Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy. Correlations with catecholamines

Copyright © 2007 Published by Elsevier Inc.Introduction: There is a well-known association between mitral valve prolapse (MVP) and low blood pressure (BP), although patients (P) often have high levels of catecholamines (CAT) and high heart rate (HR). To our knowledge, there are no studies about the effects of long-term adrenergic b-blockade on these parameters. Methods: Twenty normal individuals (N)—8 males (M) (49.9 F 12.9 years) and 12 females (F) (41.8 F 11.8 years); 46 MVP P—15 M (49.3 F 15.5 years) and 31 F (42.0 F 12.8 years). Phase1—in both N and P free of medication, determination of (1) 24H urinary epinephrine (E) and norepinephrine (NE) by HPLC; (2) rest HR by ECG; (3) 24H ambulatory HR and BP (ABM). Phase2—same tests in MVP P while taking propranolol by 10 to 12 months. Results: CAT ng/mg creatinine: E—M 5.1 F 2.5 (N), 9.1 F 3.9 (Ph1), 7.9 F 3.1 (Ph2); F 6.2 F 3.5 (N), 13.0 F 9.7 (Ph1), 10.7 F 6.7 (Ph2). Higher in P ( P b .01), lower under propranolol ( P = .002). NE—M 22.2 F 7.2 (N), 36.8 F 16.8 (Ph1), 27.4 F 10.6 (Ph2); F 28.1 F 7.3 (N), 46.2 F 18.1 (Ph1), 33.0 F 12.9 (Ph2). Higher in P ( P b .01), lower under propranolol ( P b .001). HR—M 75 F 5.4 (N), 79 F 7.2 (Ph1), 65 F 3.8 (Ph2); F 74 F 3.2 (N), 80 F 6.5 (Ph1), 69 F 6.2 (Ph2). Lower under propranolol ( P b .0001). ABM: phase1—HR higher in P. SBP and DBP lower in P. Phase2—lower HR whereas higher SBP and DBP in P under propranolol. No correlation between BP and CAT. Correlation between E levels and rest HR. Conclusions: These MVP patients had high levels of CAT, high HR, and low BP. With long-term b-blockade, HR decreased related to E, but BP raised, supporting the role of b2 receptors supercoupling on low BP in MVP.info:eu-repo/semantics/publishedVersio

Heart rate and blood pressure in mitral valve prolapse patients : divergent effects of long-term propranolol therapy and correlations with catecholamines

Copyright © 2007 The Anatolian Journal of Cardiology.Objective: There is a well known association between mitral valve prolapse (MVP) and low blood pressure (BP), although patients often have high levels of catecholamines and high heart rate (HR). The main objective of our study was to evaluate the effects of long-term adrenergic beta-blockade on these parameters. Methods: The study population consisted of 46 patients with MVP and the control group consisted of 20 normal individuals. The study had two phases: in the first phase, patients were free of medications. In the second phase, patients were under treatment with propranolol for 10 to 12 months. The tests were performed in normal individuals and patients in the first phase. Only patients underwent the same tests in the second phase. Measurement of urinary epinephrine and norepinephrine levels, by high performance liquid chromatography, was done. Rest HR was determined by electrocardiogram (ECG), and ambulatory blood pressure and HR were evaluated by 24 hours ambulatory blood pressure monitoring (ABPM) using the auscultatory method. Results: The levels of epinephrine and norepinephrine were significantly higher in patients than in normal controls and decreased under propranolol. Rest and ambulatory HR were higher in patients and decreased under propranolol. The 24 hours systolic and diastolic BPs were lower in patients, and their values increased under propranolol. Heart rate decreasing and epinephrine levels reduction were positively correlated. No correlation was found between BP increase and catecholamine levels. Conclusion: The study results show divergent effects of propranolol on blood pressure, which increased, and on heart rate, that decreased, in patients with MVP. Heart rate decrease was an expected result and depends, namely, on b1 receptors blockade. Increase in BP is an unusual response to adrenergic beta-blockade in normal conditions, and this finding supports the preponderance of b2 receptors on the BP control in patients with MVP.info:eu-repo/semantics/publishedVersio

