Effect of Ferric Sodium EDTA administration, in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine, on cardiovascular risk evaluation: exploration of the HRV frequency domain

diseases. Using the Heart Rate Variability (HRV) analysis is possible to provide an evaluation of the safety and the effectiveness of intervention. Objective: To evaluate the efficacy and safety of Ferric Sodium EDTA in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine (Ferachel forte®) 2 tabs/day for 24 days in elderly patients with secondary anaemia, by exploring the HRV frequency domain. Methods: In 45 elderly patients with secondary anaemia and/or low-moderate kidney failure, laboratory values after administration of Ferric Sodium EDTA, 2 tabs a day, in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine (Ferachel forte®) for 24 days (N=16 patients) or ferrous gluconate 63 mg/day added to saline solution, administered using intravenous access during the hospitalization period of 15 ± 5 days (N=29 patients) were evaluated. Also, ECG signals and bioelectrical impedance (BIA) were measured. Results: Oral iron supplementation with Ferric Sodium EDTA, in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine (Ferachel forte®) confirmed to be effective and safe about the cardiovascular risk in old patients. This study showed the real superiority of the oral administration about the cardiovascular risk in elderly patients in comparison with intravenous administration of ferrous gluconate. Conclusion: This study confirms that Ferric Sodium EDTA combination (Ferachel forte®) can be a valid alternative to ferrous gluconate intravenous therapy (gold standard) in the treatment of secondary anaemia in elderly patients. In fact, during the treatment, efficacy results have been maintained without statistically significant variations about cardiovascular risk, evaluated by exploring the HRV frequency domain

Physical activity and cancer prevention: a review of current evidence and biological mechanisms

Objective. The main aim of this paper is to review the evidence available from the date of PubMed?s inception to May 2011 for a link between cancer and physical activity (PA) in both animal models and humans. Methods. We decided to select studies that comply with the scheme proposed by the American College of Sports Medicine/ American Heart Association (ACSM/AHA) that distinguish occupational physical activity (OPA) and leisure-time physical activity (LT-PA), further classified in three levels of intensity (low, moderate and heavy) based on the Metabolic Equivalent of Task (MET) index. Results. Considering animal models, there was strong evidence for an inverse association between voluntary wheel exercise and the risk of colon and breast cancer. Regarding human studies, we identified the following main results: 1) colorectum: LT-PA provided an overall colon risk reduction of 13-14%; 2) breast: significant reduction in the frequency of post-menopausal (PMP) cancers in women that practiced heavy and moderate LT-PA; 3) prostate: heavy OPA and LT-PA seemed to reduce the risk of advanced prostate cancers; 4) endometrium: strong protective effect of heavy/moderate LT-PA among overweight/ obese women; 5) lung: inverse relationship between heavy LT-PA and lung cancer in former or current smokers across all histologies. Conclusion. Increased LT-PA is associated with cancer prevention in several organs, but strong biases, such as body mass index (BMI), gender and age, make it difficult to assess which aspects of PA contribute most strongly to the reduced risk. Furthermore, we found few studies that indicated a protective role for OPA in cancer prevention when compared with LT-PA

