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Electrocardiographic markers of cardiac resynchronization therapy response:delayed time to intrinsicoid deflection onset in lateral leads

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Journal of Geriatric Cardiology 2022年第1期19卷 21-30页

作者： Rubén KA Tapia-Orihuela s Michael Gharacholou samuel J Asirvatham Freddy Del-Carpio Munoz Department of Medicine Universidad Nacional Mayor de San MarcosFacultad de Medicina de San FernandoLimaPeru Department of Cardiovascular Diseases Mayo ClinicJacksonvilleFLUSA Department of Cardiovascular Diseases Mayo ClinicRochesterMNUSA

Cardiac resynchronization therapy(CRT)has emerged as an important intervention for patients with heart failure(HF)with reduced ejection fraction and delayed ventricular *** these patients,CRT has demonstrated to improve quality of life,promote reverse left ventricular(LV)remodeling,reduce HF hospitalizations,and extend ***,despite advancements in our understanding of CRT,a significant number of patients do not respond to this *** invasive and non-invasive parameters have been assessed to predict response to CRT,but the electrocardiogram(ECG)has remained as the prevailing screening method albeit with ***,an accurate,simple,and reproducible ECG marker or set of markers would dramatically overcome the current *** describe the clinical utility of an old ECG parameter that can estimate ventricular activation delay:the onset to intrinsicoid deflection(ID).Based on the concept of direct measurement of ventricular activation time(intrinsic deflection onset),time to ID onset measures on the surface ECG the time that the electrical activation time takes to reach the area subtended by the corresponding surface ECG *** on this principle,the time to ID on the lateral leads can estimate the delay activation to the lateral LV wall and can be used as a predictor for CRT response,particularly in patients with non-specific intraventricular conduction delay or in patients with left bundle branch block and QRss review is to present the current evidence and potential use of this ECG parameter to estimate LV activation and predict CRT response.

关键词： deflection intrinsic synchronization

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Cytokines and T Helper Cells in Diabetic Nephropathy pathogenesis

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Journal of Diabetes Mellitus 2016年第4期6卷 230-246页

作者： Liliane silvano Araújo marcos Vinícius da silva Crislaine Aparecida da silva Maria Luiza Reis Monteiro Lívia Helena de Morais pereira Laura penna Rocha Rosana Rosa Miranda Corrêa Marlene Antônia Reis Juliana Reis Machado General pathology and Nephropathology service Institute of Biological and Natural Sciences of Federal University of Triangulo Mineiro Uberaba Brazil Immunology Institute of Biological and Natural Sciences of Federal University of Triangulo Mineiro Uberaba Brazil General pathology Institute of Tropical Pathology and Public Health of Federal University of Goiás Goiania Brazil

Diabetic Nephropathy (DN) is considered the main cause of end stage kidney disease around the world. However, its pathogenesis is not completely established. More than just a direct consequence of chronic glycemic changes, recent studies had suggested Diabetic Nephropathy could be considered an inflammatory disease. It has been shown that concentrations of pro-inflammatory cytokines, as IL-1, IL-6, IL-18, IL-33, IFN-γ and TNF-α actively participate in development and progression of DN, and thus, are involved in pathogenesis. Besides, changes in acquired immune response, especially the presence of cellular immune response profiles of pro-inflammatory and effector nature, mainly Th1 and Th17, as the imbalance between interaction of cytokines and T regulatory cells, foment the onset and progression of DN. Here we summarize the main evidences that support the critical role of the immune system in this condition. These new conceptual advances in DN understanding are essential for development of new the rapeutical strategies and prognostic factors, which could be protagonists or adjuvants to the current ones, leading ultimately to a better clinical management of DN patients.

关键词： Diabetic Nephropathy Cytokines Cellular Immunity

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Water Quality Assessment of a Trout Farming Effluent,Bocaina,Brazil

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Journal of Water Resource and protection 2014年第10期6卷 909-915页

作者： Bernardo pinto Caramel Munique de Almeida Bispo Moraes Clovis Ferreira do Carmo Andre Martins Vaz-dos-santos Yara Aiko Tabata Joao Alexandre saviolo Osti Carlos Massatoshi Ishikawa marcos Aureliano silva Cerqueira Cacilda Thais Janson Mercante Water Resources Center Fisheries InstituteSao PauloBrazil Federal University of parana CuritibaBrazil Experimental station of salmon Sao PauloBrazil

