Gender and Health Status Response to Long-Term Oxygen Therapy in COPD Patients

Introduction: The association of gender with health status (HS) response to long-term oxygen therapy (LTOT) in very severe COPD is unclear. The aims of this study were: (1) to compare dyspnea perception and HS between male and female with very severe COPD at baseline and (2) to provide a prospective assessment of HS response to LTOT, according to gender.Patients and methods: Hypoxemic COPD (n =97, age: 65.5 +/- 9.6 years, 53% males) were enrolled in a prospective longitudinal study over 12 months or until death. St. George's Respiratory Questionnaire (SGRQ) and baseline dyspnea index (BDI) were assessed.Results: At baseline, HS impairment and dyspnea sensation were similar between genders. After 12 months of LTOT, women presented improvement in symptom (64.1 +/- 120.6 versus 40.6 +/- 122.9; P < 0.0001) and total SGRQ scores. Men also showed improvement in symptoms after 12 months (62.7 +/- 23.3 versus 49.6 +/- 22.8; P < 0.0005); however, they presented deterioration of activity, impact and total scores during the study period, with markedly decline of activity domain (68.5 +/- 20.0 versus 75.9 +/- 16.9; P = 0.008). BDI did not show significant difference by gender over the study period.Conclusions: Our results show that the HS course in very severe COPD patients differs according to gender, as females show greater response longitudinally to LTOT. (C) 2010 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.

Predictors of first-year survival in patients with advanced COPD treated using long-term oxygen therapy

Little evidence-based guidance is available to aid clinicians in determining short-term prognoses in very severe COPD patients. Therefore, the present study was designed to provide a prospective assessment (1) of the mortality rates and (2) whether the baseline measurements may be determinants of 1-year mortality in hypoxemic COPD patients receiving long-term oxygen therapy (LTOT).Seventy-eight clinically stable patients with advanced COPD treated using LTOT were enrolled in a prospective cohort study. Outcome variable: first-year mortality. Baseline measurements: categorical variables: age (<60 or >= 60 years); gender; body mass index (<20 or >= 20 kg/m(2)); fat-free mass (FFM) index (<16 [men] and <15kg/m(2) [women]; baseline dyspnea index (BDI) (<= 3 or >3); and corticosteroid use. Continuous variables: smoking history; lung function; FFM; fat mass; hemoglobin; hematocrit; arterial blood gases; forearm muscle strength; St. George's Respiratory Questionnaire (SGRQ); and comorbidity score. By the end of 1-year of follow-up, 12 patients (15.4%) had died. Kaplan-Meier curves showed that BDI <= 3 was the only variable associated with higher mortality. Cox proportional hazards analysis revealed that tower PaO2 and SPO2, higher PaCO2 and SGRQ scores were associated with reduced survival. In the multivariate analysis, BDI remained predictive of mortality (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.31-0.81), as did PaO2 (HR, 0.49; 95% CI, 0.26-0.95). These data suggest that readily available parameters as dyspnea intensity and hypoxemia severity may be useful in predicting first-year survival rates in advanced COPD patients receiving LTOT (C) 2007 Elsevier Ltd. All rights reserved.

Antibiotic treatment schemes for very severe community-acquired pneumonia in children: a randomized clinical study

