Omalizumab induced Takotsubo syndrome : case report

© The Author(s) 2019.The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected]: Omalizumab is a humanized monoclonal anti-immunoglobulin E antibody, approved for the treatment of spontaneous chronic urticaria, with high efficacy and an excellent safety profile. Although its adverse effects are rare, allergic reactions and cardiovascular events were previously described. Case summary: The authors describe the case of a 75-year-old woman, followed at the outpatient dermatology clinic due to spontaneous chronic urticaria, treated with omalizumab 300 mg every 4 weeks. After the 11th administration of omalizumab, the patient developed an episode of thoracalgia associated with electro- and echocardiographic abnormalities. Coronary angiogram excluded coronary artery disease, and left ventriculography demonstrated mid-apical akinesia and basal hyperkinesia, consistent with the Takotsubo syndrome (TS). Discussion: Takotsubo syndrome was already reported in association with other monoclonal antibodies. However, to our knowledge, this is the first case of TS following the administration of omalizumab.info:eu-repo/semantics/publishedVersio

Georeferenced analysis of urban nightlife and noise based on mobile phone data

Urban environments are characterized by a complex soundscape that varies across different periods and geographical zones. This paper presents a novel approach for analyzing nocturnal urban noise patterns and identifying distinct zones using mobile phone data. Traditional noise-monitoring methods often require specialized equipment and are limited in scope. Our methodology involves gathering audio recordings from city sensors and localization data from mobile phones placed in urban areas over extended periods with a focus on nighttime, when noise profiles shift significantly. By leveraging machine learning techniques, the developed system processes the audio data to extract noise features indicative of different sound sources and intensities. These features are correlated with geographic location data to create comprehensive city noise maps during nighttime hours. Furthermore, this work employs clustering algorithms to identify distinct noise zones within the urban landscape, characterized by their unique noise signatures, reflecting the mix of anthropogenic and environmental noise sources. Our results demonstrate the effectiveness of using mobile phone data for nocturnal noise analysis and zone identification. The derived noise maps and zones identification provide insights into noise pollution patterns and offer valuable information for policymakers, urban planners, and public health officials to make informed decisions about noise mitigation efforts and urban development.This work was supported by the Fundação para a Ciência e Tecnologia under Grant [UIDB/00315/2020]; and by the project “BLOCKCHAIN.PT (RE-C05-i01.01—Agendas/Alianças Mobilizadoras para a Reindustrialização, Plano de Recuperação e Resiliência de Portugal” in its component 5—Capitalization and Business Innovation and with the Regulation of the Incentive System “Agendas for Business Innovation”, approved by Ordinance No. 43-A/2022 of 19 January 2022)

Morphine in acute coronary syndrome : systematic review and meta-analysis

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Objective: Morphine is frequently used in acute coronary syndrome (ACS) due to its analgesic effect, it being recommended in the main cardiology guidelines in Europe and the USA. However, controversy exists regarding its routine use due to potential safety concerns. We conducted a systematic review of randomised-controlled trials (RCTs) and observational studies to synthesise the available evidence. Design: Systematic review and meta-analysis. Data sources: CENTRAL, MEDLINE, EMBASE and trial registries. Eligibility criteria for selecting studies: We included RCTs and observational studies evaluating the impact of morphine in cardiovascular outcomes or platelet reactivity measures. Data extraction and synthesis: Data were screened, extracted and appraised by two independent reviewers. The data were pooled results using a random-effects model. Outcomes included in-hospital mortality, major adverse cardiovascular events (MACE), platelet reactivity (using VerifyNow) and bleeding, reported as relative risk (RR) with 95%CI. We assessed the confidence in the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. We followed the Metaanalysis Of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and MetaAnalyses guidelines. Results: Five RCTs and 12 observational studies were included, enrolling 69 993 participants. Pooled results showed an increased risk of in-hospital mortality (RR 1.45 [95% CI 1.10 to 1.91], low GRADE confidence), MACE (RR 1.21, 95%CI 1.02 to 1.45) and an increased platelet reactivity at 1 and 2 hours (59.37 platelet reactivity units [PRU], 95%CI 36.04 to 82.71; 68.28 PRU, 95%CI 37.01 to 99.55, high GRADE confidence) associated with morphine. We found no significant difference in the risk of bleeding. We found no differences in subgroup analyses based on study design and ACS subtype. Conclusions: Morphine was associated with an increased risk of in-hospital mortality and MACE but the high risk of bias leads to low result confidence. There is high confidence that morphine decreases the antiplatelet effect of P2Y12 inhibitors.UID/BIM/50005/2019, project funded by Fundação para a Ciência e a Tecnologia (FCT)/ Ministério da Ciência, Tecnologia e Ensino Superior (MCTES) through Fundos do Orçamento de Estado.info:eu-repo/semantics/publishedVersio

