Validation study of an automated wrist monitor, omron model HEM-608, compared with the standard methods for blood pressure measurement

OBJECTIVE - The aim of our study was to assess the profile of a wrist monitor, the Omron Model HEM-608, compared with the indirect method for blood pressure measurement. METHODS - Our study population consisted of 100 subjects, 29 being normotensive and 71 being hypertensive. Participants had their blood pressure checked 8 times with alternate techniques, 4 by the indirect method and 4 with the Omron wrist monitor. The validation criteria used to test this device were based on the internationally recognized protocols. RESULTS - Our data showed that the Omron HEM-608 reached a classification B for systolic and A for diastolic blood pressure, according to the one protocol. The mean differences between blood pressure values obtained with each of the methods were -2.3 +7.9mmHg for systolic and 0.97+5.5mmHg for diastolic blood pressure. Therefore, we considered this type of device approved according to the criteria selected. CONCLUSION - Our study leads us to conclude that this wrist monitor is not only easy to use, but also produces results very similar to those obtained by the standard indirect method.

Factors associated with the donation and non-donation of embryos for research: a systematic review

Background: Systematic knowledge on the factors that influence the decisions of IVF users regarding embryo donation for research is a core need for patient-centred policies and ethics in clinical practice. However, no systematic review has been provided on the motivations of patients who must decide embryo disposition. This paper fills this gap, presenting a systematic review of quantitative and qualitative studies, which synthesizes the current body of knowledge on the factors and reasons associated with IVF patients’ decisions to donate or not to donate embryos for research. Methods: A systematic search of studies indexed in PubMed, ISIWoK and PsycINFO, published before November 2013, was conducted. Only empirical, peer-reviewed, full-length, original studies reporting data on factors and reasons associated with the decision concerning donation or non-donation of embryos for research were included. Eligibility and data extraction were performed by two independent researchers and disagreements were resolved by discussion or a third reviewer, if required. The main quantitative findings were extracted and synthesized and qualitative data were assessed by thematic content analysis. Results: A total of 39 studies met the inclusion criteria and were included in the review. More than half of the studies (n ¼ 21) used a quantitative methodology, and the remaining were qualitative (n ¼ 15) or mixed-methods (n ¼ 3) studies. The studies were derived mainly from European countries (n ¼ 18) and the USA(n ¼ 11). The proportion of IVF users who donated embryos for research varied from 7% in a study in France to 73% in a Swiss study. Those who donate embryos for research reported feelings of reciprocity towards science and medicine, positive views of research and high levels of trust in the medical system. They described their decision as better than the destruction of embryos and as an opportunity to help others or to improve health and IVF treatments. The perception of risks, the lack of information concerning research projects and the medical system and the conceptualization of embryos in terms of personhood were the most relevant motives for not donating embryos for research. Results relating to the influence of sociodemographic characteristics and reproductive and gynaecological history were mostly inconclusive. Conclusions: Three iterative and dynamic dimensions of the IVF patients’ decision to donate or not to donate embryos for research emerged from this review: the hierarquization of the possible options regarding embryo disposition, according to the moral, social and instrumental status attributed to embryos; patients’ understanding of expectations and risks of the research on human embryos; and patients’ experiences of information exchange and levels of trust in the medical-scientific institutions.

Fathers’ emotional involvement with the neonate: impact of the umbilical cord cutting experience

Aims. This paper is a report on a study analysing the effect of the umbilical cord cutting experience on fathers’ emotional involvement with their infants. Background. Participation in childbirth offers an opportunity for father and mother to share the childbirth experience, so it is vital that midwives improve the fathers’ participation in this event. Design. A quasi-experimental study with a quantitative methodology was implemented. Methods. One hundred and five fathers were recruited as part of a convenience sample in a Maternity Public Hospital in a Metropolitan City in Portugal, between January and May of 2008. The Bonding Scale, the Portuguese version of the ‘Mother-to-Infant Bonding Scale’ was used to evaluate the fathers’ emotional involvement with the neonate at different moments: before childbirth, first day after childbirth and first month after childbirth. After childbirth, the fathers were divided into three separate groups depending on their umbilical cord cutting experience. Results. The results demonstrate that the emotional involvement between father and child tends to increase during the first days after childbirth and to decrease when evaluated 1 month after birth, for fathers who did not cut the umbilical cord. However, fathers who cut the umbilical cord demonstrate an improvement in emotional involvement 1 month later. Conclusion. Results suggest that the umbilical cord cutting experience benefits the father’s emotional involvement with the neonate, supporting the benefits of his participation and empowerment in childbirth.

