Preclinical atherosclerosis and metabolic syndrome increase cardio- and cerebrovascular events rate: a 20-year follow up

BACKGROUND: Intima-media thickness (IMT) is a validated marker of preclinical atherosclerosis and a predictor of cardiovascular events. PATIENTS: We studied a population of 529 asymptomatic patients (age 62\u2009\ub1\u200912.8 years), divided into two groups of subjects with and without Metabolic Syndrome (MetS). METHODS: All patients, at baseline, have had a carotid ultrasound evaluation and classified in two subgroups: the first one without atherosclerotic lesions and the second one with preclinical atherosclerosis (increased IMT or asymptomatic carotid plaque). Cardiovascular endpoints were investigated in a 20-years follow-up. RESULTS: There were 242 cardiovascular events: 144 among patients with MetS and 98 among in healthy controls (57.4% vs. 35.2%; P\u2009<\u20090.0001). 63 events occurred in patients with normal carotid arteries, while 179 events occurred in patients with preclinical atherosclerosis (31.8% vs. 54.1%; P\u2009<\u20090.0001). Of the 144 total events occurred in patients with MetS, 36 happened in the subgroup with normal carotid arteries and 108 in the subgroup with preclinical atherosclerosis (45% vs. 63.15%; P\u2009=\u20090.009). 98 events occurred in patients without MetS, of which 27 in the subgroup with normal carotid arteries and 71 in the subgroup with preclinical atherosclerosis (22.88% vs. 44.37%; P\u2009=\u20090.0003). In addition, considering the 63 total events occurred in patients without atherosclerotic lesions, 36 events were recorded in the subgroup with MetS and 27 events in the subgroup without MetS (45% vs. 22.88%; P\u2009=\u20090.0019). Finally, in 179 total events recorded in patients with preclinical carotid atherosclerosis, 108 happened in the subgroup with MetS and 71 happened in the subgroup without MetS (63.15% vs. 44.37%; P\u2009=\u20090.0009). The Kaplan-Meier function showed an improved survival in patients without atherosclerotic lesions compared with patients with carotid ultrasound alterations (P\u2009=\u20090.01, HR: 0.7366, CI: 0.5479 to 0.9904). CONCLUSIONS: Preclinical atherosclerosis leads to an increased risk of cardiovascular events, especially if it is associated with MetS

Cirurgia do Timo num Serviço de Cirurgia Geral

AIMS: Evaluation of thymectomy cases between 1990-2003, in a General Surgery Department. Evaluation of the therapeutic efficacy in Miastenia Gravis patients. PATIENTS AND METHODS: Retrospective study based on evaluation of data from Serviço de Cirurgia, Neurologia and Consult de Neurology processes, between 1990-2003, of 15 patients submitted to total thymectomy. RESULTS: 15 patients, aged 17 to 72, 11 female and 4 male. Miastenia Gravis was the main indication for surgery, for uncontrollable symptoms or suspicion of thymoma. In patients with myasthenia, surgery was accomplish after compensation of symptoms. There weren't post-surgery complications. Pathology were divided in thymic hyperplasia and thymoma. Miastenia patients have there symptoms diminished or stable with reduction or cessation of medical therapy. CONCLUSIONS: Miastenia was the most frequent indication for thymectomy. Surgery was good results, with low morbimortality, as long as the protocols are respected

Chemotherapy cardiotoxicity: cardioprotective drugs and early identification of cardiac dysfunction.

Background: Chemotherapy cardiotoxicity is an emerging problem and it is very important to prevent cardiac dysfunction caused by anticancer drugs. The aim of this study was to assess the alterations of the cardiac function induced by chemotherapy in a follow-up of 2 years and to evaluate the cardioprotective role of angiotensin-converting enzyme inhibitors (ACEIs) in the prevention of cardiac dysfunction. Methods: A prospective study was carried out using patients with breast cancer (85 women; median age 57W12years) and other inclusion and exclusion criteria. On the basis of treatment, patients were divided into six groups: fluorouracil-epirubicincyclophosphamide, FEC (group A); FEC and trastuzumab (B); trastuzumab (C); FEC and taxotere (D); FEC, paclitaxel and trastuzumab (E); and chemotherapy and cardioprotective drugs (F). Cardiological evaluation including electrocardiogram and conventional echocardiogram with tissue Doppler imaging (TDI) was carried out at T0 (before starting chemotherapy), T1 (after 6months from the start of chemotherapy) and T2 (2 years after the end of chemotherapy). Results: Significant changes in the TDI parameters of systolic and diastolic function were observed at T1 and T2 in all patients. A significant reduction of left ventricular ejection fraction (LVEF) was observed only at T2. In the patients treated with ACEI (F), these changes were less significant than in other groups and they do not have significant changes in the indices of diastolic function. Conclusion: TDI is more sensitive than conventional echocardiogram in the early diagnosis of cardiac dysfunction and ACEIs seem to have an important role in the prevention of cardiotoxicity

Treatment decision making in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy: State of the art

No abstract availabl

Therapeutic management in Sicilian patients with definite arrhythmogenic right ventricular dysplasia/cardiomyopathy and focus on the role of implantable cardioverter-defibrillator therapy

