Ministernotomy in myocardial revascularization preserves postoperative pulmonary function

BACKGROUND: In coronary artery bypass graft (CABG) surgery, the need to perform a midsternotomy has been considered a factor for the decrease in postoperative pulmonary function. OBJECTIVE: To prospectively evaluate early postoperative (PO) pulmonary function in patients submitted to off-pump CABG, comparing the conventional midsternotomy with the ministernotomy approach. METHODS: A total of 18 patients were evaluated and assigned to the two groups: Group Conventional Midsternotomy (CMS, n=10) and Group Ministernotomy (MS, n=8). Spirometric results of the forced vital capacity (FVC) and the Forced Expiratory Volume in one second (FEV1) were obtained on the 1st, 3rd and 5th PO days and the arterial gasometry was obtained before and on the 1st PO day. The pulmonary shunt percentage and the pain score were also assessed. RESULTS: When compared in terms of percentage of the preoperative value, the FVC was higher in the MS group than in the CMS group on the 1st, 3rd and 5th PO days (p<0.001). Similar results were obtained for FEV1. The recovery of the FVC between the 1st and the 5th PO days was higher in the MS than in the CMS group (p=0,043). The PaO2 decreased on the 1st PO day in both groups (p<0.05), with a higher decrease in the CMS group (p=0.002). The shunt increased in the two groups on the 1st PO day (p<0.05); however, it was lower in the MS group (p=0.02). The reported pain score was lower and the duration of the hospital stay was shorter in the MS group. CONCLUSION: Patients submitted to CABG by MS present better preservation and recovery of pulmonary function than those submitted to CMS.FUNDAMENTO: Na cirurgia de revascularização miocárdica (RM), a necessidade da esternotomia mediana tem sido considerada um fator para a redução de função pulmonar pós-operatória. OBJETIVO: Avaliar prospectivamente a função pulmonar no pós-operatório (PO) precoce de pacientes submetidos à RM sem circulação extracorpórea (CEC), comparando a esternotomia mediana convencional com a miniesternotomia. MÉTODOS: Foram estudados 18 pacientes e alocados em dois grupos: Grupo esternotomia mediana convencional (EMC, n=10) e Grupo miniesternotomia (ME, n=8). Registros espirométricos da capacidade vital forçada (CVF) e do volume expiratório forçado no primeiro segundo (VEF1) foram obtidos antes e no 1º, 3º e 5º dias de PO, e a gasometria arterial, antes e no 1º dia de PO. Também foram avaliados o percentual do shunt pulmonar e o escore de dor. RESULTADOS: Quando comparados em percentual do valor do pré-operatório, a CVF foi maior no grupo ME do que no grupo EMC no 1º, 3º e 5º dias de PO (p<0,001). Resultados similares foram encontrados para o VEF1. A recuperação da CVF entre o 1º e o 5º dia de PO foi maior no grupo EM do que no grupo EMC (p=0,043). A PaO2 diminuiu no 1º dia de PO em ambos os grupos (p<0,05), com maior queda no grupo EMC (p=0,002). O shunt aumentou nos dois grupos no 1º dia de PO (p<0,05), porém foi menor no grupo ME (p=0,02). A dor referida e a permanência hospitalar foram menores no grupo ME. CONCLUSÃO: Pacientes submetidos à cirurgia de RM por miniesternotomia apresentaram melhor preservação e recuperação da função pulmonar que os submetidos à esternotomia mediana.OSS-SPDM Hospital Geral de PirajussaraUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Geological mapping of the Cabeço de Vide basic-ultrabasic complex: essay on geometry and metalogenesis potential

A área detém as características mínimas necessárias ao desenvolvimento da prospecção de sulfuretos magmáticos primários e mineralizações de platinóides: litologias básicas e ultrabásicas e teores de Ni, Cu, Pt e Pd, anómalos. Na cartografia à escala 1:10 000 individualizam-se quatro domínios geológicos: litologias ultrabásicas, gabróicas, o domínio metassomático, e calcários do Câmbrico. O complexo básico e ultrabásico terá resultado de dois episódios de instalação ígnea, sendo o impulso ultrabásico anterior ao que originou os gabros.The area holds minimal characteristics that are needed to develop Magmatic sulphide deposits and PGE mineralization: basic and ultrabasic lithologies and anomalous Ni, Cu, Pt, Pd grades. It is possible to discriminate four geological domains based on 1: 10 000 mapping of the area: ultrabasic lithologies, gabbroic lithologies, metasomatic rocks and Cambrian limestones. The basic-ultrabasic complex might have resulted from two different magmatic pulses (the ultrabasic event preceding the gabroic pulse)

Características psicométricas de uma versão portuguesa do "Competitive State Anxiety Inventory - 2" (CSAI-2) : dados preliminares relativos à sua validade e estrutura factorial

