Cardiotocografia Anteparto e Prognóstico Perinatal em Gestações Complicadas pelo Diabete: Influência do Controle Metabólico Materno

Objetivo: relacionar a qualidade do controle metabólico com os resultados da cardiotocografia (CTG) anteparto e avaliar sua capacidade preditiva no prognóstico perinatal de gestações associadas ao diabete. Pacientes e Métodos: estudo retrospectivo de 125 gestantes, portadoras de diabete gestacional ou clínico, no qual se relacionou a última CTG anteparto (intervalo máximo de 48 horas) à qualidade do controle metabólico materno e aos resultados perinatais. A qualidade do controle metabólico foi definida pela média glicêmica do dia do exame (MGd) e da gestação (MG) e pelo comportamento da requisição de insulina (R/insulina). Para os resultados perinatais foram analisados os índices de Apgar de 1º e 5º minuto, a classificação peso/idade gestacional, o tempo de internação, a necessidade de cuidados de UTI e a ocorrência de óbito neonatal (ONN) precoce. A capacidade diagnóstica da CTG anteparto foi avaliada pelos índices de sensibilidade, especificidade e valor preditivo positivo e negativo. Resultados: a MGd adequada (<120 mg/dL) associou-se a 2,9% dos resultados de CTG anteparto alterados e a inadequada ( > ou = 120 mg/dL), a 26,1% (p<0,005). A MG mantida inadequada se relacionou a 13,7% de CTG anteparto alterada e a adequada, a apenas 2,7% (p<0,005). O comportamento da requisição de insulina não interferiu nos resultados da CTG anteparto. Os índices de Apgar de 1º e 5º minuto, a necessidade de cuidados de UTI e a ocorrência de ONN precoce não dependeram do último traçado da CTG anteparto. O exame diferenciou o tempo de internação dos recém-nascidos: quando normal, 46,4% tiveram alta hospitalar até o 3º dia de vida e, quando alterado, 62,5% deles ficaram internados por mais de sete dias. Conclusões: os resultados alterados da última CTG anteparto relacionaram-se com níveis inadequados de MG, diária e da gestação, e não dependeram da R/insulina. O resultado normal da CTG anteparto foi adequado para garantir a saúde neonatal. Ao contrário, os resultados alterados indicaram risco de complicações nos filhos de mães diabéticas.

Influência do controle metabólico materno nos resultados da cardiotocografia anteparto e sua relação com o prognóstico perinatal, nas gestações complicadas pelo diabete

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Endocrine response and perceived stress test during an experimental challenge task in adult survivors of a childhood cancer.

BACKGROUND: Although long-term implications of cancer in childhood or adolescence with regard to medical conditions are well documented, the impact on mental health and on response to stress, which may be an indicator of psychological vulnerability, is not yet well understood. In this study, psychological and physiological responses to stress were examined.¦PROCEDURE: Fifty-three participants aged 18-39 years (n = 25 survivors of childhood or adolescence cancer, n = 28 controls) underwent an experimental stress test, the Trier Social Stress Test (TSST). Participants were asked to provide repeated evaluations of perceived stress on visual-analogical scales and blood samples were collected before and after the TSST to measure plasma cortisol.¦RESULTS: The psychological perception of stress was not different between the two groups. However, the cancer survivors group showed a higher global plasma cortisol level as well as higher amplitude in the response to the TSST. The global cortisol level in cancer survivors was increased when depression symptoms were present. The subjective perception of stress and the plasma cortisol levels were only marginally correlated in both groups.¦CONCLUSIONS: It is suggested that the exposure to a life-threatening experience in childhood/adolescence increases the endocrine response to stress, and that the presence of depressive symptoms is associated with an elevation of plasma cortisol levels. A better knowledge of these mechanisms is important given that the dysregulations of the stress responses may cause psychological vulnerability. Pediatr Blood Cancer 2012; 59: 138-143. © 2011 Wiley Periodicals, Inc.

