Nursing fever management in adult oncology patients: A literature review

Fever associated with neutropenia, blood transfusion and disease processes is common in adult cancer patients. The literature indicates however that the aetiology, rationale and symptoms of fever are often misunderstood, resulting in fever management that is not evidence-based in this cohort. Thus in this review, an overview of fever, with a focus on fever in cancer contexts, is provided. Content includes an explanation of the therapeutic function of fever, an analysis of the physiological consequences of fever and an exploration of the aetiology of fever in cancer patients. Current guidelines for fever management in cancer patients and existing nursing practice are also discussed.

Human Torque teno virus: epidemiology, cell biology and immunology

Torque teno virus (TTV) was discovered in 1997 in the serum of a Japanese patient who had a post-transfusion hepatitis of unknown etiology. It is a small virus containing a circular single-stranded DNA genome which is unique among human viruses. Within a few years after its discovery, the TTVs were noted to form a large family of viruses with numerous genotypes. TTV is highly prevalent among the general population throughout the world, and persistent infections and co-infections with several genotypes occur frequently. However, the pathogenicity and the mechanism for the sustained occurrence of the virus in blood are at present unclear. To determine the prevalence of TTV in Finland, we set up PCR methods and examined the sera of asymptomatic subjects for the presence of TTV DNA and for genotype-6 DNA. TTV was found to be highly prevalent also in Finland; 85% of adults harbored TTV in their blood, and 4% were infected with genotype-6. In addition, TTV DNA was detected in a number of different tissues, with no tissue-type or symptom specificity. Most cell-biological events during TTV infections are at the moment unknown. Replicating TTV DNA has, however, been detected in liver and the hematopoietic compartment, and three mRNAs are known to be generated. To characterize TTV cell biology in more detail, we cloned in full length the genome of TTV genotype 6. We showed that in human kidney-derived cells TTV produces altogether six proteins with distinct subcellular localizations. TTV mRNA transcription was detected in all cell lines transfected with the full-length clone, and TTV DNA replicated in several of them, including those of erythroid, kidney, and hepatic origin. Furthermore, the viral DNA replication was shown to utilize the cellular DNA polymerases. Diagnoses of TTV infections have been based almost solely on PCR, whereas serological tests, measuring antibody responses, would give more information on many aspects of these infections. To investigate the TTV immunology in more detail, we produced all six TTV proteins for use as antigens in serological tests. We detected in human sera IgM and IgG antibodies to occur simultaneously with TTV DNA, and observed appearance of TTV DNA regardless of pre-existing antibodies, and disappearance of TTV DNA after antibody appearance. The genotype-6 nucleotide sequence remained stable for years within the infected subjects, suggesting that some mechanism other than mutations is used by this minute virus to evade our immune system and to establish chronic infections in immunocompetent subjects.

Building a flexible, voluntary donation panel: An exploration of donor willingness

BACKGROUND As blood collection agencies (BCAs) face recurrent shortages of varying blood products, developing a panel comprising donors who are flexible in the product they donate based on same-time inventory demand could be an efficient, cost-effective inventory management strategy. Accounting for prior whole blood (WB) and plasmapheresis donation experience, this article explores current donors’ willingness to change their donation product and identifies the type of information required for such donation flexibility. STUDY DESIGN AND METHODS Telephone interviews (mean, 34 min; SD, 11 min) were conducted with 60 donors recruited via stratified purposive sampling representing six donor groups: no plasma, new to both WB and plasma, new to plasma, plasma, flexible (i.e., alternating between WB and plasma), and maximum (i.e., high frequency alternating between WB and plasma) donors. Participants responded to hypothetical scenarios and open-ended questions relating to their and other donors’ willingness to be flexible. Responses were transcribed and content was analyzed. RESULTS The most frequently endorsed categories varied between donor groups with more prominent differences emerging between the information and support that donors desired for themselves versus that for others. Most donors were willing to change donations but sought improved donation logistics and information regarding inventory levels to encourage flexibility. The factors perceived to facilitate the flexibility of other donors included providing donor-specific information and information regarding different donation types. CONCLUSION Regardless of donation history, donors are willing to be flexible with their donations. To foster a flexible donor panel, BCAs should continue to streamline the donation process and provide information relevant to donors’ experience.

