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Ramalho A, Castro P, Lobo M, Souza J, Santos P, Freitas A. Integrated quality assessment for diabetes care in Portuguese primary health care using prevention quality indicators. Prim Care Diabetes 2021; 15:507-512. [PMID: 33441264 DOI: 10.1016/j.pcd.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 01/25/2023]
Abstract
AIMS This study evaluates the prevention quality indicators (PQI) for Diabetes Mellitus (DM) in Portugal using contemporary data and explores their variability according to Primary Health Care (PHC) quality indicators. METHODS We conducted a retrospective observational analysis of secondary data comprising Portuguese PHC indicators by health centres group (ACES) and the National Hospital Morbidity Database. We calculated and analysed age-sex-adjusted rates for each PQI. Worse-performing ACES were identified using the 2017 median PQI values as an assessment cut-off. A multivariate logistic analysis was carried to find variables associated with the likelihood of being a worse-performing ACES for the biennium. RESULTS The median values of the indicator PQI93 - Prevention Quality Diabetes Composite were 79 and 65.2 hospitalizations per 100 000 pop, in 2016 and 2017 respectively. Diabetes long term complications (PQI 03) accounted for most of the hospitalizations. The quality indicator in PHC with greater influence on PQI93 was the proportion of DM patients with <65 years with test results for HbA1c < = 6.5%. CONCLUSIONS This study shows that some PHC quality indicators are closely related to DM care, and so their monitoring is of high importance. Diabetes long term complications (PQI 03) demand greater attention from PHC professionals.
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Affiliation(s)
- A Ramalho
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; ACHE - American College of Healthcare Executives, Chicago, IL, USA.
| | - P Castro
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; USF Camélias, ACeS Gaia - Grande Porto VII (ARS Norte) - Vila Nova de Gaia, Portugal
| | - M Lobo
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - J Souza
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - P Santos
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - A Freitas
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
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Pinto A, Santos JV, Lobo M, Viana J, Souza J, Ramalho A, Pereira A, Freitas A. Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality.
Methods
We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model.
Results
Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865).
Conclusions
Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed.
This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”.
Key messages
Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.
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Affiliation(s)
- A Pinto
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - J V Santos
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Vila Nova de Gaia, Portugal
| | - M Lobo
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - J Viana
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - J Souza
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - A Ramalho
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - A Pereira
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
- Family Health Unit Prelada, ACES Porto Ocidental, ARS Norte, Porto, Portugal
- PHC - Contractualization Department, Northern Regional Administration of Health, ARS Norte, Porto, Portugal
| | - A Freitas
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
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Santos JV, Souza J, Pinto A, Ramalho A, Pereira A, Pestana JP, Camanho A, Freitas A. Efficiency of groups of primary healthcare centres: a frontier analysis of primary care in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Primary health care (PHC) is the cornerstone of several health systems. The Portuguese PHC is organized in five mainland regions (ARS), that oversee 55 local groups of primary healthcare centres (ACES). We assessed the efficiency of all 55 ACES in mainland Portugal, as well as organizational and socioeconomic determinants of the efficiency.
Methods
A cross-sectional non-parametric frontier analysis was performed for 2017. The first model included two inputs (i.e. number of physicians and number of nurses) and a single output (i.e. number of PHC visits), while the second model included an additional output, i.e. Prevention Quality Indicator (PQI) overall composite (avoidable hospitalizations) adjusted for age and sex - as undesirable output. In a second stage, a (multivariate) Tobit regression was used to assess organizational and socioeconomic determinants of efficiency.
Results
In the first model, only 8 ACES (14.5%) were on the efficiency frontier, while 25 ACES should readjust their human resource balance. In the second model, 9 ACES (16.4%) were considered efficient. When considering quality, one ACES previously considered inefficient moved to the frontier and two ACES lost their benchmark position. The second-stage analysis indicates that groups with a higher proportion of PHC units with pay-for-performance incentives were associated with higher efficiency.
Conclusions
Most ACES have the potential to improve their production levels., A better management of human resources can contribute to improve overall efficiency. ACES with a higher proportion of units with pay-for-performance schemes seem to be more efficient. These findings contribute to the evaluation of policies to integrate and scale up PHC services locally, such as the recent primary care networks in the NHS UK.
This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”.
Key messages
Most Portuguese ACES have the potential to improve their outputs given their current level of human resources. Local groups that aggregate more PHC units with pay-for-performance schemes are associated with high efficiency.
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Affiliation(s)
- J V Santos
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, ACES Grande Porto VIII – Espinho/Gaia, ARS Norte, Vila Nova de Gaia, Portugal
| | - J Souza
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - A Pinto
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - A Ramalho
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - A Pereira
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
- Family Health Unit Prelada, ACES Porto Ocidental, ARS Norte, Porto, Portugal
- PHC Contractualization Department, Northern Regional Administration of Health, ARS Norte, Porto, Portugal
| | - J P Pestana
- NOVA School of Business & Economics, NOVA University of Lisbon, Lisbon, Portugal
| | - A Camanho
- Faculty of Engineering, University of Porto, Porto, Portugal
| | - A Freitas
- MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
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Souza J, Araújo B, Leite J, Vasconcelos A, Santos C, Aguiar M, Catai A, Brandão D, De Andrade AD. IS THERE AN ASSOCIATION BETWEEN THE PRESENCE OF ENDOTHELIAL DYSFUNCTION AND EXERCISE TOLERANCE IN CARDIAC TRANSPLANT RECIPIENTS? Chest 2020. [DOI: 10.1016/j.chest.2020.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Araújo B, Leite J, Henriques D, Souza J, Figueiredo T, Santos C, Aguiar M, Brandão D, De Andrade AD. INFLUENCE OF AUTONOMIC DYSFUNCTION ON THE FUNCTIONAL CAPACITY OF INDIVIDUALS WITH HEART FAILURE. Chest 2020. [DOI: 10.1016/j.chest.2020.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Santos JV, Viana J, Souza J, Lobo M, Ramalho A, Gonçalves-Pinho M, Freitas A. Time trends of primary care quality across Portuguese regions: using prevention quality indicators. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Primary care quality is one of the main dimensions of primary care performance and can be evaluated by several methods, e.g. studying hospitalizations for conditions that could be treated, or less severe, if appropriately managed in primary care. Accordingly, the Agency for Healthcare Research and Quality (AHRQ) developed prevention quality indicators (PQIs). In this study, we aimed to compare PQIs and their time trends across Portuguese regions.
Methods
We performed a retrospective study, using all adult public hospital discharges in mainland Portugal, between 2011 and 2015. PQI rates for the overall (PQI 90) and composite indicators (i.e. 91 - acute, 92 - chronic, 93 - diabetes) were computed using AHRQ specifications. These rates were compared between the 5 Portuguese NUTS 2 regions of residence.
Results
From the total of 407,792 hospital discharges in mainland Portugal (2011-2015) 11.9% comprised the selected PQIs, the majority related the acute composite PQI, followed by the chronic composite PQI. The hospitalization rate of the overall PQI increased from 999.5 hospitalizations (2011) to 1231,0 hospitalizations/100,000 inhabitants (2015), with an increase in all NUTS 2 regions. In 2015, while Algarve and North had the lowest PQI rates, Centro and Alentejo showed the highest ones.
Conclusions
Between 2011 and 2015, there was an increasing trend of overall and composite PQI rates. Also, important differences between Portuguese regions were found that must be further studied.
The authors thank the support given by the Project ’POCI-01-0145-FEDER-030766’ (1st.IndiQare - Quality indicators in primary health care: validation and implementation of quality indicators as an assessment and comparison tool), funded by Fundação para a Ciência e a Tecnologia (FCT) and co-funded by Fundo de Desenvolvimento Regional (FEDER) through Operacional Competitividade e Internacionalização (COMPETE 2020).
Key messages
Between 2011 and 2015, overall prevention quality indicator rate increased in Portugal. There are great differences between Portuguese NUTS 2 regions regarding prevention quality indicators.
