Brycon hilarii produced in hapas: effects in allometric growth

Biometric evaluations are essential to determine the growth characteristics related to the weight and length of fish. This study aimed to determine the growth patterns of juvenile piraputangas (Brycon hilarii) produced in hapas within an excavated pond. The piraputangas were anesthetized and micro-chipped and their biometric characteristics were measured. Subsequently, the fish were distributed in six hapas of eight m3 at the density of 20 fish/hapa, totaling 120 animals. During the experimental period six months, the fish were fed twice (5% of the biomass) a day. Every 30 days, all fish were sampled to measure the biometric characteristics of body weight (g); standard length; total length; head height; head length; body height and body width (cm). The calculations of the weight ratio with the biometric characteristics were determined using allometric equation and estimated by linear regression according to the equation log Y = log a + b log X. All tested relationships were significant by the Student t-test (p < 0.05). Allometric growth was positive for: weight x total length; standard weight x length; weight x head height; weight x head length and weight x body height. The relative condition factor of piraputangas observed in this study was 1.00. The study provided information on the allometric parameters of juvenile Brycon hilarii produced in hapas, and the relative condition factor indicated good growth conditions for piraputangas with positive allometric growth.

Induced reproduction of yellow-tailed lambari (Astyanax lacustris) with Ovopel® and buserelin acetate as alternatives to the protocol with carp pituitary extract

The objective of this study was to evaluate reproductive traits in adults of Astyanax lacustris subjected to different spawning inducers. The study involved 240 females (12.54 g ± 2.33 and 7.66 cm ± 0.63 cm) and 240 males (5.83 g ± 0.39 g and 6.14 cm ± 0.64 cm), all at reproductive age. Three different inducers were evaluated: (i) 0.4 pellets of Ovopel®/kg of body weight; (ii) 0.5 ml of buserelin acetate/kg of body weight; and (iii) carp pituitary extract (CPE) (5.5 mg CPE/kg body weight for females and 2.5 mg CPE/kg body weight for males), as well as saline solution (without hormone). The degree-hours for spawning were greater (P<0.05) for the Ovopel® treatment (with 204.93) than in the treatment with CPE (183.2). Ovary weight and gonadosomatic index were higher (P<0.05) in CPE and Ovopel® treatments when compared to buserelin acetate. The number of oocytes per female, absolute and relative fecundity were greater (P<0.05) for Ovopel® and CPE treatments. Fertilization rate was higher (P<0.05) in treatment with buserelin acetate (82.3%) in relation to Ovopel® (72.33%) and CPE (62.40%) treatments, and the highest (P<0.05) hatching rates were achieved with buserelin acetate and Ovopel®. The number of larvae per female body weight was greater (P<0.05) when Ovopel® was used. In conclusion, Ovopel® proves to be a more effective reproductive inducer for induced reproduction of A. lacustris when compared to CPE and buserelin acetate.

Multimodality imaging and systemic biomarkers in classical low-flow low-gradient aortic stenosis: key findings for cardiac remodeling evaluation

Background

Elevated levels of troponin I (hsTnT) and B-type natriuretic peptide (BNP) have been related with poor prognosis in patients with LFLG-AS. Biomarkers are less expensive, more practical and more accessible than imaging tests, so their use can be an alternative to imaging in the evaluation of patients with LFLG-AS.

Purpose

The aim of the present study is to assess multimodality imaging findings according to systemic biomarkers (i.e. hsTnT and BNP) in Low-Flow, Low-Gradient Aortic Stenosis (LFLG-AS) and reduced left ventricular ejection fraction (LVEF) patients.

Methods

Prospective study with LFLG-AS patients (LVEF &lt;50%, aortic valve area ≤1,0 cm2 and mean gradient &lt;40 mmHg) that underwent hsTNnT, BNP, cardiac magnetic resonance (CMR) with T1 mapping and 2 dimensional echocardiogram (2DEcho). All patients also underwent dobutamine stress echocardiogram to define aortic stenosis severity. Patients were divided into 3 groups according to BNP and hsTnT levels: Group 1: BNP and hsTnT levels below median (BNP &lt;395 pg/ml and TnI-Ultra &lt;0.042 ng/ml); Group 2: BNP or hsTnT higher than median; and Group 3: both hsTnT and BNP higher than median.

