Atypical depression and alcohol misuse are related to the cardiovascular risk in the general population.

OBJECTIVE: The aims of the present study were to assess the associations between mood, anxiety and substance use disorders, including their subtypes, and the prevalence of cardiovascular risk factors (CVRFs). METHOD: Thorough physical investigations, biological measures and standardized interview techniques were used to assess 3716 subjects of an urban area, aged 35-66 years. RESULTS: Atypical depression was associated with increased prevalence of overweight, diabetes and the metabolic syndrome (OR = 1.5, 95% C.I. 1.1-2.0; OR = 2.0, 95% C.I. 1.1-3.5, OR = 1.6, 95% C.I. 1.0-2.4 respectively), whereas decreased prevalence of overweight was found in melancholic (OR = 0.7, 95% C.I. 0.6-0.9) and unspecified depression (OR = 0.8, 95% C.I. 0.7-1.0). Alcohol abuse was associated with diabetes (OR = 1.8, 95% C.I. 1.1-2.9) and dyslipidemia (OR = 1.3, 95% C.I. 1.0-1.8), alcohol dependence with dyslipidemia only (OR = 1.4, 95% C.I. 1.0-2.0). Almost all mental disorders were associated with a lifetime history of regular cigarette smoking, and atypical depression, alcohol misuse and drug dependence were associated with inactivity. CONCLUSION: To conclude results emphasize the need to subtype depression and to pay particular attention to the atypical subtype. Comorbid alcohol misuse may further increase the cardiovascular risk. Efforts to diminish smoking in subjects with mental disorders could be crucial measures to reduce their high incidence of cardiovascular disease.

Epidémiologie des traumatismes sportifs de l'enfant et de l'adolescent

Résumé Introduction: Les accidents sont la première cause de mortalité et de morbidité chez les enfants et les adolescents des deux sexes dès le premier mois de vie. Ils ne sont pas le fruit du hasard et ne devraient plus être considérés comme une fatalité. Leur nombre peut être réduit de façon substantielle par une bonne compréhension des processus accidentels et une information adéquate des intervenants. Cependant, les stratégies de prévention doivent se fonder sur une analyse locale de la situation. C'est pourquoi nous avons développé en 1990 un programme d'enregistrement prospectif des accidents d'enfants et d'adolescents. Le présent travail a pour but d'analyser l'épidémiologie de la traumatologie sportive de l'enfant et de l'adolescent. Matériel et méthode: Nous disposons d'un programme d'enregistrement prospectif des accidents d'enfants et d'adolescents de 0 à 16 ans survenus dans le canton de Vaud, Suisse. De 1990 à 2000, nous avons enregistré 24'900 traumatismes aux urgences du Service de chirurgie pédiatrique du CHUV de Lausanne, dont 6'890 (28%) étaient des traumatismes sportifs. Les informations collectées dans cette étude concernent la date de l'accident, l'âge du patient, le sport pratiqué, le type de lésion(s) et le type de suivi (traitement ambulatoire, hospitalisation, etc) et permettent une analyse de l'épidémiologie de la traumatologie sportive de l'enfant sur 11 ans. Résultats: Nette prédominance masculine (1.6 :1). Plus de 50% des enfants ont entre 12 et 15 ans. Vélo, gymnastique et football dominent, représentant à eux seuls 45% des cas. La fréquence des accidents obéit, selon le sport concerné, à un rythme saisonnier et dépendant des vacances. Certaines activités comme la trottinette ou le snowboard apparaissent soudain à la faveur d'une mode. Le ski occasionne 48% de lésions des membres inférieurs, le roller 56% de lésions des membres supérieurs, le basket-ball 57% de lésions de la main, la natation et le plongeon 53% de lésions de la tête ou de la colonne cervicale. Les contusions représentent 27% des consultations. La fracture la plus courante est celle de l'avant-bras, représentant 34% des fractures de membres. Les fractures de la main représentent 69% des fractures de membres au basket-ball, contre 3% dans l'équitation où les fractures de l'humérus prédominent (42%). 10% des patients sont hospitalisés, et 55% seront revus ambulatoirement. Discussion: Chaque sport occasionne des lésions dont le type et la localisation lui sont propres et qui permettent dans la plupart des cas de reconnaître le mécanisme lésionnel et de déterminer des stéréotypes. Conclusion: Une meilleure connaissance des lésions occasionnées par chaque sport devrait permettre le développement de programmes de prévention mieux adaptés. Ils doivent associer le plus grand nombre de partenaires possibles, issus de tous les milieux et passant par une information de ceux-ci.

