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Abstract Background Resistant hypertension is characterized when the blood pressure (BP) remains above the recommended goal after taking three antihypertensive drugs with synergistic actions at their maximum recommended tolerated doses, preferably including a diuretic. Identifying the contribution of intravascular volume and serum renin in maintaining BP levels could help tailor more effective hypertension treatment, whether acting on the control of intravascular volume or sodium balance, or acting on the effects of the renin-angiotensin-aldosterone system (RAAS) on the kidney. Methods/design This is a randomized, open-label, clinical trial is designed to compare sequential nephron blockade and its contribution to the intravascular volume component with dual blockade of the RAAS plus bisoprolol and the importance of serum renin in maintaining BP levels. The trial has two arms: sequential nephron blockade versus dual blockade of the RAAS (with an angiotensin converting enzyme (ACE) inhibitor plus a beta-blocker) both added-on to a thiazide diuretic, a calcium-channel blocker and an angiotensin receptor-1 blocker (ARB). Sequential nephron blockade consists in a progressive increase in sodium depletion using a thiazide diuretic, an aldosterone-receptor blocker, furosemide and, finally, amiloride. On the other hand, the dual blockade of the RAAS consists of the progressive addition of an ACE inhibitor until the maximum dose and then the administration of a beta-blocker until the maximum dose. The primary outcomes will be reductions in the systolic BP, diastolic BP, mean BP and pulse pressure (PP) after 20 weeks of treatment. The secondary outcomes will evaluate treatment safety and tolerability, biochemical changes, evaluation of renal function and recognition of hypotension (ambulatory BP monitoring (ABPM)). The sample size was calculated assuming an alpha error of 5% to reject the null hypothesis with a statistical power of 80% giving a total of 40 individuals per group. Discussion In recent years, the cost of resistant hypertension (RH) treatment has increased. Thus, identifying the contribution of intravascular volume and serum renin in maintaining BP levels could help tailor more effective hypertension treatment, whether by acting on the control of intravascular volume or sodium balance, or by acting on the effects of the RAAS on the kidney. Trial registration Sequential Nephron Blockade vs. Dual Blockade Renin-angiotensin System + Bisoprolol in Resistant Arterial Hypertension (ResHypOT). ClinicalTrials.gov, ID: NCT02832973. Registered on 14 July 2016. First received: 12 June 2016. Last updated: 18 July 2016.

The release of dashcam footage showing a Chicago Police Department (CPD) officer fatally shooting 17-year-old Laquan McDonald in 2015 placed extraordinary scrutiny on CPD to avoid another controversial case of police misconduct. Using data on arrests as well as traffic stops and searches, we assess whether the quantity and quality of policing in Chicago changed after the video documenting this vivid incident of deadly force was released. We find that while both felony and misdemeanor arrest rates declined after Laquan's murder was publicized, this event had no discernable impact on traffic stop rates, contraband hit rates, or the ratio of felony to misdemeanor arrests. Supplemental analyses reveal that declines in felony arrest rates were most pronounced in majority-Black districts due to reductions in drug possession and firearm arrests. Our findings provide nuanced evidence of a depolicing effect that may reflect attempts by CPD to reclaim legitimacy following this pivotal event. [ABSTRACT FROM AUTHOR]

Resumo:Este artigo investiga a relação entre cultura de aprendizagem contínua, percepção de oportunidades de crescimento e desempenho individual, comparando empresas do setor público e privado. O trabalho se baseia em teorias que propõem que crenças compartilhadas sobre o apoio à aprendizagem no contexto organizacional são um importante fator situacional que pode influenciar as atitudes de funcionários e seu desempenho no trabalho. Foi realizada uma pesquisa de natureza quantitativa, por meio de questionários respondidos por funcionários da força de vendas de três organizações distintas, principais competidoras em um mesmo mercado, sendo duas delas empresas privadas e uma pública. Os resultados sugerem que a aprendizagem contínua está mais presente na cultura das empresas privadas, e está significativamente relacionada com a percepção de oportunidades de crescimento e com o desempenho.

