Mineralocorticoid receptor antagonism in acutely decompensated chronic heart failure

Spironolactone was likely to provide faster congestion relief. -------------------------------------------------------------------------------- Abstract Background/objectives Mineralocorticoid receptor antagonist (MRA) use in acutely decompensated chronic heart failure (ADCHF) may improve congestion through diuretic effect and prevent neurohormonal activation. We aimed to evaluate the clinical effect and safety of spironolactone in ADCHF. Methods Prospective, experimental, single-center, and single-blinded trial. Patients were treated with: standard ADCHF therapy or oral spironolactone 50–100 mg/d plus standard ADCHF therapy. Results During a 1 year period, 100 patients were enrolled, 50 included in the treatment group. Mean (SD) spironolactone dose (mg) at day 1 was 94.5 ± 23.3 and at day 3 was 62.7 ± 24.3. Worsening renal function (increase in pCr ≥ 0.3 mg/dL from day 1 to day 3) was more likely to occur in control group (20% vs. 4%; p = 0.038), serum potassium did not differ between groups, and plasma NTproBNP had a significant decrease in spironolactone group at day 3 (median [IQR], 2488 [4579] vs. 1555 [1832]; p = 0.05). Furthermore, a greater proportion of patients in the treatment group were free of congestion at day 3: less edema, rales, jugular venous pressure (JVP) and orthopnea (all, p < 0.05). In addition, a significantly higher proportion of patients were on oral furosemide at day 3 (44% vs. 82%; p < 0.001). Conclusions Our study supports the safety of high dose spironolactone in ADCHF and suggests a positive impact in the resolution of congestion. The important findings of our pilot study need to be confirmed in larger trials

Do registered dietitians, nutrition students, and laypeople perceive individuals with obesity differently?

(1) Background: Obesity is associated with significant social consequences, and individuals with obesity are regularly affected by weight-related stigmatization experiences. This study compares antifat attitudes among registered dietitians (RD), nutrition students, and laypeople and assesses which factors related to the perceived causes of obesity influence these attitudes. (2) Methods: An online survey was conducted in Brazil with RD (n = 336), nutrition students (n = 300), and laypeople (n = 403) with questionnaires assessing antifat attitudes and perceived causes of obesity. (3) Results: All groups presented low antifat attitudes. Minor differences in antifat attitudes were found among the three groups. Compared to RDs and nutrition students, laypeople presented higher Weight Control/Blame scores, but with a small effect size (η2 = 0.01). Weight bias was predicted by age, sex, and body mass index. External, social, and financial factors were not perceived to be very important in the development of obesity by RD and students. (4) Conclusions: Since slight differences were seen among RD and students compared to laypeople, and some perceptions of the causes of obesity indicate a stigmatized view. It is essential to place a greater focus on educating and updating these health professionals and students about weight stigma and its consequences for the mental and physical health of individuals

IL-6 and TNF-alpha polymorphisms in portuguese psoriatic patients

Introduction: Cytokines regulate the growth, function and differentiation of cells and help to steer immune response and inflammation. In this study we focused our attention in two proinflammatory cytokines: IL-6 and TNFa. It is known that their overexpression is responsible for initiation, maintenance and recurrence of skin lesions in psoriatic patients. Therefore, it is important to investigate genetic biomarkers with functional effects in the genes of those cytokines that could help to predict the severity of Psoriasis. Objectives: To investigate the hypothesis that allelic variants in IL-6 and TNF-a genes are a risk factor for the developing of severe Psoriasis. Materials and Methods: A cohort of 178 (74 females, 104 males) psoriatic patients with severe plaque type psoriasis [according to the Psoriasis Area and Severity Index (PASI)] and 206 healthy individuals were selected. Several polymorphisms in the IL-6 gene (rs1800795, rs1800796, rs2069827, rs2069840) and TNF-a (rs361525, rs1799964, rs1800629) promoter region were genotyped. SNP genotyping was performed using Mass Spectrometry (MassARRAY iPLEX–Sequenom). Results: We observed a lower frequency in the minor allele (C) of the TNFa rs1799964 SNP in psoriatic patients, compared with controls [(21.9% vs. 29.4%), p = 0.02, OR = 0.675 (0.49–0.94)]. The frequency of the CC genotype in patients was 3.93% while in the healthy control group it was 9.22% [(p = 0.04, OR = 0.403 (0.17–0.98)]. No statistical significant differences were found in the other polymorphisms. Conclusion: Our data suggest that the rs1799964 C allele could be a protective factor for developing severe psoriasis. These results were similar to the findings of Gallo et al (2012) in a Spanish population. The mechanism to explain this association remains elusive, given the lack of evidence of a functional association

