PERFIL LEUCOCITÁRIO DOS INDIVÍDUOS POSITIVOS NA SOROLOGIA PARA O SARS-COV-2

Objetivos

A COVID-19, oriunda do novo coronavírus (SARS-CoV-2) se espalhou como uma pandemia, causando mais de 4 milhão de mortes globalmente, tornando-se uma emergência de saúde pública. O número de casos de pacientes recuperados é crescente, o que pode ser crucial sobre o curso da doença. Na forma grave da doença é possível observar linfopenia e leucopenia. Estes achados podem ser auxiliares como indicadores clínicos para avaliação e progressão da doença. Desta forma, este trabalho teve como objetivo descrever o perfil leucocitário dos indivíduos positivos na sorologia para o SARS-CoV-2.

Material e métodos

Trata-se de um estudo prospectivo em que indivíduos adultos de ambos os sexos, participantes do projeto EpiSergipe e que apresentaram resultado positivo ao teste rápido para IgG/IgM confirmado por sorologia. Foram coletadas amostras de sangue periférico para realização do hemograma e análise sorológica utilizando o kit comercial de imunoensaio fluorescente (IchromaTM COVID-19 Ab) em que os procedimentos foram realizados de acordo com as recomendações do fabricante.

Resultados

Foram analisadas amostras de 847 pacientes com sorologia positiva para o SARS-CoV-2, assintomáticos ou com sintomas leves, sendo 275 do sexo masculino (32,47%) e 572 do sexo feminino (67,53%). Do total de hemogramas analisados, 9,33% apresentaram leucocitose e 2,01% leucopenia (média leucócitos totais = 7.370/mm³ /±2,10). A linfocitose foi observada em 23,61% dos indivíduos e a linfopenia foi observada em apenas 1,18% (média linfócitos = 2.550/mm³/±772). A neutrofilia foi observada em 5,90% dos participantes e a neutropenia em 5,31% (média neutrófilos = 4.280/mm³/±1,67). A maioria dos hemogramas analisados (67,41%) apresentaram todos os parâmetros normais.

Discussão

A linfocitose, de acordo com estudos, pode auxiliar na previsão e acompanhamento da progressão da COVID-19, neste estudo foi observada em 23,61% dos hemogramas analisados, enfatizando que os participantes do presente estudo eram assintomáticos e sintomáticos leves, o que pode justificar o porquê grande parte dos pacientes apresentaram parâmetros dentro da normalidade. Além disso um estudo publicado em 2021, comparou os achados hematológicos de óbitos por COVID-19 com os de sobreviventes, nos indivíduos que morreram havia maior contagem de neutrófilos e leucócitos, e uma diminuição nos linfócitos, quando comparados aos sobreviventes. Neste estudo, não houveram óbitos, as taxas encontradas de leucocitose e neutrofilia foram de 9,33% e 5,90% respectivamente, e a linfopenia 1,18%.

Conclusão

A partir dos resultados prévios encontrados, observa-se alterações no perfil leucocitário em indivíduos com COVID-19, condizentes com os descritos recentemente na literatura.

Antidiabetic activity of Musa x paradisiaca extracts in streptozotocin-induced diabetic rats and chemical characterization by HPLC-DAD-MS

ETHNOPHARMACOLOGICAL RELEVANCE

The Musa x paradisiaca L. inflorescence, known as banana blossom or banana heart, is used in traditional medicine for the treatment of diabetes mellitus.

AIM OF THE STUDY

The aim of the study was to investigate the antidiabetic activity of aqueous extracts and fractions prepared from the bracts and flowers of Musa x paradisiaca in streptozotocin (STZ)-induced diabetic rats and to chemically characterize the extracts.

MATERIALS AND METHODS

Standard aqueous extracts of the flowers, bracts, and their fractions were prepared and their chemical composition was determined tentatively by high-performance liquid chromatography coupled to diode-array detection and mass spectrometry (HPLC-DAD-MS). Changes in fasting glycemia and oral glucose tolerance were evaluated in STZ-induced diabetic rats (n = 8) treated with aqueous extracts of Musa x paradisiaca (200 mg/kg) for 20 days.

RESULTS

Chemical analyses detected 21 compounds and 17 metabolites were identified, among which were glycosylated and acetylated phenylpropanoids of p-coumaric acid and caffeic acid, as well as a glycosylated flavonol and anthocyanins. Following 15 days of treatment, the bract aqueous extracts and the methanolic fraction of the flower had significant effects on the glycemic profile after glucose load in diabetic rats as compared with the untreated diabetic group.

CONCLUSIONS

The results of the present study show the antidiabetic potential of extracts of the flowers and bracts of M. x paradisiaca.

Analysis of radiographic images and germination of Campomanesia pubescens (Mart. ex DC.) O.Berg (Myrtaceae Juss.) seeds under drying

The objective of this study was to evaluate the internal morphology of seeds of Campomanesia pubescens (Mart. ex DC.) O. Berg with varying water content through X-ray image analysis, and correlate the images with the germination of these seeds. Fruits were collected in Jataí, Goiás, Brazil, and taken to the Seed Laboratory of the Federal Institute Goiano, Rio Verde Campus, where they were processed and the seeds were extracted. To establish the predetermined water content (43%, 37%, 34%, 31%, and 28% wet basis), seeds with an initial water content of 43% were kept in an oven with forced air circulation at a temperature of 40 °C until they reached the predetermined water content levels. Next, the seeds were placed in acrylic holders with double-sided tape and transported to the Federal University of Lavras (UFLA), where they were exposed to different intensities of radiation. The X-ray test was conducted with 200 seeds per treatment, and images of the internal structures of the seeds were evaluated. The seeds were returned to the Seed Laboratory of the Federal Institute Goiano, Rio Verde Campus, where the germination test was initiated. The experimental design was completely randomized, in a factorial design (5 × 4), in which there were five water content levels and four seed classes, with four replications. The X-ray test was efficient in the identification of filled, malformed, damaged and empty seeds, which germination rate above 50% in the filled seeds. This visualization of the internal morphology of the seed can be useful to select seeds of better quality, improving the percentage of germination of C. pubescens seeds.

Long-term follow-up of adult patients with congenital heart disease and an implantable cardioverter defibrillator

OBJECTIVE

Sudden cardiac death is common in the adult congenital heart disease (ACHD) population. Knowledge and experience about the use of implantable cardioverter defibrillators (ICD) in ACHD patients is very limited. We aimed to characterize a cohort of patients with ACHD and ICDs.

DESIGN

Thirty consecutive ACHD patients submitted to an ICD implantation in a single tertiary center were evaluated. Data on baseline clinical features, heart defect, indication for ICD, type of device, appropriate therapies, ICD-related complication, and mortality during follow-up were collected.