Na pesquisa aqui relatada, visa-se investigar os antecedentes da intenção de uso de sistemas de home broker sob a ótica dos investidores do mercado acionário. Para atingir esse objetivo, por meio de referencial teórico baseado em teorias de aceitação de sistemas de informação, difusão da inovação, confiança em ambientes virtuais e satisfação do usuário, foi elaborado um modelo teórico e foram propostas hipóteses de pesquisa. Por meio de técnicas de equações estruturais baseadas em Partial Least Squares (PLS), a partir de 152 questionários válidos, coletados via web survey junto a investidores do mercado acionário brasileiro, foram testados o modelo proposto e as hipóteses de pesquisa. Identificaram-se, assim, os fatores compatibilidade, utilidade percebida e facilidade de uso percebida como antecedentes estatisticamente significantes do fator satisfação do usuário com o sistema de home broker, o qual, por sua vez, teve efeito estatisticamente significante na intenção de uso do sistema. São apresentadas, ainda, as implicações acadêmicas e gerenciais do trabalho, assim como suas limitações e uma agenda de pesquisa para essa importante área do conhecimento.

FUNDAMENTO: A descoberta da leptina como um estimulador da atividade simpática trouxe uma nova perspectiva para os mecanismos fisiopatológicos da obesidade-hipertensão. OBJETIVO: Avaliamos a relação entre a atividade simpática aumentada e as concentrações plasmáticas de leptina e aldosterona em Hipertensos Resistentes (HR), comparando os grupos com e sem Diabetes Tipo 2 (DT2). MÉTODOS: Vinte e cinco pacientes HR foram avaliados por eletrocardiografia ambulatorial para análise da Variabilidade da Frequência Cardíaca (VFC) nos domínios do tempo e frequência, os quais foram estratificados em dois períodos: 24 horas e período Diurno (D), compreendendo as medidas entre 14 e 18h (domínio do tempo) e uma hora às 15h (domínio da frequência). RESULTADOS: O grupo DT2 (n = 10) apresentou maiores concentrações de aldosterona e leptina que o grupo não DT2 (n = 15) (26,0 ± 11,5 vs. 16,9 ± 7,0 ng/dL - p = 0,021; 81,368.7 ± 47,086.1 vs. 41,228.1 ± 24,523.1 pg/mL - p = 0,048, respectivamente). Houve correlação entre aldosterona e VFC no domínio da frequência em ambos os grupos. Não-DT2 apresentaram a aldosterona correlacionada com D baixa frequência em unidades normalizadas (BFnu) (r = 0,6 [0,12 - 0,85] p = 0,018) e D alta frequência em unidades normalizadas (AFnu) (r = -0,6 [-0,85 - -0,12] p = 0,018). No grupo com diabetes, a aldosterona correlacionou-se com DBFnu (r = 0,72 [0,16 - 0,93] p = 0,019) e DAFnu (r = -0,72 [-0,93 - -0,16] p = 0,019). Apesar da importância da leptina na atividade simpática aumentada na hipertensão, não houve correlação com VFC. CONCLUSÃO: A aldosterona parece estimular a atividade simpática em HR com ou sem DT2. Essa informação combinada com a eficácia clínica dos bloqueadores de receptor mineralocorticoide em HR pode reforçar a aldosterona como alvo terapêutico relevantes em HR. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0)

