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Background: This study investigated the prognostic importance of the hemoglobin glycation index (HGI) for macrovascular and microvascular outcomes, mortality, and hypoglycemia occurrence in a type 2 diabetes cohort and compared it to glycated hemoglobin (HbA1c). Methods: Baseline and mean first-year HGI and HbA1c, and the variability thereof, were assessed in 687 individuals with type 2 diabetes (median follow-up, 10.6 years). Multivariable Cox regression was conducted to evaluate the associations of HGI and HbA1c parameters with macrovascular (total and major cardiovascular events) and microvascular outcomes (microalbuminuria, advanced renal failure, retinopathy, and peripheral neuropathy), mortality (all-cause and cardiovascular), and moderate/severe hypoglycemia occurrence. Results: During follow-up, there were 215 total cardiovascular events (176 major) and 269 all-cause deaths (131 cardiovascular). Microalbuminuria developed in 126 patients, renal failure in 104, retinopathy in 161, and neuropathy in 177. There were 90 hypoglycemia episodes. Both HGI and HbA1c predicted all adverse outcomes, except microalbuminuria and hypoglycemia. Their adjusted risks were roughly equivalent for all outcomes. For example, the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), estimated for 1 standard deviation increments, of mean first-year HGI were 1.23 (1.05 to 1.44), 1.20 (1.03 to 1.38), 1.36 (1.11 to 1.67), 1.28 (1.09 to 1.67), and 1.29 (1.09 to 1.54), respectively, for cardiovascular events, all-cause mortality, renal failure, retinopathy, and neuropathy; whereas the respective HRs (95% CIs) of mean HbA1c were 1.31 (1.12 to 1.53), 1.28 (1.11 to 1.48), 1.36 (1.11 to 1.67), 1.33 (1.14 to 1.55), and 1.29 (1.09 to 1.53). Conclusion: HGI was no better than HbA1c as a predictor of adverse outcomes in individuals with type 2 diabetes, and its clinical use cannot be currently advised. [ABSTRACT FROM AUTHOR]

Background: This study investigated the effects of weight loss during follow-up on cardiovascular outcomes in a type 2 diabetes cohort and tested interactions with clinical and laboratory variables, particularly physical activity, that could impact the associations. Methods: Relative weight changes were assessed in 651 individuals with type 2 diabetes and categorized as =5% loss, <5% loss, or gain. Associations between weight loss categories and incident cardiovascular outcomes (total cardiovascular events [CVEs], major adverse cardiovascular events [MACEs], and cardiovascular mortality) were assessed using multivariable Cox regression with interaction analyses. Results: During the initial 2 years, 125 individuals (19.2%) lost =5% of their weight, 180 (27.6%) lost <5%, and 346 (53.1%) gained weight. Over a median additional follow-up of 9.3 years, 188 patients had CVEs (150 MACEs) and 106 patients died from cardiovascular causes. Patients with =5% weight loss had a significantly lower risk of total CVEs (hazard ratio [HR], 0.52; 95% confidence interval, 0.33 to 0.89; P=0.011) than those who gained weight, but non-significant lower risks of MACEs or cardiovascular deaths. Patients with <5% weight loss had risks similar to those with weight gain. There were interactions between weight loss and physical activity. In active individuals, =5% weight loss was associated with significantly lower risks for total CVEs (HR, 0.20; P=0.004) and MACEs (HR, 0.21; P=0.010), whereas in sedentary individuals, no cardiovascular protective effect of weight loss was evidenced. Conclusion: Weight loss =5% may be beneficial for cardiovascular disease prevention, particularly when achieved with regular physical activity, even in high-risk individuals with long-standing type 2 diabetes. [ABSTRACT FROM AUTHOR]

• Allophylus edulis is a native plant of the Brazilian cerrado. • The essential oil was obtained from two locations in the state of Mato Grosso do Sul. • The dominant components of essential oils were caryophyllene oxide and α-zingiberene. • Seasonal and spatial variation can influence the chemical composition of A. edulis essential oil. Allophylus edulis (Sapindaceae), also known as "chal-chal", "vacuum" or "cocu", is a tree widely found in Brazil whose leaves are still used in folk medicine and are rich in essential oil. The focus of this research was to investigate the chemical composition profiles of the essential oil from A. edulis leaves collected seasonally (the four seasons) in two cities. The A. edulis leaves were collected in winter (July) and spring (November) 2018 and summer (January) and autumn (May) 2019, in the cities of Bonito and Dourados, in the state of Mato Grosso do Sul, Brazil. The essential oils were extracted by hydrodistillation and analyzed by gas chromatography-mass spectrometry (GC–MS). The essential oil yield in this seasonal variation study consistently ranged between 0.07% and 0.6% (wet wt.) for all samples, increasing considerably with higher temperature and during the inflorescence stage. In the oil samples obtained from Dourados, the major components present were α-pinene, caryophyllene oxide, and viridiflorol with yields of 3.04–29.81% across all four seasons, being caryophyllene oxide the most abundant (20.1–29.81%). The major compound identified in the oil samples obtained from Bonito was α-zingiberene for all four seasons, though its concentrations were highest in summer (46.90%) and spring (45.05%). The chemical composition profiles of both cities' oil samples were similar, in that they shared four sesquiterpene compounds, caryophyllene oxide, germacrene D, E-caryophyllene and viridiflorol. The study highlighted that both seasonal and geographical variation can influence the chemical composition of essential oil from A. edulis. [ABSTRACT FROM AUTHOR]

Background: The prognostic importance of changes in aortic stiffness for the occurrence of adverse cardiovascular outcomes and mortality has never been investigated in patients with type 2 diabetes. We aimed to evaluate it in a cohort of 417 patients. Methods: Changes in aortic stiffness were assessed by 2 carotid-femoral pulse wave velocity (CF-PWV) measurements performed over a 4-year period. Multivariable Cox analysis examined the associations between changes in CF-PWV, evaluated as a continuous variable with splines and as categorical ones (quartiles and stable/reduction/increase subgroups), and the occurrence of total cardiovascular events (CVEs), major adverse CVEs (MACEs), and all-cause and cardiovascular mortality. Results: Over a median follow-up of 8.2 years after the 2nd CF-PWV measurement, there were 101 total CVEs (85 MACEs) and 135 all-cause deaths (64 cardiovascular). As a continuous variable, the lowest risk nadir was at -2.5%/year of CF-PWV change, with significantly higher risks of mortality associated with CF-PWV increases, but no excess risks at extremes of CF-PWV reduction. Otherwise, in categorical analyses, patients in the 1st quartile (greatest CF-PWV reductions) had excess risks of all-cause and cardiovascular mortality (hazard ratios [HRs]: 2.0–2.7), whereas patients in 3rd quartile had higher risks of all outcomes (HRs: 2.0–3.2), in relation to the lowest risk 2nd quartile subgroup. Patients in the 4th quartile had higher risks of all-cause mortality. Categorization as stable/reduction/increase subgroups was confirmatory, with higher risks at greater reductions (HRs: 1.7–3.3) and at greater increases in CF-PWV (HRs: 1.9–3.4), in relation to those with stable CF-PWV. Conclusions: Changes in aortic stiffness, mainly increases and possibly also extreme reductions, are predictors of adverse cardiovascular outcomes and mortality in individuals with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Casearia sylvestris var. lingua (Cambess.) Eichler is widely used in traditional medicine to treat diseases. Simultaneously, the growing search for phytocosmetics has culminated in the exploration of plant extracts. In this context, this study aimed to obtain the chemical composition and antioxidant and photoprotective potential of the infusion of C. sylvestris var. lingua leaves. The techniques of UV/Vis spectroscopy, gas chromatography with mass spectrometry detector (GC-MS) and liquid chromatography with diode array detector (LC-DAD) were used to get the results. The total phenolic content in the infusion of leaves from C. sylvestris var. lingua was 101.57 mg GAE g-1, flavonoids 50.37 mg RE g-1 and tannins 1.12 mg TAE g-1. Quercetin, ferulic acid, gallic acid, ellagic acid, caffeic acid, β-sitosterol, lupeol, lupeol acetate, stigmasterol and campesterol were identified and quantified in the samples. The infusion of C. sylvestris var. lingua leaves has potential for application in phytocosmetics and sunscreens, with a sun protection factor of 8.65 ± 0.45, a UVA/UVB ratio of 1.16 and a critical wavelength of 373. [ABSTRACT FROM AUTHOR]