RESULTS

Of the 30 patients, 56.7% received appropriate therapies due to ventricular tachycardia (VT) or ventricular fibrillation (VF). The rate of inappropriate therapies and device-related complications was 33.3%. Secondary prevention and primary prevention patients with class I indications for ICD had more appropriate therapies than complication, but this relationship was reversed for patients with class II indications. Remote monitoring played an important role in diagnosing new atrial arrhythmias before scheduled visits in 46.2% of patients, leading to a change in medication. VT/VF episodes were associated with a composite of death, cardiac transplantation, and hospital admission (OR 13.0; 95% CI: 2.1-81.5).

CONCLUSION

ICDs are not only useful in preventing SCD, but also have a major role in diagnosing atrial tachyarrhythmias ahead of scheduled visits. Although improvements in ICD technology might reduce complications and inappropriate therapies, adequate selection of candidates for primary prevention still remains difficult because of the lack of clear indications.

Efeito de Líquidos Alimentares na Estabilidade de Cor de Resinas Compostas e Alternativas para Reduzir os Danos Causados

O objetivo deste trabalho é relatar, através de uma revisão de literatura, o efeito de líquidos alimentares na estabilidade de cor das resinas compostas e como reduzir o manchamento provocado. Foi realizada uma busca nas bases de dados Pubmed e SciELO, utilizando os descritores Resinas Compostas, Espectrofotometria, Bebidas e seus correspondentes em inglês. Dessa forma, foram encontrados 29 artigos, sendo 8 selecionados para estudo. Os critérios de inclusão foram artigos dos últimos 5 anos publicados nas línguas portuguesa e inglesa, que utilizassem o sistema de cor Commission Internationale de I’Eclairage L a b(CIE/lab) para análise da alteração de cor em resinas compostas submetidas à líquidos alimentares, sendo excluídos artigos que analisassem essa alteração em técnicas combinadas com outros materiais restauradores e que utilizassem outros tipos de soluções. Através do sistema CIE/ lab, valores de OE variando de 1 a 3 são perceptíveis ao olho nu e valores maiores que 3,3 são clinicamente inaceitáveis, assim, os níveis de manchamento mais elevados registrados pela espectrofotometria foram os causados por vinho tinto e café. A presença de açúcar nas bebidas aumentou a diferença de cor em relação às sem açúcar. O repolimento mostrou-se mais eficaz na diminuição das manchas que o clareamento com peróxido de carbamida a 40%. Nenhuma das tentativas para clarear novamente a restauração a fez retornar a cor do grupo controle, entretanto, reduziu o manchamento para níveis clinicamente aceitáveis.Palavras-chave: Resinas Compostas. Espectrofotometria. Bebidas.

Propriedades Mecânicas dos Pinos Intrarradiculares e sua Influência na Fratura de Dentes Tratados Endodonticamente

O objetivo deste trabalho é revisar a literatura acerca das propriedades mecânicas dos retentores intrarradiculares (RI), focando no núcleo metálico fundido (NMF) e pino de fibra de vidro, e em como influenciam na fratura de dentes tratados endodonticamente. Foi realizada busca na base de dados Pubmed, utilizando os descritores Post and Core Technique, Crowns e Dental Stress Analysis, onde 368 artigos foram encontrados e 5 selecionados. Os critérios de inclusão foram artigos publicados nos últimos 10 anos, na língua inglesa, estudos in vitro e que analisassem as propriedades mecânicas dos RI de interesse, sendo excluídos outros tipos de estudo e estudos in vitro que utilizassem dentes de animais. Forças verticais aplicadas em dentes com NMF causam estresse na raiz dental, principalmente na região apical, pois RI que possuem maior flexibilidade e menor rigidez promovem uma distribuição uniforme de tensões no dente, criando uma unidade mecanicamente homogênea e reduzindo o risco de fratura da raiz. Dessa forma, o pino de fibra de vidro é considerado mais favorável em termos de distribuição de tensão, devido ao módulo de elasticidade ser semelhante ao da dentina. É fundamental, portanto, que o cirurgião-dentista conheça as propriedades mecânicas desses materiais a fim de optar pelo tratamento mais indicado na restauração de dentes tratados endodonticamente.Palavras-chave: Post and Core Technique. Crowns. Dental Stress Analysis.

O efeito de Diferentes Tratamentos de Superfície na Resistência de União ao Cisalhamento de Cerâmica Y-TZP à Cimentos Resinosos

Este estudo buscou avaliar, através de uma revisão de literatura, a influência de diferentes tratamentos de superfície na resistência de união ao cisalhamento entre uma cerâmica de zircônia tetragonal policristalina estabilizada por ítrio Y-TZP e cimentos resinosos. Foram consultadas as bases de dados PubMed e Bireme, utilizando os descritores “Shear Strength”, “Ceramics” e “Resin Cements”. De um total de 106 artigos potencialmente elegíveis, 8 foram selecionados. Os critérios de inclusão foram estudos publicados nos últimos 7 anos, nas línguas portuguesa e inglesa, clínicos ou in vitro que avaliassem os efeitos dos métodos de tratamento de superfície na resistência de cisalhamento de um cimento resinoso à cerâmica Y-TZP. O tratamento de superfície pode influenciar significativamente os valores de resistência ao cisalhamento. A abrasão de partículas aerotransportadas seguida pela aplicação de um iniciador de zircônia produziu a maior resistência de união ao esmalte quando comparado a uma zircônia acidificada e uma zircônia silanizada. Na utilização de diferentes cimentos resinosos associados à cerâmica Y-TZP, não foram encontradas diferenças significativas entre as resistências de cisalhamento quando as cerâmicas eram submetidas a um mesmo tratamento de superfície. Sendo assim, pode ser recomendado o método de tratamento de superfície com jateamento de partículas de óxido de alumínio associado ao uso de primer de zircônia para conseguir um aumento significativo na resistência ao cisalhamento e alcançar uma maior longevidade da restauração.Palavras-chave: Shear Strength. Ceramics. Resin Cements.

Histochemistry profile of the biceps brachii muscle fibres of capuchin monkeys (Cebus apella, Linnaeus, 1758)

A general analysis of the behaviour of "Cebus" shows that when this primate moves position to feed or perform another activity, it presents different ways of locomotion. This information shows that the brachial biceps muscle of this animal is frequently used in their locomotion activities, but it should also be remembered that this muscle is also used for other development activities like hiding, searching for objects, searching out in the woods, and digging in the soil. Considering the above, it was decided to research the histoenzimologic characteristics of the brachial biceps muscle to observe whether it is better adpted to postural or phasic function. To that end, samples were taken from the superficial and deep regions, the inserts proximal (medial and lateral) and distal brachial biceps six capuchin monkeys male and adult, which were subjected to the reactions of m-ATPase, NADH-Tr. Based on the results of these reactions fibres were classified as in Fast Twitch Glycolitic (FG), Fast Twitch Oxidative Glycolitic (FOG) and Slow Twitc (SO). In general, the results, considering the muscle as a whole, show a trend of frequency FOG> FG> SO. The data on the frequency were studied on three superficial regions FOG=FG>SO; the deep regions of the inserts proximal FOG=FG=SO and inserting the distal FOG>FG=SO. In conclusion, the biceps brachii of the capuchin monkey is well adapted for both postural and phasic activities.

