Risk factors for suicide in multiple sclerosis: a case-control study

ABSTRACT Objective To evaluated the prevalence and the suicide risk in a Brazilian sample of patients with multiple sclerosis (MS) and to identify potential factors associated with the risk of suicide. A study was performed with outpatient with MS. The risk of suicide and the presence of psychiatric disorders were assessed by version 5.0 of the Mini-International Neuropsychiatric Interview (MINI). The sample of patients at risk for suicide was matched by sex and age to a control group of patients with MS. Results Eight point three percent of the patients had a past history of attempted suicide, and 8.3% had a current suicide risk, totaling 16.6%. The results of this study suggest that the risk factors associated with suicide in this population are depression, marital status single, widowed or divorced, and lower education level.

Factoriality and the pin-reutenauer procedure

We consider implicit signatures over finite semigroups determined by sets of pseudonatural numbers. We prove that, under relatively simple hypotheses on a pseudovariety V of semigroups, the finitely generated free algebra for the largest such signature is closed under taking factors within the free pro-V semigroup on the same set of generators. Furthermore, we show that the natural analogue of the Pin-Reutenauer descriptive procedure for the closure of a rational language in the free group with respect to the profinite topology holds for the pseudovariety of all finite semigroups. As an application, we establish that a pseudovariety enjoys this property if and only if it is full.

Evaluation of the heart rate and arrhythmias following the Maze procedure for chronic atrial fibrillation

PURPOSE: To assess the presence and the prevalence of arrhythmias and the variability of the heart rate in the medium-term postoperative period following the maze procedure for chronic atrial fibrillation (AF). METHODS: Seventeen patients with a mean age of 51.7±12.9 years, who previously underwent the maze procedure without cryoablation for chronic atrial fibrillation, were evaluated with the 24 hour electrocardiogram (ECG) - Holter monitoring from the 6th month after the operation. Valvular and coronary procedures were concomitantly performed. RESULTS: The mean heart rate during Holter monitoring was 82±8bpm; the maximal heart rate was 126 ± 23bpm and the minimal heart rate 57±7bpm. Sinus rhythm was found in 10 (59%) patients and atrial rhythm was found in 7 (41%). Supraventricular extrasystoles had a rate of 2.3±5.5% of the total number of heartbeats and occurred in 16 (94%) patients. Six (35%) patients showed nonsustained atrial tachycardia. Ventricular extrasystoles, with a rate of 0.8±0.5% of the total heartbeats, occurred in 14 (82%) patients. The chronotropic competence was normal in 9 (53%) patients and attenuated in 8 (47%). The atrioventricular conduction (AV) was unchanged in 13 (76%) patients and there were 4 (24%) cases of first degree atrioventricular block (AVB). CONCLUSION: After the maze procedure, the values for the mean heart rate, AV conduction and chronotropic competence approach the normal range, although some cases show attenuation of the chronotropic response, first degree AV block or benign arrhythmias.

Multiple arterial anomalies in the newborn infant. Echocardiographic and angiographic diagnosis

Multiple arterial anomalies characterized by tortuosity and rolling of the pulmonary arteries and aorta were diagnosed on echocardiography in an asymptomatic newborn infant with a phenotype suggesting Ehlers-Danlos syndrome. These changes were later confirmed on angiography, which also showed peripheral vascular abnormalities. The electrocardiogram showed a probable hemiblock of the left anterosuperior branch, and the chest x-ray showed an excavated pulmonary trunk with normal pulmonary flow.

Reactivity studies on chromene derivatives

Dissertação de mestrado em Medicinal Chemistry

Multiple recurrences of cardiac myxomas with acute tumoral pulmonary embolism

We report the case of a 42-year-old female with a second recurrence of cardiac myxoma. Her first diagnosis was at the age of 24 years, when cardiac tumors were withdrawn from her right ventricle and left atrium. Her first recurrence was at the age of 36 years, when tumors were removed from the left and right atria, and the right ventricle. Six years later, the patient was admitted to the Hospital das Clínicas de Porto Alegre complaining of sudden dyspnea, dry cough, and pain in the right hypochondrium, which bore no relation to breathing. The transesophageal echocardiography showed a small tumor in the interatrial septum, close to the superior vena cava, and 2 larger tumors in the right ventricle, 1 close to the outflow tract and the other almost completely obstructing the right branch of the pulmonary artery. The patient was referred to surgery, in which myxomas were removed from the right atrium and ventricle with extension to the right pulmonary artery. The postoperative period was uneventful.

