Therapeutic approach to patients complaining of high blood pressure in a cardiological emergency room

OBJECTIVE: To evaluate the management of patients complaining of high blood pressure (BP) in a cardiological emergency room. METHODS: Patients referred to the cardiological emergency room with the main complaint of high blood pressure were consecutively selected. The prescriptions and the choice of antihypertensive drugs were assessed. The classification of these patients as hypertensive emergencies or pseudoemergencies, according to the physician who provided initial care, was recorded. RESULTS: From a total of 858 patients presenting to the emergency room, 80 (9.3%) complained of high BP, and 61 (76.3%) received antihypertensive drugs. Sublingual nifedipine was the most commonly used drug (59%). One patient received intravenous medication, one patient was hospitalized and 6 patients (7.5%) were classified as hypertensive emergencies or pseudoemergencies. CONCLUSION: High BP could seldom be classified as a hypertensive emergency or pseudoemergency, even though it was a frequent complaint (9.3% of visits). Currently, the therapeutic approach is not recommended, even in specialized clinics.

Rheumatic carditis treated with high doses of pulsetherapy methylprednisolone. Results in 70 children over 12 years

PURPOSE: To report the result of patients treated with IV methylprednisolone divided into three groups and compare their follow-up during the last 12 years. METHODS: Seventy children with active rheumatic carditis (76 episodes) in heart failure Class III and IV (NYHA) were studied. The diagnosis was based on modified Jones' criteria. After ruling out infections and strongyloidiasis, treatment with IV methylprednisolone bolus was started three times a week until the laboratory tests became negative. Patients were divided into 3 groups, according to the time of hospital admittance: Groups 1, 2 and 3, comprising of 40, 18 and 12 children, respectively. RESULTS: Eighteen children in Group 1 (45%) were in their 1st attack: 2 series of pulsetherapy were used in 10 (25%), 3 in 9 (23%) and 4 in 21 (52%). In Group 2, 14 cases (77%) were in their 1st attack: 2 series were used in 7 (39%), 4 in 9 (50%) and 5 in 2 (11%). The echocardiogram showed a flail mitral valve in 12 (66%) of these patients (1 death occurred after mitral valvoplasty). In Group 3, 6 patients needed 5 or more series of pulsetherapy and a flail mitral valve was present in 5 (41%). One child underwent mitral valve replacement while still in the active phase, after 8 series of pulsetherapy, and another died. The number of patients who needed 5 or more series was significantly higher in Group 3. CONCLUSION: There were variations in the presentation and evolution of the cases during these 12 year. The established pulsetherapy protocol continues to be useful to treat severe cases.

A new sector of Via XVII Necropolis in Bracara Augusta: the High Empire phase

Between 2008 and 2009 a preventive excavation supervised by the Unit of Archaeology of the University of Minho was conducted in an area with approximately 5000 square meters allowing the identification of a wide sector of the Via XVII necropolis, which is one of the five roman necropolises known to have existed in Bracara Augusta. The findings enabled us to define a typological framework related with incinerations, to understand the internal organization of the necropolis and recover the ritual marks of the funerary practices between the first century BC and the second century AD.

Laboratory assessment of the hypertensive individual. Value of the main guidelines for high blood pressure

OBJECTIVE: To determine if abnormal laboratory findings are more common in individuals with hypertension and in those with other risk factors, such as obesity, smoking and alcohol ingestion. METHODS: A study was carried out in the general outpatient clinics of a university hospital (145 individuals without previous diagnosis of hypertension) and the following variables were assessed: high blood pressure (as defined by the VI Joint National Committee on Prevention, Detection and Treatment of High Blood Pressure - VI JNC), obesity [calculated using body mass index (BMI)], tobacco use, and alcoholic ingestion. The laboratory examinations consisted of the following tests: hemogram, glycemia, uric acid, potassium, total/HDL-fraction cholesterol, triglycerides, calcium and creatinine. RESULTS: High blood pressure was not associated with a higher number of abnormal laboratory tests. Hypertensive individuals with a BMI > or = 25kg/m² or normotensive obese individuals, however, had a higher frequency of diabetes (12X), hypertriglyceridemia (3X), and hypercholesterolemia (2X), as compared with hypertensive individuals with BMI <25kg/m² and preobese/normal weight normotensive individuals. CONCLUSION: High blood pressure is not associated with a higher frequency of abnormal laboratory tests. The association of high blood pressure and obesity, however, increases the detection of diabetes and dyslipidemias.