Para analisar as características psicométricas do "Competitive State Anxiety Inventory-2" (medida multidimensional do estado de ansiedade competitiva, com 27 itens), uma versão portuguesa foi administrada a 157 atletas de 5 modalidades (antes e depois da competição). Os dados obtidos sugerem uma estrutura de 3 factores idêntica à original, mas com a redução para 22 itens. Foram obtidos bons índices de fidelidade desta versão (.87 ansiedade cognitiva; .81 ansiedade somática; e .89 auto-confiança). Sugere-se a validade desta versão no estudo da relação ansiedade-rendimento desportivo

Um programa de formação para a eficácia dos treinadores da iniciação e formação desportiva

[Excerto] Introdução: De uma forma verdadeiramente notável, em nenhum outro domínio ou contexto, como no desporto, encontramos tantos indivíduos (crianças, jovens e adultos) que voluntariamente se sujeitam e «subjugam» à autoridade de uma pessoa ou duas pessoas: os(as) seus (suas) treinadores(as) (Chelladurai, 1984; Cruz & Gomes, 1996). É particularmente saliente a confiança depositada pelos atletas na capacidade do treinador e nas suas técnicas motivacionais, para atingirem objectivos pessoais. Como salientaram Smoll e Smith (1984), a relação treinador-atleta determina a forma como os atletas são afectados pela sua participação no desporto. Se é verdade que a influência do treinador vai muito além do contexto desportivo (interferindo na vida, desenvolvimento e crescimento pessoal dos atletas), também é verdade que muitos treinadores, sobretudo por falta de formação e informação, não têm uma consciência clara de como e até que ponto afectam os seus atletas (Cruz & Gomes, 1996). [...

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

5,10,15,20-Tetra­kis(1-methyl­pyridinium-4-yl)porphyrin tetra­iodide tetra­hydrate

The asymmetric unit of the title compound, C44H38N8 2+·4I−·4H2O, comprises two halves of non-equivalent cations of 5,10,15,20-tetra­kis­(1-methyl­pyridinium)porphyrin (with the full mol­ecule of each completed by the application of inversion symmetry), four charge balancing iodide anions and four water mol­ecules of crystallization (two water mol­ecules are fully occupied and four mol­ecules have a site occupancy of 50%). The porphyrin cations are arranged into supramolecular columns parallel to the b axis, mediated by π–π [centroid–centroid distance = 3.762 (4) Å] and C—H⋯π supra­molecular inter­actions [C⋯centroid distance = 3.522 (7) Å, C—H⋯centroid = 128°], leading to the formation of columns parallel to the b axis. The close packing leads to the presence of a one-dimensional channel filled with partially occupied water mol­ecules engaged in O—H⋯O and O—H⋯I hydrogen bond

Phylogenetic comparative analysis of electric communication signals in ghost knifefishes (Gymnotiformes: Apteronotidae)

Electrocommunication signals in electric fish are diverse, easily recorded and have well-characterized neural control. Two signal features, the frequency and waveform of the electric organ discharge (EOD), vary widely across species. Modulations of the EOD (i.e. chirps and gradual frequency rises) also function as active communication signals during social interactions, but they have been studied in relatively few species. We compared the electrocommunication signals of 13 species in the largest gymnotiform family, Apteronotidae. Playback stimuli were used to elicit chirps and rises. We analyzed EOD frequency and waveform and the production and structure of chirps and rises. Species diversity in these signals was characterized with discriminant function analyses, and correlations between signal parameters were tested with phylogenetic comparative methods. Signals varied markedly across species and even between congeners and populations of the same species. Chirps and EODs were particularly evolutionarily labile, whereas rises differed little across species. Although all chirp parameters contributed to species differences in these signals, chirp amplitude modulation, frequency modulation (FM) and duration were particularly diverse. Within this diversity, however, interspecific correlations between chirp parameters suggest that mechanistic trade-offs may shape some aspects of signal evolution. In particular, a consistent trade-off between FM and EOD amplitude during chirps is likely to have influenced the evolution of chirp structure. These patterns suggest that functional or mechanistic linkages between signal parameters (e.g. the inability of electromotor neurons increase their firing rates without a loss of synchrony or amplitude of action potentials) constrain the evolution of signal structure

Avaliação de espécies leguminosas na formação de cafezais no segmento da agricultura familiar no Acre.