Assessment of Thromboembolism After the Cox-Maze Procedure for Chronic Atrial Fibrillation Secondary to Mitral Valve Lesion

OBJECTIVE: To assess the occurrence of late thromboembolism after surgical repair of chronic atrial fibrillation (AF) simultaneously with repair of mitral valve using the Cox-Maze procedure. METHODS: 69 patients underwent Cox 3 procedure, with no cryoablation simultaneously with mitral valvuloplasty or prosthesis. Mean age was 49.9±13.2 years. Mean follow-up was of 31.7±19 months. Types of lesion were as follows: 33 (48%) stenoses, 23 (33%) insufficiencies, and 13 (19%) double lesions. Procedures were: 64 (93%) valvuloplasties, 3 (4%) biological and 2 (3%) mechanical prosthesis placement. There were 9 (13%) patients with previous systemic embolism and 2 (3%) had left atrial thrombi. RESULTS: Early mortality was 7% and late 1%. 2 patients (3%) were reoperated for mitral placement. At last evaluation, 10 patients (15%), were in AF. The remaining 59 (85%) were either in sinus / atrial rythm (74%) or under pacing (12%). There were no occurrence of early or late, systemic or pulmonary embolism. Permanent anticoagulation was employed in 16 cases, 10 in regular rythm and 6 in AF. The remaining 47 (75%), 2 in AF and 45 in regular rythm, did not receive anticoagulants. CONCLUSIONS: These results are in accordance with others series, where the occurrence of embolism was rare after maze procedure. Permanent systemic anticoagulation seems to be unnecessary in those cases.

Multiple Embolism in a Female Patient with Infective Endocarditis: Low Back Pain and Hematuria as the Initial Clinical Manifestations

A 59-year-old female patient with mitral valve prolapse and a previous history of lumbosacral spondyloarthrosis and lumbar disk hernia had an episode of infective endocarditis due to Streptococcus viridans, which evolved with peripheral embolism to the left kidney, spleen, and left iliac artery, and intraventricular cerebral hemorrhage. Her clinical manifestations were low back pain and hematuria, which were initially attributed to an osteoarticular condition. Infective endocarditis is a severe polymorphic disease with multiple clinical manifestations and it should always be included in the differential diagnosis by clinicians.

Development of a water-in-oil-in-water multiple emulsion system integrating biomimetic aqueous-core lipid nanodroplets for protein entity stabilization. Part I: experimental factorial design

Lipid nanoballoons integrating multiple emulsions of the type water-in-oil-in-water enclose, at least in theory, a biomimetic aqueous-core suitable for housing hydrophilic biomolecules such as proteins, peptides and bacteriophage particles. The research effort entertained in this paper reports a full statistical 23x31 factorial design study (three variables at two levels and one variable at three levels) to optimize biomimetic aqueous-core lipid nanoballoons for housing hydrophilic protein entities. The concentrations of protein, lipophilic and hydrophilic emulsifiers, and homogenization speed were set as the four independent variables, whereas the mean particle hydrodynamic size (HS), zeta potential (ZP) and polydispersity index (PI) were set as the dependent variables. The V23x31 factorial design constructed led to optimization of the higher (+1) and lower (-1) levels, with triplicate testing for the central (0) level, thus producing thirty three experiments and leading to selection of the optimized processing parameters as 0.015% (w/w) protein entity, 0.75% (w/w) lipophilic emulsifier (soybean lecithin) and 0.50% (w/w) hydrophilic emulsifier (poloxamer 188). In the present research effort, statistical optimization and production of protein derivatives encompassing full stabilization of their three-dimensional structure, has been attempted via housing said molecular entities within biomimetic aqueous-core lipid nanoballoons integrating a multiple (W/O/W) emulsion.

Electronic tongue: a versatile tool for mineral and fruit-flavored waters recognition

Natural mineral waters (still), effervescent natural mineral waters (sparkling) and aromatized waters with fruit-flavors (still or sparkling) are an emerging market. In this work, the capability of a potentiometric electronic tongue, comprised with lipid polymeric membranes, to quantitatively estimate routinely quality physicochemical parameters (pH and conductivity) as well as to qualitatively classify water samples according to the type of water was evaluated. The study showed that a linear discriminant model, based on 21 sensors selected by the simulated annealing algorithm, could correctly classify 100 % of the water samples (leave-one out cross-validation). This potential was further demonstrated by applying a repeated K-fold cross-validation (guaranteeing that at least 15 % of independent samples were only used for internal-validation) for which 96 % of correct classifications were attained. The satisfactory recognition performance of the E-tongue could be attributed to the pH, conductivity, sugars and organic acids contents of the studied waters, which turned out in significant differences of sweetness perception indexes and total acid flavor. Moreover, the E-tongue combined with multivariate linear regression models, based on sub-sets of sensors selected by the simulated annealing algorithm, could accurately estimate waters pH (25 sensors: R 2 equal to 0.99 and 0.97 for leave-one-out or repeated K-folds cross-validation) and conductivity (23 sensors: R 2 equal to 0.997 and 0.99 for leave-one-out or repeated K-folds cross-validation). So, the overall satisfactory results achieved, allow envisaging a potential future application of electronic tongue devices for bottled water analysis and classification.

