Torsemida em Comparação com Furosemida no Tratamento da Insuficiência Cardíaca: Uma Revisão Sistemática e Metanálise de Ensaios Clínicos Randomizados / Torsemide versus Furosemide in the Treatment of Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Resumo A furosemida é o diurético mais utilizado para o tratamento de sintomas de sobrecarga de volume em pacientes com insuficiência cardíaca. Dados recentes sugerem que a torsemida pode ser superior à furosemida neste contexto. No entanto, ainda não é claro se isso se traduz em melhores resultados clínicos nesta população. Avaliar se a torsemida é superior à furosemida no contexto da insuficiência cardíaca. Realizamos uma revisão sistemática e metanálise de estudos clínicos randomizados (ECRs) comparando a eficácia da torsemida em comparação com a furosemida em pacientes com insuficiência cardíaca. PubMed, Embase e Web of Science foram as bases de dados pesquisadas em busca de estudos elegíveis. Os desfechos de interesse foram internações por todas as causas, internações por insuficiência cardíaca (IIC), internações por todas as causas cardiovasculares, mortalidade por todas as causas, e melhoria de classe da NYHA. Parâmetros ecocardiográficos também foram avaliados. Foi aplicado um modelo de efeitos aleatórios para calcular as razões de risco (RR) e as diferenças médias (DM) com intervalos de confiança (IC) de 95% e nível de significância de 0,05. Foram incluídos 12 ECRs, envolvendo 4.115 pacientes. A torsemida reduziu significativamente a IIC (RR de 0,60; IC de 95%, 0,43-0,83; p=0,002; I2=0%), internação por causas cardiovasculares (RR de 0,72; IC de 95%, 0,60-0,88; p=0,0009; I2=0%), e melhora da fração de ejeção do ventrículo esquerdo (FEVE) (DM de 4,51%; IC de 95%, 2,94 a 6,07; p<0,0001; I2=0%) em comparação com a furosemida. Não houve diferença significativa no número de internações por todas as causas (RR de 0,93; IC de 95%, 0,86-1,00; p=0,04; I2=0%), mortalidade por todas as causas (RR de 0,98; IC de 95%, 0,87-1,10; p=0,73; I2=0%), melhora da classe NYHA (RR de 1,25; IC de 95%, 0,92-1,68; p=0,15; I2=0%), ou mudança de classe NYHA (DM de -0,04; IC de 95%, -0,24 a 0,16; p=0,70; I2=15%) entre os grupos. A torsemida reduziu significativamente as internações por insuficiência cardíaca e causas cardiovasculares, melhorando também a FEVE.

Abstract Furosemide is the most used diuretic for volume overload symptoms in patients with heart failure (HF). Recent data suggested that torsemide may be superior to furosemide in this setting. However, whether this translates into better clinical outcomes in this population remains unclear. To assess whether torsemide is superior to furosemide in the setting of HF. We performed a systematic review and meta-analysis of RCTs comparing the efficacy of torsemide versus furosemide in patients with HF. PubMed, Embase, and Web of Science were searched for eligible trials. Outcomes of interest were all-cause hospitalizations, hospitalizations for HF (HHF), hospitalizations for all cardiovascular causes, all-cause mortality, and NYHA class improvement. Echocardiographic parameters were also assessed. We applied a random-effects model to calculate risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) and a 0.05 level of significance. 12 RCTs were included, comprising 4,115 patients. Torsemide significantly reduced HHF (RR 0.60; 95% CI, 0.43-0.83; p=0.002; I2=0%), hospitalization for cardiovascular causes (RR 0.72; 95% CI, 0.60-0.88; p=0.0009; I2=0%), and improved LVEF (MD 4.51%; 95% CI, 2.94 to 6.07; p<0.0001; I2=0%) compared with furosemide. There was no significant difference in all-cause hospitalizations (RR 0.93; 95% CI, 0.86-1.00; p=0.04; I2=0%), all-cause mortality (RR 0.98; 95% CI, 0.87-1.10; p=0.73; I2=0%), NYHA class improvement (RR 1.25; 95% CI, 0.92-1.68; p=0.15; I2=0%), or NYHA class change (MD -0.04; 95% CI, -0.24 to 0.16; p=0.70; I2=15%) between groups. Torsemide significantly reduced hospitalizations for HF and cardiovascular causes, also improving LVEF.

Crescimento, severidade de oídio e produtividade do feijão-vagem em resposta a diferentes fontes de potássio / Growth, powdery mildew severity and yield of green beans in response to potassium sources

