Reproducibility of Left Ventricular Mass by Echocardiogram in the ELSA-Brasil

Background: Echocardiography, though non-invasive and having relatively low-cost, presents issues of variability which can limit its use in epidemiological studies. Objective: To evaluate left ventricular mass reproducibility when assessed at acquisition (online) compared to when assessed at a reading center after electronic transmission (offline) and also when assessed by different readers at the reading center. Methods: Echocardiographers from the 6 ELSA-Brasil study investigation centers measured the left ventricular mass online during the acquisition from 124 studies before transmitting to the reading center, where studies were read according to the study protocol. Half of these studies were blindly read by a second reader in the reading center. Results: From the 124 echocardiograms, 5 (4%) were considered not measurable. Among the remaining 119, 72 (61%) were women, mean age was 50.2 ± 7.0 years and 2 had structural myocardial abnormalities. Images were considered to be optimal/ good by the reading center for 110 (92.4%) cases. No significant difference existed between online and offline measurements (1,29 g, CI 95% −3.60-6.19), and the intraclass correlation coefficient between them was 0.79 (CI 95% 0.71-0.85). For images read by two readers, the intraclass correlation coefficient was 0.86 (CI 95% 0.78-0.91). Conclusion: There were no significant drifts between online and offline left ventricular mass measurements, and reproducibility was similar to that described in previous studies. Central quantitative assessment of echocardiographic studies in reading centers, as performed in the ELSA-Brasil study, is feasible and useful in clinical and epidemiological studies performed in our setting.

Serum Potassium Levels Inversely Correlate with D-Dimer In Patients with Acute-Onset Atrial Fibrillation

Background: D-dimer values are frequently increased in patients with atrial fibrillation (AF) compared to subjects in sinus rhythm. Hypokalemia plays a role in several cardiovascular diseases, but little is known about the association with AF. Objective: D-dimer values are frequently increased in patients with atrial fibrillation (AF) compared with subjects in sinus rhythm. Hypokalemia plays a role in several cardiovascular diseases, but little is known about the association with AF. The aim of this study was to investigate correlations between D-dimer and serum potassium in acute-onset AF (AAF). Methods: To investigate the potential correlation between the values of serum potassium and D-dimer in patients with AAF, we retrospectively reviewed clinical and laboratory data of all emergency department visits for AAF in 2013. Results: Among 271 consecutive AAF patients with D-dimer assessments, those with hypokalemia (n = 98) had significantly higher D-dimer values than normokalemic patients (139 versus 114 ng/mL, p = 0.004). The rate of patients with D-dimer values exceeding the diagnostic cut-off was higher in the group of patients with hypokalemia than in those with normal serum potassium (26.5% versus 16.2%; p = 0.029). An inverse and highly significant correlation was found between serum potassium and D-dimer (r = −0.21; p < 0.001), even after adjustments for age and sex (beta coefficient −94.8; p = 0.001). The relative risk for a positive D-dimer value attributed to hypokalemia was 1.64 (95% CI, 1.02 to 2.63; p = 0.040). The correlation remained statistically significant in patients free from antihypertensive drugs (r = −0.25; p = 0.018), but not in those taking angiotensin-receptor blockers, angiotensin-converting enzyme inhibitors, or diuretics. Conclusions: The inverse correlation between values of potassium and D-dimer in patients with AAF provides important and complementary information about the thromboembolic risk of these patients.

Experimental design for mixed models with application to population pharmacokinetic studies

experimental design, mixed model, random coefficient regression model, population pharmacokinetics, approximate design

Assessment of Autonomic Function by Phase Rectification of RRInterval Histogram Analysis in Chagas Disease

Background:In chronic Chagas disease (ChD), impairment of cardiac autonomic function bears prognostic implications. Phase‑rectification of RR-interval series isolates the sympathetic, acceleration phase (AC) and parasympathetic, deceleration phase (DC) influences on cardiac autonomic modulation.Objective:This study investigated heart rate variability (HRV) as a function of RR-interval to assess autonomic function in healthy and ChD subjects.Methods:Control (n = 20) and ChD (n = 20) groups were studied. All underwent 60-min head-up tilt table test under ECG recording. Histogram of RR-interval series was calculated, with 100 ms class, ranging from 600–1100 ms. In each class, mean RR-intervals (MNN) and root-mean-squared difference (RMSNN) of consecutive normal RR-intervals that suited a particular class were calculated. Average of all RMSNN values in each class was analyzed as function of MNN, in the whole series (RMSNNT), and in AC (RMSNNAC) and DC (RMSNNDC) phases. Slopes of linear regression lines were compared between groups using Student t-test. Correlation coefficients were tested before comparisons. RMSNN was log-transformed. (α < 0.05).Results:Correlation coefficient was significant in all regressions (p < 0.05). In the control group, RMSNNT, RMSNNAC, and RMSNNDCsignificantly increased linearly with MNN (p < 0.05). In ChD, only RMSNNAC showed significant increase as a function of MNN, whereas RMSNNT and RMSNNDC did not.Conclusion:HRV increases in proportion with the RR-interval in healthy subjects. This behavior is lost in ChD, particularly in the DC phase, indicating cardiac vagal incompetence.

