Evaluación corporal en atletas jóvenes de baloncesto femenino

El objetivo del presente estudio consistió en caracterizar la composición corporal en atletas jóvenes de baloncesto femenino. Como objetivo secundario se procuró verificar de que modo se correlacionaban los valores obtenidos para el índice de masa corporal, porcentaje de grasa y pliegues subcutáneos. Fueron estudiadas 11 jugadoras de Baloncesto del sexo femenino (15 y 16 años). La composición corporal fue calculada a través de la formula propuesta por Sloan - Weir y Brozek, a través de la recogida de datos relativos a los pliegues subcutáneos, y el índice de masa corporal fue calculado a través del peso y altura. Los resultados permitirán concluir que: (i) existen correlaciones significativas entre IMC y porcentaje de grasa; (ii) existen correlaciones significativas entre IMC y pliega tricipital; (iii) no existen correlaciones significativas entre IMC y pliegue suprailiaco. Los resultados del presente estudio solo se ajustan a la presente muestra debido que el número de sujetos estudiados no llegan a 30, no siendo posible así generalizar los resultados

Prognostic impact of hemoglobin drop during hospital stay in patients with acute coronary syndromes

INTRODUCTION: Bleeding is currently the most common non-cardiac complication of therapy in patients with acute coronary syndromes (ACS), and may itself be associated with adverse outcomes. The aim of this study was to determine the effect of hemoglobin drop during hospital stay on outcome among patients with ACS. METHODS: Using Cox proportional-hazards modeling, we examined the association between hemoglobin drop and death or myocardial infarction (MI) at 6 months in 1172 patients admitted with ACS to an intensive cardiac care unit. Patients were stratified according to quartiles of hemoglobin drop: Q1, or = 2.4 g/dL. We also identified independent predictors of increased hemoglobin drop (> or =2.4 g/dL) using multivariate logistic regression analysis. RESULTS: Median nadir hemoglobin concentration was 1.5 g/dL lower (IQR 0.8-2.3) compared with baseline hemoglobin (p < 0.0001). Independent predictors of increased hemoglobin drop included older Sage, renal dysfunction, lower weight, and use of thrombolytic therapy, glycoprotein IIb/IIIa inhibitors, nitrates, and percutaneous coronary intervention. Higher levels of hemoglobin drop were associated with increased rates of 6-month mortality (8.0% vs. 9.4% vs. 9.6% vs. 15.7%; p for trend = 0.014) and 6-month death/ MI (12.4% vs. 17.0% vs. 17.2% vs. 22.1%; p for trend = 0.021). Using Q1 as reference group, the adjusted hazard ratio (HR) for 6-month mortality and 6-month death/MI among patients in the highest quartile of hemoglobin drop was 1.83 (95% confidence interval [CI] 1.08-3.11; p = 0.026) and 1.60 (95% CI 1.04-2.44; p = 0.031) respectively. Considered as a continuous variable, the adjusted HR for 6-month mortality was 1.16 (95% CI 1.01-1.32; p = 0.030) per 1 g/dL increase in hemoglobin drop. CONCLUSIONS: A decrease in hemoglobin frequently occurs during hospitalization for ACS and is independently associated with adverse outcomes

Prognostic value of in-hospital worsening of renal function in patients with acute coronary syndrome

Purpose: The association between a history of renal insufficiency and poor outcome in patients with acute coronary syndrome (ACS) is well known. However, little information is available about in-hospital worsening of renal function. Our goal was to determine the prognostic impact of in-hospital worsening of renal function in patients with ACS. Methods: A total of 1228 patients consecutively admitted with ACS from January 2004 to March 2007 were reviewed. Patients deceased in hospital and patients with < 2 analysis and/or without creatinine value on admission were excluded. The selected patients were classified into 2 groups. Group I included patients with an increase in creatinine <0,5 mg/dL. Group II included patients with an increase in creatinine ≥ 0,5 mg/dL. The primary endpoint was 6-month mortality from any cause. Results: Of the 1134 patients finally selected, 1028 belonged to group I and 106 to group II. Patients of group II were older (74,08±8,8 vs 63,2±12,9; p <0,001), more frequently women (39,6% vs 26,1%; p= 0,003) and more often had diabetes mellitus (42,5% vs 25,7%; p=0,001), arterial hypertension (77,4% vs 62,0%; p=0,001) and renal insufficiency (63,5% vs 19,8%; p <0,001). Patients of group II had higher 6-month mortality compared with patients in group I (24,5% vs 5,0%; p <0,001). After adjustment for known risk factors by multivariate analysis (age, history of renal insufficiency, diabetes mellitus, creatinine value on admission, history of myocardial infarction, Killip class on admission, heart rate on admission, systolic blood pressure on admission and left ventricular systolic dysfunction), an increase in creatinine remained a independent predictor of 6-month mortality (OR=2,45; 95% confidence interval 1,42 to 4,24; p=0,0013). Conclusions: In-hospital worsening of renal function is associated with increased 6-month mortality in patients with ACS