O Brasil tem enfrentado sérios problemas com o abastecimento de fertilizantes potássicos nos últimos anos. Isso tem causado a elevação dos preços e até mesmo escassez do principal fertilizante potássico utilizado pelos produtores, o cloreto de potássio. Por isso, o objetivo do presente trabalho foi avaliar um silicato de potássio nacional (K6) como fonte alternativa ao uso do cloreto de potássio para a cultura do feijão-vagem. Para tanto, sementes de feijão-vagem cv. Macarrão Rasteiro foram semeadas a campo em espaçamento de 0,50 x 0,20 m. Empregou-se o delineamento em blocos ao acaso com quatro tratamentos e cinco repetições. Os tratamentos foram constituídos da seguinte maneira: (i) testemunha ­ sem adubação potássica; (ii) cloreto de potássio; (iii) silicato de potássio ­ K6; (iv) 50% cloreto de potássio + 50% K6. Os fertilizantes foram aplicados no momento da semeadura e as doses determinadas com base na análise de solo e nas recomendações para a cultura. Foi realizada avaliação de altura de plantas, massa fresca e seca da parte aérea, massa fresca e seca de vagens, estimativa de produtividade e ocorrência de oídio, através de notas de severidade. Verificou-se que não houve influência da adubação potássica sobre o crescimento das plantas. De maneira geral, a produtividade de vagens apresentou baixa influência da adubação. Entretanto, a produtividade total de vagens foi maior em plantas adubadas com K6 em comparação a plantas adubadas com cloreto de potássio. A aplicação de K6 também contribuiu para a redução da severidade de oídio. Dessa forma, nós concluímos que o K6 é uma fonte de potássio viável em substituição ao cloreto de potássio para o feijão-vagem. (AU)

Brazil has faced serious problems with the supply of potassium fertilizers in recent years. This has caused prices to rise and even shortages of the main potassium fertilizer used by producers, potassium chloride. Therefore, the objective of the present work was to evaluate a national potassium silicate (K6) as an alternative source to the use of potassium chloride for the green beans crop. For this purpose, green beans seeds cv. Macarrão Rasteiro were sown in the field at a spacing of 0.50 x 0.20 m. A randomized block design with four treatments and five replications was used. The treatments were constituted as follows: (i) control ­ without potassium fertilization; (ii) potassium chloride; (iii) potassium silicate - K6; (iv) 50% potassium chloride + 50% K6. Fertilizers were applied at the time of sowing and doses were determined based on soil analysis and recommendations for the crop. Plant height, shoot fresh and dry mass, pod fresh and dry mass, yield estimation and occurrence of powdery mildew were evaluated through severity scores. It was found that in terms of plant growth, there was no influence of potassium fertilization on plant growth. In addition, pod productivity showed a reduction throughout the evaluation period and little influence of fertilization. However, total pod productivity was higher in plants that received K6 compared to plants fertilized with potassium chloride. The application of K6 also contributed to the reduction of powdery mildew severity. Thus, we conclude that K6 is a viable source of potassium in substitution of potassium chloride for the green beans.(AU)

Do enhanced efficiency potassium sources increase maize yield in soil with high potassium content?

Enhanced efficiency potassium fertilizers can be a management tool that is crucial to crop sustainability in maize (Zea mays L.). However, there is a need for studies aimed at validating the use of these fertilizers in different production environments. This study aimed to evaluate the performance of maize under sources and rates of K through conventional and enhanced efficiency fertilizers in soil with high available K content. The experiment was carried out for two years in an Oxisol (605 g kg-1 of clay) with high K content (6.7 mmolc dm-3). Three sources were used, one conventional (KCl), one obtained by additives sprayed on the fertilizer surface (KCl-C), and one obtained by compacting KCl powder and adding additives (KCl-CC), associated with three K2O rates as top-dressing (50, 100, 150 kg ha-1) and a control without K2O. In all treatments, 48 kg ha-1 of K2O was applied in the sowing furrow. In the first year, maize yield increased linearly for both the KCl and KCl-C sources. The maximum yield (7,967 kg ha-1) for the KCl-CC was obtained at 88 kg ha-1. In the second year, the maximum yields for the KCl (7,553 kg ha-1) and KCl-C (8,166 kg ha-1) were obtained with 20 and 67 kg ha-1 K2O, respectively, while for the KCl-CC maize yield did not change. Enhanced efficiency K sources promote increases in maize yield ranging from 4.3 % to 7.1 %. Top-dressing K fertilization in high-fertility soils is a viable alternative for producers focused on increasing maize yield, mainly when enhanced efficiency sources are used.(AU)

Sodium chloride replacement by potassium chloride in bread: Determination of sensorial potassium threshold and effect on dough properties and breadmaking quality.

High sodium intakes represent an important risk factor for hypertension, cardiovascular diseases and kidney diseases. Even during the current COVID-19 pandemic, hypertension was related to higher mortality rate in patients with coronavirus. Thus, it is necessary to apply strategies to reduce or replace sodium content in food most widely consumed, like bread. This work aimed at determining the sensorial potassium threshold when potassium chloride is used as a sodium chloride replacer in bread formulation, and at analyzing the effects of such replacement on the properties of dough and on the technological and sensorial quality of bread. A decrease was observed in dough rheological properties with NaCl reduction in the formulation. Sensorial potassium threshold was determined and KCl was used in bread formulation as a NaCl replacement up to 0.92% of the regular salt content (2%) undetected by its characteristic taste. NaCl reduction resulted in bread with lower specific volume, higher firmness, faster staling and clearer crust. KCl bread showed similar technological to 2% NaCl bread. Finally, it was possible to replace 50% of NaCl with KCl without reducing quality and consumer acceptability.

Effect of Packaging and Salt Content and Type on Antioxidant and ACE-Inhibitory Activities in Requeson Cheese.

