Ruling out coronary heart disease in primary care: external validation of a clinical prediction rule.

BACKGROUND: The Marburg Heart Score (MHS) aims to assist GPs in safely ruling out coronary heart disease (CHD) in patients presenting with chest pain, and to guide management decisions. AIM: To investigate the diagnostic accuracy of the MHS in an independent sample and to evaluate the generalisability to new patients. DESIGN AND SETTING: Cross-sectional diagnostic study with delayed-type reference standard in general practice in Hesse, Germany. METHOD: Fifty-six German GPs recruited 844 males and females aged ≥ 35 years, presenting between July 2009 and February 2010 with chest pain. Baseline data included the items of the MHS. Data on the subsequent course of chest pain, investigations, hospitalisations, and medication were collected over 6 months and were reviewed by an independent expert panel. CHD was the reference condition. Measures of diagnostic accuracy included the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, likelihood ratios, and predictive values. RESULTS: The AUC was 0.84 (95% confidence interval [CI] = 0.80 to 0.88). For a cut-off value of 3, the MHS showed a sensitivity of 89.1% (95% CI = 81.1% to 94.0%), a specificity of 63.5% (95% CI = 60.0% to 66.9%), a positive predictive value of 23.3% (95% CI = 19.2% to 28.0%), and a negative predictive value of 97.9% (95% CI = 96.2% to 98.9%). CONCLUSION: Considering the diagnostic accuracy of the MHS, its generalisability, and ease of application, its use in clinical practice is recommended.

Differential effect of plant lectins on mast cells of different origins

Histamine release induced by plant lectins was studied with emphasis on the carbohydrate specificity, external calcium requirement, metal binding sites, and mast cell heterogeneity and on the importance of antibodies bound to the mast cell membrane to the lectin effect. Peritoneal mast cells were obtained by direct lavage of the rat peritoneal cavity and guinea pig intestine and hamster cheek pouch mast cells were obtained by dispersion with collagenase type IA. Histamine release was induced with concanavalin A (Con A), lectins from Canavalia brasiliensis, mannose-specific Cymbosema roseum, Maackia amurensis, Parkia platycephala, Triticum vulgaris (WGA), and demetallized Con A and C. brasiliensis, using 1-300 µg/ml lectin concentrations applied to Wistar rat peritoneal mast cells, peaking on 26.9, 21.0, 29.1, 24.9, 17.2, 10.7, 19.9, and 41.5%, respectively. This effect was inhibited in the absence of extracellular calcium. The lectins were also active on hamster cheek pouch mast cells (except demetallized Con A) and on Rowett nude rat (animal free of immunoglobulins) peritoneal mast cells (except for mannose-specific C. roseum, P. platycephala and WGA). No effect was observed in guinea pig intestine mast cells. Glucose-saturated Con A and C. brasiliensis also released histamine from Wistar rat peritoneal mast cells. These results suggest that histamine release induced by lectins is influenced by the heterogeneity of mast cells and depends on extracellular calcium. The results also suggest that this histamine release might occur by alternative mechanisms, because the usual mechanism of lectins is related to their binding properties to metals from which depend the binding to sugars, which would be their sites to bind to immunoglobulins. In the present study, we show that the histamine release by lectins was also induced by demetallized lectins and by sugar-saturated lectins (which would avoid their binding to other sugars). Additionally, the lectins also released histamine from Rowett nude mast cells that are free of immunoglobulins.

Bone morphogenetic proteins: from structure to clinical use

Bone morphogenetic proteins (BMPs) are multi-functional growth factors belonging to the transforming growth factor ß superfamily. Family members are expressed during limb development, endochondral ossification, early fracture, and cartilage repair. The activity of BMPs was first identified in the 1960s but the proteins responsible for bone induction were unknown until the purification and cloning of human BMPs in the 1980s. To date, about 15 BMP family members have been identified and characterized. The signal triggered by BMPs is transduced through serine/threonine kinase receptors, type I and II subtypes. Three type I receptors have been shown to bind BMP ligands, namely: type IA and IB BMP receptors and type IA activin receptors. BMPs seem to be involved in the regulation of cell proliferation, survival, differentiation and apoptosis, but their hallmark is their ability to induce bone, cartilage, ligament, and tendon formation at both heterotopic and orthotopic sites. This suggests that, in the future, they may play a major role in the treatment of bone diseases. Several animal studies have illustrated the potential of BMPs to enhance spinal fusion, repair critical-size defects, accelerate union, and heal articular cartilage lesions. Difficulties in producing and purifying BMPs from bone tissue have prompted the attempts made by several laboratories, including ours, to express these proteins in the recombinant form in heterologous systems. This review focuses on BMP structure, molecular mechanisms of action and significance and potential applications in medical, dental and veterinary practice for the treatment of cartilage and bone-related diseases.