Role of HMGB1 in cells of the circulation

The matrix of blood is a liquid plasma that transports molecules and blood cells within vessels lined by endothelial cells. High-mobility group B1 (HMGB1) is a protein expressed in blood cells. Under normal circumstances, HMGB1 is virtually absent from plasma, but during inflammation or trauma its level in plasma is increased. In resting and quiescent cells, HMGB1 is usually localized in the intracellular compartment, with the exception of motile cells that express HMGB1 on their outer surface to mediate cell migration. During cell transformation or immune cell activation HMGB1 can be actively secreted outside of the cell. Further, when a cell is damaged, HMGB1 can passively leak into extracellular environment. Extracellular HMGB1 can then participate in regulation of the immune response and under some conditions it can mediate lethality in systemic inflammatory response. The aim of this study was to evaluate the expression and functions of HMGB1 in cells of the vascular system and to investigate the prognostic value of circulating HMGB1 in severe sepsis and septic shock. HMGB1 was detected in platelets, leukocytes, and endothelial cells. HMGB1 was released from platelets and leukocytes, and it was found to mediate their adhesive and migratory functions. During severe infections the plasma levels of HMGB1 were elevated; however, no direct correlation with lethality was found. Further, the analysis of proinflammatory mechanisms suggested that HMGB1 forms complexes with other molecules to activate the immune system. In conclusion, HMGB1 is expressed in the cells of the vascular system, and it participates in inflammatory mechanisms by activating platelets and leukocytes and by mediating monocyte migration.

Negative experiences and donor return: An examination of the role of asking for something different

BACKGROUND Negative donation experiences, including vasovagal reactions, deter donor retention. However, whether this deterrence effect varies as a function of whole blood (WB) donation history and requests to donate the same or a different product remains unclear. STUDY DESIGN AND METHODS The responses of 894 eligible WB donors who had been approached to convert to plasmapheresis and 954 eligible first-time plasmapheresis donors who had been surveyed on their last donation experience and their intention to donate plasma were considered. This information was matched with individual vasovagal reaction records, deferral category, WB donation history, and subsequent donation behavioral data obtained from the blood collection agency. RESULTS Path analysis indicated that the application of a deferral and an officially recorded vasovagal reaction decreased donors' intentions to continue plasmapheresis donation, but had no effect on WB donors' intentions to convert to plasmapheresis. Consistent with past findings, vasovagal reactions occurred more frequently with female and inexperienced donors. CONCLUSION Experiencing vasovagal reactions and deferrals may not universally deter donors from continuing to donate. Rather, the offer to convert to another form of donation—in this instance, plasmapheresis—after experiencing a negative donation event while donating WB may be sufficient to eliminate the deterrence effect on retention.

Thrombin regulation in newborn infants

The coagulation system of newborn infants differs markedly from that of older children and adults. The activities of most coagulation factors and anticoagulants are low, leading to altered regulation in the formation of the key enzyme, thrombin. Timely and adequate generation of thrombin is essential, as thrombin activates platelets and many coagulation factors, cleaves fibrinogen into fibrin and activates the antithrombotic and anti-inflammatory protein C pathway. On the other hand, excess thrombin may promote thrombotic complications and exacerbate harmful inflammatory reactions. Despite the characteristic features, the newborn coagulation system can be considered physiological, since healthy newborns rarely show haemorrhagic or thrombotic complications. Sick newborns, however, often encounter clinical situations that challenge their coagulation system. The aim of this study was to clarify the behaviour of the neonatal coagulation system in selected clinical situations, with a special emphasis on the generation of thrombin. Thrombin was measured by in vivo thrombin generation markers and by thrombin generation potential in vitro. The patient groups included sick newborns undergoing intensive care and receiving fresh-frozen plasma (FFP), requiring exchange transfusions (ET) or presenting with a congenital heart defect requiring open heart surgery. Additionally, healthy newborns with inherited heterozygous factor V Leiden (FVL) mutation were studied. Thrombin generation potential was also analysed in cord plasma of healthy infants and in adults. Healthy as well as sick newborn infants showed lower total thrombin generation potential in vitro but faster initiation of thrombin generation than adults. These findings were qualitatively similar when plasma was supplemented with platelets. Platelets, however, significantly altered the effect of the major anticoagulant, activated protein C (APC), on thrombin generation potential. In accordance with previous studies, thrombin generation in healthy newborn platelet-poor plasma was resistant to the anticoagulant effects of APC, but when the plasma was supplemented with platelets APC attenuated thrombin generation significantly more in newborns than in adults. In vivo generation of thrombin was elevated in nearly all of the sick newborn infants. The low-volume FFP transfusion as opposed to the change from neonatal to adult blood in ET exerted markedly different effects on neonatal thrombin generation. FFP reduced the in vivo generation of thrombin in those newborns with the highest pretransfusional thrombin generation, thus acting as an anticoagulant agent. In those infants with lower pretransfusional thrombin generation, the effect of FFP on thrombin generation was fairly neutral. On the other hand, the combination of red blood cells and FFP, used to perform ET, significantly increased the in vivo thrombin formation and shifted the balance in the newborn coagulation system to the procoagulant direction. Cardiopulmonary bypass (CPB) also significantly increased the in vivo thrombin generation, but the thrombin generation profile during CPB differed from that previously observed in adults. Escalation of thrombin at early reperfusion was not observed in newborns; in adults, its occurrence is associated with postoperative myocardial damage. Finally, in healthy newborns with FVL heterozygosity, faster initiation of thrombin generation was observed compared with controls. Interestingly, FV level was lower in FVL-heterozygous infants, possibly to counteract the procoagulant effects induced by FVL. In conclusion, unique features regarding thrombin regulation in newborn infants were observed. These features included a novel platelet effect on the regulation of the protein C pathway. The clinical challenges mainly seemed to shift the balance in the coagulation system of newborns to the procoagulant direction. Blood component transfusions markedly affected coagulation in a manner specific to the product but that could also be altered by the clinical situation. Overall, the results highlight the need for understanding developmental haemostasis for both diagnostic and therapeutic purposes.

