Assessing Strategies for Heart Failure with Preserved Ejection Fraction at the Outpatient Clinic

Background: Heart failure with preserved ejection fraction (HFPEF) is the most common form of heart failure (HF), its diagnosis being a challenge to the outpatient clinic practice. Objective: To describe and compare two strategies derived from algorithms of the European Society of Cardiology Diastology Guidelines for the diagnosis of HFPEF. Methods: Cross-sectional study with 166 consecutive ambulatory patients (67.9±11.7 years; 72% of women). The strategies to confirm HFPEF were established according to the European Society of Cardiology Diastology Guidelines criteria. In strategy 1 (S1), tissue Doppler echocardiography (TDE) and electrocardiography (ECG) were used; in strategy 2 (S2), B-type natriuretic peptide (BNP) measurement was included. Results: In S1, patients were divided into groups based on the E/E'ratio as follows: GI, E/E'> 15 (n = 16; 9%); GII, E/E'8 to 15 (n = 79; 48%); and GIII, E/E'< 8 (n = 71; 43%). HFPEF was confirmed in GI and excluded in GIII. In GII, TDE [left atrial volume index (LAVI) ≥ 40 mL/m2; left ventricular mass index LVMI) > 122 for women and > 149 g/m2 for men] and ECG (atrial fibrillation) parameters were assessed, confirming HFPEF in 33 more patients, adding up to 49 (29%). In S2, patients were divided into three groups based on BNP levels. GI (BNP > 200 pg/mL) consisted of 12 patients, HFPEF being confirmed in all of them. GII (BNP ranging from 100 to 200 pg/mL) consisted of 20 patients with LAVI > 29 mL/m2, or LVMI ≥ 96 g/m2 for women or ≥ 116 g/m2 for men, or E/E'≥ 8 or atrial fibrillation on ECG, and the diagnosis of HFPEF was confirmed in 15. GIII (BNP < 100 pg/mL) consisted of 134 patients, 26 of whom had the diagnosis of HFPEF confirmed when GII parameters were used. Measuring BNP levels in S2 identified 4 more patients (8%) with HFPEF as compared with those identified in S1. Conclusion: The association of BNP measurement and TDE data is better than the isolated use of those parameters. BNP can be useful in identifying patients whose diagnosis of HF had been previously excluded based only on TDE findings.

On the provision of global public goods : experimental evidence on climate change mitigation issues

Magdeburg, Univ., Fak. für Wirtschaftswiss., Diss., 2011

Insulin Resistance, Dyslipidemia and Cardiovascular Changes in a Group of Obese Children

Introduction: Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders. Objectives: To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort. Methods: We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed. Results: There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001) and mean common carotid artery intima-media thickness (r=0.378; p=<0.001). In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern. Conclusions: These results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs.

Document-oriented e-learning components

Magdeburg, Univ., Fak. für Informatik, Diss., 2009

Wideband impedance spectrum analyzer with arbitry fine frequency resolution for in situ sensor applications

Magdeburg, Univ., Fak. für Elektrotechnik und Informationstechnik, Diss., 2009

Novas variedades de Cana-de-Açúcar

The authors carried out joint analyses of data referring to six experiments with varieties of sugar cane, carried out by SEGALLA and ALVAREZ in six locations in the State of S. Paulo, Brasil. The analyses showed that for cane or sugar yield, either for plant-cane or for plant-cane together with the first two ratoons, the best five varieties were CB 40-69, CB 41-76, CB 40-13, CB 40-19 and Co 419. The yield of sugar cane/for all varieties studied is given below, in metric tons produced in plant cane and the first two ratoons. Varieties Yield of sugar cane (tons/hectare) CB 40-69 205.2 CB 41-76 204.5 CB 40-13 199.4 CB 40-19 192.4 Co 419 192.1 CB 38-30 182.1 CB 41-70 181.5 Co 413 177.5 CB 38-22 174.4 CB 36-14 172.8 Co 290 166.6 CB 41-35 147.9 The least significant difference by Tukey's test, at the 5% level of probability, is A = 28.3 metric tons/hectare.