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Affiliation(s)
- J V Santos
- MEDCIDS – Department of Community Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS – Center for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, ACES Grande Porto VIII Espinho-Gaia, Vila Nova de Gaia, Portugal
| | - J Viana
- MEDCIDS – Department of Community Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS – Center for Health Technology and Services Research, Porto, Portugal
| | - J Souza
- MEDCIDS – Department of Community Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS – Center for Health Technology and Services Research, Porto, Portugal
| | - M Lobo
- MEDCIDS – Department of Community Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS – Center for Health Technology and Services Research, Porto, Portugal
| | - A Ramalho
- MEDCIDS – Department of Community Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS – Center for Health Technology and Services Research, Porto, Portugal
| | - M Gonçalves-Pinho
- MEDCIDS – Department of Community Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS – Center for Health Technology and Services Research, Porto, Portugal
| | - A Freitas
- MEDCIDS – Department of Community Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS – Center for Health Technology and Services Research, Porto, Portugal
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Peruzzi C, Nascimento S, Gauer B, Nardi J, Sauer E, Göethel G, Cestonaro L, Fão N, Cattani S, Paim C, Souza J, Gnoatto D, Garcia SC. Inflammatory and oxidative stress biomarkers at protein and molecular levels in workers occupationally exposed to crystalline silica. Environ Sci Pollut Res Int 2019; 26:1394-1405. [PMID: 30426371 DOI: 10.1007/s11356-018-3693-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
Workers chronically exposed to respirable crystalline silica (CS) are susceptible to adverse health effects like silicosis and lung cancer. This study aimed to investigate potential early peripheral biomarkers of inflammation and oxidative stress in miners. The subjects enrolled in this study were occupationally unexposed workers (OUW, n = 29) and workers exposed to crystalline silica (WECS), composed by miners, which were divided into two subgroups: workers without silicosis (WECS I, n = 39) and workers diagnosed with silicosis, retired from work (WECS II, n = 42). The following biomarkers were evaluated: gene expression of L-selectin, CXCL2, CXCL8 (IL-8), HO-1, and p53; malondialdehyde (MDA) plasma levels and non-protein thiol levels in erythrocytes. Additionally, protein expression of L-selectin was evaluated to confirm our previous findings. The results demonstrated that gene expression of L-selectin was decreased in the WECS I group when compared to the OUW group (p < 0.05). Regarding gene expression of CXCL2, CXCL8 (IL-8), HO-1, and p53, significant fold change decreases were observed in workers exposed to CS in relation to unexposed workers (p < 0.05). The results of L-selectin protein expression in lymphocyte surface corroborated with our previous findings; thus, significant downregulation in the WECS groups was observed compared to OUW group (p < 0.05). The MDA was negatively associated with the gene expression of CXCL-2, CXCL8 (IL-8), and p53 (p < 0.05). The participants with silicosis (WECS II) presented significant increased non-protein thiol levels in relation to other groups (p < 0.05). Taken together, our findings may contribute to help the knowledge about the complex mechanisms involved in the silicosis pathogenesis and in the risk of lung cancer development in workers chronically exposed to respirable CS.
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Affiliation(s)
- Caroline Peruzzi
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Sabrina Nascimento
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Bruna Gauer
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Jessica Nardi
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Elisa Sauer
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Gabriela Göethel
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Larissa Cestonaro
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Nuryan Fão
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Shanda Cattani
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil
| | - Cristiane Paim
- FUNDACENTRO, Fundação Jorge Duprat e Figueiredo, Porto Alegre, RS, Brazil
| | - Jorge Souza
- Unidade Regional de Saúde do Trabalhador (UREST), Ametista do Sul, RS, Brazil
| | - Daniela Gnoatto
- Unidade Regional de Saúde do Trabalhador (UREST), Ametista do Sul, RS, Brazil
| | - Solange Cristina Garcia
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ipiranga 2752, Santa Cecília, Porto Alegre, RS, 90610-000, Brazil.
- Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
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Abstract
ABSTRACT Pollination services performed by bees are essential for the reproduction of a great part of flowering plants. The pollen collected by Apis mellifera while performing pollination (bee pollen), has been incorporated into the human diet for its favorable nutritional components. Around 1,500 tons of bee pollen are produced annually worldwide, especially in Spain, China, Australia, Argentina, and Brazil. Despite the importance of bee pollen within apiculture, little is known about the effects of climate variations on bee pollen collection and production. We monitored the pollen collection performance of 24 different honey bee colonies in different climate conditions within a period of one year. We then analyzed the statistical interaction among the number of worker bees returning with pollen loads and 12 climatic variables, to produce a predictive mixed linear model. The results obtained showed that 7 climatic variables were statistically correlated to the pollen collection observed: Maximum temperature of the day, minimum temperature of the day, dew point temperature, relative humidity, cloud cover, rainfall, and the date of the sample. This research brings information for the development of a more effective pollen productive system.
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Affiliation(s)
- I.M. de Mattos
- Universidade de São Paulo, Brazil; The Hebrew University of Jerusalem, Israel
| | - J. Souza
- Universidade de São Paulo, Brazil
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Nardi J, Nascimento S, Göethel G, Gauer B, Sauer E, Fão N, Cestonaro L, Peruzzi C, Souza J, Garcia SC. Inflammatory and oxidative stress parameters as potential early biomarkers for silicosis. Clin Chim Acta 2018; 484:305-313. [PMID: 29860036 DOI: 10.1016/j.cca.2018.05.045] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/22/2018] [Accepted: 05/23/2018] [Indexed: 01/25/2023]
Abstract
Workers involved in mining activities are exposed to crystalline silica, which leads to constant pulmonary inflammatory reactions and severe oxidative damage, resulting in silicosis. In this work, we aimed to evaluate inflammatory and oxidative stress parameters as potential early biomarkers of effect to assess crystalline silica toxicity in workers who had occupational exposure during mining. We enrolled 38 workers exposed to crystalline silica (WECS), 24 individuals with silicosis (IWS), and 30 occupationally unexposed workers (OUW), a total of 92 participants. The WECS were divided into 2 groups, according to the time of exposure: 19 workers with 1-15 years of occupational exposure (WECS I) and 19 workers with >16 years of occupational exposure (WECS II). The inflammatory parameters assessed were L-selectin, β-2 integrin, and intercellular adhesion molecule-1 (ICAM-1) surface protein expression in lymphocytes and monocytes, complement C3 and C4, high sensitivity C-reactive protein (hsCRP), and adenosine deaminase (ADA) in serum. Plasma levels of malondialdehyde (MDA) and serum levels of vitamin C were determined as biomarkers of oxidative stress. Biochemical and hematological parameters were also investigated. L-selectin surface protein expression was significantly decreased in the WECS II group (p < 0.05), indicating the importance of this immune system component as a potential marker of crystalline-silica-induced toxicity. The MDA levels were significantly increased in the WECS I, WECS II, and IWS groups compared to the OUW group (p < 0.05). Vitamin C levels were decreased, while C3, hsCRP, ADA, and aspartate aminotransferase (AST) levels were increased in the IWS group compared to the OUW group (p < 0.05). Glucose and urea levels were significantly higher in the WECS I, II, and IWS groups compared to the OUW group (p < 0.05). Negative partial association was found between L-selectin and time of exposure (p < 0.001), supporting the relevance of this biomarker evaluation in long-term exposure to crystalline silica. Significant associations were also observed among inflammatory and oxidative stress biomarkers. Therefore, our results demonstrated the relevance of L-selectin as a potential peripheral biomarker for monitoring crystalline silica-induced toxicity in miners after chronic exposure, before silicosis has developed. However, more studies are necessary for better understanding of the use L-selectin as an early biomarker in exposed workers.
