The FACIT-Pal-14, a shortened 14-item questionnaire has been generated for the palliative care population. Future studies should complete psychometric validation of this instrument for the assessment of QOL in palliative care patients.
The high prevalence rate of psychotropic drug use found amoung military police officers in two cities of the state of Goiás in Brazil can be considered an important factor with potential influence on job activities.
Correspondência: Paulo Roberto Melo-Reis Universidade Católica de Goiás -Departamento de Biomedicina -(LEPAH-LAS-CBB) -Área IV -Bloco H -Sala 209
IntroduçãoAs anemias hereditárias são as mais comuns das doenças determinadas geneticamente e são freqüentes na população brasileira.1,2,3,4 A razão para isso se deve ao processo de miscigenação ocorrido desde o início do povoamento e colonização do Brasil e conseqüentemente da dispersão dos genes anormais que determinam doenças como hemoglobinopatias e talassemias.2 Dentre as hemoglobinopatias, as mais prevalentes na nossa população são as hemoglobinas S e C, que são capazes de produzir doença quando em homozigose. Entretanto, quando em heterozigose, o portador é clinicamente assintomático, não apresentando a doença e nem anemia. 4,5 A maioria das hemoglobinas variantes ocorre por alterações pontuais na molécula, onde um aminoácido é substituído por outro. A hemoglobina S (Hb S) como resultante da mutação do gene beta, na posição 6, onde ácido glutâmico é substituído pela valina, e também a hemoglobina C (Hb C) onde o ácido glutâmico é substituído pela lisina na mesma posição 6 do gene beta da globina. As trocas dos aminoácidos vão dar características estruturais e funcionais próprias à molécula, facilitando sua identificação pelos métodos laboratoriais de rotina. 3,4,5,6 Quando em homozigose, tanto para a Hb S quanto para a Hb C, os portadores apresentam anemia hemolítica crônica de intensidade variável e muitas vezes fatal na infância. 7,8 Os duplos heterozigotos SC são também conhecidos por doença da hemoglobina C. A herança dessa forma provém de cada um de seus genitores. Não há hemoglobina A e as taxas de Hb S e Hb C estão próximas uma da outra. 4,6 O
NO is a potent bronchodilator and NO-donor compounds have demonstrated clinical significance for obstructive airway diseases. This study evaluated the relaxation mechanisms of two NO donors, a ruthenium compound (TERPY), and sodium nitroprusside (SNP), in rat tracheas with ovalbumin-induced asthma (OVA group) and in another control group. The effect of TERPY and SNP was evaluated in tracheal rings in an isolated organ chamber. The contribution of K(+) channels, sGC/cGMP pathway, phosphodiesterases, and extra and intracellular Ca(2+) sources were analyzed. The TERPY and SNP-induced tracheal smooth muscle relaxation in both groups. However, the maximum effect induced by TERPY was higher than that of SNP in both control (110.2 ± 3.2% vs 68.3 ± 3.1%, P < 0.001) and OVA groups (106.1 ± 1.5% vs 49.9 ± 2.7%, P < 0.001). In the control group, TERPY relaxation was induced by the activation of K(+) channels and reduction of the calcium influx, while in the OVA group, these same effects were also brought about by TERPY, but with participation of the sGC/cGMP pathway. In both groups, SNP-induced relaxation occurred through the activation of K(+) channels, sGC/cGMP pathway and reduction of calcium influx. However, the activation of sGC pathway and reticular Ca(2+) -ATPase seemed to be reduced in the OVA group. Furthermore, TERPY is capable of reversing the contraction of carbachol in asthmatic bronchioles. Finally, TERPY and SNP relaxation mechanisms were modified by asthma. SNP presented less relaxation than TERPY, which induced full relaxation with greater participation of K(+) and Ca(2+) fluxes through the membrane, thereby making TERPY a promising drug for reversing the narrowing of airways.
BackgroundPrognostic factors are extensively studied in heart failure; however, their
role in severe Chagasic heart failure have not been established.ObjectivesTo identify the association of clinical and laboratory factors with the
prognosis of severe Chagasic heart failure, as well as the association of
these factors with mortality and survival in a 7.5-year follow-up.Methods60 patients with severe Chagasic heart failure were evaluated regarding the
following variables: age, blood pressure, ejection fraction, serum sodium,
creatinine, 6-minute walk test, non-sustained ventricular tachycardia, QRS
width, indexed left atrial volume, and functional class.Results53 (88.3%) patients died during follow-up, and 7 (11.7%) remained alive.
Cumulative overall survival probability was approximately 11%. Non-sustained
ventricular tachycardia (HR = 2.11; 95% CI: 1.04 - 4.31; p<0.05) and
indexed left atrial volume ≥ 72 mL/m2 (HR = 3.51; 95% CI:
1.63 - 7.52; p<0.05) were the only variables that remained as independent
predictors of mortality.ConclusionsThe presence of non-sustained ventricular tachycardia on Holter and indexed
left atrial volume > 72 mL/m2 are independent predictors of
mortality in severe Chagasic heart failure, with cumulative survival
probability of only 11% in 7.5 years.
SARS-CoV-2 currently represents a serious global public health problem. Non-pharmaceutical intervention measures (NPIs) have been widely adopted, and the testing strategy since the beginning of the infection is the most...
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