Non-exhaustive test for aerobic capacity determination in swimming rats

The aim of this study was to describe a double-bout exercise test for non-exhaustive aerobic capacity determination in swimming rats. Adult rats were Submitted to 4 swimming tests at different intensities (4%, 6%, 7%, and 8% of body mass), with intervals of 48 h between them. Two exercise bouts of equal intensity lasting 5 min were performed, separated by 2 min with blood collection for lactate analysis. For each intensity, delta lactate was determined by subtracting lactate concentration at the end of the first effort from the lactate at the end of the second effort. Individual linear interpolation of delta lactate concentration enabled determination of a null delta, equivalent to the critical load (CL). Maxima) lactate steady state (MLSS) was also determined. The estimated CL was of 4.8% body mass and the MLSS was observed at 100% of CL, with blood lactate of 5.20 mmol/L. At 90%, blood lactate stabilized, with a progressive increase to 110% CL. These results offer a potential determination of aerobic capacity in swimming rats.

Non-exhaustive test for aerobic capacity determination in running rats

A simple and applicable method for non-exhaustive aerobic evaluation in running rats is described. Wistar rats were submitted to running test at different velocities (10, 15, 20, 25 m/min) with 48 h recovery among them. At each velocity, the rats ran two bouts of 5 min with 2 min of rest between bouts. Blood samples were collected at the end of each bout for lactate determination. For each intensity, delta lactate was calculated and using deltas obtained by four tests, an individual linear interpolation was plotted. The y-intercept of linear interpolation was the null delta lactate equivalent to the critical velocity (CV). To verify the lactate stabilization at CV, the animals were submitted to 25 min of continuous exercise (15, 20, 25 m/min), with blood collection every 5 min. The estimated CV was 16.6±0.7 m/min, with significant linear regressions (R=0.90±0.03). The rats presented maximal lactate steady state (MLSS) at 3.9±0.4 mmol/L, at 20 m/min. The CV was less than MLSS but significantly correlated with this parameter (r=0.78). This non-exhaustive test seems to be valid for the aerobic evaluation of sedentary rats and this protocol underestimates the MLSS in 20%. This test seems to be the interesting method for the evaluation of rats submitted to acute exercise or physical training.

Sincronia e diacronia degli anglicismi finanziari nella comunicazione istituzionale e nella stampa specializzata: il caso degli stress test

Lo scoppio della crisi finanziaria globale del 2007 ha rappresentato un evento epocale che ha interessato una varietà di ambiti: l’economia, la finanza, il diritto, la sociologia e anche la comunicazione. Molti linguisti e ricercatori del settore terminologico si sono concentrati sulle conseguenze di questo capovolgimento nella comunicazione che ha accolto in misura crescente anglicismi finanziari provenienti dagli Stati Uniti. I documenti istituzionali, ma soprattutto la stampa generalista e finanziaria sono dovuti ricorrere per esigenze denotative agli anglicismi al fine di illustrare le cause di questo evento e proporre delle soluzioni adeguate per attenuarne gli effetti. Dopo la crisi, infatti, le autorità di vigilanza finanziaria europee hanno iniziato a mettere in campo una serie di riforme della regolamentazione finanziaria volte a prevenire la comparsa di nuove crisi sistemiche: lo stress testing costituisce uno degli strumenti che la vigilanza europea ha adottato allo scopo di valutare lo stato di salute dei bilanci degli istituti di credito e per vagliarne la solidità e la resistenza a crisi simili a quella esplosa nel 2007. Il nostro elaborato si propone di osservare in ottica diacronica il trattamento degli anglicismi finanziari del dominio dello stress testing nella comunicazione istituzionale della Banque de France e della Banca d’Italia e nella stampa economico-finanziaria francese e italiana. Per la realizzazione di tale indagine abbiamo adottato un approccio diacronico teso all’osservazione del trattamento dell’anglicismo stress test in un arco temporale che dai primi anni Duemila arriva fino ad oggi. Ai fini dell’indagine abbiamo costruito due corpora comparabili di testi istituzionali tratti dal sito Web della Banque de France e da quello della Banca d’Italia, delimitando la ricerca al dominio dello stress testing. Abbiamo successivamente compilato due corpora comparabili con testi tratti da La Tribune e Milano Finanza per osservare il trattamento degli anglicismi finanziari in un genere testuale differente, benché specializzato. Abbiamo assunto il 2007, anno di inizio della crisi, come spartiacque, suddividendo i corpora in vari subcorpora e selezionando i testi da includervi in base alla data di pubblicazione. L’obiettivo che ci siamo prefissati è quello di osservare se nel dominio dello stress testing abbia avuto luogo un’evoluzione concettuale e se questa sia riscontrabile anche dal trattamento degli anglicismi finanziari, con un focus particolare sull’anglicismo stress test.

