Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background Complex percutaneous coronary intervention (PCI) is associated with higher ischemic risk, which can be mitigated by long-term dual antiplatelet therapy (DAPT). However, concomitant high bleeding risk (HBR) may be present, making it unclear whether short- or long-term DAPT should be prioritized. Objectives This study investigated the effects of ischemic (by PCI complexity) and bleeding (by PRECISE-DAPT [PRE dicting bleeding Complications in patients undergoing stent Implantation and Sub sequent Dual Anti Platelet Therapy] score) risks on clinical outcomes and on the impact of DAPT duration after coronary stenting. Methods Complex PCI was defined as ≥3 stents implanted and/or ≥3 lesions treated, bifurcation stenting and/or stent length >60 mm, and/or chronic total occlusion revascularization. Ischemic and bleeding outcomes in high (≥25) or non-high (<25) PRECISE-DAPT strata were evaluated based on randomly allocated duration of DAPT. Results Among 14,963 patients from 8 randomized trials, 3,118 underwent complex PCI and experienced a higher rate of ischemic, but not bleeding, events. Long-term DAPT in non-HBR patients reduced ischemic events in both complex (absolute risk difference: −3.86%; 95% confidence interval: −7.71 to +0.06) and noncomplex PCI strata (absolute risk difference: −1.14%; 95% confidence interval: −2.26 to −0.02), but not among HBR patients, regardless of complex PCI features. The bleeding risk according to the Thrombolysis In Myocardial Infarction scale was increased by long-term DAPT only in HBR patients, regardless of PCI complexity. Conclusions Patients who underwent complex PCI had a higher risk of ischemic events, but benefitted from long-term DAPT only if HBR features were not present. These data suggested that when concordant, bleeding, more than ischemic risk, should inform decision-making on the duration of DAPT. (AU)

Association of CYP1A1 (cytochrome P450) MspI polymorphism in women with endometriosis.

Endometriosis is a disease that affects 10 to 15% of the women of reproductive age. It is characterized by the presence of endometrial-like tissues outside of the uterus. Some definitions claim that the functional ectopic tissue is sensitive to the action of hormones. Severity of endometriosis is defined according to a system proposed by the American Society for Reproductive Medicine, which is based on laparoscopic findings. A large number of genetic polymorphisms has been reported for CYP1A1, the gene that is responsible for enzymes involved in stage I detoxification of xenobiotics; this gene is located at 15q22-24, and encodes an isoenzyme that catalyzes the oxidation of polycyclic aromatic hydrocarbons present in phenolic compounds and epoxides. The aim of this study was to analyze the frequency of the MspI polymorphism and its relation to endometriosis. We obtained peripheral blood samples from 52 women with endometriosis (confirmed by laparoscopy) as well as 42 women without endometriosis (control group). In the case group, the women were between 25 and 35 years of age; the age range was between 25 and 57 years old in the control group. Molecular analysis was performed by polymerase chain reaction. We found a significant association (P = 0.039) between the polymorphic allele m1 and endometriosis (32.70%). In conclusion, this study showed that the m1 polymorphism is associated with endometriosis, and that W1/m1 and m1/m1 polymorphisms are more frequently observed in patients with infertility and severe endometriosis.

Walker 256 tumor-bearing rats demonstrate altered interstitial cells of Cajal. Effects on ICC in the Walker 256 tumor model.

BACKGROUND: Cachexia is a significant problem in patients with cancer. The effect of cancer on interstitial cells of Cajal (ICC) and neurons of the gastrointestinal tract have not been studied previously. Although supplementation with L-glutamine 2% may have beneficial effects in cancer-related cachexia, and be protective of ICC in models of oxidative stress such as diabetes, its effects on ICC in cancer have also not been studied. METHODS: Twenty-eight male Wistar rats were divided into four groups: control (C), control supplemented with L-glutamine (CG), Walker 256 tumor (WT), and Walker 256 tumor supplemented with L-glutamine (WTG). Rats were implanted with tumor cells or injected with saline in the right flank. After 14 days, the jejunal tissues were collected and processed for immunohistochemical techniques including whole mounts and cryosections and Western blot analysis. KEY RESULTS: Tumor-bearing rats demonstrate reduced numbers of Myenteric ICC and deep muscular plexus ICC and yet increased Ano1 protein expression and enhanced ICC networks. In addition, there is more nNOS protein expressed in tumor-bearing rats compared to controls. L-glutamine treatment had a variety of effects on ICC that may be related to the disease state and the interaction of ICC and nNOS neurons. Regardless, L-glutamine reduced the size of tumors and also tumor-induced cachexia that was not due to altered food intake. CONCLUSIONS & INFERENCES: There are significant effects on ICC in the Walker 256 tumor model. Although supplementation with L-glutamine has differential and complex effects of ICC, it reduces tumor size and tumor-associated cachexia, which supports its beneficial therapeutic role in cancer.

