterogeneous system using the microcontroller (AT90CANI28) where the protocol model CAN and the standard IEEE 802.15.4 are connected. This module is able to manage and monitor sensors and actuators using CAN and, through the wireless standard 802.15.4, communicate with the other network modules. © 2011 IEEE.

Reforming the international financial architecture: consensus and divergence

Includes bibliography

Effect of airborne particle abrasion protocols on surface topography of Y-TZP ceramic

This study aimed to evaluate Y-TZP surface after different airborne particle abrasion protocols. Seventy-six Y-TZP ceramic blocks (5×4×4) mm3 were sintered and polished. Specimens were randomly divided into 19 groups (n=4) according to control group and 3 factors: a) protocol duration (2 and 4 s); b) particle size (30 μm, alumina coated silica particle; 45 μm, alumina particle; and 145 μm, alumina particle) and; c) pressure (1.5, 2.5 and 4.5 bar). Airborne particle abrasion was performed following a strict protocol. For qualitative and quantitative results, topography surfaces were analyzed in a digital optical profilometer (Interference Microscopic), using different roughness parameters (Ra, Rq, Rz, X-crossing, Mr1, Mr2 and Sdr) and 3D images. Surface roughness also was analyzed following the primer and silane applications on Y-TZP surfaces. One-way ANOVA revealed that treatments (application period, particle size and pressure of particle blasting) provided significant difference for all roughness parameters. The Tukey test determined that the significant differences between groups were different among roughness parameters. In qualitative analysis, the bonding agent application reduced roughness, filing the valleys in the surface. The protocols performed in this study verified that application period, particle size and pressure influenced the topographic pattern and amplitude of roughness.

Daily biofilm control and oral health: Consensus on the epidemiological challenge-Latin American Advisory Panel

Our understanding of dental plaque biofilm has evolved since the nonspecific plaque hypothesis that considered plaque as a nonspecific mass of native microorganisms that, because of lack of oral hygiene, builds up in proportions great enough to overcome the host resistance threshold and affect the tooth structure and tooth supporting tissues. A great diversity of microorganisms-over 700 species-was detected in the oral cavity, and evidence shows that the investigation of specific microorganisms or associations of microorganisms as etiological agents for periodontal diseases and caries is not a simplistic approach. Although clinical evidence shows that oral mechanical hygiene is fundamental to prevent and control caries and periodontal disease, it is important to highlight that optimal control is not achieved by most individuals. Thus the complementary use of chemotherapeutic agents has been investigated as a way to overcome the deficiencies of mechanical oral hygiene habits, insofar as they reduce both plaque formation and gingival inflammation, and represent a valid strategy to change the biofilm and maintain dental and periodontal health. The role of the dental professional is to monitor patients and offer them the best recommendations to preserve oral health throughout their life. With this in mind, chemical control should be indicated as part of daily oral hygiene, together with mechanical procedures, for all individuals who present supragingival and/or subgingival biofilm, taking into account age, physical and/or psychological limitations, allergies, and other factors.