Copeptin for discriminating two-year mortality in heart failure patients with moderate to severe systolic dysfunction

© 2012 Marques JS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This article was originally published in a special issue, Cardiac Biomarkers handled by Editor(s). Dr. Virginija Jazbutyte, Institute for Molecular and Translational Therapy Strategies, GermanyBackground: Patients with heart failure and impaired systolic function may have a highly variable clinical course that renders it difficult to assess the individual prognosis. We hypothesized that ejection fraction would incompletely characterize prognosis in systolic heart failure and that biomarkers would add significant information. This study addresses the specific question whether co-peptin may add value in the evaluation of two-year prognosis in heart failure patients with known systolic dysfunction. Methods: Prospective observational cohort study in 37 patients with symptomatic chronic heart failure (classes II to IV of the NYHA classification) and moderate to severe left ventricular systolic dysfunction. We evaluated clinical, echo-cardiographic and laboratory predictors of 24-month mortality specifically assessing the role of co-peptin. Results: Six patients (16%) died during the follow-up. Patients who died had significant higher prevalence of NYHA class IV heart failure, higher blood osmolality and higher levels of NT-proBNP and co-peptin. In unvariable analysis NYHA functional class (p=0.013), serum creatinine (p=0.034), osmolality (p=0.009), NT-proBNP (p=0.013) and copeptin (p=0.003) were predictors of mortality at 24 months. Only copeptin (p=0.004) remained an independent predictor of death in Cox regression analysis. Conclusions: Our results suggest that, in patients with heart failure and impaired left ventricular systolic function, copeptin level determination may be useful for predicting mortality at two years.The study was funded by Centro de Cardiologia da Universidade de Lisboa (CCUL), Cardiology Centre of Lisbon University.info:eu-repo/semantics/publishedVersio

Condicionamento fisiológico de sementes da árvore pioneira Guazuma ulmifolia (Malvaceae) avaliado por análise computadorizada de imagens

Direct seeding is one of the most promising methods in restoration ecology, but low field seedling emergence from pioneer tree seeds still reduces its large scale applicability. The aim of this research was to evaluate seed priming for the pioneer tree species Guazuma ulmifolia. Priming treatments were selected based on seed hydration curves in water and in PEG 8000 solution. Seeds were primed in water for 16 h and in Polyethylene glycol - PEG 8000 (-0.8 MPa for 56 and 88 h) at 20ºC to reach approximately 30% water content. Half of the seed sample of each treatment was dried back to the initial moisture content (7.2%); both dried and non-dried primed seeds as well as the unprimed seeds (control) were tested for germination (percentage and rate) and vigor (electrical conductivity of seed leachates). Seedling emergence percentage and rate were evaluated under greenhouse conditions, while seedling length and uniformity of seedling development were estimated using the automated image analysis software SVIS®. Primed seeds showed the highest physiological potential, which was mainly demonstrated by image analysis. Fresh or dried primed seeds in water for 16 h and in PEG (-0.8 MPa) for 56 h, and fresh primed seeds in PEG for 88 h, improved G. ulmifolia germination performance. It is suggested that these treatments were promising to enhance efficiency of stand establishment of this species by direct seeding in restoration ecology programs.A semeadura direta é um dos métodos mais promissores para a restauração ecológica, mas a baixa emergência de plântulas em campo a partir de sementes de árvores pioneiras ainda limita sua aplicabilidade em larga escala. Avaliou-se a resposta de sementes da espécie florestal pioneira Guazuma ulmifolia ao condicionamento fisiológico. Os tratamentos foram selecionados com base em curvas de hidratação em água e em solução osmótica de Polietilenoglicol - PEG 8000. As sementes foram condicionadas em água por 16 h e em PEG 8000 (-0,8 MPa por 56 e 88 h) a 20ºC, atingindo teor de água de, aproximadamente, 30%. Metade das amostras de cada tratamento foi secada até atingir teor de água próximo ao inicial (7,2%); em seguida, avaliou-se o desempenho das sementes condicionadas submetidas ao não à secagem, além de sementes não condicionadas (testemunha), quanto à germinação (porcentagem e velocidade) e o vigor (condutividade elétrica dos exudatos das sementes). A porcentagem e a velocidade de emergência de plântulas foram avaliadas em condições de casa de vegetação, enquanto que o comprimento de plântulas e a uniformidade de desenvolvimento das plântulas foram estimados usando o software de análise computadorizada de imagens de plântulas SVIS®. As sementes condicionadas fisiologicamente apresentaram potencial fisiológico superior, demonstrado principalmente pelos resultados da análise de imagens. Assim, as sementes condicionadas em água durante 16 h ou em PEG durante 88 h, ambas não submetidas à secagem subsequente, e as condicionadas em PEG durante 56 h e submetidas a secagem, beneficiaram o desempenho germinativo de G. ulmifolia. Sugere-se que esses tratamentos são promissores para aumentar a eficiência de estabelecimento de estande dessa espécie via semeadura direta em programas de restauração ecológica