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Affiliation(s)
- Jessica Nardi
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Sabrina Nascimento
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Gabriela Göethel
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Bruna Gauer
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Elisa Sauer
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Nuryan Fão
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Larissa Cestonaro
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Caroline Peruzzi
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Jorge Souza
- Unidade Regional de Saúde do Trabalhador, Ametista do Sul, RS, Brazil
| | - Solange Cristina Garcia
- Laboratório de Toxicologia (LATOX), Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
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Souza J, Guimarães R, Siqueira M, Gil R, Araujo R, Valadão M. Watch and wait versus surgery with pathological complete response: Single institution experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Souza J, Lourenço H, Mendes G. Low-dose chemotherapy with methotrexate and vinblastine for desmoid tumors: A single institution experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx387.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gibb H, Dunn RR, Sanders NJ, Grossman BF, Photakis M, Abril S, Agosti D, Andersen AN, Angulo E, Armbrecht I, Arnan X, Baccaro FB, Bishop TR, Boulay R, Brühl C, Castracani C, Cerda X, Del Toro I, Delsinne T, Diaz M, Donoso DA, Ellison AM, Enriquez ML, Fayle TM, Feener DH, Fisher BL, Fisher RN, Fitzpatrick MC, Gómez C, Gotelli NJ, Gove A, Grasso DA, Groc S, Guenard B, Gunawardene N, Heterick B, Hoffmann B, Janda M, Jenkins C, Kaspari M, Klimes P, Lach L, Laeger T, Lattke J, Leponce M, Lessard JP, Longino J, Lucky A, Luke SH, Majer J, McGlynn TP, Menke S, Mezger D, Mori A, Moses J, Munyai TC, Pacheco R, Paknia O, Pearce-Duvet J, Pfeiffer M, Philpott SM, Resasco J, Retana J, Silva RR, Sorger MD, Souza J, Suarez A, Tista M, Vasconcelos HL, Vonshak M, Weiser MD, Yates M, Parr CL. A global database of ant species abundances. Ecology 2017; 98:883-884. [DOI: 10.1002/ecy.1682] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/22/2016] [Accepted: 11/29/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Heloise Gibb
- Department of Ecology, Environment and Evolution; La Trobe University; Melbourne 3086 Victoria Australia
| | - Rob R. Dunn
- Department of Applied Ecology; North Carolina State University; Raleigh North Carolina 27695 USA
- Center for Macroecology, Evolution, and Climate; Natural History Museum of Denmark; University of Copenhagen; Universitetsparken 15 DK-2100 Copenhagen Ø Denmark
| | - Nathan J. Sanders
- Center for Macroecology, Evolution, and Climate; Natural History Museum of Denmark; University of Copenhagen; Universitetsparken 15 DK-2100 Copenhagen Ø Denmark
| | - Blair F. Grossman
- Department of Ecology, Environment and Evolution; La Trobe University; Melbourne 3086 Victoria Australia
| | - Manoli Photakis
- Department of Ecology, Environment and Evolution; La Trobe University; Melbourne 3086 Victoria Australia
| | - Silvia Abril
- Department of Environmental Science; University of Girona; Montilivi Campus s/n 17071 Girona Spain
| | - Donat Agosti
- Naturhistorisches Museum Bern; Bernastrasse 15 3005 Bern Switzerland
| | - Alan N. Andersen
- CSIRO Ecosystem Sciences, Tropical Ecosystems Research Centre; PMB 44 Winnellie Northern Territory 0822 Australia
| | - Elena Angulo
- Departamento de Etología y Conservación de la Biodiversidad; Estación Biológica de Doñana; Avenida Americo Vespucio s/n (Isla de la Cartuja) Sevilla 41092 Spain
| | - Inge Armbrecht
- Facultad de Ciencias Naturales y Exactas; Universidad del Valle; Cali Colombia
| | - Xavier Arnan
- Departamento de Botânica; Universidade Federal Pernambuco; Avenida Prof Moraes Rego s/no Cidade Universitária Pernambuco Brazil
| | - Fabricio B. Baccaro
- Departamento de Biologia; Universidade Federal do Amazonas-UFAM; Manaus Amazonas Brazil
| | - Tom R. Bishop
- Department of Earth, Ocean and Ecological Sciences; University of Liverpool; Liverpool L69 3GP United Kingdom
- Department of Zoology and Entomology; Centre for Invasion Biology; University of Pretoria; Pretoria 0002 South Africa
| | - Raphaël Boulay
- Institut de Recherche sur la Biologie de l'Insecte et Département, d'Aménagement du Territoire Université; François Rabelais de Tours; Tours 37200 France
| | - Carsten Brühl
- Institute for Environmental Sciences; University Koblenz-Landau; Fortstraße 7 76829 Landau in der Pfalz Germany
| | - Cristina Castracani
- Department of Life Sciences; University of Parma; Parco Area delle Scienze 11/A Parma 43124 Italy
| | - Xim Cerda
- Departamento de Etología y Conservación de la Biodiversidad; Estación Biológica de Doñana; Avenida Americo Vespucio s/n (Isla de la Cartuja) Sevilla 41092 Spain
| | - Israel Del Toro
- Center for Macroecology, Evolution, and Climate; Natural History Museum of Denmark; University of Copenhagen; Universitetsparken 15 DK-2100 Copenhagen Ø Denmark
| | - Thibaut Delsinne
- Société d'Histoire Naturelle Alcide-d'Orbigny; 57 rue de Gergovie 63170 Aubière France
| | - Mireia Diaz
- Department of Environmental Science; University of Girona; Montilivi Campus s/n 17071 Girona Spain
| | - David A. Donoso
- Instituto de Ciencias Biológicas; Escuela Politécnica Nacional; Avenida Ladrón de Guevara E11253 Quito Ecuador
| | - Aaron M. Ellison
- Harvard Forest; Harvard University; 324 North Main Street Petersham Massachusetts 01366 USA
- Departments of Biology and Environmental Conservation; University of Massachusetts; Morrill Science Center and Holdsworth Hall, 611 North Pleasant Street Amherst Massachusetts 01003 USA
- Faculty of Arts, Business and Law; Tropical Forests and People Research Centre; University of the Sunshine Coast; 90 Sippy Downs Drive Sippy Downs Queensland 4556 Australia
| | - Martha L. Enriquez
- Department of Environmental Science; University of Girona; Montilivi Campus s/n 17071 Girona Spain
| | - Tom M. Fayle
- Institute of Entomology; Biology Centre of Academy of Sciences Czech Republic and Faculty of Science; University of South Bohemia; Branišovská 31 České Budějovice 370 05 Czech Republic
- Forest Ecology and Conservation Group; Imperial College London; Silwood Park Campus, Buckhurst Road Ascot SL5 7PY United Kingdom
| | - Donald H. Feener
- Department of Biology; University of Utah; Salt Lake City Utah 84112 USA
| | - Brian L. Fisher
- Entomology; California Academy of Sciences; San Francisco California USA
| | - Robert N. Fisher
- Western Ecological Research Center; U.S. Geological Survey; San Diego Field Station 4165 Spruance Road, Suite 200 San Diego California 92101 USA
| | - Matthew C. Fitzpatrick
- Appalachian Laboratory; University of Maryland Centre for Environmental Science; Frostburg Maryland 21532 USA
| | - Crisanto Gómez
- Department of Environmental Science; University of Girona; Montilivi Campus s/n 17071 Girona Spain
| | | | - Aaron Gove
- Astron Environmental Services; Perth Western Australia Australia
- Department of Environment and Agriculture; Curtin University; G.P.O. Box U1987 Perth Western Australia 6845 Australia
| | - Donato A. Grasso
- Department of Life Sciences; University of Parma; Parco Area delle Scienze 11/A Parma 43124 Italy
| | - Sarah Groc
- Instituto de Biologia; Universidade Federal de Uberlândia (UFU) Rua Ceara; Uberlândia Minas Gerais 38400-902 Brazil
| | - Benoit Guenard
- School of Biological Sciences; The University of Hong Kong; Pok Fu Lam Road Hong Kong China
| | - Nihara Gunawardene
- Department of Environment and Agriculture; Curtin University; G.P.O. Box U1987 Perth Western Australia 6845 Australia
| | - Brian Heterick
- Department of Environment and Agriculture; Curtin University; G.P.O. Box U1987 Perth Western Australia 6845 Australia
| | - Benjamin Hoffmann
- CSIRO Ecosystem Sciences, Tropical Ecosystems Research Centre; PMB 44 Winnellie Northern Territory 0822 Australia
| | - Milan Janda
- Institute of Entomology; Biology Centre of Academy of Sciences Czech Republic and Faculty of Science; University of South Bohemia; Branišovská 31 České Budějovice 370 05 Czech Republic
- Department of Biology; University of Guanajuato; Noria Alta sn. Guanajuato Mexico
| | - Clinton Jenkins
- IPÊ-Instituto de Pesquisas Ecológicas; Nazaré Paulista São Paulo 12960-000 Brazil
| | - Michael Kaspari
- Department of Biology; University of Oklahoma; 730 Van Vleet Oval, Room 314 Norman Oklahoma 73019 USA
| | - Petr Klimes
- Institute of Entomology; Biology Centre of Academy of Sciences Czech Republic and Faculty of Science; University of South Bohemia; Branišovská 31 České Budějovice 370 05 Czech Republic
- New Guinea Binatang Research Center; P.O. Box 604 Madang Papua New Guinea
| | - Lori Lach
- Centre for Tropical Biology and Climate Change; School of Marine and Tropical Biology; James Cook University; P.O. Box 6811 Cairns Queensland 4870 Australia
| | | | - John Lattke
- Departamento de Zoologia; Universidade Federal do Paraná; Caixa Postal 19020 81531-980 Curitiba Paraná Brazil
