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Intracellular mechanisms of specific beta-adrenoceptor antagonists involved in improved cardiac function and survival in a genetic model of heart failure

Bartholomeu, Jan B.; Vanzelli, Andrea S.; Rolim, Natale P. L.; Ferreira, J. C. B.; Bechara, Luiz R. G.; Tanaka, Leonardo Y.; Rosa, Kaleizu T.; Alves, Marcia M.; Medeiros, Alessandra; Mattos, Katt C.; Coelho, Marcele A.; Irigoyen, Maria C.; Krieger, Eduard
Fonte: ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD Publicador: ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
45.96%
beta-blockers, as class, improve cardiac function and survival in heart failure (HF). However, the molecular mechanisms underlying these beneficial effects remain elusive. In the present study, metoprolol and carvedilol were used in doses that display comparable heart rate reduction to assess their beneficial effects in a genetic model of sympathetic hyperactivity-induced HF (alpha(2A)/alpha(2C)-ARKO mice). Five month-old HF mice were randomly assigned to receive either saline, metoprolol or carvedilol for 8 weeks and age-matched wild-type mice (WT) were used as controls. HF mice displayed baseline tachycardia, systolic dysfunction evaluated by echocardiography, 50% mortality rate, increased cardiac myocyte width (50%) and ventricular fibrosis (3-fold) compared with WT. All these responses were significantly improved by both treatments. Cardiomyocytes from HF mice showed reduced peak [Ca(2+)](i) transient (13%) using confocal microscopy imaging. Interestingly, while metoprolol improved [Ca(2+)](i) transient, carvedilol had no effect on peak [Ca(2+)](i) transient but also increased [Ca(2+)] transient decay dynamics. We then examined the influence of carvedilol in cardiac oxidative stress as an alternative target to explain its beneficial effects. Indeed...

Entre discursos e retóricas: um estudo sobre o reconhecimento e as estratégias de enfrentamento do fracasso escolar em um município da região metropolitana de São Paulo; Between Discourses and Rhetorics: a study on the recognition of and strategies do deal with, school failure in a municipality of the metropolitan area of São Paulo

Cores, Luciano Nunes Sanchez
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: dissertação de mestrado Formato: application/pdf
Publicado em 13/05/2010 Português
Relevância na Pesquisa
36.11%
Este trabalho aborda a questão do fracasso escolar, que permanece na pauta de discussões das Políticas Públicas em Educação e é privilegiado pela pesquisa educacional desde a década de 1980. No contexto atual, o fenômeno da não-aprendizagem dos alunos advindos de classes mais pauperizadas adquiriu um caráter público e proporções inaceitáveis, exigindo ações das políticas públicas que se dirijam para seu enfrentamento efetivo. Este estudo parte, assim, da necessidade de se compreender as formas de reconhecimento e as decorrentes políticas de enfrentamento desse fenômeno na esfera dos sistemas públicos e municipais de ensino. Elege como objeto de estudo as formas de reconhecimento do fracasso escolar e as propostas de seu enfrentamento enunciadas pelos supervisores de ensino e nos documentos produzidos no âmbito da Secretaria Municipal de Educação (SME) de uma cidade da região metropolitana de São Paulo. Além da revisão bibliográfica sobre o tema, realizou-se uma pesquisa empirica, com inspirações na perspectiva etnográfica, cujo trabalho de campo baseou-se em observações participantes e entrevistas informais junto ao setor de supervisão escolar desta Secretaria de Educação, indicado como o responsável pela elaboração e implementação das propostas de melhoria da qualidade do ensino municipal. O estudo também contemplou a análise de documentos oficiais emitidos no âmbito desta Secretaria (Planos Muncipais de Educação...

