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Motor reserve: How to build neuronal resilience against ageing and neurodegeneration? Rev Neurol (Paris) 2022; 178:845-854. [DOI: 10.1016/j.neurol.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/14/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
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2
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In vivo hydrogen peroxide diffusivity in brain tissue supports volume signaling activity. Redox Biol 2022; 50:102250. [PMID: 35101799 PMCID: PMC8804256 DOI: 10.1016/j.redox.2022.102250] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/18/2022] [Accepted: 01/24/2022] [Indexed: 12/21/2022] Open
Abstract
Hydrogen peroxide is a major redox signaling molecule underlying a novel paradigm of cell function and communication. A role for H2O2 as an intercellular signaling molecule and neuromodulator in the brain has become increasingly apparent, with evidence showing this biological oxidant to regulate neuronal polarity, connectivity, synaptic transmission and tuning of neuronal networks. This notion is supported by its ability to diffuse in the extracellular space, from source of production to target. It is, thus, crucial to understand extracellular H2O2 concentration dynamics in the living brain and the factors which shape its diffusion pattern and half-life. To address this issue, we have used a novel microsensor to measure H2O2 concentration dynamics in the brain extracellular matrix both in an ex vivo model using rodent brain slices and in vivo. We found that exogenously applied H2O2 is removed from the extracellular space with an average half-life of t1/2 = 2.2 s in vivo. We determined the in vivo effective diffusion coefficient of H2O2 to be D* = 2.5 × 10−5 cm2 s−1. This allows it to diffuse over 100 μm in the extracellular space within its half-life. Considering this, we can tentatively place H2O2 within the class of volume neurotransmitters, connecting all cell types within the complex network of brain tissue, regardless of whether they are physically connected. These quantitative details of H2O2 diffusion and half-life in the brain allow us to interpret the physiology of the redox signal and lay the pavement to then address dysregulation in redox homeostasis associated with disease processes.
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3
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External causes in women assisted by the Mobile Emergency Service - SAMU, in Espírito Santo, Brazil. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
External causes are events that lead to traumas, injuries and any health problems, whether deliberate or not, with sudden onset and with immediate consequence, which may or may not lead to death or incapacitating injuries. Studies show that the main causes of death of women in fertile period are external causes, and they associate this fact with the change in habits and lifestyle adopted by this group in modern times that make them more vulnerable to the risks of becoming ill or dying from such causes. The objective of this study is precisely to analyze the prevalence of the main external causes in women assisted by SAMU 192 in Espírito Santo, Brazil, and in this way, assist in the development of accident and violence prevention strategies and also contribute to the scientific society through the description of the profile epidemiological profile of these events.
Methods
This is a cross-sectional study of primary care provided by SAMU 192, in the state of Espírito Santo, in 2015, in which only women victims of traffic accidents, aggression or falls were selected.
Results
Among the women assisted by SAMU 192, 23.5% were victims of accidents and violence. Of this total, 48.6% received assistance for falls, 46.6% for traffic accidents and 4.9% for aggression. Adulthood was the most frequent, with an average age of 44.9 ± 22.7 years.
Conclusions
External causes involving women represent a major problem in Brazil and worldwide. In Espírito Santo, falling was the most common type of external cause and mainly affected the elderly woman, while the traffic accident mainly affected the adult woman. As for the aggressions, these occurred mainly at night with association with the use of alcoholic beverages. Thus, it is immensely necessary to develop actions to promote and prevent external causes of harm to women's health in the state of Espírito Santo.
Key messages
Knowing what affects the most women's health in an emerging country like Brazil, is essential for public policy actions aimed at reducing the femininity, sexism and the death of women in general. Violence against women is an underreported event because of several factors, leading to the concealment of violence, emphasizing once again the importance of public policies for this purpose.
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Cervical vertebral osteomyelitis secondary to Streptococcus equi infection in an adult horse - case report. ARQ BRAS MED VET ZOO 2019. [DOI: 10.1590/1678-4162-11152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
ABSTRACT A 15-year-old, mixed breed, male horse was attended with a history of multiple abscesses in the cervical region with a three-year evolution. Upon admission, three fistulous tracts with drainage of purulent secretions in the cervical region, low body score, restriction of cervical movements, and painful sensitivity to palpation were observed. The horse was diagnosed with osteomyelitis secondary to Streptococcus equi infection. The initial treatment was antibiotic therapy and local curative. Owing to the lack of response, surgical debridement was performed. An initial favorable response was observed; however, after 4 months, drainage recurred, and the animal was euthanized. A post-mortem computed tomography scan was performed to obtain details of the injury. Cervical osteomyelitis is rare, and its occurrence through hematogenous spread in adult horses and the tomographic findings had not been reported previously. The long period of evolution, difficulty in performing an aggressive debridement, and the presence of multi-drug resistant bacteria contributed to the negative outcome.