No abstract availabl

The role of redox mechanisms in hepatic chronic wound healing and fibrogenesis

Under physiological conditions, intracellular and tissue levels of reactive oxygen species (ROS) are carefully controlled and employed as fine modulators of signal transduction, gene expression and cell functional responses (redox signaling). A significant derangement in redox homeostasis, resulting in sustained levels of oxidative stress and related mediators, plays a role in the pathogenesis of human diseases characterized by chronic inflammation, chronic activation of wound healing and tissue fibrogenesis, including chronic liver diseases. In this chapter major concepts and mechanisms in redox signaling will be briefly recalled to introduce a number of selected examples of redox-related mechanisms that can actively contribute to critical events in the natural history of a chronic liver diseases, including induction of cell death, perpetuation of chronic inflammatory responses and fibrogenesis. A major focus will be on redox-dependent mechanisms involved in the modulation of phenotypic responses of activated, myofibroblast-like, hepatic stellate cells (HSC/MFs), still considered as the most relevant pro-fibrogenic cells operating in chronic liver diseases

Interacciones entre Geomorfología e intervención humana sobre la composición del matorral en la cuenca del río Guadalupejo (Extremadura)

19 páginas, 4 figuras, 2 tablas, 30 referencias.[EN]: The relationships between geomorphology and scrub composition and the effects of management practices on them bave been studied in Guadalupejo River bassin (W. Spain). The mediterranean climate has an annual precipitation of 803 mm and average temperature of 15ºC. Lithology is dominated by slates with surface deposits of conglomerates and clay. The area was subdivided on homogeneous units with geomorphic and management criteria in order to sample vegetation. Pressence/absence and abundance (as cover) of 30 scrub species was recorded on 56 10 x 10m. plots. Cluster analysis was used to classify vegetation types. Main type divisions are related primarily to human management and secondarily to geomorphic and physicochemical characters of substrate. Total plant cover, specific species contribution and pioneer/mature species ratio a1l are influenced by the predominant factors mentioned above. The relative weight of physical, biotic and human factors in determining vegetation composition is discussed. It is proposed that all processes involved may fall into three main categories: limitation, organisation and disruption.[ES]: Se han estudiado las relaciones entre geomorfología y composición del matorral mediterráneo y el efecto de la intervención humana sobre las mismas. Se escogió la parte baja de la cuenca del río Guadalupejo, afluente del Guadiana por su margen derecha. El clima es de tipo mediterráneo (803 mm; y 15°) y el sustrato está formado por pizarras, conglomerados y arcillas. Se sectorizó el área con criterios geomorfológicos y de tipos de intervención humana como base para el muestreo estratificado de la vegetación; se registró la presencia de las especies y se midió su cobertura en 36 parcelas de 10 x 10 m. La Matriz de datos cualitativos se analizó mediante técnicas de análisis de clasificación aglomerativa, para determinar tipos de matorral. Las principales diferencias entre los tipos de matorral se relacionan en primer lugar con la modalidad de intervención humana y en segundo con la geomorfología y composición fisicoquímica del sustrato. La cobertura total del matorral, importancia relativa de las distintas especies y relación entre coberturas especies pioneras/especies maduras también se relacionan con estos factores predominantes. Se discute la importancia de los procesos físicos, bióticos y humanos en la determinación de la composición de la vegetación, considerándolos agrupados en 3 grupos de procesos, limitativos, organizativos y desorganizativos.Peer reviewe

Avaliação sócio-ambiental da integração tecnológica Embrapa Pecuária Sudeste para produção leiteira na agricultura familiar.

Duas características da pecuária leiteira podem ser destacadas na atualidade: a) o baixo valor do leite, que dificulta a adoção de tecnologias que favoreçam a produtividade e b) a concentração da produção leiteira em estabelecimentos pequenos, nos quais predomina a atividade em nível de subsistência, com mão-de-obra familiar e renda mensal que não ultrapassa um salário mínimo. Um projeto de pesquisa e transferência de tecnologia da Embrapa Pecuária Sudeste (São Carlos, Estado de São Paulo) vem sendo desenvolvido desde 1998 para melhoria desse cenário. Uma vez implantado o projeto em uma série de estabelecimentos na região de Votuporanga, Estado de São Paulo, desenvolveu-se este estudo, para avaliar os impactos sócio-ambientais da adoção da tecnologia. Os resultados indicam que o desempenho dos estabelecimentos melhora em função do tempo desde a adoção e que a tecnologia contribui positivamente para o desenvolvimento sustentável, sendo recomendada para transferência

Genetic transfer from several apomictic tetraploid Paspalum species to an elite group of sexual plants

Basic findings from classical genetic studies are available for exploiting apomixis in the breeding of several forage grass genera. Most Paspalum species are multiploid with a sexual diploid cytotype and conspecific apomictic polyploid (mainly tetraploid) cytotypes. Experimental tetraploidized diploids reproduce sexually and, when crossed with natural apomictic tetraploids, yield hybrid populations that segregate for reproductive mode. Genetic studies indicated that apomixis is inherited as a monogenic dominant factor. We recombined 50 selected sexual hybrids obtained from crosses between a tetraploidized sexual genotype of P. plicatulum and 9 natural apomictic tetraploid accessions of 6 species of the Plicatula group. A synthetic sexual tetraploid population (SSTP) of 600 individuals from mixed seed of the 50 intercrossed hybrids was space-planted in the field. Based on evaluations of plant vigor, seed set, ergot tolerance, regrowth after flowering, and cold tolerance, 31 plants were selected. Crosses between most selected plants and two testers, which belonged to P. guenoarum, were performed, and the generated progeny was planted into the field following a randomized block design with 3 replications. The progeny test was evaluated for seed fertility, biomass yield, and cold tolerance. This procedure allowed selection of 10 elite plants from the SSTP. These plants should contain genes recombined from six apomictic species, without the genetic determinants for apomixis. They may be polycrossed to generate an improved sexual population, or crossed with other apomictic genotypes to obtain improved apomictic hybrids.Fil: Novo, Patricia Elda. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Acuña, Carlos Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Urbani, Mario Hugo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Galdeano, Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Espinoza, Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Quarin, Camilo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; Argentin