Estudo da broca da cana de açúcar Diatraea saccharalis (Fabr. 1794)

O presente trabalho relaciona-se com o estudo da broca da cana de açúcar, no que se refere à intensidade de infestação e aos danos causados na cultura e na indústria açucareira. A única espécie encontrada nas regiões canavieiras estudadas, foi a Diatraea saccharalis Fabr., 1794 (Crambidae, Lepidoptera). Foram observadas culturas de cana-planta das seguintes variedades: Co 419, CB 41-76 e CB 40-69, nas regiões de Piracicaba, Araras, Santa Bárbasa D'Oeste e Araraquara. A amostragem consistiu na escôlha, ao acaso, de côlmos das 3 variedades citadas, que foram divididos em 3 porções: base, meio e ápice. Foi contado o número total de internódios de cada côlmo e, após a sua secção longitudinal, foram contados os internóidios broqueados em cada porção para se determinar a intensidade de infestação. Para se avaliarem os danos causados pela broca na cultura da cana e na indústria açucareira foram colhidos toletes sadios e broqueados no mesmo talhão; êstes, separadamente, foram pesados e analisados para açúcar provável por cento de cana. A intensidade de infestação média encontrada naquelas localidades para a variedade Co 419 foi de 15,8%, assim distribuída: 6,1% para a base, 6,7% para o meio e 3,0% para o ápice; para a variedade CB 41-76 foi de 21,5% sendo, respectivamente, para aquelas posições, de 6,9, 9,7 e 4,9% e para a variedade CB 40-69 foi de 28,8%, assim distribuida, 8,4, 13,8 e 6.6%. A média geral é de 22,2%. As perdas médias de pêso de cana para as variedades Co 419, CB 41-76 e CB 40-69 foram, respectivamente, de 4,4, 3,2 e 6,7% com uma média geral de 4,8%. As perdas médias de açúcar provável por cento de cana para as variedades Co 419, CB 41-76 e CB 40-69 foram, respectivamente, de 1,6 4,1 e 6,7¾, com uma média geral de 4,1%. Êstes danos representam uma perda estimada em 106.075 toneladas de cana na cultura, além de 133.166 sacas de açúcar (de 60 kg) na industria açucareira, para as 5 usinas estudadas e, na safra de 1960/61. Êstes dois dados estão relacionados com a intensidade de infestação média observada, de 22,2%.

Entwicklung eines Planetengetriebes für die Laufkatze eines Brückenkranes

Der Hauptinhalt der Bachelorarbeit ist die Konstruktion des Planetengetriebes. Das konstruierte Getriebe stellt eine Kombination aus einem Planeten- und zweistufigem Stirnradgetriebe dar. Die Vorteile des Planetengetriebes sind ein kleines Volumen, eine geringes Gewicht, eine hohe Übertragungsleistung und eine große Übersetzungswerte usw. Die Kombination von beiden Getrieben erzeugt ein neues Getriebe, das die Belastungsfähigkeit des Krans erhöht. Zum Heben von Schwerlast-Maschinen wird dieses Getriebe benötigt. Am Anfang werden die Hauptparameter des Getriebes festgelegt, z.B. Übersetzung, Motorleistung, Lebensdauer und Getriebeart. Zum Anschluss erfolgten die Konstruktion und die Berechnungen der Zahnräder, Wellen und Lager auf Festigkeit und Lebensdauer. Wichtig ist die Überprüfung der Montagebedingungen und die Festigkeit der Verzahnung von Planetengetrieben. Bei der Konstruktion der Bauteile mit CATIA wurden die Montage- und Fertigungsbedingung berücksichtigt.

Efeitos isolado e combinado de nitrogênio, fósforo e potássio no desenvolvimento do girassol (Helianthus annuus L.)

O efeito de doses crescentes de nitrogênio, fósforo e potássio, bem como de suas interações, no desenvolvimento de plantas de girassol, variedade Uruguai, foi estudado através de um experimento em vasos, como solo LVa, em Botucatu, SP. O nitrogênio e o fósforo, tanto isoladamente como em combinações influíram decisivamente nos parâmetros estudados, a saber, altura, numero de folhas, pesos de matéria seca e matéria verde das diferentes partes da planta. A influência do potássio foi relativamente pequena e verificada nos pesos de matéria seca do caule e de matéria seca da parte aérea total das plantas e no peso da água dos limbos foliares; esta influência foi constatada apenas quando em presença da dose mais alta de fósforo (166 ppm de P).

Nutrição mineral das hortaliças: LXXXVIII. Extração de nutrientes em alho-porró (Allium porrum)

Com a finalidade de estudar a extração de macro e micronutrientes durante o desenvolvimento do alho-porró, em condições de campo, foi feita a coleta de materiais a cada 20 dias, num ciclo total de 170 dias, quando cada planta atingiu o peso de 12,87 g de matéria-seca. Para uma população de 166.667 plantas por ha, a quantidade de nutrientes extraídos foi: N-115,36 kg, P-7,88 kg, K-55,16 kg, Ca-13,14 kg, Mg-7,69 kg, S-7,10 kg, B-38,89g, Cu-17,77 g, Fe-1165,49 g, Mn-52,09 g e Zn-47,15 g.