| | - Maurice Leponce
- Section of Biological Evaluation; Royal Belgian Institute of Natural Sciences; Rue Vautier, 29 Brussels 1000 Belgium
| | | | - John Longino
- Department of Biology; University of Utah; Salt Lake City Utah 84112 USA
| | - Andrea Lucky
- Entomology and Nematology Department; University of Florida; 970 Natural Area Drive Gainesville Florida 32611 USA
| | - Sarah H. Luke
- School of Biological Sciences; University of East Anglia; Norwich NR4 7TJ United Kingdom
- Department of Zoology; University of Cambridge; Downing Street Cambridge CB2 3EJ United Kingdom
| | - Jonathan Majer
- Department of Environment and Agriculture; Curtin University; G.P.O. Box U1987 Perth Western Australia 6845 Australia
- School of Plant Biology; The University of Western Australia; 35 Stirling Highway Crawley Western Australia 6009 Australia
| | - Terrence P. McGlynn
- Depatment of Biology; California State University Dominguez Hills; 1000 East Victoria Street Carson California 90747 USA
- Department of Entomology; Natural History Museum of Los Angeles County; Los Angeles California USA
| | - Sean Menke
- Department of Biology; Lake Forest College; 555 North Sheridan Road Lake Forest Illinois 60045 USA
| | - Dirk Mezger
- Division of Insects; Department of Zoology; Moreau Lab; Field Museum of Natural History; 1400 South Lake Shore Drive Chicago Illinois 60605 USA
| | - Alessandra Mori
- Department of Life Sciences; University of Parma; Parco Area delle Scienze 11/A Parma 43124 Italy
| | - Jimmy Moses
- Institute of Entomology; Biology Centre of Academy of Sciences Czech Republic and Faculty of Science; University of South Bohemia; Branišovská 31 České Budějovice 370 05 Czech Republic
- New Guinea Binatang Research Center; P.O. Box 604 Madang Papua New Guinea
| | - Thinandavha Caswell Munyai
- School of Life Sciences; College of Agriculture Engineering and Science; University of KwaZulu-Natal; Pietermaritzburg 3209 South Africa
| | - Renata Pacheco
- Instituto de Biologia; Universidade Federal de Uberlândia (UFU) Rua Ceara; Uberlândia Minas Gerais 38400-902 Brazil
| | - Omid Paknia
- Institute of Animal Ecology and Cell Biology; TiHo Hannover; Bünteweg 17d Hannover 30559 Germany
| | | | - Martin Pfeiffer
- Department of Ecology; National University of Mongolia; Baga Toiruu 47 P.O. Box 377 Ulaanbaatar 210646 Mongolia
| | - Stacy M. Philpott
- Environmental Studies Department; University of California; 1156 High Street Santa Cruz California 95060 USA
| | - Julian Resasco
- The Department of Ecology and Evolutionary Biology; University of Colorado; UCB 334 Boulder Colorado 80309 USA
| | - Javier Retana
- Universitat Autònoma Barcelona; Cerdanyola del Vallès 08193 Spain
| | - Rogerio R. Silva
- Coordenação de Ciências da Terra e Ecologia; Museu Paraense Emílio Goeldi; Belém Pará Brazil
| | - Magdalena D. Sorger
- Department of Applied Ecology; North Carolina State University; Raleigh North Carolina 27695 USA
| | - Jorge Souza
- Coordenação de Biodiversidade; National Institute of Amazonian Research; Manaus Amazonas Brazil
| | - Andrew Suarez
- Department of Entomology; University of Illinois, Urbana-Champaign; Urbana Illinois 61801 USA
| | - Melanie Tista
- Department of Tropical Ecology and Animal Biodiversity; University of Vienna; Rennweg 14 Vienna 1030 Austria
| | - Heraldo L. Vasconcelos
- Instituto de Biologia; Universidade Federal de Uberlândia (UFU) Rua Ceara; Uberlândia Minas Gerais 38400-902 Brazil
| | - Merav Vonshak
- Department of Biology; Stanford University; Stanford California 94305 USA
| | - Michael D. Weiser
- Department of Biology; University of Oklahoma; 730 Van Vleet Oval, Room 314 Norman Oklahoma 73019 USA
| | - Michelle Yates
- Centre for Behavioural and Physiological Ecology, Zoology; University of New England; Armidale New South Wales Australia
| | - Catherine L. Parr
- Department of Earth, Ocean and Ecological Sciences; University of Liverpool; Liverpool L69 3GP United Kingdom
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Gouvêa VN, Batistel F, Souza J, Chagas LJ, Sitta C, Campanili PRB, Galvani DB, Pires AV, Owens FN, Santos FAP. Flint corn grain processing and citrus pulp level in finishing diets for feedlot cattle. J Anim Sci 2016; 94:665-77. [PMID: 27065137 DOI: 10.2527/jas.2015-9459] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Four trials were conducted to evaluate the effects of flint corn processing and the replacement of corn with citrus pulp (CiP) in diets for Nellore feedlot cattle. In a 103-d finishing trial, 216 Nellore bulls (350 ± 24 kg initial BW) were used in a randomized complete block design with a 2 × 4 factorial arrangement of treatments. Factors included 2 processing methods, either ground corn (GC) or steam-flaked corn (FC), with CiP replacing each corn type at 4 levels (0, 25, 50, and 75% of DM). All diets contained 12% sugarcane bagasse and 88% concentrate (DM basis). Treatments were also evaluated in metabolism trials, in which 10 ruminally cannulated Nellore steers (389 ± 37 kg) were assigned to 2 independent but simultaneous 5 × 5 Latin squares, each using 1 method of corn processing (GC and FC). Interactions ( < 0.05) between corn processing and CiP inclusion level were observed for final BW, DMI, ADG, G:F, and HCW. With FC-based diets, added CiP linearly decreased final BW ( = 0.04), whereas with GC-based diets, added CiP quadratically increased final BW ( = 0.002). With FC-based diets, the inclusion of CiP linearly increased DMI ( = 0.03) and linearly decreased ADG ( = 0.03) and G:F ( = 0.001). Increasing CiP in GC-based diets quadratically increased DMI ( = 0.001), ADG ( = 0.005), and HCW ( = 0.003). In FC-based diets, CiP inclusion had no effect on HCW ( = 0.21). Dressing percent, LM area, and 12th-rib fat were not affected by diet ( ≥ 0.05). For steers fed GC diets, CiP inclusion in the diet quadratically decreased the molar proportion of isovalerate ( = 0.001) but linearly increased ruminal butyrate ( = 0.006). No differences ( ≥ 0.16) were observed for total VFA concentrations, acetate:propionate ratio, and ruminal NH-N as CiP replaced GC. For steers fed FC diets, the molar proportion of acetate linearly increased ( = 0.002) whereas the proportion of propionate was linearly decreased ( < 0.001), resulting in a linear increase ( = 0.001) in the acetate:propionate ratio. Replacing corn with CiP linearly reduced NEm ( = 0.001) and NEg ( < 0.001) of FC-based diets but did not affect ( = 0.15) NE values of CG-based diets. Steam flaking flint corn improved cattle performance in this trial more than has been reported for dent corn in the published literature.
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Mattos ID, Souza J, Soares A. Differential performance of honey bee colonies selected for bee-pollen production through instrumental insemination and free-mating technique. ARQ BRAS MED VET ZOO 2016. [DOI: 10.1590/1678-4162-8875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The use of bee-pollen as a nutritional supplement or as a production-enhancing agent in livestock has increased the demand for this product worldwide. Despite the current importance of this niche within the apiculture industry, few studies have addressed the pollen production. We tested the performance of free-mated (FM) and instrumentally inseminated queens (IQ) in order to establish the effect of different breeding systems on pollen production. The F1 generation of IQ queens produced 153.95±42.83g/day, showing a significant improvement on the pollen production (2.74 times) when compared to the parental generation (51.83±7.84g/day). The F1 generation of free-mated queens produced 100.07±8.23 g/day, which increased by 1.78 times when compared to the parental generation. Furthermore, we observed a statistically significant difference between the pollen production between colonies from the IQ and FM treatments. This study suggests that inseminated queens should be considered by beekeepers that aim to increase pollen production.
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Affiliation(s)
| | - J. Souza
- Universidade de São Paulo, Brazil
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De Souza CM, Souza J, Furtado CMG, Cleto JLT, Antoniuk SA, Raskin S. Kohlschütter-Tönz syndrome in siblings without ROGDI mutation. Oral Health Dent Manag 2014; 13:728-730. [PMID: 25284547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Kohlschütter-Tönz syndrome is a rare neurodegenerative disorder presenting with intractable seizures, developmental regression, and characteristic hypoplastic dental enamel indicative of amelogenesis imperfecta. Recently, mutations in ROGDI were identified in part of Kohlschütter-Tönz syndrome cases, but the siblings reported here do not have a mutation in the ROGDI gene, showing that there is genetic heterogeneity in Kohlschütter-Tönz syndrome. AIM Report two siblings that have Kohlschütter-Tönz syndrome. CONCLUSION Early onset of seizures and lack of the ability to walk without support may be signs of non-ROGDI mutations in Kohlschütter-Tönz syndrome patients.