Requeson cheese is obtained from whey proteins. The production of this cheese is the most economical way to recover and concentrate whey proteins, which is why it is frequently made in some Latin American countries. Four requeson cheese treatments were prepared with different concentrations and combinations of salts (sodium chloride and/or potassium chloride) and were conventionally or vacuum packed. Proteolysis, peptide concentration, angiotensin-converting enzyme (ACE) inhibitory and antioxidant (DPPH and ABTS) activities were evaluated over time (one, seven and fourteen days). Requeson cheese presented antioxidant and ACE inhibitory activities, however, these values vary depending on salt addition, type of packaging and time of storage. The highest values of antioxidant activity (ABTS) were found in cheese added with 1.5% NaCl and 1.5% (NaCl/KCl, 1:1). Cheese without added salt and vacuum packed presented the highest ACE inhibition percentage at day seven. Therefore, it can be concluded that requeson cheese elaborated exclusively of sweet whey, presents antioxidant and ACE inhibition activity. However, for a cheese with ACE inhibitory capacity, it is recommended not to add salts or add at 1% (NaCl) and vacuum pack it. Additionally, for a cheese with antioxidant activity, it is recommended to add salt at 1.5% either NaCl or (1:1) NaCl/KCl and pack it either in a polyethylene bag or vacuum. In conclusion, requeson cheese elaborate with 100% sweet whey is a dairy product with antioxidant and ACE inhibition activity, being low in salt and fat.

Microbial activity and carbon rates the soil in response to the application of potassium sources

The continuous use of KCl may not be sustainable in the long term in agricultural systems. High doses used in crops accumulate in the soil and plants, hindering the metabolic processes of soil organisms. This study assessed the soil microbial activity in response to the application of K sources in banana crop and effects on microbial C. The experimental design was completely randomized with four K sources: potassium nitrate (KNO3), potassium chloride (KCl), potassium sulfate (K2SO4), and monopotassium phosphate (KH2PO4) at 200 mg kg-1of K2O, besides the control (without K) and combinations KCl:K2SO4. KCl application increased microbial activity 7 days after incubation, with gradual reduction over time. The isolated application of K2SO4and the combination KCl: K2SO4at the ratio 60: 40% increased total CO2released by the microbiota. K2SO4source had the highest microbial biomass C (MBC), as well as the 60: 40 combinations. Isolated application of K sources, especially with high chloride concentration, reduces the soil microbial activity and MBC.(AU)

Determination of hedonic thresholds by varying three stimuli.

The Hedonic Threshold Methodology (HTM), through the determination of compromised acceptance threshold (CAT) and hedonic rejection threshold (HRT), has several applications by the food industry. In order to further increase the field of application of HTM, the objective was to use a mixture design in the Hedonic Threshold Methodology, to enable the determination of hedonic thresholds (CAT and HRT) by varying the intensity of three stimuli simultaneously. It was investigated how much it is possible to replace the NaCl content (1.8% flour weight basis) with two other ingredients (KCL/yeast extract or KCL/enzyme preparation), without compromising the acceptance (CAT) and without resulting in sensory rejection (HRT) of crackers. Reduction in the acceptance started to occur by reducing the NaCl content by around 64% (from 1.81% to 0.651%), with the addition of 1.149% KCl. Two combinations of KCl and yeast extract (1.783% and 0.017%, or 0.693% and 1.107%, respectively) allowed producing a cracker with no NaCl without sensory rejection. The reduction in acceptance also started to occur by reducing the NaCl content by around 40% (from 1.81% to 1.086%), with adding of 0.358% KCl and 0.356% enzyme preparation. A sensory rejection begins to occur by reducing the NaCl content by around 99% (1.81-0.012%), with the addition of 1.215% KCl and 0.573% enzyme preparation (transglutaminase). The use of the mixture design in HTM allowed the unprecedented determination of hedonic thresholds varying three stimuli. This expands the possibilities for applications of sensory thresholds.

Exogenously applied nutrients can improve the chickpea productivity under water stress conditions by modulating the antioxidant enzyme system / Nutrientes aplicados exogenamente melhoram a produtividade do grão-de-bico em condições de estresse hídrico, modulando o sistema de enzimas antioxidantes

Water stress is one of the major factor restricting the growth and development of chickpea plants by inducing various morphological and physiological changes. Therefore, the present research activity was designed to improve the chickpea productivity under water stress conditions by modulating antioxidant enzyme system. Experimental treatments comprised of two chickpea genotypes i.e. Bhakhar 2011 (drought tolerant) and DUSHT (drought sensitive), two water stress levels i.e. water stress at flowering stage and water stress at flowering + pod formation + grain filling stage including well watered (control) and three exogenous application of nutrients i.e. KCl 200 ppm, MgCl2, 50 ppm and CaCl2, 10 mM including distilled water (control). Results indicated that water stress at various growth stages adversely affects the growth, yield and quality attributes of both chickpea cultivars. Exogenous application of nutrients improved the growth, yield and antioxidant enzyme activities of both chickpea genotypes even under water stress conditions. However, superior results were obtained with foliar spray of potassium chloride on Bhakhar 2011 under well-watered conditions. Similarly, foliar spray of potassium chloride on chickpea cultivar Bhakhar 2011 cultivated under stress at flowering + pod formation + grain filling stage produced significantly higher contents of superoxide dismutase, peroxidase and catalase. These results suggests that the application of potassium chloride mitigates the adverse effects of water stress and enhanced tolerance in chickpea mainly due to higher antioxidant enzymes activity, demonstrating the protective measures of plant cells in stress conditions.