Biologia reprodutiva de Apidoras fuscoguttatus (Siluriformes, Callichthyidae) em riacho de cabeceira da bacia do alto Rio Paraná

The reproductive biology of Aspidoras fuscoguttatus Nijssen & Isbrücker, 1976 from a stream in São José do Rio Preto, northwestern São Paulo State, Brazil, was monthly investigated in the period of August 1999 to July 2000. Measurements of total length, body weight, gonadal weight and macroscopic assessment of gonadal maturation were performed. Environmental parameters were considered in order to verify associations with the reproductive period. Populational structure showed total length amplitude between 14.2 and 50.8 mm. Pronounced sexual dimorphism was verified. The largest mean values of gonadosomatic relation for females coincided with the rainy season (November to March). Mean length at first sexual maturity was different for males (30.5 mm) and females (37.1 mm). Fecundity varied between 51 and 166 oocytes. Gonadal maturation curve, frequency of maturation stages and size frequency distributions of oocytes in mature ovaries revealed a long reproductive period, suggesting fractional spawning.

Relative growth and morphological sexual maturity of Chasmagnathus granulatus (Crustacea, Varunidae) from a mangrove area in southeastern Brazilian coast

The relative growth and morphological sexual maturity of Chasmagnathus granulatus Dana, 1851 are presented for the first time to a mangrove population. The crabs were obtained during low tide periods, in the mangrove of Jabaquara Beach, Paraty, Rio de Janeiro, Brazil. All crabs in intermolt stage were sexed and had their body parts measured as follows: body height (BH), carapace length (CL) and width (CW), major cheliped propodus height (PH) and length (PL) for each sex, gonopod length (GL) and abdomen width (AW) for males and females, respectively. The relative growth was described using the allometric equation y=ax b and the size at onset sexual maturity was achieved using the software Mature I. The size of specimens ranged from 4.1 mm to 39.5 mm CW. The growth pattern was different between sexes in the cheliped relationships; the relationships BH vs. CW evidenced positive allometry for juveniles; PL vs. CW and PH vs. CW positive allometry for most crabs except juvenile females; AW vs. CW and GL vs. CW evidenced positive allometry for juveniles and isometry for adults. The relationships that best indicated the change from the juvenile to the adult phase were PH vs. CW for males and AW vs. CW for females. The size in which 50% of males from this population are mature is at 19.7 mm of CW (F=144.14; p<0.05) and for females it is at 19.2 mm of CW (F=166.54; p<0.05). The sizes obtained in this mangrove population are larger than those from previous studies, that could be attributed to a species plasticity concerning the habitat structure.

Access as a motivational device: implications for human resource management

This paper analyzes the employment relationship on the basis of the notion of access. We argue that the degree of access provided by a job is an incentive to activate the employee’s self-actualization needs. We investigate the effect of access on the workers’ performance through an agency model and provide a number of propositions with practical implications for personnel policies. Our results are consistent with the intuition emerged from the real business practice as well as with many of the arguments on the substitutive role between monetary and non-monetary incentives frequently reported in the literature.

Ensaios terapêuticos com penicilina V-Bouba (Framboesia, pian, yaws): I - Dose curatina mínima: II - Redução do número de injeções diarias: III - Redução de tempo de tratamento pelo emprêgo de doses mais elevadas

This report belongs to the series of works carried out Oswaldo Cruz Ins¬titute, on the treatment of treponematosis with penicillin. The present report deals with investigations performed in order to ascer¬tain the following points: 1) the mininal curative dosis for the initial lesions of yaws; 2) the effect of reduction of the number of injections each day, to verifie the possibility of application of penicillin in the prophylaxis of yaws in rural zones; 3) reduction of the time of treatment by application of high dosis. 1) With dosis of 150 and 100 Oxford units each four hours, clinical reco¬very was obtained after 17 days of treatment. With 50 O.u. during 40 days clinical recovery was not obtained. 2) a) With 3 injections of 400 O.u. each day (6,12 and 18 hoórs clocks) clinical recovery was obtained after 14 to 16 days; b) with 2 injections of 400 O.u. each day (6 and 18 hoors clocks), clinical recovery was obtained after 16 to 23 days; c) with 1 injection of 1.600 and 3.200 each day, clinical recovery was obtained after 30 and 20 days. 3) With dosis of 33.3 and 46.7 O.u. by each kilo of weight each four hours, during 15 days, clinical recovery was obtained more or less in 25 days. The same result was obtained with the dosis of 61.5 and 166.7 O.u. by each kilo of weight, each four hours, during 4 days. But with 100.000 O.u. in fine dosis of 20.000 in a day ou by, clinical recovery was not obtained.