Enquadramento e impacto dos sistemas de informação no Programa Aveiro Norte

O propósito deste artigo é o de demonstrar o relevo que os sistemas de informação têm em todo o processo de criação e desenvolvimento de uma nova oferta formativa potenciada pela Universidade de Aveiro no norte do distrito. Inicialmente, e com o intuito de desenvolver ferramentas para a gestão e administração do Programa Aveiro- Norte, criou-se o sítio do Programa Aveiro-Norte. A sua forte aderência por parte dos vários actores envolvidos na utilização do mesmo sistema, deu origem a novos inputs com vista ao aperfeiçoamento do mesmo, bem como novos sistemas que promovem uma maior interacção com o tecido empresarial da região. O Programa Aveiro-Norte surge como uma acção de Intervenção da Universidade de Aveiro no Norte do Distrito, com o objectivo de promover o reforço do ensino superior orientado para a formação inicial politécnica, formação especializada e requalificação profissional. Consiste numa Rede de Unidades de Formação Especializada a partir da qual se pretende implementar um conjunto de cursos, cujas propostas de formação pretendem responder não só às necessidades locais de formação inicial, mas também de actualização dos quadros das empresas e serviços existentes na região norte do distrito de Aveiro. Pretende-se que a oferta formativa do Programa Aveiro Norte articule e compatibilize tanto os graus do sistema de ensino superior que lhe estão a jusante (licenciaturas e pós- graduações) como as vias de acesso a montante, com origem no ensino secundário e pós-secundário não superior (cursos profissionalizantes, cursos de especialização , etc.). Pretendemos apresentar, de uma forma sucinta e clara, os vários sistemas em produção e desenvolvimento e como é que interagem no ‘Universo Aveiro-Norte’, dando origem a um portal informativo que promova todas as entidades envolvidas criando um fluxo de informação comum, em especial o sistema de informação do Programa Aveiro Norte

Necessidades, Recursos e Desafios

Introduction: The demographic and professional characteristics of specialists in Obstetrics and Gynecology registered in Portugal are presented and current and future needs assessed. Material and Methods: An analysis of the data from Instituto Nacional de Estatística, Ordem dos Médicos and a survey sent to the directors of the departments of Obstetrics and Gynecology of Portuguese hospitals was perfomed. In order to calculate the necessary number of specialists, established indicators of the activity of the specialty were used. Results: In 2018, there were 1 437 441 consultations of Obstetrics and Gynecology, 89 110 major gynecologic surgeries and 85 604 deliveries. For that, 1065 Obstetrics and Gynecology physicians, working 40 hours per week, with no more than 40% aged 55 years of age and older or including 30 residents per year, are deemed necessary. According to the National Institute of Statistics, in the same year there were 1143 specialists in Portuguese hospitals, of which 234 worked in private hospitals. On the other hand, 1772 specialists were registered with the Ordem dos Médicos: 1163 (66%) were aged 55 years old or above and 84% of specialists under the age of 40 were females. In 2020, there were 864 specialists, 46% of which aged years of age and older working in 39 out of the 41 public or public-private departments that answered the survey. In 2035, an increase of 7% in the required number of specialists is expected. Conclusion: In Portugal, there is not lack of Obstetrics and Gynecology specialists in absolute numbers, but the large number of specialists aged 55 years of age and older, who are exempt from shifts in emergency department work, and the existence of regional asymmetries contribute to the perpetuation of some shortages of these healthcare professionals in several departments, namely in public hospitals.publishersversionpublishe

Gestão sustentável para a conservação de espécies e habitats ameaçados na ZPE das Berlengas

UID/SOC/04647/2019 LIFE13 NAT/PT/000458 PROJETO LIFE+ BERLENGASO Life Berlengas juntou 5 parceiros numa missão comum: contribuir para a gestão sustentável da Zona de Proteção Especial (ZPE) das Ilhas Berlengas, ambicionando a conservação dos seus habitats, plantas endémicas e populações de aves marinhas.publishersversionpublishe

Temas de investigação em direitos humanos para o século XXI

Edição comemorativa do 10.º aniversário do Mestrado em Direitos Humanos da Universidade do Minho.Este livro é uma celebração do ensino e da investigação em direitos humanos que têm vindo a ser desenvolvidos, na Escola de Direito da Universidade do Minho, há já mais de uma década. A sua publicação num momento em que se avolumam os riscos para valores fundamentais subjacentes à proteção dos direitos humanos – como a igualdade e a não discriminação, a proibição da escravatura e de tratamentos cruéis, desumanos e degradantes, a liberdade de religião ou crença, entre muitos outros –, torna-o especialmente oportuno. Os sinais de aparente retrocesso no consenso das nossas sociedades a respeito desses valores – visíveis no triunfo político de discursos abertamente racistas, xenófobos, sexistas, etc. – recordam-nos que, também no mundo ocidental, os direitos humanos são um work in progress, não um dado adquirido. Os novos riscos para a dignidade da pessoa humana associados aos avanços tecnológicos andam de par com velhas formas de subalternização e de opressão. O campo para a reflexão crítica é muito vasto. Os temas que hoje (pre)ocupam académicos, decisores políticos e ativistas de direitos humanos são também aqueles que estruturam o plano de estudos do Mestrado em Direitos Humanos da Universidade do Minho. Todos estes temas surgem ao longo do presente livro, que reúne contributos de muitos dos membros da comunidade científica e académica que o Mestrado em Direitos Humanos mobilizou e ajudou a dinamizar ao longo da última década, entre docentes do Mestrado, colaboradores em júris de provas públicas e/ou na orientação de mestrandos, oradores convidados e estudantes. Os textos aqui reunidos refletem bem as sinergias interdisciplinares, interinstitucionais e inter-nacionais que o Mestrado em Direitos Humanos foi capaz de criar, não apenas pela variedade de campos disciplinares representados – Direito, Filosofia, Relações Internacionais, Antropologia –, mas também pela participação de autores que são docentes e/ou investigadores em diversas instituições nacionais e estrangeiras, como a Faculdade de Direito da Universidade do Porto, a Faculdade de Economia da Universidade de Coimbra, a Universidade Federal da Paraíba e a Pontifícia Universidade Católica de São Paulo.info:eu-repo/semantics/publishedVersio