Background: Liver stiffness measurement (LSM, which reflects fibrosis) and controlled attenuation parameter (CAP, which reflects steatosis), two parameters derived from hepatic transient elastography (TE), have scarcely been evaluated as predictors of cardiovascular complications and mortality in individuals with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD). Methods: Four hundred type 2 diabetic patients with NAFLD had TE examination (by Fibroscan®) performed at baseline. Multivariate Cox analyses evaluated the associations between TE parameters and the occurrence of cardiovascular events (CVEs) and mortality. TE parameters were assessed as continuous variables and dichotomized at low/high values reflecting advanced liver fibrosis (LSM > 9.6 kPa) and severe steatosis (CAP > 296 or > 330 dB/m). Improvements in risk discrimination were assessed by C-statistic and by the relative Integrated Discrimination Improvement (IDI) index. Results: During a median follow-up of 5.5 years, 85 patients died (40 from cardiovascular causes), and 69 had a CVE. As continuous variables, an increasing LSM was a risk marker for total CVEs (hazard ratio [HR]: 1.05; 95% CI: 1.01–1.08) and all-cause mortality (HR: 1.04; 95% CI: 1.01–1.07); whereas an increasing CAP was a protective factor for both outcomes (HR: 0.93; 95% CI: 0.89–0.98; and HR: 0.92; 95% CI: 0.88–0.97; respectively). As dichotomized variables, a high LSM remained a risk marker of adverse outcomes (with HRs ranging from 2.5 to 3.0) and a high CAP was protective (with HRs from 0.3 to 0.5). The subgroup of individuals with low-LSM/high-CAP had the lowest risks while the opposite subgroup with high-LSM/low-CAP had the highest risks. Both LSM and CAP improved risk discrimination, with increases in C-statistics up to 0.037 and IDIs up to 52%. Conclusions: Measured by hepatic TE, advanced liver fibrosis is a risk marker and severe steatosis is a protective factor for cardiovascular complications and mortality in individuals with type 2 diabetes and NAFLD. [ABSTRACT FROM AUTHOR]

Background: The prognostic importance of several hematological parameters has been scarcely investigated in type 2 diabetes. So, we aimed to evaluate their prognostic importance for development of complications in a cohort of type 2 diabetes. Methods: In a prospective study, 689 individuals with type 2 diabetes had blood red cell, platelet and leukocyte parameters obtained at baseline. Multivariate Cox analyses examined the associations between several hematological parameters (including neutrophyl-to-lymphocyte, lymphocyte-to-monocyte, platelet-to-lymphocyte, and monocyte-to-HDL ratios) and the occurrence of microvascular (retina, renal and peripheral neuropathy) and cardiovascular complications (total cardiovascular events [CVEs], and major adverse CVEs [MACEs]), and all-cause and cardiovascular mortality. Improvements in risk discrimination were assessed by C-statistics and Integrated Discrimination Improvement (IDI) index. Results: During a median follow-up of 10.5 years, 212 patients had a CVE (174 MACEs), 264 patients died (131 cardiovascular deaths); 206 had a renal, 161 a retinopathy and 179 patients had a neuropathy outcome. In multivariate-adjusted analyses, the lymphocytes count and lymphocyte-to-monocyte ratio were protective (hazard ratios [HRs]: 0.77 and 0.72, respectively), whereas the neutrophyl-to-lymphocyte and platelet-to-lymphocyte ratios were associated with increased risks (HRs: 1.19 and 1.17) for all-cause mortality. For cardiovascular mortality, the monocytes count, the neutrophyl-to-lymphocyte and monocyte-to-HDL ratios were associated with increased risks and the lymphocyte-to-monocyte ratio was protective. Higher lymphocyte-to-monocyte ratio was protective for renal failure outcome. However, none of them improved risk discrimination. Conclusions: Low lymphocytes count and leukocyte ratios that mainly included lymphocytes were predictors of macrovascular complications and mortality in individuals with type 2 diabetes. However, they did not improve risk prediction over traditional risk factors. [ABSTRACT FROM AUTHOR]

We report on the electronic properties of an artificial system obtained by the intercalation of equiatomic FeCo layers under graphene grown on Ir(111). Upon intercalation, the FeCo film grows epitaxially on Ir(111), resulting in a lattice-mismatched system. By performing density functional theory calculations, we show that the intercalated FeCo layer leads to a pronounced corrugation of the graphene film. At the same time, the FeCo intercalated layers induce a clear transition from a nearly undisturbed to a strongly hybridized graphene π-band, as measured by angle-resolved photoemission spectroscopy. A comparison of experimental results with the computed band structure and the projected density of states unveils a spin-selective hybridization between the π band of graphene and FeCo-3d states. Our results demonstrate that the reduced dimensionality, as well as the hybridization within the FeCo layers, induces a narrowing and a clear splitting of Fe 3d-up and Fe 3d-down-spin bands of the confined FeCo layers with respect to bulk Fe and Co. [ABSTRACT FROM AUTHOR]

Background: The prognostic importance of non-traditional risk factors for peripheral artery disease (PAD) development/progression is scarcely studied in diabetes. We investigated if carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) added prognostic information beyond traditional cardiovascular risk markers for PAD outcomes. Methods: Ankle-brachial index (ABI) was measured at baseline and after a median of 91 months of follow-up in 681 individuals with type 2 diabetes. Multivariate Cox regressions examined the associations between the candidate variables and the outcome. PAD development/progression was defined by a reduction in ABI ≥ 0.15 (to a level < 0.9) or limb revascularization procedures, lower-extremity amputations or death due to PAD. The improvement in risk discrimination was assessed by increases in C-statistics of the models. Results: Seventy-seven patients developed/progressed PAD: 50 reduced ABI to < 0.9, seven had lower-limb revascularizations, and 20 had amputations or death. Age, male sex, diabetes duration, presence of microvascular complications (peripheral neuropathy and diabetic kidney disease), baseline HbA1c, 24-h systolic BP (SBP) and mean cumulative office SBP and LDL-cholesterol were associated with PAD development/progression in several models. CIMT and cf-PWV were additionally associated with PAD outcomes, and their inclusion further improved risk discrimination (with C-statistic increases between 0.025 and 0.030). The inclusion of ambulatory 24-h SBP, instead of office SBP, also improved PAD risk discrimination. Conclusions: Increased CIMT and aortic stiffness are associated with greater risks of developing/progressing PAD, beyond traditional risk factors, in type 2 diabetes. [ABSTRACT FROM AUTHOR]

Resistant hypertension (RHT) is associated with obstructive sleep apnea (OSA) and increased aortic stiffness, measured by carotid‐femoral pulse wave velocity (cf‐PWV). We aimed to evaluate in a randomized controlled trial, the effect of Continuous positive airway pressure (CPAP) treatment on cf‐PWV in comparison with a control group in patients with RHT and moderate‐severe OSA. One‐hundred and sixteen patients were randomized to 6‐month CPAP treatment (56 patients) or no therapy (60 patients), while keeping their antihypertensive treatment unchanged. Carotid‐femoral pulse wave velocity was performed at the beginning and end of the 6‐month period. Intention‐to‐treat intergroup differences in cf‐PWV changes were assessed by a generalized mixed‐effects model with the allocation group as a fixed factor and adjusted for age, sex, changes in mean arterial pressure and the baseline cf‐PWV values. Subgroup sensitivity analyses were performed, excluding patients with low CPAP adherence and low cf‐PWV at baseline. CPAP and control groups had similar clinic‐laboratorial characteristics. Patients had a mean cf‐PWV of 9.4 ± 1.6 m/s and 33% presented cf‐PWV > 10 m/s. During treatment, the control group had a mean increase in cf‐PWV of +0.43 m/s (95% confidence interval [CI], +0.14 to +0.73 m/s; p =.005), whereas the CPAP group had a mean increase of +0.03 m/s (95% CI, −0.33 to +0.39 m/s; p =.87), resulting in a mean difference in changes between CPAP and control of −0.40 m/s (95% CI, −0.82 to +0.02 m/s; p =.059). Subgroup analyses did not change the results. In conclusion, a 6‐month CPAP treatment did not reduce aortic stiffness, measured by cf‐PWV, in patients with RHT and moderate/severe OSA, but treatment may prevent its progression, in contrast to no‐CPAP therapy. [ABSTRACT FROM AUTHOR]