The objective of the present study was to determine the acute effect of hemodialysis on endothelial venous function and oxidative stress. We studied 9 patients with end-stage renal disease (ESRD), 36.8 ± 3.0 years old, arterial pressure 133.8 ± 6.8/80.0 ± 5.0 mmHg, time on dialysis 55.0 ± 16.6 months, immediately before and after a hemodialysis session, and 10 healthy controls matched for age and gender. Endothelial function was assessed by the dorsal hand vein technique using graded local infusion of acetylcholine (endothelium-dependent venodilation, EDV) and sodium nitroprusside (endothelium-independent venodilation). Oxidative stress was evaluated by measuring protein oxidative damage (carbonyls) and antioxidant defense (total radical trapping antioxidant potential - TRAP) in blood samples. All patients were receiving recombinant human erythropoietin for at least 3 months and were not taking nitrates or a-receptor antagonists. EDV was significantly lower in ESRD patients before hemodialysis (65.6 ± 10.5) vs controls (109.6 ± 10.8; P = 0.010) and after hemodialysis (106.6 ± 15.7; P = 0.045). Endothelium-independent venodilation was similar in all comparisons performed. The hemodialysis session significantly decreased TRAP (402.0 ± 53.5 vs 157.1 ± 28.3 U Trolox/µL plasma; P = 0.001). There was no difference in protein damage comparing ESRD patients before and after hemodialysis. The magnitude of change in the EDV was correlated negatively with the magnitude of change in TRAP (r = -0.70; P = 0.037). These results suggest that a hemodialysis session improves endothelial venous function, in association with an antioxidant effect.

Viruses depend on cellular metabolic resources to supply the energy and biomolecular building blocks necessary for their replication. Human cytomegalovirus (HCMV), a leading cause of birth defects and morbidity in immunosuppressed individuals, induces numerous metabolic activities that are important for productive infection. However, many of the mechanisms through which these metabolic activities are induced and how they contribute to infection are unclear. We find that HCMV infection of fibroblasts induces a neuronal gene signature as well as the expression of several metabolic enzyme isoforms that are typically expressed in other tissue types. Of these, the most substantially induced glycolytic gene was the neuron-specific isoform of enolase 2 (ENO2). Induction of ENO2 expression is important for HCMV-mediated glycolytic activation as well as for the virally induced remodeling of pyrimidine-sugar metabolism, which provides the glycosyl subunits necessary for protein glycosylation. Inhibition of ENO2 expression or activity reduced uridine diphosphate (UDP)-sugar pools, attenuated the accumulation of viral glycoproteins, and induced the accumulation of noninfectious viral particles. In addition, our data indicate that the induction of ENO2 expression depends on the HCMV UL38 protein. Collectively, our data indicate that HCMV infection induces a tissue atypical neuronal glycolytic enzyme to activate glycolysis and UDP-sugar metabolism, increase the accumulation of glycosyl building blocks, and enable the expression of an essential viral glycoprotein and the production of infectious virions. [ABSTRACT FROM AUTHOR]

Cytokines induce an anti-viral state, yet many of the functional determinants responsible for limiting viral infection are poorly understood. Here, we find that TNFα induces significant metabolic remodeling that is critical for its anti-viral activity. Our data demonstrate that TNFα activates glycolysis through the induction of hexokinase 2 (HK2), the isoform predominantly expressed in muscle. Further, we show that glycolysis is broadly important for TNFα-mediated anti-viral defense, as its inhibition attenuates TNFα's ability to limit the replication of evolutionarily divergent viruses. TNFα was also found to modulate the metabolism of UDP-sugars, which are essential precursor substrates for glycosylation. Our data indicate that TNFα increases the concentration of UDP-glucose, as well as the glucose-derived labeling of UDP-glucose and UDP-N-acetyl-glucosamine in a glycolytically-dependent manner. Glycolysis was also necessary for the TNFα-mediated accumulation of several glycosylated anti-viral proteins. Consistent with the importance of glucose-driven glycosylation, glycosyl-transferase inhibition attenuated TNFα's ability to promote the anti-viral cell state. Collectively, our data indicate that cytokine-mediated metabolic remodeling is an essential component of the anti-viral response. Author summary: Viral infection often activates a host cell's intrinsic immune response resulting in the cellular secretion of cytokines, important host-defense molecules. These cytokines act on neighboring cells to make them less permissive to viral infection. Many of the mechanisms through which cytokines promote a less permissive cell state remain unclear. Our data indicate that treatment with the anti-viral cytokine TNFα induces substantial changes to cellular metabolic activity, including activating glucose metabolism. We find that these TNFα-induced metabolic changes are critical for TNFα to limit the replication of diverse viruses including Human Cytomegalovirus and two Coronaviruses, OC43 and SARS-CoV-2. Inhibition of glucose metabolism during TNFα treatment prevented the expression of a variety of known cellular anti-viral proteins. Collectively, our data indicate that cytokine-induced metabolic remodeling is an important component of TNFα's ability to promote a less permissive cell state and raises further questions about the mechanisms through which specific cytokine-induced metabolic activities contribute to various aspects of anti-viral defense. [ABSTRACT FROM AUTHOR]

