State-of-the-art treatment of hypertension: established and new drugs.

The treatment of essential hypertension is based essentially on the prescription of four major classes of antihypertensive drugs, i.e. blockers of the renin-angiotensin system, calcium channel blockers, diuretics and beta-blockers. In recent years, very few new drug therapies of hypertension have become available. Therefore, it is crucial for physicians to optimize their antihypertensive therapies with the drugs available on the market. In each of the classes of antihypertensive drugs, questions have recently been raised: are angiotensin-converting enzyme (ACE) inhibitors superior to angiotensin II receptor blockers (ARB)? Is it possible to reduce the incidence of peripheral oedema with calcium antagonists? Is hydrochlorothiazide really the good diuretic to use in combination therapies? The purpose of this review is to discuss these various questions in the light of the most recent clinical studies and meta-analyses. These latter suggest that ACE inhibitors and ARB are equivalent except for a better tolerability profile of ARB. Third generation calcium channel blockers enable to reduce the incidence of peripheral oedema and chlorthalidone is certainly more effective than hydrochlorothiazide in preventing cardiovascular events in hypertension. At last, studies suggest that drug adherence and long-term persistence under therapy is one of the major issues in the actual management of essential hypertension.

Biological variation of established and novel biomarkers for atherosclerosis: Results from a prospective, parallel-group cohort study.

BACKGROUND: Biomarkers are a promising tool for the management of patients with atherosclerosis, but their variation is largely unknown. We assessed within-subject and between-subject biological variation of biomarkers in peripheral artery disease (PAD) patients and healthy controls, and defined which biomarkers have a favorable variation profile for future studies. METHODS: Prospective, parallel-group cohort study, including 62 patients with stable PAD (79% men, 65±7years) and 18 healthy control subjects (44% men, 57±7years). Blood samples were taken at baseline, and after 3-, 6-, and 12-months. We calculated within-subject (CVI) and between-subject (CVG) coefficients of variation and intra-class correlation coefficient (ICC). RESULTS: Mean levels of D-dimer, hs-CRP, IL-6, IL-8, MMP-9, MMP-3, S100A8/A9, PAI-1, sICAM-1, and sP-selectin levels were higher in PAD patients than in healthy controls (P≤.05 for all). CVI and CVG of the different biomarkers varied considerably in both groups. An ICC≥0.5 (indicating moderate-to-good reliability) was found for hs-CRP, D-Dimer, E-selectin, IL-10, MCP-1, MMP-3, oxLDL, sICAM-1 and sP-selectin in both groups, for sVCAM in healthy controls and for MMP-9, PAI-1 and sCD40L in PAD patients. CONCLUSIONS: Single biomarker measurements are of limited utility due to large within-subject variation, both in PAD patients and healthy subjects. D-dimer, hs-CRP, MMP-9, MMP-3, PAI-1, sP-selectin and sICAM-1 are biomarkers with both higher mean levels in PAD patients and a favorable variation profile making them most suitable for future studies.

Established and emerging prebiotics and their effects on the gut microflora

The use of probiotics combined with prebiotics (synbiotics) has been proved to be more and more interesting in the market of functional foods. The use of probiotics alone has a long history whereas the concept of prebiotics is rather new, introduced by Gibson & Roberfroid(1). Efficient prebiotics are considered the compounds that are not digested and selectively promote the growth of beneficial microorganisms (such as lactobacilli and bifidobacteria) in the colon. Some established prebiotics that are currently used in the European market are fructooligosaccharides (FOS), galactooligosaccharides (GOS) and inulin. However, there are more compounds considered as "emerging prebiotics" which have not been established yet, but there is a need of further investigation on them. Some of them are oligomers of soya & xylan, isomalto-oligosaccharides (IMO), polydextrose and possibly some oligosaccharides in honey. There is still an incomplete picture of their fermentation properties but according to the studies performed till now, it is quite possible that these molecules might have the same or more desirable properties than the established ones. In this review, the effects of the established and emerging prebiotics on the gut microflora are presented, based on in vitro and in vivo studies (healthy volunteers).

Biological variation of established and novel biomarkers for atherosclerosis: Results from a prospective, parallel-group cohort study.