A systematic review

Background: Adherence to therapy has been reported worldwide as a major problem, and that is particularly relevant on inhaled therapy for Asthma and Chronic Obstructive Pulmonary Disease (COPD), considering its barriers and features. It was synthesized the global literature reporting the main determinants for adherence on these patients. Methods: Searches were made in Cochrane Library, MEDLINE, EMBASE and ISI Web of Science databases. Analytical observational epidemiological studies (cohort, case-control and cross-sectional studies) were included, reporting association between any type of determinant and the adherence for inhaler therapy on Asthma or COPD. Randomeffects meta-analysis were used to summarize the numerical effect estimates. Findings: 47 studies were included, giving a total of 54.765 participants. In meta-analyses, the significant determinants of adherence to inhaled therapy were: higher age [RR=1.07 (1.03-1.10); I2=94; p<0.0001] good disease knowledge/literacy [RR=1.37 (1.28-1.47); I2=14; p=0.33]; obesity [RR=1.30 (1.12-1.50); I2=0; p=0.37]; good cognitive performance [RR=1.28 (1.17-1.40); I2=0; p=0.62]; higher income [RR=1.63 (1.05- 2.56); I2=0;p=0.52]; being employed [RR=0.87 (0.83-0.90); I2=0; p=0.76] and using multiple drugs/inhalers [RR=0.81 (0.79-0.84); I2=0; p=0.80]. Overall, the strength of the underlying evidence was only low to moderate. Interpretation: Many determinants may be associated, either to better adherence, such as age, good disease knowledge/literacy, obesity, good cognitive performance and higher income; either to poor adherence, such as being employed or using multiple inhalers. Personalized interventions should be taken in clinical practice to address patient’s adherence according to such features.Introdução / Objetivos: A adesão à terapêutica inalatória tem sido relatada como um grande problema a nível mundial, sendo particularmente relevante no tratamento da Asma e da Doença Pulmonar Obstrutiva Crónica (DPOC), considerando as suas barreiras e características. Realizou-se uma revisão sistemática da literatura mundial sobre os principais determinantes da adesão nesses pacientes. Métodos: A pesquisa foi realizada nas plataformas de dados Cochrane Library, MEDLINE, EMBASE e ISI Web of Science. Foram incluídos estudos epidemiológicos observacionais (estudos de coorte, caso-controle e transversais) que relataram a associação entre qualquer tipo de determinante e a adesão à terapêutica inalatória na Asma ou DPOC. Foi ainda realizada meta-análise de efeitos aleatórios de forma a resumir as associações de risco. Resultados: Foram incluídos 47 estudos, dando um total de 54.765 participantes. Nas metaanálises, foram apurados como determinantes significativos da adesão à terapêutica inalatória: a idade avançada [RR = 1,07 (1,03-1,10); I2 = 94; p <0,0001]; conhecimento acerca da doença / literacia em saúde [RR = 1,37 (1,28-1,47); I2 = 14; p = 0,33]; obesidade [RR = 1,30 (1,12-1,50); I2 = 0; p = 0,37]; bom desempenho cognitivo [RR = 1,28 (1,17-1,40); I2 = 0; p = 0,62]; maior rendimento familiar [RR = 1,63 (1,05-2,56); I2 = 0; p = 0,52]; estar empregado [RR = 0,87 (0,83-0,90); I2 = 0; p = 0,76] e no uso de múltiplos fármacos / inaladores [RR = 0,81 (0,79-0,84); I2 = 0; p = 0,80]. Na restante avaliação, a força da evidência subjacente às associações de risco foi baixa a moderada. Conclusão: Verificou-se que muitos determinantes podem estar associados a uma boa adesão, como os fatores idade, bom conhecimento / literacia sobre a doença, obesidade, bom desempenho cognitivo e maior rendimento familiar; associados a uma fraca adesão, identificou-se os seguintes fatores: estar empregado ou usar múltiplos inaladores. Intervenções personalizadas devem ser efetivadas na prática clínica de forma a abordar a adesão do paciente de acordo com as características evidenciadas

A systematic review and meta-analysis of the diagnostic accuracy of the Phototest for cognitive impairment and dementia

The recently developed Phototest is a simple, easy and very brief test for detecting cognitive impairment or dementia. Objective: To evaluate the diagnostic accuracy of the Phototest for detecting cognitive impairment or dementia. METHODS: We used a manually created database to search for studies evaluating the Phototest diagnostic yield and performed an initial meta-analysis to determine sensitivity (Sn) and specificity (Sp) of diagnostic parameters. We also performed a second meta-analysis of individual participant data. RESULTS: In total, 6 studies were included in the meta-analysis. For dementia, Sn was 0.85 (95% CI, 0.82-0.88) and Sp 0.87 (95% CI, 0.85-0.99); for cognitive impairment, Sn was 0.80 (95% CI, 0.77-0.92) and Sp 0.88 (95% CI, 0.86-0.90). In the individual data meta-analysis, 1565 subjects were included, where best cut-off points for dementia and for cognitive impairment were 26/27 (Sn=0.89 (95% CI 0.85-0.91), Sp=0.84 (95% CI, 0.82-0.91)) and 28/29 (Sn=0.79 (95% CI, 0.76-0.81), Sp=0.88 (95% CI, 0.86-0.90)), respectively. CONCLUSION: Phototest has good diagnostic accuracy for dementia and cognitive impairment. It is brief, simple and can be used in illiterate persons. This makes it suitable for use in primary care settings and/or in subjects with low educational level.Phototest é um teste simples, fácil e muito rápido para detecção de comprometimento cognitivo e demência recentemente desenvolvido. Objetivo: Avaliar a acurácia diagnostica do Phototest para detecção de comprometimento cognitivo e demência. MÉTODOS: Nós usamos um banco de dados manualmente criado para estudos que avaliassem a capacidade diagnóstica do Phototest e realizamos uma meta-análise para determinar a sensibilidade (Sn) e especificidade (Ep) dos parâmetros diagnósticos. Nós também realizamos uma segunda meta-análise dos dados individuais dos participantes. RESULTADOS: Um total de seis estudos foram incluídos na meta-análise. Para demência a Sn foi 0.85 (95% CI, 0,82-0,88) e Ep 0,87 (95% CI, 0,85-0,99); para comprometimento cognitivo a Sn foi 0,80 (95% CI, 0,77-0,92) e Sp 0,88 (95% CI, 0,86-0,90). Na meta-análise de dados individuais, 1565 foram incluídos, os melhores escores de corte para demência e para comprometimento cognitivo foram 26/27 (Sn=0,89 (95% CI 0,85-0,91), Ep=0,84 (95% CI, 0,82-0,91)) e 28/29 (Sn=0,79 (95% CI, 0,76-0,81), Ep=0,88 (95% CI, 0,86-0,90)), respectivamente. CONCLUSÃO: Photest tem boa acurácia diagnostica para demência e comprometimento cognitivo. É breve, simples e pode ser usado em pessoas analfabetas. Tornando-o apropriado para o uso em cuidados primários e/ou sujeitos com baixo nível educacional.Fil: Carnero Pardo, Cristobal. Hospital Universitario Virgen de Las Nieves; España. Fidyan Neurocenter; EspañaFil: Lopez Alcalde Samuel. Fidyan Neurocenter; España. Hospital Universitario Virgen de Las Nieves; EspañaFil: Allegri, Ricardo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas ; ArgentinaFil: Russo, María Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas ; Argentin

