Testosterone deficiency increases hospital readmission and mortality rates in male patients with heart failure.

BackgroundTestosterone deficiency in patients with heart failure (HF) is associated with decreased exercise capacity and mortality; however, its impact on hospital readmission rate is uncertain. Furthermore, the relationship between testosterone deficiency and sympathetic activation is unknown.ObjectiveWe investigated the role of testosterone level on hospital readmission and mortality rates as well as sympathetic nerve activity in patients with HF.MethodsTotal testosterone (TT) and free testosterone (FT) were measured in 110 hospitalized male patients with a left ventricular ejection fraction < 45% and New York Heart Association classification IV. The patients were placed into low testosterone (LT; n = 66) and normal testosterone (NT; n = 44) groups. Hypogonadism was defined as TT < 300 ng/dL and FT < 131 pmol/L. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography in a subpopulation of 27 patients.ResultsLength of hospital stay was longer in the LT group compared to in the NT group (37 ± 4 vs. 25 ± 4 days; p = 0.008). Similarly, the cumulative hazard of readmission within 1 year was greater in the LT group compared to in the NT group (44% vs. 22%, p = 0.001). In the single-predictor analysis, TT (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.58-4.85; p = 0.02) predicted hospital readmission within 90 days. In addition, TT (HR, 4.65; 95% CI, 2.67-8.10; p = 0.009) and readmission within 90 days (HR, 3.27; 95% CI, 1.23-8.69; p = 0.02) predicted increased mortality. Neurohumoral activation, as estimated by MSNA, was significantly higher in the LT group compared to in the NT group (65 ± 3 vs. 51 ± 4 bursts/100 heart beats; p < 0.001).ConclusionThese results support the concept that LT is an independent risk factor for hospital readmission within 90 days and increased mortality in patients with HF. Furthermore, increased MSNA was observed in patients with LT

Terapia anti-hipertensiva utilizada por pacientes idosos de Porto Alegre/RS, Brasil = Antihypertensive therapy used by elderly patients from Porto Alegre/RS, Brazil

Objetivos: Descrever o perfil de utilização de medicamentos com ação no sistema cardiovascular, especialmente anti-hipertensivos, por idosos residentes na cidade de Porto Alegre. Métodos: Estudo transversal exploratório e observacional com base populacional, realizado em 2006, sobre a utilização qualitativa e quantitativa de medicamentos por pacientes idosos. O instrumento utilizado para a coleta de dados foi uma ficha de seguimento farmacológico. Resultados: Do total de 385 pacientes entrevistados, 62,3% utilizavam medicamentos com ação no sistema cardiovascular, sendo que destes, 86,3% utilizavam anti-hipertensivos. Entre os 35,3% pacientes que faziam uso de monoterapia, 38,4% utilizavam inibidores da enzima conversora de angiotensina (ECA) e 26% utilizavam beta-bloqueadores. Dos 207 pacientes em monoterapia ou terapia combinada de dois ou mais medicamentos, 59,4% utilizavam diuréticos e 51,2% inibidores da ECA. Conclusões: Os diuréticos, inibidores da ECA e betabloqueadores foram os anti-hipertensivos mais utilizados. Muitas vezes o usuário comete erros na medicação, o que pode ser resolvido com uma assistência correta a esse paciente. Diante da prevalência da hipertensão entre os idosos, observa-se a necessidade de uma maior atenção dos profissionais de saú- de a esses paciente