Blood Pressure and Hemodynamic Adaptations after a Training Program in Young Individuals with Down Syndrome

Background:Cardiovascular diseases affect people worldwide. Individuals with Down Syndrome (DS) have an up to sixteen-time greater risk of mortality from cardiovascular diseases.Objective:To evaluate the effects of aerobic and resistance exercises on blood pressure and hemodynamic variables of young individuals with DS.Methods:A total of 29 young individuals with DS participated in the study. They were divided into two groups: aerobic training (AT) (n = 14), and resistance training (TR) (n = 15). Their mean age was 15.7 ± 2.82 years. The training program lasted 12 weeks, and had a frequency of three times a week for AT and twice a week for RT. AT was performed in treadmill/ bicycle ergometer, at an intensity between 50%-70% of the HR reserve. RT comprised nine exercises with three sets of 12 repetition-maximum. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and hemodynamic variables were assessed beat-to-beat using the Finometer device before/after the training program. Descriptive analysis, the Shapiro-Wilk test to check the normality of data, and the two-way ANOVA for repeated measures were used to compare pre- and post-training variables. The Pearson’s correlation coefficient was calculated to correlate hemodynamic variables. The SPSS version 18.0 was used with the significance level set at p < 0.05.Results:After twelve weeks of aerobic and/or resistance training, significant reductions in variables SBP, DBP and MBP were observed.Conclusion:This study suggests a chronic hypotensive effect of moderate aerobic and resistance exercises on young individuals with DS.

Left Atrial Volume Determinants in Patients with Non-Ischemic Dilated Cardiomyopathy

Background:Left atrial volume (LAV) is a predictor of prognosis in patients with heart failure.Objective:We aimed to evaluate the determinants of LAV in patients with dilated cardiomyopathy (DCM).Methods:Ninety patients with DCM and left ventricular (LV) ejection fraction ≤ 0.50 were included. LAV was measured with real-time three-dimensional echocardiography (eco3D). The variables evaluated were heart rate, systolic blood pressure, LV end-diastolic volume and end-systolic volume and ejection fraction (eco3D), mitral inflow E wave, tissue Doppler e´ wave, E/e´ ratio, intraventricular dyssynchrony, 3D dyssynchrony index and mitral regurgitation vena contracta. Pearson´s coefficient was used to identify the correlation of the LAV with the assessed variables. A multiple linear regression model was developed that included LAV as the dependent variable and the variables correlated with it as the predictive variables.Results:Mean age was 52 ± 11 years-old, LV ejection fraction: 31.5 ± 8.0% (16-50%) and LAV: 39.2±15.7 ml/m2. The variables that correlated with the LAV were LV end-diastolic volume (r = 0.38; p < 0.01), LV end-systolic volume (r = 0.43; p < 0.001), LV ejection fraction (r = -0.36; p < 0.01), E wave (r = 0.50; p < 0.01), E/e´ ratio (r = 0.51; p < 0.01) and mitral regurgitation (r = 0.53; p < 0.01). A multivariate analysis identified the E/e´ ratio (p = 0.02) and mitral regurgitation (p = 0.02) as the only independent variables associated with LAV increase.Conclusion:The LAV is independently determined by LV filling pressures (E/e´ ratio) and mitral regurgitation in DCM.