Prevalência de polimorfismos nos genes ANKK1, DRD2, DRD3 e síndrome metabólica na esquizofrenia refratária

Objetivo: estimar a prevalência dos polimorfismos TaqIA, -141C e rs6280 dos genes ANKK1, DRD2 e DRD3 e avaliar sua associação com a ocorrência de síndrome metabólica em pacientes com esquizofrenia refratária. Método: estudo de delineamento transversal, realizado na Região Ampliada Oeste de Minas Gerais, que incluiu pacientes com esquizofrenia refratária em uso do antipsicótico clozapina. Foram coletados dados sociodemográficos, clínicos, antropométricos, bioquímicos e genéticos. Realizou-se análise univariada dos dados. Resultados: participaram 72 pacientes e observou-se a ocorrência de Síndrome Metabólica em 47,2%, não sendo encontrada associação da Síndrome Metabólica com os polimorfismos estudados. Houve diferença estatisticamente significante com o parâmetro do baixo HDL com genótipo homozigoto para alelo C do polimorfismo -141C do gene DRD2. Conclusão: evidenciou-se prevalência de SM elevada. O polimorfismo -141C associou-se ao baixo HDL. A análise genética e a identificação de alterações metabólicas, neste grupo de pacientes, podem nortear o tratamento medicamentoso e propiciar melhor qualidade de vida.Objective: to estimate the prevalence of TaqIA, -141C and rs6280 polymorphisms of the ANKK1, DRD2 and DRD3 genes and evaluate their association with the occurrence of metabolic syndrome in patients with refractory schizophrenia. Method: cross-sectional study conducted in the Extended Western Region of Minas Gerais, with refractory schizophrenic patients using the antipsychotic clozapine. Sociodemographic, clinical, anthropometric, biochemical and genetic data were collected. Univariate analysis of the data was performed. Results: seventy-two patients participated in the study and the occurrence of Metabolic Syndrome was observed in 47.2% of them. There was no association between Metabolic Syndrome and the studied polymorphisms. There was a statistically significant difference in the low HDL parameter with homozygous genotype for the C allele of the -141C polymorphism of the DRD2 gene. Conclusion: a high prevalence of MS was evidenced. The -141C polymorphism was associated with low HDL. Genetic analysis and identification of metabolic alterations in this group of patients can guide drug treatment and provide a better quality of life.Objetivo: estimar la prevalencia de los polimorfismos TaqIA, -141C y rs6280 de los genes ANKK1, DRD2 y DRD3 y evaluar su asociación con el síndrome metabólico en pacientes con esquizofrenia refractária. Método: estudio de delineamiento transversal, realizado en la Región Ampliada Oeste de Minas Gerais, que incluye pacientes con esquizofrenia refractária usando el antipsicótico clozapina. Fueron recogidos datos sociodemográficos, clínicos, antropométricos, bioquímicos y genéticos. Se realizó um análisis univariada de los datos. Resultados: participaron 72 pacientes y se observó el Síndrome Metabólico en 47,2%, no siendo encontrada una asociación del Síndrome Metabólico con los polimorfismos estudiados. Hubo diferencia estadísticamente significante con el parámetro del bajo HDL con genotipo homozigoto para alelo C del polimorfismo -141C del gen DRD2. Conclusión: se vio una prevalencia de SM elevada. El polimorfismo -141C se asoció al bajo HDL. El análisis genético y la identificación de alteraciones metabólicas, en este grupo de pacientes, pueden guiar al tratamiento medicamentoso y propiciar mejor calidad de vida

Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?