Mother's stress, mood and emotional involvement with the infant: 3 months before and 3 months after childbirth

Adverse effects of maternal anxiety and depression are well documented, namely on the foetus/child behaviour and development, but not as much attention has been given to the mother's emotional involvement with the offspring. To study mother's prenatal and postpartum stress, mood and emotional involvement with the infant, the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale and the Mother-to-Infant Bonding Scale were filled in and cortisol levels were measured, 3 months before and 3 months after childbirth, in a sample of 91 Portuguese women. From pregnancy to the postpartum period, mother's cortisol levels, anxiety and emotional involvement toward the child decrease. No significant change was observed regarding mother's depression. Mother's depression predicted a worse emotional involvement before childbirth, while mother's anxiety predicted a worse emotional involvement with the infant after childbirth. Additionally, pregnant women with a worse emotional involvement with the offspring are at risk of poorer emotional involvement with the infant and higher anxiety and depression at 3 months postpartum. It should be given more attention to mother's poor emotional involvement with the offspring during pregnancy, as it interferes with her emotional involvement with the infant and her psychological adjustment 3 months after childbirth.

Assessment of the DIXTAL DX-2710 Automated Oscillometric Device for Blood Pressure Measurement with the Validation Protocols of the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI)

OBJECTIVE: To assess the Dixtal DX2710 automated oscillometric device used for blood pressure measurement according to the protocols of the BHS and the AAMI. METHODS: Three blood pressure measurements were taken in 94 patients (53 females 15 to 80 years). The measurements were taken randomly by 2 observers trained to measure blood pressure with a mercury column device connected with an automated device. The device was classified according to the protocols of the BHS and AAMI. RESULT: The mean of blood pressure levels obtained by the observers was 148±38/93±25 mmHg and that obtained with the device was 148±37/89±26 mmHg. Considering the differences between the measurements obtained by the observer and those obtained with the automated device according to the criteria of the BHS, the following classification was adopted: "A" for systolic pressure (69% of the differences < 5; 90% < 10; and 97% < 15 mmHg); and "B" for diastolic pressure (63% of the differences < 5; 83% < 10; and 93% < 15 mmHg). The mean and standard deviation of the differences were 0±6.27 mmHg for systolic pressure and 3.82±6.21 mmHg for diastolic pressure. CONCLUSION: The Dixtal DX2710 device was approved according to the international recommendations.

Behavior of inflammatory markers of myocardial injury in cardiac surgery: laboratory correlation with the clinical picture of postpericardiotomy syndrome

OBJECTIVE: To verify the association of serum markers of myocardial injury, such as troponin I, creatinine kinase, and creatinine kinase isoenzyme MB, and inflammatory markers, such as tumor necrosis factor alpha (TNF-alpha), C-reactive protein, and the erythrocyte sedimentation rate in the perioperative period of cardiac surgery, with the occurrence of possible postpericardiotomy syndrome. METHODS: This was a cohort study with 96 patients undergoing cardiac surgery assessed at the following 4 different time periods: the day before surgery (D0); the 3rd postoperative day (D3); between the 7th and 10th postoperative days (D7-10); and the 30th postoperative day (D30). During each period, we evaluated demographic variables (sex and age), surgical variables (type and duration , extracorporeal circulation), and serum dosages of the markers of myocardial injury and inflammatory response. RESULTS: Of all patients, 12 (12.5%) met the clinical criteria for a diagnosis of postpericardiotomy syndrome, and their mean age was 10.3 years lower than the age of the others (P=0.02). The results of the serum markers for tissue injury and inflammatory response were not significantly different between the 2 assessed groups. No significant difference existed regarding either surgery duration or extracorporeal circulation. CONCLUSION: The patients who met the clinical criteria for postpericardiotomy syndrome were significantly younger than the others were. Serum markers for tissue injury and inflammatory response were not different in the clinically affected group, and did not correlate with the different types and duration of surgery or with extracorporeal circulation.

Initial experience in Brazil with the Helex septal occluder for percutaneous occlusion of atrial septal defects

OBJECTIVE: To evaluate the initial clinical experience with the Helex septal occluder for percutaneous closure of atrial septal defects. METHODS: Ten patients underwent the procedure, 7 patients with ostium secundum atrial septal defects (ASD) with hemodynamic repercussions and 3 patients with pervious foramen ovale (PFO) and a history of stroke. Mean age was 33.8 years and mean weight was 55.4 kg. Mean diameter by transesophageal echocardiography and mean stretched ASD diameter were 11.33 ± 3.3mm, and 15.2 ± 3.8mm, respectively. The Qp/Qs ratio was 1.9 ± 0.3 in patients with ASD. RESULTS: Eleven occluders were placed because a patient with 2 holes needed 2 devices. It was necessary to retrieve and replace 4 devices in 3 patients. We observed immediate residual shunt (< 2mm) in 4 patients with ASD, and in those with patent foramen ovale total occlusion of the defect occurred. No complications were noted, and all patients were discharged on the following day. After 1 month, 2 patients with ASD experienced trivial residual shunts (1mm). In 1 patient, we observed mild prolapse in the proximal disk in the right atrium, without consequences. CONCLUSION: The Helex septal occluder was safe and effective for occluding small to moderate atrial septal defects. Because the implantation technique is demanding, it requires specific training of the operator. Even so, small technical failures may occur in the beginning of the learning curve, but they do not involve patient safety.