Assessment of the ozone tolerance of two soybean cultivars (Glycine max cv. Sambaíba and Tracajá) cultivated in Amazonian areas.

Brazilian soybean cultivars (Glycine max Sambaíba and Tracajá) routinely grown in Amazonian areas were exposed to filtered air (FA) and filtered air enriched with ozone (40 and 80 ppb, 6 h/day for 5 days) to assess their level of tolerance to this pollutant by measuring changes in key biochemical, physiological, and morphological indicators of injury and in enzymatic and non-enzymatic antioxidants. Sambaíba plants were more sensitive to ozone than Tracajá plants, as revealed by comparing indicator injury responses and antioxidant stimulations. Sambaíba exhibited higher visible leaf injury, higher stomatal conductance, and a severe decrease in the carbon assimilation rate. Higher ozone level (80 ppb) caused an increase in cell death in both cultivars. Levels of malondialdehyde and hydrogen peroxide also increased in Tracajá exposed under 80 ppb. Sambaíba plants exhibited decreases in ascorbate and glutathione levels and in enzymatic activities associated with these antioxidants. The higher tolerance of the Tracajá soybean appeared to be indicated by reduced physiological injuries and lower stomatal conductance, which might decrease the influx of ozone and enhance oxidation-reduction reactions involving catalase, ascorbate peroxidase, ascorbate, and glutathione, most likely stimulated by higher hydrogen peroxide.

GSTM1 and GSTT1 polymorphisms in endometriosis in women from Goiás, Brazil.

Endometriosis is a gynecologic pathology with a high prevalence and unknown etiology. Therefore, an increasing number of studies has been undertaken to search for associations between endometriosis and alterations or polymorphisms in candidate genes, including glutathione S-transferase mu 1 (GSTM1) and glutathione S-transferase theta 1 (GSTT1). We analyzed the frequency of present/absent polymorphisms of GSTM1 and GSTT1 in 50 women diagnosed with endometriosis and in a control group of 46 women without complaints related to this pathology. The association of these polymorphisms with p53 gene codon 72 was also evaluated within each group, and a higher frequency of absence of GSTM1 (61%) and GSTT1 (45%) genes in the group of women studied, women with endometriosis and control group was found. The contributions of GSTM1 and GSTT1 polymorphisms to the proliferation of endometriosis were not statistically significant, but the analysis of pathology and the association of GSTM1 and GSTT1 gene polymorphisms with p53 codon 72 revealed statistical significance.

Dynamical model for competing opinions.

We propose an opinion model based on agents located at the vertices of a regular lattice. Each agent has an independent opinion (among an arbitrary, but fixed, number of choices) and its own degree of conviction. The latter changes every time two agents which have different opinions interact with each other. The dynamics leads to size distributions of clusters (made up of agents which have the same opinion and are located at contiguous spatial positions) which follow a power law, as long as the range of the interaction between the agents is not too short; i.e., the system self-organizes into a critical state. Short range interactions lead to an exponential cutoff in the size distribution and to spatial correlations which cause agents which have the same opinion to be closely grouped. When the diversity of opinions is restricted to two, a nonconsensus dynamic is observed, with unequal population fractions, whereas consensus is reached if the agents are also allowed to interact with those located far from them. The individual agents' convictions, the preestablished interaction range, and the locality of the interaction between a pair of agents (their neighborhood has no effect on the interaction) are the main characteristics which distinguish our model from previous ones.

Experimental analysis of lateral impact on planar brittle material: spatial properties of cracks.

The breakup of alkaline glass and alumina plates due to planar impacts on one of their lateral sides is studied. Particular attention is given to investigating the spatial location of the cracks within the plates. Analysis based on a phenomenological model suggests that bifurcations along the cracks' paths are more likely to take place closer to the impact region than far away from it, i.e., the bifurcation probability seems to lower as the perpendicular distance from the impacted lateral increases. It is also found that many observables are not sensitive to the plate material used in this work, as long as the fragment multiplicities corresponding to the fragmentation of the plates are similar. This gives support to the universal properties of the fragmentation process reported in previous experiments. However, even under the just mentioned circumstances, some spatial observables are capable of distinguishing the material of which the plates are made, which therefore suggests that this universality should be carefully investigated.

Polymorphism of the progesterone receptor gene associated with endometriosis in patients from Goiás, Brazil.

