O Paradoxo dos Fumadores nas Síndromes Coronárias Agudas: Será Real?

INTRODUCTION: Smoking is associated with atherosclerotic disease, but there is controversy about its protective nature after acute coronary syndrome (ACS). OBJECTIVE: To determine the impact of smoking on the presentation, treatment and outcome of ACS. METHODS: We analyzed all consecutive patients with ACS in a single center between 2005 and 2014. Current smokers and never-smokers were compared. Independent predictors of in-hospital mortality and of a composite of all-cause mortality, rehospitalization for cardiovascular causes, angiography, percutaneous coronary intervention and coronary artery bypass grafting were assessed by multivariate logistic regression. RESULTS: A total of 2727 patients were included, 41.7% current smokers and 58.3% never-smokers. Current smokers were younger, more often male, had fewer comorbidities, a typical clinical presentation, lower heart rate, systolic blood pressure, Killip class, BNP/NT-pro-BNP and creatinine, better left ventricular systolic function and less severe coronary anatomy. ST-segment elevation myocardial infarction was more common in current smokers. Current smokers received more evidence-based treatments and had less in-hospital complications, in-hospital mortality and adverse outcomes at one year. More frequent percutaneous coronary intervention at one year was noted in current smokers. Smoking was not an independent predictor of outcome when the multivariate model was fully adjusted for baseline characteristics. CONCLUSION: The smoker's paradox was not observed in this population, since all differences in outcome were explained by smokers' more benign baseline characteristics.info:eu-repo/semantics/publishedVersio

Causas de anestro em bovinos da microrregião de Juiz de Fora- MG.

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LUCIS:a learning experience to improve lifetime and operating strategies in low power PEM fuel cells

LUCIS, a demonstration project co-financed by the Innovation Agency in Portugal (AdI), was carried out in the framework of the DEMTEC Programme (Incentives to Technologically Innovative Pilot Systems). Its main goals were: Validate the reliability of proton exchange membrane fuel cells (PEMFC) when used in practical situations and the competitive advantages that these solutions can represent compared to conventional solutions; Evaluate impacts associated with the use of hydrogen and the benefits to business competitiveness. This project allowed a learning experience in real applications of low power PEMFC. Demonstrations were grouped in two large categories that covered several applications of PEMFC. The prototypes used were produced by SRE (Portugal) and were specifically designed to be used in small power applications, portable, traction or stationary. In this work, the technological validation was carried out for different stacks with power from 10 to 100W. Hydrogen was supplied by compressed gas bottles and metallic hydrides. All the fuel cells were previously characterized in specialized laboratories. Recommendations were drawn for every application in order to improve fuel cell lifetime and operating strategies

Cervical abscess in an immunocompetent patient with Mycobacterium malmoense pulmonary disease

BACKGROUND: Mycobacterium malmoense is a nontuberculous mycobacteria seen mainly in two age groups and with different clinical presentations. Most patients are male adults presenting clinical symptoms and signs similar to those of pulmonary tuberculosis. The second group is formed by immunocompetent children with localized cervical lymphadenitis. Although cervical adenitis is the main extrapulmonary manifestation of M. malmoense, virtually all cases of cervical disease were documented in children. Disseminated disease is rare and has been reported in patients with severely impaired immunity. CASE REPORT: We report a case of a 47-year-old immunocompetent man with a cervical abscess, in whom we identified a M. malmoense pulmonary disease with multiple cervical, thoracic and abdominal adenopathies. CONCLUSION: Extrapulmonary infection due to M. Malmoense needs to be considered on the differential diagnosis of cervical masses and adenopathies, not only in pediatric patients but also in adults with no impaired immunity. A high index of suspicion for nontuberculous mycobacteria is essential for the diagnosis and prognosis

Punção folicular e produção in vitro de embriões em vacas Gir submetidas a estimulação hormonal.

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Participation of the Immune System and Hedgehog Signaling in Neoangiogenesis Under Laser Photobiomodulation

Introduction:This study aimed to characterize immune and endothelial cells, myofibroblasts and pericytes, and positive cells for hedgehog proteins in late tissue repair of rats skin wounds treated with 670 nm photobiomodulation therapy (PBMT).Methods:A blind experimental study was conducted, in order to assess the effect of PBMT in later stages of healing, with emphasis on neoangiogenesis, immune cells and Hedgehog signaling. Forty Wistar rats were allocated randomly in two groups; control and treated with a diode GaAlAs laser (9 mW, 670 nm, 0.031 W/cm², spot size of 0.28 cm², fluence of 4 J/ cm2 applied every other day, until a total dose of 16 J/cm2 was achieved). Standardized skin wounds were performed and the animals were euthanized at 14, 21, 28 and 35 days. Tissue sections were subjected to hematoxylin-eosin and immunohistochemistry for CD31, NG2, smooth muscle alpha actin, CD8, CD68, Ptch, Gli-2 and Ihh. All histomorphometric data were statistically analyzed and significance level was at P < 0.05.Results:At late stages of wound healing, neoangiogenesis persisted as revealed for the number of CD31+ cells (P = 0.016) and NG2+ and smooth muscle alpha actin positive pericytes (P = 0.025), for both experimental groups. By day 21, laser-treated group had decreased CD68+ cells (P = 0.032) and increased CD8+ (P=0.038). At remodeling stage, there were positive cells for the hedgehog signaling pathway family which seemed to be activated.Conclusion: These data suggest that photobiomodulation therapy was able to modulate extracellular matrix remodelling even at the later stages of wound healing.