Results

49 patients with LFLG-AS were included (Group 1: 17 patients, Group 2: 14 patients and Group 3: 18 patients). Clinical characteristics (including risk scores) were not able to stratify these groups. Patients with elevation of both biomarkers had lower valvuloarterial impedance (P=0.03), lower LVEF (P=0.02), less moderate/severe mitral (P=0.01) and tricuspid regurgitation (P&lt;0.01) by 2DEcho. CMR identified a progressive increase (from Group 1 to 3) of right and left chamber volumes; reduction in right and left ejection fraction and a marked increase in myocardial fibrosis assessed by extracellular volume (ECV) and indexed extracellular volume (iECV) (Figure 1).

Conclusion

Higher levels of BNP and hsTnT in LFLG-AS patients were associated with worse multi-modality imaging parameters and can be a surrogate of cardiac remodeling.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): No funding

Coronary perforations and its clinical impact during CTO recanalization: a 2054 patients pooled analysis from the Latin American (LATAM) CTO registry

Introduction

Percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) are the most challenging procedures and still associated with the highest complications rates. Coronary perforation is a life-threatening acute PCI complication, but data are limited regarding its impact on mid-term outcome. We aimed to assess 30-days and 1-year outcomes in CTO PCI patients with coronary perforations.

Purpose

Analyze the clinical impact of Cto perforations during CTO PCI at short and mid-term in a muticenter continental registry in Latin America (LATAM).

Methods

We analyzed data from the continental multicenter Latin America CTO Registry including patients who underwent CTO PCI in 57 centers from 9 countries. Coronary perforation during the index procedure were categorized according to Ellis classification. We assessed 30-days adverse events and 1-year major adverse cardiac and cerebrovascular (MACCE) defined as the composite of all-cause death, myocardial infarction (MI), target vessel revascularization and stroke. MI was defined according both the LATAM CTO protocol and SCAI definitions.

Results

From January 2015 to October 2018, 2054 patients underwent CTO PCI. The median J-CTO score was 2.0 (1.0–3.0) and the median Progress score was 1.0 (0.0–2.0). The overall perforation rate was 3.7% (n=76) in which 55% were Ellis class 1, 24% Ellis class 2 and 21% Ellis class 3. No differences were found in any baseline clinical characteristics. Patients with perforation had more frequently retrograde instrumentation (P&lt;0.01) and antegrade knuckle wire (P&lt;0.01) and lower success rate (P&lt;0.01). At 30-days, perforations were associated with more heart failure (6.6% vs 1.5%, p&lt;0.01), bleeding (15.2% vs 3.7%, p&lt;0.01), transfusion (7.9% vs 1.1%, p&lt;0.01) and cardiac tamponade (13.2% vs 0.4%, p&lt;0.01). After 1-year follow-up, patients with perforations had higher MACCE rates according to both LATAM CTO protocol (18.2 vs. 9.4%; P=0.02) and SCAI definitions (22.7% vs. 11.3%; P&lt;0.01).

Conclusions

In this multicenter continental real-world analysis, coronary perforation in CTO PCI was infrequent and was related with higher anatomical and procedural complexity characteristics. Despite the similarity in clinical characteristics, patients that had coronary perforation were exposed to an increased risk of both hemorrhagic and ischemic events.

Funding Acknowledgement

Type of funding sources: None.

P4598Clinical implications and predictors of coronary perforations during chronic total occlusion percutaneous coronary interventions: insights from the multicenterLatin America CTO LATAM registry

Background

Chronic total occlusions are still considered one of the most challenging procedures in the field of interventional cardiology and the most feared complication are the perforations. In past studies and series from Asia, Europe and United States the rate of perforations in percutaneous coronary interventions are described as 0.2% whereas this rate increases to 3% when recanalization of a chronic total occlusion is attempted.

Purpose

Our study sought to identify the frequency, predictors and clinical implications of coronary perforations in chronic total occlusion percutaneous interventions in a contemporary registry with data from Latin America.