Unconscious Fearful Priming Followed by a Psychosocial Stress Test Results in Higher Cortisol Levels

Human perception of stress includes an automatic pathway that processes subliminal presented stimuli below the threshold of conscious awareness. Subliminal stimuli can therefore activate the physiologic stress system. Unconscious emotional signals were shown to significantly moderate reactions and responses to subsequent stimuli, an effect called 'priming'. We hypothesized that subliminal presentation of a fearful signal during the Stroop task compared with an emotionally neutral one will prime stress reactivity in a subsequently applied psychosocial stress task, thereby yielding a significant increase in salivary cortisol. Half of 36 participants were repeatedly presented either a fearful face or a neutral one. After this, all underwent a psychosocial stress task. The fearful group showed a significant increase in cortisol levels (p = 0.022). This change was not affected by sex, age and body mass index, and it also did not change when taking resting cortisol levels into account. Post-hoc analyses showed that the increase in cortisol in the fearful group started immediately after the psychosocial stress test. Hence, subliminal exposure to a fearful signal in combination with the Stroop and followed by a psychosocial stress test leads to an increase in stress reactivity. Copyright © 2012 John Wiley & Sons, Ltd.

Electrocardiographic changes during stress test in a patient with "Brugada syndrome".

We report a 28 year old man with the Brugada syndrome characterised by an electrocardiographic pattern of a right bundle branch block and an ST segment elevation in the right precordial leads as well as syncope. During an exercise test, we observed a normalization of the ST segment in V2+ while in the postexercise phase, the ST segment elevation in the right leads was established. This is the first case reported of the Brugada syndrome in Mexico, with spontaneous changes on the EKG masked during exercise and apparent during postexercise phase.

Ensayo no destructivo de soldaduras en pernos conectores mediante inspección acústica = Non-destructive test of welding headed studs through acoustic emission

Los pernos conectores aportan múltiples ventajas de uso, entre las que se encuentra el elevado margen de seguridad que ofrecen sus soldaduras ejecutadas mediante arco eléctrico. Estas soldaduras, aunque ampliamente fiables, son difícilmente comprobadas mediante ensayos no destructivos. Aparte de la inspección visual, que aporta gran información sobre la calidad de ejecución de la soldadura, el resto de ensayos no destructivos (líquidos penetrantes, partículas magnéticas, ultrasonidos, radiografías, etc.) resultan inviables en estos elementos. Por otro lado, los ensayos acústicos de piezas metálicas han existido siempre. Su comprobación se basaba en el análisis por medio de ¿un oído fino¿ del sonido resultante tras ser golpeado el elemento a evaluar. Con estas premisas se plantea el presente estudio de inspección de las soldaduras en pernos conectores mediante su espectro acústico. Analíticamente, la investigación se ha centrado en el cálculo informático de los primeros modos propios de vibración mediante elementos finitos. Se han modelizado diferentes grados de penetración de la soldadura mediante la modificación de las condiciones de contorno. Se ha observado que variando el número de movimientos coaccionados en los nodos pertenecientes a la soldadura se produce una reducción en su frecuencia de vibración.

The ECB AQR and the EBA Stress Test: What will the numbers tell? CEPS Commentary, 23 October 2014

From the Introduction. With the results of its asset quality review (AQR), to be published on 26 October 2014, the European Central Bank intends to provide clarity on the shape of the 120 banks it will supervise in the eurozone, and it may request a series of follow-up actions before assuming its new set of tasks under the Single Supervisory Mechanism (SSM) Regulation in November. On the same day, the European Banking Authority (EBA) will also be publishing the results of its stress test, covering 123 banks across 22 European Economic Area (EEA) countries. For the ECB, it will be a matter of setting the standard for its future task, whereas EBA, seeks to restore the confidence it lost in the 2011 stress test and 2012 capital exercise. Both institutions will need to indicate how they will cooperate in the future in these tasks, and through enhanced disclosure, strengthen the confidence in the European banking system.