Fatores associados ao padrão de sono pacientes com insuficiência cardíaca; Factors associated with sleep pattern of patients with heart failure

Santos, Mariana Alvina dos
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: dissertação de mestrado Formato: application/pdf
Publicado em 06/07/2010 Português
Relevância na Pesquisa
36.01%
INTRODUÇÃO: A insuficiência cardíaca (IC) constitui hoje um dos maiores problemas de saúde pública em todo o mundo, com números crescentes em qualquer análise epidemiológica. Além de representar grande demanda aos serviços de saúde, é responsável por prejuízo na qualidade de vida das pessoas. Alterações do sono têm sido descritas como freqüentes e comuns entre os pacientes com IC, e também é um dos sintomas de mais incômodo para esta população. OBJETIVO: Descrever o padrão de sono em pacientes com IC e analisar associações do padrão de sono com as seguintes variáveis: sexo, idade, fadiga, fadiga ao esforço, atividade física, classe funcional, terapia medicamentosa, dispnéia e índice de massa corporal. MÉTODO: Estudo transversal descritivo, com uma amostra não probabilística de 400 pacientes ambulatoriais (idade média 57,8 anos, DP=11,6; 64,8% eram homens; escolaridade média de 6,1 anos, DP=3,9; 82,5% em classe funcional II ou III) em tratamento de insuficiência cardíaca em um hospital de ensino. Os dados foram coletados por meio de entrevista em que os participantes responderam a um conjunto de instrumentos contendo: dados de demográficos e da insuficiência cardíaca; e avaliação do padrão de sono (Pittsburg Sleep Quality Index PSQI); de fadiga (Dutch Fatigue Scale DUFS)...

Higher salt preference in heart failure patients

de Souza, Juli Thomaz; Matsubara, Luiz S.; Menani, Jose Vanderlei; Matsubara, Beatriz B.; Johnson, Alan Kim; Fratucci de Gobbi, Juliana Irani
Fonte: Academic Press Ltd Elsevier B.V. Ltd Publicador: Academic Press Ltd Elsevier B.V. Ltd
Tipo: Artigo de Revista Científica Formato: 418-423
Português
Relevância na Pesquisa
45.96%
Heart failure (HF) is a complex syndrome that involves changes in behavioral, neural and endocrine regulatory systems. Dietary salt restriction along with pharmacotherapy is considered an essential component in the effective management of symptomatic HF patients. However, it is well recognized that HF patients typically have great difficulty in restricting sodium intake. We hypothesized that under HF altered activity in systems that normally function to regulate body fluid and cardiovascular homeostasis could produce an increased preference for the taste of salt. Therefore, this study was conducted to evaluate the perceived palatability (defined as salt preference) of food with different concentrations of added salt in compensated chronically medicated HF patients and comparable control subjects. Healthy volunteers (n = 25) and medicated, clinically stable HF patients (n = 38, NYHA functional class II or III) were interviewed and given an evaluation to assess their preferences for different amounts of saltiness. Three salt concentrations (0.58, 0.82, and 1.16 g/100 g) of bean soup were presented to the subjects. Salt preference for each concentration was quantified using an adjective scale (unpleasant, fair or delicious). Healthy volunteers preferred the soup with medium salt concentration (p = 0.042)...

Motivação no contexto escolar e desempenho academico; Motivation in school context and academic achievement

Carla Helena Manzini Genari
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: dissertação de mestrado Formato: application/pdf
Publicado em 27/11/2006 Português
Relevância na Pesquisa
36.14%
A presente pesquisa teve como objetivo investigar a existência de possíveis relações entre as orientações motivacionais e o desempenho acadêmico de alunos do ensino fundamental, bem como verificar se diferentes níveis de desempenho acadêmico apresentam diferentes padrões motivacionais. Participaram do estudo 150 alunos entre 9 e 12 anos de idade de uma escola pública do interior do Estado de São Paulo, que cursavam a 3ª e 4ª séries do ensino fundamental. As orientações motivacionais intrínsecas e extrínsecas foram avaliadas mediante uma escala de motivação escolar, contendo 31 questões, 15 referentes a motivação intrínseca e 16 abarcando a motivação extrínseca. O desempenho escolar foi obtido por meio de uma prova elaborada pelo Sistema de Avaliação de Rendimento Escolar do Estado de São Paulo (SARESP/2004). Os resultados mostraram que as orientações motivacionais e o desempenho acadêmico se relacionaram em alguns casos, mas que nem sempre essa relação foi clara e constante. Em relação à motivação intrínseca e o desempenho acadêmico, na quarta série os resultados apresentaram correlação significativa e positiva, revelando que quanto maior a motivação intrínseca, melhor o desempenho acadêmico apresentado pelos alunos. Na terceira série...