Objective. To compare clinical response to initial empiric treatment with oxacillin plus ceftriaxone and amoxicillin plus clavulanic acid in hospitalized children diagnosed with very severe community-acquired pneumonia (CAP).Methods. A prospective randomized clinical study was conducted among children 2 months to 5 years old with a diagnosis of very severe CAP in the pediatric ward of São Paulo State University Hospital in Botucatu, São Paulo, Brazil, from April 2007 to May 2008. Patients were randomly divided into two groups by type of treatment: an oxacillin/ceftriaxone group (OCG, n = 48) and an amoxicillin/clavulanic acid group (ACG, n = 56). Analyzed outcomes were: time to clinical improvement (fever and tachypnea), time on oxygen therapy, length of stay in hospital, need to widen antimicrobial spectrum, and complications (including pleural effusion).Results. The two groups did not differ statistically for age, sex, symptom duration before admission, or previous antibiotic treatment. Time to improve tachypnea was less among ACG patients than OCG patients (4.8 +/- 2.2 versus 5.8 +/- 2.4 days respectively; P = 0.028), as was length of hospital stay (11.0 +/- 6.2 versus 14.4 +/- 4.5 days respectively; P = 0.002). There were no statistically significant differences between the two groups for fever improvement time, time on oxygen therapy, need to widen antimicrobial spectrum, or frequency of pleural effusion.Conclusions. Both treatment plans are effective in treating very severe CAP in 2-monthto 5-year-old hospitalized children. The only analyzed outcome that favored amoxicillin/clavulanic acid treatment was time required to improve tachypnea.

Short-term vs long-term calcium hydroxide therapy after immediate tooth replantation: a histomorphometric study in monkey's teeth

Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkeys teeth after calcium hydroxide (CH) therapy for 1 and 6 months followed by root canal filling with a CH-based sealer (Sealapex (R)). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15 min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10 days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6 months later, respectively. The animals were euthanized 9 months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P = 0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10 days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy.

Perceptions of laypersons and orthodontists regarding the buccal corridor in long- and short-face individuals

Objective: To determine the perception of orthodontists and laypersons regarding the size of the dark spaces in the buccal corridors and how that affects smile esthetics in individuals with long and short faces.Materials and Methods: Images of eight smiling individuals were modified to create five sizes of dark spaces in the buccal corridors (2%, 10%, 15%, 22%, and 28%) and were submitted to a group of laypersons and a group of orthodontists.Results: Laypersons were more critical in their evaluation than orthodontists. Laypersons could not distinguish the gradation of dark spaces in the buccal corridor unless it was very plain. Orthodontists perceived this gradation beginning at 15%. Female evaluators were more critical than male evaluators in both groups.Conclusions: The presence or absence of dark spaces in the buccal corridors has little influence over smile esthetics. While this aspect must be considered in the orthodontic diagnosis, there is no justification for expanding the buccal corridor to eliminate dark spaces unless they are very evident. (Angle Orthod. 2011;81:86-90.)

Primary tooth length determination in direct digital radiography: An in vivo study

Purpose: the purpose of this in vivo study was to compare the accuracy of primary incisor length determined by direct digital radiography (straight-line measurement and grid superimposition) and measurement of the actual tooth length. Methods. Twenty-two primary maxillary incisors that required extractions were selected from 3- to 5-year-old children. The teeth were radiographed with an intraoral sensor using the long cone technique and a sensor holder (30-cm focus-to-sensor distance). The exposure time was 03 seconds. Tooth length was estimated by using straight-line and grid measurements provided by the distance measurement feature of the Computed Dental Radiography digital dental imaging system. The actual tooth length was obtained by measuring the extracted tooth with G digital caliper. Data were analyzed statistically by Pearson's correlation coefficient and a paired t test. Results: There were statistically significant differences (P=.007) between the 2 measurement techniques and between the actual tooth lengths and grid measurements. There was no statistically significant difference (P=38) between straight-line measurements and actual tooth lengths, showing that the straight-line measurements were more accurate. Underestimation of the actual tooth length, however, occurred in 45% of the straight-line measurements and in 73% of the grid measurements. Conclusion: It is possible to determine primary tooth length in digital radiographs using onscreen measurements with 0 reasonable degree of accuracy.

Short-term changes caused by fire and mowing in Brazilian Campos grasslands with different long-term fire histories

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Manipulation of Rest Period Length Induces Different Causes of Fatigue in Vertical Jumping

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Long- and medium-range components of the nuclear force in quark-model based calculations

Quark-model descriptions of the nucleon-nucleon interaction contain two main ingredients, a quark-exchange mechanism for the short-range repulsion and meson exchanges for the medium- and long-range parts of the interaction. We point out the special role played by higher partial waves, and in particular the (1)F(3), as a very sensitive probe for the meson-exchange pan employed in these interaction models. In particular, we show that the presently available models fail to provide a reasonable description of higher partial waves and indicate the reasons for this shortcoming.