Este trabalho teve como objetivo a investigação experimental do comportamento do concreto quando submetido a elevadas temperaturas. Um concreto de utilização comum em nossa região, com cimento e agregados usuais, misturados em proporções também usuais (traço), foi submeti- do a temperaturas de 300 °C, 600°C e 900 °C , de maneira a se avaliar prováveis alterações na resistência à compressão, na resistência à tração e no módulo de deformação deste concreto. O efeito do resfriamento rápido do concreto, usual em intervenções de combate a incêndios, foi avaliado; alguns dos corpos-de-prova submetidos às altas temperaturas estipuladas foram resfriados rapidamente e outros foram resfriados len- tamente (ao ambiente). A recuperação provável das propriedades mecânicas analisadas, com a reidratação do concreto - com possível redução após o efeito das altas temperaturas aplicadas - também foi avaliada; corpos-de-prova submetidos às altas temperaturas estipuladas e resfriados lentamente, foram parte imersos em água e parte envoltos em filme plástico e a seguir, cada parte correspondente foi avaliada, em relação às propriedades do concreto pesquisadas, para as idades do concreto de 28, 56, 112 e 224 dias após o resfriamento lento. Ao final deste trabalho, importantes resultados sobre o efeito de altas temperaturas nas propriedades mecânicas do concreto puderam ser obtidos; contribuindo, em muito, para o estabelecimento de parâmetros para o projeto de recuperação de estruturas submetidas ao efeito do fogo.

O efeito do comportamento do concreto perante o fogo está sendo estudado por um grupo formado no Laboratório de Estruturas e Construção Civil da Faculdade de Engenharia Civil, Arquitetura e Urbanismo da UNICAMP. Este trabalho apresenta uma investigação sobre a perda de re- sistência mecânica ocorrida em diferentes misturas de concreto depois de submetidas a temperaturas elevadas, bem como, uma investigação da influência da reidratação. As misturas foram preparadas com três diferentes agregados: argila expandida, basalto e calcário. Os corpos-de-prova C, obedecendo a mesma taxa de 300 ºC e 600 ºC foram submetidos às temperaturas de 300 aquecimento da Curva ISO-834 (1999). Após o trata- mento térmico, parte dos corpos-de-prova foram reidratados ao ar, outra parte foi imersa em água e outros envolvidos em filme plástico durante 28, 56 e 112 dias. Nestas idades os concretos foram caracterizados em relação à resistência à compressão, resistência à tração e módulo de elasticidade e assim uma avaliação da influência do tipo de agregado e da reidratação na recuperação da resistência mecânica pôde ser feita.

Abstract With the increasing use of recycled materials from civil construction, mainly as substitute for some aggregates in concrete mixtures, it is necessary to obtain technical information on the performance of these new mixtures. National and international research on the use of ceramic waste in concrete production highlight good results of this new material’s mechanical performance in environmental situations. However, little is known about its behavior at high temperatures. In this context, we sought to verify the performance of concrete mixtures produced with aggregates from ceramic block waste at high temperatures, with evaluation of their residual mechanical strength, axial compressive strength and elastic modulus, and also their tendency to spalling in fire situations. The RILEM-129 MHT method [1] was used for the assessment of residual mechanical strength, and the tendency to spalling was evaluated according to the procedure suggested by Souza and Moreno [2]. In both these evaluations, there is no national standard, and, in the case of spalling, not even an international standard. Three concrete mixtures were used, one prepared with natural coarse basalt aggregate (reference) and the other two by replacing part of this natural aggregate with aggregate from ceramic block waste (40% and 100% of substitution in volume). In the end, it is concluded that the substitution of natural coarse aggregate for lightweight aggregate from ceramic block waste can be an excellent alternative to increase the resistance of concrete to fire. Thus, the results of mechanical strength and spalling in a fire situation, unprecedented in our country, can greatly support the decision-making about the use of this alternative material in the national construction industry.