Tapping the wealth of microbial data in high-throughput metabolic model reconstruction

Genome-scale metabolic models are valuable tools in the metabolic engineering process, based on the ability of these models to integrate diverse sources of data to produce global predictions of organism behavior. At the most basic level, these models require only a genome sequence to construct, and once built, they may be used to predict essential genes, culture conditions, pathway utilization, and the modifications required to enhance a desired organism behavior. In this chapter, we address two key challenges associated with the reconstruction of metabolic models: (a) leveraging existing knowledge of microbiology, biochemistry, and available omics data to produce the best possible model; and (b) applying available tools and data to automate the reconstruction process. We consider these challenges as we progress through the model reconstruction process, beginning with genome assembly, and culminating in the integration of constraints to capture the impact of transcriptional regulation. We divide the reconstruction process into ten distinct steps: (1) genome assembly from sequenced reads; (2) automated structural and functional annotation; (3) phylogenetic tree-based curation of genome annotations; (4) assembly and standardization of biochemistry database; (5) genome-scale metabolic reconstruction; (6) generation of core metabolic model; (7) generation of biomass composition reaction; (8) completion of draft metabolic model; (9) curation of metabolic model; and (10) integration of regulatory constraints. Each of these ten steps is documented in detail.

Perfis de vinculação, coparentalidade e ajustamento familiar em pais recém-divorciados: diferenças no ajustamento psicológico

O objectivo deste estudo foi identificar, através de uma análise de cluster, perfis de regulação individualdiádica-sistémica em pais récem-divorciados (N=81) com base na vinculação, coparentalidade e ajustamentofamiliar. Três padrões de regulação foram identificados: regulado-seguro (RS), desregulado-ansioso (DA) e desregulado-evitante (DE). O grupo RS mostrou níveis mais elevados de segurança na vinculação, maior qualidade na coparentalidade e no ajustamento familiar que os grupos DA e DE. A coparentalidade e o funcionamento familiar foram as dimensões que melhor diferenciaram os clusters. Avaliando o ajustamento psicológico dos pais recém-divorciados em função dos perfis encontrados, o grupo RS apresentou maiores níveis de ajustamento psicológico do que os restantes dois grupos. Não foram encontradas diferenças no ajustamento psicológico entre os grupos DA e DE.

Exploitation of Ashbya gossypii for the production of high-value products from glycerol feedstocks

Dissertação de mestrado em Bioengenharia

Characterization of the in vivo cardiac electrophysiologic effects of high-dose cocaine in closed-chest, anesthetized dogs with normal hearts

OBJECTIVE: To characterize the cardiac electrophysiologic effects of cocaine. METHODS: In 8 dogs (9-13 kg), electrophysiologic parameters and programmed stimulation were undertaken using transvenous catheters at baseline, and after cocaine intravenous infusion (12 mg/kg bolus followed by 0.22 mg/kg/min for 25 minutes). RESULTS: Cocaine plasma levels (n=5) rose to 6.73± 0.56 mg/mL. Cocaine did not affect sinus cycle length and arterial pressure. Cocaine prolonged P wave duration (54±6 vs 73±4 ms, P<0.001), PR interval (115±17 vs 164±15 ms, P<0.001), QRS duration (62±10 vs 88±14 ms, P<0.001), and QTc interval (344±28 vs 403±62 ms, P=0.03) but not JT interval (193±35 vs 226±53 ms, NS). Cocaine prolonged PA (9±6 vs 23±8 ms, P<0.001), AH (73±16 vs 92±15 ms; P=0.03), and HV (35±5 vs 45±3ms; P<0.001) intervals and Wenckebach point (247±26 vs 280±28 ms, P=0.04). An increase occurred in atrial (138±8 vs 184± 20 ms; P<0.001) and ventricular (160±15 vs 187±25 ms; P=0.03) refractoriness at a cycle length of 300 ms. Atrial arrhythmias were not induced in any dog. Ventricular fibrillation (VF) was induced in 2/8 dogs at baseline and 4/8 dogs after cocaine. CONCLUSION: High doses of cocaine exert significant class I effects and seem to enhance inducibility of VF but not of atrial arrhythmias.