Dormancy, force and initial establishment of brachiaria and alfalfa

The Brazilian agriculture, in order to achieve high levels of mass production on pastures, requires a prior planning in its installation, which is very important, because only then it will be possible to obtain fields without invasive plants and seeds, showing high force, appropriate germination and establishment in shortest possible time for the vegetative canopy. Among the problems faced for the appropriate installation of a pasture are the low quality of seed in purity and germination, as well as the presence of invasive weeds and the low force associate of seeds. On this base, the main objective of this research is to evaluate the physiological quality of the seeds of genus Brachiaria and Medicago, as well as the reply to the different managements proposed in order to overcome the dormancy. Three studies were performed: the first evaluated the physical and physiological quality, and vegetative growth in five different lots of Brachiaria brizantha cv. BRS Piatã, evaluating the reply to the stimulus of overcoming the dormancy and different tests of the evaluation of force, with the objective of evaluating the consistent observations to purity and germination expressed in different lots. The results disclosed that most of the lots show the minimum purity and they are in agreement to the laws, however expressing low crop value. The association with high temperature and cold stress potentiated in some lots the germination, with significant increase for the association to potassium nitrate for germination and force in many observations. The second study consisted on the study of seeds of Medicago spontaneously naturalized in the state of Rio Grande do Sul, to which proceeded the consistent evaluations of physiological quality of seeds, with the objective to analyze different methods of overcoming dormancy in seeds with coloring and time of contrasting storage and to infer the influence on physiological attributes related to seed force of alfalfa. The treatments used differed from the witness expressing that the species is responsive to treatments used, with the highest averages found to germination in treatments that use manual sandpaper, with the dark coloring showing higher germination than clear coloring in certain treatments. The third study consisted on the physiological quality and growth analysis in field conditions, for four commercial species of genus Brachiaria and one of genus Medicago in search of undertake analysis and identification of the materials with better performance in the establishment of vegetative canopy in conditions in the northern region of Rio Grande do Sul. The low perceptual of physiological quality of forage seeds found in this study shows the need to increase the research to identify genotypes with good force of germination index, to attend the growing demand of the farmer sector. The seeds of genus Brachiaria and Medicago can express high level of dormancy, harming the minimum quality standards required, save exceptions that reached above the minimum establishment standards, being the final consumer the responsible for requiring quality seeds.A agropecuária brasileira, para alcançar altos níveis de produção de massa nas pastagens, necessita de um planejamento prévio em sua instalação, o que é de fundamental importância, pois só assim será possível obter campos livres de invasores e sementes apresentando alto vigor, adequada germinação e estabelecimento em menor tempo possível do dossel vegetativo. Dentre os problemas enfrentados para a instalação adequada de uma pastagem, esta a baixa qualidade de sementes em pureza e germinação, bem como a presença de plantas daninhas invasores e o baixo vigor associado às sementes. Com base nisto, esta pesquisa teve como objetivo geral avaliar a qualidade fisiológica das sementes pertencentes ao gênero Brachiaria e Medicago, assim como a resposta aos diferentes manejos de superação de dormência propostos. Foram realizados três trabalhos: o primeiro tratou de avaliar a qualidade física, fisiológica e crescimento vegetativo de cinco distintos lotes de Brachiaria brizantha cv. BRS Piatã, avaliando a resposta a estímulos de superação de dormência e diferentes testes de avaliação do vigor, com o objetivo de avaliar as observações condizentes a pureza e expressão de germinação de distintos lotes. Os resultados revelaram que a maioria dos lotes apresenta pureza mínima e está de acordo com a legislação, entretanto, expressando baixo valor cultural. A associação com altas temperaturas e estresse por frio potencializou em alguns lotes a germinação, com aumento significativo para a associação com nitrato de potássio condizente para a germinação e vigor em grande número de observações. O segundo trabalho condiz com o estudo de sementes de um acesso de Medicago naturalizado espontaneamente no estado do Rio Grande do Sul, ao qual procederam as avaliações condizentes à qualidade fisiológica das sementes, com o objetivo de analisar diferentes métodos de superação de dormência em sementes com colorações e tempo de armazenamento contrastante, e inferir sobre a influencia em atributos fisiológicos relacionado ao vigor das sementes de alfafinha. Os tratamentos utilizados diferiram da testemunha, expressando que a espécie é responsiva aos tratamentos utilizados, com as maiores médias encontradas para germinação em tratamentos que utilizaram lixa manual, com a coloração escura apresentando germinação maior que a clara em determinados tratamentos.O terceiro trabalho condiz com a qualidade fisiológica e análise de crescimento em condições de campo, para quatro espécies comerciais do gênero Brachiaria e uma do gênero Medicago na busca de proceder a análise e identificação dos materiais com melhor desempenho de estabelecimento de dossel vegetativo nas condições da região do norte do Rio Grande do Sul. Os baixos percentuais da qualidade fisiológica das sementes forrageiras encontradas neste estudo demonstram que é necessário ampliar as pesquisas para identificação de genótipos com bom índice de vigor e germinação, para atender a crescente demanda do setor pecuarista. As sementes do gênero Brachiaria e Medicago podem vir a expressar altos níveis de dormência, prejudicando os padrões mínimos de qualidade exigida, salvas as exceções que alcançam padrões superiores aos mínimos estabelecidos, cabendo ao consumidor final exigir sementes de qualidade

Suplementação vitamínica no desenvolvimento de larvas de Jundiá (Rhamdia quelen) Vitamin suplementation on Jundiá (Rhamdia quelen) larvae development

Dois experimentos foram conduzidos utilizando um delineamento inteiramente casualizado, com seis tratamentos e três repetições, para avaliar o efeito de misturas vitamínicas (MV) na larvicultura do jundiá (Rhamdia quelen). Em ambos os experimentos as rações utilizadas foram isoprotéicas (34%PB) e isocalóricas (3.500kcalED/kg). No experimento I adicionou-se MV formuladas, com ou sem suplementação de inositol e/ou vitamina C. Neste experimento a MV T2 proporcionou maior crescimento das larvas. Esta MV foi então testada em seis níveis de inclusão (2,0; 1,5; 1,0; 0,5; 0,25 e 0%) no experimento II. Comprovou-se que a composição em vitaminas da MV apresentada no T1 do experimento 2 foi a mais eficiente na larvicultura do jundiá.Two experiments were carried out by using a randomized entirely design, with six treatments and three repetitions, to evaluate the effect of vitamin mixtures (VM) in the jundiá (Rhamdia quelen) larviculture. In both experiments were used isoproteic (34%CP) and isocaloric (3.500kcal/kg feed) feeds, where in the experiment I VM was formulated, with or without inositol and C vitamin suplementation. In this experiment MV T2 provided higher larvae growth. The VM was tested in six inclusion levels (2,0; 1,5; 1,0; 0,5; 0,25 and 0%) in the experiment II. It was conclude that the vitamins inclusion on the VM utilized in T1 on the second experiment shown to be more efficient in the jundiá larviculture