Background: The prognostic importance of an increased visit-to-visit blood pressure variability (BP-VVV) for the future development of micro- and macrovascular complications in type 2 diabetes has been scarcely investigated and is largely unsettled. We aimed to evaluate it in a prospective long-term follow-up study with 632 individuals with type 2 diabetes. Methods: BP-VVV parameters (systolic and diastolic standard deviations [SD] and variation coefficients) were measured during the first 24-months. Multivariate Cox analysis, adjusted for risk factors and mean BP levels, examined the associations between BP-VVV and the occurrence of microvascular (retinopathy, microalbuminuria, renal function deterioration, peripheral neuropathy) and macrovascular complications (total cardiovascular events [CVEs], major adverse CVEs [MACE] and cardiovascular and all-cause mortality). Improvement in risk discrimination was assessed by the C-statistic and integrated discrimination improvement (IDI) index. Results: Over a median follow-up of 11.3 years, 162 patients had a CVE (132 MACE), and 212 patients died (95 from cardiovascular diseases); 153 newly-developed or worsened diabetic retinopathy, 193 achieved the renal composite outcome (121 newly-developed microalbuminuria and 95 deteriorated renal function), and 171 newly-developed or worsened peripheral neuropathy. Systolic BP-VVV was an independent predictor of MACE (hazard ratio: 1.25, 95% CI 1.03–1.51 for a 1-SD increase in 24-month SD), but not of total CVEs, cardiovascular and all-cause mortality, and of any microvascular outcome. However, no BP-VVV parameter significantly improved cardiovascular risk discrimination (increase in C-statistic 0.001, relative IDI 0.9%). Conclusions: Systolic BP-VVV was an independent predictor of MACE, but it did not improve cardiovascular risk stratification. The goal of anti-hypertensive treatment in patients with type 2 diabetes shall remain in controlling mean BP levels, not on decreasing their visit-to-visit variability. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prognostic importance of resistant hypertension (RHT) for the development of complications in a cohort of individuals with type 2 diabetes.Research Design and Methods: A total of 646 patients had the diagnosis of apparent treatment-resistant hypertension (aRHT) based on mean office blood pressure (BP) levels during the 1st year of follow-up. They were reclassified as white-coat/controlled or true/uncontrolled RHT according to 24-h ambulatory BP monitoring (ABPM), using the traditional BP cutoffs and the new 2017 American College of Cardiology (ACC)/American Heart Association (AHA) criteria. Multivariate Cox analyses examined the associations between RHT diagnoses and the occurrence of microvascular and cardiovascular complications and all-cause and cardiovascular mortality.Results: During a median follow-up of 10 years, 177 patients had a cardiovascular event (145 major ones); 222 patients died (101 from cardiovascular diseases); 200 had a renal event; 156 had a retinopathy event; and 174 patients had a neuropathy event. In relation to non-RHT individuals, aRHT (present in 44.6% and 50% by the traditional and new criteria, respectively) predicted all cardiovascular and mortality outcomes, with hazard ratios (HRs) between 1.64 and 2.16, but none of the microvascular outcomes. True RHT increased the HRs (from 1.81 to 2.25) and additionally predicted renal outcomes. White-coat/controlled RHT implied an increased risk (HRs 1.33-1.86) that was intermediate between non-RHT and true RHT individuals. Classifications using the traditional and the new ACC/AHA criteria were equivalent.Conclusions: In patients with type 2 diabetes, the presence of aRHT implied an increased risk of cardiovascular and mortality outcomes, and classification based on ABPM predicted renal outcomes and improved cardiovascular/mortality risk stratification. [ABSTRACT FROM AUTHOR]

Ants use chemical cues known as cuticular hydrocarbons (CHCs) for both intraspecific and interspecific recognition. These compounds serve ants in distinguishing between nestmates and non-nestmates, enabling them to coexist in polydomous colonies characterized by socially connected yet spatially separated nests. Hence, the aim of this study was to investigate the intraspecific aggression level between nestmates and non-nestmates of the bullet ant Paraponera clavata (Fabricius, 1775), analyze and compare their CHCs, and evaluate the occurrence of polydomy in this species. We conducted aggression tests between foragers, both in laboratory and field settings. To identify the chemical profiles, we utilized gas chromatography coupled with mass spectrometry (GC-MS). We marked the foragers found at nest entrances and subsequently recaptured these marked ants to validate workers exchange among nests. Across all nests, a low intraspecific aggression level was observed within the same area. However, a significant difference in aggression correlated to distance between nests. Analysis of the cuticular chemical profile of P. clavata unveiled colony-specific CHCs, both qualitatively and quantitatively. Notably, we observed instances of ants from certain nests entering or exiting different nests. This behavior, in conjunction with the observed low intraspecific aggression despite differences in CHCs suggests polydomy for this species. Polydomy can offer several benefits, including risk spreading, efficient exploitation of resources, potential for colony size increasing and reduced costs associated with foraging and competition. [ABSTRACT FROM AUTHOR]

To investigate the effects of body weight variability (BWV) on macro- and microvascular outcomes in a type 2 diabetes cohort. BWV parameters were assessed in 684 individuals. Multivariable Cox regressions examined associations between BWV parameters and cardiovascular outcomes (total cardiovascular events [CVEs], major CVEs [MACEs], cardiovascular deaths),all-cause mortality and microvascular outcomes. Interaction/subgroup analyses were performed according to being physically-active/sedentary and having/not lost ≥ 5 % of weight. Median follow-up was 11 years over which 194 total CVEs (174 MACEs), and 223 all-cause deaths (110 cardiovascular), occurred. There were 215 renal, 152 retinopathy and 167 peripheral neuropathy development/worsening outcomes. In general, increased BWV was associated with higher risks of CVEs, MACEs, all-cause mortality, advanced renal failure and peripheral neuropathy outcomes, but not of microalbuminuria and retinopathy outcomes. On interaction/subgroup analyses, increased BWV was associated with higher risks of outcomes in sedentary individuals and in those who did not lose ≥ 5 % of body weight. In physically-active participants or in those who lost ≥ 5 % weight, the adjusted risks were null or protective. Increased BWV was associated with most adverse outcomes; however, in those who were physically-active or consistently losing weight, it was not hazardous and might be even beneficial. [ABSTRACT FROM AUTHOR]

Background/Aims: Longitudinal studies assessing the impact of genetic polymorphisms on outcomes in patients with Type 2 Diabetes Mellitus (T2DM) and Metabolic Dysfunction‐Associated Steatotic Liver Disease (MASLD) are scarce. This study aimed to evaluate the effect of PNPLA3 and TM6SF2 risk alleles on hepatic and extrahepatic outcomes in T2DM‐MASLD individuals. Methods: Patients' polymorphisms were analysed as follows: PNPLA3 CC, CG and GG; TM6SF2 CC and CT + TT; combined comparing no mutant allele, one allele G or T or ≥2 alleles G or T. Hierarchical models were built to assess associations between polymorphisms and outcomes, independently of confounding factors. Multivariate logistic regression was used for cirrhosis and its complications and extrahepatic cancer, and Cox regression for cardiovascular events (CVEs) and all‐cause mortality. Results: In total, 407 T2DM‐MASLD patients (62.1 ± 10.5 years, 67.6% women) were followed for 11 (6–13) years. Having at least one G or T allele independently increased the risk of cirrhosis in the separate analysis of PNPLA3 and TM6SF2. Combined polymorphism analysis demonstrated an even higher risk of cirrhosis if two or more risk alleles were present (OR 18.48; 95% CI 6.15–55.58; p <.001). Regarding cirrhosis complications, the risk was higher in PNPLA3 GG and TM6SF2 CT + TT, also with an even higher risk when two or more risk alleles were present in the combined evaluation (OR 27.20; 95% CI 5.26–140.62; p <.001). There were no associations with CVEs or mortality outcomes. Conclusion: In T2DM, PNPLA3 and TM6SF2 polymorphisms, individually and additively, impact MASLD severity, with an increased risk of cirrhosis and its complications. [ABSTRACT FROM AUTHOR]