O estresse hídrico é um dos principais fatores que restringem o crescimento e o desenvolvimento das plantas de grão-de-bico, induzindo várias alterações morfológicas e fisiológicas. Portanto, a presente atividade de pesquisa foi projetada para melhorar a produtividade do grão-de-bico em condições de estresse hídrico, por meio da modulação do sistema de enzimas antioxidantes. Tratamentos experimentais compostos de dois genótipos de grão-de-bico, ou seja, Bhakhar 2011 (tolerante à seca) e DUSHT (sensível à seca), dois níveis de estresse hídrico, ou seja, estresse hídrico na fase de floração e estresse hídrico na floração + formação de vagens + estágio de enchimento de grãos incluindo bem irrigado (controle) e três aplicações exógenas de nutrientes, ou seja, KCl 200 ppm, MgCl2 50 ppm e CaCl2 10 mM, incluindo água destilada (controle). Os resultados indicaram que o estresse hídrico em vários estágios de crescimento afeta negativamente os atributos de crescimento, rendimento e qualidade de ambas as cultivares de grão-de-bico. A aplicação exógena de nutrientes melhorou o crescimento, o rendimento e as atividades das enzimas antioxidantes de ambos os genótipos de grão- de-bico, mesmo em condições de estresse hídrico. No entanto, resultados superiores foram obtidos com pulverização foliar de cloreto de potássio em Bhakhar 2011, em condições bem irrigadas. Da mesma forma, a pulverização foliar de cloreto de potássio na cultivar de grão-de-bico Bhakhar 2011 cultivada sob estresse na fase de floração + formação de vagens + enchimento de grãos produziu teores significativamente maiores de superóxido dismutase, peroxidase e catalase. Esses resultados sugerem que a aplicação de cloreto de potássio atenua os efeitos adversos do estresse hídrico e aumenta a tolerância no grão-de-bico, principalmente em razão de mais atividade de enzimas antioxidantes, demonstrando as medidas protetoras das células vegetais em condições de estresse.

Exogenously applied nutrients can improve the chickpea productivity under water stress conditions by modulating the antioxidant enzyme system / Nutrientes aplicados exogenamente melhoram a produtividade do grão-de bico em condições de estresse hídrico, modulando o sistema de enzimas antioxidantes

Water stress is one of the major factor restricting the growth and development of chickpea plants by inducing various morphological and physiological changes. Therefore, the present research activity was designed to improve the chickpea productivity under water stress conditions by modulating antioxidant enzyme system. Experimental treatments comprised of two chickpea genotypes i.e. Bhakhar 2011 (drought tolerant) and DUSHT (drought sensitive), two water stress levels i.e. water stress at flowering stage and water stress at flowering + pod formation + grain filling stage including well watered (control) and three exogenous application of nutrients i.e. KCl 200 ppm, MgCl2, 50 ppm and CaCl2, 10 mM including distilled water (control). Results indicated that water stress at various growth stages adversely affects the growth, yield and quality attributes of both chickpea cultivars. Exogenous application of nutrients improved the growth, yield and antioxidant enzyme activities of both chickpea genotypes even under water stress conditions. However, superior results were obtained with foliar spray of potassium chloride on Bhakhar 2011 under well-watered conditions. Similarly, foliar spray of potassium chloride on chickpea cultivar Bhakhar 2011 cultivated under stress at flowering + pod formation + grain filling stage produced significantly higher contents of superoxide dismutase, peroxidase and catalase. These results suggests that the application of potassium chloride mitigates the adverse effects of water stress and enhanced tolerance in chickpea mainly due to higher antioxidant enzymes activity, demonstrating the protective measures of plant cells in stress conditions.

O estresse hídrico é um dos principais fatores que restringem o crescimento e o desenvolvimento das plantas de grão-de-bico, induzindo várias alterações morfológicas e fisiológicas. Portanto, a presente atividade de pesquisa foi projetada para melhorar a produtividade do grão-de-bico em condições de estresse hídrico, por meio da modulação do sistema de enzimas antioxidantes. Tratamentos experimentais compostos de dois genótipos de grão-de-bico, ou seja, Bhakhar 2011 (tolerante à seca) e DUSHT (sensível à seca), dois níveis de estresse hídrico, ou seja, estresse hídrico na fase de floração e estresse hídrico na floração + formação de vagens + estágio de enchimento de grãos incluindo bem irrigado (controle) e três aplicações exógenas de nutrientes, ou seja, KCl 200 ppm, MgCl2 50 ppm e CaCl2 10 mM, incluindo água destilada (controle). Os resultados indicaram que o estresse hídrico em vários estágios de crescimento afeta negativamente os atributos de crescimento, rendimento e qualidade de ambas as cultivares de grão-de-bico. A aplicação exógena de nutrientes melhorou o crescimento, o rendimento e as atividades das enzimas antioxidantes de ambos os genótipos de grão-de-bico, mesmo em condições de estresse hídrico. No entanto, resultados superiores foram obtidos com pulverização foliar de cloreto de potássio em Bhakhar 2011, em condições bem irrigadas. Da mesma forma, a pulverização foliar de cloreto de potássio na cultivar de grão-de-bico Bhakhar 2011 cultivada sob estresse na fase de floração + formação de vagens + enchimento de grãos produziu teores significativamente maiores de superóxido dismutase, peroxidase e catalase. Esses resultados sugerem que a aplicação de cloreto de potássio atenua os efeitos adversos do estresse hídrico e aumenta a tolerância no grão-de-bico, principalmente em razão de mais atividade de enzimas antioxidantes, demonstrando as medidas protetoras das células vegetais em condições de estresse.