Validation of a Brazilian Portuguese Version of the Walking Estimated-Limitation Calculated by History (WELCH)

Abstract Background: The Walking Estimated-Limitation Calculated by History (WELCH) questionnaire has been proposed to evaluate walking impairment in patients with intermittent claudication (IC), presenting satisfactory psychometric properties. However, a Brazilian Portuguese version of the questionnaire is unavailable, limiting its application in Brazilian patients. Objective: To analyze the psychometric properties of a translated Brazilian Portuguese version of the WELCH in Brazilian patients with IC. Methods: Eighty-four patients with IC participated in the study. After translation and back-translation, carried out by two independent translators, the concurrent validity of the WELCH was analyzed by correlating the questionnaire scores with the walking capacity assessed with the Gardner treadmill test. To determine the reliability of the WELCH, internal consistency and test–retest reliability with a seven-day interval between the two questionnaire applications were calculated. Results: There were significant correlations between the WELCH score and the claudication onset distance (r = 0.64, p = 0.01) and total walking distance (r = 0.61, p = 0.01). The internal consistency was 0.84 and the intraclass correlation coefficient between questionnaire evaluations was 0.84. There were no differences in WELCH scores between the two questionnaire applications. Conclusion: The Brazilian Portuguese version of the WELCH presents adequate validity and reliability indicators, which support its application to Brazilian patients with IC.

Reproducibility and Reliability of the Quality of Life Questionnaire in Patients With Atrial Fibrillation

Abstract Background: Studies have shown the impact of atrial fibrillation (AF) on the patients' quality of life. Specific questionnaires enable the evaluation of relevant events. We previously developed a questionnaire to assess the quality of life of patients with AF (AFQLQ version 1), which was reviewed in this study, and new domains were added. Objective: To demonstrate the reproducibility of the AFQLQ version 2 (AFQLQ v.2), which included the domains of fatigue, illness perception and well-being. Methods: We applied 160 questionnaires (AFQLQ v.2 and SF-36) to 40 patients, at baseline and 15 days after, to measure inter- and intraobserver reproducibility. The analysis of quality of life stability was determined by test-retest, applying the Bartko intraclass correlation coefficient (ICC). Internal consistency was assessed by Cronbach's alpha test. Results: The total score of the test-retest (n = 40) had an ICC of 0.98 in the AFQLQ v.2, and of 0.94 in the SF36. In assessing the intra- and interobserver reproducibility of the AFQLQ v.2, the ICC reliability was 0.98 and 0.97, respectively. The internal consistency had a Cronbach's alpha coefficient of 0.82, compatible with good agreement of the AFQLQ v.2. Conclusion: The AFQLQ v.2 performed better than its previous version. Similarly, the domains added contributed to make it more comprehensive and robust to assess the quality of life of patients with AF.

Assessment of Intima-Media Thickness in Healthy Children Aged 1 to 15 Years

Abstract Background: Carotid intima-media thickness (CIMT) has been shown to be increased in children and adolescents with traditional cardiovascular risk factors such as obesity, hypertension, and chronic kidney disease, compared with those of healthy children. Objective: To assess the influence of sex, age and body mass index (BMI) on the CIMT in healthy children and adolescents aged 1 to 15 years. Methods: A total of 280 healthy children and adolescents (males, n=175; mean age, 7.49±3.57 years; mean BMI, 17.94±4.1 kg/m2) were screened for CIMT assessment. They were divided into 3 groups according to age: GI, 1 to 5 years [n=93 (33.2%); males, 57; mean BMI, 16±3 kg/m2]; GII, 6 to 10 years [n=127 (45.4%); males, 78; mean BMI, 17.9±3.7 kg/m2], and GIII, 11 to 15 years [n=60 (21.4%); males, 40; mean BMI, 20.9±4.5 kg/m2]. Results: There was no significant difference in CIMT values between male and female children and adolescents (0.43±0.06 mm vs. 0.42±0.05 mm, respectively; p=0.243). CIMT correlated with BMI neither in the total population nor in the 3 age groups according to Pearson correlation coefficient. Subjects aged 11 to 15 years had the highest CIMT values (GI vs. GII, p=0.615; GI vs. GIII, p=0.02; GII vs. GIII, p=0.004). Conclusions: CIMT is constant in healthy children younger than 10 years, regardless of sex or BMI. CIMT increases after the age of 10 years.