Effects of high glucose concentrations on the endothelial function of the renal microcirculation of rabbits

OBJECTIVE: To assess the acute effects of high glucose concentrations on vascular reactivity in the isolated non diabetic rabbit kidney. METHODS: Rabbits were anaesthetized for isolation of the kidneys. Renal arteries and veins were cannulated for perfusion with Krebs-Henselleit solution and measurement of perfusion pressure. After 3 hours of perfusion with glucose 5,5 mM (control ) and 15 mM, the circulation was submitted to sub maximal precontraction (80% of maximal response) trough continuous infusion of noradrenaline 10 mM. Vascular reactivity was then assessed trough dose-responses curves with endothelium-dependent (acetylcholine) and independent (sodium nitroprusside) vasodilators. The influence of hyperosmolarity was analyzed with perfusion with mannitol 15mM. RESULTS: A significant reduction in the endothelium-dependent vasodilation in glucose 15mM group was observed compared to that in control, but there was no difference in endothelium-independent vasodilation. After perfusion with mannitol 15 mM, a less expressive reduction in endothelium-dependent vasodilation was observed, only reaching significance in regard to the greatest dose of acetylcholine. CONCLUSION: High levels of glucose similar to those found in diabetic patients in the postprandial period can cause significant acute changes in renal vascular reactivity rabbits. In diabetic patients these effects may also occur and contribute to diabetes vascular disease.

The influence of patient's consciousness regarding high blood pressure and patient's attitude in face of disease controlling medicine intake

OBJECTIVE: To assess the relation between blood pressure control and the following: the Morisky-Green test, the patient's consciousness regarding high blood pressure, the patient's attitude in face of medicine intake, the patient's attendance at medical consultations, and the subjective physician's judgment. METHODS: We studied 130 hypertensive patients with the following characteristics: 73% females, 60±11 years, 58% married, 70% white, 45% retired, 45% with incomplete elementary schooling, 64% had a familial income of 1 to 3 minimum wages, body mass index of 30±7 kg/m², consciousness regarding the disease for a mean period of 11±9.5 years, and mean treatment duration of 8 ±7 years. RESULTS: Only 35% of the hypertensive individuals had blood pressure under control and a longer duration of treatment (10±7 vs 7±6.5 years; P<0.05). The retiree predominated. The result of the Morisky-Green test did not relate to blood pressure control. In evaluating the attitude in face of medicine intake, the controlled patients achieved significantly higher scores than did the noncontrolled patients (8±1.9 vs 7 ±2, P<0.05). The hypertensive patients had higher levels of consciousness regarding their disease and its treatment, and most (70%) patients attended 3 or 4 medical consultations, which did not influence blood pressure control. The physicians attributed significantly higher scores regarding adherence to treatment to controlled patients (6±0.8 vs 5±1.2; P<0.05). CONCLUSION: Consciousness regarding the disease, the Morisky-Green test, and attendance to medical consultations did not influence blood pressure control.

Diseño de sistemas de comunicaciones de alta velocidad. Design of high-speed communication systems.