Conceptual bases in restoration of scientific vertebrate collections

The scientific heritage preserved in Brazilian biological collections has inestimable value. Despite the research on curation and restoration of biological material is regarded as strategic, there is a lack of expertise in these areas in the country. These deficiencies often determine the use of obsolete or even inadequate procedures aimed at the recovery of material for research or exhibition, resulting in risk to valuable specimens. In the present work we provide a review of the literature on the restoration of biological specimens and summarize concepts employed in the restoration of mammals and birds of the Museu Nacional, Universidade Federal do Rio de Janeiro, exhibition in 2011. The aim of this work is to contribute to the development of protocols when interventions are needed to restore damaged specimens.

Evaluation of the potential of Pistia stratiotes L. (water lettuce) for bioindication and phytoremediation of aquatic environments contaminated with arsenic

Specimens of Pistia stratiotes were subjected to five concentrations of arsenic (As) for seven days. Growth, As absorption, malondialdehyde (MDA) content, photosynthetic pigments, enzymatic activities, amino acids content and anatomical changes were assessed. Plant arsenic accumulation increased with increasing metalloid in the solution, while growth rate and photosynthetic pigment content decreased. The MDA content increased, indicating oxidative stress. Enzymatic activity and amino acids content increased at the lower doses of As, subsequently declining in the higher concentrations. Chlorosis and necrosis were observed in the leaves. Leaves showed starch accumulation and increased thickness of the mesophyll. In the root system, there was a loss and darkening of roots. Cell layers formed at the insertion points on the root stems may have been responsible for the loss of roots. These results indicate that water lettuce shows potential for bioindication and phytoremediation of As-contaminated aquatic environments.

Sulfur metabolism: different tolerances of two aquatic macrophytes exposed to arsenic

The toxicity of arsenic (As) and the mechanisms of response to this pollutant were analyzed in two aquatic plant species, one sensitive and one tolerant to the pollutant, Salvinia minima and Lemna gibba, respectively. The plants, grown in nutrient solution at pH 6.5, were exposed to As concentrations of 0.0 and 1.0mgL(-1) for 3 days. Both species accumulated As in their tissues, which resulted in increases in H2O2 production. L. gibba accumulated eleven times more As than S. minima. However, L. gibba was more tolerant, as shown by the absence of cell membrane damage and, despite greater accumulation, smaller growth reduction than S. minima. Indeed, the index of tolerance to As was twenty percent higher in L. gibba than in S. minima, which most likely results from the presence of a more efficient defense system. This defense system in L. gibba is most likely based on sulfate absorption, assimilation and metabolism. L. gibba showed an increase in sulfate absorption and adenosine-5'-triphosphate (ATP) sulfurylase activity (the first enzyme of the inorganic sulfate assimilation pathway) following exposure to As. Consequently, the plant produced greater concentrations of sulfur-containing compounds that are involved in cellular detoxification, such as glutathione and non-protein thiols, and demonstrated greater enzymatic activity of γ-glutamylcysteine synthetase, glutathione S-transferase and glutathione reductase. Therefore, the plant׳s ability to increase absorption, assimilation and metabolism of sulfur are key steps for tolerance to oxidative stress triggered by metals.

Genetic variations in the leptin gene associated with growth and carcass traits in Nellore cattle

The aim of the study was to detect polymorphisms in the leptin gene and to determine the association of these polymorphisms with growth and carcass traits in Nellore cattle. The single nucleotide polymorphisms (SNPs) -1457 (AJ571671:g.-1457A>G) and A59V (AF536174.1:g. 321C>T), as well as the microsatellite BM1500 (3.9 kb downstream), were genotyped. The measures of body weight and ultrasound examinations (rib eye area, back, and rump fat thickness) were performed in 3 different periods of animal management. During the first period, the animals were fed with grass and mineralized salt ad libitum. In the second period, they received grass and concentrate, and in the third, only concentrate. After the slaughter of animals, data were collected for classification and typification of carcasses. No significant association was found between the variables assessed and SNP -1457. Conversely, SNP A59V was associated with rump fat thickness and muscle color post-slaughter. BM1500 was associated with rump fat thickness in the first period (pre-slaughter), subcutaneous fat thickness in the second, weight of the animals in the third, and length of the carcass after slaughter. These results suggest that SNP A59V and the microsatellite BM1500 might be useful for marker-assisted selection in Nellore cattle.

Genetic and environmental influences on blood pressure and physical activity: a study of nuclear families from Muzambinho, Brazil

Blood pressure (BP) and physical activity (PA) levels are inversely associated. Since genetic factors account for the observed variation in each of these traits, it is possible that part of their association may be related to common genetic and/or environmental influences. Thus, this study was designed to estimate the genetic and environmental correlations of BP and PA phenotypes in nuclear families from Muzambinho, Brazil. Families including 236 offspring (6 to 24 years) and their 82 fathers and 122 mothers (24 to 65 years) were evaluated. BP was measured, and total PA (TPA) was assessed by an interview (commuting, occupational, leisure time, and school time PA). Quantitative genetic modeling was used to estimate maximal heritability (h²), and genetic and environmental correlations. Heritability was significant for all phenotypes (systolic BP: h² = 0.37 ± 0.10, P < 0.05; diastolic BP: h² = 0.39 ± 0.09, P < 0.05; TPA: h² = 0.24 ± 0.09, P < 0.05). Significant genetic (r g) and environmental (r e) correlations were detected between systolic and diastolic BP (r g = 0.67 ± 0.12 and r e = 0.48 ± 0.08, P < 0.05). Genetic correlations between BP and TPA were not significant, while a tendency to an environmental cross-trait correlation was found between diastolic BP and TPA (r e = -0.18 ± 0.09, P = 0.057). In conclusion, BP and PA are under genetic influences. Systolic and diastolic BP share common genes and environmental influences. Diastolic BP and TPA are probably under similar environmental influences.

Critical assessment of the parameters that affect the selection of coating compounds for piezoelectric quartz crystal microbalances

The selection of the compound to be used as a coating for a piezoelectric quartz crystal is of utmost importance in the development of a chemical sensor. The relevant parameters to be evaluated (stability, sensitivity, reversibility, response time, reproducibility, and selectivity), and the main variables affecting the results and influencing the choice of coatings are discussed and illustrated with experiments performed during the evaluation of coatings to detect carbon dioxide.

