Physical Training as Non-Pharmacological Treatment of Neurocardiogenic Syncope

Background

Characterized as a sudden and temporary loss of consciousness and postural tone, with quick and spontaneous recovery, syncope is caused by an acute reduction of systemic arterial pressure and, therefore, of cerebral blood flow. Unsatisfactory results with the use of drugs allowed the nonpharmacological treatment of neurocardiogenic syncope was contemplated as the first therapeutic option.

Objectives

To compare, in patients with neurocardiogenic syncope, the impact of a moderate intensity aerobic physical training (AFT) and a control intervention on the positivity of head-up tilting test (HUT) and orthostatic tolerance time.

Methods

Were studied 21 patients with a history of recurrent neurocardiogenic syncope and HUT. The patients were randomized into: trained group (TG), n = 11, and control group (CG), n = 10. The TG was submitted to 12 weeks of AFT supervised, in cycle ergometer, and the CG to a control procedure that consisted in 15 minutes of stretching and 15 minutes of light walk.

Results

The TG had a positive effect to physical training, with a significant increase in peak oxygen consumption. The CG did not show any statistically significant change before and after the intervention. After the intervention period, 72.7% of the TG sample had negative results to the HUT, not having syncope in the revaluation.

Conclusion

The program of supervised aerobic physical training for 12 weeks was able to reduce the number of positive HUT, as it was able to increase tolerance time in orthostatic position during the HUT after the intervention period.     

Duke Activity Status Index for Cardiovascular Diseases: Validation of the Portuguese Translation

Background

The Duke Activity Status Index (DASI) assesses the functional capacity of patients with cardiovascular disease (CVD), but there is no Portuguese version validated for CVD.

Objectives

To translate and adapt cross-culturally the DASI for the Portuguese-Brazil language, and to verify its psychometric properties in the assessment of functional capacity of patients with CVD.

Methods

The DASI was translated into Portuguese, then checked by back-translation into English and evaluated by an expert committee. The pre-test version was first evaluated in 30 subjects. The psychometric properties and correlation with exercise testing was performed in a second group of 67 subjects. An exploratory factor analyses was performed in all 97 subjects to verify the construct validity of the DASI.

Results

The intraclass correlation coefficient for test-retest reliability was 0.87 and for the inter-rater reliability was 0.84. Cronbach''s α for internal consistency was 0.93. The concurrent validity was verified by significant positive correlations of DASI scores with the VO₂max (r = 0.51, p < 0.001). The factor analysis yielded two factors, which explained 54% of the total variance, with factor 1 accounting for 40% of the variance. Application of the DASI required between one and three and a half minutes per patient.

Conclusions

The Brazilian version of the DASI appears to be a valid, reliable, fast and easy to administer tool to assess functional capacity among patients with CVD.     

对SPSS统计软件中Mcnemar检验结果的讨论

目的：比较手工计算与SPSS软件计算Mcnemar检验的结果,分析结果不一样的原因。方法选取相关书籍上配对设计资料的应用实例,用两种方法计算：一是利用Mcnemar检验公式进行手工计算,二是用SPSS统计软件计算,比较两种计算方法的结果有何不同。结果手工计算的结果为P=0.001,SPSS软件计算的结果为P=0.002,两种方法的结果有出入。结论SPSS统计软件对配对设计四格表资料进行计算时采用的是一种精确检验,运用的是二项分布原理,虽然与手工计算的结果有些出入,但无论用哪种方法都不会影响到最终的统计推断。     

Determination of in vitro susceptibility of ocular Fusarium spp. isolates from keratitis cases and comparison of Clinical and Laboratory Standards Institute M38-A2 and E test methods

We evaluated the susceptibility of 85 Fusarium spp. isolates from cases of fungal keratitis with 8 antifungal drugs using the standard Clinical and Laboratory Standards Institute broth microdilution and E test methods. Members of the Fusarium solani species complex showed consistently higher MICs to the triazole drugs itraconazole, voriconazole, and posaconazole than did members of other species complexes (Fusarium oxysporum and other minor species). High MICs to amphotericin B, natamycin, and echinocandins were consistently obtained with no discrimination based on species or method. Further work is required to determine any potential correlation between MIC and clinical outcome in keratitis.     