El crecimiento exponencial del tráfico de datos es uno de los mayores desafíos que enfrentan actualmente los sistemas de comunicaciones, debiendo los mismos ser capaces de soportar velocidades de procesamiento de datos cada vez mas altas. En particular, el consumo de potencia se ha transformado en uno de los parámetros de diseño más críticos, generando la necesidad de investigar el uso de nuevas arquitecturas y algoritmos para el procesamiento digital de la información. Por otro lado, el análisis y evaluación de nuevas técnicas de procesamiento presenta dificultades dadas las altas velocidades a las que deben operar, resultando frecuentemente ineficiente el uso de la simulación basada en software como método. En este contexto, el uso de electrónica programable ofrece una oportunidad a bajo costo donde no solo se evaluan nuevas técnicas de diseño de alta velocidad sino también se valida su implementación en desarrollos tecnológicos. El presente proyecto tiene como objetivo principal el estudio y desarrollo de nuevas arquitecturas y algoritmos en electrónica programable para el procesamiento de datos a alta velocidad. El método a utilizar será la programación en dispositivos FPGA (Field-Programmable Gate Array) que ofrecen una buena relación costo-beneficio y gran flexibilidad para integrarse con otros dispositivos de comunicaciones. Para la etapas de diseño, simulación y programación se utilizaran herramientas CAD (Computer-Aided Design) orientadas a sistemas electrónicos digitales. El proyecto beneficiara a estudiantes de grado y postgrado de carreras afines a la informática y las telecomunicaciones, contribuyendo al desarrollo de proyectos finales y tesis doctorales. Los resultados del proyecto serán publicados en conferencias y/o revistas nacionales e internacionales y divulgados a través de charlas de difusión y/o encuentros. El proyecto se enmarca dentro de un área de gran importancia para la Provincia de Córdoba, como lo es la informática y las telecomunicaciones, y promete generar conocimiento de gran valor agregado que pueda ser transferido a empresas tecnológicas de la Provincia de Córdoba a través de consultorias o desarrollos de productos.

Efecto de la forestación con pináceas sobre la biodiversidad y el funcionamiento de sistemas fluviales serranos en pastizales de altura. Pine afforestation effects on ecosystem functioning and biodiversity in mountain pastureland fluvial systems.

Las acciones antrópicas han alterado los ecosistemas a escala global mediante cambios en la estructura y función de los sistemas terrestres y acuáticos. En este sentido, la deforestación de bosques ripariales impacta fuertemente sobre los sistemas lóticos como así también el proceso inverso, la conversión de pasturas naturales a bosques debido a forestaciones extensivas. Las nacientes de los arroyos de la provincia de Córdoba se ubican en pastizales dominados por gramíneas, muchos de los cuales han sido reemplazados por plantaciones de coníferas, con potenciales efectos sobre la estructura y el funcionamiento de los cursos de agua. En consecuencia, la evaluación de los efectos de esta actividad forestal sobre los arroyos es esencial para la implementación de adecuadas estrategias de manejo y conservación del recurso acuático. El objetivo de este proyecto es evaluar los efectos de la forestación con pináceas sobre la estructura y el funcionamiento de sistemas fluviales en pastizales de altura de las sierras de Córdoba. Se pretende analizar la dinámica de la biota acuática en arroyos de pastizales y en arroyos forestados. Se cuantificarán productores primarios y materia orgánica particulada y se medirán procesos ecológicos como la producción primaria y descomposición de materia orgánica gruesa. Se espera que la forestación con pináceas altere el ciclo de los nutrientes, disminuya el caudal y cambie el balance de temperatura al incrementar la sombra y el ingreso de materia orgánica particulada gruesa. En consecuencia, y debido a los cambios abióticos contrastantes generados por la implantación de pinos, podrían detectarse alteraciones drásticas en el ecosistema. Se seleccionarán seis arroyos de la subcuenca del arroyo Santa Rosa (Subcuenca Ctalamochita). Tres arroyos discurren en pastizales naturales y tres en áreas forestadas con pináceas. Se tomarán muestras de invertebrados y materia orgánica en el bentos en aguas altas y aguas bajas y se registrarán parámetros físico-químicos. Se colectarán muestras de perifiton para análisis de especies, biomasa y clorofila. Se realizarán experimentos de campo para medir la tasa de degradación de la materia orgánica y la producción primaria. La detección del grado de alteración de los sistemas naturales es el punto de partida para la implementación de apropiadas estragias de manejo del recurso. Entre los indicadores que permitirán verificar el efecto de las forestaciones estan los cambios en la biodiversidad, en la tasa de degradación de materia orgánica y en la producción primaria, como así también en la dinámica de los nutrientes y en los ciclos de caudales. Esta propuesta pretende generar lazos de interrelación entre distintos sectores para la implementación efectiva de planes de conservación y restauración y propiciar las relaciones necesarias para el logro de objetivos que beneficien a la sociedad como un todo.