Exogenously applied nutrients can improve the chickpea productivity under water stress conditions by modulating the antioxidant enzyme system

Abstract Water stress is one of the major factor restricting the growth and development of chickpea plants by inducing various morphological and physiological changes. Therefore, the present research activity was designed to improve the chickpea productivity under water stress conditions by modulating antioxidant enzyme system. Experimental treatments comprised of two chickpea genotypes i.e. Bhakhar 2011 (drought tolerant) and DUSHT (drought sensitive), two water stress levels i.e. water stress at flowering stage and water stress at flowering + pod formation + grain filling stage including well watered (control) and three exogenous application of nutrients i.e. KCl 200 ppm, MgCl2, 50 ppm and CaCl2, 10 mM including distilled water (control). Results indicated that water stress at various growth stages adversely affects the growth, yield and quality attributes of both chickpea cultivars. Exogenous application of nutrients improved the growth, yield and antioxidant enzyme activities of both chickpea genotypes even under water stress conditions. However, superior results were obtained with foliar spray of potassium chloride on Bhakhar 2011 under well-watered conditions. Similarly, foliar spray of potassium chloride on chickpea cultivar Bhakhar 2011 cultivated under stress at flowering + pod formation + grain filling stage produced significantly higher contents of superoxide dismutase, peroxidase and catalase. These results suggests that the application of potassium chloride mitigates the adverse effects of water stress and enhanced tolerance in chickpea mainly due to higher antioxidant enzymes activity, demonstrating the protective measures of plant cells in stress conditions.

Resumo O estresse hídrico é um dos principais fatores que restringem o crescimento e o desenvolvimento das plantas de grão-de-bico, induzindo várias alterações morfológicas e fisiológicas. Portanto, a presente atividade de pesquisa foi projetada para melhorar a produtividade do grão-de-bico em condições de estresse hídrico, por meio da modulação do sistema de enzimas antioxidantes. Tratamentos experimentais compostos de dois genótipos de grão-de-bico, ou seja, Bhakhar 2011 (tolerante à seca) e DUSHT (sensível à seca), dois níveis de estresse hídrico, ou seja, estresse hídrico na fase de floração e estresse hídrico na floração + formação de vagens + estágio de enchimento de grãos incluindo bem irrigado (controle) e três aplicações exógenas de nutrientes, ou seja, KCl 200 ppm, MgCl2 50 ppm e CaCl2 10 mM, incluindo água destilada (controle). Os resultados indicaram que o estresse hídrico em vários estágios de crescimento afeta negativamente os atributos de crescimento, rendimento e qualidade de ambas as cultivares de grão-de-bico. A aplicação exógena de nutrientes melhorou o crescimento, o rendimento e as atividades das enzimas antioxidantes de ambos os genótipos de grão- de-bico, mesmo em condições de estresse hídrico. No entanto, resultados superiores foram obtidos com pulverização foliar de cloreto de potássio em Bhakhar 2011, em condições bem irrigadas. Da mesma forma, a pulverização foliar de cloreto de potássio na cultivar de grão-de-bico Bhakhar 2011 cultivada sob estresse na fase de floração + formação de vagens + enchimento de grãos produziu teores significativamente maiores de superóxido dismutase, peroxidase e catalase. Esses resultados sugerem que a aplicação de cloreto de potássio atenua os efeitos adversos do estresse hídrico e aumenta a tolerância no grão-de-bico, principalmente em razão de mais atividade de enzimas antioxidantes, demonstrando as medidas protetoras das células vegetais em condições de estresse.