Diseño de una instalación de climatización utilizando energía geotérmica solar en un edificio de viviendas de Terrassa

La mayor parte del consumo energético en edificios de viviendas, se atribuye a requerimientos de calefacción y refrigeración por parte de los ocupantes para conseguir unas condiciones de confort. Las técnicas más extendidas actualmente requieren de un uso de combustibles fósiles, con la consiguiente emisión de gases de efecto invernadero y un encarecimiento en la factura energética. El rápido crecimiento económico en los últimos años ha propiciado una mejora de las condiciones económicas de la población que demanda cada vez más confort. Ello ha ocasionado un incremento de las necesidades energéticas para climatización de edificios. Por ello, se ha realizado un gran esfuerzo para disminuir la dependencia energética exterior con el fin de disponer de unas fuentes de energía alternativa y sistemas de consumo más eficientes, capaces de reducir la dependencia energética exterior así como las emisiones de gases contaminantes y de efecto invernadero. Entre las energías renovables minoritarias se encuentra la Energía Geotérmica, definida como la energía almacenada en forma de calor en el interior de la Tierra. Dicha energía con el uso de bombas de calor geotérmicas presenta una alternativa a los sistemas de climatización convencionales para abastecer las necesidades de calefacción y refrigeración que demandan los edificios de viviendas.El objetivo de este proyecto es diseñar, dimensionar y comprobar la viabilidad de una instalación de climatización para un edificio de viviendas, situado en la ciudad de Terrassa, mediante el uso de la energía geotérmica. Para ello trata los puntos siguientes: • Cálculo de cargas térmicas del edificio. • Dimensionamiento de los equipos de tratamiento de aire. • Dimensionamiento de la bomba de calor geotérmica. • Dimensionamiento del sistema de captación. • Elección de equipos y materiales a instalar. • Estudio económico del sistema geotérmico comparado con un sistema convencional. • Estudio de ahorro de emisiones de CO2 respecto un sistema convencional El cálculo de cargas térmicas del edificio se realiza mediante programa de cálculo y simulación

Analysis of Labor Qualification in Civil Construction in Manaus Amazonas

Civil construction is one of the fastest growing sectors in Brazil, and in the state of Amazonas is no different, however, it is observed that several problems are affected by direct formal companies and one of them is the unskilled labor, especially when It deals with masons and servants, in these terms, the study of this study and analysis of the qualification of the labor in the civil construction in the city of Manaus-Am. To achieve the research objectives, in the first moment of this study a bibliographic research was carried out, based on books, articles and magazines already published, and in the second stage field research and it is also a qualitative research. And according to the two surveys, it was found that construction in Manaus needs to look for new ways to qualify its workers, so that the sector can be producing their buildings with better quality, as well as making their deliveries on time. Regarding the proposal to qualify the workforce, the surveyed companies will study a way to perform training for their workers

O auxílio emergencial como política anticíclica em tempos de crise pandêmica: um estudo comparativo de Belém em relação ao Brasil a partir dos principais índices nacionais e do suporte teórico de Keynes (Paper 560)