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5
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Biodegradation of polyhydroxybutyrate and hollow glass microspheres composite films. J Appl Polym Sci 2019. [DOI: 10.1002/app.47195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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6
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Vasorelaxant effect of the Lippia alba essential oil and its major constituent, citral, on the contractility of isolated rat aorta. Biomed Pharmacother 2018; 108:792-798. [DOI: 10.1016/j.biopha.2018.09.073] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/31/2018] [Accepted: 09/12/2018] [Indexed: 10/28/2022] Open
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7
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Nouvelles stratégies de dépistage de terrain du paludisme : importance et rôle de l’infirmier coordinateur sur le projet PALUSTOP. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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8
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Different levels of supplied energy for lactating cows
affect physicochemical attributes of milk. JOURNAL OF ANIMAL AND FEED SCIENCES 2018. [DOI: 10.22358/jafs/83703/2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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9
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Effects of Lippia sidoides essential oil, thymol, p-cymene, myrcene and caryophyllene on rat sciatic nerve excitability. ACTA ACUST UNITED AC 2017; 50:e6351. [PMID: 29069226 PMCID: PMC5649868 DOI: 10.1590/1414-431x20176351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 07/07/2017] [Indexed: 01/23/2023]
Abstract
Lippia sidoides Cham is a typical herb species of Northeast Brazil with widespread use in folk medicine. The major constituents of the essential oil of L. sidoides (EOLs) are thymol, p-cymene, myrcene, and caryophyllene. Several studies have shown that the EOLs and its constituents have pharmacological effects, including antibacterial, anti-inflammatory, antioxidant and neuroprotective activity. Therefore, this work aimed to investigate the effects of the EOLs and their main constituents on rat sciatic nerve excitability. The sciatic nerves of adult Wistar rats were dissected and mounted in a moist chamber. Nerves were stimulated by square wave pulses, with an amplitude of 40 V, duration of 100 μs to 0.2 Hz. Both EOLs and thymol inhibited compound action potential (CAP) in a concentration-dependent manner. Half maximal inhibitory concentration for CAP peak-to-peak amplitude blockade were 67.85 and 40 µg/mL for EOLs and thymol, respectively. CAP peak-to-peak amplitude was significantly reduced by concentrations ≥60 µg/mL for EOLs and ≥30 µg/mL for thymol. EOLs and thymol in the concentration of 60 µg/mL significantly increased chronaxie and rheobase. The conduction velocities of 1st and 2nd CAP components were also concentration-dependently reduced by EOLs and thymol in the range of 30-100 µg/mL. Differently from EOLs and thymol, p-cymene, myrcene and caryophyllene did not reduce CAP in the higher concentrations of 10 mM. These data demonstrated that EOLs and thymol inhibited neuronal excitability and were promising agents for the development of new drugs for therapeutic use.
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10
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The relationship between blood serum BDNF and seizure frequency in temporal lobe epilepsy patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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11
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Abstract
BACKGROUND/PURPOSE Human skin anisotropy is difficult to quantify. The Cutiscan® , is allegedly, the first biometrical system to provide information on the elastic and viscoelastic properties, as well as on anisotropy and directionality of the human skin in vivo. Thus, this study aims to contribute to characterize this new device and its applicability, and to compare its behavior with two other well-known devices-the Cutometer® and the Reviscometer® . METHODS Measurements were conducted with each device in three different anatomical sites (forehead, forearm and leg) of 20 female volunteers engaged after informed consent. The participants in the study were aged 19-73 years (mean age 37 ± 18.7 years old), and were divided in two groups (n = 10), based on their age - Group I, mean age 22 ± 1.3 years; Group II, mean age 52 ± 13.7 years. RESULTS All devices were useful tools to explore the anatomical and the age dependant changes in biomechanical terms, showing different discriminative capacities. Interesting correlations were established between the variables provided by the equipment. CONCLUSION The Cutiscan® descriptors delivered excellent relationships with those from Cutometer® and Reviscometer® , while providing more detailed information about skin anisotropy through a full 360° analysis.