The concern in mitigating the negative impact generated by the discharge of nutrients in the receiving water body is a challenge for the sustainable development of Brazilian fish farms. Thus, the purpose of this study was to evaluate the water quality and environmental impact caused by trout farming system effluent with focus on discharge of phosphorus. sampling was performed on a weekly basis in triplicate from september to November 2010. sample sites were distributed according to the water flow: upstream from trout farming system, water supply, effluent, artificial wetland, mixing zone and downstream (60 m from effluent). In the field, pH, conductivity, dissolved oxygen, water temperature and turbidity were measured. In laboratory, nitrogen and phosphorus series, chlorophyll a, total solids suspended and their organic and inorganic fractions were analyzed. For the good growth of trout in production system, the abiotic factors described in the water quality monitoring demonstrated acceptable values. Environmentally, after passing through the production system and artificial wetland, there was an increase in concentrations of total phosphorus, total nitrogen, orthophosphate, ammonium, chlorophyll a, total solids suspended and their organic and inorganic fractions (p se results are related with the quality of feed, feeding management and the inefficiency of the artificial wetland. Therefore, it is necessary to use best quality feed to meet the nutritional requirements of trout, maintaining an optimal feed conversion and reducing pollution generated by effluent.

关键词： Management Feeding Water Flow Discharge phosphorus pollution

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Isolated Autoimmune Orchitis Due to IgG4 Hypersecretion presenting as Tumor-Like Mass: Case Report and Review of Literature

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Open Journal of Urology 2022年第1期12卷 51-56页

作者： Francisco marcos da silva Barroso Flavio Antunes de sousa paloma Menezes de souza Gustavo Lopes de Castro Katia Ramos Moreira Leite Monique Freire santana Roger Arthur da Cunha Alves Gabriela Ayumi Owada Borges Juan Eduardo Rios Rodriguez Urology service Getúlio Vargas University Hospital (HUGV) Manaus Amazonas Brazil General surgery service Santa Casa de Ribeir&#227 o preto Ribeir&#227 o preto Brazil sã o paulo University (Usp) Ribeir&#227 o preto Brazil Faculty of Medicine Federal University of Amazonas (UFAM) Manaus Amazonas Brazil pathology Department Sírio-Libanes Hospital S&#227 o paulo Brazil Faculty of Medicine S&#227 o paulo University (Usp) S&#227 o paulo Brazil patholgy service Getúlio Vargas University Hospital (HUGV) Manaus Amazonas Brazil Dr. Heitor Vieira Dourado Tropical Medicine Foundation Manaus Amazonas Brazil Teaching and Research Department Oncology Center Control Foundation (FCECON) Manaus Amazonas Brazil Urology service Hospital Pronto-Socorro 28 de Agosto Manaus Amazonas Brazil General surgery service Getúlio Vargas University Hospital (HUGV) Manaus Amazonas Brazil

Background: IgG4-related disease is a rare autoimmune condition that presents with lymphoplasmacytic infiltrate and fibrosis in the organ affected. Isolated testicle involvement is uncommon and there are only a few ca... 详细信息

strong>Background:strong> IgG4-related disease is a rare autoimmune condition that presents with lymphoplasmacytic infiltrate and fibrosis in the organ affected. Isolated testicle involvement is uncommon and there are only a few cases reported in the literature. strong>Casestrong> strong>presentation:strong> We report a case of isolated chronic orchitis due to IgG4 hypersecretion in a 61-year-old patient that evolved with asymptomatic tumor-like mass growth and was treated with left orchiectomy. Histopathological study revealed orchitis related to IgG4 hypersecretion disease. strong>Conclusion:strong> IgG4-related disease can be manifested as a multi or single-organ disorder. Most diagnoses are made after surgery with histopathological analysis. Most of the cases in literature stand out the difficulty in diagnosis and necessity of high suspicion due to this condition’s similarity with neoplasm presentation.

关键词： Orchitis IgG4-Related Disease Autoimmune Testicle Inflammatory

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内脏脂肪组织通过产生骨桥蛋白调控成纤维细胞衰老促进心脏衰老

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中华高血压杂志 2018年第3期26卷 299-299页

作者： sawaki D Czibik G pini M Ternacle J suffee N Mercedes R Marcelin G surenaud M marcos E Gual p Clément K Hue s Adnot s Hatem sN Tsuchimochi I Yoshimitsu T Hénégar C Derumeaux G 刘青叶鹏

