Usefulness of B-type natriuretic peptide in hypertensive patients with exertional dyspnea and normal left ventricular ejection fraction and correlation with new echocardiographic indexes of systolic and diastolic function

B-type natriuretic peptide (BNP) levels increase in systolic heart failure (HF). However, the value of BNP in hypertensive patients with suspected diastolic HF (symptoms suggestive of HF but normal ejection fraction) and its relation to myocardial function in these patients is unclear. We prospectively studied 72 ambulatory hypertensive subjects (40 women, mean age 58 +/- 8 years) with exertional dyspnea and ejection fraction greater than or equal to50%. Diastolic function was evaluated with transmitral and pulmonary venous Doppler, mitral annular velocities (pulsed-wave tissue Doppler), and flow propagation velocity (color M-mode). Systolic function was assessed with strain and strain rate derived from color tissue Doppler imaging. BNP was related to myocardial function and the presence or absence of global diastolic dysfunction. By conventional Doppler criteria, 34 patients had normal left ventricular diastolic function and 38 had isolated diastolic dysfunction. BNP values were higher in patients with diastolic dysfunction (46 +/- 48 vs 20 +/- 20 pg/ml, p = 0.004) and were related independently to blood pressure, systolic strain rate, left atrial function (p < 0.01 for all), and age (p = 0.015). Patients with diastolic dysfunction and pseudonormal filling had higher BNP levels compared with impaired relaxation (89 +/- 47 vs 35 +/- 42 pg/ml, p = 0.001). However, 79% of patients with diastolic dysfunction had BNP levels within the normal range. We conclude that in ambulatory hypertensive patients with symptoms suggestive of mild HF and normal ejection fraction, BNP is related to atrial and ventricular systolic parameters, blood pressure, and age. Although elevated in the presence of diastolic dysfunction, the BNP level mostly is in the normal range and, therefore, has limited diagnostic value in stable patients with suspected diastolic HF. (C) 2003 by Excerpta Medica, Inc.

Anotação sintética, numa perspectiva de Direito Público, ao Acórdão n.º 63/2006, em Plenário, do Tribunal Constitucional (português), de 24 de Janeiro de 2006 - qual proibição constitucional de impostos retroactivos? A tese de Oliveira Salazar.

Resumo: 1 – Sumário do Acórdão do Tribunal Constitucional n.º 63/2006, de 24 de Janeiro de 2006; 2 – Texto completo do Acórdão do Tribunal Constitucional n.º 63/2006, de 24 de Janeiro de 2006: cfr. http://www.tribunalconstitucional.pt/tc/acordaos/20060063.html , 18 de Maio de 2012; 3 – Anotação sintética; 3.1 – Introdução à anotação sintética e suas características neste caso concreto; 4 – A referência, abstracta e concreta, do princípio constitucional da «proibição de impostos retroactivos»; 5 – Alguns aspectos nucleares da eficácia temporal das normas jurídico-tributárias, brevitatis causa, das normas jurídico-fiscais; 6 – A chamada «aplicação das normas fiscais» (e/ou tributárias) no seio da «aplicação no tempo»: algumas breves notas sobre a tradição jurídico-lusitana, v.g. do ponto de vista da doutrina, a partir de 1976, designadamente até 1985; 6.1 – A tese de António de Oliveira Salazar; 7 – Conclusões. § Abstract: 1 - Summary of the Judgment of the Constitutional Court n. 63/2006 of January 24, 2006; 2 - Complete text of the Judgment of the Constitutional Court n. 63/2006 of January 24, 2006: s. http://www.tribunalconstitucional.pt/tc/acordaos/20060063.html , May 18, 2012; 3 - Synthetic Note: 3.1 - Introduction to syntheticannotation and its characteristics in this case; 4 - The reference, abstract and concrete, the constitutional principle of «prohibition of retroactive taxes»; 5 - Some aspects of nuclear the temporal validity of the legal and tax rules, brevitatis causa of legal and tax rules; 6 - the so-called «implementation of tax laws» (and/or tax) within the «Application in time»: some brief notes on the legal tradition -Lusitanian, e.g. from the standpoint of doctrine, from 1976, namely until 1985; 6.1 - The thesis of António de Oliveira Salazar; 7- Conclusions. PS: este "abstract" está tal qual como na publicação.

