Effect of Ischemic Preconditioning on the Recovery of Cardiac Autonomic Control From Repeated Sprint Exercise

Repeated sprint exercise (RSE) acutely impairs post-exercise heart rate (HR) recovery (HRR) and time-domain heart rate variability (i. e., RMSSD), likely in part, due to lactic acidosis-induced reduction of cardiac vagal reactivation. In contrast, ischemic preconditioning (IPC) mediates cardiac vagal activation and augments energy metabolism efficiency during prolonged ischemia followed by reperfusion. Therefore, we investigated whether IPC could improve recovery of cardiac autonomic control from RSE partially via improved energy metabolism responses to RSE. Fifteen men team-sport practitioners (mean ± SD: 25 ± 5 years) were randomly exposed to IPC in the legs (3 × 5 min at 220 mmHg) or control (CT; 3 × 5 min at 20 mmHg) 48 h, 24 h, and 35 min before performing 3 sets of 6 shuttle running sprints (15 + 15 m with 180° change of direction and 20 s of active recovery). Sets 1 and 2 were followed by 180 s and set 3 by 360 s of inactive recovery. Short-term HRR was analyzed after all sets via linear regression of HR decay within the first 30 s of recovery (T30) and delta from peak HR to 60 s of recovery (HRR60s). Long-term HRR was analyzed throughout recovery from set 3 via first-order exponential regression of HR decay. Moreover, RMSSD was calculated using 30-s data segments throughout recovery from set 3. Energy metabolism responses were inferred via peak pulmonary oxygen uptake (V˙O2peak), peak carbon dioxide output (V˙O2peak), peak respiratory exchange ratio (RERpeak), first-order exponential regression of V˙O2 decay within 360 s of recovery and blood lactate concentration ([Lac-]). IPC did not change T30, but increased HRR60s after all sets (condition main effect: P = 0.03; partial eta square (η2p) = 0.27, i.e., large effect size). IPC did not change long-term HRR and RMSSD throughout recovery, nor did IPC change any energy metabolism parameter. In conclusion, IPC accelerated to some extent the short-term recovery, but did not change the long-term recovery of cardiac autonomic control from RSE, and such accelerator effect was not accompanied by any IPC effect on surrogates of energy metabolism responses to RSE

Mother-to-child transmission of human immunodeficiency virus in aten years period

<p>Abstract</p> <p>Objectives</p> <p>to evaluate mother-to-child transmission (MTCT) rates and related factors in HIV-infected pregnant women from a tertiary hospital between 2000 and 2009.</p> <p>Subjects and method</p> <p>cohort of 452 HIV-infected pregnant women and their newborns. Data was collected from recorded files and undiagnosed children were enrolled for investigation. Statistical analysis: qui-square test, Fisher exact test, Student <it>t </it>test, Mann-Whitney test, ANOVA, risk ratio and confidence intervals.</p> <p>Results</p> <p>MTCT occurred in 3.74%. The study population displayed a mean age of 27 years; 86.5% were found to have acquired HIV through sexual contact; 55% were aware of the diagnosis prior to the pregnancy; 62% were not using HAART. Mean CD4 cell-count was 474 cells/ml and 70.3% had undetectable viral loads in the third trimester. HAART included nevirapine in 35% of cases and protease inhibitors in 55%; Zidovudine monotherapy was used in 7.3%. Mean gestational age at delivery was 37.2 weeks and in 92% by caesarian section; 97.2% received intravenous zidovudine. Use of AZT to newborn occurred in 100% of them. Factors identified as associated to MTCT were: low CD4 cell counts, elevated viral loads, maternal AIDS, shorter periods receiving HAART, other conditions (anemia, IUGR (intra uterine growth restriction), oligohydramnium), coinfecctions (CMV and toxoplasmosis) and the occurrence of labor. Use of HAART for longer periods, caesarian and oral zidovudine for the newborns were associated with a decreased risk. Poor adhesion to treatment was present in 13 of the 15 cases of transmission; in 7, coinfecctions were diagnosed (CMV and toxoplasmosis).</p> <p>Conclusion</p> <p>Use of HAART and caesarian delivery are protective factors for mother-to-child transmission of HIV. Maternal coinfecctions and other conditions were risk factors for MTCT.</p