Statistical multivariate approaches for identification of predictors of academic failure for first year students in medical school

Kislaya, Irina
Tipo: info:eu-repo/semantics/bachelorthesis
Publicado em //2012 Português
Relevância na Pesquisa
56.39%
Relatório de mestrado em Estatística de Sistemas (Ramo de conhecimento em Engenharia e Estatística); Academic failure is a frequent phenomena in medical education, with huge impact on the students and on the medical schools. Understanding of factors that have the strongest in uence on the probability of failure is extremely important to implement procedures for timely assistance and support to students in di culties. The main goal of this work was to gain information (factors) that can be useful in predicting, early in the rst year of the medical program, academic failure for the students of the School of Health Sciences of Minho University. To determine which factors in uence the performance of these students in the 1st year course with the highest failure rates, administrative data of three cohorts of students were analyzed using several multivariate statistical tools, namely: logistic regression, linear discriminant analysis and K-nearest neighbors discriminant analysis. The results obtained in this study provide substantial empirical evidence that combination of cognitive and non-cognitive characteristics (personality trait "Conscientiousness", change of residence at entry, anticipation of di culties due to enrollment in a medical program) and of academic achievements in the initial university courses can be useful in the early detection of failure.; O insucesso escolar é um fenómeno bastante frequente na educação médica...

Os cursos de educação e formação como uma resposta ao insucesso e abandono escolar: estudo realizado na região Douro Sul

Patrício, José; Ribeiro, Célia
Fonte: Universidade Católica Portuguesa. Departamento de Economia, Gestão e Ciências Sociais Publicador: Universidade Católica Portuguesa. Departamento de Economia, Gestão e Ciências Sociais
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
Relevância na Pesquisa
46.36%
Os Cursos de Educação e Formação (CEF) surgiram como uma medida para o combate ao insucesso e ao abandono escolar, proporcionando aos jovens percursos escolares e de formação que facilitem a construção de projectos profissionais mais de acordo com os seus interesses e expectativas, possibilitando assim a conclusão da escolaridade obrigatória. O presente estudo foi realizado em 14 escolas dos 10 concelhos pertencentes à Região Douro Sul, em que foram inquiridos 235 professores e 544 alunos. Os resultados obtidos levaram-nos a concluir que os CEF são realmente uma resposta para o combate ao insucesso e abandono escolar nesta região, pois numa população de 601 alunos matriculados no ano lectivo de 2008/2009 e dos 544 alunos inquiridos, 260 (47.79%) responderam que se não frequentassem um CEF já teriam abandonado a escola e 503 (92.50%) afirmaram que os seus resultados escolares melhoraram com a frequência de um CEF. Educational and Training Courses as a response to Academic Failure and Dropout: Study conducted in the Southern Douro Region. The Educational and Training Courses (CEF) emerged as a way to combat academic failure and school dropout, by offering young people academic and training choices that make it easier for them to follow career paths more in line with their interests and expectations...

O planejamento de estudo na educação á distância como prática discente no combate ao insucesso das avaliações académicas : estudo de caso na UNIUBE - Pólo em Belém

