DIETA HIPOSSÓDICA AUMENTA A BIODISPONIBILIDADE DE NO E A PRODUÇÃO DE PROSTANÓIDES VASOCONSTRICTORES DA COX-2 EM RATOS ESPONTANEAMENTE HIPERTENSOS

JUSTIFICATIVA E OBJETIVOS: A restrição de sal é recomendada no tratamento da hipertensão para reduzir a pressão arterial, mas a implicação sobre os fatores de risco cardiovasculares ainda é uma questão em debate. A capacidade que a dieta com restrição de sódio tem para reduzir a incidência de mortalidade cardiovascular na hipertensão ainda não é clara. O objetivo deste estudo foi avaliar o efeito de um longo período de dieta com restrição de sal sobre a reatividade de artérias mesentéricas de ratos espontaneamente hipertensos (SHR). MATERIAL E MÉTODOS: Ratos machos SHR receberam dieta normossódica (0,3% NaCl) ou hipossódica (0,03% NaCl) durante 28 semanas. Foi isolado o terceiro ramo da artéria mesentérica para análise da influência dos mediadores da reatividade vascular: oxido nítrico (NO), ciclooxigenase-2 (COX-2), espécies reativas de oxigênio (ERO) e sistema renina-angiotensina (SRRA). RESULTADOS: Após 7 meses de dieta, o grupo SHR que recebeu dieta hipossódica apresentou redução na pressão arterial sistólica (PAS) quando comparado ao que recebeu dieta normossódica (dieta hipossódica: 169 ± 4 mmHg, normossódica: 203 ± 4,7 mmHg; P <0,05). A redução na ingestão de sal não alterou a vasoconstrição induzida pela fenilefrina, mas aumentou a vasodilatação induzida pela acetilcolina. A dieta hipossódica também aumentou os efeitos da inibição da sintase de NO com L-NAME (100 mM) sob a resposta induzida pela fenilefrina e a expressão vascular da iNOS. O inibidor da ciclooxigenase, indometacina (10 &#956;M) e o inibidor da COX-2, NS 398 (1 &#956;M) reduziram a reatividade vascular à fenilefrina no grupo de dieta hipossódica concomitante a um aumento na expressão da proteína COX-2. Não houve participação das espécies reativas de oxigênio na reatividade vascular modulada pela dieta hipossódica, quando avaliadas através do uso de bloqueadores de EROs, anion superoxido, peroxido de hidrogênio, nem com o uso dos bloqueadores de receptores da ACE e do receptor para AT1, enalapril (10 &#956;M) e losartan (10 &#956;M). A expressão da proteína do receptor AT1 também foi semelhante nos dois grupos. CONCLUSÕES: Estes resultados sugerem que a dieta hipossódica modula a reatividade mesentérica, provavelmente, pelo aumento da biodisponibilidade de NO e da produção de prostanóides vasoconstritores através da via da COX-2 em ratos espontaneamente hipertensos. As EROs e o sistema renina-angiotensina local não estão envolvidos nessa resposta vascular

The computerized medical record as a tool for clinical governance in australian primary care

Background: Computerized medical records (CMR) are used in most Australian general practices. Although CMRs have the capacity to amalgamate and provide data to the clinician about their standard of care, there is little research on the way in which they may be used to support clinical governance: the process of ensuring quality and accountability that incorporates the obligation that patients are treated according to best evidence. Objective: The objective of this study was to explore the capability, capacity, and acceptability of CMRs to support clinical governance. Methods: We conducted a realist review of the role of seven CMR systems in implementing clinical governance, developing a four-level maturity model for the CMR. We took Australian primary care as the context, CMR to be the mechanism, and looked at outcomes for individual patients, localities, and for the population in terms of known evidence-based surrogates or true outcome measures. Results: The lack of standardization of CMRs makes national and international benchmarking challenging. The use of the CMR was largely at level two of our maturity model, indicating a relatively simple system in which most of the process takes place outside of the CMR, and which has little capacity to support benchmarking, practice comparisons, and population-level activities. Although national standards for coding and projects for record access are proposed, they are not operationalized. Conclusions: The current CMR systems can support clinical governance activities; however, unless the standardization and data quality issues are addressed, it will not be possible for current systems to work at higher levels