The large trans-Neptunian object 2002 TC302 from combined stellar occultation, photometry, and astrometry data

Context. Deriving physical properties of trans-Neptunian objects is important for the understanding of our Solar System. This requires observational efforts and the development of techniques suitable for these studies. Aims. Our aim is to characterize the large trans-Neptunian object (TNO) 2002 TC302. Methods. Stellar occultations offer unique opportunities to determine key physical properties of TNOs. On 28 January 2018, 2002 TC302 occulted a mv ~ 15.3 star with designation 593-005847 in the UCAC4 stellar catalog, corresponding to Gaia source 130957813463146112. Twelve positive occultation chords were obtained from Italy, France, Slovenia, and Switzerland. Also, four negative detections were obtained near the north and south limbs. This represents the best observed stellar occultation by a TNO other than Pluto in terms of the number of chords published thus far. From the 12 chords, an accurate elliptical fit to the instantaneous projection of the body can be obtained that is compatible with the near misses. Results. The resulting ellipse has major and minor axes of 543 ± 18 km and 460 ± 11 km, respectively, with a position angle of 3 ± 1 degrees for the minor axis. This information, combined with rotational light curves obtained with the 1.5 m telescope at Sierra Nevada Observatory and the 1.23 m telescope at Calar Alto observatory, allows us to derive possible three-dimensional shapes and density estimations for the body based on hydrostatic equilibrium assumptions. The effective diameter in equivalent area is around 84 km smaller than the radiometrically derived diameter using thermal data from Herschel and Spitzer Space Telescopes. This might indicate the existence of an unresolved satellite of up to ~300 km in diameter, which is required to account for all the thermal flux, although the occultation and thermal diameters are compatible within their error bars given the considerable uncertainty of the thermal results. The existence of a potential satellite also appears to be consistent with other ground-based data presented here. From the effective occultation diameter combined with absolute magnitude measurements we derive a geometric albedo of 0.147 ± 0.005, which would be somewhat smaller if 2002 TC302 has a satellite. The best occultation light curves do not show any signs of ring features or any signatures of a global atmosphere.Funding from Spanish projects AYA2014-56637-C2-1-P, AYA2017-89637-R, from FEDER, and Proyecto de Excelencia de la Junta de Andalucía 2012-FQM1776 is acknowledged. We would like to acknowledge financial support by the Spanish grant AYA-RTI2018-098657-JI00 “LEO-SBNAF” (MCIU/AEI/FEDER, UE) and the financial support from the State Agency for Research of the Spanish MCIU through the “Center of Excellence Severo Ochoa” award for the Instituto de Astrofísica de Andalucía (SEV- 2017-0709). Part of the research received funding from the European Union’s Horizon 2020 Research and Innovation Programme, under grant agreement no. 687378 and from the ERC programme under Grant Agreement no. 669416 Lucky Star. The following authors acknowledge the respective CNPq grants: FB-R 309578/2017-5; RV-M 304544/2017-5, 401903/2016-8; J.I.B.C. 308150/2016-3; MA 427700/2018-3, 310683/2017-3, 473002/2013-2. This study was financed in part by the Coordenação de Aperfeiaçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001 and the National Institute of Science and Technology of the e-Universe project (INCT do e-Universo, CNPq grant 465376/2014-2). GBR acknowledges CAPES-FAPERJ/PAPDRJ grant E26/203.173/2016, MA FAPERJ grant E-26/111.488/2013 and ARGJr FAPESP grant 2018/11239-8. E.F.-V. acknowledges support from the 2017 Preeminent Postdoctoral Program (P3) at UCF. C.K., R.S., A.F-T., and G.M. have been supported by the K-125015 and GINOP-2.3.2-15-2016-00003 grants of the Hungarian National Research, Development and Innovation Office (NKFIH), Hungary. G.M. was also supported by the Hungarian National Research, Development and Innovation Office (NKFIH) grant PD-128 360. R.K. and T.P. were supported by the VEGA 2/0031/18 grant