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III Diretrizes da Sociedade Brasileira de Cardiologia sobre análise e emissão de laudos eletrocardiográficos. Arq Bras Cardiol 2016; 106:1-23. [DOI: 10.5935/abc.20160054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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13
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Increased expression of macrophage migration inhibitory factor in the nucleus of solitary tract attenuates the renovascular hypertension. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Childhood arterial ischemic stroke: a review of risk factors. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.1398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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P-373: Relationship between oral health and nutritional status in older patients admitted in a medical ward of a general hospital. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30470-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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SUN-PP110: Nutritional Status Assessment of Hospitalized Older Adults in an Internal Medicine Ward. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30261-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Essential oil of Lippia alba and its main constituent citral block the excitability of rat sciatic nerves. ACTA ACUST UNITED AC 2015; 48:697-702. [PMID: 26132093 PMCID: PMC4541688 DOI: 10.1590/1414-431x20154710] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 04/06/2015] [Indexed: 11/29/2022]
Abstract
Lippia alba is empirically used for infusions, teas, macerates, and
hydroalcoholic extracts because of its antispasmodic, analgesic, sedative, and
anxiolytic effects. Citral is a mixture of trans-geranial and cis-neral and is the
main constituent of L. alba essential oil and possesses analgesic,
anxiolytic, anticonvulsant, and sedative effects. The present study evaluated the
effects of the essential oil of L. alba (EOLa) and citral on
compound action potentials (CAPs) in Wistar rat sciatic nerves. Both drugs inhibited
CAP in a concentration-dependent manner. The calculated half-maximal inhibitory
concentrations (IC50) of peak-to-peak amplitude were 53.2 µg/mL and 35.00
µg/mL (or 230 µM) for EOLa and citral, respectively. Peak-to-peak amplitude of the
CAP was significantly reduced by 30 µg/mL EOLa and 10 µg/mL citral. EOLa and citral
(at 60 and 30 µg/mL, values close to their respective IC50 for CAP
blockade) significantly increased chronaxy and rheobase. The conduction velocity of
the first and second CAP components was statistically reduced to ∼86% of control with
10 µg/mL EOLa and ∼90% of control with 3 µg/mL citral. This study showed that EOLa
inhibited nerve excitability and this effect can be explained by the presence of
citral in its composition. Both EOLa and citral showed inhibitory actions at lower
concentrations compared with other essential oils and constituents with local
anesthetic activity. In conclusion, these data demonstrate that EOLa and citral are
promising agents in the development of new drugs with local anesthetic activity.
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AB1021 Prevalence and Neuroimaging Correlates of Central Ataxia In Childhood-Onset Systemic Lupus Erythematosus. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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19
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Experimental protocol for kinematic analysis of the hand during the use of upper extremity orthosis. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Is carbon dioxide laser vaporization a valuable tool in the management of oral leukoplakia? A survey at an oncology hospital. Lasers Med Sci 2014; 30:1629-30. [PMID: 24570088 DOI: 10.1007/s10103-014-1551-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/11/2014] [Indexed: 10/25/2022]
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21
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Orbitary exenteration—reconstruction strategies in a Portuguese tertiary cancer center. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Limb immobilization alters functional electrophysiological parameters of sciatic nerve. Braz J Med Biol Res 2013; 46:715-21. [PMID: 23969978 PMCID: PMC3854417 DOI: 10.1590/1414-431x20132626] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Accepted: 05/03/2013] [Indexed: 11/22/2022] Open
Abstract
Immobilization, used in clinical practice to treat traumatologic problems, causes
changes in muscle, but it is not known whether changes also occur in nerves. We
investigated the effects of immobilization on excitability and compound action
potential (CAP) and the ultrastructure of the rat sciatic nerve. Fourteen days after
immobilization of the right leg of adult male Wistar rats (n=34), animals were killed
and the right sciatic nerve was dissected and mounted in a moist chamber. Nerves were
stimulated at a baseline frequency of 0.2 Hz and tested for 2 min at 20, 50, and 100
Hz. Immobilization altered nerve excitability. Rheobase and chronaxy changed from
3.13±0.05 V and 52.31±1.95 µs (control group, n=13) to 2.84±0.06 V and 59.71±2.79 µs
(immobilized group, n=15), respectively. Immobilization altered the amplitude of CAP
waves and decreased the conduction velocity of the first CAP wave (from 93.63±7.49 to
79.14±5.59 m/s) but not of the second wave. Transmission electron microscopy showed
fragmentation of the myelin sheath of the sciatic nerve of immobilized limbs and
degeneration of the axon. In conclusion, we demonstrated that long-lasting leg
immobilization can induce alterations in nerve function.
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2017 – Clinical and socio-demographic characteristics of college students in the northeast of brazil exposed to traumatic experiences: a prevalence census study protocol. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76950-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Removal of phosphorus from wastewaters by biomass ashes. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2013; 68:2019-2027. [PMID: 24225103 DOI: 10.2166/wst.2013.455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Removal batch assays of phosphates from a synthetic wastewater (SWW) and a pulp and paper mill wastewater (PPWW) with two forestry biomass ashes were performed. The supernatants were not only chemically characterized but also the ecotoxicity was determined using two organisms: Vibrio fischeri and Artemia franciscana. The addition of fly ash and bottom ash to the SWW in solid/liquid (S/L) ratios of 3.35 and 9.05 g L(-1), respectively, achieved removal percentages of phosphates >97% for both ashes. The addition of fly ash and bottom ash to the PPWW in S/L ratios of 34.45 and 46.59 g L(-1), respectively, yield removal percentages of phosphates >90% for both ashes. According to the results of the Langmuir and Freundlich isotherms, the removal of phosphates from the SWW was mainly explained by surface removal mechanisms, while the removal from the PPWW was partially explained by multi-layer mechanisms. The supernatants resulting from the treatment of SWW and PPWW with both biomass ashes did not present acute ecotoxicity.