Anotação sintética, numa perspectiva de Direito Público, ao Acórdão n.º 63/2006, em Plenário, do Tribunal Constitucional (português), de 24 de Janeiro de 2006 - qual proibição constitucional de impostos retroactivos? A tese de Oliveira Salazar.

The present article aims to analyze the Judgment no. º 63/2006 of the Constitutional Court, of January 24, 2006, verifying the characteristics of the case, under reference abstract and concrete, of the constitutional principle of the prohibition of retroactive tax. It also examines the core aspects of the temporal validity of the legal and tax rules, brevitatis causa of legal and fiscal standards. Thus, it scrutinizes the call application of tax rules (and / or tax) within the application in time, consisting brief notes on the legal tradition-Lusitanian, from the standpoint of doctrine, from 1976 to 1985 including, recalling the Thesis Salazar on non-retroactivity of tax law. § O presente artigo pretende analisar o Acórdão do Tribunal Constitucional n.º 63/2006, de 24 de Janeiro de 2006, verificando de forma sintética as características do caso concreto, sob referência abstracta e concreta, do princípio constitucional da proibição de imposto retroativos, analisando ainda os aspectos nucleares da eficácia temporal das normas jurídico-tributárias, brevitatis causa, das normas jurídico-fiscais. Para tanto, se averigua a chamada aplicação das normas fiscais (e/ou tributárias) no seio da aplicação no tempo, constando breves notas sobre a tradição jurídico-lusitana, do ponto de vista da doutrina, a partir de 1976, designadamente até 1985, recordando a Tese de Salzar sobre a não retroatividade da lei fiscal.

Relation of happiness, hope and affection with quality of life in patients with heart failure

Introduction: Meeting the actual role of positive psychology, begins to be recognized the relation of positive variables with health. Objective: To know the relation of happiness, hope and affection with quality of life in individuals with heart failure. Population and Methodology: 128 individuals with heart failure, 98 men and 30 women, 61.9±12,1 years of age, 6,6±3,9 years in school and 74,2% retired because of this disease. 56,3% were in Class III of New York Heart Association, with poor left ventricular ejection fraction (25,3±6,2%). The clinical history was of 9,4±8,5 years for this heart disease and had at least one hospitalization due to heart failure with 51,6% having ischemic heart disease.

Happiness, hope and affection as predictors of quality of life and functionality of individuals with heart failure at 3 month follow up

Introduction: Meeting the actual role of positive psychology, begins to be recognized the contribution of positive variables in health outcomes. Objective: To know the contribution of happiness, hope and affection individually and as a whole in the quality of life and functionality of individuals with heart failure. Population and Methodology: 128 individuals with heart failure, 98 men and 30 women, 61.9±12,1 years of age, 6,6±3,9 years of school and 74,2% retired because of this disease. 56,3% were in Class III of New York Heart Association, with poor left ventricular ejection fraction (25,3±6,2%). The clinical history was of 9,4±8,5 years for this heart disease and had at least one hospitalization due to heart failure with 51,6% having ischemic heart disease.

Estudo da função sistólica do ventrículo direito por ecocardiografia transtorácica: relatório de projecto

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular. Área de especialização - Ultrassonografia Cardiovascular

Isolamento e caracterização de uma proteína tóxica produzida por um isolado açoriano de Bacillus weihenstephanensis

Dissertação de Mestrado, Biotecnologia em Controlo Biológico, 27 de Junho de 2013, Universidade dos Açores.

Unesp Informa, 2015, número 63

Boletim elaborado pela Assessoria de Comunicação e Imprensa da Reitoria da UNESP

Unesp Ciência, 2015, ano 6, número 63

Revista elaborada pela Assessoria de Comunicação e Imprensa da Reitoria da UNESP

Diabetes burden in Brazil: fraction attributable to overweight, obesity, and excess weight