Predictive factors of complications after coronary stent implantation

OBJECTIVE: To analyze the predictive factors of complications after implantation of coronary stents in a consecutive cohort study. METHODS: Clinical and angiographic characteristics related to the procedure were analyzed, and the incidence of major cardiovascular complications (myocardial infarction, urgent surgery, new angioplasty, death) in the in-hospital phase were recorded. Data were stored in an Access database and analyzed by using the SPSS 6.0 statistical program and a stepwise backwards multiple logistic regression model. RESULTS: One thousand eighteen (mean age of 61±11 years, 29% females) patients underwent 1,070 stent implantations. The rate of angiographic success was 96.8%, the rate of clinical success was 91%, and the incidence of major cardiovascular complications was 7.9%. The variables independently associated with major cardiovascular complications, with their respective odds ratio (OR) were: rescue stent, OR = 5.1 (2.7-9.6); filamentary stent, OR = 4.5 (2.2-9.1); first-generation tubular stent, OR = 2.4 (1.2-4.6); multiple stents, OR = 3 (1.6-5.6); complexity of the lesion, OR = 2.4 (1.1-5.1); thrombus, OR = 2 (1.1-3.5). CONCLUSION: The results stress the importance of angiographic variables and techniques in the risk of complications and draw attention to the influence of the stent's design on the result of the procedure.

Domesticación y conservación de plantas nativas del centro de Argentina con potencial de usos múltiples. Domestication and conservation of native plants from central Argentine with multiple potential uses.

Con el retroceso de los bosques nativos se pierden hábitats y recursos fitogenéticos. Existen investigaciones científicas, técnicas y rescate de saberes populares sobre el aprovechamiento de especies autóctonas, búsqueda de productos derivados y servicios ambientales. Entre ellos se destacan estudios locales sobre principios activos con actividad pesticida y medicinal y el uso en paisajismo, mejoramiento ambiental y remediación de paisajes degradados. La información para propagar muchas especies nativas cuyo uso se promueve, no existe o no está calibrada para escala de cultivos intensivos. Este proyecto se enfoca sobre cuatro especies endémicas o nativas de Espinal y Chaco, que tienen gran valor de conservación y son promisorias por su potencial simultáneo de aplicación paisajística y para elaboración de pesticidas. La meta es promover la conservación regional de flora nativa a través del uso, con estrategias in situex situ en áreas urbanas, industriales y rurales. Los objetivos específicos son a-Conservar y caracterizar muestras de las especies Flourensia oolepis, Dolichandra cynanchoides, Lepechinia floribunda y Achyrocline satureioides en el Banco Activo de Germoplasma del Jardín Botánico Gaspar Xuárez sj de la UCC; b-Estudiar la propagación y cultivo de dichas especies y c- Transferir información y capacitar recursos humanos en técnicas de cultivo intensivo ambientalmente sustentable. La metodología contempla: a- Recolección georreferenciada de germoplasma a campo, que se conservará acondicionado en el Banco; b- Caracterización y evaluación de calidad de semillas en laboratorio siguiendo normas internacionales ISTA (peso de mil semillas, poder germinativo y viabilidad) y c- Calibración de protocolos de propagación sexual y cultivo en vivero (variables de supervivencia, sustratos, inóculos). La capacitación de recursos humanos se hará mediante pasantías y talleres de capacitación en el marco del Jardín Botánico y transferencia de información a viveristas, emprendedores y paisajistas. Como productos se esperan 40 nuevas accesiones al Banco y su correspondiente evaluación de calidad de semillas, protocolos de métodos de propagación y cultivo, la realización de un taller de capacitación y una pasantía al año y la publicación de resultados. La pertinencia de estudiar la domesticación de estas especies surge frente a su potencial de uso para múltiples fines y frente al poco desarrollo que aún presenta el sector de producción intensiva de especies nativas. Se espera que la información generada sirva de base, tanto para aportar materias primas y avanzar regionalmente en el desarrollo agroindustrial de pesticidas naturales, como para la provisión de ejemplares cultivados con técnicas conservativas de variabilidad y viabilidad genética para intervenciones paisajistas en áreas urbanas y remediación de paisajes, evitando la extracción directa del recurso.