Rôle de la topoisomérase I dans la stabilité du génome chez Escherichia coli

Les topoisomérases (topos) de type IA jouent un rôle primordial dans le maintien et l’organisation du génome. Cependant, les mécanismes par lesquels elles contrôlent cette stabilité génomique sont encore à approfondir. Chez E. coli, les deux principales topoisomérases de type IA sont la topo I (codée par le gène topA) et la topo III (codée par le gène topB). Il a déjà été montré que les cellules dépourvues des topos I et III formaient de très longs filaments dans lesquels les chromosomes ne sont pas bien séparés. Comme ces défauts de ségrégation des chromosomes sont corrigés par l’inactivation de la protéine RecA qui est responsable de la recombinaison homologue, il a été émis comme hypothèse que les topoisomérases de type IA avaient un rôle dans la résolution des intermédiaires de recombinaison afin de permettre la séparation des chromosomes. D’autre part, des études réalisées dans notre laboratoire démontrent que le rôle majeur de la topoisomérase I est d’empêcher la formation des R-loops durant la transcription, surtout au niveau des opérons rrn. Ces R-loops on été récemment identifiés comme des obstacles majeurs à l’avancement des fourches de réplication, ce qui peut provoquer une instabilité génomique. Nous avons des évidences génétiques montrant qu’il en serait de même chez nos mutants topA. Tout récemment, des études ont montré le rôle majeur de certaines hélicases dans le soutien aux fourches de réplication bloquées, mais aussi une aide afin de supprimer les R-loops. Chez E. coli, ces hélicases ont été identifiées et sont DinG, Rep et UvrD. Ces hélicases jouent un rôle dans la suppression de certains obstacles à la réplication. Le but de ce projet était de vérifier l’implication de ces hélicases chez le mutant topA en utilisant une approche génétique. Étonnamment, nos résultats montrent que la délétion de certains de ces gènes d’hélicases a pour effet de corriger plutôt que d’exacerber des phénotypes du mutants topA qui sont liés à la croissance et à la morphologie des nucléoides et des cellules. Ces résultats sont interprétés à la lumière de nouvelles fonctions attribuées aux topoisomérases de types IA dans la stabilité du génome.

Note on ""Continuous matter creation and the acceleration of the universe: the growth of density fluctuations""

Recently, de Roany and Pacheco (Gen Relativ Gravit, doi:10.1007/s10714-010-1069-2) performed a Newtonian analysis on the evolution of perturbations for a class of relativistic cosmological models with Creation of Cold Dark Matter (CCDM) proposed by the present authors (Lima et al. in JCAP 1011:027, 2010). In this note we demonstrate that the basic equations adopted in their work do not recover the specific (unperturbed) CCDM model. Unlike to what happens in the original CCDM cosmology, their basic conclusions refer to a decelerating cosmological model in which there is no transition from a decelerating to an accelerating regime as required by SNe type Ia and complementary observations.

Acelaração do universo e criação gravitacional de matéria escura fria: novos modelos e testes observacionais

Recent astronomical observations (involving supernovae type Ia, cosmic background radiation anisotropy and galaxy clusters probes) have provided strong evidence that the observed universe is described by an accelerating, flat model whose space-time properties can be represented by the FriedmannRobertsonWalker (FRW) metric. However, the nature of the substance or mechanism behind the current cosmic acceleration remains unknown and its determination constitutes a challenging problem for modern cosmology. In the general relativistic description, an accelerat ing regime is usually obtained by assuming the existence of an exotic energy component endowed with negative pressure, called dark energy, which is usually represented by a cosmological constant ¤ associated to the vacuum energy density. All observational data available so far are in good agreement with the concordance cosmic ¤CDM model. Nevertheless, such models are plagued with several problems thereby inspiring many authors to propose alternative candidates in the relativistic context. In this thesis, a new kind of accelerating flat model with no dark energy and fully dominated by cold dark matter (CDM) is proposed. The number of CDM particles is not conserved and the present accelerating stage is a consequence of the negative pressure describing the irreversible process of gravitational particle creation. In order to have a transition from a decelerating to an accelerating regime at low redshifts, the matter creation rate proposed here depends on 2 parameters (y and ߯): the first one identifies a constant term of the order of H0 and the second one describes a time variation proportional to he Hubble parameter H(t). In this scenario, H0 does not need to be small in order to solve the age problem and the transition happens even if there is no matter creation during the radiation and part of the matter dominated phase (when the ß term is negligible). Like in flat ACDM scenarios, the dimming of distant type Ia supernovae can be fitted with just one free parameter, and the coincidence problem plaguing the models driven by the cosmological constant. ACDM is absent. The limits endowed with with the existence of the quasar APM 08279+5255, located at z = 3:91 and with an estimated ages between 2 and 3 Gyr are also investigated. In the simplest case (ß = 0), the model is compatible with the existence of the quasar for y > 0:56 whether the age of the quasar is 2.0 Gyr. For 3 Gyr the limit derived is y > 0:72. New limits for the formation redshift of the quasar are also established

