In this study, we intend to test if presenteeism productivity influences the relationship between depressive symptoms and quality of life and also if this relation is conditional upon levels of ...information processing speed. Data were collected from 231 participants who completed a neuropsychological test and self-reported measures. Results revealed a significant indirect effect and a significant moderation effect. The association between depressive symptoms and presenteeism productivity was moderated by information processing speed only in their medium and high levels. Our findings suggest that individuals with higher levels of processing speed may have more difficulty in focusing on work without being distracted by health problems. The present investigation has made a significant contribution to the existing literature about cognitive function and productivity in workers with depressive symptomatology and its effects on their quality of life.
The public health system of Brazil is structured by a network of increasing complexity, but the low resolution of emergency care at pre-hospital units and the lack of organization of patient flow ...overloaded the hospitals, mainly the ones of higher complexity. The knowledge of this phenomenon induced Ribeirão Preto to implement the Medical Regulation Office and the Mobile Emergency Attendance System. The objective of this study was to analyze the impact of these services on the gravity profile of non-traumatic afflictions in a University Hospital.
The study conducted a retrospective analysis of the medical records of 906 patients older than 13 years of age who entered the Emergency Care Unit of the Hospital of the University of São Paulo School of Medicine at Ribeirão Preto. All presented acute non-traumatic afflictions and were admitted to the Internal Medicine, Surgery or Neurology Departments during two study periods: May 1996 (prior to) and May 2001 (after the implementation of the Medical Regulation Office and Mobile Emergency Attendance System). Demographics and mortality risk levels calculated by Acute Physiology and Chronic Health Evaluation II (APACHE II) were determined.
From 1996 to 2001, the mean age increased from 49 +/- 0.9 to 52 +/- 0.9 (P = 0.021), as did the percentage of co-morbidities, from 66.6 to 77.0 (P = 0.0001), the number of in-hospital complications from 260 to 284 (P = 0.0001), the mean calculated APACHE II mortality risk increased from 12.0 +/- 0.5 to 14.8 +/- 0.6 (P = 0.0008) and mortality rate from 6.1 to 12.2 (P = 0.002). The differences were more significant for patients admitted to the Internal Medicine Department.
The implementation of the Medical Regulation and Mobile Emergency Attendance System contributed to directing patients with higher gravity scores to the Emergency Care Unit, demonstrating the potential of these services for hierarchical structuring of pre-hospital networks and referrals.
Introduction: Cardiopulmonary exercise testing (CPET) is increasingly used to evaluate the overall impact of the illness on patients with chronic obstructive pulmonary disease (COPD). While ...laboratory tests of exercise performance are costly, the 6‐min walk test (6‐MWT) can be more easily performed. Although the main outcome commonly used in this field test is the distance walked in 6 min (6‐MWD), this measure does not account for differences in body weight. Previous studies showed a good correlation between the work performed during the 6‐MWT with incremental cycling CPET, an exercise modality more associated with quadriceps fatigability and with lower peak oxygen consumption than incremental walking tests.
Objective: Evaluate the correlation between the 6‐MWD and its derivative body weight–walking distance product, an estimation of the work performed during the 6‐MWT, with peak from a treadmill CPET.
Methods: Thirty COPD patients forced expiratory volume in 1 s (FEV1) = 39 ± 13%; peak predicted performed CPET to the limit of tolerance on a treadmill and 6‐MWT, 48 h apart.6‐MWD and work were correlated to resting and exercise functional variables.
Results: The work of walking during the 6‐MWT provided greater associations with peak than observed with 6‐MWD. This was the case for FEV1, forced vital capacity, inspiratory capacity, lung diffusion capacity for carbon monoxide, peak , carbon dioxide output, minute ventilation and double product (r = 0.57, r = 0.57, r = 0.73, r = 0.7, r = 0.75, r = 0.65, r = 0.51 and r = 0.4, respectively; all P < 0.05).
Conclusion: A better association was found between the work estimated from the 6‐MWT and peak achieved during CPET, in this case with a treadmill, than the 6‐MWD alone.
Please cite this paper as: Poersch K, Berton DC, Canterle DB, Castilho J, Lopes AL, Martins J, Oliveira AR and Teixeira PJZ. Six‐minute walk distance and work relationship with incremental treadmill cardiopulmonary exercise test in COPD. Clin Respir J 2013; 7: 145–152.