The size, shape, density and ring of the dwarf planet Haumea from a stellar occultation

Haumea—one of the four known trans-Neptunian dwarf planets—is a very elongated and rapidly rotating body1, 2, 3. In contrast to other dwarf planets4, 5, 6, its size, shape, albedo and density are not well constrained. The Centaur Chariklo was the first body other than a giant planet known to have a ring system7, and the Centaur Chiron was later found to possess something similar to Chariklo’s rings8, 9. Here we report observations from multiple Earth-based observatories of Haumea passing in front of a distant star (a multi-chord stellar occultation). Secondary events observed around the main body of Haumea are consistent with the presence of a ring with an opacity of 0.5, width of 70 kilometres and radius of about 2,287 kilometres. The ring is coplanar with both Haumea’s equator and the orbit of its satellite Hi’iaka. The radius of the ring places it close to the 3:1 mean-motion resonance with Haumea’s spin period—that is, Haumea rotates three times on its axis in the time that a ring particle completes one revolution. The occultation by the main body provides an instantaneous elliptical projected shape with axes of about 1,704 kilometres and 1,138 kilometres. Combined with rotational light curves, the occultation constrains the three-dimensional orientation of Haumea and its triaxial shape, which is inconsistent with a homogeneous body in hydrostatic equilibrium. Haumea’s largest axis is at least 2,322 kilometres, larger than previously thought, implying an upper limit for its density of 1,885 kilograms per cubic metre and a geometric albedo of 0.51, both smaller than previous estimates1, 10, 11. In addition, this estimate of the density of Haumea is closer to that of Pluto than are previous estimates, in line with expectations. No global nitrogen- or methane-dominated atmosphere was detected.J.L.O. acknowledges funding from Spanish and Andalusian grants MINECO AYA-2014-56637-C2-1-P and J. A. 2012-FQM1776 as well as FEDER funds. Part of the research leading to these results received funding from the European Union’s Horizon 2020 Research and Innovation Programme, under grant agreement no. 687378. B.S. acknowledges support from the French grants ‘Beyond Neptune’ ANR-08-BLAN-0177 and ‘Beyond Neptune II’ ANR-11-IS56-0002. Part of the research leading to these results has received funding from the European Research Council under the European Community’s H2020 (2014-2020/ERC grant agreement no. 669416 ‘Lucky Star’). A.P. and R.S. have been supported by the grant LP2012-31 of the Hungarian Academy of Sciences. All of the Hungarian contributors acknowledge the partial support from K-125015 grant of the National Research, Development and Innovation Office (NKFIH). G.B.-R., F.B.-R., F.L.R., R.V.-M., J.I.B.C., M.A., A.R.G.-J. and B.E.M. acknowledge support from CAPES, CNPq and FAPERJ. J.C.G. acknowledges funding from AYA2015-63939-C2-2-P and from the Generalitat Valenciana PROMETEOII/2014/057. K.H. and P.P. were supported by the project RVO:67985815. The Astronomical Observatory of the Autonomous Region of the Aosta Valley acknowledges a Shoemaker NEO Grant 2013 from The Planetary Society. We acknowledge funds from a 2016 ‘Research and Education’ grant from Fondazione CRT. We also acknowledge the Slovakian project ITMS no. 26220120029

Modified Blalock-Taussig Shunt with an Umbilical Vein Graft

We describe a modification of the Blalock Taussig anastomosis, with the interposition of a glutaraldehyde-tanned umbilical vein graft between the subclavian and pulmonary arteries. This operation was performed in 64 children: 11 were less than 1 month of age (17.2%), and 23 were between 1 and 6 months of age (34.9%). Hospital deaths occurred in six patients—all less than 6 months of age (9.4%). There was no instance of shunt occlusion noted. The clinical course was uneventful among survivors, except for one patient who died of endocarditis in the late postoperative follow-up. The shunt procedure may be performed very rapidly, with minimal dissection, allowing the use of a graft larger than the diameter of the subclavian artery. This modification of the Blalock Taussig operation compares favorably with our previous experience with other shunt procedures and may be considered a valuable alternative in the palliative surgical treatment of several malformations with severe pulmonary oligemia