Efeitos das inomogeneidades da matéria em Cosmologias Aceleradas

The recent observational advances of Astronomy and a more consistent theoretical framework turned Cosmology in one of the most exciting frontiers of contemporary science. In this thesis, homogeneous and inhomogeneous Universe models containing dark matter and different kinds of dark energy are confronted with recent observational data. Initially, we analyze constraints from the existence of old high redshift objects, Supernovas type Ia and the gas mass fraction of galaxy clusters for 2 distinct classes of homogeneous and isotropic models: decaying vacuum and X(z)CDM cosmologies. By considering the quasar APM 08279+5255 at z = 3.91 with age between 2-3 Gyr, we obtain 0,2 < OM < 0,4 while for the j3 parameter which quantifies the contribution of A( t) is restricted to the intervalO, 07 < j3 < 0,32 thereby implying that the minimal age of the Universe amounts to 13.4 Gyr. A lower limit to the quasar formation redshift (zJ > 5,11) was also obtained. Our analyzes including flat, closed and hyperbolic models show that there is no an age crisis for this kind of decaying A( t) scenario. Tests from SN e Ia and gas mass fraction data were realized for flat X(z)CDM models. For an equation of state, úJ(z) = úJo + úJIZ, the best fit is úJo = -1,25, úJl = 1,3 and OM = 0,26, whereas for models with úJ(z) = úJo+úJlz/(l+z), we obtainúJo = -1,4, úJl = 2,57 and OM = 0,26. In another line of development, we have discussed the influence of the observed inhomogeneities by considering the Zeldovich-Kantowski-DyerRoeder (ZKDR) angular diameter distance. By applying the statistical X2 method to a sample of angular diameter for compact radio sources, the best fit to the cosmological parameters for XCDM models are OM = O, 26,úJ = -1,03 and a = 0,9, where úJ and a are the equation of state and the smoothness parameters, respectively. Such results are compatible with a phantom energy component (úJ < -1). The possible bidimensional spaces associated to the plane (a , OM) were restricted by using data from SNe Ia and gas mass fraction of galaxy clusters. For Supernovas the parameters are restricted to the interval 0,32 < OM < 0,5(20") and 0,32 < a < 1,0(20"), while to the gas mass fraction we find 0,18 < OM < 0,32(20") with alI alIowed values of a. For a joint analysis involving Supernovas and gas mass fraction data we obtained 0,18 < OM < 0,38(20"). In general grounds, the present study suggests that the influence of the cosmological inhomogeneities in the matter distribution need to be considered with more detail in the analyses of the observational tests. Further, the analytical treatment based on the ZKDR distance may give non-negligible corrections to the so-calIed background tests of FRW type cosmologies