Uso do 1-metilciclopropeno no controle da maturação de maçãs cv. 'Royal Gala'

Avaliou-se o efeito do 1-metilciclopropeno (1-MCP) no controle da maturação de maçãs 'Royal Gala'. As frutas foram colhidas em dois estádios de maturação caracterizados como: estádio de maturação 1, com frutas apresentando firmeza de polpa de 82,14 N, acidez total titulável de 0,36 % de ácido málico, teor de sólidos solúveis totais de 14,10 ºBrix e produção de etileno de 2,00 nL.g-1.h-1, e estádio de maturação 2, com maçãs apresentando firmeza de polpa de 79,96 N, acidez total titulável de 0,33 % de ácido málico, teor de sólidos solúveis totais de 13,74 ºBrix e produção de etileno de 17,11 nL.g-1.h-1. Foram testadas quatro concentrações de 1-MCP: 0; 312; 625 e 1250 nL.L-1. A aplicação foi efetuada durante 48 horas, à temperatura de 20 ± 2 ºC, em câmaras com capacidade para 300 L. Após a aplicação, as frutas foram armazenadas a 20 ± 2 ºC, por 60 dias. A cada 10 dias, avaliaram-se a firmeza de polpa, a acidez total titulável, o teor de sólidos solúveis totais e a produção de etileno. O 1-MCP reduziu a produção de etileno nas maçãs e retardou a ocorrência do pico climatérico, independentemente do estádio de maturação e da concentração do produto. Em conseqüência, preservou maiores valores de firmeza de polpa e acidez total titulável.

Persistence of Transmitted HIV-1 Drug Resistance Mutations Associated with Fitness Costs and Viral Genetic Backgrounds.

Transmission of drug-resistant pathogens presents an almost-universal challenge for fighting infectious diseases. Transmitted drug resistance mutations (TDRM) can persist in the absence of drugs for considerable time. It is generally believed that differential TDRM-persistence is caused, at least partially, by variations in TDRM-fitness-costs. However, in vivo epidemiological evidence for the impact of fitness costs on TDRM-persistence is rare. Here, we studied the persistence of TDRM in HIV-1 using longitudinally-sampled nucleotide sequences from the Swiss-HIV-Cohort-Study (SHCS). All treatment-naïve individuals with TDRM at baseline were included. Persistence of TDRM was quantified via reversion rates (RR) determined with interval-censored survival models. Fitness costs of TDRM were estimated in the genetic background in which they occurred using a previously published and validated machine-learning algorithm (based on in vitro replicative capacities) and were included in the survival models as explanatory variables. In 857 sequential samples from 168 treatment-naïve patients, 17 TDRM were analyzed. RR varied substantially and ranged from 174.0/100-person-years;CI=[51.4, 588.8] (for 184V) to 2.7/100-person-years;[0.7, 10.9] (for 215D). RR increased significantly with fitness cost (increase by 1.6[1.3,2.0] per standard deviation of fitness costs). When subdividing fitness costs into the average fitness cost of a given mutation and the deviation from the average fitness cost of a mutation in a given genetic background, we found that both components were significantly associated with reversion-rates. Our results show that the substantial variations of TDRM persistence in the absence of drugs are associated with fitness-cost differences both among mutations and among different genetic backgrounds for the same mutation.

Stereotactic body radiotherapy with helical TomoTherapy for medically inoperable early stage primary and second-primary non-small-cell lung neoplasm: 1-year outcome and toxicity analysis.