© The European Society of Cardiology 2018. All rights reserved.Introduction: The most recent studies in cardiac resynchronization therapy (CRT) have been focused on attempts to improve response rate, such as the determination of the optimal placement of the left ventricular (LV) lead. The position of the LV lead guided by the site of latest electrical delay (ED), seems to be a promising strategy. The same strategy may be useful in assessing the ideal positioning of right ventricular (RV) lead in CRT. Purpose: To determine the most favorable position of the RV lead (septal versus apical) in CRT, by measuring the ED of the LV poles during septal or apical RV pacing in patients with triple-site CRT (TRIV). Methods: A single-center prospective study of consecutive patients (Oct. 2014 to Oct. 2017) submited to CRT device implantation (Quadra Allure MPTM, which allows post-implantation ED measurement) in TRIV mode - with a quadripolar lead in the LV, a RV lead positioned at the septum and a RV lead at the apex. In the follow-up, the lead position was confirmed and determined by fluoroscopic evaluation (anterior, lateral and postero-lateral in the short axis and basal, mid and apical on the long axis). The ED was measured at the 4-pole LV lead, during apical and septal RV pacing and the relation between the ED and lead position was evaluated. Results: Twenty two patients were included: 82% male, median age 78 years; 50% implanted CRT with defibrillator; 27% had ischemic heart disease and 73% non-ischemic etiology; all patients had permanent atrial fibrillation and the QRS duration was of 176±29ms. The position of the LE lead poles was classified as lateral in 44% and postero-lateral in 56%, basal in 28%, medial in 39% and apical in 34%. We evaluated 160 ED. The mean ED between the apical RV lead and the LV poles was significantly higher than the delay between septal RV lead and the LV poles [161±33ms vs 75±45ms (p<0.001)]. This difference remained significant in LV poles located in a lateral position (76±62 vs. 166±36ms; p<0.001) or in a postero-lateral position (74±30 vs. 157±31ms; p<0.001); the same ocurred for LV poles in a basal (99±62 vs. 179±24ms, p<0.001), mid (72±38 vs. 167±31ms, p<0.001) and apical location (57±24 vs. 140±32ms, p<0.001). Conclusion: The LV lead position is an important determinant of the success of CRT, but is conditioned by anatomical and technical characteristics. The optimization of CRT may then depend on the positioning of RV lead. This study demonstrated that the apical (vs. septal) RV lead positioning presents higher ED in relation to LV lead, regardless of the latter position.info:eu-repo/semantics/publishedVersio

Substratos a base de esterco de animais para produção de mudas de mamoeiro

Para obtenção de pomares vigorosos e sadios é necessário a produção de mudas com qualidade, e menor custo de formação, observando o mais adequado substrato utilizado, pois o mesmo deve ter características que permitam a boa formação e desenvolvimento da muda. Objetivou-se nesse trabalho avaliar o desenvolvimento de mudas de mamoeiro “Formosa” e “Hawaí” submetidas a diferentes dosagens de esterco bovino, ovino e caprino. O Experimento foi conduzido em casa de vegetação situada na Unidade de Aulas Práticas e Pesquisa (UAPP) do Instituto Federal de Educação, Ciência e Tecnológica do Piauí (Campus Oeiras). As sementes foram semeadas em copos de polietileno com capacidade de 0,5 L, colocando-se duas sementes por recipiente. As mudas foram desbastadas, deixando-se apenas a mais vigorosa por recipiente. A avaliação foi 70 dias após a semeadura, considerando-se as variáveis tais como: porcentagem de germinação, a altura linear das mudas (cm), diâmetro do colo (mm), número de folhas; matéria fresca da parte aérea (g), matéria fresca do sistema radicular (g), matéria seca da parte aérea (g), matéria seca do sistema radicular. Foram obtidos resultados satisfatórios nos tratamentos T5 e T8 composto de esterco ovino (1:1) e (somente esterco ovino) e T12 (somente esterco caprino)

Left atrial abnormal mechanics by speckle tracking as an early subclinical manifestation in patients with systemic sclerosis

© The European Society of Cardiology 2018. All rights reserved.Introduction: Heart involvement in systemic sclerosis (SSc) affects the prognosis of the disease when clinically evident. SSc may be associated with myocardial microvascular obstruction and micronecrosis is a presumible determinant of ventricular dysfunction, heart failure and sudden death. The aim of this study was to assess whether there were early changes of left atrial (LA) deformation by speckle tracking in patients with normal ejection fraction.info:eu-repo/semantics/publishedVersio

Educação Ambiental entre gerações: A oralidade como instrumento construtor de opiniões / Environmental Education between generations: Orality as a tool that constructs opinions

A história oral revela novos campos de investigação perpassando por diferentes paradigmas sociais. Em seus preceitos, é possível desenvolver uma educação ambiental entre gerações que almeja não só a sensibilização frente à problemática ambiental, mas mudanças conscientes e críticas de atitudes em relação ao mundo. O artigo buscou compreender como os mais velhos enxergam a importância da natureza e da sustentabilidade, por meio da percepção de alunos da Universidade da Maturidade UMA/UFT ao longo de suas relações e lembranças. Ao relembrar o passado e comparar com atualidade, os velhos destacam as mudanças causadas pelo homem ao meio ambiente, ressaltando a importância do diálogo na construção do saber ambiental. Este diálogo aproxima gerações, amplia as relações sociais e a compreensão da realidade além dos limites postos pelo modelo educacional, frutos do modelo racional vigente.