Leguminosas quando consorciadas com o café e usadas como adubação verde podem contribuir fornecendo nitrogênio e proteção ao solo pela adição de matéria orgânica. O trabalho foi conduzido com o objetivo de avaliar o efeito do uso de leguminosas no sistema de produção de café, no segmento de agricultura familiar, visando promover a implantação e a manutenção dos cafezais de forma técnica e economicamente sustentável. O experimento foi conduzido no período de novembro de 2000 a abril de 2003, em delineamento experimental de blocos ao acaso em esquema de parcelas subdivididas, com quatro repetições. Os tratamentos utilizados nas parcelas foram as leguminosas (Stizolobium atterrimum, Cajanus cajan, Canavalia endiformis e Flemingia congesta) e a testemunha (sem leguminosa) e, nas subparcelas, duas doses de N (0 e 22 g de N por cova). A Flemingia congesta e a Mucuna aterrima foram as leguminosas que mais influenciaram positivamente a produtividade dos cafeeiros, independente da adubação nitrogenada. Em relação à testemunha, o aumento em produção foi de 109% quando utilizou-se a Flemingia congesta e 52% com a Mucuna aterrima. A Flemingia congesta foi também a leguminosa que melhor controlou as invasoras, dado o volume de fitomassa produzida e a possibilidade de 2 cortes durante um período de doze meses, evidenciando o potencial desta leguminosa na formação de novos cafezais no Acre. Por outro lado, a Canavalia ensiformis, leguminosa que é normalmente utilizada nas entrelinhas dos cafeeiros pelos cafeicultores, do Acre e de outras regiões produtoras, neste trabalho influenciou negativamente a altura das plantas, diâmetro da copa e crescimento dos cafeeiros

CXCL6 is an important paracrine factor in the pro-angiogenic human cardiac progenitor-like cell secretome

Studies in recent years have established that the principal effects in cardiac cell therapy are associated with paracrine/autocrine factors. We combined several complementary techniques to define human cardiac progenitor cell (CPC) secretome constituted by 914 proteins/genes; 51% of these are associated with the exosomal compartment. To define the set of proteins specifically or highly differentially secreted by CPC, we compared human mesenchymal stem cells and dermal fibroblasts; the study defined a group of growth factors, cytokines and chemokines expressed at high to medium levels by CPC. Among them, IL-1, GROa (CXCL1), CXCL6 (GCP2) and IL-8 are examples whose expression was confirmed by most techniques used. ELISA showed that CXCL6 is significantly overexpressed in CPC conditioned medium (CM) (18- to 26-fold) and western blot confirmed expression of its receptors CXCR1 and CXCR2. Addition of anti-CXCL6 completely abolished migration in CPC-CM compared with anti-CXCR2, which promoted partial inhibition, and anti-CXCR1, which was inefficient. Anti-CXCL6 also significantly inhibited CPC CM angiogenic activity. In vivo evaluation also supported a relevant role for angiogenesis. Altogether, these results suggest a notable angiogenic potential in CPC-CM and identify CXCL6 as an important paracrine factor for CPC that signals mainly through CXCR2.This study was supported by funding from the European Commission (HEALTH-2009_242038) and by grants from the Spanish Ministry of Science and Innovation (SAF2012-34327 and SAF2015-70882-R to AB and BIO2012-37926 and BIO2015-67580-P to JV), the Research Program of the Comunidad Autónoma de Madrid (S2010/BMD-2420) and the Instituto de Salud Carlos III (RETICS-RD12/0019/0018 to AB and RETICS-RD12/0042/0056 to JV).S

Three- dimensional assessment of craniofacial asymmetry in children with transverse maxillary deficiency after rapid maxillary expansion: A prospective study

ObjectiveThe aim of this study was to evaluate craniofacial asymmetry in children with transverse maxillary deficiency, with or without functional unilateral posterior crossbite (UPC), before and after rapid maxillary expansion (RME).Setting and sample populationA sample of 51 children with cone beam computed tomography scans obtained before RME (T1) and a year after RME (T2).Material and methodsThis prospective study consisted of 2 groups: 25 children with functional UPC (6.77 ± 1.5 years) and 26 children without UPC (7.41 ± 1.31 years). Linear and angular measurements were obtained from zygomatic, maxilla, glenoid fossa and mandible, using original and mirrored 3D overlapped models. All right and left side comparisons in both groups and intergroups asymmetries were compared using MANOVA and t test for independent samples, respectively, statistically significant at P < .05.ResultsThe UPC group showed no side differences, but mandibular horizontal rotation at T1, and this asymmetry was improved in T2. The non- UPC group showed at baseline significant lateral asymmetry in orbitale, position of palatine foramen, respectively, in average 2.95 mm and 1.16 mm, and 0.49 mm of average asymmetry in condylar height. The glenoid fossa was symmetric in both groups at T1 and T2.ConclusionsChildren with transverse maxillary deficiency showed slight morphological asymmetry, located in the mandible position in cases of UPC, and in the orbital and maxillary regions in cases without UPC. One year after RME, patients improved their craniofacial asymmetry, with significant changes in the mandible and correction of the mandibular rotation in patients who presented UPC.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156195/2/ocr12370_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156195/1/ocr12370.pd