Enzymatic response of the eucalypt defoliator Thyrinteina arnobia (Stoll) (Lepidoptera: Geometridae) to a bis-benzamidine proteinase Inhibitor. i

Ingestion of proteinase inhibitors leads to hyperproduction of digestive proteinases, limiting the bioavailability of essential amino acids for protein synthesis, which affects insect growth and development. However, the effects of proteinase inhibitors on digestive enzymes can lead to an adaptive response by the insect. In here, we assessed the biochemical response of midgut proteinases from the eucalypt defoliator Thyrinteina arnobia (Stoll) to different concentrations of berenil, a bis-benzamidine proteinase inhibitor, on eucalyptus. Eucalyptus leaves were immersed in berenil solutions at different concentrations and fed to larvae of T. arnobia. Mortality was assessed daily. The proteolytic activity in the midgut of T. arnobia was assessed after feeding on plants sprayed with aqueous solutions of berenil, fed to fifth instars of T. arnobia for 48 h before midgut removal for enzymatic assays. Larvae of T. arnobia were able to overcome the effects of the lowest berenil concentrations by increasing their trypsin-like activity, but not as berenil concentration increased, despite the fact that the highest berenil concentration resulted in overproduction of trypsin-like proteinases. Berenil also prevented the increase of the cysteine proteinases activity in response to trypsin inhibition.

Admission heart rate as a predictor of mortality in patients with acute coronary syndromes

INTRODUCTION

Heart rate (HR) is a prognostic factor in stable angina. However, in the context of acute coronary syndromes (ACS), it is less studied.

AIMS

To evaluate the influence of admission HR as a prognostic factor in patients with ACS.

METHODS

We evaluated in-hospital, 30-day and one-year mortality in patients with ACS, according to admission HR.

RESULTS

We analysed 1126 patients, 69% males, mean age 64 years, 59% with ST-segment elevation acute myocardial infarction and 15% on medication with a beta-blocker. On admission, 14% presented signs of heart failure. In 10%, left ventricular ejection fraction was < 35%. In-hospital mortality was 7.1%, 30-day mortality 9.1% and one-year mortality 10.7%. The best cut-off of HR to predict mortality was 80 bpm (sensitivity 64-66% and specificity 54-55%). By multivariate analysis, a heart rate ≥ 80 bpm was an independent predictor of all-cause mortality (HR 1.50, 95% CI: 1.01-2.23, P = 0.047).

CONCLUSIONS

In a population with ACS, a higher admission HR is an independent predictor of short- and medium-term prognosis, which is also independent of left ventricular function.

[Impact of age on treatment and outcomes after acute myocardial infarction, particularly in very elderly patients]

INTRODUCTION

The elderly population admitted for acute myocardial infarction is increasing. This group is not well studied in international trials and is probably treated with a more conservative approach.

OBJECTIVES

To evaluate the presentation and treatment of myocardial infarction according to age, particularly in very elderly patients.

METHODS

We studied 1242 consecutive patients admitted with acute myocardial infarction, assessing in-hospital, 30-day and one-year mortality during follow-up for each age-group. Patients were divided into four groups according to age: <45 years (7.6%); 45-64 years (43.3%); 65-74 years (23.4%); and ≥75 years (25.7%).

RESULTS

Elderly patients had a worse risk profile (except for smoking), more previous history of coronary disease and a worse profile on admission, with the exception of lipid profile, which was more favorable. With regard to treatment of the elderly, although less optimized than in other age-groups, it was significantly better compared to other registries, including for percutaneous coronary angioplasty. Both complications and mortality were worse in the older groups. In elderly patients (≥75 years), adjusted risk of mortality was 4.9-6.3 times higher (p<0.001) than patients in the reference age-group (45-64 years). In these patients, the independent predictors of death were left ventricular function and renal function, use of beta-blockers being a predictor of survival.

CONCLUSIONS

Elderly patients represent a substantial proportion of the population admitted with myocardial infarction, and receive less evidenced-based therapy. Age is an independent predictor of short- and medium-term mortality.

Usefulness of tissue Doppler imaging to predict arrhythmic events in adults with repaired tetralogy of Fallot

INTRODUCTION

Adults with repaired tetralogy of Fallot (TOF) may be at risk for progressive right ventricular (RV) dilatation and dysfunction, which is commonly associated with arrhythmic events. In frequently volume-overloaded patients with congenital heart disease, tissue Doppler imaging (TDI) is particularly useful for assessing RV function. However, it is not known whether RV TDI can predict outcome in this population.

OBJECTIVE

To evaluate whether RV TDI parameters are associated with supraventricular arrhythmic events in adults with repaired TOF.

METHODS

We studied 40 consecutive patients with repaired TOF (mean age 35 +/- 11 years, 62% male) referred for routine echocardiographic exam between 2007 and 2008. The following echocardiographic measurements were obtained: left ventricular (LV) ejection fraction, LV end-systolic volume, LV end-diastolic volume, RV fractional area change, RV end-systolic area, RV end-diastolic area, left and right atrial volumes, mitral E and A velocities, RV myocardial performance index (Tei index), tricuspid annular plane systolic excursion (TAPSE), myocardial isovolumic acceleration (IVA), pulmonary regurgitation color flow area, TDI basal lateral, septal and RV lateral peak diastolic and systolic annular velocities (E' 1, A' 1, S' 1, E' s, A' s, S' s, E' rv, A' rv, S' rv), strain, strain rate and tissue tracking of the same segments. QRS duration on resting ECG, total duration of Bruce treadmill exercise stress test and presence of exercise-induced arrhythmias were also analyzed. The patients were subsequently divided into two groups: Group 1--12 patients with previous documented supraventricular arrhythmias (atrial tachycardia, fibrillation or flutter) and Group 2 (control group)--28 patients with no previous arrhythmic events. Univariate and multivariate analysis was used to assess the statistical association between the studied parameters and arrhythmic events.

RESULTS

Patients with previous events were older (41 +/- 14 vs. 31 +/- 6 years, p = 0.005), had wider QRS (173 +/- 20 vs. 140 +/- 32 ms, p = 0.01) and lower maximum heart rate on treadmill stress testing (69 +/- 35 vs. 92 +/- 9%, p = 0.03). All patients were in NYHA class I or II. Clinical characteristics including age at corrective surgery, previous palliative surgery and residual defects did not differ significantly between the two groups. Left and right cardiac chamber dimensions and ventricular and valvular function as evaluated by conventional Doppler parameters were also not significantly different. Right ventricular strain and strain rate were similar between the groups. However, right ventricular myocardial TDI systolic (Sa: 5.4+2 vs. 8.5 +/- 3, p = 0.004) and diastolic indices and velocities (Ea, Aa, septal E/Ea, and RV free wall tissue tracking) were significantly reduced in patients with arrhythmias compared to the control group. Multivariate linear regression analysis identified RV early diastolic velocity as the sole variable independently associated with arrhythmic history (RV Ea: 4.5 +/- 1 vs. 6.7 +/- 2 cm/s, p = 0.01). A cut-off for RV Ea of < 6.1 cm/s identified patients in the arrhythmic group with 86% sensitivity and 59% specificity (AUC = 0.8).