Smoking in acute coronary syndromes--the "smoker's paradox" revisited

INTRODUCTION: Although a well-known risk factor for coronary disease, smoking has long been associated with lower short-term mortality in acute coronary syndromes (ACS). There are few recent works on Portuguese populations examining all aspects of smoking in ACS, particularly the interaction between smoking and other risk factors, and the management and prognosis of patients according to smoking status. OBJECTIVE: We sought to examine clinical characteristics, presentation, in-hospital treatment, angiographic features and prognosis of patients with and without smoking history admitted with ACS. METHODS: A total of 1228 patients consecutively admitted with ACS from January 2004 to March 2007 were analyzed. Patients were classified into two groups, those with present or past smoking habits (n=450) making up Group I and those without smoking habits (n=778), Group II. The main outcome analyzed was overall mortality during hospital stay and at 6 months. RESULTS: Smokers and former smokers were younger and more frequently male (odds ratio [OR] = 22.46; 95% confidence interval [CI]: 12.94-38.96), and less often had diabetes (OR = 0.41; 95% CI: 0.30-0.54), hypertension (OR = 0.31; 95% CI: 0.24-0.39) and renal insufficiency (OR = 0.26; 95% CI: 0.18-0.36). Patients with smoking habits more frequently presented with ST elevation (OR = 1.32; 95% CI: 1.04-1.67), more often received evidence-based medical therapy, namely beta blockers (during hospital stay, OR = 2.42; 95% CI: 1.63-3.56 and at discharge, OR = 1.45; 95% CI: 1.03-2.1) and statins (at discharge, OR = 2.48; 95% CI: 1.2-6.1), and more frequently underwent coronary angiography (OR = 2.15; 95% CI: 1.63-2.84). Although smokers and former smokers had lower in-hospital mortality on univariate analysis (OR = 0.54; 95% CI: 0.31-0.96), this association was not confirmed on multivariate analysis, with adjustment for known short-term mortality predictors (OR = 1.25; 95% CI: 0.61-2.54). Similarly, multivariate analysis failed to confirm lower 6-month mortality for smokers and former smokers (OR = 2.0; 95% CI: 1.17-3.41). CONCLUSIONS: Clinical characteristics and management options differed between ACS patients with and without smoking habits. These differences explained the lower shortterm mortality initially observed between the two groups. In our population of patients admitted with ACS, we did not find a real "smoker's paradox"

Contrast-induced nephropathy after an acute coronary syndrome.

Purpose: Contrast-induced nephropathy (CIN) is a form of hospital-acquired acute renal failure that sometimes develops after giving iodinated radiocontrast agents. The growing number of patients who undergo coronary angiography and percutaneous revascularization after acute coronary syndrome (ACS) brought more relevance to this entity. It’s actually one of the most frequent forms of hospital-acquired acute renal failure. The purpose of this study was to define the predictors and prognostic value of CIN in a population of patients admitted with ACS. Methods: A total of 558 patients consecutively admitted with ACS and submitted to cardiac catheterization procedure, from January 2004 to April 2006, were reviewed. CIN was defined as impairment of renal function occurring within 48 hours after administration of contrast media and manifested by an absolute increase in the serum creatinine level of at least 0.5 mg/dL or by a relative increase of at least 25% over the baseline value (in the absence of another cause). The patients were classified in 2 groups according to the occurrence of CIN. The primary endpoint was in-hospital mortality. Results: Of the 558 patients reviewed, 5% (n=28) developed CIN. Patients with CIN were older (69.6 ± 10.5 vs 61.5 ± 11.7; p <0.001) and more often had diabetes mellitus (42.9% vs 24%; p=0.02) and renal insufficiency (48% vs 14.7%; p <0.001). There were no differences regarding ACS presentation (with or without elevation in the ST segment) and in-hospital medical treatment. Patients with CIN had higher in-hospital mortality (10.7% vs 0.6%; p <0.001). After adjustment for confounding variables by multivariate analysis (age, renal insufficiency, heart rate on admission, systolic blood pressure on admission and Killip class on admission), CIN remained an independent predictor of in-hospital mortality. Conclusions: CIN occurred in 5% of our patients admitted with ACS. Risk factors associated with CIN were advanced age, diabetes and pre-existing renal insufficiency. CIN was an independent predictor of in-hospital mortality