Regulación transcripcional y relación entre estructura y función de proteínas relacionadas con el metabolismo de colina en Pseudomonas aeruginosa. Transcriptional regulation and relationship between structure and function of proteins related with the choline metabolism in Pseudomonas aeruginosa.

El objetivo general de este proyecto es dilucidar los mecanismos de acción a nivel molecular de enzimas y proteínas involucradas en el metabolismo de colina en Pseudomonas aeruginosa, con énfasis en la identificación de residuos aminoacídicos críticos y regulación de la expresión de los genes en estudio. Los objetivos específicos que se palntean involucran abordajes bioquímicos y moleculares y serán llevados a cabo mediante técnicas de biología molecular y bioquímica (mutación sitio-dirigida, deleción génica, expresión y purificación de proteínas, fusión transcripcional a genes reporteros, etc). Planteo de hipótesis: las proteínas que se inducen por colina (fosforilcolina fosfatasa (PchP), fosfolipasa C (PlcH), acetilcolinestera (AchE), proteínas periplásmicas unidoras de colina (PUch) podrían compartir: a) una organización génica y responder a la regulación por proteínas regulatorias o a factores ambientales de manera similar; b) residuos aminoacídicos conservados que intervengan en la unión o interacción con diferentes ligandos, principalmente, colina. Para ello, se plantean los siguientes Objetivos Específicos: 1) identificar las zonas promotoras de los genes que codifican para PchP, PlcH, AchE y PUch, a fin de localizar posibles sitios de unión a proteínas reguladoras y los factores ambientales que afectan la actividad promotora. 2) determinar en las proteínas mencionadas los residuos aminoacídicos de importancia involucrados en la catálisis y en la interacción con ligandos, principalmente en la unión a compuestos de alquilamonio; 3) Se iniciarán estudios que demuestren la relación entre la inducción por colina de varios factores de patogenicidad la virulencia del microorganismo, empleando mutantes simples o múltiples en estos factores y como modelo de patogenicidad el nematodo C. elegans. A partir de los resultados obtenidos se pretende tener un conocimiento profundo sobre la regulación molecular y bioquímica de varias enzimas comprometidas en la patología que produce P. aeruginosa. Esto más el conocimiento de la fisiología de este microorganismo abre el camino para la búsqueda de posibles blancos de acción de drogas. Por otro lado, se espera tener un conocimiento integral sobre la regulación de la expresión de las actividades enzimáticas relacionadas con el metabolismo de colina y la respuesta de P. aeruginosa ante la presencia de compuestos de alquilamonio utilizados como nutrientes. Se espera conocer el papel que desempeña cada uno de los sitios de unión a los diferentes ligandos para el funcionamiento y control de las enzimas mencionadas y explicar el comportamiento diferencial de las enzimas frente a distintos sustratos y otros ligandos. El conocimiento de los sitios de unión a compuestos de alquilamonio permitirá encontrar esos dominios en diferentes proteínas del género Pseudomonas y otras bacterias Gram negativas. Desde el punto de vista evolutivo, se podrá comparar la similitud de los sitios de unión a colina entre proteínas de organismos eucariotas con procariotas (ej. PUch de bacterias Gram positivas, transportadores de colina, proteína C reactiva, AchE de eucariotas contra las encontradas en bacterias del género Pseudomonas, fosfolipasas A, C o D, etc.). Este proyecto permitirá concretar al menos dos tesis doctorales (Sanchez, Otero) más varios trabajos finales de grado (tesinas) que son y serán realizados por alumnos de la carrera de Microbiología en la UNRC. Les permitirá a los doctorandos y a los alumnos de grado adquirir una formación bastante integral ya que utilizarán herramientas de la fisiología general bacteriana, de la bioquímica clásica, de la biología molecular y de la bioinformática.

Some results of study of variations of light ions concentration and their connections with the ionizing radiation and sub-micron aerosol content in air under the conditions of Tbilisi city

Results of analysis of variations of sum light ions concentration and their connections with radon, galactic cosmic rays intensity and content of sub-micron aerosols by diameter ≥ 0.1 micron in surface boundary layer of Tbilisi city are given.

The Feedback Effect of Intensity of Ionizing Radiation With the Light Ions Content in Atmosphere. Paradox (the Tbilisi Type of a Smog), or Usual Phenomenon for the Strongly Pollution Cities?.

თბილისში მსუბუქი იონების, რადონის და გალაქტიკური კოსმოსური სხივების ნეიტრონული კომპონენტის ინტენსივობის 2009-2010 წლებში კომპლექსური მონიტორინგის მონაცემების მიხედვით გამოვლენილია მაიონიზებელი გამოსხივების ინტენსივობისა და ატმოსფეროში მსუბუქი იონების შემცველობის უკუკავშირის ეფექტი.

Interaction of the brain-specific Arf-GAP protein p42 I P 4 (centaurin α1, ADAP1) with the metalloendopeptidase nardilysin and modulation by tubulin

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2012