In vitro protection of umbilical cord blood–derived primitive hematopoietic stem progenitor cell pool by mannose-specific lectins via antioxidant mechanisms

BACKGROUND: Earlier we reported that an oral administration of two mannose-specific dietary lectins, banana lectin (BL) and garlic lectin (GL), led to an enhancement of hematopoietic stem and progenitor cell (HSPC) pool in mice. STUDY DESIGN AND METHODS: Cord blood–derived CD34+ HSPCs were incubated with BL, GL, Dolichos lectin (DL), or artocarpin lectin (AL) for various time periods in a serum- and growth factor–free medium and were subjected to various functional assays. Reactive oxygen species (ROS) levels were detected by using DCHFDA method. Cell fractionation was carried out using lectin-coupled paramagnetic beads. RESULTS: CD34+ cells incubated with the lectins for 10 days gave rise to a significantly higher number of colonies compared to the controls, indicating that all four lectins possessed the capacity to protect HSPCs in vitro. Comparative analyses showed that the protective ability of BL and GL was better than AL and DL and, therefore, further experiments were carried out with them. The output of long-term culture-initiating cell (LTC-IC) and extended LTC-IC assays indicated that both BL and GL protected primitive stem cells up to 30 days. The cells incubated with BL or GL showed a substantial reduction in the ROS levels, indicating that these lectins protect the HSPCs via antioxidant mechanisms. The mononuclear cell fraction isolated by lectin-coupled beads got enriched for primitive HSPCs, as reflected in the output of phenotypic and functional assays. CONCLUSION: The data show that both BL and GL protect the primitive HSPCs in vitro and may also serve as cost-effective HSPC enrichment tools.

Improving outcome of childhood bacterial meningitis by simplified treatment : Experience from Angola

Background Acute bacterial meningitis (BM) continues to be an important cause of childhood mortality and morbidity, especially in developing countries. Prognostic scales and the identification of risk factors for adverse outcome both aid in assessing disease severity. New antimicrobial agents or adjunctive treatments - except for oral glycerol - have essentially failed to improve BM prognosis. A retrospective observational analysis found paracetamol beneficial in adult bacteraemic patients, and some experts recommend slow β-lactam infusion. We examined these treatments in a prospective, double-blind, placebo-controlled clinical trial. Patients and methods A retrospective analysis included 555 children treated for BM in 2004 in the infectious disease ward of the Paediatric Hospital of Luanda, Angola. Our prospective study randomised 723 children into four groups, to receive a combination of cefotaxime infusion or boluses every 6 hours for the first 24 hours and oral paracetamol or placebo for 48 hours. The primary endpoints were 1) death or severe neurological sequelae (SeNeSe), and 2) deafness. Results In the retrospective study, the mortality of children with blood transfusion was 23% (30 of 128) vs. without blood transfusion 39% (109 of 282; p=0.004). In the prospective study, 272 (38%) of the children died. Of those 451 surviving, 68 (15%) showed SeNeSe, and 12% (45 of 374) were deaf. Whereas no difference between treatment groups was observable in primary endpoints, the early mortality in the infusion-paracetamol group was lower, with the difference (Fisher s exact test) from the other groups at 24, 48, and 72 hours being significant (p=0.041, 0.0005, and 0.005, respectively). Prognostic factors for adverse outcomes were impaired consciousness, dyspnoea, seizures, delayed presentation, and absence of electricity at home (Simple Luanda Scale, SLS); the Bayesian Luanda Scale (BLS) also included abnormally low or high blood glucose. Conclusions New studies concerning the possible beneficial effect of blood transfusion, and concerning longer treatment with cefotaxime infusion and oral paracetamol, and a study to validate our simple prognostic scales are warranted.