We investigated a possible link between endometriosis and polymorphism of the progesterone receptor gene (PROGINS). The endometriosis group consisted of 54 patients with a diagnosis of endometriosis by laparoscopy, and the control group comprised 44 women without endometriosis. Genotypes for PROGINS polymorphisms (A1/A1, A1/A2 and A2/A2) were determined by polymerase chain reaction and analyzed on a 2% agarose gel stained with ethidium bromide. The frequency of polymorphic genotypes (A1/A2 and A2/A2) was significantly higher in patients with endometriosis (33%) than in the control group (16%). We conclude that there is a significant correlation between PROGINS polymorphism and endometriosis.

RsaI polymorphism of the ERß gene in women with endometriosis.

We examined the frequency of RsaI polymorphism of the ERß gene in 54 patients diagnosed with endometriosis and 46 controls. Peripheral blood was collected from women undergoing laparoscopy with a confirmed diagnosis of endometriosis. Polymorphisms of the ERß gene and p53 were assessed by PCR and analyzed on 2% agarose gel stained with ethidium bromide. The AG polymorphism genotype frequency in patients with endometriosis was 59.3%, with 40.7% GG. In the control group, the frequency of AG was 6.5%, with 93.5% GG. The frequency of heterozygous AG was nine times higher in patients with endometriosis than in the control group (P < 0.0001).

Experimental analysis of lateral impact on planar brittle material.

The fragmentation of alumina and glass plates due to lateral impact is studied. A few hundred plates have been fragmented at different impact velocities and the produced fragments are analyzed. The method employed in this work allows one to investigate some geometrical properties of the fragments, besides the traditional size distribution usually studied in former experiments. We found that, although both materials exhibit qualitative similar fragment size distribution function, their geometrical properties appear to be quite different. A schematic model for two-dimensional fragmentation is also presented and its predictions are compared to our experimental results. The comparison suggests that the analysis of the fragments' geometrical properties constitutes a more stringent test of the theoretical models' assumptions than the size distribution.

Design and assembly of an experimental laboratory for the study of atmosphere-plant interactions in the system of fumigation chambers.

An experimental laboratory was designed and assembled at the Botanical Institute of São Paulo, Brazil, in order to research atmosphere-plant interactions through the use of a system of fumigation chambers. A system of three "closed" fumigation chambers was designed to be used inside or outside the laboratory. The system was built to be used with a single pollutant or a mix of them. The innovation in this system is to allow chemical reactions inside the chambers that simulate atmospheric chemistry, especially photochemical processes involving high levels of ozone. Assessment of the performance and applicability of the system was based on the response of Nicotiana tabacum Bel W3 exposed to ozone produced alternatively by a generator and inside the chamber by reactions of its precursors. The results showed that the system can be well applied to the study of atmospheric chemistry interactions and the effects on plants.

Avaliação da produção de bezerros em confinamento ou em suplementação exclusiva / Evaluation of production of calves in feed lot or in creep feeding systems

Avaliou-se o desempenho de vacas e bezerros desmamados aos 90 (D90) e aos 210 (D210) dias, utilizando-se 36 vacas Beefalo-Nelore, multíparas e seus bezerros, em delineamento experimental de blocos ao acaso, com 18 repetições, sendo nove machos e nove fêmeas. Aos 90 dias pós-parto os bezerros foram pesados e distribuídos em dois tratamentos, adotando-se para a formação do bloco o peso e o sexo do bezerro. Os dois tratamentos foram creep-feeding (D210) e confinamento (D90). Os bezerros (D210) foram criados em pastagem de Brachiaria decumbens e B. humidicula com 48 hectares Os bezerros (D90) foram confinados em 7,95m²/animal e receberam capim elefante picado e concentrado. As médias de consumo de matéria seca do concentrado, do peso ao desmame e do ganho de peso foram 0,56 e 1,69kg/dia; 208,68 e 185,67kg; 0,75 e 0,52kg/dia, respectivamente, para bezerros D210 e D90. Matrizes D90 apresentaram maior peso (448,86kg) aos 210 dias pós-parto. Sugere-se a suplementação excluviva, ou creep-feeding, para desmame de bezerros mais pesados

Performances of cows and calves weaned at 90 (D90) and 210 days of age (D210) were evaluated, using 36 Beefalo-Nelore multiparus cows and their calves, in a randomized block experimental design, with 18 replicates of nine animals of each sex. Calves were allotted to treatments using as criteria to form blocks, the weight and sex of the animal. Calves (D210) were raised in 48ha pasture of Brachiaria decumbens e B. humidicula. Calves (D90) were raised in feedlot condition, in an area of 7.95m² /animal, and were fed chopped elephant grass and concentrate. The average concentrate dry matter intake, weaned body weight and weight gain were, respectively, 0.56 and 1.69kg/day; 208.68 and 185.67kg; 0.75 and 0.52kg/day respectively for D210 e D90 calves. Cows from D90 treatment showed higher body weight (448.86kg) at 210 days post partum. Creep-feeding is suggested for weaning heavier calves

Electrochemical potential of free and immobilized Cratylia mollis seed lectin.