Remote system for detection of low-levels of methane based on photonic crystal fibres and wavelength modulation spectroscopy

In this work we described an optical fibre sensing system for detecting low levels of methane. The properties of hollow-core photonic crystal fibres are explored to have a sensing head with favourable characteristics for gas sensing, particularly in what concerns intrinsic readout sensitivity and gas diffusion time in the sensing structure. The sensor interrogation was performed applying the Wavelength Modulation Spectroscopy technique, and a portable measurement unit was developed with performance suitable for remote detection of low levels of methane. This portable system has the capacity to simultaneously interrogate four remote photonic crystal fibre sensing heads. Copyright © 2009 J. P. Carvalho et al

Haematological and biochemical parameters in Churra-da-Terra-Quente ewes from the northeast of Portugal

Hematological and biochemical parameters, including plasma electrolytes and thyroid hormones, were determined in 73 clinically healthy Churra-da-Terra-Quente ewes, a typical breed from the northeast of Portugal. The hemogram values were: erythrocytes 9.8±1.51012/L; haemoglobin 118.1±19.1g/L; haematocrit 40.8±5.9%; leukocytes 5.7±1.8109/L; and platelets 544.3±177.2109/L. The thrombin time was 17.3±1.7 seconds. The values of biochemical parameters were: total protein 76.4±6.1g/L; glucose 2.87±0.60mmol/L; total cholesterol 1.65±0.33mmol/L; aspartate aminotransferase 155.9±49.2U/L; alanine aminotransferase 23.2±9.6U/L; γ-glutamyl transferase 48.0±18.7U/L; total alkaline phosphatase 121.6±76.1U/L; glutamate dehydrogenase 6.4±3.7U/L; urea 7.32±2.22mmol/L; creatinine 123.0±54.1μmol/L; total calcium 2.53±0.25mmol/L; phosphorus 2.10±0.46mmol/L; magnesium 1.01±0.09mmol/L; sodium 152.04±3.65mmol/L; potassium 4.7±0.4mmol/L; ionized calcium 1.32±0.07mmol/L; total thyroxine 111.75±42.29nmol/L; total triiodothyronine 1.01±0.28nmol/L; free T4 11.93±1.78pmol/L; free T3 4.22±1.33pmol/L; and thyroid-stimulating hormone 0.18±0.19μIU/mL. Although differences among the Churra-da-Terra-Quente breed and other breeds may occur, the hematological and biochemical parameters, plasma electrolytes, and thyroid hormones, for this indigenous breed, were generally situated within the reference intervals previously reported for sheep

Balanços energéticos agropecuários: uma importante ferramenta como indicativo de sustentabilidade de agroecossistemas.

No Brasil, pouca atenção se tem dado às formas e caminhos com que os fluxos energéticos se distribuem nos sistemas produtivos. Na agropecuária, a atenção tem sido voltada a novas fontes de energia (biomassa) ou em tecnologia alternativa, visando a racionalização do uso de energia fóssil ou elétrica. Entretanto, a agricultura tem se desenvolvido baseada fortemente na utilização intensiva de máquinas agrícolas, com conseqüente uso de combustíveis fósseis. Um fator de estrangulamento muito forte no consumo energético geral tem sido a utilização massiva de fertilizantes derivados do petróleo nos agroecossistemas. Estudos de Balanços Energéticos visam determinar os pontos de estrangulamento energético fundamentando a busca por tecnologias poupadoras de energia, especialmente aquelas de origem fóssil (combustível, fertilizante, agrotóxicos, energia despendida na fabricação das máquinas e implementos, etc.). No Brasil, a Região Sul, é onde se encontram vários trabalhos buscando uma agricultura mais auto-sustentável, do ponto de vista da utilização da energia. Em vista da possibilidade de eventuais futuras crises energéticas, o presente trabalho procura analisar o estado-da-arte dos estudos em Balanço Energético, no Brasil e no Mundo, como uma ferramenta de indicação da sustentabilidade dos sistemas agropecuários