Thiophene- and carbazole-substituted N-Methyl-Fulleropyrrolidine acceptors in PffBT4T-2OD based solar cells

The impact of fullerene side chain functionalization with thiophene and carbazole groups on the device properties of bulk-heterojunction polymer:fullerene solar cells is discussed through a systematic investigation of material blends consisting of the conjugated polymer poly[(5,6-difluoro-2,1,3-benzothiadiazol-4,7-diyl)-alt-(3,3‴-di(2-octyldodecyl)-2,2′;5′,2″;5″,2‴-quaterthiophen-5,5‴-diyl)] (PffBT4T-2OD) as donor and C60 or C70 fulleropyrrolidines as acceptors. The photovoltaic performance clearly depended on the molecular structure of the fulleropyrrolidine substituents although no direct correlation with the surface morphology of the photoactive layer, as determined by atomic force microscopy, could be established. Although some fulleropyrrolidines possess favorable lowest unoccupied molecular orbital levels, when compared to the standard PC71BM, they originated OPV cells with inferior efficiencies than PC71BM-based reference cells. Fulleropyrrolidines based on C60 produced, in general, better devices than those based on C70, and we attribute this observation to the detrimental effect of the structural and energetic disorder that is present in the regioisomer mixtures of C70-based fullerenes, but absent in the C60-based fullerenes. These results provide new additional knowledge on the effect of the fullerene functionalization on the efficiency of organic solar cells.This work was financially supported by: Base Funding — UIDB/00511/2020 of the Laboratory forProcess Engineering, Environment, Biotechnology and Energy — LEPABE — funded by national funds through theFCT/MCTES (PIDDAC). This work was partially funded within the scope of the project i3N, UIDB/50025/2020 & UIDP/50025/2020, financed by national funds through the FCT/MEC. Thanks are also due to FCT/MEC for thefinancial support to QOPNA (FCT UID/QUI/00062/2019), CICECO-Aveiro Institute of Materials (UIDB/50011/2020& UIDP/50011/2020), CQE (FCT UIDB/00100/2020), and CIQUP (FCT UID/QUI/UI0081/2019) research units, throughnational funds and where applicable co-financed by the FEDER, within the PT2020 Partnership Agreement. H.G.thanks Fundação para a Ciência e a Tecnologia (FCT) for his PhD scholarship (SFRH/BD/103009/2014). The researchcontracts of F.F. (REF. -168-89-ARH/2018) is funded by national funds (OE), through FCT—Fundação para aCiência e Tecnologia, I.P., in the scope of the framework contract foreseen in the numbers 4, 5, and 6 of article 23,of the Decree-Law 57/2016, of August 29, changed by Law 57/2017, of July 19. M.M.F. acknowledges also supportfrom FCT under the project IF/00894/2015

Fast and efficient microfluidic cell filter for isolation of circulating tumor cells from unprocessed whole blood of colorectal cancer patients

Liquid biopsy offers unique opportunities for low invasive diagnosis, real-time patient monitoring and treatment selection. The phenotypic and molecular profile of circulating tumor cells (CTCs) can provide key information about the biology of tumor cells, contributing to personalized therapy. CTC isolation is still challenging, mainly due to their heterogeneity and rarity. To overcome this limitation, a microfluidic chip for label-free isolation of CTCs from peripheral blood was developed. This device, the CROSS chip, captures CTCs based on their size and deformability with an efficiency of 70%. Using 2 chips, 7.5 ml of whole blood are processed in 47 minutes with high purity, as compared to similar technologies and assessed by in situ immunofluorescence. The CROSS chip performance was compared to the CellSearch system in a set of metastatic colorectal cancer patients, resulting in higher capture of DAPI+/CK+/CD45- CTCs in all individuals tested. Importantly, CTC enumeration by CROSS chip enabled stratification of patients with different prognosis. Lastly, cells isolated in the CROSS chip were lysed and further subjected to molecular characterization by droplet digital PCR, which revealed a mutation in the APC gene for most patient samples analyzed, confirming their colorectal origin and the versatility of the technology for downstream applications

O “paradoxo dos fumadores” revisitado.