This article investigates the relationship among continuous learning culture, perception of growth opportunities and individual performance, comparing companies in the public and private sectors. The paper is based on theories that propose that shared beliefs about support for learning in the organizational context are an important situational factor that can influence the attitudes of employees and their job performance. A quantitative research was conducted with survey questionnaires answered by employees of the sales force of three distinct organizations, all major competitors in the same market, being two private and one public. The results suggest that continuous learning is more present in the culture of private companies, and it is significantly related to the perception of growth opportunities and performance. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Administração is the property of Instituto de Administracao da FEA-USP and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Eletrônica de Sistemas de Informação is the property of Revista Electronica de Sistemas de Informacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses a study which hypothesizes that myocardial extracellular volume fraction (MECVF) correlates positively with the connective tissue volume fraction in a rodent model of hypertensive heart disease. It mentions the quantification of MECVF with a parsimonious two-space water-exchange model. The detection of MECVF in a mouse model and in patients with hypertension history through cardiac magnetic resonance is also discussed.

Copyright of Revista Eletrônica de Sistemas de Informação is the property of Revista Electronica de Sistemas de Informacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Software development companies face a globalized, highly competitive and turbulent environment, where efficiency, efficacy and innovation capacity are critical for survival. In this context, small and medium enterprises (SMEs) tend to suffer the most due to the scarcity of resources to which they are usually subjected and their dependence on a few more powerful customers. This paper describes the elaboration and test of a model that draws on the resource-based view and knowledge-based view to explain the differences in performance of software SMEs. The analysis of data collected from 265 Brazilian companies suggests that: absorptive capacity contributes significantly to the development of a company's stock of technological knowledge: the flexibility of the IT infrastructure, managerial capacity, and IT technological knowledge are strong predictors of software development performance; and organizational performance is positively influenced by software development performance and managerial capacity. The implications of these findings are then discussed. [ABSTRACT FROM AUTHOR]

Copyright of Revista Eletrônica de Sistemas de Informação is the property of Revista Electronica de Sistemas de Informacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Cardiovascular disease is the leading cause of death in Brazil, and hypertension is its major risk factor. The benefit of its drug treatment to prevent major cardiovascular events was consistently demonstrated. Angiotensin-receptor blockers (ARB) have been the preferential drugs in the management of hypertension worldwide, despite the absence of any consistent evidence of advantage over older agents, and the concern that they may be associated with lower renal protection and risk for cancer. Diuretics are as efficacious as other agents, are well tolerated, have longer duration of action and low cost, but have been scarcely compared with ARBs. A study comparing diuretic and ARB is therefore warranted. Methods/design: This is a randomized, double-blind, clinical trial, comparing the association of chlorthalidone and amiloride with losartan as first drug option in patients aged 30 to 70 years, with stage I hypertension. The primary outcomes will be variation of blood pressure by time, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new subclinical atherosclerosis and sudden death. The study will last 18 months. The sample size will be of 1200 participants for group in order to confer enough power to test for all primary outcomes. The project was approved by the Ethics committee of each participating institution. Discussion: The putative pleiotropic effects of ARB agents, particularly renal protection, have been disputed, and they have been scarcely compared with diuretics in large clinical trials, despite that they have been at least as efficacious as newer agents in managing hypertension. Even if the null hypothesis is not rejected, the information will be useful for health care policy to treat hypertension in Brazil. [ABSTRACT FROM AUTHOR]

Background: Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a populationbased intervention to prevent the incidence of hypertension and the development of target-organ damage. Methods: This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution. Discussion: The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a populationbased perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil. [ABSTRACT FROM AUTHOR]