Terapéutica racional, mediante indicadores de eficacia antimicrobiana, de la mastitis caprina utilizando marbofloxacina y cefquinoma. Rational therapeutics, indicators of antimicrobial efficiency in the mastitis goats using marbofloxacine and cefquinome

La producción de leche de cabra es considerada en nuestro país, y en la provincia de Córdoba, una alternativa productiva para el desarrollo sustentable y socio – económico de la población. Por otra parte, existe una mayor demanda del mercado nacional e internacional de esta leche, por lo que los productores deben garantizar la seguridad y calidad de la misma de acuerdo a las normas vigentes. Es por ello que el control y tratamiento de las diferentes enfermedades es de vital importancia tanto para maximizar la producción del hato como para cumplir con los cánones de seguridad exigidos. En este contexto la mastitis caprina es una de las enfermedades que afecta la productividad del sector, y para controlarla una de las medidas a emplear es la terapéutica con antimicrobianos. Se trabajará en este proyecto con marbofloxacina y cefquinoma, estableciendo pautas racionales (eficaces y seguras) para su empleo en la afección a nivel regional. Los indicadores de eficacia estarán fijados de acuerdo a los parámetros integrados de farmacocinética (FC) y farmacodinamia (FD). Estos últimos (FD) serán calculados a través de la determinación concentraciones inhibitorias mínimas de cepas bacterianas aisladas de mastitis caprinas en Córdoba. Se establecerán los parámetros farmacocinéticos a dosis únicas y múltiples para la marbofloxacina (5 mg/kg IV, IM) y cefquinoma (2 mg/kg IV, IM e IMM) a partir de muestras de suero y leche de cabras Anglo Nubian (n = 6 por antimicrobiano; diseño cruzado en función de la ruta de administración). Se determinarán sus concentraciones en dichos fluidos, por cromatografía líquida de alta precisión. Los resultados FC/FD para ambos medicamentos se compararán con parámetros recomendados por expertos para cada tipo de antimicrobiano y se utilizarán como medida para recomendar una terapéutica racional, fundamental para optimizar la posología, garantizar la eficacia clínica, y reducir al mínimo la selección y propagación de cepas resistentes de agentes patógenos. The production of milk of goat is considered the province of Cordoba, a productive alternative for the sustainable development and partner - economically of the population. There is a major demand of the domestic and international market of this milk, for what the producers must guarantee the safety and quality of the same one of agreement to the in force procedure. It is for it that the control and treatment of the different diseases performs vital importance so much to maximize the production of the herd as to expire with the safety demanded. In this context the mastitis goat is one of the diseases that affect the productivity of the sector, and to control her one of the measures to using is the therapeutics with antimicrobial. One will be employed at this project with marbofloxacine and cefquinome, establishing rational guidelines (effective and sure) for his employment in the affection to regional level. The indicators of efficiency will be fixed in agreement to the integrated parameters of pharmacokinetics (PK) and pharmacodinamics (PD). The latter (PK) will be calculated across the determination inhibitory minimal concentrations of bacterial strains isolated of mastitis goat in Córdoba. The parameters will be established pharmacokinetics to the only and multiple doses for the marbofloxacine (5 mg/kg the IV, IM) and cefquinome (2 mg/kg the IVth, IM and IMM), From samples of whey and milk of goats Anglo Nubian (n = 6 for antimicrobial; design crossed depending on the route of administration). Its concentrations will decide in the above mentioned fluids, for liquid chromatography of high precision. The results PK/PD for both antimicrobial will be compared with parameters recommended by experts for every type of antimicrobial and will be in use as measure for recommending a rational, fundamental therapeutics for optimizing the dosage, for guaranteeing the clinical efficiency, and to reduce to the minimum the selection and spread of resistant of pathogenic agents.

Experimental study of local heat transfer during quenching of metals by spray and multiple jets

Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2011

Impact of Intensive Physiotherapy on Cognitive Function after Coronary Artery Bypass Graft Surgery

Background: Coronary artery bypass graft (CABG) is a standard surgical option for patients with diffuse and significant arterial plaque. This procedure, however, is not free of postoperative complications, especially pulmonary and cognitive disorders. Objective: This study aimed at comparing the impact of two different physiotherapy treatment approaches on pulmonary and cognitive function of patients undergoing CABG. Methods: Neuropsychological and pulmonary function tests were applied, prior to and following CABG, to 39 patients randomized into two groups as follows: Group 1 (control) - 20 patients underwent one physiotherapy session daily; and Group 2 (intensive physiotherapy) - 19 patients underwent three physiotherapy sessions daily during the recovery phase at the hospital. Non-paired and paired Student t tests were used to compare continuous variables. Variables without normal distribution were compared between groups by using Mann-Whitney test, and, within the same group at different times, by using Wilcoxon test. The chi-square test assessed differences of categorical variables. Statistical tests with a p value ≤ 0.05 were considered significant. Results: Changes in pulmonary function were not significantly different between the groups. However, while Group 2 patients showed no decline in their neurocognitive function, Group 1 patients showed a decline in their cognitive functions (P ≤ 0.01). Conclusion: Those results highlight the importance of physiotherapy after CABG and support the implementation of multiple sessions per day, providing patients with better psychosocial conditions and less morbidity.