OBJECTIVE To estimate the burden of type 2 diabetes mellitus and its percentage attributable to overweight and obesity in Brazil.METHODS The burden of diabetes mellitus was described in terms of disability-adjusted life years, which is the sum of two components: years of life lost and years lived with disability. To calculate the fraction of diabetes mellitus attributable to overweight, obesity, and excess weight, we used the prevalence of these risk factors according to sex and age groups (> 20 years) obtained from the 2008 Pesquisa Dimensões Sociais das Desigualdades (Social Dimensions of Inequality Survey) and the relative risks derived from the international literature.RESULTS Diabetes mellitus accounted for 5.4% of Brazilian disability-adjusted life years in 2008, with the largest fraction attributed to the morbidity component (years lived with disability). Women exhibited higher values for disability-adjusted life years. In Brazil, 49.2%, 58.3%, and 70.6% of diabetes mellitus in women was attributable to overweight, obesity, and excess weight, respectively. Among men, these percentages were 40.5%, 45.4%, and 60.3%, respectively. Differences were observed with respect to Brazilian regions and age groups.CONCLUSIONS A large fraction of diabetes mellitus was attributable to preventable individual risk factors and, in about six years, the contribution of these factors significant increased, particularly among men. Policies aimed at promoting healthy lifestyle habits, such as a balanced diet and physical activity, can have a significant impact on reducing the burden of diabetes mellitus in Brazil.

Characterization of the volatile fraction emitted by phloems of four pinus species by solid-phase microextraction and gas chromatography–mass spectrometry

Pine forests constitute some of the most important renewable resources supplying timber, paper and chemical industries, among other functions. Characterization of the volatiles emitted by different Pinus species has proven to be an important tool to decode the process of host tree selection by herbivore insects, some of which cause serious economic damage to pines. Variations in the relative composition of the bouquet of semiochemicals are responsible for the outcome of different biological processes, such as mate finding, egg-laying site recognition and host selection. The volatiles present in phloem samples of four pine species, P. halepensis, P. sylvestris, P. pinaster and P. pinea, were identified and characterized with the aim of finding possible host-plant attractants for native pests, such as the bark beetle Tomicus piniperda. The volatile compounds emitted by phloem samples of pines were extracted by headspace solid-phase micro extraction, using a 2 cm 50/30 mm divinylbenzene/carboxen/polydimethylsiloxane table flex solid-phase microextraction fiber and its contents analyzed by high-resolution gas chromatography, using flame ionization and a non polar and chiral column phases. The components of the volatile fraction emitted by the phloem samples were identified by mass spectrometry using time-of-flight and quadrupole mass analyzers. The estimated relative composition was used to perform a discriminant analysis among pine species, by means of cluster and principal component analysis. It can be concluded that it is possible to discriminate pine species based on the monoterpenes emissions of phloem samples.

Insuficiência renal aguda secundária a acidentes ofídicos botrópico e crotálico. Análise de 63 casos

Sessenta e três pacientes com insuficiência renal aguda secundária a acidente ofídico foram tratados no CTI do Hospital das Clínicas da UFMG. Em 32 pacientes (51%) o acidente foi produzido por serpentes do gênero Bothrops (grupo bio-trópico) e em 32 pacientes (49%) pela cascavel sul-americana (grupo crotálico). As principais complicações apresentadas pelos pacientes foram a uremia (100% dos casos), hiperpotassemia (89% dos casos), anemia (78% dos casos), infecção urinária (37% dos casos), hiper-hidratação (17% dos casos), parada cardíaca (14% dos casos) e edema agudo dos pulmões (11% dos casos). Cinco pacientes do grupo crotálico (16%) tiveram insuficiência respiratória aguda atribuída à ação neurotóxica do veneno, quatro dos quais se recuperaram completamente. Sete pacientes do grupo botrópico (22%) tiveram necrose cortical renal diagnosticada em cinco através da biópsia renal e em dois na necropsia. Quarenta e cinco pacientes (71%) foram tratados com diálise peritoneal e a hemodiálise foi necessária em dois pacientes, um dos quais havia sido submetido a diálise peritoneal. Em 17 pacientes (27%) o tratamento foi conservador. Cinqüenta e cinco pacientes receberam alta hospitalar, quatro dos quais com insuficiência renal crônica secundária a necrose cortical renal e oito (13%) faleceram. Os óbitos foram atribuídos a edema pulmonar agudo em quatro pacientes, a estado de choque em dois pacientes e a coma e infecção respiratória após parada cardíaca em dois pacientes.