Exogenously applied nutrients can improve the chickpea productivity under water stress conditions by modulating the antioxidant enzyme system / Nutrientes aplicados exogenamente melhoram a produtividade do grão-de bico em condições de estresse hídrico, modulando o sistema de enzimas antioxidantes

Water stress is one of the major factor restricting the growth and development of chickpea plants by inducing various morphological and physiological changes. Therefore, the present research activity was designed to improve the chickpea productivity under water stress conditions by modulating antioxidant enzyme system. Experimental treatments comprised of two chickpea genotypes i.e. Bhakhar 2011 (drought tolerant) and DUSHT (drought sensitive), two water stress levels i.e. water stress at flowering stage and water stress at flowering + pod formation + grain filling stage including well watered (control) and three exogenous application of nutrients i.e. KCl 200 ppm, MgCl2, 50 ppm and CaCl2, 10 mM including distilled water (control). Results indicated that water stress at various growth stages adversely affects the growth, yield and quality attributes of both chickpea cultivars. Exogenous application of nutrients improved the growth, yield and antioxidant enzyme activities of both chickpea genotypes even under water stress conditions. However, superior results were obtained with foliar spray of potassium chloride on Bhakhar 2011 under well-watered conditions. Similarly, foliar spray of potassium chloride on chickpea cultivar Bhakhar 2011 cultivated under stress at flowering + pod formation + grain filling stage produced significantly higher contents of superoxide dismutase, peroxidase and catalase. These results suggests that the application of potassium chloride mitigates the adverse effects of water stress and enhanced tolerance in chickpea mainly due to higher antioxidant enzymes activity, demonstrating the protective measures of plant cells in stress conditions.(AU)

O estresse hídrico é um dos principais fatores que restringem o crescimento e o desenvolvimento das plantas de grão-de-bico, induzindo várias alterações morfológicas e fisiológicas. Portanto, a presente atividade de pesquisa foi projetada para melhorar a produtividade do grão-de-bico em condições de estresse hídrico, por meio da modulação do sistema de enzimas antioxidantes. Tratamentos experimentais compostos de dois genótipos de grão-de-bico, ou seja, Bhakhar 2011 (tolerante à seca) e DUSHT (sensível à seca), dois níveis de estresse hídrico, ou seja, estresse hídrico na fase de floração e estresse hídrico na floração + formação de vagens + estágio de enchimento de grãos incluindo bem irrigado (controle) e três aplicações exógenas de nutrientes, ou seja, KCl 200 ppm, MgCl2 50 ppm e CaCl2 10 mM, incluindo água destilada (controle). Os resultados indicaram que o estresse hídrico em vários estágios de crescimento afeta negativamente os atributos de crescimento, rendimento e qualidade de ambas as cultivares de grão-de-bico. A aplicação exógena de nutrientes melhorou o crescimento, o rendimento e as atividades das enzimas antioxidantes de ambos os genótipos de grão-de-bico, mesmo em condições de estresse hídrico. No entanto, resultados superiores foram obtidos com pulverização foliar de cloreto de potássio em Bhakhar 2011, em condições bem irrigadas. Da mesma forma, a pulverização foliar de cloreto de potássio na cultivar de grão-de-bico Bhakhar 2011 cultivada sob estresse na fase de floração + formação de vagens + enchimento de grãos produziu teores significativamente maiores de superóxido dismutase, peroxidase e catalase. Esses resultados sugerem que a aplicação de cloreto de potássio atenua os efeitos adversos do estresse hídrico e aumenta a tolerância no grão-de-bico, principalmente em razão de mais atividade de enzimas antioxidantes, demonstrando as medidas protetoras das células vegetais em condições de estresse.(AU)

Particle characterisation of traditional homeopathically manufactured medicine cuprum metallicum and controls

Homeopathy is highly controversial. The main reason for this is its use of very highly dilute medicines (high homeopathic potencies, HHP), diluted beyond the Avogadro/Loschmidt limit. Research using several different methods has demonstrated the presence of particles, including nanoparticles of source material, in HHPs. This study aims to verify the results of a previous publication that detected the presence of particles in all dilutions. We used the Nano Tracking Analyzer (NTA) to examine dilutions of a commonly used homeopathic medicine, an insoluble metal, Cuprum metallicum, for the presence of particles. The homeopathic medicines tested were specially prepared according to the European pharmacopoeia standards. We compared the homeopathic dilutions/dynamizations with simple dilutions and controls including a soluble medicine. We observed the presence of solid material in all preparations including HHPs (except for pure water). The measurements showed significant differences in particle sizes distribution between homeopathic manufacturing lines and controls. Homeopathic medicines do contain material with a specific size distribution even in HHPs diluted beyond the Avogadro/Loschmidt limit. This specificity can be attributed to the manufacturing and potentization process. This material demonstrates that the step-by-step process (dynamized or not) does not match the theoretical expectations in a dilution process. The starting material and dilution/dynamization method influences the nature and concentration of these NPs.

Suicidio con cloruro de potasio: Reporte de un caso / Suicide with potassium chloride: Case report

Resumen El suicidio es el uso deliberado de violencia externa con la intención de quitarse la vida, y el uso de medicamentos es una forma en la que esta se puede consumar, el cloruro de potasio es uno de los medicamentos que en concentraciones elevadas tienen efectos letales, por lo que el objetivo de este artículo científico es detallar características farmacológicas del cloruro de potasio, y los elementos a considerar en el estudio postmorten de cadáveres cuando se sospecha de una intoxicación por cloruro de potasio con manera de muerte suicida; con la metodología de estudio de artículos científicos, exposición de un caso clínico y discusión de la importancia del análisis de los elementos aportados y solicitados durante la investigación médico legal, también la especial y delicada importancia de una correcta recolección de muestras biológicas y continentes de medicamentos para el estudio toxicológico y químicoanalítico; de esta manera se concluye que el Cloruro de potasio es un fármaco con efectos colaterales dañinos en la función eléctrica cardiaca, la determinación de la manera de muerte es un trabajo complejo para el médico forense en este tipo de casos, y los resultados de la pericias complementarias a la autopsia tienen mucha importancia para el análisis de este tipo de casos.