Competição entre megaspórios em milho

The experiments reported were started as early as 1933, when indications were found in class material that the factor for small pollen, spl, causes not only differences in the size of pollen grains and in the growth of pollen tubes, but also a competition between megaspores, as first observed by RENNER (1921) in Oenothera. Dr. P. C. MANGELSDORF, who had kindly furnished the original seeds, was informed and the final publication delayed untill his publication in 1940. A further delay was caused by other circunstances. The main reason for the differences of the results obtained by SINGLETON and MANGELSDORF (1940) and those reported here, seems to be the way the material was analysed. I applied methods of a detailed statistical analysis, while MANGELSDORF and SINGLETON analysed pooled data. 1) The data obtained on pollen tube competition indicate .that there is about 3-4% of crossing-over between the su and sp factors in chromosome IV. The elimination is not always complete, but from 0 to 10% of the sp pollen tubes may function, instead of the 50% expected without elimination. These results are, as a whole, in accordance with SINGLETON and MANGELSDORF's data. 2) Female elimination is weaker and transmission determined as between 16 to 49,5%, instead of 50% without competition, the values being calculated by a special formula. 3) The variability of female elimination is partially genotypical, partially phenotypical. The former was shown by the difference in the behavior of the two progenies tested, while the latter was very evident when comparing the upper and lower halves of ears. For some unknown physiological reason, the elimination is generally stronger in the upper than in the lower half of the ear. 4) The female elimination of the sp gene may be caused theoretically, by either of two processes: a simple lethal effect in the female gametophyte or a competition between megaspores. The former would lead not only to the abortion of the individual megaspores, but of the whole uniovulate ovary. In the case of the latter, the abortive megaspore carrying the gene sp will be substituted in each ovule by one of the Sp megaspores and no abortion of ovaries may be observed. My observations are completely in favor of the second explication: a) The ears were as a whole very well filled except for a few incomplete ears which always appear in artificial pollinations. b) Row arrangement was always very regular. c) The number of kernels on ears with elimination is not smaller than in normal ears, but is incidentally higher : with elimnation, in back-crosses 354 kernels and in selfed ears 390 kernels, without elimination 310 kernels per ear. d) There is no correlation between the intensity of elimination and the number of grains in individual ears; the coefficient; of linear correlation, equal to 0,24, is small and insignificant. e) Our results are in complete disagreement whit those reported by SINGLETON and MANGELSDORF (1940). Since these authors present only pooled date, a complete and detailed analysis which may explain the cause of these divergences is impossible.

Envelhecimento das aguardentes

1 - Colour, by itself, does not constitute a solid ground for judging of the age of a brandy because the more or less pronounced colour it acquires through aging can also be obtained by the addition of oack essence to newly distilled brandy. 2 - Urder the same conditions, colour intensity of a brandy wiU depend upon the nature of the wood and the condition of the storage. 3 - In accordance with the experimental results obtained by the present writers it rests no doubt that fermentation facility ferment resistence, produce and quality of the brendy all are factors depending upon the variety of the sugar cane. In addition, the authors presume that the variety of sugar cane has also influence upon the alteration of composition of the brandy submitted to aging. 4 - All aging phenomena of the brandy are accompanied by volume decreasing, what happens in a slow and continuous manner depending upon storage and environment conditions 5 - During brandy aging the alcoholic degree is greatly af- fected by evaporation, increasing or decreasing in accordance to the hygrometric state of the air and the teriperature in the place where the tuns are stored. 6 - The specific weight of the brandy is inversely proportio- nal to its alcoholic degree, but directly proportional to the extracts since the latter indicates the amount of dissolved residues. 7 - Brandy which shows high specific weight together with high alcoholic degree cannot be considered as aged. It may, however, be takens for brandy artificially coloved in order to conceal its actual age. 8 - The amount of extracts increases with aging, since it is the result of the solvent action of the brandy upon the soluble extractive substances of the wood. Notwithstanding that the extract, considered alone, has no value in determining the age of a brandy, since nothing easier is ohan to nake it change artificially. 9 -During aging the brandy get acidity in physiological as well as in physical way, but never by the action of microorganisms. 10 - The estturs produced during aging by the action of acids upon alcohols are the mean factors of the savour (bouquet) of a brandy and therefore every thing shall be done tor fhr estherification of a preserved brandy being not limited. 11 - Aeration increases esther formation, reduces the aging- time and turn better the taste qualities of the brandy. 12 - Due to the great proportion of high alcohols ordinarily found in the brandy, their analytical discrimination will be greatly important. 13 - The high alcohols are not responsable for the disastrous consequences of the alcoholism, but the high percentage of uthyl alcohol present in the brandy. 14 - The aldehydes appear always in high rate in the brazilian brandys in consequence of some intermediary products of the oxydation of the alcohols being left in the brandys during aging. 15 - The age has little or no influence on the quantity of phurphurol present in a brandy whose amount varies greatly the manner in which the wines to be distilled are treated. Wines centrifugalized or filtered before distillation always give rise to brandys poorer in phurphurol as compared with those distilled without these treatments. 16 - Though greatly variable, brandys of good qualities generally show a high residues coefficient, never under 200 mmg 17 - Lusson - Rocques oxydation coefficient cannot be indis- criminately applied to any brandy class, being, on the contrary, specifically destined to cognacs.