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Determination of trace elements in bovine semen samples by inductively coupled plasma mass spectrometry and data mining techniques for identification of bovine class. J Dairy Sci 2012; 95:7066-73. [DOI: 10.3168/jds.2012-5515] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 07/10/2012] [Indexed: 01/11/2023]
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Multi-element determination in Brazilian honey samples by inductively coupled plasma mass spectrometry and estimation of geographic origin with data mining techniques. Food Res Int 2012. [DOI: 10.1016/j.foodres.2012.07.015] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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M132 CERVICAL CYTOLOGY OF WOMEN ON EXTENDED REGIMENS OF THE VAGINAL CONTRACEPTIVE RING VERSUS COMBINED ORAL CONTRACEPTIVE PILLS. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61327-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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M122 LIPID PROFILE OF WOMEN ON EXTENDED REGIMENS OF COMBINED ORAL CONTRACEPTIVES: DO DIFFERENT TYPES OF PROGESTOGENS MAKE A DIFFERENCE? Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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M125 COMBINED ORAL CONTRACEPTIVES ON EXTENDED REGIMENS: EFFECTS ON INSULIN RESISTANCE ACCORDING TO TYPE OF PROGESTAGEN. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61320-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Characterization of chars produced in the co-pyrolysis of different wastes: decontamination study. JOURNAL OF HAZARDOUS MATERIALS 2012; 207-208:28-35. [PMID: 21899951 DOI: 10.1016/j.jhazmat.2011.07.115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 06/03/2011] [Accepted: 07/19/2011] [Indexed: 05/31/2023]
Abstract
The present work is devoted to the study of the decontamination of chars obtained in the co-pyrolysis of plastics, biomass and tyre wastes. The chars were extracted with several organic solvents of different polarities either individually or in sequence. The ability of each selected extractant to remove toxic pollutants was evaluated by comparing the extraction yields and by characterizing the crude extracts with a combination of chemical analysis and toxicity bioassays. Also, the mineral composition of the treated and non-treated chars was assessed. The results obtained in this study indicate that hexane is the more efficient extraction solvent to be used in the organic decontamination of chars obtained in the co-pyrolysis of plastics, tyres and biomass. A sequential extraction with solvents of increasing polarity can provide a better decontamination of the raw pyrolysis char than any individual extraction. The compounds removed from the char during the decontamination process are mainly aliphatic hydrocarbons and aromatic hydrocarbons, therefore a material that may be upgraded to be used as a fuel and/or as raw material for the organic chemical industry.
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Toxicity of char residues produced in the co-pyrolysis of different wastes. WASTE MANAGEMENT (NEW YORK, N.Y.) 2010; 30:628-635. [PMID: 19932606 DOI: 10.1016/j.wasman.2009.10.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 10/02/2009] [Accepted: 10/21/2009] [Indexed: 05/28/2023]
Abstract
Char residues produced in the co-pyrolysis of different wastes (plastics, pine biomass and used tyres) were characterized using chemical and toxicity assays. One part of the solid chars was submitted to extraction with dichloromethane (DCM) in order to reduce the toxicity of the char residues by removing organic contaminants. The different volatility fractions present in the extracted char (Char A) and in the raw char (Char B) were determined by progressive weight loss combustion. A selected group of heavy metals (Cd, Pb, Zn, Cu, Hg and As) was determined in both chars. The chars were subjected to the leaching test ISO/TS 21268 - 2, 2007 and the resulting eluates were further characterized by determining a group of inorganic parameters (pH, conductivity, Cd, Pb, Zn, Cu, Hg and As contents) and the concentrations of several organic contaminants (volatile aromatic hydrocarbons and alkyl phenols). An ecotoxicological characterization was also performed by using the bio-indicator Vibrio fischeri. The chemical and ecotoxicological results were analyzed according to the Council Decision 2003/33/CE and the criteria on the evaluation methods of waste ecotoxicity (CEMWE). The results obtained in this work indicated that the extraction with DCM is an effective method for the removal of organic contaminants of high to medium volatility from pyrolysis solid residues, thus decreasing their toxicity potential. Zn can be leached from the chars even after the DCM extraction treatment and can contribute to the ecotoxicity of the eluates obtained from chars. Both chars (treated and non treated with DCM) were classified as hazardous and ecotoxic wastes.