CONCLUSIONS

Our results suggest that TDI may detect RV dysfunction in patients with apparently normal function as assessed by conventional echocardiographic parameters. Reduction in RV early diastolic velocity appears to be an early abnormality and is associated with occurrence of arrhythmic events. TDI may be useful in risk stratification of patients with repaired tetralogy of Fallot.

Impact of obesity on results after primary angioplasty in patients with ST segment elevation acute myocardial infarction

INTRODUCTION

Obesity is an important risk factor for the development of diabetes, hypertension, coronary disease, left ventricular dysfunction, stroke and cardiac arrhythmias. Paradoxically, previous studies in patients undergoing elective coronary angioplasty showed a reduction in hospital and long-term mortality in obese patients. The relation with body mass index (BMI) has been less studied in the context of primary angioplasty.

OBJECTIVES

To evaluate the impact of obesity on the results of ST-segment elevation acute myocardial infarction treated by primary angioplasty.

METHODS

This was a study of 464 consecutive patients with ST-segment elevation acute myocardial infarction undergoing primary angioplasty, 78% male, mean age 61 +/- 13 years. We assessed in-hospital, 30-day and one-year mortality according to BMI. Patients were divided into three groups according to BMI: normal--18-24.9 kg/m2 (n = 171); overweight--25-29.9 kg/m2 (n = 204); and obese-- > 30 kg/m2 (n = 89).

RESULTS

Obese patients were younger (ANOVA, p < 0.001) and more frequently male (p = 0.014), with more hypertension (p = 0.001) and dyslipidemia (p = 0.006). There were no differences in the prevalence of diabetes, previous cardiac history, heart failure on admission, anterior location, multivessel disease, peak total CK or medication prescribed, except that obese patients received more beta-blockers (p = 0.049). In-hospital mortality was 9.9% for patients with normal BMI, 3.4% for overweight patients and 6.7% for obese patients (p = 0.038). Mortality at 30 days was 11 4.4% and 7.8% (p = 0.032) and at one year 12.9%, 4.9% and 9% (p = 0.023), respectively. On univariate analysis, overweight was the only BMI category with a protective effect; however, after multivariate logistic regression analysis, adjusted for confounding variables, none of the BMI categories could independently predict outcome.

CONCLUSIONS

Overweight patients had a better prognosis after primary angioplasty for ST-segment elevation acute myocardial infarction compared with other BMI categories, but this was dependent on other potentially confounding variables.

Percutaneous closure of atrial septal defects: a decade of experience at a reference center

INTRODUCTION

Atrial septal defects (ASD) are among the most common congenital anomalies and account for 10% of congenital heart disease in the pediatric age-group and 30% in adults. Closure is indicated when there is evidence of hemodynamic significance or after a paradoxical embolic event. Ten years ago, percutaneous closure became the treatment of choice in our center for all patients with a clear indication and favorable anatomy. In this paper we report the experience of this first decade.

OBJECTIVE

To assess the short- and long-term results of our ten-year experience with percutaneous closure of atrial septal defects.

METHODS

We studied retrospectively all patients with ASD treated with a percutaneous approach between November 1998 and December 2008. The pediatric age-group consisted of patients younger than 19 years old. Demographic data, clinical indications, minor and major complication rates, success rate and long-term outcome were assessed.

RESULTS

In the first ten years of experience 510 patients, of whom 166 were in the pediatric group, were treated in our center by a team of adult and pediatric cardiologists. The overall success rate of the procedure was 98% (97.5% in ASD and 99.5% in patent foramen ovale (PFO). The minor complication rate was 3% (3.4% in ASD and 2% in PFO). The most frequent complication was supraventricular tachycardia. The major complication rate was 1.2% (0.6% in ASD and 2% in PFO). Two patients developed cardiac tamponade due to hemopericardium that was resolved by pericardiocentesis, without need for surgery. One patient had an arterial pseudoaneurysm corrected by vascular surgery. There was no device embolization and no need for urgent surgery in this population. During follow-up two patients had recurrence of ischemic stroke, one had a transient ischemic attack and another had a hemorrhagic stroke. Mortality was 0.6% (0.6% in ASD and 0.5% in PFO). There were no in-hospital deaths. During follow-up there were two deaths, both in the adult group.

DISCUSSION AND CONCLUSION

In this population the success rate was high and most of the complications were minor. The results of this collaboration between adult and pediatric cardiologists in the first ten years of activity confirm the safety and efficacy of percutaneous closure of septal defects, when there is careful patient selection and a standardized technique.

Lack of association between glutathione S-transferase polymorphisms and primary glioma in a case-control study in Rio de Janeiro

The glutathione S-transferases (GSTs), a family of phase II isozymes, detoxify several carcinogens. Genetic variations in GSTs have been associated with increased risk for cancer due to a heritable deficiency in detoxification pathways for environmental carcinogens. Conflicting findings have been reported about the association between constitutive GST polymorphisms and gliomas in different populations. The present case-control study examined 78 patients with primary glioma and 347 controls from Rio de Janeiro. DNA was isolated from whole blood, and four genetic polymorphisms (GSTM1, GSTM3, GSTT1, and GSTP1) were determined by PCR-RFLP. The distributions of the genotypic frequencies of these polymorphisms did not differ significantly between cases and controls and were as expected by Hardy-Weinberg equilibrium (P > 0.05). Risk analysis did not show an association between GSTs and primary glioma, suggesting that these polymorphisms do not influence the risk of primary glioma, at least in this population in Rio de Janeiro, Brazil.

Does admission NT-proBNP increase the prognostic accuracy of GRACE risk score in the prediction of short-term mortality after acute coronary syndromes?

BACKGROUND

NT-proBNP has prognostic implications in heart failure. In acute coronary syndromes (ACS) setting, the prognostic significance of NT-proBNP is being sought. We studied short-term prognostic impact of admission NT-proBNP in patients admitted for ACS and in association with GRACE risk score (GRS).

METHODS AND RESULTS

We studied 1035 patients admitted with ACS. Patients were divided in quartiles according to NT-proBNP levels on admission: Q1 <180 pg/ml; Q2 180-691 pg/ml; Q3 696-2664 pg/ml; Q4 2698-35 000 pg/ml. Groups were compared in terms of short-term all-cause mortality. Patients with higher NT-proBNP had worst GRS on admission. They also received less aggressive treatment. In-hospital mortality was 0.8%, 3.0%, 5.8% and 12.8% (P<0.001) and 30-day mortality 1.6%, 4.6%, 6.5% and 16.7% (P<0.001) respectively. In multivariate logistic regression analysis, NT-proBNP is an independent predictor of in-hospital (OR 2.35; 95% CI: 1.12-4.93, P=0.022) and 30-day mortality (OR 2.20; 95% CI: 1.17-4.12, P=0.014). However, NT-proBNP does not add any incremental benefit to GRS for prediction of outcome by ROC curve analysis.

