The aim of the present study was to compare the modulation of heart rate in a group of postmenopausal women to that of a group of young women under resting conditions on the basis of R-R interval variability. Ten healthy postmenopausal women (mean ± SD, 58.3 ± 6.8 years) and 10 healthy young women (mean ± SD, 21.6 ± 0.82 years) were submitted to a control resting electrocardiogram (ECG) in the supine and sitting positions over a period of 6 min. The ECG was obtained from a one-channel heart monitor at the CM5 lead and processed and stored using an analog to digital converter connected to a microcomputer. R-R intervals were calculated on a beat-to-beat basis from the ECG recording in real time using a signal-processing software. Heart rate variability (HRV) was expressed as standard deviation (RMSM) and mean square root (RMSSD). In the supine position, the postmenopausal group showed significantly lower (P<0.05) median values of RMSM (34.9) and RMSSD (22.32) than the young group (RMSM: 62.11 and RMSSD: 49.1). The same occurred in the sitting position (RMSM: 33.0 and RMSSD: 18.9 compared to RMSM: 57.6 and RMSSD: 42.8 for the young group). These results indicate a decrease in parasympathetic modulation in postmenopausal women compared to young women which was possibly due both to the influence of age and hormonal factors. Thus, time domain HRV proved to be a noninvasive and sensitive method for the identification of changes in autonomic modulation of the sinus node in postmenopausal women.
Background-The pattern of progression of a meal from the stomach to the caecum in diabetes mellitus is controversial and the differential roles of transit through the jejunum and the ileum have not been investigated in diabetes.Aims-To determine gastric emptying and transit rates through proximal and distal regions of the small bowel in type I diabetic patients. Subjects-The study included six diabetic patients with evidence of autonomic neuropathy (DM-AN group), 11 diabetics without autonomic dysfunction (DM group), and 15 control volunteers. Methods-Gastric emptying and small bowel transit of a liquid meal were evaluated scintigraphically in these subjects. Transit through regions ofinterest corresponding to the proximal and distal small intestine up to the caecum was determined and correlated with gastric emptying rates, cardiovascular measurements of autonomic function, and the occurrence of diarrhoea. Results-Gastric emptying and transit through the proximal small bowel were similar in the three groups. The meal arrived to the caecum significantly earlier in DM-AN patients (median; range: 55 min; 22->180 min) than in the DM group (100 min; 44->180 min, p<0.05) or in controls (120 miin; 80->180 min, p<0.02). Accumulation of chyme in the distal small bowel was decreased in DM-AN patients, who showed values for peak activity (30%; 10-55%) significantly lower than in the DM group (49%; 25-77%, p=0.02) and controls (50%; 30-81%, p=0.02). In DM patients (n=17), the time ofmeal arrival to the caecum was significantly correlated with both orthostatic hypotension (coefficient of contingency, C=0 53, p<0.01) and diarrhoea (C=0.47, p<0.05), but not with gastric emptying rates. Conclusions-Patients with type I diabetes mellitus and sympathetic denervation have abnormally rapid transit of a liquid meal through the distal small bowel, which may play a part in diarrhoea production.
SUMMARY Haemodynamic responses to. sustained isometric exercise (handgrip at 30% of maximum voluntary capacity) were studied in 10 patients with Chagas's cardiopathy without previous or current heart failure. Five of the patients (group 1) had profound impairment of parasympathetic control of heart rate. They had no tachycardia in response to intravenous administration of atropine and no bradycardia during phase IV of the Valsalva manoeuvre. The other five (group 2) showed normal vagal regulation of heart rate, as judged by chronotropic responses to these tests.The heart rate change (mean (SD)) elicited by the handgrip test was significantly lower in group 1 (from 93 0 (14 1) to 95-0 (16-7) beats/min) than in group 2 (from 78-2 (15-8) to 92-8 (18 1)
Introduction Many authors have written about the need to treat patients closer to their beds, in order to observe them more as distinct people. The FAST HUG mnemonic, which consists of a checklist, was suggested as an idea to be employed everyday, by professionals dealing with patients who are critically ill. Minding these questions and motivated by an idea of follow patients' treatment closer, we have put into practice the instrument developed by Jean-Louis Vincent, evaluating the seven most important procedures in critically ill patients, and performed the FAST HUG. This checklist consists of seven items to be evaluated: Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head-of-bed elevation, stress Ulcer prevention, and Glucose control. Knowing that the pressure ulcer is one of the challenges faced by ICU nurses, related to patients' need to stay at rest, to be under rigorous control or more complex therapy, it was decided to create the eighth item on the checklist: S, for skin. It stands for skin treatment, with the techniques used in the unit (Braden Scale), monitoring and evaluating closer skin integrity, and allowing nurses to calculate the scoring average of the Braden Scale, and greater incidence of ulcer in interned patients. Objective To expose the shortcomings found during the FAST HUG application, and to show results obtained with the eighth item of the FAST HUG mnemonic: S-Skin. Methods A descriptive study, based on institutional data, was carried out in the adult ICU of a private hospital. It was performed from 2 to 27 June 2008, except on weekends. Three hundred and twenty-three patients were involved. The checklist was carried out during the afternoons by the head nurse, or the assistant nurse of the unit. In order to do this job, a spreadsheet was elaborated to control data, updated every week. This spreadsheet provided graphics for a more objective control of the results obtained. The idea was exposed to the team, during a training program, and so we started the activities. Results and discussion For 20 days of the checklist, 323 patients were evaluated for the eight items. The real shortcomings most frequently found were related to thromboembolic prophylaxis (85%) and glucose control (90%). These shortcomings were immediately evaluated and, depending on this analysis, this item would go on or not, according to the patient's clinical situation. The shortcomings found were tracked just as they were detected, and their cause would be discussed in a multidisciplinary group, and a solution was found. If the item was not observed, it would be 1. Vincent JL: Give your patient a fast hug (at least) once a day.
A análise econômica indicou reduzido custo de produção do derivado, cerca de R$ 0,20 (vinte centavos de real), para cada 100 ml. O iogurte de leite de búfala constitui-se excelente derivado e pode ser usado como alternativa em Programas Especiais, financiados pelo Governo, com vista à redução da fome de comunidades de baixa renda, pois possui elevado valor calórico/proteico, baixo custo, utiliza matérias primas regionais, além da geração de renda e trabalho, através do incentivo à produção leiteira e à fruticultura regionais. PALAVRAS-CHAVE:Amazônia Oriental, derivado lácteo, fruticultura regional. YOGURT BUFFALO MILK FLAVORED WITH MANGO (Mangifera indica L.): SENSORY ACCEPTION AND PRODUCTION COST ABSTRACT:The objective was to develop and evaluate buffalo milk yogurt flavored with mango (Mangifera indica L.), tropical fruit widely consumed in the North Region, Brazil. Buffalo milk (Bubalus bubalis) was subjected to heat treatment (95 °C/5 minutes), cooled to 45 °C and inoculated with 2.5% lactic culture, followed by addition of sweet sauce prepared at 35% mango pulp, 35% sucrose and 30% water, homogenized for five minutes. The day after the elaboration, the derivative was subjected to sensory evaluation, with untrained. The analysis showed good acceptance, with an average score of 7.4. As for intent to purchase 47.3% of the judges, of course buy the product, 26.4%, may buy, and 26.3% would not buy. The economic analysis indicated reduced cost of production, about US$ 0.20 (twenty cents) per 100 ml. Yogurt buffalo milk is excellent and can be used as an alternative for Special Programs, funded by the Government, with a view to reducing hunger in low-income communities, because it has high fat/protein, low-cost and used regional materials, in addition
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