Ambulatory blood pressure monitoring of patients with heart failure: a new prognosis marker

OBJECTIVE: To evaluate the relationship between 24-hour ambulatory arterial blood pressure monitoring and the prognosis of patients with advanced congestive heart failure. METHODS: We studied 38 patients with NYHA functional class IV congestive heart failure, and analyzed left ventricular ejection fraction, diastolic diameter, and ambulatory blood pressure monitoring data. RESULTS: Twelve deaths occurred. Left ventricular ejection fraction (35.2±7.3%) and diastolic diameter (72.2±7.8mm) were not correlated with the survival. The mean 24-hour (SBP24), waking (SBPw), and sleeping (SBPs) systolic pressures of the living patients were higher than those of the deceased patients and were significant for predicting survival. Patients with mean SBP24, SBPv, and SBPs > or = 105mmHg had longer survival (p=0.002, p=0.01 and p=0.0007, respectively). Patients with diastolic blood pressure sleep decrements (dip) and patients with mean blood pressure dip <=6mmHg had longer survival (p=0.04 and p=0.01, respectively). In the multivariate analysis, SBPs was the only variable with an odds ratio of 7.61 (CI: 1.56; 3704) (p=0.01). Patients with mean SBP<105mmHg were 7.6 times more likely to die than those with SBP > or = 105 mmHg CONCLUSION: Ambulatory blood pressure monitoring appears to be a useful method for evaluating patients with congestive heart failure.

Influence of Quality of Sleep on the Nocturnal Decline in Blood Pressure During Ambulatory Blood Pressure Monitoring

OBJECTIVE: To assess the influence of the quality of sleep on the nocturnal physiological drop in blood pressure during ambulatory blood pressure monitoring. METHODS: We consecutively assessed ambulatory blood pressure monitoring, the degree of tolerance for the examination, and the quality of sleep in 168 patients with hypertension or with the suspected "white-coat" effect. Blood pressure fall during sleep associated with a specific questionnaire and an analogical visual scale of tolerance for ambulatory blood pressure monitoring were used to assess usual sleep and sleep on the day of examination. Two specialists in sleep disturbances classified the patients into 2 groups: those with normal sleep and those with abnormal sleep. RESULTS: Fifty-nine (35 %) patients comprised the abnormal sleep group. Findings regarding the quality of sleep on the day of ambulatory blood pressure monitoring as compared with those regarding the quality of sleep on a usual day were different and were as follows, respectively: total duration of sleep (-12.4±4.7 versus -42.2±14.9 minutes, P=0.02), latency of sleep (0.4±2.7 versus 17±5.1 minutes, P<0.001), number of awakenings (0.1±0.1 versus 1.35±0.3 times, P<0.001), and tolerance for ambulatory blood pressure monitoring (8±0.2 versus 6.7±0.35, P=0.035). An abnormal drop in blood pressure during sleep occurred in 20 (18%) patients in the normal sleep group and in 14 (24%) patients in the abnormal sleep group, P=0.53. CONCLUSION: Ambulatory blood pressure monitoring causes sleep disturbances in some patients, and a positive association between quality of sleep and tolerance for the examination was observed.

Incorporation of hybrid phase change materials in plastering mortars for increased energy efficiency in buildings

Tese de Doutoramento em Engenharia Civil.

Caso 4/2003 - Paciente de 61 anos, portadora de cardiopatia da doença de Chagas, com disfunção ventricular, taquicardia ventricular recorrente e marcapasso cardíaco, que apresentou morte em assistolia após ressecção cirúrgica de aneurisma de ponta

A 61 year-old Chagasic woman, with previous left ventricular systolic disfunction, ventricular tachychardia and cardiac pacemaker, presented cardiac arrest in asystolia after surgical ressection of apical aneurysm.

Avaliação da Eficácia do Programa Eco-Escolas na Região Autónoma da Madeira – Os concelhos da Ponta do Sol e da Ribeira Brava

Dissertação de Mestrado em Gestão e Políticas Públicas

Population dynamics of O-group plaice, Pleuronectes platessa L., on sandy beach nursery grounds in Galway Bay, the West Coast of Ireland, 2002 to 2006.

The recruitment of 0-group plaice to sandy beach nursery grounds in Galway Bay was examined, using a Riley push-net, from February to June in 2005 and 2006. Sampling was carried out every two weeks on spring tides. Three beaches were sampled, Ballyloughan, Silverstrand and Glann na Ri. Archived 0-group plaice, for Ballyloughan and Silverstrand, from 2004, were processed. Results were compared to findings from a previous study carried out in 2002 and 2003 (Allen 2004). Otolith microstructure analysis was used to determine hatching dates, larval duration, settlement dates, post-larval age and daily growth rates of 0-group plaice in April and May 2005. Results were compared to a previous study (Allen 2004). Hatching dates in Galway Bay ranged from late January to early April in 2005. No significant difference in hatching dates was observed between years or between beaches sampled. Larval duration of 0-group plaice in Galway Bay ranged from 21 to 45 days for fish sampled in April and May 2005. No significant difference was observed in larval age between beaches sampled in Galway Bay or between years in April 2003 and 2005. A significant difference was observed between larval age and years in May 2003 and 2005, however no significant difference was observed between beaches. Settlement timing was calculated using push-net data and otolith microstructure analysis. Settlement of 0-group plaice in Galway Bay generally started in early March and finished in May. Settlement patterns, calculated using otolith microstructure analysis, in 2003 and 2005, were not significantly different to one another. There was also no difference in settlement patterns between the beaches sampled. Results from the present study showed no spatial difference in the pelagic life cycle stages of fish caught in April and May 2003 and 2005.