CONCLUSIONS

NT-proBNP is an independent predictor of in-hospital and 30-day mortality after ACS, independently of left ventricular function, but does not increase the prognostic accuracy of GRS.

A new risk factor for infective endocarditis

Body piercing has become an increasingly common practice in recent decades, especially among young people. However, it is not a completely safe procedure and may have serious complications such as infective endocarditis, which can occur in individuals with or without previous heart disease. In this paper we report a case of endocarditis after body piercing in a young woman with a pacemaker who needed surgical intervention. We also review cases of endocarditis after piercing described in the literature. Now that the recommendations of the American Heart Association for prophylaxis of infective endocarditis are more restricted, we discuss the need for inclusion of body piercings among procedures requiring prophylactic therapy in high-risk individuals.

Results of primary angioplasty in a reference center: in-hospital outcomes

INTRODUCTION

Primary angioplasty is accepted as the preferred treatment for acute myocardial infarction in the first 12 hours. However, outcomes depend to a large extent on the volume of activity and experience of the center. Continuous monitoring of methods and results obtained is therefore crucial to quality control.

OBJECTIVE

To describe the demographic, clinical and angiographic characteristics as well as in-hospital outcomes of patients undergoing primary PCI in a high-volume Portuguese center. We also aimed to identify variables associated with in-hospital mortality in this population.

METHODS

This was a retrospective registry of consecutive primary PCIs performed at Santa Marta Hospital between January 2001 and August 2007. Demographic, clinical, and angiographic characteristics and in-hospital outcomes were analyzed. Independent predictors of in-hospital mortality were identified by multivariate logistic regression analysis.

RESULTS

A total of 1157 patients were identified, mean age 61+/-12 years, 76% male. Mean pain-to-balloon time was 7.6 hours and primary angiographic success was 88%. Overall in-hospital mortality was 6.9%, or 5.5% if patients presenting in cardiogenic shock were excluded from the analysis. Previous history of heart failure, cardiogenic shock on admission, invasive ventilatory support, major hemorrhage, and age over 75 years were found to be associated with increased risk of in-hospital death.

CONCLUSIONS

In this center primary PCI is effective and safe. Angiographic success rates and in-hospital mortality and morbidity are similar to other international registries. Patients at increased risk for adverse outcome can be identified by simple clinical characteristics such as advanced age, cardiogenic shock on admission, mechanical ventilation and major hemorrhage during hospitalization.

Adherence to guidelines in the treatment of acute coronary syndromes: progress over time

BACKGROUND

Treatment of acute coronary syndromes (ACS) has changed considerably in the last few years, as reflected in various proposals for guidelines by the ACC/AHA/ESC based on clinical evidence. We analyzed the clinical implementation of these recommendations in our patient population between 2002 and 2005.

METHODS

This was a retrospective study of 368 patients admitted in 2002 and 420 patients admitted in 2005 for ACS (with and without ST-segment elevation). We analyzed clinical characteristics and treatment strategies.

RESULTS

There were no differences in terms of age, gender ratio, risk factors for coronary artery disease, or previous myocardial revascularization. There was a decrease in the number of patients with previous myocardial infarction and renal insufficiency on admission, and an increase in patients with ST-segment elevation on admission. Treatment with clopidogrel (6% vs. 87%), beta-blockers (54% vs. 79%), angiotensin-converting enzyme inhibitors (72% vs. 84%) and statins (78% vs. 91%) increased (all with p < 0.001). On the other hand, there was a slight decrease in the use of aspirin (98% vs. 95%, p = 0.039) (with greater use of clopidogrel) and ticlopidine was no longer used (46% vs. 0%, p < 0.001). Use of glycoprotein IIb/IIIa receptor antagonists did not change significantly (66% vs. 67%, p = NS). Percutaneous coronary interventions increased (53% vs. 67% p < 0.001). There was no difference in in-hospital mortality (8.2% vs. 6.4%) or 30-day mortality (9.0% vs. 8.6%), but mortality was lower at one-year follow-up (17.1% vs. 11.7%, p = 0.039). Statins and beta-blockers are independent predictors of mortality during follow-up, with a protective effect.

CONCLUSIONS

Between 2002 and 2005, treatment of ACS improved significantly according to existing guidelines, leading to improvement in medium-term mortality.

NT-proBNP values and Weber functional class in patients with chronic heart failure

OBJECTIVE

To assess the correlation between NT-proBNP values and Weber functional class as determined by cardiopulmonary exercise testing (CPET) in patients with chronic heart failure (CHF).

METHODS

We studied 95 patients, 68 male, mean age 50.4 +/- 10.5 years, with CHF due to dilated cardiomyopathy (DCM), 65% of non-ischemic etiology, classified by symptom-limited treadmill CPET (modified Bruce protocol) as follows: 48 Weber class A, 27 class B, 16 class C and 4 class D. NT-proBNP values (pg/ml) were determined after 15 minutes rest immediately prior to CPET. There were no significant differences between the groups in gender, age or percentage of patients taking ACE inhibitors or ARBs and beta-blockers. Left ventricular ejection fraction was higher in class A and B (27.6+/-8.3%) than in class C and D (19.7+/-6.2%, p=0.001). Serum creatinine was lower in class A (0.97+/-0.22 mg/dl) than in classes C or D (1.16+/-0.26, p=0.006).

RESULTS

NT-proBNP was: class A=1325.8+/-1500.3, class B=3473.0+/-2575.3 (p<0.001 vs. class A), class C=6193.1+/-2066.8 (p<0.001 vs. A and B), while in class D it was 11821.8+/-5489.7. There was an overall significant correlation between NT-proBNP and peak oxygen uptake (r=-0.66, p<0.001). On ROC curve analysis, an NT-proBNP value of 1766.5 pg/ml was found to be the best cut-off to discriminate class A vs. non-A (AUC=0.896, p<0.001, 95% CI 0.834 to 0.957, sensitivity=79%, specificity=83%), while a value of 5029.0 was the best discriminator of class B vs. class C or D (AUC=0.865, p<0.001, 95% CI 0.760 to 0.970, sensitivity=82%, specificity=80%).

CONCLUSIONS

In patients with CHF due to DCM, NT-proBNP values correlate with Weber class as determined by CPET, and this study presents discriminative values.

Is chronic nitrate therapy associated with a different clinical presentation of acute coronary syndrome?

BACKGROUND

Nitrate therapy can induce ischemic preconditioning with a consequent increase in tolerance to ischemia. In the context of acute coronary syndromes (ACS), nitrates may result in a different presentation. with greater protection.

OBJECTIVES

To investigate in a population of patients with ACS whether previous chronic use of nitrates results in a different presentation of ACS.