Teorias f(R) de gravidade na formulação de Palatini

In this dissertation, after a brief review on the Einstein s General Relativity Theory and its application to the Friedmann-Lemaitre-Robertson-Walker (FLRW) cosmological models, we present and discuss the alternative theories of gravity dubbed f(R) gravity. These theories come about when one substitute in the Einstein-Hilbert action the Ricci curvature R by some well behaved nonlinear function f(R). They provide an alternative way to explain the current cosmic acceleration with no need of invoking neither a dark energy component, nor the existence of extra spatial dimensions. In dealing with f(R) gravity, two different variational approaches may be followed, namely the metric and the Palatini formalisms, which lead to very different equations of motion. We briefly describe the metric formalism and then concentrate on the Palatini variational approach to the gravity action. We make a systematic and detailed derivation of the field equations for Palatini f(R) gravity, which generalize the Einsteins equations of General Relativity, and obtain also the generalized Friedmann equations, which can be used for cosmological tests. As an example, using recent compilations of type Ia Supernovae observations, we show how the f(R) = R − fi/Rn class of gravity theories explain the recent observed acceleration of the universe by placing reasonable constraints on the free parameters fi and n. We also examine the question as to whether Palatini f(R) gravity theories permit space-times in which causality, a fundamental issue in any physical theory [22], is violated. As is well known, in General Relativity there are solutions to the viii field equations that have causal anomalies in the form of closed time-like curves, the renowned Gödel model being the best known example of such a solution. Here we show that every perfect-fluid Gödel-type solution of Palatini f(R) gravity with density and pressure p that satisfy the weak energy condition + p 0 is necessarily isometric to the Gödel geometry, demonstrating, therefore, that these theories present causal anomalies in the form of closed time-like curves. This result extends a theorem on Gödel-type models to the framework of Palatini f(R) gravity theory. We derive an expression for a critical radius rc (beyond which causality is violated) for an arbitrary Palatini f(R) theory. The expression makes apparent that the violation of causality depends on the form of f(R) and on the matter content components. We concretely examine the Gödel-type perfect-fluid solutions in the f(R) = R−fi/Rn class of Palatini gravity theories, and show that for positive matter density and for fi and n in the range permitted by the observations, these theories do not admit the Gödel geometry as a perfect-fluid solution of its field equations. In this sense, f(R) gravity theory remedies the causal pathology in the form of closed timelike curves which is allowed in General Relativity. We also examine the violation of causality of Gödel-type by considering a single scalar field as the matter content. For this source, we show that Palatini f(R) gravity gives rise to a unique Gödeltype solution with no violation of causality. Finally, we show that by combining a perfect fluid plus a scalar field as sources of Gödel-type geometries, we obtain both solutions in the form of closed time-like curves, as well as solutions with no violation of causality

Differential effect of plant lectins on mast cells of different origins

Histamine release induced by plant lectins was studied with emphasis on the carbohydrate specificity, external calcium requirement, metal binding sites, and mast cell heterogeneity and on the importance of antibodies bound to the mast cell membrane to the lectin effect. Peritoneal mast cells were obtained by direct lavage of the rat peritoneal cavity and guinea pig intestine and hamster cheek pouch mast cells were obtained by dispersion with collagenase type IA. Histamine release was induced with concanavalin A (Con A), lectins from Canavalia brasiliensis, mannose-specific Cymbosema roseum, Maackia amurensis, Parkia platycephala, Triticum vulgaris (WGA), and demetallized Con A and C. brasiliensis, using 1-300 µg/ml lectin concentrations applied to Wistar rat peritoneal mast cells, peaking on 26.9, 21.0, 29.1, 24.9, 17.2, 10.7, 19.9, and 41.5%, respectively. This effect was inhibited in the absence of extracellular calcium. The lectins were also active on hamster cheek pouch mast cells (except demetallized Con A) and on Rowett nude rat (animal free of immunoglobulins) peritoneal mast cells (except for mannose-specific C. roseum, P. platycephala and WGA). No effect was observed in guinea pig intestine mast cells. Glucose-saturated Con A and C. brasiliensis also released histamine from Wistar rat peritoneal mast cells. These results suggest that histamine release induced by lectins is influenced by the heterogeneity of mast cells and depends on extracellular calcium. The results also suggest that this histamine release might occur by alternative mechanisms, because the usual mechanism of lectins is related to their binding properties to metals from which depend the binding to sugars, which would be their sites to bind to immunoglobulins. In the present study, we show that the histamine release by lectins was also induced by demetallized lectins and by sugar-saturated lectins (which would avoid their binding to other sugars). Additionally, the lectins also released histamine from Rowett nude mast cells that are free of immunoglobulins.

Silicon monosulphide radiative association

Rate coefficients for radiative association of silicon and sulphur atoms to form silicon monosulphide (SiS) molecule are estimated. The radiative association is due mainly to approach in the E(1)Sigma(+) and A(1)Pi states of SiS. For temperatures ranging from similar to 1000 to similar to 14 000 K, the rate coefficients are found to vary from 8.43 x 10(-17) to 2.69 x 10(-16) cm(3) s(-1). Our calculated rate coefficient is higher than the values used in modelling the chemistry of Type Ia supernovae.

Imobilização de fraturas femorais em gatos usando pino intramedular conectado ou não ao fixador esquelético externo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Determinação da virulência e da resistência antimicrobiana em Staphylococcus spp. isolados de pacientes do Serviço de Dermatologia do Hospital das Clínicas da Faculdade de Medicina de Botucatu, SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Community-associated methicillin-resistant Staphylococcus aureus in non-outbreak skin infections

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Community-associated methicillin-resistant Staphylococcus aureus in non-outbreak skin infections

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The influence of handrim design on the contact forces on hands'surface: a preliminary study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)