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Affiliation(s)
| | | | | | | | | | - S Raskin
- Rua Saldanha Marinho, 1782, Curitiba Parana 80730-180 Brazil; Tel: +55-41-33066838, e-mail:
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Abstract
BACKGROUND In the global context of contemporary psychiatric deinstitutionalization, the phenomenon of psychiatric readmission imposes important challenges, as it exposes the fragility of the network of mental health services. AIMS To gather, synthesize and analyse the national and international scientific literature regarding the phenomenon of psychiatric readmission in the context of deinstitutionalization. METHODS Through the combination of descriptors, an integrative review was performed of publications from the period 1997 to 2010 included in the MedLine, PubMed, LILACS, SciELO and PsycINFO databases. Selection of the articles was based on pre-established inclusion and exclusion criteria. Three authors independently evaluated the eligibility of the articles. The level of inter-judge concordance was calculated, using the formula: agreement = Σ possible concordance subtracted from real discordance divided by the number of articles. Information about the selected studies was systematized and analysed. FINDINGS Sixteen articles met the inclusion criteria. Studies conducted and published in international journals, mainly in the USA, with a quantitative approach predominated. In general, the studies addressed the phenomenon of psychiatric readmission after the restructuring of mental health care. The variables investigated were clinical and sociodemographic factors and the characteristics of the mental health service associated with readmission, as well as the programs developed specifically for patients vulnerable to hospital readmissions. CONCLUSIONS It was noted that the perspective of the patient regarding their readmissions, as well as the interface with the social and familial context in which they maintain their social relationships and care for their health, was largely unexplored by the literature.
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Affiliation(s)
- V Machado
- Department of Psychology, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil.
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Affiliation(s)
- J. Souza
- Graduate Program on Physical Education and Health, Physical Education, Catholic University of Brasilia, Brazil
| | - H. Simoes
- Graduate Program on Physical Education and Health, Physical Education, Catholic University of Brasilia, Brazil
| | - C.S. Campbell
- Graduate Program on Physical Education and Health, Physical Education, Catholic University of Brasilia, Brazil
| | - F. Pontes
- School of Arts, Sciences and Humanity, University of São Paulo, Brazil
| | - D. Boullosa
- Graduate Program on Physical Education and Health, Physical Education, Catholic University of Brasilia, Brazil
| | - J. Prestes
- Graduate Program on Physical Education and Health, Physical Education, Catholic University of Brasilia, Brazil
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Ferrer M, Javaloyes G, García Nuñez I, Gastaminza G, Goikoetxea M, Gamazo C, Souza J, Sastre B, del Pozo V, Blanca M. Ara H 9 Is The Main Allergen In Peanut Allergic Patients In The Mediterranean Area Regardless The Symptom Severity. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rodríguez D, Rosa R, Souza J. Health Recommendation System based on Cellular Network in a Secure Way. Informatics 2010. [DOI: 10.2316/p.2010.727-004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Silva C, Souza J, Mota V, Pereira M, Silva S. Antimicrobial activity of crude extract of Brazilian tree leaves against Staphylococcus aureus. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lameira J, Alves C, Santos L, Santos A, de Almeida Santos R, Souza J, Silva C, da Silva A. A combined X-ray and theoretical study of flavonoid compounds with anti-inflammatory activity. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.theochem.2008.04.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Shih HT, Khalighi K, Cohen M, Matricaria L, Mcdonald H, Souza J, Nguyen L. P-096 Mutil-center clinical experience of using direct current fibber to induce VF in ICD patients: A randomized, prospective, crossover study. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b89-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | | | - M. Cohen
- Memorial Regional Hospital, Pembroke Pines, Fl
| | | | - H. Mcdonald
- Asheville Cardiology Associates, Asheville, NC
| | - J. Souza
- Fountain Valley Hospital, Santa Ana, Ca
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Santana AM, De Godoy Netto ΑV, De Almeida ET, Mauro ΑE, Souza J, Santos RHA. Crystal structure of di-μ(N,S)-thiocyanato-bis[(N-benzylideneaniline- C2,N)palladium(II)], [Pd(C6H4CH=NC6H5)(μ-SCN)]2. Z KRIST-NEW CRYST ST 2002. [DOI: 10.1524/ncrs.2002.217.jg.147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Santana AM, De Godoy Netto ΑV, De Almeida ET, Mauro ΑE, Souza J, Santos RHA. Crystal structure of di-μ(N,S)-thiocyanato-bis[(N-benzylideneaniline- C2,N)palladium(II)], [Pd(C6H4CH=NC6H5)(μ-SCN)]2. Z KRIST-NEW CRYST ST 2002. [DOI: 10.1524/ncrs.2002.217.1.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lima GFD, Santos RHA, Souza J, Lechat JR. Crystal structure of N-(1,2-diphenyl-2-hydroxyethylidene)-N'-(2,4-dinitrophenyl)- hydrazine, C20H16N4O5. Z KRIST-NEW CRYST ST 2001. [DOI: 10.1524/ncrs.2001.216.14.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Barbosa AC, Jardim W, Dórea JG, Fosberg B, Souza J. Hair mercury speciation as a function of gender, age, and body mass index in inhabitants of the Negro River basin, Amazon, Brazil. Arch Environ Contam Toxicol 2001; 40:439-444. [PMID: 11443378 DOI: 10.1007/s002440010195] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2000] [Accepted: 11/08/2000] [Indexed: 05/23/2023]
Abstract
Human mercury contamination can be monitored through hair analysis of mercury's inorganic and organic form as methylmercury (Me-Hg). Hair total mercury and Me-Hg were studied in a Negro River fish-eating population in relation to age, gender, and body mass index (BMI). This riverbank population eats fish at least twice a day and is exposed to high levels of Me-Hg. Total mercury ranged from 1.51 microg/g to 59.01 microg/g, with only 21% of the sampled population having Hg concentration of less than 10 microg/g hair. The mean percentage of Me-Hg was 71.3% (range 34% to 100%) of the total mercury in hair. No statistically significant differences were found in regard to age groups (children and adults) or BMI. However, women had significantly lower total mercury in hair than men, but the percentage of Me-Hg was not significantly different. Women in fertile age (15-40 years) had hair total mercury ranging from 1.65-32.63 microg/g, and 65% in this subgroup had hair mercury above 10 microg/g hair. The percentage of Me-Hg concentration in hair of this freshwater, fish-eating population is comparable to populations eating ocean fish from different parts of the world and does not seem to be affected by age, gender, and BMI.
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Affiliation(s)
- A C Barbosa
- Department of Chemistry, and Department of Nutrition, C.P. 04322, Universidade de Brasilia, 70919-970 Brasilia, Brazil
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Zivin A, Souza J, Pelosi F, Flemming M, Knight BP, Goyal R, Morady F, Strickberger SA. Relationship between shock energy and postdefibrillation ventricular arrhythmias in patients with implantable defibrillators. J Cardiovasc Electrophysiol 1999; 10:370-7. [PMID: 10210500 DOI: 10.1111/j.1540-8167.1999.tb00685.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The relationship between postdefibrillation ventricular arrhythmias and shock strength is poorly understood in patients with implantable defibrillators. The purpose of this study was to characterize the relationship between postdefibrillation ventricular arrhythmias and shock strength. METHODS AND RESULTS Forty-three patients with an implanted defibrillator underwent six separate inductions of ventricular fibrillation (VF) after a step-down defibrillation energy requirement (7.3 +/- 4.6 J) was determined. For each of the first three inductions of VF, the first two shocks were low energy and equal to approximately 75% of the defibrillation energy requirement (5.4 +/- 3.3 J), or to the defibrillation energy requirement plus 10 J (17.5 +/- 4.3 J). After the first two shocks, subsequent shocks were programmed to the maximum available energy (29.0 +/- 2.5 J). The alternate technique was used for the subsequent three inductions of VF. Postdefibrillation ventricular arrhythmias were noted. Postdefibrillation ventricular arrhythmias with a cycle length < or = 300 msec were more frequent after a low-energy shock (19%), than after a high-energy shock (1.5%; P = 0.005). Postdefibrillation ventricular arrhythmias with a cycle length < or = 300 msec were more frequent after a high-energy shock (32%), than after a low-energy shock (7.1%; P = 0.002). A relationship between the cycle length of the postdefibrillation ventricular arrhythmias and the absolute defibrillation energy was observed (P < 0.001; r = 0.6), and ventricular arrhythmias with a cycle length > 300 msec were uncommon after shocks < or = 10 J (P = 0.001). The characteristics of ventricular arrhythmias after maximum-energy shocks were similar to those that occurred after high-energy shocks. CONCLUSIONS Postdefibrillation ventricular arrhythmias with a cycle length < or = 300 msec are more common after shocks of strength associated with a low probability of successful defibrillation. Postdefibrillation ventricular arrhythmias with a cycle length of > 300 msec are more common after high- and maximum-energy shocks, and are directly related to the absolute defibrillation energy.