We report an advanced organic spin-interface architecture with magnetic remanence at room temperature, constituted by metal phthalocyanine molecules magnetically coupled with Co layer(s), mediated by graphene. Fe- and Cu-phthalocyanines assembled on graphene/Co have identical structural configurations, but FePc couples antiferromagnetically with Co up to room temperature, while CuPc couples ferromagnetically with weaker coupling and thermal stability, as deduced by element-selective X-ray magnetic circular dichroic signals. The robust antiferromagnetic coupling is stabilized by a superexchange interaction, driven by the out-of-plane molecular orbitals responsible of the magnetic ground state and electronically decoupled from the underlying metal via the graphene layer, as confirmed by ab initio theoretical predictions. These archetypal spin interfaces can be prototypes to demonstrate how antiferromagnetic and/or ferromagnetic coupling can be optimized by selecting the molecular orbital symmetry. [ABSTRACT FROM AUTHOR]

Brazil, which has a great territorial extension, with fertile soils and availability of water and, in this way, can produce a diversity of vegetal products with bioenergetics potential. Thus, this study aims to evaluate the technological characteristics of saccharine substrates of direct fermentation for ethanol production as well as to analyze the fermentative profile of FT-858 yeast in different culture conditions. For this, a bibliographic survey was carried out comparing the technological qualities of the analyzed biomasses. To evaluate the fermentative capacity, the saccharine substrates were used at concentrations of 18 and 32°Brix at 30 °C for 24 hours in test tubes containing Durhan tubes. For the analysis of the fermentation profile the yeasts were grown in 2% YPD medium and the biomass obtained was used in the saccharine substrates of direct fermentation for 50 hours. The saccharine substrates presented potential for ethanol production: sugar cane and saccharine sorghum. The yeast FT-858 presented fermentation capacity in the different substrates in the concentrations of Brix analyzed, presenting a better fermentative performance in sugarcane broth and the highest concentrations of ethanol occurring in the times of 10 and 15 hours of fermentation for both substrates. [ABSTRACT FROM AUTHOR]

This study describes a novel electrochemical method to determine the herbicide trifluralin in samples of water, fruit juice, and vegetable extracts in the presence of surfactants, using a glassy carbon electrode (GCE). In acidic media, trifluralin was irreversible on the glassy carbon electrode surface at −0.5 V vs. Ag/AgCl. Surfactant presence on the electrode–solution interface modified current intensities and shifted the reduction peak potential of trifluralin. Different types of surfactant and their concentrations were investigated. The anionic surfactant significantly enhanced the peak current intensity of trifluralin. Under optimal analytical conditions, an analytical curve was obtained in the concentration range of 0.48–32.20 µM. The limits of detection and quantification were estimated at 0.031 and 0.104 µM, respectively. The method was successfully applied to quantify trifluralin in samples of water, orange and tomato juice, and green pepper, carrot, and onion extracts, with recovery rates of 97.9–102.1%. The results were in good agreement with those obtained using high-performance liquid chromatography, indicating that the proposed electrochemical method can be employed to quantify trifluralin in various types foods, with sensitivity, specificity, selectivity and reproducibility. [ABSTRACT FROM PUBLISHER]

Objective: To assess, in a randomized, double-blind, and placebo-controlled trial, the efficacy and safety of diacerein, an immune modulator anti-inflammatory drug, in improving glycemic control of patients with type 2 diabetes.Research Design and Methods: Eighty-four patients with HbA1c between 7.5 and 9.5% (58-80 mmol/mol) were randomized to 48-week treatment with placebo (n = 41) or diacerein 100 mg/day (n = 43). The primary outcome was the difference in mean HbA1c changes during treatment. Secondary outcomes were other efficacy and safety measurements. A general linear regression with repeated measures, adjusted for age, sex, diabetes duration, and each baseline value, was used to estimate differences in mean changes. Both intention-to-treat (ITT) analysis and per-protocol analysis (excluding 10 patients who interrupted treatment) were performed.Results: Diacerein reduced HbA1c compared with placebo by 0.35% (3.8 mmol/mol; P = 0.038) in the ITT analysis and by 0.41% (4.5 mmol/mol; P = 0.023) in the per-protocol analysis. The peak of effect occurred at the 24th week of treatment (-0.61% [6.7 mmol/mol; P = 0.014] and -0.78% [8.5 mmol/mol; P = 0.005], respectively), but it attenuated toward nonsignificant differences at the 48th week. No significant effect of diacerein was observed in other efficacy and safety measures. Diarrhea occurred in 65% of patients receiving diacerein and caused treatment interruption in 16%. Seven patients in the diacerein group reduced insulin dosage, whereas 10 in the placebo group increased it; however, mild hypoglycemic events were equally observed.Conclusions: Diacerein reduced mean HbA1c levels, with peak of effect at the 24th week of treatment. The drug was well tolerated and may be indicated as adjunct treatment in patients with type 2 diabetes, particularly in those with osteoarthritis. [ABSTRACT FROM AUTHOR]

Increased aortic stiffness has been recognized as a predictor of adverse cardiovascular outcomes in some clinical conditions, such as in patients with arterial hypertension and end-stage renal disease, in population-based samples and, more recently, in type 2 diabetic patients. Patients with type 2 diabetes have higher aortic stiffness than non-diabetic individuals, and increased aortic stiffness has been correlated to the presence of micro- and macrovascular chronic diabetic complications. We aimed to review the current knowledge on the relationships between aortic stiffness and diabetic complications, their possible underlying physiopathological mechanisms, and their potential applications to clinical type 2 diabetes management. [ABSTRACT FROM AUTHOR]

• Do tests for CAN and 24-hour HRV improve the prediction of cardiovascular outcomes? • Low HRV was a better predictor of adverse outcomes than clinical tests of CAN. • HRV parameters improved risk discrimination for cardiovascular and mortality outcomes. To investigate whether tests for cardiovascular autonomic neuropathy (CAN) and 24-hour heart rate variability (HRV) could improve the prediction for outcomes in type 2 diabetes. 541 type 2 diabetic individuals performed tests of CAN. A subsample (3 1 3) had 24-hour HRV (the standard deviation of all normal RR intervals [SDNN] and the standard deviation of the averaged normal RR intervals for all 5 min segments [SDANN]). Multivariate Cox regressions examined the associations between CAN/low HRV with cardiovascular events (CVEs) and all-cause mortality. The improvement in risk discrimination of adding CAN/HRV was tested by C-statistics and by the Integrated Discrimination Improvement (IDI) index. 25% had CAN, and 17–18% had low HRV, respectively by SDANN-SDNN. Over a median follow-up of 12 years, there were 177 CVEs and 236 all-cause deaths in the whole cohort, and 96 CVEs and 129 all-cause deaths in the subsample. CAN was associated with 40% excess risks of CVEs/all-cause mortality, low HRV was associated with 2-fold higher risks of outcomes. HRV improved risk discrimination for CVEs/mortality with increases in C-statistics up to 0.039 and IDIs up to 25%. Low HRV was a better predictor of outcomes than tests of CAN, and it improved risk discrimination. [ABSTRACT FROM AUTHOR]

Biodiesel is an alternative fuel that has been used for partial or total substitution of diesel to reduce its environmental impacts. Prior studies on this topic have focused on the quest for better synthesis process, new catalysts and low-cost non-food and raw materials to improve the economic and sustainable production as well as product quality. In this study, acidic oil from macauba, a palm tree native to South America that has no food uses, was converted into biodiesel. The esterification and transesterification reactions were performed with methanol, ethanol and isobutanol with the goal of improving the cold properties of the biodiesel. The isobutyl ester exhibited the lowest freezing point temperature but underperformed outside of international specifications for kinematic viscosity; it also exhibited a low ester content. The methyl and ethyl esters were within the specifications of the international standards for ester content, density, kinematic viscosity and sulphur content. The ethyl ester produced from macauba oil displayed better properties in cold conditions than methyl and isobutyl esters studied here, with a cold filter plugging point of 0 °C. Its onset crystallisation temperature was reduced from −5.96 to −13.41 °C when subjected to fractional crystallisation. The ethyl ester exhibited the best lubricity value among the other esters studied. [ABSTRACT FROM AUTHOR]