Helicops modestus (Ophidia: Dipsadidae): reproducción

Los datos sobre la reproducción de serpientes son escasos, sobre todo porque es difícil encontrar a estos organismos en su hábitat natural. Se proporcionan algunos datos inéditos sobre la reproducción de Helicops modestus (Günther, 1861), un dipsádido con amplia distribución geográfica en Brasil

Burnout in medical students: A systematic review of experiences in Chinese medical schools

© 2017 The Author(s). Background: To identify the: extent to which medical students in China experience burnout; factors contributing to this; potential solutions to reduce and prevent burnout in this group; and the extent to which the experiences of Chinese students reflect the international literature. Methods: Systematic review and narrative synthesis. Key words, synonyms and subject headings were used to search five electronic databases in addition to manual searching of relevant journals. Titles and abstracts of publications between 1st January 1989-31st July 2016 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesised. Results: Thirty-three studies were eligible and included in the review. Greater levels of burnout were generally identified in males, more senior medical students, and those who already experienced poorer psychological functioning. Few studies explored social or contextual factors influencing burnout, but those that did suggest that factors such as the degree of social support or the living environment surrounding a student may be a determinant of burnout. Conclusions: Greater understanding of the social and contextual determinants of burnout amongst medical students in China is essential towards identifying solutions to reduce and prevent burnout in this group

Adsorption of NGF and BDNF derived peptides on gold surfaces

This study tackles the interaction between gold surfaces and two peptide fragments named NGF(1-14) and BDNF(1-12), able to mimic the proliferative activity of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF), respectively. The physical adsorption processes at the solid surface from both single and binary peptide solutions, at physiological and acid pH, were investigated by QCM-D and CD experiments, as well as by molecular dynamics calculations. The relevant physicochemical properties at the hybrid bio-interface, including peptide-surface interaction, conformational changes, hydrodynamic thickness, viscoelastic parameters, competitive vs. synergic behaviour of the two peptide fragments towards the surface were scrutinized. Biological assays with neuronal cells pointed to the maintenance in the biological activity of NGF(1-14) and BDNF(1-12) peptide molecules within the adlayers on the gold surface

General practitioners' perceptions of population based bowel screening and their influence on practice: a qualitative study

© 2017 The Author(s). Background: Although largely preventable, Australia has one of the highest rates of bowel cancer in the world. General Practitioners (GPs) have an important role to play in prevention and early detection of bowel cancer, however in Australia this is yet to be optimised and participation remains low. This study sought to understand how GPs' perceptions of bowel screening influence their attitudes to, and promotion of the faecal occult blood test (FOBT), to identify opportunities to enhance their role. Methods: Interviews were conducted with 31 GPs from metropolitan and regional New South Wales (NSW), Australia. Discussions canvassed GPs' perceptions of their role in bowel screening and the national screening program; perceptions of screening tests; practices regarding discussing screening with patients; and views on opportunities to enhance their role. Transcripts were coded using Nvivo and thematically analysed. Results: The study revealed GPs' perceptions of screening did not always align with broader public health definitions of 'population screening'. While many GPs reportedly understood the purpose of population screening, notions of the role of asymptomatic screening for bowel cancer prevention were more limited. Descriptions of screening centred on two major uses: the use of a screening 'process' to identify individual patients at higher risk; and the use of screening 'tools', including the FOBT, to aid diagnosis. While the FOBT was perceived as useful for identifying patients requiring follow up, GPs expressed concerns about its reliability. Colonoscopy by comparison, was considered by many as the gold standard for both screening and diagnosis. This perception reflects a conceptualisation of the screening process and associated tools as an individualised method for risk assessment and diagnosis, rather than a public health strategy for prevention of bowel cancer. Conclusion: The results show that GPs' perceptions of screening do not always align with broader public health definitions of 'population screening'. Furthermore, the way GPs understood screening was shown to impact their clinical practice, influencing their preferences for, and use of 'screening' tools such as FOBT. The findings suggest emphasising the preventative opportunity of FOBT screening would be beneficial, as would formally engaging GPs in the promotion of bowel screening

Targeting redox metabolism of the maize-Azospirillum brasilense interaction exposed to arsenic-affected groundwater