Abstract Suicide is the deliberate use of external violence with the intention of taking one's life, and the use of medications is one way in which this can be consumed, potassium chloride is one of the medications that in high concentrations have lethal effects, Therefore, the objective of this scientific article is to detail the pharmacological characteristics of potassium chloride, and the elements to be considered in the postmortem study of corpses when potassium chloride poisoning is suspected as a suicidal death; with the methodology of study of scientific articles, presentation of a clinical case and discussion of the importance of the analysis of the elements provided and requested during the medical-legal research, also the special and delicate importance of a correct collection of biological samples and drug containers for toxicological and chemical analysis; In this way, it is concluded that potassium chloride is a drug with harmful collateral effects on cardiac electrical function, determining the manner of death is a complex job for the forensic doctor in this type of case, and the results of the expertise complementary to the autopsy are very important for the analysis of this type of case.

Accidental epidural catheter infusion of potassium chloride for postoperative analgesia: A case report.

An infusion of 100 cc of 0,2% potassium chloride was accidental performed through a thoracic epidural catheter, inserted to perioperative analgesia, to a 66 years old man who was scheduled for right hemicolectomy, 48 h after surgery. Paresis of upper limbs, flaccid paralysis of lower limbs and a sensitive level at T8 was observed. An epidural lavage with an initial dose of 20 cc of saline was slowly injected, followed for a saline infusion of 20 cc per hour. Neurologic signs were totally reverted some hours later and 24 h after the incident the physical exam was normal. We reviewed the clinical presentation of the complication and its mechanisms, the more frequent clinical evolution, as well as treatment measures and strategies to prevent the incident.

Accidental epidural catheter infusion of potassium chloride for postoperative analgesia: A case report. / Infusión accidental de cloruro de potasio a través de un catéter epidural para analgesia postoperatoria: reporte de caso clínico.

An infusion of 100cc of 0,2% potassium chloride was accidental performed through a thoracic epidural catheter, inserted to perioperative analgesia, to a 66years old man who was scheduled for right hemicolectomy, 48hours after surgery. Paresis of upper limbs, flaccid paralysis of lower limbs and a sensitive level at T8 was observed. An epidural lavage with an initial dose of 20cc of saline was slowly injected, followed for a saline infusion of 20cc per hour. Neurologic signs were totally reverted some hours later and 24hours after the incident the physical exam was normal. We reviewed the clinical presentation of the complication and its mechanisms, the more frequent clinical evolution, as well as treatment measures and strategies to prevent the incident.

Reduction of sodium content in pork coppa: physicochemical, microbiological and sensory evaluation

Sodium reduction and the substitution of sodium chloride by other salts have been extensively studied in order to produce healthier foods. Coppa is a pork cured product that receives high levels of sodium through the salting process. The objective of this work was to evaluate the impact of reductions in Sodium Chloride (NaCl), substitution by Potassium Chloride (KCl) and reductions in the re-salting time on the physicochemical, microbiological and sensorial characteristics in pork coppa. Four treatments were applied: T1 with 2 days of salting, 2 days of re-salting and 35 % reduction of NaCl; T2 with 2 days of salting and 3 days of re-salting and 35 % reduction of NaCl; T3 with 2 days of salting and 2 days of re-salting and replacing 35 % of NaCl by KCl; T4 with 2 days of salting and 3 days of re-salting and 35 % replacing NaCl by KCl. Control: standard treatment was applied with 100 % of NaCL and salting time was 2 days and then 5 days to re-salting. The reduction in sodium content in processed pork Coppa produced no microbiological nor physicochemical changes. The reduction in salting together with salting and re-salting time and the partial replacement of NaCl by KCl resulted in reductions from 2,000 mg to 1,600 mg of sodium. Sensory evaluation demonstrated that the reduction in re-salting time was efficient using the ideal profile method which showed that treatments T1 and T2 were efficient in creating a product that meets consumer expectations.

Reduction of sodium content in pork coppa: physicochemical, microbiological and sensory evaluation

Sodium reduction and the substitution of sodium chloride by other salts have been extensively studied in order to produce healthier foods. Coppa is a pork cured product that receives high levels of sodium through the salting process. The objective of this work was to evaluate the impact of reductions in Sodium Chloride (NaCl), substitution by Potassium Chloride (KCl) and reductions in the re-salting time on the physicochemical, microbiological and sensorial characteristics in pork coppa. Four treatments were applied: T1 with 2 days of salting, 2 days of re-salting and 35 % reduction of NaCl; T2 with 2 days of salting and 3 days of re-salting and 35 % reduction of NaCl; T3 with 2 days of salting and 2 days of re-salting and replacing 35 % of NaCl by KCl; T4 with 2 days of salting and 3 days of re-salting and 35 % replacing NaCl by KCl. Control: standard treatment was applied with 100 % of NaCL and salting time was 2 days and then 5 days to re-salting. The reduction in sodium content in processed pork Coppa produced no microbiological nor physicochemical changes. The reduction in salting together with salting and re-salting time and the partial replacement of NaCl by KCl resulted in reductions from 2,000 mg to 1,600 mg of sodium. Sensory evaluation demonstrated that the reduction in re-salting time was efficient using the ideal profile method which showed that treatments T1 and T2 were efficient in creating a product that meets consumer expectations.(AU)