This paper describes a cheap and efficient simple electroanalytical method for determination of carbendazim in some citrus fruits juices: tangerine, lemon and orange. The electrode used was characterized electrochemically using cyclic voltammetry and square wave voltammetry, evaluating the response of the fungicide on the electrode surface. The electrochemical method for the determination of carbendazim was developed using the optimized conditions, obtaining a calibration curve in a linear range of 2.75 to 87.30 μg L-1 with a detection limit of 1,95 μg L-1. After constructing the analytical curve it was applied the proposed methodology in fruits obtaining recovery values between 93.3% and 99.1%. The obtained results show that citrus fruits commercialized in the local market are free of carbendazim. [ABSTRACT FROM AUTHOR]

Brazilian food industry employs several kinds of fruits in manufacturing food products, including the bocaiuva fruit ( Acrocomiaaculeata ). The two-dimensional gas chromatography with mass spectrometric detector (GC × GC/TOFMS) was employed to analyze bio-oils generated from the endorcap, bark and fiber of bocaiuva residues. The bio-oil generated from the endocarp proved to be of the highest complexity in the set with 151 tentatively identified compounds. On the other hand, the bio-oils generated from the bark and the fiber led to 111 and 78 tentatively identified compounds, respectively. Using standards, 24 compounds (59.91% of the total) were confirmed in the bio-oil of bark, while 28 compounds (42.23%) and 19 compounds (47.60%) were confirmed for fiber and endocarp bio-oils, respectively. In bio-oils of endocarp and bark the compounds were identified and classified as phenols, alcohols, carboxylic acids, esters, ethers, aldehydes, ketones, anhydrides and hydrocarbons. There was a predominance of hydrocarbons in the bio-oils of fiber, with no identification of ethers, anhydrides and aldehydes. [ABSTRACT FROM AUTHOR]

Studies related to communication on spiders show that, as in other invertebrates, the interactions between conspecifics are also made through chemical signals. Therefore, in order to assess whether the composition of cuticular compounds might be involved in interactions that occur during the days after the emergence of juveniles in Latrodectus geometricus , we conducted behavioral and cuticular chemical profiles analysis of females and juveniles of different ages. The results show that females, regardless of their reproductive state, tolerate juveniles of other females with up to 40 days post-emergence and attack juveniles of 80 days post-emergence. Cuticlar chemical analysis shows that while the profile of juveniles is similar to adult’s profile, they can remain in the web without being confused with threat or prey. Also, cuticular chemical profiles vary between different populations probably due to genetic and environmental differences or similarities between them. Finally, females in incubation period are able to detect the presence of eggs within any egg sac, but cannot distinguish egg sacs produced by conspecifics from the ones they had produced. [ABSTRACT FROM AUTHOR]

Drop-in fuels have attracted great interest for automotive and aeronautical use. In this work, bio-hydrocarbons were obtained from palm kernel oil (palmist oil) within the distillation range of diesel and jet fuel. Green fuels were produced through the hydrodeoxygenation of palmist fat and its hydrolyzed product by using Pd/C as a catalyst. The process is efficient for hydrodeoxygenation with conversions of up to 96% after 5 h of reaction, at 10 bar of H 2 pressure and 300 °C, which are mild conditions compared with the majority of the processes described in the literature. The hydroprocessing products were analyzed by infrared spectroscopy, thermal analysis and gas chromatography–mass spectrometry. The freezing temperatures of the biofuels were determined by DSC. Up to 5% deoxygenation products can be used in commercial jet fuel without compromising the cold fuel properties. [ABSTRACT FROM AUTHOR]

Macauba is a still little investigated and exploited palmaceae native to South America with a high oil yield (6200 kg/ha). Its almond oil is rich in lauric acid and presents low acidity. In this study, we carried out the transesterification of crude Macauba almond oil over homogeneous catalysts using methanol, ethanol, isopropanol and isobutanol. Its products were characterized by 1 H NMR, kinematic viscosity, density, lubricity and cold performance through DSC analysis and cold filter plugging point. A worse conversion to monoesters was obtained over the isopropyl route, while high conversions were observed with ethanol if compared with methanol. Also, winterization of the ethanolysis product was conducted and the crystallization temperatures of the synthesized biofuels and blends with fossil diesel or jet fuel were evaluated. The results indicate the feasibility of replacing conventional commercial biodiesel with those proposed in this work as they exhibit possible performance gains. However, the preliminary results indicate that only small proportions could fit the biojet fuel performance specifications at low temperatures. [ABSTRACT FROM AUTHOR]

Context:Hibiscus sabdariffaL. (Malvaceae) is a species widely used in folk medicine for the treatment of some disorders.Objective:This study evaluated the effects ofH. sabdariffa(HS) on the development of the male reproductive tract in rats followingin uteroexposure.Materials and methods: Pregnant rats received 250 or 500 mg/kg of HS extract or vehicle from gestational day 12 until day 21 of lactation.Results and discussion: Both doses of HS increased the body weight of male offspring at weaning, without compromising the puberty onset parameters. At puberty, there was a significant increase in the vas deferens absolute weight and a significant reduction in the relative weight of kidney at higher dose. These animals also presented a significant reduction in the sperm number in the caput/corpus of epididymis after exposure to both doses and a reduction in the sperm number in the cauda epididymis for the lower dose. At adulthood, the highest dose significantly reduced the sperm production in relation to controls and both doses provoked a reduction in the relative sperm number in the epididymis without affecting the sperm morphology.Conclusion: These findings demonstrated that maternal exposure toH. sabdariffacan adversely influence the male reproductive system in rats. [ABSTRACT FROM PUBLISHER]

The agricultural use of pesticides can be a source of risks for human health and for the environment. Considering that soil is one of the main final destination of pesticides after application, this study presents the validation of an analytical method for atrazine, fipronil and its metabolites (desulfinyl, sulfide and sulfone) residues quantification in soil using High Performance Liquid Chromatography (HPLC) with diode array detector (DAD). The validated method consists in shaking soil + methanol for one hour, following extract centrifugation for 30 minutes and filtration. The method showed average recoveries between 79 and 110% for both soils and all pesticides, with variation coeff icients below 13%. All analytical calibration curves showed determination coefficients (R²) higher than 0.999. The quantification limit for fipronil, desulfinyl, sulfide and sulfone was 4 µg g-1 and for atrazine 2 µg g-1. The validated method showed adequate to be used with success in soil samples. [ABSTRACT FROM AUTHOR]

We propose in this study the use of household appliances, microwave oven and household blender without adaptation, in fatty acid ethyl ester synthesis from the transesterification of waste frying oil for use in chemistry lessons at different levels of education. The advantage in using the microwave oven, in particular, is in reducing reaction time by almost 10 times compared to traditional experiments. Furthermore, the use of such appliances without adjustments, both of the oven as the blender, eliminates the need for sophisticated equipment and glassware high cost. The success of the reaction, even in these conditions, can be noticed by CCD analysis and ¹H NMR spectrum. The realization of biodiesel synthesis in the classroom with the aforementioned tools allows relating chemical concepts such as transesterification reactions, saponification, combustion, stoichiometry and catalysis with environmental issues surrounding sustainable development, recycling and biofuel. [ABSTRACT FROM AUTHOR]

The prognostic importance of baseline and serial glycated hemoglobin (HbA) changes for cardiovascular outcomes is still debated. We aimed to evaluate it in 620 high-risk individuals with type 2 diabetes (mean age 60.4 years, 37 % males, 55 % Caucasians). Patients had HbA levels measured at study entry and serially during follow-up. Primary end points were total cardiovascular events (CVEs), major CVEs (non-fatal myocardial infarctions and strokes plus cardiovascular deaths) and all-cause mortality. Cardiovascular and non-cardiovascular mortalities were secondary end points. HbA was evaluated either as a continuous variable and categorized at clinically relevant cutoffs. Multivariate Cox regressions assessed the associations with end points. After a median follow-up of 6.6 years, 125 total CVEs occurred (90 major CVEs), and 111 patients died (64 from cardiovascular diseases). After statistical adjustments for other cardiovascular risk factors, baseline and mean first-year HbA predicted all end points, except non-cardiovascular deaths; and hazard ratios tended to be higher for mean first year than for baseline HbA. Each 1 % (10.9 mmol/mol) increase in mean first-year HbA increased 27 % the risk of major CVEs occurrence (95 % CI 11-45 %). Updating HbA for values obtained beyond the second year of follow-up did not improve its predictive performance. The cardiovascular protection was observed until HbA values lower than 6.5 % (48 mmol/mol). Moreover, the magnitude of HbA reduction during the first year of follow-up was predictive of better cardiovascular outcomes, independent of baseline HbA levels. In conclusion, better glycemic control, especially during the first year of follow-up, is determinant of better cardiovascular outcomes in high-risk patients with type 2 diabetes, without any detectable lower threshold level of HbA. [ABSTRACT FROM AUTHOR]