OBJECTIVE: This study investigated the effectiveness of stereotactic body radiotherapy with helical TomoTherapy (T-SBRT) for treating medically inoperable primary and second-primary early stage non-small-cell lung neoplasm (SPLN) and evaluated whether the movement of organizing pneumonia (OP) within the irradiation field (IF) can be detected via analysis of radiological changes. METHODS: Patients (n = 16) treated for 1 year (2011-12) at our hospital by T-SBRT at a total dose of 60 Gy in five fractions were examined retrospectively. Outcome and toxicity were recorded and were separately described for SPLN. CT scans were reviewed by a single radiologist. RESULTS: Of the 16 patients, 5 (31.3%) had primary lung malignancies, 10 (62.5%) had SPLN, and 1 case (6.3%) had isolated mediastinal metastasis of lung neoplasm. Pathological evidence was obtained for 72.2% of all lesions. The median radiological follow-up was 11 months (10.5 months for SPLN). For all cases, the 6- and 12-month survival rates were 100% and 77.7% (100% and 71.4%, respectively, for SPLN), and the 6- and 12-month locoregional control rates were 100% in all cases. 2 (12.5%) of 16 patients developed grade 3 late transient radiation pneumonitis following steroid therapy and 1 (6.3%) presented asymptomatic infiltrates comparable to OP opacities. CONCLUSION: T-SBRT seems to be safe and effective. ADVANCES IN KNOWLEDGE: Mild OP is likely associated with radiation-induced anomalies in the IF, identification of migrating opacities can help discern relapse of radiation-induced opacities.

Compostos bioativos presentes em amora-preta (Rubus spp.)

A amora-preta (Rubus spp.), pequena fruta de clima temperado, possui coloração atraente, variando do vermelho púrpura ao azul, devido ao elevado teor de antocianinas. As antocianinas, juntamente com os carotenoides, compõem os pigmentos naturais, majoritários encontrados em diversas frutas. Diversos estudos têm relatado a importância destes pigmentos naturais como protetores e/ou inibidores de doenças degenerativas, porém são escassos os estudos sobre compostos bioativos presentes em amora-preta cultivada no Brasil. Os objetivos do presente estudo foram identificar as antocianinas e os carotenoides presentes em amora-preta, determinar os conteúdos totais de compostos fenólicos, carotenoides, flavonoides, antocianinas totais, monoméricas, poliméricas e copigmentadas, e a capacidade antioxidante frente aos radicais livres ABTS e DPPH. O teor total de carotenoides foi baixo (86,5 ± 0,2 µg/100 g), com all-trans-β-caroteno (39,6 %) e all-trans-luteína (28,2 %) como os majoritários. As amoras-pretas apresentaram elevado potencial antioxidante principalmente pelo teor representativo de antocianinas monoméricas (104,1 ± 1,8 mg/100 g de fruto), presença de antocianinas poliméricas (22,9 ± 0,4 %), baixa porcentagem de antocianinas copigmentadas (1,6 ± 0,1 %) e altos teores de compostos fenólicos (241,7 ± 0,8 mg equivalente de ácido gálico/100 g) e de flavonoides totais (173,7 ± 0,7 mg equivalente de catequina/100 g). Cianidina 3-glucosídeo foi a antocianina majoritária (92,9 %). Diante destes resultados, a amora-preta pode ser considerada uma fonte natural rica em antioxidantes e pigmentos.

Safety profile of prasugrel and clopidogrel in patients with acute coronary syndromes in Switzerland.