Background: Hypertension, diabetes and obesity are not isolated findings, but a series of interacting interactive physiologic derangements. Taking into account genetic background and lifestyle behavior, AI (autonomic imbalance) could be a common root for RHTN (resistant hypertension) or RHTN plus type 2 diabetes (T2D) comorbidity development. Moreover, circadian disruption can lead to metabolic and vasomotor impairments such as obesity, insulin resistance and resistant hypertension. In order to better understand the triggered emergence of obesity and T2D comorbidity in resistant hypertension, we investigated the pattern of autonomic activity in the circadian rhythm in RHTN with and without type 2 diabetes (T2D), and its relationship with serum adiponectin concentration. Methods: Twenty five RHTN patients (15 non-T2D and 10 T2D, 15 males, 10 females; age range 34 to 70 years) were evaluated using the following parameters: BMI (body mass index), biochemical analysis, serum adiponectinemia, echocardiogram and ambulatory electrocardiograph heart rate variability (HRV) in time and frequency domains stratified into three periods: 24 hour, day time and night time. Results: Both groups demonstrated similar characteristics despite of the laboratory analysis concerning T2D like fasting glucose, HbA1c levels and hypertriglyceridemia. Both groups also revealed disruption of the circadian rhythm: inverted sympathetic and parasympathetic tones during day (parasympathetic > sympathetic tone) and night periods (sympathetic > parasympathetic tone). T2D group had increased BMI and serum triglyceride levels (mean 33.7 ± 4.0 vs 26.6 ± 3.7 kg/m² - p = 0.00; 254.8 ± 226.4 vs 108.6 ± 48.7 mg/dL - p = 0.04), lower levels of adiponectin (6729.7 ± 3381.5 vs 10911.5 ± 5554.0 ng/mL - p = 0.04) and greater autonomic imbalance evaluated by HRV parameters in time domain compared to non-T2D RHTN patients. Total patients had HRV correlated positively with serum adiponectin (r = 0.37 [95% CI -0.04 - 1.00] p = 0.03), negatively with HbA1c levels (r = -0.58 [95% CI -1.00 - -0.3] p = 0.00) and also adiponectin correlated negatively with HbA1c levels (r = -0.40 [95% CI -1.00 - -0.07] p = 0.02). Conclusion: Type 2 diabetes comorbidity is associated with greater autonomic imbalance, lower adiponectin levels and greater BMI in RHTN patients. Similar circadian disruption was also found in both groups indicating the importance of lifestyle behavior in the genesis of RHTN. [ABSTRACT FROM AUTHOR]

palhares l.c., gallani m.-c.b.j., gemignani t., matos-souza j.r., ubaid-girioli s., moreno h. jr, franchini k.g., nadruz w. jr & rodrigues r.c.m. (2010) Quality of life, dyspnea and ventricular function in patients with hypertension. Journal of Advanced Nursing 66(10), 2287–2296. Aim. This paper is a report of an investigation of the relationship between health-related quality of life and left ventricular function among patients with hypertension who did not fulfil the criteria for heart failure. Background. Heart failure is a common consequence of hypertension, with Doppler echocardiography being the gold-standard tool to evaluate left ventricular function, mainly hypertension-induced left ventricular damage. Echocardiographic data indicating poorer ventricular function have been related to lower levels of health-related quality of life in patients with systolic and/or diastolic heart failure. However, data are still lacking regarding the correlation between health-related quality of life and left ventricular function and structure in patients with hypertension who do not fulfil the criteria for heart failure. Method. Between September 2005 and February 2007, 98 patients with hypertension without systolic or diastolic heart failure were evaluated. Health-related quality of life was assessed using the Medical Outcomes Study Short Form-36. Left ventricular function was evaluated through Tissue Doppler echocardiography. Results. Statistically significant but weak correlations (varying from r = −0·22 to 0·35) were observed between some of the Short Form-36 domains and echo data. To consider the potential effect of dyspnoea in this relationship, patients were split according to the presence or absence of the symptom. In the subgroup without dyspnoea, similar patterns of correlation were observed (varying from r = 0·26 to 0·32). In the subgroup with dyspnoea, however, more and stronger correlations were observed between echo data and health-related quality of life domains, varying from r = −0·40 to 0·50. Conclusion. Nurses should be aware of the relevance of evaluating the functional echocardiographic data of patients who not fulfil heart failure criteria, but who experience dyspnoea in order to implement appropriate action plans. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Gestão da Tecnologia e Sistemas de Informação / Journal of Information Systems & Technology Management is the property of Revista de Gestao da Tecnologia e Sistemas de Informacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this study, we conduct a review of the international and the Brazilian literature on business-IT strategic alignment and present a critical analysis of fundamental problems observed in the field. We argue that conceptual shortcomings, such as the lack of clarity in constitutive definitions of the alignment construct and the plethora of often overlapping antecedents discussed in the literature, restrain systematic knowledge development in the field. We propose a conceptual definition of business-IT strategic alignment, striving for clarity and parsimony, and highlight its distinction from the definition of operational alignment. The antecedents in the literature are further analyzed so as to formulate a synthetic conceptual model for the nomological network that links these constructs. We conclude the article stressing that additional theoretical and empirical endeavors regarding business-IT alignment are needed, emphasizing that such efforts should be conducted with greater attention to the issues discussed in this review. [ABSTRACT FROM AUTHOR]