The electrochemical potentials for free or immobilized Cratylia mollis seed lectin (Cra) were obtained through potentiostatic techniques. A saline solution was used as support to control the charge distribution between saturated calomel electrode and platinum electrode (working electrode). The electrochemical potential to free Cra was determined at the following concentrations: 0.6, 0.9 and 1.0 mg/ml in an aerated environment under different temperatures (5, 10 and 20 degrees C). The best electrochemical potential was obtained with 1.0 mg/ml, at 5 and 10 degrees C, 87 and 102 mV, respectively. Electrochemical potential to Cra immobilized on glass beads activated with 3-aminopropyltriethoxysilane described a linear behavior in relation to the increase in glucose concentration. The development of techniques to define interface electrical parameters will be able to give information about charged groups adsorbed to electrode surface revealing interactions particularly in biological systems.

Measurements of atmospheric carboxylic acids and carbonyl compounds in São Paulo City, Brazil.

Winter atmospheric measurements of gaseous lower carbonyl and carboxylic acids were carried out simultaneously (in 1999) at two distinct urban sites located in the city of São Paulo, Brazil. The greater metropolitan area of São Paulo is the largest industrialized region of Latin America and has a highly polluted atmosphere. It has an unconventional mix of vehicle types in that a variety of gasoline blends, including oxygenated ones, are used. Mixing ratios of formic and acetic acids ranged, respectively, from 0.6 to 19.4 and from 0.1 to 10.6 ppbv in one of the sites studied and from 1.4 to 18.4 and from 0.4 to 6.7 ppbv in the other site. High values of formic to acetic ratios were found, especially in the latter site (average = 4.3), suggesting that photochemical production was the predominant source of the formic and acetic acid during the afternoon. Differing from the acids, levels of carbonyls were similar at both sites. Higher average mixing ratios of acetaldehyde and formaldehyde were found in the morning (18.9 and 17.2 ppbv) and gradually decreased from midday (9.5 and 11.8 ppbv) to evening (7.2 and 10.2 ppbv). In the morning, vehicular direct emission seemed to be the main primary source of formaldehyde and acetaldehyde, whereas at midday and evening these compounds appeared to be mainly formed by photochemistry. Secondary photochemical production of organic acids and aldehydes (rather than primary emissions from vehicles) was shown to be more important in São Paulo's atmosphere from midday to evening, particularly on days with strong solar radiation.

[Nursing residency: a 20-year experience]. / Residência de enfermagem: uma trajetória de 20 anos.

This descriptive study about Nursing Residence is an attempt to understand the period between 1978 and 1998. Describes the evolution occurred on Residence about programs organization, theoretical and research activities, preceptory, avaliation and future perspectives. The study has a Qualitative Approach. The data was collected with Documental Analysis. The actuals beliefs and tendencies are indicating that the residence programs must be constructed by Nursing Residents and Preceptors. The Nursing Residence is a valuable strategic of especialization of nurses at service.

Proximal femoral osteotomy as the primary operation for young adults who have osteoarthrosis of the hip.

We report the results of proximal femoral osteotomy that was performed to treat osteoarthrosis in twenty-three consecutive young adults (twenty-five hips) who had a mean age of thirty-eight years (range, eighteen to fifty-three years). The mean duration of follow-up was seven years (range, two to twelve years). With conversion to a total hip replacement as the end point, the rate of survival at twelve years was 67 per cent (95 per cent confidence interval, 37 to 88 per cent). Four hips (16 per cent) were converted to a total hip replacement at a mean of eight years after the osteotomy. For the patients who did not have conversion to a total hip replacement, the mean score for pain, according to the system of Merle d'Aubigné and Postel as modified by Charnley, improved from 3.4 points preoperatively to 5.1 points postoperatively, the mean score for walking ability improved from 3.9 to 4.7 points, and the mean score for range of motion improved from 3.2 to 4.2 points. These results compare favorably with those following other forms of operative treatment of osteoarthrosis of the hip in young adults. In addition, the osteotomy does not preclude subsequent replacement arthroplasty if one is necessary.

Avaliacao da funcao renal em pacientes com retencao nitrogenada submetidos a urografia com bolus. / Evaluation of renal function in patients with nitrogenous retention subjected to urography with bolus

Os autores realizaram 16 urografias em pacientes portadores de insufiencia renal aguda e cronica, com altas doses de contraste iodado, obtendo imagens radiograficas diagnosticas, sem no entanto, evidenciarem alteracoes na funcao renal, baseado na dosasgem sanguinea de creatinina pre e pos exame radiologico. Tambem nao foram notados efeitos colaterais do tipo hipersensibilidade