In vitro protection of umbilical cord blood-derived primitive hematopoietic stem progenitor cell pool by mannose-specific lectins via antioxidant mechanisms.

BACKGROUND: Earlier we reported that an oral administration of two mannose-specific dietary lectins, banana lectin (BL) and garlic lectin (GL), led to an enhancement of hematopoietic stem and progenitor cell (HSPC) pool in mice. STUDY DESIGN AND METHODS: Cord blood derived CD34+ HSPCs were incubated with BL, GL, Dolichos lectin (DL), or artocarpin lectin (AL) for various time periods in a serum- and growth factor free medium and were subjected to various functional assays. Reactive oxygen species (ROS) levels were detected by using DCHFDA method. Cell fractionation was carried out using lectin-coupled paramagnetic beads. RESULTS: CD34+ cells incubated with the lectins for 10 days gave rise to a significantly higher number of colonies compared to the controls, indicating that all four lectins possessed the capacity to protect HSPCs in vitro. Comparative analyses showed that the protective ability of BL and GL was better than AL and DL and, therefore, further experiments were carried out with them. The output of long-term culture-initiating cell (LTC-IC) and extended LTC-IC assays indicated that both BL and GL protected primitive stem cells up to 30 days. The cells incubated with BL or GL showed a substantial reduction in the ROS levels, indicating that these lectins protect the HSPCs via antioxidant mechanisms. The mononuclear cell fraction isolated by lectin-coupled beads got enriched for primitive HSPCs, as reflected in the output of phenotypic and functional assays.CONCLUSION: The data show that both BL and GL protect the primitive HSPCs in vitro and may also serve as cost-effective HSPC enrichment tools.

Decisões judiciais no campo da biotecnociência: a bioética como fonte de legitimação

A tese analisa decisões judiciais prolatadas em casos da bioética clínica, especificamente: requerimento de autorização para interrupção de gestação de feto anencéfalo, liberdade de recusa à imposição de procedimento de transfusão de sangue em razão de crença religiosa em paciente Testemunha de Jeová e a mudança de nome e sexo de transexual com ou sem realização de cirurgia de transgenitalismo. A escolha dos três tipos de casos levados a julgamento ao Poder Judiciário se deu em virtude de serem questões características ao direito existencial, de repercussão no Ser do indivíduo, em seus direitos personalíssimos. Para isso foram analisadas 84 decisões judiciais, mediante a aplicação da teoria Principiológica de Beauchamp & Childress e análise de cada decisão quanto à aplicação dos quatro Princípios que desenvolve: do respeito à autonomia, da não maleficência, da beneficência e da justiça. O resultado da análise demonstrou que ao utilizar os quatro Princípios, com especificação e ponderação dos mesmos, o julgador profere decisões de cunho liberal. Quando não utiliza os Princípios ou extrapola os limites de sua aplicação, o julgador profere decisões de cunho conservador. As decisões judiciais de caráter liberal são despidas de preconceitos e moralismos e permitem o respeito aos direitos individuais sem descuidar dos direitos dos demais membros da sociedade. As decisões conservadoras se baseiam na literalidade da lei e violam direitos individuais, sem acrescentar segurança à sociedade. A apropriação desta teoria da ética biomédica pelo biodireito, se apresenta como método seguro e eficaz na prolação de decisão judicial em casos da bioética clínica e conduz o julgador a decisões mais justas por serem apoiadas em boas razões.

Alorreatividade dos enxertos ósseos homólogos na reconstrução alveolar em humanos