Nicotine replacement therapy appears to be safe when used by healthy patients to aid in smoking cessation; however, the immediate acute effects of nicotine replacement therapy on the circadian rhythm of blood pressure (BP) and endothelial function in heavy smokers are not well understood. Twenty-six heavy smokers were requested to stop smoking for 48 hours. BP and heart rate were recorded over 48 hours by ambulatory BP monitoring, with beat-to-beat changes being monitored for the first 10 hours by a noninvasive finger device. The reactivity of the brachial artery was evaluated using flow-mediated dilation immediately after smoking cessation, before the application of a 21-mg nicotine patch or placebo patch, and 24 hours after patch placement. Transdermal nicotine caused a mild but significant elevation in BP in the early morning in 21 of 26 volunteers. The decrease in nocturnal BP was attenuated in patients with the nicotine patch compared with the placebo patch; this was associated with impaired endothelium-dependent vasodilation. [ABSTRACT FROM AUTHOR]

Aim: To compare the acute effects of ascorbic acid on vasodilation of veins and arteries in vivo.Methods: Twenty-six healthy non-smokers and 23 healthy moderate smokers were recruited in this study. The dorsal hand vein compliance technique and flow-mediated dilation were used. Dose-response curves to bradykinin and sodium nitroprusside were constructed to test the endothelium-dependent and -independent relaxation before and after acute infusion of ascorbic acid.Results: Smokers had an impaired venodilation with bradykinin compared with non-smokers (68.3%±13.2% vs93.7%±20.1%, respectively; P<0.05). Ascorbic acid administration in the dorsal hand vein significantly increased the venodilation with bradykinin in smokers (68.3%± 13.2% vs 89.5%±6.3% before and after infusion, respectively; P<0.05) but not in non-smokers (93.7%±20.1% vs 86.4%±12.4% before and after infusion, respectively). Similarly, the arterial response in smokers had an impaired endothelium-dependent dilation compared with that in non-smokers (8.8%±2.7% vs 15.2%±2.3%, respectively; P<0.05) and ascorbic acid restored this response in smokers (8.8%±2.7% vs 18.7%±6.5% before and after infusion, respectively; P<0.05), but no difference was seen in non-smokers (15.2%±2.3% vs 14.0%±4.4% before and after infusion, respectively). The endothelium-independent dilation did not differ in both the groups studied. No important hemodynamic change was detected using the Portapress device.Conclusion: Smokers had impaired endothelium-dependent vasodilation responsiveness in both arterial and venous systems. Ascorbic acid restores this responsiveness in smokers. [ABSTRACT FROM AUTHOR]