METHODS

We studied 287 patients (65 +/- 13 years, 66% male) admitted to our department in the first six months of 2005 with ACS (with and without ST-segment elevation). Of these, 8% were under nitrate therapy at the time of admission. In this group, 27% presented ACS without ST-segment elevation, while in the group without nitrates this value was 58% (p = 0.005). By univariate analysis, the use of nitrates was a predictor of the preferential occurrence of non-ST-segment elevation ACS (OR 0.27, 95% CI 0.10-0.71). After correction for the potential influence of variables (age, gender, previous revascularization and smoking) by multivariate logistic regression, nitrate therapy remained a borderline predictor of clinical presentation as non-ST-segment elevation ACS (OR 0.37, 95% CI 0.13-1.04, p = 0.059).

CONCLUSIONS

Previous use of nitrates was associated with a tendency to present as non-ST-segment elevation ACS. This finding may be explained by the hypothesis that nitrates induce pharmacological preconditioning, reducing the transmural extent of myocardial infarction.

Impact of combination medical therapy on mortality in patients with acute coronary syndromes

INTRODUCTION

Conventional risk stratification after acute myocardial infarction is usually based on the extent of myocardial damage and its clinical consequences. However, nowadays, more aggressive therapeutic strategies are used, both pharmacological and invasive, with the aim of changing the course of the disease.

OBJECTIVES

To evaluate whether the number of drugs administered can influence survival of these patients, based on recent clinical trials that demonstrated the benefit of each drug for survival after acute coronary events.

METHODS

This was a retrospective analysis of 368 consecutive patients admitted to our ICU during 2002 for acute coronary syndrome. A score from 1 to 4 was attributed to each patient according to the number of secondary prevention drugs administered--antiplatelets, beta blockers, angiotensin-converting enzyme inhibitors and statins--independently of the type of association. We evaluated mortality at 30-day follow-up.

RESULTS

Mean age was 65 +/- 13 years, 68% were male, and 43% had ST-segment elevation acute myocardial infarction. Thirty-day mortality for score 1 to 4 was 36.8%, 15.6%, 7.8% and 2.5% respectively (p < 0.001). The use of only one or two drugs resulted in a significant increase in the risk of death at 30 days (OR 4.10, 95% CI 1.69-9.93, p = 0.002), when corrected for other variables. There was a 77% risk reduction associated with the use of three or four vs. one or two drugs. The other independent predictors of death were diabetes, Killip class on admission and renal insufficiency.

CONCLUSIONS

The use of a greater number of secondary prevention drugs in patients with acute coronary syndromes was associated with improved survival. A score of 4 was a powerful predictor of mortality at 30-day follow-up.

Morphology and preliminary enzyme characterization of the salivary glands from the predatory bug Podisus nigrispinus (Heteroptera: Pentatomidae)

Podisus nigrispinus (Dallas) is a common predator in agricultural and natural systems in Neotropical America. Its feeding strategy involves extra-oral digestion and to better understand this process its salivary glands were extracted and subjected to morphological and preliminary enzyme characterization. The salivary glands of P. nigrispinus are formed by a pair of main and accessory gland complexes. The main salivary glands are further divided into an anterior and a posterior lobe. The compartmentalization of the salivary gland complex is likely to be important for the production, activation and release of the digestive enzymes used in the extra-oral digestion of prey items. Proteases and lipase, important digestive enzymes involved in zoophagy, were detected in the salivary glands of P. nigrispinus. The prevailing trypsin-like protease activity was characterized by using the serine-protease substrate N-alpha-benzoyl-L-Arg-p-nitroanilidine (L-BApNA) and the trypsin inhibitors tosyl-L-lysine chloromethyl ketone (TLCK) and benzamidine. The KM value obtained for trypsin-like activity was 1.57 mm and the different peaks of optimum pH and temperature activity suggest the presence of multiple forms of this enzyme in P. nigrispinus. Detection of amylase activity in the salivary glands of this predator suggests its ability to digest starch and obtain nutrients from plants, which may have adaptative value under prey scarcity.

Detection of a chloramphenicol efflux system in Escherichia coli isolated from poultry carcass

An active chloramphenicol efflux system was demonstrated in a multiresistant E. coli isolated from poultry carcass. The effect of different concentrations of chloramphenicol on the original strain and on the plasmid-cured strain was determined in the presence and in the absence of CCCP, an uncoupler of the proton-motive force. Minimal inhibitory concentration (MIC) was lower in the presence of CCCP in the original strain. The plasmid-cured strain displayed lower resistance for chloramphenicol than the wild type, but the MIC was not affected by CCCP. The combined results indicate a plasmid encoded energy dependent resistance mechanism. 3H-chloramphenicol accumulation within the cells was measured by scintillation counting. The uptake or the efflux of 3H-chloramphenicol was influenced by CCCP in the original strain, but not in the plasmid-cured strain. More than one chloramphenicol resistance mechanism may exist in this strain. E. coli is an important commensal or pathogen that inhabits the gastrointestinal tracts of humans and animals, so a plasmid encoded active drug resistance mechanism can be a potential source of horizontal transfer of resistance.

Selective pulmonary vasodilators for severe pulmonary hypertension: comparison between endpoints

The therapeutic approach to severe pulmonary arterial hypertension (PAH), whether primary or secondary to connective tissue disorders, thromboembolic phenomena or congenital heart disease with Eisenmenger syndrome, has evolved in recent years following the introduction of selective pulmonary vasodilators, including prostacyclin analogs and endothelin receptor antagonists.

AIM

To correlate three different endpoints (6-minute walk test, Tei index and peak tricuspid regurgitation velocity by Doppler echocardiographic study) during follow-up of PAH patients under selective vasodilator therapy.

METHODS

Eleven patients (9 female, age 42 +/- 18 years) with severe PAH (> or = 65 mmHg), 64% with Eisenmenger syndrome, in NYHA class > or = II, were assessed during a follow-up of 11 +/- 8 months. Eight patients were already under therapy with iloprost or bosentan.

RESULTS

There was no correlation between the three endpoints before and after therapy as assessed by Pearson's correlation coefficient. There was, however, an improvement in all of them after selective vasodilatory therapy.

CONCLUSION

Therapeutic response can be accurately measured by the traditional endpoint (6-minute walk test) or by echocardiographic endpoints. However, the lack of correlation between them excludes their use as alternatives in patient follow-up.

Eisenmenger syndrome in the adult--experience with new drugs for the treatment of pulmonary hypertension

BACKGROUND

The last few years have seen significant progress in the treatment of advanced pulmonary arterial hypertension (PAH). The efficacy of new drugs has been proved mainly in idiopathic PAH or PAH associated with connective tissue diseases. As the pathophysiologic patterns are similar, it is reasonable to use these drugs also in Eisenmenger syndrome or in other congenital heart defects with PAH related to initial high pulmonary flow.