Arsenic in groundwater constitutes an agronomic problem due to its potential accumulation in the food chain. Among the agro-sustainable tools to reduce metal(oid)s toxicity, the use of plant growth-promoting bacteria (PGPB) becomes important. For that, and based on previous results in which significant differences of As translocation were observed when inoculating maize plants with Az39 or CD Azospirillum strains, we decided to decipher the redox metabolism changes and the antioxidant system response of maize plants inoculated when exposed to a realistic arsenate (AsV) dose. Results showed that AsV caused morphological changes in the root exodermis. Photosynthetic pigments decreased only in CD inoculated plants, while oxidative stress evidence was detected throughout the plant, regardless of the assayed strain. The antioxidant response was strain-differential since only CD inoculated plants showed an increase in superoxide dismutase, glutathione S-transferase (GST), and glutathione reductase (GR) activities while other enzymes showed the same behavior irrespective of the inoculated strain. Gene expression assays reported that only GST23 transcript level was upregulated by arsenate, regardless of the inoculated strain. AsV diminished the glutathione (GSH) content of roots inoculated with the Az39 strain, and CD inoculated plants showed a decrease of oxidized GSH (GSSG) levels. We suggest a model in which the antioxidant response of the maize-diazotrophs system is modulated by the strain and that GSH plays a central role acting mainly as a substrate for GST. These findings generate knowledge for a suitable PGPB selection, and its scaling to an effective bioinoculant formulation for maize crops exposed to adverse environmental conditions.Fil: Peralta, Juan Manuel. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Instituto de Investigaciones Agrobiotecnologicas. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Instituto de Investigaciones Agrobiotecnologicas.; ArgentinaFil: Bianucci, Eliana Carolina. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Instituto de Investigaciones Agrobiotecnologicas. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Instituto de Investigaciones Agrobiotecnologicas.; ArgentinaFil: Romero Puertas, María C.. Consejo Superior de Investigaciones Científicas. Estación Experimental del Zaidín; EspañaFil: Furlan, Ana Laura. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Instituto de Investigaciones Agrobiotecnologicas. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Instituto de Investigaciones Agrobiotecnologicas.; ArgentinaFil: Castro, Stella Maris. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Instituto de Investigaciones Agrobiotecnologicas. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Instituto de Investigaciones Agrobiotecnologicas.; ArgentinaFil: Travaglia, Claudia Noemi. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Instituto de Investigaciones Agrobiotecnologicas. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Instituto de Investigaciones Agrobiotecnologicas.; Argentin

Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital

OBJECTIVES: To describe noninvasive positive-pressure ventilation use in intensive care unit clinical practice, factors associated with NPPV failure and the associated prognosis. METHODS: A prospective cohort study. RESULTS: Medical disorders (59%) and elective surgery (21%) were the main causes for admission to the intensive care unit. The main indications for the initiation of noninvasive positive-pressure ventilation were the following: post-extubation, acute respiratory failure and use as an adjunctive technique to chest physiotherapy. The noninvasive positive-pressure ventilation failure group was older and had a higher Simplified Acute Physiology Score II score. The noninvasive positive-pressure ventilation failure rate was 35%. The main reasons for intubation were acute respiratory failure (55%) and a decreased level of consciousness (20%). The noninvasive positive-pressure ventilation failure group presented a shorter period of noninvasive positive-pressure ventilation use than the successful group &#91;three (2-5) versus four (3-7) days&#93;; they had lower levels of pH, HCO3 and base excess, and the FiO2 level was higher. These patients also presented lower PaO2:FiO2 ratios; on the last day of support, the inspiratory positive airway pressure and expiratory positive airway pressure were higher. The failure group also had a longer average duration of stay in the intensive care unit &#91;17 (10-26) days vs. 8 (5-14) days&#93;, as well as a higher mortality rate (9 vs. 51%). There was an association between failure and mortality, which had an odds ratio (95% CI) of 10.6 (5.93 -19.07). The multiple logistic regression analysis using noninvasive positive pressure ventilation failure as a dependent variable found that treatment tended to fail in patients with a Simplified Acute Physiology Score II$34, an inspiratory positive airway pressure level &gt; 15 cmH2O and p

The Italian Museo Nazionale dell’Antartide

These abstract proceedings were produced based on the program for the POLAR2018 SCAR/IASC Open Science Conference, updated until 25 May 2018