心肺运动试验对COPD的评估价值

采用自行车功率计做功，通过体积描记仪和能耗测试系统，监测３８例男性慢性阻塞性肺疾病（ＣＯＰＤ）患者和３０例正常男性对照者的心肺运动试验，发现运动试验指标与年龄呈负相关；ＣＯＰＤ组做功、每分通气量、摄氧量、ＣＯ２产生量的改变与用力肺活量、最大呼气中段流量、第一秒用力呼气量、呼气流量峰值等反映阻塞性通气障碍的肺功能指标显著相关提示心肺运动试验主要指标的改变可反映阻塞性通气功能障碍，有助于ＣＯＰＤ的评估     

复方黄连液对氧气湿化液中常见致病菌的体外抗菌效果研究

[目的]研究复方黄连液对氧气湿化液中存在的常见致病菌的体外抗菌效果,从而为复方黄连液作为氧气湿化液的临床应用提供科学依据。[方法]采用试管两倍稀释法,测定复方黄连液对测试菌种的最低抑菌浓度（MIC）。[结果]复方黄连液对金黄色葡萄球菌、大肠杆菌、铜绿假单胞菌、粪肠球菌均具有很强的抑制作用,MIC均为0.78%（7.8mg/mL）;对白色念珠菌的抑制作用稍弱,MIC为3.125%（31.25mg/mL）。[结论]复方黄连液对氧气湿化液中常见致病菌有很强的抑菌作用,具有临床应用价值。     

婴幼儿青霉素过敏试验判断标准探讨

介绍了５０例３岁以下住院患儿青霉素过敏试验的观察和分析。按本组判断标准确定结果，阳性率为８％。阴性者用药后无１例发生过敏反应。本标准组与习用标准组对比（χ２＝６．７８，Ｐ＜０．０１），差异明显。认为婴幼儿青霉素过敏试验的操作方法及其判断标准因其皮肤的解剖生理特点及小儿免疫生理状况的特异性而应该与成人有所差别。     

国外药典与中国药典的无菌检查用真菌培养基的灵敏度比对

微生物培养基是微生物生长繁殖需要的一种生物营养物质。无菌试验用培养基是药品无菌检验的重要手段，中国药典无菌检查法中检查真菌用的培养基改良马丁培养基是用于检查样品是否污染真菌。而BP、EP、USP、JP等国家药典用大豆-酪蛋白消化培养基检查此项。进口药品的药品标准及厂报标准大多都参照国外药典制定，为了与国际接轨，了解大豆-酪蛋白消化培养基能否替代改良马丁培养基，我们参照中国药典培养基灵敏度检查法对中国药典改良马丁培养基与大豆-酪蛋白消化培养基进行了比对试验。现报告如下.     

TDI-FP法检测肿瘤患者ERCC1 Asn118Asn基因多态性

目的建立一种可靠、敏感、全面的ERCC1 Asn118Asn基因多态性检测新方法,用于预测肿瘤患者对铂类的耐药性。方法以ERCC1基因第4个外显子Asn118Asn的一对引物行PCR扩增227例临床样本DNA,将荧光偏振检测技术与模板指导的末端延伸反应(TD I-FP)结合,应用探针杂交延伸反应对临床样本扩增产物进行ERCC1 Asn118Asn基因多态性检测,并以DNA序列测定验证检测结果。结果227例临床样本DNA中,119例(52.4%)ERCC1 Asn118Asn基因为C/C纯合子(AAC)基因型,88例(38.8%)为C/T杂合子基因型,20例(8.8%)为T/T纯合子(AAT)基因型。但DNA序列测定法检出杂合子基因型仅33例。结论本研究初步建立了特异性较好、操作简便、无需标记探针的临床标本ERCC1 Asn118Asn基因多态性检测新方法,有望用于肿瘤患者铂类耐药性的检测。     

Is the pattern of solid‐phase gastric emptying different between genders?

BACKGROUND: In the 13C-octanoate breath test, the shape of the 13CO2 excretion curve in the ascending portion reflects a pattern of gastric emptying (GE). Recent scintigraphic studies have revealed an overall delay in solid GE in fertile women compared with men. However, it remains unknown whether women have a different GE pattern compared with men. As a symptomatic delay in solid GE is specific to the female gender, it could be hypothesized that the 13CO2 excretion curve is different in shape between genders. MATERIALS AND METHODS: Because the ascending gradient of the 13CO2 excretion curve is often biphasic, the dual function of y(t) = ( a1 . tb1 + a2 . tb2) e(-K.t) was applied to fit the breath data, where a1, b1, a2, b2, and K are constants. Assessed on the 4 h-based breath samples obtained after ingestion of a 320-kcal muffin containing 100 mg 13C-octanoate, the time versus 13CO2 excretion curve was created from 31 adult volunteers (15 men and 16 women). The curve shape was characterized by the dual function, and was compared between genders. RESULTS: In both genders, the ascending gradient exhibited the biphasic feature, characterized by an initial steep rise and the subsequent blunted increase, while the descending gradient followed the monotonous decay. The initial rise was steeper and the subsequent increase was more blunted in women than in men. CONCLUSION: Women exhibit a gender-specific pattern of the 13CO2 excretion profile. A possible explanation for this gender difference is that the post-gastric feedback regulation is more potent in women than in men.