Observation of Higgs boson production in association with a top quark pair at the LHC with the ATLAS detector

The observation of Higgs boson production in association with a top quark pair ( tt¯H ), based on the analysis of proton–proton collision data at a centre-of-mass energy of 13 TeV recorded with the ATLAS detector at the Large Hadron Collider, is presented. Using data corresponding to integrated luminosities of up to 79.8 fb −1 , and considering Higgs boson decays into bb¯ , WW⁎ , τ+τ− , γγ , and ZZ⁎ , the observed significance is 5.8 standard deviations, compared to an expectation of 4.9 standard deviations. Combined with the tt¯H searches using a dataset corresponding to integrated luminosities of 4.5 fb −1 at 7 TeV and 20.3 fb −1 at 8 TeV, the observed (expected) significance is 6.3 (5.1) standard deviations. Assuming Standard Model branching fractions, the total tt¯H production cross section at 13 TeV is measured to be 670 ± 90 (stat.) −100+110 (syst.) fb, in agreement with the Standard Model prediction.Peer Reviewe

Morphological and Postural changes in the foot during pregnancy and puerperium : a longitudinal study

The aim of this study is to observe the morphological and postural changes to the foot that take place during pregnancy and the puerperium. Method: In this descriptive, observational, longitudinal study, we analysed 23 pregnant women, with particular attention to morphological and postural aspects of the foot, at three time points during and after pregnancy: in weeks 9-13 of gestation, weeks 32-35 of gestation and weeks 4-6 after delivery. The parameters considered were changes in foot length, the Foot Posture Index (FPI) and the Hernández Corvo Index, which were analysed using a pedigraph and taking into account the Body Mass Index (BMI). The same procedure was conducted in each review. Results: The statistical analyses obtained for each foot did not differ significantly between the three measurement times. A pronator-type footprint was most frequently observed during the third trimester of pregnancy; it was predominantly neutral during the postpartum period. Statistically significant differences between the measurement times were obtained in the right foot for cavus vs. neutral foot type (between the first and third trimesters and also between the first trimester and the puerperium) (in both cases, p < 0.0001). Conclusions: Foot length increases in the third trimester and returns to normal in the puerperium. According to FPI findings, the third trimester of pregnancy is characterised by pronation, while the posture returns to neutrality during the postpartum period. During pregnancy, the plantar arch flattens, and this persists during the puerperium. The incidence of cavus foot increases significantly in the third trimester and in the puerperium

Measurement of photon–jet transverse momentum correlations in 5.02 TeV Pb + Pb and pppp collisions with ATLAS

Jets created in association with a photon can be used as a calibrated probe to study energy loss in the medium created in nuclear collisions. Measurements of the transverse momentum balance between isolated photons and inclusive jets are presented using integrated luminosities of 0.49 nb$^{-1}$ of Pb+Pb collision data at $\sqrt{s_\mathrm{NN}}=5.02$ TeV and 25 pb$^{-1}$ of $pp$ collision data at $\sqrt{s}=5.02$ TeV recorded with the ATLAS detector at the LHC. Photons with transverse momentum $63.1 31.6$ GeV and pseudorapidity $\left|\eta^\mathrm{jet}\right| 7\pi/8$. Distributions of the per-photon jet yield as a function of $x_\mathrm{J\gamma}$, $(1/N_\gamma)(\mathrm{d}N/\mathrm{d}x_\mathrm{J\gamma})$, are corrected for detector effects via a two-dimensional unfolding procedure and reported at the particle level. In $pp$ collisions, the distributions are well described by Monte Carlo event generators. In Pb+Pb collisions, the $x_\mathrm{J\gamma}$ distribution is modified from that observed in $pp$ collisions with increasing centrality, consistent with the picture of parton energy loss in the hot nuclear medium. The data are compared with a suite of energy-loss models and calculations.Peer Reviewe