Methods

We reported the data of a prospective multi center Latin American registry from January to December 2018 in 1066 patients who underwent chronic total occlusion percutaneous interventions in 30 centers in the following countries: Brazil, Argentina, Puerto Rico, Chile, Colombia, Ecuador and Mexico. Coronary perforation was defined as evidence of extravasation dye or blood from the coronary artery during or following the procedure. A stepwise logistic regression was performed to investigate the independent predictors of coronary perforations.

Results

The mean age was 64.2±10.7 years, 79.8% were male, 35.3% diabetics and 6.7% had heart failure. The most commonly involved CTO vessel was right coronary artery (41.4%), the mean J-CTO score was 2.0±1.3 and the mean CL score was 2.7±1.6. The overall procedural success rate was 81.9%. Coronary perforation occurred in 3.3% of cases: type 1 in 1.8%, Type 2 in 0.9% and Type 3 in 0.6%. In comparison with patients without coronary perforation was observed, those with such complication required more often blood transfusion (8.6% vs. 0.7%; p<0.001), experienced more cardiac tamponade (13.4% vs. 0.4%; p<0.001), but not all-cause in-hospital mortality (0 vs. 1.0%; p=1.0; respectively). At multivariate analysis, the independent predictor of coronary perforation was an activated clotting time (ACT) during PCI >470 seconds (OR 6.5; 95% CI 2.4 - 17.3; p<0.001), baseline heart failure (OR 4.2; 95% CI 1.2 - 14.6) and J-CTO score ≥2 (OR7.5; 95% CI 1.0–59.1).

Conclusions

Coronary perforation during percutaneous interventions in Latin America occurred in 3.3% of patients, being related with adverse events but not in-hospital all-cause mortality. Pharmacological management, high anatomical complexity and heart failure were identified as independent predictors of this still and so feared complication.

Acknowledgement/Funding

None

NP-59 test for preoperative localization of primary hyperaldosteronism

PURPOSE

Adrenal venous sampling is generally considered the gold standard to identify unilateral hormone production in cases of primary hyperaldosteronism. The aim of this study is to evaluate whether the iodine-131-6-β-iodomethyl-19-norcholesterol (NP-59) test may represent an alternative in selected cases.

METHODS

Patients submitted to laparoscopic adrenalectomy for suspected primary hyperaldosteronism (n = 27) were retrospectively reviewed. When nuclear medicine tests were preoperatively performed, their results were compared with the histopathologic findings and clinical improvement.

RESULTS

Nuclear medicine tests were realized in 13 patients. In 11 (84.6%), a planar anterior and posterior NP-59 scintigraphy was performed and a SPECT/TC in two (15.4%). Scintigraphy indicated a preoperative lateralization in 12 out of 13 patients (92.3%). When the value of NP-59 tests was based on pathologic results, it showed a sensitivity of 90.9% and a positive predictive value of 83.3%. When the nuclear medicine test's performance was based on postoperative blood pressure control, both sensitivity and positive predictive value were 91.6%.

CONCLUSIONS

Nuclear medicine tests represent a useful tool in the preoperative localisation of primary hyperaldosteronism with a high sensitivity and positive predictive value. In patients with contraindications to adrenal venous sampling like contrast allergies, or when it is inconclusive, scintigraphy can represent a useful and non-invasive alternative.

Comb sign in intestinal obstruction secondary to desmoplastic reaction due to an ileal neuroendocrine tumor

This article report the case of an intestinal obstruction secondary to desmoplastic reaction of an ileum neuroendocrine tumor (NET), that was radiologically diagnosed by the comb sign. This is an infrequent clinical manifestation of NETs, often underdiagnosed, related to local overproduction of serotonin.

