Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Resistance of squash cultivars to Aphis gossypii

As plantas da família Cucurbitaceae são prejudicadas pelo ataque de um amplo espectro de insetos e microrganismos. Dentre os insetos sugadores que atacam a abobrinha Cucurbita pepo (L.), o pulgão Aphis gossypii (Glover) (Hemiptera: Aphididae) merece destaque, uma vez que suas ninfas e adultos sugam a seiva das folhas constantemente, além de ser potencial vetor de vírus. A presente pesquisa foi realizada com o objetivo de avaliar diferetes cultivares de abobrinha italiana quanto à resistência a esse pulgão. Utilizaram-se as cultivares Novita, Sandy, Caserta Cac Melhorada, Novita Plus, Samira, AF-2858 e Caserta TS em ensaios de laboratório (T= 25±2ºC; UR= 70±10% e fotoperíodo= 12 h). Na fase jovem avaliou-se a duração dos estádios ninfais do pulgão, a duração total da fase jovem e suas viabilidades, confinando indivíduos sobre discos foliares das cultivares. Na fase adulta, observou-se a duração do período reprodutivo, a fecundidade e o ciclo biológico. Com base nos resultados obtidos, constatou-se a ocorrência de elevado nível de antibiose e não-preferência para alimentação em 'Sandy', que prolongou a duração da fase jovem, causou mortalidade ninfal próxima a 70%, além de reduzir a produção de ninfas e a longevidade dos insetos. A cultivar 'Novita Plus' também induziu significativa mortalidade ninfal, porém inferior à constatada em 'Sandy', indicando uma resistência moderada dessa cultivar.The Cucurbitaceae plants are damaged by attack of a wide spectrum of insects and microorganisms. Among the sucker insects causing damages on squash Cucurbita pepo (L.), the aphid Aphis gossypii (Glover) (Hemiptera: Aphididae) is pointed as one of the most important, once their nymphs and adults suck the sap of the leaves continuously, besides being potential vector of virus. The present research evaluated different cultivars, aiming to identify the resistance against this aphid. The cultivars Novita, Sandy, Caserta Cac Melhorada, Novita Plus, Samira, AF-2858 and Caserta TS were used in laboratory assays (T= 25±2ºC; RH= 70±10% and fotophase= 12 h). In the immature phase the duration of nymphal instars was evaluated, the total duration and their viability, confining individuals on leaf disks from cultivars. In the adult phase the duration of reproductive period, the fecundity and the biological cycle were observed. The cultivar 'Sandy' expressed high level of antibiosis and feeding non-preference against A. gossypii, increasing the nymphal stage and causing mortality near to 70%. Besides, this cultivar reduced the production of nymphs and the longevity of the insects. The 'Novita Plus' cultivar also induced significant nymphal mortality, however in lower levels than those verified in 'Sandy', indicating a moderate resistance.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

In situ Effect of Nanohydroxyapatite Paste in Enamel Teeth Bleaching

Federal University of Para. Department of Restorative Dentistry. Belem, PA, Brazil.Federal University of Para. Department of Restorative Dentistry. Belem, PA, Brazil.Federal University of Para. Department of Restorative Dentistry. Belem, PA, Brazil.Federal University of Para. Department of Restorative Dentistry. Belem, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Departamento de Toxicologia. Ananindeua, PA, Brasil.Federal University of Para. Department of Restorative Dentistry. Belem, PA, Brazil.AIM: Evaluate in situ the effect of nanohydroxyapatite paste (nano-HAP) before bleaching with hydrogen peroxide 35% (HP35%) by ion chromatography (IC) Knoop hardness number (KHN) and tristimulus colorimetry (TC). MATERIALS AND METHODS: A total of 60 fragments were obtained from third molars included (3 mm × 3 mm × 3 mm) and the specimens were divided into three groups (n = 20): Gas chromatography (CG) (negative control group) = no bleaching; HP35% (positive control group) = HP35% whitening (whiteness HP35%); nano-HAP = application for 10 minutes before bleaching treatment + HP35%. The specimens were fixed to the volunteers' molars. The KHN and TC were measured before and after bleaching. For IC, the dentin layer was removed, leaving the enamel that was crushed, and autoclaved for chemical quantification (calcium, fluorine, and phosphorus). The results of KHN and TC were analyzed statistically by analysis of variance (ANOVA) followed by Tukey test (p < 0.05). RESULTS: The HP35% group showed reduction of the Ca, F, and P ions. The initial and final KHN mean of the CG and nano-HAP did not differ statistically; however, the group of HP35% did differ statistically. The mean ΔE of the HP35% and nano-HAP groups did not differ statistically from each other. However, they differed from the CG. CONCLUSION: The nano-HAP paste preserved the KHN, promoted the lower loss of Ca and P ions and an increase of F ions when compared with the CG, but did not influence the effectiveness of the bleaching treatment. CLINICAL SIGNIFICANCE: Nano-HA is a biomaterial that has shown positive results in the prevention of deleterious effects on the enamel by the action of the office bleaching treatment