O presente artigo procurou investigar a importância do programa governamental de transferência de renda mínima, denominado “auxílio emergencial”, que foi utilizado durante a pandemia de Covid-19, tendo como base para análise um estudo comparativo da cidade de Belém em relação ao Brasil, a partir dos principais índices nacionais e do suporte teórico do economista John Maynard Keynes. O auxílio emergencial tinha como principal objetivo mitigar os impactos sociais e econômicos causados pela crise pandêmica, isto é, prover suporte aos trabalhadores informais, pequenos empresários e contribuintes do INSS, que foram afetados durante a pandemia. Os dados da análise incluíram o Produto Interno Bruto (PIB), o Produto Nacional Bruto (PNB), a inflação, preços da cesta básica e índices de pobreza e extrema pobreza em uma pesquisa exploratória qualitativa. A principal conclusão é que o auxílio emergencial se mostrou uma política anticíclica demasiadamente importante, pois ajudou a mitigar os efeitos da inflação do período pandêmico e serviu como “colchão” de proteção social aos mais necessitados, já que o incremento na renda das classes mais humildes possibilitou um relativo aumento do poder de compra e consumo, confirmando a importância do uso e aplicação do auxílio emergencial para atenuar os efeitos da pandemia de Covid-19.Palavras-chave: Auxílio emergencial. Covid-19. John Maynard Keynes. Política anticíclica

Influence of systemic strontium ranelate on the progression and as adjunctive therapy for the nonsurgical treatment of experimental periodontitis

Strontium Ranelate (SR) presents overlapping osteoanabolic and anti-resorptive activity. However, the effects of SR on the progression of periodontitis through the alveolar bone and its potential applicability as adjunctive therapy to scaling and root pl

Blockade of CXCR1/2 chemokine receptors protects against brain damage in ischemic stroke in mice

OBJECTIVE: Ischemic stroke may result from transient or permanent reductions of regional cerebral blood flow. Polymorphonuclear neutrophils have been described as the earliest inflammatory cells to arrive in ischemic tissue. CXCR1/2 receptors are involved in the recruitment of these cells. However, the contribution of these chemokine receptors during transient brain ischemia in mice remains poorly understood. In this work, we investigated the effects of reparixin, an allosteric antagonist of CXCR1/2 receptors, in a model of middle cerebral artery occlusion and reperfusion in mice. METHODS: C57BL/6J male mice treated with reparixin or vehicle were subjected to a middle cerebral artery occlusion procedure 1 h after the treatment. Ninety minutes after ischemia induction, the monofilament that prevented blood flow was removed. Twenty-four hours after the reperfusion procedure, behavioral changes, including motor signs, were analyzed with the SmithKline/Harwell/lmperial College/Royal Hospital/Phenotype Assessment (SHIRPA) battery. The animals were sacrificed, and brain tissue was removed for histological and biochemical analyses. Histological sections were stained with hematoxylin and eosin, neutrophil infiltration was estimated by myeloperoxidase activity and the inflammatory cytokine IL-iβ was measured by ELISA. RESULTS: Pre-treatment with reparixin reduced the motor deficits observed in this model of ischemia and reperfusion. Myeloperoxidase activity and IL-iβ were reduced in the reparixin-treated group. Histological analysis revealed that ischemic injury was also attenuated by reparixin pre-treatment. CONCLUSIONS: Our results suggest that the blockade of the CXCR1/2 receptors by reparixin promotes neuroprotective effects by reducing the levels of polymorphonuclear infiltration in the brain and the tissue damage associated with middle cerebral artery occlusion and reperfusion

Oral Angiotensin-(1–7) prevented obesity and hepatic inflammation by inhibition of resistin/TLR4/MAPK/NF-κB in rats fed with high-fat diet

AbstractObesity is characterized by a pro-inflammatory state commonly associated with type 2 diabetes and fat-liver disease. In the last few years, different studies pointed out the role of Angiotensin (Ang)-(1–7) in the metabolic regulation. The aim of the present study was to evaluate the effect of oral-administration of Ang-(1–7) in metabolism and inflammatory state of high-fat feed rats. Twenty-four male Sprague Dawley rats were randomized into three groups: High Fat Diet (HFD); Standard Diet (ST); High Fat Diet+Angiotensin-(1–7) [HFD+Ang-(1–7)]. Glycemic profile was evaluated by glucose tolerance and insulin sensitivity tests, plasmatic glucose and insulin. Cholesterol, HDL and triglycerides analyses presented lipidic profile. RT-PCR evaluated mRNA expression to ACE, ACE2, resistin, TLR4, IL-6, TNF-α and NF-κB genes. The main results showed that oral Ang-(1–7) decreased body weight and abdominal fat-mass. In addition, HFD+Ang-(1–7) treated rats presented enhanced glucose tolerance, insulin-sensitivity and decreased plasma-insulin levels, as well as a significant decrease in circulating lipid levels. These alterations were accompanied by a marked decreased expression of resistin, TLR4, ACE and increased ACE2 expression in liver. Furthermore, Ang-(1–7) decreases phosphorylation of MAPK and increases NF-κB expression. These alterations diminished expression of interleukin-6 and TNF-α, ameliorate inflammatory state in liver. In summary, the present study showed that oral-treatment with Ang-(1–7) in high-fat feed rats improved metabolism down-regulating resistin/TLR4/NF-κB-pathway