Estudo sôbre a variação da produção leiteira na raça holandesa malhada de preto

The authors studied the effects of calving time, season and time elapsed after calving on milk production of the Holstein Friesian Breed of the "Escola Superior de Agricultura "Luiz de Queiroz" (Piracicaba, Brasil), 180 lactation periods of 300 days were studied, with 15 calvings in each month. Statistical analysis of the data proved : 1. That calving in May, June, July or August, that is, in the driest months, the cows give a milk production 17,3% larger than calving in December, January, February, March or April. August is the best month for calving, and February is the worst. 2. Spring is the most favorable, and Autumn the most unfavorable season for milk production. 3. The decrease of milk production during the lactation period depends largely on calving time. But, on the whole, linear regression can be used as a good aproximation, with a correlation coefficient r = - 0,9926 and a monthly decrease, per month elapsed after calving, of 8,06 percent of the general mean. 4. Diagram 1 shows the effects of calving month on milk production. The limits of 5%, 1% and l%o of probabilities are given there.

Riqueza em óleo nas sementes, amêndoas e cascas das bagas de mamona

This paper is a joined publication of the Depts. of Genetics and of Technology, of the E. S. A. "Luiz de Queiroz", Universidade de São Paulo, and deals with the variation of the percentage oil content in the whole seeds, the embryos and the seed-coat of 28 varieties of castor-beans (Ricinus communis, L.). Primarily, the authors, as a justification of this paper, make reference to the applications which castor-oil has in industry, medicine, etc. In accordance with the weight of 100 seeds, the varieties of castor-beans were classified into 3 classes : small seeds (100 seeds less than 30 g), medium seeds (100 seeds between 30 g and 60) and large seeds (100 seeds more than 60 g). The percentage of oil in the seed, embryo and seed-coat, the dimensions of the seeds and the weight of 100 seeds are given for every variety in table 1. In order to obtain an estimate of the variability for the methods of determination of the oil percentage, in the 3 differents parts of the seeds and also in the 3 groups of seeds, the coefficient of variability was calculate (table 2). It is showed that the variation in the seed and embryo is low and that in the seed-coat is very high. The analysis of variance, with regard to the difference among the 3 types of seeds (small, medium and large), among the 3 parts of the seed (whole seed, embryo and seed-coat) and residual error, is given in table 3. Only, the oil content of whole seeds among types of seeds was significant at the 5% level. The t test among the correspondent means is not significant for the difference between medium and large seeds is significant between both these types (medium and large) and small seeds. The fiducial limits in relation to the mean of the oil percentage in the 3 differents types of seed, show that there is one variety (n. 1013-2), which has a percentage of oil, in the medium type of seed, significantly at the 5% level (table 4), higher than the general mean. Since the distribution of the percentage of oil in the seedcoat is discontinuous, 5 groups were established (table 5). All the differences between groups are significant (table 6). For practical purposes, when we have to remove the seed coat, one should eliminate those varieties which loose at least 3% of oil by this procedure. There is a significant linear correlation at 5% level between the percentage of oil in the seed and in the embryo, of the smali and medium type of seeds (table 7), and also, when taking the 3 types together (lower part of table 7), one finds that the same is true. Also, the correlation between the percentages of oil in the embryo and in the seed-coat of the 3 types together is significant at 5% level. According to the results obtained in relation to the percentage in 28 varieties studied, it can be recommended, for breeding purposes, to work only with those varieties which belong to the medium and the large types of seeds.

Determinação da média aritmética e desvio padrão de quocientes de séries independentes e dependentes

The authors prove some approximate formulas for the computation of the mean and the standard error of quotients of two variates, correlated or uncorrelated, with not too high coefficient of variation. The formulas obtained are subsequently applied to some date on mensuration of horses of the Brazilian breed Mangalarga, by the eclectic system of LESBRE. The relsults obtained directly by the actual computation of the quotients as well as by means of the formulas with the aid of statistics of the numerators and the denominators are given in table 3, showing excellent agreement.

O regime de chuvas em Pesqueira

The authors studied the rainfall in Pesqueira (Pernambuco, Brasil) in a period of 48 years (1910 through 1957) by the method of orthogonal polynomials, degrees up to the fourth having been tried. None of them was significant, so that it seems that no trend is present. The mean observed was 679.00 mm., with standard error of the mean 205.5 mm., and a 30.3% coefficient of variation. The 95% level of probability would include annual rainfall from 263.9 up to 1094.1mm.