Enxerto ósseo homólogo é utilizado independentemente da compatibilidade HLA entre doador e receptor ou uso de drogas imunossupressoras. Considerando o volume de transplantes ósseos realizados no Brasil e o possível efeito deletério da sensibilização HLA para o transplante de órgãos sólidos, este estudo tem como objetivo avaliar a alorreatividade do enxerto ósseo homólogo fresco-congelado utilizado na reconstrução alveolar com finalidade de reabilitação oral com prótese sobre implantes. Anticorpos anti-HLA e anti-MICA foram monitorados através do teste Labscreen Mixed, nos intervalos 0, 7, 30, 90 e 180 pós transplante ósseo em 15 pacientes (6 homens e 9 mulheres, idade média 58,1, DP=10,1) que estavam em tratamento no Instituto de Odontologia da Pontifícia Universidade Católica do Rio de Janeiro. Caso resultado do teste Mixed fosse positivo (Razão de fundo normatizado, NBG>4,5) o teste Labscreen Single (tecnologia antígeno único por pérola, SABA) era realizado para verificar se os anticorpos anti-HLA eram específicos ao doador. Nenhum paciente relatou transplante prévio, 4 relataram transfusão prévia e todas as mulheres relataram gravidez. Dez pacientes não apresentaram reação positiva no dia 0 sendo considerados não sensibilizados previamente (NSP); destes, 6 pacientes permaneceram sem nenhuma evidência de sensibilização, 2 pacientes apresentaram reação positiva para Classe I e II; 2 para Classe I apenas; e 2 para MICA, sendo considerados sensibilizados pelo enxerto ósseo oral. Dois pacientes apresentaram aumento de Intensidade Média de Fluorescência (ΔMFI>1000) de anticorpos específicos ao doador para Classe I e Classe II, e 2 somente para Classe II, demonstrando uma reação específica ao doador. Os resultados sugerem uma alorreatividade HLA oscilatória ao enxerto ósseo homólogo em reconstruções alveolares, confirmada pela formação de anticorpos anti-HLA específicos ao doador em 4 pacientes (27%) da amostra.

Associação entre práticas de alimentação e ganho de peso intra-hospitalar em recém-nascidos prematuros de muito baixo peso de nascimento.

Este trabalho avaliou [1] os fatores associados à ocorrência de restrição ao ganho de peso observada na alta hospsitalar e [2] a associação entre as práticas de alimentação e o ganho de peso durante a internação, em recém-nascidos prematuros de muito baixo peso de nascimento (501 a 1.499g) na maternidade do Hsopital Geral de Bonsucesso (Rio de Janeiro). Os dados foram coletados de forma retrospectiva para os nascimetnos do período compreendido entre junho de 2002 a junho de 2004. Do total de 247 recém-nascidos incluídos no estudo, 203 tiveram alta hospitalar. As características ao nascimento, asmorbidades e as práticas de alimentação foram levantadas dos prontuários de acordo com um questionário de pesquisa. O menor peso de nascimento, ser pequeno para idade gestacional-percentil 3, o maior escore CRIB e a ocorrência de sepse foram associados à ocorrência de restrição ao ganho de peso extra-uterino na alta. Das cento e cinquenta e oito crianças com peso adequado ao nascimento, sessenta e nova (43,7%) encontravam-se com peso abaixo do 3 percentil na alta. Nesses casos de restrição ao ganho de peso foram preditores: a ocorrência de sepse, de doença metabólica óssea e o maior número de transfusões sanguíneas, embora a capacidade de explicação do modelo tenha sido pequena (14%). Estas situações merecem destaque na prática neonatal, pois podem ser marcadores de um pior desempenho no que diz respeito ao ganho de peso durante a internação. Uma vez que as morbidades explicaram pouco a c]ocorrência de restrição ao ganho de peso extra-uterino, em especial os casos intrahospitalares. Foi analisada a associação entre evolução do peso nos primeiro dois meses de vida e as práticas de alimentação. Utilizando a análise de regressão longitudinal de efeitos mistos foi observado que o número de dias para o início de dieta enteral, de dias para atingir a dieta plena, de dias para início de dieta parenteral e de dias de uso de dieta parenteral, influenciaram a evolução precoce do peso (até 17 dia). O número de dias para início da dieta parenteral não influenciou a evolução do peso após o 17 dia de vida. Os resultados do presente estudo sugerem 1) que o menor peso de nascimento, ser pequeno para idade gestacional, ter maior escore CRIB e a ocorrência de sepse associam-se a ocorrência de restrição ao ganho de peso extra-uterino; 2) dentre os recém-nascidos com peso apropriado ao nascimento, a ocorrência de sepse, de doença metabólica óssea e o maior número de transfusões sanguíneas associaram-se a um pior desempenho ponderal; 3) que as práticas de alimentação decididas precocemente associam-se ao ganho de pseo intra-hospitalar e a revisão destas pode melhorar o desempenho ponderal de recém-nascidos prematuros de muito baixo peso de nascimento.