Sousa, Jacqueline Andréa Furtado de
Fonte: Universidade de Évora Publicador: Universidade de Évora
Tipo: masterthesis
Português
Relevância na Pesquisa
36.01%
O tema da dissertação trata de “ O planejamento do estudo na educação a distância como prática discente no combate ao insucesso das avaliações acadêmicas: estudo de caso na Uniube - pólo em Belém”. O objectivo da investigação consiste em registar e analisar os hábitos de estudo dos estudantes em regime de ensino a distância. A literatura da especialidade indica que os estudantes que planejam o seu trabalho conseguem melhores resultados nas avaliações acadêmicas no domínio da educação a distância, nível de formação superior. A investigação procura explorar estas indicações através de um estudo de caso, com recurso à entrevista grupo focal. Os sujeitos foram seleccionados de um grupo de estudantes do curso de pedagogia, turma 3, da UNIUBE, Belém, Brasil. Os estudantes foram divididos em dois grupos e comparados os resultados obtidos. Os resultados obtidos confirmam que os alunos têm vantagens em planejar os estudos de acordo com as indicações metodológicas proporcionadas pelos professores e pela Universidade; ABSTRACT:The theme of dissertation is " THE planning of the study in distance education as practice students in the fight against academic failure of the evaluations: a case study in Uniube – polo in Belém”. The purpose of research is to record and analyze the habits of study of students distance learning. The literature of specialty indicates that students plan its work achieve better results in academic assessments in the field of distance education...

Escola e comunidade: missão ou miragem no combate ao insucesso e abandono escolares, no período 1997/2007, no Concelho do Alandroal

Barrenho, Cristina de Jesus
Fonte: Universidade de Évora Publicador: Universidade de Évora
Tipo: masterthesis
Português
Relevância na Pesquisa
36.01%
Este estudo procurou conhecer a realidade do insucesso/abandono escolares no Concelho de Alandroal, no período de 1997-2007, identificando as causas das duas problemáticas e as medidas educativas de resolução, a partir de uma amostra de 41 sujeitos. Pretendemos identificar e caracterizar os episódios de insucesso e abandono escolares protagonizados por um grupo de alunos que iniciaram o seu percurso escolar em 1996/1997, no Concelho de Alandroal. No corpus teórico deste estudo, procedemos à revisão da literatura e à análise de normativos legais que abordam e regulamentam esta temática, de maneira a olhar para ela, de forma reflexiva. Ao nível do corpus empírico, utilizámos uma metodologia quantitativa/qualitativa, no sentido de obtermos o melhor conhecimento e interpretação desta realidade. Os resultados permitem concluir que existe uma relação entre as causas individuais, familiares, escolares e do meio envolvente que levaram ao insucesso e abandono escolares. Sublinhou-se a importância da implementação de medidas educativas adequadas e a sua relação com as instituições do concelho de Alandroal que levaram parte dos sujeitos a concluir o ensino obrigatório com sucesso; ABSTRACT: This study aimed to know the reality of failure / dropping out of school in the Municipality of Alandroal in the period 1997-2007...

A comprehensive approach towards academic failure : the case of Mathematics I in ISEG graduation

Lopes, Margarida Chagas; Fernandes, Graça Leão
Fonte: ISEG - SOCIUS Publicador: ISEG - SOCIUS
Tipo: info:eu-repo/semantics/other
Publicado em //2012 Português
Relevância na Pesquisa
66.37%
Despite the enormous progress in graduation completion rates along the last decade, academic failure in Portuguese Higher Education is still attracting concern. This is particularly true for some 1st. year critical subjects as Mathematics. Most research and analyses on the issue are focused upon either the “academic” or the “non academic” determinants of failure whilst it becomes more and more obvious that the explanation, or at least an important part of it, resides in the interaction between those two sets of features. Having developed previous research on the basis of the former factors to elucidate failure rate in ISEG graduation, we are now analyzing the joint influence of both kind of determinants. For that purpose we rely upon students’ information retrieved from ISEG Pedagogical Observatory Database and the outputs of a Survey on Attitudes Towards Mathematics 1 (SATM 1) which has been especially redesigned and addressed to 1st. year students.