Studying nonlinear effects on the early stage of phase ordering using a decomposition method

Nonlinear effects on the early stage of phase ordering are studied using Adomian's decomposition method for the Ginzburg-Landau equation for a nonconserved order parameter. While the long-time regime and the linear behavior at short times of the theory are well understood, the onset of nonlinearities at short times and the breaking of the linear theory at different length scales are less understood. In the Adomians decomposition method, the solution is systematically calculated in the form of a polynomial expansion for the order parameter, with a time dependence given as a series expansion. The method is very accurate for short times, which allows to incorporate the short-time dynamics of the nonlinear terms in a analytical and controllable way. (c) 2005 Elsevier B.V. All rights reserved.

On the V-type asteroids outside the Vesta family - II. Is (21238) 1995 WV7 a fragment of the long-lost basaltic crust of (15) Eunomia?

Context. The V-type asteroids are associated with basaltic composition. Apart from ( 1459) Magnya, an asteroid that is clearly dynamically and mineralogically unconnected to the Vesta family, all currently known V-type asteroids are either members of the Vesta family, or are hypothesized to be former members of the dynamical family that migrated to their current orbital positions. The recent identification of ( 21238) 1995 WV7 as a V-type asteroid introduces the possibility that a second basaltic asteroid not connected with the Vesta family exists. This asteroid is on the opposite side of the 3: 1 mean motion resonance with respect to Vesta, and it would be very unlikely that a member of the Vesta family of its size (D > 5km) migrating via either the Yarkovsky effect or repeated close encounters with Vesta survived the passage through such a resonance.Aims. In this work we investigate the possibility that ( 21238) 1995 WV7 originated as a fragment of the parent body of the Eunomia family and then migrated via the interplay of the Yarkovsky effect and some powerful nonlinear secular resonances, such as the (s - s(6)) - ( g(5) - g(6)). If (15) Eunomia is, as claimed, a differentiated object whose originally pyroxene-enriched crust layer was lost in a collision that either created the Eunomia family or preceded its formation, can (21238) be a fragment of its long-lost basaltic crust that migrated to the current position?Methods. We mapped the phase space around (21238) and determined which of the nonlinear secular resonances that we identified are stronger and more capable of having caused the current difference in proper i between (21238) and members of the Eunomia family. We simulated the Yarkovsky effect by using the SWIFT-RMVSY integrator.Results. Our results suggest that it is possible to migrate from the Eunomia dynamical family to the current orbital location of ( 21238) via the interplay of the Yarkovsky effect and the (s - s6) - (g5 - g6) nonlinear secular resonance, on time-scales of at least 2.6 Gyr.Conclusions. (15) Eunomia might be the third currently known parent body for V-type asteroids.

Magnetic Field Line Escape: Comparison with Mean Free Path

In the present work, we determine the fraction of magnetic field lines that reach the tokamak wall leaving the plasma surrounded by a chaotic layer created by resonant perturbations at the plasma edge. The chaotic layer arises in a scenario where an integrable magnetic field with reversed magnetic shear is perturbed by an ergodic magnetic limiter. For each considered line, we calculate its connection length, i.e. the number of toroidal turns that the field lines complete before reaching the wall. We represent the results in the poloidal section in which the initial coordinates are chosen. We also estimate the radial profile of the fraction of field lines, for different temperatures, whose connection lengths are smaller than the electron collisional mean free path.