BACKGROUND Biomarkers are a promising tool for the management of patients with atherosclerosis, but their variation is largely unknown. We assessed within-subject and between-subject biological variation of biomarkers in peripheral artery disease (PAD) patients and healthy controls, and defined which biomarkers have a favorable variation profile for future studies. METHODS Prospective, parallel-group cohort study, including 62 patients with stable PAD (79% men, 65±7years) and 18 healthy control subjects (44% men, 57±7years). Blood samples were taken at baseline, and after 3-, 6-, and 12-months. We calculated within-subject (CVI) and between-subject (CVG) coefficients of variation and intra-class correlation coefficient (ICC). RESULTS Mean levels of D-dimer, hs-CRP, IL-6, IL-8, MMP-9, MMP-3, S100A8/A9, PAI-1, sICAM-1, and sP-selectin levels were higher in PAD patients than in healthy controls (P≤.05 for all). CVI and CVG of the different biomarkers varied considerably in both groups. An ICC≥0.5 (indicating moderate-to-good reliability) was found for hs-CRP, D-Dimer, E-selectin, IL-10, MCP-1, MMP-3, oxLDL, sICAM-1 and sP-selectin in both groups, for sVCAM in healthy controls and for MMP-9, PAI-1 and sCD40L in PAD patients. CONCLUSIONS Single biomarker measurements are of limited utility due to large within-subject variation, both in PAD patients and healthy subjects. D-dimer, hs-CRP, MMP-9, MMP-3, PAI-1, sP-selectin and sICAM-1 are biomarkers with both higher mean levels in PAD patients and a favorable variation profile making them most suitable for future studies.

An exposition of the book of Solomon's Song : commonly called Canticles, wherein the authority of it is established and vindicated against objections, both ancient and modern; several versions compared with the original text; the different senses both of Jewish and Christian interpreters considered and the whole opened and explained in proper and useful observations /

Mode of access: Internet.

Nine sermons, on the nature of the evidence by which the fact of Our Lord's resurrection is established : and on various other subjects ; to which is prefixed A dissertation on the prophecies of the Messiah dispersed among the heathen /

Mode of access: Internet.

A COEXISTÊNCIA DOS GRUPOS NO ESPAÇO ESCOLAR: OS ESTABELECIDOS E OS OUTSIDERS

A pesquisa apresenta uma análise das relações de poder, no espaço da Educação Infantil do Município de Ribeirão Pires, focada no trabalho das Educadoras não-docentes e das Professoras de Desenvolvimento Infantil de duas escolas, localizadas em duas regiões distintas: uma na região central, e a outra em um vilarejo afastado do centro. O foco principal é o conflito entre esses dois grupos de profissionais, um foco secundário e complementar são as deficiências de funcionamento, que contribuem para a existência de conflito entre os grupos. A hipótese que norteia a pesquisa é a de que, as educadoras não-docentes, enquanto grupo veterano, valem-se da antiguidade, afirmando-se por meio de seus saberes tácitos ou empíricos, e as PDI, por sua vez, valem-se da titulação/diploma. A pesquisa foi realizada por meio de entrevistas e da observação na unidade escolar, visou apreender as diferenças estabelecidas entre os grupos de educadoras e professoras, mas, sobretudo, entender a forma com que ambas expressam as relações de poder no espaço e no tempo escolar. A pesquisa requereu como base, três referenciais analíticos: Norbert Elias (2000), que aborda as relações de poder; o Estudo de Sociologia do Desvio de Becker (2008) e o Estigma de Erving Goffman (1891). Partindo do estudo dos três autores foi possível observar, dentro das relações de poder entre os grupos de educadoras e professoras, algumas tendências e disposições coletivas, como: afirmação de superioridade pela tradição, afirmação de superioridade por títulos, inclinações a estigmatização, sentimentos de vitimização e a baixa burocratização institucional, corretamente podemos constatar, no que diz respeito ao foco secundário da pesquisa, a apresença nas escolas estudadas, de um baixo nível de burocratização institucional, o que contribui para estimular conflitos entre grupos docentes analisados. A pesquisa poderá contribuir para o debate em torno de assuntos relacionados com a modalidade Educação Infantil e seus agentes, tal qual ela se configura no Brasil.