OBJECTIVE: To assess safety up to 1 year of follow-up associated with prasugrel and clopidogrel use in a prospective cohort of patients with acute coronary syndromes (ACS). METHODS: Between 2009 and 2012, 2286 patients invasively managed for ACS were enrolled in the multicentre Swiss ACS Bleeding Cohort, among whom 2148 patients received either prasugrel or clopidogrel according to current guidelines. Patients with ST-elevation myocardial infarction (STEMI) preferentially received prasugrel, while those with non-STEMI, a history of stroke or transient ischaemic attack, age ≥75 years, or weight <60 kg received clopidogrel or reduced dose of prasugrel to comply with the prasugrel label. RESULTS: After adjustment using propensity scores, the primary end point of clinically relevant bleeding events (defined as the composite of Bleeding Academic Research Consortium, BARC, type 3, 4 or 5 bleeding) at 1 year, occurred at a similar rate in both patient groups (prasugrel/clopidogrel: 3.8%/5.5%). Stratified analyses in subgroups including patients with STEMI yielded a similar safety profile. After adjusting for baseline variables, no relevant differences in major adverse cardiovascular and cerebrovascular events were observed at 1 year (prasugrel/clopidogrel: cardiac death 2.6%/4.2%, myocardial infarction 2.7%/3.8%, revascularisation 5.9%/6.7%, stroke 1.0%/1.6%). Of note, this study was not designed to compare efficacy between prasugrel and clopidogrel. CONCLUSIONS: In this large prospective ACS cohort, patients treated with prasugrel according to current guidelines (ie, in patients without cerebrovascular disease, old age or underweight) had a similar safety profile compared with patients treated with clopidogrel. CLINICAL TRIAL REGISTRATION NUMBER: SPUM-ACS: NCT01000701; COMFORTABLE AMI: NCT00962416.

V0 production in p+A collisions at √s = 41.6 GeV

Inclusive doubly differential cross sections d 2 σ pA /dx F   dp T 2 as a function of Feynman-x (x F ) and transverse momentum (p T ) for the production of K S 0 , Λ and Λ¯ in proton-nucleus interactions at 920 GeV are presented. The measurements were performed by HERA-B in the negative x F range (−0.12

Copeptin is associated with kidney length, renal function, and prevalence of simple cysts in a population-based study.

Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P<0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (β=-2.1; 95% confidence interval [95% CI], -3.3 to -0.8; P=0.002) and kidney length (β=-1.2; 95% CI, -1.9 to -0.4; P=0.003) but positively with 24-hour urinary albumin excretion (β=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (β=0.08; 95% CI, 0.05 to 0.10; P<0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts.

Caracterização biométrica, física e química de frutos da palmeira bocaiuva Acrocomia aculeata (Jacq) Lodd

Frutos de palmeira bocaiuva (Acrocomia aculeata (Jacq.) Lodd.), coletados em Dourados (MS) e Presidente Epitácio (SP), foram analisados quanto ao aspecto biométrico, a composição química e as características físicas, visando a avaliar seu potencial alimentício. Os frutos de bocaiuva das regiões de procedência não apresentaram diferenças significativas entre si nas características biométricas. O rendimento médio da polpa foi de 42% em relação ao fruto inteiro, sendo superior ao encontrado na literatura para outros frutos de palmeiras. As determinações físicas e químicas da polpa dos frutos das regiões de Mato Grosso do Sul e São Paulo caracterizam a polpa como sendo pouco ácida (pH 5,70 a 6,29). As amostras de Dourados - MS, foram consideradas mais doces (14,53% de açúcares redutores totais) e com maior teor de vitamina C (34,57 mg.100 g-1) em relação às amostras de Presidente Epitácio-SP (11,46 mg.100 g-1). Porém, a intensidade da cor amarelo-laranja foi maior na polpa dos frutos de Presidente Epitácio (SP), sugerindo maior conteúdo de carotenoides.

Composição de carotenoides em passifloras do cerrado

O objetivo foi avaliar, por HPLC, a composição qualitativa e quantitativa de carotenoides em maracujás do cerrado. Frutos procedentes de acessos nativos de quatro espécies (Passiflora cincinnata, P. nitida, P. setacea e P. edulis) foram analisados, utilizando, como referência, o maracujá-amarelo comercial (P. edulis). As polpas de maracujá apresentaram neoxantina, violaxantina, cis-violaxantina, anteraxantina, luteína, zeaxantina, β-criptoxantina, poli-cis-caroteno, prolicopeno, cis-ζ-caroteno, trans-ζ-caroteno, trans-β-caroteno, 13-cis-β-caroteno e fitoflueno. Em geral, os teores de carotenoides entre as espécies e entre os acessos da mesma espécie foram significativamente diferentes. A espécie P. edulis apresentou o maior número de carotenoides, com diferença entre os acessos. Em um acesso de P. edulis comercial, foi encontrado o trans-β-caroteno como o carotenoide principal (7,8±0,8 µg g-1) e no outro o trans-ζ-caroteno (11,4±0,4 µg g-1). Dois acessos de P. edulis nativos do Cerrado apresentaram cis-ζ-caroteno como carotenoide majoritário (6,28±0,15 µg g-1 e 12,1±0,7 µg g-1, casca amarela e roxa, respectivamente). O perfil de carotenoides em frutos de espécies de maracujá apresentou diversidade de composição, com potencial de uso para melhoramento genético para agregar maior valor ao produto e estimular o seu consumo.