Efeito da sedação na microcirculação de pacientes em choque séptico

Ao longo dos últimos anos, apesar de todo desenvolvimento e pesquisa, a mortalidade na sepse permanece elevada. Na área de microcirculação foram realizados estudos em modelos experimentais de sepse ao longo das últimas duas décadas, quando se observou, através de técnicas invasivas, alterações como redução expressiva da densidade capilar funcional. A técnica denominada sidestream dark field (SDF) imaging, recentemente desenvolvida, permite a avaliação da microcirculação de forma transcutânea. A utilização desta técnica permitiu evidenciar a redução da densidade capilar funcional em pacientes com sepse grave quando comparado a um indivíduo saudável. Posteriormente, foi demonstrado que alterações persistentes na microcirculação de pacientes sépticos, mesmo com sinais vitais estabilizados, estão associadas com pior prognóstico.Evidentemente, os pacientes com sepse grave ou choque séptico sofrem uma grande quantidade de intervenções terapêuticas, aonde muitas delas alteram a microcirculação. Estudos analisando a microcirculação em pacientes em uso de nitroglicerina, corticóide, recebendo hemotransfusão ou ainda infusão de noradrenalina foram publicados recentemente.Entretanto, até o presente momento, não existem publicações que descrevam a influência dos sedativos na microcirculação de pacientes com choque séptico. As drogas mais comumente utilizadas para sedação de pacientes em ventilação mecânica são o sedativo midazolam e o anestésico propofol. Os objetivos do estudo foram: avaliar o efeito dos principais agentes sedativos utilizados na prática clínica na microcirculação de pacientes com choque séptico utilizando a técnica de sidestream dark field imaging, comparar os efeitos na microcirculação do midazolam com o propofol em pacientes com choque séptico e verificar se existe relação das alterações microcirculatórias provocadas pelos sedativos com as variações de diferentes parâmetros hemodinâmicos, gasométricos ou metabólicos como pressão arterial, índice cardíaco, lactato e saturação venosa central de oxigênio. Foram estudados (estudo prospectivo) 16 pacientes internados no Centro de Terapia Intensiva da Casa de Saúde São José. Os pacientes internados com diagnóstico de choque séptico e que possuíam indicação clínica de ventilação mecânica e de suspensão diária da sedação foram submetidos ao estudo da microcirculação na mucosa sublingual utilizando a técnica de sidestream dark field imaging. Estes pacientes foram sedados conforme orientação do protocolo já existente de sedação, inicialmente com propofol e posteriormente com midazolam. Os principais resultados observados foram:a macrohemodinâmica não diferiu nos 2 momentos do exame, o BIS (bispectral índex of sedation) se manteve na faixa recomendada nos 2 momentos do exame, tendo aumentado quando o paciente acordava, conforme esperado, e a proporção de vasos pequenos perfundidos e o índice de fluxo da microcirculação foram significativamente menores, enquanto o índice de heterogeneidade foi significativamente maior quando os pacientes estavam recebendo infusão de propofol quando comparados com a infusão de midazolam. Concluímos que, em pacientes com choque séptico, a administração de midazolam resulta em uma melhora dos parâmetros microcirculatórios quando comparada com a administração de propofol. Essa diferença não pode ser atribuída a alterações de variáveis hemodinâmicas sistêmicas.

Determination of phthalate acid esters plasticizers in plastic by ultrasonic solvent extraction combined with solid-phase microextraction using calix[4]arene fiber

Ultrasonic solvent extraction combined with solid-phase microextraction (SPME) with calix[4]arene/hydroxy-terminated silicone (C[4]/OHTSO) oil coated fiber was used to extract phthalate acid esters (PAEs) plasticizers in plastic, such as blood bags, transfusion tubing, food packaging bag, and mineral water bottle for analysis by gas chromatography (GC). Both extraction parameters (i.e. extraction time, extraction temperature, ionic strength) and conditions of the thermal desorption in a GC injector were optimized by analysis of eight phthalates. The fiber shows wonderful sensitivity and selectivity to the tested compounds. Owing to its high thermal stability (380 degreesC), the carryover effect that often encountered when using conventional fibers can be reduced by appropriately enhancing the injector temperature. The method showed linear response over two to four orders of magnitude with correlation coefficients (r) better than 0.996, and limits of detection (LOD) ranged between 0.006 and 0.084 mug l(-1). The relative standard deviation values obtained were less than or equal to 10%. bis-2-Ethylhexyl phthalate (DEHP) was the sole analyte detected in these plastics and recoveries were in the ranges 95.5-101.4% in all the samples. (C) 2004 Elsevier B.V. All rights reserved.