Interfaces : educação especial & seguridade social

Com a Constituição da República Federativa do Brasil (1988), a intersetorialidade imprimiu nas políticas públicas de educação e seguridade social uma construção e uma operacionalidade mais articuladas e interdependentes. Entre as leis e portarias interministeriais, destaca-se o Programa Benefício de Prestação Continuada na Escola, que atende pessoas com deficiência de zero a dezoito anos de idade. Nesta pesquisa, questionam-se as interfaces entre as políticas públicas da educação especial e da seguridade social. São objetivos da pesquisa: analisar as interfaces das políticas públicas sociais – educação especial e seguridade social – no que se refere à garantia de direitos à educação de crianças com deficiência ou Transtornos Globais do Desenvolvimento, entre zero e cinco anos, no município de Vitória, Estado do Espírito Santo; identificar como se configuram as interdependências entre profissionais da educação especial e da seguridade social e os familiares (pais ou responsáveis) dessas crianças perante seus processos educacionais; compreender os diferentes movimentos entre as instituições de educação e da seguridade social e suas implicações para a inclusão escolar das crianças com deficiência ou Transtorno Global do Desenvolvimento; analisar como os profissionais da educação e da seguridade social lançam perspectivas para os processos de inclusão escolar e estabelecem diálogo com a família acerca da educação dessas crianças. Esta é uma pesquisa de natureza qualitativa, estudo de caso com coleta de dados empíricos e bibliográficos, na qual foram sujeitos: mães de três crianças de três Centros Municipais de Educação Infantil de Vitória; professoras da sala de atividades e de educação especial, pedagogas e diretoras; técnicos das Secretarias Municipais de Vitória: Educação, Saúde e Assistência Social e do Instituto Nacional do Seguro Social. As técnicas empregadas para coleta de dados foram a entrevista o grupo focal e o diário de itinerância. Foram procedimentos adotados para o registro dos dados a audiogravação de entrevistas e de grupos focais e anotações em diário de itinerância. Os dados foram organizados em cinco categorias de análise, produzidas por meio das narrativas dos familiares e dos profissionais participantes da pesquisa. Os conceitos de Norbert Elias, interdependência e configuração, relação de poder – estabelecidos e outsiders –, processos sociais e relação entre sociedade e Estado (balança do poder) contribuíram para compreender os dados, por serem observados nas categorias produzidas. Os resultados apontam para a fragilidade de Global do Desenvolvimento, no município de Vitória. Revelam, ainda, uma inconsistência de fluxos de referência e contrarreferência e lacunas na dimensão técnica e operativa para as interfaces das políticas públicas intersetoriais com práticas profissionais que cumpram o papel político conforme outorga a legislação federal e municipal. As considerações se ampliam para discussões entre o instituído e o instituinte – políticas públicas e práticas profissionais – que priorizem a efetivação da intersetorialidade diante das demandas do público investigado com vista à garantia dos direitos de acesso a uma educação de qualidade.

De "Patiamarillos" y "Tierrafueras": Encuentros, desencuentros y conflictos en tiempos de patrimonialización

Esta investigación se centra en identificar y entender los procesos de distinción social y espacial en el marco de las dinámicas de patrimonialización que han caracterizado al pueblo de Barichara, Santander en las últimas décadas. Basada en la etnografía, se lleva a cabo un acercamiento a las prácticas cotidianas de algunos de sus habitantes para comprender la complejidad de dinámicas que se desarrollan en un contexto atravesado por fronteras sociales. A través de historias de vida y situaciones sociales, se pretende dar cuenta de las experiencias contrastadas de personas que comparten un mismo pueblo pero que se ubican en posiciones diversas en el espacio social. En esta investigación se reflexiona sobre las múltiples modalidades de relacionamiento: los encuentros, los desencuentros y los conflictos.

Att integrera i det svenska samhället : En undersökning om kvinnor med invandrarbakgrund och deras syn på introduktion och andra faktorer som påverkar inträdet i det svenska arbetslivet och samhället

The integration policy in Sweden shall encourage individuals to support themselves and take part in society. It shall alsocontribute to equal rights and opportunities for women as well as for men. In Borlänge this has resulted in a program ofintroduction for new arrivals from other countries. However, at the unit responsible for economic support, they havediscovered that women with immigrant background more often than men seem to have trouble starting or became to anending of the program, which then especially leads women to a long-term dependence for economic support. The purpose of this study has therefore been to investigate what factors affect immigrant women’s participation in theintroduction, and what significance this participation has for their possibilities to become economically self-supporting,and integrated into Swedish society. Previous research shows that some of the obstacles for the integration of immigrant women can be that they give birthto many children, are unskilled or have a low degree of education and that they tend to be living under patriarchalgender patterns. Another problem seem to be that some women are not even known as members of the municipalities.All of these problems are as well what was shown in my own study. I have used theoretical perspectives from Bourdieu, Elias & Scotson, Giddens, Roman and al-Baldawi in my analysis.Bourdieu have interesting thoughts about capital, habitus and field, which can help us to understand how individuals arebeing shaped and are given different opportunities to act in a special way or direction. Elias & Scotson describesthrough their study around established and outsiders how the process of integration can take place and what effects thatcan be shown for the opportunities to succeed in that part. Giddens, Roman and al-Baldawi then give us different waysto look at the patriarchy and family structures around the world. The result of this study shows that the willingness to integrate and be able to take care of your own support for living isan important part for the women for succeeding. For the other women, that don’t succeed, it turns out to be just like theprevious research has been shown. Gender patterns, many children and a low or no education skill all seems to be partof the issue. It is also suggested that the generosity of the Swedish welfare system might hinder rather than help someimmigrant women to become integrated into Swedish society.