Introdução: O termo “paradoxo dos fumadores” surgiu na sequência de vários estudos que descreveram uma menor mortalidade a curto prazo nos doentes com história de tabagismo, internados com Síndrome Coronário Agudo (SCA). No entanto, trabalhos mais recentes têm contestado a existência deste fenómeno. Objectivo: Avaliar a ocorrência do “paradoxo dos fumadores” na nossa população de doentes internados por SCA. Métodos: Foram analisados 1228 doentes admitidos consecutivamente por SCA de Janeiro 2004 a Março 2007. Os doentes foram classificados em 2 grupos, o grupo I incluindo os doentes sem história de tabagismo (n=778) e o grupo II os doentes com história de tabagismo (n=450). Os “endpoints” foram a morte no internamento e morte total aos 6 meses. Resultados: Verificou-se que os doentes sem história de tabagismo eram mais idosos (68,25 ± 12,22 anos contra 58,13 ± 11,91 anos), mais frequentemente do sexo feminino, e apresentavam com maior frequência diabetes mellitus (DM), hipertensão arterial (HTA) e insuficiência renal (p <0,05). Os doentes que nunca fumaram tiveram mais frequentemente enfarte agudo do miocárdio (EAM) sem supra de ST enquanto os doentes com história de tabagismo tiveram mais EAM com supra de ST (p <0,05). Os doentes sem história de tabagismo eram mais frequentemente medicados com nitratos, diuréticos e antagonistas de cálcio e menos com β – bloqueadores (p <0,05), não se tendo encontrado diferenças quanto à restante terapêutica médica. Os doentes com história tabágica foram mais frequentemente submetidos a coronariografia (p <0,01). Apesar de se observar, na análise univariável, maior mortalidade intra-hospitalar e aos 6 meses nos doentes sem antecedente de tabagismo (p <0,05), a análise multivariável, com o ajuste para os factores de risco mais reconhecidos (idade, classe KK na admissão, pressão arterial sistólica e frequência cardíaca na admissão, disfunção ventricular esquerda, presença de insuficiência renal) não permitiu confirmar esta associação. Conclusão: Na nossa população de doentes internados por SCA, não se verificou nenhum “paradoxo dos fumadores”. A ocorrência de maior mortalidade observada entre os doentes sem história de tabagismo correlaciona-se provavelmente com as diferenças das características basais dos doentes, nomeadamente idade mais avançada e maior número de co-morbilidades (DM, HTA e insuficiência renal)

Impacto do tipo de fibrilhac¸ão auricular no contexto das síndromes coronárias agudas: características clínicas e prognóstico

INTRODUCTION: Atrial fibrillation (AF) is widely recognized as an adverse prognostic factor during acute myocardial infarction, although the impact of AF type - new-onset (nAF) or pre-existing (pAF) - is still controversial. OBJECTIVES: To identify the clinical differences and prognosis of nAF and pAF during acute coronary syndromes (ACS). METHODS: We performed a retrospective observational cohort study including 1373 consecutive patients (mean age 64 years, 77.3% male) admitted to a single center over a three-year period, with a six-month follow-up. RESULTS: AF rhythm was identified in 14.5% patients, of whom 71.4% presented nAF and 28.6% pAF. When AF types were compared, patients with nAF more frequently presented with ST-elevation ACS (p=0.003). Patients with pAF, in turn, were older (p=0.032), had greater left atrial diameter (p=0.001) and were less likely to have significant coronary lesions (p=0.034). Regarding therapeutic strategy, nAF patients were more often treated by rhythm control during hospital stay (p<0.001) and were less often anticoagulated at discharge (p=0.001). Compared with the population without AF, nAF was a predictor of death during hospital stay in univariate (p<0.001) and multivariate analysis (OR 2.67, p=0.047), but pAF was not. During follow-up, pAF was associated with higher mortality (p=0.014), while nAF patients presented only a trend towards worse prognosis. CONCLUSIONS: AF during the acute phase of ACS appears to have a negative prognostic impact only in patients with nAF and not in those with pAF