Diversidade da ictiofauna do Alto Rio Paraná: composição atual e perspectivas futuras

É apresentada uma síntese sobre os peixes do Alto Paraná, com base em dados de coleções, dados de literatura e novas coletas. Trezentas e dez espécies, de 11 ordens e 38 famílias, são referidas para a drenagem, aumentando significativamente números anteriores. Dentre as espécies da área, 236 (76,1%) são autóctones, 67 (21,6%) alóctones e sete (2,3%) exóticas. As principais causas de ocorrência de espécies não nativas (alóctones e exóticas) foram a dispersão a partir do baixo Paraná, após a construção do Reservatório de Itaipu e o escape de pisciculturas. A maior parte das espécies referidas (65%) tem porte pequeno, sendo menor que 21 cm de comprimento; dentre essas, a maioria ocorre apenas em riachos e cabeceiras. Apesar da ictiofauna do Alto Paraná ser uma das melhor conhecidas e mais estudadas, o número de espécies descritas ou referidas para a área tem crescido exponencialmente, o que indica que a riqueza apresentada está longe de representar a realidade. de fato, várias novas espécies têm sido descritas nos últimos anos e cerca de 50 novas espécies, já reconhecidas, estão em fase de descrição. A melhoria no conhecimento sobre a ictiofauna do Alto Paraná é proporcional ao número de pesquisadores envolvidos em estudos na bacia e reflete, de modo inequívoco, iniciativas recentes que têm estimulado e incrementado pesquisas taxonômicas, facilitado o acesso ao material depositado em coleções científicas e aumentado as coletas em áreas e ambientes pouco amostrados. Entretanto, mantido o ritmo de descrições de novas espécies ocorrido até agora nessa última década, as 50 novas espécies já reconhecidas estariam descritas apenas dentro de dez anos, um tempo demasiadamente longo. Por essa razão é muito importante que a comunidade científica e os órgãos de fomento encontrem e viabilizem iniciativas de modo a aumentar esse ritmo de descrições de novos táxons e disponibilizar esses novos nomes mais rapidamente.

Errors in nonword repetition: bridging short- and long-term memory

According to the working memory model, the phonological loop is the component of working memory specialized in processing and manipulating limited amounts of speech-based information. The Children's Test of Nonword Repetition (CNRep) is a suitable measure of phonological short-term memory for English-speaking children, which was validated by the Brazilian Children's Test of Pseudoword Repetition (BCPR) as a Portuguese-language version. The objectives of the present study were: i) to investigate developmental aspects of the phonological memory processing by error analysis in the nonword repetition task, and ii) to examine phoneme (substitution, omission and addition) and order (migration) errors made in the BCPR by 180 normal Brazilian children of both sexes aged 4-10, from preschool to 4th grade. The dominant error was substitution [F(3,525) = 180.47; P < 0.0001]. The performance was age-related [F(4,175) = 14.53; P < 0.0001]. The length effect, i.e., more errors in long than in short items, was observed [F(3,519) = 108.36; P < 0.0001]. In 5-syllable pseudowords, errors occurred mainly in the middle of the stimuli, before the syllabic stress [F(4,16) = 6.03; P = 0.003]; substitutions appeared more at the end of the stimuli, after the stress [F(12,48) = 2.27; P = 0.02]. In conclusion, the BCPR error analysis supports the idea that phonological loop capacity is relatively constant during development, although school learning increases the efficiency of this system. Moreover, there are indications that long-term memory contributes to holding memory trace. The findings were discussed in terms of distinctiveness, clustering and redintegration hypotheses.

Vortex lattice of a long superconducting wire with a columnar defect

In the present work we study a long superconducting wire with a columnar defect in the presence of an applied magnetic field. The cross section of the cylinder is assumed to be circular. The field is taken uniform and parallel to the cylinder axis. We use the London theory to investigate the vortex lattice inside the wire. Although this theory is valid in the limit of low vortex density, that is, when the nearest neighbor vortex distance is much larger than the coherence length, we can obtain a reasonable qualitative description of lattice properties. We calculate: (1) the vortex lattice structure using the simulated annealing technique; (2) the magnetization curve as a function of the applied field.