Modos de ser e modos de viver : a trajetória dos estrangeiros em Natal/RN

This work aims to understand the trajectory of immigrants living in Natal / RN, between the years 1990 and 2009, their motivations for this change, their sociability relations, as well as the impact of this group in Natal and specifically, in the district of Ponta Negra, where most of them established their residences or work. Considering that the historical, political, economical and social environment where these immigrants are inserted, are different from that experienced by former immigrants who came to Brazil in the late nineteenth and early twentieth centuries, a period of mass migration, it was revealed that immigration studied in contemporary Natal constitutes a new configuration (Elias, 1994). This new configuration is represented by several characteristics that distinguish this contemporary immigration, as: the relationship established by these foreigners, both with their country of origin and the destination, the formation of social networks that offer support to newcomers and those already installed, the relations of sociability with locals and a new relationship of belonging with the space, since the possibility of coming and going from one country to the other, allows a (re)production of their original ?? social and economic life in the new space. The research methodology was based on the analysis of narrative interviews, in light of the theory of Schütze (1977) in order to understand the faces of this immigration. As theoretical support for the data analysis the theories of authors such as Norbert Elias, presentedin his work about the established and outsiders, Pierre Bourdieu, and his concept of habitus, distinction and style of life, Georg Simmel, and his study of life in the metropolis, his analysis of the foreigner and his theory of sociability, among others. This study attempted to give visibility to foreigners living in Natal, who experience the dynamics of the district of Ponta Negra and reconstruct their daily relations of sociability in this space. In fact, the presence of foreigners in this urban context allows for the construction of new configurations, both in terms of the physical space of the neighborhood, which has been modified by the touristification process and the real estate market, which is molded to meet this demand, but also in their social sphere, with regard to the relations established between foreign residents and locals. In seeking to characterize these migratory experiences it could be understood that the trajectories of each foreigner is part of a broader social structure, which cannot be evaluated neither disconnected from the contexts in which they operate, nor under a single point of view

Da fábrica patronal à Cooperativa autogerida: processos educativos

Pós-graduação em Educação Escolar - FCLAR

Analysis of a Local HIV-1 Epidemic in Portugal Highlights Established Transmission of non-B and -G Subtypes

Existing data supports Portugal as the Western Europe country with highest HIV-1 subtype diversity. However, detailed phylogenetic studies of Portuguese HIV-1 epidemics are still scarce. Thus, our main goal was to analyze the phylodynamics of a local HIV-1 infection in the Portuguese region of Minho. Molecular epidemiological analysis was applied to data from 289 HIV-1 infected individuals followed in the reference Hospital of the province of Minho, Portugal, in which isolated viruses had been sequenced between 2000 and 2012. Viruses of the G (29.1%) and B (27.0%) subtypes were the most frequent, followed by recombinant forms (17.6%), C (14.5%), F1 (7.3%) and A1 (4.2%) subtypes. Multinomial logistic regression revealed that the odds of being infected with A1 and F1 subtype increased over the years when compared with B, G, C or recombinant viruses. As expected, polyphyletic patterns suggesting multiple and old introductions of subtypes B and G were found. However, transmission clusters of non-B and -G viruses among native individuals were also found with the dates of the most recent common ancestor estimated to the early 2000s. Our study supports that the HIV-1 subtype diversity in the Portuguese region of Minho is high and has been increasing in a manner that is apparently driven by factors other than immigration and international travel. Infections with A1 and F1 viruses in the region of Minho are becoming established and were mainly found in sexually transmitted clusters, reinforcing the need for more efficacious control measures targeting this infection route.