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Affiliation(s)
- A Zivin
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0022, USA
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Knight BP, Zivin A, Souza J, Flemming M, Pelosi F, Goyal R, Man C, Strickberger SA, Morady F. A technique for the rapid diagnosis of atrial tachycardia in the electrophysiology laboratory. J Am Coll Cardiol 1999; 33:775-81. [PMID: 10080480 DOI: 10.1016/s0735-1097(98)00614-7] [Citation(s) in RCA: 227] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to determine if the atrial response upon cessation of ventricular pacing associated with 1:1 ventriculoatrial conduction during paroxysmal supraventricular tachycardia is a useful diagnostic maneuver in the electrophysiology laboratory. BACKGROUND Despite various maneuvers, it can be difficult to differentiate atrial tachycardia from other forms of paroxysmal supraventricular tachycardia. METHODS The response upon cessation of ventricular pacing associated with 1:1 ventriculoatrial conduction was studied during four types of tachycardia: 1) atrioventricular nodal reentry (n = 102), 2) orthodromic reciprocating tachycardia (n = 43), 3) atrial tachycardia (n = 19) and 4) atrial tachycardia simulated by demand atrial pacing in patients with inducible atrioventricular nodal reentry or orthodromic reciprocating tachycardia (n = 32). The electrogram sequence upon cessation of ventricular pacing was, categorized as "atrial-ventricular" (A-V) or "atrial-atrial-ventricular" (A-A-V). RESULTS The A-V response was observed in all cases of atrioventricular nodal reentrant and orthodromic reciprocating tachycardia. In contrast, the A-A-V response was observed in all cases of atrial tachycardia and simulated atrial tachycardia, even in the presence of dual atrioventricular nodal pathways or a concealed accessory atrioventricular pathway. CONCLUSIONS In conclusion, an A-A-V response upon cessation of ventricular pacing associated with 1:1 ventriculoatrial conduction is highly sensitive and specific for the identification of atrial tachycardia in the electrophysiology laboratory.
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Affiliation(s)
- B P Knight
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA.
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Manfroi WC, Zago AJ, Cruz R, Oliveira J, Kirschnick LS, Ordovás K, Candiago RH, Souza J, Ribeiro LW, Leitão C, Brizolara ML. Lack of a relationship between serum ferritin levels and coronary atherosclerosis evaluated by coronary arteriography. Braz J Med Biol Res 1999; 32:303-7. [PMID: 10347788 DOI: 10.1590/s0100-879x1999000300009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Many clinical and epidemiological studies have demonstrated the relationship between serum ferritin and ischemic heart disease. In the present study we evaluated the relationship between coronary heart disease (CHD) and serum ferritin levels in patients submitted to coronary arteriography. We evaluated 307 patients (210 (68.7%) males; median age: 60 years) who were submitted to coronary angiography, measurement of serum ferritin and identification of clinical events of ischemic heart disease. Serum ferritin is reported as quartiles. Ninety-six patients (31.27%) had normal coronary angiography (group 1) and 211 (68.73%) had coronary heart disease (group 2). Of the patients with CHD, 61 (28.9%) had serum ferritin levels higher than 194 ng/ml (4th quartile), as opposed to only 14 (14.58%) of those without CHD (P = 0.0067). In the 2nd quartile, 39 patients (18.48%) had CHD, while 35 patients (36.46%) had normal coronary arteries (P = 0.00064). Multivariate analysis of the data showed that the difference between groups was not statistically significant (P = 0.33). We conclude that there is no independent relationship between coronary heart disease and increased levels of serum ferritin.
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Affiliation(s)
- W C Manfroi
- Serviço de Cardiologia, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Brasil.
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Manfroi WC, Ludwig R, Kirschnick LS, Souza J, Ribeiro LW, Ordovás K, Leitão C, Cruz R, Candiago R. Comparative study for the identification of myocardial ischemia by contrast ventriculography under the effect of isosorbide mononitrate and by perfusional myocardial scintigraphy in patients with ischemic heart disease. Arq Bras Cardiol 1999; 72:171-83. [PMID: 10488576 DOI: 10.1590/s0066-782x1999000200005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate and compare the usefulness of cineventriculographies, before and after nitrate use, to technetium-99m sestamibi scintigraphy for the identification of myocardial ischemia. METHODS Twenty-six patients were studied at basal conditions and 5 minutes after intravenous administration of isosorbide mononitrate (0.3 mg/kg), to evaluate the performance and regional wall motion of the left ventricle (LV). The results were compared too those obtained with technetium-99m sestamibi scintigraphy. RESULTS Before nitrate, contrast ventriculography identified 30 normal segments, 62 hypokinetic segments, 28 dyskinetic segments, and 14 akinetic segments. After drug administration, 99 segments were normal, 11 hypokinetic, 11 dyskinetic, and 13 akinetic. Myocardial scintigraphy revealed 110 ischemic segments and 18 fibrotic segments (p < 0.005). After drug administration, the ventriculography showed increase in the velocity of circumferential fiber shortening (p = 0.0142), the ejection fraction (p = 0.0462), decrease in the end-systolic volume (p = 0.0031) and no change in end-diastolic volume. CONCLUSION Contrast ventriculography using nitrate proved to be similar to perfusional myocardial scintigraphy in the identification of myocardial ischemia.
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Affiliation(s)
- W C Manfroi
- Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Williams JT, Southerland SS, Souza J, Calcutt AF, Cartledge RG. Cells isolated from adult human skeletal muscle capable of differentiating into multiple mesodermal phenotypes. Am Surg 1999; 65:22-6. [PMID: 9915526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Wound healing is the response of tissue to injury that results in scar formation. Tissue regeneration would be a more ideal response. Previously, we have isolated a population of cells from avian, rodent, and rabbit skeletal muscle capable of differentiating into multiple mesodermal phenotypes. The present experiments were designed to determine whether a similar population of cells exist in human skeletal muscle. Separate cell preparations from skeletal muscle on an amputated leg of a 75-year-old female and the pectoralis muscle of a 27-year-old male were enzymatically dissociated and cultured to confluence in Eagle's minimal essential medium with 10 per cent preselected horse serum, then trypsinized, filtered, and slowly frozen in 7.5 per cent dimethylsulfoxide to -80 degrees C. The cells were thawed and plated with the same media plus dexamethasone (a nonspecific differentiation agent) at 10(-10) - 10(-6) M concentrations for up to 6 weeks. Immunological and histochemical staining assays were performed. Phenotypes observed included stem cells with typical stellate morphology (control), skeletal myotubes (anti-myosin), smooth muscle (anti-a-actin), bone (von Kossa stain), cartilage (Alcec blue), and fat (Sudan black B). These experiments establish the existence of a population of mesenchymal stem cells in human skeletal muscle capable of differentiating into multiple mesodermal phenotypes. The possibility exists of manipulating the mesenchymal stem cells to achieve appropriate regeneration of mesenchymal tissues in the injured patient.