Metabolic alterations in experimental models of depression

Introduction: Major depressive disorder is one of the most prevalent psychiatric disorders and is associated with a severe impact on the personal functioning, thus with incurring significant direct and indirect costs. The presence of depression in patients with medical comorbidities increases the risks of myocardial infarction and decreases diabetes control, and adherence to treatment. The mechanism through which these effects are produced is still uncertain. Objectives of this study were to evaluate the metabolic alterations in female Wistar rats with induced depression, with and without administration of Agomelatine. The methods included two experiments. All data were analyzed by comparison with group I (control), and with each other. In the first experiment we induced depression by: exposure to chronic mild stress-group II; olfactory bulbectomy-group III; and exposure to chronic mild stress and hyperlipidic/ hyper caloric diet-group IV. The second experiment was similar with the first but the rats received Agomelatine (0.16mg/ animal): group V (depression induced through exposure to chronic mild stress), VI (depression induced through olfactory bulbectomy) and VII (depression induced through exposure to chronic mild stressing hyperlipidic/ hypercaloric diet). Weight, cholesterol, triglycerides and glycaemia were measured at day 0 and 28, and leptin value was measured at day 28. The results in the 1st experiment revealed significant differences (pconclusion, significant correlations were found between high level of triglycerides and depression induced by chronic stress and olfactory bulbectomy. Agomelatine groups had a lower increase of triglycerides levels

Perumusan Strategi Pemasaran Suku Cadang pada PT. United Indobali Denpasar

PT. United Indobali Denpasar merupakan penyalur resmi suku cadang merek Suzuki wilayah Bali. Banyaknya pesaing yang masuk membuat persaingan semakin ketat. Tujuan penelitian ini adalah untuk mengetahui strategi bisnis dan implikasinya pada strategi pemasaran suku cadang di PT United Indobali Denpasar. Responden penelitian diambil dari pengambil kebijakan di Perusahaan berjumlah 7 orang. Teknik analisis data pada penelitian ini dengan menggunakan matrik IE. Berdasarkan matrik IE posisi Perusahaan berada pada sel V maka strategi yang sesuai adalah pertahankan dan pelihara. Implikasi pada strategi pemasaran yaitu penetrasi pasar, pengembangan pemasaran produk, peningkatan kualitas layanan

From "Free Information" to Its (Geo)referencing and Analysis: The "Costs" of Open Source

ENG-Is it possible, starting from free data or free information, also available online, to get a representation of them on paper, consequently highlight- ing the real spatial component? How to handle normal address lists and to achieve their transformation into geographic coordinates, expressed in lati- tude and longitude? What difficulties come up against and how can we face and overcome them? This contribution, trying to return an updated image of the current situation, highlights potential and critical points of mecha- nisms and procedures rarely accessible in an effective manner. Finally, it dwells on the opportunities offered by information sharing and knowledge since they facilitate the individual and collective growth, the participatory processes and the social justice. ITA-È possibile, a partire da dati o informazioni libere, disponibili anche in rete, ottenere una loro rappresentazione grafica che ne metta in evidenza la reale dimensione spaziale? Come gestire semplici liste di indirizzi e ottenere la loro trasformazione in coordinate geografiche, espresse in latitudine e longitudine? Quali difficoltà si incontrano e come si possono affrontare e superare? Questo contributo, cercando di offrire un quadro aggiornato della situazione attuale, mette in evidenza le potenzialità e i punti critici di meccanismi e procedure volti a ottenere questi risultati. Infine, vengono sottolineate le opportunità offerte dalla condivisione di informazioni e conoscenze in quanto possono agevolare la crescita individuale e collettiva, i processi di partecipazione e la giustizia social