As relações existentes entre o cuidado às doenças crônicas não transmissíveis e o alcance das políticas de prevenção na atenção primária à saúde / The relations between the care for chronic non-communicable diseases and the scope of prevention policies in primary health care

As doenças cardiovasculares constituem a grande maioria das doenças crônicas no Brasil, sendo a hipertensão arterial sistêmica a mais prevalente. Essas doenças representam a primeira causa de mortalidade, de hospitalizações e causam um grande impacto econômico para o país. Um importante indicador utilizado para verificar a qualidade dos serviços de atenção básica é o de Internações por Condições Sensíveis à Atenção Primária, o qual pode ajudar a incrementar a capacidade de resolução ao identificar áreas prioritárias de intervenção, colocando, em evidência, problemas de saúde que necessitam de melhor seguimento e coordenação entre os níveis assistenciais. Estudo descritivo, qualitativo, do tipo relato de experiência. O presente trabalho é um relato de experiência da vivência de acadêmicos de medicina da Universidade Estácio de Sá, durante as atividades práticas da disciplina Saúde da Família. Dentre os atendimentos acompanhados, destacou-se o caso de um idoso de 84 anos, com história clínica pregressa de hipertensão arterial sistêmica e diabetes mellitus tipo II. A hipertensão arterial sistêmica e o diabetes mellitus tipo II são causas importantes de morbimortalidade, além de causadores de incapacidade de afastamento do trabalho. Um dos importantes papeis da Estratégia Saúde da Família é a prevenção desses acometimentos, por meio de busca ativa, acompanhamento ambulatorial, promoção e educação em saúde. A análise do caso e suas relações e desdobramentos congregam um conjunto de situações evidenciam a necessidade de enfatizar junto às equipes de APS a importância da busca ativa e a identificação das necessidades de cuidados dos indivíduos em cada território, bem como a ampliação das ações de promoção e prevenção, por meio de campanhas educacionais e suporte ambulatorial

Forest disturbance and growth processes are reflected in the geographical distribution of large canopy gaps across the Brazilian Amazon

Canopy gaps are openings in the forest canopy resulting from branch fall and tree mortality events. The geographical distribution of large canopy gaps may reflect underlying variation in mortality and growth processes. However, a lack of data at the appropriate scale has limited our ability to study this relationship until now. We detected canopy gaps using a unique LiDAR dataset consisting of 650 transects randomly distributed across 2500 km(2) of the Brazilian Amazon. We characterized the size distribution of canopy gaps using a power law and we explore the variation in the exponent, alpha. We evaluated how the alpha varies across the Amazon, in response to disturbance by humans and natural environmental processes that influence tree mortality rates. We observed that South-eastern forests contained a higher proportion of large gaps than North-western, which is consistent with recent work showing greater tree mortality rates in the Southeast than the Northwest. Regions characterized by strong wind gust speeds, frequent lightning and greater water shortage also had a high proportion of large gaps, indicating that geographical variation in alpha is a reflection of underlying disturbance processes. Forests on fertile soils were also found to contain a high proportion of large gaps, in part because trees grow tall on these sites and create large gaps when they fall; thus, canopy gap analysis picked up differences in growth as well as mortality processes. Finally, we found that human-modified forests had a higher proportion of large gaps than intact forests, as we would expect given that these forests have been disturbed. Synthesis. The proportion of large gaps in the forest canopy varied substantially over the Brazilian Amazon. We have shown that the trends can be explained by geographical variation in disturbance and growth. The frequency of extreme weather events is predicted to increase under climate change, and changes could lead to greater forest disturbance, which should be detectable as an increased proportion of large gaps in intact forests.Peer reviewe