Extração e caracterização do amido de diferentes genótipos de bananeira

A banana, uma das principais herbáceas cultivadas em grande quantidade no mundo e importante fonte de energia para as pessoas, tem obtido interesse como matéria-prima para a produção de farinha e fécula para uso alimentício e outros fins industriais, devido ao elevado conteúdo de amido nos frutos verdes. O trabalho teve como objetivo caracterizar os frutos verdes de sete genótipos de bananeira quanto à composição química e avaliar o conteúdo de amilose, propriedades de pasta e térmicas dos amidos destes genótipos. Os resultados obtidos mostraram diferenças significativas na composição química dos frutos, com maior teor de amido na cultivar Figo Cinza. As análises dos amidos mostraram valores de amilose de 26,68 a 33,95% e propriedades de pasta com elevado pico de viscosidade, baixa resistência à temperatura e agitação (quebra de viscosidade) e tendência à retrogradação para todos os amidos. Nas propriedades térmicas, os amidos mostraram um endoderma, temperatura de gelatinização na faixa de 60 a 73ºC com DH variando de 11,6 a 16,99 J g-1 na gelatinização e 4,11 a 7,97 J g-1 na retrogradação.

Caracterização fenólica das uvas 'Alicante' e 'Syrah' cultivadas em safra fora de época

O objetivo do trabalho foi caracterizar a evolução da maturação fenólica das videiras 'Alicante' e 'Syrah' (Vitis vinifera L.) cultivadas fora de época. A área experimental foi instalada em uma propriedade pertencente à Vinícola Intervin®, localizada em Maringá-PR. Os vinhedos foram estabelecidos em julho de 2001, e as plantas foram conduzidas no sistema latada (4,0 x 1,5 m), enxertadas sobre o porta-enxerto IAC 766 'Campinas'. As podas curtas de formação (duas gemas) foram realizadas no fim do mês de agosto de 2007 e 2008, e as podas longas de produção (oito gemas) foram realizadas no fim de fevereiro de 2008 e 2009. As avaliações foram realizadas em duas safras fora de época (2008 e 2009), a partir do início da maturação das uvas até sete dias após a colheita. Foram utilizadas 20 plantas representativas de cada variedade. Para a evolução da maturação fenólica das uvas, foi determinado o teor de antocianinas e o índice de polifenóis totais (IPT) do mosto das bagas. Por ocasião da colheita, foi avaliado o teor de resveratrol do mosto das uvas. Para a 'Alicante', a média do teor de antocianinas foi de 55,4 mg 100g-1, IPT de 474,0 mg 100g-1 e teor de resveratrol de 7,6 µg g-1. Para a 'Syrah', observou-se teor médio de antocianinas de 44,8 mg 100g-1, IPT de 487,7 mg 100g-1 e teor de resveratrol de 6,4 µg g-1. Considera-se que a evolução da maturação fenólica das uvas estudadas neste trabalho (progressiva para antocianinas e oscilatória para IPT) e o teor dos compostos fenólicos no momento da colheita são adequados para que estas sejam utilizadas como matéria-prima na elaboração de vinhos finos.

Assessment of subjective and hemodynamic tolerance of different high- and low-flux dialysis membranes in patients undergoing chronic intermittent hemodialysis: a randomized controlled trial.