Background: Smoking has been associated with periodontitis severity and is considered a risk factor for its development. It has been reported that matrix metalloproteinase (MMP) produced by host cells plays a major role in periodontal tissue destruction. Thus, the present study tested, in rats, the hypothesis that local increased levels of MMP-2 would be associated with the enhanced periodontitis-related bone loss after intermittent cigarette smoke inhalation (CSI). Methods: Twenty-seven adult male Wistar rats were used. A ligature was placed around one of the mandibular first molars of each animal and they were randomly assigned to the following control (N = 13) or CSI (N = 14) group. Sixty days later, the animals were sacrificed, the gingival tissues harvested, and the specimens processed For decalcified sections. Extracts from the gingival tissues were prepared and assayed for MMP-2 expression. Results: Intergroup comparisons (unligated sites) showed that CSI might directly affect alveolar bone (0.16 ± 0.03 mm² versus 0.24 ± 0.09 mm² for non-smokers and smokers, respectively; P = 0.001). Moreover, CSI significantly enhanced bone loss resulting from experimental periodontitis (0.64 ± 0.35 mm² versus 1.50 ± 0.50 mm² for non-smokers and smokers, respectively; P <0.05). In addition, zymography demonstrated that CSI also enhanced both MMP-2 leveis and activity in the gingival tissues around ligated teeth. Conclusion: Within the limits of the present investigation, it can be assumed that the effect of CSI on MMP-2 levels and activity may account for the increased periodontitis progression rate observed in smokers. [ABSTRACT FROM AUTHOR]

Background: A series of animal and in vitro data confirms that nicotine impairs bone healing, diminishes osteoblast function, and causes autogenous bone graft morbidity. Therefore, this study aimed to investigate the impact of nicotine on the healing of bone defects treated by the guided bone regeneration (GBR) principle. Methods: Sixteen mongrel dogs were used. One defect was surgically created bilaterally and randomly assigned as an expanded polyletrafluoroethylene (ePTFE) membrane site or a non-membrane control site. The animals were randomly assigned to one of the following groups: group 1, placebo (n = 8) and group 2, subcutaneous administration of nicotine (2 mg/kg) twice daily (n = 8). After 4 months, the animals were sacrificed and the specimens routinely processed for semi-serial decalcified sections. The evaluated parameters were bone height, bone width, bone density, and bone area of newly formed bone. Results: Intergroup analysis (Kruskal-Wallis) showed that membrane-protected defects in the placebo group demonstrated an increased bone area when compared to membrane-protected defects in the nicotine group and non-membrane sites, regardless of nicotine administration (P <0.05). In addition, nicotine administration significantly affected bone density in membrane- and non-membrane-protected sites (P <0.05). Conclusions: Within the limits of the present study, nicotine might affect, but not prevent, bone healing in defects treated by guided bone regeneration. The mechanisms of this effect should be investigated further. [ABSTRACT FROM AUTHOR]

Background: A series of isolated studies has focused on the influence of smoking on bone around titanium implants. This study proposes to investigate the impact of two conditions, i.e., nicotine administration and cigarette smoke inhalation, on the healing around implants. Methods: Forty-five Wistar rats were used. After anesthesia, the tibiae surface was exposed and a screw-shaped titanium implant was placed bilaterally. The animals were randomly assigned to one of the following groups: Group 1: control, n = 19; Group 2: intermittent cigarette smoke inhalation, n = 15; and Group 3: subcutaneous administration of nicotine (3 mg/kg) twice daily, n = 11. After 60 days, the animals were sacrificed. The degree of bone-to-implant contact (BIC) and the bone area (BA) within the limits of the threads of the implant were measured in the cortical (zone A) and cancellous bone (zone B) areas. Results: In zone A, cigarette smoke presented a significant negative influence on BIC and GA (Kruskal-Wallis test, P <0.05). In contrast, the administration of nicotine did not influence either parameter (P >0.05). In zone B, cigarette smoke inhalation also resulted in a decreased percentage of BIC compared to the control group (P <0.05). In addition, the BA was significantly decreased in groups 2 and 3 when compared to controls (P >0.05). Conclusion: The negative impact of smoking on implant outcomes may be related to more than one molecule present in the cigarette smoke and nicotine seems to partially contribute, especially in the cancellous bone. [ABSTRACT FROM AUTHOR]