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Affiliation(s)
- J T Williams
- Mercer University School of Medicine, Medical Center of Central Georgia, Macon, USA
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Abstract
PURPOSE Adenosine is a useful agent for the diagnosis and termination of tachycardias. The purpose of this study was to identify the rhythms for which adenosine is prescribed in hospitalized adults and to identify the reasons for its misuse. PATIENTS AND METHODS Data were collected from the medical records of 100 patients who received intravenous adenosine while hospitalized at a university medical center. The characteristics of the patients, rhythms treated with adenosine, and dosages of adenosine were analyzed. In addition, internal medicine house officers were administered a questionnaire referring to an electrocardiogram of atrial fibrillation with a rapid ventricular response. RESULTS The arrhythmias for which adenosine was administered consisted of regular, narrow-QRS complex tachycardias in 33% of patients; atrial fibrillation in 32% of patients; regular, wide-QRS complex tachycardias in 23% of patients; atrial flutter in 10% of patients, and multifocal atrial tachycardia in 2% of patients. The mean (+/-SD) number of doses of adenosine given to each patient was 1.6+/-0.8, and the mean dose of adenosine was 7.8+/-2.8 mg. Internal medicine house officers prescribed 70% of the doses of adenosine and were as likely to use it for patients with atrial fibrillation as were surgical house officers. There was a 2% incidence of proarrhythmia, including asystole and polymorphic ventricular tachycardia. Thirty-one percent of the 100 house officers in our survey misdiagnosed a 12-lead electrocardiogram of rapid atrial fibrillation as paroxysmal supraventricular tachycardia, suggesting that adenosine may have been misused for atrial fibrillation because of errors in rhythm diagnosis. Only 5% of those who correctly diagnosed atrial fibrillation also answered that adenosine would be likely to terminate the arrhythmia, suggesting that a misunderstanding that adenosine terminates atrial fibrillation is not a common reason for its misuse. CONCLUSIONS Approximately 40% of hospitalized adults who are treated with adenosine receive the medication unnecessarily for atrial fibrillation or atrial flutter, and this misuse results in unnecessary expenses and risks of adverse effects. The primary reason that adenosine is misused for atrial fibrillation is the inability to recognize that rhythm on an electrocardiogram. House officers need additional education on the electrocardiographic recognition of atrial fibrillation.
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Affiliation(s)
- B P Knight
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA
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Mello DA, Rouquayrol MZ, Araújo D, Amadei M, Souza J, Bento LF, Gondin J, Nascimento J. [Health promotion and education: a diagnosis of sanitation conditions using participatory research and community education (São João dos Queiróz - Quixadá/Ceará, Brazil)]. CAD SAUDE PUBLICA 1998; 14:583-95. [PMID: 9761612 DOI: 10.1590/s0102-311x1998000300015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This study was conducted in a rural community, São João dos Queiróz, a township in the county of Quixadá, Ceará, Brazil, using a combination of participatory research and community education in compliance with the health promotion reference and principles of the 1986 Ottawa Charter. The project was joined by representatives of several local government institutions and organizations from the grassroots community movement. The theme generating the research, as defined by an assembly meeting of the community association, was a diagnosis of sanitation conditions in the community. The starting point was the assessment of local conditions. Results showed adverse local conditions in sanitation, literacy, income, and employment. Suggestions for solving the problems were organized so as to be included in the planning agenda for local health policies. Evaluation was procedural and enriched with daily research activities. The problem-solving pedagogical approach developed during the educational process contributed to a critical reconstruction, appropriation, and sharing of the resulting knowledge.
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Affiliation(s)
- D A Mello
- Núcleo de Estudos em Saúde Pública, Universidade de Brasília, SQN 315, Bloco B 504, Brasília, DF, 70744-020, Brasil
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Weiss R, Knight BP, Bahu M, Zivin A, Souza J, Goyal R, Daoud E, Man KC, Strickberger SA, Halter JB, Morady F. Cardiac electrophysiologic effects of norepinephrine in human beings. Am Heart J 1998; 135:945-51. [PMID: 9630097 DOI: 10.1016/s0002-8703(98)70058-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The electrophysiologic effects of norepinephrine (NE) in human beings have not been previously described. METHODS The electrophysiologic effects of NE infused at a rate of 25 ng/kg/min were determined in 21 patients with a mean age of 41 +/- 11 years and without structural heart disease who underwent an electrophysiology procedure. In a subgroup of 10 patients electrophysiologic parameters were measured at baseline, after the infusion of NE, and after administration of beta-blockade while in continuous NE infusion. RESULTS The baseline NE plasma concentration of 298 +/- 153 pg/ml increased to 708 +/- 419 pg/ml after the infusion of NE. NE significantly increased the mean blood pressure, sinus cycle length, corrected sinus node recovery time, ventriculoatrial block cycle length, and the atrial and ventricular effective refractory periods. In a subset of 10 patients 0.2 mg/kg propranolol administered during continued infusion of NE resulted in a further increase in sinus cycle length, atrial-His interval, and ventricular refractoriness. CONCLUSION A physiologic elevation in the plasma NE concentration results in a depression of sinus node function and atrioventricular conduction and in prolongation of atrial and ventricular refractoriness. Some of NE's effects are partially offset by beta-adrenergic stimulation.
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Affiliation(s)
- R Weiss
- Department of Internal Medicine, University of Michigan and the Veteran Administration Medical Center, Ann Arbor, USA
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Goyal R, Syed ZA, Mukhopadhyay PS, Souza J, Zivin A, Knight BP, Man KC, Strickberger SA, Morady F. Changes in cardiac repolarization following short periods of ventricular pacing. J Cardiovasc Electrophysiol 1998; 9:269-80. [PMID: 9554732 DOI: 10.1111/j.1540-8167.1998.tb00912.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION "Cardiac memory" (primary T wave change) is thought to occur after 15 minutes to several hours of right ventricular (RV) pacing. The two components of the temporal change in repolarization are memory and accumulation. The purpose of this study was to examine quantitatively the effect of short periods of ventricular pacing on the human cardiac action potential, using monophasic action potential (MAP) recordings. METHODS AND RESULTS Thirty-one patients (ages 43+/-14 years) with structurally normal hearts undergoing a clinically indicated electrophysiologic procedure were enrolled. Catheters were placed in the right atrium (RA) and RV, and a MAP catheter was positioned at the RV septum. APD90 was calculated from digitized MAP recordings. MAP morphology comparisons were performed using the root mean square (RMS) of the difference between complexes. All pacing was at 500-msec cycle length. There were four pacing protocols: (1) RA pacing was performed for approximately 15 minutes to evaluate temporal stability of the MAP recordings (5 pts); (2) to evaluate the memory phenomenon, four successive 1-minute episodes of RV pacing were interspersed with 2 minutes of RA pacing (5 pts); (3) the accumulation phenomenon was evaluated by assessing the effects of 1, 5, 10, and 15 minutes of RV pacing on the MAP during RA pacing (16 pts); and (4) 20 minutes of RV pacing was followed by 10 minutes of RA pacing to correlate visually apparent T wave changes with changes in MAP recordings (5 pts). In the control patients, no changes in APD90 or RMS analysis were noted during 14.9+/-1.4 minutes of RA pacing. In the second protocol, RMS of the difference between the baseline MAP complexes and the signal average of the first 50 beats following each of four 1-minute RV pacing trains demonstrated progressively greater differences in morphology after successive episodes of RV pacing. In protocol 3, RMS analysis identified a progressively greater difference between the baseline MAP recording and the average of the first 50 beats after 1, 5, 10, and 15 minutes of RV pacing. In protocol 4, visually apparent changes in T waves occurred in parallel with the RMS of the difference between the baseline MAP recordings and the average of the first 50 beats after 20 minutes of RV pacing. Similar changes also were demonstrated by APD90 analysis. CONCLUSION This study is the first to demonstrate that episodes of abnormal ventricular activation as short as 1 minute in duration may exert lingering effects on the repolarization process once normal ventricular activation resumes.
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Affiliation(s)
- R Goyal
- Department of Internal Medicine, The University of Michigan Medical Center, Ann Arbor 48109-0022, USA
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Goyal R, Syed Z, Mukhopadhyay P, Tran B, Souza J, Zivin A, Pelosi F, Flomming M, Knight B, Man K, Strickberger S, Morady F. Effect of a change in rate on atrial repolarization. J Am Coll Cardiol 1998. [DOI: 10.1016/s0735-1097(98)81915-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Strickberger SA, Man KC, Souza J, Zivin A, Weiss R, Knight BP, Goyal R, Daoud EG, Morady F. A prospective evaluation of two defibrillation safety margin techniques in patients with low defibrillation energy requirements. J Cardiovasc Electrophysiol 1998; 9:41-6. [PMID: 9475576 DOI: 10.1111/j.1540-8167.1998.tb00865.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION In patients undergoing defibrillator implantation, an appropriate defibrillation safety margin has been considered to be either 10 J or an energy equal to the defibrillation energy requirement. However, a previous clinical report suggested that a larger safety margin may be required in patients with a low defibrillation energy requirement. Therefore, the purpose of this prospective study was to compare the defibrillation efficacy of the two safety margin techniques in patients with a low defibrillation energy requirement. METHODS AND RESULTS Sixty patients who underwent implantation of a defibrillator and who had a low defibrillation energy requirement (< or = 6 J) underwent six separate inductions of ventricular fibrillation, at least 5 minutes apart. For each of the first three inductions of ventricular fibrillation, the first two shocks were equal to either the defibrillation energy requirement plus 10 J (14.6+/-1.0 J), or to twice the defibrillation energy requirement (9.9+/-2.3 J). The alternate technique was used for the subsequent three inductions of ventricular fibrillation. For each induction of ventricular fibrillation, the first shock success rate was 99.5%+/-4.3% for shocks using the defibrillation energy requirement plus 10 J, compared to 95.0%+/-17.2% for shocks at twice the defibrillation energy requirement (P = 0.02). The charge time (P < 0.0001) and the total duration of ventricular fibrillation (P < 0.0001) were each approximately 1 second longer with the defibrillation energy requirement plus 10 J technique. CONCLUSION This study is the first to compare prospectively the defibrillation efficacy of two defibrillation safety margins. In patients with a defibrillation energy requirement < or = 6 J, a higher rate of successful defibrillation is achieved with a safety margin of 10 J than with a safety margin equal to the defibrillation energy requirement.