Clinical experience and experimental data suggest that intradialytic hemodynamic profiles could be influenced by the characteristics of the dialysis membranes. Even within the worldwide used polysulfone family, intolerance to specific membranes was occasionally evoked. The aim of this study was to compare hemodynamically some of the commonly used polysulfone dialyzers in Switzerland. We performed an open-label, randomized, cross-over trial, including 25 hemodialysis patients. Four polysulfone dialyzers, A (Revaclear high-flux, Gambro, Stockholm, Sweden), B (Helixone high-flux, Fresenius), C (Xevonta high-flux, BBraun, Melsungen, Germany), and D (Helixone low-flux, Fresenius, Bad Homburg vor der Höhe, Germany), were compared. The hemodynamic profile was assessed and patients were asked to provide tolerance feedback. The mean score (±SD) subjectively assigned to dialysis quality on a 1-10 scale was A 8.4 ± 1.3, B 8.6 ± 1.3, C 8.5 ± 1.6, D 8.5 ± 1.5. Kt/V was A 1.58 ± 0.30, B 1.67 ± 0.33, C 1.62 ± 0.32, D 1.45 ± 0.31. The low- compared with the high-flux membranes, correlated to higher systolic (128.1 ± 13.1 vs. 125.6 ± 12.1 mmHg, P < 0.01) and diastolic (76.8 ± 8.7 vs. 75.3 ± 9.0 mmHg; P < 0.05) pressures, higher peripheral resistance (1.44 ± 0.19 vs. 1.40 ± 0.18 s × mmHg/mL; P < 0.05) and lower cardiac output (3.76 ± 0.62 vs. 3.82 ± 0.59 L/min; P < 0.05). Hypotension events (decrease in systolic blood pressure by >20 mmHg) were 70 with A, 87 with B, 73 with C, and 75 with D (P < 0.01 B vs. A, 0.05 B vs. C and 0.07 B vs. D). The low-flux membrane correlated to higher blood pressure levels compared with the high-flux ones. The Helixone high-flux membrane ensured the best efficiency. Unfortunately, the very same dialyzer correlated to a higher incidence of hypotensive episodes.

Coronary vasomotor responses to isometric handgrip exercise are primarily mediated by nitric oxide: a noninvasive MRI test of coronary endothelial function.

Endothelial cell release of nitric oxide (NO) is a defining characteristic of nondiseased arteries, and abnormal endothelial NO release is both a marker of early atherosclerosis and a predictor of its progression and future events. Healthy coronaries respond to endothelial-dependent stressors with vasodilatation and increased coronary blood flow (CBF), but those with endothelial dysfunction respond with paradoxical vasoconstriction and reduced CBF. Recently, coronary MRI and isometric handgrip exercise (IHE) were reported to noninvasively quantify coronary endothelial function (CEF). However, it is not known whether the coronary response to IHE is actually mediated by NO and/or whether it is reproducible over weeks. To determine the contribution of NO, we studied the coronary response to IHE before and during infusion of N(G)-monomethyl-l-arginine (l-NMMA, 0.3 mg·kg(-1)·min(-1)), a NO-synthase inhibitor, in healthy volunteers. For reproducibility, we performed two MRI-IHE studies ∼8 wk apart in healthy subjects and patients with coronary artery disease (CAD). Changes from rest to IHE in coronary cross-sectional area (%CSA) and diastolic CBF (%CBF) were quantified. l-NMMA completely blocked normal coronary vasodilation during IHE [%CSA, 12.9 ± 2.5 (mean ± SE, placebo) vs. -0.3 ± 1.6% (l-NMMA); P < 0.001] and significantly blunted the increase in flow [%CBF, 47.7 ± 6.4 (placebo) vs. 10.6 ± 4.6% (l-NMMA); P < 0.001]. MRI-IHE measures obtained weeks apart strongly correlated for CSA (P < 0.0001) and CBF (P < 0.01). In conclusion, the normal human coronary vasoactive response to IHE is primarily mediated by NO. This noninvasive, reproducible MRI-IHE exam of NO-mediated CEF promises to be useful for studying CAD pathogenesis in low-risk populations and for evaluating translational strategies designed to alter CAD in patients.