Aims Reduced heart rate variability (HRV), an early sign of diabetic cardiovascular autonomic neuropathy (CAN), is associated with worse cardiovascular outcomes. The objective was to evaluate relationships between HRV parameters and three pre-clinical cardiovascular disease markers (left ventricular hypertrophy [LVH], aortic stiffness and carotid atherosclerosis) in type 2 diabetes. Methods In a cross-sectional study, 313 patients with type 2 diabetes performed 24-h Holter monitoring, carotid ultrasonography (intima-media thickness and plaques measurements), aortic pulse wave velocity measurement and echocardiography (left ventricular mass index [LVMI] measurement). Time-domain HRV parameters were the standard deviation of all normal RR intervals (SDNN), the standard deviation of the averaged normal RR intervals for all 5 min segments (SDANN), the root mean square of differences between adjacent R-R intervals (rMSSD), and the percentage of adjacent R-R intervals that varied by >50 ms (pNN50). Multivariate linear and logistic regressions assessed associations between HRV parameters and the three markers of pre-clinical cardiovascular disease. Results Patients with reduced HRV had longer diabetes duration, greater prevalences of microvascular complications, lower physical fitness, and higher heart rate, glycated hemoglobin, albuminuria and LVMI than patients with normal HRV. On multivariate regressions, after adjustments for several confounders, reduced SDNN and SDANN were independently associated with LVH and aortic stiffness. No HRV parameter was associated with carotid atherosclerosis. Conclusions Two reduced HRV parameters, SDNN and SDANN, which reflect cardiovascular autonomic imbalance, were associated with LVH and aortic stiffness, markers of pre-clinical cardiovascular disease. These findings may offer insights into physiopathological mechanisms linking CAN to worse cardiovascular prognosis. [ABSTRACT FROM AUTHOR]

Frontal plane T-wave axis and QRS-T angle are novel electrocardiographic ventricular repolarization parameters that have been scarcely evaluated in type 2 diabetes. The aim was to investigate the factors associated with these parameters of abnormal ventricular repolarization in a cross-sectional analysis of 594 patients with type 2 diabetes. Clinical, laboratory, 2D-echocardiographic, ambulatory blood pressure (BP) monitoring, aortic pulse wave velocity (PWV) and carotid ultrasonographic data were obtained. Digital 12-lead ECG was recorded, and frontal plane T-wave axis and QRS-T angle were automatically measured. T-wave axis was considered abnormal if >75° or <15° and QRS-T angle if ≥73° in men and ≥67° in woman. Associations were assessed by bivariate tests and multivariate logistic regressions. One hundred and four (20.9 %) patients had abnormal T-wave axis, and 84 (14 %) had increased QRS-T angle. Patients with abnormal ventricular repolarization were older and had greater prevalence of micro- and macrovascular diabetic complications than patients with normal repolarization. They had higher office and ambulatory BPs, greater prevalence of the non-dipping pattern, and greater left ventricular mass, aortic PWV and carotid intima-media thickness. On multivariate analysis, abnormal ventricular repolarization parameters were independently associated with left ventricular hypertrophy, non-dipping pattern, higher ambulatory systolic BPs, glycated hemoglobin and common carotid intima-media thickness, and with the presence of coronary artery disease. In conclusion, abnormal frontal plane T-wave axis and QRS-T angle are independently associated with several markers of pre-clinical atherosclerotic disease; whether these associations represent additional cardiovascular risk in type 2 diabetes shall be confirmed in prospective studies. [ABSTRACT FROM AUTHOR]

Objective: The prognostic importance of carotid-femoral pulse wave velocity (PWV), the gold standard measure of aortic stiffness, has been scarcely investigated in type 2 diabetes and never after full adjustment for potential confounders. The aim was to evaluate the prognostic impact of carotid-femoral PWV for cardiovascular morbidity and all-cause mortality in a cohort of 565 high-risk type 2 diabetic patients.Research Design and Methods: Clinical, laboratory, ambulatory blood pressure (BP) monitoring, and carotid-femoral PWV data were obtained at baseline. The primary end points were a composite of fatal and nonfatal cardiovascular events and all-cause mortality. Multiple Cox survival analysis was used to assess the associations between carotid-femoral PWV, as a continuous variable and categorized at 10 m/s, and the end points.Results: After a median follow-up of 5.75 years, 88 total cardiovascular events and 72 all-cause deaths occurred. After adjustments for potential cardiovascular risk factors, including micro- and macrovascular complications, ambulatory BP, and metabolic control, carotid-femoral PWV was predictive of the composite end point but not of all-cause mortality both as a continuous variable (hazard ratio 1.13 [95% CI 1.03-1.23], P = 0.009 for increments of 1 m/s) and as categorized at 10 m/s (1.92 [1.16-3.18], P = 0.012). On sensitivity analysis, carotid-femoral PWV was a better predictor of cardiovascular events in younger patients (<65 years), in those with microvascular complications, and in those with poorer glycemic control (HbA1c ≥7.5% [58.5 mmol/mol]).Conclusions: Carotid-femoral PWV provides cardiovascular risk prediction independent of standard risk factors, glycemic control, and ambulatory BPs and improves cardiovascular risk stratification in high-risk type 2 diabetes. [ABSTRACT FROM AUTHOR]

OBJECTIVE-The prognostic importance of carotid-femoral pulse wave velocity (PWV), the gold standard measure of aortic stiffness, has been scarcely investigated in type 2 diabetes and never after full adjustment for potential confounders. The aim was to evaluate the prognostic impact of carotid-femoral PWV for cardiovascular morbidity and all-cause mortality in a cohort of 565 high-risk type 2 diabetic patients. RESEARCH DESIGN AND METHODS-Clinical, laboratory, ambulatory blood pressure (BP) monitoring, and carotid-femoral PWV data were obtained at baseline. The primary end points were a composite of fatal and nonfatal cardiovascular events and all-cause mortality. Multiple Cox survival analysis was used to assess the associations between carotid-femoral PWV, as a continuous variable and categorized at 10 m/s, and the end points. RESULTS-After a median follow-up of 5.75 years, 88 total cardiovascular events and 72 allcause deaths occurred. After adjustments for potential cardiovascular risk factors, including micro- andmacrovascular complications, ambulatory BP, and metabolic control, carotid-femoral PWV was predictive of the composite end point but not of all-cause mortality both as a continuous variable (hazard ratio 1.13 [95% CI 1.03-1.23], P = 0.009 for increments of 1 m/s) and as categorized at 10 m/s (1.92 [1.16-3.18], P = 0.012). On sensitivity analysis, carotid-femoral PWV was a better predictor of cardiovascular events in younger patients (,65 years), in those with microvascular complications, and in those with poorer glycemic control (HbA1c $7.5% [58.5 mmol/mol]). CONCLUSIONS-Carotid-femoral PWV provides cardiovascular risk prediction independent of standard risk factors, glycemic control, and ambulatory BPs and improves cardiovascular risk stratification in high-risk type 2 diabetes. [ABSTRACT FROM AUTHOR]

