994 resultados para Intra-operator variability


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BACKGROUND: A few studies have suggested an association between prenatal exposure to methylmercury and decreased heart rate variability (HRV) related to autonomic heart function, but no study has examined this association using baroreflex sensitivity (BRS). In this study we assessed the distribution of BRS and immediate orthostatic hypotension (IOH) in young Seychellois adults and their associations with exposure to prenatal and recent postnatal methylmercury. METHODS: Subjects in the Seychelles Child Development Study (SCDS) main cohort were evaluated at age 19 years. Non-invasive beat-to-beat blood pressure (BP) monitoring (Finapres, Ohmeda) was performed at rest and during active standing in 95 consecutive subjects. Recent postnatal mercury exposure was measured in subjects' hair at the age of 19 years and prenatal exposure in maternal hair grown during pregnancy. BRS was estimated by sequence analysis to identify spontaneous ascending and descending BP ramps. HRV was estimated by the following markers: PNN50 (relative numbers of normal-to-normal intervals which are shorter by more than 50 ms than the immediately following normal-to-normal intervals); rMSSD (root mean of the squared sum of successive interval differences); LF/HF (low frequency/high frequency component ratio); ratio of the mean expiratory/inspiratory RR intervals (EI ratio); and the ratio between the longest RR interval 30 s after active standing and the shortest RR interval at 15 s (Max30/Min15). IOH was estimated by the deepest BP fall within the first 15 s after active standing up. RESULTS: Prenatal MeHg exposures were similar in boys and girls (6.7±4.3, 6.7±3.8 ng/g) but recent postnatal mercury levels were higher in males than females (11.2±5.8 vs 7.9±4.3 ng/g, p=0.003). Markers of autonomic heart rate control were within the normal range (BRS: 24.8±7 ms/mm Hg, PNN50: 24.9±6.8%, rMSSD: 68±22, LF/HF: 0.61±0.28) in both sexes. After standing, 51.4% of subjects had a transient systolic BP drop>40 mm Hg, but only 5.3% reported dizziness or had syncope. Prenatal and recent postnatal MeHg levels, overall, were not associated with BRS, E/I ratio, PNN50, rMSSD, LF/HF ratio, Max30/Min15 ratio, and IOH. CONCLUSIONS: This study provides no support for the hypothesis that prenatal or recent postnatal MeHg exposure from fish consumption is associated with impaired autonomic heart rate control.

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BACKGROUND: Chronic kidney disease (CKD) accelerates vascular stiffening related to age. Arterial stiffness may be evaluated measuring the carotid-femoral pulse wave velocity (PWV) or more simply, as recommended by KDOQI, monitoring pulse pressure (PP). Both correlate to survival and incidence of cardiovascular disease. PWV can also be estimated on the brachial artery using a Mobil-O-Graph; a non-operator dependent automatic device. The aim was to analyse whether, in a dialysis population, PWV obtained by Mobil-O-Graph (MogPWV) is more sensitive for vascular aging than PP. METHODS: A cohort of 143 patients from 4 dialysis units has been followed measuring MogPWV and PP every 3 to 6 months and compared to a control group with the same risk factors but an eGFR > 30 ml/min. RESULTS: MogPWV contrarily to PP did discriminate the dialysis population from the control group. The mean difference translated in age between the two populations was 8.4 years. The increase in MogPWV, as a function of age, was more rapid in the dialysis group. 13.3% of the dialysis patients but only 3.0% of the control group were outliers for MogPWV. The mortality rate (16 out of 143) was similar in outliers and inliers (7.4 and 8.0%/year). Stratifying patients according to MogPWV, a significant difference in survival was seen. A high parathormone (PTH) and to be dialysed for a hypertensive nephropathy were associated to a higher baseline MogPWV. CONCLUSIONS: Assessing PWV on the brachial artery using a Mobil-O-Graph is a valid and simple alternative, which, in the dialysis population, is more sensitive for vascular aging than PP. As demonstrated in previous studies PWV correlates to mortality. Among specific CKD risk factors only PTH is associated with a higher baseline PWV. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02327962.

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La esparceta es un tradicional cultivo forrajero de gran importancia en determinadas zonas del nordeste español a cuya mejora agronómica y genética se ha prestado poca atención. El presente trabajo analiza la variabilidad existente en los materiales cultivados en nuestro país del tipo común o de un corte y estudia la existencia de diferencias ecotípicas y su caracterización. Los resultados obtenidos ponen de manifiesto la gran variabilidad existente intra e interpoblacional, diferenciándose perfectamente las esparcetas de uno y dos cortes. La diferenciación dentro de cada uno de estos tipos no es tan clara. La zona más homogénea y mejor caracterizada es la de Teruel.

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We performed a spatiotemporal analysis of a network of 21 Scots pine (Pinus sylvestris) ring-width chronologies in northern Fennoscandia by means of chronology statistics and multivariate analyses. Chronologies are located on both sides (western and eastern) of the Scandes Mountains (67°N-70°N, 15°E-29°E). Growth relationships with temperature, precipitation, and North Atlantic Oscillation (NAO) indices were calculated for the period 1880-1991. We also assessed their temporal stability. Current July temperature and, to a lesser degree, May precipitation are the main growth limiting factors in the whole area of study. However, Principal Component Analysis (PCA) and mean interseries correlation revealed differences in radial growth between both sides of the Scandes Mountains, attributed to the Oceanic-Continental climatic gradient in the area. The gradient signal is temporally variable and has strengthened during the second half of the 20th century. Northern Fennoscandia Scots pine growth is positively related to early winter NAO indices previous to the growth season and to late spring NAO. NAO/growth relationships are unstable and have dropped in the second half of the 20th century. Moreover, they are noncontinuous through the range of NAO values: for early winter, only positive NAO indices enhance tree growth in the next growing season, while negative NAO does not. For spring, only negative NAO is correlated with radial growth.

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