DESENVOLVIMENTO E COMPOSIÇÃO CORPORAL DE ALEVINOS DE JUNDIÁ (Rhamdia quelen) ALIMENTADOS COM DIETAS CONTENDO DIFERENTES FONTES DE LIPÍDIOS

Foram testadas três fontes de lipídios em rações experimentais para juvenis de jundiá Rhamdia quelen com a inclusão de 5% na dieta de óleo de canola (T1), óleo de fígado de bacalhau (T2) ou banha suína (T3), usando o delineamento inteiramente casualizado com três tratamentos e três repetições. O desempenho e o rendimento de carcaça não foram afetados pelas fontes de lipídios testadas, porém estas influenciaram na maior deposição de proteína na carcaça dos peixes do tratamento T1 e de gordura na carcaça no tratamento T3

Testosterone Deficiency Increases Hospital Readmission and Mortality Rates in Male Patients with Heart Failure

Background: Testosterone deficiency in patients with heart failure (HF) is associated with decreased exercise capacity and mortality; however, its impact on hospital readmission rate is uncertain. Furthermore, the relationship between testosterone deficiency and sympathetic activation is unknown. Objective: We investigated the role of testosterone level on hospital readmission and mortality rates as well as sympathetic nerve activity in patients with HF. Methods: Total testosterone (TT) and free testosterone (FT) were measured in 110 hospitalized male patients with a left ventricular ejection fraction < 45% and New York Heart Association classification IV. The patients were placed into low testosterone (LT; n = 66) and normal testosterone (NT; n = 44) groups. Hypogonadism was defined as TT < 300 ng/dL and FT < 131 pmol/L. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography in a subpopulation of 27 patients. Results: Length of hospital stay was longer in the LT group compared to in the NT group (37 ± 4 vs. 25 ± 4 days; p = 0.008). Similarly, the cumulative hazard of readmission within 1 year was greater in the LT group compared to in the NT group (44% vs. 22%, p = 0.001). In the single-predictor analysis, TT (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.58–4.85; p = 0.02) predicted hospital readmission within 90 days. In addition, TT (HR, 4.65; 95% CI, 2.67–8.10; p = 0.009) and readmission within 90 days (HR, 3.27; 95% CI, 1.23–8.69; p = 0.02) predicted increased mortality. Neurohumoral activation, as estimated by MSNA, was significantly higher in the LT group compared to in the NT group (65 ± 3 vs. 51 ± 4 bursts/100 heart beats; p < 0.001). Conclusion: These results support the concept that LT is an independent risk factor for hospital readmission within 90 days and increased mortality in patients with HF. Furthermore, increased MSNA was observed in patients with LT

Testosterone Deficiency Increases Hospital Readmission and Mortality Rates in Male Patients with Heart Failure

Background: Testosterone deficiency in patients with heart failure (HF) is associated with decreased exercise capacity and mortality; however, its impact on hospital readmission rate is uncertain. Furthermore, the relationship between testosterone deficiency and sympathetic activation is unknown. Objective: We investigated the role of testosterone level on hospital readmission and mortality rates as well as sympathetic nerve activity in patients with HF. Methods: Total testosterone (TT) and free testosterone (FT) were measured in 110 hospitalized male patients with a left ventricular ejection fraction < 45% and New York Heart Association classification IV. The patients were placed into low testosterone (LT; n = 66) and normal testosterone (NT; n = 44) groups. Hypogonadism was defined as TT < 300 ng/dL and FT < 131 pmol/L. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography in a subpopulation of 27 patients. Results: Length of hospital stay was longer in the LT group compared to in the NT group (37 ± 4 vs. 25 ± 4 days; p = 0.008). Similarly, the cumulative hazard of readmission within 1 year was greater in the LT group compared to in the NT group (44% vs. 22%, p = 0.001). In the single-predictor analysis, TT (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.58–4.85; p = 0.02) predicted hospital readmission within 90 days. In addition, TT (HR, 4.65; 95% CI, 2.67–8.10; p = 0.009) and readmission within 90 days (HR, 3.27; 95% CI, 1.23–8.69; p = 0.02) predicted increased mortality. Neurohumoral activation, as estimated by MSNA, was significantly higher in the LT group compared to in the NT group (65 ± 3 vs. 51 ± 4 bursts/100 heart beats; p < 0.001). Conclusion: These results support the concept that LT is an independent risk factor for hospital readmission within 90 days and increased mortality in patients with HF. Furthermore, increased MSNA was observed in patients with LT