The leaves and flowers of the aquatic and medicinal plant Ludwigia lagunae was collected in Dourados-MS, Brazil and their essential oils were analyzed by GC and GC-MS. Fifty three and forty nine components were identified in the leaf and flower oils of L. lagunae, respectively. The major constituents in the leaf oil were α-amorphene (5.3%), γ-eudesmol (5.1%), Δ-amorphene (5.0%), δ-cadinene (4.3%), germacrene D (4.1%), β-copaene (4.1%), spathulenol (4.1%) and γ-cadinene (4.0%) and flower oil were spathulenol (5.8%), β-gurjunene (4.7%), δ-cadinene (4.4%), limonene (4.3%), β-copaene (4.2%) and aromadendrene (4.1%). Leaf and flower oils showed moderate free radical scavenging activity compared with the BHT. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The prognostic value of microalbuminuria is unsettled in resistant hypertension. The objective was to evaluate the importance of baseline and serial changes in albuminuria as predictors of cardiovascular morbidity and mortality in patients with resistant hypertension. Methods: 531 resistant hypertensives had urinary albumin excretion rate (UAER) measured prospectively at baseline and at the 2nd year of follow-up. Primary endpoints were a composite of fatal and non-fatal cardiovascular events, all-cause and cardiovascular mortalities. Total strokes and coronary heart disease (CHD) events were secondary endpoints. Multiple Cox regression assessed the associations between UAER and endpoints. Results: After a median follow-up of 4.9 years, 72 patients died, 42 from cardiovascular causes; 96 cardiovascular events occurred, 42 strokes and 47 CHD events. After adjustment for several cardiovascular risk factors, baseline UAER, either analyzed as a continuous variable or dichotomized at different cut-off values, was an independent predictor of the composite endpoint, all-cause and cardiovascular mortality, strokes and CHD events. Each 10-fold increase in UAER implied a significant 1.6, 1.5, 2.0, 1.5 and 1.6-fold higher risk, respectively, for each of the above endpoints. Serial changes in microalbuminuria status during follow-up tended to parallel changes in cardiovascular risk, regression of microalbuminuria was associated with a 27% lower risk and development with a 65% higher risk of having a cardiovascular event. Conclusions: Baseline albuminuria strongly predicts cardiovascular morbidity and mortality in resistant hypertensive patients and serial changes in microalbuminuria may translate into changes in risk. Microalbuminuria reduction may be a goal of anti-hypertensive treatment. [Copyright &y& Elsevier]

The antimicrobial activity of the hexanic extracts and fractions of fruits of Campomanesia pubescens pubescens (D.C) O. Berg and Campomanesia adamantium (Cambess.) O. Berg were assayed against six microorganisms. The hexanic extracts of C. pubescens and C. adamantium fruits were also investigated in their composition by gas chromatography-mass spectrometry and high-performance liquid chromatography with diode array detection. The results of this study showed the presence of 34 volatile compounds and flavonoids in the hexanic extract of C. pubescens and 33 volatile compounds and flavonoids in the hexanic extract of C. adamantium. [ABSTRACT FROM AUTHOR]

Quantification of prepared samples by analysis using high performance liquid chromatography with DAD detection was developed to analyze rutin, 6-methoxyapigenin, and 6-methoxyapigenin-7-O-β-D-glucopyranoside isolated from methanolic extracts of different genus: Syngonanthus, Leiothix and Eriocaulon (Eriocaulaceae). The linearity, accuracy, and the inter-day precision of the procedure were evaluated. The calibration curves were linear. The recoveries of the flavonoids in the samples analyzed were 96.3% to 98.5%. The percentage coefficient of variation for the quantitative analysis of the flavonoids in the analyses of the samples was under 5%. The antimicrobial activity of the five methanol extracts of these Eriocaulaceae species was assayed against the microorganisms Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Salmonella setubal, Saccharomyces cerevisiae and Candida albicans. Measured MIC values ranged from 1.25 to 10.00 mg/mL. The flavonoid contents suggest that Eriocaulaceae species may be a promising source of compounds to produce natural phytomedicines. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Diabetes is a risk factor for increased arterial stiffness; however, few studies had investigated its associated factors. The aim was to evaluate the correlates of increased arterial stiffness in type 2 diabetes, particularly the relationships with microvascular complications. Methods: 482 type 2 diabetic patients without peripheral arterial disease were evaluated in a cross-sectional study. Clinical (including tests of cardiovascular dysautonomy), laboratory, ECG, echocardiographic and 24h ambulatory blood pressure monitoring data were obtained. Arterial stiffness was assessed by carotid–femoral (aortic) and carotid-radial (peripheral) pulse wave velocity (PWV) measurements. Statistics included multivariate linear and logistic regressions to investigate the independent correlates of increased arterial stiffness. Results: No diabetes-related variable was associated with peripheral arterial stiffness. 148 patients (31%) had increased aortic PWV (>12m/s). On multiple linear regression, retinopathy and nephropathy, besides age, heart rate, 24h pulse pressure, diabetes duration, dyslipidemia and number of antihypertensive drugs in use, were independently associated with aortic PWV. On multivariate logistic regression increased aortic stiffness was associated with retinopathy (odds ratio: 3.83, 95% confidence interval [CI]: 2.24–6.56, p <0.001) and peripheral neuropathy (odds ratio: 1.79, 95%CI: 1.06–3.02, p =0.03) after adjusting for possible confounding variables. Other variables associated with increased aortic stiffness were older age, heart rate, diabetes duration, 24h pulse pressure, dyslipidemia and physical inactivity. Conclusions: In type 2 diabetic patients, increased central arterial stiffness is associated with the presence of microvascular complications independent of other established determinants of aortic stiffness. [Copyright &y& Elsevier]

The article presents a study which aims to assess the importance of nocturnal blood pressure (BP) reduction in predicting cardiovascular morbidity and mortality in patients with resistant hypertension (RH). As the study's methodology, 556 subjects with RH went through clinical and laboratory examinations as well as ambulatory BP monitoring. In order to asses the association of nocturnal BP reduction with cardiovascular events, multiple Cox regression was employed. Results reveal that the nondipping pattern was an independent predictor of coronary heart disease events. Based on the results, it was concluded that nocturnal BP variability pattern is an important cardiovascular prognostic marker.

Aims: To investigate interactions between more/less strict treatment targets (HbA1c, systolic blood pressure, LDL-cholesterol) and clinical characteristics (age, diabetes duration and presence of complications) for occurrence of cardiovascular/microvascular complications and mortality in type 2diabetes.Methods: 690 individuals were followed-up for 10 years (median). Interactions between treatment targets, estimated as mean values during the first 2-years, and clinical characteristics were tested in multivariable Cox regressions adjusted for other risk factors. Hazard ratios (HRs) were estimated in stratified analyses for cardiovascular/microvascular outcomes and mortality.Results: During follow-up, 214 patients had a cardiovascular event (175 MACEs); and 265 died (132 cardiovascular deaths); there were 206 renal, 161 retinopathy and 181 peripheral neuropathy events. There were interactions between treatment parameters and clinical characteristics, in most of them the HRs were higher in older individuals, in those with longer diabetes durations and with complications, particularly for the cardiovascular outcomes and mortality. For microvascular outcomes the opposite was observed. For cardiovascular mortality, the HRs of higher HbA1c were 1.31 (1.08-1.58) and 1.09 (0.88-1.34), respectively with longer/shorter diabetes duration (p-for-interaction 0.11); and 1.43 (1.14-1.79) and 1.02 (0.85-1.23) in older/younger individuals (p-for-interaction 0.019).Conclusions: Our findings do not support less strict treatment targets for older individuals, with longer diabetes duration or with complications, particularly for cardiovascular and mortality prevention. [ABSTRACT FROM AUTHOR]

The article presents a prospective study which investigates the importance of office and ambulatory blood pressures (BPs) as predictors of cardiovascular morbidity and mortality in Rio de Janeiro, Brazil. In the study, 556 resistant hypertensive (RH) patients underwent clinical-laboratory BP monitoring examinations. It states that the patients' body mass index, physical inactivity, previous cardiovascular diseases and the number of antihypertensive drugs in use have been determined. Results reveal that higher ambulatory BP predicts cardiovascular morbidity and mortality in RH individuals.