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P932 Prevalence of weight gain in the gynecologic endocrinopaties. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62419-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chemical and ecotoxicological characterization of solid residues produced during the co-pyrolysis of plastics and pine biomass. JOURNAL OF HAZARDOUS MATERIALS 2009; 166:309-317. [PMID: 19118946 DOI: 10.1016/j.jhazmat.2008.11.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 11/11/2008] [Accepted: 11/11/2008] [Indexed: 05/27/2023]
Abstract
A mixture of 70% (w/w) pine biomass and 30% (w/w) plastics (mixture of polypropylene, polyethylene, and polystyrene) was subjected to pyrolysis at 400 degrees C, for 15 min, with an initial pressure of 40 MPa. Part of the solid residue produced was subjected to extraction with dichloromethane (DCM). The extracted residue (residue A) and raw residue (residue B) were analyzed by weight loss combustion and submitted to the leaching test ISO/TS 21268-2 using two different leachants: DCM (0.2%, v/v) and calcium chloride (0.001 mol/L). The concentrations of the heavy metals Cd, Cr, Ni, Zn, Pb and Cu were determined in the eluates and in the two residues. The eluates were further characterized by determining their pH and the concentrations of benzene, toluene, ethylbenzene and xylenes (BTEX). The presence of other organic contaminants in the eluates was qualitatively evaluated by gas chromatography, coupled with mass spectrometry. An ecotoxicological characterization was also performed by using the bio-indicator Vibrio fischeri. The chemical and ecotoxicological results were analyzed according to the French proposal of Criteria on the Evaluation Methods of Waste Ecotoxicity (CEMWE). Residue A was not considered to be ecotoxic by the ecotoxicological criterion (EC(50) (30 min) >or=10%), but it was considered to be ecotoxic by the chemical criterion (Ni>or=0.5mg/L). Residue B was considered to be ecotoxic by the ecotoxicological criterion: EC(50) (30 min)<or=10%. Besides that, residue B was considered to be hazardous according the European legislation (BTEX concentrations higher than 100 ppb). The results indicate that volatile organic contaminants can be present in sufficient amounts in these residues and their eluates to induce ecotoxicity levels. The extraction of the pyrolysis residue with DCM was an efficient method for removing lighter organic contaminants.
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Stimulation of NMDA and AMPA glutamate receptors elicits distinct concentration dynamics of nitric oxide in rat hippocampal slices. Hippocampus 2009; 19:603-11. [DOI: 10.1002/hipo.20536] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Determination of aromatic compounds in eluates of pyrolysis solid residues using HS-GC-MS and DLLME-GC-MS. Talanta 2009; 80:104-8. [PMID: 19782198 DOI: 10.1016/j.talanta.2009.06.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Revised: 06/09/2009] [Accepted: 06/12/2009] [Indexed: 10/20/2022]
Abstract
A method for the determination of 15 aromatic hydrocarbons in eluates from solid residues produced during the co-pyrolysis of plastics and pine biomass was developed. In a first step, several sampling techniques (headspace solid phase microextraction (HS-SPME), static headspace sampling (HS), and dispersive liquid-liquid microextraction (DLLME) were compared in order to evaluate their sensitivity towards these analytes. HS-SPME and HS sampling had the better performance, but DLLME was itself as a technique able to extract volatiles with a significant enrichment factor. HS sampling coupled with GC-MS was chosen for method validation for the analytes tested. Calibration curves were constructed for each analyte with correlation coefficients higher than 0.999. The limits of detection were in the range of 0.66-37.85 ng/L. The precision of the HS method was evaluated and good repeatability was achieved with relative standard deviations of 4.8-13.2%. The recoveries of the analytes were evaluated by analysing fortified real eluate samples and were in the range of 60.6-113.9%. The validated method was applied in real eluate samples. Benzene, toluene, ethylbenzene and xylenes (BTEX) were the compounds in higher concentrations. The DLLME technique coupled with GC-MS was used to investigate the presence of less volatile contaminants in eluate samples. This analysis revealed the presence of significant amounts of alkyl phenols and other aromatic compounds with appreciable water solubility.
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Influence of clay incorporation on the physical properties of polyethylene/Brazilian clay nanocomposites. JOURNAL OF NANOSCIENCE AND NANOTECHNOLOGY 2008; 8:1937-1941. [PMID: 18572596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
High density polyethylene/Brazilian clay nanocomposites were prepared by the melt intercalation technique. A montmorillonite sample from Boa Vista/PB, Northeast of Brazil, was organically modified with esthearildimethylammonium chloride (Praepagen WB) quaternary ammonium salt. The unmodified and modified clays with the quaternary ammonium salt were introduced in 1, 2, 3 and 5 wt% in a PE polymer matrix. The dispersion analysis and the interlayer distance of the clay particles were obtained by X-ray diffraction (XRD) and transmission electron microscopy (TEM). The mechanical properties of tensile and the flammability of the nanocomposites were studied. In general, the mechanical properties of the systems presented superior values compared to the matrix. The systems showed a reduction on the burning rate, indicating that the flammability resistance of nanocomposites was improved.