Revascularização direta do miocárdio sem circulação extracorpórea: estudo crítico dos resultados em 391 pacientes Direct myocardial revascularization without extra-corporeal circulation: results in 391 patients

Os autores analisam os resultados obtidos em 391 pacientes consecutivos e não selecionados e submetidos a revascularização direta do miocárdio sem o circuito cardiopulmonar, operados de setembro de 1981 a fevereiro de 1985. Neste mesmo período, foram realizadas um total de 1568 cirurgias de revascularização, sendo esta alternativa tática aplicável em 24,9% dos casos. Da casuística apresentada, 318 (81,3%) eram do sexo masculino e 73 (18,7%), do feminino e as idades de 35 a 76 anos, oscilando em torno da mediana 56. As condições pré-operatórias indicativas da cirurgia foram as seguintes: insuficiência coronária crônica 286 (73,1%) casos; pós trombólise coronária 42 (10,7%); infarto agudo em evolução 18 (4,6%); pós angioplastia mal sucedida 18 (4,6%); reoperàções 14 (3,6%); síndrome intermediária 12 (3,1%) e revascularização em dissecção aórtica crônica 1 caso. Pontes únicas foram realizadas em 175 (44,7%) pacientes, duplas em 192 (49,1%) e triplas em 24 (6,1%), com a média de 1,6 pontes/paciente. A artéria mamária foi usada para 109 casos, artéria mamária heteróloga bovina em 2, sendo, nos demais, utilizada a veia safena. A mortalidade hospitalar foi de 2,5% (10/391), o que difere, significativamente, da mortalidade de 5% verificada para um grupo de 1177 pacientes operados no mesmo período, com a circulação extracorpórea. Comparamos, prospectivamente, as complicações pós-operatórias observadas em um grupo de 378 pacientes operados sem a circulação extracorpórea, contra um grupo controle de 689 pacientes tratados da maneira convencional, no que diz respeito à incidência de arritmias, infarto per-operatório, complicações pulmonares, neurológicas, infecciosas e hemorrágicas. Verificamos uma incidência menor, estatisticamente significante, para as complicações pulmonares, neurológicas e de arritmias no grupo operado sem a circulação extracorpórea, não diferindo das demais complicações entre os dois grupos. Concluem os autores que a revascularização do miocárdio sem utilização da extracorpórea se consolidou, ao longo destes 4 anos de experiência, como tática de eleição em lesões da coronária direita, descendente anterior, ou ambas, face às vantagens que apresenta.<br>The authors analyse the results of 391 consecutive non-selected patients who underwent direct myocardial revascularization (MR) without cardiopulmonary bypass (CPB) from September 1981 to February 1985. In the same period we performed a total of 1568 revascularization procedures; thus 24.9% were MR without CPB. Out of the 391 patients, 318 (81.3%) were male and the ages varied from 35 to 76, with a median of 56 y/o. The surgical procedure was performed due to: chronic coronary insufficiency 286 (73.1%), after coronary thrombolysis 42 (10.7%), evolving acute myocardial infarction 18 (4.6%), ill-succeeded angioplasty 18 (4.6%), redos 14 (3.6%), intermediate syndrome 12 (3.1 %) and chronic aortic dissection 1. Single bypass was performed in 175 (44.7%) patients, double in 192 (49.1%) and triple in 24 (6.1%) with an average of 1.6 grafts/patient. The mammary artery was utilized 10Q times, bovine heterologous mammary 2 and all remaining cases received saphenous vein grafts. The hospital mortality was 2.5% (10/391) which is significantly different from our 5% hospital mortality in 1177 patients operated on the same period with CPB. We prospectively compared the postoperative complications in 378 patients without CPB against 689 patients with CPB concerning arrhythmias, perioperative myocardial infarction, neurologic, infectious, pulmonary and hemorrhagic complications