59 research outputs found
Efficacy of beta-blocker therapy in symptomatic athletes with exercise-induced intra-ventricular gradients
<p>Abstract</p> <p>Background</p> <p>Upright exercise stress echocardiography (SE) induces significant intraventricular gradient (IVG) and systolic anterior motion (SAM) in a large proportion of symptomatic athletes, who may therefore benefit from a negative inotropic therapy.</p> <p>The purpose of the present study was to assess the effect of chronic oral ÎČ blocker therapy on the occurrence of exercise-induced IVG and mitral valve SAM, in symptomatic athletes.</p> <p>Methods</p> <p>We enrolled 35 symptomatic athletes (age = 23 ± 11 years) with IVG (>30 mmHg) during SE off therapy. All repeated SE on chronic oral beta-blocker therapy (atenolol up to 50 mg, bisoprolol up to 10 mg, or metoprolol up to 100 mg daily according to physician-driven choice).</p> <p>Results</p> <p>On therapy, there was during SE a reduction in IVG (35 off vs 17 on beta blocker, p < 0.01), decrease of IVG (102 ± 34 mmHg off vs 69 ± 24 mmHg on beta blocker, p < 0.01), peak heart rate (178 ± 15 bpm off vs 157 ± 9 bpm on beta blocker), SAM (24 off vs 9 on beta blocker, p < 0.001), symptoms during SE (17 off vs 2 on beta blocker p < 0.001), ST segment depression (13 off vs 2 on beta blocker, p < 0.001).</p> <p>Conclusions</p> <p>In athletes with positive screening on medical evaluation for sports practice and IVG on exertion, treatment with oral beta blockers improved symptoms in the large majority of patients. Symptomatic benefit was mirrored by objective evidence of improvement of echocardiographic signs of obstruction (IVG and SAM) and reduction of ischemia-like electrocardiographic changes.</p
Signs Workshop: the importance of natural gestures in the promotion of early communication skills of children with developmental disabilities
This article emphasises the importance of natural gestures and describes the framework and the development process of the âSigns Workshopâ CD-ROM, which is a multimedia application for the promotion of early
communication skills of children with developmental disabilities. Signs Workshop CD-ROM was created in the scope of Downâs Comm Project, which was financed by the Calouste Gulbenkian Foundation, and is the result of a partnership between UNICA (Communication and Arts Research Unit of the University of Aveiro) and the Portuguese Down Syndrome Association (APPT21/Differences).Calouste Gulbenkian Foundatio
Nonalcoholic steatohepatitis and hepatocellular carcinoma: Brazilian survey
OBJECTIVE: The majority of cases of hepatocellular carcinoma have been reported in individuals with cirrhosis due to chronic viral hepatitis and alcoholism, but recently, the prevalence has become increasingly related to nonalcoholic steatohepatitis around the world. The study aimed to evaluate the clinical and histophatological characteristics of hepatocellular carcinoma in Brazilians' patients with nonalcoholic steatohepatitis at the present time. METHODS: Members of the Brazilian Society of Hepatology were invited to complete a survey regarding patients with hepatocellular carcinoma related to nonalcoholic steatohepatitis. Patients with a history of alcohol intake (>;20 g/day) and other liver diseases were excluded. Hepatocellular carcinoma diagnosis was performed by liver biopsy or imaging methods according to the American Association for the Study of Liver Diseasesâ 2011 guidelines. RESULTS: The survey included 110 patients with a diagnosis of hepatocellular carcinoma and nonalcoholic fatty liver disease from nine hepatology units in six Brazilian states (Bahia, Minas Gerais, Rio de Janeiro, SĂŁo Paulo, ParanĂĄ and Rio Grande do Sul). The mean age was 67±11 years old, and 65.5% were male. Obesity was observed in 52.7% of the cases; diabetes, in 73.6%; dyslipidemia, in 41.0%; arterial hypertension, in 60%; and metabolic syndrome, in 57.2%. Steatohepatitis without fibrosis was observed in 3.8% of cases; steatohepatitis with fibrosis (grades 1-3), in 27%; and cirrhosis, in 61.5%. Histological diagnosis of hepatocellular carcinoma was performed in 47.2% of the patients, with hepatocellular carcinoma without cirrhosis accounting for 7.7%. In total, 58 patients with cirrhosis had their diagnosis by ultrasound confirmed by computed tomography or magnetic resonance imaging. Of these, 55% had 1 nodule; 17%, 2 nodules; and 28%, â„3 nodules. CONCLUSIONS: Nonalcoholic steatohepatitis is a relevant risk factor associated with hepatocellular carcinoma in patients with and without cirrhosis in Brazil. In this survey, hepatocellular carcinoma was observed in elevated numbers of patients with steatohepatitis without cirrhosis
Re-engineering Primary Epithelial Cells from Rhesus Monkey Parotid Glands for Use in Developing an Artificial Salivary Gland