Alguns factores e condicionantes do sucesso escolar académico: a aplicação de modelos de regressão

Afonso, Carlos Miguel
Tipo: info:eu-repo/semantics/masterthesis
Publicado em //2010 Português
Relevância na Pesquisa
46.47%
Dissertação de mestrado em Prospecção e Análise de Dados; O insucesso escolar tem vindo a motivar o estudo em vários domínios das ciências sociais, através não só da reflexão sobre o fenómeno e politicas educativas, bem como através da construção de modelos conceptuais e explicativos do insucesso escolar. O insucesso escolar em ambiente académico pode assumir outros contornos de complexidade que são merecedores de estudo, o que evidencia a necessidade de vislumbrar quais os seus principais factores. O estudo, no qual esta tese se baseia, teve como objectivo a construção de um modelo sócio-psicológico explicativo do sucesso escolar, bem como descortinar os principais factores sociológicos e psicológicos do insucesso académico numa instituição de ensino superior – o Instituto Politécnico de Bragança (IPB). Para isso procedeu-se à construção de um questionário para aplicar a uma amostra de 200 alunos de dois estabelecimentos do ensino (ESSA - Escola Superior de Saúde; ESTIG – Escola Superior de Tecnologia e Gestão) do IPB. Após a recolha da amostra aplicaram-se os Modelos de Regressão Linear Múltipla e de Regressão Logística, por forma a obter os modelo sociológico...

Students’ Voices at a Portuguese University: Academic Motivation and its Relationship with Academic Success

Valadas, Sandra Teodório; Gonçalves, Fernando Ribeiro; Faísca, Luís; Vilhena, Carla Cardoso
Fonte: Routledge Publicador: Routledge
Tipo: Artigo de Revista Científica
Publicado em //2005 Português
Relevância na Pesquisa
36.27%
In this paper the authors will try to point out some evidences that emerged from the data collected in the year of 2000 by the Permanent Observatory for Teaching and Learning Quality of the University of Algarve. Data presented here will report exclusively to students’ representations concerning the institution, themselves, their teachers and the curriculum, since we consider that students are the privileged informants about their own academic experience. The main topic explored refers to students’ evaluation of the influence of academic motivation on the abandonment of studies in higher education. Theoretical framework will also be presented. We will present some behavioral symptoms that students evaluated as relevant indicators of lack of academic motivation. Also, the analysis will concern the meanings students attribute to academic failure as well as students’ points of view about their own failure, according to their academic experience.

Automatic Regulation of Hemodynamic Variables in Acute Heart Failure by a Multiple Adaptive Predictive Controller Based on Neural Networks

Kashihara, Koji
Fonte: Kluwer Academic Publishers-Plenum Publishers Publicador: Kluwer Academic Publishers-Plenum Publishers
Tipo: text
Português
Relevância na Pesquisa
36.03%
Automated drug-delivery systems that can tolerate various responses to therapeutic agents have been required to control hemodynamic variables with heart failure. This study is intended to evaluate the control performance of a multiple adaptive predictive control based on neural networks (MAPCNN) to regulate the unexpected responses to therapeutic agents of cardiac output (CO) and mean arterial pressure (MAP) in cases of heart failure. The NN components in the MAPCNN learned nonlinear responses of CO and MAP determined by hemodynamics of dogs with heart failure. The MAPCNN performed ideal control against unexpected (1) drug interactions, (2) acute disturbances, and (3) time-variant responses of hemodynamics [average errors between setpoints (+35 ml kg?1 min?1 in CO and ±0 mmHg in MAP) and observed responses; 6.4, 3.7, and 4.2 ml kg?1 min?1 in CO and 1.6, 1.4, and 2.7 mmHg (10.5, 20.8, and 15.3 mmHg without a vasodilator) in MAP] during 120-min closed-loop control. The MAPCNN could also regulate the hemodynamics in actual heart failure of a dog. Robust regulation of hemodynamics by the MAPCNN was attributable to the ability of on-line adaptation to adopt various responses and predictive control using the NN. Results demonstrate the feasibility of applying the MAPCNN using a simple NN to clinical situations.