Ecology of the parasitic endohelminth community of Piaractus mesopotamicus (Holmberg, 1887) (Characiformes) from Aquidauana and Miranda Rivers, Pantanal, state of Mato Grosso do Sul, Brazil

In this study the structure and diversity of the endohelminth community, as well as its interactions with 73 specimens of Piaractus mesopotamicus are described. The fish were caught in Aquidauana and Miranda rivers, both located in the Pantantal region, in the state of Mato Grosso do Sul. A total of 608,788 specimens of helminthes were found, representing five species: Dadaytrema oxycephala, Chabaudinema americanum, Spectatus spectatus, Rondonia rondoni and Echinorhynchus jucundum. D. oxycephala was more prevalent (91.78%) followed by R. rondoni (73.97%). Simpson's index indicated dominance in the endohelminth infracommunities (C = 0.396) and D. oxycephala was considered central species. A total of 54 hosts had between 2 and 3 species of helminthes. The pairs of the species R. rondoni/D. oxycephala and S. spectatus/D. oxycephala showed significant positive correlation between abundances. There was a significant positive correlation between total length and abundance of S. spectatus (rs = -0.2467 and p = 0.0353). Abundance of R. rondoni between the periods of 1/2003 and 2/2003 (p = 0.0356) and 1/2003 and 4/2004 (p = 0.0009) was significantly different. There was significant prevalence of E. jucundum in the female hosts.

Ecology of the parasitic endohelminth community of Pseudoplatystoma fasciatum (Linnaeus, 1776) (Siluriformes: Pimelodidae) from the Aquidauana River, Pantanal, State of Mato Grosso do Sul, Brazil

This study investigated the structure and diversity of the endohelminth community and its interactions with Pseudoplatystoma fasciatum, caught in the Aquidauana River, in the State of Mato Grosso do Sul, Brazil. Ten helminth species were represented in 1,228 specimens of parasites found in the intestine and mesentery of 33 specimens of P. fasciatum. Cestodes were observed in the intestine, while nematodes Cucullanus sp. in the mesentery. Contracaecum sp. Type 1, Spatulifer rugosa and Choanoscolex abscisus showed the highest mean intensity and mean abundance and Nomimoscolex sudobin showed the highest prevalence. Simpson's index indicated dominance in the endohelminth infracommunities (C = 1.0792) and Choanoscolex abscisus was considered the central species. A clumped pattern of dispersion according to Green's index was related. 69.69% of hosts analyzed had between 2 and 5 species of endohelminths. Mean diversity was H = 0.5517 (SD = 0.4209). Two pairs of species showed significant positive association and four pairs presented significant positive correlation among abundance data. Significant negative correlations between total length and prevalence and abundance of Peltydocotyle rugosa and Nomimoscolex sudobim were found. However, no significant correlation was observed between condition factor and abundance, as well as total length and diversity. There was significant prevalence of Harriscolex kaparari in male hosts.

[The process of nursing care in mental health]

This is an essay about the nursing working process in mental health. Several conceptions have substantiated the psychiatric assistance, as well as the proposals of reorientation of those practices; nursing practices have been related to that process. The professionals' standpoint determines the choice of a tendency and the understanding of the health-illness process. The need of reviewing the nursing working object, as well as its practice in view of the transformations in mental health assistance, has pointed towards new professional attitudes regarding the person with psychic disorders, as well as towards the acquisition of knowledge besides that one obtained at college courses.

[Association of thymoma and severe intestinal strongyloidiasis]

A 59-years-old man with thymoma and severe intestinal strongyloidiasis is reported. The authors pointed out a possible influence of immunological response related with thymoma in the development of hyperinfection by Strongyloides stercoralis.

Development of an antivenom against toxins of Lonomia obliqua caterpillars

Skin contact with caterpillars of Lonomia moths causes haemostatic disorders that may evolve into a haemorrhagic syndrome. Replacement therapy has been shown to exacerbate the clinical symptoms of this envenoming. In this study it is shown that horses immunized with a bristle extract of L. obliqua caterpillars produced IgG antibodies that completely neutralized, in vitro, the toxin(s) responsible for the blood incoagulability observed in rats. This antivenom offers the possibility of specific treatment for envenoming caused by contact with caterpillars of Lonomia moths.

[Sodoku--a case report]

Rat-bite fever results from an infection with the organism Spirillum minus. The authors report a symptomatic patient with fever, malaise, and ulcer in forehead after a rodent exposure. The organism was identified in darkfield examination of the ulcer exudate. Penicillin was the drug used with clinical improvement of symptoms.