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Chemical and ecotoxicological characterization of ashes obtained from sewage sludge combustion in a fluidised-bed reactor. JOURNAL OF HAZARDOUS MATERIALS 2007; 147:175-83. [PMID: 17261348 DOI: 10.1016/j.jhazmat.2006.12.064] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Revised: 12/22/2006] [Accepted: 12/29/2006] [Indexed: 05/13/2023]
Abstract
In 1999, the DEECA/INETI and the UBiA/FCT/UNL started a researching project on the partition of heavy metals during the combustion of stabilised sewage sludge (Biogran), in a fluidised-bed reactor, and on the quality of the bottom ashes and fly ashes produced. This project was entitled Bimetal and was funded by the Portuguese Foundation for Science and Technology. In this paper only the results on the combustion of Biogran are reported. The combustion process was performed in two different trials, in which different amounts of sewage sludge and time of combustion were applied. Several ash samples were collected from the bed (bottom ashes) and from two cyclones (first cyclone and second cyclone ashes). Sewage sludge, bed material (sand) and ash samples were submitted to the leaching process defined in the European leaching standard EN 12457-2. The eluates were characterized for a set of inorganic chemical species. The ecotoxicological levels of the eluates were determined for two biological indicators (Vibrio fischeri and Daphnia magna). The results were compared with the limit values of the CEMWE French Regulation. The samples were also ranked according to an index based on the chemical characterization of the eluates. It was observed an increase of the concentration of metals along the combustion system. The ashes trapped in the second cyclone, for both combustion trials, showed the highest concentration of metals in the eluates. Chemically, the ashes of the second cyclone were the most different ones. In the ecotoxicological point of view, the ecotoxicity levels of the eluates of the ashes, for both combustion cycles, did not follow the same pattern as observed for the chemical characterization. The ashes of the first cyclone showed the highest ecotoxicity levels for V. fischeri and D. magna. This difference on chemical and ecotoxicological results proves the need for performing both chemical and ecotoxicological characterizations of the sub-products of such type of thermal processes.
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Correction of long term joint contractures of the hand by distraction. A case report. ACTA ACUST UNITED AC 2005; 58:1148-51. [PMID: 16039631 DOI: 10.1016/j.bjps.2005.04.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2004] [Revised: 04/18/2005] [Accepted: 04/26/2005] [Indexed: 11/15/2022]
Abstract
Joint contractures are a common complication of hand trauma. The conventional treatment consists of arthrolysis, tenolysis and occasionally arthrodesis. Frequently, this does not achieve a good result, particularly when there has been a long delay in presentation. Progressive lengthening of a joint by distraction (joint distraction) allows the release of joint contractures even in cases of failure of traditional methods. We present a case of a delayed (20 years) work related traumatic flexion deformity of the PIP joint of the left index and middle fingers. This was the result of a complete division of both flexor tendons of both fingers. The range of movements, both active and passive, was limited to 90/100 degrees in the index finger and 95/100 degrees in the middle finger. Following joint distraction using our lengthening device (Antãotrade mark, Portugal) the patient was able to achieve an active and passive range of movements of 10/100 degrees for the PIP joint of the index finger and 40/100 degrees of the middle. This clinical case shows the simplicity and application of our technique for the correction of joint contractures.
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A pilot study to evaluate the safety and feasibility of the administration of AZT/3TC fixed dose combination to HIV infected pregnant women and their infants in Rio de Janeiro, Brazil. Sex Transm Infect 2004; 79:448-52. [PMID: 14663118 PMCID: PMC1744786 DOI: 10.1136/sti.79.6.448] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To evaluate the safety and feasibility of zidovudine and lamivudine (AZT/3TC) given to HIV infected pregnant women and their infants in Rio de Janeiro, Brazil. METHODS This open label phase II study enrolled 40 HIV infected antiretroviral naive women >or=20 weeks gestation, CD4 <500 cells x10(6)/l, from two public hospitals. TREATMENT fixed dose AZT 300 mg/3TC 150 mg by mouth every 12 hours until labour; AZT 300 mg by mouth every 3 hours until delivery; infants: AZT 4 mg/kg every 12 hours plus 3TC 2 mg/kg every 12 hours for 6 weeks. Blood haematology and chemistry were monitored; adherence evaluated by pills count; efficacy measured by changes in lymphocyte (CD4) and viral load, and by HIV RNA-PCR tests performed at birth, 6 and 12 weeks, to diagnose infant infection. No women breast fed. RESULTS PATIENT CHARACTERISTICS mean age 24.48 (SD 3.5) years; gestational age 24.5 (4.5) weeks; AZT/3TC duration 14.4 (4.4) weeks; vaginal delivery: 11/39; caesarean section: 28/39. Entry and pre-labour CD4: 310/486 cells x10(6)/l (p<0.001); entry and pre-labour viral load: 53 818/2616 copies/ml (p<0.001). Thirty nine women tolerated treatment with >80% adherence; one was lost to follow up. Five newborns were excluded from 3TC receipt. All 39 babies were uninfected. Haematological toxicity in newborns was common: anaemia in 27; neutropenia in five (two severe); platelets counts <100000 in two. All values recovered on study completion. CONCLUSIONS Fixed dose AZT/3TC is well accepted, gives improvements in CD4 and viral load; no infants were HIV infected. Haematological toxicity in infants needs careful monitoring.