Comparison between the Effects of Bretschneider's HTK Solution and Cold Blood Cardioplegia on Systemic Endothelial Functions in Patients who Undergo Coronary Artery Bypass Surgery: a Prospective Randomized and Controlled Trial.

OBJECTIVE: To investigate the effects of Bretschneider's histidine-tryptophan-ketoglutarate (HTK) solution and cold blood cardioplegia on systemic endothelial functions. METHODS: A total of 50 patients who underwent isolated coronary artery bypass surgery between March 2018 and May 2018 were randomly divided into two groups - group 1 (Bretschneider's HTK solution, n=25) and group 2 (cold blood cardioplegia, n=25). Data related to the indicators of endothelial dysfunction were recorded. Flow-mediated dilation was measured together with the assessment of the values of endothelin-1, von Willebrand factor, and asymmetric dimethylarginine to identify endothelial dysfunction. Then, the two groups were compared regarding these values. RESULTS: The most significant result of our study was that the endothelin-1 level was significantly higher in group 2 than in group 1 (P<0.001). The value of flow-mediated dilation was found to increase to a lesser degree on the postoperative days compared to the value at the day of admission in group 1 (P=0.002 and P=0.030, respectively). CONCLUSION: Cardiopulmonary bypass leads to endothelial dysfunction. Our results revealed that Bretschneider's HTK solution causes less severe endothelial injury than cold blood cardioplegia.

Comparison between the effects of bretschneiders htk solution and cold blood cardioplegia on systemic endothelial functions in patients who undergo coronary artery bypass surgery: a prospective randomized and controlled trial

Abstract Objective: To investigate the effects of Bretschneider's histidine-tryptophan-ketoglutarate (HTK) solution and cold blood cardioplegia on systemic endothelial functions. Methods: A total of 50 patients who underwent isolated coronary artery bypass surgery between March 2018 and May 2018 were randomly divided into two groups - group 1 (Bretschneider's HTK solution, n=25) and group 2 (cold blood cardioplegia, n=25). Data related to the indicators of endothelial dysfunction were recorded. Flow-mediated dilation was measured together with the assessment of the values of endothelin-1, von Willebrand factor, and asymmetric dimethylarginine to identify endothelial dysfunction. Then, the two groups were compared regarding these values. Results: The most significant result of our study was that the endothelin-1 level was significantly higher in group 2 than in group 1 (P<0.001). The value of flow-mediated dilation was found to increase to a lesser degree on the postoperative days compared to the value at the day of admission in group 1 (P=0.002 and P=0.030, respectively). Conclusion: Cardiopulmonary bypass leads to endothelial dysfunction. Our results revealed that Bretschneider's HTK solution causes less severe endothelial injury than cold blood cardioplegia.

Pregnancy during the course of Cushing's syndrome: a case report and literature review.

SUMMARY: Cushing's syndrome is an endocrine disorder that causes anovulatory infertility secondary to hypercortisolism; therefore, pregnancy rarely occurs during its course. We present the case of a 24-year-old, 16-week pregnant female with a 10-month history of unintentional weight gain, dorsal gibbus, nonpruritic comedones, hirsutism and hair loss. Initial biochemical, hormonal and ultrasound investigations revealed hypokalemia, increased nocturnal cortisolemia and a right adrenal mass. The patient had persistent high blood pressure, hyperglycemia and hypercortisolemia. She was initially treated with antihypertensive medications and insulin therapy. Endogenous Cushing's syndrome was confirmed by an abdominal MRI that demonstrated a right adrenal adenoma. The patient underwent right laparoscopic adrenalectomy and anatomopathological examination revealed an adrenal adenoma with areas of oncocytic changes. Finally, antihypertensive medication was progressively reduced and glycemic control and hypokalemia reversal were achieved. Long-term therapy consisted of low-dose daily prednisone. During follow-up, despite favorable outcomes regarding the patient's Cushing's syndrome, stillbirth was confirmed at 28 weeks of pregnancy. We discuss the importance of early diagnosis and treatment of Cushing's syndrome to prevent severe maternal and fetal complications. LEARNING POINTS: Pregnancy can occur, though rarely, during the course of Cushing's syndrome. Pregnancy is a transient physiological state of hypercortisolism and it must be differentiated from Cushing's syndrome based on clinical manifestations and laboratory tests. The diagnosis of Cushing's syndrome during pregnancy may be challenging, particularly in the second and third trimesters because of the changes in the maternal hypothalamic-pituitary-adrenal axis. Pregnancy during the course of Cushing's syndrome is associated with severe maternal and fetal complications; therefore, its early diagnosis and treatment is critical.