A Canadian context for the Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure (ASCEND-HF) trial

Armstrong, Paul W; Rouleau, Jean-Lucien
Fonte: Pulsus Group Inc Publicador: Pulsus Group Inc
Tipo: text
Publicado em /07/2008 Português
Relevância na Pesquisa
36.08%
Congestive heart failure comprises a major public health problem destined to grow enormously over the next decade. Paradoxically, and in contrast to acute coronary disease, acute heart failure has been relatively understudied. Current standards of care involve the use of intravenous diuretics and vasodilators; inotropic agents have been restricted to in-hospital use because of concern about their potential harmful effects. The emergence of recombinant human B-type natriuretic peptide (BNP) provides an interesting therapeutic alternative because of its capacity to promote vasodilation as well as increase salt and water excretion, and improve pulmonary congestion by reducing left ventricular filling pressure. This agent will be explored in the Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure (ASCEND-HF), the largest ever trial conducted in acute decompensated heart failure. Patients will be studied through day 30 with end points of all-cause mortality in rehospitalization as the primary composite outcome. A variety of mechanistic substudies are planned as well as an assessment of the health care economic implications of acute heart failure and the pathophysiological elements hypothesized to modulate the expected treatment effect examined. The trial is embedded in an academic research organization motif and promises to provide a significant contribution to the body of knowledge in acute heart failure and the care of patients so afflicted.

The Connection Between Academic Failure and Adolescent Drinking in Secondary School

Crosnoe, Robert
Tipo: text
Publicado em //2006 Português
Relevância na Pesquisa
46.21%
Academic failure and drinking are both problematic aspects of the adolescent stage of the life course, and the connection between these two behaviors can disrupt the basic functioning of individuals and schools. Drawing on theories of problem behavior from multiple disciplines, this study attempted to determine whether academic failure was a risk factor for adolescent drinking, and vice versa, and then to identify the mechanisms underlying these two longitudinal associations. Cross-lagged models of data from 11,927 middle school and high school students in the National Longitudinal Study of Adolescent Health revealed that the number of classes failed in one year predicted alcohol use a year later more than early alcohol use predicted later class failures. Aspects of social bonding (e.g., attachments to adults) and symptoms of general maladjustment (e.g., delinquency) did more than opportunity structures (e.g., peer norms) to explain the connection between these two behaviors over one year of secondary school.

Gender, Self-Perception, and Academic Problems in High School

CROSNOE, ROBERT; RIEGLE-CRUMB, CATHERINE; MULLER, CHANDRA
Tipo: text
Publicado em //2007 Português
Relevância na Pesquisa
36.1%
Given the increasing importance of education to socioeconomic attainment and other life course trajectories, early academic struggles can have long-term consequences if not addressed. Analysis of a nationally representative sample with official school transcripts and extensive data on adolescent functioning identified a social psychological pathway in this linkage between external feedback about early struggles and truncated educational trajectories. For girls, class failures absent of diagnosed learning disabilities engendered increasingly negative self-perceptions that, in turn, disrupted math and science course-taking, especially in family and peer contexts in which academic success was prioritized. For boys, diagnosed learning disabilities, regardless of class performance, engendered the same changes in self-perception and the same consequences of these changes for course-taking across family and peer contexts. These results reveal how ability labels and ability-related performance indicators come together to influence the long-term educational prospects of girls and boys attending mainstream schools in which the majority of students do not have learning disabilities or severe academic problems. Keywords: education, learning disability...

Academic Failure in Secondary School: The Inter-Related Role of Health Problems and Educational Context

Needham, Belinda L.; Crosnoe, Robert; Muller, Chandra
Tipo: text
Publicado em //2004 Português
Relevância na Pesquisa
46.3%
This study explores whether the interplay of health problems and school environment predicts academic failure, an individual event with consequences for the life course, as well as for society at large. This exploration proceeds in three steps: 1) we examine whether physical and mental health problems are an academic risk factor during secondary school; 2) we investigate the academic mechanisms underlying this risk status; and 3) we explore whether this risk status varies by school context. A series of logistic regressions reveals that self-rated health and emotional distress are both associated with greater likelihood of failing one or more classes in the next year and that absenteeism, trouble with homework, and student-teacher bonding account for much of these associations. Associations of physical and mental health problems with academic failure vary only slightly across schools, however. We discuss the implications of these findings for both research and policy and argue that the examination of overlap among different domains of adolescent functioning can advance the sociological understanding of health, education, and social problems in general.