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Ecotoxicological assessment of leachates from MSWI bottom ashes. WASTE MANAGEMENT (NEW YORK, N.Y.) 2002; 22:583-593. [PMID: 12214969 DOI: 10.1016/s0956-053x(02)00009-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In this paper, chemical and ecotoxicological data of leachates from bottom ashes collected in different Municipal Solid Waste Incinerators (MSWI) are shown. The bottom ashes were collected in Belgium (three incinerators--samples B1 to B3), France, Germany, Italy and United Kingdom (one incinerator in each country--samples F1, D1, I1 and UK1, respectively). Both chemical and ecotoxicological characterizations of leachates were done on the framework of the European Directive 91/689/EEC and the European Council Decision 94/904/EC. This work was carried out under the European project called Valomat, which was supported by the European Commission through Brite-Euram III program. Twenty-one inorganic parameters were analyzed. The ecotoxicological assays were done under standard laboratory conditions, using the bacterium Photobacterium phosphoreum, the freshwater alga Pseudokirchneriella subcapitata, the crustacean Daphnia magna and the vegetable Lactuca sativa. Chemical data varied from sample to sample. Similar results were obtained in biological assays. The samples can be classified as ecotoxic/hazardous according to the French proposal for a Criterion and Evaluation Methods of Waste Ecotoxicity (CEMWE) and the German regulation on Hazardous Waste Classification (HWC). However, samples B1, B2, B3 and D1 comply the maximum limits for direct valorization category defined in the French Classification of Bottom Ashes based on their Polluting Potential (CBAPP). Sample B1 presented the lowest level of ecotoxicity, being considered as the most interesting to be used in the development of new materials for civil engineering works.
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Assessment of a rapid HIV test strategy during labor: a pilot study from Rio de Janeiro, Brazil. JOURNAL OF HUMAN VIROLOGY 2001; 4:278-82. [PMID: 11907385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
OBJECTIVES To use two rapid human immunodeficiency virus (HIV) tests at labor, measure test acceptance and performance, and measure HIV prevalence in these women. METHODS Between February and October 2000, two rapid tests (Determine; Abbott, Chicago, IL, U.S.A. and Double Check; Orgenics, Yavne, Israel) were used in three public maternities in Rio de Janeiro, Brazil. Enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) analysis confirmed positive and discordant results. RESULTS Of the 858 patients who were enrolled, the mean gestational age was 36 weeks (median = 39, mode = 40) and 17 (2%) refused testing. Of the 841 patients tested, 13 were positive by both tests, which represents a 1.5% prevalence (95% confidence interval: 0.7%-2.3%); all were confirmed by ELISA and WB analysis. Seven samples gave discordant results by the rapid tests; of these, six were ELISA-negative/WB-negative and one was ELISA-negative/WB-indeterminate. The positive predictive value for samples that were positive by both rapid tests simultaneously was 100%. CONCLUSIONS Two rapid HIV tests used at labor were well accepted (98%). When the combined results of the two rapid tests (but not a single rapid test) were analyzed, this strategy was as efficient as the standard ELISA and WB HIV strategy for correctly classifying individuals.
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Impairment of cardiac performance by laparoscopy in patients receiving positive end-expiratory pressure. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 1999; 134:76-80. [PMID: 9927136 DOI: 10.1001/archsurg.134.1.76] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The cardiopulmonary effects of the combination of abdominal and thoracic pressures in humans have not been well delineated. OBJECTIVE To study the cardiopulmonary effects of 15 mm Hg of intra-abdominal pressure in the presence and absence of 10 cm H20 of positive end-expiratory pressure (PEEP). DESIGN Prospective. SETTING University hospital. METHODS Nine patients undergoing laparoscopic cholecystectomy had pulmonary compliance, cardiac output, exhaled carbon dioxide, and preload (left ventricular end-diastolic volume) determined at 4 points while undergoing ventilation with (1) no PEEP before pneumoperitoneum; (2) 10 cm H20 of PEEP and no pneumoperitoneum; (3) no PEEP and 15 mm Hg of pneumoperitoneum; and (4) 10 cm H20 of PEEP and 15 mm Hg of pneumoperitoneum. Preload and cardiac output were determined by means of transesophageal echocardiography. Pulmonary compliance and exhaled carbon dioxide were determined by an attachment to the end of the endotracheal tube. MAIN OUTCOME MEASURES Preload, cardiac output, exhaled carbon dioxide, and pulmonary compliance. RESULTS There was no significant change from baseline in preload, cardiac output, or pulmonary compliance when either PEEP or pneumoperitoneum was applied separately. However, there was a significant decrease in preload (P<.01), cardiac output (P = .01), and exhaled carbon dioxide (P =.04) when PEEP and pneumoperitoneum were applied together. Pulmonary compliance was not significantly affected at any of these points. CONCLUSIONS There was a significant reduction in preload and cardiac output when there was intra-abdominal pressure of 15 mm Hg in the presence of 10 cm H20 of PEEP. This combination of pressures may pose a contraindication to laparoscopic surgery.
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Eradication of brucellosis from a cattle herd in the Amazonian region (short communication). Acta Vet Hung 1998; 46:19-23. [PMID: 9704507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The authors intend to elaborate a brucellosis eradication program which could be used in the Amazonian region, an area characterised by extremely extensive animal husbandry practices. Under such conditions, eradication by selection is the only feasible approach. Brucellosis has been successfully eradicated from a herd with 22.1% prevalence of infection by two serological surveys using an indirect ELISA and the complement fixation test.