Abstract: Aims: Microvascular complications are associated with increased mortality in diabetes. The objective of this study was to investigate the predictors of microvascular complication development and progression in a prospective study of Brazilian type 2 diabetic patients. Methods: A prospective follow-up study was carried out with 471 type 2 diabetic outpatients. Primary end points were the development or progression of retinopathy, peripheral neuropathy, and clinical nephropathy. Predictors were assessed for each individual microvascular complication and also as a composite outcome by Kaplan–Meier estimation of survival curves and by uni- and multivariate Cox analysis. Results: During a median follow-up of 57 months (range 2–84 months), 196 patients (41.6%) developed or had a progression in microvascular disease. Retinopathy occurred in 22.5%, nephropathy in 19.1%, and neuropathy in 15.5% of the patients. In Cox multivariate analysis, increased echocardiographic left ventricular mass (LVM) and longer diabetes duration were selected as predictors for all end points. Higher mean fasting glycemia was a predictor for retinopathy and neuropathy, lower serum high-density lipoprotein (HDL) cholesterol for neuropathy, and higher total cholesterol for nephropathy. Increased LVM [hazard ratio (HR): 1.39, 95% CI: 1.23–1.56], higher fasting glycemia (HR: 1.19, 95% CI: 1.04–1.36), and longer diabetes duration (HR: 1.28, 95% CI: 1.11–1.47) were the predictors of the composite end point. Conclusions: Development and progression of microvascular complications in Brazilian type 2 diabetic patients are associated with worse hypertension and metabolic control. Additional studies are necessary to show if modification of these risk factors can reduce the burden of morbidity and mortality related to microvascular disease in type 2 diabetes. [Copyright &y& Elsevier]

To determine the prevalence of dyslipoproteinemias and their related factors in a Brazilian systemic lupus erythematosus (SLE) population, fasting lipids were measured in 185 female SLE outpatients. Age, BMI, smoking, post-menopausal status, presence of diabetes and hypertension, SLE duration, number of ARA criteria, drug treatment and disease activity (by SLEDAI) were registered. Statistics included uni and multivariate logistic regression. Eighty-nine patients (48.1%) had hypercholesterolemia, 55 (29.7%) had hypertriglyceridemia and 109 (58.9%) had either. On multivariate analysis, 24-h proteinuria (OR = 2.08, 95% CI: 1.11–3.88), BMI (OR = 1.08, 95% CI: 1.01–1.16) and post-menopausal status (OR = 2.48, 95% CI: 1.25–4.92) were associated with hypercholesterolemia. Disease activity was related to low HDL-cholesterol (OR = 2.59, 95% CI: 1.20–5.58) and, in pre-menopausal patients, also to hypertriglyceridemia (OR = 1.16, 95% CI: 1.03–1.30). Antimalarial use was protective for hypertriglyceridemia (OR = 0.44, 95% CI: 0.22–0.90). In conclusion, the increased prevalence of dyslipoproteinemias is due to proteinuria, obesity and SLE activity. Antimalarials have beneficial effect on lipid profile that may be due to reduction in disease activity. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate infection-related mortality and its predictors in Brazilian type 2 diabetic patients. Methods: It was carried out a long-term prospective study with 471 type 2 diabetic outpatients. Several clinical, laboratory and electrocardiographic variables were recorded at baseline. Predictive factors for infection-related mortality were evaluated by Kaplan-Meyer estimation of survival curves, univariate and multivariate Cox survival analysis. Excess infection-related mortality in this cohort was evaluated by comparing its rate with that of the Rio de Janeiro background population and calculating standardized mortality rates (SMR). Results: During a median follow up of 57 months (range: 1–86 months), 40 (33.1%) patients died from infection-related causes. After adjusting for age and sex, the infection-related SMR was 6.6 (95% confidence interval [95% CI]: 4.8–9.0). In Cox multivariate analysis the predictors of infection-related mortality were older age (hazard ratio [HR]: 1.91; 95% CI: 1.35–2.70), pre-existing peripheral arterial disease (HR: 3.86; 95% CI: 1.80–8.28) and cerebrovascular disease (HR: 3.28; 95% CI: 1.24–8.70), lower HDL-cholesterol (HR: 2.50; 95% CI: 1.32–4.74) and increased 24h-proteinuria (HR: 1.22; 95% CI: 1.08–1.37). After excluding patients with peripheral and cerebrovascular disease at baseline, neuropathy and coronary heart disease were selected as predictors of mortality, besides older age and proteinuria. Conclusions: Brazilian type 2 diabetic patients have a six-fold excess infection-related mortality than the general population. This increased mortality is mainly determined by the presence of micro and macrovascular complications. Multifactorial risk interventions are needed in order to decrease this burden of infection-related mortality. [Copyright &y& Elsevier]

The ozonised sunflower oil, Bioperoxoil®, was tested for its antimicrobial activity against some pathological strains in vitro together with its healing potential against Staphylococcus aureus in vivo. Bioperoxoil® was tested against S. aureus, Pseudomonas aeroginosa, Candida albicans, S. typhimurium and Escherichia coli suspensions using the agar diffusion method. Healing experiments were carried out with Wistar rats through topical application of 3.5 mg/ml of the ozonised oil up to the 7th day after inoculation with S. aureus. Bioperoxoil® showed anti-inflammatory effects against all strains tested, with MIC values ranging from 2.0 to 3.5 mg/ml. Bioperoxoil® also demonstrated protective effects on skin connective tissue and to enhance wound healing during the treatment, as compared to a neomycin–clostebol association used as a positive control. The overall results indicated a significant antimicrobial activity, anti-inflammatory and wound-healing properties for Bioperoxoil®, as compared to other antimicrobial agents commercially available. [ABSTRACT FROM AUTHOR]

The prognostic importance of electrocardiographic ventricular repolarization QT parameters (maximum rate-corrected QT interval—QTcmax, QT interval dispersion–QTd, and QTcd), in relation to other risk markers, on cardiovascular and cardiac mortality, and on total fatal or nonfatal cardiovascular events, was evaluated prospectively in 471 type 2 diabetic outpatients. During a median follow-up of 57 months (range: 2–84), 121 (25.7%), patients died, 44 (36.3% of them) from cardiovascular causes and 106 (22.5%) fatal or nonfatal cardiovascular events were observed. In Cox proportional hazards multivariate analysis, both QTd and QTcmax were independent predictors of cardiovascular and cardiac mortality (hazard ratio [HR]: 1.34, 95% confidence interval [95% CI]: 1.12–1.59, for each 10-ms increments in QTd and HR: 1.17, 95% CI: 1.03–1.21 for 10-ms increments in QTcmax, for cardiovascular mortality). They were also predictors of total fatal or nonfatal cardiac and cardiovascular events (HR: 1.18, 95% CI: 1.05–1.33 for QTd and HR: 1.09, 95% CI: 1.04–1.15 for QTcmax). Additional independent prognostic markers for total cardiovascular events were the presence of previous cardiac disease, cerebral or peripheral vascular disease, age, male gender, known diabetes duration, heart rate, and serum triglycerides. Excluding patients with prior cardiac disease did not change significantly the prognostic performance of QTd but decreased that of QTcmax. In conclusion, QT interval parameters give additional prognostic information in patients with type 2 diabetes mellitus, beyond that obtained from traditional risk factors. QT interval dispersion seems a better prognostic marker than maximum QT interval, particularly in patients without previous cardiac diseases. [Copyright &y& Elsevier]

Electrocardiographic repolarization parameters are potential markers of arrhythmogenic risk and have not been evaluated in Chagas' disease. The aim of this report was to investigate their associations with LV systolic function assessed by two-dimensional echocardiography. In a cross-sectional study involving 738 adult outpatients in the chronic phase of Chagas' disease, maximal QTc and T wave peak-to-end (TpTe) intervals, and QT, QTapex (QTa), JT and TpTe interval dispersions, and variation coefficients were measured and calculated from 12-lead standard ECGs. Clinical, radiological, ECG, and echocardiographic data were recorded. In bivariate statistical analysis, all repolarization parameters were significantly increased in patients with moderate or severe LV systolic dysfunction, and these patients showed more clinical, radiologic, and ECG abnormalities. Receiver operating characteristic curve analysis demonstrated that isolatedly QTd had the best predictive performance for LV dysfunction, with an 80% specificity and 67% sensitivity for values >60 ms in the subgroup of chagasic patients with abnormal ECGs and no heart failure. Multivariate logistic regression selected, as the best predictive model for LV dysfunction in this subgroup of patients, the presence of cardiomegaly on chest X ray (OR 14.06, 95% CI, 5.54–35.71), QTd > 60 ms (OR 9.35, 95% CI, 4.01–21.81), male gender (OR 7.70, 95% CI, 2.98–19.91) and the presence of frequent premature ventricular contractions (PVCs) on ECG (OR 4.06, 95% CI, 1.65–9.97). This model showed 90% specificity and 71% sensitivity. In conclusion, QTd was associated to LV systolic function and could be used to predict asymptomatic dysfunction in chronic Chagas' disease. The presence of cardiomegaly, frequent PVCs, and male sex refined LV function stratification in these patients. (PACE 2003; 26:1326–1335). [ABSTRACT FROM AUTHOR]