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Affiliation(s)
- S A Strickberger
- University of Michigan Medical Center, Ann Arbor 48109-0022, USA
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Weiss R, Knight BP, Bahu M, Zivin A, Souza J, Goyal R, Daoud E, Man KC, Strickberger SA, Morady F. Long-term follow-up after radiofrequency ablation of paroxysmal supraventricular tachycardia in patients with tachycardia-induced atrial fibrillation. Am J Cardiol 1997; 80:1609-10. [PMID: 9416948 DOI: 10.1016/s0002-9149(97)00753-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Four of 12 patients (33%) with paroxysmal supraventricular tachycardia (PSVT) and tachycardia-induced atrial fibrillation (AF) had recurrences of paroxysmal AF after successful catheter ablation of the PSVT. This study demonstrates that AF often remains a problem after radiofrequency catheter ablation of PSVT in patients with tachycardia-induced AF, and it may not be possible to predict in which patients this will be the case.
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Affiliation(s)
- R Weiss
- Department of Internal Medicine, The University of Michigan Medical Center, Ann Arbor 48109-0022, USA
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Zivin A, Knight BP, Souza J, Bahu M, Weiss R, Goyal R, Daoud EG, Man KC, Strickberger SA, Morady F. Predictors of crossover to a left ventricular approach for atrioventricular junction ablation. Am J Cardiol 1997; 80:1611-2. [PMID: 9416949 DOI: 10.1016/s0002-9149(97)00754-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In a retrospective analysis of patients referred for atrioventricular node radiofrequency ablation, male gender and a history of hypertension were found to be predictors of crossover to a left ventricular approach for success. This subgroup of patients may benefit from early crossover if initial attempts at right-sided ablation fail.
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Affiliation(s)
- A Zivin
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0022, USA
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Knight BP, Weiss R, Bahu M, Souza J, Zivin A, Goyal R, Daoud E, Man KC, Strickberger SA, Morady F. Cost comparison of radiofrequency modification and ablation of the atrioventricular junction in patients with chronic atrial fibrillation. Circulation 1997; 96:1532-6. [PMID: 9315543 DOI: 10.1161/01.cir.96.5.1532] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Because it is not clear which technique is less expensive, the purpose of this study was to compare the cost of radiofrequency modification and ablation of the atrioventricular (AV) node in drug-refractory patients with atrial fibrillation and an uncontrolled ventricular rate. METHODS AND RESULTS The initial nominal charges for a successful procedure were compared in 10 patients with chronic atrial fibrillation who underwent modification of the AV node ($13 109+/-2002) and 14 similar patients who underwent ablation and pacemaker implantation ($28 302+/-2023, P<.001). On the basis of the long-term follow-up of patients who underwent each procedure, it was assumed that 31% of patients selected for the modification procedure would require a permanent pacemaker for inadvertent AV block or because of AV nodal ablation after a failed modification procedure and that the recurrence rate after AV node ablation would be 2%. The annual charges during follow-up were predicted and adjusted for recurrences and the need for additional procedures. The adjusted total charges at 1 year of follow-up were significantly lower for the modification procedure ($19 389+/-2002) than for the ablation procedure ($28 485+/-2023, P<.001). After 10 years of follow-up, the cumulative, adjusted charges for modification were $20 016 (42%) less than for ablation. CONCLUSIONS The initial charges generated by AV node modification are significantly lower than for AV node ablation in patients with chronic atrial fibrillation. Even when adjusted for higher failure and recurrence rates, the modification procedure retains a major cost advantage over ablation during long-term follow-up.
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Affiliation(s)
- B P Knight
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-4025, USA
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Abstract
Alcohol abuse is one of most serious problems in public health and the Wernicke-Korsakoff syndrome one of the gravest consequences of alcoholism. The pathology is often undiagnosed in its less evident presentations, therefore an accurate diagnostic approach is a critical step in planning treatment. Besides new pharmacological proposals, treatment is based on the restoration of thiamine, although this is insufficient to prevent the psychological decline of a great number of patients. The cognitive impact of the pathology is derived from the interaction of alcoholic neurotoxicity, thiamine deficiency and personal susceptibility. In this article the history, epidemiology, clinical and neuropathological features of the Wernicke-Korsakoff syndrome, as well as some aspects of its treatment and prognosis, are described.
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Affiliation(s)
- C Zubaran
- Departamento de Bioquímica da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Goyal R, Zivin A, Souza J, Shaikh SA, Harvey M, Bogun F, Daoud E, Man KC, Strickberger SA, Morady F. Comparison of the ages of tachycardia onset in patients with atrioventricular nodal reentrant tachycardia and accessory pathway-mediated tachycardia. Am Heart J 1996; 132:765-7. [PMID: 8831363 DOI: 10.1016/s0002-8703(96)90308-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Atrioventricular nodal reentrant tachycardia and accessory pathway-mediated tachycardia may have different ages of tachycardia onset. Symptom onset data were obtained in 519 patients (atrioventricular nodal reentrant tachycardia, 231, accessory pathway-mediated tachycardia, 288). The mean age of the patients at the time of evaluation was 47 +/- 17 years (atrioventricular nodal reentrant tachycardia) and 37 +/- 15 years (accessory pathway-mediated tachycardia). The mean age of symptom onset was 32 +/- 18 years for atrioventricular nodal reentrant tachycardia and 23 +/- 14 years for accessory pathway-mediated tachycardia. A significantly greater proportion of patients with atrioventricular nodal reentrant tachycardia had the initial onset of symptoms after the age of 20 years (atrioventricular nodal reentrant tachycardia, 67% vs accessory pathway-mediated tachycardia, 41%, p < 0.001). In summary, there is a different mean age of symptom onset for patients with atrioventricular nodal reentrant tachycardia and accessory pathway-mediated tachycardia.
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Affiliation(s)
- R Goyal
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, USA
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45
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Abstract
The economics and complexity of health care will continue to require better and faster methods of information access. As a multipurpose resource, physician networks can offer a host of benefits to institutions, caregivers, and patients. Early entrants into this technological arena can expect some degree of competitive advantage by attracting physicians who want sophisticated support systems and by expediting referrals for specialized care. Whether or not this proves to be of long-term merit, the need for administrative and patient care information systems will likely increase in the future. In this respect, innovation is purely a point in time.
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Chapman PD, Wetherbee JN, Vetter JW, Troup P, Souza J. Strength-duration curves of fixed pulse width variable tilt truncated exponential waveforms for nonthoracotomy internal defibrillation in dogs. Pacing Clin Electrophysiol 1988; 11:1045-50. [PMID: 2457883 DOI: 10.1111/j.1540-8159.1988.tb03950.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Six anesthetized dogs (wgt 19.6 + 1.1 kg) underwent defibrillation trials using truncated monophasic pulses of 2.5-20 msec in duration. The current pathway consisted of a 4 cm2 RV catheter electrode (cathode) and a 13.9 cm2 subcutaneous chest wall patch (anode). Fibrillation was induced by alternating current and defibrillation attempted 10 seconds later. Only one test shock was assessed for each fibrillation episode. The various durations were tested randomly, and the minimum peak voltage and energy resulting in defibrillation was determined for each. Shorter pulse durations were associated with lower energies with pulses of 2.5-15 msec having significantly lower energy thresholds than shocks of 20 msec (P less than 0.05). The relationship between duration and voltage threshold is hyperbolic with minimum voltage between 7.5 and 12.5 msec while the shortest and longest pulses were associated with the highest voltage thresholds. Shocks of 5 to 15 msec were associated with significantly lower voltage threshold than 2.5 msec pulses (P less than 0.05). The threshold average current (Iav) reached a nadir at 10 msec. Shocks in the midrange of those tested resulted in the best combination of low average current and energy requirements for defibrillation using this nonthoracotomy lead system.
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Affiliation(s)
- P D Chapman
- Medical College of Wisconsin, Division of Cardiology, Milwaukee 53226
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