There is no satisfactory conventional treatment for patients who experience irreversible salivary gland damage after therapeutic radiation for head and neck cancer or because of Sjögren's syndrome. Additionally, if most parenchyma is lost, these patients also are not candidates for evolving gene transfer strategies. To help such patients, several years ago we began to develop an artificial salivary gland. In the present study, we used a non-human primate tissue source, parotid glands from rhesus monkeys, to obtain potential autologous graft cells for development of a prototype device for in situ testing. Herein, we present 3 major findings. First, we show that primary cultures of rhesus parotid gland (RPG) cells are capable of attaining a polarized orientation, with Na+/K+-adenosine triphosphatase, zonula occludens-1, and claudin-1 distributed in specific domains appropriate for epithelial cells. Second, we show that RPG cells exhibit 2 essential epithelial functions required for graft cells in an artificial salivary gland device (i.e., an effective barrier to paracellular water flow and the generation of a moderate transepithelial electrical resistance). Third, we show that RPG cells can express functional water channels, capable of mediating directional fluid movement, after transduction by adenoviral and adeno-associated virus type 2 vectors. Together these results demonstrate that it is feasible to individually prepare RPG cells for eventual use in a prototype artificial salivary gland.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63202/1/ten.2006.12.2939.pd
Matrix interpretation of multiple orthogonality
In this work we give an interpretation of a (s(d + 1) + 1)-term recurrence
relation in terms of type II multiple orthogonal polynomials.We rewrite
this recurrence relation in matrix form and we obtain a three-term recurrence
relation for vector polynomials with matrix coefficients. We present a matrix
interpretation of the type II multi-orthogonality conditions.We state a Favard
type theorem and the expression for the resolvent function associated to the
vector of linear functionals. Finally a reinterpretation of the type II Hermite-
Padé approximation in matrix form is given
Radioprotectors and Mitigators of Radiation-Induced Normal Tissue Injury
The article reviews agents in clinical use or in development as radioprotectors and mitigators of radiation-induced normal tissue injury
Quality control of B-lines analysis in stress Echo 2020
Background
The effectiveness trial âStress echo (SE) 2020â evaluates novel applications of SE in and beyond coronary artery disease. The core protocol also includes 4-site simplified scan of B-lines by lung ultrasound, useful to assess pulmonary congestion.
Purpose
To provide web-based upstream quality control and harmonization of B-lines reading criteria.
Methods
60 readers (all previously accredited for regional wall motion, 53 B-lines naive) from 52 centers of 16 countries of SE 2020 network read a set of 20 lung ultrasound video-clips selected by the Pisa lab serving as reference standard, after taking an obligatory web-based learning 2-h module (
http://se2020.altervista.org
). Each test clip was scored for B-lines from 0 (black lung, A-lines, no B-lines) to 10 (white lung, coalescing B-lines). The diagnostic gold standard was the concordant assessment of two experienced readers of the Pisa lab. The answer of the reader was considered correct if concordant with reference standard reading ±1 (for instance, reference standard reading of 5 B-lines; correct answer 4, 5, or 6). The a priori determined pass threshold was 18/20 (â„ 90%) with R value (intra-class correlation coefficient) between reference standard and recruiting center)â>â0.90. Inter-observer agreement was assessed with intra-class correlation coefficient statistics.
Results
All 60 readers were successfully accredited: 26 (43%) on first, 24 (40%) on second, and 10 (17%) on third attempt. The average diagnostic accuracy of the 60 accredited readers was 95%, with R value of 0.95 compared to reference standard reading. The 53 B-lines naive scored similarly to the 7 B-lines expert on first attempt (90 versus 95%, pâ=âNS). Compared to the step-1 of quality control for regional wall motion abnormalities, the mean reading time per attempt was shorter (17â±â3 vs 29â±â12 min, pâ<â.01), the first attempt success rate was higher (43 vs 28%, pâ<â0.01), and the drop-out of readers smaller (0 vs 28%, pâ<â.01).
Conclusions
Web-based learning is highly effective for teaching and harmonizing B-lines reading. Echocardiographers without previous experience with B-lines learn quickly.info:eu-repo/semantics/publishedVersio
Comparação entre cultivares de soja quanto Ă preferĂȘncia alimentar de Cerotoma arcuata e suscetibilidade a um isolado do vĂrus do mosaico severo do caupi
- âŠ