荞麦(Fagopyrum tataricum Gaertn.和F. esculentum Moench.)对紫外线B辐射的响应研究

近二十多年来，基于对臭氧层衰减、紫外线B（UV-B）增强的担心，研究者希望了解到紫外线辐射对不同作物的影响情况，增强UV-B辐射条件下是否对作物的生长发育、产量质量构成威胁。在本试验中，我们首先探讨了双子叶作物黄瓜（Cucumis sativus）和大豆（Glycine max）对不同紫外波段的生物效应[分别为B-UVA（315-400 nm），N-UVA（315-340 nm），B-UVB（275-400 nm）和N-UVB（290-340 nm），UV-（>400nm）作对照]。我们观察到所有的UV波段处理都使黄瓜和大豆的生长受到抑制，并且细胞受到不同程度的氧化伤害；UV波段处理的作用效果与不同波段的紫外有效生物辐射剂量有关。处理差异在UV-B波段内部和UV-A波段内部同样存在。植物生长UV辐射公式（BSWF）能很好的预测本试验UV-B波段内的平均植物效应，但不能预测UV-A波段的植物效应。短波UV-A的生物作用强于长波UV-A。光合色素的变化与UV波谱差异和种间差异有关。在高的紫外/可见光背景下，UV-A处理同UV-B同样导致光合色素的降低，但黄瓜类胡萝卜素/叶绿素比例升高。与其他研究者的试验结果比较后，我们认为紫外线B辐射的生物效应一致性很高，但紫外线A波段的生物学效应存在较大争议。因此我们在本试验的基础上仅进行荞麦[苦荞(Fagopyrum tataricum Gaertn.)和甜荞(Fagopyrum esculentum Moench.)]对紫外线B波段的响应研究。 我们对苦荞品种-圆籽荞进行了连续两个生长季节的大田半控制试验以观察UV-B辐射对苦荞生长、发育、产量及叶片色素的影响；试验小区进行降低UV-B、近充足UV-B和增强UV-B辐射处理。我们的试验表明在不同强度UV-B辐射下苦荞的生长、地上部生物量积累及最终产量都有所下降，但苦荞的发育加快；当前条件下的日光紫外线B辐射对植物生长和产量也造成负面影响。植物光合色素被日光及增强UV-B辐射降低；UV化合物及卢丁含量在中低剂量的UV-B辐射强度下显著升高，但在高剂量的增强UV-B辐射下短期升高后迅速下降。我们的试验表明苦荞是一个对UV-B高度敏感的作物。苦荞对UV-B的敏感性与UV-B剂量、外界环境因素及生长季节有关。 单个苦荞品种的试验结果使我们认识到外界UV-B辐射已经对苦荞生长发育构成逆境条件，未来全球气候变化条件下增强紫外线B辐射可能使其处于更不利的生长环境中。因此我们有进行了多个种群进行UV-B响应观察并筛选耐性种群。我们对15个苦荞种群进行增强UV-B辐射处理（6.30 kJ m2 UV-BBE，模拟当地25%的臭氧衰减），我们观察苦荞UV-B辐射效应存在显著的种内差异，UV-B辐射对多数种群具有抑制作用，但对一些种群还有刺激作用。我们采用主成分分析方法与作物UV-B响应指数（RI）来评价苦荞作物UV-B辐射耐性。我们发现作物的UV-B耐性不仅与其原产地背景UV-B强度有关，而且与作物相对生长效率、次生代谢产物含量（如卢丁）及其他因素有关。我们观察到苦荞伸展叶总叶绿素变化与UV-B耐性成正相关；室内苦荞幼苗的UV-B辐射致死试验表明：苦荞种群死亡率与其UV-B耐性成负相关。 此外，我们对甜荞的UV-B辐射响应也进行了初步研究。选取美姑甜荞、巧家甜荞和云龙甜荞进行5个梯度的增强UV-B辐射室外模拟试验。我们观察到UV-B辐射显著降低了甜荞的生长、生物量及产量；并严重影响了甜荞的生殖生长，降低了花序数、种子数和结实率；并且UV-B辐射对甜荞的抑制作用存在显著的剂量效应。三种甜荞品种存在显著的种内差异，其中美姑品种UV-B耐性最强，且膜脂受UV-B辐射氧化伤害最小，这与该品种UV-B辐射下较高的GR酶活性、APX酶活性和PPO酶活性、以及含量更高的抗坏血酸有关。甜荞的次生代谢也受到增强UV-B辐射的影响，其香豆酰类化合物在UV-B辐射下升高显著，而槲皮素含量也在高剂量UV-B辐射下有所增加；卢丁含量依赖UV-B辐射剂量而变化，中低剂量UV-B辐射下其卢丁含量逐渐升高，但在高剂量辐射下逐渐下降。 通过对生长在高海拔地区的荞麦作物(苦荞和甜荞)进行的室外研究，我们认识到作物不同品种存在很大的耐性差异，这就为UV-B耐性育种创造了有利条件。进一步加大荞麦种质资源筛选力度并深入认识荞麦抗性机理，在此基础上通过杂交或其他基因融合手段培育抗性品种，对高剂量UV-B辐射地区的荞麦产量的提高将起到重要推动作用，并使荞麦生产能有效应对未来全球气候变化条件下UV-B辐射可能升高的威胁。 During last few decades, due to concern of ozone layer depletion and enhancement of ultraviolet B radiation（UV-B, 280-315 nm), the agronomist want to know the responses of different crop species to UV-B. In the first experiment of our study, the effect of different UV band [B-UVA（315-400 nm), N-UVA（315-340 nm), B-UVB（275-400 nm), N-UVB（290-340 nm）and UV-（>400nm, as control)] on the cucumber（Cucumis sativus）and soybean（Glycine max）were investigated in growth room. Spectra-dependent differences in growth and oxidation indices existed within UV-A bands as well as UV-B bands. The general biological effects of different band were UV- ＜ B-UVA＜ N-UVA＜N-UVB＜B-UVB. The plant growth biologically spectra weighting function（BSWF）matched well with average plant response in UV-B region, but not in UV-A region. Shorter UV-A wavelength imposed more negative impact than longer UV-A wavelength did in both species. The effect on photosynthetic pigment was related to different UV bands and different species. The photosynthetic pigment content was decreased by UV-A spectra as well as UV-B spectra. In comparison with the results of previous studies, we found that the wavelength-dependent biological effect of ultraviolet B radiation has high consistency, but the biological effect of ultraviolet-A radiation was inconsistent. We narrow our following study on the effect of ultraviolet B radiation on the buckwheat（tartary buckwheat and common buckwheat). The tartary buckwheat（Fagopyrum tataricum