Obesity and Hypertension, Heart Failure, and Coronary Heart Disease—Risk Factor, Paradox, and Recommendations for Weight Loss

Artham, Surya M.; Lavie, Carl J.; Milani, Richard V.; Ventura, Hector O.
Fonte: the Academic Division of Ochsner Clinic Foundation Publicador: the Academic Division of Ochsner Clinic Foundation
Tipo: text
Publicado em //2009 Português
Relevância na Pesquisa
36.01%
Obesity prevalence has reached epidemic proportions and is independently associated with numerous cardiovascular disease (CVD) risk factors, including diabetes mellitus, hypertension, dyslipidemia, cancers, sleep apnea, and other major CVDs. Obesity has significant negative impact on CVD, including hypertension, coronary heart disease, heart failure, and arrhythmias via its maladaptive effects on individual CVD risk factors and cardiac structure and function. Despite this negative association between obesity and the incidence and prevalence of CVD, many studies have demonstrated that obese patients with established CVD might have better short- and long-term prognosis, suggesting an “obesity paradox.” This intriguing phenomenon has been well documented in populations with heart failure, coronary heart disease, and hypertension. This review summarizes the adverse effects of obesity on individual CVD risk factors; its role in the genesis of CVDs, including heart failure, coronary heart disease, and hypertension; and the obesity paradox observed in these populations and the potential underlying mechanisms behind this puzzling phenomenon and concludes with a discussion on the potential benefits of weight reduction.

Empirically Derived Subtypes of Child Academic and Behavior Problems: Co-Occurrence and Distal Outcomes

Reinke, Wendy M.; Herman, Keith C.; Petras, Hanno; Ialongo, Nicholas S.
Tipo: text
Português
Relevância na Pesquisa
36.29%
The aim of this study was to identify classes of children at entry into first grade with different patterns of academic and behavior problems. A latent class analysis was conducted with a longitudinal community sample of 678 predominantly low-income African American children. Results identified multiple subclasses of children, including a class with co-occurring academic and behavior problems. Gender differences were found in relation to the number of identified classes and the characteristics of academic and behavior problems for children. Several of the identified classes, particularly the co-occurring academic and behavior problems subclass for both genders, predicted negative long-term outcomes in sixth grade, including academic failure, receipt of special education services, affiliation with deviant peers, suspension from school, and elevated risk for conduct problems. The finding that subclasses of academic and behavior problems predict negative long-term outcomes validates the importance of the identified classes and the need to target interventions for children presenting with the associated class characteristics. Implications for early identification, prevention, and intervention for children at risk for academic failure and disruptive behavior problems are discussed.

Sleep disordered breathing and post-discharge mortality in patients with acute heart failure

Khayat, Rami; Jarjoura, David; Porter, Kyle; Sow, Angela; Wannemacher, Jacob; Dohar, Robert; Pleister, Adam; Abraham, William T.
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: text Formato: text/html
Português
Relevância na Pesquisa
36.03%
Background Hospitalizations for heart failure are associated with a high post-discharge risk for mortality. Identification of modifiable predictors of post-discharge mortality during hospitalization may improve outcome. Sleep disordered breathing (SDB) is the most common co-morbidity in heart failure patients. Design, setting, and participants Prospective cohort study of patients hospitalized with acute heart failure (AHF) in a single academic heart hospital. Between January 2007 and December 2010, all patients hospitalized with AHF who have left ventricular ejection fraction (LVEF) ? 45% and were not already diagnosed with SDB were the target population. Main outcomes and measures Patients underwent in-hospital attended polygraphy testing for SDB and were followed for a median of 3 years post-discharge. Mortality was recorded using national and state vital statistics databases. Results During the study period, 1117 hospitalized AHF patients underwent successful sleep testing. Three hundred and forty-four patients (31%) had central sleep apnoea (CSA), 525(47%) patients had obstructive sleep apnoea (OSA), and 248 had no or minimal SDB (nmSDB). Of those, 1096 patients survived to discharge and were included in the mortality analysis. Central sleep apnoea was independently associated with mortality. The multivariable hazard ratio (HR) for time to death for CSA vs. nmSDB was 1.61 (95% CI: 1.1...