Vascular endothelial growth factor (VEGF) is an essential angiogenic signaling element that acts through its two tyrosine kinase receptors, inducing both proliferation of endothelial cells and ...vascular permeability. Given the importance of vasculogenesis and angiogenesis to early pregnancy, it is of interest to understand the mechanisms regulating vascular development at this stage. We previously demonstrated that VEGF and receptors are up-regulated during embryo implantation in an unique animal model, the mink, a species displaying obligate embryonic diapause. Herein we examined the role of prostaglandin E2 (PGE2) as a regulator of VEGF during early pregnancy and established the mechanisms of this regulation. We demonstrate that activated embryos secrete PGE2 and that expression of PGE synthase protein in the uterus is dependent upon direct contact with invading trophoblast cells during implantation. Using mink uterine stromal cells transfected with mink VEGF promoter driving the luciferase reporter gene, we show that PGE2 induces promoter transactivation and that this response can be eliminated by blockade of protein kinase A. Treatment with antagonists to PGE2 receptors EP2 and EP4 eliminated the PGE2-induced response in transfected cells. Deletional studies of the promoter revealed that a region of 99 bp upstream of the transcription start site is required for PGE2-induced transactivation. Mutation of an AP2/Sp1 cluster, found within the 99 bp, completely eliminated the PGE2 response. Furthermore, chromatin immunoprecipitation assays confirmed binding of the AP2 and Sp1 transcription factors to the endogenous mink VEGF promoter in uterine cells. PGE2 stimulated acetylation of histone H3 associated with the promoter region containing the AP2/Sp1 cluster. Taken together, these results demonstrate that PGE2 plays an important role in regulating uterine and thus placental vascular development, acting through its receptors EP2 and EP4, provoking protein kinase A activation of AP2 and Sp1 as well as acetylation of histone H3 to transactivate the VEGF promoter.
Sporotrichosis is a subacute or chronic fungal infection caused by Sporothrix schenckii, which is commonly acquired by traumatic inoculation of the fungus carried in a contaminated material into the ...skin. Joint involvement is the most frequent extracutaneous manifestation in immunosuppressed patients. We report the case of an immunocompetent woman who acquired sporotrichosis through the scratch of a sick cat. She presented skin lesions and arthritis possibly because of a hypersensitivity reaction. Treatment resulted in complete cure up to 13 months of clinical and serological follow-up.
NaRu(SO3)(TCNQ)(bpy)2 and Ru(SO3)(bpy)2(TCNE) complexes were synthesized and characterized. Metallocyclopropane is configuration for TCNE and TCNQ is coordinated by nitrile. Impedance spectroscopy ...indicated a temperature-dependent relaxation process.
NaRu(SO3)(TCNQ)(bpy)2 and Ru(SO3)(bpy)2(TCNE) complexes were synthesized and characterized by means of electrochemical techniques and electronic, vibrational and electron paramagnetic resonance (EPR) spectroscopies. Vibrational data indicated a metallocyclopropane configuration for TCNE while TCNQ ligand is coordinated through the nitrile fragment. EPR data indicated the reduced state for the metal centers and for the TCNQ ligand (TCNQ−). The values of the potentials assigned to the redox processes associated to the TCNX ligands indicated a decrease in the electron transfer barrier. Data of dielectric measurements hinted that TCNQ containing complex is more polarized than the TCNE containing compound. Impedance spectroscopy measurements indicated a temperature-dependent relaxation process for both the complexes. However, for TCNQ containing complex, the results suggested the transition from long-range to short-range mobility. In addition, two values of activation energy (2.0 and 0.6eV) were calculated for this complex suggesting a phase transition process.