老化通过增加包括骨桥蛋白（osteopontin，OpN）在内的细胞外基质（extracellular matrix，ECM）蛋白的沉积引起心脏结构和功能改变进而导致进行性间质纤维化。虽然已知OpN参与各种病理状况，但其在心肌衰老中的作用仍不清楚。

关键词：骨桥蛋白成纤维细胞衰老内脏脂肪组织心脏衰老调控 matrix 细胞外基质间质纤维化

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Ergonovine stress echocardiography: Recent experience and safety in our centre

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World Journal of Cardiology 2010年第12期2卷 437-442页

作者： Alejandro Cortell pedro marcos-Alberca Carlos Almería JoséL Rodrigo Leopoldo pérez-Isla Carlos Macaya JoséLuis Zamorano University Clinic san Carlos Cardiovascular InstituteProfesor Martín Lagos Street

AIM:To study recent experience and safety of ergonovine stress echocardiography in our ***:In this study we collected the clinical variables of patients referred since 2002 for ergonovine stress echocardiography,in addition to indications,the results of this test,complications,blood pressure and heart rate values during the test and the number and results of tests requested before this ***:We performed 40 tests in 38 patients,2 tests were carried out to verify therapy *** prevalence of classic cardiovascular risk factors was low and the most frequent indication was chest pain (57.5%).Coronary angiography was performed in 32 patients,and showed normal coronary arteries in 27 patients and non-significant stenosis in 5 *** 16 patients,coronary angiography was carried out after a positive or inconclusive ischemia *** 6 patients had a normal stress test(5 exercise electrocardiography tests and 1 nuclear imaging test).Of the 40 ergonovine stress echocardiography tests,6 were positive(4 in the right coronary artery territory and 2 in the circumflex coronary artery territory),all of them by echocardiographic criteria,and by electrocardiographic criteria in only 3(50%).The presence of non-significant coronary artery stenosis was more frequent in patients with positive ergonovine stress echocardiography(50%vs 6%,p =0.038),and were related to ischemic *** the maximum stress stage,there was a higher systolic(130.26±19.17 mmHg vs 136.58±27.27 mmHg,95%CI:-12.77 to 0.14 mmHg,p=0.055)and diastolic blood pressure(77.89±13.49 mmHg vs 83.95± 15.73 mmHg,95%CI:-10.41 to-1.69 mmHg,p=0.008) than at the baseline stage,and the same was registered with heart rate(73±10.96 beats/minvs 79.79± 11.72 beats/min,95%CI:-9.46 to-4.11 beats/min,p ss,there were only 2 hypertensive reactions during the last stage,which did not force a premature end to the test,without sustained tachy or bradyarrhythmias,and the technique was

关键词： Coronary angiography Ergonovine Myocardial ischaemia stress echocardiography Vasospasm

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Empathy Levels of Dental students of Central America and the Caribbean

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Health 2015年第12期7卷 1678-1686页

作者： Víctor patricio Díaz-Narváez Ana María Erazo Coronado Jorge Luis Bilbao Farith González Mariela padilla Madeline Howard Guadalupe silva Joel Arboleda Mirian Bullen Robert Utsman Elizabeth Fajardo Luz Marina Alonso marcos Cervantes Facultad de Odontología Universidad San Sebastián Santiago Chile Universidad Autónoma de Chile Santiago Chile Universidad Metropolitana Barranquilla Colombia Facultad de Medicina Universidad Libre Seccional Barranquilla y Fundación Universitaria San Martín Sede Puerto Colombia Barranquilla Colombia Facultad de Odontología Universidad de Cartagena Cartagena Colombia Universidad Latinoamericana de Ciencia y Tecnología San José Costa Rica Facultad de Odontología Universidad de Costa Rica San José Costa Rica Universidad Central del Este San Pedro de Macorís República Dominicana Facultad de Odontología Universidad de Panamá Ciudad de Panamá República de Panamá Faculty of Health sciences Universidad del Tolima Ibagué Colombia División de salud Universidad del Norte Barranquilla Colombia Facultad de Ciencias sociales Universidad del Norte Barranquilla Colombia

Objective: The aim of this study is to check whether there are differences in the distribution of empathy levels in dental students from nine faculties of dentistry Colombia, panama, Costa Rica and Dominican Republic. Methods: The levels of empathy and matrices of empathy construct matrices are estimated dental students by using the Jefferson scale of physician Empathy, the spanish version for students (s version) culturally validated in Colombia, panama, Costa Rica and Dominican Republic measured by arbitrator criteria. Cronbach α is estimated. Data of empathic orientation of the studied factors between faculties are analyzed and compared by ANOVA and Duncan test and matrices of empathy construct using discriminant analysis. Results: We find that there are differences in levels of empathy between universities, courses, gender and interaction between the Dental Faculty (University) and Course. The comparison between matrices shows unexplained variances and differences observed between the levels of empathy in student populations. Conclusions: Variability in empathy is observed in the studied factors and among student populations. The variability is an empirical finding, but is not possible in this work, to explain why.

