Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Morpho-anatomical, physiological and biochemical changes in rubber tree seeds

The physical, physiological and biochemical changes during the development until the dispersal of rubber tree seeds were evaluated with the purpose of estimating the point at physiological maturity. A total of 30 plants were selected at different points in a commercial planting area and had their flowers marked during the anthesis and every 15 days after marking. Fruits and seeds were collected for analysis of moisture content, dry matter, diameter and length. Details of the anatomy ultra-structure of the seeds were evaluated. The seed emergence, emergency speed index, heat resistant proteins and oxidative stress enzymes were examined. It was observed that fruits reached maximum size at 120 days after anthesis and seeds at 150 days. The seeds acquired germination capacity after 150 days. At 175 days, they presented the highest percentage of dry matter and lowest moisture, in addition to a higher percentage of germination and vigor. Therefore, it was possible to conclude that the physiological maturity of the rubber tree seeds occurs at 175 days after anthesis, and coincides with its maximum physiological quality. At 175 and 180 days post-anthesis, there is a greater expression of heat resistant proteins as well as low molecular weight and greater oxidative stress enzyme activity

New potential Plasmodium brasilianum hosts: tamarin and marmoset monkeys (family Callitrichidae)

Submitted by Sandra Infurna ([email protected]) on 2017-11-28T10:46:19Z No. of bitstreams: 1 denise_alvarenga_etal_IOC_2017.pdf: 1666047 bytes, checksum: a2765b278874426fe2e73ac0954878d3 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2017-11-28T12:28:07Z (GMT) No. of bitstreams: 1 denise_alvarenga_etal_IOC_2017.pdf: 1666047 bytes, checksum: a2765b278874426fe2e73ac0954878d3 (MD5)Made available in DSpace on 2017-11-28T12:28:07Z (GMT). No. of bitstreams: 1 denise_alvarenga_etal_IOC_2017.pdf: 1666047 bytes, checksum: a2765b278874426fe2e73ac0954878d3 (MD5) Previous issue date: 2017Fundação Oswaldo Cruz. Centro de Pesquisa René Rachou. Laboratório de Malária. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas, Rio de Janeiro, RJ. Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa, Diagnóstico e Treinamento em Malária. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Centro de Pesquisa, Diagnóstico e Treinamento em Malária. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Malária. Rio de Janeiro, RJ, Brasil.Centro de Primatologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Doenças Febris Agudas, Rio de Janeiro, RJ. Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Centro de Pesquisa, Diagnóstico e Treinamento em Malária. Rio de Janeiro, RJ, Brasil.Centro de Primatologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil / Centro Universitário Serra dos Órgãos. Teresópolis, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Centro de Pesquisa, Diagnóstico e Treinamento em Malária. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Malária. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisa René Rachou. Laboratório de Malária. Belo Horizonte, MG, Brasil.Non-human primates (NHPs) as a source for Plasmodium infections in humans are a challenge for malaria elimination. In Brazil, two species of Plasmodium have been described infecting NHPs, Plasmodium brasilianum and Plasmodium simium. Both species are infective to man. Plasmodium brasilianum resembles morphologically, genetically and immunologically the human quartan Plasmodium malariae. Plasmodium brasilianum naturally infects species of non-human primates from all New World monkey families from a large geographic area. In the family Callitrichidae only the genus Saguinus has been described infected so far. The present study describes the natural infection of P. brasilianum in tamarins and marmosets of the genera Callithrix, Mico and Leontopithecus in the Atlantic forest

Efeito do estresse hídrico e térmico na germinação e no vigor de sementes de cenoura

O objetivo deste trabalho foi avaliar o efeito do estresse hídrico e térmico na germinação e no vigor de sementes de cenoura. Foram conduzidos dois experimentos na Universidade Federal de Viçosa, utilizando-se três lotes de sementes de cenoura, sendo o lote 1 do cv. "Carandaí", os lotes 2 e 3 do cv. "Brasília". No experimento 1 - Estresse hídrico - Quatro potenciais osmótico, 0,0; -0,3; -0,6 e -0,9 MPa foram utilizados para o umedecimento do papel substrato, com uma solução de PEG 6000 nas concentrações de 0; 17,16; 25,68 e 32,16 g L -1. As sementes foram, então, avaliadas quanto à germinação e ao vigor . Para o experimento 2 - Estresse térmico - Três temperaturas, 15, 20 e 35 foram utilizadas na condução dos testes para avaliação da qualidade das sementes. Utilizou-se como substrato para as sementes o papel toalha umedecido com água, na proporção de 2,5 vezes o peso do papel. Conclui-se que a germinação das sementes de cenoura não foi afetada até potenciais de -0,3 MPa. O comprimento da radícula e a primeira contagem de germinação foram eficientes para avaliar o vigor das sementes de cenoura, sob estresse hídrico e térmico, permitindo a classificação dos lotes testados. Temperaturas de 15 e 35 oc influenciaram negativamente a germinação e o vigor das sementes de cenoura.The objective of this study was to evaluate the effect of water and thermal stress on the germination and vigor of carrot seeds. Two experiments were performed in the Universidade Federal de Viçosa; three lots of carrot seeds were used, lot 1 of cv. "Carandaí " and the lots 2 and 3 of cv. "Brasília ". In experiment 1 - Water stress - Four osmotic potentials, 0.0; -0.3; -0.6 and -0.9 MPa were used to humidify the paper substratum, with a solution of PEG 6000 in concentrations of 0; 17.16; 25.68 and 32.16 g L-1. Germination and vigor were estimated. For experiment 2 - Thermal stress - Three temperatures were used, 15°, 20° and 35° C, to evaluate the quality of the seeds. It A paper towel humidified with water was used as substratum, in the proportion of 2.5 times the weight of the paper. It is concluded that the germination of the carrot seeds was not affected by potentials of -0.3 MPa. The length of the roots and the first germination count were efficient to evaluate the vigor of the carrot seeds, under water and thermal stress, allowing the classification of the tested lots. Temperatures of 15° and 35° C influenced the germination and the vigor of the carrot seeds negatively