Estudo da deformação miocárdica para detecção precoce de disfunção ventricular esquerda em doentes submetidos a quimioterapia com antraciclinas

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Área de especialização: Ultrassonografia cardiovascular

Enantiomeric fraction evaluation of pharmaceuticals in environmentalmatrices by liquid chromatography-tandem mass spectrometry

The interest for environmental fate assessment of chiral pharmaceuticals is increasing and enantioselective analytical methods are mandatory. This study presents an enantioselective analytical method for the quantification of seven pairs of enantiomers of pharmaceuticals and a pair of a metabolite. The selected chiral pharmaceuticals belong to three different therapeutic classes, namely selective serotonin reuptake inhibitors (venlafaxine, fluoxetine and its metabolite norfluoxetine), beta-blockers (alprenolol, bisoprolol, metoprolol, propranolol) and a beta2-adrenergic agonist (salbutamol). The analytical method was based on solid phase extraction followed by liquid chromatography tandem mass spectrometry with a triple quadrupole analyser. Briefly, Oasis® MCX cartridges were used to preconcentrate 250 mL of water samples and the reconstituted extracts were analysed with a Chirobiotic™ V under reversed mode. The effluent of a laboratory-scale aerobic granular sludge sequencing batch reactor (AGS-SBR) was used to validate the method. Linearity (r2 > 0.99), selectivity and sensitivity were achieved in the range of 20–400 ng L−1 for all enantiomers, except for norfluoxetine enantiomers which range covered 30–400 ng L−1. The method detection limits were between 0.65 and 11.5 ng L−1 and the method quantification limits were between 1.98 and 19.7 ng L−1. The identity of all enantiomers was confirmed using two MS/MS transitions and its ion ratios, according to European Commission Decision 2002/657/EC. This method was successfully applied to evaluate effluents of wastewater treatment plants (WWTP) in Portugal. Venlafaxine and fluoxetine were quantified as non-racemic mixtures (enantiomeric fraction ≠ 0.5). The enantioselective validated method was able to monitor chiral pharmaceuticals in WWTP effluents and has potential to assess the enantioselective biodegradation in bioreactors. Further application in environmental matrices as surface and estuarine waters can be exploited.

Variáveis Ecocardiográficas Predizentes de Terapêuticas Apropriadas de Taquidisritmias Ventriculares em Doentes Submetidos a Terapêutica de Ressincronização Cardíaca Combinada

INTRODUCTION: The significant risk of sudden arrhythmic death in patients with congestive heart failure and electromechanical ventricular dyssynchrony has led to increased use of combined cardiac resynchronization therapy defibrillator (CRT-D) devices. OBJECTIVES: To evaluate the echocardiographic variables in patients undergoing CRT-D that predict the occurrence of appropriate therapies (AT) for ventricular tachyarrhythmia. METHODS: We analyzed 38 consecutive patients (mean age 60 +/- 12 years, 63% male) with echocardiographic evaluation before and 6 months after CRT-D implantation. Patients with AT were identified in a mean follow-up of 471 +/- 323 days. A standard echocardiographic study was performed including tissue Doppler imaging (TDI). Responders were defined as patients with improvement in NYHA class of < or = 1 in the first six months, and reverse remodeling as a decrease in left ventricular end-systolic volume of < or = 15% and/or an increase in left ventricular ejection fraction of > 25%. RESULTS: The responder rate was 74%, and the reverse remodeling rate was 55%. AT occurred in 21% of patients, who presented with greater left ventricular end-diastolic internal diameter (LVEDD) before implantation (86 +/- 8 vs. 76 +/- 11 mm, p = 0.03) and at 6 months (81 +/- 8 vs. 72 +/- 14 mm, p = 0.08), and increased left ventricular end-systolic internal diameter (66 +/- 14 vs. 56 +/- 14 mm, p = 0.03) and lower ejection fraction (24 +/- 6 vs. 34 +/- 14%, p = 0.08) at 6 months. In the group with AT, the responder rate was lower (38 vs. 83%, p = 0.03), without significant differences in reverse remodeling (38% for the AT group vs. 60%, p = 0.426) or in the other variables. By univariate analysis, predictors of AT were LVEDD before implantation and E' after implantation. Age, gender, ischemic etiology, use of antiarrhythmic drugs, reverse remodeling and the other echocardiographic parameters did not predict AT. In multivariate logistic regression analysis, both LVEDD before implantation (OR 1.24, 95% CI 1.04-1.48, p = 0.019) and postimplantation E' (OR 0.27, 95% CI 0.09-0.76, p = 0.014) remained as independent predictors of AT. CONCLUSIONS: In patients undergoing CRT-D, episodes of ventricular tachyarrhythmia occur with high incidence, independently of echocardiographic response, with LVEDD before implantation and E' after implantation as the only independent predictors of AT in the medium-term. These results highlight the importance of combined devices with defibrillation capability.