At a fixed magnetic filling fraction, fractional quantum Hall states may display a plethora of interaction-induced competing phases. Effective Chern-Simons theories have suggested the existence of ...multiple interaction-induced short-range entangled phases also at integer quantum Hall plateaus. Among these, a bosonic phase has been proposed with edge modes carrying representations based on the E8 exceptional Lie algebra. Through a theoretical coupled-wire construction, we provide an explicit microscopic model for this E8 Abelian quantum Hall state, at filling ν=16, and discuss how it is intimately related to topological paramagnets in 3+1 dimensions. Still using coupled wires, we partition the E8 state into a pair of non-Abelian, long-range entangled states. These two states occur at filling ν=8, demonstrating that even topological order may also exist at integer Hall plateaus. These phases are bosonic, carry chiral edge theories with either G2 or F4 internal symmetries, and host Fibonacci anyonic excitations in the bulk. This suggests that the ν=8 quantum Hall plateau may provide an unexpected platform to realize decoherence-free quantum computation by anyon braiding. We also find that these topological ordered phases are related by a notion of particle-hole conjugation based on the E8 state that exchanges the G2 and F4 Fibonacci states. We argue that these phases can be tracked down by their electric and thermal Hall transport satisfying a distinctive Wiedemann-Franz law κxy/σxy/π2kB2T/3e2<1, even at integer magnetic filling factors.
Myelodysplastic syndromes (MDS) and juvenile myelomonocytic leukemia (JMML) are rare hematopoietic stem cell diseases affecting children. Cytogenetics plays an important role in the diagnosis of ...these diseases. We report here the experience of the Cytogenetic Subcommittee of the Brazilian Cooperative Group on Pediatric Myelodysplastic Syndromes (BCG-MDS-PED). We analyzed 168 cytogenetic studies performed in 23 different cytogenetic centers; 84 of these studies were performed in patients with confirmed MDS (primary MDS, secondary MDS, JMML, and acute myeloid leukemia/MDS+Down syndrome). Clonal abnormalities were found in 36.9% of the MDS cases and cytogenetic studies were important for the detection of constitutional diseases and for differential diagnosis with other myeloid neoplasms. These data show the importance of the Cooperative Group for continuing education in order to avoid a late or wrong diagnosis.
The aim of this study was to investigate the effects of two consecutive extreme conditioning program training sessions (24 h apart) designed to enhance work-capacity that involved both cardiovascular ...and muscular exercises on cytokines, muscle power, blood lactate and glucose. Nine male members of the extreme conditioning community (age 26.7 ± 6.6 years; body mass 78.8 ± 13.2 kg; body fat 13.5 ± 6.2%; training experience 2.5 ± 1.2 years) completed two experimental protocols (24 h apart): (1) strength and power exercises, (2) gymnastic movements, and (3) metabolic conditioning as follows: 10 min of as many rounds as possible (AMRAP) of 30 double-unders and 15 power snatches (34 kg). The same sequence as repeated on session 2 with the following metabolic conditioning: 12 min AMRAP of: row 250 m and 25 target burpees. Serum interleukin-6 (IL-6), IL-10, and osteoprotegerin were measured before, immediately post and 24 h after workout of the day (WOD) 1, immediately post, 24 and 48 h after WOD 2. Peak and mean power were obtained for each repetition (back squat with 50% of 1 repetition maximum) using a linear position transducer measured before, immediately post and 24 h after WOD 1, immediately post and 24 h after WOD 2. Blood lactate and glucose were measured pre and immediately post WOD 1 and 2. Although both sessions of exercise elicited an significant increase in blood lactate (1.20 ± 0.41 to 11.84 ± 1.34 vs. 0.94 ± 0.34 to 9.05 ± 2.56 mmol/l) and glucose concentration (81.59 ± 10.27 to 114.99 ± 12.52 vs. 69.47 ± 6.97 to 89.95 ± 19.26 mg/dL), WOD 1 induced a significantly greater increase than WOD 2 (
p
≤ 0.05). The training sessions elicited significant changes (
p
≤ 0.05) in IL-6, IL-10 and osteoprotegerin concentration over time. IL-6 displayed an increase immediately after training WOD 1 197 ± 109% (
p
= 0.009) and 2 99 ± 58% (
p
= 0.045). IL-10 displayed an increase immediately after only WOD 1 44 ± 52% (
p
= 0.046), and decreased 24 and 48 h following WOD 2 (~40%;
p
= 0.018) as compared to pre-exercise values. Osteoprotegerin displayed a decrease 48 h following WOD 2 (~25%;
p
= 0.018) as compared with pre intervention. In conclusion, two consecutive extreme conditioning training sessions increase pro/anti-inflammatory cytokines with no interference on muscle performance in the recovery period.
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