Development of sensing systems for environmental monitoring

This project focused on the investigation and the development of a chemical sensing system for the determination of chromium Cr6+ and a bio-reactor followed by electrochemical detection at a glassy carbon electrode, for the determination of organochlorine compounds. The conjugation of Cr6+ with 1,5-diphenylcarbazide was studied at various types of electrodes such as glassy carbon, ultra-trace epoxy-graphite, chemically or un-modified carbon-paste and dropping-mercury. The cyclic voltammetric behaviour of the complex was also investigated. In addition, the possibility of developing a chemical sensor, Le. an electrochemical probe capable of sensing Cr6+ through its complexation with 1,5-diphenylacarbazide was studied. The conjugations of l-chloro-2,4-dinitrobenzene, 2,4-dichloronitrobenzene and ethacrynic, which are electrophilic organochlorine compounds, with reduced glutathione, were studied in order to test the bioreactor developed, based on the immobilisation of glutathione s-transferase. This was carried out at different types of electrodes such as glassy-carbon, gold, silver, platinum, epoxy-graphite, hangingmercury, and ferrocene-modified rotating-disc electrodes.

monitoring-based approach to object-oriented real-time computing

Monitoring, object-orientation, real-time, execution-time, scheduling

Controlled resolution reconstruction of one-dimensional permittivity profiles

Electromagnetic scattering inverse problems, microwave imaging, reconstruction of dielectric media, remote sensing, tomography

Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First- Morning Micturition and in the Afternoon

Background: The importance of measuring blood pressure before morning micturition and in the afternoon, while working, is yet to be established in relation to the accuracy of home blood pressure monitoring (HBPM). Objective: To compare two HBPM protocols, considering 24-hour ambulatory blood pressure monitoring (wakefulness ABPM) as gold-standard and measurements taken before morning micturition (BM) and in the afternoon (AM), for the best diagnosis of systemic arterial hypertension (SAH), and their association with prognostic markers. Methods: After undergoing 24-hour wakefulness ABPM, 158 participants (84 women) were randomized for 3- or 5-day HBPM. Two variations of the 3-day protocol were considered: with measurements taken before morning micturition and in the afternoon (BM+AM); and with post-morning-micturition and evening measurements (PM+EM). All patients underwent echocardiography (for left ventricular hypertrophy - LVH) and urinary albumin measurement (for microalbuminuria - MAU). Result: Kappa statistic for the diagnosis of SAH between wakefulness-ABPM and standard 3-day HBPM, 3-day HBPM (BM+AM) and (PM+EM), and 5-day HBPM were 0.660, 0.638, 0.348 and 0.387, respectively. The values of sensitivity of (BM+AM) versus (PM+EM) were 82.6% × 71%, respectively, and of specificity, 84.8% × 74%, respectively. The positive and negative predictive values were 69.1% × 40% and 92.2% × 91.2%, respectively. The comparisons of intraclass correlations for the diagnosis of LVH and MAU between (BM+AM) and (PM+EM) were 0.782 × 0.474 and 0.511 × 0.276, respectively. Conclusions: The 3 day-HBPM protocol including measurements taken before morning micturition and during work in the afternoon showed the best agreement with SAH diagnosis and the best association with prognostic markers.

Kinetic schemes for the relativistic hydrodynamics

Hyperbolic systems, non-relativistic and relativistic Euler equations, kinetic schemes, conservation laws, discontinuous solutions, high order accuracy

Elektrochemisches Monitoring mikrobieller Aktivität : Grundlagen und Anwendung in der Abwasserreinigung

Bioactivity sensor, wastewater purification, electrochemistry, microbial activity, metabolic pathways

Emotional modulation of memory encoding and performance monitoring

Performance monitoring, ERN, CRN, Pe, Memory, Llist learning, Emotion, IAPS, N2, Reinforcement Learning Hypothesis, Conflict Monitoring Hypothesis

Ambulatory Blood Pressure Monitoring: Five Decades of More Light and Less Shadows

Abstract Casual blood pressure measurements have been extensively questioned over the last five decades. A significant percentage of patients have different blood pressure readings when examined in the office or outside it. For this reason, a change in the paradigm of the best manner to assess blood pressure has been observed. The method that has been most widely used is the Ambulatory Blood Pressure Monitoring - ABPM. The method allows recording blood pressure measures in 24 hours and evaluating various parameters such as mean BP, pressure loads, areas under the curve, variations between daytime and nighttime, pulse pressure variability etc. Blood pressure measurements obtained by ABPM are better correlated, for example, with the risks of hypertension. The main indications for ABPM are: suspected white coat hypertension and masked hypertension, evaluation of the efficacy of the antihypertensive therapy in 24 hours, and evaluation of symptoms. There is increasing evidence that the use of ABPM has contributed to the assessment of blood pressure behaviors, establishment of diagnoses, prognosis and the efficacy of antihypertensive therapy. There is no doubt that the study of 24-hour blood pressure behavior and its variations by ABPM has brought more light and less darkness to the field, which justifies the title of this review.