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[Contraceptive choices and experience of sexuality: a comparison between sterilized and non-sterilized women in a metropolitan area of southeastern Brazil]. Rev Saude Publica 1996; 30:452-9. [PMID: 9269095 DOI: 10.1590/s0034-89101996000500008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A cross sectional study involving 357 women, 174 of them sterilized and 183 non-sterilized, with a view to comparing their sexual and reproductive behaviour, was undertaken. The questionnaire was based on previous focus group discussions with both women and men, to find out the best way to approach related questions. The results show that sterilized women-who are older and more often have steady partnerships than non-sterilized women-fulfil traditional gender roles more closely than the others. Furthermore, no sterilized woman had used the condom in the month prior to the interview. It is suggested that public messages for the prevention of the spread of the HIV, sexually-transmissible disease and cervical cancer should target women who have been sterilized for the purpose of increasing the use of the condom in accordance with specific strategies.
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[NO TITLE AVAILABLE]. Rev Inst Med Trop Sao Paulo 1991. [DOI: 10.1590/s0036-46651991000600009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Antígeno del polisacárido capsular (Ag PC) de Cryptococcus neoformans fue detectado por la técnica de aglutinación de latex (AL) en LCR y suero de pacientes con Sindrome de Inmunodeficiencia Adquirida (SIDA) y primer episodio de neurocriptococosis, usando como patrón el examen micológico (examen directo y cultivo) de LCR. Se obtuvo una sensibilidad del 100% de AL para detectar AgPC de C. neoformans, el cual por su rápidez permite tratamiento específico precoz. Títulos iniciales de AgPC de la levadura en esos pacientes pueden ser > 1.000.000, pareciendo que cuando esos títulos están presentes en suero, se relacionan con mortalidad durante el tratamiento. En los pacientes que sobrevivieron se observó que el examen micológico directo y AgPC de C. neoformans, en LCR y suero, permanecen positivos aún después de tratamiento y mejoría clínica del paciente.
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Food-borne botulism. A review of 13 outbreaks. ARCHIVES OF INTERNAL MEDICINE 1988; 148:578-80. [PMID: 3341859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Thirteen outbreaks of food-borne botulism occurred between 1970 and 1984. Fifty patients were affected, with 30 of them requiring hospitalization. The number of patients per outbreak ranged from one to ten (mean, 3.8). All outbreaks were caused by home-prepared foods: nine by smoked ham, one by bacon, one by sausage, and one by mussels; contaminated food was not found in one outbreak. Bacteriologic study was performed in 11 outbreaks and type B toxin, the only found, was detected in eight of them. Generalized muscular weakness, visual disturbances, extreme dry mouth, and severe constipation were observed in all inpatients. Palpebral ptosis, dysphonia, urinary retention, postural hypotension, and respiratory impairment were also reported, but not in all inpatients. Identical, but less severe, manifestations were registered in the 20 ambulatory patients. Electromyographic study showed decreased motor action potential and posttetanic facilitation. Pulmonary function, studied in four inpatients, was decreased in three. All patients recovered fully. Management consisted of supportive measures, symptomatic treatment, and nursing care. Equine antitoxin was not administered and assisted ventilation was unnecessary.
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[Human red blood cells as specific growth hormone receptors (author's transl]. REVISTA DE INVESTIGACION CLINICA; ORGANO DEL HOSPITAL DE ENFERMEDADES DE LA NUTRICION 1981; 33:37-43. [PMID: 6267678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Problems with radical corrective surgery after ascending aorta to right pulmonary artery shunt (Waterston's anastomosis) for cyanotic congenital heart disease. Heart 1975; 37:1105-12. [PMID: 1191425 PMCID: PMC482927 DOI: 10.1136/hrt.37.11.1105] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Forty-five patients with Fallot's tetralogy or pulmonary atresia had total correction 2 to 6 years after palliative ascending aorta to right pulmonary artery anastomosis (Waterston's shunt). The operative mortality for total correction is increased in this group. Patients shown subsequently to have had a good anatomical correction died unexpectedly with high central pulmonary artery pressure, falling arterial PO2, low cardiac output, and progressive acidosis. The cause of this syndrome was difficult to determine. Histological examination of the lungs showed that severe pulmonary arteriolar thickening was not present. The factors apparently predisposing to these postoperative difficulties were kinking of the right pulmonary artery and/or lone perfusion of the right lung, remaining uncorrected for several years, in patients with pulmonary atresia or with Fallot's tetralogy with a shunt performed under the age of 3 years. In survivors, stenosis of the right pulmonary artery frequently occurred but was rarely severe. In view of these difficulties, early haemodynamic and angiocardiographic assessment is recommended in all patients with aorta to right pulmonary artery anastomosis, irrespective of the clinical result, in order to delineate the central pulmonary artery anatomy and assess perfusion of each lung; if kinking of the right pulmonary artery and inadequate perfusion of the central pulmonary arteries and left lung are demonstrated, early radical corrective surgery is recommended.
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