OBJECTIVES

To evaluate our early experience with new drugs for PAH in patients with Eisenmenger syndrome.

METHODS

A retrospective study of five patients, aged 28 to 51 years (39.6 +/- 9.94), four female, with Eisenmenger syndrome due to atrial septal defect (n = 2), patent ductus arteriosus (n = 2) or ventricular septal defect (n = 1), who began therapy with iloprost (n = 4, later associated with sildenafil in one patient) and bosentan (n = 1), between April 2001 and May 2003. The existence of severe and fixed PAH, with predominant right-to-left shunt, was confirmed by hemodynamic study in all cases. The patients were evaluated by clinical examination, Doppler echocardiography and the six-minute walk test before treatment and throughout follow-up (9 to 34 months, 19.8 +/- 9.04). Before treatment two patients were in NYHA class III and three in class III with periods in class IV. By Doppler echocardiography the right ventricle-right atrium (RV-RA) gradient was 74 to 111 mmHg (90.6 +/- 15.73) and the Tei index was 0.53 to 2.05 (1.13 +/- 0.62). In the six-minute walk test the distance was 214 to 500 meters (296.8 +/- 115.27).

RESULTS

All patients improved clinically, though three are still in class III. One patient is in class II and one patient died. At the latest evaluation the RV-RA gradient was 60 to 112 mmHg (84.8 +/- 19.11) and the Tei index was 0.5 to 1.33 (0.85 +/- 80.32). In the six-minute walk test a net increase in the distance covered was evident: 376 to 520 meters (420 +/- 57.89). The treatment was well tolerated in all cases, without serious adverse effects.

CONCLUSIONS

Though the number of patients was small, our initial experience with the new specific drugs for PAH in Eisenmenger syndrome showed promising results, with clinical and functional improvement and without adverse effects.

Molecular and karyologic variation in the genus Isothrix (Rodentia, Echimyidae)

Phylogenetic relationships among available samples of the genus Isothrix using mitocondrial gene cytochrome b were carried out and a new karyotype of Isothrix specimens referred to Isothrix negrensis from the mid course of Rio Negro, in the Brazilian Amazon, was described. Molecular, karyological and morphological data of Isothrix negrensis was compared to that of I. bistriata and I. pagurus. Cytochrome b DNA sequence analyses clearly separate I. negrensis from I. bistriata and genetic distances estimates between then are greater than between species of the related genus Mesomys. The median-joining analysis postulated the presence of two median vectors between I. bistriata haplotypes from adjacent localities, suggesting that genetic isolation between them is unrelated to geographic distance. These results confirm previous molecular differences suggesting that I.bistriata is a composite of several taxa. The karyotype of Isothrix negrensis also differs from those reported for I. bistriata and I. pagurus. In relation to the external morphology I. negrensis differs from I. bistriata by the overall darker dorsal coloration, head darker than dorsum, presence of a longitudinal line of blackish hairs in the proximal part of the tail extending until near to its base, dorsal surface of hind feet covered with yellowish hairs and stripe of light hairs in the head reduced to a small patch.

Postprandial symptoms in dysmotility-like functional dyspepsia are not related to disturbances of gastric myoelectrical activity

Gastric dysrhythmias, such as tachy- or bradygastria, have been reported in patients with functional dyspepsia (FD), but their role in symptom production is uncertain. It is also not known whether gastric dysrhythmias in these patients can be elicited by physiological gastric distension with a meal. We investigated the relationships between symptoms after ingestion of different volumes of water following a test meal and gastric dysrhythmias in FD patients. Fourteen patients with dysmotility-like FD and 13 healthy volunteers underwent paired electrogastrography (EGG) studies. Fasted subjects ingested 150 ml of yoghurt with either 150 ml (low volume) or 300 ml (high volume) water in random order. Fasting and fed EGGs with monitoring of symptoms were performed in both studies. Ten FD patients (71.4%) reported upper abdominal discomfort and bloating after the low volume meal, but only one (7.1%) presented an abnormal EGG (dominant frequency in the 2-4-cpm range: 58%). Following the high volume meal, 7 patients (50%) had symptoms, but none had EGG abnormalities. No significant differences were found between FD patients and controls for any of the EGG variables, in any test. In FD patients with postprandial symptoms, the percentage of the EGG dominant frequency in the normal range (median, 84.6%; range, 76.0-100.0%) was similar (P>0.20) to that in those without symptoms (88.5%; 75.0-100.0%). We conclude that disturbances of gastric myoelectrical activity are unlikely to play a role in the origin of postprandial upper abdominal discomfort and bloating in dysmotility-like FD.

Efficacy of linear and convex transducers for ultrasound-guided transvaginal follicle aspiration

A new device was developed to hold linear transducers for transvaginal follicle aspiration. Efficacy of follicle aspiration was compared using a linear 6 MHz and a convex 5 MHz transducer. Fifty-five cows were submitted to follicle aspiration at random days of the estrous cycle. Aspirations were conducted with linear (n=28) and convex (n=38) transducers with 18 G needles at a negative pressure corresponding to 13 ml H(2)O/min. A greater number of follicles were aspirated using convex than to linear probe (12.4 versus 7.8, respectively, P<0.05). Mean number of oocytes and recovery rates were similar for convex (5.4 and 48.6%) and linear (4.6 and 59.3%) transducers. Limited space between the linear transducer and needle guide restricted access to some portions of the ovary, reducing the number of follicles aspirated using a linear transducer. The newly developed adaptor allowed greater stability, holding the ovaries firmly against the linear transducer. This diminished mobility permitted a similar number of oocytes to be recovered with both transducers. In conclusion, this new adaptor provided a low cost alternative for routine follicle aspiration and oocyte recovery in cattle.

Histoenzymology and morphometry of the masticatory muscles of tufted capuchin monkey (Cebus apella Linnaeus, 1758)

Samples of the anterior and posterior regions of the masseter and temporal muscles and of the anterior belly of the digastric muscle of 4 adult male tufted capuchin monkeys (Cebus apella) were removed and stained with HE and submitted to the m-ATPase reaction (with alkaline and acid preincubation) and to the NADH-TR and SDH reactions. The results of the histoenzymologic reactions were similar, except for acid reversal which did not occur in fibers of the fast glycolytic (FG) type in the mandibular locomotor muscles. FG fibers had a larger area and were more frequent in all regions studied. No significant differences in frequency or area of each fiber type were detected, considering the anterior and posterior regions of the masseter and temporal muscles. The frequency of fibers of the fast oxidative glycolytic (FOG) and slow oxidative (SO) types and of FOG area differed significantly between the anterior belly of the digastric muscle and the mandibular locomotor muscle. The predominance of fast twitch (FG and FOG) fibers and the multipenniform and bipenniform internal architecture of the masseter and temporal muscles, respectively, are characteristics that permit the powerful bite typical of tufted capuchin monkeys.