关键词： Empathy Jefferson scale of physician Empathy (JspE) Levels of Empathy

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Environmental geochemistry studies and health risk assessment to identify priority areas for remediation of polluted soils in the santa Maria de la paz (s.L.p., Mexico) mining district

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Chinese Journal Of Geochemistry 2006年第B8期25卷 61-61页

作者： Israel Razo Fernando Diaz-Barriga Javier Castro marcos Monroy Universidad Autonoma de san Luis potosi/Instituto de Metalurgia/san Luis potosi S.L.P. (Mexico)

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中国经济放缓后对地缘政治的影响（英文）

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文化发展论丛 2016年第3期 268-289页

作者：玛科·克斯卡·利玛伯南布哥州联邦大学伯南布哥州联邦大学亚洲研究中心伯南布哥州联邦大学国际塞尔索·富尔塔多中心

本文有两个写作目标，第一个目标是，在讨论亚洲地区成为当今世界新经济中心这一问题的同时，探讨中国自2013年以来经济放缓对东南亚国家联盟所带来的影响及后者回归正常的方式。第二个目标是要指明中国面对的主要挑战，并对“中国在全... 详细信息

本文有两个写作目标，第一个目标是，在讨论亚洲地区成为当今世界新经济中心这一问题的同时，探讨中国自2013年以来经济放缓对东南亚国家联盟所带来的影响及后者回归正常的方式。第二个目标是要指明中国面对的主要挑战，并对“中国在全球地缘政治中是否能成为未来的中心”这一问题进行了分析。

关键词：中国经济放缓东南亚国家联盟地缘政治

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Deep sedation during gastrointestinal endoscopy: propofol-fentanyl and midazolam-fentanyl regimens

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World Journal of Gastroenterology 2013年第22期19卷 3439-3446页

作者： marcos Eduardo Lera dos santos Fauze Maluf-Filho Dalton Marques Chaves sergio Eiji Matuguma Edson Ide Gustavo de Oliveira Luz Thiago Ferreira de souza Fernanda C simoes pessorrusso Eduardo Guimares Hourneaux de Moura paulo sakai Department of Gastroenterology Hospital das Clínicas University of Sao Paulo Medical School Sao Paulo CEP 05403-900 Brazil Cancer Institute of sao paulo state Sao Paulo CEP 01246-000 Brazil

AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODs: After obtaining approval of the research ethics committee and informed consent, 200 patients were evaluated and referred for upper gastrointestinal endoscopy. patients were randomized to receive propofol-fentanyl or midazolam-fentanyl (n = 100/group).We assessed the level of sedation using the observer's assessment of alertness/sedation (OAA/s) score and bispectral index (BIs). We evaluated patient and physician satisfaction, as well as the recovery time and complication rates. The statistical analysis was performed using spss statistical software and included the MannWhitney test, χ 2 test, measurement of analysis of variance, and the κ statistic. REsULTs: The times to induction of sedation, recovery, and discharge were shorter in the propofolfentanyl group than the midazolam-fentanyl group. According to the OAA/s score, deep sedation events occurred in 25% of the propofol-fentanyl group and 11% of the midazolam-fentanyl group (p = 0.014). Additionally, deep sedation events occurred in 19% of the propofol-fentanyl group and 7% of the midazolamfentanyl group according to the BIs scale (p = 0.039). There was good concordance between the OAA/s score and BIs for both groups (κ = 0.71 and κ = 0.63, respectively). Oxygen supplementation was required in 42% of the propofol-fentanyl group and 26% of the midazolam-fentanyl group (p = 0.025). The mean time to recovery was 28.82 and 44.13 min in the propofolfentanyl and midazolam-fentanyl groups, respectively (p severe complications in either group. Although patients were equally satisfied with both drug combinations, physicians were more satisfied with the propofol-fentanyl combination. CONCLUsION: Deep sedation occurred with propofolfentanyl and midazolam-fentanyl, but was more frequent in the former. Recovery was faster in the propofol-fentanyl group.

关键词： Endoscopy Deep sedation Anesthetic administration Anesthetic dose Adverse effects

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