Gaertn.）cultivars Yuanziqiao was grown in the sheltered field plots for two consecutive seasons under reduced, near-ambient and two supplemental levels of UV-B radiation. The crop growth, photosynthetic pigments, total biomass, final seed yield and thousand-grain weight were decreased by near-ambient and enhanced UV-B radiation, while crop development was promoted by enhanced UV-B radiation. Leaf rutin concentration and UV-B absorbing compound was generally increased by UV-B with the exception of 8.50 kJ m-2 day-1 supplemental levels. Our results showed that tartary buckwheat is a potentially UV-B sensitive species. Study on one cultivars showed that ambient solar radiation had present a stress to tartary buckwheat. This makes it necessary to observe the UV-B response of many cultivars and screen tolerant cultivars. Fifteen populations of tartary buckwheat were experienced enhanced UV-B radiation simulating 25% depletion of the stratospheric ozone layer in Kunming region, and plant responses in growth, morphology and productivity were observed. Principal components analysis（PCA）was used to evaluate overall sensitivity of plant response to UV-B as well as response index. The different populations exhibited significant differences in responses to UV-B. The photosynthetic pigments of young seedlings were also affected significantly under field condition. On the other hand, the healthy seedlings of different populations were exposed to the high level of UV-B radiation in growth chambers to determine the plant lethality rate. The plant tolerance evaluated by multivariate analysis was positively related to total plant chlorophyll change, but negatively related to lethality rate. In other hand, the UV-B responses of the other important cultivated buckwheat species, common buckwheat（Fagopyrum esculentum Moench.), were also studied preliminarily. Three widespread cultivated variety（Meigu, Qiaojia and Yunlong cultivars）were provided with five level of enhanced UV-B radiation outdoors. We observed that the crop growth, development and production were significantly decreased, and reproductive production, like anthotaxy number, seed number and seed setting ratio, was also decreased. Dose-dependent inhibition effect caused by enhanced UV-B radiation also existed in common buckwheat. Significant intraspecific difference existed in those three cultivars. The Meigu cultivars with dwarfed growth and lower production have highest UV-B tolerance as well as lowest damage in cell membrane, this could be associated with profound enhancements of glutathione reductase（GR）activity, ascorbate peroxidase activity and polyphenol oxidase activity as well as higher ascorbic acid concentration. The secondary metabolism was also affected by UV-B radiation, with profound elevation of coumarin compound and moderate increase of quercetin concentration. Rutin concentration was peaked in 5kJ m-2 UV-B. The contrasting effect of UV-B radiation on different populations indicated that there existed abundant genetic resources for selecting tolerant populations of common and tartary buckwheat. Much effort needed be pose on screening of buckwheat germplasm and clarification of mechanism of buckwheat tolerance to UV-B. On this base the tolerant cultivars could be bred by hybridization and other gene transfusion method, this would help increase buckwheat yield in high ambient UV-B region and counteract the effect of possible enhanced UV-B radiation in future.